Atlasof HumanAnatomy
Editedby R.PutzandR.Pabst Putz withRenate incollaboration
13th,revised Edition Translated byDr.M...
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Atlasof HumanAnatomy
Editedby R.PutzandR.Pabst Putz withRenate incollaboration
13th,revised Edition Translated byDr.M.Lutz,K.Kopsieker Dietz, Sarah Budowick, of Michael Withtheassistance Dr.Dorothea Hennessen plates 768coloured 76tables
URBAN& FISCHERMUNiCh. JCNA
Addressesof the editors: ProfessorDr. med. R. Putz Vorstanddes AnatomischenInstituts Ludwig-Maximilians-Universitet PettenkoferstraBe11 80336 Miinchen, Germany ProfessorDr. med. R. Pabst Leiter der Abteilung fiir Funktionelle und AngewandteAnatomie MedizinischeHochschule,Hannover Carl-Neuberg-StraBe I 30625 Hannover,Germany
This atlas consistsof two volumes: Vol. 1: Head,neck, upper limb
This atlas was founded by Iohannes Sobottat, former Professorof Anatomy and Director of the Anatomical Institute of the University of Bonn, Germany.
GermanEditions: l. Edition: 1904-1907I. F. LehmannsVerlag,Munich 2.-11.Edition:1913-19441. F. LehmannsVerlag,Munich 12. Edition: 1948and following editions Urban & Schwarzenberg,Munich 13.Edition:1953 14.Edition:1956 15.Edition:1957 16.Edition:1967(ISBN3-541-02816-5) 17.Edition:1972(ISBN3-541-02817-3) 18.Edition:1982ISBN 3-541-02818-1) 19.Edition:1988(ISBN3-541-02819-X) 20. Edition:1993(ISBN3-541-1736GX) 21. Edition: 2000 (ISBN 3-437-4194041
Vol. 2: Thorax, abdomen,pelvis, lower limb Foreign Editiors: Translation: Editorial staffat Urban & Fischer: Producer: Coverdesign: Coverillustration:
Dr. M. Lutz K. Kopsieker Dr. med. DorotheaHennessen AlexanderGattnarzik RenateHausdorf CarstenTschirner MichaelBudowick
Arabic Edition Modern TechnicalCenter,Damascus ChineseEdition HoChi Book Publishing,Taiwan CroatianEdition NakladaSlap,lastrebarsko Dutch Edition Bohn Stafleuvan Loghum,Houten English Edition (with nomenclaturein English) Lea & Iebiger previousEnglish Edition (with nomenclaturein latin) Urban & Schwarzenberg,Munich French Edition Atlas dAnatomieHumaine Tec& Doc Lavoisier,Paris Greek Edition GregoryParissianos,Athens Hungarian Edition az ember anat6mi6jiinakatlasza SemmelweisKiad6
Nomenclaturein latin Vol. 1 Head,Neck, Upperlimb. - 13th End. ed. - 2001 Vol. 2 Thorax, Abdomen,Pelvis,Lower Limb. - l3th Engl. ed. - 2001
IndonesianEdition Atlas Anatomi Manusia Penerbit Buku KedokteranEGC,Iakarta Italian Edition Atlante di Anatomia Umana UTEI Torino lapaneseEdition Igaku Shoin Ltd., Tokyo KoreanEdition Panmun Book Company,Seoul Polish Edition Atlas anatomii cztowieka Urban & Partner
All rights, including that of translation, reserved.No part of this publication may be reproduced,stored in a retrieval system,or transmitted in any other form or by any means,electronic,mechanical,recording,or otherwise without the prior written permission of the publisher. Typesetting:Typodata,Munich Repmduction:Typodata,Munich Printed in Germanyby Appl, Wemding @ Urban & Fischer 2001
UFtcdate information you find under: Urban & Fischer:http'.//www.urbanfischer.de
PortugueseEdition (with nomenclaturein PortuSuese) Atlasde AnatomieHumana Editoria GuanabaraKoogan,Rio de Janeiro PortugueseEdition (with nomenclaturein Latin) Atlas de Anatomie Humana Editoria GuanabaraKoogan,Rio de Janeiro SpanishEdition Atlas de Anatomia Humana Editorial Medica Panamericana.BuenosAires/Madrid Turkish Edition Insan Anatomisi Atlasi Beta Basim Yayim Dagitim, Istanbul
Preface Followingthe extremelygoodillustrationsin the last editionof the Atlaswhichwasbroughtinto beingbyl. Sobottain 1903,the editorsandpublishersaskedthemselves whatcouldbeimproved upon in such a classicwork. It becameclear from the many lettersand discussions with studentsand colleagues that the conceptobviouslystill fits into the panoramaof study,and that the macroscopic anatomyremainswithout question,together with other basicsciences, one of the fundamentsof medicine. Althoughthe Atlasis primarilydirectedat thosestudyingpreclinicalmedicine,it has nevertheless as "TheBookfor life as a doctor"all that is necessaryto be a companionthroughthe clinical studiesand a referencebook during working life. In with the most importanyurgentwishes,the new accordance editionhasa seriesof alterations. In the neweditionwe have - a total of 133 new illustrationsdrawn basedon original dissections, e.g.the series0f sectionsof the brainandthorax, - replacedthe blackandwhiteillustrations, - broughtillustrationsof clinicalapplication up to dateaccording to the development of the technique, e.g.endoscopy or X-ray, - introducedthe schematic ofjoint strainand - revisedthe tablesof musclescompletely. As the secondimportantgoalwe haveimprovedthe readability by - the introductionofconspicious coloursfor the chapters, - colourcodingthe labellingof topographic illustrations, - the consistentadditionof orientationsketchesto the cross sectionsandline of vision, - the revisionand new arransementof the tried and tested tablesandby - the introductionof small"wind mills" drawingyour attention to the surroundingillustrations.
R. Pabst: Head, neck, thoracic wall, abdominal wall, thorax, abdomen,pelvis.
The followingartistshaveearnedour thanksfor the manynew drawings which they have producedin their already proven manner:Ulrike Brugger,RiidigerHimmelhan,SonjaKlebe,and Horst RuB.It is due to their effortsthat the tried and tested Thefreeelectronicprocess"sobottaStyle"hasbeenmaintained. aswellastheproductionof the printswas ing of the photographs carriedout by MichaelBudowick.We are also gratefulto our in the variousclinicswho put the illustrationsat our colleagues disposalfor this editionaswell (seeAcknowledgements). from the instituteswho We wouldlike to thank the colleagues and for were involvedmost sincerelyfor their understanding the very importantstimulus.Dr. N. Sokolovand A. Buchhorn prepareddissections meticulouslyto serveas a basisfor many us with our S.Fryk andG.Hoppmannassisted newillustrations; wordprocessing. The editorswouldfinally like to thank explicitlythe colleagues and of the editorialoffice,especiallyDr. DorotheaHennessen A. Gattnarzik,w.ho despiteexternal turbulenceconsistently the productionof the new edition.Theproduction accompanied was lookedafter in the initial stagesby P. Mazzettiand finally carriedout with greatcommitmentby R. Hausdorf.RenatePutz was responsiblefor the conversionof the NominaAnatomica and the texts.A of the references and for the standardisation to the specialthanksto all the peoplewho devotedthemselves nerve-rackingproof readingand the putting togetherof the index. If "Sobotta"is able to appearwith new contentsand in new splendourthen it is due to the entirely constructive We wouldalsolike to thank our of all concerned. collaboration of the lack of time we had for familiesfor their understandins them.
Of course,the new nomenclatirre(Terminologia Anatomica), whichhasbeenvalidsinceOctober1998,hasbeenincluded.The Many innovationsin this atlas are basedon the critic and glossaryaidsthoseinterested in the background of our specialist suggestionsmade by studentsand colleagues.The editors languagc. were and are extremelythankfulfor theseand would ask the users of this edition not to shy away from sendingus their The division of the revisionof the chapters,apart from the comments. commondiscussions overthe conceptandthe mutualcorrection, wasretainedand is as follows: 1999 September R.Putz: Generalanatom)lupper limb, brain, eye,ear, back, MunichandHannover, lowerlimb; R.PutzandR.Pabst
Contents(volume I) Generalterms of directionand positionin the body Referencesto the coloured illustration plates . A c k n o w l e d g e m e n.t.s.
Parts and Regionsof the Body PassiveLocomotorSystem Active LocomotorSystem Digestiveand RespiratorySystem Urinary Tract and Genital Organs EndocrineSystem VascularSystem SurfaceProjectionof the Internal Organs Central and Peripheral Nervous System Skin and Appendages
Head, Caput, and Neck, Collum Regionsof the Head and Neck, Regiones capitis et colli . . . Skull, Ossacranii, and TemporomandibularIoint, Articulatio temporomandibularis . Muscles,Vesselsand Nerves of the Head Nose,Nasusexternus,and NasalCavity, C a v i t a sn a s i . . . ParanasalSinuses,Sinusparanasales.. Oral Cavity,Cavitasoris . . . Maxilla and Mandible,Mandibula Teeth,Dentes Palate,Palatum Tongug,Lingua SuprahyoidMuscles,Mm. suprahyoidei, and Hyoid Bone,Os hyoideum Large Salivary Glands,Glandulaesalivariae majores Arteriesand Nervesofthe Tongueand Palate Baseofthe Skull, Basiscranii . Vesselsand Nervesof the Tongue Frontal Sectionsofthe Head Larynx ThyroidGland,Glandulathyroidea Pharynx Muscles,Vesselsand Nervesofthe Neck Sectionsofthe Headand Neck
SurfaceAnatomy Bones, loints,Ligaments Musclesof the UpperLimb . Vessels and Nervesof the UpperLimb . . .... CrossSections ofthe UpperLimb . . Areasof Distributionof the CervicalPlexusand the BrachialPlexus.
VII VII VIII
6 -l 0 |-12 l3 14 l5 t6-21 22-23 24-27 28-29
30-I 63 30-31 3 2 - 7| 72-88 89-91 92-94 95-96 97-98 99-106 107 1 0 8 1- 1 2 113 114-117 118 119 l2O-121 122-123 124-133 134-135 136-140 141-159 160-163
164 165-185 186-222 223-250 251-256
Cranial Cavity,Cavitascranii, and Dura Mater of the Brain, Dura mater cranialis Vesselsof the Head Nerves of the Brain, Nervi craniales Dura Mater of the Brain, Dura mater cranialis, and A r a c h n o i dA, r a c h n o i d em a a t e r c r a n i a l i s. . . . . . . . . Vesselsof the Brain BrainC , e r e b r u m. . . . Diencephalon M i d b r a i n ,M e s e n c e p h a l o.n. . . . Brain Stem,Truncus encephali Nuclei of the Cranial Nerves . Cerebellum Ventricular Systemand SubarachnoidSpace DeepVesselsof the Brain Fornix . Associationand CommissuralFibres Internal Capsule,Capsulainterna, Pyramidal Tract, Tractus pyramidalis,and BasalNuclei . Frontal Sectionsof the Brain Horizontal Sectionsof the Brain SagittalSectionsof the Brain Magnet ResonanceTomographySectionsof the
B r a i n. . SpinalCord,Medullaspinalis E y e , O r g a n u m v i s.u s
278-281 282-285 286-293 294-295 296-298 299-300 301 302-305 306-315 316-317 318-319 320 321-323 324-327 328-334 335-338
.. 339-340 ...... 341-355 .....
35G380
Eyelid,Palpebrae, andOrbitalCavity,Orbita 356-360 LacrimalApparatus 361 u s ,c u b l i u l b i. . E x t r a o c u l a r M u s cMl e ...... 362-365 Eyeball,Bulbusoculi 366 Vessels of the Eye 367 I r i sa n dP u p i l. . 368 Fundusoculi . LenseandOcularFundus, 368-371 OpticNerve,N.opticus ..... 372-373 V i s u aP l a t h w a y. . . . . 374-375 Muscles, Vessels andNervesof theOrbital Cavity. 376-379 Sections of the OrbitalCavity . 380
381 Overview ..:::::::,:::::::::::::.. 382 Auricre AuricularMuscles,Musculiauriculares 383 ExternalAcousticMeatus,Meatusacusticus externus, andTympanicMembrane, Membranatympani. . . . 384 auditoria 385-386 AuditoryOssicles, Ossicula . . 387-389 TympanicCavity,Cavitastympani ...... 390-391 AuditoryTube,Tubaauditiva .. 392-396 InternalEar,Auris interna 397 AuditoryandVestibularPathways 398 TemporalBone,Ostemporale .. 399-400 NervesoflnternalEar.... Appendix Index..
25-
258-259 260-266 2 6 7- 2 7 7
4Ol-417 4Ol-417
II) ContentS(vrlurne Generalterms of directionand positionin the body References to the colouredillustrationplates . . . . . .. Acknowledgements ...
.
Back SurfaceAnatomy VertebralColumn,Columnavertebralis Musclesof the Back,Mm. dorsi,Musclesof the Nape o f t h e N e c k ,M m s u b o c c i p i t a l easn, d N e c kM u s c l e s , Mm. colli Sectionsthroughthe VertebralColumn Vesselsand Nervesof the Backand of the Occioital Region Vesselsand Nervesof the VertebralCanal.
Thoracic and Abdominal Walls SurfaceAnatomy.... Ribs,Costae Sternum ThoracicCage,Caveathoracis MammarG y l a n dM , a m m a. . . . . Vesselsand Nerves of the Thoracic and Abdominal Walls . . SegmentalSensoryInnervation Musclesof the Thorax,Mm. thoracis,and Abdominal M u s c l e sM, m . a b d o m i n i s. . . . . lnguinal Canal,Canalisinguinalis Diaphragm,Diaphragma
Lumbosacral PIexus, Plexuslumbosacralis AnteriorAbdominalWall Sectionsthrough the AbdominalWall
Thorax Heart,Cor Trachea Lungs,Pulmones . . .. OutlineSilhouette of theHeart Projection of the TracheaandBordersof the Lungs andPleura Oesophagus Thymus
VII VII VIII
pleuralis, and PleuralCavity, Cavitas 1 1 4 1- 1 5 Mediastinum 116-117 Aorta.. 118-119 Posterior Mediastinum . .2. 0 - 1 2 1 A u t o n o mN i ce r v o uSs y s t e m , P a r s a u t o n o m i c a . . . . 1 122-131 throughthe Thorax Sections
l-47 I 2 26
27-40 41 42-45 46-47
48-75 4B 49-50 5 t- 5 2 5 4 -5 5 56 57 58-66 67 68-70 71 72-73 74-75 76-t3l 76-91 92-93 94-102 103 104-105 106-110 ll1-113
Stomach, Gaster. tenue. Intestinum SmallIntestine, Colon..
132-136 137-139 140-141
Liver, Hepar,Gallbladder,Vesicabiliaris, and Bitiary Ducts Pancreas Spleen,Splen[Lien] PeritonealCavity,Cavitasperitonealis,Development. Positionof the Abdominal Viscera,Situs viscerum . . Truncus coeliacusand Aa. & Vv. mesentericae
142-149 l s 0 -1 5 2 153 1541 - 55 156-167
superiorandinferior Portalvein,V.portae Kidney,Ren[Nephros] S u p r a r e nG a l a n dG, l a n d u lsau p r a r e n a l i.s. . . . . . . . . UrinaryBladder,Vesicaurinaria..... Organs MaleUrogenital FemaleUrogenitalOrgans ... Rectum A. renalis Space. . . . Vessels andNervesofthe Retroperitoneal ExteriorMaleandFemale PelvisandPerineum, ... G e n i t aOl r g a n s throughthe AbdomenandPelvis Sections
SurfaceAnatomy Bones,JointsandLigaments Musclesof the LowerLimb . andNerves BloodVessels Sections throughthe LowerLimb . . Distributionof the Nervesof the Plexus lumbosacralis Appendix I n d e x. .
168-177 178-179 180-lB6 187 187-188 lB9-193 194-204 205-207 208 209-221 222-239 240-261
262 263-307 308-347 . . . 348-378 379-386 ....
387-388 389-405
.... 389-40
Generalterms of directionand positionin the body The following terms indicate the relative location of organs and parts of the body to each other, partly without taking into considerationthe position of the body in space as well as the location and direction to the extremities.This concept is not only acceptable for human anatomy but also for practical medicine and the comparativeanatomy.
General terms
= runninglengthways(e.g.Musculuslongitudinalongitudinalis lis superiorof the tongue) sagittalis= lying on a sagittalplane = lying on a transversalr/transverse plane transversalis = runningtransversely (e.g.Processus transversus transversus of the thoracicvertebrae)
Terms of direction and position for the extremities
anterior - posterior = from the front - from the back (e.g. Arteriae tibiales anterior et posterior) ventralis - dorsalis = lying ventral - dorsal superior - inferior = above - below (e.g. Conchaenasales superior et inferior) cranialis - caudalis = lying cranial - caudal dexter - sinister= right - left (e.g. Arteriae iliacae communes dextra et sinistra) internus - externus = internal - external superficialis - profundus = superficial - deep medius, intermedius = lying in the middle between two other things (the Concha nasalis media lies in the middle between the Conchanasalis superior and inferior) medianus= lying on the middle line (Fissuramedianaanterior of the spinal cord).By making a median sagittal sectionthe body is dividedinto two mirror images. medialis - Iateralis = lying towards the middle of the body, lying towards the side (e.g.Fossaeinguinales medialis et lateralis) frontalis = relating to the plane of the forehead (frontal plane), (e.g.Processusfrontalis of the maxilla)
proximalis - distalis = at the base of the extremity - at the end of the extremity (e.g. Articulationes radioulnares proximalis et distalis) For the upper limbs: radialis - ulnaris = relating to the radial - relating to the ulnar side (e.g. Arteriae radialis et ulnaris) For the hand: palmaris - dorsalis = relating to the palm - relating to the back of the hand (e.g. Aponeurosis palmaris, Musculus interosseus dorsalis) For the lower limbs: tibialis - fibularis = relating to the tibial side - relating to the fibular side (Arteria tibialis anterior) For the foot: plantaris - dorsalis= relating to the sole of the foot - relating to the back of the foot (instep)(e.g. Arteriae plantareslateralis et medialis,Arteria dorsalis pedis)
References to the colouredillustrationplates The multi-colouredillustrations of this book are basedon didactic observations:The contrasts should be emphasized.Where it is difficult to differentiatebetweenstructures,they should be made easily recognizable.The colours used for the different kinds of tissue (such as tendons, cartilage, bone and muscles) and the tracts (such as arteries, veins, lymphatic vessels, nerves) are different from those found in a living, dead or preserved body. Here, arteries are red, veins are blue, nerves yellow, lymphatic vesselsand glands are generally representedas green. In addition to the artists who createdthe basis for the complete collection of illustrations with Prof. Sobotta and the following editors Prof. Becher,Prof. Ferner and Prof. Staubesand(K. Hajek, Prof. E. Lepier,F. Batke,H. v. Eickstedt,K. Endtresser,I. Kosanke, I. v. Marchtaler,I. Dimes,U. Brugger,N. Lechenbauer,L. Schnellbiicher, and K. Schuhmacher),the following also drew for the current edition: Ulrike Brugger, Riidiger Himmelhan, Sonja Klebe, and Horst RuB. A series of original photographs were worked over electronically by Michael Budowick. A number of computer diagrams were producedby Henriette Rintelen.
platesas Thefollowingplatenumbersindicatenewlydeveloped well as drawingsdueto fundamental corrections: U.Brugger 3 6 - 3 8 ,5 2 , 5 3 , 6 1 ,1 3 6 ,1 3 7 , 2 3 5 - 2 3 7 , 2 8 4 , 3 9 6 - 3 9 8 , 4 3 0 1, 532-534,537,539-541,551,570-577,598 M. Budowick 449,452,474,486,498,548 R. Himmelhan 437 S.Klebe 138,460,507,508,511-514 H. Rintelen 604-606 H. RuJS 22 (insert),144,338-340,444,445,447,449,471,472, 545,687
Generaltermsof directionandpositionin the body The following terms indicate the relative location of organs and parts of the body to each other, partly without taking into considerationthe position of the body in space as well as the location and direction to the extremities.This concept is not only acceptable for human anatomy but also for practical medicine and the comparativeanatomy.
tongitudinalis= running lengthways(e.g. MusculuslongitudinaIis superiorof the tongue) sagittalis= lying on a sagittalplane = lying on a transversalplane transversalis = runningtransversally transversus (e.g.Processus transversus of the thoracicvertebrae)
General terms
Terms of direction and position for the extremities
anterior - postertor = from the front - from the back (e.g. Arteriae tibiales anterior et posterior) ventralis - dorsalis = lying ventral - dorsal superior- inferior = above- below (e.g. Conchaenasalessuperior
proximalis - distalis = at the base of the extremity - at the end of the extremity (e.g. Articulationes radioulnares proximalis et distalis)
et inferior) cranialis - caudalis = lying cranid - caudal dexter - stnister= right - left (e.g. Arteriae iliacae communes dextra et sinistra) internus - externus= internal - external superficialis - profundus = superficial - deep medius, intermedius = lying in the middle between two other things (the Concha nasalis media Iies in the middle between the Conchanasalis superior and inferior) medianus= lying on the middle line (Fissuramediana anterior of the spinal cord).By making a median sagittal sectionthe body is divided into two mirror images. medialis - lateralis = lying towards the middle of the body, lying towards the side (e.g.Fossaeinguinales medialis et lateralis) = frontalis relating to the plane of the forehead (frontal plane),
For the upper limbs: radialis - ulnaris = relatinS to the radial - relating to the ulnar side (e.g. Arteriae radialis et ulnaris)
(e.g.Processusfrontalis of the maxilla)
For the hand: palmaris - dorsalis= relating t0 the palm - relating to the back of the hand (e.g. Aponeurosis palmaris, Musculus interosseus dorsalis) For the lower limbs: tibtalis - fibularis = relating to the tibial side / relating to the fibular side (Arteria tibialis anterior) For the foot: plantaris - dorsalis = relating to the sole of the foot - relating t0 the back of the foot (instep)(e.g. Arteriae plantareslateralis et medialis, Arteria dorsalis Pedis)
to the colouredillustrationplates References The multi-colouredillustrations of this book are basedon didactic observations:The contrasts should be emphasized'Where it is difficult to differentiatebetweenstructures,they should be made easily recognizable.The colours used for the different kinds of tissue (such as tendons, cartilage, bone and muscles) and the tracts (such as arteries, veins, lymphatic vessels, nerves) are different from those found in a living, dead or preserved body. Here, arteries are red, veins are blue, nerves yellow, lymphatic vesselsand glands are generally representedas green' In addition to the artists who createdthe basis for the complete collection of illustrations with Prof. Sobotta and the following editors Prof. Becher,Prof. Ferner and Prof. Staubesand(K. Hajek, Prof. E. Lepier,F. Batke,H. v. Eickstedt,K. Endtresser,I' Kosanke, I. v. Marchtaler,K. Dimes,U. Brugger,N. Lechenbauer,L. Schnellbiicher, and K. Schuhmacher),the following also drew for the current edition: Ulrike Brugger, Rtidiger Himmelhan, Sonja Klebe, und Horst RuB. A series of original photographs were worked over electronically by Michael Budowick. A number of computer diagrams were producedby Henriette Rintelen.
platesas Thefollowingplatenumbersindicatenewlydeveloped corrections: well as drawingsdueto fundamental U.Brugger 707,923,924,927-932,934,936,937,1366,l37B R. Himmelhan 1367,1368,1370,1372, 1374,1375 S.Klebe 1162,1174,1175, 1218,1222,1223,1250,1349 H. Rul3 - 1284,1302-1304 7 BB,7 98,1281
Acknowledgements The editors would like to thank the following colleaguesfor providing the pictures of ultrasound,computedtomography, magneticresonancetomographyas well as endoscopicand colourphotographsof operationalpractice:
Prof. Reiser & Dr. Glaser, Institute of Clinical Radiology, Universityof Munich (figs.307,578-582,705a, b, 771,1369,1371,1373,13771 Prof. Rudzki-Ianson,Polyclinicfor Orthodontics,University of Munich (figs.80,8l) Dr. Scheibe,DepartmentofSurgery,RosmanHospital,Breisach ( f i g s1 . 233a-c) Prof.Schillinger,Gynaecological Clinic,Universityof Freiburg (figs.1072-10741 Dr. Dr. Schliephake,Facio-MaxillarySurgery, University of Medicine,Hannover (figs.167,212,2131 Prof. SchlijBer,GynaecologyCentre, University of Medicine, Hannover (figs.1071a, b, 1080,1082,1083,1130) Neuroradiology,Departmentof Radiology, Prof. Schuhmacher, Universityof Freiburg (figs.448a,b) Munich Dr. Sommer& AssistentProf.Bauer,Radiologists, (figs.650,1234-12361 Polyclinic,Universityof Munich Prof.Stotz,Orthopaedic (fig. 1193) Universityof Munich Prof.Vogl,Polyclinicfor Radiology, (figs.440, 442,631,632) Prof.Vollrath,ENTClinic,Miinchengladbach (tigs.246-2481 Prof. Wagner (dec.),DiagnosticalRadiologyII, University of Medicine,Hannover ( f i g s . 9 1 41,0 1 4 , 1 0 1120 2 01, 0 2 31, 0 9 0 ) Universityof Freiburg Prof.Wenz,Departmentof Radiology, (tig.7a7) Dr. Willfiihr, Departmentfor Abdominaland Transplantation Surgery,UniversityofMedicine,Hannover (fig. 1001) AssistentProf.Wimmer,Departmentof Radiology,Universityof Freiburg (tig.778\
Prof.Altaras,RadiologyCentre,GieBenUniversity (figs.964,979,9801 Dr. Baumeister, Departmentof Radiology, FreiburgUniversity (fig. 109s) Prof.Daniel,Departmentof Cardiology,Universityof Medicine, Hannover (figs.862-864,935) Prof. Galanski & Dr. Kirchoff, Department I of Diagnostic Radiology,Universityof Medicine,Hannover (figs.924,1144a,b,1154, 1155) Prof. Galanski & Dr. Schiifer, Department I of Diagnostic Radiology, Universityof Medicine,Hannover (figs.B3Ba, b, 888,933,958,1139,1147,1150,11521 Prof. Gebel Departmentof Gastroenterology and Hepatology, UniversityofMedicine,Hannover (figs.253a,b,966,975,976,981,990,991, 1026,1043) Dr.Goei,Radiology, Heerlen,TheNetherlands (figs.1010,1011) (with permissionfromRadiology173:137-141,19891 Dr.Greeven, St.ElizabethHospital,Neuwied (figs.166,1182) Prof. von der Hardt, PaediatricClinic, Universityof Medicine, Hannover (figs.893) Dr. Hennig,Departmentof Radiology,Universityof Freiburg (fig.529) Prof.Ionas,Urology,UniversityofMedicine,Hannover (figs.1050a,b, 1051) Prof.Kremers,Polyclinicfor DehtalPreservation and Periodontics, Universityof Munich (fig.182) Prof.Kunze,Paediatric Clinic,Universityof Munich (figs.15-18) Dr. Meyer, Departmentof Gastroenterologyand Hepatology, Universityof Medicine,Hannover Additionalillustrationsweretakenfromthe followingbooks: (figs.906.949a,b,959,1086) Prof. Pfeifer,RadiologyDepartmentof the SurgicalClinic, UniBirkner, R: The typical X-ray of the skeleton, Urban & 1990 versityof Munich Munich-Vienna-Baltimore Schwarzenberg, (figs.306,319,321,748-751,789-792,1199,1230,1231,1260, (fig.1200) 12611 Welsch,U. (Editor):Sobotta- Histology,5th Edition,Urban& 1985 AssistentProf. Rau, Departmentof Radiology,Universityof Munich-Vienna-Baltimore Schwarzenberg, (figs.635,646) Freiburg (figs.875,886,887) Wicke, L.: Atlas of X-ray Anatomy,3rd Edition, Urban & 1985 Prof.Ravelli,Instituteof Anatomy,Universityof Innsbruck, Munich-Vienna-Baltimore Schwarzenberg, (figs.905a,b, 1076) Itig.746l Prof. Reich, Clinic for FacioMaxillary Surgery,University of Wilhelm,K.,R.Putz,R.Hierner,R.E.Giunta:Plasticsurgeryof the 1997 Munich-Vienna-Baltimore Bonn hand,Urban& Schwarzenberg, (figs.133,134) (fig.s8)
Anatomy General 1 1
sagitlal plane
2 median sagittal plane 3 fronial olane 4 transverse olane
o
sagittalaxis transvers€axts longitudinalaxis
Figs. 1 a-c Planesand axis 0fthe humanbody. a sagittalplane,sagittaland Iongitudinal(= vertical)ax's b transverseplane(= horizontalplane),transverseand sagittalaxis c frontal plane(= coronalplane),longitudinaland transverseaxis
Lineamedianaanterior-
-
LineasternalisLin€aparasternalisLineamedioclavicularis
Linea medianaPostgtior Unea paravertebnlis -
cranialis(= superior)-
-
lateralis-
Lineascapularis Lineaaxlllarispostgrior
Linsaaxillarisanterior- -
palmaris-
-
r"oi"ti. /
/
caudalis(= inferior)/ libularis-
b directionaland Figs.2 a, b Linesof orientation, positionalterms usedfor the humanbody. a ventral (= anterior)view b dorsal(= posterior)view
\ lateralis
dorsalis
2
Parts of theBody
-----
Caput
----*
Collum
----Thorax
llembrum superius
F e m u r- - - - - -
llembrum Inferius
C r u s- - - - - - - -
Fig. 3 Surfaceanatomyof the male; veRtralview.
Fig. 4 Surfaceanatomy of the female; ventral view.
PartsoftheBody 3
---
Caput
Truntus, Dorsum
Membrum superlug
M a n u s- - - -
F e m u-r- - - - - -
Membrum lnterlus
C r u s- - - - - - - -
P e s- - - - - - - -
Fig. 5 Surfaceanatomyof the male; dorsalview.
Fig. 6 Surfaceanatomyof the female; dorsalview.
4
Regions of theBody
/ Regiocervlcalisanterior Rogiost€rnocleidomasloid€a \ Reglodeltoidea 1
- R€gioc€Mcalls lateralis : Trigonumclavipec{oralo - R€gioprestemalls
Regioaxillads R6giomammada R€giobrachii anledor -
-
Regiop€ctoralis
- - Regioinframammada - - Regloepigastdca - Raglohypochonddaca
Reglocubltalisanterior,Fossacubltalis
- Regloumbllicalig - Regloabdomlnalislateralis
R€gloantabrachliposterior - -
- Regioinguinalis
Rsgio ant€brachilanterior -
Reglopubica [Hypogastriuml
-
R€gio urogenitalis
Trigonum femoris-R€giofemorisantsrior/
R€giogenus anterior - -
Fig. 7 Regionsofthe humanbody,Regiouescorporis; venbal view.
oftheBodY Regiora
- Regilopadeialis - R€gloocclpiElls
- Regloc€rvicall6Posbtlo. Regiodelloidoa \
- Regloverl€bra[s
Rogioscapulans--
B€gio axillaris - - Rogloinftascapuletls
Regio brachil postsrior -Rogiocubltalb postorior
Regloant€brachliantotio. R€gioantsbrachilposledor -
Palmalvolal Regioglutealls /
Fegb lemotu posterlor
Regiog€nus postgrior,Fossapoplitea
R€giosura€ -
Rgglocrudspostador--\ R€giocruris anterior - -
OoEUmpedis Calx lReglo calcan€al
Fig. I Regionsofthe humanbody,Regionescorporis; dorsalview.
5
PassiveLocomotorSystem.Skeleton
Sternum\
(Pars ceruicalis)
(Parslumbahs) R a d i u-s* - ----
O sc o x a e- - --Ossa catpi---:--
o s s a- melacarp' o s s a- - digitorum lPhalangesl
Patella -
Ossatarsi - - Ossametatarsi
Fig.9 Skeleton,Systemaskeletale; ventral view.
Ossatarsi-
Fig. l0 Skeleton,Systemaskeletale; dorsalview.
Regions of the human body Caput Collum Truncus Thorax Abdomen Pelvis Membrum superius Cingulumpectorale[Cingulummembrisuperioris] Parsliberamembrisuperioris Membrum inferius Cingulumpelvicum[Cingulummembriinferioris] Parslibera membriinferioris
Marrow Bone
I I
(Cafiila9oarticularrs)
_-
Substantia soonoiosa Medullaossiumiubra
; --' (Extremitas proximalis)
-
Bones lhat can be touched through the skin Distnbutionof haematopoiesis in the bone marrow
Figs. 11a, b Skeleton,Systemaskeletale. a ventral view b dorsalview
Ltnea epiphysialis
Melaphysis (proximalis)
Corpus Periosteum
- -
Metaphysis (distalis)
(Extremitas distalis)
Cavitas medullaris; Medulla ossium llava
/ Fossa olecrani
--
Substantiaspongiosa Medulla ossium rubra
\ Cartilagoarticularis
Fig. 12 Structure0f a longbone,0s longum, the humerusis shownas an examPle; longitudinalsection. lines)are discs(epiphyseal Theossifiedepiphyseal just visible.
7
8
Passive Locomotor System, 7. EW -_ 18.-19.U \ 15.-18.U :-\
1 5 . - 1 6 . u- _ ^ 1.U --__
--
18.-20.U --13,-15.U
18.-21.U 2.-5. LM --
------10.-12.
5.U --
------18. U ------18.-19.
2.-s.u-2,-1,|J -'.
a m-25..u/
U
-7.-8.U --
LJ
6.-7.EM - 16.-18.U
--8. EW --7\
---15.-18. U
\ ts.-zo. u
1
7.-8.EW --
13.-15.U
\ 4.-6.U
\ re.-zo. u EWEM. LM. U.
13.-16. u -_
8.-r3.U -
1.U --
5.-7. U 1.1.-18. U 10.-12. U
__--12.U -- 8.-12.U --
!--..-.."
19.-17.U 1 0 .E M - - -
L--
5.-6.U -17.-19.U-12.-11.1J-'
1 7 F 1 8 .U
7. EW 7.-8. EW --
--N.11.U
--7.+.U --s.-2. u
6. Ll,l -\
--
17.-18.U
17.-18.U -2.-4.1) .'
,--3.-1.U 9. EW 3.-4.U 1.-z.u 3.-5.U -
\ .|5.-21. U --
5. EM
v
\8.EM \9.Ew
Os scapholdeum 3.-6. LM Os lunatum3.-6. Ll Os fep€zlum 3.-8. U Os t"pezoHeum 3.-7. U
Os plsiforme8.-12. U Os tiquetrum 1.- 4. U Os hainatrm 2.-5. LM Os cadhtrm 2.-4. LM
Fig. 13 Appearanceofendochondralossificationcentes and the ossiflcationof the epiphysealplatesof the upporlimb (averageagesaccordingto v. [.lxz, 1956;Exnnn,1990;Heucr and B,rsr,1994).
Talus7. EM Calcaneus5.-6. EM Os navicularo4. U Oscriboldoum10. EM
Os c|lnefformom€dlab 2.-3. U Os clinglformoInbimedum 3.-4. U Os glnellbrme labralg .|2. LM
Fig. 14 Appearanceofendochondralossification centresand the ossiflcailonof the epiphysealplatesof the lower limb (averageagesaccordingto v. Lrrz, 1956; Exxrn, 1990;Hnucxand Bmr, 1994).
. -t System,SkeletalDevelopment
Fig. 15 Radiographof the hand of a 4t/z-year-okl child; dorsopalmarorientation(PA); ( m a l e ,r . ) .
1 2 3 4
Ulna, diaphysis Radius,diaphysis Ulna, dislal epiphysis Radius,distal epiphysis
5 Lunatebone,Os lunatum bone,Os triquetrum 6 Triquetral 7 Scaphord bone, Os scaphoideum
Fig.l7 R a d i o g r a pohf t h e h a n do f a n l l - y e a r old arlolescent; d o r s o l l a l m aorr i e n t a t i o n( P A ) ; (femak:,r )
Fig. 16 Radiographof the hand of a 7-year-old c hi l d ; dorsopalmarorientation(PA); ( m a l e ,r . ) .
I Hamate bone, Os hamatum 9 Capitate bone Os capitatum
10 Trapezoidbone, Os trapezoideum 11 Trapeziumbone, Os trapezium
Fig. lB Radiographof the hand of a 13-year-old adolescent; tlrientation(PA); rkrrsopalmar (male ,r )
10
Passive Locomotor System,Ioints
Fig. 19 Fibrousjoint,Articulatio fibrosa,exemplified by the sutures r of theskull.
joint, Fig. 21 Osseous Articulatioossea,exemplified by thesacrum.
joint, Fig.20 Cartilaginous Articulatiocartilaginea, exemplified by the symphysis.
1 1a lb 2 3 4 5 6 7 I 9 10
Membrana synovialis Intima Subinlima Membrana tibrosa A-cells B-cells Fat cells Capillaryvessels with fenestration Venules Lymphatic vessels Nerves Collagenfibres
Capsula articularis
--
Labrumarticulare
--
(Cartilago articularis)
- -
Cavilasarticularis
Linea epiphysialis ----
--
Recessus articularis
- -
Membrana svnovialis lslratum synbvialel Capsula articularis fibrosa Membrana lStratumlibrosuml
Vagina synovialis
--
Fig.22 Synovialjoint, Articulatio synovialis,exemplifiedby the shoulder joint; sectionin the scapularplane.
11
Musclesand TendonSheaths System, ActiveLocomotor
1 Lineot muscle action 2 Leverarm of muscle 3 Axis of rotalion ol joint
(Cavitassynovialis)\\ Mesotendineum \ Tendo
\
Epitendineum \
Fig. 23 Structureof the skeletalmuscle, the brachialismuscleis shownas an example.
a Musculusfusiformis
e Musculusintersectus
b Musculusbiceps
f Musculussemipennatus
Fig.24 Structureofthe tendonsheath,Vaginatendinis, by the finger. exemplified
c Musculusbiventer
g Musculuspennatus
d Musculusplanus
Figs.25a-g Typesofmuscle. a singlehead, parallelmusclefibres b doublehead, parallelmusclefibres c doublebelly, parallelmusclefibres d multi head. flat muscle e parallelmulti-bellymuscle fibreswith tendinous intersections muscle f unipennate g bipennatemuscle
12
ActiveLocomotor System, MuscleGroups
Fig.26 Surveyof themuscular system; ventralview.
Fig.27 Surveyof the muscularsystem; rlorsalview.
Digestiveand RespiratorySystem
*t """'riilr,ii-::! propria\_ fCavilasoris
Glandula p arotidea -'(jlanoulae l, | -salrvariaeI Glandula sublingualis/ majores | -/ \ Glandula submandibularis
|
.
Oesophagus
----
Gaster
Vesica biliaris lfellea] - -
Fig. 28 Survey ofthe digestivesystem; medial view (headand neck); ventral view (trunk).
/ Sinusparanasales ---.-7t'
Lobussuperior I I Pulmo srnrster I / Lobusinferior
rvey of the respiratory system; (headand neck);ventral view (thorax).
13
T4
UrinaryTractand GenitatCrgans
Organa uflnafla
--
Duciusdeferens
Vesicaurinaria - Glandula vesiculosa - Ductusdeferens - Proslata
Urethramasculina -Penis Organa genitalia masculinaexterna
----
Urethra masculina
-----
Glandula bulbourethralis
Organa genitalia masculinainterna
Epididymis Ductusdelerens Testis
Scrotum----l-
Fig. 30 Surveyof the urinaryandreproductive systemof the male; medialview.
Organa uflnana
Vesicaurinaria\ U r e t h rfae m i n i n a- - : : \ _
Organa genitalia leminina externa
C l i t o r i s- - - - Labiumminus pudendi Labiummajus pudendi
Fig. 31 Survey of the urinary and reproductive system of the female; medial view.
Organa genitalia feminina interna
system Endocrine 15 HYPothalamus
-' - -
Glandula pineafts ICorpus Pineale]
---
---
G l a n d u l a e. - parathyroideae superioret inferior
Glandulathyroidea
Glandula suprarenalrs - -
I n s u l a ep a n c r e a l i c a e- - ' -
-'l
O v a r i u m- - - - - - -
------*
lesLls
Fig. 32 Survel'of the endocrinesystemof the male; ventralview
Fig. 33 Surveyof the endocrinesystemof the female; ventralview.
Endocrine organs All organs whose primary funcdon is the producdon of hormonesare calledendocrineorgans.Theseare: hypophysis, pineal gland, Glandula pinealis [Corpus pineale], thpotd and parathyroid glands,pancreadcislands,testis and ovary. Other organs are also endocrinologicallyactive. The brain for exampleproducesthe hormonesthat contol the hypophysis,but the production of hormones is not a primary function of the brain. Other examplesare the kidneysthat producethe erythre
poietin and the right atrium of the heart, where the atrial natriuredc peptide is produced.Betweenthe epithelold cells of the gasfrointestinalpassagetlere are cells of the diffirse neuro endocrtnesystem(A?IJDsystem).Theymainly affect adJacent cells, and coordlnatethe different functions of an organ. Stric0y speaking, nearly dl organs produce hormones, as in the immune system where they coordinate tlte production and funcdon of cells of the immune system.
I6 A carotisinterna-_ A carotisexterna- A carotiscommunis dextra- - - A subclavia dextra--
- - - - -
A carotiscommunissinistra /
/ Truncusbrachiocephalicus sinistra - - A. subclavia - - Arcusaortae --
Parsascendensaortae lAorlaascendens]
- -
Parsdescendensaortae[Aorladescendensl, Parsthoracicaaortae[Aorlathoracical
- - Truncuscoeliacus A mesentericasuperior
-A. orofundabrachii- - --
- A. renalis --
Parsdescendensaortae[Aortadescendens] ParsabdominalisaortaelAortaabdominalis] --
A. testicularis'
--
Bifurcatio aortae
--
inferior A. mesenlerica
--
A iliaca communis
--
A iliacaexterna --
A. femoralis/ A profundafemoris /
A tibialisoosterior--
A. tibialisanterior- -
A dorsalispedis - -:
Fig. 34 Surveyofthe vascularsystem: arteriesof the systemiccirculation; ventralview. ' in the female: A. ovarica
A. iliaca inlerna
VascularSYstem,Veins
externa\ V iugularis anteraor V jugularis \ \ interna. V iugutaris V subclavia \ V azvoos
L7
V brachiocephalacadexlra V brachiocephalica sinistra
/
-
V thoracicainterna
\
V cavasuPerior
.-V axillaris- -
-
Col
V cephalica- V b a s i l i c a- - Vv brachiales---
- V renalis --
sinistra. V testicularis V portaehepatis * V splenica
dextra'- V testicularis *..- V mesentericainlerior
V iliaca communis - -
--
V iliaca interna - -
V mesentericasuPerlor -
V. iliaca externa -:
/ V lemoralis
\
V cava inlerior
\ V temoralis \ V prolundalemoris
- -
V poplitea
V saphenamagna--( --
V saphenaParua
--
--
V tibialisantenor
V tibialisPostenor
Fig. 35 Surveyofthe vascularsystem: venoussystem; ventralview. The superficialveinsare shownin the right' the deepveinsin the left leg. * in the female: V. ovarica
18
VascularSystem, Main Branchesof Arteriesand Veins
\.
t12
9
I 1 2 3 4 5
A subclavia A lhoracicainterna Truncusthyrocervicalis Truncuscostocervicalis A. vertebralis
1 2 3 4
1 2 3 4 5 6
Truncuscoeliacus A gaslricasinislra A hepaticacommunis A solenica
A iliacacommunis A. iliacainterna A iliacaexterna A. epigaslrica inferior A. circumflexa iliumprofunda R. pubicus
19a 'I Pars ascendensaortae 2 Bulbusaortae 3 Aa coronariae 4 Arcusaortae 5 lsthmusaortae 6 TruncusbrachioceDhalicus 7 A. carotiscommunis sinistra 8 A subclavia sinistra 9 A carotiscommunis dextra 10 A subclaviadextra 11 A carotisinterna 12 A carotisexterna 13 Parsthoracicaaortae 14 Parsabdominalisaortae 15 A sacralismediana 16 Biturcatioaortae 17 A. iliacacommunis 18 A iliacainlerna 19 A iliacaexterna
1 A carotiscommunis 2 A carotisexlerna 3 A carotisinterna 4 A. thyroidea superior 5 A. pharyngeaascendens 6 A lingualis 7 A facialis I A occioitalis 9 A. auricularis oosterior 10 A. temporalis suoerficialis 1l A. maxillaris
Figs. 36 a-g Aorta and the main arteries; diagram of the branches. a Aorta b A. subclavia c A. carotis externa
1 2 3 4 5 6 7 I I 10 l1
A mesenterica superior A pancrealicoduodenalisinlerior Aa jejunales Aa ileales A ileocolica A. colica dexlra A colica media A mesentericainlerior A. colica sinistra Aa sigmoideae A. rectalissuperior
1 A iliacacommunis 2 A iliacaexterna 3 A, iliacainterna 4 A obturatoria 5 A. pudendainterna 6 A gluteainferior 7 A iliolumbalis I Aa sacraleslaterales 9 A gluteasuperior 10 A. umbilicalis, Parspatens 11 A. vesicalis inferior 12 A. rectalismedia
d Truncuscoeliacus e A. mesentericasuperior and A. mesentericainferior f A. iliaca externa I A. iliacainterna
16 rl
14 \4
1 2 3 4 5
V. cavasuoerior V. brachioceohalica dextra V. brachioceohalica sinistra V jugularisinterna V. subclavia
Fig.37
6 7 I 9
V azygos W. intercostales oosleriores V. hemiazygosaccessoria V. hemiazygos
V. cavasuperior,tributaries.
1 2 3 4 5 6 7
V cavainlerior Vsacralismediana V iliacacommunis V iliacainterna V iliacaexterna V. phrenica inferior Vv.heoaticae
Fig.38
4
8 V renalis 9 Vlesticularis/ovarica 10 V suDrarenals 1'l Vv intercostalesoosteriores 12 V lumbalisascendens 13 Vv.lumbales 14 V. iliolumbalis
V. cavainferior,tributaries.
Veins System, Vascular 19
Fig. 39 Diagram showing the function of the venous valves.The arrows pointing right indicate the normal blood flow towardsthe heart when the valvesopen.The arrows pointing left indicate the reverseddirection of the blood flow when the valvescloseto stop regurgitation.
f,
Corpus numerl
AP-radiograph(phlebography)of the brachial, Fig. 40 axillary and cephalicveins and some of their tributary vessels. The venousvalves can be clearly identified, especiallyin the axillary vein.
Fetutcircutatiott
20
Arcus aortae
I
\
Aa pulmonales
Truncus brachioceohalicus - -
--
D u c t ua srleriosus" - -
Truncus pulmonalis
V cava superior - --
Atnum cordissinislrum
Foramen ovale' Atrium cordis dextrum - - - - -
--
V cava inlerior - Vv hepalicae
Venlriculuscordis sinister
Septum interventriculare
- Ventriculuscordis dexter
-_L---____<'.
- -
--
l/l lll Vesicabiliaris---.1------F
\--'---s_-/-
r'-.
--
Pars lhoracica aortae lAorta lhoracica]
A mesentericasuperior Aa renales
V u m b t l i c a l-i -sV cava interior -V iliaca communis
Pars abdominalisaortae lAorta abdominalisl A, mesentencainlerior
iliaca communis
----
umbilicales Placenla
A iliacaexterna A iliacainlerna
I I I Vesica urinaria
Fig. 41 Diagram of the fetal circulation; the colours indicate the degreeof oxygenationof the blood, e. g. purple = intermediate.The arrows indicate the direction of the blood flow.
Changesfrom fetal to postnatalcirculation: '
The valve-like connection between the right and left atrium through the Foramen ovale is closed passively by apposition and later by fusion when respiration starts.
'
"
The Ductus arteriosus (BorALLo) lakes some months to close by proliferation of the endothelium and by contraction of the muscles
**
shortcut betweenthe right and left atrium
shortcut betweenthe Truncus pulmonalis and Arcus aortae * * ' shortcut between the umbilical vein and inferior vena cava
' * * The Ductus venosus (ARANzlo) becomes the Lig. venosum in the hilar area of the liver.
Vusr:ukrSystem, LymphuticSystem
2T
Truncus;ugularrs , \
V l u g u l a r r si n l e r n a \ Duclus lymphatrcusdexter \
)
\\
( A n g u l u sv e n o s u s ) \ V subclavia -
- -
Nodr lymphoideicervicales -
Arcus ductus thoracrcl
Truncus subclavrus Duclus lhoracrcus Nodi lymphoideraxrllares/
Pars abdominalis Cisterna chyli
-1 Nodi lymphorderabdominrs - parielaleset viscerales
-
Trunci intestinales
- Truncilumbales Nodi lymphoideipelvis - panetaleset viscerales
Nodi lymphoideringuinales
Fig. 42 Survey of the vascular system lymphatic vesselsand the larger groups of lymph nodes; ventral view.
N o d r l y m p h o r d e-r- cervtcales anlenores
Nodi lymphoidei ceruicaleslaterales Nodi lymphoidei axillares
N o d rl y m p h o i d e -i - axillares
Figs.43 a, b Drainingareasof superficial regional lymph nodes. a ventrolateralview b dorsolateralview
Nodr lymphordel r n gu r n a l e s
There is considerablevariation between individuals.The draining areascan overlap,both horizontally and vertically.
Nodi lymphoidei rn9urnares
22
SurfaceProjectionof theInternal Organs
Oesophagus
SplenILien] Fancreas Ouodenum rcluil
Fig. 44 Projectionof the viscera onto the surfaceof the body; ventral view.
u r l
of the visceraontothe Fig.45 Projection surfaceof the body; dorsalview.
organs oftheInternat 23
---------------
Pulmo Cor Diaphragma
--
--
--------
Fig. 46 Projectionof the viscera onto the surfaceof the body; viewed from the right.
ADpendix vermilormis
Rectum
of the visceraontothe Fig.47 Projection surfaceof the body; viewedfrom the left.
24
Centraland PeripheralNervousSystem,Cranialand SpinalNerves
xl N. cervicalistCll. Radir anterio:r
Medullaoblongata
M€dullasoinalis
Fig.48 Surveyof the centralnervoussystemand the cranialnerves; lateralview
Radixposterior\ Radixanterior \ R. posterior - --'_: N.intercostalis
/ Radixantedor
R cutaneuslaleralis \
_ / Radixpostorior Ganglionsensorium / - nervispinalis - Truncusnervi spinalis --
R posterior
-
N. intercoslalis
- R. communicans - Gangliontrunci sympalhici
Fig.49 Diagram ofthe spinal nerve,exemplifiedby two thoracic nerves.
25 P o n s- - - - - - * _ * _
--
N o c u l o m o t o r i u[sl l l ] - N faciahs [vll]
Ganglion ceruicale \ supeflus
-
N glossopharyngeus
ilxl N vagus [X]
l'/
N cardaacus \ -:
ceruicaltssupeflor
A carolts communls cervicale \ Ganolion medium \ N cardiacus -ceruicalismedius G a n g l i o ncervicothoracicum .' lstellatum] tt Ansa subclavia ,'' / N cardiacus cervicalisinferior
-
----f N l a r y n g e u sr e c u r r e n sd e x l e r
- - Arcusaorlae:Plexuscardracus
+
P a r s a s c e n d e n sa o n a e - - - - - - - T r u n c u ss v m p a l h r c u s-:- € Gangiraihoracrca
\
N splanchnicusmajor - -
pars thoracicaaortae- - - - - - -:l at R r c o m m u n i c a n l e s-
.4{-'
Truncusvagalisanterror Truncusvagalispostelior
N s p l a n c h n i c um s inor --
Truncus sympathicus: - Gangha lumbalia
--
Nn splanchnrcilumbales -
Plexus mesentertcussuperlor Pars abdomrnafisaortae. /
--
- -superior Pfexushypogastricus
--
||
Plexusaorticus abdomrnalis A . m e s e n l e r l c, nat e n o r-'- - ' - - i l f P l e x u sm e s e n l e r l cIunsl e r l o r
-----
A r l f a c a c o m m u n t-s- - - - - ; 1
i,tj
-'i ;f; ' ,'l/i
I e"r..,"ni"ti.
F;il;
Truncussympathicus: G a n g l i saa c r a k a
N n s p l a n c h n r c-rsacrales
Ganghon rmpar - -
Fig. 50 Sympathetic[)art,Parssympathica,of the nervoussystem. autonomr(; The gangliaalignedon both sidesof the vertebralcolumn togetherwith their respectiveconnectionsare callec t h e s y m p a t h e t itcr u n k , T r u n c u ss y m p a t h i c u (sg r e e n ) .
part, Parsparasympathica, Parasympathetic Fig. 51 of the autonomicnervoussystem' fibres (purple)usuallyrun together The parasympathetic fibres. nervous with the other
26
PeripheralNervousSystem,Cervicaland BrachialPlexus
N h y p o g l o s s u s[ X l l ] - -
N occipitalisminor - - 'N h y p o g l o s s u s[ X l l ]
--1. Plexus ceruicalis
--+."
N a u r i c u l a rm i sa g n u s- -
-A
\
N t r a n s v e r s u s c o l l -i Ansa ceruicalis.Radix supenor - Ansa cervicalis,Radix inlerior - -
N d o r s a l r ss c a p u l a e- : - - r : - N phrenicus
Plexus brachialis
N suprascapularis N subscapularis N subclavius
c7
Truncus supenor Truncus meorus
c8 Truncus inferior
Survey of the cervical and Fig. 52 brachial plexus.
Branches of the Plexus cervicalis and the Plexus brachialis Plexuscervicalis(Nn.cervicales:C 1- C4;:Rr. anteriores) Ansacervicalis Radixsuperior Radixinferior (Punctum nervosum) N. occipitalis minor N. auricularismagnus N. transversus colli Nn.supraclaviculares mediales, intermedii,iaterales
(M.longuscolli,M. longuscapitis, Rr.musculares M. rectuscapitisanterior,Mm. intertransversarii, M. scalenus medius) M. levatorscapulae, M. trapezius, N. phrenicus
.:t:..,rt.ir:r:.
Plexusbrachialis (Nn. cervicalesC4/5-N. thoracicus T1, R. anterior) Parssupraclavicularis: T r u n c u s u D e r i o r +) - . . . ,. I urvlslones antenores et rruncusmeolus+ I ;I-runcus - - ' : - : , "Inlenor ; " ' ; " + ./I p o s t e r i o r e s
Parsinfraclavicularis: lateralis(e Divisionesanteriores) Fasciculus N. musculocutaneus Radixlateralis N. medianus, (e Divisiones anteriores) medialis Fasciculus N. dorsalis scapulae Radixmedialis N. medianus, N. suprascapularis N. ulnaris (oftenbranchof Fasciculus posterior) Nn.subscapulares brachiimedialis N. cutaneus N. subclavius medialis N. cutaneus antebrachii N. thoracicus longus posteriores) posterior (+ Divisiones Fasciculus (oftenbranchof Fasciculus Nn.pectorales lat.andmed.) N. axillaris (oftenbranches N. thoracodorsalis of Fasciculus N. radialis posterior) (M.longuscolli,Mm.scaleni) Rr.musculares
PeripheralNervousSystem,Lumbosacraland coccygealPlexus
N subcoslalis
Plexus lumbalis
I R . l e m o r a k s- N genitolemoralrs 1 R. oenrtalis
\-
N cutaneus temoris lateralis
- -
Plexus lumbosacralrs
N t e m o r a l i -s-N obturatorius T r u n c ulsu m b o s a c r a l s- N gluteussuperior- -
L5 -.-S1 Plexus sacralis
N gluteus inlerior \\
/ I N .t i b u t a r i s N ischiadicus I communrs r I N. trbratis
N cutaneus lemoris oosterior
S5
- -
t N pudendus ,, inferiores .'' Nn anales [rectales]inferiores N coccygeus ,, N anococcYgeus
Plexus coccygeus
Co
Fig. 52 Surveyof the lumllosacralplexus,Plexus l lexus, , l e x u sl u m b a l i ss; a c r a p l u m b o s a c r a l (i sl u m b a rp l e x u s P Plexussacralis)and coccygealplexus,Plexuscoccygeus
Branches of the Plexus lumbosacralis Plexus lumbalis (Nn. lurnbalesL1-I4, Rr. anteriores)
plexus s4cralts (Nn.lumbales L4-Nn. sacrales S4r Rr. anteriores)
N.iliohypogastricus
N. gluteussuperior N. gluteusinferior N. ischiadicus N. cutaneusfemorisposterior N. pudendus (Mm.gemelli,M. quadratusfemoris, Rr.musculares Mm.obturatorii,M. piriformis,M. levatorani)
N. ilioinguinalis N. cutaneusfemorislateralis N. femoralis N. genitofemoralis N. obturatorius
Plexus coccygeus (Nn. sacrales S4-N. coccygeusr Rr. anterlores) R.anterior N. coccygeus, N. anococcygeus
27
28
skin, cteavage Lines
Fig. 54 Cleavagelines of the skin; ventral view.
Fig. 55 Cleavagelines of the skin; dorsal view.
Fig. 56 Cleavagelines of the skin of the head and neck; ventral view.
Fig. 57 Cleavagelines of the skin of the headand neck; lateral view.
skinandAppendages 29
/ (Plexusvasalisdermalis)
/ (Plexusvasalissubdermalis) ?
,a
I ---
I
s--Vaslymphaticumprolundum/
(Plexusvasalis subcutaneus) (Plexusvasalis epifascialis)
,'
Septumrntermusculare /
|
| (Arteria; Venaintramuscularis)
' (Arteria; Venasublascralis)
| (Arteria; Venaintraseptalis)
F i g . 5 8 S e c t i o nt h r o u g ht h e s k i n ( 1 0 - t i m ees n l a r g e d ) . Margo liber \ Corpus 1
ungurs i--
I
vattun--24 ungurs -.\ '><.
tunuta--f-
)
F i g . 5 9 D i s t a lp h a l a n rw i t h f i n g e r n a i l ; tkrrsalview. * | h r .r ' l x r n r rh i u n t r s l l s o r a l l c r ll h f ( u l i ( l ( '
/
rponycnrum
Corpusunguis Matrixunguis Hyponychium
I
\
Margo Iber
,
\
\
Hyponychium , t, Eponychium , i / vallumunguis i l///
/
Aponeurosis dorsalis
Phalanx dislalis
EPidermrs -
-
Cutis-
-
Subculis/ \ M. flexordigitorum prolundus. Tendo
Vallum / u n gu r s
Fig. 60 Distal phalanr; the fingernailhas beenpartially removed; dorsal view.
Fig. 61
Distal phalanx, Phalanx distalis;
sagittal section.
}fi
Head, caput
Fig.62 Headand neck,Caputet Collum; ventral view (30%).
z Regio lronlalis
Flegioorbitalis _z Regio infraorbitalis Regio zygomatica _ / Regio nasalis
Regio oralis
z
Trigonvm submentale
.z
submandibulare z Trioonum -
/
'
Regio buccalis
//
.t
) cerulcalls
Trigonum caroticum
I anterior 7 frigonummuscularelomotracheale] J _/ Regio sternocleidomastoidea
//
Fig. 63 Regionsof the head and neck, Regionescapitis et colli; ventral view (30%).
l I Regio..
minor Fossasupraclavicularis
Regionsof Head and Neck, Regionescapitis et colli
Fig.64 Headand neck,Caputet Collum; lateral view (30%).
/
Regio parietalis
Regio frontalis---
Begioorbitalis-_ _ Regio nasalis -
_
Regio zygomatica- Regio intraorbitalis- Regio oralis - Regiobuccalis--Regio mentalis - -
- - Regiosternocleidomastoidea --
Regiocervicalisposterior ) Regio Trigonum l cervicalis omoclaviculare , lateralis
FossasuDraclavicularis minor- - - -
Fig. 65 Regionsof the head and neck, Regionescapitis et colli; lateral view (30%).
Regio deltoidea
3it
Head, Caput
r'1T *"*-*^*P!
**q'
i +\\\
,,'-"'
,ir{ ----
e
/
/ piritormis Apertura
Fig.66
S k u l l ,C r a n i u m ;
o r i e n t a t i o ni n t h e " e a r e l e l i n e " ( O h r ' \ u g e n E l t e n t ' , O A I i o r s o - r . a l l e t"l( i e r m a n h o t i z r t n t a l p l i t n e " ) ; v r : n t r a lv i e w ( 7 0 % )
Frons
Bonesof the Skull, Ossacranii
*r--.-E-
_/
Os lrontale, ', f ronlalis Squama --
/-\
sulura lrontolacflmalis Sutura sPhenolrontalrs\
/
_
Sutura lronlonasalls
\
\
Margo supraorbrtalis \ S u l u r ac o r o n a l i s \
/
Os Panelal€. \ A n g u l u ss p h e n o r d a l r s Os sphenoidale, \
A l am a i o r
\ .\.-
Os lrontale,Hars oroIaIs
- --- r ,,".,9n'"t1"1,13l,";
-l-
.T
--
---Fissura o r b i l a l i ss u p e n o r
I
-
Os lemporale
-
Sulura lrontozygomatica
-
Os lacrimale
Ir.
O s s p h e n o i d a l e-,- Ala minor
-*-
O s s p h e n o r d a l e-, - Ala major O s z y g o m a l i c u m- -
.6
,/ 7/
-
Fissura orbitalisinfeflor / -
I t/
/ [,4argoInlraorbrlahs
t .>/ a
/
)
!
./':
/ S u t u r az y g o m a t i c o m a x i l l a r i s
I Os elhmoidale l/ septum nasr l a-\ osseum I i \ vomer Iz
concha nasalis Inferior
R"rua mandrbulae /
ri
"
t
\
,'")i,
F o r a m e nm e n t a l e
S u l u r ai n t e r m a x i l l a r i s
/
I
-:
Concha nasalrsmedia
'\
7
Spina nasalrs anlenor
Forameninfraorbitale
.4
/ Maxilla Proc alveolaris
- : i ".3' : -i
\
'\'
Suluranasomaxillaris
C o r p u sm a n d i b u l a e
Os frontale
Os lemporale
Os nasale
C o n c h an a s a l i sI n l e r r o r
Maxrlla
Mandrbula
os zvqomatrcum
Os lacrimale
F i g . 6 7 S k u l l ,C r a n i u m ; \ e n t r a l\ i e t t ( 7 0 ' l )
I
Vomer Os ethmoidale
m
Os parietale Os sphenoidale
34
Head, caput
F r o n s\ \ \ \
\ occiput
\ Arcuszygomaticus
Fig. 68 Skull,Cranium; orientationin the "ear€yeline" (Ohr-Augen-Ebene, 'Germanhorizontalplane"); OAEor so-called lateralview(80%). * Pointsfor measurements in anthropology.
Bonesof the Skull,Ossacranii
/
Suturasquamosal
Os parietale
Suturacoronalis\ Suturasphenolrontalis \
'
/
,;.
superior Lineatemporalis
/
Linea temporalisinlerior
/ Tuberparietale
- Sutura squamosa Os ethmoidale,. Lamrnaorbitalis'\
z Sutura panelomastoidea
Sutura \ _ lronlolacflmalrs \ Os lacrimale \
-
Sutura lambdoidea
-
(Sutura squamomasloidea)
Sutura \
Spina/ nasalis anteri6r
\ SuturaocciDitomastoidea
\
\ lSutura ' - - squamomasloidea)
\ Porusacusticus externus
Sutura/ zygomaticomaxillaris
occipitalis Condylus eroc stytoideus
Sutura/ temporozygomatica
I I Mandibula, Proc condylaris
\
Proc coronoideus Mandrbula.
t{
t\
\ Angulus mandibulae
I
/ Protuberantia mentafts
\ Basismandibulae t corpusmandibulae
\
\ Foramenmentale
I I
Os lacrimale
Os temporale
Os zygomalicum
Maxilla
Os occipitale
Os sphenoidale
Mandibula
Os nasale
Os ethmoidale
Os lrontale Os parietale
Fig. 69 Skull, Cranium; lateralview (80%).
Head, Caput
Os parielale Fossa mandibularis Os temporale, Pars squamosa Frssuratympanosquamosa Ficcrrra
\ t,
, \.
,
//
\
norra-
Squamosa \
I/teatus acusticus externus\ Vaginaprocessus styloidei\
\
\
arliculare /Tuberculum Fotamenspinosum / /
/Os
'\
\
temporale.Proc zygomalrcus /
Foramen ovale /
,,
\\
Ala maior
/ Os zygomaticum, 7' Proc. tempora|s
I
/ Foramen lacerum /, Os zygomaticum
.,
-,
p r o c -. - - - - - - - _ _ stylordeus
_ (-
Canalis caroticus
Foramen infraorbrtale Fossa scaphoidea Maxrtla
---
- - Fissurapterygo maxillaris -
Canalis nerui hypoglossi Canahs
---
' - - - . . . / 2
i
Fotanen--.-JU9Urare
Ptoc plerygoideus, Lamina lateralis Proc pterygoideus, Lamrna medialis
--"')'
-
Spina nasalis anterior -
Hamulus preryg0roeus -
-r-
Tuberculum pharyngevm t' - r'
Atlas,Arcus anlern'/ .-tfr -t-r"')L{ Lamrnaarcus
t-
ui"T::,.'ff
Axis, Dens Proc spinosus
/
.- vomer -- Foramen Incrstvum - Os sphenoidale, Corpus - Maxilla,
t
Foramen patatnum malus \ Linea mylohyoidea
/ t..
4..
\ ' Proc articularis interior lzygapophysis]
/ Foramentransversarium / Proc lransversus, Tuberculum oosterius
\
1
\
\ \t
\
\ t
\
Proc transversus. Tuberculum anterius
\
ta.
\
Srl.r.
Foramen lacerum
mylohyordeus
Lig sphenomandrbulare
For"."n
mandrbulae
t,n stylomandibulare
Canalis caroticus
F i g . 7 0 S k u l l ,C r a n i u m ; hemisectionof the mandibleand the upper part of the vertebralcolumn; inferolateralview (80%).
F,"#.iirarinrs
\ Foramen sphenoPalatinum \ Os palatinum, Lamtna horizontalis
-F
Bonesof the Skull,Ossacranii
Suturasagittalis \ /
Foramen parietale
Foramen parietale -- -
Suturalambdoidea
(Osinterparietale; Os Incae)
/
-----*i
Os Parietale
(\l - Ossasuturalia
--
(SuturaocciPitalis iransversa,Var.)
- - Os iemporale - -
\ (Cristaoccipitalis exlerna)
\
\
, ranium; F i g . 7 l S k u l lC dorsalview(70%). " Points for measurementsin anthropoloSy
LineanuchalissuPerior
Linea nuchalisinferior
Proiuberantia occipitalisexterna
Os occioitale
+.q i
Head,Caput
/ Ossanasalia
Tuberfronlale Suturacoronalis\
Tuber parietale
-
/ Squamaoccipiralis
Fig.72 Skull,Cranium; superiorview(80%). in " Pointsfor measurements anthropology
Foramina Darietalia
Bonesof the Skull,Ossacranii
39
Sulcussinussagittalissuperioris\\ / Os frontale
-
Foveolaegranulares
--< sururacoronalis
--
Sulcussinussagittalissuperioris
I Suturalambdoidea
Fig.73 Cranialvault,Calvaria; inferiorview(80%).
Sulciarteriosi el v€nosi
Head, Caput
\
Fig.74 Skull, Cranium; paramediansection; medialview (80%). * Points for measurementsin anthropology
Inion'
g
,/Foramen parietale
/ Sulciarteriosi
Dorsum sellae \
\ /
Sella lurcica \
,/ Sutura squamosa / Apex panls
Lamina el \ Foramina cribrosa \
Sinus frontalis \
petrosae Eminentaa / / arcuala
.,
Foramen-.ft caecum ).t-!
(
--i+ cnstaealli
/ Sutura lambdoidea
ethmoidale, Lamina perpendicularis
Sinus sphenoidalis Vomer exlerna \
C€nalis Inctsrvus p r o c- ' . palatinus, Crista
\
ni.iti;l ll
Alveolus dentalis Foramen Inctsrvum
\
ta \ \
Sulcussinussigmoidei
Foramenmastoideum
Porusel Meatusacusticusinternus
\
/
/
i Pro. intrajugularis lCanalis nervihypoglossi
\
Os palatinum Hamulusplerygoideus Incisurapterygoidea
\ '
Proc styloideus
Laminamedialis Proc pterygoideus,
'
Proc pterygoideus,Lamina lateralrs Proc pterygoideus. Fossa pterygoidea
Os lrontale
Os sphenoidale
Os parietale
Os temporale
Os occiPitale
Maxilla
Os nasale
Vomer Os palatinum
Os elhmoidale
Fig.75 Skull,Cranium; section; paramedian medialview(80%).
Sulcus sinus transversi
-'6-"j
Head, Caput
Sella turcica,\ Fossa hypophysialis \
;2
---
Fossa cranii media
FOSSa CranI OOSteflor
Fig.76 Baseof the skull (internalsurface), Basiscranii interna; superiorview (80%).
4:\ CristafrontalisI
,/ Canalisopticus
Proc clinoideusposterior \ Fissura orbitalissuperior \
:1.
'' \.
/ SuturasPhenofrontalis
Os sohenoidale,Ala minor 1
z Fossahypophysialis /
Foramenrotundum\
anterior Proc clinoideus /
Lingula sphenoidalis \
Sulcuscarolicus / Sutura sphenosquamosa
Foramenlacerum' \
/ Sulcus arteriosus Foramen ovale \
/
Fissura petrooccipitalis
Foramen sprnosum
- Spinaossis sphenoidalis -
Sulcussinus Petrosi interioris -
Sulcusnerui petrosiminoris Sulcusnervi petrosrmaioris Facies anterior panrs petrosae
-
Fissura petrosquamosa
t,OrUS
-
acuslicus rnlernus -
/ -
/ Os temporale, Parspetrosa
-
\ \
/
\
/
. t.
Fossasubarcuala
\
MargosuperiorpartisPetrosae I jugulare Foramen
Os parietale sigmoidel
Proc Jugularts Canalis condylaris
Sulura occipitomastoidea Canalis nervt hypoglossl
jugulate Tuberculum
Canalisnervihypoglossi
Protuberanliaoccipitalisinterna
\.
t't
Os occipitale
I
Forat"n lugulate
Sulcussinus
Sulcussinus petrosisupenoris Foramen mastoideum
Margosuperior parlis pelrosae
\\
\
'\
Sulcussinusttansversi clivus Foramenmagnum
interna) (CristaocciPitalis superrorls Sulcussinussagittalis
Os lrontale
Os ethmoidale
Os temporale
osparietate
Os sphenoidale
Os occiPilale
Fig.77 Baseof the skull (internalsurface),Basiscranii interna; superiorview (80%). Contentsof the foraminasee Fig.454 antl page267.
* "
| h ( ' l i r r a m o n l a t f r u m i s r ; l t t s t rtl t r a l i l \ { ' r l l f f i l r t r xi l r l i l i l A e ( l ; i l ) r ( xa r t i l a g ol , i l s i l l i s ) . i l u r i n x t h { . g r o s t h ( , 1t h ( ' s k t t l l l h ( ' l w { , l x ) n c si l t c s c l ) i l r i l t { rllr \ l h { ' s l ) h ( ' n { H X l r i l ) i lsavl n t : h t t n r l r o s iSsr, n l h r t n t l r r l s i s p l t t ' n r x x irp i l i t l t s '
Head, Caput
, Fossa incisiva:Foramina incisiva
/ (Toruspalatinus) Foramenpalatinum majus; Canalisoalatinus maior
Palatumosseum \
/ Foramenlacerum
Fissura sphenopetrosa
Fissura petrooccipitalis
-
Fig. 78 Baseof the skull (externalsurface), Basiscranii externa; arrow in the left hypoglossalcanal,Canalisnervi hypoglossi; inferior view (90%).
Proc masloideus
Bonesof the Skull, Ossacranii
/, Fo'amenincisivum
Spinanasalisposterior\ Vomer,Alaevomeris \ .
,- / :/
/ SuturaPalatinamediana / Maxilla,Proc palatinus '
Proc pyramidalis\. Os palatinum, Maxilla,Proc zygomaticus \ Proc.pterygoideus,\ Lamlnameolalls \
/ Os palatinum,Laminahorizontalis
\
\
, Suturapalatinatransversa
/ Forumenpalatinummajus
/
Hamuluspterygoideus \ / Fissuraorbitalisinlerior Proc.pterygoideus,\ Laminalateralis \
/ Arcuszygomaticus
Os sphenoidale, Ala maior
- Crisla intratemporalis plerygoideus, - Proc. medialis Lamina
O s t e m p u a l e ,- _ / i tsroc. \ zygomalcus
-
Foramen ovale - Tuberculum pharyngeum
Foramen-J lacerum l-\ Foramen- -\ spinosum t-
Tuberculum articulare
-
Fossa - mandibularis
- - Canalis carolcus
S p i n a o s s i s- - sphenoidalis
-
Canaliculus mastoideus - Fossa jugularis
Proc. slyloideus
-
Meatusacusticus exlernus Fossa jugularis
Foramen slylomastoideum - Sutura occipitomastoidea - Proc masloideus - lncisura mastoidea
/ Foramen Jugulare
\
Os parietale " Foramen mastoideum
/
Canalisnervi hypoglossi
/ \ canalis condylaris
FOSSUta
petrosa / Condylus occipitalis
\ Foramenmagnum
Canalis condylaris 1"\" Linea nuchalis superio,
/
tt
* \
Protuberantiaoccipitalisexterna'
Maxrlla
I
Linea nuchalis inlerior
Os palatinum
Os sphenoidale
Os frontale
I
Vomer
Os temporale
osparietate
ffi
Os zygomaticum
Os occipitale
Fig. 79 Baseof the skull (externalsurface),Basiscranii externa; canal,Canalisnervi hypoglossi; arrow in the left hypoglossal inferior view (907n).
Contentsof the foraminaseeFig' 454 and page267.
Head, Caput
z Sutura lambdoidea Sutura sagiltalis - _
/
C e l l u l a ee t h m o i d a l e s
M a r g o s u p r a o r b i t a l i s- - Frssuraorbitalissuperior - - _
Meatus nasi superior S e p t u mn a s i
/ /
Mealus nasi medius
- -
Os temporale, Pars petrosa
- -
Meatus acusticusexternus
- -
Cellulae mastoideae
Concha nasalis media S i n u sm a x i l l a r i s Concha nasalis inlerior
--
Proc mastoideus
S p i n a n a s a l i sa n t e r i o r - -
Palatum durum
Ramus mandibulae
A x i s ,D e n s -
-
-
F i g .B 0 S k u l l ,C r a n i u m ; PA-radiograph. " T h e s o c a l l e d" i n n o m i n a t e "l i n e h a s n o a n a t o m i cc o r r e l a t i o ni,t i s a n a r t e f a c tr e s u l t i n g from the projecti0n
Meatus nasi inferior
Cavitas nasi
Corpus mandibulae
Bonesof the Skull,Ossacranii
- -
"tiiJioers anterior
--
Os lrontale, - Parsorbitalis
- -
Fossa hypophysialis
- -
Sutura lambdoidea
_-
Fossa.
- -
Cellulae mastordeae
* -
Meatus acuslicus externus
mandtDUlans
Sinus - trontalis C e l l u l a e- ethmordales Os nasale - Sinus - sphenoidalrs
--
Caput mandibulae
- -
Atlas,Arcus anterior
\
Atlas, Tuberculum Posterius
\
Axis, Dens
\
C o r p u smandrbulae
g/^r
"tiiJ'oeus posterior
Proc sprn0sus verlebrae ceruicalisll
Carlilago eprglottrca Os hyoideum Corpus
S k u l l ,C r a n i u m ; F i g .B l lateralradiograph; bilateralstructuresare proiectedupon eachother. ' *'
p o s k ' r i o rw a l l o f t h o m a r i l l a r y s l n u s c h a r a ( : t e r i s t si c( r u ( ; t u r eo f f l a t b o n c so f ( h e s k u l l
\
Ramus mandibulae
^ t"*-.
Head,Caput
Fonticulus anterior\
Os parietale
(Suturatrontalis)-
Os frontale,Tubertronlale -
Maxilla,Proc.frontalis\ .. -- Foramensupraorbitale
- *
Os sohenoidale, Alamajor - -
Os temporale
Septumnasiosseum - Forameninfraorbitale- -
- -
\
/
Os zygon,aticum
Mandibula
\ (Symphysismandibulae)
Fig.82 Skull,Cranium,of a neonate; ventralview (80%).
-
Os lacrimale
Os occipitaic
Os ethmoidale
Os frontale
Maxilla, Os incisivum
Os sphenoidale
osparietate
Os zygomaticum
Mandibula Os nasale,Os temporale,
anterior - Fonticulus
Suturacoronalis os frontale,Tuberlrontale -
/ Os parietale,Tuberparietale
Fonticulussohenoidalis Os sohenoidale, Ala maior posterior - Fonticulus Os zygomaticum / Squamaoccipitalis
Aperturapiriformis
- Sutura lambdoidea
Mandibula
- Fonticulus mastoideus
Parssquamosa' Os temporale, Anulustympanicus/
I Parslateralis Osoccipitale,
t
Os temporale,Parspetrosa
Fig. 83 Skull, Cranium,of a neonate; lateral view (80%).
Bonesof the Skull,Ossacranii
Suturatrontalis
7 Os lrontale,Squamafrontalis ,/ Suturacoronalis
//
/ --
Ospatielale, Tuber Parietale
posterior Fonticulus
Sulurasagittalis-
- - os occipitale,Squamaoccipitalis
Fig. 84 Skull, Cranium,of a neonate; superiorview (80%).
I
T
Vomer
Os occipitale, Os palatinum
Os trontale
Os temporale
Os parietale
Mandibula
Maxilla,Os incisivum
oszygomaticum
I
Os sohenoidale
Os occipitale,Squama occipitalis - -
(Suturaoccipitalistransversa, Var) - -
masloideus- Fonticulus Os temporale,Parspetrosa - Os temporale,Parssquamosa- -
- -
Os occioitale.Parslateralis
Foramenmagnum
Parstympanica, Anuluslympanicus Os lemporale,Parspetrosa Os sphenoidale,Proc pterygoideus a
---Maxilla.
Yomet'
- Os palatinum,Lamina hoflzontalis
- -
Proc palaiinus
1osincisivuml
Mandibula
Fig. 85 Skull, Cranium,of a neonate; inferiorview (80%).
Head,Caput i1t'r
Squama lrontalis, Facies exlerna
Tuberfronlale \
Margoparietalis- -.,, I I
I
--'-
Arcussuoerciliaris
- - - -
----
'\
/
Incisurasupraorbitalis
4.. t
/ Parsorbilalis,Faciesorbitalis Parsnasalis
\
FaciestemDoralis Margosupraorbitalis
Proc zygomaticus
\.
' Incisura frontalis
Gr"b"rr"
spinanasalis
Fig. 86 Frontal bone,Os frontale; ventral view (80%).
7 Glabella
,/ Aperturasinusfrontalis
(Spina trochlearis)\
\\ Arcussuperciliaris \\ Margosupraorbitalis
/
t_ ,'
\
t Incisurasupraorbitalis --
Fovealrochlearis , -
Pafs orbilalis, Facies orbitalis
- -
---
Foramenethmoidaleanterius
Incisuraelhmoidalis
Fig.87 Frontalbone,Os frontale; inferior view (80%).
Fossa glandulae lacrimalis
Proc zygomaticus
cranii Bonesof the Skull,'Ossa
Os frontale.Squamalrontalis Os nasale. Lamina et Foramina cribrosa :
/ lncisurasupraorbitalis'
-.,i
// Fossa glandulaelacrimalis \
Margosupraorbilalis
/-
elhmoidalis Labyrinthus --
/ Laminaet Foramina cribrosa
\
Ptoc zygomaticus
Laminaperpendicularis
Os nasale
Os ethmoidale
Os lrontale
Frontalbone,Os frontale;ethmoidbone,Os ethmoidale; Fig. 88 nasalbones,Ossanasalia; inferior view (60%). 'Tho sul)raorbitalfissure, In(:isurasupraorbitalis,may be repla(;edhy a supraorl)ital foramen
Margo lacrimalis \\\
/
Proc frontalis, Crista lacrimalis anlerior
Incisuralacrimalis - Margo inlraorbitalis -\.
r
z Foramen infraorbitale
F a c i e s o r b i t a l i s- - -
/
Faciesinfratemooralis
/
-
/ (Crislazygomatico' alveolaris)
Fossa canina
--
nasalis Incisura --
Foramina alveolaria
Spinanasalisanterior
Proc zygomaticus
Tuber maxillae
- -
Proc alveolafls
/
\
Faci"" ant"rio,
F i g . 8 9 M a x i l l a r yb o n e ,M a x i l l a ; l a t e r a vl i e w ( r . , l 2 O % 1 .
Head, Caput
Soina nasalis oosterior
Suturapalalrna transversa
t
+"/ ^!f,
- -
Foramenincisivum/
Soina nasalis anterior
Fig.90 Hardpalate, Palatum durum;maxillarysinus, Sinusmaxillaris; inferiornasalconcha, Concha nasalis inferior; the maxillarybonehasbeensectioned obliquely; superiorview.
Maxilla
Os sphenoidale
Os palatinum
Concha nasalis inlerior
Suturaoalatinatransversa
Os palatinum,Proc pyramidalis
.r
Foramenpalatinum majus
---
Foramenpalatinummaius - - -:
\ Sulci palatini
Maxilla,Proc zygomaticus
'-
--
r 1 \
sp,n""patatinae
Maxilla, Proc palatinus
\ (os incisivum) \
Suturapalalinamediana
Fig. 91 Hard palate,Palatumdurum; inferior view.
Bonesof the Skull, Ossacranii
M a r g o l a c r i m a l i s- - - -
/ Incisurasphenopalalina Maxilla. Proc frontalis ---
--
Lamina culans
:
- - Maxilla, Facies nasalis
Spinanasalisanterior
g^.-19r3til,11 perpendi-
,,j )--I
Cristaconchalis---
_.../ ', $
\ Crislaconchalis Spinanasalisposlerior
t\
Maxilla,Proc.palatinus-l \ Maxilla
Suturapalalinatransversa
Os palalinum
Fig.92 Maxillary bone, Maxilla; palatine bone, Os palatinum; medialview (r.). / Procorbitalis Incisurasphenopalatina \
Incisura\ sphenopalatina \\ Proc--sphenoidalis Sulcuspalatinusmajot - - Laminaperp€ndicularis, Faciesmaxillaris
-
LaminahorizontalisI I I
--\
- - Sulcuspalalinusmaior Proc pyramidalis-
Fig.94 Palatinebone,Ospalatinum; dorsalview (r., 140%).
Fig.93 Palatinebone,Ospalatinum; lateralview (r., 140%).
---//
Proc.orbitalis Incisurasphenopalatina
-
Proc.sphenoidalis Laminapetpendicularis, Facies nasalis
---
Faciesnasalis -
Cristaconchalis
/-
Lamina - - -
:-
horizonlalis
fig. 95 Palatinebone,0s palatinum; medialview (r., 140%).
- Faciespalatina
SprnanasalisPosleriot
\
Proc.pyramidalis
Foramenpalatinummaius
i5:$
5 4
Head, caput
I
Os frontale:
Laminaet Foraminacribrosa , Squamafrontalis, /' Faciesinterna
\\
/, Cristasphenoidalis /
, Sinussphenoidalis
S i n u s: lrontalis --
/
S u t u r a- - fronlonasalis
os -'-,
nasale
/ Fossahypophysialis Dorsumsellae ,
!
Osethmoidale,Laminaperpendicularis Maxilla,/ Proc.lrontalis / Os lacrimale
t
\ Hamuluspterygoideus
tlilY,T;*",* y,t::'8r,",,",rt'-oi,f,i'f
Maxilla
Os palatinum
Os trontale Os nasale Os sphenoidale
I I I
Os ethmoidale Vomer Os lacrimale
Fig. 96 Bony nasal septum, Septum nasi osseum, with adjacentbones of the skull; paramediansection; the middle nasal conchahas been removed; medial view (1.).
z Alavomeris
I I
Alaevomeris
Crislachoanalis vomens
Fig,97 Vomer,Vomer; lateralview (140%).
Fig. 98 Vomer,Vomer; dorsalview (140%1.
Bonesof the Skull,Ossacranii
z Laminaet Foraminacribrosa
Cristagalli
/
Os nasale -
Conchanasalissuperior
,/
Sinussphenoidalis
/-
_
Foramensphenopalatinum
---
corpus Os sPhenoidale'
Meatusnasisuoerior--Concha nasalis media ----
Meatusnasimedius---Conchanasafisinlerior -'-
Spinanasalisanterior-
- Os palatinum, Laminaperpendicularis
- --
Meatusnasiinferior
Proa.plerygoideus, Laminamedialis
/ \
/ Canalisincisivus-
Mealusnasi inlerior
\ HamulusPterygoideus \ Os palalinum,Laminahorizonlalis \ Maxilla,Proc.palatinus
Fig. 99 Lateral wall of the nasal cavity,Cavitasnasi, with adjacentbonesof the skulh paramediansection; medialview (r.).
osparietate
I
' Synostosisof the former Synchondrosissphenooccipitalis
I
Sinuslrontalis\
ossphenoidale
Maxilla
Os occipilale
Os lrontale
Os palatinum
Os nasale
ffi
Os eihmoidale
conchanasatrsrnrenor
I
Os lacrimale
/ Laminael Foraminacribrosa
\\
Apertura\ -sinuslrontalis' Conchanasalis media - -
ffi
ethmoidalis / Labyrinthus / Aperturasinussphenoidalis
\
/ Sinussphenoidalis
Os nasale - --
--{r--' t. , ----
Foramen sphenopalatinum OsPalatinum' Crislaethmoidalis
conchanasalisinlerior, Proc ethmoidalis
SPina-' nasalis anlenor Canalis Incrsrvus
Hamuluspterygoideusl
Fig. 100 Lateralwall ofthe nasalcavity,Cavitasnasi, with adjacentbones; paramediansection;the middlenasalconchahasbeen removed; medialview (r.). ' Theprobemarksthe connectionof the frontal sinuswith the middle nasalmeatus.
jj;
Head, Caput
Ala cristae galli
/
Lamtna perpendrcularis
\
Cnsta galli
/
/
/
Lamina orbitalis
Cellulae ethmoidales
, Labyrinthus ethmoidalis /,
lamina/ perpendicularis Cellulae/ ethmoidales
\ Concha nasalis media \
F i g . 1 0 1 E t h m o i rbl o n e ,O s e t h m o i r l a l e ; superiorvielr'( l;10%).
Proc uncinatus
Fig. 102 Ethmoitlbone,Os ethmoidale; l a t e r a vl i e w ( 1 1 0 % ) .
* i r l s or a l l c r lI a m i n a p i r l t r l a , l ) ( ' ( rar a u s ( '{ ) f I h ( , l r a l x ' rt h i n n a l u r ( ' r )tfh r sl x ) n ( '
I Foramina zygomaticoorbilalia /Facies
/
---
orbitalis
Proc frontalis
/ Fotamen zygomattcoorbrtale
Foramen zygomaticotemporale
FOramen zygomaticolaciale
proc temporalis - -
temporalrs Facies lateralis
Fig. 103 Zygomaticbone,Oszygomaticum; lateralview (r., 120%1.
Fac
Fig. t04 Zygomaticbone,Oszygomaticum; superomedial view (r., 120%).
Bonesof the Skull, Ossacranii
Foramina ethmoidalla anlenus et posterrus
/
Incisuralronlalis \
Canalisopttcus Fissura superror orbitalis
/ -t Os ethmoidale,\ Lamina orbitalis \ \ S u t u r al r o n t o m a x i l l a r i-s-
--
- :
iygomalrcolrontahs) OszYgomatrcum
-----
Os sPhenoidale Ala maior Facies orbitalis
---
Oszygomatrcum Faciesorbitalis
C r i s t al a c r i m a f t as n l e n o r- - - Crisla lacnmalisposlenor -
(Sulura
,-
- zygomaticolaciale
Os palalinum, / Proc orbitalis
- -
/ \ \
Fissura orbilalisinlerior
Sulcus inlraorbitalrs
Sutura zygomaticomaxillaris
F i g . 1 0 5 O r l t i t ,O r l r i t a ; t h e l l r o l r el i e s i n t h e i n f r a o r b i t arl: a n a l ; v ( l n t r o l i t t e r vaile u ( l , I l 0 ' l ' )
I
Os nasale
ilIil
Os trontale
Os temporale
Vomer
{effi
Os zygomaticum
Os sphenoidale
Maxrlla
Os palahnum
Concha nasalis inlerior
Os lacrimale
Os ethmoidale
I Sinus trontalis \
Cellulaeethmoidales /
\
Crista galli Os ethmoidale t-aminaperpendicularrs
i
// Os trontale Pars orbilalis
---
I
- -
Frssuraorbttalts suPerior
--
Os lemporale. Pars squamosa
I
II I I
Os sphenoidale.Ala maior, Facies orbitalis
/
4
Fissura orbitalisinlerror
----
t
-
YrS i n u sm a x i l l a r i s Vomer
,l
--
Maxilla,Proc alveolafls
'
t \
/
\ .:
\-
. Dens molaris -
\
os zygomaticum
Canalisinlraorbitalis
Sulut" zygomaticomaxillaris
Concha nasalis media
Concha nasalis inlerior
Cavitas nasi. Meatus nasi inlerior
Maxilla. Proc Palatinus
-r-ig. 106 l:at;ialsktrleton,Vist;trrot;ranium; f r o n t a ls e c t i o nt h r o u g ht h t rm i r l t l l tor f t h e o r b i t ; v e n t r a lv i e w ( 9 0 % )
,,.f
Head, Cctltttt
Squama - - Jrontalis. Facies Inlerna
Os parietale
---
S u t u r as p h e n o l r o n t a l i s
_--
Os temporale. Pars squamosa
O s s o h e n o i d a l eA. l a m i n o r
O s s p h e n o t d a l e-,- Ala major, Facies orbitalis
--
Foramina -' zygomaticoorbitalia
-CanaIs infraorbitalis-/
Os sohenoidale.Corous
-Sanussphenoidalis \ Foramenrotundum
\ Canalispterygoideus t..
\
S r n u sm a x r l l a r i s-
Fossa pterygopalatina
\ Proc pterygoideus lt\ |
'
Hamulus pterygoideus
I
| ^^^^,,^ __,_.,^ -^,-_ lAlveoli dentales
F i g . 1 { ) 7 l i a c i a sl k e l e t o n\, i s c e r o r ; r l n i u m ; s a g i t t asl e ( i l i ( )tnh f o u g ht h e m i r l t l l eo l t h e o r l ) i t ; m e r l i avl i e u ( r ) Os lrontale
Os nasale
Maxilla
Os lacflmale
Os palatinum
Os temporale
Os sphenoidale
Os elhmordale
/
Os zygomaticum
*
Os trontale Sutura ethmoidolacrimalis /
Fotamen ethmordaleanterius /, Os ethmoidale.Lamina orbrlalis /
,/ Os nasale
\
Fotamen ethmotdateposrer,us
,'
_/
Canaftsoplrcus - -
Os palatinum Proc orbitahs
- - -
M a x r l l aC , r i s l al a c r i m a l i sa n t e r i o r- - - - -
- - -
Os lacrimale,Crista lacflmalisposterior /
Foramen sphenopalatinum
Os sphenoidale Corpus
S u l c u si n fr a o r b i t a l i s/ Proc pterygordeus Lamina lateralis
Maxilla Proc zygomaticus -
- -
Hamulus pterygordeus
\ Maxilla, Proc alveolaris
F i g . l t ) t l I : a r ; i aslk e l e t o n\, i s r ; e l o c l a n i u m ; s a g i t t asl e tt i o n t h r o u g ht h e m i t l r l l eo f t h e o r b i t ; l a t e r a tl i e n ( 1 . )
Bonesof the Skull, Ossacranii
palatrnum,Proc orbitalis / Os
Cellulae - ethmoidales
Os ethmoidale, . Lamina orbitalis
Os lacrimale
-
_/
FOSSa
Suturazygomaticomaxillaris
\
sacci lacflmalis
\
Sulcus inlraorbitalis
Fig. 109 l;ar;ialskeleton,\ ist;t'rttt;ranium; t r a n s v e r s see ( j t i o nt h r o u g ht h e m i r l t l l eo f t h e o r b i t ; s u p e r i o rv i e u ( 1 . ) .
I I
Maxilla
Os zygomaticum
I
Os temporale
Os lacrimale
,ffiffi
Os ethmoidale
Os palatinum Os sphenoidale
I Arcus zygomalrcus
Fossa inlratemporalis Foramen ovale Foramenspinosum Alamaior, Spina5ssrssphenoidalis Proc pterygotdeus (crista zygomaticoalveoiaris)
Os Palatrnum. Laminaperpendicularis. FossaPterYgoPalatrna \
Foramina alveolaria
Proc Pyramidalis Os palatinum.
Os sphenoidale, Proc. plerygoideus. Hamulus plerygordeus
lirssa,I:ossapterygopalatina; Pterygopalatine Fig. ll0 the zygomaticarch has lteenremovetl; l a t e l a lv i e u ( 1 . ) .
59r
Head, Caput
Corpus,
/
Crista sphenoidalis , Ala minor
Apertura sinus\ sphenoidaIs'\
/ Fissura orbitalis supetnl
//
A Ala major -
M a r g oz y g o m a t i c u s- -
\ -
\ canatis pterygordeus
Foramen rolundum /
\
F a c i e sm a x i l l a r i s/
\
\
Proc pterygoideus.Lamina medialis /
\
Crista infratemporalis
Concha sphenoidalis
Spina ossis sphenoidalis
Proc pterygoideus Laminalateralis
Incisurapterygoidea
Hamulus pterygoideus
F i g . 1 1 1 S p h e n o i rbl o n e ,O s s p h c n o i r l a l e ; v e n t r avl i e r ' ( 1 0 0 % ) .
Sulcus carolicus
F o r a m e nr o t u n d u m I I _l F r s s u r a\ I orbitalrssuperior \ |
I
Dorsum sellae posterior , Proc clinoideus I
ti I
Irt i
anterior / Proc.clinoideus
i
i
I
,Araminor -
- ----
Ala major Facies cereorails
S u l c u sa n e r i o s u s
L r n g u l as p h e n o i d a l i s S u l c u sl u b a e a u d i t i v a e
--S o , n , o s s i ss p h e n o i d a l i s C a n a l i sp t e r y g o r d e u s/
/
\
C o r p u s* /
\. /
\
rroc vagrnails
/ B o s l r u ms p n e n o i d a l e
/
Proc plerygoideus L a m r n am e d r a l r s
\ tt,
I I I
\
'
Fossa scaphordea Canalis pterygoideus
Proc pterygoideus Lamina lateralrs
FossaPtervgordea
Incisuraotervoordea H a m u l upst " r y g o , o " J s
Fig. 112 Sphenoidbone,Os sphenoidale; dorsalview (100%). The sphenoidbone in Figs.111and 112originatesfrom an adolescent,thereforethe sphenroccipital suture still exists * view of the area facing the spheno-occipitalsynchondrosis,Synchondrosis sphenooccipitalis
Bonesof the Skull' Ossacranii
I
(Proc.clinoideus medius)
I t
rotundum / Foramen
.I SulcusPrechiasmaticus
Proc'clinoideuspostenol
Ala malor,Margofrontalis t
/Jugum
sphenoidale
Proc.clinoideus anterior \
1l
l Ala^inor
i ,l/ --1!;951;o'0"'"' \ \
Fissura--! suPenor orbitalis
i
\
\
+ ?,
\
---
\
Sellaturcica' FossahypoPhysialis
---
//\\\\ A l am a j o r , Margosquamosus
---
---t
Foramenspinosum
ru'"ut ""'o''""
"..\ll
-",
ForamenovaE
\ LingulasPhenoidalis --Proc intraiugularis Incisuraiugularis Proc iugularis
- - -;;
Tuberculumiugulare - - - Os occiPitale'Parslateralis
----
'.-
---Foramenmagnum Sulcussinussigmoidei
--'-,
I
'Sufcussinustransvetsi
(Cristaoccipitalisinterna)
I t
/
/ Eminenliacruciformis
/
occipiialisinlerna Protuberanlia
I I I
Fig. 113 Occipitalbone,Osoccipitale; of an adult; bone,Ossphenoidale, sp-henoid Canalis canal, hypoglossal probein the riSht nervihypoglossi; superiorview. Synchondrosis ' Thesohenooccipitalsynchondrosis, second rpn.tl"".ltpi,"fit trsei towardsthe endof the rlicadeof life to becomea synostosls'
M"roo aastoideus
62
Head, caput
/
Margoparietalis / Parssquamosa,Faciestemporalis
Sulcusarteriaetemporalis mediae a Foveolasupramealica.
\
Cristasupramastoidea '\
\
\\
/ Margosphenoidalis
Incisuraparietalis (Spinasuprameatica) -_
Foramenmastoideum-\
_
_--
Proc zygomaticus
Margooccipitalis -__
---
--Fissuratympanomastoidea
K
\.
lncisuramastoidea/
\'
Trber"urumarricurare
\ Fossamandibularis, Faciesarticularis \ Fissurapetrotympanica
Proc.mastoideus/
I I I pars tympanica/
\\ i
rl I
\
v"gin" p,o.".rus stytordei I Proc.styloideus
I Meatusacusticus externus
Fig;114 Temporal bone,Ostemporale; Iateralview(r., 120"/ol.
Parssquamosa
Parstympanica
Fig. 115 Temporalbone,Os temporale,ofa neonate; lateralview (r.,240%ol.
ffi
Parspetrosa
,,j
Bonesof the Skull,Ossacranii
parietalis z Incisura ,/ MargosuperiorPartrsPelrosae
- Sulcusarteriosus
- Margosphenordalis -
-
Fossasubarcuata '...
\
Apexpartrspetrosae
Margo occrpitalis
Sul"rs sinussigmoidel
vestibuli Apenuracanaliculi
Proc intrajugularis
Proc styloideus
internus Pcrusacusticus
Fig. ll6 Ttrmlxrrallrone,Os ttrmllorale; mcdial vien' (r., I l0Y").
Proc zygomaticus
- /
-/
arlrculare Tuberculum
- -
Canalis carotlcus
Fossulapelrosa Apertura canaliculicochleae
Fossa mandibulans
Fissura petrotympanrca
-'
Mealus acusltcusexternus
Proc intraiugularis F o s s al u g u l a r i s
styloidei Vaginaprocessus
Proc styloideus
Parstympanica
Foramen stylomastoideum
Proc mastoideus
/
'
lncisura mastordea
Margo occipitalis
T Sulcus arteriae occiPitalis
Foramen masloideum
'l'trmltoral lrontr,Os t()mlx)rale; l'ig. ll7 i n t e r i o rt i e t r ( r . , I l 0 " l ' ) .
;;
Head,Caput
Margosagittalis\
\
parietale / Tuber
Foramenparietale\ Faciesexterna\
A n g u l u s- occipitalis
\ Lineatemporalisinterior
\ Angulus sphenoidalis
Fig. 118 Parietalbone,Osparietale; lateralview(r.,80%).
//
Foramenparietale
Angulus. ocopfails
//
--
Maroo frontaTis
\
Sulcusarteriae / meningeaemediae
Margosquamosus Fig. 119 Parietal bone, Os parietale; medial view (r., 80%).
Facies interna
of the Skull,Ossacranii
Squama occipitalis \ \
/ Lineanuchalissuprema Protuberantia occipitalisexlerna\ \
/ Lineanuchalissuperior
Margolambdoideus-
- z Lineanuchalisinferior -
(Cristaoccipitalisexterna)\ \ {IC';
.i-i--_ l,
l
i
,'
,"'{,r' Margo masloideus
,^;
---
- Fossacondylaris
- Canaliscondylaris
- - Proc.jugularis
- - Canalisnervihypoglossi / magnum Foramen
\ CondylusocciPitalis
/
\ Parslateralis
/ Parsbasilaris Fig. 120 Occipital bone,Os occipitale; inferior view (120%).
:superioris Sulcussinussagittalis /, Margolambdoideus
- Fossacerebralis
- Eminentia crucilormis
- - _ Sulcussinustransversi _--
- Protuberantia occipitalisinterna
_--
Fossacerebellaris
Margomastoideus
(Cristaoccipitalisinlernal- -
P r o cj u g u l a r i s - - -
- --
Canaliscondylaras
- Sulcussinussigmoidei jugulareTuberculum
--
/
/ / occipitalis Condylus
' Parsbasilaris
\ Canalisnervihypoglossi
Occipitalbone,Os occipitale, Fig. l2l of a young adult. ventral view ( 1207o). * view of the area adiacent to the Synchondrosis sphenooccipitalis
Parslateralis
qi f'.r Head,Caput r=":'
- - Caputmandibulae - - Foveapterygoidea
--
Prcc condylaris
R"rr. mandibulae
,L--
\ (Tuberosilas masseterica) Angulusmandibulae
Corpus mandibulae Fig. 122 Mandible, Mandibula; superolateralview (90%).
- - Bamusmandibulae
Foveasublingualis\ --
Foramenmandibulae
, - -
--f Corpus mandibulae I
Sulcusmylohyoideus
- (Tuberositas pterygoidea) --
- Fossadigastrica Spinamentalis
Angulusmandibulae
\ Fovea submandibularis
Linea mylohyoidea
Fig. 123 Mandible,Mandibula; medialview (righthall 100%). / Proc condylaris
Proc corc
/ Juga alveolaria
-
Ramusmandibulae
Foramen mentale
/
/ II\ Basismandibulae I Tuberculum mentale
| I
'Corpusmandibulae mentalis Protuberantia
Fig. 124 Mandible, Mandibula; ventral view (80%).
Bonesof the Skull,Ossacranii
{3;r
/ Proc condylaris
--
Lingula mandibulae
- -
Sulcusmylohyoideus
I Arcusalveolaris I
,l
Linea mylohyoidea
--Foveasublingualis
----
(Foramen linguale) mandibulae) (Symphysis
Fossadigastrica
Fig. 125 Mandible, Mandibula; inferior view (90%).
Foramenmentale
Fig. 126 Mandible,Mandibula,of an old person; superolateralview (9070).
Thealveolarpart is completelyatrophied,movingthe opening of the mentalforamenandthe exit of the mentalnerve upward.
Proc coronoideusi Ramusmandibulae. Proc condylaris
- -
Fig. 127 Mandible, Mandibula, of a neonate; superolateralview (140%).
Densdeciduus (Symphysismandibulae)
Foramenmenlale
Compareto the ramusand the bodyof the mandibleas well as the coronoidprocessin Figs. 122and 126'
Head,Caput
/Os temporale,Proc.zygomalicus I
Caosulaarticularis \
/Os zygomaticum Porusacusticusexternus\
--Proc. pterygoideus, Laminalateralis
temporomandibularis, Lig lalerale
Proc styloideus
- Proc.coronoideus
Proc.condylaris Lig stylomandibulare
Fig. 128 Temporomandibularjoint, Articulatiotemporomandibularis; lateralview.
lFossahypophysialis I Dorsumsellae .z |
Sinussphenoidalis \
-
Corpus /Os sphenoidale, -zClivus -Spina ossissphenoidalis
Cavitasnasi,Choana --
--Lig
pterygospanale
- Canalisnervihypoglossi
f Laminalateralis Proc pterygoideus 1 \Laminamedialis-
-:--Proc
styloideus
\ Lig.sphenomandibulare \Lig. stylomandibulare \ Ramusmandibulae \
Lingula mandibulae
\ Sulcusmylohyoideus \Anoulusmandibulae: (Tuberositas pterygoidea) \
Linea mylohyoidea
Fig. 129 Pterygospinalligament and sphenomandibularligament; paramediansection; medial view.
69 Fossamandibularis, Faciesarliculatis
Discusardcularis Caput mandibulae Porusacuslicusoxtemus Os zygomatiorm /
Proc. coronoklgus/
Collummandibulae
t
Proc. mastoideus Capsulaa.thularis /
Proc. svoideus Ramusmandibulae
joint, Articulatiotemporomandibularis; Fig. 130 Temporomandibular sagittalsection;the mouthis almostclosed; lateralview. Tuberculumarticular€ / I I Discw articulads Caput mandibulae Porusacuslic6 extemus Os rygpmalicum/
Collummandibulae
Proc. masbiteus Proc. @ronokteus/ Proc. styloi&r.E
Ramusmandibulao
Fig. 131 Temporomandibularjoint, Articulatio temporomandibularis; sagittal section;mouth open; lateral view. Comparethe posidon of the articular condyleand the position of the articulardiscin Figs.130and 131.
Head,Caput
/
/ M pterygoideus lateralis
/ Discusarticularis
Fig.132 Temporomandibularjoint,Articulatiotemporomandibularis; sagittalsection; lateralview(90%).
1 Meatusacusticusexlernus 2 Proc.condylaris 3.Discus articularis 4 Os lemporale,Fossamandibularis
5 Os temoorale,Tuberculumarticulare mandibulae 6 Incisura 7 Proc coronoideus
Articulatio Fig. 133 Temporomandibularjoint, temporomandibularis; mouthclosed; lateralradiograph; after injectionof a contrastmediumin the articularcavity (arthrography).
Fig.134 Temporomandibularjoint,Articulatio temporomandibularis; as in Fig.133. mouthopen.Projection lateralradiograph; the differentpositionof the articularcondyle Compare andthe positionof the articulardiscin Figs.133and 134. SeealsoFigs.130and 131.
Temporomandibular Joint,Articulattotemporomandibularis
Proc temporalis / Os zygomaticum, 7 Ala major, Crisla infratemporalis
,,
/ Os temporale, Proc.zygomaticus
Fossamandibularis, Faciesarticularis
,-
-*.-
Caputmandibulae - Capsulaarticularis
--
Collummandibulae
\ M pterygoideus medialis
- M. pterygoideus Insertio; medialis, pterygoidea) (Tuberositas
Fig. 135 Temporomandibularjoint,Articulatio temporomandibularis;musclesof mastication,Mm. masticatorii;
sagittal section;the condylar and coronoidprocessesare shining through;lateralview.
Muscles of mastication, Mm. masticatorii (Figs.132,135-138,l4l,142) 'vVhenclosing M. massetercan be felt through the skin easily.It runs from the Angulusmandibulaeto the Arcus zygomaficus" lateralisrunsventrallyftom the M. pterygoideus thejawsonecanalsofeelthebellyof M. temporalisin the Fossatemporalis. joint.M. pterygoldeus medialisis cn the medialsurfaceof Ramusmandibulae. temporomandibular Function
Muscle Innervation
Origin
Insertion
1. M. temporalis profundi Nn.temporales (N. mandibularisIV/3J) 2. M. masseter N. massetericus (N. mandibularts[V/ 3])
0s temporale,belowLinea temporalisinferior and deep layerof Fasciatemporalis
Closesthe iaw, posterior Apex and medialsurfaceof mandibulae fibres retractthe mandible Proc.coronoicleus
Arcus zygomaticus Pars superficialis: inferior border,anterior2/3 (tendinous) Pars profunda: posterior t h i r d ,i n n e r s u r f a c e
Pars superficialis: Angulus mandibulae,Tuberositas masseterica Pars profunda: lateral surface o f R a m u sm a n d i b u l a e
3. M. pterygoideusmedialis N. pterygoideusmedialis (N.mandibularis[V/3])
pterygoideaand Lamina Medialsurfaceof Angulus Fr.rssa lateralisof Proc.pterygoideus, mandibulae,Tuberositas pterygoidea partly Proc pyramidalisof Os palatinum
4. M. pterygoldeuslateralis N. pterygoideus lateralis (N. mandibularis[V/3])
Caput superius: lateral surfaceof Laminalateralisof Proc. pterygoideus, Tuber maxillae Caput inferius (accessory) Faciestemporalisof Ala majorossissphenoidalis
Closesthe jaw
Closesthe jaw
Closesthe jaw, protrudesthe Foveapterygoideaof Proc. c o n d y l a r i s m a n d i b u l a e , d i s c um s andible Caput inferius: opensthe and capsuleof Articulatio jaw temporomandibularis
Head,Caput
--
aM. temporalis
- -
R frontalis superficialis, O O V.;A. temporalis ,* R temporalis (Vll)
---
N opticusflll --Cellulaeelhmoidales Meatusnasisuoerior-Conchanasalismedia - --Sinusmaxillaris
--
Conchanasalisinlerior---
-
Parsprofunda aM masseter,
------
GlandulaeDalatinae - -
Dorsumlinguae--Maxilla,Proc alveolaris--Densmolarisll ---
Lingua
(Vll) ,* R. zygomaticus
--
|l M. masseler,Parssuperlicialis Ductusoarotideus Glandula oarotidea accessoria CM buccinator OA. facialis
- - Comusmandibulae "--
M. mylohyoideus Noduslymphoide submandibula
--
- - Glandula submandibularis Venteranterior 1M. digastricus, lPlatysma
Fig. 136 Muscles of mastication,Mm. masticatorii; frontal section; ventral view (60%).
Cartilagonasilateralis I Cavitasnasi \ Plexuscavernosusi , \ Conchanasalismedia a \ Meatusnasiinterior \ \ M orbicularis oculig \ ) Sinusmaxillaris\
\
I
Cartilagoalarismajor -.ticularisoculi 1 -.... / Sinusmaxillaris ,
/ aM zygomaticusmaior
Maxilla \
/ Arcuszygomaticus _ - corpus adiposumbuccae
M temporalisa \ Proc.coronoideus-
aM. temporalis
--
M. pterygoideus lateralisf -_
--
N. lingualis
gM masseter
- -
laleralis a M. pterygoideus
N. alveolaris inferior
N masselericus -V. temporalissuperlicialisa - -
--
A. temporalissuperticiatis1 -J
--
Cartilagoauriculae - Glandulaoarotidea / A alveofaris intetiot a
\\ --
Ramusmandibulae tM
pterygoideus medialis
inferior aA alveolaris superficialis temporalis tV
OA.maxillaris N auriculotemporalis \ GlandulaDarotidea
/ /
\
eroc.stytoto"u"i I i | A. carotisinternaO
| A vertebralis3 I
I jA. vertebralis interna aV. jugularis ' OA. carolisinterna a M levaiorveli palatini a M longuscapilis
Fig. 137 Musclesof mastication,Mm. masticatorii; horizontalsection; inferior view (60%).
f
Musclesof Mastication,Musculimasticatorii
/ N opticusilll / N lrochlearisllvl [lll] /, N oculomotorius M /, N. trigeminus
/ N abducens[vl] A temporalis,-R. frontalis / A carotisintema M lemporalis--
Capsulaarlicularis--_
laleralis,-M plerygoideus Caputsuperius lateralis,M pterygoideus Caputinferius
F
- Fossamandibularis
---
Discusarticularis
---
Caputmandibulae
--
Palatummolle -
Lig.sphenomandibulare
----
N lingualis N. alveolarisinlerior
-M pterygoideusmedialis M masseler /
a
/
--
Hamuluspterygoideus
/ Angulusmandibulae --
M mylohyoideus
Cornumaius / Os hyoideum, - M genioglossus --\ Platysma/
M omohyoideus
M. geniohyoideus
\ M. thyrohyoideus \ M sternohyoideus
Fig. 138 Musclesof mastication,Mm. masticatorii; frontal sectionin the areaof the Articulatio horizontalsectionin the areaof temporomandibularis, the Calvaria; 0s hyoideummoveddorsally,capsuleof the Articulatio nearlycompletelyremoved; temporomandibularis dorsalview.
*.1?
Head, Caput
Facial muscles, Mm. faciei (Figs.139-142) The'facialmugclesorigtnateonly partly homri:ircumsciibed boneareasand:leadto tbsrskin. Muscle Innervation
Origin
Insertion
Function
Musclesof the forehead,top of head,temple 1. M. occipitofrontalis N.faclalls[!If] ,,,,,,, togetherIvl occipitofrontalis and M. tempore parietalisare referredto as M. epicranius . 2. lVLtemporopar"leteliq N.faciattsW 3. M. auricularis anterior N faciatts.fVll] ,:::, 4. *f. auricrilnris suirerlor N.facialis[Vil] 5. M. auricularis poctorior N.facialtsffi
Venter frontalis: Skin of forehead, commonmuscle plexuswith Mm.procerus, corrugator, depressor supercilii,andorbicularis oculi
Galeaaponeurotica
Move the scalp
Venter occipitalis: Linea nuchalissuprema Skinof the temple,Fascia temporalis
Galeaaponeurotica
Fasciatemporalis
Spinahelicis
GaJea aponeurotica
Rootof the auricle
Movethe auricle
Proc.mastoideus, tendonof Rootof the auricle M. sternocleidomastoideus
Muscles of the eyelid 6. &I. orbiculSris ocull' N.facialis[VI]
rlrr
:i::i:'
iiiii:,:'
Parsorbitalis:Parsnasalis of 0s frontale,Proc.frontalis of the maxilla,Oslacrimale, Lig.palpebrale mediale, Saccuslacrimalis Pars palpebralis: Lig. palpebralemediale,Saccus lacrimalis Pars lacrimalis: Crista lacrimalisposteriorof Os lacrimaie
orbitalopeningas Surrounds a sphincter Pars orbitalis: Lig. palpe. bralelaterale,laterallyforms a muscularloop Parspalpebralis: Lig. palpebrale laterale
Closesthe eyelids, compressesthe Sacculus lamimalis, moves the eyebrows
Pars lacrimalis: surrounds the Canaliculilacrimalesand the lateralpart of the eyelids
7. M. depresior superclfii N.facialis[Vn]
Parsnasalisof Osfrontale partofParsorbitalisof M. orbicularisoculi
Medialthird of the skin of the eyebrows
8. I\[ cornrgator supercilli N. factalis [VII] 9. M. procerus N. factatbMII
Parsnasalisof 0s frontale
Medialthird of the skin of the Move the skin of the forehead eyebrows, Galeaaponeurotica and the eyebrows
Osnasale,Cartilagonasi lateralis
Skinof Glabella
Parsalaris:Iugumalveolare abovethe lateralincisor
Parsalarisl alar,borderof the nares
Parstransversa:Jugum of the caninetooth alveolare
Pars transversa:cartilago aponeurosis nasilateralis, overthe bridgeof the nose
of the medial Jugumalveolare lnclsor
Cartilagoalarismajor, Cartilagoseptinasi
Nasal muscles 10.M. nasalis N. facialis UIII
11.
Movethe nose,in particular the nostrils
Continuation + p 76
Facial Muscles,Musculi faciei
Galea aponeurotica
\
/ M procerus Os nasale
/
/
lvl.epicranius.\ M occipitolrontafts, \ Venter frontalis
lvl cotrugatorsupercilii palpebralemediale /, Lig
/, M. levatorlabii araeque supenons nasl
M depressor supercilii\
M nasalis
/
M. orbrcularis ocuil, Hars orbitalis
/ M temporoparietalis-
/ M, levator raDilsupenons
l\.4orbiculariso c u l i .P a r s palpebralrs
/. M o r b i c u l a r l s,
M. zygomaticus
/
t z --
--
M z y g o m a t i c u- -smtnor --
M l e v a t o r- - t ' labii superioris
---
M zygomatrcus malor
M.zygomaticus malor
M. depressor sepunasl M levalor angulioras parotidea Glandula
Corpusadiposum buccae"*
M l e v a l o r a n g u l i o r i s- -.M orbicularisols. -' Pars marginalis
M buccinator
.- M masseler. Pars supedicialis
M r i s o r i u s/ - Platysma Platysma/'
M depressor angulioris / -
/ Plalysna z/
-
M depressor labii inferioris z
-
Foramen mentale
-
M depressoranguli oris M deoressor labii inleriorrs
M sternocleidomastoideus
\ Platysma
M m e n t a l i s/
\ Fascia cervicalis,Lamina superficialis
M orbicularis oris, / Parslabialis
Fig. 139 Facialmuscles,Mm. faciei; musclesof mastication,Mm. masticatorii; the right side showsthe superficial,the left side the deep layer; ventralview (80%). * clinical: STENSEN's duct * * clinical: BrcHAr'sfat-ball
Head, Coput
\
Facial muscles, Mm. faciei (continuation) Muscle
Origin
Insertion
Function
Major part of the lips
Movesthe lips, the alaeof the nose,the cheeks,and the skin of thechin Increases the pressuein the oral cavity,importantwhen blowingair andin chewing
Innervation
Opening of the mouth 12-M. orbicularis oris N. factalis[VIl
Pars marginalis and Pars I labialis: iateralofAngulus oris
13.M. bucclnator N. factalls[WI]
Posteriorpart of Proc. Angulusoris,upperand alveolarismaxillae,Raphe lowerlips; basisof the cheek pterygomandibularis, posterior part of Proc.alveolaris mandibulae
14.M. depressorlabii inferioris N. facialis[Vn] 15. M. lwator labii supertoris N.facinlis[Vn]
Basismandibulae medioinferiorof Foramenmentale
Lowerlip, chin,deepfibresof mucosa
Margoinfraorbitalisand adjacentpart of Proc. zygomaticus maxillae, originatesin M. orbicularis oculi
Upperlip
16. M. mentnlls N. facialtsMl
Iugum alveolareof the lowerlateralincisor
Skin of the chin
17. M. tranwersus mend N.factalts[WI]
Transversepart of M. mentalis
Skin of the chin
18. M. depressorangull orls N. factnlts[Wf]
Basismandibulae,inferior of Foramenmentale
Lowerlip, cheek,lateralof Angulusoris, upperlip
19.M. rlsorlus Fasciaparotideomasseterica Angulusoris,upperlip N. facialis [VI[] (often part of the platysma or M. depressoranguli oris) 2& lv!"lwator angUli mts 1:,;;,:1p6tsucaninamaxillae Angulusoris
Movethe lips,the nostrils, the cheeksandthe skin of the chin
N.facldlls[W] 21. M. qgonadors maJor N. faclalls[VI]
Oszygomaticumcloseto Angulusoris, upperlip Suturazygomaticomaxillaris
22. l[. zlgonadtns mlnor N. faciallsW
0s zygomaticumcloseto Angulusoris, upperlip Suturazygomaticomaxillaris
23. l\d.levator labli supedorts alaequenast N.lMaUstWIl
Proc.hontalis maxiUae; part of M. orbicularisoculi
Alaeof the noseand upperlip; deepfibres:lateraland posteriorcircumferenceof the
Neck 2f. Plr0vnr N,wlls twl
Sasismandibulae,Fascia l',:l:l::::: rl.:;,;,1 11p61e116ffi
Skin inferior of the Clavicula, Fasciapectoralls
Tensionof the skin of the neck
FacialMuscles,Musculifaciei
A.; V. temporalissuperficialis\ M. auricularisanlerior\
I
M. epicranius,M occipitotrontalis, \ Venlertronlalis
7l
/ M. epicranius,M. temporoparietalis // Galeaaponeurotica
M. orbicularisoculi,Parsorbitalis ,/ M. auricularis sup€nor
M orbicularisoculi,Parspalpebralis\ M. depressorsupercilii\
M. epicranius, M. occipitolronlalis, Venter occipitalis
M. procerus1 M. orbicularisoculi, Parsorbitalis M. levatorlabii \ supenons alaequenasi M nasalis -
-
M. levator labii supenons
M. auricularis poslerior
M. semispinalis capitis M. zygomaticusmtnor M. st€rnocleidomastoideus
M orbicularisons M. zygomaticus/ maJor Panniculus/ adiposus
M. spleniuscapitis
\ M. trapezius
M. orbicularisoris /M. depressor/ labiiinlerioris M. mentalis M. depr€ssorangulioris / t . M. risorius /
\ Fasciacervicalis,Laminasuperficialis
Platysma/
Ftg. 140 Faclalmuscles,Mm. faciei; lateralvlew (60%).
Heod, Caput
Arcus\ zygomatcus \
/ Galea aponeurolica
M epicranius,Moccipitotrontalis, Venterfrontalis\
z Pericranium
M corrugator supercilii q M. orbicularisI Parspalpebralis; \. parsorbitalis oculil M procerus\ M depressor1 supercilii \
/
/ Fasciatemooralis, Laminasuoerlicialis
\ /
/ M epicranius, M. temporoparietalis
Lig. palpebrale \ mediale Os nasale :
M nasalis
/
M epicranius, M occipitofrontalis, Venter occipitalis
- -
Articulatio temporomandibularis, Capsula articularis, Lig.laterale
mtnor M. levatorangulioris M orbicularis ofls
M zygomaticusmalor M. depressorlabiiinferioris
---
/ M mentalis
M sternocleidomasloideus M masseter Corpusadiposum ouccae
/I /l tl
M. orbicularis oris'
i M risorius' \ Glandulasubmandibularis
M depressorl angulioris ' '
Fasciacervicalis, Laminasuoerticialis
M. digastricus,Venteranlerior
Fig. 141 Facialmuscles, Mm.faciei; musclesof mastication,Mm. masticatorii; Laminaprofundaand Laminasuperficialisof the temporalfasciahavebeenpartially removed; the massetericand the parotidfasciaehavebeen completelyremoved; lateralview (60%).
FacialMuscles,Musculifaciei
/ M lemporalis ,/ Galeaaponeurotica M epicranrus, M occrpilofrontalis, Venlerlrontalis\ ,/ Arcuszygomaticus
M corrugator supercilii \
\
M orbicularis oculi\
/
./ Articulatio temooromandibularis, Caosulaarticularis. Lig. lalerale
M depressor supercilii \ M levator labii superioris alaeque nasi \
\
\
\ M levalorlabiisuperioris \ N. inlraorbitalis ) \ :-12 M. nasalis. / M. epicranius, M occipitotrontalis, Venteroccipitalis
M levator \ anguli oris
- Meatus acusticusexternus cartilagineus Ramus mandibulae M semispinalis capitis - Proc slyloideus
M orbicularis oris DuctusparotideusM buccinatorM masseter,Parsprofunda
- A temporalissuperficialis; M. styloglossus
M orbicularis oris -
- M. slernocleidomastoideus - M. digastricus,Venterposlerior
M depressorlabiiinfenons
- M spleniuscapitis
-M depressor angulioris M digastricus, Venleranterior t M massefer, Parssuperficialis ,' / M stylohyoideus ./ / os hyoideum / M sternohyoideus
N hypoglossus [Xlll
- M lrapezius - V jugularis interna M. levalor scaoulae
/ /
/ M omohyoideus
\ N vagus [X] tr 7
/ M thyrohyoideus
7
M slernothyroideus
\
t,
pharyngis inlerior/ M constrictor
\. t \ \
\
- M scalenusmedius \ M scalenusooslerior
Plexus brachialis
M scalenusanterior
o caroliscommunis
M sternocleidomasloideus
Fig. 142 Facialmuscles,Mm. faciei;musclesof mastication,Mm. masticatorii;suprahyoidand infrahyoid muscles,Mm. suprahyoideiand infrahyoidei; the auricle, the zygomaticarch, the massetermuscle and some of the facial muscleshave been partially removed; lateral view (60%).
Head, Caput
B superficialis, I A. temporalis I I
media\ A. temporalis
parietalis
/ A maxillaris
A temporalis R. trontalis1 superlicialis,
A. zygomaticoorbitalis \ / A. siylomastoidea Aa temporalesprolundae1 anterioret oosterior \
A lransversafaciei \ A. meningea media:
A. sphenopalatina \-
A. alveolaris- superiorposterior
- R. mastoideus \ R. sternocleidomastoideus
A labialissuperior-A palatinadescendens
--
A. buccalis A. labialis interior -
R. mentalis A. facialis
.tr'l
| talis / inleriorI A. alveolaris A. lhyroideasuperior/
A palatinaascendens
- -
A. facialis
--
ascendens A pharyngea
--
A. carotisexterna - -
A. carotisinterna
--
Bilurcalio carotidis
' A. carotiscommunis
Fig. 143 Externalcarotidartery,A. carotisexterna, andits branches; lateralview (60%).
theHead veinsof 8 1
7 V. diploicaoccipitalis - v. emissariapariotalis
,/ lz'
/'
, V. t€mpotalis superficialis
dioloica - - V. temioralis posterior
---
V. labialissup€rior- -
V. occipilalis
V. retromandibularis ----
v. pharyng€a v. cervicalisprofuirda
V. labialisint€rior - V. iugularisextema \r V submenialis/'
,t
', / v. comitansnervi hypoglossi ' V.lacialis
.tl ,/ /
i |
I V. thyroideasuperiorI
\ V.jugularisintema
Fig. 144 Internaljugular vein,V. jugularisinterna, and its extracranialtributaries; lateralview (60%).
V. emissariamastoidea
Head, Caput
tN canalispterygoidei
N ophthalmicus[V/1] | N maxillaris[V/2]
Rr musculares'
N lrigeminus[V] \ t. G a n g l i o ng e n i c u l i -
/, !. supraorbitalis H. lateralrs
/
\\
,'
t'
N. supraorbilalis, H. meorails
-/
,,
N suPraorbrlalrs
.--'
'
N .s u p r a t r c c h l e a r i s
.L-r--
N petrosus profundus
--
Rr nasales
-l'---
Ganslion rnrelus (lX;/
N zygomatrcus
---
o p h a r y n g llxl u s] /' N .g l o s srpnaryngeus [el X
...1
N.mandibularis lv/3)/
_KS{Fff, ,f ;h Y,/ V
,,, z '
, ,' '
.' N . f aciarislvlrl c i a l i s l V/'l l l
i
,^&/',i
Rr alveolares
I / II l'i ; i,, l' ,/ t | : l, i i; i! \llt r
./ti;l / Proc.stytoideus ./ i
N infraorbilalis
supenores Posterrores
:-.>
I
i,
-\: \ l\r
\ R alveolaris Suoerlor
,.1
meolus
$' \
N alveolaris lnt"rio, //
I
,\
N. tinsuatisi
Y,
N palatinus major
/
N palatinus maJor
I
i-i
\ N sublingualis
Ganglion submandibulare N mylohyordeus /
Fig. 145 Nervesof the face,trigeminal(V), facial(VII), glossopharyngealnerves (IX), and their branches; mediansection;
\
N mentalis
the parts of the nervesin view are colouredyellow,those hiddenby boneare light yellow; medialview (60%). * b r a n c h e ss u p p l y i n gt h e m u s c l e so f m a s t i c a t i o n
N maxillaris[V/2]
N mandibularis[Vi3]
Fig. 146 Faceand neck, Faciesand Collum;sensoryinnervation; lateralview (30%).
Muscles, Vesselsand Nervesof the Head
V temporalissuperliclalls,B trontalis€ I I A lemporalissuperticialis.R parietalisa t
\
V temporalissuperlicialis,R parietaliss \
N auriculotemporalis
,'
(v/3)
ffi,fYgomaticotemgorates
ti_
A a u r i c u l a r i s o\ posteflor
Rr zygomataci (vil)
V occipitalis49 \
Rr zygomaticotaciales (V/2)
\ occipitalisa --/
G V angularrs
/
oA angulans
N occipitalis malor cervicahs[C2], R posterior)
Rr temporales (vil)
N occipitalisminor (Plexuscervicalis)
-
a A transversa tacrei
--A transversal faciei
Dr"trs . parotideus
-
\ c V tacialis \ o A facialis
N auriculaflsmagnus (Plexusceruicalis) \ V retromandibularisqJ /
\
R buccalis(Vll)
R marginalismandibularis(Vll)
#
265
Vesselsand nerves of the head; Fig.147 layer; superficial Iateralview (90%). * clinical: STENSEN's duct
148
Head, Caput
Galea aponeurotica
/
..
/ OA temporalis superficialis, H. lrontails
/ A. temporalisa -\ supenrcralrs, R parietalis
N. suora(V/1), orbitalis Rr.medialis
,t
',/
el lateralis
//
aA..supraorortails
i --
oA supra-
R zygomaticolemporalis
(vt2')
trochlearis
N auriculolemporalis (v/3)
N supralrochlearis(V/1)
B auricularis o -anterior
R. zygomaticofacialis(V/2)
A ;V temporaliso o guperficialis
A auricularisposterior;o R. auricularis
(x)
N laciatislvil] \ Plexus intraparotideus (vil)
\ \
a
A.; N. infra(V/2) orbitalis
Rr zygomatici (Vll) oA labialissuperior
R buccalis \ N auricularis maonus (Plexuscervic-alis)
\ \
R marginalismandibularis \
.t1 V retromandibularis a -' V jugularis externaO /
\ \
oA facialis
oV facialis
* v,149 r47tl 266
Fig. 148 Vesselsand nerves of the head; middle layer; the superficial part of the parotid gland has been removed to show the Plexus intraparotideus; lateral view (90%).
(Vll) Rr buccales oA labialisinferior
N buccalis (V/3)
N mentalis(v/3)
and Nervesof theHead Muscles,Vessels
Fasciatemporalis,Laminasuperlicialis\
V temporalismediaa r i
o \ A temporalissupedicialis, R. parietalis \
M temporalis
la
R. frontalis t o A temporalissuperficialis' lateralis R. N. supraorbitalis, ! / M occipitoirontalis' O M. epicranius, 'r Venterfrontalis
! i
oculi / a M. orbicularis
Fascialemporalis,\ Laminaorofunda \
i
N. supraorbitalis, R. laleralis
/ /'
M epicranius, o \ \ M iemporoparietalis
/ a A. supratrochlearis '
A. temporalis O\ \ superlicialis
N. supraorbitalis, R medialis
' -
N. zvoomatiius, R. zir[omaticotemporalis
A zvoomaticoa -orbitalis
N supratrochlearis N. inlratrochlearis N. zygomaticus, R. zygomalicofacialis -
N. occipitalis ma,or
N ethmoidalis anleflor, R nasalis exlernus
- o A. angularis
A occipitalisa -
-
N. infraorbitalis a M. masseter -I M. lovatorlabii superlons \ O M. zygomatacus maior
N auriculolemporalis N auricularis postenor A auricularispostetiota / - -
N lacialis [Vlll
\
l------
N occipitalisminor
''-
\oA.buccalis
.--l-r \ t..t. \
.. 4., I I I I I
(vll) R stylohyoideus M stylohyoideus a)
I
A carotisinternao I
\
\
oA. lacialis o M. zygomalicusmajot
\
a M. buccin'rtor N. masselericus t M odicularisoris N. buccalis
\ Ramusmandibulae \ N mentalis N. alveolarisinleriol
tr.
\ a A. alveolarisinferior \ 1M. masseter \oAlacialis
t\\ \
\ \
t oM digastricus,venleranlerior
I o v submenlalis A. lingualisa V. retromandibularis o
o V. facialis
exlerna 1 V jugularis
17150
A8m Fig. 149 Vesselsand nervesof the head; mostof the craniofacialmuscles,the parotidglandand the branchesof the facialnervehavebeenremoved; the massetermuscleand the temporalfasciahavebeen sectionedand reflected; the mandibularcanalis partially exposed; lateralview(90%).
Head, Caput
protunda postenor; I N massetericis: 7 oA temporalis N temporalisprofundus ;OA masseterica / / 1 /rM.pterygoideuslateralis 1// protunda anterior / a A, temporalis
a M temporalis \ A temporalis mediao \ A temporalissupedicialis,a \ R. panetalis
Arcuszygomaticus \
N supraorbitalis, Fl lateralis
/
\
N supraorbitalis,R medrafts
/
A zygomalico-o \ orbilalis \
/ Os zygomalicum
/
Articulatio \ temporomandibularis, Lig laterale
/ /
N infraorbitalis O A supratrochlearis
A transversaO \ \ faciei --
Meatusacusticus\ externus \ cartilagineus
aA angularis N infratrochlearis
N meatusacustici \ externi
--
aA
N vagus[X], R auricularis N auriculotemporalis
infraorbitalis N ethmoidalis anterior,R nasalis
exlernus
N faciahs[Vll] A stylomastoidea o -
N inlraorbitalis
A auricularisposteflor O -
A auricularisprofunda o / A tympanicaanteriorO / A occipilaliso
A maxillaris a /
/
A meningea media o /
\ :
/
\ \
A carotisexternaa / \
M massetera / \
N mylohyoideus
t
'ttirti
/
/ clandula submandibularis N mylohyoideus
Fig. 150 Arteriesand nervesof the face; deeplayer;the zygomaticarch,the ramus of the mandible,the masseterand the temporal muscleshave been partially removed;
/
A maxillaris A occipitalis
N buccalis c M buccinator
o A tacialis N mentalts 1R AiN
mentalis alveolarisinferior
a M pterygoideusmedialis I
oA submenlalis
\
aA faciatrs
the mandibularcanalis exposed; lateralview
A meningea media
-condylans A auricularis/ Posterior
o
t
aA buccalis
\
N lingualis
M'{?
' a Rr.dentales; A. alveotaris I o Rr.peridentales.i superior posterlor
,'l
/
Rr alveolares supenores posteriores
M pterygoideus lateralis
/ N alveolarisinferior / N lingualis
A a l v e o l a r i -s- infeflor A carotis -
Figs. 151a-c Variationsof the maxillary arterv.
A. maxillarislateralof M. pterygoideuslateralis(60%1, A meningeamediaoriginates proximalof A. alveolarisinferior b A meningeamediaoriginatesoppositeto A. alveolarisinferior C A. meningeamediaoriginatesdistal of A. alveolarisinferior
Muscles,Vesselsand Nervesof the Head
N auflculotemporalis / I I t
a \ A temporalis superticiahs, R. panetalis \
'A
temporalismedia / *M /'
temporalis , Arcus zygomalicus
/
N meatus \
'
acusltcl
externi
prolundaposterior; / o A. temporalis prolundus N. temporalis ,
Nmandibularislv/3] lateralis o N.;M. pterygoideus
u R auricularis \
/ a A. maxillaris . N inlraorbitalis
\
/ Os zygomaticum A ; N a u r i c u l a r i s oa posteflor
/ a A inlraorbitalis , O A. sphenoPalatina N supratrochlearis
a \ A. temooraiis supediciaIs
Rr alveolaressuperiores posteflores N. intratrochlearis
-
N lacialis[Vlll N auriculotemporaIs
on angularis
]--
R digastricus -
A occipitalisa / / A tympanicaanteriora
/
A meningea mediaa'
a / A maxillaris Chordatympani '
/ /
/ M styloglossusa/ /
N massetericus
1
N buccalis --
A, alveolaris nlerior o /
\:
M. digastricus, a Venterposlerior N hypoglossus [Xl|] / A tingualis a / A palatinaascendenso /
N infraorbitalis
---
I M buccinator 1 A. buccalis
a M pterygoideusmedialis Lingua inlerior N. alveolaris
i
N lingualis
M . h y o g l o s s u s/o _ i / M stylohyoideusa N, vagus[X] / Ansacervicalis '/ A caroliscommunis a / I A thyroidea superiora'
-
Mandibula
- sublingualis Glandula
\\-\
: I M. mylohyoideus
/
/ Glandula submandibularis N. mylohyotdeus
Fig. 152 Arteries and nervesof th.eface;deeplayer; the zygomatit;alch and malor parts of the right half of the mandible have been removed;the buccinator muscle togetherwith the mucous membraneof the mouth ]tave been partially removed; lateralview.
6%
37o
4
c
Variationsof Figs. l53a-d the maxillary artery.
o/o
tB% d
A. maxillarismedialof M. pterygoideuslateralisand medialof N. lingulis and N. alveolarisinferior b A. maxillarisbetweenN. lingulis and N. alveolarisinferior c A. maxillaristhrough a loop of N. alveolarisinferior d Origin of A. meningeamediadistal of the origin of A. alveolarisinferior
Head, Caput
\
a Plexuspterygoideus Fascialemporalis,LaminaprofundaI
/cVtemporalismedia
Ramusmandibulae N massetericus;A masseterica O V. maxillarist A temporalissuperficialis, O\ R. parietalis \ N. auriculo- \ temporalis \
/ a A. temporalissuperficialis, R. frontalis 7 ,/
t aM temporalis .t
/ a M epjcranius,M occipitotrontalis, Venterfrontalis lateralis N supraorbitalis,R
/
V temporalis{} \ media
7 oM orbicularisoculi
A lemporalisa \ \ meora
N supraorbitalis, R medialis - - Os zygomaticum
N. auriculo- \ temporalis ar.
N supratrochlearis / o A angularis
V temporalis{s \ superficialis .a
N inlratrochlearis
Meatusacusti-\ cusexlernus \ cartilagineus ..
---
R auricularis
oA dorsalisnasi --
(x)
aA facialis
N auricularis posterior
N inlraorbitalis
N. facialis
tvilI A temporalis o superficialis
-
--
A auricularisa posterior A. maxillaris a /
-
A occioitaliso
-
A. carotisexlernaa z V. retromandi-: bularis
-
/
/ tig' sphenomandibulare ,, Mmasselera/ t N ;A alveolaris inlerior a /
* V prolundalaciei
o M buccinator
o A buccalis
\ a M orbicularisoris '
-;-lVlacialis
/
/
N lingualis A carotis inlerna I
N buccalis
-
/ \
/
A carotisexternaar
N mentalis
Plexus dentalis inferior
/
M digastricus, Venterposterior1 A. lingualisI
o M digastricus,Venteranlerior
/ \
/
I A facialis
'
M stylohyoideus t
M pterygoideus medialisa V retromandibularis e
N mylohyoideus I ,u V submentalis s V tacialis
Fig. 154 Vesselsand nerves of the face; deep layer; state of dissectionsimilar to Fig. 150; lateral view.
(
Nose,Nasusexternus
Carlilago alaris major, \ Crus laterale \
(Cartilago nasi lateralis)
/ z Carlilaoo alarisriajor, Cruslaterale
- - Cartilagines nasl accessoflae
Carlilagoalarismaior, Crusmediale
Cartilago - septi nasi
\ Cartilago alarisminol
Cartilagoseptinasi
/
/ Ala nasi
Nasalcartilages,Cartilaginesnasi; Fig. 156 inferior view (90%).
Fig. 155 Nasal skeleton; ventral view (90%).
SuluralrontonasalisI / Suturalrontome.xillaris
Maxilla, Proc \ - trontalis
- Sutura nasomaxillaris
Os nasale - -(Cartilagines nasilaterales)
Cartilagoalarismajor, Cruslaterale Cartilago / alaris major, Crus mediale
\
- - Cartilagines alaresminores
// Cartilagoseptinasi
Fig. 157 Nasalskeleton; lateralview (90%).
Head, Caput
/ Crista galli Lamina el Foraminacribrosa
Sinussphenoidalis \
\
\
It;di" r I
i: 1--
frontonasatis Sutura
r,t$,
\-\ Fril
-t
Laminaperpendicularis - - - Os ethmordale,
!\.U
Dorsumsellae-Fossahypophysialis
\
Sinuslrontalis
)',...
Clivus-
.- Yomer'
Cartilaooalarismaior. Crusm-ediale
\ Spinanasalisanterior
FossapterygoideaHamuluspterygoideus/ Suturapalatinatrana""ra"
/
- Fossaincisiva: Canalisincisivus
/ \
/ (Suturavomeromaxillaris)
Maxilla,Proc palatinus
Fig. 158 Nasalseptum,Septumnasi; lateralview (r.).
Concha nasalis media \
ii Carlilagos€ptinasi --
Meatusnasi inferior
---
- -
Fig. 159 Part of the lower concha,Conchanasalis inferior, with mucosaand Plexus cavernosus.
Conchanasalisinferior
Glandulae nasales
nast9 Cavitas Cavity, SinuslrontalisI
Tractusolfactorius \ Sellaturcica r
./
Nn. oltactorii[l
\ ) / Conchanasalismedia
SinussDhenoidalis-
/ Conchanasalisinferior
/ Umonnasi Tonsillapharyngea- -
Fig. 160 Lateralwall ofthe nasalcavity,Cavitasnasi; paramediansection;the mucousmembranehasbeenpartially removed; medialview (1.). Conchanasalismedia \
\
Cellulae--ethmoidal€s posteriores Sinus - - sphenoidalis
Tonsilla- - pnaryngea -Vestibulum nasl
Palatummolle - Conchanasalisinf€rior
I N. nasooalatinus 1 2 3 { 5 6
Sinuslrontalis Ouctusnasolacrimalis Cellulaeethmoidalesanleriores Sinusmaxillaris Cellulaeethmoidales oosteriores Sinussphenoidalis
lMttilt"
Fig. 161 NasalcavitY,Cavitasnasi; orificesof the paranasalsinuses,Sinusparanasales, duct,Ductusnasolacrimalis; andof the nasolacrimal paramediansection;partsof the middleand inferior nasalconchaehavebeenremoved; medialview(1.). Thecolouredprobesare situatedin the orificesof the paranasalsinusesand the nasolacrimalduct.
I
Head, Caput
--Sinuslrontalis
Cellulaeethmoidales ---
Sinusmaxillaris
Fig.162 Paranasalsinuses,Sinusparanasales; projection onto the face; ventral view. The sphenoidalsinusesare not shown.
Sinustrontalis-
Sinusmaxillaris/
Fig. 163 Paranasalsinuses,Sinus paranasales; projection onto the face; lateral view. The ethmoidal sinuses,Cellulaeethmoidales, are not shown.
ParanasalSinusegSinusparanasales
/ Sinusfronialis ,/ (Foramencaecum) Cellulae elhmoidales \ anleriores
gyrorum 7 lmpressiones
Cellulae ethmoidales mediae Cellulae ethmoidales - oosleriores
Chiasmaopticum
/
sinuses,Sinusparanasales; Fig. 164 Paranasal sinuses,frontalsinusesand projectionof the sphenoidal ontothe anterior ethmoidales) ethmoidalsinuses(Cellulae cranialfossa; superiorview (80%).
Os ethmoidale
septumnasi
o,
Orlrita,Pariesinlerior
/1.LJ 4. LJ
0 Sinusmaxillaris
Il
Maxilla,Proc.palalinus
_:_
f
_ _
M a x i l l a- - - - - - - -
of the maxillaryand frontal sinuses. Fig. 165 Development Ll {= 1"o"nt,*r) agein Years.
Head,Caput
/ Sinusfronlales
/ Cellulae ethmoidales anteriores
Os zygomaticum, Proc frontalis r
-:-\
Cellulaeethmoidalesoosteriores- -
Os zygomaticum, Proc frontalis
- - Forameninfraorbirate
- - Cellulaeethmoidalesposteriores - - Arcuszygomaticus
\ Sinussohenoidalis
Fig. 166 Paranasalsinuses,Sinus paranasales; PA-radiograph;the beam is oriented in the occipito-oral direction with the mouth open; anteroinferiorview (80%).
OralCavity,Cavitasoris
I Densincisivus
---:--
Arcuspalatoglossus - -
Arcuspalatopharyngeus
Fig. 167 Oral cavity,Cavitasoris; ventral view.
Glandulae labiales
M. orbicularisoris
Glandulae buccales
\
/
M levatorlabiisuoerioris -
M. levatorangulioris
/ /
M. zygomaticus maiol
--
Glandulaebuccales
M buccinator--
--
M risorius
\ M buccinator Glandulae buccales et labiales /
Labiuminferius /
I
/M. rant"li.
\ M. orbicularisoris
Fig. 168 Musclesofthe oralregion,Regiooralis; the mucousmembranehasbeenremoved; somesmall salivaryglandshavebeenpreserved; internalview(80%).
Head, Caput
Proc.pterygoideus, LaminamedialisI M tensorveli palatiniI
M. pterygoideus medialis /
Torustubarius
7/ , M. levatorvati oalatini f ,i u..
pharyngea / Tonsilla / M pterygoideus / laieralis / Lig spheno/ mandibulare / Ramusmandibulae
..FqplF-
pterygomandrbulafls
- -
Lig.apicisdentis
- - Membranaatlantooccipitalisanterior
Glandulae labiales - .-
- - Articulatioatlantoaxialismediana --Proc styloideus -M styloglossus -M stylopharyngeus --- Caruncula sublingualis
Lig.stylohyoideum Lig stytomandibulare \ M. stylohyoideus
Glandulasublingualis- -
\ M longuscapitis
M. orbicularisoris -
- Fasciacervicalis, Lamina pretrachealis
M. genioglossus M. digastricus
\ Os hyoideum, Cornumajus
M. mylohyoideus-
\ Membrana thyrohyoidea M geniohyoideus
/
\ M hyoglossus \ Fasciacsrvicalis, Laminapretrachealis
Os hyoideum, Corpus
\ M sternocleidomastoroeus \ \ os hvoideum. \ M. thyrohyoideus Cornl minus
Fig. 169 Oral cavity,Cavitasoris; paramediansection;the pharynx,larynx and tonguehave beenremoved; medialview. Thepharyngealtonsil becomessmallerin ageand is often barelyidentifiable.
Maxilla and Mandible, Mandibula
Juga alveolaria --
Fig. 170 Upperandlowerdentalarch,Arcusdentalis male; of a 2B-yearold superiorandinferior,viscerocranium teeth; occlusionof the lateralview.
Densmolarislll [serotinusl
Dentesoremolares\
---Dens
Denscaninus/
molarisll
- Densmolarislll [serotinusl'
Dentesincisivi--< DenscaninusDensmolarisl-Dentesoremolares,Radices
--
Foramenmentale/
Fig. 171 Maxilla, Maxilla and mandible, Mandibula, of a 20-yearold male; the dental rou$ have been exposed by removing the alveolar walls; lateral view. ' Thelowerthird molarhasnotyeterupted.
Head,Caput
Suturapalatomaxillaris \
Suturapalatinamediana\
Maxilla,Proc.palatinus-__
Maxilla,Proc.alveolaris---_
-
Dentesmolares
-
Sulcuspalatinus malor
\
Foramina palatinaminora
--Foramenpalatinum malus
'
Fig.172 Hardpalate,palatumosseum;upperdentalarch, Arcusdentalissuperior; photograph of the specimenof an adult: inferiorview (150%).
\ Ospalatinum, Lamina horizontalis
Cho"n"
Note the variation of the four incisors from the normal position (Fig. 192).
-
Foramen mandibulae
vestibulal -Densmolarislll [serotinusl
Densmolarisll
-
Densmolaris|
Tunicamucosaoris,Gingiva
-
Denspremolaris ll
Foramen mentale
/ Denspremolaris | / Denscaninus / Densincisivus lateralis
\
Densincisivus mediatis
Fig. 173 Mandible,Mandibula;lowerdentalarch,Arcus dentalis inferior; gingiva, Gingiva; superiorview (110%). ' oral: lingual in the mandible and palatal in the mnilla
Dentes{p Teeth,
vestlbulal - Enamelum Corona clinica
Corona dentis
Cervix dentis
Margogingivalis
--
Radix dentis
-
-
Foramen apicis dentis
-
-
Radix clinica
Cementum
Periodontium IDesmodontiuml
Canalisradicis dentis; Pulparadicularis
Aoex radicisdentis
Fig. 174 Incisor,Densincisiws; Iongitudinalsectionwith alveolarboneandsurroundingtissues. schematic
+
dlstal
Faciesvestibularis
7 Cuspisdentis
Cuspisdentas -
Apexcuspidis -
/ lFacies contactus); Faciesmesialis / Cuspisdentis
(Faciescontactus); Faciesdistalis \ Cuspisdentis \ Tuberculum dentis
Facies lingualis
lowercanine,Denscaninus Fig. 175 Permanent permanens; vestibularview (r.,400%). Fig. 176 Secondlowerdeciduousmolar,Densmolarisdeciduus; vestibularview (1.,400%). Thetwo strongrootsare slightly bent distally (typicalfeatureof theseroots).
Fig. 177 First upperpermanentmolar,Densmolaris primus; viewofthe occlusalsurface(r',250%1. Theocclusalsurface,Faciesocclusalis,usuallyhastwo vestibular(buccal)and two oral (lingual)cusps' Cuspides. * Occasionally (60%)a fifth cuspexists,locatedon the rnesiolingual surfaceof tfie crownof the first uppermolar,TuberculumCARABEII'
100
Head,caput
1234567
8
Fig. 178 Permanentteeth,Dentespermanentes; vestibularview (1.,120%).
1 2 3 4
Oensincbiws I Densincisiws ll Denscaninus DenspremolarisI
5 6 7 8
Denspremolarisll Dens molaris I Densmolarisll Densmolarislll lserotinusl
1234567
8
Fig. 179 Permanentteeth,Dentespermanentes; mesialview 0., 120%).
Dentesl reeth, 0 1
7
I
654321
Fig. 180 Permanentteeth,Dentespermanentes; oral view 0., 120%). (Foridentificationof numbersseepage100)
87654321
Fig. 181 Permanentteeth,Dentespermanentes; distalview (1.,120%). (Foridentificationof numbersseepage100)
Head, Caput
Arcuszygomaticus\ intraorbitalis\ .\ \ Canalis
Palatumdurum
/, Tuberculumarticulare
TSeptumnasi /Orbita
\
/
aill
Meatusacusticus externus
Proc condylaris -
Velum palatinum -
- - Dens molafls ll
Canalis mandibulae -
- Os hyoideum
Dens caninus /
\
Foramenmentale -
\ D"na premolaris ll
\ Dens molarisI
Fig. 182 Maxilla,Maxilla and mandible,Mandibula; panoramicradiograph;completedentition;no wisdom teeth; some teeth are filled. * piece to bite on of the panoramic radiograph machine
right
t6 15 14 13 t2 4 B 47 46 45 44 43 42
22 23 24 25 26 27 28 left mandible
Nomenclatureof the teethin the adult
reeth,Dentes 103 Dentesincisivi
Dentesincisivi
Dens caninus
Dens ll molaris
Dens molarisI
D€ns canlnus
Dens molarisI
Dens ll molaris
Fig. 183 Deciduousteeth,Dentesdecidui,ofa 3-yearold child; vestibularview (1.,130%).
Dens D€ns incisivuslateralis caninus
Dens molarisI
Dens molarisll
w0ffiw
D€ns Dens incisivuslaleralis caninus
Dens molarisI
Dens molarisll
Fig. 184 Deciduousteeth,Dentesdecidui,ofa 2-yearold child; upperroq vestibularview; lowerrow,obliqueinferior view (1.'130%). The dentalrootsare not yet fully calcified'
maxilla 63 64 S 73 74 I J mandible
left
Head,Caput
Dentesmolares(decidui)
Densmolaris(p€rmanens)ll /
Dentespremolares(permanentes)/
-
Denscaninuslpermanens)/
\
-
Canalis mandibulae
-
Densmolaris(permanens)|
Foramenmentale
Dentesincisivi(permanentes)
Fig. 185 Facialskeleton, Viscerocranium; deciduous teeth, Dentesdecidui,of a S-year-old child; the permanentteethare colouredblue; ventralview
Denscaninus(deciduus)/
Canalismandibulae
Dentesmolares(decidui)/ \
Dentesmolares(decidui)/
: \
Denscaninus(permanens)-
\
\
ll Densmolaris(permanens)
Densmolaris(permanens)|
Dentespremolares(permanentes)
Foramenmenlale
Fig. 186 Facial skeleton,Viscerocranium;deciduousteeth, Dentesdecidui; same specimenas in Fig. 185; ventrolateral view.
Teeth,Dentes
8-12 M 16-20 M
'12-16
M
\
/4
-_
20-30 M -
Fig. 187 Maxilla,Maxilla,with deciduousteeth,Dentes decidui; inferior view The numbers on the left give the mean time of eruption in months(M),the numberson the right the sequenceof eruption. The times oferuption vary considerably;somedifferencesexist betweenmale and female,and there are also differences betweenthe maxilla and the mandible
9-13J \
\\
9 - 1 2J \ 1 0 - 1 3J \
5-7 J -
Fig. lBB Maxilla,Maxilla,with permanentteeth,Dentes permanentes; inferior view. The numbers on the left give the mean time of eruption in years(l), the numbers on the right the sequenceof eruption. The times of eruption vary considerably
Head, Caput
N ophlhalmicuslV/1]-----
. ,'/
N maxillans[V/2]
/
Nn alveolaressupeflores
N trigeminus [V] Ganglion kigeminale 'N mandibularis lV/31
N lingualis /
N alveolaris inletiot /
Plexus dentalis inletiot /
the maxilla and the mandible have been partially removed; the mandibularcanalhas beenexposed; lateral view
Fig. 189 Maxillarynerve(V/2),N maxillaris;mandibular nerve(V/3),N. mandibularis;
Ganglion trigeminale
\
/
N infraorbitalis
/
/
Rr ganglionares [Radix sensorial
/
/
R alveolaris superiorantenor
/
Cavitastympani--
.-
_--
Sinusmaxillaris
N intraorbitalis
ChordatympaniN tympanicus/ Foramenstylomastoideum
,,,9, N vaguslXl' 1' ,' / N glossopharyngeusllXl ,/ N caroticusinternus/ A. carotisinterna/
' Rr.alveolares anteriores, superiores PlexusdentalissuPerior
t I I M pterygoideus medialis/
medii superiores Rr alveolares I R alveolaris superiormedius
' N. canalis pterygoidei Ganglion pterygopalatinum
Fig. 190 Rootsof the pterygopalatineganglion; sagittal section; the facial canal, the tympanic cavity and the pterygoid canal
Br alveolaressuperioresposteriores
the trigeminalSanglionhasbeenlifted havebeenexposed; superolaterally; lateralview.
Palate,Palatum
Dens incisivus(latelalis) \
(medialis) / Densincisivus
Denscaninus-- D e n sp r e m o l a r|i s- - -
-
Papilla incisiva
- Plicae palatinaetransversae
ll - -: Denspremolaris --Densmolarisl
Palatumdurum
Densmolarisll -
Densmolarislll Iserotinus]
- Raphe Palati
Palatum molle [Velum palatinuml
--Arcuspalatoglossus - Arcuspalalopharyngeus
Fig. 191 Hard and soft palate,Palatumdurum and molle; upper dentalarch,Arcus dentalissuperior; inferior view.
' orifices of the palatine glands,Glandulaepalatinae
-
Raphe palati /
Glandulae Palatinae
/ o A palatinamalor major N palatinus
-Hamulus plerygoideus \ \
malus FoamenPalatinum
-/
- - HamulusPterygoideus M uvulae N ---
pharyngls supenor' a M constrictor ParsbuccoPharYngea
---
ArcuspalatopharYngeus
>--
aM
Arcuspalatoglossus
-
RaphePterygomandibularis
- t M palatoglossus
/ Tonsilla Palatina
\
lsthmustaucium, Parsoralispharyngis
\
\
\
Fig. 192 Oral cavity,Cavitasoris; palatinemuscles'Mm' palati; the tongue has been pulled forward; most of the oral mucosa
buccinator
N lingualis
a M constrictorPharyngissuPerior, ParsglossoPharYngea
TonsillaPalatina
o M palatopharyngeus
palatine glands coveringthe palatehas been removedto show the andtheorientationofthemusclesofthesoftpalate;ventralview.
108
Head,caput -
LabiumsuperiusVestibulumons Maxilla -
Palatummolle [Velumpalatinuml
Tonsillapalatina / / - /
oorsum-linguae
Plica salpingopharyngea Arcus palatopharyngeus
.Labiuminlerius--
Parsoralispharyngis
Veslibulum/ ons
I Arcuspalatoglossus i I Tonsillalingualis;Cryptaetonsillares
Fig. 193 Oral cavity,Cavitasoris; pharynx,Pharynx; paramediansection;the tonguehasnot beencut but
extendsoverthe planeof the section; medialview. Epiglonis \
Plicaglossoepiglonica lateralis, Tonsillalingualis;Cryptaetonsillares\\
Plica glossoepiglotlica mediana /
Vallecula epiglottica /
Foramencaecumlinguae\
Fladixlinguae
/ M. palalopharyngeus
Sulcusterminalislinguae
- - Tonsillapalalina
Fossulaelonsillares,Cryptaetonsillares --
Dorcumlinguae,-Pars poslerior
(Plicatriangularis)
Arcuspalaloglossus
Papillae loliatae -
-\ Papillaefungiformes-\ Papillaeliliformes-
Dorsumlinguae, Parsanterior Margolinguae
\ Corpuslinguae Sulcusmedianuslinguae
Apexlinguae--
Fig. 194 Dorsum ofthe tongue,Dorsum linguae; root ofthe tongue,Radix linguae; palatine tonsils, Tonsillae palatinae; the right palatine tonsil has been sectioned; superior view (80%).
us[Xl
---
I I I I
N glossopharyngeus[X]
bitt6r sout salty sw€€l
N. lingualis
Innervationanddistributionofthe fourtypes Fig. 195 oftastein the dorsumofthe tongue,Dorsumlinguae.
Lingua rongue, 1 09 superior\ M longitudinalis
/. M transversuslinguae
linguae -Aponeurosis / Seplumlinguae
Tunicamucosalinguae - -
7 Foramencaecumlinguae
Radixlinguae
--
Carlilago ePiglotlica
//
/ Aditus laryngis
- Ventriculuslaryngis
M. mylohyoideus
M geniohyoideus
I / os hyoideum
\
cartilagothyroidea
Lingua;mandible,Mandibula; Fig. 196 Tongue, partsof the larynx,LarYnx; mediansection; lateralview M. verticalislinguae -
_--
superior M longitudinalis
linguae -M. transversus
\M. longitudinalis inlsrior Septumlinguae
lMm.genioglossi
Fig.197 Tongue,lingua; frontalsectionthroughthe centralpart of the tongue; ventralview. z Aponeurosislinguae Seplum --
/ M. transversuslinguae
linguae
Glandulalingualis -
-
Fig. 198 Tongue,lingua; frontal sectionthroughthe tip of the tongue; ventralview.
11ff
Head,caput
Dorsumlinguae,Parsanteriorr
/
Corpuslinguae\
!
Tunicamucosaoris-
\
Papillaefoliatae t Papillavallata , Dorsumlinguae,Parsposterior
7' /
\,
/Radixtinguae
/.t
/
-^
Mpalatoglossus
/
--
M. styloglossus
--
M stylopharyngeus
M. longitudinalis inlerior-' - -
M constrictorpharyngismedius
/-
M. genioglossus/ t M. geniohyoideus/
/
M. hyoglossus/
\
/
Os hyoideum,Comu majus
Os hyoideum,Corpus/
Membranathyrohyoidea/ \ M. thyrohyoideus
Fig. 199 Musclesof the tongue,Mm.linguae; the mandiblehas beensectioned: lateralview (80%).
M. hyoglossus
Tunicamucosaoris\
M. palatoglossus /
M. styloglossus / M stylopharyngeus M conslrictorpharyngissuperior, Parsglossopharyngea
Mandibulapharyngis medius, M. constriclor Parsceratopharyngea
M. longitudinalis inletiot -
g"nonyli-"rr//
i
\
M. genioglossus,
/ M. geniohyoideus/ / M chondroglossus/
Os hyoideum, Cornuminus/
I s/
Fig. 200 Musclesof the tongue,Mm. linguae; the mandible has been sectioned;the hyoglossusmuscle has been partially removed; lateral view (80%).
Musclesof the Tongue,Musculi linguae
Frenulumlinguae
Ap€xlinguae\
z Faciesinferiorlinguae,Plicafimbriata
-
Tunicamucosaons
Ssptumlinguae - M. genioglossus 7 M. palatoglossus
M. constriclorpharyngissuperior, Parsglossopharyngea M. chondroglossus / M. constrictorpharyngismedius, Parschondropharyngea / M. hyoglossus I
Mm.geniohyoidei
Fig. 201 Musclesof the tongue,Mm.linguae; muscleshavebeenremoved the genioglossus from the mandible: ventroinferiorview (80%). M. styloglossus I
Papillaefoliatae\ \l
Tunicamucosaoris \
r M. palatoglossus Tonsillapalatina
/ Proc.styloideus /
Apexlinguae-interior- M. longitudinalis 7- - -
Lie. stylohyoideum
M.stylopharyngeus M. genioglossus-
M. constrictorpharyngissuporior, Pars glossophatyrEoa
Mandibula -
M. constrictorpharyngism€dius, Pars chordr@haryng€a M. constrictorpharyngism€dius, ParsceratoPharyngea
/ M. geniohyoideus
Os hyoideum,Cornuminus
M€mbranathyrohyokjea-
Os hyoideum,Cornumaius
/
A.; v. laryngeasup€.ior; N. laryngeussup€not M. thyrohyoideus
Cartilagothyroidea,Laminasinistra/
M, constrictorpharyngisinf€rior' Parsthyrbpharynges Tub€rculumthyroidouminl€rius
Fig.2O2 Musclesof the tongue,Mm. linguae;musculature of the pharynx,Tunicamuscularispharyngis;larynx,Larynx; geniohyoid andthyrohyoidmuscleshavebeen the hyoglossus, sectioned; lateralview (60%).
It11
Head, Caput
Muscles of the tongue, Musculi linguae (Figs.196-200) Onedifferentiatesbetweeninternal (lvlrn.longitudinatressuperior and iuferior and M. tansversus linguae) and external (Ivt gonlogloseus, M. hltgbssus, M. drondmgllossus, M. atyioglossue and M. palatoglossus) muscleso1thetongue. Muscle Innervatlon
Origin
tnsertion
Function
L.M:'Iongltsdlnalts su&dff N. hytpogloss.ts [XI{] Closeto the Dorsum linguae
Apextinguae
Radix linguae
Retractsandbroadens the tongue
Radixlinguae
Retractsandbroadens the tongue
2. IW longiturllnrlls lnftrlor Apexlinguae /V.ltpogfossrrsEnl """ Closeto the,inftrlor guxface of the tongue 3. M. transWnsus[ngtiee N. hypoglossus ffi 4' M. gentoglossus ati N. hypoglossu,s ffil
Lateralmarginsof the tongue; Lateralmarginsof the tongue; Narrowsand elongatesthe Septumlinguae Aponeurosislinguae tongue Spinamentalismandibulae Aponeurosis linguae Protrudesanddepresses the rongue, movesthe tip of the tongue 5. M. hyoglosgs linguae t::ll1::::: CornumajusandCorpusossis Aponeurosis Depresses andretracts N. hypogkiisus hyoidei (lateralpart) [XIl "'ll the tongueandthe rootof the 6. M. chondroglossus Cornuminusossishyoidei Aponeurosis linguae tongue (lateralpart) N,hw&assws,FIII,: N. hypglossns[XI] ri:
.-
'l',,1
8. M. palatogl,ossus N. glossopharyngeus [fr], N. vags [XJ,and .,i, i{ accessOllirs,Rrdlix::::': crantalls[XIJ
(anterior Proc.styloideus margin)ofOstemporale, Lig.srylomandibulare and Lig.stylohyoideum
Entersthe lateralpartsof the tonguefrom dorsocranial
palatina Aponeurosis
Musclesof tongue,especially Elevates the rootof the transverse muscle tongue,depresses the soft palate,narrowsthe Isthmusfaucium
Retractsandelevates the tongue
Muscles of the palate (Figs.192,682) Th;:;ur.le";l* Muscle .::r::. Innervation
velipaladn! o.t;i are:lvl tensor ".li*.. .::,,,,
*ti:paaunifii ru.u
Origin
Insertion
pslefliif l. l{. levabitli plwrygeus [n, X] Plexr.r,s
palatina Parspetrosaossistemporalis Aponeurosis (inferiorsurface); Cartilagotubaeauditivae
2. M. tensor veli palatfud N. musanf tensoriswli patatiniof N. mandihilaris : :r::r::rr i'l:::ll::' tV/31 Surroundsthe Hamulus
Fossascaphoidea on the basisof the Laminamedialis of the Proc.pterygoideus; Spinaossissphenoidalis; Tubaauditiva(membranous part)
palatina Aponeurosis
3. M. uvulae' Plwtsphayryettsof ,.
Aponeurosis linguae
Stromaof the uwla
. Function Elevates andtensesthesoft palate;narrowsthe Isthmus faucium;dilatesthe auditory tube Tenses the softpalate; dilatesthe auditorytube
Shortensandthereby broadens the uvula
SuprahyoidMuscles,Mm. suprahyoidei,and Hyoid Bone, Os hyoideum
-
(Raphe mylohyoidea) --
Alveolusdenlalis m o l a r i sl l l (Dens extractus) Foramen mentale
- Tuberculum mentale
I Venteranteflor:M dioastricus { \Venterposterior -
---
M s t y l o h y o i d e -u-s- -
Lig stylohyoideum
M stylohyoideus
M drgastflcus.(Ansa lendinis) - -
Os hyoideum, Corpus
M digastricus,Tendo inlermedius
Cornumajus-Os hyoideum, Fig. 203
'
Mandible, Mandibula;
suprahyoid muscles, Mm. suprahyoidei;
l i n e o f o r i g l n o f t h e m y l o h y o i dm u s c l e
*
" arca of insertion of the anterior belly 0f the digastric muscle
ventroinferior view. Soinamentalis suoerior\
M g e n i o g l o s s u s- -
M m y l o h y o i d e u s- -
/ M geniohyoideus Os hvoideum.Cornua minora -
Foramen / z mandibulae
Os hyoideum, Cornumajus
Fig. 204 Mandible,Mandibula;suprahyoidmuscles, Mm suprahyoidei; hyoid bone,Os hyoideum;
I
os hyoideum Corpus
musclesand the mandiblehavebeensectioned; the genioglossal suDenorvlew
, Cornumrnus
Corpus- -
Fig. 205 Hyoid bone,Os hyoideum; ventrosuperiorview.
Hyoid bone,Os hyoideum; Fig. 206 dorsolateralview.
t.
,:i
T
.i{
-*""ri
Head,Caput
M zygomalicusmalor I I I masseter \ I I I I t. I I I I t I I I I rl
Glandulaparotidea, Pars superticialis
-
Glandrla parotid€a :loogssoria
-
Corpus adiposumbuccae
-
M. risorius
-
M. dopressorangulioris
M. masseler; Fasciarmssoteri€
Fasciaparotidoa Platysma M. sternodeido.nasloirsus: Fasciacawicalis, Laminasuperficialis
Fasciacowicalis, Laminasuporticialis Os hyoid€um
FIg.207 Paroddgland, Glandulaparotidea; lateralview (70%). Notethe accessorygland along the parotid duct
v.: A. tacialis
LargeSalivaryGlands,Glandulaesalivariaemaiores
submandibulares 7 Nodilymphoidei
A ;V facialiso o 1
\\ Glandulasubmandibularis
\
- - GlandulaParotidea N facialis[VlU,R. colli
a V. jugularisexterna
//
o M. dioastricus, VentdrPoslerior
/ /
N. hypoglossus[Xlll --
Platysmao
o M stylohyoideus o o N. laryngeussuperior; V; A. laryngeasuPenor
M. digastricus,Venteranterioro
- o o A.; v. thyroideasup€rior Fascia cervicalis, Lamina superficialis
\ o M. mylohyoideus
/
o M constrictorpharyngisinlerior
'o
o A submentalis
i' l
\
Nodilymphoideisubmandibulares
M thyrohyoideus
o M. omohyoideus, Ventersupenor
O M. sternohyoideus
gland,Glandulasubmandibularis; Fig. 208 Submandibular the platysmahasbeenremoved; view (80%). inferolateral
A;V submentalis'ol Platysmao ..
A . ;V l a c i a l i s o o l
i
o r, M. mylohyoideus
o M. Plerygoideus medialis / DuctusParotideus GlanoulaParotideaaccossona / rt a
M. massglor: Fasciamassetenca
- -
Glandulasublingualis\ M. digastricus,'- -Venteranterior
Glandula Parotidea
- -
NoduslymPhoideus submandibularls
- -
Fasciacervicalis, LaminasuPerficialis
-M genioglossuso
V retromandibularis
-V sublingualiso
M. digastricus' VenterPostenor
A lingualiso Ganglion submandibulare / M genionyoideuso / M mylohyoideus'
/) /
/
\
Ductussubmandibularis
-
Glandula submandibularis
submandibularis Glandula / M slyloglossusO N hypoglossus [Xlll
t'
I M hyoglossuso'
\o t,t .tytot'yoio"r.
Fasciacervicalis, LaminasuPerficialis
\ a M digastricus,Venteranterior
Large salivary Slands, Glandulae salivariae majores; Fig. 209 the mylohyoid muscle and the anterior belly of the digastric muscle have been sectioned; inferolateral view (80%).
Head, Caput
Ductussublinguales minores Carunculasublingualis \
--
M pterygoideusmedialis
Duclussublingualis maior * *--
N lingualis
M genioglossus- Glandula submandibularis
M geniohyoideus -
\ Ductussubmandibularis M digastricus,Venteranterior -
- Os hyoideum
Glandulasublingualis' M mytohyoideus
Fig. 210 Submandibulargland,Glandulasubmandibularis; sublingualgland,Glandulasublingualis; mediansectionthrough the mandibleand the hyoid bone;
medialview. Notethe closetopographicalrelationshipof the lingual nerve and the submandibularduct.
major / Ouctussublingualis Denscaninus - Carunculasublingualis - -
Oenspremolans | Densoremolaris ll - -
_ - Ductussubmandibularis
D e n s m o l a r i s -l -
- -
Gingiva
Densmolarisll - - - Glandula sublinoualis
Oensmolarislll lserotinusl--
- Glandula submandibularis \ M hyoglossus Radix linguae /
N
hypoglossus IXll]
Os hyoideum,Cornu majus
Fig. 211 Sublingualglan-d,Glandulasublingualis; supenorvlew. submandibulargland,Glandulasubmandibularis; Notethe closetopographicalrelationshipof the lingual nerve the genioglossus andthe hyoglossus muscleshavebeensectioned; and the submandibularduct. the tonguehasbeenremoved;
maiores sativariae LargeSalivaryGlands,Glandulae 1
T7
Lingua,Faciesinferior-- -
Densmolarislll [serotinus]
--
DensmolarisI
-Frenulumlinguae - Plicasublingualis Carunculasublingualis--
-
Denspremolarisll
-
DensPremolarisI
--
Denscaninus -
I oensincisivus I Oral cavity, Cavitasoris; orifice of the Fig.2l2 submandibularduct, Caruncula sublingualis; obliquesuperior view ( 170%).
Papilladuclusparolidei-
Ftg. 213 Orificeofthe parotidduct,Papillaductusparotidei; venhal view (300%). The orifice of the duct is locatedoppositeto the secondupper molar.
ll Densincisivus
Head, Caput
- Maxilla
-
Uvula palatina - -
N lingualis
M palatoglossus a -_-
M styloglossusa -Mm.pharyngis r --
1 M genioglossus
- - 1 A. prolundalinguae --
Mandibula
- r M mylohyoideus --
r M geniohyoideus
N hypoglossus[Xl|l M. hyoglossusr* /
\1 A sublingualis
/
M. constrictorpharyngismedius,I Parschondropharyngea
Fig. 214 Arteries and nerves of the tongue,Lingua; paramediansection;the pharynx has been exposedand the hyoglossusmuscle sectioned; medial view (80%).
/
N palatinus major A. Palatinamaior , o
Tonsillapalatina\ _ R tonsillaris N. glossopharyngeus IXl A. palatinaascendens, OFl tonsillaris N glossopharyngeus IXl, Rr linouales
Fig.215 Arteriesandnervesofthe palate,Palatum,and of the inferior surfaceof tongue,Radixlinguae; mediansection;the backofthe tonguehasbeenpulled forward;the mucousmembranehasbeenpartially removed; medialview (80%).
Baseof the Skull,
M. lrapezius,Tendo, M. recluscapitisposl€riorminor , I M. semispinahs capilis ,
occipiialisexlerna , Protuberantia
M. rectuscapilisposteriormajor , \
/
Canaliscondylaris
Condylusoccipitalis. M. obliquuscapitissuperior\
/
M. recluscapilislateralis\
petrooccipilalis Synchondrosis
/
Ap€x partaspelrosae
M. sternocleidomasloideus \
Canaliscaroticus
/ M spleniuscapilis \
Forameniugulete
M. longissimuscapitis \
//, lubaeaudilivae / Cdrtilago
M. digaslricus,\ Venterposlerior - j M. slyloglossus\
\
'/
Arliculalio / temporomandibularis, Caosulaarticularis
/
laleralis M. pterygoid€us
M stylohyoideus\ Articulatio- -\' I temDoromandibulais, \ Capsulaarliculatis
Li9. laterale
,-
Collummandibulae
--
M. stylopharyngeus -_ M lemporalis-M. zygomaticusmaiof Lig.pleryEospinale Proc.plerygoideus,-Laminalal€ralis lale'alis -' M. pferygoideus \r
-
M. masseler Lig.stylohyoid€um
--
M stylohyoideus
\-
M masseler.Parssuoerticialisz-
Lig.stylomardibulare
--
- -
M. masseter,Parsprolw:dlaz/
-
medialis M. Plerygoid€us
Angulusmandibulae
M. levator veli Dalatini
\ Hamulusplerygoideus
M. levator veli Dalatini / I
medialis/ M. pterygoideus
I I
\ Proc.pterygoideus, Laminamedialis
I
M. lensorveli Palatinil
\ M. longuscapilis
\-
\ Basismandibulae \ M. recluscaDilisanterior
M. genioglossus/ i
\ M. mylohyoideus l\
| M. geniohyoideus
\ M. digaslricus,V€nteranlerior
Baseof the skull, Basiscranii,with Fig. 216 muscularorigins;masticatorymuscles, Mm. masticatorii; the left half of the mandiblehasbeenremoved; inferior view (80%).
Head, Caput
/
lingualis Glandula
Ductussublingualis major /
Plica fimbriata
Caruncula sublingualis Ductussublingualis major \
/
Ouctussublingqales minores Plicasublingualis
Ductussubmandrbularis \ Septum linguae \
\
a M genioglossus
/
I
o M geniohYoideus
.
N ;A;V sublingualO i sO - _
/ Glandulasublingualis
A. tinguatis: O _' v, com[ansnervrnypogtossr a
oM stYloglossus
--
o M hyoglossus
N lingualis A M mylohyoideus Ganglionsubmandibulare Glandula submandibularis
--N hypoglossus [Xll] --
M mylohyoideus a ---Glandula submandibularis
1M slylohyoideus Oshyoideum
-
A ; V laryngea superior:O O / N. laryngeus superior
Venteranterior O M digaslricus,
Ventersuperior a M omohyoideus,
\ o M sternohyoideus
z Membranathyrohyoidea medianum Lig thyrohyoideum Cartilago thyroidea -
a M thyrohyoideus pharyngis inferior a M constnctor
(Lobus pyramrdalis,Var 1 -"
M cricothyroideus1 -/
\
Glandula thyroidea, / Lobus dexter
Cartilago cricoidea /
Fig.2l7 Vesselsandnervesofthe tongue,Lingua; largesalivaryglands,Glandulaesalivariaemajores; larynx, Larynx;thyroid gland,Glandulathyroidea; the suprahyoidmuscleshavebeensectioned;the infrahyoidmuscleshavebeenpartially removed; ventroinferiorview ( 140%).
C M sternothyroideus
/
Plica fimbriata
M genioglossus / a
sublingualis / Glandula A sublingualtsa -
z o o A: V sublingualis
OA Profundalinguae
/
N lingualis
/
o Y P r o f u n d al i n g u a e
---
M h y o g l o s s uas - - - - -
aM
_--
styloglossus
N hypoglossus [Xll] A sublingualisO
A l i n g u a l ias) - -
a M hyoglossus ----
M h y o g l o s s uas - - -
oA carotisexterna suPerior' N laryngeus R internus
superiorI -A lhyrordea
A carotis exlerna O
/
----
/a
-
carotidis a Bifurcatlo
OAlaryngeasuPerior
M geniohyoideus a \
oA thyroideasuPerior
Os hyoideum \ oA carotiscommunis
Membrana thyrohyoidea
Glandula thyroidea, Lobus dexter
/
\
\
/ A thyroideasuPerior,I R. glandularisanterior -M cricothyroideusI
/
Cartilagothyroidea
Glandula thyroadea' Lobus sinister
Lig cncothYroideummedianum
\ lsthmus glandulaethyroideae
I i
I racnea '
Fig.218 Vesselsandnervesofthe tongue'Lingua; larynx, Larynx;thyroid gland,Glandulathyroidea; the suprahyoidmuscleshavebeensectioned; the infrahyoidmuscleshavebeenremoved; ventroinferiorview (140%).
I22
Head,caput
Falx cerebri
R. lateralis . r N. supraorbitalis, /
Sinuslrontialis '
oA. suPraorbitalis
.
Duramatercranialis '
. o N'suPraorbitalis
hz'
t
- o M. obliquussuperior
M.temporalisO-_
superioris; - - - - o M:'.,3i?JT$3i3l"" O A. lacrimalis
Cellulaeethmoidales -__
Glandula lacrimalis ,l N.opticus rul: retinae O O V;4. cenlralis
Septumnasi--_ ---
Conchanasalis-infgrior
t\
A. transversatacieio
c M.rectuslaleralis a M.r€ctusmedialis Corpusadiposumorbitae a M. reclusinfgrior
.aN.infraorbitalis .
R. buccalis(Vll)
\
Densmolarisll ---
a M. massgter
\ Sinusmaxillaris
A.; V.facialis1 o ---
\ Ductusparotideus
' Ductussubmandibulans- Glandulasublingualis--
\
a M buccinator
\
Lingua
V.;A,; N. alveolarisinferiorI j s /
PlatysmaO / / M. mylohyoideus a
/
/
M. digastricus,Venleranleriora
\
\1aA.;
a M. genioglossus r1 M. geniohyoideus
Fig. 219 Oral cavity,Cavitasoris; maxillary sinus,Sinus maxillaris;orbit, Orbita;cranialcavity,Cavitascranii;, frontal sectionthroughthe headof a 48-yearoldmaleat the levelof the seconduppermolar;the oral cavity,the maxillary sinusand the cranialcavityhavebeenexposed; ventralview. Notethe sizeof the maxillarv sinus.
Vlingualis
Frontal Sectionof the Head
SinussaoitlalissuDerior,
\
Galeaaponeurotica ,\ l t\
\
\\
alx cerebri -
M. levator palpebrae a suPerioris
- o M. rectusmedialis SePtumnasi
-M r e c l u s u p e r i o r a- - - - - - - - - - - - - -Suturafrontozygomatica M obliquus superiu1 -'
- - -
, concha nasalisinferior
l' i,---
D e n sm o l a r ilsl
___-
Lingua Corpusadiposumbuccae Ductussubmandibularis
N intraorbitalis /
// sublingualis Glandula
A facialisa -
inferior O a N ;A ; V alveolaris
--_
A. lingualisa-
SK \\ a
M genioglossus '
z' M. geniohyoiders a
mytorryoideus;i
\
platysma
I M digastricus,Venteranterior
"
Fig.22O Oral cavity,Cavitasoris; orbit, Orbita; cranialcavity,Cavitascranii; frontal sectionthroughthe headof a neonateat the levelof the seconduppermolar;the oral cavityand the cranialcavityhavebeenexPosed; ventralview. Notethe absenceof the maxillary sinusand the close topographicalrelationshipof the developingteethand to Fig.219. the orbit.ComPare
Neck,Collum
_-
Incrsura thyroidea supeflor
Cornusuperius
- - Tuberculum thyroideum super|us
z Cornusuperius
Lamina - _ dextra
/
- Prominentia laryngea
- -
/ Lineaobliqua-
-
D
lncisural thyroidea inferior
Fig.22l Thyroidcartilage,Cartilagothyroidea; lateral view.
/ Tuberculum thyroideum supeflus Lamina sinistra Tuberculum lhyroideum rnrenus Cornuinferius
Fig.222 Thyroidcartilage,Cartilagothyroidea; ventral view.
Facies articulares aMenoideae ,
/
/
Cartilago epiglonica
I
Facies articutaris tnyroioeal Laminacartilaginisi
f:?:
cricoideae
Fig.223 Cricoidcartilage, Cartilagocricoidea; ventrosuperiorview.
Colliculus I Foveatriangularis j , Cristaarcuata:_ \
Fig.224
Fig.225 Epiglotticcartilage, Cartilagoepiglottica; dorsal view.
Cricoidcartilage,
Cartilago cricoidea; dorsal view.
I Cartilagocorniculata | , Cartltagoarytenoidsa 1)^i I proc.m
/, Cartilagocorniculata
/, Cartilago corniculaia
/
Proc muscularis
Fovea - oblonga Ptoc / muscularis
/
Lig. vocale
Facies-articularis lhyroidea Arcus cartilaginis cricoideae'
/ Cartilago arytenoidea; Articulatio cricoaMenoidea
I Facies' I
articularis thyroidea
Fig.226 Cricoidcartilage, Cartilago cricoidea;arytenoidcartilage,Cartilago arytenoidea;corniculatecartilage, Cartilagocorniculata; ventrosuperiorview.
'
Lamina cartilaginis cricoideae
Fig.227 Cricoidcartilage,Cartilago cricoidea;arytenoidcartilage,Cartilago arytenoidea;corniculatecartilage, Cartilagocorniculata; dorsalview.
I Arcusl cartilaginis cncoroeae
I
Facies arlicularis thyroidea
Fig.22B Cricoidcartilage,Cartilago cricoidea;arytenoidcartilage,Cartilago arytenoidea;corniculatecartilage, Cartilagocorniculata; lateralview.
Larynx - Os hyoideum, Cornumajus -_ Os hyoideum, Os.r Cornumrnus h y o. r. d e u m , Corpus Lig thyrohyo-
Cartilago eprglonrca
I
t
t
ideum laterale t
Membrana thyrohyoidea
Lt9 thyrohyoideum medranum
c"rtilago tflticea Cartilago thyroidea, Cornu supenus
Cartilago epiglottica
Lig thyro-hyordeum medranum
Petiolus-epiglottidrs corpu, preadiposum epiglottrcum Lig thyro- /
pharyngeum
epiglotlicum Cartilagothyroidea -
- Cartilago arylenotoea, Proc.vocalis
Ligg vocalra thyroidea, Cornu inferius
Lig --.cricothyroideum meoranum
\
Capsula articularis cricothyroidea
/ Lig cricothyroideum medlanum
--
/ Arcus cartilaginrs cricoideae
Arcuscartilaginis cncoideae Lig cricotracheale /
Conuselaslicus-
)-
- Cartitaglnestracheales
Fig.229 Larynx,Larynx;hyoid bone,Os hyoideum; trachea,Trachea; ventralview. The adiposetissueof the larynx fills the spacebetween the thyrohyoidmembraneand the epiglottis. * f o r a m e nf o r t h e s u l ) t ' r t o rl a r l n g t r a la r t c r ) a n ( l \ e i n a n d t h e i n t e r n a l l ) r a n c ho f t h e s u l x ' r i o rl a r , v n g ( t anle r v e
\ Facres articularis thyroidea
Cartilaginestracheales
Fig. 230 Larynx,Larynx;hyoid bone,Os hyoideum; the upper part of the larynx and the hyoid bonehavebeensectioned in the medianplane;both arytenoidcartilages,the cricoidcartilage and the upper trachealcartilageshavebeenpreserved; lateral view. *foramenforthesuperiorlar-vngealarter}andveinandtheintelna|l)Ianchofthe superior larYngealnerve
epiglotlrca / / Cartilago
Corpus \ _ Os hyoideum, _ Lig hyoepiglotticum -\
- - Membrana thyrohYoidea
Bursa infrahyordea -
-
Cartilagothyroidea,Cornu superius
thyroidea,Lamina dextra - - Carltlago
m e d r a n u m- - - Lig thyrohyoideum Corpus adiposum preepiglotticum
--
/ Lrg thyroepiglotticum,Petiolusepiglottidis
--
Lig cricopharyngeum
--
-
Cartilagoarytenoldea
Lig vestibulare Lig vocale /
Li9 cricopharyngeum Lig cflcothyrordeummedianum
-
- - - Lamina cartilaginiscricoideae
- - .Tunicamucosa Pharvnx,
Ligg anularra /
Lamina cartilaginis cricoideae
----
Trachea. Paries membranaceus
Fig.231 Larynx,Larynx;hyoidbone,Oshyoideum; mediansection;lateralview (r.). Ihe probe is situated between the epiglottis and the laryngeal adipose tissue.
Neck,Collum
Laminacartilaginiscricoideae Lig.cricoarytenoideum \
\
---fA Cartilagothyroidea,Cornusuperius
/ Cartilagocorniculala \
-
- -Conuselaslicus
Conuselasticus
Lig.vocale
Arcuscartilaginisc ricoideae' / Cartilagothyroidea
Incisurathyroideasuperior
Fig. 232 Laryngealcartilages,Cartilagineslaryngis; vocalligament,Lig.vocale;elasticcone,Conuselasticus; ventrosuperiorview.
Os hyoideum, Cornuminus; z Os hyoideum,Cornumaius
Cadilago epiglonica \ \
//
lalerale Lig thyrohyoideum
Carlilagolriticea\\ Membrana thyrohyoidea
- Corpusadiposumpreepiglotticum ----
Cornusuperius Cartilago thyroidea,
Cartilagocorniculata
Cariilagothyroidea,Laminasinistra- - -Cartilagoarytenoidea
- - -- Capsulaarticulariscticoarytenoidea
Lg. cncoarlenoroeum
- -
-' capsulaarticulariscricolhyroidea
- -
'
Cartilagothyroidea,Cornuinterius
Capsulaarticulariscricoihyroidea
Lig.cricopharyngeum
Ligg.anularia
Fig. 233 Laryngealcartilages,Cartilagineslaryngis; Iaryngealjoints,Articulationeslaryngis;hyoidbone, Oshyoideum;trachea,Trachea; larynx of an adolescent; dorsalview. In the adult the laryngealcartilagesoftencalcifyor ossify'
- - Cornuminus Os hyoideum, ------
Corpus Os hyoideum,
Membranathyrohyoidea
Os hyoideum,Cornumajus laterale Lig.thyrohyoideum Cartilagotriticea
Cartilagothyroidea,Cornusuperius
medianum , thyrohyoideum
Cartilagothyroidea,Laminasinistra Incisurathyroideasuperior Lineaobliqua
Lig cricothyroideum
Cartilagothyroidea,Cornuinferius Capsulaarticulariscricothyroidea
-' Arcuscartilaginiscricoideae Parsrecta M cricothyroideus,
/
r'
,'I tracheales Cartilagines //
Parsobliqua M. cricothyroideus,
Fig.234 Larynx,Larynx;hyoidbone,Oshyoideum; cricothyroidmuscle,M. cricothyroideus; ventrolateralview. *
foramen for the superior laryngeal artery and vein and the internal branch of the superior laryngeal nerve '* axis of Articulatio cricothyroidea
Cornumalus Os hyoideum,
Epiglonis
-------
--
Cartilagothyroidea,Cornusuperius
- Tuberculumcuneiforme - Cartilagocorniculata
Membranathyrohyoidea Corpusadiposumpreepiglonicum obliquus, M. arytenoideus Parsaryepiglonica
Cartilagoarytenoidea M aMenoideusobliquus transversus M arytenoideus M cricoaMenoideusposterior Faciesarticularisthyroidea
--- - -
lateralis M cricoaMenoideus Parsrecta l ' M cricothvroideus Parsobliqua ) Cartilagotrachealis
- Trachea,Pariesmembranaceus
Fig. 235 Laryngealmuscles,Mm.laryngis; partsof the right thyroidcartilageandof the riSht greater horn (Cornumajus)of the Oshyoideumare sectioned; dorsolateralview. ' foramenfor the superiorlaryngealartery and vein and the internal branchof the superiorlaryngealnerve
Neck, Collum
---
Os hyoideum, Cornumajus
- - Cartilagotriticea ---
Cartilago thyroidea, Cornusuperius
-M a$enoideus obliquus, Parsaryepiglonica
- Cartilago cuneiformis
- ---
---
M aMenoideusobliquus
M aMenoideus transversus
---
Capsulaarticulariscricothyroidea- - Carlilago cricoidea, Lamina - - -
Carlilago corniculata CartilagoaMenddea
Carlilago thyroidea,Cornu inferius
- - - M. cricoaMenoideusposterior
Carlilago trachealis Trachea, Paries membranaceus --
Fig. 236 Laryngealmuscles,Mm. laryngis; The mucosaon the epiglottisand on the larynx can still be seen; dorsal view. ' tbramen lbr the superior laryngeal artery and vein and the internal branch of the superior laryngeal nerve
Os hyoideum, Cornuminus - _ Os hyoideum, Cornumajus Epiglonis Cartilaoo lrilicea -
Tuberculumcuneitorme --]
thyroidea, Cornusuperius _-- Cartilago - - - Catlilagocuneilormis
-Tuberculumepiglotticum
M. aMenoideustransversus- Ventriculus laryngis--- M aMenoideus obliquus-
---------. --.--
posterior M cricoarytenoideus
Cartilagothyroidea,Laminasinistra -
-
i
Plica vocalis M vocalis M cricothyroideus M cricoaMenoideus lateralis
-
Cartlago thyroidea, Lamina dextra
Cartilagotrachealis
Fig.237 Larynx,Larynx; the dorsalwall hasbeensplit in the medianplane,the two halves areretractedlaterallyby two'hooks;on the right sidethe mucous membranehasbeenremoved: dorsalview. * foramen for the superior laryngeal artery and vein and the internal branch of the superior laryngeal nerue
Larynx
Musclesof the larynx (Figs.234-237) partsofthe larynxto eachother. Themusclesof,thelarynxconnectthe cartilaginous Muscle Innervation
Origin
Insertion
1, M. cricothyroideus N. larpgeus superiorof N.vags [X] . Parsrecta {sUpqIficial) :rr,,r Parsobliqttar{AQi*)::,,
Arcusof Cartilagocricoidea (outersurface)
the vocalcordsby Laminaof CartilagothYroidea Tenses cricoidea (caudalmarginto the anterior movingthe Cartilago axis to its transverse according borderof the inferiorhorn)
N. laryngeus recuirensof N. vagu.s[X] 3. M. cricoarytenoideus lateralis . ..,,:,,.:r,,r: N. laryngew rectrrensof N. vagus[X] ,4. M. arytenoiitdiig,::';' hansversus recurreruof N. Iaryngeu,s N. vagu.s[X] 5. M. arytenoideus obllguus ',,,,,,,,:,,, ,, N. laryngeusre:$rbns of N. vagus[X] .
:; l: :: i,:::::: ].: '
]
6. M. vocalis recuryens of N. laryngeus N. vagus[X] ,,,:t:),,
Laminaof Cartilagocricoidea Proc.muscularisand dorsalsurfaceof Cartilago (dorsalsurface) arytenoidea
Opensthe RimaglottidisbY turningCartilagoarYtenoidea outwardsalongits longitudinal axisand movingit laterally Closesthe Rimaglottidis(Pars bYturning intermembranacea) inthe Cartilagoarytenoidea wardsalongits longitudinalaxis
Arcusof Cartilagocricoidea (lateralmarginof upperpart)
Proc.muscularisof Cartilago arytenoidea
Cartilagoarytenoidea (lateraledgeanddorsal surface)
Closesthe Rimaglottidis of the Cartilagoarytenoidea bY oppositeside(lateraledgeand (Parsintercartilaginea) the two approaching dorsalsurface) arYtenoideae Cartilagines Rimaglottidis the Narrows the Proc.muscularisof bY (Parsintercartilaginea) side(aPexand opposite the two approaching dorsalsurface) arytenoideae Cartilagines Pars aryepiglottica: CartilagoepiSlottica (lateralborder) Tensesthe vocalfoldsand Proc.vocalisandFovea formsthe edgeof the vocal oblongaof Cartilago cord arytenoidea
(basis arytenoidea Cartilago of dorsalsurface) Parsaryepiglottica: Cartilagoarytenoidea (apex) Cartilagothyroidea (dorsalsurfaceof Incisura)
Continuation -+ p 131
a M. cricothyroideus
b Mm. arytenoideiobliquusandtransversus
c M. cricoarytenoideuslateralis
d M. cricoarytenoideus Posterior
Figs. 238 a-d Diagram showing the function of the laryngeal muscles,Mm. laryngis; the direction of movementis indicated by arrows; the yellow arrows indicate tension of the vocal cord;
bluearrows ofthe muscles; the redarrowsshowcontraction indicaterotation.On the left sidethe musclesare relaxed,on the right they are contracted;superiorview.
Neck,Collum
Lig hyoepigbnicum \
-z
preepisronicum corpus adiposum .r*}s
Radix linguae //
Cartilago epiglotlica
Os hyoideumlaryngis / Vestibulum
Bursaintrahyoidea-Lig thyrohyoideum medianum--
,, Tuberculumcuneiforme;Canilagocuneiformis Cartilagocorniculata / Tuberculumcorniculatum;
Lig thyro€piglotlicum -Canilago thyroidea - -
M. arylenoideus lransversus
--
Plica vestibularis -
Ventriculuslaryngis$ Plica vocalis /
a
-
Lamina carlilaginis cricoideae
Conuselasticus;Cavitasinfraglonica
Lig cricothyroideum medianum/ \ Tunicamucosa
Arcus cariilaginis cncoideae /
- Trachea. Paries membranaceus Cartilagines tracheales -' \
lslhmusglandulaethyroideae--
Fig.239 Larynx,Larynx; mediansection; medialview(r.,90%).
--
(Spatium o€sophagot;acheale) Trachea
'
clinical: Macula flava, becauseof the yellowishelastic tissue underneath the mucosa
"
clinical: MoRGAcNT's ventricle
Radixtinguae..
Radix linguae :-
-$.\
c"p.$-""f,1ff.:H -- *NN\ preepiglotticum \ Os hyoideum-
Corpusadiposum preepiglotlicum Lig. lhyrohyoideummedianum
Os hyoideum-
/ Tuberculumcunsilorme; Cartilagocuneiformis --
hyoepigbnicum
-
Carlilago epiglottica
- - Tuberculumcun€ilorme: Cartilagocuneitormis \ Tuberculum
Tuberculum comiculatum: Cariilagocorniculata
Lig.thyroepiglotticum
M. aMenoideus transversus
Cartilagothyroidea' -
Lamina cartilaginis cricoideae
Fig.240 larynx,Iarynx; mediansection;the positionof the epiglotticcartilage is shownduring respiration; medialview (r., 80%).
Flg.24l Larynx,Larynx; mediansection;the positionof the epiglotticcartilage when swallowing;due to the elevationof the whole larynx the epiglottic cartilage is passivelypushedposteriorly by the prffipiglottic adiposetissue,CorpusadiposumpreepiSlotticum; medialview (r., 80%).
Larynx
7 Papillaevallatae
Rr linguales
7 Tunica mucosa ltnguae N glossopharyngeus[lX]
\
/
N glossopharyngeus [lX]
f
A palatinaascendens,R tonsillarisa \\
Rr tonsillares
TonsillaPalatina
---
Cornumaius\\ Os hyoideum, - - -
Epiglottis
N l a r y n g e u s s u P e r i -o-r- _ Fa
Vallecula ePiglottica
A l a r y n g e as u p e r i o r o - - - - l - -
- - -
Cartilagothyroidea,Cornu supenus
Rr interni suPerior, N laryngeus
----
a M aMenoideusobliquus
Cartilagothyroidea.Lamrnasinistra
N laryngeusrecurrens
Cartilagothyroidea,Cornu inferius
i
M cricoaMenoideus Posterior
Glandula thYroidea A laryngeainferioro
--
Rr trachealesa
- -
--
Trachea N laryngeusrecurrens'Rr oesophageales
of the Fig.242 Arteriesand nervesof the larynx, Larynx,and linguae: Radix root of the tongue,
Glandula parathyroideasuperior
Glandula parathyroideainleriol
O A thyroideainlerior
recurrens N laryngeus tongue has the mucous membranecovering the root of the partially removed; dorsalview (140%).
been
Musclesof the larYnx (Continuation) Muscle Innervation
Origin
7. M. thyroarYtenoideus N. Iaryngeusrecurrensof N. vagus[X]
Laminaof cartilagothYroidea (inner surfacecloseto the origin of M. vocalis)
ParsthyroePiglottica _ N. Iaryngeusrecurrensof N. vagusftl
Insertion
Function
Narrowsthe Rima glottidis Proc.muscularis(anterior bY surface),Cartilagoarytenoidea (Parsintermembranacea) movingthe Cartilagines (anteriorsurface) inwardsalong arytenoideae their longitudinalaxis
Laminaof cartilagothYroidea CartilagoePiSlottica (lateralmargin) (inner surfacecloseto the origin of M. thYroarytenoideus)
Narrows the larYngeal entrance
Neck, Collum
Sacculuslaryngis\
Glandulae laryngeales \ / Plica vocalis
,&\\ M lhyroarytenoideus - z Rima glottidis
N laryngeus superior, R internus
M vocalis
--
superior OA laryngea --
Cartilago --lhyroidea, Lamina sinislra
Cartilagoarytenoidea
.:x
a Vv laryngeae superiores
\ '---/: Becessus pirilormis
-- -
'{'
a M constrictorpharyngis meotus "
=--
:-.-M.constrictorpharyngis inlerior
-W
?-^ -I
---.- --r-__
Mm pharyngis {Tunicamuscularispharyngisl
_...-..1---.-F
. ,,"""#i3,3?l"oti'8,i'
Fig.243 Larynx,Larynx; crosssectionthroughthe vestibularfolds; superiorview(2007o).
Cavitas pharyngis
't) Plexus pharyngeus venosus The white arrow showsthe connectionbetweenthe laryngeal ventricleand the laryngealsaccule. * c l i n i c a l :M o R c A c N r 'vse n t r i c l e
/Rrmaglonidis, /' ParsInlermembranacea Lig vocale \ M vocahs
7
/ ,l M thyroarytenoideus
N laryngeus superior \ A laryngeasuperiorO -
a
E
Vv laryngeaesuperioreso --l Cartilagothyroidea,Laminasinistra
- / Carlilagoarytenoidea
- Articulatiocricoarytenoidea
i
\. Recessuspirilormis c
qoo6Jc
'
Tunicamucosa
s M. cricoarytenoideus Frosterior
/ 'Lamina Tunica mucosal
carlilagi cflcoroeae
Fig.244 Larynx,Larynx; crosssectionthroughthe vocalfolds; superiorview(200%).
\ . M- constrictorpharyngisrnterior
Larynx
Figs. 245a, b Laryngoscopy. a indirectlaryngoscopy. The tongue has been pulled forward to create sufficient spacefor the laryngoscope, in order to see the vocal folds. b direct, endoscopical laryngoscopy.
Rima glottidis Plica vestibularis
Fig.246 Directlaryngoscopy; positionof the vocalfolds duringrespiration.
Carlilago arytenoidea; - Cartilagocorniculata Recessus pirilormis - -
lncisura interaMenoidea
Rima glotlidis Plica veslibularis
lncisura interaMenoidea
Fig.247 Directlaryngoscopy; positionof the vocalfoldsduring phonation.
Epiglottis
Fig. 248 Directlaryngoscopy; positionof the vocalfoldsduring whispering(the intercartilaginous part of the Rimaglottidisis open). Notethe bulgingforwardof the vestibularfold.
Plica vocalis Rima glotiidis, Pars inlercartilaginea
Rimagbnidis, Parsintermembranacea Plicavestibularis
Neck,Collum
Cornuminus
/
Os hyoideum,Corpus Bursaeinfrahyoideae-_
Cornumajus - /
- /
Cartilaoo triticea-
_-
Liq. thyrghyoideum medianum
-
Glandula thyroidea; (Lobus pyramidalis' Var )
Membrana thyrohyoidea Membrana-lhyrohyoidea
Cartilago- thyroidea, Cornusuperius ' - Prominenlia laryngea
Cartilagothyroidea, Laminadextra
Cartilago thyroidea, Laminadextra
Lig.cricothyroideum - - medianum M cricothyroideus, \ P'arsrecta
medianum Glandula - thvroidea. LobuSdexter
Glandula\ thyroidea, Lobusdexter
/
- Glandula thyroidea, Lobu:;sinister
/ M cricothyroideus, Parsobliqua
/
/ M cricothyroideus, Parsrecta
- Trachea
Fig.249 Hyoidbone,Oshyoideum; larynx,Larynx; thyroidgland,Glandulathyroidea;trachea,Trachea; ventralview (80%).
Fig.250 Hyoid bone,Os hyoideum;larynx, Larynx; thyroid gland, Glandulathyroidea;trachea,Trachea; ventralview (80%). * A conical pyramidal lobe (Lobus pyramidalis)can reach the Lig. thyrohyoideum medianum It is consideredto be a developmental variant
Cartilago epiglottica \
- - -Os hyoideum\ Membranathyrohyoidea\
\!
\.
\\
- Membranaquadrangularis
;
- - Vestibulum laryngis
obliquus,Parsaryepiglottica / - M. arytenoideus Sacculuslaryngis
_z
_- M thyrohyoideus Fasciacervicalis.Laminaoretrachealis-Lig.vestibulare- -
Plica vestibularis
-- -
Rimavestibuli- Ventriculuslaryngis- -
Plica vocalis
- -
M constrictorpharyngisinferior, Parsthyropharyngea
Cartilagothyroidea,Laminasinistra*-
Lig vocals --
A; V.thyroideasuperior--
M sternothyroideus
--
lateralis M cricoarvtenoideus
Rimaglonidis '
- M vocalis
Cavitasinfraglottica--7
\ M cricothyroideus
Cartilago cricoidea --
- Conuselastrcus
Lig cricotracheale --
-
CartilagotrachealisLigg anularia -'
- - -
Glandula lhyroidea
Trachea
Glandula oarathvroideainferior
Fig.251 Larynx,Larynx;thyroidgland,Glandulathyroidea; frontal sectionthroughthe centreof the larynx; dorsalview (120%1.
Thvroid Gtand, Glandula thYroidea
lsthmus glandulaethyroideae Lamina superficialis / Fascia cervicalis, / sPlatysma \,/
rmpara \ Plexusthyroideus Laminapretrachealis Fasciacerulcalis, \
/
I
Glandula thyroidea,Capsula fibrosa \
- | V. jugularisanterior tr M sternohyoideus _---- tM sternothyroideus
Tunica mucosa tlacheae; \ Cartilago trachealis \ \ Glandula thvroidea, \ Lobus sinister
--
o M sternocleidomasloideus
t\
--
fachea
R cardiacusceruicalis \ \ superior
--
Oesophagus
Ansa cervicalis,
(Rr musculares)
\
N laryngeusrecurrens
internaa V jugularis -N vagus[Xl A carotiscommunlsO .- cervico' Ganolion thoracicu-m [stellatuml M longuscolli s - -. M scalenusanterior.; - M scalenusmedius"-1- *
--
\\ '{ a
i!
Laminaprevertebralis Fasciacervicalis,
i I VertebracervicalisVll
! 'a
t A trryluruEdrrrr'rl
membranaceus A. thvroidea inferior; Glaniiula parathyroidea inlerior
Thyroidgland,Glandulathyroidea; Fig.252 transversesection through the viscera of the neck at the level of the secondtrachealcartilage;
inferior view (90%). * clinical: retro-oesophageal space,Spatium retrooesopha8eum
A carolis communls
I
A carotisl communls
i M tonous - colli
it
u"n"or"' Vll ceruicalis
Figs. 253a, b Thyroidgland,Glandulathyroidea' a transversesonographicsection;the wavesrun from ventralto dorsal; inferior view (r., 200%). ' shadow of the trachea
lV jugularisinterna oA carotiscommunis
/ M longuscolli
thyroidea, , Glandula Lobusdexter i lsthmusglandulaer I thyroideaei I l1
v tnY'o'do"al
I A thyroidea
'l
b transversesonographicsection;the wavesrun from ventral to dorsal;inferiorview (r.' 200%)' Thedireciionof the bloodflow is indicatedby different colours(red:towardsthe receiver,artery;blue:awayfrom sonography' the receiver,vein);colour-coded ' shadow of the trachea
Neck.Cotlum
Concha nasahsInferior Synchondrosispetrooccipitalis\-
Tonsillapharyngea \
\
,Clivus
\
I
pharyngeum Tuberculum / Os occiprtale, nasalis supenor / Concha
'#wF,n
M levator -veli palalini
-/
-
Pr^.
| _tf '-
'c
- - Foramen
stylomastoideum
---Al
-.-J,.Recessus pnaryngeus
mrel^i.la'
Cellutae mastoideae
---Ptoc
stylordeus
\ - -rli - - M digastricus,--Venter posterior
C o n c h an a s a l i s
media
"7 - - - - ostiumpharyngeum I tubae auditivae 'I
Glandula parotidea Noduli lymphoideipharyngeales
--
-
-Torus levatorius Halalum molle [Velum palatrnum]
,, )r
-Arcuspalalopharyngeus Uvula palatina
-
t\
\
-
Glandula submandibularis
/
\
\
/ Lingua, Paprllaev allatae Radix linguae: Papillaevallatae
/
\
\Os -
Eprqronrs / Plica aryepiglottrca
/
t
/ /
Tuberculumcunerlor^e, Cartilago cuneiformis
\
/ \
/
/ Tuberculum corniculatum; Cartilago corniculata
Glandulae parathyroideaeinleriores
-
Fig.254 Pharynx,Pharynx; frontal section through the mastoid processes;
Plica salpingopharyngea
Glandulae pharyngeales
Septumnasi
\Tonsilla
(Plica pharyngoepiglottica)
M pterygoideusmedialis Lig stylomandibulare
palatina,Fossulaetonsrllares
hyoideum.Cornu majus
Cartilagothyroidea,Cornu superius
Recessus pinformis Plica nerui laryngeisuperioris Incisurainterarytenoidea
\; V thyroideainferior
the pharynx has beenexposedby a longitudinalmediansection; dorsalview (80%).
Musclesof the pharynx (Figs.255,256,258) Themusclesof the pharynxcanbe dividedinto constrictor (Mm.constrictores pharyngissuperior,mediusand:inferior) andlevator (M.stylopharyngeus, M. salpingopharyngeus, andM. palatopharyngeus) muscles. Muscle
Origin
Insertion
Function
Membranapharyngobasilaris, Raphepharyngis(from Tuberculumpharyngeumof Os occipitaleto the Angulus mandibulae)
Constrictthe pharynx from dorsally.In srvallowingtogetherwith the soft palateit closesthe Epipharynxfrom the Mesopharynx. Contractionsin u'aveform help to transportthe foodto the oesophagus.
Innervation
Constrictor musclesof the pharynx pharyngis Parspterygopharyngea: 1. M. constrictor superior Rr.pharyngealesof N. glossopharyngeus [IX]
Laminamedialisof Proc pterygoideus(dorsalmargin), Hamulus ossis ptefygoidei Pars buccopharyngea: Raphe pterygomandibularis, M. buccinator Pars mylopharyngea: Linea mylohyoideaof the mandible Pars glossopharyngea: M. transversuslinguae
Pharynx
-..Arcuszygomaticus M tensor veli palatini -M levatorveli palatini - -
tf'
//
extelnus; / Porusacusticus externus Mealusacusticus , / Fasciapharyngobasilaris
malor M l e v a t o r- - - labii superions alaeque nasi M levator labii superioris
/ - z M. stvlohyoideus
--
- - Condylus occipitalis - - Proc mastoideus
Proc pterygoideus, Laminalateralis M zygomaticusminor M levator anguli oris
-
--
M. digastricus, Venterposterior - Proc styloideus -. Hamuluspterygoideus - Lig stylohyoideum .- Raphepterygomandibularis
--1
- Ductusparotideus; M buccinator M orbicularis oris,- Parslabialis
-----
M depressor angulioris ---
styloglossus ". stylopharyngers M. VenterPosterior M digastricus,
M h y o g l o s s u s- M mentalis Platysma
-
Venteranterior M digastricus, M mylohyoideus
- .Cornumaius Os hyoideum, - superior; A.;v. laryngea N. laryngeus superior
/
/ M sternohyoideus
-
./
/ M omohyoideus
/
- M constrictorpharyngisinferior, Parsthyropharyngea
/ M thyrohyoideus Cartilago thyroidea, Lamina sinistra
Membrana thyrohyoidea
.- M constrictorpharyngisinlerior, Parscricopharyngea
-
M cricothyroideus, Pars recla
- - Oesophagus
-
Cartilago lrachealis
/ M cricothvroideus,Pars obliqua
Fig. 255 Pharyngealmuscles,Mm. pharyngis; facialmuscles,Mm. faciei; the mandiblehas beenpartiallyremoved; lateralview (1.).
'1 3
of the constrictorPharyngis supenormuscle
Muscles of the pharynx (continuation) Muscle Innervation
Origin
Insertion
Constrictormusclesof,theph,r,::,:: 2.M.conshictorpharyngis Parschondropharyngea: Raphepharyngis medius fu. pharyngealesof N. glossopharyngeus [X] andof N.vagttsffi 3. M. constrictor pharyngis lnferior Rn pharyngealesof N.vag.s [X]
(medialthird) Cornumajusossishyoidei Parsceratopharyngea:Cornu majusossishyoidei
Pars thyropharyngea:Carti- Raphepharyngis lagothyroidea(outersurface, (medialandlowerthird) behindLineaobliqua) Pars cricopharyngea:CartiIagocricoidea(lateralsurface) Parstracheopharyngea:CartilagotrachealisI (lateral surface)
Function . , . 4 . : , r . : : i . , ., , . ' .:. .:.. :::.t,:i:l:i.::
Constrictthe pharynxfrom dorsally.In swallowingtogetherwith the palatine muscles- theYclosethe Epipharynxfrom the Mesopharynx.Their contractions in waveformhelp to transport the foodto the oesophagus.
Neck. Collum
{
Svnchondrosis \ p6kooccipitaIs
:
\ evator, )alatrnr \
Cellulae \ i .>\ mastoideae
\\
, , Dorsum lt---ll lr 1l
\
rl
\
1l
, Fascia pha(yngobasilatis
t
lr
, For.amen . . slytonlastoroeum
) / ..i/,/
lt
l/,t,
muscularis - (Fasciculus accessonus) - Llg sphenomandibulare ti
M pterygoideus laleralis
t
_-
- Proc styloideus
M. constriclor pharyngis superior, Parspterygopharyngea
Glandulae pharyngeales - Lig stylohyoideum -
-
M stylohyoideus M pterygoideus medialis-
-
*
Glandula parotidea -
/--
M digastricus, Venterposterior-
M pterygordeus medialis/ Mandibula -
-
lvl digastricus,Venter postenor M constrictorpharyngissuperior Pars buccopharyngea M stylopharyngeus
M styloglossus ttS sphenomandibulare M constrictorpharyngissuperior, Pars mylopharyngea
M pterygoideusmedialis
\ M stylohyoideus
Glandulasubmandibularis
\
M styloglossus /
M digastricus,Venter posterior
v
\ M constrictor pharyngis superior, Parsglossopharyngea \ \ M constrictor pharyngis medius, Parschondropharyngea
/ M stylohyoideus Os hyoideum, Cornumajus /
\ M constrictorpharyngis medius, Pars ceratopharyngea \ M constrictorpharyngisinJerior,Pars thyropharyngea
/ Raphepharyngis
-
l. Glandula thvroidea.Lobus sinisler -
M conslriclorpharyngisinferior,Pars cricopharyngea
-
Oesophagus,Tunica musculans
-
Glandula thyroidea,Lobus dexter
Glandulae parathyroideaesuperioret inferior -
Tunicamuscularis- - Oesophagus,
-
Glandulae parathyroideaesuperioret inferior
Trachea
Fig.256 Pharynx,Pharynx; frontal sectionthroughthe mastoidprocesses; the pharyngealfasciahas beencompletelyremoved; dorsalview (8070).
Muscles of the pharynx (continuation) Muscle Innervation
Origin
Levatormusclesof the pharynx 1. M. palatopharyngeus Rn plgtyngealeeof,,.1:: :l:l N. glossopharyngeus [X] 2. M. salpin$ophdiynipuj' ::' Rr.pharyngealesof pharyngeus IIX] N. glosso 3. M. stylopharyngeus R. musculistylopharyngei rrb./ lt :lglossiip/r arynSdlisIIE
palatina, Aponeurosis Hamulusossispterygoidei
Insertion
Function
.-.
.::
lateral Obliquelydescending, and dorsalwall of pharynx, Cartilagothyroidea
the Isthmus Constricts faucium,lowerssoftpalate
Cartilago tubaeauditivae 0bliquely descending,lateral (freemargin,inferiorsurface) wall of pharynx
Elevates thepharynx
Proc.styloideus of 0s temporale
Elevates thepharynx
0bliquely descending, lateralwall of pharynx, (Cartilagothyroidea)
Pharyrw
N vagus[X] N glossopharyngeus [lX] BulbussuPeriora \ venaelugularls \ '\ S i n u sI - - * , \ lransversus Sinusa sigmoideus Ganglion supenus
N accessorius [Xll,R internus pharyngis superior . d4M constrictor
\
OVv pharyngeae
,
jugulare / Foramen
"rl
-'Os
/r
temPorale
I
--
A carotisinternaO - R auricularis Proc mastoideus
-
oA meningea poslenor N caroticus internus inferius Ganglion
(tx)
-*-
N accessorius [Xl], R externus
aA carotisinterna
N accessorius [Xll
--Proc styloider'rs interius Ganglion
-
inferius(X) Ganglion
-
N. iugularis(Truncus symPathicus) t Ramusmandibulae Ganglioncervicalesupenus (TruncussYmPathlcus)
N hypoglossus lxlll a -M stylopharyngeus N glossopharyngeus IlXl R pharyngealis
Venterposteliora -M digastricus,
-
suPerior N laryngeus
-
A carotisexternaa
oA pharyngeaascendens N glossopharyngeus [lxl TruncussymPathicus
- OA Palatinaascendens
\ oA facialis \ aA. lingualis \ R internus suPerior, N laryngeus R N laryngeussuperior, externus - aA. thyroidea suPenor
R pharyngealis
o suPerior A thyroidea
suPerior cervicalis N cardiacus (Truncus sYmPathicus)
/ --
aV jugularisinterna
--
oR pharyngealis N. vagus[X]
Rr pharyngeales
--
aA carotiscommunis communls Plexuscaroticus
pharyngis inferiora M constrictor -
Truncussympathicus
superior ceruicalis R cardiacus Glandula thyroidea
N vagus[X]
- -
-t
-
a Bulbusinleriorvenaeiugularis
-
OR pharyngealls medlum cervicale Ganglion
/ inlerioro A thyroidea
-
-*
- aA thyroidea inferior Ganglion ceruicothoracicum [stellatum]
R cardiacuscervicalissuperior
t
I
\
N cardiacuscervicalismedlus (TruncussYmPathicus)
andnervesofthe pharynx'Pharynx'and Fig.257 Vessels Space,Spatiumlateropharyngeum; the Parapharyngeal frontalsectionthroughthe jugularforamina,Foramina jugularia; jugular on",n. f"it sidethe carotidartery and the internal vein havebeenremoved; dorsalview. Thewpakpoint at the transitionof the M' constrictor pharyngisinferior andTunicamuscularisof the oesophagus is calledLnlnrR'striangle.
,//258 : {900
Neck, Collum
Tonsillapharyngea
Truncusnerviaccessorii, R internus N vagus[X] \ -\ N glossopharyngeus\-----.
il-xr
Fascia , pharyngobasilaris I
--
tubaeauditivae; , Cartilago Ostiumpharyngeumtubaeauditivae i N hypoglossus It l [Xll]
N vagus[X] N. accessorius [Xl], I runcusnerutaccessonl a Bulbus superior venaejugiJlaris
,,
--iv
a Sinustransversus
,u,'
a Sinussigmoideus
It
,"1"'t,
VIIP
-
Ganglion inferius(X)
OA carotisinlerna
-
a A.occipitalis
__--
N hypoglossus txill
7----
Truncusnervi accessorii, B externus
P r o cm a s t o i d e u s
Torustubarius
Ganglion cervicalesuperius
a M. digastricus, Venterposlerior
(Truncus sympathicus)
--*
* M tensorvelipalatini
.----
M uvulaeI
I M constrictorpharyngis suoenor ;* M. salpingopharyngeus
- -
Plicasalpingopharyngea
---
T o n s i l l a p a l a t i n a* - -
.--.Arcuspalatopharyngeus
r M palatopharyngeus Sulcusterminalis Dorsumlinguae, Parsposlerior
Plicaaryepiglonica --__\ Os hyoideum, Cornumajus --.. Tuberculum cuneilorme----
N laryngeus superior; O a A : V laryngea superior
Tuberculum corniculalum- -
---
t M arytenoideus obliquus, Parsaryepiglonica
Recessusoiriformis,- Plicanervilaryngeisuperioris
N vagus[X]
/ Incisurainlerarytenoidea
--
€ M aMenoideustransversus; M arytenoideus obliquus
--.
s M cricoarytenoideusposterior
N vagus[X] Truncussympathicus, Plexuscaroticus communis
Oesophagus, Tunicamuscularis- - _
-*---
Glandula lhyroidea
Ganglion cervicale medium
Glandula parathyroideainferior
--
A thyroidea inleriorO *.----
o Truncuslhyrocervicalis
_--
Bulbusinferiora _ venaeJugularis
-
:-
N vagus[X], R cardiacus ceruicalis superior o Bulbusinferiorvenaejugularis -.-
lslellatuml A;V subclaviao
/
---
/ V brachiocephalica sinistraa O A carotiscommunis \
a A subclavia a v subclavia
N vagus[X]
N laryngeus recurrens
o V brachiocephalicadextra
N laryngeus recurrens \
257x 900
N vagus[X] Pars descendens aortae O -
Fig.258 Pharynx,Pharynx;larynx, Larynx; parapharyngeal space,Spatiumlateropharyngeum; frontal sectionthroughthe jugular foramina,Foramenjugularia; the posteriorpharyngealwall has beensectionedin the median plane;on the right sidethe mucousmembranehasbeenremoved: dorsalview.
Trachea, Paries membranaceus
- o Truncusbrachiocephalicus -
o v cavasuperior
The 3rd to 8th cranialnervesare numberedIII to VIII. Parts of the pharynx: A nasalpart (Parsnasalis:Epipharynx,Nasopharynx) B oral part (Parsoralis:Mesopharynx,Oropharynx) C laryngealpart (Parslaryngea:Hypopharynx,Laryngopharynx)
I
Muscles,Vesselsand Nervesof the Neck B a s i sm a n d i b u l a e P l a t y s m a \
N,4sternohyoideus M digastricus,Venter anterior / / Os hyoideum M mylohyordeus /
G l a n d u l as u b m a n d i b u l a r i s \ \, A;Vtacialis, \ t'
M pterygoideus medralis
Xl
,,;
-
\r]
't M spleniusceruicis
M masseter
parolidea
i
M stylohyoideus M levator scapulae Lig thyrohyoideum medianum
---
- - _ -
i/ levator scapulae
N,l digastricus, Venter posterior
/
M scalenus medius "i
M e m b r a n at h y r o h y o i d e a- -
M longus capitis
M constrictorpharyngis interior
jugularisrnterna-A carorrscommunls:V
M s c a l e n um s edrus -
:trltl/
:;f
/--{l'L
-M . o m o h y o r d e u s . T e n d o. I F a s c l ac e r u i c als. prelrachealis r e l r a c h e a , ' r.\ . . ' \ l r sL Lamina . a m i n ap | .. ..,/l ../., ; supraclavicularis .,
Plexusbrachiars PL'"''""1J:'"il::":". --"'n.4-r M omohyoideus,Venlerinferior
M trapezius v cephalica
C l a v i c u l a.
,
/
:/
lQ,
t{ii
.\
-T
'r ryi urucd
--
Lig cricothyroideum edianum
_ -
Arcus cartilaginiscflcoideae
M cricothyroideus
M sternohyordeus
| | .\ ,,__ t'(,rf,\';[-r;V .--l
Urdgu
i/ omohyoideus
|
l\'
'.
vdr
I\',\$L-
-..
...
-
.-
..
I
'i
-;--.
G l a n d u l at h y r o i d e a
_-
,
'z'
M scalenus medius
.
r:;li:'''i
*l ll
-:-' -.'.:
\l
I
-*--l|
I I
M pectoralis I mlnor A axillaris, M pecloralismajor, Pars clavicularis
M serratusanterior
I
l
f(oc coracotdeus
I I \r,
\
t' t-s a s c r a clavroectoralrs Mm intercoslalesexterni
t. \ r,^ costoclavlculare\
\\ -| racnea
l
|
M d"rtoid"r.
V cephalica M pectoralis major
I I Parsclavicularis t Lig.interclaviculare I lClavicula
\ sternum
Articulatiosternoclavicularis
Fig. 259 Musclesof the neck, NIm colli; on the left side the neurovascular bundlehas beenremoved; on the right the pectoralismajor musclehas beenpartially retractedinferiorly;ventralview (70%)
Lateral muscle of the neck (Figs. 259, 262, 267) anteriorly It reachesfromProc.mastoideus M. sternocleidomastoideus hasthe sameoriginas M. trapezius(sameinnervation). andinferiorlyandis integratedinto the Laminasuperficialis of the Fasciacervicalis. Muscle
Origin
Insertion
Function
Posteriorpart of Proc. andlateralhalf mastoideus of LineanuchalissuDerior
Fixesand elevatesthe head, flexesthe caudaland extends the cranialcervicalvertebrae and the joints of the head. One sidealonebendsthe head anteriorlyand rotatesit to the oppositeside.If the head is fixed it assistsin deep inspiration
Innervation M. sternocleidomastoideus Caputsternale:Longtendon N. accasorius of theventralsurfaceof the [XI]; Plexuscenicalis sternum Caputclaviculare:short tendonof thesternalthirdof theClavicula
Neck,Collum
Suprahyoidmuscles(Fig.260) Thesuprahyoidmusclesform the bottomof the mouth and are the antagonistsof ihe inli:inyoiit mtliiictes. Theanteriorbelly of M. digastricuslies superficially.As a wide plateM. mylohyoideus is the basisof the floor of ,therqguth,,Totlq,inside is .. M. geniohyoideus, The posteriorbelly of M. digastricusandrM.styloidoiisarga bitdeepegrand:dorsaL:,':::::, rrlit: ::1r1,,r:t::: Muscle Innervation 1. M. digastricus Veriteranterioi: N. mylo hyoideus(N. mandibularis :':i rr: N/sl); Venterposterior:R- digastricus (N. facialisIVII) 2. M. stylohyoideus R stylohyoideus (N.facialis [VII]) 3. M. mylohyoideus N. mylohyoideus (N. mandibularisN/31) 4. M. geniohyoideus p{IIl N. hypoglossus
Origin
Insertion
Function
Venterposterior:Incisura mastoidea of 0s temporale; intertendonto the lesserhorn ofthe hyoidbone
Venteranterior:Fossa dlgastricamandibulae
Depresses the mandible, andfixesthe elevates hyoidbone;assists M. mylohyoideus
Proc.styloideusof Os temporale
Lateralmarginof Corpusossis Fixesthe hyoidbone,pullsit hyoidei.Oftensurroundsthe backwardandupwardduring intertendon of M. digastricus swallowing
ShorttendonfromLinea Raphemylohyoidea andupper mylohyoidea mandibulae; both marginof Corpusossishyoidei musclesforma plateacross the mandibulararch Anteriorsurfaceof Corpus ShorttendonfromSpina ossishyoidei mentalismandibulae. The musclesof bothsideslie closetogether, with a septum betweenthem
Raisesthe floorof the mouth andthe tongue(in swallowing),depresses the mandible, elevates thehyoidbone AssistsM. mylohyoideus (elevating the tongue), fixes and elevatesthe hyoid bone,depresses the mandible
Inftahyoidmuscles(Fig.259) Theinfrahyoidmusclesare differendatedaccordingto their insertion:M. sternohyoideus, M. sternothyroideus, M. thyrohyoideus, andM.omohyoideus.Thefourmusqlesarewith!ntheLaminapretrachealisofFasc!9cervicaliq.....i:l.i::l]i:. Muscle Innervati.on 1. M. sternohyoideus Ansecervicalis:,:. (Plexuscenicalis) 2. M. sternothyroideus Ansa ceryicalis (Plexttscervicalts) i 3. M. thyrohyoideirs Ansa cervicalis (Plutus cervi.calis)
4. M. omohyoideus i:: Ansacervtaalis " (Plexusceruicalis) Consistsof'twofleshy belliesunitedby a central ' tendonconnectedto the carotidsheath(Vagina : carotica) , ,,
Origin
Insertion
Cranialmarginof Cartilago costaeI, innersurface of Manubriumsterniand joint sternoclavicular Innersurfaceof Cartilago costaeI, innersurfaceof Manubriumsterni,caudalto M. sternohyoideus Outersurfaceof the Lamina of Cartilagothyroidea
Corpusossishyoidei
Venterinferior: Superior marginof scapulabetween Angulussuperior andIncisura scapulae
Outersurfaceof thyroid cartilage(opposite the origin of M. thyrohyoideus) Lateralthird of Corpusand rootof Cornumajusof 0s hyoideum
Ventersuperior:Caudal borderof the lateralouter surfaceof Corpusossi hyoideum
Function Fix the 0s hyoideum, depress the larynxandthe hyoidbone; assistin swallowing; indirectly flex the headandcervical joints,assistin respiration (together with M. thyrohyoideusand M. omohyoideus) Fixesthe 0s hyoideum, it, elevates the depresses larynx;assistsin swallowing(workstogether with M. sternohyoideus, M. sternothyroideus and M. omohyoideus) Fixesthe Oshyoideum, depresses it; assistsin swallowing; indirectlyflexes joints; the headandcervical tensesthe cervicalfascia throughthe connection of its centraltendonto the carotidsheath(workstogether with.M. sternohyoideus, M. sternothyroideus and M. thyrohyoideus)
Musclesof the Neck,Muscult colli
/ M stylohyoideus Parotidea , Glandula
I 1,/ .l
i l
M stylopharyngeus / Lig.stylohyoideum;
,'
ii,'
,/ r"'
venterposterior / M. digastracus,
./ u'
/
M slernocleidomaslordeus
M masseter - -
/
M semispinaliscapitls
Mandibula - -
,.;r
M d i g a s t r i c u s- ,Venter anteflor
M solenius caoatis
M mylohyoideus
O s h y o i d e u -m- "; - 1
l----
Membrana thyrohyoidea
1
l \
M o m o h y o i d e u sV, e n t e rs u p e r i o r- - - ' M sternohyoideus "' / M thyrohyoideus
- M s c a l e n uasn t e r i o r
M levator scapulae
//
,\
--
M s c a l e n u sm e d i u s
-.-
M scalenusposlerior
/ Clavicula,Extremitassternalis
/ M omohyoideus, Venter infenor
// r
/
Musclesof the neck,Mm colli; Fig. 260 musclehas been removed; a largepart of the sternocleidomastoid lateralview (1.,70Y.\.
Scalenemuscles (Fig.260) The three scalenemuscl6g,M. scalenusanterior, M. scalenusmedius,and M. scalenusposteriorform a plate of musclesat the side of the cervical column and reach to the upper ribs. Muscle Innervation
Origin
Tuberculaanterioraof Procc. 1. M. scalenus anterior DirectbrunchsaJPIws er- transversiof 3rd (4th) to 6th vtcalisand Plauts,b|ii&talis cervicalvertebrae 2. M. scalenusmedlu......:ll::,:,Tuberculaanterioraof Procc' Dilect bmrchesof PIquscer- transversiof all cervical vicatisand Plr4:tti]b@htftlls vertebrae 3. M. scalenusposterior Dirutbrunctusof PIa ils w brrchblts vtcallsand Plex;us
Tuberculaposterioraof Procc.transversiof Sth and 6th cervicalvertebrae
lnsertion Shorttendonto Tuberculum musculiscalenianteriorisof CostaI Shorttendonto CostaI, lateralof M. scalenus anterior,behindSulcus arteriaesubclaviae Shortand flat tendonto the uppermarginof CostaII (III)
Function
Thorax Elevatethe two cranialribs (musclesof inspiration) Vertebral column lateralflexionof the cervical column
Neck,Collum
\
1 M. longus capitis
Fossajugularis-__
Os occipitale, Pars basilaris
r, M rectuscapitisanterior-_ I \ Membranaatlantooccipitalis anterior
-
Canalis nerui hypoglossi
M. recluscapitislateralis M digastricus,Venterposterior
- M longissimus capitis- M splenius capitis-
- - 'Articulatio atlantoaxialis lateralis, Capsulaarticularis M. scalenus medius-- Mm intertransversarii anteriores cervrcts M intertransversarius oosteriorceruicis M scalenus medius- -r
---
anterius Atl"a.Tuberculum
---
M longuscapitis M levatorscapulae
--
.M longus capitis - -
M longuscolli medius M scalenus
-
M scalenus medius-M scalenus anterior-
-
Tuberculum anterius' M inlertransversarius anterior cervtcrs
M scalenusmedius- _
-
M scalenus anterior
posteriorM scalenus (M intercostaliscervicis)
,--
M scalenusmedius- _ -
(M intercostalis cervicis)--A. subclavia dextra - - -
A subclavia sinistra
_--
posterior M scalenus
M scalenus anleiot -"
V subclavia-dextra C o s t al l - -
\\ ttr..
M longuscolli/
V brachiocephalica sinistra
\
Vertebra thoracica lll, Proc transversus
\
V.cavasuperior'
/ Truncus
brachioceohalicus
A; V thoracicainterna
\ A carotiscommunis sinistra \ A / carotiscommunis dexlra Arcusaortae
Fig. 261 Muscles of the neck, Mm. colli; frontal section through the apex of the petrous part of the temporal bone; the viscera of the neck have been removed; on the left side the scalenemuscleshave also been removed: ventral view (80%).
I -VIl = lst to 7th cervicalvertebrae I - 3 = lst to 3rd thoracic vertebrae * The Tuberculum anterius of the 6th cervical vertebra is called Tuberculum caroticum.
Prevertebralmuscles(Fig.261) The prevertebralrnusclesare locatedon both sidesof the cervical and the cranial part of the thoracic vertebral columtr.The anterior lateral parts of Atlas and Axis are connectedby the short M. rectus capitis anterior. 0n the anterior side, the prevertebralmusclesare coveredby the Laminaprevertebmlisof the Fasciacervicalis., Muscle Innervation
Origin
Insertion
1. M. redrs mpids anterior Rr.venf:alesof Pt*us cervicalis
Atlas,Proc.transversus
2. M. longqs,capids Directbranches of Ptatus @r.,icalis
Tuberculaanterioraof Procc.transversiof 3d to 6th cervicalvertebrae
Parsbasilarisof 0s occipitale FIexthe cervicalcolumnand headventally; in unilateralinnervationthey inclineandrotatethe headto Outersurfaceof Pars the sameside basilarisof Osoccipitale
Function
(
CervicalFascia,Fasciacervicalis
Li9 auriculareanterius Articulatiotemooromandibularis, I Caosulaarticularis
Posteflus I Lig auriculare M auricularissuperior t I i '
I
,Mhelicismaior
i I THerix minor I I ," ,, M.heticis - Laminatrasi I LA ,:'
I I / s - flEL&Wa.,, rWW't
,/
W4-'-g t'
M tragicus M tragicus
-,--
-*''
-
R a m u sm a n d i b u l a e
, "
ptoc styloideus Ptoc
-
-
Fascla masseterica; M masseter
M styloglossus
Platysma- -
- - -
Venierposterior M. digastricus,
M stylohyoideus, lenoo --
Fascia ceruicalis - -
- '-
Mandibula - -
-
Laminasuperficialis Fasciacervicalis,
-
M stylohyoideus
/
Fascia cervicalis, Lamina superlicialis
---= M mylohyoideus
-M digastricus, Venleranterior VentersuperiorM omohyoideus,
Lig stylohyoideum M sternocleidomastoideus
/ M omohyoideus M. sternohyoideus.- a/.-
Fascia cervicalis, Lamina suDerficialis
Fascia ceruicalis, Lamina pretrachealis - .- -
/ M. omohyoideus, venlertnlenor
Fascia cervicalis,.- --_ Lamina super{icialis
Trioonum omoclaviculare Platysma' fnchea'
\ Platysma \ Trigonum omoclaviculare
,'
/ M sternocleidomastoideus
i I minor Fossa suDlaclavicularis
Cervical fascia,Fasciacervicalis; Fig.262 the head has been turned to the right;
' V externa iugularis M.sternocleidomastoideus the sternocleidomastoidmuscle has been partially removed;ventrolateralview (80%).
Prevertebral muscles (Continuation) Muscle Innervation
Origin
Insertion
Function
3. M. longuq colli Direct b ranchesof Plexus cervicalis
Medial part: bodyof the firstthoracicandthe last cervicalVertebrae Superiorlateral part: Tuberculaanterioraof of the Procc.transversi cranialcervicalvertebrae Inferior lateralpart: Lateralsurfaceof the bodies thoracicvertebrae of theu14rer
Medial part: Bodiesof the uppercervicalvertebrae
Flexesthe cervicalcolumn and the head ventrallY; in unilateral innervation it inr:linesand rotatesthe head to the same side
SuperiorlateralPart: anteriusof Atlas Tuberculum andbodiesof the following cervicalvertebrae Inferior lateral Part: TendontQProcc.transversi of the lowercervicalvertebrae (6th)
Neck, Collum
Fascia cervicalis Laminasup€rlicialis
I I
Laminaprelrachealis Laminapreverl€bralis
Figs.263 a, b Diagramof the cervicalfascia. a transverse section(compare to Fig.285) b mediansection(compare to Fig.282)
/ .-urun{q. \ \
),.^Ai,-^^^.i^^idea --"{;*,
// Arcusvenosus\\ jugularis
\-
--
V jugularis antgrior
\\
\
Fig.264 Projectionofthe visceraofthe neckonto the surfaceand surgical situs of the lower tracheotomy; posteriorly; the neckhasbeenhyperextended ventral view.
to op€nthe tracheahavebeenmarked The surgicalapproaches in red. ' conlotomy *' upper Facheotomy(abovethe isthmus of the thFoid gland) r * r lower tracheotomy(belowthe isthmus of the thyroid gland)
and Nervesof theNeck Muscles,Vessels
/ o V auricularisPosleriol N. auricularisPosterior(Vll) / ,/ a A auricularisPoslerior
/ /
,/ /
./ t'
,/ Jf
Glandula parotidea
tr
/ o M. epicrantus, M oicipitofrontalis' Venleroccipitalis
G / o A. occipitalis
magnus, N. auricularis R posteriot t V jugularisexternaa
- a v. occioitalis colli, N. transversus Rr.superiores
magnus, N auricularis R anterior N occipitalisminor I M. sternocleidomastoideus N transversuscolli, Rr.inferiores
-. I
N. auricularismagnus -
o M. levatorscapulae -
N accessorius[Xll i-
aM trapezius
Nn.supraclaviculares laterales
Nn suoraclaviculares mediales '
intermedii Nn suoraclaviculares
Iz'*
Fig. 265 Vesselsand nervesof the ventraland the lateral ..lion, of the neck,Regionescervicalesanteriorand lateralis; superficiallaYer; lateralview (1.,70%1.
Neck, Collum
//
aV awicvlarisposterior
N occipitalis minor
..
Platysma*
//
V. lacialis *
N. facialis[Vlll,R. colli
---
aA occipitalis
a V. occipitalis
N. occipitalismaior
-+'
V. relromandibularis $
N auricularismagnus
R. communicans
I M spleniuscapitis a M. levatorscapulae lM trapezius N accessorius[Xll Nodilymphoideicervicales laterales.NodisuDerficiales Nn suDraclavicularos laterales
Arcusvenosusiugularisa Nn.supraclaviculares
\-t \\
Nn suoraclaviculares intermedii
265x267
Fig.266 Vessels andnervesofthe lateralregionofthe neck, Regiocervicalislateralis; parts of the platysmahavebeenretractedsuperiorly;mostof the superficiallayerofthe cervicalfasciahasbeenremoved; lateralview (1.,70%1.
The areawherethe cutaneousbranchesof the cervicalplexus appearat the posteriorborderof the sternocleidomastoid muscle is clinicallytermedEnr'spoint.Duringlymphadenectomies in this regionthe accessorynervecan easilybe damaged.
and Nervesof theNeck Muscles,Vessels
a V auricularisPosterior V retromandibularis t N lacialis[Vll],R colli
/a
\
inlerna V jugularis -.
V facialist
M sternocleidomastoideus
/. /
Glandula \. submandibularis
N occioitalisminor
,o a A ;V occipiialis N. occipitalis mapr
/
M digastricus, t Venteranlerior r
R suprahyoideusa(A lingualis)
R. intrahyoideuga.-_ (A lhyrordea supenor) A carotisexternao --
---
r M spleniuscapitis
A laryngeasuperiota-Plexus cervicalis
A. thyroidea superiora ' N accessorius[Xl]
-'A carotis . d | U i l J U vcommun | | | | | | u l n J ! - .is . . )1
Plexusbrachialis,Truncussuperior N vagus [X]
_/
a A. transversacolli, R. suDerficialis
'z
M omohyoideus,* -Venter superior
,,
D\-----
r--- * V;"",T,",1{3J1"?''
M sternohyoideus * /
Ansacervicalis, / Radixsuperior (Plexuscervicalis)
/ o A. transversa colli, R. prolundus
M. sternothyroideus a / M scalenusanleriora A transversacollio V iugularisexternaa /
A suprascapularis I
\ \
/
A subclavial
/
lr
/
./ I'
Plexusbrachialis, Parssupraclavicularis
V cephalica
c M deltoideus
I A. thoracoacromialis, R deltoideus
M pecloralismajor4 /
Fig.267 Vesselsand nervesof the ventraland the lateral regionsof the neck,Regionescervicalesanteriorand lateralis; the superficialand middlelayerof the cervicalfasciahave beenremoved; lateralview (1.,70%).
152 n,r
266x
Neck,Collum
\
,'
I
/ Nodi lymphoideiparotidei suporficiales
Noduslymphoideus buccinatorius_ - /
Nodilymphoideifaciatesr.
Nodi lymphoidei mastoidsi
M. digastricus,e \ Venier anterior
Nodilymphoidei/ subm€ntales Nodilymphoideiceryicaleslalerales.- Nodi prolundi superiores M. omohyoid€us, Ventersup€rior: - - I Nodilymphoideicervicaleslaterales,--Nodiprofundiinterior€s N. accessorius[Xll --
V iugularisinterna a --
\
- P-
\\
Noduslymphoideus cervicalislateralis,/ Nodusprofundusinferior I M. scalenusanteriorI /
I
a M. trapezius
oM. scalenusposlerior
I
\
r M. scalenusmedius
Plexusb,rachialis, Parssupraclavicularis
' a M. omohyoideus, Venterinferior
Fig. 268 Superficiallymphaticvessels,Vasalymphatica superficialia,and lymph nodes,Nodilymphoidei,of the head and neckof an 8-year-oldmale; the platysmaand the superficiallayerof the cervicalfascia as well as the cervicalplexushavebeencompletelyremoved; the sternocleidomastoid musclehas beenpartially removed; lateral view. During surgicalremovalof the lymph nodesfrom the lateral regionof the neck the accessorynerveis in greatdanger!
R marginalismandibularis Glandulaparotidea \
M stylohyoideus{ \
/*oV;A
facialis
//
\
/
/
/
/
Glandulasubmandibularis
/ V retromandibularis | \
z' |
N hypoglossus [Xll]
\\
N. mYlohYoideus
-
tD M. mylohyoideus
.z
-.-t -' /
.'
/
/
o MM. O . dOEaslrEus' igaslricus' \t^^.;.-^r-^^. Venl6r antetior
-..-
| M hyoglossus
N. accsssorius[Xll
N. hypoglossus [Xll] Ansacervicalis, RadixsuPenol --
aA. lingualis
N vagus[X] \
V iugularisexternaa -
Tendointermedius a M. digastricus,
\ Os hyoideum | / M. sternocleidomastoideus
in,"rn". i v. jugularis
I
A. carotisexlema o I
tt \ o A lhyroidea suoenor
\ aA lingualis a
a
A. laryngeasuperior;N. laryng€ussupslior
triangle, andnervesof the submandibular Fig.269 Vessels Trigonumsubmandibulare; inferolateralview.
<1o/o
4"/o
121"
30%
35%
12%
5"h
Fig.270 Levelof the biturcationof the commoncarotidartery' with referenceto the cervicalspine'
10/o
Neck,Collum
M digastricus a V facialis a
N. hypoglossus [Xlll Vfacialis a
\
retromandibularis / oV N cervicalis[C2],8anterior t/ /
\
\ \
/'
/,
posterior oA. auricularis /
I
posterior (N.facialis) N auricularis / a M sternocleidomastoideus
N accessorius[Xl]
-
N occipitalis minor
'
M mylohyoideus o _-
A l i n g u a l ias - -
A carotisexternaO --A laryngeasuperior 1 -" Ansacervicalis, Radixsuperior A lhyroidea superior1 --'
N. cervicalis [C3],R anterior .'i
R sternocleidomastoideus o ---
N cervicalis[C4],R anterior
V l h y r o i d e a s u p e r iao (- - - - -
Ansacervicalis,Radixinferior Plexusbrachialis, Truncussuperior
' A ceruicalisascendens a - -
- aA transversa colli,R super{icialis
M omohyoideus I --
a M trapezius ---
oM.omohyoideus, Venterinferior
-
Glandula thyroidea-
.
- - - ------_
j A t r a n s v e r s ac o l l i ,
(A ceruicalisa superticialis, Var)
R profundus
oA subclavia
N phrenicus
-- aV jugularisexterna -
M scalenusanterioro
-------.-:-
Bulbusinferioro venaejugularis A caroliscommunisO N vagus[X]
ov subclavia
/ /
// /
'
-
.
ti
,/ M pectoratismajor,r Parsclavicularis / M sternocleidomastoideus a
\ o oA ;V thoracoacromialis
267x Fig.27l Vesselsand nerves of the lateral region of the neck, Rpgiocervicalis lateralis; most of the sternocleidomastoidmuscle has been removed; lateral view (1.,80%). * The thyrohyoid branch runs temporarily alongside the h)?oglossal nerve, its origin, however, is the ventral root, Radix anterior, of the Ansa cervicalis
oV cephalica
a M pectoralis mtnor
aM deltoideus
and Nervesof theNeck Muscles,Vessels
N hypoglossus [XlU /
a V retromandibularis T aVjugularisinterna
./
t/
//
R sternocleidomastoideus a \ (A. occipitalis) \ Alacialisa\ Platysma t M mylohyoideus t N mylohyoideus
/
/ l.//
,
Naccessorius[Xl]
'// tll
aa
\ ,, lz
\
,,
a M. sternocleidomastoideus
-/,
\
/ oA. occipitalis
\
/
aM sPlaniuscapitis
A submentalis a M digastricus,o .Venteranlerior
aA.occipitalis
--
A carotisexternaa -N laryngeus superior
.
A carotisinterna O .-.A laryngeasuperioro--. A thyroideasuperiot a "
--
oM levatorscapulae
N vagus[Xl
N. cervicalis[C5],R anterior
M omohyoideus, I .-Ventersuperior
N corvicalis [C6],R. anterior '
Var.) superficialis' o(A ceruicalis
--
A caroiiscommunis O .-Ansaceruicalis (Plexus cervicalis) A thyroideainferiot a
-'-
A corvicalis a -ascendens
A. vertebralis, at Parsprevertebralis
/
-
N phrenicus
i M. deltoideus
-
Glandula thyroidea.'
' .
// / // /.
/ TruncusthyroceruicalisO A subclavia O
A thoracica inlerna)
/
/a \
tr. '\ / V jugularis externaa M pectoralismaior,Parsclaviculariso
ta.
t
Plexus brachialis, Pars inlraclavicularis
OA axillaris
\ aA thoracoacromialis \ 1M Pectoralis minor
a V axrllafls \ o V cephalica
27t/ andnervesofthe lateralregionofthe Fig.272 Vessels neck,Regiocervicalislateralis,and the clavipectoral triangle,Trigonumclavipectorale; muscle,the deeplayer;mostof the sternocleidomastoid omohyoidmuscleand the veinshavebeenremoved; lateralview (1.,80%).
t
Neck. Collum
N mylohyoideus
N vagus[X] N hypoglossus [Xtt] AfacialisOl
\\
-t.
A submenlalis a -
i
s V jugularis interna Rr communicantes (Truncus sympathicus) , / aA occipitalis
I
/
A carotisexternao \\
a R mastoideus
t
N occipitalisminor
.
A carotisinlernaa _ Ganglion cervicale superius (Truncussympathicus)
N occipitalis malor
N accessorius
-
txtl
- oA cervicalis ascendens Ansacervicalis,Radixsuperior (Ptexuscervtcalts)
N phrenicus
M. constrictor pharyngis inferiorr __ N cardiacuscervicalissuperior M sternothyroideus t \--_+_
n. -;'--
(canglion synipathicum accessonum)
-
OA. transversacolli, B. superficiatis
* M scalenus anterior
V t h y r o i d e a s u p e r.i o t- - - - - - -
,
Plexusbrachialis, Parssupraclavicularis
A thyroidea inferior 1
N suprascapularis
Ganglion cervicalemedium
aA suprascapularis
--
Truncus1 thyroceruicalis A s u b c l a v oi a - - - - - - -
Clavicula
A thoracicainterna a
N laryngeus recutrens
o R acromialis (A thoracoacromialis)
Trachea V lhyroidea inferior *
-
N cardiacuscervicalis medius (Truncus
sympathicus) ,, V vertebralis, i -Pars prevertebralis A. carotiscommunisa /V jugularis internaa /
//
--
aA axittaris
- aA thoracoacromialis
/
V,jugularis externa. / M peclordlis maior n, /
\
/
\
/
costa | / N pectoralis medialis
^-^#tnn ttz 4OO
--
I
!
/
V brachio- a / cephalicastnistra
a M. pectoralis minor,Tendo
\
M p e c t o r a l i sa l mrnor
I I V cephalica e I
A; V thoracicalateralis O s
t.
'.
\
oV cephalica
Plexus brachialis, Pars infraclavicularis, Fasciculusmedialis
,] V axillaris
N. intercostobrachialis \ N thoracodorsarrs \ \ N thoracicuslongus *Vv thoracoepigastricae
Fig.273 Vessels andnervesof the lateralregionof the neck, Regiocervicalislateralis,and the clavipectoraltriangle, Trigonumclavipectorale; deeplayer;the clavicle,the sternocleidomastoid muscleand the greatvesselshavebeenpartially removed;the inferior part of the infrahyoidmuscleshasbeencompletelyremoved; lateralview (1.,B0%). Theventral rami of the respectivecervicalnervesare correspondinglynumberedV to VIII.
Arteriesof theNeck
Fig. 274 Subclavianartery, A. subclavia, andits branches; lateralview (r.,807").
A vertebralis,Pars I intracranialisI --
A. vertebralis,Parsatlantica
- - - A. vertebralis,Parslransversaria
A. cervicalisDrofunda
VertebracervicalisVll \ / Truncusthyrocervicalis Verlebrathoracica| -
- A thyroideainferior - A. subclavia - - - A. carotiscommunis
(A scapularis desc€ndens,var.)
---
A. suprascapularis A thoracicainlema - - -- .Truncusbrachiocephalicus
A. intercostalis suprema
----
Clavicula
Manubriumstemi ll -A intercostalisposterior A axillaris /
.---
I A. intercostalisposlstior
-- - -A. thoracica intema
l% 2% 5Y6 90% 2%
Fig. 275 Levelof entranceof the vertebralartery into the fiansverseforamina.On the right sidethe classical,"textbook" On the left sidethe variationin entry caseis demonstrated. levelscanbe seen.Thefrequencyis indicatedin percentages.
Figs.276a-f Variationsin formingthe iluncus by A. transversa A. thyroideainferior,A. suprascapularis, colli, and A. thoracicainterna.A. vertebralisand branchoff separately. Truncuscostocervicalis
Neck, Collum
Lig.longitudinale anterius I M longuscaprtis. M scalenus mediuso \ R interganglionaris \ TruncussvmDathicus. Ganglion cervicale medium '. N. phrenicus \ M. scalenusanleriorO \ M scalenuspos V. vertebr VertebracervicalisVll, Proc transversus-_ A. vertebralis1 -Truncusthyrocervicalis a A ; V.cervicalisprofundaO o --
t
/ vertebracervicalislll
\ Discusintervertebralis
//
\
\\
-
O A verlebralis,Parstransversaria
I
\
\
/ ./' , /'
/
Truncussuperior) Truncusmedius ptexusbracrriatis I TruncusinferiorJ
(Nn phrenici
accessorii)
Ganglioncervicothoracicum lstellatuml
Ansasubclavia
\
\N
' \ \
A ; V . t h o r a c i c a i n t e r n a a l/
/'
-
/
-r'"
i
\
1 A carotis communrs
I M. longuscolli
3 Arcusaortae
o Truncusbrachiocephalicus
Pleuraparietalis/ V cavasuperiora
o Vv. brachiocephalicae dexlra el sinistra
Fig,277 Vesselsand nerves in the transitional area betweenthe neck and the thorax; deep layer; the scalenemusclesand the prevertebral muscleshave been removedon the right side; ventral view (60%). Note the close relationship of the sympathetictrunk, the brachial plexus and the apex of the lung. The ventral rami of the spinal nerves are correspondingly numbered lV to VIII.
Figs. 278a-d Variationsofthe origin ofthe vertebralartery. Percentages indicatethe frequencyof occurence.
1A. subclavia
\
cosla I
Muscles,Veinsand Nervesof theNeck
M digastricus,Venteranterior* \ V iugularisanteraor6 \ V. submentalis* \,
V. lacialis * \
t, t
tt
submandibularis Glandula 1
\
{r M. mylohyoideus
-
--
\\ \\ \\ tr..
\ \\ \ (\ rl\
V retromandibularia " -_
t: f
-\\
Al--M stylohyoideus
')
. - - -1 .4
V facialis* ---'l
--*u.occipitalis
/ V occipitaliss
-
*Vjugularisexterna
interna$t V jugularis --
V thyroid€asuperior*' --
*i V thyroideasuperior
--
exlerna+ V jugularis
@,Mslernocleidomasloideus Ansacervicalis,RadixsuPerior (Plexuscervicalis)
A carotiscommunisa -
*V jugularisinterna
-* \ M. slernocleidomastoideus
-
lslhmusglandula€thyroideae -
V. cervicalis superficialis li I
*V jugularisexlerna -
V transversacolli 5 \
s V. jugularisanterior / t M. omohyoideus - aM traDezius
V cephalica s
ta. t \
M. p€cloralismajor t R. Derforans(A thoracicainterna)O
\ a V thoracoacromialis 6 V axillaris
\
R. culaneusanteriorPectoralis Rr.perlorantes(A.;V thoracicainterna)a t V thyroideainleriorc
\
av.cephalica e M Pecloralis malor
I M sternocleidomastoideus
t Arcusvgnosusiugularis
+/,280 --f-
Fig.279 Veinsof the neck,Collum; the fasciasof the neckhavebeencompletelyremoved; and the on the left sidethe sternocleidomastoid pectoralismaiormuscleshavebeenpartially removed; ventralview (80%).
Neck,Collum
M mylohyoideus.
a M digastricus,Venteranterior
Os hyoideumq \\ M-hyoglossusar
\
\
\
a \ V. retromandibularis
I
/ ' M. mylohyoideus N. lingualis/ ' M. ,
aslricus,Venteranterior
i./"
\
t i , '/
\
/
!
t 7
,r'
/
A. lacialis
.....'
M s t e r n o h y o i d e u s- -a--
M . t h y r o h y o i d e u s-r-
--
M omohvoideusf --
* V thyroideasuperior * M sternocleidomastoideus
A thyroideasuperioro -V thyroidea superior* --
Ansacervicalis, Radixsuperior (Plexuscervicalis)
Cartilago thyroidea
V.jugularis exlerna* --
N vagus[Xl
Glandula thyroidea - -
/ *' V thyroideamedia
Plexusthyroideusimpar* - N. vagus[X]
N accessorius[Xll N phrenicus ,, Plexus brachialis, Parssupraclavicularis
..
\
A transversao : colli
V. transversa: colli
-
V jugularis'. anterior
-
-
A subclaviao -
V subclavia *
V brachio-* cephalica dextra
-
a M. omohyoideus Clavicula
o A. subclavia; . V jugularis externa
- 3 V subclavia -
V thyroidea * tnlenor
\ rl V cephalica \
-
V thoracicainterna*
c V jugularis interna
a M pecioralismajor
/ / I v. cavasuperior* / V brachiocephalica sinisira* Parsascendensaortaea
\
costa I \ o A. carotiscommunis; N. laryngeusrecurrens sinister
,rr#"t Fig. 280 Vessels andnervesofthe neck,Collum,andofthe upperthoracicaperture,Aperturathoracissuperior; deeplayer;the mid-portionof the clavicles,the first and the secondribs and the sternumhavebeenremoved: ventralview (80%).
Theconfluenceof V.jugularis interna and V. subclaviais known clinicallyasvenousangle.
Muscles,Vesselsand Nervesof the Neck
t M masseter
{l M splenius capitis I Lig nuchae I
4r.@
-
Glandula parotidea
--
adiPosus Panniculus
-
a M. longissimus capitis
-
o M semispinaliscapilis
-
Glandulasubmandibularis
| M trapezius -
Mstylohyoideusc/,.' t M .t e v a t o r s c a o u l a e o - ' I / -. M. splenius6grvigiS ' A carotisexlernaO ' o interna A carolis A carotiscommunis ' Ventersuperior M omohyoideus, internao V iugularis
a M digastricus,VenterPosterior
aM scalenusmedius -
a M longissimusceruicis -
Plexusbrachialis -
loV:A
--
subclavia
a M iliocostaliscervicis
-M scalenusanleriorc M. sternohvoidousa
t
a -M slernothyroideus M s u b c l a v i uTse, n d oe ' -
-
I M, serratus posterlor superlor
i -Mm intercostalesexterni intercostalis externaMembrana
--
a M iliocostalis thoracis
-maiora M pectoralis
t. Mm intercostales inlerni |
\
,l l'
t M serratusanterior
-
t
coar",,'
\
Costall
andnervesofthe lateralregionofthe neck, Vessels Fig. 281 Regiocervicalislateralis; deeplayer;the shouldergirdle hasbeenremoved;the splenius capitismusclehasbeenretractedsuperiorly,the spleniuscervicis and the levatorscapulaemuscleshavebeenretractedventrally; lateralview (r., 80%). Notethe courseof the subclavianvein on the ventral sideof the scalenusanteriormuscle,and the courseof the subclavianartery and the brachialplexusin the scalenegapbetweenthe scalenus mediusmuscles. anteriorandscalenus
Neck, Collum
Os nasale 1
(Cartilagonasilateralis)\ Seplumnasi \\ Toruslevatorius\
Sinussohenoidalis Alavomerissinistra i Ostiumpharyngeumtubaeauditivae; / Torustubarius Corpus | , Os sphenoidale,
\
Plica salpingopharyngea \
Cartilagoalarismajor, Crusmediale
/ //
Vestibulum nasi -
/ Tonsillapharyngea, (Bursapharyngealis); pharyngeus Recessus
/ Fasciapharyngobasilaris / Membrana atlantooccipitalis anterior
Naris / Maxilla--
/ Atlas[C ll, Arcusanterior 7'
Palatummolle - -[Velumpalatinum] - Plicasalpingopharyngea
' .z
',//
Ltg- apicis dentis
mediana / Articulatioatlantoaxialis / Arcuspalatopharyngeus Os c icir it3le
Foramen caecum linguae --
Lig.transversumatlantis
Caruncula sublingualis --
Tonsillapalatina M genioglossus.Mandibula
Lig cruciforme atlantis
-
* M. geniohyoideus M m y l o h y o i d e u s-*-
--
Lig.thyrohyoideum medianum,BursainfrahyoideaLig. hyoepiglotticum Cartilagoepiglonica-
---
- Corpusadiposumpreepiglotticum Lig. thyroepiglotticum
a iV
CartitagothyroideaPlicavestibularis; Ventriculuslaryngis;Plicavocalis -
- - -,
Spaiiumretropharyngeum Tuberculum cuneiforme Tuberculumcorniculatum posterius Lig.longitudinale M. arytenoideus iransversus: Lamina cartilaginis cricoideae Spatium epidurale
R. cricothyroideus (A.;V. thyroideasuperioO;a 6 Lig.cricothyroideum medianum
Duramaterspinalis
t
' Arcuscartifaginis cricoideae
Lig longitudinale anterius
Fascia cervicalis, Lamina superlicialis -
- -
Fascia cervicalis, Lamina pretrachealis -
Fascia ceruicalis, Lamina prevertebralis
lslhmusglandulaethyroideae(Spatium retrooesophageum)
V thyroidea inferior*. -' Arcusvenosusjugularis l M sternolhyroideus a
Trachea,Pariesmembranaceus \
\.'l I
\ I
oesophagus lspatiumoesophagotracheate)
Trachea
a Truncus brachiocephalicus
Fig.282 Head,Caput,andneck,Collum; paramediansection;the nasalseptumhasbeenpteserved; medialrespectivelylateralview (1.,80%). to openthe trachea. The arrowsmark the surgicalapproaches * coniotom)4 throughthe mediancricothyroidligament '" uppertracheotomy: abovethe isthmusof the thyroidgland * * * lowertracheotomy: b€lowthe isthmusof the thyroidgland
Median Sectionof the Head
ir#$
Palatum molle \ lvelum palatinuml \
/ Lig.hyoeFigbnicum
---
Eltglottis
--
OshyoiJeum
- -
M. constnclor pharyngismedius
--
Lrg.hYohyoideummdianum
. Dens-I rnc|srvus oris,M orbicularis Parslabialis
M.constnc{or pharynglssuP€nor
--
Cattilagothyroilea
- - M. aMerrixl€us Fanswfsus - - -
M geniohyoileus
--M mylohyoileuq/
I I
Lig.cticohyroiJ€unlmdianum Cartitagocti:oilea Fasciacervicalis, LaminasuPetlicialis
\ Cartilagines tracfreales
Glandulathyrordeal
Facial part of the head,Caput,and the neck' Collum; Fig. 283 median sectionthrough the head of a neonate; medialview (110%).
M. consticlor pharyngis inferior
neonatesand The position of the larynx is much higher in the 282' Fi8' to Compare adults. in than infants
N. maxillads [V/iZ]
I
[lxl N.glossopharyngeus N.vaousPq
Pharynx; Fig. 284 Sensoryinnervationofthe pharynx' medial view.
Neck,corrum
162
PlatysmaO Cartilagothyroidea , M slernohyoideus | \
\
/ Lig. vocale
\
,'
7 Cartilago cricoidea
7 Cartilagoarytenoidea / Recessuspiritormis
,'
/ O M. conslrictorpharyngisinterior O A. thyroideasuperior
M. slernothyroideus o -_
--
A. carotiscommunisO -_
D Truncussympathicus -z
Ganglioncervicalemedium {: \-
O M . l o n g u sc o l l i
N . v a g u s l x lf - V.iugularisintemao -a A. cervicalisascendens
M. slemocleido-o -masloideus
-
. N. spinatis[C5l
N. phrenicus* /
-
OViugularisexterna
./
M. scalenusanledorO /
/
- vertebra cervicalisV. CoDUs
M. scalenusmediusO /
--
M. levatorscapulaeO / M spleniuscerviciset captis O /
Spatiumsubarachnoideum Spatiumepidurale; O Piexusvenosus vertebralisinternus
- Periosleum
-/
M. semispinaliscarritis O / M. multifiduscervicisO /
Duramaterspinalis
/ \ o M. spinalis
M. trapeziusO Medullasdnalis
\
verlebra cervicalis lv. Proc.soinosus
Flg.285 Neck,Collum; transversesectionthrough the glottis; superior view. Notethe cenftl posiflon of the spinal canalin the middleof the neck.
'z
''
Sectionof theHead Transverse
lo ll ' \ M sternohyoideus M sternothyroideuso \ M sternocleidomastoideusa \
,a
7 Trachea
,
Nl vaous[Xl .-
OY jugularisinterna a V iugularis externa
_--
Oesophagus.- -- -
- -
NoduslymPhoideus lateralrs' ceruicalis inferior Nodusorolundus
Clavicula - -
-.---
M o m o h y o i d e u s-a-
aA carotiscommunis
-.-
M s c a l e n u s a- . anterlor
A cervicalis ascendens; N phrenicus
o
Plexrisbrachialrs
-
N laryngeus recurrens --
a V vertebralis -
* M scalenus
medius
-
/
o A vertebralis -
costa I
N spinalis - o M supra' spinatus
Vertebra/ l, thoracica Corpus Medulla spinalis thoracica
,tn
v thyroideainlerior
V thyroidea inferiora --
M longus colliO
lI ;t
anterior V jugularis
lsthmus glandulaethYroideae\--
Ivl scalenusa Posterior / M scalenusO meolus
I
-sc"prl"
-
\ o M. trapezius \
o M levatorscaPulae
l, Proc spinosus thoracica Vertebra
Fig.286 Neck,Collum; transversesectionthroughthe first thoracic vertebrain an elderlYPerson; inferiorview (80%).
164
rlpperLimb
Thenal Pollex [Digitus primusl r
IndexIDigitussecundusl Digitusmedius[ertiusl I I I
/
Palmalvolal I
M. brachioradialis
- I I | Digitusanularis[quartus] Digitusminimus[quintusl Hypothenar
I I I I Brachium,' Anlebrachium,l Regio Beoio - anlebrachii EPlCOndYluS brachii anterior antenor meorails
Plicaaxillarisanterior
' Regioaxillaris,Fossaaxillaris tricepsbrachii
Fig.287 Arm, Brachium; surfaceanatomy; ventralview(r., l5%).
I | Regio deltoidea, M deltoideus I I
I
j
(Radius) Proc.styloideus
Olecranon
brachioradiaris
, Dorsummanus Pollex[Digitusprimus] I | __ , Index[Oigilussecundus]
iM.
PlicaaxillarisDosterior- -
oigitr. mediusltertiusl i-l ' Digitusanularis [quartus] Digitusminimuslquintusl
M. latissimusdorsi I
Proc styloideus(Ulna)
M tricepsbrachii
Fig.288 Arm, Brachium; surfaceanatomy; dorsalview (r., 15%).
Limb,Ossamembrisupertoris of the UPPer Bones
165
Crngulum pectorale
- Articulatio humeroradialis
Pars libera membrl supenons
' --
- -'
Articulatioradioulnarisdistalis
radiocarPalrs Articulatio Articutatiomediocarpalis \-----
> - - -
carpometacarpales Articulationes Arliculationes metacarpophalangeae
Drgitimanus, Ossadigitorum: - Phalanx proxrmalts - Phalanxmedta - Phalanxdistalis manusdistales - - - - Articulationes interphalangeae - - -\
Upperlimb, Membrumsuperius; Fig.289 the skeletonand the articularregions; ventralview(r.,25%1.
166
upperlimb
Ioints of the upper limb, Articulationes membri superioris (Fig.289) Ioints of the shoulder girdle, Articulationes cinguli membri superioris Ioint Sternoclavicularj oint, Articulatiosternoclavicularis
Acromioclayicular j oint, Articulatio acromioclayicularis
Type of ioint Irregularjoint,Articulatio irregularis joint Functionally: spheroidal (special feature:Discus articularis) Planejoint,Articulatioplana joint Functionally: spheroidal (specialfeature:variable,often incomplete Discusarticularis)
Movement Rotation arounda sagittalaxis(elevating theshoulder), rotationarounda longitudinalaxis(forwardandbackwardmovement of the shoulder), rotationaroundthe longitudinataxisof the clavicle(swingingthe arm) Rotation arounda sagittalaxis(elevating theshoulder), rotationarounda transverse axis(swingingthe arm), rotationarounda longitudinalaxis (forwardand backwardmovement ofthe shoulder= protraction and retraction)
Ioints of the free upper limb, Articulationes membri superioris liberi Shoulder (hurnoral)joint, Articulatiohumeri Spheroidaljoint, Protraction Articulatio spheroidea Retraction
(flexion) Anteversion (extension) Retroversion
Abduction Adduction Medial rotation Lateralrotation (Circumduction:a combinationof anteversion, abduction,retroversionand adduction)
Elbow (cubital) joint, Articulatio cubiti joint, a) Humeroulnar Articulatiohumeroulnaris joint, b) Humeroradial Articulatiohumeroradialis
Hingejoint, Ginglymus
Flexion Extension
Spheroidaljoint, Articulatio spheroidea (functionally restricted)
Flexion Extension Rotation
c) Proximalradio-ulnarjoint, Articulatioradioulnarisproximalis
Trochoid (pivot)joint, Articulatio trochoidea
t_ rronailon
Distal radio-ulnar joint, Articulatioradioulnarisdistalis Ioints of hand a) Wristjoint, Articulatioradiocarpalis b) Midcarpaljoint, A-rticulatio mediocarpalis Carpometacarpaljoints Itr-V, Articulationes carpometacarpales
Trochoid (pivot) joint, Articulatio trochoidea
I
Ellipsoidjoint, Articulatioellipsoidea
) Ulnar abduction I Radialabduction I I Palmar flexion / Dorsalextension
Carpometacarpaljoint of the thumb, Articulatiocarpometacarpalis pollicis
Specialtype of hingejoint
I
Supination
Planejoints, Articulationesplanae
Very variable movements
joint, Sellar(saddle-shaped) Articulatiosellaris
Abduction Adduction Opposition Reposition
Metacarpophalangealj oints, Articulationes metacarpophalangeae Spheroidaljoints, Articulationesspheroideae (tunctionally restricted)
Interphalangealjoints, Articulationes interphalangeae manus
Hingejoints, Ginglymi
Flexion Extension Abduction. Adduction* ("relativeto the middle finger) Flexion Extension
ctavicuta ctavicte, 161
Corpusclaviculae \
Extremitas acromialis
Extremitas sternalrs
Fig. 290 Clavicle,Clavicula; superiorview (1.,707o).
Facies articularis acromialis
Corpusclaviculae \ sternalis\ Extremitas
Extremitas acromialis ---Faciesarticularis sternalis
-
Foramennulnctum
lmpressioligamenti cosloclavicularis
Linea trapezotdea
conoideum Tuberculum
Sulcusmusculisubclavii
Fig. 291 Clavicle,Clavicula; inferior view (1.,707").
I
Clavicula
,
Discusarlicularis Lig inlerclaviculate
- Capsulaarticularis costalisl/ Cartilago
a
sterni/ Manubrium
/ manubriosternalis Symphysis
--
anterius Lig sternoclaviculare
radiatum / Lig.sternocostale
\ Cartilagocostalisll
sternoSternoclavicularjoint,Articulatio Fig.292 clavicularis; the right joint hasbeenexposedby a frontal section; ventralview (70%).
(rpperLimb
168
I |
Incisura scapulae
li,
fuberculum supraglenoidale \ t, Proc coracoideus .
, Maroosuoerior / Angulussuperior _ Fossa - - supraspinata
Acromion-
- Spina. scaourae
cavitas--
Tuberculuminfraglenoidale/
!
glenoidalis
/i l
Anguluslateratis/
t -
/
"n'J**:f"""i i\
Facies posteflor
Facrescostalis-
Margolateralis/
i
lAngulusinferior
Fig.293 Scapula,Scapula; dorsalview (1.,35%).
Fig.294 Scapula,Scapula; lateralview(1.,40%).
,Aciomion I | / Faciesarticularis / clavicularis
AngulussuperiorMargosuperior- Fossa - -
\ Cavilas
\
glenoidalis
- Acromion
\ collu. scapulae
2\- - Margo laleralis
Sternum-
I I Angulusinferior
Fig.295 Scapula,Scapula; ventralview (1.,35%).
:\ :\ i\
\\
\\
Planummedianum'
Fig.296 Shouldergirdle,Cingulumpectorale; superiorview (1.). Theanglesshownare meanvaluesfor an adult. ' median plane r r scapular plane
-numerus169 Caputhumeri \
/ sulcus intertubercularis / Tuberculummaius
\
Collumanatomicum- -
/
/ Capul. n.umefl
Tuberculummaius -
Tuberculum- mtnus
Cristatuberculi- mrnons
- - - Cristatuberculimaioris
- - - Sulcusnerviradialis
----
Margomedialis\ Faciesanleromedialis\
Fossacoronoidea\
Epicondylus/ medialis
FacigsDosterior
\\ \
/
\
/ Cristasupraepicondylaris lateralis
-- Fossaradialis --Epicondylus laleralis
/ I
Trochleahumeri/
Trochlea humeri /
Condylushumeri\
\ Sulcusnerviulnaris
Fig.298 Humerus,Humerus; dorsalview(1.,45%).
Fig.297 Humerus,Humerus; ventralview(1.,45%).
Tub€rculumminus Sulcusintertubercularis \ - Collumanatomicum Inserlionof the tendonsof: 1 M. supraspinatus 2 M. infraspinatus 3 M teresminor
Tuberculummaius - -/-
/
Fig.299 Humerus,Humerus; proximalview(1.,100%).
I
I70
upperlimb
Lig coracoacromiale \\
- - -
M. supraspinalus -__
----
Lig coracoclaviculare, Lig. lrapezoideum
Bursasynovialis Lig. coracoclaviculare, Lig. conoideum
Proc.coracoid€us
--Lig coracohumerale ---*
Tuberculum maius--
Lig.transversum scapulae suoenus lncisurascaoulae Bursasubtendineamusculi subscapularis
-M subscapularis,Tendo - Vaginatendinisintertubercularis - Collumchirurgicum
Capsulaarticularis, - (superius) Ligg.glenohumeralia: - (medium) - (inferius)
M. bicepsbrachii,Caputlongum-CristatuberculimaiorisSulcusintertubercularis
Tuberculuminfraglenoidale
\ Crista tuberculi minoris
(Recessusaxillaris)
Fig. 300 Shoulderjoint, Articulatio humeri; ventral view (r., B5%).
Proc.coracoideus I
Lig transversumscapulaesuperius
Lig coracohumerale I
Spina scapulae
Tuberculum majus -
Caosulaarticularis
Fig. 301 Shoulderjoint,Articulatiohumeri; the acromionhasbeenremoved; dorsalview (1.,85%).
Articulatiohumeri I Il I
M supraspinatus
Bursasubacromialis I
,/ Ltg
coracoacromlale
-
Proc coracoideus
M suorasOinatus'----
maius -Tuberculum M inlraspinatusr--
--
-M teres minol'-
Lig.coracohumerale
M subscaPularis'
Vaginatendinisintsrtubercularis
-*
-
M. biceos brachii,CaPut longum
M subscapularis'
* Thesemuscular tendons constitutethe so-calledrotator cufi
Shoulderjoint,Articulatiohumeri; Fig. 302 hasbeenremoved; muscle the deltoid lateralview(t.,70%1. Lig acromioclaviculare \ Lig coracoacromiale\
t-
-
Acromion\
Extremitasacromialis Clavicula,
\
\\ M supraspinatus
Spinascapulae
M infraspinatus
M teresminor
Capsulaarticularis
Fig. 303 Shoulderjoint, Articulatio humeri; dorsalview (1.,B0%).
M triceosbrachii,CaPUtlongum
172
upperLimb /
Facies articularisclavicularis
/ M supraspinatus Lig coracohumerale
---
M biceps brachii,Caput longum, Tendo
* -
Labrum glenoidale
- -
Cavitas glenoidalis
.-.-
Vaginatendinisintertubercularis --
--
Caput humeri
Scapula
M biceps brachii,Caput longum, Tendo - \ (Recessusaxillaris)
Fig. 304 Shoulderjoint, Articulatiohumeri; sectionin the scapularplane; ventralview (r.,80%). * ossifiedepiphysealplare
Proc coracoideus/
/
Lig. coracoacromiale /
-
Cavitas glenoidalis
Labrum glenoidale /
- -
M tricepsbrachii,Caputlongum
Fig. 305 Shoulderjoint, Articulatiohumeri; the joint capsulehas been sectionedalong the glenoid lip; the head of the humerus has been removed; lateral view (1.,80%).
Shoulderloint, Articulatio humeri
173
majus-Tuberculum infraglenoidale Tuberculum Tuberculum minus-Margolateralis / Sulcusinlertubercularis
:.:I
J
Fig. 306 Shoulderjoint, Articulatiohumeri; AP-radiograph;standing,arm hanging loosely,scapula with parallelto the planeof the film (joint in O-position planes movement); main of all three regards to ventralview (r.).
i,4 deltordeus.Pars clavicularis .-
-
Tuberculum minus -
Sulcusinterlubercularis; M. bicepsbrachii, Caputlongum,Tendo
- -
majus Tuberculum
- -
Parsacromialis M deltoideus,
Labrum glenoidale -
- -
Capulhumeri
Cavitas glenoidalis -
- -
humeri, Articulatio Cavitasarticularis
- -
Parsspinalis M. deltoideus,
--
M. inlraspinatus
M coracobrachialis
M subscapularis Scapula-
Fig. 307 Shoulderjoint, Articulatiohumeri; cross-sectionalimage through the centre of curvature of the humeral head obtainedwith computedtomography(CT); upper arm in central position; the joint cavity has been filled with air (pneumo-CT); inferior view (1.).
174
upperlimb
Incisuratrochlearis \
\\
--
Olecranon
Proc. coronoideus IncisuraradialisTuberositasulnae - -
-
Caputulna€--
- -
Cristamusculi suDinatoris
Facies medialis
- Circurnlerentia arlicularis
Fig.308 Ulna,Ulna; ventralview (1.,50%).
Fig.310 Ulna,Ulna; radialview (1.,50%).
Proc.styloideus ulnae
Fig. 309 Ulna,Ulna; dorsalview (1.,50%).
Radius 175
--
Foveaarticularis
--
Circumlerenlia articularis Faciesanterior
Corpusradii Corpusradii
Margoanterior--
--
Margointerosseus Faciesoosterior
--
Margoposteriol
/ lncisuraulnaris
- -Proc.styloideusradii ---
--
Faciesarticularis carpalis
Proc.styloideusradii
Fig.313 Radius,Radius; ulnarview(1.,50%).
Fig.311 Radius,Radius; ventralview (1.,50%). \ I
Tuberculumdorsale
Proc styloideusradii
Fig.312 Radius,Radius; dorsalview (1.,50%). * groovesand crestsfor the extensortendons
176
trpperlimb
Humerus Lig. anulareradiiI
Trcchloahumed
Collumradii;
i
M. Ucepsbrachii,TendoI
-
Circumfefgntia \ ariicularis \
--
Epicondylu meorails Proc.coronoidgus
Corpusulnae, Faciesanterior
Fig. 314 Elbowjoint, Articulatiocubiti; the distancebetweenthe componentsof the joint hasbeenenlarged; ventralview (r., 55%).
Fig. 315 Elbowjoint, Articulatiocubiti; 90oflexionand90osupination; medialview (r.,55%).
Corpushumeri / Corpus humeri
/
/ Capsulaarticularis
/ Capsulaarticularis, Mehbrana librosa
/
Lig collaterale-ulnare
Epicondylus lateralis
- Lig.collateraleradiale
Epicondylus- - lateralis ---( Lig.collaterale radiale
--
oecranon
Lig.anulareradii--Lig. anulareradii \ \
Collumradii M. bicepsbrachii,Tendo
Chordaobliqua-
Fig. 316 Elbowjoint, Articulatiocubiti; ventralview(1.,55%).
Fig. 317 Elbowjoint, Articulatiocubiti; dorsalview (1.,55%).
Etbowloint, Articulatiocubiti
r17
i M. triceps brachii, medtale ,' Caput
l
N ulnaris
+
M brachioradialis \.
Septum intermusculare brachiimediale
H u m e r u s\
carPr\ M extensor radialislongus
M pronator teres,CaPUt humerale
Epicondylus \
Eprcondylus medialis
taterails
\
- / Trochlea humeri
Lig collaterale \ radtale \
- - Sulcusnervi ulnans
C a p i t u l u m- humerl
--
Lig anulare radrl
--
Caput radii M extensor carpi radialts brevls
--
-
M supinator/
Lig collaterale ulnare Mm tlexores, Caput commune '1
Proc coronotoeus
/
. /' Lrg quadratum
/' 'M.
/Bursa
\
brcipitoradialis
bi""oa uracnii,tendo
M. pronatorteres' caput ulnare
radii 6 Tuberositas 7 Proc coronordeus humeri 8 Trochlea I Olecranon medialis lO Epicondylus 1'1CristasuPraePicondYlaris medialis
Fig. 319 Elbow joint, Articulatio cubiti; AP-radiograPh.
Fig. 318 Elbowjoint, Articulatiocubiti; frontal section; ventralview (r., 55%).
/
2 3 4 5
Crista suPraePicondYlarrs lateralis Epicondyluslateralis Capitulumhumeri Caput radil Collum radii
M triceps brachii
Fossa olecrant \
Fossa coronordea
M triceps\ brachii, t. Tendo
V mediana cubiti
Bursa subculanea olecranl
A brachialis M pronator teres
- N medianus
)l
I Trochleahumeri
IA ulnaris
radialis 'I Humerus Fossaolecrani Olecranon lncisurairochlearis Ulna
2 3 4 5
Fig. 320 Elbowjoint, Articulatiocubiti; sagittalsection; medialview (1.,607").
Fig. 321
6 Radius 7 Collumradii I Caputradii 9 Proc coronotdeus 10 Fossacoronoldea
Elbow joint, Articulatio cubiti;
lateral radiograPh
178
trpperltmb / Tuberositasradii
/Tuberositas ulnae
/ Proc.coronoideus Lig anulareradii --
, Incisura Itrochlearis
anulareradii tLig. trochlearis I / Arliculatioradioulnaris proximalis
joint,Articulatio Fig.323 Proximalradio-ulnar proximalis; radioulnaris ventroproximal view(r.,B57o).
Chordaoblioua -
- Radius
Faciesposteriorl
Faciesposterior posterior / Margo Margines inlerossei
/, Radius - Facies laleralis
Margo / antenor Membranainterosseaantebrachii
Fig. 324 Crosssectionthroughthe bonesof the forearm; distalview (1.,115%).
I Articulatio radio- ,
ulnarisdistalis, Capsulaarticularis
Fig.322 Connectingstructures of the bonesof the forearm; the annularligamenthasbeensectioned; ventralview (1.,50%).
Proc.styloideus -_ utnae
Articulalio radioulnaris distalis'
I Faciesarticulariscarpalis
Fig. 325 Distalradio.ulnarjoint,Articulatio radioulnarisdistalis; the articulardischasbeenseparated from the radiusandpulledto the ulnarside; dorsodistal view(r.,B5%).
manut ossa Hand, 1 7 9 Os scaphoideum \ TuberculumossisscaPhoider 1 ossistrapezii\ Tuberculum Os trapezium- Os trapezoideum Os hamatum Proc.styloideus-_ lll ossismetacarpi
Hamulusossishamati Basisossismetacarpi
l-Os metacarpi
*--
Corousossismetacarpi
--Ossasesamoidea
---
CaPutossismetacarPi
Corpusphalangis
Phalanxproximalis-
- Tuberositas phalangisdistalis
Phalanx distalis-
-
I U III IV V
Pollex[DigitusPrimus] Index[Digitussecundus] Digitusmedius[tertius] Digitusanularis[quartus] Digitusminimus[quintus]
Fig.326 Bonesofthe hand,Ossamanus; the distancebetweenthe boneshasbeenenlarged; palmarview (r.,70'/"1.
180
rrpperLimb Radius\ Os lunatum\ Proc.styloideusradii \
\
Os scaphoideum 1
\
/ Ulna / Caputulnae
\\
/ Proc styloideusulnae \
Os capitatum Tuberculumossistrapezii Ossacarpi
Ostrapezium----
- - - Os hamatum,Hamulus ossishamati
--Ostrapezoirleum Os metacarDi ---
--Ossasesamoidea
Ossametacaroil-V
Caputossismetacarpi --t Phalanx Droximalis - -
Ossadigitorum
Caputossismetacarpi/
/ / Caputphalangis '/ / / Basisphalanois/ // Corpusphalangis/ /, / Corpusphalangis/
.
\ Phalanxmedia --Pharanxdistalis
Caput phalangis
Phalanx distalis /
\ Ph"l"n, proximalis
Fig.327 Bonesof the hand, Ossamanus; palmar view (r., 50%).
,'l /
/ Fladius
Tuberositasphalangisdistalis/
,, Os lunatum Proc.styloideus ulnae --Oslriquetrum--Os pisiforme- Os hamatum Basisossismelacarpi----
Pro" styloideus radii ---_-'
Os scaPhoideum
----
Oslrapezoideum
- - .nrti"rt"tio caroometaI carpalispollicis' fu \ Os capitatum - Os metacarpiI \
\
\ Articulatiomelacarpoohalanoea oollicisr' \ Phalanx proximalis
\
Phalanx distalis
\ Phalanx Droximalis
Fig.328 Bonesofthe hand,Ossamanus; dorsalview (r.,50%). ' also called sellar ioint of the thumb '* also called proximal phalangeal ioint of the thumb
Corpusphalangis/ Caputphalangis/
Iointsof theHand,Articulationes
Articulatioradioulnaris distalis,Caosulaarticularis Proc styloideusulnae
Radius
--
Ptoc styloideusradii
Os lunatum
Lig ulnocarpalepalmare Lig. radiocarpale Palmare Os pisiforme---
Lig pisohamalum
Lig.carpiradiatum -
Lig. pisometacargale
Hamutusossishamali / Lig.carpometacarpale oalmare
ArticulatiocarpometacarPalis pollicis, Capsulaarlicularis
os capitatum
l-
I
Ligg. palmaria
Ossa sesamoidea
I
/
I
Fig.329 Iointsandligamentsof the hand,Articulationeset Ligamenta manus; palmarview (1.,75%).
Ligg. metacarpalia. transversa prolunda
Lio. - radiocarpale\ dorbale
//
-Proc styloideusradii
Ligg.inlercarpdia dorsalia
/ -/ - Os scaDhoideum
- dorsalia Ligg.intercarpalia Os trapezoideum
Ligg. carpometacarpalia dorsalia -
Fig. 330 Jointsand ligamentsof et LiSamenta the hand,Articulationes manus; dorsalview(1.,75%).
Proc.styloideus
-
Os triquetrum -
Os hamatum -
Os capitatum
Ligg. metacarpalia dorsalia
Ligg. collateralia
metacarpophalangeao' Articulation€s Cetrsulaearliculares
I82
upperLimb
Proc ' z styloideus radii
.- Faciesarticularis carpails
Proc - styloideus radii
----Ulna Tuberculum dorsale
I
\Tuberculum dorsale
Froc styloideusulnae
I t^ Haotus
Fig.331 Radius,Radiusand ulna, Ulna; d i s t a lv i e w ( 1 . , 7 5 % \ .
Fig. 332 Radiocarpaljoint, Articulatio radiocarpalis; proximal articularsurface distalview (r.,7 5'/"\.
Articulatio radioulnaris distalis Ulna \ Caputulnae \ Articulatioradioulnarisdistalis \
Os triquetrum- Lig collaterale carpiulnare --
Articulatiomediocaroalis --
/ / Os trapezoideum
Os hamatum- -
---
Os lraPezium - - Articulaliocarpometacarpalis
Lig intercarpale interosseumtl r
Articulationes carpometacarpales
,//:
Ligg metacarpalia interossea /
,i--
lrI,|'
,'\:
tt'
,'
;i\ 1'l
I
Fig. 333 Intercarpaljoints,Articulationescarpi; section parallel to the dorsal aspectof the hand.
* metacarpi I
Finger loints,Articulationesdigitorum
-
183
Os metacarpi
- Os metacarprpollicis
Lig collaterale\ - -
Arliculatio metacarpoPhalangea, Capsula articularis
M flexor pollicisbrevis--
/
Ossa sesamoidea
Lrg collaterale-
M llexor polhcislongus -
- -f Articulationes interphalangeaeI
-
Phalanx media *-
Lig collaterale
Fig. 334 Fingerioints,Articulationesdigiti; lateral view
joint ofthe thumb, Fig. 335 Metacarpophalangeal pollicis; Articulatio metacarpophalangea radiopalmarview (r.). A transverseligament betweenthe sesamoidbonesintegrates the radial and lateral collateralligaments into a common joint' ligamentoussystemwhich limits the extensionof the
Cavitas medullaris
Os metacarpi
(Cartilago articularis) Phalanx proximalis - -
- Articulatiometacarpophalangea Caosula articularis
Tendo - -
Caputphalangis
Fig. 336 Fingerjoints,Articulationesdigiti; sagittalsection;lateralview. Notethat the flexor creasesdo not appeardirectlyover the joint cavity.
1Artlculatiointerphalangeamanus distalis*" - - Phalanx medra
joint) * cliniOal:MP (= metacarpophalangeal *' c l i n i c a l :P I P ( = p r o x i m a li n t e r p h a l a n g e aj ol i n t ) * * * clinical: DIP (= distal interphalangealjoint)
I84
rrpperlimb
Proc.styloideusulnae-- - _ - - Tuberculumossisscaphoidei
- - - BasisossismetacarDill Hamulusossishamati-
Ossametacaroi/
- Phalanx media
\
Fig.337 Hand,Manus; PA-radiograph. Notethat the pisiformboneis projectedonto the triangularbone.
Phalanxdistalis
ofthertpperLimb 185
R1 forces workingon the scapula Fs -- forcosworkingon the scapulaandon the apparatusholdingthe scaPula loint Fsr forcesworkingon the sternoclavicular Frh for@onlhethorax Fsa tractionforceson M. seriatusanlerior
Fig.338
whenthe arm is abducted' Ratioofforceson the shouldergirdle
Fc lor@ olthe weight of the arm FAb forcs of the abduclot musdes Rr resultingforceof F6 and F16 Fs torce of the adductingmuscles Rs resultingforce in the shoulderioinl
Fig. 339
Ratioof forceson the shouldergirdle when the arm is slightly abducted.
Fpr lorceol the flexingmuscleson the elbowjoint Fs weightol what is heldin the hand R5 resultingforcein the elbowjoinl
Fig. 340
Ratio of forceson the elbow joint when the arm is'flexed'
upperlimb
186
/ M trapezius
Clavicula \
--
M pectoralismajor, -Pars clavicuiaris
Y ceghalica
-
- -
"
--
N intercostobrachialis
/ M. triceps brachii Caput laterale
M teres major
M triceps brachii, Caput longum
V basilica--
-
M biceps brachii M brachialts -
- - laterale / ,, -brachii /
N cutaneus antebrachii medialis
- M triceps brachii \ Septum Intermusculare brachiimediale
N musculoculaneus, N cutaneus antebrachii lateralis Aponeurosis musculibiciprtis brachii
/ Septumintermusculare
/
N cutaneus brachiimediahs
N medianus--
V mediana cubiti
M biceps brachii, Caput breve
--
N. cutaneus brachii posleflor
/-
M bicepsbrachii
--- N cutaneus posterior antebrachii
M triceps brachii, Caput mediale
--
Olecranon :
M brachioradialis -
\ Epicondylus medialis
-
Spina scapulae
Epicondyluslateralis
M anconeus
M extensorcarpi radialislongus
/ -
M flexor carpi ulnaris
-
/
--
M extensor carpi radialis brevts
M extensor carpi ulnaris M tlexor carpi radialis
N radialis,B superficialis
---
M brachioradialis,--
M p a l m a r i sl o n g u s
Tendo
N cutaneusanlebrachii medialis
M extensor digitorum
M extensor digiti minimi /
- -
M flexor carpi ulnaris /
antebrachii Mm extensorescarpi radiahs,Tendines
Fig. 341 Fasciaof the flexor musclesof the upper limb; ventral view (r., 25"/"1.
M extensor pollicisbrevis - -
Capul ulnae, Proc styloideusulnae
- Aponeurosis palmaris
M abductor pollicislongus
/
Retinaculum muscurorum extensorum
\ M extensor pollicislongus, Tendo
Fig.342 Fasciaof the extensormusclesof the upper limb; dorsal view (r., 25"/"\.
Limb oftheuPPer Musctes t 87 M traoezaus M. levaior scaDulae --
/ M spleniuscervicis 'Venterinferior ,M. omohyoideus' / M. slernocleidomastoideus
medius-M scalenus --M. scafenusDostetior M scalenusanlerior -Acromion
-
M. slernohyoideus
-
Clavicula
-l Spinascapulae pectoralismajor M. trapezius -
M. deltoideus
Fasciainfraspinata M. teresminor
M. pecioralismaior,Parsabdominalis
M. teresmajor -M. tricepsbrachii,Caputlongum
z M. serratusantenor
'
M. tricepsbrachii,Caputlaterale
-
dorsi M. latissimus
-Arcus costalis - - VaginamusculirectiaMominis, Laminaanterior
-
M. tricepsbrachii,Tendo "
\
brachiilaterale Seotumintermusculare M tricepsbrachii,Caputmediale
--
M. obliouusexternusabdominis
M biceos brachii M. brachialis
teres M oronator
- - Epicondyluslateralis
Olecranon --
M extensorcarpiradialislongus
M. anconeus - M brachioradialis M extensordigitorum
- - M. extensorcarpiradialisbrevis
- - M. flexorcarpiradialis
Tendines M extensordigitorum,
- - M. llexorpollicislongus - M. abductorPollicislongus --
extensorum--\ musculorum Retinaculum
M. extensor oollicisbrevis - M. extensorpollicislongus,Tendo - - M. abductorpollicislongus,Tendo - M. extensorpollicisbrevis,Tendo - M. adduclorPollicis
Mm.interosseidorsales
Fig. 343 Musclesof the upperlimb,the thoraxand the inferiorpart of the neck; lateralview (r.,23%1.
188
(rpperLimb M. levatorscapulae\ M longuscapitis \\ M. scalenus medius-.- __M. scal€nusanterior- -
I M. scalenus i posterior
\ )
I I
Acrom
M. deltoideus
//
Clavicula
M. omohyoideus, Ventersup€rior/
/
---1 M omohvoideus. ') ventei inferior ,
_, -/-, -' "{--4 Mm.sternocleidom astoidei
{
---
-
--t"'l
\\\\
M biceps brachii, CapullorEum M. biceps brachii, Caput breve
M coracobrachialis
M.teresmaior Mm intercoslales inle.ni -'
-- -
Mm. intercostales exlerni
M. subscapularis
M serratusanlerior M. latissimusdorsi
" --
M senalusanlerior
M. pecloralisminor / -
M. latissimusdorsi
.?
M. pecloralismajor //
- -
M. rectusabdominis
Arcuscoslalis / - -
Lineaalba /
Fig.344 Musclesof the arm,the thoraxandthe inferior part of the neck; the left shoulderhasbeenretractedby a hook; ventrolateral view (1.,30%). f Caputlongum- * M. bicepsbrachiiI ( Caput breve - -*
M. oblhuus€xt€rnusabdominis
Theribs are numberedI, II, IV to VII
'{J. _- -
_ -
Humerus vaginatendinisinlerlubercularis
Lig. coracoacromiale
Clavicula/
N suprascapularis \\ Lig.lransversumscapulaesup€rius--
Spinascapulae
Fig. 345 Shoulderand musclesofthe shoulder; the deltoidmusclehasbeenremoved:the end of the claviclehas beenmadetransparent; superiorview (r., 60%).
' Thesetendonsconstitutethe-so{alledrotatorycuff (compareto Fig.302).
oftheshoulder Musctes 1 19 I M subclavius
Clavicula 1 Proc. coracoideus \
M deltoideus Capsulaarticularis- - Articulatioacromioclavicularis, A c r o m i o n- - - -
Lig conoideum li}. coracoclaviculare, ----
Venterinleriol M. omohyoideus, -
- (Bursamusculicoracobrachialis) M o€ctoralisminor M biceps brachii, Caput breve
M serralusantenor minor M. rhomboideus
-.-
M coracobrachialis
M. deltoideus/ Vaginatendinis / interlubercularis
M. levator scaPulae
-
M. supraspinatus --\ Lig transversumscapulae ll supenus
--
// / .z
-
M. subscapularis
1
M. pectoralismaior /
/
/ dorsi,Tendo M. latissimus
- M rhomboideus malor
// \
M tricepsbrachii,Caputlaterale
-
'-j M bicepsbrachii, Caputlongum
- M. teresmaior
M. coracobrachialisM biceos brachii, Ciout breve
Margomedialis
/
M triceps brachii' Capul longum
\
'
Fig. 346 Shoulderand musclesof the shoulder; some of the superficial muscleshave been removed; ventral view (r., 45%).
*
\ M. serratusanterior Capsulaarticularis, (Ricessusaxillaris)
triangular space,Spatium axillare mediale quadrangular space,Spatium axillare laterale
"
Venterinferior / M omohyoideus,
scaPulae M levator \
7 Acromion
/ Bursasubdeltoidea Angulussuperior
M rhomboideus mlnor M supraspinatusM trapezius -
--
f.
Spinascapulae M. rhomboideus-malor - - - M. tricepsbrachii' Caput longum --
M teresminor -
M. teresmaior -
/
Angulusinlerior dorsi M. latissimus
/
//
/ M serlatusanterior
/
Fig.347 Shoulderandmusclesof the shoulder; dorsalview(r.,45%).
* "
triangular space, Spatium axillare mediale quadrangular space, Spatium axillare lat€rale
Fascia brachii
upperlimb
190
Lig coracoacromiale, , M biceps brachii,Caput longum, Tendo
Bursasubacromialis \
Lig trapezoideum
/
/, Lig coracohumerale
M supraspinatus*-
/ M subclavius
M deltoideus \
' ,
-
\
\
\ \
' Capsulaarticularis
M. oectoralis malor
Fascia oectoralis
Fasciaoectoralis. (Hiatusvenaecephalicae) Lig conoideum
Proc coracoideus lBursa musculi coracobrachialis)
M pectoralisminor
\ M bicepsbrachii,Caputbreve M coracobrachialis
M teresminor*/ / Cavitasglenoidalis Labrum glenoidale /
\ Bursasubtendinea musculisubscapularis \ M subscapularis'
/ M triceps brachii, Caput longum
Fig. 348 Shoulderjoint, Articulatiohumeri; the humeral head has been removed; lateral view (r., 90%).
t The tendonsof these musclesconstitute the srcalled rotatorv cuff
Ventralmusclesof the shoulder(Figs.344,346,348,B1B,819) Miiegtor;ilsm1|6lr,a,i.,nr.-iiim.*n..iiiir'"tiii""'rali!un,6ioyortm*t,,i*tli*,i.,;'u.una.,oo*tl..,"tiiahrlii+horrtderg[dlemuscles,M.pds
mlnor,Ivlsubclavius,andM.subscapularls.T'later.reaches'fomlte-anteriorsufaceoflhesqqP.uIatgihurruj:.:] Mtscld Innemation 1. M. pectomlis maior , NrLpecbmls medlattsand : ii' Iabmlls (Plet
,r::r
,::,
,:::r,
rrhr:,
Origin Pars clavicularis: Clavicula (sternal haif) Pars sternocostalis: Manubrium and
Corpussterni,Cartilasocostalisof I st to 6ih ribs Pars abdominalis:rectussheath '::l (anteriorlayer)
(2nd)3rdto 5th ribs (closeto the .t:ii: 'lr. bonecartilageborder)
.
3. M. subclavlus N. subclavlus (Plo.us bmchlqlis, Par6spmclavirzlar&] 4. lll" subscapularls NtL subs€g,pulares (Plotus bmchlalls, Parsl,rfrtclqvhulails) lilr,
:ii::.
::lilr:
::1i::
Apexof Proc.coracoideus scapulae
lst rib (closeto thebonecartilage border)
Clavicula, lateralthird,thefascia is connectedto the advenutiaof v subclavia
Facies costalis, Fossasubscapularis
part Tuberculum minusandadiacent
.::,
:::, l:i::
Insertlon Cristatuberculimajorishumeri
Function Shoulderjoint: Adduction(esp.whenthe arm is elevated), medialrotation, Parsclavicularis:anteversion Shoulder Sirdle: Depression, anteversion, lifts the upperribs when the shoulderglrdle is fixed Thorax: Lifts tle sternumand enlarges the thorax(assistsin extreme inspiration) Shoulder girdle: Depression, lifts the upperribs when the shouldergirdle is fixed Thorax: Enlargesthe thorax (assistsln extreme inspiration) Shoulderglrdle: (little effectivity), Depression resistantto lateralpulling on the clavicle Shoulderglrdle: Medialrotation,abductionin the scapularplane(cranialpart): adduction in the scapularplane (caudalpart)
313,:i:1#:Ti1['jili3lil,'.i$"1"]i:1X underthe insertion)
Movementof the ShoulderJoint
T9I
longitudinalis
Retroversio (Extensio)
Axis transversalrs
interna
Fig. 349 Shoulderjoint; movementin the sagittalplane.
Fig. 350 Shoulderjoint; movementin the frontal plane.
Fig. 351 Shoulderjoint; movementin the transversePlane
Lateral musclesof the shoulder (Figs.343,345, 347,348) fromit by the Bursa separated is founddeeper, M. supraspinatus influences the surfaceanatomyof the shoulder. considerably M. deltoideus It runs undirneaththe Fornixhumerioler the shoulderjoint to the humerus. subdeltoidea. lvluscle/ Innervation
Origin
Insertion
Function
l. M. deltoideus N. axillaris (Plexus brachialis, Pats i nfrac lavicularis)
Pars clavicularis: Acromial third of clavicle
Tuberositasdeltoidea (Bursa subdeltoideabetween m u s c l ea n d g r e a t e rt u b e r c l e )
Shoulder joint: Pars clavicularis:Adduction (from
Pars acromialis: Acromion Pars spinalis: Inferior margin o f S p i n as c a p u l a e
2. M. supraspinatus N. suprascapularis (Plexusbrachialis, Parssupraclavicularis)
F o s s as u p r a s pni a t a , F a s c i as u p r a s p i n a t a
60 degieesmoreandmoreabducanteversion tion),medialrotation, Abductionto the Parsacromialis: horizontal plane Pars spinalis: Adduction (from 60 de$ees more and more abduct i o n ) ,l a t e r a lr o t a t i o n ,r e t r o v e r s i o n all parts: support the weight of the aIm
P r o x i m a lf a c e to f t h e S r e a t e r tubercle
Shoulder joint: Abduction in the scaPularPlane to the horizontal Plane,lateral t'otailon
Dorsal muscles of the shoulder (Figs.347,348) M- teresminor,M. teresmaior.M. latissimusdorsiis a trunk-armmusclev/ith its originon the Fromcranialto caudalthereare:M, infraspinatus, back,it is locatedcranialt0 M. teresmaJor. Insertion
lduscld Innervation
Origin
1. M. infraspinatus N. suprascapularis (Pletusbrachialis, ris) Parssupraclavieula
I n f e l i o r s u r f a c eo f S p i n as c a p u l a e , M e d i a l f a c e to f t h e g r e a t e r tubercle F o s s ai n f r a s p i n a t aF, a s c i a infraspinata
2. M. teresminor N. a,
C a u d a ls e c t i o no f F o s s a i n f i ' a s p i n a t am , e d i a lt h i r d o f Ivlargolateralis
Distal facet of the greater tubercle
, n g u l u si n f e r i o r M a r g ol a t e r a l i sA
C r i s t ao f l e s s e rt u b e r c l e{ m e d i a l o f M . l a t i s s i m u sd o r s i ) ;t h e t w o tendons are separatedllY Bursa s u b t e n d i n e am u s c u l il a t i s s i m i dolsi C r i s t ao f l e s s e rt u b e r c l e( w i t h f l a t , s p i l a l t e n d o na r o u n dM , t e r e s m a i o r ) ;t h e t w o t e n d o n sa r e s e p a r a t e db y B u r s as u b t e n d i n e a m u s c u l il a t i s s i m id o r s i
Procc.sninosi of the 6 lotver thoracii veltebrae,lumltar vertebrae(by Fasciathoracolumb a l i s ) ,F a c i e sd o r s a l i so f t h e s a c r a l b o n e ,l a b i u m e x t e r n u mo f C r i s t a i l i a c a( ( l o r s a tl h i r d ) ; r i b s 9 t o l 2 ; often further origins from Angulus inleriol scapulae
Function Shoulder joint: Cranial part: lateral rotation, a6rluctionin ttre scaPularPlane Caudal part: lateral rotation, aIIuctioffi the scapularPlane Shoulder joint: Lateral rotation, adduction in the s c a p u l a rp l a n e Shoulder joint: Medial rotation,adduction in the s c a p u l a rp l a n e
Shoulder joint: Lateral rotation,adduction, retrovelslon Shoulder girdle: of the A d d u c t i o na n d d e P r e s s i o n Scapula
I92
rlpperlimb
M trapezius \
M. deltoideus -
M p€ctoralismaior --
M. t6r6sm4or
- - M. latissimusdorsi M. bic€psbrachii -
- - M. triceps bracfiii, Capul longum
M. braciialis -
- - S€pftrmintermuscularebrachii laterale
M. brachioradialis -
- M. tric€ps brachii, Capul modial€
-
M. iriceps brachii,T€ndo
M. extensorcarpi radialislongus - -
Eilcondylus lateralis -
M. extensorcarpiradialisbrevis -
Fig. 352 Musclesof the brachialregion; dorsolateral view (1.,45%).
MusctesoftheArm 193
/
--
Clavicula
M subclavius --
Lig coracoclaviculate --
M supraspinatus
P(oc.coracoideus --
Venlerinferior M omohyoideus,
M oectoralisminor --
superius scapulae Lig lransversum
M coracobrachialis
-
--
M deltoideus
M biceps brachii, Caput breve, Tendo
M subscapularls -. -
M. pectoralismajor,Tendo
M. teresmajor - M biceosbrachii,Caputlongum,Tendo
M triceosbrachii,Caputlongum
M triceps brachii,Caput mediale
--
M bicepsbrachii,Caputlongum
--
M bicepsbrachii,Caputbreve
-
Seotum intermuscularebrachii mediale M brachialis
medialisEPicondylus brachii musculibicipitis Aponeurosis
--
M. bicePsbrachii' Tendo --
M brachioradialis
--
M extensorcarpiradialislongus - M extensorcarpiradialisbrevis
Fascia antebrachii
-
Fig. 353 Musclesof the brachialregion; ventralview (1.,40%). * triangular space,Spatium axillare mediale * " q u a d r a n g u l a sr p a c e S , p a t i u ma x i l l a r el a t e r a l e
I94
rtpperlimb
//
M trapezius
- M pectoralis minor
-
-
---
---
M. deltoideus
Vaginatendinisintertubercularis
M biceps brachii,Caput breve
M bicepsbrachii,Caputlongum
\ N musculocutaneus - M dettoideus \ Corpushumeri M tricepsbrachii,Caputlongum
M triceps brachii,Caput mediale --
Septum intermuscularebrachii mediale --.
Epicondylus mediatis-. --
M. brachialis,Tendo
Fasciaantebrachii--
Aponeurosis musculibicipitis brachii-
M brachioradialis
---
M extensor carpiradialislongus M biceos brachii.Tendo
M biceps brachii --
Fig. 354 Musclesof the brachialregion; deeplayer;the deltoidmuscleand the bicepsbrachii muscle have been partially removed; ventralview (1.,40%).
MusctesoftheArm 195
M infraspinatus
M. triceps brachii, Caput longum
M t e r e sm i n o r- - Collumchrrurgicum M biceps brachii,Caput longum' Tendo
M leres mtnor
-
M pectoralismajor,Tendo --! M teres malor
Sulcusneruiradtalis--
-
M triceos brachii,Caput laterale
M biceps brachii --
--
M tricePsbrachii,Caput medlale
brachiilaterale Seotumintermusculare
M brachioradialis-
--
M extensor carpi radialis longus
M extensor carpi radialisbrevis
M lriceos brachii,Tendo
--
- -
-M extensordigitorum
Fig. 355 Musclesof the brachialregion; deep layer;the deltoid muscle has been partially removed; dorsalview (1.,45%). * triangular spa(ie,Sl)atiumaxillare mediale - * , l u a d r a n g u l asr l ) d 't ' . s l ) a t i u ma x i l l a r el a t c r a l e
196
upperLimb
Ventralmusclesof the arm (Figs.352-354) M. bicepsbrachiiformsthe surfaceanatomyof the ventralsideof the arm.Closeto its caputbreve(shorthead)is M. coracobrachialis. Thedeepest is M. brachialis. MuscIe Innervati.on
Origin
Insertion
1. M. bicepsbrachii N. musculocutaneus (Plexusbrachialis,Pars infraclavicularis)
Caput longum: Tuberculum supraglenoidale, Labrum glenoidale(tendonthrough shoulderjoint)
Tuberositas radii (Bursa Shoulderjoint: bicipitoradialis), Aponeurosis Caputlongum:abduction, musculibicipitisbrachiito anteversion, medialrotation Fasciaantebrachii Caputbreve:adduction, anteversion, medialrotation
Caput breve: Apex of Proc. coracoideus (lateralof M. coracobrachialis)
Function
BothDartstogether:support the weightof the arm Elbowjoint: Flexionandsupination
2. M. coracobrachialis N. musculocutaneru (Plexusbrachialis,Pars infraclavicularb) Normallythe N. muscuiocutaneusgoesthrough M. coracobrachialis
Apex of Proc.coracoideus (medial of Caput breve of M. bicepsbrachii)
Faciesanterior humeri (medialand distal of Crista tuberculiminorisl
Shoulderioint: Adduction, anteversion, medialrotation
3. M. brachialis N. musculocutaneus (Plexusbrachialis,Pars infraclavicularis)
Faciesanteriorof humerus Idistal of Tuberositas deltoidea,betweenthe Septa intermusculariamedialeand lateralel
Tuberositas ulnae
Elbowjoint: Flexion
Dorsal musclesof the arm (Figs.352,355) M. tricepsbrachiiis the biggestof the dorsalmusclesof the arm.It is thres.headed. Onits ulnar:sideM. anconeus follows ,i,:' asa prolongation of Caputmedialeandruns into the fbrearm. ::ir ri::. Muscle Innervation
Origin
Insertion
Function
1. M. triceps brachii N. radialis (PlexusbrachialE, Parsinfraclavicularis) Caputlongumoperates twojoints; Caputlateraleand Caput medialeoperateonejoint
Caputlongum:Tuberculum infraglenoidale, inferiorpart of Labrumglenoidale
0lecranon(Fibresof Caput longum take a longitudinal course,thoseofCaput mediale and lateralean obliquecourse They have a common broad tendon)
Shoulderjoint: (Caputlongum), Adduction supportthe weightof the arm Elbowjoint: Extension
posterior Facies ulnae,distal of olecranon
Elbowioint: Extension
2. M. anconeus N. radialis (Plexusbraehialis, Pars infraclavicularis)
Caputmediale:Facies posterior humeri(medial anddistalof Sulcusnervi radialis), Septumintermusculare brachiimediale Caputlaterale:Facies posterior humeri(lateraland proximalof Sulcusnervi radialis), proximal2/3 of Septumintermusculare brachiilaterale Epicondylus lateralis, the lateralpartof Caputmediate musculitricipitisbrachii
of theArm, Origtnsand Insertions Muscles
M trapezius\ M pecloralisminor\ \\ \ M. deltoideus\
tM. I
subclavius
,/ M. sternocleidomastoideus
I
- -
M. oecloralismaior, Pais clavicularis'
\
Lig costoclaviculare
M. coracobrachialis \
M. biceosbrachii, Caput breve M. supraspinatus--
--
M. subscaDularis M. biceps brachii, Capul longum
M. latissimusdorsi M tricepsbrachii,Caputlongum M. teresmajor / M. pectoralismaior / M deltoideus/
\
\ --
r97
M. omohyoideus,Venter inlerior
\
M. serratusanterior
\
M. subscaoularis
M serratusanterior
M. coracobrachialis
M brachialis
M. brachioradialis , M. pronatorteres, humerale /' Caput / , Epicondylusmedialis
M articulariscubiti \ M exlensorcarpi\ radialislongus M. extensorcarPi radialisbrevis M. supinalor/ M. bicepsbrachii/ M. llexordigilorumprolundus/
M. flexorcarpiradialis M palmarislongus M llexorcarpiulnaris,Caputhumerale superticialis' M. flexordigitorum Caouthumeroulnare -ulnare pronalor Caput teres, M. -M. brachialis \ M flexorcarpiulnaris, Caputulnare \ \ M. llexordigitorum superlicialis Y-/ -
/
Fig. 356 Muscularoriginsandareasof insertionon the clavicle,scapula,humerusandproximalpartsof the radiusandulna; ventralview (r.).
Venterinlerior M. omohyoideus,
t M trapezrus
M sternocleidomasloideus \ M subclaviusM sternohyoideuspectoralismajor,ParsclavicularisM. levalorscapula M supraspinatus/ minor / M rhomboideus
/
M deltoideus
/ M supraspinatus M. inlraspinatus _/ -
--
M. infraspinatus/
M. teresminot / M tetesmaior /
M triceosbrachii, Caoutlaterale -
rhomboideusmajor
-
| M latissimusdorsi! (Origoscapularis,Var')
M. teres minol M triceps brachii, Caput longum
M. delloideus
-
M. brachialis
-
Foramen nulriclum
M tricepsbrachii,CaPUtlaterale
M. lricepsbrachii,Caputmediale -
M brachioradialis
intermusculareSeotum ' brachiilalerale
Fig.357 Muscularoriginsandareasof insertionon the clavicle,scapula,humerusandproximalpartsof the radiusandulna; dorsalview (r.).
-
M. extensordigitorum;. M. exlensorcarPluhans
\ M. anconeus
198
upperlimb
-
M tricepsbrachii, .--Caput mediale
M biceps brachii
Septum.intermuscula{e -_ olacnilmedrale
- Aponeurosis musculibicioitis brachii Epicondylusmedialis -
M palmaris longus -
-
M biceps brachii. Tendo
M. brachioradialis
M flexor caroi radialis -
M flexorcarpiulnaris -
M. extensor carpiradialislongus
M flexordigitorumsuperlicialis --
- M extensorcaroiradialisbrevis
--
M- flexorcarpiulnaris,Tendo --f
I
, M. tlexorcarpiradialis, Tendo --f
--
M abductorpollicislongus
--
M brachioradialis,Tendo
--
M tlexor pollicislongus
-
M palmaris longus,Tendo --
M flexordigitorum superficialis
M abductorpollicislongus,Tendo
\ M pronatorquadratus \ Retinaculum musculorum extensorum
Fig. 358 Anterior antebrachialmuscles; ventralview (1.,50%).
oftheForearm I99
M brachialis
M triceosbrachii,-Caoutmediale
Seotumintermusculare brachiimediab
M. supinator Bursabicipiloradialis
Tendo-M. biceDsbrachii,
M. palmarislongus---
radialislongus M exlensorcarpi
--
M pronatorteres
M flexorcarpiulnalis-M. flexor caroi radialis --
-superlicialis' M. llexordigitorum Caouthumeroulnare
-superficialis M flexordigitorum -
longus M. abductorPollicis
M llexorpollicislongus
Tendo--M llexorcarpiulnaris,
M. pronatorquadralus
Tendo--_ M llexorcarpiradialis,
M. exlensorPollicisbrevis, Tendo Tendo M. brachioradialis,
M palmarislongus,Tendo--
Fig. 359 Anterior antebrachialmuscles; middle layer; the long palmar muscle and the radial ttexor muscle of the wrist have been partially removed; ventral view (1.,50%).
200
UpperLimb
M tricepsbrachii,Caputmediate- -
Septumintermusculare brachiimediale --
M brachioradialis
ri\ Epicondylusmedialis --
--
M. supinator
--
M bicepsbrachii,Tendo
--
M extensorcarpiradialislongus
M pronatorteres --
Mm llexores, Caoutcommune- -
M flexorcaroiulnaris---
M oronatorteres
M flexordigitorumsup€rlicialis- -
- -
M. abduclorpollicislongus
M tlexorcarpiulnaris.Tendo - - M flexorpollicislongus
M pronatorquadratus M. flexorcaroiradialis.Tendo M palmarislongus,Tendo
'
M abductorpollicislongus,Tendo M. brachioradialis, Tendo
Fig. 360 Anterior antebrachialmuscles; middle layer;the superficialflexor muscleshavebeen partially removed; ventral view (1.,50%).
Musclesof theForearm
brachiimediale-Seotumintermusculare -
M brachialis
medialis Epicondylus - M brachioradialis
M oronator teres.CaPutulnare--
--
M biceps brachii,Tendo
---
Radius.Faciesanterior
-A ;V interossea Posterlor
-M flexordigitorum Profundus --
M extensorcarpiradialislongus
M flexorpollicislongus,Caputhumerale- - - M. oronatorteres M flexorcaroiulnaris-- M tlexorpollicislongus Caputradiale - - M flexordigitorumsuperficialis,
prolundus, Tendines M. flexordigitorum - -
M flexor Pollicislongus,Tendo
Tendo-M flexorcarPiulnaris,
Tendines superlicialis, --M flexordigitorum
--
Tendo M. brachioradialis,
---
quadratus M Dronaior
--
M palmarislongus,Tendo- - -
Fig. 361 Anterior antebrachialmuscles; deep layer; the suPerficialflexor muscleshave been PartiallY removed; ventral view (1.,50%).
----
Radius. Facies anterior
Tendo M flexorcarpiradialis,
common muscular origin of the superficial flexors (Mm flexores,Caput commune)
20r
202
IrpperLimb
/ Septum intermuscularebrachii mediale
M brachialis-
M extensor carpiradialislongus-*.
_--
Capitulum humeri--.
- -
extensor carpiradialisbrevis- Lig collaterale radiale /
Humerus, Epicondylus medialis Lig collateraleulnare Trochlea humeri
M brachialis, Tendo
N radialis, -R protundus M pronator teres,Caputulnare
- Bursabicipitoradialis M biceps brachii,Tendo --
(Bursacubitalis Inlerossea) Chordaobliqua
M s u p i n a t o- -r
M flexorpollicislongus
M flexorpollicislongus-M llexor digitorumsuperficialis,Caput radiale -
--
profundus M flexordrgitorum
M pronator leres- -
Membrana interossea antebrachii M tlexorpollicislongus--
M exlensor carpi radialislongus --
--
M abductor pollicislongus - M brachroradialis,Tendo --
M extensor pollicisbrevis,Tendo- -(
M opponens pollicis
_-
M pronatorquadralus
_-
M llexot carpi radialis, Tendo
-..
Retinaculummusculorumflexorum
_ -
Os pisiforme
_-
M a b d u c t o r d i g i tm i inimi,Tendo M o p p o n e n sd i g i t im i n i m i
--
M abductorpollicisbrevis -_ M flexor pollicisbrevis, Caput superficiale--
M flexordigiti minimi brevis
_-
M flexor pollicislongus, Tendo --
Mm lumbricales
M t l e x o r d i g i l o r upm r o l u n d uTs e , n d i n e-s- - - - /
M flexorcarpiulnaris. Tendo
--/-/
- / -l
--
M flexordigitorum supedicialis,Tendines
- \
M abductor digiti miniml
l--
Fig.362 Anterior antebrachialmusclesand musclesof the hand; deeplayer;the superficialflexor muscleshavebeenremoved; ventral view (r., 45'/"1.
oftheForearm Musctes 203 ventral muscles of the forearm, superficial group (Figs.358-360) carpirqdialis,M' palmati$'longus, Fromradialto ulnarthe superficialmusclesof the forearmare:M. pronatorteres,M. flexor ulnaris' carpi andM. flexor M. flexordigitorumsuperficialis Function. Insertion Origin Muscle Innervation Elbowjoint: Caput humerale: EPicondYlus Facieslateralisradii 1. M. pronatorteres Pronation, Caputhumerale: (medial third) interSeptum humeri, medialis N. medianus flexion mediale muscularebrachii (Plexusbrachialis, Caputulnare:Pronation Parstnfraclavicularis) Faciesmedialis Caput ulnare: ulnae (distalof Proc. coronoideus)
2. M. flexor carpi radialis N. mediantn (Plexus brachialis, Pars infraclavicularis)
3. M. palmaris longus N. medianus (Plexusbruchiatis, Pars infraclavicularts) (variable) 4. M. flexor digitorum superficialis N. medianus (Plexusbrachialis, Pars infraclavicularis)
5. M. flexor carpi ulnaris N. ulndris plexusbrachialis, iiri iiiaiioiicrk *l
Elbowjoint: pronation Flexion, Wrist joint: Palmarflexion, radialabduction Elbowjoint: Aponeurosis Palmaris Epicondylusmedialis,Fascia Flexion antebrachii Wrist joint: Palmarflexion,tensionof palmaraponeurosis Elbowjoint: Flexion of bases the 4 long tendonsto Caput humeroulnare: the rnedial phalangesof, Eficonaytus meclialishumeri, Wrist joint: Flexion,ulnar fingers2-5 Pioc.coionoideus abduction Caput radiale: Faciesanterior Articulationes meta(II-V): radii (distalof M. Pronator carpophalangeae teres) Flexion,adduction Articulationes interphalangeae(Il-V): Flexion Elbowjoint: Os oJ caput humerale:Epicondylus os piriforme,basis medialishumeri,Septuminter- metacarpiV andOshamatum Flexion and Wrist joint: (byLigg.pisometacarpale brachiimediale musculare pisohamatum) Palmarflexion,ulnar caput ulnare:olecranon, abduction ulnae(uPPer MargoPosterior 2,/3),Fasciaantebrachii
Epicondylusmsdialis humeri, Fiscia antebrachii
Basisof -os metacarpill (often III)' palmar surface
* Regardingthe wrist palmar flexion is also called flcxion; dolsal flexion is called e\tension
Ventral muscles of the forearm, deep group (Figs' 361,362) pollicislongusand the distal quarteris Tothis groupbelonS:mediallythe M. flexordigitorumprofundus;laterallytheM. flexor quadratus. coveredby the M. pronator Function* Insertion Origin Muscle Innervation Basesof the distalphalanges Wrist joint: Palmarflexion Faciesanteriorulnae 1. - M. flexor digitorum of fingers2-5 Articulationesmeta(proximal2,/3),Membrana piotuttA,rs " (II-V): interossea carpoPhalangeae IJInarpart: N. ulnari.s, adduction Flexion, radial part:N. medianus (Plexusbrachialis, ArticulationesinterPars infraclavicularis) (II-V): Flexion phalangeae joint: Palmarflexion Wrist Caput humerale: Epicondylus Basisof Phalanxdistalisof 2. M. flexor pollicis longus t n u m D t h e h u m e r i metamedialis Articulatio N. medianus (I): (Plexusbrachialis, carpophalangea Caput radiale: Faciesanterior adduction Opposition, Pars infraclavicular is) radii (distalof Tuberositas radii) Articulatio interphalangea(I): Flexion Radio-ulnarjoints: MargoandFaciesanterior MarSoanteriorulnae(distal 3. M. pronatorquadratus Pronation radii quarler) N. interosseus-anteri.or (N. medianus, Plexusbrachi' a lis, Parsinfi'acIavicular is) ( l o r s a lf l c x i o n i s c a l l c ( lc x t c n s i 0 n ' I l e g a r ( l i n gt h c \ { r i s t l ) a l m a rf l c x i o n i s a l s r rc a l l c df l c x i o n ,
204
(rpperlimb
M. biceosbrachii- -
-
M. tricepsbrachii,Caputlalerale
Seotumintermusculare brachiilaterale
M. brachioradialis--
M. tricepsbrachii,Caputmediale M tricepsbrachii,Tendo
M exlensorcarpiradialislongus -
--
M. extensorcarDiradialisbrevis -
M. anconeus
--
M tlexorcaroiulnaris
M brachioradialis, Tendo -
M. extensorcarpiradialislongus,Tendo -M. extensorcaroiradialisbrevis.Tendo - -
pollicisbrevis M. extensor M. extensordigitorum
M abduclorpollicislongus M. abductorpollicislongus,Tendo-_
/
M. extensorpollicisbrevis,Tendo -_
M. extensor digitiminimi
M. extensorcarpiulnaris
M. extensorcarpiradialisbrevis,Tendo--
Ulna M exlensorpollicislongus,Tendo
M. exlensorcarpiradialislongus,Tendo-' Radius //
/
-
Retinaculummusculorum enensorum
Fig. 363 Antebrachial musclesandmuscles of the distalpart of the upperarm; lateral(radial)view(1.,45%). positionbetween Theforearmis in an intermediate pronationandsupination.
oftheForearm Musctes 205
M brachialis
-
- - Seotuminlermusculare brachiilalerale
M. brachioradialis !t'
carpiradialislongus M. extensor
- -
M. triceDs brachii, Caput mediale
- M. triceosbrachii,Tendo
- -
- M. an@neus
-carpiradialisbrevis M extensor - M. flexorcarpiulnaris
digitorum- M. oxtensor
- -
- -
longus-M abduclorPollicis
M extensor Dollicis brevis
-
--
M extensor carPl ulnarls
M. extensordigiti minimi
ulnaris'Tendo M extensorcarpi
Tendinesdigitorum, M. extensor carpiradialislongus,TendoM extensor -carpiradialisbrevis,Tendo M extensor Radius-
Antebrachialmusclesand musclesof the Fig. 364 distal part of the uPPerarm; dorsolateralview (1.,50%). The forearm is in an intermediateposition between pronation and suPination.
206
upperlimb
Septumintermusculare brachiilaterale-M tricepsbrachii,Tendo
_-- -
M tricepsbrachii,Caputmediale
---
Olecranon
M extensor carpiradialislongus---
Mm. extensoresdigitorumet digiti minimi--
-
- -
M. anconeus
M. tlexorcarDiulnaris
M extensor caroiradialisbrevis---
M supinator--
M extensor caroiulnaris
Fladius- M. pronator teres,Tendo- -
M abductorpollicislongus-
digilorum, Tendines z M. extensor
I M. extensorpollicislongus- f
z M. exlensorcarpiulnaris,Tendo
M. extensorindicis- ' M extensor oollicisbrevis--
z Ulna
M extensor caroiradialisbrevis.Tendo- M extensorcarpiradialislongus,Tendo- - ] -M extensorpollicisbrevis,Tendo--1 pollicislongus,Tendo-M extensor
M. extensorcarpiulnaris,Tendo \ M. extensor digitiminimi,Tendo
Fig. 365 Antebrachial muscles; the extensormuscleof the fingers,M. extensor digitorum,andthe extensormuscleof the little finger, M. extensor digiti minimi,havebeenpartiallyremoved; dorsolateral view (1.,45%). Theforearmis in an intermediate positionbetween pronationandsupination.
oftheForearm 207
Olecranon lateralis Epicondylus
- Lig collateraleradiale Lig anulare radii - -
carDiradialisbrevis---M extensor
M supinator M flexorcarpiulnaris
Corpusulnae radii- CorPUs teres,Tendo-M pronator M extensorpollicislongus--
pollicislongus-M abductor
indicis M extensor
pollicisbrevis\ M extensor Radius\
- -
Membranainterosseaantebrachii
\ longus,. M abductorPollicis tenoo \\ caroi M extensor ' radialisbrevis,-- \ : Tendo
--
Tendo M exiensorcarpiulnaris,
--
Caputulnae
pollici. - M extensor T#l.d
--
extensorum' musculorum Retinaculum
- extensorum' musculorum Retinaculum carpiradialislongus'-M extensor I enoo -
Ligg carpometacarpalia dorsalia
M extensor indicis,Tendo --
dorsalislll M interosseus dorsalislV M interosseus
pollicislongus,extensor I enoo dorsalisll M interosseus
dorsalis| / M interosseus Os metacarpi ll
/
Fig. 366 Antebrachialmusclesand musclesof the hand; deeplayer;the superficialextensormuscleshavebeen removed; dorsolateralview (1.,45%). The forearm is in an intermediateposition betweenpronatlon and supination.
\ M extensor digilorum,Tendines
extensorum nave The tendon sheathsformed by the Retinaculummusculorum been longitudinallYexPosed
208
upperLimb
Humerus\ / Humerus z Seplumintermusculare brachiimediale M brachioradialis \
- Seotumintermusculare brachiimediale
M brachioradialis M bicepsbrachii --
N medianus
M. biceps brachii
N radialis. R orotundus--
-
Lig collaterale radiale
Lig collalerale radiale -
-
M bicepsbrachii, Tendo
Aponeurosismusculi ' bicipitisbrachii
--
N radialis, R profundus
N medianus
- Aooneurosis musculi biciDitisbrachii -
- M pronatorteres, Caputulnare M biceps brachii,
M supinator
/
-
Tendo
M oronatorteres. Caouthumerale
M supinator - M palmarislongus
M pronatorteres - M palmarislongus -
M. flexor caroi radialis
Radius -
M flexor caroi radialis
Membranainterosseaantebrachii -
Radius
-M pronatorquadratus -
-M pronatorquadralus
Canaliscarpi
M brachioradialis, Tendo
/
Supinatio
Fig.367 Forearmin supination; ventral (palmar) view (r., 40%). The arrows mark the direction of pull generated by the main supinator muscles.
je,on"tio
Fig.368 Forearmin pronation; elbow:ventral view; hand: dorsal view (r.,40"/'1. The arrows mark the direction of pull generated by the main pronator muscles.
Movementof the UPPerLimb
209
Axis rotationis
Axis lransversalls
Extensio Fig. 369 Elbowjoint; movementin the sagittal Plane.
Fig.370 Elbowjoint; of the hand. turningmovements
AMuctio radialis
Fig.371 Wristjoints; in the sagittalPlane. movement
Fig.372 Wristjoints; in the frontalPlane. movement
Margolateralishumeri, Septumintermusculare brachiilaterale
Proc.styloideusradii
Margolateralishumeri (distal lateralis, part),Epicondylus bracNi Septumintermusculare laterale
II, Basisof OsmetacarPi dorsalsurface
lateralishumeri, Epicondylus Lig.anulareradii
III, Basisof OsmetacarPi dorsalsurface
Elbow ioint: suPination Flexion,pronation,
Elbow ioint: suPination Flexion,pronation, Wrist ioint: Dorsalflexion,radial abduction
2I0
(rpperlimb M. brachioradialis -
/,M brachialis
M extensor carpi radialis longus \
M exlensorcaroiradialisbrevis --
M flexor digitorumsuperficialis, Caoul humeroulnare
\ M. pronatorteres, Caputulnare \M brachialis r \ M flexorpollicislongus \ \ Chordaobliqua
\ M. bicepsbrachii M flexordioitorum suoerficialis. Caputradiale
\ M llexorcarpiulnaris, Caputulnare
M. pronatorteres --
\ M. llexordigitorum prolundus
M llexorpollicislongus
tM pronatorquadratus
Membrana interossea antebrachii
M pronatorquadratus
M. brachioradialis
Fig.373 Muscularoriginsandareasof insertion on the radius,ulnaanddistalpart of the humerus; ventralview (r.).
triceps brachii,Caput mediale
Seotumintermusculare brachiimediale - -
M. brachioradialis
M triceosbrachii:M. arliculariscubili - --M tricepsbrachii Epicondylus medialis--Mm tlexores. Caoutcommune/ M anconeus --
- M extensorcarpiradialislongus - - Epicondylus lateralis -M extensor caroiradialisbrevis \ M extensor digitorum \
M extensorcarpiulnaris
M. flexorcaroiulnaris / profundus-M llexordigitorum M extensor carpiulnaris- - Membrana interossea antebrachii--M extensorpollicislongus
--
M pronatorteres
' - - M. abductorpollicislongus
---
M extensor oollicisbrevis
M. extensorindicis -M abductorpollicislongus M. exlensordigitiminimi-. M. exlensordigitorum - M. extensorcarpiulnaris -'
M. extensorpollicisbrevis M extensorpollicislongus M extensorcarpiradialislongus M. exlensorcaroiradialisbrevis
Fig. 374 Muscularoriginsandareasof insertion on the radius,ulna anddistalpart of the humerus; dorsalview (r.).
sctesoftheForearm 2Il Dorsal muscles of the forearm, superficial group (Figs.363-365) To this groupbelong(fromradial to ulnar):M. extensordigitorum,M. extensordigiti minimi, and M. extensorcarpi ulnaris Muscle/Innervation
Origin
Insertion
1. M. extensordigitorum (communis) N. radialis (Plexusbrachialis, Pars infraclavicular is)
Epicondyluslateralishumeri, Ligg. collateraleradiale and anulare radii, Fascia antebrachii
of Dorsalaponeuroses fingers 2-5
2. M. extensordigiti minimi N. radialis (Plexusbrachialis, Parsinfi'aclavicularis)
Epicondyluslateralishumeri, Ligg. collateraleradiale and anulare radii, Fascia antebrachii
of finger5 Dorsalaponeurosis
3, M, extensorcarpi ulnaris N. rad.ialis (Plexusbrachialis, Pars infraclavicularis) from Separated M. extensordigitorumand M. extensordigiti minimi by a distinct Septum intermusculare
V, Caputhumerale:Epicondylus Basisof OsmetacarPi dorsalsurface lateralishumeri,Lig. radiale collaterale Caputulnare: Faciesposterior ulnae(proximal2/31, Fasciaantebrachii
Function* Elbowjoint: Extension Wrist joint: Dorsalflexion,ulnarabduction Articulationes metacarpophalangeae(II-V)/ (II-V): interphalangeae Extension Elbowjoint: Extension Wrist joint: Dorsalflexion,ulnarabduction Articulatio metacarpophalangea(V)/ interphalangea(V): Extension Elbowjoint: Extension Wrist joint: Dorsalflexion,ulnarabduction
* Regardingthc wrist palmar flexion is also called flexion, dorsal flexion is called extension
Dorsal muscles of the forearm, deep group (Figs.365, 366) Theupperthird of the radius(lateralside)is coveredby M. supinator.Distalfollow(frornlateralto medial):M. extensorpollicis longus,M. extensorindicis,M. abductorpollicislongus',M.extensorpollicisbrevis. Origin
Insertion
Function"
1. M. supinator N. radialis (Pla<usbrachtalis, Parsinfraclavicularis) so-calledsupinatortunnel for R. profundusof N. radialis 2. M. extensorpollicis longus N. radialis (Plexusbrachialis, Pars infraclavicuIaris)
lateralishumeri, Epicondylus radialeand Ligg.collaterale anulareradii,Cristamusculi supinatoris ulnae
Faciesanteriorradii (proximalanddistalof radii) Tuberositas
Radio-ulnarjoints: Supination
posterior ulnae Facies (distalquarter), Membrana interossea
Phalanx distalis of the thumb
3. M. extensorindicis N. radialis (Plexusbrachialis, Pars infraclavicularis)
Faciesposteriorulnae (distalquarter), Membrana interossea
of the Dorsalaponeurosis indexfinger
Wrist joint: Dorsalflexion,radialabduction Articulatio metacarpophalangea(I): adduction Reposition, Articulatio interphalangea(I): Extension Wiist joint: Dorsalflexion,ulnarabduction Articulatio meta(II): carpophalangea adduction Extension, Articulatio interphalangeal(II): Extension
Muscle/lnnervation
C o n t i n u a t i o n+ p 2 1 2
2I2r*,rlimb
--
M palmarislongus,Tendo
M. Dalmaris brevis - -
Hypothenar--(
\
Mm. lumbricales
I Fig. 375 Muscles of the hand; palmar view (1.,70%\.
If no palmaris longusmuscleexists(20%),the palmaraponeurosis is proximallyattachedto the Retinaculummusculorumflexorum.
Dorsalmusclesof the forearm,deepground (Continuation) MruscleJInnervation 4. M. abductor pollicis longus N. mdialis (Plexusbrachialis, Parsinfraclavicularis)
Origin Faciesposteriorulnae, Membranainterossea, Facies posteriorradii
Insertion Basisof OsmetacarpiI
5. M. extensorpollicis brwis N. mdialis (Plexttsbmchialis, Parstnfraclwicularis)
Faciesposteriorradii, Membranainterossea
Thumb,basisofPhalanx proximalis
* Regarding the wrist palmar flexion is also called flexion, dorsal flexion is called extension
Function* Radio.ulnar joints: Supination Wrist ioint: Palmarflexion,radial abduction Articulatio metacarpc. phalangeapollicis: Extension Wrist joints: Palmarflexion, radialabduction Articulatio carpometacarpalis poUicis: Abduction,reposition Articulatio metacarpo. phalangeapollicis: Extension
heathsoftheHand 2I3 V€gina tendinis musculi tlexoris pollicislongi
/
flexorum\ musculorum tendinum Vaginacommunis
/
M flexor carDiulnaris,Tendo --
VaoinatendinummusculorumaMucloris lonii el extensorisDollicisbrevis
/
vaginatendinismusculiflexoriscarpiradialis
/
musculorum flexorum Retinaculum
M opponens Pollicis
-
M abductordigiti minimi -
M llexor oollicisbrevis
- -
M aMuctor Pollicis brevis
-
M llexor digiti minimi brevis -
1
M opponens digiti mrnimi -
Vagina tendinis musculi llexoris pollicislongi
-
M adductor Pollicis, Caput transversum
tendinum/ Vaoina communis flexorum musculorum
M lumbricalisI
Vaginae synovialesdigitorum manus -
i
I
)
Fig. 376 Synovialsheathsof the tendons, Vaginaetendinum,of the hand; p a l m a rv i e w ( 1 . , 7 0 % 1 .
Hypothenar muscles (Figs.375, 376, 379, 381, 382) Tothis groupbelong(fmmoutsideto inside):M. abductordlgiti miuiml,M. flexordigfti mlnhl b$st/tqM"9rymrys dlsld nlniml regionls M. rylqarls brwis. Themuscleof the skin in 68 hJpothenar Function Insertion Origin Muscle Innervation Tensesskin,ofhypothenar Skin of hypothenar lponturosispalmaris, L M. palnaris brode :i:iliiiii:l: region medialmargin(occasionally N. ttlrurts,ns,rpeffid.giii::;::;: :::'::',;,1;;1:f 11111 (Plausbmdrlalis, 0s trapezium ) Parctnfuclavtcularts) (se\reral budlcs) separated C o n l i n u a t i o nJ l ) 2 1 4
upperLimb
2L4
/ Fascia antebrachii
Fletinaculummusculorumftexorum
N ulnans N medianus M . f l e x o rp o l l i c i s - - - - - - - - : I
l o n g u sT, e n d o
,i 1;E
- * - Hamulus ossishamati
Vagina lendinis musculi - -- flexoris pollicislongi
il---
M llexor
Mesotendineum - -
Tendines M flexor carpi radialis, - '- Tendo Os trapezium .-
- Vagina communis tendrnumusculorum flexorum
Vagina tendinis musculi -' flexoris carpi radralis
7*- - r,afrexordigilorum prolundus Tendines
Llgg carpometacarpalia palmaria Os trapezoideum -
\ os hamatum
Os capitatum /
Fig.377 Palmarcarpalsynovialsheathsof the tendons,Vaginaetendinum; transversesectionthrough the carpalcanalat the levelofthe carpometacarpal loints; distal view (r., 175"/"\.
a
90%
b 5 % 5y.
Figs.378 a-d Typicalvariationsof the palmar synovialsheaths of the tendons.
c
<1%
d
<1%
Within thesesheathsinflammatoryprocesses may spreadrapidly, thereforethey must be handledcarefullyduring surgery
Hypothenar musCles (Continuation) Muscle Innervation
Origin
Insertion
Function
2. M. abductor digiti minimi N. uLnaris, R. profundus (Plexusbrachtalis, Parsinfraclavicularts)
Os pisiforme, Lig pisohamatum,Retinaculu m musculorumflexorum
Dorsalaponeurosis of the little finger
3. M. flexor digiti minimi breyis N. ulnaris,R. profundus (Plexusbrachialis, Parsinfraclavicularis) (variable)
Retinaculum musculoru m flexorum, Hamulusossis hamati
Basis of the Phalanx proximalis of the little finger
joint (V) Carpometacarpal 0pposition joint (V) Metacarpophalangeal Abduction Interphalangealjoint (V) Extension joint (V) Carpometacarpal 0pposition
4. M. opponensdigiti minimi N. ulnaris,R. profundus (Plexusbrachialis, Pars infraclavicular is)
Retinaculum musculorum flexorum, Hamulusossis hamati
joint (V) OsmetacarpiV,ulnarsurface Carpometacarpal Opposition
Metacarpophalangeal joint (V) Abduction, flexion
- -
Membrana Inlerosseaantebrachll
quadratus pronator
-M brachioradialis,Tendo
M flexor pollicislongus,Tendo Lrg radiocarPalePalmare Vagrnatendrnismusculi llexoris carpi radialis
- -
- -
1,,4tlexor carpi ulnaris,Tendo
--
M flexor digitorumprofundus,Tendines
.- -
m u s c u l o r u -mvagrna tendinum longiet extensorls abductoris
os pisilorme
pollicisbrevrs
Retinaculummusculorumllexorum M abductorPollicrsbrevls
- -
-
.- .-
--
M flexor pollicisbrevrs, CaPUtsuPerficiale M o p p o n e n sp o l l i c i s
Ni abductordlgrtlmlnlml
|
M llexor digitt mrnimibrevis -
M opponens digiti minimi
.- Mm lumbricales
--
- -M abductor Pollicisbrevis - M tlexor pollicrsbrevis,
M abductordrgitiminimi
- -
Caputprolundum
M flexor pollicisbrevis, Caput superflciale
M adductor Pollicis, Capul transversum
Vaoina tendinismusculi -llexoris pollicislongi
-
ArticulatiometacarpophalangeaV,
Capsulaarticularts
-
- M. int"roaa"idorsales
)
-
Mm/ interossei dorsales \
\
I I
M. llexor digitorum superticialis,Tendines
Mm interosseipalmares
M flexor digitorum supedrcialis,Tendtnes
F i g . 3 7 9 M u s c l e so f t h e h a n d ; deeplayer;the Retinaculummusculorumflexorumhas been seciioned;somesuperficialmuscleshavebeenpartially removed; palmarview (r.,90%).
216
upperLimb
M tlexor digitorumprolundus,Tendines
lumbricalislV
lumbflcalislll
M flexor digitorumsuperficialis,Tendines
M llexor digitorumsupedicialis,Tendines \Z-
M llexor digitorumprotundus,Tendines /
Fig. 380 Lumbricalmuscles, Mm. lumbricales; palmar view (1.,557").
Thenar muscles (Figs.375, 376, 379, 3Bl, 382) TheM. abductorpollicisbrevis,the M. flexor pollicisbrevis,the M. opponenspollicisand the M. adductorpollicisconstitutethe superficialto deeplayersof the thenar muscles. Muscle Innervation
Origin
Insertion
Function
1. M. abductor pollicis brevis N. medianus (Plexusbrachialis, Pars infraclavicular is)
Retinaculum musculorum flexorum,Tuberositas ossis scaphoidei
Radial sesamoidbone and radial sideof the basisof the proximalphalanxof thumb. Insertsin the dorsal aponeurosisof the thumb
Articulatio carpometacarpalispollicis: Abduction,opposition
2. M. flexor pollicis brevis Caputsuperficiale:N. me dianus;Caputprofundum: N. ulnaris,R profundus (Plerusbmchialis,Pars infraclavicularis)
Caput superficiale: Retinaculummusculorum flexorum Caputprofundum:Ossa capitatum, trapezium, trapezoideum andbasisof OsmetacarpiI
Radialsesamoidboneand radial side of the basisof the proximalphalanxof thumb Insertsin the dorsal aponeurosisof the thumb
Articulatio carpometacarpalispollicis: adduction Opposition,
3. M. opponenspollicis N. medianr.sand N. ulnaris (Plexusbrachialis,Pars infraclavicularis)
Retinaculum musculorum flexorum, Tuberculum ossis trapezii
Entirelength of the radial borderofthe Os metacarpiI
Articulatio carpometacarpalispollicis: adduction 0pposition,
4. M. adductor pollicis N. ulnaris,R profundus (Plexusbrachialis,Pars infraclavicularis)
Caputobliquum:Oscapita- Ulnar sesamoidboneand tum andbasisof theOsmeta- ulnar side of the basisof the proximalphalanxof thumb. carpiII, Lig.carpiradiatum
Articulatio carpometacarpalispollicis: Adduction, opposition
Caputtransversurn: Palmarsurface of theOs metacarni III
Insertsin the dorsal aponeurosisof the thumb
Articulatio metacarpophalangeapollicis: Flexion
Articulatio metacarpophalangeapollicis: Flexion
Articulatlo metacarpophalangeapollicis: Flexion
sclesoftheHand 2I7
M pronatorquadratus\ Articulatioradiocarpalis\
/ Radius / M. abductorpollicislongus,Tendines
Canaliscarpi\ M flexorpollicisbrevis,Caputprolundum\ Os pisiforme:
/ M llexorcarpiradialis,Tendo flexorum musculorum z Relinaculum / M abductorPollicisbrevis
minimi:. M abductordigiti /
M flexorpollicisbrevis,Caputsuperficiale brevis,Caputprofundum / M flexorpollicis
llexorum- - musculorum Retinaculum
//
M opPonens Pollicis
M opponens digiti minimi - -
M llexor digili minimi brevis --
/ M abductorpollicisbrevis
M interosseus dorsalislV --
:-ii
M. flexor oollicisbrevis, caput suirerficiate -
lll - M interosseus Dalmaris M aMuctor digiti minimi -
M adductorDollicis
-
M. llexor oollicis longus, Tendo
-
M flexordigitorum --
Tendo suoerficialis.
M. inieross€us dorsalisI
-
Mm.lumbricales
-
Tendo super{icialis, M llexordigttorum
-
Vinculalonga
Vincula / longa
l
I l vinculatendinum
- vincutumoreve,,l Vinculum/ breve \ profundus,Tendo/ M flexorctigilorum
M. flexordigitorumprotundus,Tendo
Musclesof the hand; Fig. 3Bl deep layer; the superficial and deep flexors of the fingers and some of the thenar and hypothenar muscleshave been removed; palmarview (1.,70%1.
2L8
upperlimb
/ Lig. radiocarpalepalmare
Canaliscarpi\ Ulna
M flexorcarpiradialis,Tendo M flexorcarpiulnaris, Tendo--
Retinaculum musculorum llexorum
Os Pisiforme-. Retinaculum musculorum flexorum-\
/ M. flexorpollicisbrevis,Caputprofundum
M abductordigiti minimi --
,, M adductorpollicis,Caputobliquum
M opponens digitiminimi- _
Caputtransversum / M adductorpollicis,
M interosseus palmarisll \\ M opponenspollicis palmarislll \ _ M interosseus M. flexordigitiminimibrevis---
M interosseus dorsalislll .---
M abductoroollicis brevis
M abductor digiti minimi - - - M. flexor pollicisbrevis
M adductor pollicis
M interosseusdorsalislV -
M. interosseus dorsalisI \ M inlerosseuspalmarisI \
M inlerosseusdorsalis ll Vinculalonga
M flexordigitorumprolundus,Tendo' \ M flexordigitorum superficialis, Tendines
\
Vinculum breve
protundus, M flexordigitorum Tendo
Fig. 382 Musclesof the hand; deepestlayer; the two headsof the adductor muscle of the thumb havebeensectioned; palmar view (1.,70%).
of theHand Tendons
2r9
Vaoinatendinummusculorum carpiradialium 5xtensorum
extensorum\\ musculorum Retinaculum - - Vaginatendinis.musculi carplulnarls extensoras
Interosseus dorsalisI
-t\*r/' lM.
Tendines digitorum, extensor
Fig. 383 Dorsal carpal synovial sheathsof the tendons; dorsalview (1.,80%).
Siratum fibrosum / Vagina tendinis, /',Atlicvlatiometacarpophalangeall, / /' CaPsula articularis Lig collaterale \
Tendo /M extensorindicis, dorsalisI /M interosseus
Lig collaterale \
- M lumbricalisI --Os
-\.-
-I
vinculatendinumI
--
I
synovialeI Stratum Vaginatendinis, Tendo superlicialis, M llexordigitorum
ll metacarpi
M interosseus oalmarls M. flexordigitorum orofundus,Tendo
phalangis distalis Tuberositas
Insertionsof the tendonson the index finger; Fig. 384 the two flexors of the finger have been of tendons the luxatedfrom their tendonsheaths; lateral(radial)view (r, B5%).
musclesof the fingers Notonlythetendonsof the properextensor insertin the muscles lumbrical and but alsothe interosseous fingers' the of aponeuroses Notethe courseof thesetendonsin relationto the axisof the joint. metacarpoPhalangeal
220
upperlimb
/
M extensordrgrtorum,Tendines
Retinaculummusculorumextensorum\
M extensor carpi radialisbrevis,Tendol M extensor carpi radialislongus,Tendo \
M extensor carpiulnaris, Tendo
- * Os trapezium M exlensor oolhcrsbrevis,Tendo -M- extensor pollicislongus,Tendo - -
exlensor digiti minimi
ll - Os metacarpi
M interosseusdorsahs ll
--
M interosseus dorsalis| -
F i g . 3 8 5 M u s c l e so f t h e h a n d ; , 0%). d o r s a lv i e w ( 1 . B
Connexusinlertendinei
Musclesand Tendonsof the Hand
221
Inlerosseus \ d o r s a l i sl l \
,/ M, interosseus dorsalislll M interosseus dorsalisI
M Interosseus -p a l m a r i sl l l
-
M i n t e r o s s e u s- palmaris ll
/
M Interosseus dorsalis lV
Mm interossel parmares
lumbricales, Tendines
muscles, Fig. 386 Palmarinterosseous Mm. interosseipalmares; palmarview (1.,557") musclesalsoextend The palmar interosseous of the fingers int()the dorsalaponeuroses (arrows).
Dorsalinterosseousmuscles, Fig.3B7 Mm interosseidorsales; dorsalview (1.'557"). Both the extensorsof the fingersand all the and lumbricalmusclesextend lnlerosseous of the fingers' into the dorsalaponeuroses
Muscles of the palm (Figs.375,379-387) Themusclesof the palmdo not presenta uniformgroup. with the tendonsof M. flexordigitorumprofundus. The Mm. lumbricalesare closelyassociated TheMm. interosseipalmaresand the Mm. interosseidorsalesfill the spacesbetweenthe metacarpalbones,Ossametacarpi' Insertion
Muscles Innervation
Origin
1. Mm. lumbricales I-IV N. medianus(1,II); N. ulnarisAII, N) (Plexusbrachtalis, Pars infraclavicularis) 2. Mm. interossei palmares
The radialside of the tendons Runfrom radialinto the of the dorsalaponeuroses I and ll as well as the sides fingersII-lV o f t h e t e n d o n sI l - l V o f M. flexordigitorumprofundus facing each other
Ulnar side of the metacarpal boneII. radial side of the N. ulnaris(Platus brachialis, metacarpalbonesIV and V
I-m
Runinto the dorsal of the fingersII, aponeuroses IV anclV
Parsinfraclavicularis)
Function Metacarpophalan geal joints
(r-v)
radialabduction FIexion. Interphalangealioints (II-V) Extension Metacarpophalangeal ioints (trr ry V) Flexion,adduction (in relationto themiddlefinger) tnterphalangealj oints
(tr,ryV)
Ertension Thesides,facingeachother, 3. Mm. interosseidorsales bonesl-V of themetacarPal I-fV N. ulnaris(Plarusbrachial$ (two-headed) Parsinfraclavicularis)
Runintothedorsal of the aponeuroses fingersII-lV
Metacarpophalangealioints (in (II-V)Flexion, abduction relationto the middlefinger) Interphalangealioints (II-V) Extension
222
LipperLimb 2 ' 3 4 ' 5 ' M f l e x o rd i g i l o r u mp r o f u n d u s , Tendines' M flexor pollicrslongus M flexor carpr radialis \ Os scaphoideum \ M brachioradialis ,\ M abductorpollicrsbrevis . M flexor carpi radialis . \
\
\^ / ,'rr'
234 5 M- flexordigitorum superficialis, Tendines*
M flexor carpi ulnaris M tlexor digiti minimi brevis M abductordigiti minimi
M. opponens pollicis pollicisbrevis-M abductor
M opponens digiti minimi
M flexor pollicisbrevis, Caput profundum M adductor pollicrs,Caput obliquum -iM abduclor oollicisbrevis M adductor pollicis.Caput transversum Mm Interosseidorsales -
-'/-
i/ \
-
M flexor digfltiminrmibrevis
-
M abductor digitiminimi M tlexor digiti minimi brevis
M flexor pollicislongus /
Mm Interosseipalmares -
M tlexor digitorumsuperfictalis-
/ M tlexordigitorum profundus
Fig. 3BB Muscularoriginsand insertionson the bonesof the hand; palmar view (r ). ' The flexors of the fingers insert on the 2nd to 5th fingers
Innervation of the musclesof the upper limb N. thoracodorsalis
M. latissimus dorsi M. teresmajor(Var.)
N. suprascapularis
M. supraspinatus M. inhaspinatus
Nn.subscapulares
M. subscapularis M. teresmajor
N. axillaris
M. deltoideus M. teresminor
N. radtalis
M. tricepsbrachii M. anconeus M. brachioradialis M. extensorcarpiradialis longus M. extensor carpiradialis brevis M. extensor carpiulnaris M. extensor digitorum M. extensordigiti minimi M. extensorpollicislongus pollicislongus M. abductor M. extensorpollicisbrevis M. supinator
N. musculocutaneus
M. bicepsbrachii M. brachialis M. coracobrachialis
N. medianus
M. pronatorteres M. flexorcarpiradialis M. palmarisIongus M. flexordigitorumsuperficialis M. flexordigitorumprotundus(radialpart) M. flexorpollicislongus M. pronatorquadratus M. flexorpollicisbrevis pollicis M. opponens M. abductorpollicisbrevis Mm.lumbricales I, II
N. ulnaris
Mm.lumbricales III, IV Mm. interosseidorsales Mm. interossei palmares M. flexorcarpiulnaris M. flexordigitorumprofundus(ulnarpart) M. palmarisbrevis M. abductordigiti minimi M. flexordigiti minimi brevis M. opponens digitiminimi polticis M. opponens M. flexorpollicisbrevis pollicis M. adductor
Innervation Cutaneous
I c8
223
T2 I J
Fig. 389
Segmentalinnervation (dermatomes)of the upper limb; ventral view
c4 tl
fa3.
c5 vo I
ll
c8 I
Wlr
r! T3
Fig. 390
|
r2
Segmentalinnervation (dermatomes)of the upper limb; dorsal view.
N cutaneus N radialis, brachiilateralisinletiot . N. axillaris,N. cutaneusbrachii 7- lateralissuPerior
,,
/
I Nn supraclaviculares Rr.cutaneil anteriores I Pectorales Nn. int"r"o"t"l", I Rr.cutanei I laterales I pectorales,/
I N intercostobrachialis brachiimedialis N cutaneus
Fig. 391
Cutaneousnerves of the upper limb; ventral view.
N cutaneusbrachiiposterior I inferior N radialis N. cutaneus brachiilateralis I I posterior,/ | antebrachii , N. cutaneus
)
Nn supraclaviculares I
N. musculocutaneus, N. culaneus antebrachii lateralis I
N axillaris,N cutaneus brachii lateralissuperior
N radialis ns ulnaris I digitalesdorsales/
-Nn thoracici,- - ( - - > : Rr cutanei posleriores
\-
N cutaneusbrachiiposteriorI N radialis. N cutaneus brachii medialis
Fig. 392
N cutaneus antebrachiimedialis
Cutaneousnerves of the upper limb; dorsal view.
N medianus,Nn digitales palmares propfll
224
upperlimb
Plexus brachialis. . Pars supraclavicularis'\
----
A axillaris
N cutaneus brachii medialis
N axillaris-----
N cutaneus-.brachiilateralis sup€nor
N cutaneus antebrachii medialis
A. circumflexa .- -_ humeri posterior A circumtlexa humeri anterior A orolundabrachii ---
N. musculoculaneus
A. collateralis
e.
utnans supenor
A collateralismedia ----
N radialis
A brachialis
N cutaneusbrachii Post€rior A collateralis radialis---N. cutaneus brachii*-lateralisinferior
- - A collateralis ulnarisinterior
N cutaneus-antebrachii lateralis
-*
A radialis --
R. superficialis
*-
A recurrens radialis---
R profundus
--
----A radialis -
---
A int"ror""" communrs
A interossea anteflor A comitans nervimediani
A interosseaoosterior- - - R. dorsalis(N ulnaris)
R posterior - A recurrens ulnaris - A ulnans
A interossearecurrens
N. cutaneus antobrachii posterior
- Retearticulare cubiti R anterior
R palmaris(N ulnaris) - R carpalisdorsalis
R communicans cum nervoulnari -_-----
Nn.digitales- palmares communes
---
/ Nn disitales---1< parmares propnl
(N ulnaris) B Profundus (N ulnaris) R superlicialis Nn. digitales patmares communes
palmares proprii A radialisindicis
/
-
Aa digitales oalmares communes
Aa digitales palmares propnae
Fig.393 Nervesof the upperlimb; ventralview.
Fig.394 Arteriesof theupperlimb; ventralview.
of theAxilla LymphaticVessels
/ I
225
Vasa lymphaticasuperlicialia
V cephalica
t'
\ \ \ \ \ \ \
- /
Nodi lymphoidei axillares
t\
(Plexuslymphaticus axillaris)
Papilla / mammana
'11.'
Vasa / lymphatica supenrcralla
Vv thoraco- / eprgastricae
V basilica -
Nodi lymphotdeicubitales
/
V cephalica -
-Esg0 Fig. 395 Superficiallymphaticvessels,lymph nodes andveins of the arm, lateralthoracicwall and axillary reSlon; ventralview (1.,50%).
226
rJpperLimb
Nn supraclaviculares intermedii Nn supraclaviculares laterales
\
A M deltoideus,Fascra t
.=l
A t h o r a c o a c r o m i aRl i sp ,e c t o r a l iOs - - - L I
I I
I
, tM
V c e p h a l i c aa - - -
+. Fascia brachii ,
/. ,,
Nodi lymphoideiaxillaressuperficiales ,'/ A thoracicalaterals o /
/ ,'
V thoracoepigastricaa zl M latissimusdorsi, Fascia 6 / Br cutanei lateralespectorales (Nn intercostales) M serratusanterior,Fascia g /
,ru'#t" Fig. 396 Vesselsand nerves ofthe upper arm, shoulder and clavipectoraltriangle, Trigonum clavipectorale; lateral view (r., 50%).
p€ctoralis major
Rr cutanei anteriores pectorales (Nn intercostales)
221 postertor Fasciculus lateralis Fasciculus medialis Fasciculus Clavicula
ReteacromialeO Acromion-
/
a A subclavia
\ O V subclavia
/
M d e l t o i d e u s , O- Pars clavicularis
-
O M subclavius
M d e l t o i d e u s , -aParsacromialis Fasciaclavipectoralis V cephalicaa
Nn.pectorales medrates
O A thoracoacromialis, Rr pectorales -
O M. Pectoralismajor, Pars clavicularls
- a M. pectoralas major, Parssternocostalls
,no'*"t triangle,Trigonumclavipectorale; Fig. 397 Clavipectoral the clavicular part of the pectoralismajor muscle has been sectioned; ventral view (r., 5070).
Clavicula I Rete acromiale \ :-----
R clavicularis
R acromialis / A axillaris /
A subclavia
- -
A thoracoacromialis
pectorales
Fig.398 BranchesofA.thoracoacromialis, ventral view.
228
(JpperLimb
n
N intercoStobrachialis A : V t h o r a c r c al a l e r a h sO a M pectorallsmalor a Papilla mammaria
,
€
I
o V axillaris
au subscapularis
L \ t
Nn thoracici, Nn Intercostales, Rr mammarii lalerales
OV lhoracoepigastrica
i
\ \ \ \ \
i
c i r c u m l l e xhau m e rpi o s t e r i o r I o aA rv les les s brachialis, nfraclavicularis
M serratusanteflor a .
\
'l t;
\ \ \
3M
N intercosto brachialis
N axlllaris teresmajor
l.'
\aan,Vcircumflexa scapulae
\
t
\
dorsi ar M latissimus
a aA; V lhoracodorsalis
N thoracodorsalis
N t h o r a c i c u sl o n g u s
I
tM obriqrr. externus abdominis
Nn thoracici,Nn intercoslales, Rr cutanei lateralespectorales '
a Vv thoracoepigastricae
2!7r+oo 815<).>407 996/l Fig. 399 Axillary fossa,Fossaaxillaris; the fasciae of the axillary region and of the lateral thoracic wall have been removed: inferior view (1.,50%).
229
Lateral Watlof the Thoraxand theAxilla
Plexus brachialis,Pars supraclavrcularrs N phrenicus M scalenusanteflora
A subclavia / a 7 Clavicula
\
T r u n c u s t h y r o c e r u i c a l i s O \, A vertebralisO A carotrscommunrs O\ Ansa ceruicalis
7 O A axillaris
\
M sternothyroideus a --.---\----.-_ M s t e r n o h y o i d eau s- - ; - _ N v a g u s[ X ] V b r a c h i o c e p h a l i coa - -
__*_*
------------3* M de toideus
M sternocrero a o -- - - - - - -
Nn intercostales, Rr cutanei anteriores pectorales
4.. \ \
a M Pectoralis major
a V cephalica
o A axillaris
o V axillaris \
1M
pectoralisminor
N intercostobrachaalis
N thoracodorsalis a a A ; V thoracicalateralis OoA:V
lhoracodorsalls
N thoracicuslongus
\
\iM \
/
externusabdominis M obliquus / M. ser tus anleriorr
N thoracicus [T4],N ntercostalis pectoralis R. cutaneusldler-alis latissimusdorsi
o V thoracoePigastrica
Rr mammarii laterales
,nnlft,no' Lateral thoracic wall; infraclavicular fossa, Fig. 400 Fossainfraclavicularis;axillary fossa,Fossaaxillaris; the pectoralismajor muscle has been removed; Iateral view (1.,6070).
upperLimb
230
r Nodr lymphordercervicalesanleriores, Nodi superficialesel protundi i V iugularisexterna O M sternocleidomastoideusa \
j| i
len l r sn um aiie ls d i u s . sq ecaa le scm M. splenius ceruicis
,
I i I
cM
levalor scapulae
M . o m o h y o i d e u s ,a \ Venler superior
Nn supraclaviculareslaterales /
A , V t r a n s v e r s aa l l colli, R superlicialis
\
/ Nodr lymphoideicervicales laterales.Nodi superficiales /
\
aM trapezrus
/ Clavicula /
,,
N suprascapularis
aM deltoideus
,/ Nodilymphoidei \. -* ceruicaies ant cil^adi.
ot
- OaA;V suprascapurafls
nr^l
M scalenus| anterior
- oM pectoralis m tn o r
--
M s t e r n o h y o i d e*u s- -
- OV cephalica
Truncus.-sinister ,ugularis
-
Noduslymphoideus- lateralis, cervicalis Nodusprotundus inlerior B u l b u si n l e r i o r * v e n a el u g u l a n s
-
oM pectoralis malor
--
Ductus' thoracrcus, Pars cervicalis V jugularis anlerior )
-
Arcus t / venosusJUgularis Articulatio/ sternoclavicularis, Discusarticularis
---
/,1
;/
/ M subclavius| lvf pectoralis maior)
/
aV cephalica \
'
A subclaviao /
OA circumtlexa humefl posleflor OV brachtahs
-
/ V jugularisexlerna| / T r u n csi u b c l a v i u s et bronchomediastinalissinister
N radialis
N musculocutaneus
- --
/
Nodi lymphoidei subscapulares
N ulnaris Nodi lymphoidei axillareslaterales
N cutaneus brachii medialis
\ a V brachialis \
,/."qGe{ Costall
/
Nodi lymphordeiintercostales
N thoracicuslongus
f ' r " * ^ ^ , ,|" . 1
/ Nodilymphoidei N intercosto pectorales brachrahs
OM serratusanterior o A , V t h o r a c i cl a t e r a l r s
Axillary fossa,Fossaaxillaris; Fig.401 deep layer of the neck; the clavicle has been partially removed;the pectoral muscleshave been sectioned; ventral view (1.,60%). Compareto Fig. 814.
NervesoftheArm 23I Nn suoraclaviculareslaterales
N cutaneus brachii medialis
N cutaneus antebrachiimedialis
V cephalica
--
-/
N. musculocutaneus' N. cutaneus antebrachiilateralls
/
.-
V medianacublti
N cutaneus antebrachilmedlalis, R Posterior ---
N radialis,Ncutaneus antebrachiiPosterior
--N cutaneus antebrachiimedialls. R anterior --
V mediana antebrachil
w5$ao7 4lr Fig. 402 Superficialveins anclnervesof the anteriorbrachial region,Regiobrachiianterior,and of the anteriorelbou region' Resiocubitalisanterior;r'entralvier'r(1.,35%) V cephalica
V cephalica -
-
-
V basilica
(V mediana cephalica)
V mediana antebrachii
Figs. 403 a-c Variationsof the superficialveins of the region of the right elbow. The veins of this regionare preferredfor venipunctureand i ntravenousiniections.
V baslllca
-
(A. brachiahs Var )' superJicialis,
-
(V mediana basilica)
-
V basilica
-
V mediana antebrachil c
-
v cephalica -
iniections there iS ThiS \ artation is rare llorvever,u ith regard to intravenous r o n s i r l e r a l r lrei s k o f a ( c i d e n t a li n t r a a r t e r i ailn i e c t i o n
232
upperLimb Rete acromiale \ Nn supraclaviculareslaterales
N axrllaris. cutaneus brachrilateralissuperior
Rr cutanei (A ; V circumflexa humeri posterior)
N axillaris.N cutaneus brachii lateralissuoerior
N. cutaneus brachiiposteriorf It radialis interior| ru cutaneusbrachiilateralis
V cephalica -N radialis,N cutaneus antebrachiiposterior --
*
N cutaneus brachii medialis
a14O9
tr
4t2 Fig. 404 Superficialvesselsand nervesof the posterior brachialregion,Regiobrachii posterior,and of the elltowregittn, Regiocubitalisposterior; d o r s a lv i e w ( 1 . , 3 5 % 1 .
Superficialveinsof the arm The cephalic vein developson the radial side of the back of the hand out of the Retevenosumdorsalemanus,receives intakefrom the palmthroughthe intercapitularveins and then runs proximally on the radial side of the forearmtowardsthe elbow.There it anastomoses with the basilic vein and then continues,generallyratherweaker,in the lateralbicipitalsulcus to the clavipectoraltriangle where it perforatesthe fasciaand flows into the axillary vein. The basilicvein originateson the ulnar side of the backof the hand, runs in the ulnar area of the forearm on the ventral surfaceproximallytowardsthe elbowandjoins up herethrough
the median cubital vein with the cephalicvein, whereby it usuallybecomes sffon8er.It piercesthe Fasciabrachiibelowthe middleof the upperarm in the medialbicipitalsulcusandflows into the medialbranchof the brachialvein. A very variabletransverseanastomosiscalled mediancubital vein connectsthe basilic vein and the cephalic vein. It is supplied from the front side of the arm over the median vein. antebrachial The medianbasilic and the median cephalicveins form connectionsbetweenthe basilic,cephalicand medianantebrachial velns.
and Nervesof theAxilla and Shoulder Vessels
superlus\ \ scapulae Lig transversum N suprascapularis\
233
Venterinlerior r o M omohyoideus,
Nn subscapulares -_ / Proc coracoideus Parsinfraclavicularis' Plexusbrachialis, '/ medialis Fasciculus
A axillarisO : Plexus brachialis.Pars infraclavicularis, \
/ OM pectoralisminor
posterior Fasciculus
/ a M. deltoideus
N axillaris \
-
A circumllexascapulae O :
a M coracobrachialis O M biceosbrachii,Caputbreve
/ -
Plexusbrachialis, Parsintraclavicularis, Fasciculuslateralis N musculoculaneus
M subscaoularisO -
- a M. pectoralismajor -
M teresmaiorO - -
O M. biceos brachii, Caput longum
- OA circumflexa humeri anlerlor - O A. circumflexahumeriposterior
O A subscapularis O A thoracodorsalis N thoracodorsalis
M latissimus dorsiO -
N cutaneus brachii medialis
N ulnaris N medianus
-
N radialis
aA
brachialis
N culaneus anlebrachirmedialis o vu brachiales O M triceps brachii, Caput longum : --
Fig. 405 Vesselsand nervesof the axillary fossaand the shoulder; the clavicle has been sectioned;the arm has been removedfrom the thorax; ventralview (1.,60%).
/, a M suPraspinalus
Clavicula \ R.acromiatiso-
M s u p r a s p ' n a l u s\a-
_-
/=-
l/--
o A suprascapularls - -
Lig transversumscapulae supenus
scapulae Inlerius
--
M inlrasoinatus a -
a M deltoideus --
Arliculatiohumen, Capsula articularis
Spina scapulae
--
a M inlraspinatus )--
M deltoideusa -
lM -
N axillarrs N axillaris,N cutaneus brachii laleralissuperior / A circumflexa humeri posterioro
OA circumllexa scapulae
\
N a x i l l a r i s . Rm u s c u l a r i s
\ a M tricepsbrachii,CaPutlongum
Fig. 406 Vesselsand nervesof the shoulder; the deltoitland the trapeziusmuscleshavebeenpartially removed; d o r s a lv i c w ( 1 . 6, 0 % )
leresminor
aM teresmaior
796 lt "7AA,ff ' 410
234
upperlimb
Plexus brachialis,Pars infraclavicularis, Fasciculusmedialis
/
o M deltoideus
Plexus brachialis,Pars infraclavicularis, Fasciculusposterior
--
a V cephalica
Plexus brachialis,Pars infraclavicularis, Fasciculuslateralis
--
a A circumflexahumeri anterior
--
a M bicepsbrachii, Caput longum, Tendo
A axillarisO N axillaris N cutaneus brachii medialis
--t
M pectoralismajor
N cutaneus antebrachiimedialis
N musculocutaneus--7, N.ulnaris N. radialis ----
Vv brachialeso/
s M biceps brachii,Caput breve
N medianus
A brachialisO
-
/
/ A prolundabrachiiO V basilicaO
/
a
--
*
M biceps brachri,Caput longum
A collateralis ulnarissuoeriora --
a V cephalica
Seotum intermuscularebrachii mediale -
N musculocutaneus, lateralis N cutaneusantebrachii A collateralis ulnarisInlerioro--
N medianus
-
muscullbicipitis brachii Aooneurosis
Fig.407 Vessels andnervesof the anterior brachialregion,Regiobrachiianterior; ventralview (1.,45%).
235 M coracobrachialis |
\ /
oM deltoideus
N axillans
taM oectoralis major --M t e r e s m a j oar
-
N radialis
-
oM coracobrachialis
N musculocutaneus
N medianus
-
brachii A protunda
aM. biceps brachii
M triceDsbrachii,Caput longum a
N ulnaris ulnarissuPeriot A collateralis -M triceos brachii,Caput medlale Q
N. musculocutaneus, lateralis antebrachii N. cutaneus
ulnarisinleriora A collateralis -
aA brachialis
N, medianus
medialis Epicondylus -
aM. brachioradialis
a/ Mm tlexoresantebrachll
Arteriesand nervesof the anterior Fig. 408 brachialregion,Regiobrachii anterior; ventralview (1.,45%).
236
upperLimb
M deltoideus a
--
a M l e r e sm a j o r
N axillaris,N cutaneus brachii lateralissuperior
--
i, deltoideus O A p r o t u n d a b r a c h rR
\ a i,4 triceps brachii,Caput longum N radialis,N culaneus brachii posterior
'
\
N radialis
\ \
M triceps brachii,Caput lateralea .- -
prolundabrachii
OA
O A brachialis
M bicepsbrachiro --.Septum intermuscularebrachii laterale .- .- .M b r a c h i a l i s O- - . - _ A collateralisradralisO -- -N cutaneus brachii lateralisinterior
N radialis,N cutaneus antebrachiiposterior M triceps brachii,Caput medialea -N musculocutaneus,N culaneus anlebrachiilateralis
-
--
O A collalerahsulnarisInleflor
-j
Epicondyluslaleralis- - M b r a c h i o r a d i a h s o- -
N ulnaris - -
O Rete articularecubilr
M anconeusO Olecranon M extensor carpr radrals longus rt M extensor carpi radialis brevisa
*,#ii\
Arteriesand nervesof the posterior Fig. 409 brachial region, Regiobrachii posterior; dorsal view (1.,40%).
Arteriesand l,lervesof the Arm
237
, Articulattohumerl, /'Capsula articularis N axillaris
/
'
, | M t e r e sm i n o r t
o M t e r e sm a i o r
M d e l t o i d e u sa -
- -
O A c i r c u mlfe x a h u m e r ip o s t e r l o l
N radralrs,N cutaneus brachiiposterrol p r o f u n d ab r a c h i i ,l l d e l t o i d e u s
-
aA
-- -
--
OA brachralls a i/rt triceps brachii Caput longum
O A P r o l u n d ab r a c h r i
M t r i c e o s b r a c h i iC a p u t l a t e r a l ea - N c u l a n e u sb r a c h i il a t e r a l l sI n t e r l o r M bicePs brachii il -
a M t r i c e p sb r a c h i i ,C a p u t l a t e r a l e
- -
A collateralisradialis,(R anterior) O M b r a c h i a l i sa -
--
aA
- -
a M triceps brachii Caput medrale
c o l l a l e r a l lm s edla
N radialis,N cutaneus antebrachlrposterlor
N musculocutaneus N cutaneus antebrachlrlateralis --
aA
) -A c o l l a t e r a l irsa d i a l i s (, R p o s t e r i o r O
N ulnarls
E p i c o n d y l u sl a l e r a l r s- - M b r a c h r o r a d i a l ias - l\,4extensor carpi radialis longus o
* -
M extensor carpi radialisbrevis a
- -
c o l l a l e r a l iu s l n a r i sI n l e r l o r
I
--
-
O Rete articularecubrtl
-
O A r e c u r r e n su l n a r l s
aM anconeus
Arteriesandnervesof the posterior Fig. 410 brachialregion,Regiobrachiiposterior; dorsalview(1.,45Y.1. * quadrangular space,Spatium axillare laterale
238
trpperLimb
N .r a d i a l i s , N. cutaneus I brachiiposterior I
V basilica a -
N cutaneus brachiimedrahs
\ /\
N radialis, N cutaneus antebrachii Posterior
N cutaneus brachii medialis
-
o V cephalica
N cutaneus
V cephalica * -
antebrachiimedialis
N musculocutaneus N cutaneus antebrachii lateralis
N cutaneus antebrachiimedialis, R posteflor
--
a V mediana cubrti
-
N cutaneus antebrachiimedialis, R anterior
* V mediana antebrachii N cutaneus antebrachii medialis, R posterior
(V mediana s ' basillca) V b a s i l i c a* - -
N muSCUlocUtaneUs, N cutaneus antebrachii lateralis
--
s V cephalica
N radiahs, R supedicialis -
R palmarrs (N ulnaris)
N radialis, N cutaneus antebrachii posterior
N radialis, R superticialis
--
i
V basilica
O A radralis
R palmaris (N medianus)
V c e p h a l i c as - B dorsalrs (N ulnaris)
402 ,.^ lt/+tt + /l 423 Fig.411 Superficialveins and nerves of the anterior antebrachialregion, Regio antebrachii anterior; ventral view (1.,45%).
Fig.4l2 Superficial veins and nerves of the posterior antebrachialregion, Regio antebrachiiposterior; dorsalview (1.,45%1.
Vesselsand Nervesof the Forearm
F a s c i a b r a c h i i\
\\ \\
. o A. collateralis 7 Septum I ulnaris /'intermusculare mediale brachrr superior I ,,
V cephalicaa\
V b a s i l i c aa - _
| M tricepsbrachii,a Caputmediale
-
N ulnaris; A collateralsO ulnarissuperior
Fascia / antebrachii
a M biceps brachii
-
--
aA --
,r'
ToAbrachiatis ,, a M, biceps brachii
N ulnaris ulnaris inferior / M b r a c h i a l i sa
brachialis
Epicondylus medialis
--
\ A ulnaris1 /
-
\ M flexor a carpi ulnaris
-
r M supinator
O M biceps brachii,Tendo
-
a A radialis \
lM pronalor aM pronator teres gM brachioradralis
a M extensor carpiradialis DTEVIS
-
brachrl N radialis, R prolundus
a M biceps Tendo brachii,
teres
\
M llexor a carpl radialis
N radialis, R superficialis N radralis, R profundus
\ aA recurrens radialis \
M palmarisa tongus
1 M supinator
aM flexorcarpi radialis M flexor O carpi ulnaris
M palmaris O longus --
OM flexordigitorum superficialis
---
a M flexor p o l l i c i sl o n g u s
---
Aponeurosrs palmaris
Aponeurosis musculibicrPitis
--
a A radialis
-\:
Fascia -antebrachii
a A collateralis radialis
- /
: I
Aponeurosis
--
A u l n a r i sO - - -
a M brachioradialis
musculibacipitis N rnedianus brachii
/
N ulnaris, R dorsalis
N radialis
7
A collateralis O -
a M brachiahs
N medianus
Septumintermusculare brachiimediale H u m e r u s-, Epicondylus medialis
239
OM abductor pollicislongus -
M flexora drgrtorum supedicialis
N ulnaris A u l n a n sa - -
a A radialis a M. pronator quaoralus
-
O M brachioradialis, Tendo
-
aA radialis
N medianus R palmaris (N ulnaris) R dorsalis (N ulnaris) A u l n a r i sO , --
\,M exrensor - :3l33il: p o l l r c rosr e v r s Tendo
M palmaris| brevrs
407 n,n
v""
n'-1/l 423
Fig. 413 Arteries and nerves of the anterior antebrachial region, Regio antebrachii anterior; ventral view (r., 45%).
Arteriesand nervesof the anterior Fig. 414 antebrachialregion,Regioantebrachiianterior; ventralview (1.,45Y").
240
(rpperLimb
M bicepsbrachiie \_
/ .-
a A collateralis u l n a r i ss u p e r i o r
A brachialis a N ulnaris
N ulnaris
|
N. radialis, R. 'Profundus
/
-
tprconoylus medialis
O A collateralis radialis (R anterior)
M b r a c h i a l i s|
-t-
u O A radialis
N medianus
--
-
a A recurrens radialis
M pronatora teres, Caputulnare
N radialis, R superficialis / \
A recurrensO / ulnans
i
a M brachioradialis
\
t
-
M flexor a / drgitorum superficialis, Caput radiale
a M pronatorteres
A u l n a r i s ,O / B carpalis dorsalis
M flexor t carpr ulnans
aA
radialis
--
*M tlexorcarpi radialis.Tendo -.-
OA radiahs, R palmaris superlicialis
r_ \
Fig.415 Arteriesandnervesof the anterior antebrachialregion,Regioantebrachiianterior; deeplayer; ventralview (1.,45%).
-
t M biceps brachii.Tendo
R dorsalis (N ulnaris) M flexora d i g i l o r u ms u p e r ifc i a l i s , Tendines
M flexor* c a r P ru l n a n s , Tendo
--
a A, interossea communts
-
| M pronator teres
\
O A interossea posteflor
N interosseus antebrachii anterior a M brachioradialis, Tendo
-
N radialis, R super,ficialis O A radialis
-
N medianus -
I
- t
M brachroradialis, Tendo M pronalor quadratus
- a M flexor pollicis longus -
t
-._
M flexor carpi radralis, Tendo
a A radialis, R palmaris superlicialis - I M palmarrs longus,Tendo
* M palmaris l o n g u s ,T e n d o
408 ".. lrt+to " 414/l 424
a A recurrens radialis
-
-
M llexor+ -digitorumprofundus, Tendines
R palmaris (N medianus)
/
-,
I M brachioradialis. Tendo
\
/
A interossea a anterior A u l n a r iO s -
N radialis, R superficialis
--'1
R dorsalis
-
N ulnaris -:
--
(N ulnaris)
Mm flexores a antebrachii
A c o m r t a nas neruimediani
OA radialis
-
-
o A interossea communrs | M tlexor pollicislongus
--
-
l,/ supinator
N .r a d i a l i s . H. prolunous
A recurrensa ulnaris
N medianus
/
M f l e x o r c a r p iI ulnaris,Tendo
M bicepsbrachii N radialis
z O A ulnaris
M b r a c h i a l i sa
M flexor I carpi radrals
-
ulnaris inlerior
' /
M pronator t teres
O A brachialis
A collateralis a -
N radialis E'omi ceodnidavl liuss- - :
-
408
* I'
415/l 424
Arteriesandnervesof the anterior Fig.416 antebrachialregion,Regioantebrachiianterior; deeplayer;the flexor digitorumsuperficialismuscle hasbeenpartiallyremoved; ventralview (1.,45%).
Arteriesand Nervesof theElbowRegion
a \ A collateralis ulnarissuperior
.t
/ a A collateralis ulnarisinlerior N medianus
Septum- intermusculare brachiimediale
--
\ Epicondylus medialis N ulnaris
a A brachialis
--
o M bicepsbrachii
--
e M brachialis
- - Aponeurosis muscull brachii biciPitis
- Olecranon
--
I - f Caputhumerale M. llexor.l carpiulnarisI CaPUtulnareo *I
a M brachioradialis N radialis
--
-f H .p o s t e r i o r a A recurrens{ urnafls R.anteriora__ I
; Mm tlexores antebrachii
--
a A ulnaris
--
a A radialis
-M.flexora digitorumprolundus
a M oronatorteres N medianus
--
Fig. 417 Arteries and nerves of the ulnar and anterior elbow region, Regiocubitalis anterior; the flexor musclesof the forearm have been partially removed; medial(ulnar)view (1.,6070)' -
N radialis
- -- a A. collateralis (R.anterioo radialis, A b r a c h i a l i sO - -
N medianus
a M brachioradialis
.-
---
a Mm extensores carpi radiales
N radralis, R superficralis
N radialis, R prolundus
-A radialisa A recurrens a radialis
-..
--
-carpiw --M extensor radialisbrevis
t M extensol digitorum
e M.supinator N radialis, R profundus
--
a A interossea recurrens
Arteries and nerves of the anterior elbow Fig. 4f8 region, Regiocubitalis anterior; the radial muscles of the forearm have been sectioned; Iateral (radial) view (1.,60%).
24r
242
upperLimb
.t
z O A collateralis radialis
A collateralisO -radialis
--
M b r a c h i o r a d i a l i s *- -
-
M extensorcarpia radialislongus
-
a A collateralis ulnarisinferior N ulnaris
M. brachioradialisO -
N ulnaris
a A recurrensM extensor carpia utnafls radialislongus
- Epicondylus medialis Epicondylus lateralis
- a Retearticulare cubiti
M extensor carpi a radialisbrevis
--
O M anconeus
- O A interossea recurrens
- | M anconeus M supinator a -
a M extensor N radialis, carpiulnaris R prolundus
N radialis, R profundus
M extensor carpia radialisbrevis
A interossea a poslenor
- O A interossea poslerior
Rr musculares
\
M e x t e n s oar - digitorum
M abductorpolhcisa \ longus M extensorpolliciso \
I
--
M. abductor | poilrcrsrongus
--
a M exlensor carpiulnaris, Tendo
orevts N radialis, R superticialis A interosseaanterior a -
-Retinaculum musculorum extensorum
- a M extensor digitiminimi, Tendo
- a Retecarpale oorsale R dorsalis (N ulnaris)
Fig.419 Arteriesandnervesofthe posterior antebrachialregion,Regioantebrachiiposterior; dorsalview (1.,45%).
a M extensor digitorum
--
Fl profundus nerviradialis, N interosseus antebrachii posterior
Membrana inlerossea -N radialis, B superficialis M extensorl pollicisbrevis
a M extensor pollicislongus,Tendo
--
O M extensor pollicislongus
---
I
M extensol
carpiulnaris, Tendo Retinaculum musculorum extensorum -
R dorsalis (N uharis)
Fig. 420 Arteries and nerves of the posterior antebrachial region, Regio antebrachii posterior; deep layer; dorsal view (1.,45%).
teriesoftheHand 243 - -
A ulnaris
--
B carpalisPalmaris R carpalisdorsalis
----
R palmarisProlundus
--fR palmaris superlicialis
Aa metacarpalesPalmares ArcuspalmarissuPerlicialis
- -
communes Aa digitales Palmares
/ Aa digitalespalmaresproorrae - Aa digitales PalmaresProPnae
Fig.421 Arteriesof thehand; palmarview(r.,70%).
Figs.422 a-d Variationsof the deeppalmar arch,Arcus palmaris profundus. a simple,closedArcus palmarisprofundus("textbook"case) b doubledulnar part
with A. interosseaanterior(.) c anastomosis d both radial fingers are supplied by A. radialis, the three ulnar fingers are supplied by A. ulnaris
244
UpperLimb
N m e d i a n u s .R p a l m a r i s
N cutaneus antebrachiilateralis
N ulnaris,R palmaris A u l n a r i sa - -
N ulnafls
palmaris _ - Aponeurosis M p a l m a r i s b r e vai s - N u l n a r i s ,R p a l m a r i s
// N medranus.Rr oalmares
N ulnaris,Rr palmares palmares proprii Nn digrtales A d i g i t a l ipsa l m a r icso m m u n ias - Aa digrtalespalmares propriae a
Lrg metacarpaletransversum superficiale
q),+z+
Fig.423 Arteries and nerves of the palm of the hand, Palma; palmarview (1.,70%).
O A p r i n c e p sp o l l i c i s
Arteries and Nervesof the Hand
A u l n a r i sa
_-
O A radralts N medtanus
M tlexor carpi ulnarisa -.N u l n a r i s ,R p a l m a r i s
--
l l e x o r c a r p ir a d i a l i s , T e n d o
aM
, palmarissuperficialis a A r a d i a l i sR
Os pisiforme
N medianus, R Palmaris F e t i n a c u l u mm u s c u l o r u ml l e x o r u m
-
N ulnaris,R Protundus
-
A u l n a r i sR p a l m a r i s p r o l u n d u s- -O
a M abductor Pollicisbrevrs .-
N medianus
N ulnaris R superficialis -'-
.) M flexor Pollicisbrevis
N digitalisPalmarisProprlus
a M adduclor Polllcrs
R c o m m u n i c a n sc u m n e r v ou l n a r l
N digitalisPalmarrscommunrs
N medranus, N digitalisPalmarls communrs
--
Arcus palmaris suPerficialisI
-
- Aa digitalespalmares communes a
I I I I '
a Aa digitalesPalmaresProprrae
Nn digitalesPalmaresProprrl
nrr?o'u r\rteriesantl nervesof the palm of the hand, Fig.424 Palma; has been removed; deeplayer;the palmaralroneurosis p a l m a rr i e u ( 1 . 7, 0 % )
37'1n
35Yo Figs. 425 a-c Variations of the superficial palmar arch, Arcus palmaris suPerficialis a closedArcus palmaris superficialis ("textbook"case) b supply to the three ulnar fingers by A. ulnaris c supply to all fingers by A. ulnaris
13Yo
245
246
upperLimb
/ aM pronatorquadratus
/ aA radialis
A u l n a n sO - - -
-
M llexor caroi ulnaris t
O R carpalis palmaris a M tlexor carpi radialis,Tendo
A ulnaris,R carpalisa) palmaris N ulnaris,R palmaris
superlicialis a R palmaris llexorum Retinaculum musculorum -
N ulnaris,R, superficialis N ulnaris,R prolundus
o M flexorpollicislongus,Tendo cM
-z -z
.,
M abductorI digitiminimi
opponensPollicis
) M llexor pollicisbrevis, Caput superficiale
z O Arcuspalmarisprolundus /
A u l n a r i sa, - R palmarisprofundus
a M adductorpollicis O A PrincepsPollicis
_--
palmares Mm interossei o --
a M abductorpollicisbrevts
--_--
M adductorpollicis a - -
---
Aa metacarpalesO -palmares Mm llexores digitorum,a -lendtnes I
a Aa digitalespalmares propriae
dorsalisI a M interosseus
M m l u m b r i c a l e s -O-
416
#
Nn digitales palmares proprii a Aa. digrtales palmares propnae
424
Fig.426 Arteriesandnervesof the palmof the hand,Palma; deeplayer;the transverseheadof the adductormuscleof the thumb,M. adductorpollicis,hasbeensectioned; palmarview(1.,75%1.
241 N radialis,Rr superliciales -
OA radialis
:exlenSorum musculorum Retinaculum \,-
posterior N radials,N cutaneusantebrachii
Rete carPaledorsale a
Vaornatendtnismusculi llexorrscarpi radialis
/
alA radialis,R palmarissuperlicialis
-
OA radialis
-
A radiahs,R carpalisdorsalis a -
M extensor carDiradialisbrevis,Tendo a
-
-
-.ndo M e x t e n s o r c a rrpaid i a l i s l o n g u s , T e a
-
A radtaliso --
/
a M abductor Pollicisbrevis
-
Tendines e -M extensordigitorum, Os metacarPill
pollicisbrevis'Tendo o M extensor
aM opPonensPollicis
-
pollicislongus'Tendo o M extensor
/
Aa metacarpales dorsales O
-
/
Nn digitales dorsales
-
OA digilalisdorsalis
-
oM
adductorpollicis
M interosseusdorsalis I a
M l u m b r i c a l ias /
N digitalispalmaris ProPrius O A digitalis Propria Palmaris
-
N digrtalisdorsalis
4r9
42s#42s l-lv' Vaoinaetendinummusculorumextensorum: i vlEiiii teintinummusculorumabductorislongi et dxlensorisPollicisbrevis m extenso.Illn.caaj radialium rr Viiirii i6-n'din'um'muscutoru lll Vadinatendinismusculiexlensorispolllcls.longl lV Vadinatsndinummusculorumextensorisdlgltorum et Extensorisindicis
Fig.427 Arteriesand nervesofthe hand; lateral(radial)view (r.,65%).
24SupperLimb N radialis,N cutaneus antebrachiiposterior
I I
V cephalica \
N radialis,Fl superficiails -
venosum oorsaremanus
/
V cephalica
Nn digitalesdorsales
/
Fig. 428 Vesselsand nervesof the back of the hand.Dorsummanus: dorsalview (1.,70%\.
Vv intercapitulares
Arteries and Nervesof the Hand
Membrana inlerossea\
M extensor pollcis brevts a \
249
O M extensor carpi ulnaris
/
\
M abductor pollicislongus.Tendo a \\
interosseaanterior
aA
/
N. radialis,R. Profundus, N. interosseusantebrachiiposterior
z
extensorum--musculorum Retinaculum
Rete carpale dorsale O --
-
O A u l n a r i s , Rc a r p a l i s d o r s a l i s
A radialis O -
--
R perforans I --
oA radialis,R carpalisdorsalis
A princepspollicisO - -
M extensor pollicislongus, | Tendo
-
M adductorpollicisa -
\
lAa
metacarpalesdorsales
420
xil7+ Fig.429 Arteriesand nervesof the backof the hand,Dorsummanus; deeplayer; dorsalview (1.,70%).
250
upperLimb
Canalis carpi
i
1/ i/
M flexor carpi radialis,Tendo
-i
z Fascia antebrachii
/Aulnaris
N medianus
i M palmarislongus, Tendo .-
1/
z N. ulnaris
)\
.-.
Retinaculummusculorumflexorum .- .- --
O sp i s i f o r m e
--Thenar .---_
,.t----'HyPothenar - - Lrgg metacarpaliaPalmaria :-
Canalis carpi - -
, )---
M extensor Tendo digitorum, Ossametacarpi
t
-:--I I
profunous, M flexordigitorum Tendines
{ J-----.-
patmaris ooon"rrosis M tlexordigitorum Tendines superficialis,
---Mr lumbricales (Aponeurosis dorsalis)- Phalanxproximalis-- profundus, M tlexordigitorum Tendo M llexordigilorumsuperficialis, Tendines
-'i
Vaginatendinum
Fig. 430 Fasciasof the hand; the compartmentshavebeenpartly opened; palmar view * ** '""
c l i n i c a l :G R A Y S o Nl'isg a m e n t c l i n i c a l :C L E L A N Dl 'i sg a m e n t c l i n i c a l :C a n a l i su l n o c a r p a l i s( l o g ed e G U Y o N )
oftheHand 25I
A. interosseaanteriora
---
interossea Membrana
---
O A. interossea Posterior
---
a M extensordigilorum
- O M abductorpollicislongus'Tendines
' quadratus M. Pronator
-
pollicislongus,Tendo a M extensor
- Radius
' Tendines profundus' M llexordigitorum ---
Articulatioradiocarpalis
f lexorum musculorum Retinaculum o Tendines superficialis, M. llexordigitorum
--
Os lunatum
--
o Retecarpaledorsale
- -
- - Os caPitatum
Rete caroale PalmareO *--
AooneurosisPalmaris- -.
- - Os metacarPi lll, Basis
lll O --r A metacarpalis Palmaris ---
--
ll a M. interosseus Palmaris
lll o --palmariscommunis A digitalis
--
dorsalislll a M interosseus
--
dorsalisI O A metacarPalis
' supedicialis ArcusPalmaris
-M l u m b r i c a l i sl l l , T e n d oO - A digitalispalmaris PropriaO O A digitalis dorsalis
Phalanx oroximalis -
Vagina tendinum
-
Phalanx media
\ Phalanx distalis
Fig.431 Hand,Manus; ,ulittut sectionthroughthe ulnar aspectof the middlefinger; ulnar view . * clinical: CLELAND's ligament * * clinical: GRAYSoN'sliSament
252
upperLimb N digitalisdorsalis
Fig.432 Arteriesand nervesof the index finger,Index; lateral(radial)view (r., B0%)
digitorum,
Corpus phalangis \ N digitalisdorsalis
N drgitalisdorsalis
Peflosteum
il M tlexor digilorum prolundus,Tendo
; A digitalispalmaris propria
N digitalispalmarisproprius \
Vagina tendinum digiti
M tlexor digitorum superficialis,fendo a /
Fig. 433 Middle finger,Digitusmedius [IIl]; crosssectionthroughthe shaft of the proximalphalanx; distal view.
s o t : a l l e dd o r s a la p o n e u r o s i isn w h i c h t h c t e n ( l o n so f t h ( ' c r t c n s o rr l i g i t o r u m l u s (l c s r a ( l i a t e m u s ( : l ea n ( l t h o t ( ' n d o n so f t h e i n t e R r s s r r r uasn d l u m l r r i r : am
Periosleum \
--
N digitalispalmarisproprius / lrrf flexor digrtorumprolundus fendo I
\
I
A drgitalispalmarispropna
Vagina tendinum digiti
/
Fig. 434 Middle finger, Digitus medius [II!; cross section through the shaft ofthe middle phalanx; distal view.
* so called dorsal aponeurosis The position of the arteries and nerves of the finSers remains constant,enabling easy accessfor local anaesthesiaor to stop bleeding.
CrossSectionof the Arm
253
N culaneus brachii lateralassupertor
M bicepsbrachii * r. V cephalica o \
,/
,/
N. cutaneus .. brachil meolalrs
/
N medianus aA brachialis
-'
OV brachialis
--
- Telasubcutanea, Panniculus adiposus
N cutaneus mediahs antebrachii
H u m e r u s-
N ulnaris --
Fasciabrachii-
cutaneus brachrl lateralisinferior
oV basilica
\ {}M. triceps brachii, Caput mediale
N cutaneus antebrachii posterlor \ l M t r i c e p sb r a c h r i , C a p u tl o n g u m / Seplum intermusculare brachii laterale
'3"""0t"i c / lJ8::l: " Brat;hialregion,Brachium; Fig. 435 crosssectionthrough the mitltlleof the upperarm; distal 'v'ien(r , 120'/,).
\
N radialis
N cutaneus brachiimedialis
\Vhenthe shaft of the humerusfractures,the radial nerve is in its path through the radial sulcus,due to its enrlangerecl p r o x i m i t yt 0 t h e h u m e r a ls h a f t
V cephalrca
M brachialis Humerus
Septum intermuscularebrachii laterale
Fig. 436 Brachial region, Brachium; cross-sectionalimage obtainedwith magneticresonance
--
M b i c e p sb r a c h l l
- -
V brachialis
--
V basilica
- -
Septum intermuscularebrachii mediale
--
M triceps brachii
(MRT)throughthe middleof the upperarm; tomography distalview(r.).
254
IrpperLimb M. palmarislongus,Tendoo I I
/ O v mediana antebrachii
M flexordigitorum a \ suoenrcralrs \
/ O A. ulnaris
N medianus \ N ulnaris
M flexorc€rpia \ raorails \ flexorpollicislongusa \
\
_-
a M flexorcarpiulnaris
A r a d i a l i s a\ \ N radialis
M brachioradialis o
---
V cephalica O --
o M flexordigitorum profundus
M. extensorcarpi O -radialis brevis Radius --
-Fascia antebrachii
o M extensorcarpiulnaris
/
M extensorcarpiradialislonguso
\ o M. extensor indicis; M extensorpollicislongus
/
t \' M abductorpollicislongus
\ OA interosseaposterior posterior N. interosseus antebrachii
o M. extensordigitorum
Forearm,Antebrachium; Fig.437 crosssectionthroughthe middleof the forearm; distalview (r., 720o/o\.
M flexorcarpi -radialis
M. flexordigitorum- superficialis
--
M paharis longus,Tendo
- -
M. llexor carpiulnaris
--
M flexor protundus digitorum
- -
Ulna
M. brachioradialis---
M. flexorpollicis- - longus R a d i u s- - -
---
Fig.438 Forearm,Antebrachium; imageobtainedwith magnetic cross-sectional resonancetomography(MRT)throughthe middle of the forearm: distalview (r.).
interossea Membrana antebrachii
255 CutisI \. \
longus, M. palmaris Tendines M tlexordigitorum superticialis, N. medianus, R. palmaris -_ \.\l -
N medianus
\ \, t.
-
'\
/ Fascia antebrachii
i l
/ O M, flexof digitorumsuperficialis' I
/
M flexor carpi radialis,Tendo'
A . ;N u l n a r i s
/O
7 I M flexorcarpiulnaris
M llexorpollicislongus,Tendo*a --_ A r a d i a l i s o- - -
N ulnaris,R. dorsalis
N musculocutaneus. lateralis N cutaneus antebrachii pollicis longus,Tendines'a - M abductor a V.ceohalica; N radialis,R superficialis
) M flexordigilorumprolundus'
------
quadratus o M pronator
- - - - Articulatioradioulnaris distalis, Recessussaccilormis
-'
pollicisbrevis'Tendo*a -M extensor Tendoa / M brachioradialis, Mm.extensorescaroiradialesa longuset brevis,Tendines*
---*----
- -
Ulna Tendo' carpiulnaris, o M. extensor
-
Radius/
,"
Fasciaantebrachii
/ Telasubcutanea
,j
/ I M extensorpollicislongus,Tendo*| V basilicao
Articulatioradioulnarisdistalis - a M extensor digitiminimi' \oM
t, t
extensorindicis*
aM exrensordigitorum'
l I Retinaculum extensorum musculorum
Fig. 439 Forearm,Antebrachium; cross-sectionalimage at the level of the distal radio-ulnarjoint; distal view (r., 90%). ' Thesetendons run through synovial sheaths,Vaginaetendinum, at this level
Mm llexores-
- - Ulna,Caputulnae
- - Articulatioradioulnarisdistalis, Cavilasarticularis
Fig.440 Forearm,Antebrachium; imageobtainedwith computedtomography cross-sectional (CT)at the levelof the distal radioulnar joint; distalview (r.).
256
(rpperLimb M palmaris longus,Tendo C \
/, Hypofienal
Retinaculummusculorumflexorum \
-l n' e\ n a r
.\
\\
N medianus- -_
)
--
M f l e x o rp o l l i c i sl o n g u s ,T e n d oC - 'M
a
A;N
flexor carpi radialis,Tendo t - - _ Ostrapezium ---
M abductorpollicislongus, Tendo | -M extensor oollicisbrevis. Tendo I
--
---
V cephalica a --
-..
A r a d i a l i so - ..
Mm extensorescarpi radiales,Tendines * --
t
M extensor pollicislongus, Fendo * / t
\
/ Os traoezotdeunr
\
Fig.441 Carpus,Carpus; crosssectionthroughthehamulusof thehamatebone,Hamulus ossishamati;thesynovial Vaginae sheaths, tendinum, areshown; distalview(r.,100%).
oahamatum
* M extensor digiti minimi, Tendo
taV
.. \
* M extensor carpi ulnaris,Tendo
basitica
os capitatum
ts M extensor digitorum,Tendo
* M extensor indicis,Tendo ' carpal tunnel syndrome:comprossionof tht: median nerve in the carpal canal . . u l n a r t u n n o l s y n d r o m c :c o m p r e s s i o n o f t h e u l n a r n e r v ei n t h e s o c a l l e du l n a r t u n n e l{ l o g ( d : e GUYoN)
Thenar --
Os metacarpipollicis,Basis - -
- - -
Retinaculummusculorumtlexorum
---
Canaliscarpi; (Mm flexoresdigitorum)
- - -
Hamulus ossis hamati
Os trapezium- - Os trapezoideum
- -
Hypothenar
- -
Os hamatum
--*
Oscapitatum
--(Mm extensoresdigitorum)
Fig.442 Carpus,Carpus;cross-sectional imageobtainedwith computedtomography(CT)throughthe hamulusof the hamatebone; distal view (r.). palmares a Aa digitales communes; N medianus Mm lumbricalesa M flexor polhcisbrevis, rF . Caput superficiale
superlicialis, , t M. flexordigilorum Tendines I
\ tt
/
i M abductor digiti minimi
/
M flexor pollicis longus, Tendo, a -. ' Vagina iendinis
a M. gPponens
--
M abductor pollicis longus t - - -
olgllt mlnlml
- - Os metacarpiV
M opponens pollicis a - -
*-
profundus, c M tlexordigilorum Tendines
Os metacarpipollicis - --
M extensor pollicrsbrevis a - -
e M e x t e n s o r d i g i tm i inimi
M extensor pollicis longus, c -Tendo, Vagina tendinrs M tlexor oollicisbrevis. I Cad,utorofundum
'
\
r -M adductorpollicis
\
M interosseusdorsalisI a \
,'i
lll Os metacarpr
Fig. 443
/
,ti
a M interosseuspalmaris lll
dorsalislV t M interosseus lv Os metacarpr
palmansll t M interosseus
o M interosseus dorsakslll t M extensor digitorum,Tendines
Metacarpus,Metacarpus;crosssectionthrough the middle of the 3rd metacarpalbone;distal view (r., 95%).
n
Ptexusbrachiatis Z)
rFl
Innervation patterns of Plexus cervicalis and Plexus brachialis motor
sensory
Plexus cervicalis
c 1 - c 4( c 5 )
Ansa cervicalis Radixsuperior Radixinferior
Mm. infrahyoidei Skin supeliolof PI'ocmastoldeus Sl
N. occipitalis minor N. auricularis magnus N. transversus colli Nn. supraclavicularesmediales
Skin of antefiorneckregion Skin of lateralneckregion,infraclavicular areaof chestand shoulder
Nn. supraclaviculares intermedii Nn. supraclaviculares laterales Rr. musculares
M. Ionguscolli,M. longuscapitis,NI.rectus capitis anteriot',Ir'[m.i ntet'transverlvl.levatorscapulae, salii, (M. trapezius), M . s c a l e n um s edius
N. phrenicus
Diaphragma
Plexus brachialis (c5) c4-Tl (T2) N. dorsalis scaPulae
Mm lhomlloidei M levatorscapulae,
(c3)c4(c5)
Pleura Anteriolpalt of pericardium, of the central peritoneum diaphraginatica, partsof the diaPhragm
c4,c5
N. suprascapularis C4-C6 Nn. subscaPulares
M. infraspinatus M. supraspinatus,
N. subclavius
M. subclavius
N, thoracicus longus
M. serratusanterior
Nn. pectorales c8-T1 N. thoracodorsalis
M pectoralismaior,M. pectoralisminor
(M teresmajos) M. subscapularis,
c5-c7
(c4)c5,c6
c5-c7(c8)
c6-c8 Rr.musculares N.musculocutaneus c5-c7
M latissimusdorsi,M. teresmaior M. longuscolli,M longuscaPitis M. bicepsbrachii, M coracobrachialis, M. brachialis
Skin of the radialsideof the forearm Skin of the radialsideof the Palm (3,5fingers)
N. medianus
c6-T1
Skin of the ulnarsideof the hand(palmar: 1,5fingers,dorsal:2,5 fingers)
N. utnaris c6:T1
Mm. interossei Skin of the medialsideof the upperarm
N. cutaneus brachli medialis TI _T2 N. cutaneus antebrachii medialis C8-T1 N. axillaris
c5.c6
N. radialis
c6-Tr
Skin of the ulnar sideof the forearm M. teresminor M. deltoideus, Skin of the dorsalsideof upperarm, forearm M. tricepsbrachii,M. anconeus, M- extensorcarpi radialis and hand {2,5 radial fingers,with the M. brachioradialis, exceptionof the terminal phalanges) longus,M. extensorcarpiradialisbrevis, digitorum' extensor M. iurrinator, M. M. exiensorpollicislongus,M. abductor oollicislongus,M. extensorpollicisbrevis, M. extensorcarpi M. extensoiindicis, ulnaris
|
258 Vv superiorescerebri
\
(Plicapetroclinoideaposterior) \ (Plica petroclinoideaanteriorl
\
\
\
N trochtearis [tV] \ N oculomotorius Illl] \ Proc clinoideusanterior \
7 Falx cerebn
/ N trigeminus [V],Parssensoria
z')
/ N tflgeminus [V],Parsmotoria
\ \ -\
\\
v
N opticusflll \
z Tentoriumcerebelli
\
-.-
Incisuratentorii
_---
N l a c i a l i s[ V l l ]
--
-----
N veslibulocochlearis lviltl
N g l o s s o p h a r y n g lexul s N v a g u s{ X l N accessorius [Xl]
-tt***-
- -Os temporale, Parspetrosa
Fig. 444 Cranialdura mater,Dura matercranialis; t h e s k u l l h a s b e e ne x p o s e rl la t e r a l l l ; left superiorview. * g a l ) si n t h e r u r c l l r a l falx
The Dura mater cranialis The Dura mater cranialis covers the cranial cavity entirely and adheres to the bones of the skull. The cerebrai falx juts out at the sagittal level and runs from the Crista galli to the ridge of the cerebellar tentorium. This, in turn, spans the posterior cranial fossa and is attached along the transverse sinus and the ridge of the pyramid. The edges of the tentorial notch, Incisura tentorii, cover the mesencephalonand
run laterally into the Plicae petroclinoideae anterior and posterior,which go to the anterior and posteriorclinoid processes. The cerebralfalx and the cerebellartentorium divide the cranialcavityinto threespaces, for the two cerebralhemispheres and the cerebellum. Thesespacesare not entirely separated fromoneanother.
duraematris 259
mater cranialis and Stnus
Sinus petrosus inlerior a /
Sinus sagittalissuperror
--
Sinus sagittallsinterior
Sinus sphenoparietalis \ Vv supertorescerebrl
- - A carotis interna -
N o p t i c u us l - _ ---
V magnacerebll
. -s. - _ Sinuscavernosu - - Sinustransversus H y p o p h y s i-sS i n u si n t e r c a v e r n o s-i -
l-----
-
--
S i n u ss i g m o i d e u s
----
----
S i n u sr e c t u s
----
C o n f l u e nssi n u u m
--
sinusocciPitalis
?n---
s i n u .m a r g i n a l i s \ Foramenmagnum
suPerlor Sinusoetrosus
Cranialdura mater,Dura matercranialis, Fig. 445 and dural sinuses,Sinusdurae matris; the skull has beenexposedlaterally;the Tentorium cerebellihas beenpartially removed; left suPertorvtew.
263) alsopage Location of the Sinus durae matris (see Calvaria,Falx cerebri and Tentorium cerebelli uPerior Sinussagittalis Sinussagittalisinferior Sinusrectus
Anterior and medial cranial fossa
posteriOrCranialfOssa
SinussphenoParietalis Sinuscavernosus Sinusintercavernosi SinuspetrosussuPerior Sinuspelrosquamosus
Confluenssinuum Sinustransversus Sinussigmoideus Sinusmarginalis SinusocciPitalis inferior Sinuspetrosus Plexusbasilaris
Brain, Encephato
260
--
A. carotis interna. Pars cavernosa
A. temporalis superficialis.
- A. supraorbilafis A opnrnar-lI m r c aI \ A supratrochlearis _ -
A basilaris
A angularis A sphenopalatina A infraorbitalis - ^
-
--
Pcraurd
A verlebralis
descendens A infraorbrtalisAa temporales profundae
---
A labialissuperior.--
A auricularis posterior
A b u c c a l i s- A transversa'laciei A alveolarisinferior / A maxillaris/ palatinaascendens A labialis inlerior --' A facialis-A s u b m e n t a l i s- - A lingualis -
-- A vertebralis -
A carotis extena /
/
A thyroideasuperior/ A caroliscommunis
Fig. 446 Externalarteriesof the head; viewedfrom the left.
Internal carotid artery, A. carotis interna Theinternalcarotidartery is dividedinto four parts.The Pars ceryicalis begins at the commoncarotid artery and runs throughthe carotidtriangleto the baseof the skull. Within the Os petrosum,the Pars petrosa runs in the carotidcanaltogetherwith the (sympathetic) internalcarotid plexusand the internalvenouscarotidplexus.After leaving the canalon the ventralsideof the tip of the pyramidit is only separated by a septumof thin boneor connective tissuefrom the trigeminalganglionwhichlies laterally.
that ascendsin the Canaliscaroticoclinoideus on the medial aspectof the anteriorclinoidprocess.In the cavernous sinus the internalcaroidarterygivesoff a seriesof smallarteriesto the surroundingstructures.
Making anothersharp bend, known as the "carotidgenu", it perforatesthe inner layer of the Dura mater cranialis, gives off the ophthalmicartery dnd passesinto the Pars space cerebralis.With this it arrives in the subarachnoid and divideswithin the latera-lareaof the chiasmaticcistern into the anterior cerebralartery and the medial cerebral The Pars cavernosapassesthrough the cavernoussinus in artery (A. cerebri media).The connectionto the posterior a heavilykinkedS-shaped loop,the so-called carotidsiphon.It cerebral artery is made by the posterior communicating runs alongthe bodyof the sphenoidbonein a shallowgroove artery.
'$ of theBrain rteries
:3 *
A c a o s o m a r g r n a-l -t -s- - - A c e r e b r im e d r a
.--
A cerebri anterior - - -
---
A communlcans Posterlor
---
A cerebrrPosterror
---
A i n l e r i o ra n l e r i o rc e r e b e l l l
------
--
A . c a r o t l sI n l e r n a . Pars cerebralls
A basilaris A i n l e r i o r p o s t e r r ocre r e b e l l i
A carotis inlerna, Pars Petrosa
A vertebralrs
I
".-:I \.G
--_ \
A c a r o t i s i n t e r nP a a r sc e r u t c a l l s
A carottsexterna
A carotis communls
l r t e r i e so f t h e h e a t l ; Fig.447 Intertlaa v i e n e r lt r u m t h e l e f t .
F i g s . 4 4 Ba , b l n t e r n a lc a r o t i da r t e r y ,A c a r t t t i si n t e r n a ; radiographsafter injectionof a contrastmedium (angiography).
AP ratliograph,cligitalsubtractionangiography(DSA) (DSA) b lateralrarliograph,digital subtractionangiography
a
262
Brain, Encephato /
V thalamostriatasuperior
/
parietalis V emissaria inferior / Sinussagittalis / V internacerebri superior / / Sinussagittalis
)-- Y;lslr" --
V basalis"
V ophthalmica -supenor
V angularis-l
- -
-S i n u scavernosus
\ \
Plexusvenosusforaminis ovalis
-- /'--
V emissaria occipitalis
Confluens sinuum V occipitalis
V emissaria mastoidea
Sinus sigmoideus
Bulbussuperiorvenaejugularis
^HIEXUS ./
plery9oideus
V lacialis
/
/
7l
/ V retromandibularis
V jugularis internaI
Fig.449 Veinsof the head; viewedfrom the left. *
G A L E N ' Sl e i n R o s E N T H A I ' s\ e i n " * LABBf's anastomosis "'
Vv. emissariae- Foraminain the skull V. emissariaparietalis- Foramenparietale., - Foramenmastoideum V. emissariamastoidea V. emissariaoccipitalis- Foramenin the areaof the Protuberantiaoccipitalisexterna V. emissariacondylaris- Canaliscondylaris
Plexusvenosuscanalisnervi hypoglossi- Canali.s nervi hypoglossi Plexusvenosusforaminis'ovalis- Foramenovale Plexusvenosuscaroticusinternus - Canaliscaroticus
inusduraematris 263
V ophthalmicasuperior \
\
/ Sinussphenoparietalis
Sinus intercavernosi
Sinuscavernosus /
meola V meningea
Plexus basilafls \
S i n u sm a r g l n a l r s- -
Bulbussuperror venaejugularis
- Sinussigmoideus Sinus occipitalis --
Confluens stnuum -
Sinus sagittalissuperror
Sinustransversus
-
F i g . 4 5 0 D u r a ls i n u s e sS, i n u sd u r a em a t r t s ; the cranialvault has been removed;the venousslnuses havebeenfilled rvith a plasticcomponent; supenorvlew. * L e g g i ' s a n a s t o m o s ius i t h t h e s u l ) e r f i i(a l m i d d l et ; e r e b r arle i n s ' \ r m e r l i u es u l r e r t i irr l e r r e r e l r r i
The sinuses of the dura mater, Sinus durae matris TheSinusduraemaFisconsistof venouschannelswith no musculartissueor valves,whichdrainthe brainby bridgingveins' Mostof the bloodflowsthroughthe Sinussigmoideiand the Vv.jugularesinternae.In addition,therearesomesmallervalveveins,e.g.Vv' betweenthe inha-andextracranial lessconnections Vv. emissariae. very variable and the superiores ophthalmicae
The two cavernoussinuses have a central position, being locatedin the middle cranial fossato the right and left of the Sella turcica. They are linked by the Sinus intercavernosi and are also connecteddirectly and indirectly with most sinusesas well as with veins in the orbits and Fossaeinfratemporales.
Brain, Encephat
264
V emissariaparietalis \
Lacunae laterales
\
\
Os parietale \
Sinussagittalis superior \
/ Sutura sagitlalis
/ Granulationesarachnoideae
.}
- -
Epiderm,s
--
Cutrs D e r m r[sC o r i u m ] , f
\
Galea aponeurotica
\_
V v d i p l o i c a e- -
L a m i n ai n t e r n a Dura mater cranialis Arachnoideamater cranialis Pia mater cranialis Spatium / subarachnoideum
subarachnoideum
--
,
I a,
Substantlaalba /
,t
-a
t'/g . N
Cortex cerebri Gyri cerebri
Falx cerebri
N
v
Fig. 451 Cranialvault, Calvaria,and meninges,Meninges; frontal sectionthrough the crown of the head. In the adult the cerebrospinalfluid is mainly absorbedin the
and alsovia lymphaticsheathsof Granulationesarachnoideae the small vesselsof the pia materand the perineuralsheathsof the cranialand spinal nerves.
Suturasagittalis\
W diploicae---( occipitales
/ \
Vv diploicae temporales anteriores
W diploicae temporales posteriores
Fig.452 Diploic canals,Canalesdiploici, and diploic veins, Vv. diploicae, of the cranial vault;
the Lamina externa of the bonesof the cranial vault has been removed; dextrosuperior view.
Baseof the Skull,Internal Suface,Basiscranii interna
/
suPerror Sinussagittalis Ouramatercrantalis\
M rectussupeflori \
Falx cerebri ,
|
V nasotrontalis,i* \ A ophthalmica O \
265
!
,/
a Sinus sagittalisinferior meningeusanterior
/ aR /
\
OA ethmoidalisanterior / a Sinus intercavernosusanterlor
/
M levalorpalpebrae superiorlsO \\
N opticusl|] / aA carotisinterna
Bulbusoculi:
N ophthalmicus[V/1]
/
/, OA meningea media, R frontalis
N opticuslll
N trochlearis lvl N oculomotorius Illl]
V lacrimalis6 -
N maxillaris [V/2] Plexuscaroticus internus
Vv crliaress / V oohthalmacasupenor s --
Gangliontrigeminale*
/
A carotisanterna O $ Sinuscavernosus
R meningeus(V/3)
/
Sinus sphenoparietalis,* -
/
meningeamedla
aA
/
N petrosusmaior
/
/ OA tymPanicasupenor
-
N, pelrosus mlnor O A meningea media, R parietalis
Hypophysrs -
-S t n u s# intercavernosus Posterior Plexusbasilaris o
N tngeminus [Vl -
Sinuspetrosusa / superlor N glossopharyngeus
Sinus lransversus$
N tacialislvlll Nveslibulocochlearis lvilrl superror o SinusPetrosus
\
-\ --
Tentoriumcerebelli
1A meningeamedla' R petrosus
/ z
N vagus[Xl
\ /
'i
\
N accessorius [Xl] N hypoglossus[Xll]
\
/
\ \
/ Sinussagittahsinleriorl
7
sinusrectus*/ / sinuumI I Contluens
I
t\
t
1A
N intermedius
a Sinussigmoideus a (". meningeus) (4. occipltalls)
O A labyrinthi
Foramen jugulare
N abducens [V|]
N accessorius [Xl]
vertebralis,Rr meningei
Medulla oblongata
\ Falx cerebri a Sinus sagitlalissuPerior
44450',tr 454/'
the roof of the left orbit and the cerebralfalx havebeen Basiscranii Fig.453 Baseof the skull (internalsurface), removedtogetherwith the right part of the Tentoriumcerebelli; interna,with cranialduramater,Duramatercranialis,dural superiorview. craniales; Nervi sinuses.Sinusduraematris,andcranialnerves' * clinical: Glssrn's Sanglion
Brain,Encephato
266
Nn olfactoriill A c o m m u n i c a n sa n t e r i o ra \ Pars oostcommunicalisa , \ A cereDrl?nle''o' pars precommunrcalrso \ N o p t i c u sl l l \. t \ A c a r o t i si n t e r n a .O , Pars cerebralis \ I A ophthalmicaa\ \\
cribrosa / Foramrna / Hypophysis , Canalisopticus /
A c e r e b rm i e d i aO a a \ , N trochlearis lvl
ta
,
/
/, Proc. clrnoideus Posterior
,/
/, Fissura orbitalis supelor
N frontalis \tt V ophthalmicasuperior O \ N lacrimalis \
i'\,
N a b d u c e n s[ V l ]
\
N nasociliaris
.
\' \
7 Foramen rotundum
N o c u l o m o t o r i u !sl l l
cerebriposterior
A carotis interna,O Pars cavernosa
/aA
N maxillaris[V/2]
- Sulcuscaroticus
A communicans posteflor O --.P l e x u sc a r o t i c u sI n t e r n u s
- Foramenlacerum
Plexus venosus caroticusinternus a - -P l e x u sv e n o s u sa - - foramrnro s valis N mandibulafls[V/3]
(
_ ---
earso
- A. cerebri I precommunicalis posterior'l ParsO -I postcommunicalis Fl
Foramen ovale S u l c u sa m e n i n g e a e medrae
- - - Apexpartispetrosae --
manin^ailc
F o r a m e ns p i n o s u m
-- .-
A m e n i n g e am e d i a O -
Canalis caroticus
N petrosus minor
A superiorcerebelli
N petrosus major
-H r a t u sc a n a l i s nervi petrosi minoris
A b a s i l a r i sO - N t a c i a l i s[ V l l l
N v e s t i b u l o c o c h l e[aVrlilsl ] N accessorius [Xl] posterior A meningea O/ N vagus[X] / N glossopharyngeus lXl S i n u ss i g m o i d e uos /
N hypoglossus[Xl|]
/
\
Hiatus canalis nervi petrosi majoris
\
Porus acusticus inlernus
\
a A labyrinthi
\
F o r a m e nj u g u l a r e
\
S u c u s s i n u ss i g m o r d e i
\aA
\ Canalis nervi hypoglossi
./
Medulla oblonoata /
inferioranterior cerebelli
\
/,//
P i a m a t e rc r a n i a l i s/
/
./
/
/
\
1
,'
/ Spatium subarachnoideum
\
\ \
\ /
\
o A vertebralis
o A. inferrorPosterior cerebelll
F o r a m e nm a g n u m
o S i n u so c c i p i t a l i s
/ A r a c h n o i d e am a t e r c r a n i a l i s
/ Duramatercranralis
of the vesselsand nervesthrough the Fig. 454 Sitesof l)assage , n r lt h e i n t e r n a ls u r f a c eo f t h e b a s eo f t h e s k u l l ,B a s i sc r a n i ii n t e r n a a , i r c u l u sa r t e r i o s t tcse r e b r i( \ \ I r l t s ) ; a r t e r i a lc i r c l eo f t h e c e r e b r u mC s u r ) e n o vr l e w
Nervicraniates 267
Foraminaof the Baseof the Skulland CraniallYerves,
Structures in the foramina of the base of the skull caroticus Canalis internus(Truncussympathicus, Plexuscaroticus' GanglioncervicalesuPerius) Plexusvenosuscaroticusinternus A. carotisinterna,ParsPetrosa
Lamina cribrosa Nn. olfactorii []
anterior A. ethmoidalis opticus Canalis N. opticus[II] A. ophthalmica n. optici Vaginae Meninges; FissuraorbitalissuPerior Medialpart: (N.ophthalmicus N. nasociliaris [V/1]) N. oculomotorius [lll] N. abducens [VI] Lateralpart: N. trochlearis[lV] N. frontalis(N.ophthalmicus [V/1]) (N.ophthalmicus N. lacrimalis [V/1]) media) R.orbitalis(A. meningea superior V.ophthalmica Foramenrotundum N. maxillaris[V/2] Foramenovale N. mandibularis[V/3] Plexusvenosusforaminisovalis Foramenspinosum (N.mandibularis[V/3]) R. meningeus media A. meningea Fissurasphenopetrosa N. petrosusminor(N.glossopharyngeus [lX]) Foramenlacerum N. petrosusmajor(N.facialis[VII]) N. petrosusprofundus(Plexuscaroticusinternus)
Cranial nerves, Nervi craniales
1. Nn.olfactorii[] 2. N. opticus[II] 3. N. oculomotorius [IIl] 4. N. trochlearis[V]
Exit fromor entryinto the brain Bulbusolfactorius Chiasmaopticum cerebri,Sulcus Pedunculus oculomotorius Dorsalto the Tectum mesencephali Lateralmarginof thePons
5. N. trigeminus[V] - N. ophthalmicus [V/1] I - N. maxillaris[V/2] I Gangliontrigeminale - N. mandibularis[V/3] ) PonsandPyramis Between 6. N. abducens [VI] 7. N. facialis[Vll] \ Cerebellopontine angle B. N. vestibulocochlearis [VIll]J Medullaoblongata, Sulcusposterolateralis (retroolivaris) 12.N. hypoglossus [XII]
Sulcus Medullaoblongata, anterolateralis
internus Meatusacusticus N. facialis[VII] N. vestibulocochlearis [VIII] A. labyrinthi Vv.labyrinthi jugulare Foramen AnteriorPart: N. glossoPharYngeus IlX] inferior SinusPetrosus PosteriorPart: N. vagus[X] N. accessorius [XI] Bulbussuperiorvenaejugularis Sinussigmoideus; ascendens) (A. pharyngea posterior A. meningea Canalisnervi hYPoglossi N. hypoglossus [XI! Plexusvenosuscanalisnervi hypoglossi condylaris Canalis V. emissariacondYlaris Foramenmagnum Medullaspinalis Medullaoblongata; spinales N. accessorius [XI],Radices Plexusvenosusvertebralisinternus Sinusmarginalis; A. vertebralis A. sPinalisanterior Meninges
Function of the cranial nerves (GSE) Generalsomaticefferent(motor)fibressupplythe ofthe trunk andupperand skeletalmusculature (lll, XII) VI, IV limbs lower the (GVE) Generalvisceralefferent(motor)fibres-s-upply (III, IX' X) VII' musculature vessel blood and viscera .(SVE) Specialvisceralefferent(motor)fibressupplythe pharynx,partsof the muscles, facialandmasticatory M' trapezius M. sternocleidomastoideus, oesophagus,
(v,vll,IX, x) fibresofthe body: (SSA) Specialsomaticafferent(sensory) sight,hearing,senseof balance(ll' VIII)
268
Brain, Encephato Dorsum sellae
posteriorSinusintercavernosus
\
/ Neurohypophysis
\
D i a p h r a g m a s e l l a e- - _ _
N o p l i c u s l l l-l - - - = Sinusintercavernosus anlenor -
/ Sinussphenoidalis
\
Sella turcica, Fossa hypophysialis
Os sphenoidale,Corpus
Fig. 455 Pituitary gland, Hypophysis[Glandulapituitarial; median section; viewed from the left.
The pituitary gland is embeddedin the venoussinus system sinuses(anterior of the cranialdura mater.The intercavernous and posterior)connectthe right and left cavernoussinuses.
Draphragma sellae Sinusintercavernosi \
\
Sinuscavernosus \ N oculomotorius llll \
\
A carotisinterna,-Parscavernosa
\\
---
---
----
A carotisinlerna, Pars cerebralis P r o c c h n o i d e u sa n t e r i o r Inlundibulum
N . t r o c h l e a rfilsV l - - * _ * _ : N a b d u c e ntsv l l - - - - - -
--
N o p h l h a l m i c u s[ V / 1 ] - - - - - - - :
D u r am a t e cr r a n i a l i-s- -
---
---
Neurohypophysisl Hypopnys,s ' IGlandula Adenohypophysis I bituitarial
)'
- --
Sella turcica, Fossa hypophysialis Sinus sphenoidalis
- Apexpartispelrosae - Fissurasphenopelrosa \ (Fibrocartilagobasalis)
Fig.456 Pituitarygland,Hypophysis (Glandula pituitaria)andcavernous sinus,Sinuscavernosus; frontalsection; dorsalview. (Proc clinoideus medius)\ N opticuslll]-.A carotisinlerna,Parscerebralis----{. A o p h t h a l m i c-a
t.
The two sphenoidsinusesare usuallyof differentsizesand the septumis generallytortuous.
_-
Sulcusprechiasmalicus
Hypophysis[Glandulapituitaria]
----
N a b d u c e n[sV l l
N oculomotorius llll -__ Fissurasphenopeirosa
N trochlearis[V]-N. ophthalmicus [V/11--
---
A carolis interna.Pars cavernosa
N maxillaris IV/21-- Ganglion trigemrnale
Fig.457 Cavernoussinus,Sinuscavernosus; the lateralwall of the sinus formedby the Dura materhasbeen
removed; the trigeminal ganglion has been pulled laterally; viewed from the left.
l,
TrigeminalNerve,Nervustrigeminus
I
A cerebri antenor dexlra, - P a r sp o s t c o m m u n r c a l i s
Inlundrbulum \
\\
/ ,.J
N o p t i c u sI l l
A carolrsInterna, Pars cerebralrs
h"*-=ta
Substantianigra
----
-16-r
- -
ce Pedunculu s rebri, Cruscerebrl
-'
:- - - - N oculomotorius lltl N trochlearis lvl
-A ophthalmica - -
(Plica petroclinoidea anterior)
--
N t r r g e m i n u [sV ] , Radix motoria
N o p h t h a l m r c uIsV l l l "
- N trigeminus [Vl Radix sensoria
Ganglronlrigeminale' -
N maxrllarislVl2l -'
\
N abducens [Vl]
-Ntacialislvlll
i..
\
N vestibulocochlearis[Vlll]
N mandibulaflsIVl3l -'
Fig. 458 Arteriesand nervesof the pituitarl fossa, Sellaturcica,and the cavernoussinus,Sinuscavernosus; the Dura materhas beenpartially removetl; view. superolateral * r l i n i ra l :( ; ^ s s t l R s Sanglion
/
Arachnordeamaler cranialis
\ N m a x l l l a r l sw t z ) - - -
4l
r-=
-
!-tI
,-.-\.
---
)-r;
t
:a<-r a+'d('Lt.
\'
\
\\ \ Dura mater cranialis
\ (Cisternatrigeminalis)
Fig. 459 Trigeminal cistern, Cisternatrigeminalis, and trigeminal ganglion,Gangliontrigeminale; cross sectionat the level where the maxillary nerve branchesoff the ganglion.
N t r r g e m i n u[ Vs ]
i'i
.: Tt.}
Brain,Encephato
N o p t r c ulsl l \
Hypophysis [Glandula piluilatia) /'
/
Corpus mamillare
Pedunculus cerebri
,/
N o p h l h a l m i c u s[ V / 1 ]
N k o c h l e a r i sl V l - _
--
N maxrllaris[V/2]
N t r i g e m i n u sI V I - _
--
N m a n d i b u l a r i [sV / 3 ]
- -
C e r e b e l l u mF, l o c c u l u s
N a b d u c e ntsv l l - - - F
N lacialis IVlll - -'
N v e s l i b u l o c o c h l e a r[iVs l l l ] - -
-
N glossopharyngeusllxl //
Pyramis
N vagus[X] / I
N accessorius[Xl] /
N h y p o g l o s s {uXst l l i
I I Sulcusanterolateralis
Fig. 460 Pointsof exit of the cranial nerves,Nervi craniales; inferior view t
\ o l f a ( ; t o r i u (sl ) c n t e r s I n t o l h ( , r o s t r a lc n d o f r h c I r a (t u s o l l i l (t o n u s , t h c l l u l l ) u s o l f a c t o r i u sC o m p a r ek ) F i g s 1 6 0a n r l - 1 5 { * * c l i n i c a l :B o c l t D A r t i K ' ss t r u c t u r ( 0' f t h c r h o r o i i ll t l e r u s
N. oculomotorius[III] Nuclei(qualities)
Pointof exit frorrrthebrain
. Nucl.n. III (GSE) . Nucl.accessorius nervi oculomotorii (GVE) -+ Ganglionciliare lnner sideof Pedunculus cerebri
Locationin the subarachnoid Cisterna basalis, Cisterna space interpeduncularis Pointof entry throughthe Roofof Sinuscavernosus Duramater ::,, Pointof entry throughthe Fissuraorbitalissuperior baseof skull . Motor: Distributionarea - M. levatorpalpebrae sup., Mm.rectisup.,med.,inf., M. obliquusinferior . Parasympathetic: - M. ciliaris,M. sphincter pupillae
Adjacentto the nerve
. Sensitive fibresof N. nasociliaris (V/1) . Sympathetic fibresof the Plexusophthalmicus
N. trochlearis [IV] Nuclei(qualities) Pointof exit from the brain
Nucl.n. IV (cSE)
Inferiorof Colliculusinf. Locationin the subarachnoid Cisternaambiens,Cisterna r.rl: space basalis Pointof entry throughthe Between Plicapetroclinoidea Duramater ant.andpost. Pathwayin the Duramater Lateralwall of Sinus cavernosus Pointof entry throughthe Fissuraorbitalissuperior baseof skull . Motor: Distributionarea - M. obliquussuperior
Nervicraniates 27 I
Cranial Nerves,
N o c u l o m o t o r i!ul lsl , R s u P e r i o r i Radrxsensona ' N n a s o c i l i a r i s jI i
supertor / lvl obliquus
Fissura orbitalissuperior I
Tectum mesencephati --<1
-.'
--
N lrochlearis!Vl - N t r i g e m i n u s[ V ] G a n g l i o nt r i g e m i n a l e- - N abducens [Vll --
: \ \ p^^. Pyramis medullae oblongatae
ophthalmrca N. caroticus internus
\
t.. \
M rectuslateralis
-
Nn ciliaresbreves
Ganglion ciliare
Radrx parasymPathica
Radix sympathica
Fig. 461 Oculomotornerve,N. oculomotoriusUIII; t r o c h l e a nr e r r e ,\ . t r o c h l e a r i [sl \ ' ] ; a b d u c e nnt e n e , N . a b < l u c e n[ sV l ] ; lateralview (r ). * { { ) n n e t( r ) n s \ \ i t h t h c t r i g e n i n i l l g a n g l i o l l
N supraorbitalrs I N elhmoidalisanlerior,
l l
Ganglion trigeminale \
/ n a o i xm o t o r i a- trigeminus [V] { -\ R a d i xs e n s o r i a Pons -
Glandula lacnmalis
tt , communicanscum nervo zygomatico \ N zygomaticus N n c i l i a r e sl o n g l .
Ganglion ciliare R communicanscum ganglio ctltart F r s s u r ao r b i l a l r s u P e r i o r
Fig. 462 Ophthalmicnerve, N . o p h t h a l m i c u [sV / 1 ] ; l a t e r a vl i e w ( r . ) .
N. abducens [VI] Nuclei(qualities) Pointof exit from the brain
. Nucl.n. VI (GSE) PonsandPyramis Betlveen
Locationin the subarachnoid Cisternabasalis space upperthird of the clivus Pointof entry throughthe Duramater AboveApexpartispetrosae, Pathwayin the Dura mater throughthe Sinuscavernosus, lateralof A. carotisinterna Pointof entry throughthe baseof skull
Fissuraorbitalissuperior
Distributionarea
. Motor: - M. rectuslateralis
N. trigeminus [V] Nuclei(qualities)
. Nucl.mesencephalicus n. V andNucl.spinalisn.V (GSAandGVA) . Nucl.motoriusn.V (SVE)
Pointof exit from the brain
Lateralmarginof Pons
Location,inthe subarachiOitt space Pointof entry throughthe Duramater
Cisternabasalis,Cavum trigeminale lateral Ggl.trigeminale: wall of Sinuscavernosus
N. ophthalmicuslY/ll Pathwayin the Duramatef Exit throughthe baseof skull
lateral wall ofSinuscavernosus FissuraorbitalissuPerior
D i s t r i b u l i o n a r e a , . : t t : t , : : : l :.i : lSensitive: :r, : ' : : : l : : l l l : : : : l,: , : - Tentoriumcerebelli ,:::: - Forehead, uPPerlid, back of the nose,Sclera,Cornea - Cellulaeethmoidales, nasal Sinussphenoidalis, cavity(anteriorPart) . Parasympathetic: Adjacentto the nerve - R. communicans cumn. (Glandula zygomatico lacrimalis)
27
2
Brain, Encephato Rr orbitalesI I Rr nasales posterioressuperioreslateraleset mediales
N infraorbitalis
N trigeminus[V]
Haorx sensofla
---
tsons
Foramen infraorbitale
7//
/ /a . / /,//
Rmeningeus' 'i
Fig. 463 Maxillary nerve, N m a x i l l a r i s[ V / 2 ] ; lateralview (r.)
Ganglion pterygopalalinum
..
R zygomaticofacrahs R zygomaticotemporalis
,
/
Nn alveolaressuperiores /
N pharyngeus
N. palalinus major
',/
/ Ganghon trigeminale
\- -t-)d '*"..\-='r:\
I !
i
1
Fo'a eno,ate olrcum ,/Ganglion /,/
N m a n d i b u l a r r s t V -/ *3 1 R meningeus- -
.
Nn temporalesprofundi /./
N Pterygoideuslateralis ,,
,
plerygoideusmedialis ,/ N buccahs
Foramen sptnosum -/'/ ,'
N auriculolemporalis
N lingualis z/
Rr ganglionares z Ganglion submandibutare
A meningea media
_-Chorda tympani (N faciatis)
/
N massetericus
z'
't l
N alveolaris inlerior
Fig. 464 Mandibularnerve, N. mandibularis[V/3]; lateralview (r.).
Rr linguates
/
/
//
N mylohyoideus
/
,'
Plexus denlalis inlerior
N. maxillaris lY/Zl
N mentalis Foramen mentale
N. mandibularisIV/31
Pathwayin the Dura rnater
Lateralwall of Sinuscavernosus
Exit thmugh the baseof skull
Foramenovale
Exit throughthe baseof skull
Foramenrotundum
Distributionarea
Distribution area
. Sensitive: - DuraofFossacraniimedia - Cheek,lowerlid, lateralsideof nose, upperlip - Teethandgingivaof the maxilla, Cellulaeethmoidales posteriores, Sinussphenoidalis, Sinusmaxillaris, Conchae nasalessuperiorandmedia, Palatum, Tonsillapalatina,roofof pharynx . Parasympathetic: - Rr.ganglionares ofGgl.pterygo. palatinumto Glandulae nasales, palatinaeand lacrimalis
. Motor: - Musclesof mastication, M. tensor veli palatini,M. mylohyoideus, (Venteranterior) M. digastricus . Sensitive: - Duraof Fossacraniimedia,Cellulae mastoideae - Skinof the mandible,temple,cheek, auricle(upperpart),auditorycanal, eardrum(exteriorsurface) - Teethandgingivaof the mandible, tongue(anterior2/3l,,Isthmus faucium . Sensory: - Tongue(anterior2/3) . Parasympathetic: - Chordatympani(of Nucl.salivatorius sup.to Ggl.submandibulare: Glandulaesubmandibularis andsublingualis) - Fibresfrom Ggl.oticum(Glandula parotidea)
Adjacentto the nerve
Adjacentto the nerve
Nervicraniates 77 3
Ganglion geniculi - N facialis[Vll] --
N stapedius--
- -. Canalis nervi lacialis -
- Foramenstylomastoldeum -
cum nervovago -R communicans
Fig.465 Facialnerve, N. facialis[VII]; the facialcanal and the tympaniccavitYhave beenexposed; lateralview (r.).
Rr temporales Rr zygomaticl Rr buccales
cumneruoglossopharyngeo R communicans
(R lingualis) R marginalismandibularis R colli
* c l i n i t ; a lc: e r e b e l l o p o n t i naen g l e
I
Fig. 466 Vestibulocochlearnerve, N. vestibulocochlearis[VIII]; the membranouspart of the labyrinth has been drawn at a higher magnification;dorsolateralview (r.).
internus Meatusacusticus
N vestibularis N cochlearis N vestibulocochlearis
lvilrl
anterior)per" lateraliset \. \ Nn.ampullares \ ,' N.utricularis I !,iJ"",io|. N.utriculoampullaris )
\ ,t N. saccularis \ par. inreno, N ampullaflsPostenorJ Ganglion vestibulare
* clinical: cerebellopontineangle
N. facialis [VII] Nuclei (qualities) . Nucl. n. VII (SVE)
. Nucl salivatorius superior(GVE) . Nucl.solitarius (SVA)
angle Pointof exitfrom Cerebellopontine the brain pontocerebellaris Cisterna basalis, Location in thesub- Cisterna arachnoidspace Fundusmeatusacusticiinterni Exit fromDura materand entry into the baseof skull Canalisnervifacialis Pathwayin the bdseof skull Foramenstylomastoideum Pointof exit throughthe base of skull Distributionarea . Motor: - Mimicmuscles, Mm.auriculares - M. digastricus posterior), (Venter M. stylohyoideus - M. stapedius
Adjacentto the nerve
. sensory: - Tongue(anterior2/3) . Parasympathetic: nasales Glandulae lacrimalis, Glandula palatinae(viaGgl.pterySopalatinum), and submandibularis Glandulae (viaGgl.submandibulare) sublingualis . Sensitive fromN. trigeminusto the face
N. vestibulocochlearis[VI[ Nuclei (qualities)
. Nucll.cochleares and (SSA) vestibulares
Point of exit from the brain
angle Cerebellopontine Cisternabasalis,Cisterna pontocerebellaris
Locationin the subarachnoid sl)ace Exit h'om Dura mater and entry into the baseof skull Pathwayin the baseof skull Distributionarea
Fundusmeatusacustici interni Tothelabyrinthof thepetrous part of the temporalbone . Organof Conrt . Organofequilibrium
27
$
t*^, Encepharon N. glossopharyngeus[IX] Nuclei(qualities) . Nucl.ambiguus(SVE) . Nucl.spinalisn. V (GVA) ' Nucl.solitarius (SVA) :::' . Nucl.salivatorius inferior(GVE)
Medulla oblongata, \ Sulcusretroolivaris \-'
:
N mandibularis [V/3] - Ganglion oticum - N petrosusminor
i--
- .N glossopharyngeus
lxl
jugutare'-- - - -i,\>'X Foramen
- Plexustympanicus
Ganglion superius(lX) - - - -,-:.R . c o m m u n i c a n- s - - * - \ t .. i.,u, cumramoauriculari nerurvagl GanglioninleriuslVtl'y " R musculistylopharyngei R sinus caroticr /
- N tympanicus
/
A carotisinterna,Sinuscaroticus Glomuscaroticum/
\R,ringuares
\
\
\
\ \
/ A carotis communis
Rr tonsillares
Rr pharyngeates
Fig.467 Glossopharyngealnerve, N. glossopharyngeus IX]; lateralview (r.).
J '/1 Pons --+'--
.:\ vi
. R auricularis - R meningeus _ - R .c o m m u n i c a cnus m nervogrossopnaryngeo
- '
inferius(X) / Ganglion
--
Rr pharyngeales
N- vagus[X] -
--
N laryngeus supenor
N laryngeus--recurrens A subclavia -
A carotiscommunisTruncusbrachiocephaIcus Arcusaortae Parsthoracica aortae Truncusvagalis Posterior Plexus oesophageus Diaphragma Rr, hepatici Truncus coeliacus -
the Cisternabasalis Locationrin subarachnoid space jugulare Foramen Pointofentry base through:,the of skull "r: Distributionarea . Motor: - Musclesof the pharynx(cranialpart), M. levatorvelipalatini,M. uvulae, ::r:,,,, ' M. palatoglossus, M. palatopharyngeus, M. stylopharyngeus ' Sensitive: - Pharyngeal mucousmembrane ,:r: (cranialpart),palatinetonsil,tongue (posterior third) - Plexustympanicus, Tubaauditiva - Sinuscaroticus . Sensory: .,,r - Tongue(posteriorthird) ' ParasymPathetic: Glandulaparotidea(viaGgl.oticum) - Glandulae (posterior) ":ii linguales
j=-'
Sulcusretroolivaris Ganglion superius(X) - Fo?men jugulate
oliveandTuberculumcuneatum Pointof exit from Between the brain,
- Br cardiaci ceruicales - supeflores
N laryngeus recurrens
--2--Rt - - -
---
cardiaci ceruicalesinferiores Rr cardiacrthoracici
Plexuscardiacus
- - Rr bronchiales - - Plexuspulmonalis - .-.Truncusvaoalisanterior
: _--
-----*-
Hiatusoesophageus
Rr gasficiposteriores Rr coeliaci Rr renales
Fig.468 Vagalnerve,N. vagus[Xl; bothnerves; ventralview.
N. vagus [X] (SVE) Nuclei(qualities) . Nucl.ambiguus . Nucl.spinalisn. V (GVA) . Nucl.solitarius(SVA) . Nucl.dorsalisn. X (GVE) Pointof exit from Sulcusposterolateralis ,,thebrainii:'I Cisternabasalis Locationin the space subarachnoid jugulare Foramen Pointof e4.try throughttiCbase of skull Distributionarea . Motor: - Musclesof thepharynx(inferiorpart), M. levatorveli palatini,M. uvulae - Musclesof the larynx . Sensory: - Tongue(posterior third) . Sensitive: - Duraof Fossacranialisposterior - Meatusacusticus externus(m00nshaped, inferiorpart) . Parasympathetic: - Organsof the neck,thoraxand abdomenup to the ClNnoupoint BdHrrr
tcrantates2T5
Cranial Nerves,Nerv
N. accessorius[XI] R a d i c e s c r a n i a l e s- - = _
--
Truncus nerui accessorii
--
Radices sOinales---
\
N vaguslxl R internus \ R externus \ Foramen jugulare
Xucfei:(tlUli@s),: ' Nucl' ambiguusand Nucl' n' Xl (SVE) Pointof exit from ' Radicescraniales(dorsalof the olive) ' RadicessPinales the brain (Medullacervicalis- lateral) Locationin the subarachnold spac€ Pointof'Cntryin the baseof skull
Cisternabasalis
Foramenmagnum(Radicesspinales)
Disribiiiiiliilarea''
Mfl loriernocleidomastoideus - M. trapezius
Fig.469 AccessorYnerve, N. accessorius[XI]; lateralview (r.).
N. hypoglossus[XIII . Nucl.n. XII (SVE) Pointofre)dtfrom the braia r, in the Location subarachnoid space Pointof exit throughthe base of skull Distributionarea
.I'.1A) A
Radixsuperior- -a--l (Plexusceruicalis)
Radix inlerior --i (Plexus cervicalis) i
A n s a c e r v i c a l-i-sl -
\:. \
rR thyrohyoideus
Fig.470 HyPoglossalnerve, N. hypoglossus [XII]; lateralview (r.).
Sulcusanterolateralis Cisternabasalis
Canalisnervi hYPoglossi
. Motor: - Musclesof the tongue - M. styloglossus, M. hYoglossus' M. genioglossus
3 ? f)
Brain, Encephaton Corpuscallosum, Genu,
j Septumpellucidum
Falx cerebri \
A cerebrianterior -
..-t
.,
\---.-c
Bulbusolfactorius\ TractusolfactoriusChiasmaopticum N. ooticustlll -Tractusopticus N oculomotorius tltll .- _ _ (Plicap€troclinoidea _
''fi+itt:--:;iiffi- --"J:ffi ;::l; ---
anterior) N t r o c h l e a rtitsv l - _ _ _ _ _ N a b d u c e n s t v-t-l _ _ _ _
Nucleusruber
N t r i g e m i n ut vs l - - _ _ _ _ _ Tentoriumcerebelli ---
Colliculus superiorsinister
_ _ _
Col[culiinferiores
N .f a c i a ltivsl l l - - - - _ _ _ _ ' N . v e s t i b u l o c o c h l e a r i-s - -
- ---
.- tl
--l
Velummedullare superius Sinusrectus
[vil|]
Pedunculi cerebellares Vermis cerebelli
Ventriculus quartus - - r:
A . b a s i t a r i -s- Velummedullareinlerius 'N accessorius [Xl],Radicesspinales/
--
Plexus choroideusventriculiouarti
Apenura mediana ventriculiquarti
- - - rubercurum ;rl;=)1f, srac,re )=r)a\,Y;:---==->-!':l---Tubercurumcuneatum rJf $; .r: F t::t --:
\', - -=i \ - *--.j--i-
Fig' 471 course of the cranial nerves' Nn. craniales,through the subarachnoidspace;
-'_/
tu0er(
- - - _
Medulla spinalis
the left halvesof the cerebrum,cerebellumand tentorium of the cerebellum have been removed, dorsosuperiorview (1.).
The parasympatheticgangliaof the head Thesegangliacontain,first and foremost,perikaryaof post_ superius run through without interruption. A series of ganglionic,parasympathetic nerve cells. preganglioniccells small branchesof the ganglionsupply the secretionof the from the accessory nucleusof the oculomotornerve and the lacrimalglands,as well as the mucousmembranesor the inferiorandsuperiorsalivatorynucleiendthere. glands of the sinuses,of the nasal cavity and the palate Fibresfrom the accessorynucleusof the oculomotornerve etc. (Nucleusaccessorius nervi occulomotorii), which reach the The submandibularganglion alsogetsparasympathetic fibres ganglionover the N. oculomotorius (Radixparasympathica), from the Nucleussalivatoriussuperiorvia facial nerve and the are convertedin the Ganglionciliare.Sensoryfibresfrom the Chordatympaniwhichjoin the lingualnerve.Syrnpathetic roots nasociliarynerve(Radixsensoria)and the sympathetic fibres comefrom the ganglioncervicalesuperius.Thepostganglionic of the internalcarotidplexus(Radixsympathica)passit without fibres reach the submandibularand sublingualglands via transformation.Theparasympathetic fibresgo (via short ciliary lingualnerve. nerves)to the ciliary muscle (accommodation) and to the Parasympathetic fibres reachthe Ganglionoticum from the M. sphincterpupillae(constriction of the pupil). inferior salivatorynucleus over the trunk of the glossoParasympatheticfibres run ftom the Nucleus salivatorius pharyngeal nerveand the tympanicnervewhich emergesfrom superioroverthe trunk of the facialnerveto the greaterpetrosal it. The sympatheticroots come in turn from the Ganglion nerve, then into the nerve of the pterygoidcanal to the cervicale superius.The postganglionic fibres anive in the pterygopalatineganglion. Sensoryfibres from the maxillary auriculotemporal nerveoverthe R. communicans and go on to nerve and sympatheticfibres from the Ganglioncervicale the parotidgland.
277 / Capsulainterna
/ .t
Ventriculus lateralis,Cornutemporale
lateralis, Ventriculus cornufrontale
/
A. carotisinlerna, Parscerebralis
- -
A oohthalmica
-:
A cerebriposterior \C i s l e r n a a m b i e n s :- - - - . - - - - < . Pedunculuscerebri
A carotisinterna, Parscavernosa
- Gangliontrigeminale
\
/
N. ophthalmicus [V/3]
N maxillaris[V/2]
N mandibularisl Iv/3]
Fig. 472 Courseof the cranialnerves,Nn. craniales,through the middlecranialfossa,Fossacranii media;
the temporal lobe has been lifted and partially removed; lateral view.
V cerebelli --
I
N tacialis[Vll]
- Sinustransversus N t r i g e m i n u[ V s ]- -
Pons\ N vestibulocochlearis[Vlll]
Canalis nervi lacialis
-
N glossopharyngeuslxl
N vaousIXI /
=4..t-l
--.__E /.
\
/,
i N hypoglossus [Xl|]'
\
N accessorius[Xl]l
Fig. 473 Courseof the cranial nerves,Nn. craniales,through the posteriorcranialfossa,Fossacranii posterior;
For"t"n stylomastoideum
sinussigmoideus
Duramatercranialis
the left hemisphereand the tentorium of the cerebellumhave been partially removed; view dextroposterior
27
8
Brain, Encephato
Sinussaginalis superior:_
Laminainterna Granulationes\ arachnoideae \
A. meningea media, R frontalis
L a c u n a e- - - laterales
-I
Granulationes arachnoideae
Duramater cranialis
\
Fig.474 Cranialdura mater,Dura matercranialis; the cranialvault has beenremoved;the superiorsagittal sinus and some lateral lacunas.Lacunaelaterales.have been exposed; suDenorvtew.
A. meninoea media. R. parietilis
279
Sinus sagitlalis- suPeflor
Vv mediaesupediciales cerebrl - A sulci centralis
Vv supeflorescerebfl, Vv parietales
-
Rr.paracentrales
- A sulci poslcenvalis
- A parietalis Posterior Lacunae laterales
- R gyriangularis
Vv superiores cerebri,Vv occipitales
R parietooccipitalis
Fig.475 Superficialarteriesand veins of the brain; the cranialdura mater has beenremoved;the superior sagittalsinus has beenexposed; supenorvlew. arachnoideae, The arachnoidgranulations,Granulationes are the draining sitesfor the cerebrospinalfluid.
280
Brain, Encephato
cerebri / Fissuralongitudinalis
/ Arachnoidea mater cranialis
Vv superiores cerebfl, W parietales
\
Fig.476 Brain,Encephalon, with arachnoid, Arachnoideamatercranialis; superiorview. * also termed PAccHroNr's sranulations
arachnoideae* Granulationes
Meninges 28I
Bulbusolfactorius\
/ Tractusolfactorius
Hypophysis \
/ N. opticuslll
- A carotisinterna
Cisternainterpeduncularis
--
--
N aMucenslvll --
N. trigeminus [Vl
+ -
N. lacialis[vlll
- - N. vestibulocochlearis tvilrl --
N glossopharyng€us
ttxl ---
f i --
--
N vagus[X] N. accessorius [Xl]
Arachnoideamater cranialis
Pia matercranialis
\ Medullaoblongata
\ A. vertebralis / Hemispheriumcerebelli
Cisternacerebellomedullaris
with arachnoid, Fig.477 Brain,Encephalon, matercranialis; Arachnoidea inferiorview.
Brain, Encephato
282
A. communicans anterior\ Chiasmaopticum\ A frontobasalis lateralis1
\
z Bulbusollactorius
\
medialis / A. trontobasalis
\
/ Tractusoltactorius
/ N.opticus ul A. cerebrianterior,\ Parsprecommunicalis All lsegmentum Areasubcallosa\
,, A.carotisinterna posterior / A. communicans
\
N oculomotorius !lll
//
z A.cerebriposterior, Parspostcommunicalis lsegmentumP2l / A suoeriorcerebelli N trigeminus[V]
,z
z A. labyrinthi
A. cerebrimedia,- - Parsinsularis [SegmentumM2]
N facialislvlll
--' Lobusilemporalis
ryilrl -
Substantiaperforata poslerior A. cerebriposleaior,/ Parsprecommunicalis Pll [Segmentum
--
-l
A. superior' cerebelli
Plexus choroideus ventriculiquarti
N.glossopharyngeus
- A inferior anteriorcerebelli
A. basilarisN. abducens[Vl] /
/
N. hypoglossus[Xll]
V/454
N vestibulocochlearis
--
A. choroidea -anterior
-
Hemispherium cerebetli
\
A vertebralis
t
/
/ A. spinalisanterior
/ ,'
N vagus[X]
N. accessorius[Xl] '
'
Fig.478 Arteries ofthe brain; the temporal lobe has been partially removed; inferior view.
A. inlerior Dosterior cerebelli
Medullaspinalis
See Fig. 482 regarding the segments of the arteries of the brain.
/ A. communicans anterior -- Aa centralesanteromediales -" Aa. centrales anleromediales A. carolisinterna,Parscerebralis: _
- -
A communicans oosterior- - - -
\--- . -
--
Aa.centralesanterolaterales
--- A. choroidea anlerior - R. chiasmaticus nerviouutultu( R. ilervt n, oculomotorii
A.;;i;';;;;;ri;
- R.hypothalamicus t -Aa.iuberiscinerei \ '. A superiorcerebelli Aa ponlis- A. basilaris- A . v e r t e b r a l -i s- A. soinalisantsrior-
Fig.479
\
\
'Aa
Aa. centrales posteromediales
mesencephalicae
-- - A labyrinthi A inferioranteriorcerebelli - -
A inferior oosterior cerebelli
Arterialcircleof the cerebrum,Circulusarteriosuscerebri(Wruts).
283
Figs.480 a-g Arterialcircleof the cerebrum, Circulusarteriosuscerebri,variations. a-c Variationsin the anteriorpart d-f Variationsin the posteriorpart unitevery far caudal g Aa.vertebrales
A labyrinthi**
N trigeminus [V] \
cerebelli\ A suDerior
\
t A. cerebriPosterior, 7- Parsprecommunicalis / N oculomotorius [ll|l
A basilaris
,N vestibulocochlearis
Nilrl N tacialis [Vlll
Aa.pontis
Ftoccutus
--Plexuschoroideus quarti' ventriculi -N .v a g u s[ X ] - --) N glossopharyngeus [X]
\l.-.-.-N
-. N accessorius [Xl],Radicescraniales / N hypoglossus [Xll]
\
cerebelli A inleriorposterior lA
Fig. 481 Arteries of the rhombencephalon,Rhombencephalon; the midbrain has been sectioned; dextroinferior view. The anterior inferior cerebellarartery usually (in about B0%)
abducens[Vl]
A inferioranleriorcerebelli
Parsintracranialis vertebralis,
passesabovethe abducentnerve, N' abducens,but in this figure at one point it also runs beneath it ' clinical: BocHolLrK's structure of the choroid plexus * * In about 15%the labyrinthine artery, A labyrinthi, originatesdirectly from the l-.asilararterY
3*h"4 ,, Rr paracentrales R frontalisposteromedialis--
7 R precunealis
Rr lrontales--
Sulcusparietooccipitalis
,
R parietooccipitalis
--
R l r o n t a l i s- intermediomedialis
- -
R parietooccipitalis
- -
R parietalis
--
R calcarinus
*-
A occipitalismedialis lsegmentum P4l
- / A callosomarginalis
\
/ A trontobasalis medialis
A occipitalislateralis {Segmentum P3l
\ H corporiscallosidorsalis
/ A cerebrianterior, Parspostcommunicalis 42] [Segmentum
\
A cerebri media. Pars sphenoidalis[Segmentum M1]r
I
R occioitotemDoralis
A cerebrianterior
I
Parspostcommunicalis A cerebriposterior, P2] [Segmenlum
A cerebrimedia
Fig.482 Arteriesof the medialandbasalsurfaces of the cerebrum; medialview.
A cerebriposterior
I
SeeFig.478 regaldingthe segmentsof the arteriesof the brain.
Falx cerebri A callosomarginalis
/ ,'
/
callosum,Truncus /, Corpus
,
lateralis,Parscentralis Yentriculus
lL/
Fornix, Corpus
/
/
/
Plexus choroideus venlflcultlateralts
Capsulainterna Capsulaexterna
/
Capsulaextrema
i:-
--
\1
-\'
-
Aa insulares
/g
A cerebri media, Rr terminales
.- -
Aa centrales anterolaterales
.--- Corpus amygdaloideum
i V basalis/ Plexusbasilans/
A basilaris/
\
A cerebrrposterior Cisterna pontocerebellaris
\
A cerebri media, Pars sphenoidalis
Pons
Fig. 483 Arteriesand veins of the brain, Aa. et Vv. cerebri; frontal section;
the arteriesare shownon the right, the veins on the left; dorsalview.
MedianSecttonof theBrain
285
Adhesio interthalamica
Truncus Corouscallosum, Foramen inlerventriculare \
Septumpellucidum\
\
Corpus I Fornix, terlii ventriculi ctroroideus Plexus | 1 ventriculitertii Tela choroidea I I I pinealis / Glandula
Ventriculuslateralis,Cornufronlale\
Splenium / Corpuscallosum, /, V magna cerebrl
/ A. cerebnPoslerior
A. cerebrianterior,\ Parspostcommunicalis,\ A. oericallosa
/ Sulcusparieto/' occipitalis
Genu - - Corpuscallosum,
I -\: Corpuscallosum,Rostrum- -
t -\:i Commissuraanierior - L a m i n a l e r m i n a-l -i s-
--
anterior- .A communicans HypothalamusChiasmaopticum/ / A. carotisinterna
Sulcus calcarinus
.- Commissura poslerior - Aqueductus mesencephali
/
- Tectum mesencephali \
/ A basilaris /' ,/ Thalamus/ l' Pons / ,/ A vertebralis'
Fig. 4S4
Medial surface of the hemispheres, Facies medialis
Vermis cerebelli
\ Ventriculusquartus - -
Medulla oblongata
Hemispheriumcerebelli, Tonsillacerebelli
\ Canaliscenlralis
hemispherii cerebri; diencephalon, Diencephalon,
andbrainstem,Truncusencephali; anteriorly; mediansection,staggered viewedfromthe left.
Fig. 485 Diagramof the centralnervoussystem; mediansection.
' Theseparts of lhe brain togetherconstitutethe brain stem, Truncus encephali
286
Brain, Encephalo Fissuralonglludinalis cerebri
Polusfrontalis \
\
/ Sulcusfrontalissuperior
\
Gyrustrontalissuperior \ / Sulcuslrontialisinferior
Gyrusfrontalismedius -
- Sulcus prec€ntralis
Sulq/s centralis
Gyrusangularis--
Lobufusparietalissuperior .'
Sulcus intraDarietalis
-
Lobuluspariotalisinletiot /
--Srl"u" p"rigtooccipitalis I
I I Polus occipitalis t
Fig.486 Cerebrum,Cerebrum; the leptomeninges havebeenremoved; superiorview. Thesizeof the gyri canvary greatly. In this brain of an elderlypersonthe two Gyri frontalessuperiores vary enormously
BasalSurfaceof theBrain
Inlundibulum \ Sulcio.bitales\
/ Sulcusollaclorius
Gyriorbitales\
t \
N. opticusfll \
287
. Bulbusolfactorius '
, Tractusolfactorius
Hvooohvsis Polustemporalis\
\\
Substantiaperlorata \ anterior - N. oculomotorius [l] -
\
Gvrusoarahippocampalis, '' ljncus C o r p u s m a m i l l a -r _ e_ _
-
Gyrusoccipito- .- .- - .-i temporalis lateralis .j.
Fossa interpeduncularis [Vl, _- N. trigeminus Radixmotoria
-----rt inferior I ",i31:li: -
N. mandibularis [V/31
Pedunculuscerebti - - -
G y r u -s- - parahippocampalis
----
Ganglion trigeminale
----
N trochlearisllvl
-----
N trigeminuslY - -
Pons
----
N i n t e r m e d i u- s- - N facialis ---
--
tvill N vestibulo-cochlearis lvllll / Lobus / llocculonodularis, Flocculus .' / Hemispherium cerebelli Plexuschoroideus/ quarti ventriculi
N.trigeminusM, Radixsensoria N. abducens [Vl]
- - Hemispherium cerebelli - Oliva \ Pyramismedullae oblongatae
,// ,/
N glossopharyngeus lxl /
,'
\
/
N vagus[Xl / N hypoglossus [Xll] /
\ Tonsilla cerebelli
/ll
N. accessorius[Xll /
Medulla oblongata, Fissura mgdiana anlerior
t
i tt
.t,\
t Polusoccipilalis
I
t nervicervicalis Filaradicularia i tcll t / pyramidum Decussatio
\ Medullaspinalis Vermiscerebelli
Fig. 487 Cerebrum,Cerebrum,brain stem, Truncus encephali,with cerebellum,Cerebellum,and cranial nerves, Nervi craniales; the leptomeningeshave been removed; inferior view.
288
Brain,Encepharo , Sulcuscentralis Lobustrontalis \
Fissuralongitudinalis- cerebri Lobusfrontalis*
/
/Lobusparietalis
Lsulcusparietoz'occipitalis b.
SulcuscentralisPolustrontalis - Polus occipitalis Fossalateralis/ / cerebri I / Polustemporalis
parietooccipitalis LobusocciDiialis-
\ Lobus occipilalis
\
iLobusremporatis\ lncisura I prsoccipitalis lsulcuslateralis
Polusoccipitalis/
Lobicerebri; Fig.489 Lobesofthe cerebrum, lateralview.
Fig.488 Lobesof the cerebrum,Lobicerebri; supenorvlew. Poluslrontalis\ Lobusfrontalis\ Fissuralongitudinalis\ cerebri
\ tGyrus
Polustemporalis-_
Lobuslrontalis\
Fossa lateraliscerebri \ Lobustemporalis- --Dienc€phalon Lobuslimticus,- Gyrus parahippocampalis Sulcuscollateralis- Sulcushippocampalis
cinguli
/. Lobus limbicus -/ Sulcuspariotooccipitalis
Polusfrontalis
- Sulcus calcarinus - Polus occipilalis
-
Mesencephalon -
--
Incisura preoccipitalis /
/ LobusocciDitalis Polusoccipitalis/
//
Fig.490 Lobesofthe cerebrum,Lobicerebri; inferiorview.
Lobrc occipitalis
'\ lLobus temporalis lncisurapre' Diencephalon/ i! | Sulcushippocampalis/ | Sulcuscollateratis
Fig.491 Lobesofthe cerebrum,Lobicerebri; medialview. Operculum lronlale , Sulcuscentralis parietalis / Lobus -
\
Fig.492 Development of the bnain; embryo; modelof the brainof a 2-month-old mediansection. compareto Fig.485.
Operculumparietale
Lobustemporalis
ofthe brain; Fig.493 Development brain of an approximately4-month-oldfetus (crown-rump length,20 crn); lateralview.
Gyriof the CerebralHemisPheres
Margosuperior \
289
/ Sulcuscentralis
/ Sulcusintraparietalis
/ Sulcuset Fossalateraliscerebri
\
preocciPitalis Incisura
Fig.494 Gyri,Gyri,ofthe cerebralhemispheres; lateralview (1.).
I Margosup€rior
- -
\, ft./ -*la'Gyrustemporalisinferior \
Margoinferomediatis
Gyri,Gyri,ofthe cerebralhemispheres; Fig.495 medialview (r.).
lsthmusgyri cinguli
Encephalon
Operculumlrontale;Operculumparietale \ Gyrustrontalisinferior,, ', Parsopercularis
,'
,, Gyruspostcentralis , Sulcuspostcentralis
Gyrustrontalis superior\
, Sulcuslateralis,R poslerior Sulcusintraparielalis
_--
Gyrusfrontalismedius-
Gyrussupramarginalis
_ --
Gyrusangularis
_-Polusfrontalis-
>--
Lobulusparietalis supeflor
Gyrusfrontalis inferior,-Parstriangularis Gyrusfrontalisinlerior,'Pars - - orbitalis --( Ranterior/ Sulcuslateralis* - - I t R. ascendens/
parietooccipilalis --.-
Sulcustemporalis supenor
Polustemporalis, Gyrustemporalissupeior /
,, ----
i Sulcustemporalissuperior/ GyrustemporalismediusI
'
Polusoccipitalis
\ Incisurapreoccipitalis Sulcustemporalisinferior
Fig.496 Gyri, Gyri, and sulci, Sulci, of the cerebral hemispheres; lateralview (1.). * fissure of SYLvrus * * fissure of Ror.ANDo
insulae / Sulcuscircularis Sulcuscentralis insulae
/ Gyruslongusinsulae
Gyri breves insulae
/
\ Incisurapreoccipitalis ' Lobuslemporalis
Fig.497 Gyri, Gyri, and sulci,Sulci,ofthe cerebral hemispheres; the parts which coverthe insula,Opercula,of the frontal,parietaland temporallobeshavebeenremoved; lateralview (r.).
29r
Gyrtand Sulciof the CerebralHemispheres
Fissuralongiludinalis cerebri , Polusfrontalis\
i
Gyrusrectus \
/
Sulciorbitales
7 Tubercinereum
----
cerebri Fossalateralis Trigonumollactorium - -
Fossa-inlerpeduncularis
Sulcustemporalis inferior
Corpus mamillare
---
Gyrioccipito-- temporales medialiset lateralis
--
-Gyrus -lemporalis inferior Substantia'-perlorata Posterior -
Pedunculus c€r€bri
Substantia nrgra
Sulcus hippocampalis
Sulcus collateralis
Gyrus / parahippocampalis occipitotsmporalis lslhmusgyricinguli/ \ Teomentum meisencephali
Gyruscinguli/
\ Tectummesenceohali, ColliculussuPerior
Gyruslingualis/
\ Aeueductusmesencephali \ Corpuscallosum,Splenium Polusoccioitafis/
' Sulcuscalcarinus
Gyri, Gyri, and sulci,Sulci,ofthe Fig.49S cerebralhemispheres; the midbrainhasbeensectioned; inferior view.
292
Brain, Encephato
I JI
Fig.499 Cytoarchitectonicallydefinedcorticalareas of the cerebral hemispheresaccordingto Bnoou-lNN; individual areasare numbered;the different symbols indicate different cell types; lateral view (1.).
20 Fig. 500 Cytoarchitectonicallydefined cortical areas of the cerebral hemispheresaccordingto Bnoou.a.Nn; individual areasare numbered;the different symbols indicate different cell types; medial view (r.).
FunctionalCorticalAreasof the CerebralHemispheres
293
Gyrusfrontalisinferior,/ ParsoDercularis \
Fig. 501 Functionalcorticalareasofthe cerebralhemispheres accordingto FoEnsrEn; lateralview.
I
ffiffi
primarymolorar6a se@ndarymolor area
ffi
I
pnmarysensory area secondarysensoryarea
Gyrus temporalisttanevercusantelbl
Theprimary acousticregionO extendsoverthe upperrim of the temporallobeontoits internal surface.
I
ffiffi
I
ffiffi
primaryauditoryarea s€condaryauditoryarea primaryvisual atea s€condaryvisual atea
/ Gyrus prec€ntralis
Flg. 502 Functionalcortical areasofthe cerebral hemispheresaccordingto FoERSTER; medial view.
29
{
,**, Encephaton
c h o r o r d e av e n t r i c u ltie r t i i
F o r n i xC, o l u m n a- - Gyrusparaterminalis C o m m r s s uar a n t e r l o -r - * A r e a s u b c a l l o s- -at
*
---r-1'fela ---l-
-Thalamus
------
- S t r i a m e d u l l a r i st h a l a m i
- S u l c u sh y p o t h a l a m r c u s ---=- - - - - Commissura habenularum
Lamina t e r m i n a l i-s- - F Hypothalamus - Recessus supraopticus B e c e s s uisn f u n d i b u-l-i Chiasmaopticum- Corousmamillare sinrstrum-
- Becessus suoraoinealis
- Recessus pinealis - Glandula pinealis - Commissura postenor - .-Tectum
Cislerna chiasmatica -
mesencephali
l- -Tegmentummesencephali - Aqueductus mesencephali interpeduncularis Cisterna
A cerebriposterior-- Sinusintercavernosus Adenohypophysis
Lobuluscenlrahs -Velum medullare superius
-Neurohypophysis A basilaris'
- Pons
Plexusbasilaris-
Fig. 503 Third ventricle,Ventriculustertius; mediansection; medialview.
Fornix,Corpus \ Corpuscallosum, Rostrum- - _
Foramen interventriculare
Adhesio interthalamica
/Thalamus.
Columna fornicis - Commissura anterior - -
- - Nucleusdorsomedialis , //, / .{
-=-----::--: Area hypothatamicd --.--
Area hyPothalamica
-N u c l e ip r e o p t i c i - -
---:_____
NUCIeUSOOr Nucleus dorsalis hypotharaml
lateralis
- - Fasciculus mamillothalamicus
Nucleusoantenor
Sulcus hypothalamicus Tractus paraventric.ulg- -----hypophysialis
--_
Nucleusposterior hypothalami
suprachiasmaticus
Fasciculus mamillotegmentahs
------
Becessussupraoplrcus --
Chiasmaopticum Nucleussupraopticus N opticuslll
( N u c l ecio r p o r i s
--]--
mamillaris) .-
A hypophysialissuperior (A carotisinterna, Parscerebralis)
--
Tractushypothalamohypophysialis
-
-
.-Adenohypophysis
:--
Vv portales hypophysiales A hypophysralis inferior(A carotisinterna,Parscavernosa)
Nuclei tegmentales
-*--
-
\ -
Neurohypophysis Fig. 504 Hypothalamus; w i t h s e m i - t r a n s p a r en ut c l e i ; m e d i a lv i e w .
Nucleus ruber Subslantiapertorata posteflor Nucleus ventromedialis hypothalami
Nuclei tuberaleset arcuati Tractus supraopticohypophysialis
Nucleiof the Thalamus
295
Capsula interna
t"
Nucleireticulares
?/
/
/l
Nucleianteriores
k
/
Nuclei mediales
-
Nuclei mediani;Adhesio interthalamica
b left cerebralhemisphere;lateral view.
ta ttt )
\\
Nucleusparafascicularis \ \
)
I I I I
1 1
Nual"raa"ntromedianus Nuclei dorsales: Nucleus posterior; Nuclei pulvinares (Nuclei metathalami) Nucleus corporis
geniculati lateralis; Nucleuscorporis geniculati medialis
laleralis,/ Ventriculus Cornuoccipitale
transversesectionthrough the left cortical hemisphere;superiorview.
c right cerebralhemisphere;medial view.
Figs. 505 a-c Nucleiand corticalprojectionsof the thalamus. The nuclei and the cortical areaswhich belong togetherare shown in the samecolour.
Nucleuscaudatus, Corpus.
Fibraecorticorubrales; Fibraecorticosoinales: Fibrae Fibraecorlicoreticularos; Fibraelhalamoparietales corticothalamicae:
Genucapsulaeinternae, \ Fibraecorliconucleares \ \ Thalamus \
Badiationes thalami
centrales Fibl.ae temporopontinae
- _-
- -
->--
Radialiones thalami posteriores Fibrae Darieto
occipitopontinae - T r a c t u s o p t i c-u-s- -
- -
Pulvinar thalami
--colliculussuperior - Pedunculus cerebri---
inferior Colliculus
Fig. 506 Thalamic radiations, Radiationes thalami, and internal capsule,Capsulainterna; frontal section which has separated the two parts; lateral view (1.).
Radiatiooptica
Radiatioacustica
Crus posterius capsurae tnternae
29
6
Brain, Encephato
.\s\--/-
Ventriculus lateralis, Cornulrontare
.z
{:"';
Fissuralongitudinalis cerebri .z
(Cenlrumsemiovale)
Commissura anlerior
llll ./ N. oculomotorius
Chiasmaopticum - //
N trochlearis lvl
_-
N trigeminus [V]
N abducens[Vl]
-.-
--
-----.-
Plexuschoroideus ventriculi ouarti -
Hemispherium cerebelli -
N t a c i a l i s[ V l l ]
- N vestibulocochlearis [Vltll N. glossopharyngeus [tX]
- N. vagus [X]
/
- N accessorius [Xt]
Medulla oblongata /
\ N hypoglossvs [Xtt]
Fig. 507 Anteriorrostralcommissure, Commissura anrenor, andbrainstem,Truncusencephali; the basalpartsof the cerebrumhavebeenpartiallyremoved; inferiorview Chiasmaopticum- -
--
Inlundibulum. t u o e r c t n e r e u m- _ _ _
-----/'
Trigonum olfactorium
--
|yl .'/t
>-1 C o r p u s m a m i l l a r- e ___.,
N. oplicusflll
l.
N a |
, - tt,''
r,
--
SubstantiaDerlorataanterior
/-
Tractusopticus
ii.-- - /
SubstantiaperforataDosterior
\ Aqueduclus mesencephal
Fig. 508 Midbrain, Mesencephalon, and diencephalon, Diencephalon;
the midbrain
inferior view
has been transversely
sectioned:
Mesencephalon Midbrain, 297 Glandulapinealis*\ / Teclummesencephali
Colliculussuperior\ Stratagriseacolliculisuperioris\ Brachiumcolliculiinlerioris\
\
Aqueduclusmesencephali--
mesoncephali ' Tegmentum
Substantiagriseacentralis- -Formalioreticularis Pedunculus cerebri
compacta fPars Substantia I nr9ra lpars reticularis - Cruscetebri
Nucleusruber /
I
Fossainleroeduncularis
Fig. 509 Midbrain,MesencePhalon; crosssectionat the levelof the superiorcolliculi; inferiorview. * also termed cerebral ePiPhYsis
/ Stratagriseacolliculisuperioris medialis Fasciculuslongitudinalis Nucleusmotoriusnervilrigemini
/
/ Nucleusaccessoriusnervi oculomolorii - Nucleusnervioculomotorii
- Corpusgeniculatummedial€ Lemniscusmedialis-
- Nucleusnber -/
Tegtnontum.. mesenc€pna[
-
paristoFi pontinae; Fibraetemporopontinae
- Fi corticoEinal€s; corti@nu (FilaradbularianeNi oculomotorii) Fibraelronlopontinae
Nucleiand fibres of the midbrain, Fig. 510 Mesencephalon; schematiccrosssecdonat the lenelof the superior colliculi.
298 Ventriculus tertius\ Recessus suprapinealis \\ \
/ C o m m r s s u r ap o s l e r i o r / .l
Trigonum habenulare : G l a n d u l ap i n e a l i s - _
Stra lermrnairs
/ ,'
/7
/ //
/
-
Iaeniachoroidea
4; - -
Brachiumcolliculiinferroris ---
- -
-I
- Trrgonum lemniscilateralis Frenulumveli medullarisSuperiorlg -
-
- -
-
N trochtearis[tV] -
-
Metalhalamus, Corpus geniculatummediale
M"t"th"r"rrr, Corpusgeniculatum laterale
Colliculus superior
Colliculus inlerior Pedunculus cerebeltaris medius
Pedunculus cerebellaris suoerror--
Thalamus, P u l v i n a rl h a l a m i
Velummedullare superius
Fossa rhomboidea,Eminentia medialis'
Fig. 511 Midbrain,Mesencephalon, and pineal body, Glandulapinealis; dorsosuperiorview.
Septumpellucidum\ Corpuscallosum, Truncus1 Nucleuscaudatus. Caput -_._
/ Fornix,Columnae
\--
--
ForamenInrerventriculare --
laleralis, Cornufrontate / Venlriculus /
//
(Recessus triangularis) anterior - / Commissura
Tuberculumanterius lhalami --
/ Ventriculus tertius .-.--+_ Striaterminalis
Btachiumcolliculi superioris
--
Laminaaflixa +--a T a e n i a c h o r o i d e a- - Trigonum habenulare ---
-'
Colliculus superior
.'.-
Corpusgeniculatum mediale
- posteiot Commissura ---
G l a n d u l a p i n e a l-i-s-
Corpusgeniculatum lalerale
Thalamus, Pulvinarthalami /
-
Pedunculus cerebri/ N trochlearis flVl
B r a c h i u mc o l l i c u liin f e r i o r i s
Colliculusinterior
/
Frenulum velimedullans supenons
-
Vermis cerebelli,Lingula cerebelli -
Tela choroidea ventriculiquarli /
\1
tt
Fossa rhomboidea,Sulcus medianus /
\1
/ Aperturamedianaventriculi quart Tuberculum cuneatum/
ta
tt /i
/ Fasciculus cuneatus
\ 1
M e d u l l as p i n a l i s
\ \
Pedunculus cerebellaris superior
\ - Froccurus .
\ \
t
Pedunculuscerebellarismeotus
Pedrnculra cerebellarisintenor
Peduncutus floccculi
quartl Ap"rtrr" lateralis ventricutr
Plexuschoroideus quarti ventricuti
gracile Tuberculum gracilis Fasciculus
Fig. 512 Brainstem,Truncusencephali; the Corpuscallosumand the majorpartsofthe cerebellum have beenremoved;the Telachoroideaof the fourth ventriclehas been split in the midlineandfoldeddownon the right side; dorsosuperiorview.
BrainStem,Truncusenceqhali
veli - - Frenulum medullarissuPerioris
Brachium colliculiinferioris --
Fig. 513 Rhomboidfossa,Fossarhomboidea; v i e w o f t h e f l o o r o f t h e f o u r t hv e n t r i c l e ; the cerebellarlteduncleshavebeenremoved; dorsosulleriorvien'.
299
- - Velummedullare superlus
C o l l i c u l u si n l e r l o r - - -
ce Pedunculu s r e b r i- - -
Locuscaeruleus
--
N t r o c h l e a r i s l l v-l- -
Eminentia medialis
--
- Colliculus lacialis PedunculuscerebellarissuPeflor
- - FoveasuPerior Pedunculuscerebellarismedius
Sulcuslimitans Pedunculuscerebellarisinlerior
-
\ Aperturalateralis quarti ventriculi
Sulcusmedianus
\ Areavestibularis
quarti / ventriculi Striamedullaris Velum medullareinferius
/
Trigonum nervi hypoglossi
\
Fovea inferior
/
Trigonum nervi vagi
\ Area Postrema
cuneatum Tuberculum
\ Funiculus lateralis Glandula Pinealls
\
Brachium colliculisuPerloris \ Corpus geniculatummedrale \ Brachium colliculiinlerioris \
/ Sulcusintermedius Posterior Sulcus medranus
\
Corpusgeniculatumlalerale
Tractusopticus - -
--
sR-
Pons Radrxmolorra N. trige-i minus[V] [ Rad* sensoria
N l a c r a l r s{ V l l l - - - ; --
N v e s t i b u l o c o c h l e a rIiVs l l l ]
--
--
. I Radices craniales N accessoflus l fYil ' "' I( RadrcessPtnales
N trochlearis {lvl
--
suPerrus Velummedullare
--
Pedunculuscerebellarlssuperror
--
s edrus P e d u n c u l u sc e r e b e l l a r i m
- -
PedunculuscerebellarrsInlerior
\ Fasciculus gracilis
-
Fossa rhomboidea Sulcus medianus
cuneatum Tuberculum Tuberculumgracile
F i g . 5 1 4 B r a i ns t e m ,T r u n c u se n c e p h a l i ; obli(luevieu of the floor of the fourth ventricle; the cerellellar[)eduncleshavebeenremoved; lateralvieu.
Radix anterior I N c e r v r c a | s[ C 1 ] I I Rad,, posterior
Walls of the tburth ventricle Roof/anterior wall
VelummedullaresuPerius
Floor
Fossarhomboidea Velummedullareinferius;Plexuschoroideus <- VentriculusIII mesencephali Aqueductus -+ basalis Cisterna laterales Aperturae Aperturamediana+ Cisternacerebellomedullaris Canaliscentralis
Openings
\ Fasciculus cuneatus
P u l v i n a rt h a l a m i
--
--
-', N glossopharyngeusllX) --N hypoglossus lxtll N vagus[X] -
Roof/posteriorwall
Tuberculumgracite
- - Colliculus suPerior - - Colliculus inferior
cerebrr - Pedunculus
Pyramis medullae oblongatae
medullae oblongatae \
3 00
Brain, Encephato Nucleus accessorius nerui oculomolofli
-
f
Nucleusmotorius nervitrigemini- - -1-
Nucleus mesencephalicusnerui trigemini
- - -
'. Nucleus nervrabduce'rlrs
I
Nucleus nervi lacialis - - -'-
N u c l e u ss a l i v a t o f l u s u p e r i o r- - -
-
-----
Nucleus cochlearisposterior
Nucleus salivaloriusinlerior t
Nr.l"u. vestibularissuperror l Nucteusvestibutaristateralis I Nuclei \ Nucleus veslibulaflsInferior vestrbulares I \ Nucleus vestrbulaflsmediahs )
/t. . -
N u c l e uasm b i g u u s-
\
Nucleusdorsalisneruivagi \ Nucleus nerui hypoglossi /
\
Nucleus spinahsnervi lrigemini
Nucleus solilarius
Nucleus nervi accessorii /
F i g . 5 1 5 C r a n i a ln e r v e s N , e r v ic r a n i a l e s ; topographicpositionof the nuclei; dorsal view.
Efferentnuclei on the left, afferentnucleion the right. ' ( l i n i ( a l : \ u r l e u s s t ' n s o r r u sp r i n t : r p a l i sn c r \ i l r i g e m r n i
general somalic elferent nuclei (GSE)
general and special viscero-atlereninuclei (G/SVA)
general vrscero-etferentneuclei (GVE)
general somalic atlerent nuclei (GSA)
special viscero-etlerentnucler (SVE)
special somatic atferentnuclei (SSA)
S u l c u s m e d r a n-u- s- - l
vil.tx.x vil,tx.x v, vil,tx,x, xl ilt rv vr xtl
Fig. 516 Cranialnerves,Nervi craniales; diagrammaticcrosssectionthroughthe rhomboidfossa,
the nuclei. demonstrating Seealsothe tableon p. 267.
Nucleiof theCranialNerves
- -
Nucleusruber
301
Glandula Pinealis
- - Nucleusaccessorius neruioculomotorii
Pedunculuscerebn. Crus cerebrl
Nucleus nervi trochlearts
N trigeminus tvl
Nucleusneryroculomolorll
--
N trochlearis [lV]
- - Nucleusmesencephalicus nervi trigemini
- .-
nervi Nucleusmotorius
--
- - (Nucleus pontinusnervitrigemini') Nucleusneruiabducentis
Nucleivestibulares Nucleus nervi lacialts
-
N abducens [Vl]
suPerior Nucleussalivatortus --
N lacialis [Vll]
-
N vestibulocochlearis[Vlll]
- -r
.?
/
-/
- -
- - -
interior Nucleussalivatorius Nucleus dorsalis nervi vagi
N glossopharyngeus[lX] -N vagus [X]
Nuclercochleares
r' ll\
NucleusnervihyPoglossi
/.)r -4:-: N hypoglossusLxttl
Nucleussolitarrus N accessorius [Xl] Nucleusspinalisnervltrigemini
- -
I
Nucleus nerui accessorti
generalsomaticeflerentnuclei(csE)
generaland specialvisc€ro-afferentnuc{ei(G/SVA)
nuclei(GVE) generalviscero-efferent
goneralsomaticafterentnuclei (GSA)
nuclei(SVE) sp€cialviscero-efferent
ffiffiffi
(sSA) nuclei aft€rent somatic sp€cial
Fig. 517 Cranialnerves,Nervi craniales; topographicpositionof the nuclei; medialview. ' clinical:principalsensorynucleusof triSeminalnerve, Nucleussensoriusprincipalisnervi trigemini
302 Plexus choroideusvenlriculitertii Adhesiointerrhatamica\ F o r n i x , C o l u m'n\ \a Forameninterventriculare\
\ \
I
I
| |
I |
i
I
Ventriculuslertius /
Thalamus /
Tela choroidea ventriculitertii
/
F o r n i x .C r u s
Commissura anterior\ L a m i n at e r m i n a l i s- _
C o r p u cs a l l o s u m
_-
Corpus callosum. \ Hostrum -_
{ffi_..::":"",:
-
Hypothaldmus - .--
- -
#--
Tectummesencephatl
-
C o r p u sm a m i l l a r e- _ _
Cumen
C h i a s m ao p t i c u m _ - R e c e s s u si n t u n d i b u l -i - Fossa interpedunculais - - -
- -Hypophysis Tegmenlum-" mesencephali
- ----
Lingulacerebelli
----
F a s c i c u l u sl o n g i t u d i n a l i -s- medialis
Foliumvermis - .-
A rrasilaria-"
- S u l c u sb u l b o p o n t i n u sz / Fossa rhomboidea .
Lobulus centralis
.' ,, \ \
Velum medullaresuperius Fasttgtum
Tuber vermis
Plexus choroideus ventflculiquarti
Pyramis vermis
U v u l av e r m i s
\ Nodulus
Fig.5lB Thirrlantlfourth,,,entrir;le,\'entriculi t e r t i u sa n ( l( l u a r t u s ; m e r l i a ns e c t i o nt h r o u g ht h e b r a i ns t e m ; merlialr,ierr.
Tectum.mesencephali. Lamrnatectalis /
Aqueductus
Fissura prima
mesencephali
-----
Declive
F o l i u mv e r m i s
7--
Lobus cerebelll Posterror
tt : M e d u l l as p r n a l i s
Tuber vermrs - -
pyramis vermis U v u l av e r m i s
I -
N o d uu s
Fig. 519 Parts of the cerebellarvermis, Vermis cerebelli; median section.
LOOUS lloccLrlonodulafls
cerebeuum 303 Lobulus cenlralis \
/ L r n g u l ac e r e b e l l l
/
anterlor z Lobulusquadrangularis Parsantenor
C u l m e n-
--
F i s s u rpar i m a
-
Declive
L o b u l u ss i m p l e x . L o b u l u sq u a d r a n g u l a r r s posleflor
-
- -
Lobulus semilunarisinferior
F o l i u mv e r m i s Tuber vermis
F i g . 5 2 0 C e r e b e l l u mC, e r e b e l l u m ; dorsosuperiorview.
Hemispherium cerebelli
vermts cerebelli
Ala lobuli centralis \ L o b u l u sq u a d r a n g u l a r iasn t e n o r \
F i s s u rp a r i m a- - \
l,u I
Lobulus simplex. .- .Lobulus quadrangulafls postefior
I
I
LOOUS
L o b u l u ss e m i l u n a r i si n f e r i o r- -
a---
T u b e r v e r m i s cerebelli
----
Pyramrsvermts
posterior
L o b u l u sg r a c i l i s - - L o b u l u s b i v e n t e- r- Fissura secunda - -
( Frssuranodulolloccularrs)
Tonsillacerebelli Flocculus /
--.-
Nodulus
Fig. 521 Cerebellum,Cerebellum; the cerebellarcortex has been spread out.
Lobus flocculonodulans
304
Brain, Encephato
lDeclive
Velummedullare superius , quarti Tegmenvenlriculi \ Velummedullare inlerius\ Hemispheriumcerebelli --
ta / -
-t-
Pedunculuscerebellarissuperior -
Pedunculuscerebellarismedius
_-
Flocculus
\
Fissura honzontahs
Recessuslaleralis'quani ventriculi
- Fissuraposterolateralis
Hemispheriumcerebelli -
flocculi Pedunculus Valleculacerebelli I
\
uvuravermis
\ Nodrlra
Fig.522 Cerebellum,Cerebellum; the cerebellarpeduncleshavebeensectioned; ventralview.
Lobulussemilunaris superior-
- Tubervermis _--
PYramisvermis
Fissurahorizontalis - _-
- Lobulussemilunaris inlerior
Tonsillacerebelli
-
-
Fig.523 Cerebellum,Cerebellum; dorsoinferiorview.
Uvulavermis Nodulus
Hemisoheriumcerebelli
cerebetrum 305 ,, Laminatecti / Pedunculuscerebellarissuperior z/
Lingulacerebelli
z Plexuschoroideusventriculiquarti - Nucleusdentatus -.
Hilumnucleidentati-
Corpusmedullare cerebelli
- Cortexcereb€lli
Nodulus-
Velummedullareinlerius-
Tonsilla cerebelli Medulla oblongata /
/
Cerebellum; Fig. 524 Cerebellum, frontalsection; dorsalview.
superiorum\ cerebellarium Decussatiopedunculorum /
quartus / Ventriculus 7 Velummedullaresuperius
medialis\ Fasciculuslongitudinalis
/
Lingula cerebelli
superior- Pedunculuscerebellaris Coriex cerebelli--_
Stratummoleculare\ Stratumgranulosum
(Laminae albae) -
-Fissurae cerebelli
CorDusmedullarecerebelli t
Nodulus
Fig.525 Cerebellum,Cerebellum; obliquesectionthroughthe superiorcerebellarpeduncles; dorsalview.
Hilumnucleidenlati
3 06
Brain, Encephoro Granulationesarachnoideae / Pars centralis Cornu frontale \ Crslernapeflcallosa \
\ /\ \-
S p a t i u ms u b a r a c h n o i d e u m- -
z - --
z'
Srnussagitlalissuperior P l e x u sc h o r o i d e u s v e n t r i c u llia t e r a l i s P l e x u sc h o r o i d e u s ventriculrlertii
- _-
* - r Foramen interuentriculare
---Cornu
Ventriculustertius - -
---
C o r n ut e m p o r a l e
Cisternachrasmatica * *
---
Cisierna interpeduncularis- -
V magnacerebri
---
Aqueductus mesenceohali
--
* clinical: Foramen of MoNnoe *' clinical: cerebral aoueduct of Syrvrus
G r a n u l a t i o n eas r a c h n o i d e a ePia maler cranials : S i n u ss a g i t t a l i sr n f e r i o r\
\
S i n u sr e c t u s
- - - Ventriculus quartus
C r s t e r n ap o n t o c e r e b e l l a r i .s- -
Fig.526 Ventricles ofthe brain, Ventriculi encephali,and subarachnoidspace,Spatium subarachnoideum;diagram of the circulation of the cerebrospinalfluid, Liquor cerebrospinalis, from the ventricles to the subarachnoid space.
occipitale
C o n f l u e nssi n u u m
- Plexuschoroideus quarti ventriculi
.- - .Apertura mediana ventricuilquanl \ ... Crsternacerebellomedullarisposterior \
Apertura lateralis
P a r sc e n t r a l i s / F oramen inlerventriculare
/ S r n u s a g i t t a lsi su p e r i o r
Arachnoideamater cranialis -
/
( S p a t i u ms u b d u r a l e )- -
/ Plexus chorordeus ventriculi tertii Conu - - temporale
S p a t i u ms u b a r a c h n o i d e u m- . -
- - Cornu occ prtale
D u r a m a t e rc r a n i a l i s , * Falx cerebrl Cornu tronlale - -
-.-
Cisterna pericallosa - -
--
Ventriculuslertius - - -
Cisterna chiasmalica - -
Spatium subarachnoideum v magna cerebri Sinus reclus
Cisternainterpeduncularis pontocerebellaris Crsterna -
Fig.527
Ventricles of the brain, Ventriculi encephali, and subarachnoid space, Spatium subarachnoideum; median section; medial view.
Aqueductus mesencephall
\ Ventriculus quartus - Cislerna cerebellomedullarisposterior - C a n a l i sc e n t r a l i s
Cerebrospinal fluid, Liquor cerebrospinalis The cerebrospinalfluid, Liquor cerebrospinalis, is proclucedby the entire lining of the inner ventricularcavities,the ependymal layer, especiallyfrom the region of the Plexus choroidei It flows throughboth of the foraminainterventricularia(Mor.rnoe) into the third ventricleand from there through the Aqueductus mesencephali(Svt"vrus)into the fourth ventricle and into the central canal of the spinal cord. The Apertura mediana (Mnceuorus)and the Aperturaelaterales(l,uscHxn)of the fourth ventricleare the only connectionsto the externalsubarachnoid spaces,the Spatiumsubarachnoideum. The fluid moistensthe entire brain and the soinalcord.
In the areasof the lymphaticsheathsof the small vesselsof the pia mater,of the perineural sheathsof the cer-ebrospinal nerves and over the arachnoidgranulations(PncctttoNr) the fluid is reabsorbedinto the venous bloodstream. The bottlenecksof the ventricular systemsare in danger of obstruction:Foraminainterventricularia,Aqueductusmesencephali,Aperturae medianaand laterales.If they becomeobdisturbanceor inflammation,it structeddue to a developmental internus.A dilationof the Spatium can lead to a hydrocephalus subarachnoideum, e.g.secondaryto an atrophyof the brain, is known as hydrocephalus externus.
ltentriclesol' the Brain, Ventricttliencepholi
I V e n t n c u l u st e r t l u s I / V e n t rc u l u sl a l e r a l l sP a r sc e n t r a l l s
l/
,z Recessus suPrapneal s
z'b,
.-
RecessusPrnealrs --
V e n t n c u l u sa t e r a l t s- - -
AqueductusmesencePnall --
--
V e n t n c u l u sl a t e r a l l s C o r n ul e m P o r a l e
V e n t n c u l u sq u a r t u s
C o l l r c u l u lsa c t a l t s:
/
S t f l a em e d u l l a r e s- v e n t rc u l lq u a r t t )
t,-""olr-'qT
Fastrgrum
- -
R e c e s s u sl a t e r a l r vs e n t r l c u lql u a n
-
A p e r l u r ar e d r a n d v e n l ' r c . l 'o u a n
-
Fig. 52tt
V e n t r i c uu s a t e r a l l s C o r n uo c c l P l l a l e
C a n a ls c e n t r a l i s
\ e n t f i ( i ( ' so f t h t ' l r t ' t t i n\ .( ' l l t l i ( t l l i e n t e p h a l i ;
c 0 t r o s i 0 t tc a s t s l l c t i t l l t ' n ; r i t ' u e r l r t l r l i r l r t t ' l rl t o l r t h e l t ' l t
Pars cenlralrs p e l l u cd u m Cornu o c c r p r t a l e V e n t rc u l u s l a l e r a sl Foramrna n t e r v e n l n c u l aar
Cornu lemporale C o r nu lrontale
Ventflculus l e r l r us
Fig. 529 Ventriclesof the brain, Ventriculi encephali,and subarachnoidspace,Spatium subarachnoideum; three-dimensionalreconstructionfrom data obtainedwith magnetic resonancetomography (MRT) in a living subject; sinistroventralview.
-
c s l e r n aa m b t e n s
-
C r s t e r n at o s s a e l a l e r a l l sc e r e b r r
The basal cisterns and the subarachnoidspaceof the spinal cord are shown.
308
Bratn,Encephato , Sulcuscentralis I
/ Lobusparietalis
Foramenintervenlriculare \ z Parscentralis Cornufrontale \ Ventriculus tertius / Cornuoccipilale
Lobusfrontalis -\
///
Sulcuslateralis- -
Lobusoccipitalis
Lobustemporalis- -
I Cornutemporale/
Pons /
Fig.530 Ventriclesof the brain,Ventriculiencephali; projectionontothe surfaceof the brainandskull; lateralview.
Lobusfrontalis \ /,Cornufrontal€ /, Fo@menintervenlriculare / Parscenlralis Sulcuslaleralis \
//
\
Ventriculus. terlius / Aquoductusmesencephali
Lobustemporalis\\\ / Cornutempotale Pons --_
quarlus , V€ntriculus
- Aoerturalateralis
Cereb€llum
- Canaliscenlralis
Medullaoblongata //
Fig. 531 Ventriclesof the brain, Ventriculiencephali; projectionontothe surfaceof the brain and skull; ventral view.
corpuscauosum 3 09
Polusfrontalis \
longitudinaliscerebri
superior-__ Gyrusfrontalis
/ Gyruscinguli A. cerebrianlerior, / - A. oericallosa
Strialongitudinalis'\ mediatis I tndusium gnseum StrialongitudinalisI lateralis )
Polus occiPitalis /
I Fissuralongitudinalis cerebri
CorPus Corpuscallosum, Fig.532 callosum;the superiorPartsof the cerebralhemisphereshavebeenremoved; superiorview.
#*
Brain,Encephoron
310
Gyrus cinguli - Corpus callosum, Genu
Ventnculuslateralis,Cornu lrontale _
--
Corpus callosum, Rostrum
--
N u c l e ucsa u d a t u sC a p u t
V t h a l a m o s t r i a tsau p e r i o r
_-I n s u l al l o b u s I n s u l a n s l - _
__
S t r i at e r m i n a l i s
-----
-------/Ependymum
- - C o r p u cs a l l o s u mT,r u n c u s
V e n t r i c u l u lsa l e r a l i s , - - Pars centralis
F o r n i xC, r u s
---
P l e x u sc h o r o i d e u s v e n t n c u l li a t e r a l i s
Fimbna hippocampi - - Glomus choroideum
Hippocampus Trigonumcollaterale
- .-
Gyrus fasciolaris
\ Tapetum
S u l c u sc a l c a r i n u s /
Fig. 533 Lateral ventricles,Ventriculi laterales; the superior parts of the cerebralhemispheres have been removed; superior view.
Walls of the lateral ventricles Cornu frontale Anterior wall Roof Medial wall Lateral wall FIoor Opening
Pars centralis Corpuscallosum, Genu Corpuscallosum, Truncus Septumpellucidum Nucleus caudatus, Caput Corpuscallosum, Rostrum -+ Foramen interventriculare Ventriculus tertius
Roof Medialwall Lateral wall Floor
Corpuscallosum, Truncus Fornix,Crus;Septumpellucidum Nucleus caudatus, Corltus Striaterminalis; Laminaaffixa, Plexuschoroideus; Fornix,Crus
ventricutitaterates Ventricles,
3 I I
)
V e n t r i c u l u lsa t e r a l r sP, a r s c e n l r a l i s\
N u c l e u s c a u d a tC u so r p u s- . -
F o r n i xC, r u s
I n s u l al L o b u sI n s u l a fsl] - -
Fossa lateralis P o l u sl e m p o r a l i s
Calcar avis
.-\
ffi.t
-/ ventriculuslateralis cornu temporate-
'
'-_,,-t
Fimbria hippocampr/
/
-- Ventriculuslateralis, C o r n uo c c i p i l a l e
/'
I
,G_-L/_
/ \
, \
Hippocampus, Alveushippocampi
;
E m i n e n t i ac o l l a t e r a l r s '
53s# Fig. 534 Lateral ventricles,Ventribuli laterales; the superior parts of the cerebral hemispheres have been removed; left oosteriorview
Walls of the lateral ventricles Cornu temporale
Cornu occipitale Roof/lateral wall
Tapetum (Radiatiocorporis callosi; Radiatiooptica)
Medial wall
Calcaravts
Floor
Eminentia l;if,1:H1,..,'aterale;
Roof/lateral wall
Nucleuscaudatus,Cauda; Tapetum(RadiatiocorpopiScallosi; Radiatioacustica)
Medial wall
Fimbria hippocampi;Plexus choroideus
Floor
Eminentiacollateralis;Alveus hippocampi
3I/
n,oin, Encephaton
Hippocampus
Alveushippocampi j*.
--r
--.Trigonumcollaterale - - Sulcushippocampalis \ Gyrusdentatus --
Gyrusparahippocampalis
Sulcuscollateralis
of the lateral Fig. 535 Temporalhorn,Cornutemporale, ventricle,Ventriculuslateralis; frontalsection;the roofhasbeenremoved; view (1.). dorsosuperior
- Plexus choroideusventriculilateralis
Ependymum \ -l -Ventriculus lateralis,- ---,1 Cornutemporale
-
/ Fimb(ia hippocampi
- Sulcushippocampalis
--\_ Alveushippocampi Peshippocamp - -i_ grisea --Substantia Substantia alba *-
-_
Sulcuscollateralis medialis Gyrusoccipitotemporalis
---____/
Fig. 536 Temporalhorn, Cornutemporale,ofthe Iateral ventricle,Ventriculuslateralis; schematicfrontal section.
taterates Lateral Ventricles,ventricuti
3 1 3
Genu - Corpuscallosum,
\>//'
G Y r u sc r n g u l i
Ventticuluslateralls, Cornu lrontale
-'
l l-
,
--
C o r p u sc a l o s u mR. o s t r u m
,7 ------' /\
Cavum sePti Pellucidi
CaPUt - - - Nucleuscaudatus,
Septum Pellucidum F o r n i x ,C o l u m n a Foramen interuentrlculare CaPsulainterna
Stria termrnalls Ventriculuslateralrs, Pars centralls Fornix,CorPUs Insula ILobus insularis]
F o r n i xC. r u s - Plexuschoroadeus lateralis ventriculi -FimbriahippocamPr -- .-
Hippocampus--
Tela choroideavenlriculiterlii
collaterale-Trigonum
Calcar avis -
Ventflculuslateralis, / Cornu occipitale
Fig.537 Lateralventricles,Ventriculilaterales; t h e u p p e rp a r t so f t h e c e r e b r ahl e m i s p h e r easn d the Corpuscallosumhavebeenremoved; suoertorview
$4x
Fissura longiludinaliscerebrr \
EPendYmum -- Ventriculuslateralis,Pars centralls
lateralis- .ventricuk Plexuschoroideus Nucleus caudatus.CorPUs - - -
Laminaatlixa ---,
lnatainus -
--
V thalamostriatasuperiol
--
F o r n i xC, o r P u s
* -
Plexus choroideusventriculiterlrl
Tela choroidea ventriculitertli /
Fig. 538 Centralparts,Partescentrales,of the lateralventricles' Ventriculilaterales,and the third ventricle,Ventriculustertius; schematicfrontal section.
Brain, Encepharon
3I4
F o r a m e n- - - - I - - inlpruanlrr.r
rlr /a
ILobusinsularisl
------. -
Cauda Fornix,Crus - --
Nucleuscaudatus, Corpus Plexuschoroideus ventriculi tertii Tela choroidea ventriculitertii
.--. Hippocampus Trigonumcollalerale ---
Ventnculus lateralis,-Cornuoccipitale
4s+r 537/l Fig.539 Lateralventricles,Ventriculilaterales; the Corpuscallosumand the columnsof the fornix havebeendissected; supenor vlew.
Taenia fornicis \ Taenia choroidea \\
\\
--
Fornix,Columna
_-
Forameninterventriculare
/ - _ _
Taenialhalami (Fissuratelodiencephatica)
Fig. 540 Taeniae ofthe Plexuschoroideus ofthe cerebrum; superiorview.
-
V interna cerebri
-
Glandula pinealis
-
V magna cerebri
-
Vermis cerebelli
Lateral Ventricles,Ventriculilaterales,anrl
Ventricle.Ventriculustertius
V e n t r i c u l u lsa l e r a l r s , C o r n uf r o n t a l e C a v u m s e p t rp e l l u c r d l
S e p t u mp e l l u c r d u m- - -
----j
,n I
!
- N u c l e ucsa u d a t u sC,a P U t
--
F o r n r xC o l u m n a
i'
F o r a m e n n t e r v e n l r i c u l a r e- - -
V,
supenor V thalamoslilata
- - - -'
Adhesro intenhalamica'
T a e n t at h a l a m l
S t f l at e r m t n a l t s
Taenia chorotdea
Aqueductus mesencePhala
N u c l e u sc a u d a t u s C a u d a
Commissura Posterior Recessus Pinealis
P l e x u sc h o r o i d e u s v e n t ( c u l rt e r t i i
Commissura habenularum - -
Tela chorordeaventflcullterlrl -
V magna cerebrl
G l a n d u l ap i n e a l i s
Recessus supraplnealls
V Inlernacerebrl
l./ Lateral ventricles,Ventriculi laterales,and the Fig. 541 third ventricle, Ventriculus tertius; parts of the cerebralhemispheres,Corpus callosum,fornix, choroidalplexus and Tela choroideaof the third ventricle have been removed; superroruew. * Adhesio interthalamica has been sectioned in the median plane
The walls of the thl rd ventricle Roof Anterior wall Lateral wall Posteriorwall
ventriculitertii;Plexuschoroideus Telachoroidea Laminaterminalis anterior; Commissura Fornix,Columnae; opticus Recessus triangularis; Recessus Sulcushypothalamicus; interthalamica; thalami;Adhesio Striamedullaris Thalamus; Hypothalamus posterior habenularum; Commissura Commissura pinealis Recessus Recessus suprapinealis;
Floor
infundibuli Recessus
Openings
<- Ventriculilaterales interventricularia Foramina -+ Ventricultts quartus mesencephali Aqueductus
5ggll
3g*
Brain,Encepharon V internacerebri Foramen \ Inlerventnculare'\
\
/
\
\
Sinus sagittahsinleriol
I
V magna cerebri
- _-
V magna cerebri /
\
/
\
,\
,/
\
c,^..^ ^^-'/, Sinussaginalis supeflor
/
I /
Vv. internae cerebri
/
V superiof vermis
i--L -'- /l r ,
_ -
Vv.superiores cereorl
V. choroidea inferior
Sinus rectus
V basalis/
\.
\ / / V jugularis/
\ \
\ conrluens
sinuum Sinustransversus \ Sinr" sigmoroeus \\
Fig.542 Deepveins of the brain, Venaeprofundae cerebri,and dural sinuses,Sinusduraematris; drawn from a phlebogramof the sinuses; lateralview.
) Fig. 543 Deepveins of the brain,Venaeprofundaecerebri; dorsolateralview.
Foramen Interuentriculare a
V thalamostriatasupeflor \
V antenor septr pellucidi
'{ ,/
rharamus
1 --
f\
Vv internae cerebri
-_J.-,/.-)
L' Fig. 544 Deep veins of the brain, Venaeprofundaecerebri; the superiorlamellaof the Telachoroideaof the third ventricle has been removed; superior view.
V choroidea superior
ssetsoftheBratn 3I7
A frontobasalismedialis \
A cerebrianterior \\
/
/ Ventriculuslateralis, cornu fronlale
anteriorseoti / z V. pellucidi
A cerebri media \ \
/
Lamina atlixa
--
-
R choroideus / posterior
/ Glomuschoroideum
\
I I
Falx cerebri
superior Sinussagittalis
Fig. 545 Arteriesand veinsof the brain, Arteriae et Venaecerebri; Corpuscallosum parts of the cerebralhemispheres, and fornix havebeenremoved; superiorview.
V interna cereorl
Tela choroidea ventriculi tertii
318
Brain,Encephaton
7 Slriae I longitudinales I laterales ou I /.' I V L lndusium ./
Fornix,Corpus-_ Foramina interventricularia
(Parslibera)-t f Fornix, Columna j \ \ (Parstecta)\
--Fornix,commissura - -
Corpuscallosum, Splenium
Pars anlerior
--
Commissura anterior
Gyrusfasciolaris
Pars posterior
Fornix.Crus / Corpusamygdaloideum
Corpusmamillare/
/
-
\ Pes hippocampi /
Taenra fornicis
Fimbria hippocampi
Gyrusdentatus
Fig. 546 Both fornices,Fornices,and anteriorcommissure, Commissuraanterior; th reedimensional diagram; sinistrodorsalview.
Sulcuscinguli\ Corpuscallosum, Splenium\
/, Corpuscallosum,Truncus / Septumpellucidum - Fornix,Columna(Parslibera)
Fornix,Crus\
F oamen intervenlriculare
-
Sulcusparietooccipitalis \
- Corouscallosum. Genu
Cuneus\ Sulcuscalcarinus -
- Corpuscallosum, Rostrum - Polusfrontalis
--
Bulbusolfactorius Commissura anterior
Tractusollactorius Thalamus-
a, \N opticusul \ Lamina terminalis ,
Fimbria hippocampi //
Gyrusdentatus/
/
Fasciculus mamillothalamicus /
\ Fornix,Columna(Parstecta)
Corpusmamillare I Gyrusparahippocampalis, Uncus
Fig.547 Fornix,Fornix, the Corpuscallosumand the anteriorcommissurehave beensectionedin the medianplane;the inferior part of the diencephalonand parts of the medialaspectof the parahippocampal gyrus,Gyrusparahippocampalis, have beenremoved; inferomedialview (1.).
/ Gyrusrectus Bulbusollactorius--
Tractusolfactorius-/ ChiasmaoPlicum Trigonum olfactorium-us opticus
Fornix.Columna--
Corpus-mamillare amygdaloideum
Uncus --
Gyrus-parahippocampalts
Gyrus -dentatus
--
Corpus callosum, Truncus
Fornix,Crus -- Corpuscallosum, Splenium Fonix, ' Commissura
/ Gyrusfasciolaris
Fig.548 Fornix,Fornix; the basalparts of the brain havebeenremoved; inferior view. TheFissuralongitudinalishasbeenpulled apart somewhat and the Lobusfrontalis appearsshortened.
320
Brain, Encephato Frbrae arcuatae cerebri \
Cingulum \
Fasciculus uncinatus-Fasciculuslongitudinalisinletrct /
Fig. 549 Associationfibres,Neurofibraeassociationrs: projectiononto the left cerebralhemisDhere: viewed from the left.
Badiatio corporis callosi
I
/ Commissura posterior i I Commissura habenularum
Fig. 550 Commissural fibres,Neurofibrae commissurales; three{imensionalview;mostof the Corpuscallosumhas beensectionedin the paramedianplane;singlefibres of the Corpuscallosumare shown; viewedfrom the left.
fl ramidal Tract,Tractuspyramidalis
32r
Truncus\ Corpuscallosum, Gyruscinguh\ s Sutcuscorpo.isca,,"t,... Genu. Corpuscallosum.
tr )-.\; J:Tatr
/ Gyrusprecentralis
SulcusParietoocciPitalis
/ --, - Caosulainterna,Crusanterius-
callosum, CorPUs Splenium
---
Caosulainterna,Genu --Tractusopticus/
Corpusgeniculatum laterale
Sulcuscalcarinus
/
Pedunculus cetehti /
/ --
--
/ Pyramrs
Projectionfibres;Neurofibraeprojectionis; Fig.55l the internalcapsule,Capsulainterna,and the pyramidaltract,
medius cerebellaris Pedunculus
Tracluspyramidalis,Fibraecorticospinales
Tractus pyramidalis,have been exposed; viewedfrom the left.
Gyrusprecentralis**
/
Sulcus centralls
- -
Tractustrontooontinus
Radiationesthalami centrales
- -
Fibrae parietoPontinae; FibraeoccipitoPonlinae
Medulla oblongata -
lateralas - - Tractuscorticospinalis \ Tractuscorticospinalis anterior
Fig. 552 Internalcapsule,Capsulainterna,and pyramidal tract,Tractuspyramidalis; functionalaspects; viewed ftom the right.
* *' '**
fibres running to the Lamlna quadrigemina and to the nuclei ofthe rhombencephalon perlkarYa of the Pyramldal bact perikarya ofarea 6 and 8 (premotorcortex)
322
Brain, Encephato
Caput /, Nucleuscaudalus, thalamianleriores / Radiationes
Capsula Interna,Crus anterius /l
/ Tractustrontopontinus
/\
Mm bulbi
/
Capsulainterna,Genu - .- .Globuspalliduslateralis;.- otoousirirriJuimeoLtG
Mm larYngis
."
..
-.t
---
Mm PharYngis Mm palati et faucium Mm masticatorii L4m linguae
Capsulainterna,Crusposterius_ ---
Mm laciei --
Mm colli
- -
Capsulaextrema
-*-
l n s u l al L o b u si n s u l a r i sC] ,o n e x- - ' -
-------
Mm digilorum manus
Mm manus Mm antebrachii i/m brachii M m c i n g u l ip e c t o r a l i s Mm thoracis Mm abdominis
A - -- -- - t M m .m e m b n[ r " . , , [ | .f,j" ---
. :
\ -\
Intenons ,J [ ;";
\ Mm droitorumoedis Mm vesicae urinariae:Mm recti
' tnatamus 'Fibrae corticospinales,Fibrae curticorubrales;Fibrae corlicoreticularest Fibrae corticothalamicae;Fibrae thalamoDarietales: Radiationesthalami centrales Radiatioacustica
Radiatiooptrca
F i g . 5 5 3 I n t e r n a lc a p s u l eC , a p s u l ai n t e r n a ; functionalorsanisation.
Organisation of the internal capsule and its arterial supply Supplyingartery Crus anterius Radiationesthalami anteriores* Tractus ftontopontinus Genu Fibrae corticonucleares Crus posterius (Parsthalamolentiformis) Fibrae corticospinales Fibrae corticorubrales Fibrae corticoreticulares Fibrae corticothalamici Fibrae thalamoparietales* Radiationesthalami centrales* Pars sublentiformis Radiatiooptica Radiatioacustica Fibrae corticotectales Fibraetemporoponti nae Pars retrolentiformis Radiationesthalami posteriores* Fibrae occipitopontinae * Togetherthese fibres are called the Coronaradiata.
I A. centralisanteromedialis J (A.cerebrianterior,Parsprecommunicalis)
Aa.centralesanterolaterales (A.cerebrimedia,Parssphenoidalis); A. choroidea anterior (A.carotisinterna,Parscerebralis)
323 Fissuralongitudinalis cerebri \ ,,
Gyrusfrontalissuperior\ Truncus\ Corpuscallosum.
/
Radiatio corporis callosi \
,7:
lateralis.\ Ventric_ulus Hars cenlrails
Nucleussubthalamicus parietalis / Lobus /. capsulainterna
t€
/ Nucleuslentiformis
Nucleuscaudatus,\ uapur
,i'4
Ventriculus tertius\
Ir
Globuspalliduslateralis
/
, lamiq3medullaris tateralts
,''
/ Capsulaexterna
.1 ,,
- - Claustrum
Gyriinsulae-
- - Caosulaextrema
Sulcuslateralis-
-Putamen-
Laminamedullaris medialis
- - Nucleuscaudatus, Cauda
Globuspallidusmediahs lateralis, Ventriculus Cornutemporale
- Tractusopticus - Lobustemooralis
Pes hippocampi / Corpora mamillaria /
\ Substantia nigra, Parscompacta
T ll 4
Pedunculuscerebellaris /
meorus
i,c,
\ Pedunculuscerebri, Cruscerebri
, /',{$
N facialis z lvill
/, ri,
\\
N, vestibulocochlearis[Vllll /
medialis longitudinalis Fasciculus
\ Flocculus
N glossopharyngeus ilXl / N vagus[Xl /
Plexuschoroideusventriculiquarta
/
Nucleusolivarisinlerior/
\ Hemisoheriumcerebelli
///
Hilum nuclei olivaris inferioris/
i
/./'/ /
\ Fossainterpeduncularis
I
1
/ pyramidum Decussatio
Fig. 554 Pyramidaltract,Tractuspyramidalis,and basal nuclei,Nucleibasales; obliquesectionwith differentdepthon eachsidethroughthe posteriorcrus of the internalcapsule,the cerebralpeduncles and the Medullaoblongata; ventralview. l-lll | ll lll
= = = =
thalamic nuclei, Nuclei thalami: Nuclei mediani Nuclei antoriores Nuclei ventrales
Basal nuclei, Nuclei basales ') Nucleuscaudatus -
I P"tt'*t lentiformis
Nucleus
J
striatum' ' cornus
l pu11i6ut, I Ctolus palliduslateralis/medialis(Claustrum CorPusamygdaloideum
324 Gyrus lrontalissuperior \ \t Fissura longitudinaliscerebri r \ Sulcus crnguli . t. G y r u s c i n g u l i-
/ Margo supenor '
, A c e r e b r i a n t e r i o r , Ac a l l o s o m a r g i n a l i s
t\
Truncus /, Corpuscallosum,
./ //
Seglun Pellucidum
,t
v . m e d i a. supentctatts cerebrl
_--' Fossa lateralis ---t-cerebrl Gyn insulae --
-.--
A cerebri media --
_1
Cisterna pericallosa -
Area subcallosa
- --*-
Tractusoltactorius/
-*-*-
G y r u sr e c t u s
A. cerebri anterior, Pars postcommunicalis Margo inferolateratis
| Margo inferomediahs
Fig.555 Brain,Encephalon; frontal section through the anteriorpart of the frontal horns of the lateralventricles; dorsalview.
Gyrusirontalissuperior\ FissuraIongitudinalis cerebri1 'Sulcuscinguli:_ Gyruscrngu
/ Margo superior / A callosomarginalis ,, Cisterna pericallosa
Qorpuscallosum, Truncus
,z
Gyruslrontalismedius .- - --
/: Nucleuscaudatus. Caout -
Radialio corporis callosi
//
.//
Sulcuscorporis callosi--__
Septum pellucrdum
//
/// / /-/
- -
Ventriculuslateralis, Cornu frontale
- - Capsulainterna, Crusanterius Sulcus circularisinsulae - -
Sulcuslateralis--+
-.-
Capsulaexlerna
--
Corpuscallosum, Roslrum Capsutaextrema
cereorl
Claustrum 'i insulae Gyri insulae
:
--
Gyru lemporali
suoerior '/\ Cisternatossae / laleralis cerebri / Gyrusparaterminalis Gyrustemporalisinlerior/ / pericallosa; Crsterna Cisternalaminaeterminalis
communtcans
lGyrus rectus Traclusollactorius
'
Margo inferomedrahs
F i g . 5 5 6 B r a i n ,E n c e p h a l o nf r; o n t a ls e c t i o n through the posteriorpart of the frontal horns of the lateralventricles; dorsalview.
FrontalSectionsof the Brain
325
, Fissura longitudinaliscerebrl
G y r u sl r o n t a l i ss u p e n o r\ Gyrus cingulit
,/
a callosomarornalls
z/,
Claustrum \
"l.\
I
'.,,. clsre.larossae,alp.ascereo.r_.,'--_^
iemporales
t
.ri.
k
-t--'
nylrurrrdrdrrrus \ Recessus /,/A c o m m u n i c a n s p o s t e r i o r inlundibuli
rrahippo- / Gyrus parahippocampalrs
C a p s u l ea x t e r n a
---:____._-i---
capsulae\lrema
\ Recessus supraopticus
Fig.557 Brain,EncePhalon; frontal sectionthroughthe interventricularforamina; dorsall'ien' Gyrus lrontalis suPerlor\ Fissura longitudinaliscerebri .
Gyruscinguli\
-.
/
Truncus Corpuscallosum, , SePtumPellucidum
,'
\
Gyrus lrontalis medius \
Fornrx. Corpus\ NucleuscaudatusCorpus\
Ventriculuslateralis,Pars centralrs
,/ /
/'
\
Stria terminalis\
- Plexus choroideus ventriculilateralis Tela choroidea venl.icult ledii
/'
. t - / /
--
Gyrus frontalisinlerior -
G v ' r n s u t -a{e_ _ 1
--.*
-\
_k
-i't.t
(,('lr-t'--__--'
o2"'
t'Y
|
_-f
'',
Stna medullaristhalami
extrema - .- CaPsula
_-- ventncutuslerrrus
Cornu lemPorale
I
Hippocampus. ^tl Gyruo-
Plexus choroideus ventnculrlentl
/ /
Putamen \
: ;
:i occipitote'p?llii' lateralis Thatamus/ 1
i
I i
p oproarlai sl im e deidarlai sl rl s l !I G y r u s o c c i p iIltoetm em sm G y r u sp a r a h i p p o c a m p a l i s /
I
i t
tt."' ', \. \
\. ! ':H y p o t h a l a m u s \ A b a s i l a r i s
F i g . 5 5 8 B r a i n ,E n c e p h a l t t n ; f r o n t a ls e c t i o nt h r o u g ht h e m a m m i l l a r yb o d i e s ; dorsalview.
- N o c u l o m o t o r il ul l sl
cisternainrerpeduncularis 'aris,(cisternapontrs)
326 Gyrusfrontals superior \ F i s s u r al o n g i t u d i n a l icse r e b r i:
s e d i a l i se t l a t e r a l i s / I n d u s i u mg r i s e u m S t r i a el o n g i t u d i n a l em
\
Truncus 7 C o r p u cs a l l o s u m
G y r u s f r o n t a l i sm e d i u s\
,, Ventriculuslateralis.Pars centralis /
z P l e x u sc h o r o i d e u s v e n l n c u l li a t e r a l i s /
-cyrus trontatrs'",",,o, 5: fi
S t r i at e r m i n a l i s
- Lamina affixa
::::1fi)':
:
S u l c u sl a t e r a l r s-
InsulalLobusrnsrlarisl- -[- - - - ] - -YG y r u st e m p o r a lsi su p e r i o- r_-L--'
\
-.-
F o r n i x .C r u s
- -
Plexus choroideus
- -
Stria medullaristhalami
., -
G y r u st e m p o r a lm i se d i u s- C o r p u s g e n l c u l a t u m l a t e- -r V a t;e- _ - - - -
--::--] 1___-
'Sr.S-t+r-;;''1*[;it'"
-4i 1
t
:;v:T-+------=w-'.--' o,/ ""H1",:';11:il: Ventriculuslateralis Cornu temporale : Gyrus temporalisinlerior /
t
N u c l e ursu b e r/
/
Gyrus occipitotemporalislateralis/
// ,/' Gyrus occipitolemporalismedia|s / / / Gyrus parahippocampalis
/
caPSUlaexterna
-
-ff
+'dr l'<)\:* \r. --.
K
\\. ' '4.
\.
t
Arveus h,ppocamp,
ii;,p,hd_ -'-* \ : :ll?11.llo?"."'o' G y r u sd e n l a t u s
\
ta
t..
-
C a p s u l aI n t e r n a
\
A . c e r e b r rp o s t e n o r
c,""r""}o'"n.
t (Tr""lus cerebellorubrarrs) . \ Tractus pyramidalis
Ventriculuslertrus /
\ pons t tt4edulla oblongata
Fig.559 Brain,Encephalon; f r o n t a ls e c t i o nt h r o u g ht h e m i r l r l l eo f t h e t h i r r l r e n t r i r ; l e ; rlorsalr ien l n m a n l c a s e st h e r i g h t a n r ll e l t t h a l a m u sa r e t r a n s \ e r s e l \ c r t n n e c t eat lt t h i s l e \ e l l r r t h e , \ r l h e s i ri )n t e r t h a l a m i ( . a . G y r u sp r e c e n t r a l i \s
/ I n d u s r u mq r i s e u m , medialiset lateralis /' Stflae long-itudrnales
G y r u sc i n g u l r\
7 CorpuscallosumTruncus
Crsternapeflcallosa \
,, Ventriculuslaleralis Pars centralis / Plexus chorordeusventflculrlateraIs
Gyruspostcentralis \
v thalamostriataSuperror: _ Gyrus postcentralis\ Nucleus caudatus Corpus .-
Cisterna lossaelaleralis cerebri T h a l a m u-s Gyrustemporalis superiormesencephali
P u t a m e n-
-
G y r u st e m p o r a lm t se d i u s- -
.l:--II--
Nucleus caudatus. Cauda -
---
Gyrustemporalis inleror /
P l e x u sc h o r o i d e u s ventricul laleralis A l v e u sh i p p o c a m p i F i m b r i ah i p p o c a m p i
V e n t r i c u l u lsa t e r a l i s C o r n ut e m p o r a l e - Cisterna ambiens
G y r u so c c i p i t o t e m p o r a lliast e r a l i s\
Gyrus occipitolemporalismedialis / Gyrus parahippocampalis/
f
/ Cerebellum
Fig.560 Brain,Encephalon; frontal section through the posterior wall of the third ventricle; dorsal view.
\
A cerebrrposterior
\Venlncutus tenrus
F u n r c u l u sp o s l e r r o r
FrontalSectionsof theBrain
---Gyruspostcentralis
327
cerebri z Fissutalongitudinalis / A callosomarginalis
Lobulusoarietalisinlerior\ Gyruscinguli- -
/
Cisternaoericallosa-
lateralis, rql velu,vvrve / Ventriculus Parscenlralis z Corpuscallosum, Splenium /
/ Plexuschoroideus lateralis ventriculi
Gvrus: \ supramarginalis A. cerebrimedia-fossae- -, Cisterna -
Fornix,Crus
--
- V thalamostriala supenor - Capsulainterna
tairiiiiiicereori
Nucleuscaudatus. Cauda
- FimbriahippocamPi
- Cislernaambiens Colliculus superior-Gyrustemporalisinlerior " - Gyrusparahippocampalis ,'' ' lateralis Gyrusoccipitotemporalis
Fig.561 Brain,Encephalon; frontal sectionthrough the pineal body,Glandulapinealis,and the fourth ventricle; dorsal view.
L
./
\ v internacerebri
,'
medialis/ Gyrusoccipitotemporalis
' ventriculilaleralis -Gyrusdentatus \ Ventriculuslateralis, Cornutemporale
//
/ Flocculus / / Vermiscerebelli/ Oliva/
\ Ventriculus quartus
supeflor\\ Lobulusparietalis
grisea / Substantia
R. precunealis :
/ Substantiaalba
- Sulcussubparietalis Lobulusoarietalisinlerior-
/ CislernaquadrigeFinalis
- Precuneus SulcUsoarieloocciDitalis
Tapetum - Corouscallosum,
Gyrusangularis Sulcustemporalis supeflor Calcaravis-
- Ventriculus lateralis, Cornuoccipitale
- A. occipitalismedialis
Gyrustemporalismedius Sulcuscalcarinus
--
V magnacerebri
' Gyrustemporalisinlerior GyrusoccipitolemPoralis
- -
talerails
\ Nucleusdentatus
/ Hemisoheriumcerebelli \
Fig.562 Brain,Encephalon; frontal sectionthrough the occipital horns of the lateral ventricles; dorsal view.
Tonsillacerebelli
Vermiscerebelli
328
Bratn, Encepnoio
Fissuralongitudinalis cerebri I Gyrusfrontalissuperior\
Gyrusfrontalismedius \
\
Arachnoidea matercranialis
- A. cerebrianterior. R fronlalisoosteromedialis
-
Gyruscinguli
GyrusprecentralisSulcuscentralis---
Gyruspostcentralis--
A cerebrianterior. A. callosomarginalis
Gyrussupramarginalis-
Sulcuslateralis,/ Ramusposterior
--
--
Fig.563 Brain,Encephalon; horizontalsectionjust abovethe Corpuscallosum; superiorview, Thesubarachnoidspaceappearssomewhatenlargedin Figs. 555 to 577,especiallyaround the sulci of the brain, becauseserial sectionsof old individuals havebeentaken as a basisfor thesefigures.
Coronaradiata; Radialiocorporis callosi
A. cerebrianterior, R. precunealis
A. occipitalis medialis, Rr parietales
HorizontalSectionof theBruin
Gyrusfrontalissuperior \ Sulcuscinguli\
329
r Fissuralongitudinalisc€rebti A. caltosomarginalis i t A. cer€brianterior, Trunqrs callosum, Corpus /
Gyruscinguli\ minor
Corpuscallosum,Fo
is, Comu
Venfictlus I / z lrontale
Nucleuscaudatus,Caput\
- ,z Sotum oelhr*lrn, Cawm doptiP.kJcid Gyrusprecenlralis-
Sulcusceniralis Yqtlr Pars
--
Gyrus Postcentralis-
- V.thalant supofpr --
Striateminalis
--
Lobulusparietalis inferior
Corpr.Bcarosum' Truarcus atfixa
Nucleuscaudalus, Corpus
--
\
Gyrusangularis--
Pbxus wntirti
b
Fomix, Crus
\ colpus callosum' Forcepsmaitr
Gyruscinguli //
Corpuscallosum, (Gyri occipitales) /
Sulcussuboarietalis
Fissuralongitudinalis
I I I I Cuneus
\ Precuneus \ Sulcusparietooccidtalis
Fig.564 Brain,EncePhalon; horizontal secflonthrough the cenhal part of the lateralventricles; superlor view.
um
330
Brain,Encephato
Fissura longitudrnaliscerebri ,.
uyruscrnguil\
I I
i
G y r u st r o n t a | sm e d i u s 1
/
A cerebri anlerior,A callosomarginalis
mr i s e u m /, Indusiug 7 Corpus callosum,Genu
Cislerna pericallosa \
/, Ventriculuslaleralis,Cornu fronlale Seplum pellucidum
//
/
Gyrusfrontalis inlerior- _ Nucleuscaudatus, CaputF o r n i xC o l u m n a \
Venlriculuslateralis Pars centralis
/
/
Plexus choroideusventriculi lateralis
/
b*
\.
Gyrusprecentralis \
/
Stria terminalis
S u l c u cs e n t r a l i :s \ Gyruspostcentralis InsulalLobusinsularis]
,.
Claustrum Putamen- -
Rr terminales - Telachoroidea
r ._ _ ,
T h a l a m u-s Cisterna fossae-.lateraliscerebri
-
Fissuratransversa cereorl
-
Plexuschoroideus ventriculi laleralis
G y r u s t e m p o r a l i s- -
supeflor N u c l e ucsa u d a t u s- , Cauda
-
Corpus callosum, Splenium
Fornix,Crus
-
Hippocampus * Ventriculus lateralis, Bulbuscornusoccipitalis
S u l c u tse m p o r a l -i ssupenor
t
(Gyri occipitales) --
-
-.
I
3ulcuslunatus-Fissura longitudinaliscerebri'
t
Tapetum Corpuscallosum, Gyrus crnguli
Sulcus subparietalis
Precuneus
Sulcus parietooccrpitalis
UUNEUS
Fig.565 Brain,Encephalon; horizontalsectionthroughthe floorof the centralpart of the lateralventricles; superiorview.
HorizontalSectionof theBrain
Polusfrontalis \ Gyruscingulil \ Gyrusfrontalisinlerior\
t-,
cerebri I Fissuralongitudinalis I t A. cerebrianterior,A. callosomarginalis |
!
/lndusiumgriseum 7 Corpuscallosum,Genu lateralis,Cornufrontale / Ventriculus
\
7 SePtumpellucidum
V. anteriorseptiPellucidi\
/ Fotnix,Columna Nucleuscaudalus,Capul:
Capsulainterna, Crusanterius ,, Plexuschoroidous / ventriculilaleralis $Porilt V. thalarnostsiatra
-z Gyruslronlalisinlerior-
Capsulaintema,
-z
InsulalLobusinsularis]-
Capsulaextrema
---
Cisternalossae- laleraliscerebri Claustrum
riculat€
Foramenint
- Capsulaexl€rna --
Putamen-
Capsulaintoma, Crusposterius
- - Ventriculus tertius Rec€ssugsuprifinealis Telachoroidea ventriculitertii
- C R
Nucleuscaudatus, Cauda
---
-Sulcustemporalis sup€nor --
intorna, optis.
FimHh hlrpocaflpi Plexuschoroideus ventriculilatefalis Fornix,commissura
\ Hippocampus
Gyrustemporalismedius
\ Ventriculuslateralis, Cornuoccipitale
Gyruscinguli
Corpuscallosum, Forcepsmaior \ calcaravis
(Gyrioccipitales)
\ Corpuscallosum,Splenium \ Sulcuscalcarinus cerebri Fissuralongitudinalis
Fig. 566 Brain,EncePhalon; horizontal sectionthrough theupper part of the third ventricle; superiorview
332
Bratn, Encephato
Poluslronlalis I
Gyruscinguli\
I
cerebri I Fissuralongiludinalis A. cerebrianterior,A. callosomarginalis 7
Cisternapo.icallosa /, Corpuscallosum,Forcepsminor
Gyrusfrontalisinferior\
/ Ventriculuslateralis,Cornutrontale
Fissuralongitudinalis cerebri\ Nucleuscaudalus, Caput \
/ Corpuscallosum,Rostrum
\
Cistema pericallosa\
/ Catrsulainlema, Crus anterius - Ar€asubcallosa
Cisternatossaelateraliscerebri-
z-
Commissuraanterior\
--
lnsulalLobusinsularis]-
Laminaterminalis Fornix,Columna Capsulainlema, Genu laminao msdullares medialiset lateralis - Vonlriculustertius
Claustrum\\ Gyrus temporatrssuperior - Adhesiointerthalamica
- Capsulaextrema Capsulaextema
sulcus temporalissuperior -
- Capsula intema, Cnis posterius
Globi pallidi msdialis el lateralis
- Hypolhalamus - Commissura posterior
ThalamusGyrustemporalismedius
'-. Habenula
Cistema ambiens -
\ Capsulaintema, Radiado@tica \ Fimbdahippocamd
Nucleuscaudatus-Rocsssuspinealis/
\ Alv€ushippocampi
Glandulapinealls/
Plexuschoroijeus vs'|tric1rlilatoralis
Gyrus parahippocampalis/
Trigonumcollato.ale \ ventriculuslateralis, Comu occipitale \ sulcuscollal€ralis
Calcar avis lsthmusgyri cinguh/
/
Sulcuscalcarinus/
I
/
/ Sulcuslunatus
I I I Polusoccipitalis
\ A, c€robri poslerior I I V. magnacerebri I I \ Vermiscerebelli I I I Fissuralongitudinalis cerebri
Flg.567 Brain,Encephalon; horizontal secdonthrough the central part ofthe third ventricle at the level of the Adhesiolnterthalamica; superior view.
HorizontalSectionof theBmin
333
corebri I Fissuralongitudinalis Gyruscinguli
Cistema pericallosa \
/ Gyrus parat€tminalis Capsulainlema,Crusanterius
Gyrusfrontalisinferior\ ,, Laminateminallg Nudeus ceudatus,caput
Gommissuraanlerbl
.z
Cistemafossa€ lateraliscerebri :Putamen-
-zFomix, Columna Fasciculus -/ rawtuutu! - -z mamillothalamicus
Gyrus t€mporalissuperior Claustrum -
- Sulcushypolhalaryriors
SulcustemporalissuP€tbr Hypothalamus-
- Capsulainterna' Crus poclerius
Gyrustemporalis meotus Nodeus ruber Corporagenidjlala lateral€el mediale Nucleuscaudalus, Cauda Gyrus temporalis m60tus
Fimbrbhhpcamfr -*-
Plexuschoroileus vonlticuli la|oralis
\ Eminenliacollateralis
/ Hippocampus Cistema ambi€ns
Alveus hlttpocampi
Ventrio.rluslderalis, Comu temporal€
/
/ Gyrus parahippocampalis
\ Gyrusdentatus
t
Sulcuscollateralis
\ SulcushippocamPalis
/
\ n. \
(Gyrioccipitalos)
poeterlot ""rebri
m mesencephali, Collbulus sup€rior
\ Aouaduatr. t""encoPhali \ vermis cerebeili I Fissuralongitudinaliscorebri
Fig.568 Braln,EncePhalon; horizontal sectlonthrough the third ventricle at the level of the beginning ofthe aqueductofthe midbrain, Aqueductusmesencephali; superior view.
334
Brain, Encephato
Gyrusrectus I Gyri orbitales \
A cerebri anterior
I I
I I
Fissura longiludinaliscerebri
i t/
t
n C;i^s t e r ncah i a s m a t i c a
\
A c o m m u n i c a n sa n t e r i o r\ / Lamina terminalis A cerebri anterior \
/ Recessus supraopticus - Recessus inlundibuli
Cisterna fossae lateralrscerebri -
_ - Ventriculustertius
A cerebri media -
- Tractusopticus
G y r u s p a r a h i p p o c a m p a l i-s _ Gyrus occipitotemporalislateralrs
- C o r p u sm a m m i l l a r e - Corpus amygdaloideum
A c o m m u n i c a n sp o s l e r i o r- - t s -
\-
- ( G y r u sa m b r e n s )
--Hypothalamus
Crus cerebri
- Fossainterpeduncularis - .Cisternainterpeduncularis
- Pes hippocampi -
Substantia nigra --
:--
A cerebri posterior -N u c l e u sr u b e r -
)
Hippocampus
.- Ventriculuslateralis Cornu temporale
-
- E m r n e n t r ca o l l a t e r a l t s
--E Cisterna ambiens -
\ S u l c u sh i p p o c a m p a l i s \ S u l c u sc o l l a t e r a l i s
Tegmentum / mesencephali
- Hemispherium cerebelll
Tectum mesencephali / C o l l i c u l u si n f e r i o r
\ A q u e d u c t u sm e s e n c e p h a l i F r e n u l u mv e l i m e d u l l a r i s u p e r i o r i s/
\ V e r m i sc e r e b e l l i
G y r u sl i n g u a l i/s
Fig.569 Brain,Encephalon; staggered horizontalsectionthroughthe floor of the third ventricleat the levelof the mammillarvbodies: supenoruew
of theBrain SagittalSections
335
interthalamica I Adhesio
Foramenintervenlriculare Gyruslrontalissuperior I Sulcuscinguli \ | Hypolhalamus\ Gyruscinguli \
'l
Truncus 1 Corouscallosum, \ Septumpellucidum:_
\ / Thalamus 7 Commissurahabenularum Posterior / Commissura
Genu : Corouscallosum,
/
Rostrum Corouscallosum.
Glandula Pinealis
SPlenium / Corpuscallosum,
Gyrusparaterminalis-
V. magnacerebtl
..
/ Sulcusparietooccipilalis
Commissuraanterior - LaminalerminalisA cerebra anterior --
- Tectum
anterior A communicans
1l N o p t i c u lsl l - - A carotisinlerna /
I
i-,r..
Hypophysist / Corpusmamillare
).
posierior/ A communicans I A. basilaris'
pon"iI Pons
Medulla oDlonoala
Corpuscallosum,TruflcuS1
\
L-----
I
/ I n. vertebraris i
Ventriculuslateralis.ParscentralisI 1 V thalamostriata superior\ Nucleuscaudatus, Caput \
I i!
I mesencephati Tegmenrum
Fig. 570 Brain, Encephalon; median section; viewed from the left.
- - Vermiscerebelli
+
cerebelli Hemispherium Ventriculus ouartus
quarti ventriculi Pleruschoroideus quarti ventriculi mediana Aperlura
-\ Canaliscentralis
, Plexuschoroideusventriculilateralis | , Thalamus t: 7 GYruscinguli N^ 7' Sulcuscentralis /
Capsulainterna\\
/ -/
lateralis,--. Ventflculus Cornutrontale
Tela choroidea ventriculi tettii
7 Forntx,Crus Fornix,Commissura Corpuscallosum,Splenium
Genu -Corouscallosum,
/ Sulcusparietooccipitalas
anterior- Commissura Corouscallosum.Rostrum -
- - N. trochlearis[Vl
--
- - Pons /
Fig.571 Brain,Encephalon; sagittalsectionthroughthe left hemisphereat the levelof the Caputnucleicaudad; viewed from the left.
Pedunculuscereb€llarismedius
,/
/ N. glossopharyngeus [X] I N. vagus[X] '
Sulcuscalcarinus
t Aperturalateralisventriculiquarti \, , \ ru lacialis[Vll] \ \ N accessorius[Xl]
336
Brain, Encephato Nucleuscaudatus, Corpus\ Capsulainterna,Crusanterius\ Globuspalliduslateralis\ / Sulcuscentralis / Thalamus / Venlriculuslateralis,Parscentralis Plexuschoroideusventriculi latoralis z Fornix,Crus - Hippocampus
- Sulcuscalcarinus ,z/ GfobuspallidusmedialisA. carotisinlerna /
,r'
zX ) ,/
Hemispherium cerebelli I 7/ I / I A. cerebri posterior I I Gyrusparahippocampalis I I Pedunculus medius cereb€llaris pons /
Nucleusdentatus
Fig.572 Brain,Encephalon; sagittalsectionthroughthe left hemisphereat the levelof the Corpusnucleicaudati; viewedfrom the left.
Globuspalliduslateralis\ Globuspallidusmedialis1
CapsulainlernaI I
\
/ Sulcuscentralis / Nucleuscaudatus,Cauda / Glomuschoroideum Trigonumcollalerale
,z
Tagelum
lateralis. / / Ventriculus Cornuo@ioitalo
lnsula[Lobu9 -Insuransl a:^mtnissura anlenot -' A. cerebrimdia -'--Cistemalossaelateraliscerebri --
-
Corpusamygdaloideum " / Pl€xuschoroideus venlirculilareralis / r) / Gyrus parahippocampalis t Hippocampus
I
,'
/ Fimbria lo rhippocampi ilPPrrudrrPr
I/
/ A. carebriposterior
-ncephalon; Fig.573 Braisagittalsectionthroughthe left hemisphereat the levelof the Corpusamygdaloideum; viewedfrom the left.
of theBrain SagittalSections
lnsula[Lobusinsularisl-Claustrum-Cisternalossaelateraliscerebri/ A. cerebrimedia / Putamen/
/
/ Hippocampus
Fig.574 Brain,Encephalon; at the sagittalsectionthroughthe left hemisphere levelof the cornu temporale; viewedfrom the left.
/
Sulcuscentralis
Cislernafossaelateraliscerebri/ Insula[Lobusinsularis]/ A. cerebrimedia/ cer€bglli Hemispherium
Fig.575 Brain,Encephalon; sagittal sectionthrough the left hemisphereat the level of the Insula; viewedfrom the left.
337
33
8
Brain, Encephat
Sulcuscentralis
Cisternalossaelateraliscerebri /
A cerebri media /
Fig.576 Brain,Encephalon; sagittal section through the left hemisphereat the level of the Polus temporalis; viewed from the left.
Cisterna fossae lateraliscerebri /
Flg.577 Brain,Encephalon; sagittalsectionttrroughthe left hemisphereat the levelof the Fossalateraliscerebri: viewedfrom the left.
oftheBrain 339
HorizontalSections
- -
C e l l u l a ee t h m o i d a l e s
B u l b u so c u l i ' - -
N o p t i c u lsl l - .. Chrasmaoplicum
V e n l f l c u l u sl a t e r a l r s , C o r n ut e m p o r a l e
- -
.- .-
-' Hippocampus
-
Vermrscerebelli
- -
-
- .S u l c u sc a l c a r r n u s
\
Fig.57B Brain,Encephalon; horizontalsectionalimageobtainedwith magnetic tom0graphl'(N{RT)throughthe midbrainand the resonance i n f e r i o rh o r n so f t h e l a t e r a vl e n t r i c l e s ; sul)enor\ le\\
Pedunculuscerebri
Tegmentummesencephali
AqueductusmesencePhali
Tectum mesencephali
579 580 578
V e n t r i c u l u lsa t e r a l r s. - - Cornu lrontale
- ---
Cisterna interpeduncularls
N u c l e u s c a u d a t u sC a P U t ---S e p t u mP e l l u c r d u m
---
F o r n r xC o l u m n a
I n s u i al L o b u si n s u l a r i s-] V e n t r i c u l tuesr t i u s- - Thalamus -
-
F O r n r xu, r u s \
Ventriculuslateralis, Cornu occipilale
- Fissura longitudinaliscerebrl
Fig.579 Brain,Encephalon; horizontal sectionalimage obtainedwith magnetic resonancetomography (MRT) through the floor of the central parts of the lateral ventricles; supenor vlew.
Fig.5B0 Brain,EncePhalon; horizontal sectional image obtained with magnetic resonance tomography (MRT) through the third ventricle and the beginning of the inferior horns of the lateral ventricles; superior view.
Brrtin,L'ncclthctlon
C o r p u sc a l l o s u m F l o s t r u m\
\
G y r u so n g u 1
Sepllm i pe lucldlmi
I Forarnen l Fornx* / C o r p u sc a l l o s u mz . Inlerventflculare/ Un C U S I
S u l c u sc e n l r a l t s
C o r p u sc a l l o s u m G e n u :
V e n t f l c u l u tse r l i u s Thalamus*
V e n l rc u l u sl e r l t u s \ Hypothalamus
/
C o r p u sc a l l o s u m , Splenrum
-
Su cus paletooccipttalts
C o r p u sm a m r l l a r e-
C h r a s m ao p l r c u m . . --
Tentoflum cerebelll
-
C r s t e r n ac h a s m a t t c a-
S i n u ss p h e n o r d a l i s-
S u l c u sc a c a n n u s
G l a n d u l ap r n e a l r s
T e c t u mm e s e n c e p h a l l
H y p o p h y ss - -
V e r m i sc e r e b e l l l C i s t e r n ai n t e r p e d u n c u l a r r- s
\
Ltn9ua
A q u e d u c t u sm e s e n c e p h a l l
P a r s n a s a l r sp h a r y n g r s \
P a r s o r a l r sp h a r y n gs /
\ Epgtoilrs
P a r s l a r y n g e ap h a r y n g r s
\
\
M e d r l l as p , n a l , s
V e n t r r c u l uqsu a r t u s
Crslerna cerebellomedullafls
Fig.5til Brain,[:nr;epharon; mediansectionalimageobtainedwith magneticresonance tomography(MRT) * The contours of thesc strurtLtr()sare somcwhat falsified due to the "l)artial volumCoffi'|t "
,,,I
-
S i n u ss a g t t a ls s u p e ro r
-
G y r u sc n g u l l
- - C o r p u sc a l l o s u m T r u n c u s V e n l n c u l u sl a t e r a l r sC o r n u l r o n l a l e
-
I n s u l aI L o b - s ' n s u r a r . s ]
-
C r s l e r n al o s s a el a t e r a l t sc e r e b r l
-
C h r a s m ao p t r c u m -
-
N u c l e u sc a u d a t u s C a p u l C a p s u l ar n l e r n a S e p t u mp e l l u c r d u m
N u c l e u sl e n t r l o r m r s
A c a r o l r sn t e r n a
S i n u ss p h e n o r d a l i s -
Fig.582 Brain,Encephalon; frontal sectionalimageobtainedwith magnetic resonancetomography(MRT)throughthe ventralpart of the third ventricle.
S r n u sc a v e r n o s u s
spinales antlSpinalNerves,l',lervi spinatis, SpinalCord,llteclutlu 34L
- Os occipilale
/t
Ganglion.sensorlumnervl sprnallsll Inlumescentiacervrcalls
_ - \
Ganglia sensorlanervorum sprnallumcervlcallum
a,/ Bt' r\ r. Nn lhoracici Radices posteriores /
,tt
\ I t t / t /
Z / l
M e d u l l as p i n a l i s/
'
t f
t T Cauda equina /
-./,/ ,
Alaossisilium
I
spinalcord,Medulla Fig. 583 Brain,Encephalon, spinalis,and spinal nerves,Nervi spinales; the brain and spinal cord in a neonate;the posteriorwall of the vertebralcanaland the spinaldura materhave been removed;the intervertebral foramina have been exposed; dorsal view. In the newborn, the spinal cord extendstwo vertebral segmentsfurther caudallythan in the adult.
342
SpinolCord,Medulla spinalis
N glossopharyngeus lxl \ N vagus [X] \
/ Pons / Medullaoblongata
- Fossa rhomboidea
\
-
N hypoglossus [Xlll \
Obex
N
nypogrossus lxill
Arcusanterior - / atlantis
--
N accessorius [Xl] -- Decussatio pyramidum
- -
-
Nn cervrcales
lc 1-c 8l
- Ganglia sensoria neryorum spinahum
Sulcusanterolateralis
Radix posterior
7\ 8-
Fissura mediana anterior
(c 8)
- Arcusvertebrae Vll cervicalis
-4
Radix posterior
- Arcusvertebrae I lhoracicae
t\
(r 1)
2Duramater sprnalis
- C o s t al l l - CostalV
4-
S e g m e n t -a- - - l
5-
thoracica[1-1 2] = Pars thoracica
Sulcus posterolateralis
67-
-
Dura maler sprnalis
Sulcusmedianus posterior
I --:
- -
-- -
Radix posterior (r 12)
Arcus vertebrae thoracicaeXll
Arcusvertebrae l u m b a l iIs Radix posterior / ( L1 )
Nn lumbales lL 1-L 5l Caudaequina /
A/
-
F i l u mt e r m i n a l e
5/
1/
/, --
Nn sacrales ls 1-s 5l
Gangliasensoria nervorum spinalium (s 1-5)
os sacrum i
Parsduralis
J
I
5/
/)*
|
/ N coccygeus /
t
I ./ /
-
\ Filumterminale, Parsduralis
Fig.58s
os coccygis [Vertebraecoccyqeae l-lv]
Fig.584 Spinal cord, Medulla spinalis, and spinal nerves, Nervi spinales; the spinal cord after exposure of the vertebral canal, the intervertebral foramina and the subarachnoid space; dotsal view. As the segments of the spinal cord are numbered according to the spinal nerves, and the uppermost spinal nerve is counted as the first cervical nerve, there are B cervical segments.
Fig.585 Spinalcord,Medullaspinalis,and spinal nerves,Nervi spinales; the vertebral canal and the subarachnoidspacehave been exposed;dorsal view. Fig. 586 Spinal cord, Medulla spinalis, and spinal nerves,Nervi spinales; the vertebral canal and the subarachnoidspacehave been exposed;ventral view.
Segmentsof the SpinatCord,Segmentame'dullaespinalis
M. tricepsbrachii: C7 M brachioradialis M. extensorcarpiradialislongus M. extensorcarpiradialisbrevis M. supinator M. pronatorteres M. flexorcarpiradialis M. flexorpollicislongus M. abductorpollicislongus pollicisbrevis M. extensor M. extensorpollicislongus M. extensordigitorum indicis M. extensor M. extensorcarpiulnaris digitiminimi M. extensor M. flexordigitorumsuperficialis M. flexordigitorumProfundus M. flexorcarpiulnaris M. abductorpollicisbrevis M. flexorpollicisbrevis pollicis M. opponens M. flexordigiti minimi M. adductorpollicis M. abductor digiti minimi: CB Mm. interossei:CB
Segmenta cervrcalra[1-8] -l-6-]
@
S e g m e n t at h o r a c i c a[ 1 - 12 ]
S e g m e n t al u m b a l i a[ 1 5 ]
343
C6-CB C5_C6 C5 C7 C5-C7 LJ _UO
C6-C7
c6-c7 C6_CB C6-CB C 7- T 1 C6_CB C6-CB C6-CB C6_CB C6.CB wl - I t
C 7_ T I C7.TI C7-T1 C7-T1 C6_C7 C 7_ T 1 CB_T1 CB_T1 C B- T 1
S e g m e n t as a c r a h a[ 1 - 5 ]
Segmentacoccygea l1-31
l5l J--\/
l)\
\7
\ Fig. 587 Segmentsof the spinalcord,Segmentamedullae spinalis; schematicmedian section;the different regional segmentsare shown in differentcolours; viewed from the left.
Segmental innervation of the muscles of the arms, muscles of important
M. supraspinatus M. teresminor M. deltoideus:C5 M. infraspinatus M. subscapularis M. teresmajor M. biceps:C6 M. brachialis M. coracobrachialis
C 4 -C 5 C5_C6 C4-C6
cs-c6 C5_C7 C5_C6
cs-c6 LD_U,/
Segmentalinnervation of the muscles of the legs' muscles of important diagnostic value ( a c t ; o r t l i ntgo l U u n t N r u , q .R l ea n d S c H I - t a c x ) T12-L3 L2 Ll, M. iliopsoas: L4-15 M. tensorfasciaelatae L4_S1 M. gluteusmedius L4-S1 M. gluteusminimus L4_S2 M. gluteusmaximus L5_S1 internus M. obturatorius L5_S1 M. piriformis L2-L3 M. sartorius L2-L3 M. pectineus L2-L3 M. adductorlongus ',,: L2-L4 M. quadriceps:L3 L2-L4 M. gracilis L2-L4 M. adductorbrevis L3_14 externus M. obturatorius L3-14 M. adductormagnus L 4 - S1 M. semitendinosus L4-S1 M. semimembranosus L4_S2 M. bicepsfemoris L4 L5 M. tibialis anterior: L4 L4_S1 M. extensorhallucislongus L4_S1 M. popliteus L4-S1 M. extensordigitorumlongus L4.52 M. soleus:L5 I,.5 L4-52 M, gastrocnemius: 'r Lf,_)I M. fibularislongus ,' L5-S1 M. fibularisbrevis :,: : L5_S2 M. tibialis posterioi:S1 L5_S3 M. flexordigitorumlongus Lf,_JJ M. flexorhallucislongus L4_S1 M. extensorhallucisbrevis L4_SI M. extensordigitorumbrevis L5_S1 M. flexordigitorumbrevis L5-S1 hallucis M. abductor L5_S3 M. flexorhallucisbrevis s 1- s 2 M. adductorhallucis
344
Spinal Cord,Medulla spinalis
/
Fissura mediana anlerior
Fissuramediana antenor
,/ Dua malel spinalis
--
-
Lig denticulalum
Nn lumbales
\ Conusmedullaris
Radix posterior, / Fila radicularia
\
Arachnoidea z mater spinahs
.
F i l u mt e r m i n a l e
- Duramater spinalis
Cauda equina /
Ouramalerspinahs
\ N coccygeus Fig. 588 Spinalcord,Medulla.spinalis, and spinal meninges,Meningesspinales; the subarachnoidspacehas beenexposed; dorsalview.
F i g . 5 8 9 S p i n a lc o r d ,M e d u l l as p i n a l i s ; inferior part with the Caudaequina;the subarachnoid spacehas beenexposed; ventralview.
/
Duramatersprnalis
Figs.590 a-c Rootsof the spinalnerves, Nervispinales, Radices; typicalcoursewithin the subarachnoid space. a cervicalsegment, Segmentum cervicale b thoracicsegment,Segmentum thoracicum c lumbarsegment,Segmentum lumbale
345 Truncusneruisoinalis, R communicans Truncus nerurspinalis,R anteflor \
nervispinalis sensorium - Ganglion
Epineurium R posteriorTruncusnervispinahs,
- - Duramatersoinalis
Ganglion spinale--
--
RadixPosterior N spinalis,
Spatiumsubarachnoideum - Piamaterspinalis
(Spatium subdurale) Duramaterspinalis/ Plexusvenosus/ Spatium epidurale; ./ ' veriebralis rnlernus oosteriot / / Periosteum
/t
nr""nnoto"amaterspinalis
Fig. 591 Contentsofthe vertebralcanal,Canalisvertebralis; horizontalsectionthrough the fifth cervicalvertebra; suDenorvlew.
posterius Lig longitudinale \ / Filum termrnale Plexus venosus verlebralisinternusanterior
\
R meningeus Truncusnervispinalis, \ 7, Cauda equina
Ganglion trunci sympathicr - r'
- N spinalis,Radix anteriol
- R communicans Truncusneruispinalis.
R Truncusnervispinalis,
\ N spinalis,Radixposterior
.' Truncusnervisoinalis.R ooslerrclr R lateralis /
/
R medialis /
Pia mater spinalis ,
tt.
tt
/
\ Arachnordea matersPinalis
,,'(Spatiumsubdurale)
/ I I
Spatium subarachnoideum/
I Lig tlavum/
\ Duramaterspinalis Spatiumepidurale Periosteum
Fig. 592 Contentsof the vertebralcanal,Canalisvertebralis; horizontalsectionthroughthe third lumbarvertebra; superiorview.
346
spinatcord,Med /, Corpus vertebrae
Truncussymoathicus, Ganglion truncisympathici 1
/ M e d u l l as p i n a l i s
R c o m m u n i c a n s1 R meningeus 1 G a n g l i o ns e n s o r i u mn e r u is p i n a l i s
T r u n c unse r vsi p i n a l i -s- - - R p o s t e r i o-r- N Intercostalis -
.-.
\l '
/
Radix anlerior
,z
i
l-oramen Intervertebrale J ---F l a d i xp o s l e r i o r --C a n a l i sv e r l e b r a l i s
Costa
---Araraverlebrae
R lateralis -.---
proc spinosus
R medialis '---
Mm dorsi
(R -
(F culaneus medialis)
F i g . 5 9 3 S p i n a nl e r r e ,\ e r r u s s g r i n a l i s ; t h o r a c i rrre g i o n ; (liagram.
G a n g l i o ns e n s o r i u mn e r u is p i n a l i s_ _ _ Plexus venosus vertebralis - -
internus posterior Fl poslerior--
--M
quadratuslumborum
- - Proc articularis superior
Arachnoideamater spinalis - _ S p a t i u ms u b a r a c h n o i d e u m- Pia mater spinalis - -
--V
s p i n a l i sp o s l e n o r
Duramaterspinalis- C a u d ae q u i n a - Truncus nervi sptnalts. - R anlerior N s p i n a l i s *, - Radix anterior N s p r n a l i s .- Radrx poslenor
- - M interlransversaflus laleraltslumborum
--
Fig. 594 Contentsofthe vertebralcanal,Canalisvertebralis; lumbar and lumbosacral part; the vertebral arches have been removed; dorsal view.
Lig iliolumbale
Arteries of the SPinal Cord
A soinalisposterior
A spinalisanterior - -
Fig. 595 Arteriesof the spinalcord,Medullaspinalis; diagram.
A spinalisanteflor -A cervicalisascendens - - -
Pars ascendensaortae - -
R spinalis A intercoslalisposlenor A spinalisanteflor
- - - Pars descendens aonae
N spinalis, Radix anteraor Aa intercostales postefl ores
Ganglion- nervispinalis sensorium Truncusneruispinalis-(A radicularismagna)*
Cauda equina
Fig. 596 Arteriesof the spinalcord,Medullaspinalis; diagram. ' clinical: AoA.}fitEmcz's artery
347
348 Lig longitudinaleposteflus
(V basivertebralis) \
\
I
PIexusvenosusvertebralis externus anlerior
,'"
Plexusvenosusvertebralis- - posterior Internus
--
V lumbalis ascendens
Plexus venosus vertebralis - - externus oosterior
Fig. 597 Veinsof the vertebralcanal,Canalisvertebralis; demonstrationof the venousplexus.
OiscusInlervertebralis, Anulusfibrosus\
--
Lig longitudinaleposterius ----
_--
_--
Capsulaarticularis
Lig longitudinaleanterius
R meningeus
Ganglion lrunci sympalhici
---
R communicans griseus
-*-
R c o m m u n i c a n sa l b u s
I I I
I I
R posterior (R medialis) (R lateralis)
I I I Trrncusneruispinalis
Ganglion sensorium nerui spinalis
Fig. 598 Nervesof the vertebralcolumn,Columnavertebralis; somaticand vegetativeinnervation.
349
andNervesof the vertebralcolumnand thespinal cord vessels
N spinalis,Fila radicularia
,/ Duramaterspinalis \
,, superior\\ Proc articularis
,,
materspinalis Arachnordea -/
O A spinalisanterior, anlerior R radicularis
Lig denticulatum --
Truncusnerutspinalis, R posterior Ganglion sensorium nervrsprnalrs
Truncusnervispinalis, R anterior 'Spatium subarachnoideum
Arcus verlebrae - 1--
Arachnoidea
matersPinalis R. meningeus
-----Rr.sPinalesO (A inlercostalisposterior)
--
Fovea coslalis orocessus transversi
o Plexusvenosus vertebralis internus anterior
- -
Lig. longitudinale poslerlus
,
Truncussympathicus, Rr communicantes Fovea costalissuperior\\
--: - - - - - Corpusvertebrae
\
exlernusa \ M intercostalis
---
L i g .l o n g i l u d i n a l e antenus
Costar
/ o V hemiazygos
\l
/
-t s a -A : V i n t e r c o s t a l iO
,'
,ffi*--/
Fascia endothoracica / Pleura Parietalis, Parscdstalis
/
endothoractca M rntercostalls
-
-;'
- O Pars lnoractca aonae
-
Truncus vagails postenor; Plexus oesopnageus O Aa oesophageae
Truncus sympathrcus
N splanchnicus ma)or a Oiaphragma, Centrum lenolneum V azygoso \/',
ha^2ri.2o
a
Plexus aorlicus lnoracicus
/
/
N . p h r e n i c u s : AV..; a a ' oencardtacopnrenlca
,\, i
t I V cavainlerior
of the vertebralcanal,Canalisvertebralis; Fig.599 Contents stepwise; the thoracicpart hasbeenexposed ventralview
350
Spinal Cord,Medulla spinalis
posterior Sulcusmedianus \ \ posterior Sulcusintermedius \
7
gracilis Fasciculus
rrnicutusooste,io, cuneatus,i 7 Fasciculus ) -( gelatinosa centralis / Substantia
sutcusposterotale,"b) eE f
\'
1 -?;*'>,--\ / 13
,"
:::::
Radrx posteflor Fila radicularia
substantiaseratinosa
rti '!
'j ll ' I
'{'\ \
\ Sulcusanterolateralis \ pi, materspinalis
Fissura mediana anterior
posterior Sulcusmedianus \ Substantiagelatinosa\
// Radix posterior
posterior / Funiculus
;\ \
'/ Columnaposterior Cornuposterius
- Funiculus lateralis
\ columna posterior, Cornu postenus
Substantia gelatinosa cenlralis *41 / Cofumnaanterior, Cornuanterius / / Commissura albaanterior
Columna iniermedia, Cornu laterale
I
\
substantia gelatinosa centralis I Fissuramedianaanterior
Funiculus anterior
c I Sulcus medianus posterior I
/
/ ColumnaposteriorC ornuposterius
\
/ Columnaanlerior, Cornuanlerius
grisea Substantia gelatrnosa centralis Substantia
Canaliscentralis
Fissura mediana anterior
Figs.600a-d Spinalcord,Medullaspinalis; horizontalsections;the myelin sheathshavebeenstained. a b c d
cervicalpart, Parscervicalis thoracicpart, Parsthoracica lumbarpart, Parslumbalis sacralpart, Parssacralis
Nuclei and Reflexesof the Spinal Cord
Substantiagelatinosa \
/
/
Nucleus marginalis
-
Nucleusproprius\
Columnaposterior Cornuposterius
posterior - - Nucleusthoracicus -
Columna intermedia,Cornu Iaterale
Nucleus
tx'
,'\7
-
! I'
r r
c a n a l i sc e n t r a l i s
(Substantiagrisea intermediacentralis)
,
\
Columna anteflor Cornu anterius
Nuctei
spinalis; Fig. 601 Spinalcord,N'letlulla laminar organisationof the gret matteraccordingto features(asdescribetlbr Rlxr:o, 1952); r\ toarchitectural a t h o r a c i cs e g m e n (t T 1 0 )i s s h o u n a s a n e r a m p l e . T h er l e v e l o p m e natn d n u m b e ro f t h e l a m i n a er a r f i n t h e rlifferentsectorsof the spinalcord.
'1= spinal ganglion 2 = interneurons 3 = motoneuronof venlral horn 4 = skin 5 6=motorendplales 7 = m u s c l es p i n d l e
of the spinalcord; Fig.602 Reflexes reflex(bineural,proprio left sideofthe picture:monosynaptic ceptive;e.g.patellartendonreflex,Achillestendonreflexetc.); reflex(polyneural, right sideofthe picture:polysynaptic e.g.abdominalwall reflex,cremastericreflex, exteroceptive; plantarreflexetc.).
351
352
Spinal Cord,Medulla spinalis
Fasciculus septomarginahs" \ Fasciculus inlerfascicularis' \ tl
t\\
\\ \ propriiposteriores Fasciculi
proprii-Fasciculi lalerales Tractus-corticosprnalis (pyramidalis) lateralis
-)<.---=<'*.
t\ t\t .. I
t t
\t\
I t
a\
lr\ tl
\\
t
\\l
-f-ZJ
s posterior* / Tractus sprnocerebellafl
I I
\
\rta
I 't tl
Tractusrubrospinalis
I \'l
\t.
,
at
Tractusreticulospinalis
.-7 I ' T J-r/
\
Fibrae olivospinales
-
\
/ Tractusreliculospinalis; Tractustectospinalis
\
Tractusvestibulospinalis medialis
Tractusspinolateralis thalamicus
Tractusspinocerebellaris anteflor""
Tractusspinoolivaris
Tractusspinothalamrcus antenor; Tractusspinotectalis
propriianteriores Fasciculi
(pyramidalis) Tractuscorticospinalis anterior
Fasciculuslongitudinalismedialis
Fig. 603 Spinal cord, Medulla spinalis; schematicorganisationof the white matter; an inferior cervical segment is shown as an example.Afferent (= ascending)tracts are colouredblue, efferent (=descending)tracts red.
In the areasmarked+, ++ and +++dss6sndlng collaterals of the posteriorfuniculuscanbe found.
'
+ ScHULTzE'sbundle (Pars cervicalis) ++ FLrcssrc's oval field (Pars thoracica) +++ PurLrppr-Gor.,rBAuLT triangle (Pars lumbalis; Pars sacralis)
clinical: FLEcHsrc'sbundle clinical: Gowens' bundle ** " clinical: GoLL's tract '* * * clinical: BURDACH'S tract
Cellular structure of the spinal cord Root neurons Efferentrootneurons(perikaryain the greysubstance, grisea,axonsin the anteriorradix) Substantia - multipolarmotorrootcells(motoneurons) - multipolarvisceralrootcells(CB-L3:connection to the sympathetic trunk; 52-S5:connection to the pelvic parasympathetic ganglia) Afferentrootneurons(perikaryain the spinalganglia,axonsin the posteriorradix) - pseudounipolar sensoryrootcells(formingthe Funiculusposterior, connections to the anterior,Iateraland posteriorcolumns) Interneurons (multipolarcellsin the greysubstance, Interneurons grisea) Substantia - interneurons in the strictsense(homolateral connections) - commissural cells(contralateral connections) - association cells(shortsegmental connections in the Fasciculiproprii) Columncells(multipolarcells;perikaryain the greysubstance, grisea,longascending axons or descending Substantia formthe tractsof the funiculi)
cord thespinat
n
Fnr
J )
, GyrusPostcentralls Gyrusposlcentralis \\
-.--
Fibrae thalamoparietales
- -
Lemniscusmedialis
Fibrae thalamoparietales
Thalamus
' N trigeminus[V] /
Nuclei nervi trigemini /
/ lemniscorum Decussatio / N u c l e ucsu n e a t uzs ; Nucleusgracilis cunealusFasciculus
\-\ t-
lateralis Tractusspinothalamicus anterior (Fasciculus Tractusspinothalamicus TractussPinoreticularis anterolateialis) TractussPinotectalis Tractusspinoolivaris
gracilis/ Fasciculus
4
,l
sensorium Ganglion neruispinalis
Fig. 604 Tractsof the epicritic (blue)and protopathic(green)sensibility; ovcrvlew.
Long tracts within the sPinal cord Afferenttracts Pathwayof epicriticsensibility(tactilepathway) vibrati0n,andsenseof position) (exactdifferentiati0n of touch,pressure, 1. Neuron(uncrossed) thejointsaswell asfrommusclespindles of the periosteum, of the skin andmucousmembranes, (exteroceptors) Fromreceptors andgracilisfasciculus(rootcells, iuneatefasciculus etc.to the cuneatenucleusandgracilisnucleusin the Medullaoblongata: (see Fig. 603) ganglia); collaterals perikaryain the spinal descending 2. Neuron(crossed) perikaryain the cuneate (cuneate nucleus,gracilisnucleus)to the thalamus(mediallemniscus, Fromthe Medullaoblongata (Fibraecuneocerebellares) nucleusandgracilisnucleus).Branchingoff of fibresto the cerebellum 3. Neuron(uncrossed) fibres,perikaryain the thalamus) gyrus(thalamocortical to the postcentral Fromthe thalamusto the cortex,especially sensibility(painpathway) Pathwayof protopathic generalpressureperception) (pain,temperature, 1. Neuron(uncrossed) of the skin,the mucosaetc.to the centralnucleusof the posteriorfuniculus,laminaeI' IV' VII Fromreceptors(exieroceptors) perikarya (roots in the spinalganglia) cells, andVIII somefibrespossiblyuncrossed) 2. Neuron(crossed, (anteriorandlateral Fromthe posteriorhornto the thalamus,in the reticularformationandto the tectumofthe mesencephalon tract;perikaryain the posteriorfuniculi) tract,spinotectal spinothalimictract,spinoreticular 3. Neuron(uncrossed) fibres,perikaryain the gyrus(thalamocortical to the postcentral Fromthe thalamus,amongothers,to the cortex,especialiy geniculatum mediale geniculate parts body, corpus medial of the alsoto thalamus),
J
354
Spinal Cord,Medulla spinalis
Pedunculus cerebellaris superior
Vermiscerebelli -
/
N spinalis\
Pedunculuscerebellarisinlerror
ftaclus spinocerebellaris poslerior
/
f .actus spinocerebellansanlerior
/
Nucleus thoracrcus posterior
Cornuposterius /
\
Ganglion sensorium nerui spinalis
Fig. 605 Tractsof the unconscious d e e ps e n s i b i l i t y ; overvlew.
Long tracts within the spinal cord (continued) Afferent
tracts
Tract of unconscious deep sensibility (unconscious but exactspatialdifferentiationas a basisfor the coordinationofmovementby the cerebellum) To the anterior lateral cerebellospinaltract 1. Neuron(uncrossed) From receptors(proprioceptors)in muscles,ligaments,and in the connectivetissue t0 the thoracic nucleus of the posterior column (rootcells,perikaryain the spinalganglia) 2. Neuron(mainly crossed) From the posteriorhorn to the cerebellum,particularlyto the anteriorpart of the cerebellarvermis throughthe superior cerebellarpeduncle(anteriorspinocerebellar tract,perikaryain the thoracicnucleus) To the posterior cerebellospinaltract 1. Neuron(uncrossed) From the end organs(proprioceptors) in muscles,ligamentsand in the connectivetissuet0 the nuclei of the posteriorand anteriorcolumns(rootcells,perikaryain the spinalganglia) 2. Neuron(probablyuncrossed) From the posteriorhorn to the cerebellumthrough the inferior cerebellarpeduncle(posteriorspinocerebellar tract,perikarya in the posteriorhorn)
cord thespinat
AFF
J )
Gyrusprecentralis -
Fibrae corticospinales - -
Corpus striatum --
Thalamus -
-
Nucleusruber
- (Tractus cerebellorubralis) nigraSubstantra Nucleipontis Fibraepontocerebellares -
etc \ Tractusbulboreticulospinalis
Tractusrubrospinalis TractusreticulosPinalis TractusvestlbulosPinalis Tractustectosplnalls
Cornuanterius Radix-anterior \ lmolonal \
N spinalis
Fig. 606
Tractsof the motor
:llill;Ji"llliL,,on,u, n"^ ", Long tracts within the spinal cord (continuedl Efferenttracts (motor end pathway) is . The motor system consistsof a large number of nuclear areasand tracts.The "final common pathway" - the traditional schemeofdescription complexity extraordinary the despite and formed by the motoneurons.For didactic reasons has beenmaintainedhere. (so-called) Pyramidal tract 1. (Central)neuron (crossed) and posteriorcolumns From the c0rtex through tire internal capsuleand the cerebralpeduncleto the interneuronsof the anterior (lateral corticospinaltiact, anterior corticospinaltract, perikarya in the precentralgyrus) bulbi) and Fibraecorticonucleares branchingoffoifibres to the nuclei ofthe cranialnerves(Fibraecorticonucleares 2. (Peripheral)neuron (motorend pathway,cx-motoneurons) horn) From the anterior horn to the mbtor endplatesof the skeletalmusculature (motoneurons,perikarya in the anterior (so-called)Extrapyramidal motor system 1. Centralneurons(crossedand uncrossed) nucleiofthe From the cerebralcortex,particularlyto the precentralgyrus anclthe corticalareasin front of it includingthe of the development and etc' cerebellum nigra, Substantia red nucleus, nucleus, thalamus,iubthalamic telencephalon, vestibulartracts, regulatingfeedbackto the interneuronsof the anteri0rcolumn (rubrospinaltract,medialand lateralspinal reticulospinaltract,tectospinaltract) 2. Peripheralneuron (motorend pathway,c-motoneurons) perikaryain the anteriorhorn) of the skeletalmusculature(motoneurons, From the anteriorhorn to the motor enclplates
)
Eye,Organumvisus
(Sulcuspalpebralis superior) I palpebrarum Commissura lateralis I
i / Supercilium
;Supercrlrum I
- Tunica conjunctiva bulbi Angulus oculi -lateralis; Commissura lalerahs parpeorarum Flima palpebrarum
-
Caruncula lacrimalis
- A n g u l u so c u l i medialis
Clliae -
\
Palpebra inferiort ,t' / (Sulcuspalpebronasalis)
i | palpebraruml Angulus ocuhmediahs, Commtssura medialis
Sulcussclerae/
lrrs' /, l ! P u p iillllaa ' Ii P a l p e b rian l e r i o r '
/ Lrmbuspostenor palpebrae
Limbusanteriorpalpebrae'
Fig.607 Eyelids,Palpebrae; lids closed; ventralview (r.).
commissura medialis parpeDrarum
I Papilla lacrimalis(inlerior)
F i g . 6 0 8 E y e ,O c u l u sa, n d e ) e l i d s P , alpebrae; l i d so p e n ; v e n t r a lv i e w ( r ) . ' lighrr('fl('\
Limbus posteriorpalpebrae
rns\-
surcus screrae \'t \r 'r Pupirta \ '\ \.
\
Limbus anteriorpalpebrae I
r imh,,c .hto,i^, ^.r^6hr..
*\t'":3li:ll':11"?11""11:" \ Ii",ffi";i I
i
I Tunica -;;D;6;il; coniuncriva ;i i \ \ \
t
1 , Caruncula ,,' lacrimalis / Commissura medialis parpeorarum - Angulusoculi medialis - Plica semilunaris conjunctivae
parpeorae
I I i ,/z t' plicasemilunansconruncrii?i,(^i"..' | ,r' ' / I | punctumlacrimale/ ! lli i l P a p i l l a l a c r i m a l i s ( i n f e r i o-0 '
i I ! ' Caruncula lacrimalis I i C o m m i s s u r a m e d i a l i s p a l p e b r a !r u m r A n g u l uosc u l m i edialis'
Fig.609 Eye,Oculus,andeyelids,Palpebrae; the palpebralfissureis wide openbecausethe eyelids havebeenpulledapart; the gazeis orientatedsuperolaterally; ventralview (r.). . liSht reflex
^,,su,usuLu,,
;
.",,:*i$i1,,"*, tI Paloebrarum i commissuralaterahs'
I
I
t\\ |
I
Lacustacrimatis/ I / palpebrae Limbusposterior
\Punctumtacrimate; (inferioo Papillalacrimalis ' ( S u l c u sp a l p e b r a li insf e r i o ,
\ 't
i ; I Limbusanteriorpalpebrae
Fig.610 Eye,Oculus,andeyelids,Palpebrae; the upperlid hasbeeneverted;the gazeis orientated inferiorly;ventralview(r.). It is sometimes difficultto evert(ectropionise) the upper lid dueto the stiffnessof the superiortarsus(* *). This procedureis necessaryto removeforeignbodiesfrom the andit is bestaccomplished usinga small conjunctivae hook(.) with a roundend.
Musculifaciei OrbitatCavity,Orbita,andFacialMuscles,
Margosupraorbitalis \ \
Ala minor.. Os sphenoidale,
Fossa glandulae lacrimahs\
Foramen supraorbitale'\
lrontahs' | Incisura
Faciesorbitalis Parsorbitalis, / Os frontale, z Fdvea trochlearis
I
\
\ I \ \ \,|
\
35?
/
Proc zygomaticus \_ Os trontale,
z Canalis oplicus
//
Fotamenethmoidaleposlerius
--
Foramenelhmoidaleanterius
--
Margo medialis
- -
Os lacrimale
- - Sulcus lacrimalis
Proc frontalis-Os zygomatrcum,
- -
Fissuraorbitalis superior-
- Fossasaccilacrimalis
\-]-.i
t... / Faciesorbrtalis Os zygomaticum,
Crisia lacrimalis anlerior
- posterior Cristalacrimalis
)./ \ Maxilla,Proc frontalis
/ Foramenzygomaticolaciale
\ Inciguralacrimalis \ Os ethmoidale, Lamina orbitalis
Fissuraorbitalisrnleior /
\ Os palatinum,Proc orbitalis
/ Sulcus infraorbitalis:Canalis infraorbitalis Margo inkaorbitalis'
Fig.611 Orbitalcavity,Orbita; ventrolateralview (r.). ' Thesestructurescan be presentas foraminaor fissures.
M occipitotronlalis.Venler frontalis\
M depressor supercilii I I
lFor"r"n
inlraorbitale
\
Maxilla,Facies orbitalis
In the orbital cavitythe followingwalls canbe distinguished: Pariessuperior,Parieslateralis,Pariesinferior and Paries medialis.
/
M procerus
supercilii /, M corrugator - Os nasale
M orbicularisoculi,\ Pars palpebralis \
palpebrale - ,- Lig. mediale oculi, - - M. orbicularis Parsorbitalis
M levator \ labri superiofls alaeque nasi
M levatot labiisuperioris alaequenasi
-M orbicularisoculi.- \ \ Pars orbitalis
- M. nasalis
M levator -labii superioris
--
M levator labiisuperioris
--
M zygomaticus malor
--
M levalor anguli oris z
Mm.faciei,in the Fig.612 Facialmuscles, of the eye; neighbourhood ventralview.
M zygqmaticus mrnor
Eye,Organumvisus
-
- -
>--
Tunica conjunctivapalpebrarum
Tarsussuperior G l a n d u l at e arsales*
+- - Faciesposterior palpebrae
Facies anterior parpeorae
-
Cilia
\
Limbus posterior parpeorae
M orbiculario s culi Pars palpebralis
L i m b u sa n t e r i o rp a l p e b r a e
F i g . 6 1 3 U p p e rl i r l ,P a l p e l r r sau p e r i o r ; p h o t o g r a l J(h) li l m i ( r r ) s{() l r i ts ; r e irm e n :a z a ns t a i n : s a g i t t asl e c t i o nl;o u m a g n i f i c a t i 0 n * r l i n i ra l : \ l t , t E o r i a ng l a n ( i s
/
G l a n d u l a et a r s a l e s
Angulus oculi lateralis \ /
.-
A n g u l u so c u l rm e d r a l i s
C o m m i s s u r am e d i a l i s parpeDrarum
/ Commissura lateralis parpeorarum / Rimapalpebrarum
-Ia/r s u sr n l e f l o r
/
Fig.6l4 Eyelids,Palpebrae; excretoryductules of the tarsal glands; dorsalview (1.).
G l a n d u l a et a r s a l e s
-orou, orbita cavity, 3 59 / Septumorbitale Septumorbitale\
/ TarsussuPerior
/ Lig. palpebralemediale
- Os nasale
- Maxilla,Proc.trontalis Septumorbilale \ Tarsusinlerior Os zygomaticum
has been exposed;the tendon of M. levatorpalpebrae superioris has been sectionedlaterally in order to make the palpebralpart of the lacrimal gland visible;
Fig. 615 Orbital entrance,Aditus orbitalis, and lacrimalgland,Glandula with eyelids,Palpebrae, lacrimalis; the orbicular muscle has been removed;the orbital septum
M. levatorpalpebraesuPerioris\
ventralview (r.).
/
IncisurasuPraorbitalis Tendo suPerior, - M obliquus
Fornix \ conjunclivae -superlor t\
- Corpusadiposumorbitae
Glandula lacrimalis, - Pars orbitalis
Tarsussuperior-(Raphepalpebralis-Lig. lateralis): palpebralelaterale
--
--
Lig. Palpebrale mediale
- -
Saccus lacrimalis
--
Lig. Palpebrale mediale
Rimapalpebrarum
Fornixconjunctivae inferior
/ Os zygomaticum Tarsusinlerior/
/
--
Forameninfraobilale
M obliquusinferior/
Fig. 616 Orbitalentrance,Aditusorbitalis,with eyelids' Palpebrae; the orbital septumhas beenremoved;the levator muscle of the uppereyelidhasbeensectioned; ventralview (r.).
Organum
Foramina ethmoidalia anterius et ooslerius Os ethmoidale,Lamina orbitalis Fissuraorbitalissuperior
I Canalis opticus I I 'J Ossphenoidale. --
Alaminor ---:
- Os nasale -
Os sphenoidale, Ala major
-
Fissuraorbitalisinterior
-
Margo lateralis -
Os lacrimale
Foramen zygomalicoorbilale
suoerior .-= - Fissuraorbitalis
Maxrlla, Proc frontalis Canalis nasolacrimalis
FOSSa
pterygopalatina Os sphenoidale, proc pterygoideus
eroc.l 1 'l Pyramidalis Ospalatinum \ Proc.orbitalis
\ Fissura orbitalis inferior
.
\
.
\
Sinusmaxillaris
Fig.617 Medialwall, Pariesmedialis,of the orbital cavity, Orbita; the wall has beenexposedby a vertical sectionthrough the axis of the orbital cavitv: lateral view (r.).
\ \
Fissura pterygomaxillaris
\ Maxilla, Facies orbitalis
i.
Sinusmaxillaris
Canalis intraorbiialis
Fig. 6lB Lateralwall, Parieslateralis,of the orbital cavity, Orbita; the wall has been exposedby a vertical sectionthrough the axis of the orbital cavitv: medialview (r.).
/ N lacrimalis
Parsorbitalis\ Glandula lacrimalis,
/ A lacrimalis
cumneruozygomaiico / R communicans _z Suturasphenozygomatica - M rectuslateralis z N oplicus[|l] - -
R communicans cumnervozygomatico t'
- Fissuraorbitalis inferior \
/ Foramenzygomaticoorbitale
Fig. 619 Innervationof the lacrimalgland,Glandula lacrimalis;
Os sphenoidale,Ala majol
N inlraorbitalis
\ N zygomaiicus
the lateralwall ofthe orbitalcavityhas beenexposedby a vertical section; medialview (r.).
Lacrimal apparatus,Apparatuslacrimalis The Glandulalacrimalissecretsa fluid, tears,via the Ductuli excretorii into the conjunctivalpouch. It is spread over the corneaby blinking and is collectedin the lacrimal lake,Iacus Iacrimalis,alongthe backedgeof the lowerlid. By immersing the lacrimalopeningin the lacrimallakethe lacrimalductscan transport the lacrimal fluid into the lacrimal sac, Saccus lacrimalis,partly through capillaryattractionand partly by sucking.
The nasolacrimal canalis about20 mm long and 5 mm wide and containsthe nasolacrimal duct.It startsat the Fossasacci lacrimalisand ends,protectedby the Plicalacrimalis,in the nosebelowthe Conchanasalisinferior.In the newbornthe nasal openingof the nasolacrimal duct may still be obstructed by a membrane.
LocrimolApparatus,Apparatuslacrimalis
F o r n r xc o n j u n c t r v aseu p e f l o r\
lacrimalis uperror / Canaliculus G l a n d u l al a c r i m a l r sD u c t u l ie x c r e t o r i \i
/
L 4 o r b i c u l a r i os c u l i
I
Fonix sacci lacrimalis
,/
I I
-
7),.
- -
Saccus lacrimalis
- -
Canaliculuslacrimalisinferiol
--
P a p i l l al a c r i m a l l s i Punctum lacrimale
- T u n i c ac o n j u n c t i v ab u l b r
-*-
Fornlx conjunctrvaetnlelor
---
- / N inlraorbitalis
Concha nasaltsmedia D u c t u sn a s o l a c r i m a l i s P l i c al a c r i m a l i s
- - -
/ T u n r c ac o n i u n c t i v ap a l p e b r a r u m
Carunculalacrimalis
Meatus nasi inferlor Concha nasalis inferiol
/
S r n u sm a x i l l a r s T u n t c am u c o s a
F i g . 6 2 0 l . a c r i m aal l ) l ) a r a t u sA,l ) l ) a r a t ulsa c r i m a l i s ; t h t :e r e l i t l sh a l e l t e e nl ) u l l e (al \ \ a \ f r r t mt h e e l e b a l l ;t h e n a s o l a c r i m at llt t t ; th a sb e e ne r p t t s e rt l o w nt o i t s o r i f i c e i n t o t h e i n f e r i o rn a s a lm e a t u s ; \ e n t r a l\ i e \ \ ( r ) Canalrculus lacnmalrs upeflor
P a p i l l al a c n m a l r s P u n c t u ml a c r t m a l e
S a c c u sl a c r t m a l r s
C a r u n c u l al a c n m a l r s \
'\ uanalrculus
l a c r m a l r ss u p e l o r
Lrg palpebrale meorate
'\ \
Fornrx\ sacct \ lac(malrs
I
A m p u l l ac a n a l i c u llia c r i m a l l s
! t.' ! |
, Caruncula lacrimalis ,t
l /" t/
//
/ Pal?ebta supenor
L,g . palpebrale meorale Saccus lacnmalrs Maxilla ---' Proc lronlalrs
ta \
\ Patpebra Inlenor \ M o r b r c u l a r ios c u l t
n a s oa c n m a l r s
lacrimalls InJenor
\ P a p i1 al a c rm a l i s : P u n c l u ml a c f l m a l e
M oblrquus tnlerror
Fig. 621 Lacrimal apparatus,Apparatuslacrimalis; the orbicular muscle has been partially removedfrom the maxillarybone;the medialpalpebralligamenthas beensectioned; ventrolateralview (1.).
lacrimalis; Fig. 622 Lacrimalapparatus,Apparatus the nasolacrimalduct and the lacrimal canaliculi have been exposed; ventrolateralview (1.).
aEa J0
L
Eye,Orgonum visus
M obliquussuperior,Trochlea
M rectusmedialis - - -
M. obliouusinlerior
---
M rectussuoerior
M. rectusinferior
M. obliquus superior M. levatorpalpebraesuperioris
--
M rectuslateralis
Anulustendineus communis
Fig. 623 Extraocularmuscles,Mm. bulbi; superiorview (r.). The axis of the eyeballis sagittally orientatedwhereas the musclesof the eye are orientatedalongth'eaxis of the orbital cavity.
M levatorpalpebraesuperioris\ obliquus superio'\
/ M. reclus / supenor
/ M orbitalis - Os frontale superiot _ - - Fissuraorbitalis
N o p t i c u s t l l-l -
-:-
Lacerlusmusculirectilaleralis
M. rectusmedialis-- Alamajor Os sphenoidale,
Cellulae ethmoidales -
\ M recluslateralis
N opticus!ll, Vaginaexterna/
M reclus inletiot
/
Periorbita/
Fig.624 Extraocularmuscles,Mm. bulbi; demonstrationof the origin on the commonannular tendon; frontal sectionthrough the orbital cavity;the optic nerve has beensectioned; ventralview (1.).
Nervesupply of the extraocularmuscles N. oculomotorius [IIl] M. Ievatorpalpebraesuperioris M. rectussuperior M. rectusmedialis M. rectusinferior M. obliquusinferior
N. trochlearls FYl, ,, ,, 'M. obliquussupeditt N abducens [VIJ :i:, M. rrctus lateralis
Musculibulbi Muscles, Extraocular
-
M reclussuDerior
/ M rectusmedialis
/ M rectuslateralis
I
,q.
bulbi Tunicaconiunctiva '/
'
t '
cornea/
I
\
\ . /
'!
M obliquusinferior
/\ ht
-
M rectusinferior
Mm.bulbi; muscles, Fig.625 Extraocular the partsof the muscleswhichinserton the eyeballhavebeenpulledawayfromthe eye; ventralview(r.). M rectussuperior superior,\ M obliquus tenoo \
\
/ N opticus[ll]
/ M roctuslateralis
\ M obliquusinferior
Mm.bulbi; muscles, Fig.626 Extraocular havebeenpulledawayfromthe eye; whichinserton theeyeball the partsof the musctes (r.). dorsalvievr'
M rectuslateralis
obliquusinlerior
M rectusinlerior/
\ N oPticus[l|]
muscles,Mm.bulbi; Fig.627 Extraocular the parts of the muscleswhich insert on the eyeballhavebeenpulledawayfrom the eye; view(r.). dorsosuperior
363
Eye,Organumvisus
M levator palpebrae superiofls \
Marco suoraorbitalrs
/
M o b l i q u u ss u p e r i o rT e n d o - _
M reclus medialis,Tendo -_
- - -
Os lrontale Proc zygomaticus
---
G l a n d u l al a c r i m a l r s Pars orbitalis
- - -
i,4 rectus lateralrs Tendo
Tunica conjunctivabulbi - -
-
Margo laleralrs
M a r g om e d i a l i s - -
--
M o b l i q u u si n t e r i o rT e n d o
M obliquus inletor -' --M o b l i q u u si n l e r i o r Margo inlraorbitalis -
\
-
\
Forrr"n
\
inlraorbitale
\ Os zygomaticum
F i g .6 2 8 E r t r a o c u l a m r u s tl e s ,\ l m . l r u l l r i ; t h e e l e l i t l s ,t h e o r b i r ; u l am r u s c l ea n r lt h e o r b i t a ls e l ) t u m h a v eb e e nr e m o r e r lt;h e e l e b a l li s a l r t l u r t e rml t ' r l i a l l r l r e n t r a lr i e n ( l ) .
/
M levalor palpebrae supenons
Os lronlale -
:-\ft5f,\v'
, M rectus supeflor
ocutl / Butbus M rectus lateralrs
/
Periorbita - -
A n u l u st e n d i n e u s communrs
-:t
-
N o p l i c u sl l l
! M a r g o r n l r a o r b i l a l i -s
-':'i-\ \
\
M obliquus inletiot / \ Maxilla /
Os sphenordale
M r e c t u sr n l e r i o r
Fossa inlratemporalis
\ F i s s r r ao r b r l a l i sr n l e r i o r S r n u sm a x r l l a r r s/
Fig. 629 Extraocularmuscles,Mm. bulbi; the lateral wall of the orbital cavity has been removed; lateral view (1.).
fuIusculibulbi ErtraocularXIuscles,
s u p e ro r , T r o c h l e a / M obliquus o D i l q u u s\ supenor \ Tendr
lI,/
/ , B u l b u so c u l l /, M ..lev3lol patpeDtae supeflofls
/ N/ levator palpebrae s u p e ro n s
. +of,
--a'2
M obliquus suPeflor Tendo
G l a n d u l atacflmals P a r s o r b r t ar s C o r P u s-
Os sphenordale A a malor -
ororlae M o b l i q u u ssupenor M rectus'alerails - M r e c t u ss u p e r i o t - M o b l i q u u ss u p e r i o r
\\
A n u l u sl e n d r n e u s/ communts C h r a s m ao p t r c u m/ -
i,4 levator palpebrae superiorls
' N optrcus lll
\
l : r t r a o t t t l a l 't t t t t s tl e s , \ l n t l t t t l l r i ; t h e 1 9 6 l s9 t l r o t h 9 r ' | i t i r l ( a \ i t i e s I t a r t ' l r e e n r e n r o \ ( ' ( l ;t h e o l ) t i ( ( l a n a l sh a \ e l t e e n e r p o s e t l ; t h e l e r a t o l n 1 s ( l ( ' o f t h e u l r p e l e r t ' l i r lh a s l r t , t , np a r t i a l l yf e l n o \ e ( lo n t h e r i g h t s i ( l e ; Irig.630
sul)eftot\ l('\\ -
, y r io r b i t a l e s L o b u sf r o n t a l i sG
-
P a r i e ss u p e r t o r
-
P a r i e sm e d i a l i s
-
Paries lateralis
M r e c t u sl a t e r a l r s
-
C e l l u l a ee t h m o r d a l e s
lM rectus med alrs
.- Paries Inleflor
e v a l o rp a p e b r a es u p e ro r s M r e c t u ss u p e n o r i\,4oblrquussupenor
--t
N o p t r c u sl l l
' - S i n u sm a x i l l a r i s
|\.4rectus Inier or
.- Cavrlas nasl
r l a t m u s (l e s ,\ l m l r u l b i ; I r i g .6 3 1 l : r t | a o u l \ i t \ { ) l ) t a i n (r' r( il t h m a g n e t ir(e s o n a l l ( o t o m o g r a l r h l ' ( I I R ' l ) ; ' ot l, o r l r i t a( a f l o n t u ls c r t i r r n ai nl r u g t ' t h r o u g h l h ( , ( ( ' n t r (t h \ e n t r a l\ i ( ' \ \
Lens -
-
P a n e sm e d t a l t s
B u l b u so c u l C o r p u sv t t r e u m -
-
C e l l u l a ee t h m o i d a l e s
-
P a r i e sl a t e r a l r s
N,4rectus laleralrs -
N o p tc u sl l l - M rectusmedalrs - .-
- C a n a l i so p t r c u s -
L o b u si e m p o r a ls
muscles,Mm bulbi; Fig. 632 Eyeball,Bulbusoculi,and extraocular transversesectionalimage through the optic nerve obtainedwith magneticresonancetomography(MRT); supenorvlew.
Eye,organum
366
Axisexternus bulbi Polusanteriorbulbi /Verlexcorneae; / . Polusanteriorlentis ' / anlerior' Laminalimitans '. > / r^-i-^riair^^^^^-., LaminalimitansDosterior"
Epithelium anterius\ Cameraanteriorbulbi;Humoraquosus. Faciesanterior \ \ nn I '''t"l l.Faciesposterior. Cornea-_ Reticulumtrabeculare\ \
/
/
.Ins.
,r',
Limbus corneae
irgi"iriJocorneatis /
Tunicaconiunctivabulbi ---
Sinusvenosussclerae**' _ - Tunicaconiunctiva --
Cameraposteriorbulbi; - Humoraquosus .4
Fibraecirculares)
J'''"'"''' \- ;i:Ift?""",".
Orbiculusciliaris- \
,
sphincterpupillae ".
posterior/' i Facies
M. rectus medialis
Camerapostremalvilrealbulbi;Corpusvitreum
Axis inlernusbulbi \ Discusnerviopticil \
I
Choroidea
-' Spatiumperichoroideum Sclera-' Excavatio disci --
Laminacribrosascleraez'
\ Maculalulea,Foveacentralis \ Polusoosteriorbulbi
Vaginaexternanervioptici/ --
subarachnoidale Spatiumintervaginale
Fig.633 Eyeball, Bulbusoculi; schematic horizontalsectionthroughthe siteof exit of the optic nerve.
* clinical: BowMAN's membrane ** clinical: DESCEMET'S membrane * * * clinical: ScHLEMM's canal
Size of the eyeball (Averagedataderivedfrom the anatomicaland ophthalmological literature) 24,0mm
1 3 , 0m m 7,8mm 59 diopters 43 diopters 19diopters 6 1- 6 9 m m
and Tunicsof theEYe Vessels
Cornea
I I
S i n u sv e n o s ussc l e r a e '
I
iridismalor , Circulusarteriosus anterior /, V conjunctivalis /
A conjunctivalisanteflor
I /
A ciliarisantenol
lCirculusarteriosus i r i d i sm i n o r
Ora serrata --
V ciliaris anteflor
-
-
M rectus laleralis
A ciliarisposteriorlonga
V a s a s a n g u i n e ar e t i n a e \ -
Choroidea \
)
\: \
\ V centralisretinae
\.
V vorticosa
Lamina choroidocapillaris
** L a m i n av a s c u l o s a
Sclera
\ V episcleralis
\ A episcleralis \ A ciliarisposlerior longa ciliarespostenoresbreves
A centralisretrnae -
F i g . 6 3 4 B l o o t vl e s s e l so f t h e e i e b a l l ,B u l b u so t : u l i ; diagram.
"u'''""' :.:llll:li, :llll' Tunics of the eye, Tunicae bulbi External fibrous tunic, Tunica fibrosa bulbi - cornea (transparent,pronouncedcurvature) - sclera(lessercurvature,opaque,in childrenbluish-white,in older individuals yellowish-white) Intermediate vascular tunic, Tunica vasculosa bulbi - iris with a centralround opening,the pupil, Pupilla - ciliary body,Corpusciliare,with the ciliary muscle,ciliary process,Zonulaciliaris with Fibraezonularesand Spatia zonularia - choroid
Internal tunic (retina),Tunica interna bulbi - blind part,Parscaecaretinae(fromthe Margopupillaris iridis to the Oraserrata) heavily iridial part,Parsiridicaretinae(singlelayered, pigmented) unpigmented) ciliarypart,Parsciliarisretinae(singlelayered, - opticpart,Parsopticaretinae(multFlayered) (rodcells- darkandbright 1st neuron:photoreceptors vision) colour cells vision;cone 2nd neuron:bipolarneuronswithin the retina(Ganglion retinae) their opticum); 3rd neuron:multipolarneurons(Ganglion longaxonsform the N. opticusandprovidedirectinformationvia theTractusopticito thevisualcentreof thebrain
,n"f }B
"t1
€;.
r,
i
Eye,Organumvisus
I Cornea I I
Camera anterior \
I
M sphinctep r upillae
- - Maroo
Slroma iridis
pupiltafls
Faciesposterior, posterius\ Epithelium Faciesanterior, Epithelium anterius\\ propriacorneae\ Substantia Sinusvenosussclerae'. Angulus iridocornealts\
-
Pars iridicaretinae
Reticulumtrabeculare -.-.-
- Cameraposterior
: \ . /--_ 1i
l' F - . r. o r a e
\
-
upalta zonulares zonularia
M ciliaris
I l Z o n u l ac i l i a r i s . *
Corpusciliare
Fig.635 Eyeball,Bulbusoculi, schematichorizontal section through the centre of the pupil. * clinical: ScHr-EMM's canal ** clinical: ZrNN'szonule
Lens,Faciesanterior \
lNn
ciliares
/ lris,Margopupillaris / Reticulumtrabeculare
Lens, \ '\ Polus anlerior M c i l i a r i s\
lris, Facresanterior
Nn ciliares - _
tsilcaetnots ' \
Choroidea
I A n u l u si r i d i sm i n o r l
Fig. 636 Iris, Iris andpupil,Pupilla; the scleraandthe corneahavebeendetached; ventralview (400%).
Thering-shaped suspension appartusof the lens, Zonula ciliaris (Zinn's zonule), consists of fragilerigid fibres,whicharekeptundertension by the elasticiryof the lens and alsoby the M. ciliaris. The intraocular fluid or aqueous humour, Humor aquosus,is producedby the epithelium of the Procc.ciliaresin the posteriorchamber and flows through the iris into the anterior chamber, whereit drainsinto Sculrnu's canalin the area of the iridocornealangle. Here the Reticulumtrabeculare(alsocalledLig. pectinatum) formsa densemeshworkwith fissures,Spatia anguli iridocornealis. Any narrowing0f the iridocorneal angleor otherinterference with the resorptionof the aqueoushumour may result in increasedintraocularpressure,known as glaucoma.
Iris
/ Anulusiridisminor
Plicae iridis \
Margopupillaris- -
z Anulusiridismalor
- Feticulum lrabeculare
)-
\
Margo ciliaris
/ Lens.Faciesanterior
\ Parsiridicaretinae
F i g . 6 3 7 l r i s ,I r i s ; the scleraandthe corneahavebeendetached; ventralview(500%). Parsciliarisrelinae
/ Procc ciliares \
Spatiazonulana - Fibraezonulares; Plicae ciliares \
Cornea,FaciesPoslenor
Corpusciliare-
ciliaris/ Orbiculus \
Plicae iridis
lris, Faciesposterior/
Fig.638 lris,Iris; alongits ciliary margin; the iris hasbeendetached dorsalview(300%).
/ lris,FaciesPosterior
E(--
O r a s e r r a t -a- - - (
\ \ Procc ciliares \ Plicae ciliares
Plicae iridis
Fig.639 Iris, Iris; sectionof Fig.638; dorsalview (700%).
,_
?
liqit
'4 E}
*
Eye,Organumvisus
/ Aequalol
Facresanterior \
I
Polusanterior
/ Axis
lPolusoosterior lFaciesposterior
Fig.640 Lens,Lens; ventralview (600%). Under certainopticalconditionsa star with multiple rays can be demonstrated(in adults),whereasin the lens of the neonatea star with three rays is found.
Fig.64l l.ens,Lens; viewedfrom the equator(6007").
Aequator -+
I
Capsulalentis/ Faciesanterior
\\ \\
\Coaexlentis
\ Nucleuslentrs
lPolusposterior
Substantia lenlis
FIg.642 Lens,Lens; the lens hasbeensectionedalongthe meridian; the capsulehasbeenpartially retracted; viewedfrom the equator(600%).
Fig.643 Lens,Lens; schematicdemonstrationof the fibres of the lens in the neonate; viewedfrom the equator(800%). Thereis a displacementof 60obetweenthe anterior and the posteriorstar.
FundusocutiSTI
OcularFundus,
/ Arteriolatemporalisretinaesuperlor
Venulamacularis supeflor\
/. Venulatemporalisretinaesuperlor / Venulanasalisrelinaesupenor macularis superior-Arteriola
nasalisretinaesuperior Arteriola
/ -
Fovea centralis.Foveola - -
-
-
Arterlola macularis inle(io( /
\
Discusnerviootici
(Venulamedialisretinae)
(Arteriola medialis retinae)
nasalisretinaeinferior Arteriola
\ Venulanasalisrelinaeinlerior
/ Venula macularis inlerior
I \ Venula temporalrsretinaeinlerior Arleriolatemporalisretinaeinlerior
/
Fig. 644 Bloodvesselsof the retina,\rasasanguinearetlnae; view of the ocularfundus; ventralview (r.,,100%). ArteriolalemDoralisretinaesupenor
* Macula lutea, Fovea centralts \
- Venulatemporalisretinaesuperior
- Discusnervioptici"
- Venulatemporalis retinaeinlerior
\ ArteriolaternDoralis retinaeinferior
Fig. 645 Ocularfundus,Fundusoculi; imageof the centralregion; ophthalmoscopic ventralview (r.,600%).
t clinical: yellow spot *' clinical: blind spot
Eye,Organumvisus
lExcavatio disci
lLaminacribrosasclerae I
Laminafuscasclerae /
$EF. lzi'.r - , i]':': '' - - -'-
\Substantia propria sclerae - Vagina externa nerui optici *
I
--
Lamina/ episcleralis
A.; V. centralisretinae/ I
Vagina inlerna nervi optici **
$ii N opticus!|]
Fig.646 Opticnerve,N. opticus[I]; horizontalsectionthroughits siteof exit fromthe eyeball; (1000%).
The cranialdura mater* as well as the cranialarachnoidand Pia mater cranialis * * accompanythe optic nerve to the eyeball, Bulbusoculi.
Vagina externa nervi optici r
/ Spatium interuaginalesubarachnoidale
- Vagina interna nervi optici
A : V centralisrelinae /
Fig.647 Opticnerve,N. opticus[II]; crosssectioncloseto the eveball: (1500%).
OpticNerve,Nervusopticus
VagrnaInternaI Periorbita
N . o p t i c u !sl ] , \ Parscanalis \
M levator palpebrae supeflofls
Anulus tendineuscommunrs\ Dura mater cranials I
N o p t i c u lsl l , : Parsintracranialis\
M rectus superior
- Hypophysis N opticus !ll, Pars orbitalis
Traclusopticus- A ophthalmica
orbitae Corpusadiposum
)\,
A c a r o t i si n t e r n a ,- Pars cerebralis
Sinus cavernosus -
--
-
--
M recluslaterahs
M rectusinferior
Fig. 648 Optic rrerve,N. opticus[II]; t h e o p t i cc a n a l ,( a n a l i so p t i c u sh, a sb e e ne x p o s e d ; 100%). lateralvilr
s f t h e o p h t h a l m i ca r t e r y ; F i g s .6 4 9 a , b V a r i a t i o n o s u p e r i o rv i e w ( r . ) .
vvr
PUJ
u,,,d, q
-
--
suPenorls M levatorpalpebrae
--
M rectussuperior
- -
orbitae Corpusadiposum
--
N o p t i c u lsl l
--
M rectusinferior
--
Sinussphenoidalis
-
Palpebrasuperior - -
.. Camera anterior Palpebra inferior Bulbus oculi Camera postrema [vitrea] "'
---
I Fig. 650 Orbital cavity, Orbita; vertical sectionalimage along the optic nerve obtainedwith magneticresonancetomography (MRT); lateral view (r.).
S i n u sm a x i l l a r i s
Bulbusollactorius\
7 B u l b u so c u l i / Aa ciliarcs Gyri orbitales \
retrnae / A centralis
N o p t i c uIsl l l
_--
Tractusolfactorius
A ophthalmica
--
,--
A c a r o t i si n t e r n a
- A choroidea anterior -.-
Tractus opticus
.- .- Tractusopticus R a d i xm e d i a l i s - - Tractusopticus Radixlaleralis - - Corpus genlcutatum mediale - - Corpus genrcuratum laterale
Aqueductus mesencepnall
- Radiatiooptica
Tectum .-mesencephali, Colliculus superior
\ Plexus choroideus ventriculilalerahs
V magnace(ebri \ Brachium colliculisuperioris
S u l c u sc a l c a f l n u s 'R
calcarinus
(Area striata)
F i g .6 5 1 C e r e l r r u mC, e r e b r u ma, n ( l\ i s u a ll ) a t h \ \ a ) ; t h e m i r l b r a i na n ( lt h e l x ) n sh a \ e b e e ns e c t i o n e o t lb l i t l u e l l ' ; t h e l e f t t e m p o r aal n d o c < ; i p i t l lo l r e sh a v eb e e np a r t i a l l l rem0r'erl; i n f e r i o rv i e u
Visual pathway lst neuron: rod andconecellsofthe retina 2nd neuron: bipolarneuronsof the retina(perikaryain the Ganglionretinae) 3rd neuron:multipolarneuronsof the retina(perikaryain the Ganglionopticum).Theaxonsof the Ganglionopticumreach primarilythe Corpusgeniculatum laterale(Radixlateralis),however, somefibresalsoenterthe Corpusgeniculatum mediale(Radixmedialis),the hypothalamus andgo directlyto the cortexof the brain.Theyrun via the N. opticusto the Chiasmaopticum,wherethe fibresof the nasalpart of the retinacrossto the contralateral side.In eachTractus opticusthosefibresarefoundwhichtransportthe informationfromthe contralateral halvesof the visualfield. 4th neuron: theseaxonsmainlyrun from the Corpusgeniculatum lateraleto areas17and 18ofthe cerebralcortexin the area aroundthe Sulcuscalcarinus(Areastriata).
rIFT
P
visuatPathwav 5 / f
1 visual field of the lett eye 2 common visual field 3 visual lield ot the righl eye
N o p t i c uIsl l l - - \ Ganglion ciliare\ A carotis interna,A ophthalmica\
-
\ Chiasmaopticum
-Ganglion ceruicale superius T r a c t u s o p t i c -u-sN oculomotorius llll --
^\L R a d i a t a o o p t i c-a- - - - - -
4(1 - - - Collicufusrrr"rror - sutcuscatcarinus \{7:
---J
J\
drawing; Fig. 652 Thevisualpathway;schematic the medialsurfacesof the occipitallobesareshownin an atypicalposition; superiorview.
of the visualfield occupiesan disproportionately Thecentral,area largeareaof projectionon the visual cortex.The'coloursreferto the quadrantsof the visualfield' * plane of refraction of light
Eye,Organumvisus
/ oA supraorbitalis
G
N supraorbitalis, R medialis -__
\
/
>< !..'\-.
lateralis N supraorbitalis,R
/-,-
{EM levatorpalpebraesuperions
Lr',
z Glandulalacrimalis, Pars orbitalis
, ..t N r1}^$
N supratrochlearis \ Corpusadiposum orbitae\\ R meningeus anteriorO \ \
M reclus superior
\
A ethmoidalisanterior O \-
OA lacrimalis
M obliquus superior N lacrimalis
N nasociliaris A o p h t h a l m i c aO - -
N frontalis --
:s---
-
N aMucens[Vl]
N trochlearis lvl N ophthalmicus[V/1]
N maxillaris[V/2]
Canalisopticus N. opticus[ll]
--G'i-1
--scA ophthatmica. A carotis interoa O --
N mandibularis [V/31, R meningeus N oculomotoriusllll
N mandibularis [V/31 N trochlearis lvl Ganglion trigeminale
N. abducens[Vll R tentorius
N trigeminus [Vl
654
Fig. 653 Arteriesand nervesof the orbital cavity,Orbita; the roof of the orbital cavityhasbeenremoved;the superior orbital fissurehasbeenexposed; superiorview (r.).
and Nervesof theOrbttalCavity Muscles,Vessels
lateralis N suoraorbitalis,R
,
A supraorbitalis O *-
3?
a M. levatorpalpebraesuperioris Parsorbitalis lacrimalis, - Glandula
R medialis N supraorbilalis, M rectus superlor
N supratrochlearis N lacrimalis
A ophthalmica O/
a M rectus lateralis
M obliquussuperioro-
Ganglion ciliare
N. abducens[Vll
N oculomotorius illll, R superior
N. nasociliaris
N ophthalmicus [V/11
N.opticus ul
N maxillaris[V/21
A ophthalmicao -
N mandibularis [v/31
A carotisinternao -
N oculomotolius illll
-
N trochleafls[Vl
-i-
Ganglion lrigeminale
N trigeminus[Vl
N abducens [Vll
+/'/655
6$tr Fig. 654 Arteriesandneryesof the orbitalcavity'Orbita; the roof of the orbital cavityhasbeencompletelyremoved; the frontal nervehasbeenpartially removed;the superior orbital fissurehasbeenexposed;demonstrationof the ciliary ganglionby retractingthe levatormuscleof the uppereyelidandthe superiorrectusmuscleof the eyeball; superiorview (r.).
Eye,Organumvisus
/ il M levator palpebraesuperioris
M obliquussuperior, Tendoa \
/ ll M rectussuperior
A supratrochlearisO \
/
M obliquussuperiora \
Glandula lacrimalis, Pars orbitalis
/
A dorsalsnasiO 1 R meningeus anteriora \
M reclus medialis I N infratrochlearis N lacrimalis
tA ethmoidalisanterior O
a A lacrimalis
--N ethmoidalisanterior
'----
a M rectuslateralis
N nasociliaris A elhmoidalisposterior O N ethmoidalisposterior
O Aa ciliares
N ciliarislongus N abducens [Vl]
M o b l i q u ussu p e r i oI r - - - ' 7
N oculomotorius!lll, R inlerior
-'--)
N t r o c h l e a nl tsv l
Ganglion crhare
N oculomoloriusll|]. H. SUOeflOr M levator palpebrae * supenofls
Radix parasympathica [oculomotoria](lll)
-
Radix sensoria (V/1)
M rectussuperiorI
Radix sympathica (N caroticus Internus)
/
N opticus [ll] A . o p h t h a l m i c aa
A c a r o t i si n t e r n aO /
...,
N o p h t h a l m i c u s[ V / 1 ] /o
-
N o c u l o m o t o r i u lsl l l
N trochlearis lvl
/
N trigeminus [V],Radixsensoria
N abducens [Vl]
654x Fig. 655 Arteries and nerves of the orbital cavity, Orbita; the roof of the orbital cavity has been removed;the superior orbital fissure has been exposed;the levator muscle of the upper eyelid, the superior rectus and the superior oblique musclesof the eyeballhave been partially removed;the lateral rectus muscle has been retractedlaterallv: superior view (r.).
rtrul,\'ervesof the OrbitalCa+'iA' .\luscles,I ?s.sc1s
t
levator palPebraesuPeriorls
zlM
a M rectus superior
M o b l i q u u ss u p e r l o r ,t Trochlea
--
M obliquus superior Tendo a
--
M o b l i q u u ss u p e r i o r*
--
/lM
rectuslateralis
retinae - O OA ; V centralis Vagina externa neryl opllcl
--
-
R meningeusanlerior O
N opticus[ll]
--
sM obliquusinlerior tM
--
rectusinferior
N inlratrochlearis A ethmoidalisanterior O
-
N ethmoidalisanterior
-
A ethmoidalisPosteriorlt
-
N zygomaticus
N ethmoidalisPosterlor
-- -
M rectus medialis *
--
A ophthalmica a
M levator palpebrae a
N infraorbitalis
--
M o b l i q u u ss u P e r i o rI
on infraorbrtalis
-
N oculomotorius Illl]' R interior
lM
rectuslateralis
--
-
superlorls M rectussuperiorl'
N abducens [Vl]
N o p t i c u Isl l ]
N maxillaris [V/2] Canalis opticus
\
N ophthalmicus[V/1]
A o p h t h a l m i c aO N mandibularis[V/31 N o c u l o m o t o r i u lsl l l N a b d u c e n s[ V l ]
\
N t r i g e m i n u[ V s1
655# Fig. 656 Arteries and nerves ofthe orbital cavity, Orbita; the roof of the orbital cavity has been removed;the superior orbital fissure and the optic canal have been exposed;the optic nerve and the extraocular muscles (with the exception of the inferior oblique muscle) have been partially removed; superior view (r.).
Eye,Organum vis
\ -----=-Os lrontale - - - - S q| *.'. -*i.i-'.+-.-
M levalorpatpebraesupenons -
-\
N. lrontal
/
ll--:.-\ z
M rrectus M e c t u ssuperior superior A. ophthalmica )hthalmrcaa
N. nasocrlrars
/
M obliquus ol supenof -"'
N rrochlearis lvl M. rectus medialis
N.. l aaccrri immaal ilsi s N N o c u l o m o t o r i u lsl l l ] , R n s s uuPp ee f f ur fi o r V. ophthalmr.a
-- - - - t ' l - ' L f ri 't---L # ' -
qtnarior
-
-AAq
-
M e a l l r sn a s i ssuperior lroprio nasi l,4eatus
4\
zy9omalrcum Concha nasalis media llll, B. inlerior N infraorbilalrs
rectus Inler M. recIUS M. infer
/rl)l
-L;--
I
( V ) ; A . i n l r a o r b i t a l i s' a - '
Sinusmaxillaris
Fig.657 Orbitalcavity,Orbita;frontal sectionthrough the middleof the extracranialcourseof the optrcnerve; v c n t r a lv i e w ( r ) . Os lrontale .- .--
/, O A supraorbltalis
- jfi)=----7:-t superioris
N supraorbitalis M obliquus superior M rectus medialis
-
- -- Os ethmoidale Meatus nasi superior
_-
c o r p u sa d i p o s u m o , u i t a e- - - ! l.l \t -\ -r.
-
C e l l u l a ee t h m o i d a l e s
- -
C o n c h an a s a l i sm e d i a
\1
-
Periorbita
aN intraorbitalis
Fig. 658 Orbitalcavity,Orbita;frontal sectionthrough the posteriorpart of the eyeballl)ehin(lthe tendinousinsertionof the inferior o b l i q u em u s c l e v; e n t r a lv i e w ( r . ) ,, Os lrontale
M epicranius /
/^
7 renorolla
/ Supercilia - i
t
N trontalis /
M levator palpebrae superions
M orbiculario s culi
/
M rectussuperior
Fornix conjuncttvaesuperior .- _
,, a A ophthalmica
Palpebra superior - i -
Palpebra inferior - Tarsus inferior Fornix conjunctivaeinfelor Sclera Septum orbitale Corpus adiposum orbilae -' Maxilla -
Fig.659
Vagina externa nerui optlci
M reclus inferior
M o b l i q u u si n t e r i o r
.*:-,
N infraorbilalis --.-.-
S i n u sm a x i l l a r i s
Orbitalcavity,Orbita;verticalser;tionthroughthe eyeballand the optic nerve;lateralvierv(l )
oftheEar vervtew
Os temporale I
Ossicula auditus
/, Cavitastympani
vestibularis - Labyrinthus
LabYrinthuscochlearis
Fig.660 Ear,Auris; semi-schematicdrawing; the external acousticmeatus, the tympanic cavity,the auditory tube and parts of the temporal bone have been exPosed; ventralview (r., 110%).
Parts of the ear,Auris Auris externa Auricula externus Meatusacusticus Auris media Cavitastympani Membranatympanica auditus Ossicula Tubaauditiva
Auris interna Labyrinthusmembranaceus - Labyrinthusvestibularis - Labyrinthuscochlearis Labyrinthusosseus - Vestibulum - Canalessemicircularesossei - Cochlea - Meatusacusticus internus
Partsof the membranouslabyrinth, Labyrinthus membranaceus(Figs.694,695) Labyrinthus vestlbularis Spatiumperilymphaticum Utriculus Ductussemicirculares - Ductussemicircularis anterior - Ducfussemicircularis posterior - Ductussemicircularis lateralis Ductusutriculosaccularis DuctusendolymPhaticus endolymphaticus Saccus Sacculus Ductusreuniens
Labyrinthus coohlqaris SpatiumperilYmPhaticum - Scalatympani - Scalavestibuli Aqueductusvestibuli Aqueductuscochleae Ductuscochlearis
3 8 1
382
Ear,Auris
Helix Scapha -
Cruraantihelicis
Fossatriangularis
Cymbaconchae
(Tuberculum - auriculare)
Crushelicrs
Antihelix -
Incisura anterior
Helix -
Cavitasconchae Tragus
Concha auriculae -
Cavitasconchae Helix / Incisuraintertragica Antitragus/
Lobulusauriculae/-
Fig. 661 Auricle,Auricula; lateralview (r.).
H e l i xC , r u sh e l i c i s
Scapha/
Spina helicis
- Os temporale Pars squamosa
A n t i h e l i x\
/
/ //
/ Incisuraintertragica
Cartilago meatusacustici/
/
/
Incisuraecartilaginismeatus acustici
/
stylordeus
/ Proc mastoideus
Fig. 662 Auricularcartilage, Cartilagoauricularis, with parts of the temporal bone; all soft tissues have been removed: oblique ventral view (r.).
Musculiauriculares AuricularMuscles,
383
M helicismajor
/
M helcis minor
_-
---
M tragrcus
C a u d ah e l i c i s
rM anlitragicus
Fig. 663 Auricular muscles;\'lm. auriculares; ventralvierv(r.).
/ M obliquus auriculae
Lig auriculare superius-__
---
M transversusauflculae
' - Meatusacusticus externus
\ Lig aurrcularepostertus
; l m .a u r i c u l a r e s ; F i g . 6 6 4 A u r i c u l a rm u s c l e sN tlorsalr ierr (r.)
Sensorynervesupplyof the auricle,Auricula N. vagus[X], R. auricularis: baseof the externalacousticmeatusandposterior part of the externalsurfaceof the tympanic sickle-shaped membrane N. auricularis magnus,R. posterior(Cz/C3lt posteriorsurfaceof the auricle N. auricularis magnus,R. anterior lC2/C3): anteriorsurfaceof the auricle
N. mandibularis [V/3]' N. auriculotemporalis,N. meatus acustici externi and Rr. membranaetympani: anteriorroot-of the auricle,floor,anteriorwall androofof the externalacousticmeatus'aswell as a largepart of the tympanicmembrane N. facialis [Vtr], N. auricularis posterior, R. auricularis: all auricularmuscles
Liar,Auris
384
Capul mallei
Becessusepitympanicus \
/
/ Lig malleisuperius , R"""".r. Pars ,. epitympanicus,
/
Os temporale Mealus acusticus externus
/
'i - --. 'l)/
,!'
--
z
Cartilagoauriculae
Porusacusticus externus
Meatusacusticusexternus cartilagineus
Membranatympanica Bulbussuperiorvenaejugularis Os occipitaleArliculatioatlanlooccipitalis
\
Carlilago auriculae
Cellulae mastordeae
Fig.665 Externalacousticmeatus,Meatusacusticusexternus; tympaniccavity,Cavitastympani,and cochlea,Cochlea; frontal section; dorsalview (r.).
Plica mallearisposterior \
Meatusacusticus externus, (Pariesposterior)
/
Pars flaccida*
/
/
Plica mallearis anletio(
Pars tensa
Anulus / fibrocartilagineus
Fig. 666 Tympanicmembrane,Membranatympanica; otoscopicimage; obliquelateralview (r.,600%). ' *t
Fig.667 Tympanicmembrane,Membranatympanica; diagramshowingits quadrants; lateralview (r.).
clinical: SHRAPNELL'smembrane typical light reflex
for betterorientation.Thelongerdiameteris 10-11mm and the shorterdlqmeterabout9 mm in the adult. A bright:hiangular'coneoflight" reflectedfrom the otoscope is usuallyseenin the anteroinferiorquadrant(II).
385 Caput mallei -
(Facies articularis).- _ .-
Proc lateralis- Proc lateralis- -
Proc anterior/
/ mallei Manubrium
M a n u b r i u mm a l l e i-
, alleus; F i g .6 6 9 M a l l e u sM v e n t r a lv i e $ ( r . ,7 0 0 % ) .
, alleus; F i g .6 6 8 M a l l e u s M lateralview (r, 700'ln)
Corpusincudis\ , (Faciesarticularis) Crusbreve--__
(Facies
\
Proc lateralis -
Proc lenticularis
Manubrium mallei
l n c u s ,I n c u s ; Fig.67l lateralview (r.,700%).
Fig. 670 Malleus,Malleus; d r l r s a vl i e u '( r , 7 0 0 % ) .
- Corpusincudis
---
Crusbreve
_--
CrusPoslerrus
BasrsslaPedis
Fig.672 Incus,Incus; medialview (r.,700%).
Fig.673 Stapes,StaPes; superiorview(r.,700%).
386
Ear,Auris C a p um t allei
Proc lateralis
C r u sl o n g u m Proc anterior / Articulatro"l ncudostapedialis
C r u sa n t e r i u s- Basis slapedis
Fig.674 Auditory ossicles,Ossiculaauditus; natural position; s u p e r o m e d i av li e w ( r , 6 0 0 % ) .
Lig mallei superius
I I
I I
Lig incudissuperius
_ - Lrg Incudis posterius
--[ t$
Lig mallei anterius - -
_ - Chorda tympani
-M tensor tympani,Tendo - -
A tympanica posterior
- - - Membrana stapedialis
Fig. 675 Iointsandligamentsof the auditoryossicles, Articulationesand Ligamentaossiculorumauditus; coveredby a mucousmembranein situ; superomedial view (r.,800%).
TympanicCavity,CavitastYmpani
L r g m a l l e rs u p e i l u S\ \
F l e c e s s u sm e m b r a n a et y m p a n i c a es u p e ro r C h o r d at y m p a n
C a p u t m a l l e iI
387
/ P a r e s t e g m e n t a l i sB, e c e s s u se p i t y m p a n r c u s
- -
-
M e a t u sa c u s t i c u se x t e r n u sqti^ac
/
Umbo membranae lympantcaeu
t
Membrana lympanca/
l : i g . 6 7 6 T t n r ; r a n i r . a irt r , C a ri t a st r m p a n i ; f l o n t a ls e t ; t i r t n l r e n t r a lr i e * ( t ' )
Bountlaries of the tympanic cavity, Cavitas tympani Name
Constituents
Paries tegmentalis (roof)
Recessus epitympani- Fossa craniimedia, tympani Meninges, cus,Tegmen l0c tpm nnra lp\ Lobustemporalis
Neighbouring organs
Suturapetrosquamosa
Pariesjugularis (floor)
Prominentiastyloidea
Specialfeatures
Clinical complications
Vascularcanaliculiin the Tegmenand in the suture:route of infection
Meningitis, abscessof the temporal lobe
Variableform and size Fossajugularis, Bulbussuperiorvenae of the Cellulae jugularis tympanicae,bony
Septicthrombosis of the V. jugularis interna (pyaemia)
laminaemay be partiallyabsent Promontorium,Fenestra cochleae,Fenestra vestibuli,Prominentia canalisfacialis, Membranatympanica secundaria
Labyrinthusmembranaceus, N. facialis
lvrrl
Infectionof the Iabyrinth(deafness), facialparesis
Pariesmembranaceus (lateralwall)
Membrana tympanica, Manubrium ma]lei (Chordatympani)
Meatusacusticus externus, Articulatio temporomandibularis
tympanic membrane (e.g.byoverzealous cleaning)
Pariesmastoideus (posterior wall)
Antrum mastoideum, Cellulaemastoideae, Prominentiacanalis semicircularis Iateralis, Prominentia canalisfacialis
Variable pneumatiN. facialisfVIIl, sationof the Cellulae Sinussigmoideus, Fossa craniiposterior, mastoideae cerebellum
Mastoiditis,sinus thrombosis,meningitis, cerebellarabscess, facial paresis
Pariescaroticus (anteriorwall)
Ostium tympanicum tubae auditivae, Canalismusculotubarius
Canalis caroticus, Sinuscavernosus, N. abducens [VI], Ganglion trigeminale
Parieslabyrinthicus (medialwall)
Apical pneumatisation of the pyramids (Cellulaetympanicae)
Auditory tube: route of infection of the apicalCellulae pneumaticae, abducensparesis, otitis media
388
Ear,Auris i/t tensor lympani. Tendo
anterior / Plicamallearis
I
Proc cochlearilormis \
epitympanicus , Recessus
M tensor tympani \
- -
C a P U tm a l l e i - - -
L i g m a l l e is u p e r i u s
---
L i g i n c u d i ss u p e r i u s
----
Septumcanalismusculotubarii Tuba auditiva /
Corpusincudis - Chorda tympani
/
Ostiumtympanicum' tubaeaudilivae Canalis caroticus
/
/
//
-
Incus, Crus breve
\
L i g i n c u d i sp o s t e r i u s
\
Fossa Incudis
\
I n c u s ,C r u s l o n g u m
t-
Anulustibrocarlilagineusz M a n u b r i u mm a l l e i /
\
/ t I
Membrana tympanica /
\ Plica mallearisposteriof \ N facialis IVI|]
Proc lenticularis
Fig. 677 Lateralwall, Pariesmembranaceus, of the t v m l ) u n i((a v i l ) ,( d v i t a st ) m l ) a n i : s a g i t t asl e c t i o nm ; o s to f t h e a u d i t o r yt u b ea n d t h e f a s c i ao f the tensormuscleof the t)'ml)anonhavelleenremove(l; m e d i a lv i e w ( r . ,1 0 0 % )
Malleus, Proc lateralis I I Spina tympanica minor \ \ I
Meatusacusticus\-
/
C o l l u mm a l l e i
/
S p i n a t y m p a n i c am a j o r
externus /
Plica malleans antenor.Chorda tympanl
-
- - Plica mallearisposterior: Chorda tympani
M tensor tympani,Tendo
- ----
Manubriummallei -.--
Eminentiapyramidalis /
M tensortympanl
-
Incus,Cruslongum/
\
Fossula lenestrae cochleae
I I I
\
Slapes
Incus Proc lenticulans
Promontorium
I M stapedius.Tendol
\ A n u l u sl i b r o c a r t i l a g i n e u s
Fig. 678 Tympanic cavity, Cavitastympani; the tympanic membrane has been removed; lateral view (r., 400%).
TympanicCavi$, CavitastYmPani
Cellulae mastoideae \
\
/
Feneslra vestibull Canalis nerui facialis
/
/
Proc cochlearilormis - -
-
\ t
ta
Canalis nervi facialis / Foramen stylomastoideum/
Psrrgs ls[yrrnthicus
\
I
z'
/ /
\ \
389
lmpresslo trigeminalis
---
Ostiumtympanicum tubae audrtivae
---
Canaliscaroticus
Fossula leneslrae vestibuli
Promontorium
srlcra promonlorrl
Fossulafenestrae cochleae
Fenestracochleae
subiculumpromontorii
Fig. 679 Medial wall, Paries labyrinthicus, of the tympanic cavity, Cavitas tympani; the lateral wall and the adjacent parts of the ventml and superior walls have been removed; the Canalis nervi facialis and Canalis caroticushave been exposed; ventrolateralview (r., 170%).
Antrum masloideum
\ /
,
Feneslra vestibuli
,'
-
Canahs nervi facrafts
C e l l u l a emasloroeae
Proc. cochlearitormrs
'
.-
_-zi'-
-
- --
Pafles masloroeus
Septum canalis musculotubarii
- 'Ostiumtympanicum tubaeauditivae
F o s s ai n c u d i s -
- -
S i n u sp o s t e r i o-r- -
-
(
Meatusacusticusexternus
Srl"us promontorii
Promontorium
\ cellulaetympanicae f
Sinustympani/
\ Fossulalenestrae cochleae \ Sulcus'tympanicus
/ promontorii Subiculum Proc mastoideus /
\ Proc stylordeus
Fig. 680 Medialwall, Parieslabyrinthicus,of the tympaniccavity, Cavitastympani; verticalsectionthroughthe longitudinalaxis of the petrosalbone; ventrolateralview (r., 170%).
390
Ear,Auris
I
- Os palatinum,Lamina horizontalis
I
Os sphenoidale, Ala major, Facies temporalis
Foramen ovale -
Sorna ossis sohenoidalis - - - Os temporale, Prrc
natr^a,
- Condylus occipitalis
Fig. 6Bt Cartilageof the au
M uvulae
\
d,:
M t e n s o rv e l i p a l a t i n i Aponeurosispalatina
pteryg0roeus
/ Foramen lacerum / F o r a m e no v a l e
M tensor veli palatini
- M tensor veli palatinr,Origo - L a m i n al a t e r a l i \s I Cartilagotubae I audilivae - Lamina medialis,/
M levator veli paiatini -
- Fossa mandibulafls Cartilagotubae auditivae -
- Semicanalistubae auditivae - M levator veli palatini Origo - Canalis caroticus,Ape(ura externa
F i g . 6 8 2 P a l a t i n em u s c l e sM , m l e \ a t o re t t e n s o rr e l i p a l a t i n i , a n d c a r t i l a g eo f t h e a u d i t o r l t u b e ,C a r t i l a g rt )u l ) a ea u ( [ i t i v a e ; on the leftthe musculao r r i g i n sa r e s h o w n ;t h e s o f t p a l a t e( \ e l u m pulled has been forwartl; l)alatinunr) inferior vielr.
Auditory Tube,Tubaauditiva
- -
c
391
Dura mater cranialis
--il.
M tensortympani-
Semicanalismusculi tensoristympanl
,t - Septumcanalis musculotubarii
#;"
semjcanar'|stubae aud'tivae
,'lrt'
,lr. 'Tunica mucosa 683 684 685
l
t.,
Fig.683 Audikrry(pha11ngotympanic)tube, T u b aa u d i t i v a ; crosssectionthrough its osseouspart; l a t e r a vl i e w ( r , 1 5 0 0 % ) / L
l m p r e s s i ot r i g e m i n a l t s D u r a m a t e rc r a n i a l i s
D u r a m a t e rc r a n i a l i s\ tubae auditivae, ', Cartilago Lamina lateralis Facies posteriorpartis petrosae /
Pl"t*.
4!.--
Canahs caroticus Os temporale P a r sp e t r o s a
loraminis ovalis
-
-h-:// ",-" I
-
N mandibularis
lv/31 -
\
- -
M tensor velipalatinl
M levalor veli palatrni
Fig.684 Auditory(pharyngotympanic)tube, Tuba auditiva; cross sectionthrough its lateral cartilaginouspart; lateral view (r., 400%).
Foramen ovale
Tuba auditiva
M tensor veli pala!nl
\ Tuba audiliva, Pars cartilaginea, Lamina membranacea
pharyngeus/ Recessus
\ M levalor veli palatrni
Cartilaoo - tuba6 auditivael Lamtna medlalls
tube, Fig.685 Auditory(pharyngotympanic) auditiva; Tuba crosssectionthroughits medialcartilaginouspart; lateralview(r.,400%).
Ear,Auris
392
7 Cochlea
N cochlearis\
Canalissemicircularis anterior
N vestibularis
-
N vestibulocochlearis[Vlll] /
-
'
Fig.6B6 Internaleaq Auris interna,and vestibulocochlear nerve,N. vestibulocochlearis [VIII]; castmodelsprojectedin their natural positiononto the petrosal bone; suDenorvlew.
Canalis semicircularis lateralis
Canalis semicircularis posterior
Porusacusticus internus
to lateralThe axis of the cochlearuns from medialdorsal-sur)erior ventral-inferior.
Foramenrotundum--
.qS\,
A carotisinterna, Parscavernosa
Foramenlacerum
N petrosusmajor -Synchondrosis sphenopetrosa Cochlea Porus acusticus internus
N facialis[Vll], geniculi Ganglion N facialis[Vll]
Ductussemicircularis anterior N vestibulocochlearis[Vlll]
N cochlearis
lateralis Duclussemicircularis N vestibularis
Foramen jugulare
Sulcussinussigmoidel posterior Ductussemicircularis
Fig. 687 Internalear,Auris interna,with facialnerve, nerve, N. facialis[VII], and vestibulocochlear N. vestibulocochlearis [VIII]; projectioninwards; superiorview (r.).
osseus Labvrinth,Labyrinthus Osseous
anteriof ,/ Canalissemicircularis
Ampullaosseaanterior I I Maculacribrosasuperiorl j I \ \ Cristatransversa
7 Crusosseumcommune / Crusosseumsimplex
Area cochlearis-
-
posterior Canalissemicircularis
--
lateralis Canalissemicircularis
- Amoullaosseaoosterior \
uocnrea
labyrinthi Vestibulum
Fenestra cochleae
Macula cribrosa media
Fig. 6BB Osseouslabyrinth,Labyrinthusosseus; the osseouscoveringof the membranouslabyrinth has beenmilled out of the petrosalbone; view (r.,300%). dorsosuperior
/ Canalis semicircularisanterior / Ampulla ossea anterior
Crusosseumc o m m u n e\
7/7 Ampulla ossea lateralis
-
Cupula cochleae
C a n a l isse m i c i r c u l a-r i slateralis Vestibulumlabyrinthi
Canahs semicircularisPosterior
/
/ Ampullaosseaposterior / cochleae Fenestra
\ \
Basis cochleae
Fenestravestibuli
Fig. 689 Osseouslabyrinth,Labl'rinthusosseus; the osseouscoveringof the membranouslabyrinth has beenmilled out of the petrosalbone; ventrolateralview (r.,300%).
, Canalis semicircularisanterior
q Cristavestibuli Recessus ellipticus \ Canahs semicircularis.- -lateralis
\ / scalatympani Lamina modioli
/ Macula cribrosa mgdia - -
- Hamuluslaminae spiralis
posteriorCanalissemicircularis
- - -
't Fossula fenestrae cochleae /
/
/
,"."r.r.
Lamina spiralisossea
Lamina soiralissecundaria
cochlearis
| I cristafenestrae cochleae
Fig. 690 Osseouslabyrinth,Labyrinthusosseus; the hollowspaceshavebeenmilled out; ventrolateralview (r., 300%).
393
Ear,Auris
394
.- -- Cellulaetympanicae
Canalis nerui facialis -- -
- -
Canalis semicircularis anterior
- -
Canalis semicircularis lateralis
--
Crusosseumcommune
Foramen ovale .--Apexpartispetrosae -. --
- -
Meatusacusticus- internus - Synchondrosis petrooccipitalis Sulcussinuspetrosi- inferroris
- -
Aqueductusvestibuli
- -
Sulcus sinus sigmoidei
.--
.--Synchondrosis sphenopetrosa Sulcusnervipetrosi-maJons Foramenlacerum- -
Canalis semicircularis Posterior
Foramen jugulare
--
Semicanalistubae auditivae
_ -
Cavitas tympani
- .- Cochlea -- -- Canalis nervi lacialis
Canaliscaroticus- S y n c h o n d r o s-i-s sphenopetrosa Apexpartispetrosae-Meatusacusticus- internus
.- -
Canalis semicircularis lateralis
--
Vestrbulum
- -
Fenestravestibuli
- -
Canalis semicircularis anterior
rf/ Figs.691 a, b Osseouslabyrinth,Labyrinthusosseus; milled out of the petrosalbone. a dorsosuperiorview (r.,300%) b s u p e r i o rv i e w ( r , 3 0 0 % )
6-
6 9 1a
Scala vestibuli
\
/
Tractusspiralisloraminosus \
Lamina spiralisossea
,, i ! " 1t t t ,
Cupula cochleae
./ -z!,
X:i..--
h",ill3f,
L a m r n a-
Modiolus cocnreae
secunoana
Canalis spiralis modioli
Scala / tympani
Canalis longitudinalis modioli
Tractussprrahs loraminosus
\ Meatus acusticus Inlernus
\
Fundusmeatus acusticiinterni
Fig.692 Spiralcanalof the cochlea,Canalisspiralis cochleae; milled along the axis of the modiolus; superiorview (1.,40070).
/ Meatusacusticus internus
\ Area cochlearis
Fundusmeatusl acusticiinterni
Fig.693 Internalacousticmeatus,Meatusacusticus internus,and its floor,Fundusmeatusacusticiinterni; the posteriorwall has beenpartially removed; medialview (r., 500%).
membranaceus Labyrtnth,Labyrinthus Membranous
N utricularis\
N sacculans \
\\
antelior semicircularis / Ductus
Utriculus
lateralis el anterior\ Nn ampullares
I I
/
!.' h,
\\
u.
7 AmPulla membranacea anleltol
-/
/Ampulla membtanacea lateralis
-/ .t
\
/
- Crus membranaceum commune
N utriculo-: ampullaris - -
- Ductus semicircularis Posterior
Ductus / cochlearis
N cochlearis
395
--
- - Ductus endolymPhaticus - - - Duclus semicircularis lateralis
/
--
/ N vestibularis
- _ Crua membranaceum simplex --
N ampullaris/ posterior
AmPulla memDranacea Posterior
' Sacculus vestibularis
Ouctuscochlearis
membranaceus; nerve,N. vestibulocochlearis Fig. 694 Vestibulocochlear [Vlll], and mornbranouslabyrinth,Labyrinthus drawing; semi-schematic dorsal view (r., 7 00"/"\. Ductusendolymphaticus \ Saccusendolymphaticus \ \\
\\
Amoullamembranacea I antarior l/
/ Os temporale'Parspetrosa' ,,' Faciesposteriorpanlspelrosae
cranialis
.'
/ Ductus utriculosaccularis
Utriculus\
-' Sacculusvestibularis --
- Crus membranaceum commune
\
Cupula - _ cochleae
Caecum vestibulare
C a e c u m- - cupurare Duclus '-' cochlearis Scala -' vestibuli
//
F:/
Duclus / reuntens Scala tympani /
/
Canahculuscochleae /
Duclus semicircularis Posterior
.tt, .t/l /
/l
,r staoes ,
.t Fenestracochleae /
Fig. 695
-: \ Fenestra vestibuli
Membranouslabyrinth,Labyrinthusmembranaceus'
Ampullamembranacea posterior
396
Ea,;Auris
Cupula cochleae
\
Scala lympani -
/
;!. ..i..iil it::,ri.
'l
Ductuscochlearis/
Ductussemicircularis lateralis
/
- -
/
Canalis semicircularis lateralis
---
A m p u l lm a embranacea lateralis
I
-\N utricularis - -
I N saccularis /
7 I
\
N ampullarisposterior /
/
/ Sacculus vestibularis
- - -
Ampulla membranacea anlenor
Utriculus
Canalis semicircularisanterior
\ Ductus semicircularrs anrerror Fig. 696 Vestibulocochlear nerve,N. vestibulocochlearis [VIII],and membranouslabyrinth,Labyrinthusmembranaceus; schematicdrawing;the corticalbonehas beenpartially removed; superiorview (r.,300%).
Ductuscochlearis\
\
S c a l av e s t i b u h
_--
Ductuscochlearis,Pariesexternus -Striavascularis\ -Organumspiralet,Membrana reticularis - -
- --
Prominentia spiralis_
Sulcusspiralisexternus- _ -C r i s t a b a s i l a r-i-sD u c t u s c o c h l e a r-i s- -, Pariestympanicus
-
Duclus cochlearis. Paries vestrbularis**
-
Membrana tectoria
_ -
Sulcus spiralis internus
_ - -
Labium limbi vestibulare
- .- -
Lamina spiralisossea
---
(R nervicochlearis)
----
G a n g l i o ns p i r a l ec o c h l e a e
Lamina b a s i t a r i -s- - -
Fig.697 Cochlea,Cochlea,and spiral organ,Organum spirale; schematiccrosssectionthroughoneofits turns; (2000%). * clinical:organof Conrr ** clinical:RDrssNrn's menbrane
\
Limbus spiralis
\
Labium limbi tympanicum
\
Scala tympani
Auditoryand VestibularPathwaYs
397
Auditory path\'vay (mainlycrossed fibles)
C o l l i c u l u- \s . inferior Corpusmediale
lst neuron:bipolarcells of the Ganglion spirale cochleae.The fibres form the N. cochlearisof the N. vestibulocochlearis.Fibresfromthe basalpart of the cochleareach the Nucleuscochlearis posterior,and those ftom the aPical part the Nucleuscochlearis anterior. 2nd neuron: multipolar neurons of the The fibres from the Nucleicochleares. anteriormainlypass Nucleus cochlearis (partlyformin theCorpustrapezoideum with a further neuronin ing synapses to the the Nucleuscorporistrapezoidei) oppositesideand form the Lemniscus to the Collicuwhichconnects lateralis, lus inferior.Very few fibres join the lateralisof the sameside. Lemniscus The fibres of the Nucleuscochlearis posteriorcross the Fossarhomboidea superficiallyand enter the Lemniscus side. lateralisof theopposite
\-
Nucleus \ lemniscilateralis \ - L e m n i s c u sl a t e r a l r s Nucleus \ o l t v a f l ss u p e f l o r - - _
.
\
\
N u c l e u s-
, N. vestibulo / c o c h l e a r i sl V l l l l , / N. cochlearis
o l i v a r i si n f e r i o r
Nucleus cochlearisposterior
Nucleus cochlearis anletiot /
G a n g l i o ns p i r a l e/ cocnleae
Nucleus corporis lrapezotdei /
Labyrinthus/ cochlearis
F i g .6 9 8
3rd or 4th neuron:from the Colliculusinto the Colliculussuferior connections perior,to the cerebellumbut predomi mediale. nantlyto theCorpusgeniculanrm 4th or 5th neuron:the Radiatioacustica connects the Corpus geniculatum mediale with HrscHr's transverse gyrus and WrRucxE's centre of the temporallobe.
Auditorlpathway
T h a l a m u s-
Vestibular pathway lst neuron: bipolar cells of the Ganglion vestibulare: The fibres form the N. vestibularisof the N. vestibulocochlearis on the floor of the internal acoustic meatus. They pass to the Nuclei vestibulares. 2nd and following neurons:from the Nucleus vestibularis lateralis (DeIrrns' nucleus) fibres run to the Formatio reticularis, to the motor nuclei of the cranial nerves III, IV and VI (via the Fasciculus longitudinalis medialis), to the Nucleus ruber and as the Tractusvestibulospinalis into the anterior column of the spinal cord. From the Nucleus vestibularis medialis (ScHwarer's nucleus) and the Nucleus vestibularis inferior (Rorrrn's nucleus) parts of the Tractus vestibulospinalis and connections with the Formatio reticularis are formed. The Nucleus vestibularis superior (BecurenEw'snucleus) provides some fibres for the cerebellum.
N u c l e u s- - F neruroculomolofll N u c l e u s- nervi trochlearis
-
> Nucleusvestibularrs- - -
/
. Ganglion I veslibulare
i
SuPefiOr
Nucleus vesttbulanslateralrs N u c l e u sz / v e s t i b u l a r iisn l e r i o r N u c l e u s/ nerui abducentis N u c l e u s/ v e s l r b u l a r im s edralis
Labyrinthus/ vestibularis
/
I N veslibulocochlearis[Vlll], N vestibularis
N u c l e u sc u n e a t u s/
Fig.699 pathway.
Vestibular
* connectionswith the cerebellum
398
Ear,Auris Antrum mastoideum I Emrnentia arcuata /, Stapes; Fenestravestibuli
Promontorium \ Foramen slylomastoideum/
Fenestracochleae
\ C"n"l,. nervi facialis
Fig.700 Petrosalbone,Os temporale,Parspetrosa; verticalsectionin the longitudinalaxis; ventralview (r.). * p r o b ei n t h e c a r o t i dC a n a l
Canalis semrcircularislateralis
/ Feneslravestibull
Canalis nerui facialis
/ Cavitastympani
- Fissurapetrotympanica Sulcussinussigmoidei\ _ - Parstympanica
.qit !: CJF
J,
Canalis nervi lacialis /'
* - Fissuratympanomastordea - Vagina processus styloidei
.tl
Cellulae mastoideae z/
{,, / Proc mastoideus
Fig.701 Temporalbone,Ostemporale; the internal spacesand the groovefor the sigmoid sinushavebeenexposed; lateralview (r.).
399 (N vagus) R auricularis \ Chordatympani\
\ lN I
tympanicus Plexustympanicus I internus) (Plexuscaroticus N caroticotympanicus -|
i-i ,'';-;";il;;; o"'T"::L:: i
&j-i
,'"
,, N petrosusminor /A carotisinterna - Ganglion inferius(lX) - - Plexuscaroticusiniernus - N canalispterygoidei (Radixfacialis)
\/ \/ / posterior (N facialis) auricularis (N vagus)/ R auricularis \chordatympan'
Fig.7O2 Facialnerve,N. facialis[VII], glossopharyngeal nerve,N. glossopharyngeus UXl, and vagalnerve,N. vagus [X]; the petrosalbonehas beenpartiallysectioned; here; the nervesare shownsemi-transparent ventralview (r.).
Crurastapedis\
M tensor tympani, Tendo
/
Proc cochleariformis
/ N petrosusmalor Ductus semicircularislateralis- r-
/ M tensortympani
Canalis semicircularis- lateralis
-
musculi Semicanalis tensoristympani
- - Seotumcanalis musculotubarii - Semicanalis tubae auditivae
-pyramidalis Eminentia
- - Promontorium M stapedius,Tendoz/ \ N tympanicus Caputstapedis/ \ Cavitas tympani
N tacialis[Vll]/ \ Sinus tympani
Canalisneruifacialis/
Facial nerve, N. facialis [VlI] and Fig. 703 tympanic cavity, Cavitas tympani; vertical section along the longitudinal axis of the petrosal bone; the facial canal has been exposed; ventral view (r.).
400
Ear,Auris N maxillaris [V/21 N petrosus major N ophthalmicus[V/1]
N mandibularis[V/3] /
Chorda tympani
Ganglion geniculi Ganglion trigeminale
N oculomotorius llll
..
/Md
\
)
A carotis interna O \
N trigeminus [V] N facialis[Vll]
N abducens [Vl] N vestibulocochlearis[Vlll] . /'
Stapes/ / N, glossopharyngeus [X] N vagus[X]
/
-: -:
N accessorius [Xl]
Proc mastoideus R digastricus
-\
/ Sinustransversus a
Canalis nervl facialis
I M stylohyoideus \ B stylohyoideus \ I M digastricus, Venterposterior
/ Foramenstylomastoideum N facialis[Vll]
Fig.7O4 Facialnerve,N. facialis[Vll] in the petrosal bone,Os temporale,Parspetrosa; the petrosalbone has beenpartiallymilled;the facialcanal and the tympanicr;avityhavebeenexposed; dorsalview (r.).
Cochlea Cavitas tympani; Ossicula auditus
Porusacusticus externus
I
I
petrosae Apexpartas , Os occipitale, I Clivus
Tuba auditiva Cochlea
Caputmandibulae ,
\ \
ll
\\
/ celutaemastoideae
i Canalissemicircularis lateralisI
\ Porusacusticus inrernus \ I Canalissemicircularis posterior
I
rt
Cellulaemastoideael i Cavitastympani;| auditus Ossicula
I
|
!
lOsoccipitale,Clivus i | Porusacusticus internus
| iI poslerior Canahssemicircularis
Figs.705a,b Petrosal bone,Ostemporale, Parspetrosa;horizontalsections,obtainedwith high-resolutioncomputedtomography(HRCT); inferior view (r.). a at the levelof the Canalissemicircularislateralis b inferior to the Canalissemicircularislateralis
Index
Index The numbersin bold type indicatepages wherethe terms appearin the figure legendsor tables
A A b d o m e n2 , 6 Abdominalaorta+ Parsabdominalis aortae Abdominalwall reflex 351 Abductio - (Articulatiohumeri) 191 - radialis (Articulatioradiocarpalis) 209 - ulnaris (Articulatioradiocarpalis) 209 A-cells 10 Achillestendonreflex 351 Acromioclavicularjoint - lateral+ Articulatio acromioclavicularis - medial+ Articulatio sternoclavicularis Acromion19,143,168,170-173, 187-190,227 ADAMKrEwrcz's artery + Arteria(-ae) radiculariamagna Adductio - (Articulatiohumeri) 191 Adenohypophysis268, 294 Adhesiointerthalamica 276, 285, 294-295,302,307,3r5, 326,332, 335 Aditus - laryngis 109,131 - orbitalis 359 Aequator366,370 Afferent neurons 352 Afferent tracts 354 Ala - cristaegalli 43, 56 - lobulicentralis303-304 - m a i o r 3 3 ,3 6 ,4 5 ,4 8 ,5 7 - 6 1 , 7 1 , 357,360,362,365,390 - minor 33, 42-43,58,60-61,93, 3sz 360 - nasi 89 - ossisilium 341 - vomeris 54, 160 Alveolidentales41,58, 113 Alveushippocampi311-312, 326-327,332-333 Amiculumolivare 323 Ampulla - canaliculilacrimalis361 - m e m b r a n a c e a a n t e r3i o9r5 - 3 9 6 - - Iateralis395-396 - - posterior395 - osseaanterior 393 - - lateralis393 - - posterior393 Angleof iris 368 AngulusCi) acromii 168 - frontalis 64 - inferior 168,189 - i r i d o c o r n e a l3 i s6 6 , 3 6 8 - lateralis168 - mandibulae35,47,66-68,73, 119 - mastoideus64 - occipitalis64 - oculilateralis356,358 - - medialis356,358 - sphenoidalis33,64 - superior 168,189 - venosus2l Ansa - cervicalis26, 26, 87,135,142, 1 4 9 ,1 5 l - 1 5 41, 5 7 - t 5 82, 2 9 , 2 5 7 , 275
An3d. - subclavia25, 156 - tendinis(M digastricus)l13 Antebrachium2-3, 164-165, 174 175,178,187,198-2lL, 238-242 - crosssection254,255 - cT 255 - fascia 186 _ MRT 254 - muscles210-211 Anteversio - (Articulatiohumeri) 191 Antihelix 382 Antitragus 382 Antrum mastoideum387,389, 398 Anulus - fibrocartilagineus 384,386-388 - fibrosus 348 - iridis major 368 369 - - minor 368-369 tendineuscommunis362, 3 6 4 - 3 6 53, 7 3 - tympanicus48-49,384 Anus 13 Aorta 158,347 - abdominalis+ Parsabdominalis aortae - ascendens+ Parsascendens aortae - branches18 - descendens + Parsdescendens aortae - thoracica+ Parsthoracicaaortae Apertura - externacanaliculicochleae63 - - canaliscarotici390 - lateralis298-299,306,307-308, 335 - mediana276,298,302,306, 3 0 7 - 3 0 83, 3 5 - piriformis 32, 52 - sinusfrontalis 50, 55 - - sphenoidalis55,60 - thoracissuperior 158 - vestibuli63 Apex - (Cornuposterius)350 - cuspidis99 - l i n g u a e1 0 8 ,1 1 0 - 1 1 1 partispetrosae41,63, ll9, 266, 268,392,394,400 radicisdentis 99 Aponeurosis d o r s a l i s2 9 , 2 5 0 - linguae 109 musculibicipitisbrachii 186, 193-194,198,208,234,239,241 - p a l a t i n a1 1 9 , 3 9 0 - palmaris 186,212,212, 239, 244, 250-251 Apparatuslacrimalis360-361 Appendixvermiformis13,22-23 APUDsystem 15 Aqueductus - mesencephali 285,291,294, 2 9 6 - 2 9 73, 0 2 ,3 0 6 ,3 0 6 ,3 0 7 - 3 0 8 , 315,326,333 33s, 339-340, 374 - vestibuli381,394 Arachnoidea - matercranialis 122-123,264,266, 269,280-28r,306,324,328 - - spinalis 344-346,349 Arcus - alveolaris(Mandibula)66-67 - anterioratlantis 36, 47, 160,342
Arcus - aortae 16,20, 25, 144,156,160, 274,347 - cartilaginiscricoideae124-127, 1 3 0 ,1 3 4 ,1 4 1 1, 6 0 c o s t a l i s1 8 7 - 1 8 8 - dentalisinferior 97-98 - - superior 97-98,107 - ductusthoracici21 - palatoglossus 95, 107-108 - palatopharyngeus 95, 107-108, 1 3 6 ,1 4 0 ,1 6 0 - palmarisprofundus224,243,243, l+t - - superficialis224,243,245,251 - posterioratlantis 36 - superciliaris 50 - venosusfugularis 146,148,157, 1602 , 30 - vertebrae342,346,349 - zygomaticus34, 45,59,78-79, 86-87,94,102,137 Atea - cochlearis381,393-394 - hypothalamicalateralis 294 - nervi facialis 394 - postrema 299 - striata 374,374 - subcallosa282, 294,321,324, 3 3 2- 3 3 3 - vestibularis299 - - inferior 394 - - superior394 Arm + Brachium ArteriaCae) - alveolarisinferior 72, 80,85-88, 116,122-127,260 - - superiorposterior80,86 - a n g u l a r i s7 1 , 8 0 , 8 3 - 8 8 , 2 6 0 - auricularisposterior18,80, 83-88, 147,r52,260 - - profunda 86 - axillaris 16,141,153-155,224, 227,229,233-235 - basilaris260-261,266,276, 281 28s,294,302,325,335,347 - brachialis16,177,224,233-237, 239 241,253 - - superficialis23[ - b u c c a l i s8 0 , 8 5 - 8 8 2 , 60 - caflosomarginalis 261,279,284, 324-325,327-332 - carotiscommunis16,18,25, 79-80,87,tzl, 135,139-141,144, 149 1501 , 5 1 ,1 5 2 - 1 5 91, 6 2 - 1 6 3 , 229,260-261,274 - - e x t e r n a1 6 ,1 8 ,8 0 , 8 0 ,8 5 - 8 6 , , 4 e l,5 t - 1 5 4 ,1 5 9 , 8 8 ,r 2 l , 1 3 e 1 260-261 - i n t e r n a1 6 , 1 8 , 7 3 , 8 08,5 ,8 8 , 1 0 6 ,r 3 9 - 1 4 01, 5 3 - r 5 4 1 , 59, 258 260,260,261,261, 265 266,267,268-269,274, 277,281-282, 285,294,322, 335-336,340,373-378, 391-392,399-400 ---DSA26l - - - radiograph(ap) 261 - centralesanterolaterales282,284, 322 - - anteromediales 282,322 - - posteromediales282 - centralisretinae 122,367,372, 374,379 - c e r e b rai n t e r i o r2 6 0 , 2 6 1 , 2 6 6 , 269, 276-27 7, 282, 284- 285, 309, 317,322,324,328-335
Arteria(ae) cerebri m e d i a2 6 0 , 2 6 1 , 2 6 6 , 2 8 2 , 2 8 4 , 317,322,324,327,330,334, 336-338 - - posterior260,261,266,277, 282-285, 294,3r7,325-326, 332-334,336 - cervicalisascendens152-155, 162-163,347 - - protunda 155-156 - - superficialis152-153,155 - choroideaanterior 282, 317,322, 374 - ciliares 374,378 - - posterioresbreves 367 - ciliaris anterior 367 - - posteriorlonga 367 - circumflexahumeri anterior 224, 233-234 - - - posterior224,228,230, 232-233,237 - - ilium protunda 18 - - scapulae228,251 - colicadextra 18 - - media 18 - - sinistra 18 - collateralis media 224,237 - - radialis 224,236-237,239-242 - - ulnarisinferior 224,234-237, 239-242 - - - superior224,234-235, 239-241 - comitansnervi mediani 224, 240, 254 - communicansanterior 266, 282,' 285,324,334 - - posterior260,261,266,287, 325,334-336 - conjunctivalisanterior 367 - coronariae 18 - digitalesdorsales247,251-252 - - palmarescommunes224, 243-245,Z5r-252,256 - - - propriae224,243-247, 251-252 - dorsalisnasi 88,378 pedis 16 - epigastricainferior 18 - episcleralis 367 - ethmoidalisanterior265,267, 376,378-379 - posterior378-379 - f a c i a l i s1 8 ,7 2 ,8 0 , 8 3 - 8 8 ,1 1 4 - 1 1 5 , 122-123,139,141,151,153-154. 157-158,260 - femoralis 16 - fibularis 16 - frontobasalislateralis 282 - - m e d i a l i s2 6 1 , 2 8 2 , 2 8 4 - gastricasinistra 18 - gluteainferior 18 - - superior 18 - hepaticacommunis 18 - hypophysialisinferior 294 - - superior294 - ileales l8 - iliaca communis 16,18,20, 25 - - externa 16,18,20 - - interna 16,18,20 - iliolumbalis l8 - inferior anteriorcerebelli 261 266,282-283 - - posteriorcerebelli 266, 282-283 - infraorbitalis 80, 84, 86-87, 260, 379-380 - insulares 284
&uX
rndex
Afterta@e) - intercostalis(-es) posteriores155, 347,349 - - suprema155 - interosseaantetior 224, 240, 242, 249,251,254 - - -communis 16,224,240 - . posterior201,224,240,242, 251,254 - - recurrens 224,241-242 - intramuscularls 29 - intraseptalis 29 - jeiunales 18 - labialisInferior 80,84, 260 - - superior80,84,260 - labyrinthi 265-266, 267, 282-283,392 - lacrimalis 122,360, 376-378 - laryngeainferior 131 - - superior lll,ll5,120-121, 127- 128, l3t - 132, 137,140, 1 4 9 ,1 5 1- 1 5 3 - l i n 8 u a l i s1 8 , 8 0 , 8 5 , 8 7 - 8 81, 1 5 , 118,120-123, 139,t5t - 152,260 - lumbales 20 - masseterica86,88 - maxillarls 18,72, 80, 86, 86-87, 88,260 - meningeamedia 80, 86-82 260, 265-266,267,27 2, 278,376 - - posterior 139,266,267 - mesencephalicae282 - mesentericalnferior 16,18,20, 25 - - superior 16,18,20,25 - metacarpalesdorcales 247,249, 251 - - palmares 243,246,251,256 - nasopaladnall8 - nutricia 7 - obturatoria 18 - occipitalis18,72,80,83,85-88, 140,147-149,153-154,260 - - lateralis 284 - - medialis 284,327-328 - ophthalmica 260, 260, 261, 265-266, 267, 268- 269,271, 276 - 277, 373, 37t, 374-380 - ovarica 16 - palatinaascendens80,8Z 118, 1311 , 39,260 - - descendens 80,260 - - major 107,118 - pancreaticoduodenalisinferlor 18 - parietalisposterior 279 - p€ricallosa285,309 - pericardiacophrenica349 - pharyngeaascendens18,80, 139, 267 - pontis 282-283 - poplitea 16 - princepspolllcis 224,243-244, 246,249 - protundabrachll 16,224, 234-237 - - femoris 16 ,- - linSuae ll8, 121 - pudendainterna 18 - pulmonales 20 - radialis 16, 177,224, 238-241, 243, 245- 247,249,254- 256 - - indicis 224,243-244 - radicularlsmagna 347 - rectalismedia 18 - - superior 18 - recurrensradlalis 224.239-241 - - ulnarls 224.237.240-242 - renalis 16,20,25 - sacraleslaterales l8 - sacralismediana18 - scapularisdescendens155 - sitmoideael8 - sphenopalatina80, 87,260 - spinalisanterior 267,282,347, 349 - - posterior 347 - splenica 18 - stylomastoidea80,86
Arteria(te) - subclavia 16,18, 25, l4O, 144,149, 1 5 2 - 1 5 51, 5 5 ,1 5 6 ,1 5 8 - 1 5 91, 5 9 , 227,229-230,274 - - branchesl8 - subfascialis29 - sublinglalis 87,ll8, 120-121 - submentalis80,86-82 115, 152-t54,260 - subscapularis233 - sulci centralis 279 - - postcentralis279 - - precentralis 279 - superiorcerebelli 266, 282-283 - supraorbitalis 84, 122,260, 376-378,380 - suprascapularis 149,153-155, 227,230,233 - supratrochlearis84-86, 260, 378 - temporalespmfundae 260 - temporalis 73 - - media 80.86-88 - - profundaanterior 80, 86 - - - posterior80,86-87 - - superficialis18,72,77,79-80, 83-88,260 - testicularis 16 - thalamotuberalis282 - thoracicainterna18,144,153-152 226 - - lateralis 154,226,228-230 - - superior227,230 - thoracoacromialis 149,152-154, 226-227,229 - - branches 227 - thoracodorsalis228-229, 233 - thyroideainferior 131,135-136, 139-140,153-155 - - superior18,80,82121,134,139, 149,151-154,158,160,162,260 - tibialis anterior 16 - - posterior 16 - transversacolli 149,152,154,158, 229-230 - - faciei 80,83,86,122,260 - tuberis cinerei 282 - tympanicaanterior 86-87 - - posterior 386 - - superior 265 - ulnaris 16,177,214,224, 239-241, 243-246, 249-250, 254-256 - umbilicales18,20 - vertebralis18,72,135,153,155, 155, 156,156, 162-163,229, 260-261,?65-266,267,281-283, 285,302,335,347 - vesicalisinferior 18 - zygomaticoorbitalis80, 83, 85-86 Arteries - brain 282 - harld 243,247 - head 26O,261 - systemiccirculation 16 - upper limb 224 - vascularsystem 16 Arteriola(-ae) - macularisinferior 371 - - superior 371 - medialisretinae 371 - nasalisretinaeinferior 371 ---superior3Tl - temporalisretinaeinferior 371 ---superior3Tl Articulatio(-nes) - acromioclavicularis165,166, 168, 1 7 0 ,1 7 3 ,1 8 8 - 1 8 9 - atlantoaxialislateralis 144 - - m e d i a n a9 6 , 1 6 0 - atlantooccipitalis384 - carpi 182 - carpometacarpalis(-es) 165,166, 182 - - p o l l i c i s1 6 6 , 1 8 0 - 1 8 2 - cartilaginea 10 - cinguli membri superioris 166 liberi 166
Articulatio(-nes) - cricoa$enoidea 124,132 - cricothyroidea126,127 - - axisofarticulation127 - cubiti 165.166.U6 - - axes 209 - - frontal section 177 - - radiograph(ap) 177 - - radiograph,latenl 177 - - ratioofforces 185 - - sagittalsection 177 - digiti 183 - fibrosa l0 - humer[ lq.Ms, 166, l7O-172, 190,233,237 - - axes l9l --cT173 - - radiograph(ap) l73 - - ratioofforces 185 - - section(scapularplane) lO, 172 - humeroradialis 165,166 - humeroulnaris 165,166 - incudomallearis386 - incudostapedialis386 - interphalangeae manus 166, 183, 220 - - - distales29, 165,183,183 - - - p r o x i m a l e s1 6 5 , 1 8 3 , 1 8 3 - laryngis 126 - manus 181 - mediocarpalis165,166, 182 - membri superioris 166 - metacarpophalangea(-ae) 165,166, t81,183,215,219 - - pollicis 180,183 - ossea 10 - ossiculorumauditus 386 - radiocarpalis 165,166, 182,182, 217,251 - radioulnarisdistalis 165,166, 178, 178, tBt-182,208,255 - - proximalis165,166,178,VA - stemoclavicufarisl4l, 166-167, 168.226.230 - synovialis 10 - temporomandibularis 68,68-71, 78-79,86, 119,137,145 - - radiograph 70 Associationfibres 320 Associationneurons 352 Asterion 34 Atlas 36, 144,160,347,384 Atrium - cordisdextrum 20 - - sinistrum 20 Atrophyof the brain 306 Auditorypathway 397 Auricula 381,382 - innervation 383 Auris 381 - externa 381 - interna 381,392 - media 381 Autonomicnervoussystem - parasympatheticpart 25 - sympatheticpart 25 Axes - elbowjoint 209 - humanbody I - shoulderjoint191 - wrist toints 209 Axilla 164,165,224-225, 225,228, 229,229-230 Axillary fossa+ Axilla Axis 36 - externusbulbi 366 - internus bulbi 366 - (Lens)370 - longitudinalis(Articulatiohumeri) l9l - ofrotation,joint ll - opticus 366 - rotationis(Articulatiocubiti) 209 - sagittalis(Articulatiohumeri) 191 - - (Articulatioradiocarpalis)209
.4xis - transversalis(Articulatiocubiti) 209 - - (Articulatiohumeri) 191 - - (Articulatioradiocarpalis) 209
B Basalganglia 323 Baseof the skull ll9 - extemal surface 44,45 - foramlna 267 - internalsurface42,43,265, 266 Basion40,65 Basis - cochleae393 - (Cornuposterius) 350 - cranli 119 - - externa 44-45 - - interna 42-43,265-266 - mandibulae 35, 66, ll9, l4l - ossismetacarpi 179,184,251 - phalangis(Manus)179-180 - stapedls385-386 B<ells 10 BEoHTEREW'S nucleus 397 BIcur's fat-ball+ Corpus(ora) adlposumbuccae Bifurcatio - aortae 16,18,20 - carotidis80. 121 Blind spot+ Discusnervi optici BoCHDATEK'S structureof th€ choroid plexus 270,283 Bones - longe,structure 7 - ofthehand180 - o f t h es k u l l 3 3 , 3 5 , 4 1 , 4 8 Bowtrl,cN's membrane+ lamina limitans anterior Brachium2-3, 164-165,169, 186- 187,192- 197,231, 234-237 - arteries 224 - colliculiinferioris 297-299 - - superioris 298-299,374 - crosssection 253 - fascia 186 - lymphaticvessels 225 - MRT 253 - muscles186-222 - surfaceanatomy 164 Brain + Encephalon Brain stem 285, 287, 296, 298, 299 Bregma38,40 cortical areas 292 BRoDM^NN'S Bronchipfincipales 13 Bulbus(-i) - aortae 18 - cornusoccipitalis 330 - inferior venaejuSularis 139-140, 152.230 - oculi 265,339,363-365, 365-368,373-375, 378,380 - olfactorius 91,276,281-282, 287, 318-319,335,374 - (Rhombencephalon) + Medulla oblongata - superiorvenae jugularis 139-140, 262-263,267,384,387 Bunolfir's tract + Fasciculus(-i) cuneatus Bursa(-ae) - bicipitoradialis 176-177,199,202 - cubitalisinterossea202 - infrahyoidea125,130,134,160 - musculi coracobrachialis 1 8 9 -1 9 0 - pharyngealis 160 - subacromialisl7l-172, 189-l9O - subcutaneaacromialis 226 - - olecrani 172 186 - subdeltoidea189,195
CapsulaarticularE Burca(te) - subtendineamusculisubscapularis - - (Articulauotemporornandibularis) 68- 69,71,,73, 1 7 0 ,1 9 0 - synovialis 170 7 8 - 7 9 , 1 1 9 , 1 31 74 ,5 - - (Columnavertebralis) 348 - - cricoarytenoidea 126 - - cricothyroidea125-128 - externa 294, 322-326,330-332 - extrema 284, 322-326, 330-332 Caecum13 - fibrosa(Glandulathyroidea) 135 - cupulare 395 - interna 277,284, 295, 311, - vestibulare395-396 3 1 3 - 3 1 43,2 1 ,3 2 1 ,3 2 2 - 3 2 7 , Calcaneus,development8 3 2 9 - 3 3 33, 3 5 - 3 3 63, 5 5 Calcaravis 310-311,313-314,322 - - arterial supply 322 3 3 1- 3 3 2 - - organisation322 Calvaria39,264,264 - lentis 370 Calx 5 C a p u t2 - 3 , 6 , 3 0 - 3 1 Camera - breve(M bicepsbrachii) 186, - anteriorbulbi 366, 368, 373 - posteriorbulbi 366,368 188-189,793-194,196, 197, - postremabulbi 366, 373 233-234 - commune(Mm. flexores) 777,2OO, - vitrea + Cameraposhemabulbi 201,210 Canaliculus(-i) - (Cornuposterius) 350 - cochleae395 - lacrimales 360 humerale(M. flexor carpi ulnaris) - lacrimalisinferior 361 20s,.24r - (M. flexor pollicis longus) 201 ---superior361 - - (M.pronatorteresl177,797, - mastoideus45 203,210 Canalls(+s) - humeri 19,169,172-173 - analis 13 - humeroulnare 197,199,2O3, - caroticoclinoideus260 - caroticus 36, 45, 63, ll9, 144,260, 210 - inferius 71,73 266,267,387,3A7,388, 389. (M. tdceps brachii) laterale 390-391,394 - carpi 208,217-218,250 t86-187, 189,192,195,196, r97, - cenFalis 285,302,306-308,335, 204-205,236-237,253 - longum (M. bicepsbrachii) 350-351 - condylaris 36, 43, 45, 65, 119, 170-173, 188-190,193-195,196, 197,234 267 - - (M.tricepsbrachii)171-172, - diploici 264 - i n c i s i v u s4 1 , 5 4 - 5 5 , 9 01, 1 8 186-182 189-190,192-194, - infraorbitalis 57,57, 58, 102,272, 196, 197,233-237,253 - mallei 384-388 357,360 - mandibulae47, 66-67,69-71,73, - longitudinalismodioli 394 - mandibulae 97, lO2, 104,106 400 - mediale(M. hiceps brachii) 172 - musculotubarius63, 144,387 - nasolacrimalis52,360 t86- 187,192-195,196,198-199, - nervi facialis 106, 273, 273, 277, 204- 206, 2lO, 235-237, 239, 253 (Nucleuscaudatus) 11,284,298, 389,389,394,398-400 - - hypoglossi36,41,43,44,45, 310,313-315,322-325,329-333, 335,339-340 45, 61, 65, 68, r44, 266,267, - obliquurn(M. adductorpollicis) 275,275 - nutricius 7 218,272 - ossismetacarpi179-180 - opticus43, 57-58, 61,266,267, phalangis(Manus) 179-180 357,360, 365, 373, 376, 37I - profundum(M. flexor pollicis - palatinusmajor 44,58 - posterior 400 brevis) 215,217- 218,222, 256, - pterygoideus58,60, 106 257 - radiale 199,2O3,210,240 - radicisdentis 99 - tudii 175,177,201 - semicircularis(€s) 381,400 - stapedis385,399-400 - - anterior 392-394,396 - superficiale 202, 215,217,246, - - lateralis 392-394,396, 256,257 398-400,400 - s u p e r i u s7 1 , 7 3 - - posterior392-395,400,400 - spiralis cochleae394 transversum(M. adductorpollicis) - - nodioli 394 213,215,218,222 - ulnocarpalis 250 ulnae 174,180,182,186,207,220, - vertebralis 345,346,346, 255 - ulnare (M. flexor carpi ulnaris) 348-349 - - veins 348 197,203,210,241 - - (M. pronatorteres) 172 point 274 CANNoN-B0HM 20L- 202, 203, 208, 210,240 Capitulumhumeri 169,176-177, Carotidgenu 260 202 Carotidsiphon 260 Capsula - articularis (Articulatio Carpaltunnel syndrome 256 joint of the thumb Carpometacarpal atlantoaxialislateralis) 144 - - (Articulatiocubiti) 176 + Articulatio carpometacarpalis - - (Articulatiohumeri) 10, pollicis Carpus 165 1 7 0 -t 7 1 ,1 8 9 -1 9 0, 2 3 3 , 2 3 7 - crosssection256 - - (Articulatiointerphalangea - cT 256 distalis)29 - joints 182 - - (Articulatiometacarpophalangea) 181,183,215,219 Cartilaginousjointl0 - - (Articulatioradioulnarisdistalisl Cartilago(-ines) - alaris(-es) maior 72,89,91,160 1 7 8 ,l 8 l , 2 0 8 - - minores 89 - - (Articulatiosternoclavicularis) articularis Z l0 167,230
c
Cartilago(ines) - arytenoidea 124-128,132-133, 162 - auriculae72,382,384 - corniculata 124,126-128,130, 1 3 3 ,1 3 6 - costalis 167 - cricoidea 120,124,1?9, 134,146, 161-t62 - cuneiformis128,130,136 - epiglottica 47, 109,124, 125-126, 130,134,160 - laryngis 126 - meatusacustici 382 - nasi72,89 - - accessoriae89 - - lateralis72,89,91,160 - seDtinasi89-90 - thyroidea l}g, 111,120-121,124, 125-128,130-132,r34, 136-137, 141,146,158,160-162 - tracheales125-128,130,134-135, t37. 16l - triticea 125-128,134 - tubaeauditivae119,140,390,390' 391 Caruncula - lacrimalis356,361 - sublingualis 96, 116-117,ll7, 120' 160 Cauda - equina 341-347 - helicis 382-383 - (Nucleuscaudatus)298,315,323, 925-327,330-331,333,336-337 caudalis(=inferior) 1 Cavitas(-tes) - articularis (tuticulatio cubiti) 177 - - (Articulatiohumeri) 10, 171 - conchae382 - coronae99 - cranii 122-123 - dentis 99 - glenoidalis 168,172-173,l9O - infragloftica 130,134 - medullaris Z 183 - nasi 13,46, 55,57,68,72,91,94' 365 - oris 13,95-96, l07-l08,ll7, 122-123 - - propria 13,108 - pharyngis 132 - synovialis ll - t y m p a n i1 0 6 , 3 8 1 , 3 8 4 , 3 8 2 387-389, 394,396, 398-399, 399, 400,400 Cawm - septipellucidi313,315,329 - trigeminale 271 Cellulae - ethmoidales46-47,56-57,59,72, 92, 122,27l, 339, 362, 365, 380 - - anteriores91,93-94 - - mediae 93 - - posteriores91,93-94,272 - mastoideae46-47,106,136,138, 272, 384,387,389,398,400 - pneumaticae391 - tympanicae389,394 Cementum99 Centralnervoussystem 24 Centrum - semiovale296,309 - tendineum 349 angle 273 Cerebellopontine Cerebellurn24, 270, 285, 287, 288, 303-305,308,321,326,333,341, 355,387 Cerebralhemisphere290 - corticalareas 293 - gyri 289-291 - sulci 290-291 Cerebrospinalfluid + Liquor cerebmspinalis Cerebrum 24, 286-287, 288, 341, 374
Cervix - (Cornuposterius) 350 - dentis 99 Chiasmaopticum 93, 268-269, 276, 282, 285, 287,291,294,296, 302, 307,325, 339-340, 365,373-374, 374,375 C h o a n a4 9 , 6 8 , 9 8 ,1 3 6 Chordacae) - obliqua 176,178,197,270 - tympani 82, 87,106,272, 273, 276,384,386-388,399-400 Choroidea366-367,567, 368, 372 Cilia356,358,380 Cingulum - (Cerebrum)320 - membri inferiorls + Cingulum pelvicum - - superiorls+Cingulum pectorale - pectorale 6, 165'168 - - ratioofforces 185 - pelvicum 6 Circulation - fetal 20 - postnatal 20 Circulus - arteriosuscerebri(Wus) 266, 2A2-283 - - iridis maJor 367 ---minor367 Circumferentia - articularis (Radlus) U5-176, U8 - - (Ulna) 174 Clsterna - ambiens 27O,277,281,307, 326-327.332-335 - basalis 270-271, 273-275 - cerebellomedullaris281,306, 340 - chiasmatica260, 281,294, 306, 334,340 - chyli 21 - fossaelateraliscerebri 281,307' 324-327,330-334,336-338,340 - interpeduncularls 27O, 281, 294, 306,325,334,339-340 - pericallosa 306,324, 326-327, 3 3 0 ,3 3 2 - 3 3 3 - pontocerebellarls273, 281,284' 306,325 - quadrigeninalls 327 - trigeminalis 269,269 Claustrum 284, 322-323, 323, 324-326,330-333,337 Clavicle+ Clavicula Clavicula 6, 19,l4l, 743,145,149, 154-155,158,163,165,167,167, 188-189. 168,170-.173,186, r92-r94,227,?30 CtEuND'sligament 250, 251 Clitoris 14 Cliws ,S3,55,68, 90, 136,138,400 Coclilea 381, 384, 392-394,396, 400 Colliculus(-i) - (CartilaSoarytenoidea)124 - facialis 299,307 - inferior 2i6, 295, 298-299, 327, 334,397,3q7 - superior 291,295,297-299, 327, 3 3 3 . 3 7 5. collum 2-3,,6,30-31, 157-158, 160-163 - anatomicum 169 - chirurgicum 169-17O,189,795 - mallei 385,388 - mandibulae 67,69,71, ll9 - radii 175-178 - s c a p u l a e1 9 , 1 6 8 , 1 7 3 - sensoryinnervation 82 Colon 22-23 - ascendens13 - descendens13 - sigmoideum 13 - transversum 13
Index
Columna(-ae) a n t e r i o r3 5 0 - 3 5 1 - ( F o r n i x )2 9 4 ,2 9 8 , 3 0 23, 1 3 - 3 1 5 , 3 1 8 3 1 9 ,3 2 3 ,3 2 5 , 3 3 0 - 3 3 33,3 9 - i n t e r m e d i a3 5 0 - 3 5 1 - p o s t e r i o r3 5 0 - 3 5 1 - vertebralis6,348 - - nerves 348 Commissura - albaanterior 350 - anterior 285,294,296,296,Z9g, 302,307,315,318,319-320, 325, 332-333,335-336,350 - epithalamica285 - ( F o r n i x )2 9 4 ,3 1 O , 3 1 8 - 3 1393,1 , 335 - habenularum294,298,315,320, 335 - lateralispalpebrarum356,359 - medialispalpebrarum356,358 - posterior 294, 298, 3tS, 320, 332, 335 Comrnissuralfibres 320 Commissuralneurons 352 Concha(-ae) - auriculae382 - nasalisinferior 33, 46,i2,5i,57, 72, 90, 90, 91,93, 122 123,136, 361 media 33,46, 55-57,72, 90-91, 93, 136,272,361,380 superior 55, 91,136,272 - sphenoidalis60 Condylus - humeri 169 - occipitalis35-36,4b, 65, flg,137, 390 Conecells 367,374 Confluenssinuum 259,259, 262-263,265,276,306,316 Coniotomy146,160 Connexusintertendinei219-220 Conus - elasticus 125-126,126, l2B, 1gO, 134 - medullaris 341-342, 344 Cor 15-17,22-23 Corium + Dermis Cornea363-364,366-367,367, 368-369,374,380 Cornu - anterius (Medullaspinalis) 350-351,355 - frontale 277,285, 295-296,Z9g, 306-308,310,313-315,324-325, 329-332,335,339-340 - inferius (Cartilagothyroidea) t 2 4 - 1 2 8 ,r 3 1 - laterale(Medullaspinalis) 351 - m a j u s 7 3 , 9 6 ,1 1 0 - 1 1 11,1 3 1 , 16, rr8, 125-128,131,134,136_138, 140 - m i n u s 9 6 , 1 1 0 - 1 1 11,1 3 , 1 2 5 - 1 2 7 , 134 - occipitale295,306-308,310, 3 1 1 ,3 1 3 - 3 1 43, 2 7 ,3 3 1- 3 3 2 ,3 3 6 , 339 - posterius(Medullaspinalis) 3 5 0 - 3 5 13, 5 4 - superius(Cartilagothyroidea) 124-128,131,134,136 - temporale277,284,296,306-308, 3tt, 323,325-327,333-334,332 337,339 Corona - clinica 99 - dentis 99 - radiata 322,328 Coronalplane+ frontal plane Corpus(-ora) - adiposumbuccae 72, 75, 78, 114, 123 - - orbitae 122,359,365,373,376, 380 - - preepiSlottictm 125-127,130, 160
Corpus(tra) amygdaloideum 284,3lB 319, 3 2 3 , 3 2 5 , 3 3 4 , 3 3 63,3 6 callosum276,284-285,2BB,291, 2 9 4 ,2 9 8 ,3 0 2 ,3 0 9 ,3 1 1 3, 1 3 3 l s , 3 1 8 - 3 2 13, 2 3 -3 2 7 ,3 2 9- 3 3 2 ,3 3 5 , 340,374 - cerebelli305 - ciliare 366,367,368-369,373 claviculae 167 - (Fornix) 284-285,294,313, 3 1 8 - 3 1 93,2 5 ,3 3 0 ,3 3 5 - geniculatumlaterale 296-299, 321,326,333,374,374,375 mediale296,298-299,326, 333,353, 374,374,375, 397, 397 - humeri 7, 19,169,176-177, 194 - incudis 385-388 - linguae 108,110 mamillare270, 285,287,29l, 294, 296, 302,318-319,323,325,325, 3 3 4 3 3 5 ,3 4 0 , 3 7 4 - mandibulae33, 35, 46,66,72 - maxillae 47 - medullare305 - ( N u c l e u s c a u d a t uZs9)S , 2 9 8 , 3 n , 313-315,325-326, 329,336,336 - (Oshyoideum)47,96,110,113, 1 2 7- 1 2 8 ,1 3 4 - (Ossphenoidale) 36, 54 55, 59, 6 0 , 6 8 ,1 6 0 ,2 6 8 , 3 6 0 ossismetacarpi179 - p h a l a n g i(sM a n u s )1 7 9 - 1 8 0 , 2 5 2 - pineale+ Glandulatae) pinealis ^ radii 175-176,207 - s t r i a t u m3 2 3 , 3 5 5 - trapezoideum397 - ulnae 174,176,207 - unguis 29 - Yertebrae 162-163,346, 349 - vitreum 365-366 Cortex - cerebelli 305 - cerebri 264 - lentis 370 Conrt'sorgan+ 0rganum spirale Corticalareas - cerebralhemispheres293 - c)'toarchitectonically defined 292 - accordingto FoERSTER 293 - functional 293 Costa(-ae) 6, 19,144,154-156, 158-159,763,230,341-342,346, 349 Cranialcavity 122,123 Cranialnerves 24, 267, 27O, 276-277,301 - tunctions 267 - nuclei 300,301 - - motoric 355 cranialis(=superior) 1 Cranium 6, 32-38, 40-41, 46-49 Cremastericreflex 351 CristaCae) - arcuata124 - basilaris396 - choanalisvomeris 54 - conchalis(Maxilla) 53 - ethmoidalis53,55 - fenestraecochleae393 - frontalis 39,43 - galli 41,46, 54-57,90,365 - infratemporalis 36, 45, 60,7l - lacrimalisanterior 51,57-58,357 - - posterior57-58,357 - musculi supinatoris 174 - nasalis(Maxilla)41,90 - - (0s palatinum)41 - occipitalisexterna 3Z 65 - - interna 43,61,65 - sphenoidalis54,60 - supracondylarislateralis 169,177 - - medialis 169,176-177 - supramastoidea62 - transversa393-394
Crtsta(te) - t u b e r c u l i m a j o r i1s6 9 - 1 7 0 m i n o r i s1 6 9 - 1 7 0 vestibuli393 - zygomaticoalveolaris 36, 51,59 Crus(-ra)2-3 anterius(Capsula interna) 295, 3 2 1 - 3 2 2 , 3 2343, 1- 3 3 3 ,3 3 6 - - ( S t a p e s3) 8 5 - 3 8 6 - antihelicis382 - b r e v e3 8 5 - 3 8 6 , 3 8 8 - cerebri 269,296-297,.301, 323, 3 3 4 ,3 3 9 - ( F o r n i x )3 0 2 , 3 1 0 , 3 1 3 - 3 1 4 , 3 1 8 - 3 1 93,2 6 - 3 2 73, 2 9 - 3 3 0 , 335-336,339 - helicis 382 laterale(Cartilagoalaris major) 89,91 l o n g u m3 8 4 - 3 8 6 , 3 8 8 - mediale(Cartilagoalaris major) 89-90,160 - membranaceum commune395 - - simplex 395 -- osseumcommune393-394 - - simplex 393 posterius(Capsula interna) 295, 322,331-333 - - (Stapes)384-386 - stapedis399 Cryptae - linguales108 - tonsillares108 CT (computedtomography) - Antebrachium255: - Articulatiohumeri 173 - Carpus256 - Metacarpus256 - shoulderjoint173 Cubita 165 Culmen 302-304 Cuneus 289, 291,318,329-331 Cupulacochleae 393-396 Cuspisdentis 99 Cutaneousinnervation,upperlimb 223 Cutis 29,253-255,264 Cymbaconchae382
D Deciduous teeth 103,105 Declive302-304 Decussatio(-ones) - lemniscorum353 - pedunculorum cerebellarium superiorum302,305 - pyramidum 287,321,323, 342 Deepsensibility,subconscious 354 DErrERs'nucleus 397 Dens(-tes) - axis 36,46 - caninus 97-98,100,102-103,102 116-lt7 - d e c i d u i4 8 , 9 9 ,1 0 3 ,1 0 4 ,1 0 5 - incisivi 46, 95,97-98, 99, 100, 102-103,107,116-117, 167 - molaris(-es)57,72, 97-98, 99, 1O0, 102-103,107,116-117, 122-123 - - I t 9 7 - 9 8 , 1 0 0 , 1 0121 6 - 1 1 7 - permanentes99-101, 104 - premolares97-98, 100,1O2,104, 107,116-117 - serotinus+ Dens(-tes) molarisIII Dentinum 99 Dermatomes223 Dermis 264 DEScEMET's membrane+ Lamina limitansposterior Desmodontium+ Periodontium Diaphragma22-23,257,274,349 - sellae268 Diaphysis - (Radius)9 - (Ulna) 9
Diencephalon285,288,296 Digestivesystem,ventral view 13 Digitusti) - anularis 164,179 - (Manus) 165 - medius(Manus) 164,179,2i2 - minimus(Manus) 164,179 - primus(Manus)+ Pollex - quartus (Manus)+ Digirusfi) anularis - quintus (Manus)+ Digitus(-i) mlnlmus - secundus(Manus)+ Index - tertius (Manus)+ Digitusci) medius DIP (distalinterphalangealjoint) lB3 DipIoE39,47,264 Discus - articularis (Articulatioradioulnaris distalis) 178,182 - - (Articulatiosternoclavicularis) 159,167,230 - - (Articulatiotemporomandibularis)69-7 l, 71, 73 - intervertebralis156,348 - nervi optici 366,371 distal 98-99 distalis 1 Divisiones - anteriores(Plexusbrachialis) 26 - posteriores(Plexusbrachialis) 26 Dorsalaponeurosis218,252 dorsalis 1 Dorsum 3 - linguae 72, 95, 107-108,108,110, 1181 , 40 - manus 4,164,248-249 - pedis 4-5 - sellae41,43, 54, 60, 68,90,93, r38,258,268 Ductuli excretorii(Glandula lacrimalis)359,360, 361 DuctusCus) - arteriosus 20 [BoTALLo] - cochlearis381,384,395-396 - deferens 14 - endolymphaticus 381,395 - lymphaticusdexter 21 - nasolacrimalis 91,360, 361 - parotideus72, 75, 78-79, 83, 114-115,122,137 - r e u n i e n s3 8 1 , 3 9 5 - 3 9 6 - semicircularis(€s) 381 - - anterior 381,392,395-396 - - lateralis381,392,395-396,399 - - p o s t e r i o 3r 8 1 , 3 9 2 , 3 9 5 - sublingualis(-es) major 116,120 - - m i n o r e s1 1 6 , 1 2 0 - submandibularis 87,115-116,120, 122-123 - thoracicus 21,230, 349 - utriculosaccularis 381,395 - venosus[ARANrn]20 D u o d e n u m1 3 , 2 2 Dura - matercranialis122-123, 258-259,264-265,265,266, 268-269,277,278,279,306,373, 391,39s - - spinalis 160,162,342, 344-346,349 Duralsinuses+ Sinusduraematris
E Ear 381 Ear-Eye-Line 32,34 Efferentneurons 352 Efferenttracts 355 Elbowjoint + Articulatio cubiti Eminentia - arcuata63,398 - collateralis311,333-334,337 - cruciformis61,65 - hypothenaris+ Hypothenar
Index 'lri!
Eminentla m e d i a l i s2 9 8 - 2 9 9 - p y r a m i d a l i3 s 8 8 - 3 8 93, 9 8 - 3 9 9 - thenaris+ Thenar Enamelum99 Encephalon285,325,330,339-340, 341,34r - arteries282 - atrophy 306 - cT 339 - development288 - frontal seclion 324-326,327 - horizontalsection328-329, 331-3333 , 34 - mediansection335 - MRT 339-340 sagittalsection335-337,338 - ventricle308 Endocrineorgans 15 Ependymal layer 306,310,312-313 Epicondylus - lateralis(Humerus)169,176-177, 186- 187,192,201,205-207, 270, 2 3 2 ,2 3 4 , 2 3 6 - 2 3 72,4 2 - medialis(Humerus)164,169, 176- 177, 186,193- 194, 198- 199, 202,204,210,239-242 Epicriticsensibility(tactilepath) 353 E p i d e r m i s2 9 , 2 6 4 Epididymis14 Epiglottis 108,127- 128,131,133, 1 3 6 ,1 4 0 ,1 6 1 , 3 4 0 Epineurium345 Epipharynx 140 Epiphysisdistalis 9 Epitendineum11 Epithelium - anterius(Cornea)366,368 - posterius(Cornea)368 Eponychium29 Eru'spoint 148 Ethmoidbone+ Osethmoidale Excavatio disci 366,372 Extensio - (Articulatiocubiti) 209 - (Articulatiohumeri) 191 - (Articulatioradiocarpalis)209 Exteroceptivereflex 351 Extraocular muscles362-363, 364-365 - innervation 362 Extrapyramidal motorsystem355 Extremitas - acromialis19,167,170-171 - distalis(Humerus)7 - proximalis(Humerus) 7 - sternalis143,167 Eyeball366-367,368 - size 366 Eyelidmuscles 74
F Face,sensoryinnervation 82 Facialmuscles 74-75, 76,77-78, 357 Facialskeleton 57-59, 104 Facies - anterior(Cornea)368 - - (lris) 366,368 - - (Lens)366,368-370 - - (Maxilla)51 - - palpebrae358 - - partispetrosae43 - - (Radius1 ) 75-176,178,20r - - (Ulna) 174,176,178 - anterolateralis (Humerus)169 - anteromedialis (Humerus)169 - articularisacromialis167 - - (Articulatiotemporomandibularis)137 - - arytenoidea124 - - c a r p a l i s1 7 5 , 1 7 8 , 1 8 2 - - clavicularis168,172 - - sternalis 167 - - thyroidea124-125,127
Facies - cerebralis{Ossphenoidale) 60 - - (Ostemporale)63 - contactus99 - costalis(Scapula)168 - distalis 99 - externa(Osfrontale) 50 - - (Osparietale)64 - inferiorlinguae 109,111,117 - infratemporalis51 - interna(Osfrontale)54, 58 - - (Osparietale)64 - lateralis(0s zygomaticum)56 - - (Radius)175,178 - lingualis 99 - maxillaris(Ospalatinum)53 - - (Ossphenoidale) 60 - medialishemispheriicerebri 285 - - (Ulna) 174,178 - mesialis 99 - nasalis(Maxilla)53 - - (Ospalatinum)53 - occlusalis99 - orbitalis(Maxilla)51,352360 - - (Osfrontale)50, 357,360 - - (Ossphenoidale) 33, 57-58,60, 357 - - (OszySomaticum) 56-52 352 360 - palatina 53 - posterior(Cornea)368-369 - - (Humerus)169 - - (Iris)366,368-369 - - ( L e n s )3 6 6 , 3 7 0 - - palpebrae358 - - partispetrosae391,395 - - (Radius)175,178 - - (Scapula)168 - - ( U l n a )1 7 4 , 1 7 8 - sensoryinnerYation 82 - temporalis(Osfrontale) 50 - - (Ossphenoidale) 60,390 - - (Ostemporale)62 - - (Oszygomaticum)56 - vestibularis 99 Falx - cerebelli259 - cerebri 122-123,258, 258, 264-265,276,284,306,317 Fascia11 - antebrachii186,192-195,205-206, 2r2, 2r4, 239,244,250,254-255 - axillaris 225-226,228 - brachii 226,239,253 - cervicalis75, 77-7 8, 96, ll4-115, 134-135,141,145,145,146, 160-16t - clavipectoralis 141,226-227 - endothoracica349 - infraspinata 182 192 - masseterica 78,114-115,145 - parotidea77,78,114 - pectoralis190,227 - pharyngobasilaris 137-138,140, 160 - t e m p o r a l i 7s 8 , 8 5 , 8 8 Fascias - o f t h e h a n d2 5 0 - of the upperlimb 186 Fasciculusfi) - anterolateralis353 - cuneatus298-299,350,352-353, 353 - gracilis 298-299,350,352,352, 3 5 3 ,3 5 3 - interfascicularis 352 - lateralis(Plexusbrachialisl26, 26, 224,227,233-234 - longitudinalis inferior 320 - - m e d i a l i s2 9 7 , 3 0 2 , 3 0 5 , 3 2 3 , 352, 397,397 - - superior320 - mamillothalamicus 294,318,323, - medialis(Plexusbrachialis)26, 26, 154,224,227,233-234
Fasciculus(t) - muscularisaccessorius138 - posterior(Plexusbrachialis)26, 2 6 ,2 2 4 ,2 2 7 ,2 3 3 - 2 3 4 - propriianteriores352 - - laterales352 - - posteriores352 - septomarginalis 352 - transversi212,244 - uncinatus320 Fastigium 302,307 F e m u r2 - 3 , 6 , 3 2 2 - development8 Fenestra - cochleae387,389,393,395,398 - vestibuli387, 389,393-395,398 Fetalcirculation 20 Fibrae - arcuataecerebri 320 - circulares366 - corticonucleares 295,297,322, JCC
- - bulbi 355 - corticoreticulares 295,322, 322 - corticorubrales295,322, 322 22, 295,297,321, corticospinales 322,355 - corticotectales 322,322 - corticothalamicae 295,322,322 - cuneocerebellares 353 - frontopontinae297 - meridionales366 - occipitopontinae321,322 - olivospinales352 - parietopontinae 292 321 - pontocerebellares355 - temporopontinae295, 297, 321-322,322 - thalamoparietales295, 322, 322, 353 - zonulares367,368-369 Fibrocartilagobasalis 268 Fibrousjoint l0 Fibula 6 - developmentI fibularis 1 Filum(-a) - radicularia(N.spinalis)287,299, 344,349-350 - -- nervi oculomotorii 297 - terminale 342,344-345 Fimbriahippocampi310-313, 3 1 8 - 3 1 93,2 6 - 3 2 73, 3 1- 3 3 3 ,3 3 6 Final commonpathway 355 Fingerjoints + ArticulationesdiSiti Fissura(-ae) - antitragohelicina382 - cerebelli305 - horizontalis(Cerebellum) 303-304 - longitudinaliscerebri 280, 286-288,291,296, 309,313-314, 323-334,339 - medianaanterior (Medulla oblongata)287 - - - (Medullaspinalis)342,344, 350 - nodulofloccularis 303 - orbitalisinferior 33, 36,45, 57,59, 357,360,364 - - s u p e r i o r3 3 , 4 3 , 4 6 , 5 7 , 6 0 - 6 1 , 266,267,270, 27l, 27l, 357, 360,362,376 - petrooccipitalis43-44, 400 - petrosquamosa 36, 43,62 - petrotympanica 36,62-63, 398 - posterolateralis 304 - prima 302-303 - pterygomaxillaris 36,360 - secunda302-303 - sphenopetrosa 44,267,268,391 - telodiencephalica 314 - transversacerebri 330 - tympanomastoidea36, 62, 398 - tympanosquamosa 36
FLEcHSTG'S bundle+ Tractus posterior . sDinocerebellaris dreirisrc's ovalfield+ Fasciculus(-i) septomarginalis Flexio - (Articulatiocubiti) 191,209 - (Articulatiohumeri) 191 - (Articulatioradiocarpalis)209 Flocculus27O,283,287,296, 298, 303-304.323.327 Foliumvermis302-303 Folliculilinguales118 Fonticulus(-i) - anterior 48-49 - mastoideus48-49 - posterior48-49 - sphenoidalis48 Foramen(-ina) - alveolaria51,59 - apicisdentis 99 - baseoftheskull 267 - caecumlinguae41,43, 108-109, 160 - - (Osfrontale) 93 - cribrosa 41,43, 51,54-56, 90, 266 - ethmoidaleanterius 50, 57-58, 352 360 - - posterius57-58,357,360 - incisiYum 36, 41,44-45, 52 - infraorbitale 33, 36, 48, 51,57,94, 272,357,359,364 - interventriculare 262, 285, 288, 294,298,302,306,306, 307-308, 3 1 0 ,3 1 3 - 3 1 63,1 8 , 3 2 53, 3 1 ,3 3 5 , 339-340 - intervertebrale4z 346 - jugulare 36, 43-45, ll9, 139, 2 6 5 - 2 6 6 , 2 6,72 7 4 ,2 75 , 3 9 2 , 3 9 4 - lacerum 36, 43-45, 266, 267, 390, 392,394 - linguale 67 - Luscgrur+ Apertura lateralis - M,rcrxorr+ Apertura mediana - magnum 36, 43, 45, 49, 61,65, 259,266,267 - mandibulae 36, 66-67,98, 113 - mastoideum36-37, 41,43, 45, 62-63 - m e n t a l e3 3 , 3 5 , 4 8 ,6 6 , 7 5 , 9 7 - 9 8 , 102,104,113,272 - MoNnor+ Forarnen(-ina) interventriculare - nutricium 167,174-175,197 - ovale(Cor) 20 - - ( O ss p h e n o i d a l e3 )6 , 4 3 , 4 5 , 5 9 , 61,266,267,272, 272, 390-392, 394 - palatinaminora 52,98 - palatinummajus 36,44-45, 5 2 - 5 3 ,9 8 , 1 0 7 - parietale37-38, 41,64 - rotundum43, 58,60-61,266,267, ?72,272,392 - singulare 394 - sphenopalatinum36, 55, 58 - spinosum 36, 43, 45, 59, 61,266, 267,272,392 - stylomastoideurn45,63, 106, 136,138,273, 273, 277,389,398, 400 - supraorbitale33,48, 51,357 - transversarium 36 - zygomaticofaciale36, 56-57, 59, 357 - zygomaticoorbitale 56, 58,360 - zygomaticotemporale 56 Forceps - m a j o r3 2 0 , 3 2 9 , 3 3 1 - minor 320,329,332 Forearm+ Antebrachium Formatioreticularis292 350,353, s97 Fornix 276,284-255, 294, 298, 302, 310,313-315,318,318,319,319, 323,325-327,329-333,335-336, 339-340
,
Index
Fornix - conjunctivae inferior 356,359, 3 6 1 ,3 8 0 - - s u p e r i o r3 5 9 , 3 6 1 , 3 8 0 saccilacrimalis361 Fossa(-ae) - axillaris + Axilla - canina 51 - cerebellaris61,65 - cerebralis65 - condylaris 65 - coronoidea169,177 - craniianterior42 - - m e d i a4 2 , 2 7 2 , 2 7 7 , 3 8 7 - - p o s t e r i o 4r 2 , 2 7 4 , 2 7 7 , 3 8 7 - cubitalis4 - digastrica66-67 - glandulaelacrimalis50-51,357 - hypophysialis 42-43, 47, 54, 61, 68,90,93,268 - incisiva44,90 - incudis 388-389 - infraclavicularis 186,229 - infraspinata 168 - infratemporalis59,364 - interpedunculais 287,291,297, 302,323,334 - jugularis 45, 63, 144,387 - lateraliscercbri 288-289,291, 3 1 1 3, 2 4 , 3 3 8 - mandibularis36, 45,47,62-63, 69-71,73,137,390 - olecrani 169,177 - poplitea 5 - pterygoidea41,60,90 - pterygopalatina58, 59, 360 - radialis 169 - rhomboidea298, 299, 302, 342 - saccilacrimalis 59, 357,360 - scaphoidea36,60 - subarcuata43,63 - subscapularis168 - supraclavicularisminor 30-31, 141,145 - supraspinata 168 - supratonsillaris 108 - triangularis 382 Fossula(-ae) - fenestrae cochleae384,388-389, 393 - - vestibuli 389 - petrosa45,63 - tonsillares(Tonsillapalatina) 108, 136 Foveafae) - articularis 175 - centralis366,371 - costalisprocessustransversi 349 - - superior349 - inferior 299 - oblonga 124 - pterygoidea66,71 - sublingualis 67 - submandibularis 66-67 - superior299 - triangularis 124 - trochlearis50,357 Foveola(-ae) 371-372 - granulares 39 - suprameatica62 Frenulum - Iinguae 109;111.;117 - veli medullarissuperioris 298-299,305,334 Frons 32 Frontalbone+ 0s hontale Frontalplane 1, 1 Functionalcorticalareasaccording to FoERSTER 293 Fundus - meatusacusticiinterni 273,394, 394 - oculi 371 Funiculus - anterior 350
Funiculus lateralis(Medullaoblongata)299 - - (Medullaspinalis)350 p o s t e r i o 3r 2 6 , 3 5 0
Glandula(ae) Gyrus(i) - occipitotemporalislateralis parathyroidea inferior 15,131, 282 1 3 4 - 1 3 61,3 8 1, 4 0 2 8 9 , 2 9 13, 2 5 - 3 2 7 , 3 3 4 - - medialis289,291,312,325-327 s u p e r i o r1 5 ,1 3 1 1, 3 8 - parotidea13,72, 75, 78, 114,ll4, - orbitales287,289,291,324,334, 1 1 5 1, 3 6 ,1 3 8 ,1 4 1 , 1 4 3 , 1 4 7 , 1 5 1 , 365,374 - parahippocampalis 157-159,272,274,276 G 287-289, 291, a c c e s s o r i7a2 , 7 8 ,l l 4 - l l 5 312,318,318,319,325-327, - pharyngeales136,138 ualeaaponeurouca/ 5, / / - /e, 332-334,336-337 - paraterminalis289,294,324,333, 83-84, 122-123,264,27I pinealis 15,276,285,294,297, vein + Vena(-ae)magna G,q.LEN's 298, 299,301 302,314-315,327, 335 - postcentralis286,289-290,293, cerebri 3 3 2 ,3 3 5 ,3 3 9 - 3 4 0 Ganglion(-ia) pituitaria+ Hypophysis 309,326-330,353,353 - cervicalemedium25, 139-140, - precentralis286,289-290,293, salivariaemaiores13,115,120 1 5 4 , 1 5 6t,6 2 sublingualis\3, 87,96, 115-116, 3 2 1 ,3 2 6 , 3 2 8 - 3 3 03,s 5 ,3 5 5 - - s u p e r i u s2 5 , 1 3 9 - 1 4 0 , 1 5 4 , 2 6 7 , - r e c t u s2 9 1 ,3 1 9 3, 2 4 , 3 3 4 - 3 3 5 tl6, 120- 123,272-27 3, 276 276,375 submandibularis13,72, 78, suprarnarginalis 286,289-290, - cervicothoracicum 25, 135, 8 6 - 8 7 ,1 1 5 1, 1 5 ,1 1 6 i,l 6 , 1 2 0 ,1 3 6 , 327-328 1 3 9 -1 4 0 ,1 5 6 1 3 8 ,1 4 1 1, 4 9 ,1 5 1 - 1 5 31, s Z1 5 9 , temporalisinferior 289-291, - ciliare 27O,271,276,374 -375, 272-273,276 324-327 - suprarenalis15 * - medius 289-290,325-327, 3 7 7 , 3 7,73 7 8 - coeliacum25 tarsales358 3 3 1- 3 3 3 - Glsseru+ Ganglion(-ia) - thyroidea15,22, 120,l2O, 121, - - superior289-290,324-327, trigeminale l2l, 131,134,134,135,r35, 330-333 - geniculi 82, 106,273,392,400 - - transversus 1 3 8 - 1 4 11,4 3 ,1 4 6 ,1 5 2 - 1 5 31, 5 8 , anterior 293 - impar 25 161 - inferius(N.glossopharyngeus) - tracheales126,135 82, - vesiculosal4 139,274,399 H - - (N.ya8us)139-140,274 Glaucoma368 - lumbalia 25 Globus Habenula332 - opticum 367,374 - palliduslateralis284,322-323, Hamulus - oticum 82, 272,272,274,274, - laminaespiralis 393 323,325,332,336 - ossishamati 179-181,184,214 276 m e d i a l i s2 8 4 , 3 2 2 - 3 2 3 , 3 2 3 , - pelvica 25 - pterygoideus36, 41,45, 54-55, 3 2 5 ,3 3 2 , 3 3 6 - pterygopalatinum 82, 106,106, Glomus 58-60,68, 73,90,96, 107,119,137, 272,272-273,276 caroticum 274 390 - retinae367,374 - choroideum310,313 Hand,joints + Manus,joints - sacralia25 G n a t h i o n3 2 , 3 4 H e a d3 0 , 3 1 - sensorianervorumspinalium342, - arteries260,261 Go['s tract + FasciculusCi) - parasympatheticganglia 276 3 4 4 - 3 4 63, 4 8 - 3 4 93, 5 3 - 3 5 4 gracilis ----cervicalium34l - regions30,31 Gonion34 ----lumbalium34l - veins 262 GowrRs'bundle+ Tractus ----sacralium341 spinocerebellaris anterior Helix 145,382 - sensoriumnervi spinalis 24 Granulationesarachnoideae264, Hemispherium - spiralecochleae273,396-397, - cerebelli 277,281-282, 285, 287, 278,279,280,306 397 GMYSoN'S ligament250, 251 296, 303-304, 323,327,334-338 - stellatum+ Ganglion(-ia) - (Cerebrum)341 GSA(generalsomato-afferent nuclei) cervicothoracicum 267,300,301 H e p a r1 3 , 2 0 , 2 2 - 2 3 - submandibulare - N trigeminus[Vl 271 82, 87,115,120, HESCHL'S transversegyrus 397 272,272-273,276 GSE(generalsomato€fferentnuclei) Hiatus - superius(N glossopharyngeus) - canalisneM petrosimajoris 266 2 6 7 ,3 0 0 , 3 0 r - N abducens[VI] 271 274 minoris 266 - - (N.vagus) 139,274 - N hypoglossuslxlll 275 - maxillaris 53, 55 - sympathicum - oesophageus274 accessorium154 N. oculomotorius[III] 270 - thoracica25 - N trochiearistI\ 270 - venaecephalicae190 - trigeminale106,106,265, GUYoN's compartment(Canalis Hilum - nucleidentati 305 268- 269,269, 271,271, 272, 277, ulnocarpalis)250,256 - - olivaris inferioris 323 287,376-377,387,391,400 GVA(generalviscero-afferent nuclei) - trunci sympathrci 24, 345-346, 267 Hippocampus 284,310-313,318-319, - N. glossopharyngeus 348 325-326, 330-334,336-337,339 UXI 274 - vestibulare272,397 - N. trigeminus[V] 271 Humerus6, 165,169,fi f -fi 2, - N. vagus [X] 274 G a s t e r1 3 ,1 5 , 2 2 - 2 3 176-177, 188-189,202,208,239 Gastrointestinalsystem,APUDGVE(generalvisceroefferentnuclei) Humoraquosus366,368 system 15 2 6 7 , 3 0 03 , 01 Hydrocephalus - N. facialis[VII] 273 - externus 306 Geniculumnervi facialis399 - N glossopharyngeus - internus 306 Genu [IX] 274 - (Capsula - N. vagus [X] 274 internal 295,319, Hyoid bone+ Oshyoideum 3 2 1- 3 2 2 ,3 2 2 ,3 2 5 ,3 3 1- 3 3 2 Gyrus(-i) pubica Hypogastrium+ Regio(-nes) - (Corpuscallosum) 276,285, 310, - angularis286,289-290, 327,329 Hyponychium 29 - brevesinsulae 290 313-315,318,320-321,330-33t, Hypopharynx 140 - cerebralhemisphere289-291 3 3 5 ,3 4 0 Hypophysis15,258-259,265-266, - cerebri 264 Germanhorizontalplane 32,34 268,268, 270, 281,285, 287,302, - cinguli 288-289,291,309-310, Gingiva98, 98,116-117 3 2 5 ,3 3 5 ,3 3 9 - 3 4 03, 7 3 Glabella 50 3 1 3 ,3 1 9 3 , 2 1 ,3 2 4 - 3 3 33, 3 5 ,3 4 0 Hypothalamus15,285, 294,302, - d e n t a t u s3 1 2 , 3 1 8 - 3 1 9 , 3 2 6 - 3 2 7 Glandula(-ae) 325,332-335,340 - buccales95 - f a s c i o l a r i 3s 0 9 - 3 1 0 , 3 1 8 - 3 1 9 - semi-transparentnuclei 294 - bulbourethralis 14 - frontalis inferior 289-290,293, Hypothenar 164,212,214, 250,256 - labiales95-96 324-326,330-333 - lacrimalis 122-123,271,271-273, - - medius 286,289-290,309, 3 5 9 , 3 5 9 , 3 6 03, 6 0 ,3 6 1 ,3 6 4 - 3 6 5 , 324-326,328,330 I - - superior 286,289-290,309, 3 7 6 - 3 7 83, 8 0 - laryngeales 132 323-326,328-329,335 Ileum 13,22 - linguales 109,120,274 - insulae 323-325 Impressiotnes) - nasafes90,272-273 - lingualis 291,327,333-334 - gyrorum 43,93 - pafatinae72, 96, 107,lO7, - longusinsulae 290 - ligamenticostoclavicularis167 - occipitales329-331,333 - trigeminalis389,391 272-273
'
Index
', i,
Incisura(-ae) - anterior 382 - cartilaginismeatusacustici 382 - ethmoidalis50 - frontalis 50,57,357 - interarytenoidea 131,133,136, 140 - intertraSica 382 - jugularis(Osoccipitale)61 - l a c r i m a l i s5 1 , 3 5 7 - mandibula6 e6,70 - mastoidea37,45,62-63 - nasalis51 - parietalis62-63 - preoccipitalis 289-290 - pterygoidea41,60 - radialis 174,176 - scapulae168,170 - sphenopalatina 53 - supraorbitalis50-51,359 - tentorii 258 - thyroideainferior 124 - - superior 124-127 - trochlearis 174,176-178 - tympanica388 - ulnaris 175 I n c u s 3 8 4 - 3 8 5 , 3 8 53, 8 8 lndex 164,179,252 Indusiumgriseum 309,313,318, 3 2 6 ,3 3 0 - 3 3 1 Infrahyoidmuscles 142 Intundibulurn(Hlpophysis) 268-269, 285,287,296, 339 Inion 40 Insertion,muscle 11 Insula(-ae)282,284,288,310-311, 3 1 3 - 3 1 43,2 2 ,3 2 6 ,3 3 0 - 3 3 2 , 336-337,337,339-340 - pancreaticae15 Internalear 392 Interneurons351-352 Inter?halangealioints + Articulationesinteryhalangeae Intestinuml5 - crassum13 - t e n u e1 3 , 2 3 Intima 10 Intumescentia - cervicalis 341-342 - lumbosacralis341-342 Iridocornealangle 368 Iris 356,366,367,368,368, 369, 369 Isthmus - aortae l8 - faucium 107 - glandulaethyroideae 121,130, 1 3 4 - 1 3 5l,5 Z 1 6 0 , 1 6 3 - gyri cinguli 289, 291,332
I I e j u n u m1 3 , 2 2 lugumCa) - alveolaria(Mandibula)66,97 - - (Maxilla)51,97 - sphenoidale61
L 's anastomosrs 262-263 LA.RBf Iabium - inferius 95, 108-109 - limbi tympanicum 396 - - vestibulare 396 - majuspudendi 14 - minuspudendi 14 - superius95, 108 labrum - acetabuli173 - articulare10 - glenoidale172,190 Labyrinth + labyrinthus
l:,. ,,,1. 'rl' ,ill:
Ligamentum(4) L e n s3 6 5 - 3 6 9 . 3 7 0 . 3 7 3 Labyrinthus - thyrohyoideum laterale 125-127 - cochlearis381.381.397 Leverarmofmuscl1 e1 - - medianum120,125,127,130, - e t h m o i d a l i5 Lien+ Splen s1,55-56 - membranous395,396 1 3 4 .1 4 1 1. 6 0 - 1 6 1 Ligamentum(-a) - transversumatlantis 160 - acromioclaviculare170-172, 190 - membranaceus381. 387. 395-396 - - scapulaeinferius 233 - anulareradii 176-778,207 - osseous393,394 - - - superius170,188-189,193, - - stapediale386 - o s s e u s3 8 1 , 3 9 3 - 3 9 4 - anularia 125-127,134 - v e s t i b u l a r i3s 8 1 . 3 8 1 . 3 9 7 233 - trapezoideum170,172,189-190 - apicisdentis 96, 160 Lacertusmusculi recti lateralis 362 - auriculareanterius 145 ulnocarpalepalmare 181 Lacrimalapparatus 360' 361 - vestibulare125,134 - - posterius145,383 Lacrimalgland+ Glandula(-ae) vocale 124-126,726, 132,134, superius383 lacrimalis - carpi radiatum 181 162 Lacuna(-ae) laterales264,27I -279 Limbus dorsalia 181, carpometacarpalia Lacuslacrimalis 356, 360, 361 -208 anteriorpalpebrae356, 358 207 tamMa 40 - corneae 366 - - palmaria 181,214 lamina(-ae) - posteriorpalpebrae356, 358 - collaterale - affixa 298,310,313-315,326,329 - spiralis 396 - - carpi radiale 182 - albae 305 ---ulnarel82 - anterior (Vaginamusculi recti Limen - - radiale 176-177,202,207-2OB - insulae 290 abdominis)187 - nasi 9l - - ulnare 176-177,202 - arcusvertebrae36,346 - collateralia(Articulatiometa- basilaris396 Lineofaction,muscle 11 - cartilaginiscricoideae 124-126, Linea(-ae) 181,183,219 catpophalangea) - alba 188 - conoideum 170,172,189- l9O 1 3 0 ,1 3 2 ,1 6 0 - axillaris anterior 1 - coracoactomiale - choroidocapillaris367 170-172, - - posterior I - c r i b r o s a4 1 , 4 3 , 5 15, 4 - 5 6 , 9 0 , 2 6 7 1 8 8 -1 9 0 - epiphysialis7,10 - coracoclaviculare170, 172, 189, - - sclerae366,372 - innominata 46 - dextra (Cartilagothyroidea) 193 - medianaanterior I - coracohumerale170-172,190 1 2 4 - 1 2 s , 1 2 8 , 1 3143, 7 - - posterior 1 - costoclaviculare747,167,197 - episcleralis372 - medioclavicularis1 - cricoarytenoideun 125-126 - externa39,47,264,278 - mylohyoidea36,66-68 - cricopharyngeum125-126 - horizontalis36, 45, 49,52-55,98, - nuchalisinferior 3Z 45,65 - cricothyroideumrnedianum 121, 390 - - superior37,45,65 - interna 39,47,264 125,127,130,134,141,160-161 - - suprema 65 - cricotracheale125-126,134 - lateralis(Cartilagotubaeauditivae) - obliqua (Cartilagothlroidea) 124, - cruciformeatlantis 160 390-391 - denttculatum344-345,349 - - (Proc.pterygoideus) 127 36,41,45, - - (Mandibula) 66 - flava 345-346 s 2 , 5 4 , s 8 ,6 0 ,6 8 , 1 1 91, 3 73, e 0 - parasternalis I - glenohumeraleinferius 170 - limitansanterior 366,368 - paravertebralis 1 - - medium 170 - - posterior 366 - scapularis 1 - - superius170 - medialis(Cartilagotubae - sternalis 1 - hyoepiglotticum125, 127,l3O, auditivae)390-391 - ternporalisinferior 35,38,64 - - (Proc.pterygoideus) 160-161 36,41,45, - - superior35,38,64 - iliolumbale 346 52,54-55, 60, 68,96, 119,390 - hapezoida 167 - incudisposterius386,388 - medullarislateralis(Nucleus - - superius386,388 Linesoforientation,human body I lentiformis) 323, 325, 332 - intercarpaleinterosseum 182 - - medialis(Nucleuslentiformis) Lingua 72, 87,94, lO9, ll8, l2O-121, - intercarpaliadorsalia 181 122-123.136,340 323,325,332 - interclaviculare747,160,167 - membranacea391 Lingula - laterale(Articulatiotemporo- modioli 393-394 cerebelli 294,302-305 - mandibulae 66-68 - orbitalis 35, 56-59,352 360 mandibularis)68,78-79, 86, ll9, - parietalis(Pericardiumserosum) sphenoidalis 43,60-61,392 t37 - longitudinaleanterius 156,160, Liquorcerebrospinalis306 349 - perpendicularis Lobulus(-i) (Osethmoidale) 348-349 - auriculae 382 - - posterius160,345,348-349 41,51,68,90 - biventer303-304 - mallei anterius 386 - - (Ospalatinum)53-52 59 - centralis 294,302-304 - - laterale386-387 - pretrachealis96, 134-135,141, - gracilis 303 - - superius384,386-388 145-146,160 - paracentralis289 - manus 181 - prevertebralis135, 146,160 - parietalisinferior 286, 289-290, - metacarpaletransversum - protunda(Fasciatemporalis) 78, 327,329 profundum 181 78,88 - - superior 286,289-290,327 ---superficiale244 - sinistra (Cartilagothyroidea) 124, - quadrangularisanterior 303 - metacarpaliadorsalia 181 126-128,131- 132,134,137 - - posterior 303 - - interossea 182 - spiralisossea393-394,396 - semilunarisinferior 303-304 - - palmaria 181,250 - - secundaria393-394 - - superior303-304 - nuchae 159 - superficialis(Fasciacervicalis)75, - simplex 303 7 7- 7 8 , 8 5 ,1 1 4 - r 1 51, 3 5 ,1 4 5 - 1 4 6 , - ossiculorumauditus 386 - p a l m a r i a1 8 1 , 1 8 3 Lobus(-i) 1 6 0 -1 6 1 - palpebralelaterale 359 - - (Fascia anterior (Hypophysis)+ temporalis)78,78,85 - - mediale75,78,357,359,361 - tecti 302,305 Adenohypophysis - pectinatum 368 - terminalis 276,285, 294,302, 318, cerebellianterior 302-303 - posterior 302-303 - pisohamatum 181 325,332-335 - tragi 145,382 cerebri 288 pisometacarpale181 - dexter (Glandulathyroidea) - pterygospinale68,68,119 - vasculosa367,367 138 120-121,134-135, quadratum 177 Iaryngopharynx 140 - flocculonodularis287,302-303 - radiocarpaledorsale181 Inryngoscopy 133 - frontalis 288,290,308, 365 -, - palmare 181,215,218 larynx 13,lll, 120-121,125-128, - inferior pulmonis 13 - sphenomandibulare 36, 68,68,73, 130-132.134.140 - insularis+ Insula - innervation 274 8 8 .9 6 . 1 3 8 - limbicus 288 - sternoclaviculare - m u s c l e s1 2 9 , 1 3 1 anterius 167 - mediuspulmonisdextri 13 - sternocostaleradiatum 167 Lateralventricle+ Ventriculus - occipitalis 290, 308, 318 - stylohyoideum36,96, 111,113, lateralis - parietalis290,308,323 1 1 9 r, 3 7 - 1 3 81, 4 3 ,1 4 5 lateralis 1 - posterior(Hypophysis)+ - stylomandibulare68, 96, 119, Lemniscus - lateralis353.397.397 Neurohypophysis 136 - pyramidalis120,134 - thyroepiglotticum125,130,160 - medialis297,353
, ,rl
Index
Lobus(i) sinister(Glandulathyroidea)121, 1 3 4 - 1 3 51, 3 8 ,1 4 3 ,1 4 6 - superiorpulmonis 13 - temporalis282,290,308,323, 3 6 5 ,3 8 7 Locuscaeruleus299 Longbone,strucrure 7 Longitudinalaxis 1 Lowerjaw + Mandibula Lowerlimb - ossification 8 - ossificationcentres I Lunula 29 LuscHr,c.'s foramen+ Apertura lateralis Lymphatc tracts,ventral view 2l Lymphaticvessels - arm 225 - axilla 225
M Macula - cribrosamedia 393 - - superior 393 - flava 130 - lutea 366 MAGENDTUS' foramen+ Apertura mediana Malleus 385,385, 388,400 Mandibula6, 33, 35, 47-49, 66-67, 87,96,97 -98, 109,110-I 11,113, 1 1 81, 3 8 1 , 43,145,160 - panoramicradiograph 102 Manubrium - mallei 385-382 387,388 - sterni 155,160,167 Manus 2-3, 165,179,181,183-184, 212-222, 243-249, 252,256 - arteries 243,247 - bones 180 - compartments250 - joints 181 - - axes 209 - - distal 166 - - proximal 166,182 - ligaments 181 - muscles 212, 215,217-218,220 - muscularorigins and insertions 222 - nerves 247 - radiograph(ap) 9, 184 - synovialsheathsof tendons 213 - - do5al 219 Margo - anterior(Radius)175,178 - - (Ulna) 178 - ciliaris 369 - frontalis (Osparietale) 64 - - (Ossphenoidale)61 - gingivalis 99 - inferolateralis 289,324 - inferomedialis289,324 - infraorbitalis(Maxilla) 51 - - (Orbita)33,56,357,364 - insularis + Insula - interosseus (Radius)175,178 - - (Ulna) 174,178 - lacrimalis51,53 - l a m b d o i d e u3s8 , 6 1 , 6 5 - lateralis(Humerus)169 - - (Orbita)357,360,364 - - (Osfrontale) 51 - - (Scapula)168,173 - - (Unguis) 29 - liber (Unguis) 29 - linguae 108 - mastoideus61,65 - medialis(Humerus) 169 - - (Orbita)357,364 - - (Scapula)168,189 - occipitalis(Osparietale) 64 - - (Ostemporalel 62-63 - occultus(Unguis) 29
Md.rgo Mesopharynx140 - parietalis(Osfrontale)50 Mesotendineum 11,214,252 - - (Ossphenoidale) 60-61 + Osfsa)metacarpale/ Metacarpalia - - (Ostemporalel62-63 metacarpi posterior(Radius)175,178 joints + Metacarpophalangeal - - (Ulna) 174,178 Articulatiotnes)meta- pupillaris 368-369 carpophalangeae - sagittalis64 joint of the Metacarpophalangeal - sphenoidalis62-63 thumb + Articulatio(-nes) - squamosus (Osparietale)64 metacarpophalangea pollicis - - (Ossphenoidale) 60-61 Metacarpus165 - superior(Cerebruml 289, 324 - crosssection256 - - partispetrosae42-43, 63 Metaphysis 7 - - (Scapula)168 - distalis(Humerus)7 - supraorbitalis - proximalis(Humerus)7 (Orbita)357,364 - - (os fronrale)33,46, 50-51 Metathalamus296,298 - zygomaticus60 Metencephalon285,288 Masticatory muscles71, 75, 78, 119 Modioluscochleae394 - hontal section72,73 Monosynapticreflex 351 - horizontalsection 72 MoNRoE's foramen+ Foramen(-ina) Matrix unguis 29 interventriculare Maxilla 33, 36, 45,47-49, 51,52-53, MoRGAGNI's ventricle+ 5 3 ,5 4 - 5 5 ,5 7- 5 9 ,7 2 ,8 9 - 9 1 ,9 3 , Ventriculusti) laryngis 9 7 , 9 8 ,t O 5 ,1 0 8 ,1 1 8 1 , 6 0 - 1 6 13,5 7 , Motoneuron90,351 3 5 9 - 3 6 13, 6 4 ,3 8 0 Motor end path 355 - panoramicradiograph 102 Motor end plate 351 Maxillary sinus 52, 122 MP (metacarpophalanSeal ioint) Meatus 183 - acusticusexternus 36,45-47, MRT (magneticresonance 62- 63, 70, 102, 137,381,38r, tomography) - Antebrachium 254 3 8 3 - 3 8 43, 8 4 ,3 8 7 3 , 8 7 ,3 8 8 - 3 8 9 - - - cartilagineus79,86,88, 384 - Brachium253 - - i n t e r n u s4 1 , 2 6 7 , 2 7 3 , 2 7 4 , 3 8 1 , - Encephalon339-340 394,394 Musclespindles351 - nasiinferior 46, 55, 57,72, 90, 93, Muscles - Antebrachium 203, 209-210, 361 - - m e d i u s4 6 , 5 5 211 - - s u p e r i o r4 6 , 5 5 , 7 2 , 3 8 0 - bicipital 11,11 - nasopharyngeus160 - bipennate11,11 - biventer 11 medialis 1 - Brachium 196 Mediansagittalplane I - caput ll Medulla - oblonSata24-25,265-266,267, - digastric 1l - eyelid 74 275, 281,285, 287- 288,296, - facial 74,76,76 298-299,308,321,326,335, - fascia 11 341-342,353 - ossiumflaYa 7 - flat 11,l1 - - rubra 7 - Insertio 11 - spinalis 24, 162-163,267, 276, - larynx 129,131 - leverarm 11 282,287- 288,299,302,323, - l i n e o f a c t i o n1 1 340- 341,347-342, 344, 346,347, - multi-headed11,11 350-351,352 - - afferenttracts 354 - origin ll - - cellularorganisation 352 - parallelfibres l1 - - efferenttracts 355 - prevertebral 144, 145 - - long tracts 353, 354-355 - rotationalaxis11 - single-headed1l Mnnou'sglands+ Glandula(-ae) - strap 11 tarsales - with tendinousintersections Membrana - atlantooccipitalis anterior 96, 144, 1l - Tendo 11 160 - fibrosa(Capsulaarticularis) 10, - of the tongue+ Musculusfi) 176 linguae - intercostalis - types ll externa 159 ' interosseaantebrachii 178,202, - unipennate11 - u p p e rl i m b 1 8 8 - 2 2 2 207-208, 210,215,242,249,251, - - innervation222 - quadrangularis 134 venter 11 - reticularis396 Muscularorigins and insertions - stapedialis386,399 - hand 222 - sterni 226 - upperlimb 197,210 - synovialis(Capsula articularis)l0 Muscularsystem,ventral and dorsal - tectoria(Ductuscochlearis)396 view 12 - thyrohyoidea 96, 110-111, 120-121, Musculus(-i) - abdominis322 125- 127,134, 137,l4l, 143 - tympanica381,381,384,384, - abductordigiti minimi (Manus) 3 8 6 - 3 8 23 8 7 , 3 8 8 202,213,2r4, 215,217- 218,222, - - secundaria387 222,246,256,257,343 - hallucis 343 Membrum - i n f e r i u s2 - 3 , 6 - - p o l f i c i s b r e v i2s 0 2 , 2 1 3 , 2 1 5 , - s u p e r i u s2 - 3 , 6 , 1 6 5 , 22,222, 2 1 6 ,2 1 7- 2 1 8 2 Meninges264,387 245-247,343 - spinales344 - - - longus 186-182198-200, Mesencephalon277,285, 288, 202, 204,207,210,212,217, 296-297,298,298,374 222, 239,242,247,249,2s1, mesial 98-99 254-256,257, 343
Musculus(i) adductorbrevis 343 - - longus 343 - - magnus 343 - pollicis 187,213,216,217-218, 222,222, 245- 247,249,256, 257,343 - anconeus186-187,195,796,197, 204-207,210,222,236-237,242, 257 - antebrachii322 - antitragicus383 - articulariscubiti 197,210 - arytenoideus obliquus 127-128, 129,131-132, 134,140 - - transYersus127-128,129,13O, 132,140,160-161 - auricularis(-es)273, 383 - - anterror 74,77 - - posteflor74,77,85 - - superior74,77,145 - biceps [1 - - brachii 164,170-t73,176-178, 1 8 6 - 1 9 01, 9 2 - 1 9 5 , 1 9 6 , 197-202, 204,208,210,222, 226,233- 237,239- 241,253, 257,t43 - - femoris 343 - bipennatus 11 - biventer 11 - brachialis ll, 177,186-187, 192-195,196,197-202, 204-205, 210,222, 235-237,239-241,253, 257,343 - brachli 322 - brachioradialis164,172 186- 187,192-t9 5, 197-202, 204- 206, 208, 209, 210,215, 222,222, 235-237;239- 242, 254-255,257,343 - buccinator72, 75,76,78-79, 84-88,95-96, 107,114,122,137 - bulbi 322,362-765 - chondroglossus 110-111, 112 - ciliaris 27O,276,366,367,368, 368 - cinguli pectoralis 322 - colli 141,143-144,322 - constrictorpharyngisinferior 79, 111,115,120, 132,134, 137,137, 138-139,141,143, 161-162 - - - m e d i u s1 1 0 - 1 1 1 , 1 1 8 , 1 3 2 , 1 3 7 , 1 3 71 ,3 8 - 1 3 9 , 1 6 1 - - - s u p e r i o r1 0 21 1 0 - 1 1 1 , 1 3 6 , 137-140, 154,161 - coracobrachialis 173,188-189, 193- 194,196,197,222, 226,233, 235,257,343 -- corrugatorsupercrlrr74, 75, 7 8 - 7 9 ,3 5 7 - cricoarytenoideus lateralis t27-128,129,134 - - posterior127-128,129, 131-132,140 - cricothyroideus 120-121,127,127, 128,r29,134,137,141 - deltoideus141,143,149,152-154, 164,173, 186-190,191,192-195, 1 9 72, 2 2 , 2 2 6 - 2 2 72,2 9- 2 3 0 , 2 3 3 - 2 3 7 , 2 5, 73 4 3 - depressoranguli oris 75, 76, 77-79, 114,137 - - l a b i i i n f e r i o r i s7 5 , 7 6 , 7 7 - 7 9 , 95 - - s e p t i n a s i7 4 , 7 5 , 3 5 7 - - s u p e r c i l i7i 4 , 7 5 , 7 7 - 7 9 , 3 5 7 - d i g a s t r i c u 7s 2 , 7 8 - 7 9 , 8 58, 7 - 8 8 , , 1 5 - 1 1 61,1 9 - 1 2 0 , 9 6 ,1 1 3 1 122- 123,136- 141,142, 143- 145, 149-153,157-159,272-273, 400 - digitorum manus 322 - - pedis 322 - dorsi 346 - epicranius74, 75, 77-79, 85, 88, 147,380
Index
Musculus(t) extensor 343 - - carpiradialisbrevis 177, t86- 187,192- 193,t95, 197- 19I, 202,204-207,209,210,220, 222, 236- 237,239,241- 242, 2 4 7 , 2 5 42 5 6 , 2 5 7 , 3 4 3 - - - - longus 177,186-187, 192-195,197-202, 204-207,209, 210,220, 2 2 2 , 2 3 6 - 2 3 7 , 2 4214 2 , 247,254-256,257,343 - - - ufnaris 186,197,204-207, 210, ztt , 220, 222, 222, 242, 2 5 4 - 2 5 6 , 2 5, 374 3 - digiri minimi 186,204-206, 211,211,220,222,242, 255-256,343 - - digitorum 186-187,195,197, 204- 207,210,ztl, 219- 22r, 222, 24t-242,247,250-252, 254-256,257,343 ---brevis343 ---longus343 - - hallucisbrevis 343 ---longus343 - - indicis 206 207,210,211,219, 2 5 4 - 2 5 6 , 2 5, 374 3 pollicisbrevis 186 187,199, 2 0 2 , 2 0 4 - 2 0 72,t 0 , 2 1 2 ,2 2 0 , 222,239,242,247,249, 2 5 4 - 2 5 6 , 2 5, 37 4 3 l o n g u s1 8 6 - 1 8 7 , 2 0 4 , 206- 207,210,?tl, 220,222, 242,247,249,251,254-256, 257,343 faciei 75, 77-79, 322,357 - faucium 322 - fibularis brevis 343 - - longus 343 flexorcarpiradialis 186-187, 197-202, 203, 208,210,214, 217 218,222,222, 239-240, 245- 246,2s0, 254-256, 257,343 - - - ulnaris 186,197-202,203, 204-208, 210,213,215,218, 222,222, 239-241,245-240, 2 4 9 , 2 5 4 - 2 5 5 , 2 5, 374 3 - - diSitiminimi 257,343 - - - - b r e v i s ( M a n u s2)0 2 , 2 1 3 , 2 1 4 , 2 1 5 , 2 1 72 1 8 , 2 2 2 - - digitorum brevis 343 longus 343 - - - protundus29,197,201-202, 203, 210,214 219,222,222, 240 241.250-252,254 256, 2 5 7, 3 4 3 superficialis197-202, 203, 2 1 0 , 2 1 42 1 9 , 2 2 2 , 2 2 2 , 239 240.250-252,25+.256, 2 5 7, 3 4 3 - - hallucisbrevis 343 longus 343 - - p o l l i c i s b r e v i s1 8 3 , 2 0 0 , 2 0 2 , 213,215,216,217- 218,222, 2 2 2 ,2 + 5 - 2 4 62, 5 6 ,2 5 7 ,3 4 3 l o n g u s1 8 3 , 1 8 7 , 1 9280 2 , 203,210,214-215,217,222, 222, 23e-240.246,254 256, 2 5 7, 3 4 3 - flexoresantebrachii177,200,ZOl, 235,240-241 digitorum(Manus)246,256 - tusiformis ll - gastrocnemius 343 - genioglossus 73, 96, 109-111,ll2, 1 1 31, 1 s l 1 6 ,1 1 8 - 1 2 31,6 0 1 6 1 , 275 g e n i o h y o i d e7u3s , 9 6 ,1 0 9 1 l l , 1 1 3 , 1 1 5 -1 1 6 1, 1 8 - 1 2 3r,4 2 , \ 6 0 - 1 6 1 - gluteusmaximus 343 - - medius 343 - - minimus 343 - gracilis 343 h e l i c i sm a j o r 1 4 5 , 3 8 3 - - minor 145,383
Musculus(i) - hyoglossus87,96, 110-111, ll2, 115-116,118,120-121,137,,141, 151,157-158,275 - iliocostalis cervicis 159 - - thoracis 159 - iliopsoas343 - infrahyoidei 79, 135,142,257 - infraspinatus171,173,188-190, l9l, 195, 197,222, 233,257,343 - intercostales externi 141,159,188, 349 - - i n t e r n i 1 5 9 ,1 8 8 , 3 4 9 intercostaliscervicis 144 - interossei dorsales(Manus) 187, 215,217,2t9-220, 221,222,222, 246-247,249 2 ,5 1 ,2 5 6 , 2 5 7, 3 4 3 - - palmares215,217-219,221, 221,222,222, 246,251,256, 2 5 7, 3 4 3 - intersectus11 - intertransversarii 257 - - anteriorescerYicis 144 - lateraleslumborum 346 - - pbsteriorescervicis 144 - laryngis 127-129,322 - latissimusdorsi 164,187-189, r 9 r , 1 9 2 ,1 9 72, 2 2 ,2 2 6 ,2 2 8- 2 2 9 , 233,257 - l e v a t o r a n g uol ir i s 7 5 , 7 6 , 7 8 - 7 9 , 95, 137,3s7 - - l a b i i s u p e r i o r i 7s 5 , 7 6 , 7 7 - 7 9 , 8 5 , 9 5 ,1 3 7 , 3 5 7 .- - - alaequenasr75,76, 77-79, 137,357 - palpebrae superioris122-123, 265,270,359,362,362, 3 6 4 - 3 6 53, 7 3 ,3 7 6 r 3 8 0 - - scapulae 79,141,143-144, 147- t48, 150,153,159, 162-163,187-189,197,230,257 - - v e l i p a l a t i n i7 2 , 9 6 , 1 1 2 , 1 1 9 , 1 3 6 -1 3 8 2 , 7 4 , 3 9 03, 9 0 , 3 9 1 - linguae 110-112,322 longissimus capitis 119,144,159 - - cervicis 159 longitudinalis inferior 109-111, t12 - - superior 109,112 - longuscapitis 72, 96, ll9,141, 144,144,156,188,257 - - colli 135,145,156,162 163, 257 - lumbricales(Manus)202, 2 1 ?- 2 1 3 ,2 1 5- 2 1 72, 1 9 2 , 21, 22r-222, 246,247,250- 251,256, 257 - m a s s e t e7r1 , 7 2 7 3 , 7 5 , 7 87 9 , 8 5 - 8 6 ,8 8 , 1 1 4 -1 1 5 1 , t 9 ,1 2 2 -1 2 3 , 141,143,145,159 - m a s t i c a t o r7i il - 7 2 , 7 5 , 7 8 - 7 9 , 119,322 frontalsection72, 73 - - horizontalsection72 membriinferioris 322 - m e n t a l i s7 5 ,7 6 ,7 7- 7 9 , 9 5 , 1 3 7 , 143 multifiduscervicis i62 - myfohyoideus 72-73, 87,96, 109, i l 3 , 1 1 5 -1 1 6 1, 1 8 -1 2 0 ,1 2 2 -1 2 3 , 137,141,142,143,t45, ls1 1s3, 157-158,160-161,272 - n a s a l i s7 4 , 7 5 , 7 7 7 9 , 3 5 7 obliquusauriculae383 - - capitissuperior 119 - - e x t e r n u s a b d o m i n1i s8 7 - 1 8 8 , 226,228-229 inferior 27O,359,361-362, 3 6 2 ,3 6 3 - 3 6 4 , 3 7 93-8 0 - s u p e r i o r1 2 2 - 1 2 32, 7 0 ,2 7 1 , 359,362,362,363-365, 376,380 obturatorius externus343 internus 343 occipitofrontalis 74, 75, 77-7 9, 85, 88, 147,357
Musculus(i) - omohyoideus 73,79, 115,120,137, 141,142,143,145,148-150, 152-154,157-159,162-163, 187-189,193,197,229-230,233 - opponens digiti minimi (Manus) 202,213,214,215,217-218,222, 222,256,257 - - pollicis 202,213,215,216, 2 1 7- 2 1 8 ,2 2 2 ,2 2 2 ,2 4 6- 2 4 7 , 2 5 6 , 2 5 7, 3 4 3 - orbicularisocnli 72, 74,75, 77-79, 8 5 ,8 8 ,3 5 7 - 3 5 83, 6 1 ,3 8 0 - - oris75,76,77-79,85,88, 95 96,137,161,357 - orbitalis 362 - palatl 107,322 - p a l a t o g l o s s u1s0 7 - 1 0 81, 1 0 - 1 1 1 , ltz, 118,274 - palatopharyngeus 107-108,138, 140,274 - palmarisbrevis 212,213,222, 2 3 9 ,2 4 4 , 2 5 7 - - longus 186,197-201,203,208, 210,272,222,239-240,250, 254-256,257 - pectineus 343 - pectoralis major 141,143,149, 152-154,157-159,186-190,190, 192,195,197,226-230,233-235, 257 - - minor 141,152-154,188-190, 190,193- 194,197,229-230, 233,257 - pennatus11 - pharyngislll, 118,132,137,322 - piriformis 343 planus ll - popliteus 343 - procerus74,75,77-78, 137,357 - pronatorquadratus198-202,203, 208, 210,215,217,222, 239-240, 246,251,255,257 - teres 172 187,197,199-202, 203,206-208,210,222, 239 247,254,257,343 - pterygoideus lateralis70-71,71, 72 - 73 , 8 6 - 8 7 9 , 6 , 1 1 9 1, 3 8 - - m e d i a l i s7 1 , 7 1 , 7 2 - 7 3 , 8 6 - 8 8 , , 3 6 ,1 3 8 , 9 6 , 1 0 6 ,l l 5 1 1 61, 1 9 1 141 - quadratuslumborum 346 - quadriceps femoris 343 rccti 322 - rectusabdominis188 capitisanterior 119,144,144, 257 - lateralis119,144 ---posteriormajorll9 - - minor 119 - - i n f e r i o r1 2 2 - 1 2 3 , 2 7 O , 3 6 2 362,363-365,373,379 -380 - - f a t e r a l i s1 2 2 - 1 2 3 , 2 7 1 , 2 7 1 360, 362, 362, 363-367, 373, 376-380 - - medialis 122-123,270,362, 3 6 2 , 3 6 3 - 3 6 6 , 3 7 83 8 0 - - s u p e r i o r1 2 2 - 1 2 3 , 2 6 5 , 2 7 O , 3 6 2 ,3 6 2 , 3 6 3 - 3 6 53, 7 3 , 376 380 rhomboideusmajor 189, 197,257 minor 189,197,257 risorius 75,76,77-78, 95, 114 - salpingopharyngeus 138,140 - sartorius343 - scalenusanterior 79, 135,141, 143,143,144,149- 150,r52, 154, 1 s 6 ,1 5 9 ,1 6 2 -1 6 3 ,r 8 7 -1 8 8 , 229-230 - - m e d i u s7 9 , 1 3 5 , 1 4 1 , 1 4 3 , 1 4 3 , 144,150,156,159,162. 163 1 8 7 -1 8 8 ,2 3 0 , 2 5 7 - - p o s t e r i o 7r 9 , 1 4 3 , 1 4 3 , 1 4 4 , 1 5 0 , 156,163,187-188 - semirnembranosus 343 - semipennatus1l
MLtsculus(i) -, semispinaliscapitis 77,79, 119, ' 143,159,162 - semitendinosus 343 - serratusanterior 141,159, -t89, 197,226,228 230,257 187 - - posteriorsuperior 159 - soleus343 - sphincterpupillae 270, 276,366, 368 - spinalis 162 - spleniuscapitis77,79,119, 143-t44,148-150,153,159,t62 - - cervicis 141,159,162,187,230 - stapedius106,273,386,388,399 -- sternocleidomasaoidelJs 75, 77-7 9, , 1 9 1, 3 5 ,1 4 1 1, 4 1 , 8 5 ,9 6 ,1 1 4 1 143-145,147-153,157-158, 162-163,187-188,t97,226, 229-230,275 - sternohyoideus 73, 79, 111,115, 1 2 0 ,1 3 5 ,1 3 7 , 1 4 1r 4, 2 , t 4 3 , 1 4 5 , 149,154,158-159,162- 163,187, 197,229-230 - sternothyroideus79, 120, 134-135,141,142,149,1.54, 159-160,162-163,r88, 229 - styloglossus 79, 87,96, ll0-111, 1 1 2 ,1 1 5 1 , 1 8 - 1 2 11,3 7 - 1 3 81, 4 5 , 275 - stylohyoideus79, 85, 87-88, 96, 1131 , 1 5 1, 1 9 - 1 2 01,3 7 - 1 3 81, 4 1 , 742,143,145,151-152,157,159, 273,400 - stylopharyngeus 119, 96, 110-111, 137-138,r38, 139,143,274 - subclavius141,159,188-190,190, 197,227,230,257 - subscapularis 770-171,173, 188-190,190,193-194,197,222, 2 3 3 ,2 5 7, 3 4 3 - supinator 177,197,199-202, 206-208, 210,zrl, 222, 239-242, 257,343 - suprahyoidei79, ll3, 142 - supraspinatus163,170-172, 188-190,tgt, 192-193,197,222, 2 3 3 ,2 5 7, 3 4 3 - temporalis71,72-73,79, 85-88, 1'19,122 - temporoparietalis74, 75, 77-7 8, 85 - tensorfasciaelatae 343 - - t y m p a n i1 0 6 , 3 8 4 , 3 8 6 - 3 8 8 , 391,399 - - velipalatin9 i 6,112,119,137, 1 4 0 , 2 7 2 , 3 9 03,9 0 ,3 9 r - t e r e sm a i o r 1 8 6 - 1 8 91, 9 1 , 192- 193,195, 197,222,228,233, 235-237,257,343 - - minor 171,187,189-190,191, 195, 197,222, 237,257,343 - thoracis322 thyroarytenoideus127,l3l, 132 - thyrohyoideus 73, 79, 96, ll0-lll, 115,120,134,137,141,142,143, 158,162 - tibialis anterior 343 - - posterior343 - t r a g i c u s1 4 5 , 3 8 3 - transversus auriculae383 linguae 109,ll2 - - menti 76 trapezius77,79, 85, 119,141,143, 147-148,150,152,157,159, 162-163,186-187,189,192,194, 1 9 7 , 2 2 6 , 2 3 0 , 2, 25 7 5 - tricepsbrachii 164,171-172, 177,186-187,r89- 190,192-195, 196, 197-200, 204-206, 210,222, 2 3 3 ,2 3 5 - 2 3 7 , 2 3 92,4 2 ,2 5 3 ,2 5 7, 343 - urrrlae 107,ll2, 140,274, 390 - verticalislinguae 109 - vesicaeurinariae 322 - vocalis 128,129, 132,134
Index
lllusculus(i) Nervus(i ) cutaneus antebrachii NeNus(i) - zygomaticus - - - m e d i a l i s2 6 , 2 6 , 1 8 6 , major 72,75,76, - mandibularis IV/3) 82, 87,106,tO6, 7 7- 7 8 , 8 5 ,9 5 , 1 1 4 l,L g , 1 3 73, 5 7 -224, 223 231,233_234,238, 266,267,268 269,272,274,277, - - m i n o r7 5 , 7 6 , 7 7 - 7 9 , 1 3 7 , 3 5 7 253,257 2873 , 76-377,373 98 , 3 ,3 9 1 ,4 0 0 Myelencephalon - - - posterior223-224,231-232, 285 massetericus 71, 72, 85-88,272 2 4 8 - maxillaris 236-238,247 lV/21 82, 106,106, - - brachiilateralisinferior 2 6 5 - 2 6 6 , 2 6 72, 6 8 - 2 6 92, 7 2 ,2 7 7 , N 2 2 3 - 2 2 42, 3 2 ,2 3 6 - 2 3 7 2 8 7 , 3 7 6 - 3 7 7 , 3 7490, 0 - - - - superior223-224, - meatusacusticiexterni 86-82 383 Nares 89, 160 232_233,236 medianus26, 26, 177,186,203, Nasalcartilage89 - - - m e d i a l i s2 6 , 2 6 , 1 8 6 , 208,214,216,221-222, 223-224, Nasalcavity 55, 91 2 2 3 - 2 2 42, 2 6 ,2 3 0 _ 2 3 42, 3 8 , 233- 235,239- 24r,244- 245,250, Nasalmuscles 74 257 253-256,257 N a s i o n3 2 , 4 0 - - - p o s t e r i o r1 8 6 , 2 2 3 - 2 2 4 , 2 3 2 , - mentalis 82, 84-86, 88, 106,272 Nasopharynx 140 - musculitensorisveli palatini 112 236-238. Neck 30-31, 157-158,160-162, - - femorislateralis 27,27 - musculocutaneus 26, 26, 186,194, 163 ---posterror27,27 196, 222, 223-224, 230- 231, - fascia 145,146 - digitalesdorsales(N. radialis) - 238, 244, 253- 255, 257 233 - lateralregions 159 - mylohyoideus82, 86-88, 142, 2 2 3 , 2 4 -72 4 8 ,2 5 2 - r e g i o n s3 0 , 3 1 - - - (N.ulnaris) 223 151-154,272 - sensoryinnervation 82 - - palmarescommunes - nasociliaris82, 266,267,270, Nephros+ Ren (N.medianus)223-224,252 2 7 1 ,2 7 6 , 3 7 63- 7 8 ,3 8 0 Nerves - - - - (N.[lnarisl 223-224 - nasopalatinus 91,272 - hand 247 - - - proprii (N medianus) - obturatorius 27 - upperlimb 224 - occipitalismajor 82-83, 85, 223-224,245-247,250,252 Nerws(-i) - - - - (N.ulnaris) 223-224, 147-149,154 - abducens 24,73,265-266, - - minor 26,26,83,85,147-149, LYll 244-245,247 267, 268-271,27t, 276_277, - dorsalisscapulae26,26,257 152,154,257 - ethmoidalisanterior 82,85-86, 281-283, 287,296,301,335,362, - oculomotorius Ull) 24-25, 73, 258, 376-380,387,400 271,378-s79 265-266,267, 268-270,270,271, - accessorius 24,1J9-140,l4l, posterior IXI]I 271,378-379 277, 276, 276,277, 281- 283, 147-r54, 158,258,265_266,267 - facialis , 2 8 7- 2 8 8 ,2 9 6 ,3 0 1 ,3 2 5 ,3 3 5 - 3 3 6 , lVlll 24-25,74,76,82, 270, 275, 276-277,281_282,287, 82,84-88, 106,115,142, 3 6 2 ,3 7 5 - 3 8 04, 0 0 296,299,301,335,342,400 - olfactoriiLll 24,e1-266,267 148- 149,258,265-266, 267, - alveolares superiores106,272 2 6 9- 2 70 , 2 72 - 2 73 , 2 73 , 2 76 , ophthalmicus lV/ ll 82, 106,2h5, - alveolarisinferior 72-73,82, 281-283,287,296,299,301, 267,268-270, 27t, 277, 287, 85-88, 106,116,122-123,272 3 2 3 ,3 3 5 ,3 8 3 ,3 8 7 ,3 8 8 ,3 9 2 376-379,400 - ampullarisanterior 273,395-396 - o p t i c u st l l l 2 4 , 7 2 - 7 3 , 1 0 6 , 1 2 2 , 392,399,399,400 - - lateralis273,395-396 - femoralis 27,27 258- 259,265-266, 267, 268- 270, - - posrerior272,395-996 - fibulariscommunis27 276- 277,281-282, 287,294,296, - analesinferiores 27 - frontalis 266,267,271,376, 319,335,339,360, 362-365,372, - anococcygets27,27 380 372-373, 374, 374, 375-380 - auricularismagnus26, 26,83-94, - genitofemoralis27,27 - palatiniminores118,272 -148, 147 257, 383 glossopharyngeus - palatinusmajor 82, 107,118,272 [lX] 24-25, - - posterior85,87-88,147,152, - pectoralis(€s)26,257 8 2 , 8 2 ,1 0 6 ,1 0 8 ,1 1 2 ,1 1 8 1, 3 1 , 273,383,399 - - lateralis190 136-137,138,138,139,140, - auriculotemporalis72, 82-BB, - - medialis 154,190 258,265-266,267, 270,274, 273,3A3 - petrosusmajor82, 106,265-266, 274,276-277,281-283, 287, - axillaris 26, 26, l9l, 222, 296,299,301,323,335,342, 2 6 7 , 2 7 3?, 9 2 , 3 9 9 - 4 0 0 223- 224, 228,232- 237,257 - - minor 82,106,265-266,267, 399,399,400 - buccalis84-88,272 - gluteusinferior 27,27 274,399 - canalispterygoidei82, 106,399 - - superior 27,27 - profundus82, 106 - cardiacuscervicalisinferior 25 - hypogastricus25 - pharyngeus272 ---medius25,139,154 - hypoglossus - phrenicus26, 26, 152-154,156, lxlll 24,26,79,97, - - - superior25,139,154 rr2, 115-116,118,120-121, 158,162- 163,229,257,349 - caroticotympanicus399 - - accessorius156 139-140,r42, 151- 154,157-158, - caroticusinternus 106,139,271, - pterygoideuslateralis 71,87,272 265- 266,267,270, 275, 275, 378 - - m e d i a l i s7 1 , 2 7 2 , 3 9 1 276-277, 282-283, 287,296, 299, - cervicales 24, 24, 26, 83, 85, - pudendus2Z 27 3 0 1 ,3 3 5 ,3 4 2 - iliohypogastricus27,27 152-153,342 - radialis 26,26, 177,186,196,202, - ciliares 368 - ilioinguinalis2Z 27 208,209,ztt -212, 222, 223- 224, - - breves271,276,378 - infraorbitalis79, 82, 84-88, 106, 230-242,247-249, 253-255,257 - - longi 271,378 - rectalesinferiores+ Nervusci) r22- 123,272, 360- 362, 380 - coccygeus24, 27, 342, 344 - infratrochlearis 85-88, 271, analesinferiores - cochlearis273, 384,392,395-397 - saccularis273,395-396 378-379 - craniales24, 265,27O,276-277, - intercostalis24,26, 226,228-229, - s a c r a l e s2 4 , 2 7 , 3 4 2 287,300 - spinales 24, 162-163,341-342, 341,345,349 - - n u c l e i3 0 0 , 3 0 1 - intercostobrachialis 26, 154,186, 344-345,346,347,349 - - - general somato-afferent - spinalis 353-355 223,228-231 - intermedius106,265, 287,323 (csA) 301 - splanchnicilumbales25 - - - generalsomato-efferent - interosseusantebrachiianterior (GSE) - - pelvici 25 300,301 - - sacrales25 203,224,240,254 - - - generalviscero-afferent(GVA) - - - p o s t e r i o2 r 42,249,254 splanchnicus major 24-25,349 - ischiadicus2Z 27 300, 301 - minor 25 - - - generalviscercefferent - jugularis 139 - stapedius273 - lacrimalis82,266,267,271-272, (cvE) 300,301 - s u b c l a v i u2 s6,26,257 ---motoric355 - subcostalis27 3 6 0 ,3 7 6 - 3 7 83, 8 0 - - - specialsomatoafferent(SSA) - laryngeusrecurrens25,129,131, - subfingualis82, 120-121 300, 301 135,140,154,tsq,163,274 subscapularis26, 26, l9O-191, - - - specialviscero-afferent(SVA) - - superior 111,115,120-121,129, 222,233,257 300,301 - supraclavicularesintermedii 131-132, 137,139 140,151,153, 26, - - - specialviscerc€fferent(SVE) 275 147-148,223,226,257 - lingualis 72-73, 82, 86-88, 300, 301 - - l a t e r a l e s2 6 , 1 4 7 - 1 4 8 , 2 2 3 , 2 2 6 , - cutaneusantebrachiilateralis 186, 1 0 6 - 1 0 8u, 5 - 1 1 6 ,1 1 8 ,1 2 0 - 1 2 1 , 230-232,257 223-224, 231,234- 238,244, - - m e d i a l e s2 6 , 1 4 7 - 1 4 8 , 2 2 3 , 158,273 - l u m b a l e s2 4 , 2 7 , 3 4 2 , 3 4 4 254-255 226,257
Nervus(-i) supraorbitalis82,84-86, 88, tzz, 2 7 1 , 3 7 63 7 7 , 3 8 0 - s u p r a s c a p u l a r2i s6 , 2 6 , 1 5 4 l,g 8 , 191,222,230,233,257 - supratrochlearis 82, 85-89,27l, 376-377 - temporales profundi 71,86-87, 272 t h o r a c i c2 i 4 ,2 6 - 2 7 .2 2 3 ,2 2 8 - 2 2 9 , 341-342,349 - thoracicuslongus 26,26, 154, 228-230,257 - thoracodorsalis 26,26, 154,191, 2 2 2 ,2 2 8 - 2 2 92, 3 3 ,2 5 7 - tibialis 27 - transversuscolli 26, 26, 147-149, 257 - t r i g e m i n u s 2 4 , 7 3 , 8 2 , 9 2 ,1 0 6 , [Y) 2 5 8 ,2 6 5 ,2 6 9- 2 71 ,2 7r , 2 72 , 276-277,281-283,287,296,299, 301,316,353,376-379,400 - trochlearis 24,73,258, [IVl 265-266, 267,268- 270, 270-271, 276-277, 287,296, 298- 299,301, 335,?62,376-378,380 - tympanicus 82, 106,274,399 - ulnaris 26, 26, 177,2O3,zlt, 213, 2t4, 214-216,22r- 222,223- 224, 230,233-237,239-242, 244-246, 248,250,253-256,257 - utricularis 273,395-396 - utriculoampullaris 273,395 - vagus[X] 24-25,79,86-87,106, 108,135,136-137,139-140,149, 151- 154,158,162- 163,229,258, 2 6 5 - 2 6 6 , 2 6,72 7 0 ,2 7 4 ,2 7 4 , 275-277,281-283,287,296, 299, 3 0 1 ,3 2 3 ,3 3 5 , 3 4 2 , 3 8 33, 9 9 , 3 9 9 , 400 - vestibularis273,392,395-397 - vestibulocochlearis [VIII] 24, 258, 2 6 5- 2 6 6 ,2 6 7 ,2 6 9- 2 70 , 2 73 , 2 73 , -283, 276-277,281 287,296,299, 3 0 1 ,3 2 3 ,3 3 5 , 3 4 2 ,3 9 2 , 3 9 2 , 3 9 5 , 396,396,397,397,400 - zygomaticus82, 85,271-272, 360, 379-380 Neurofibrae - associationis320 - commissurales 320 - projectionis 321 Neurohypophysis268, 294 Neurons - afferent 352 - efferent 352 Nodulus(-i) - (Cerebellum)302-305 - lymphoideipharyngeales'136 Nodusfi) - lymphoideus(-i) abdominis parietales21 viscerales21 - - a x i l l a r e s2 1 , 2 2 5 , 2 3 0 ---centrales230 ---laterales230 ---superficiales226 - - buccinatorius150 - - cervicales anteriores21, 160, 230 ----protundi230 ----superficiales230 - - - l a t e r a l e s2 1 , 2 3 0 '---protundi230 - inferiores150,163 - superiores150,162 - - - - s u p e r f i c i a l e1s4 8 , 1 5 0 , 2 3 0 - - cubitales225 - - deltopectorales230 - faciales150 - - inguinales2l - - intercostales 230 - - jugulodigastricus 150 - - juSuloomohyoideus 150 - - mastoidei150 - - occipitales150
Index
Nodus( i) lymphoideusti) - - parotideisuperficiales150 - - pectorales230 pelvisparietales21 viscerales21 - - submandibulares 72, 115, 150 - - submentales150 - - subscapulares 230 Nucleus(-i) - accessorius nervi oculomotori 2 7 0 , 2 7 6 , 2 9 73,0 0 - 3 0 1 - ambiguus274-275,300-301 - anterior(€s)hypothalami294 - - thalami 295,323 - arcuati 294 - basales323 - c a u d a t u s2 9 5 ,2 9 8 ,3 1 0 - 3 1 1 , 313-315,322-323, 323, 324- 327, 329-333,335-337,339 - centralis(Medullaspinalis)353, 353 - centromedianus 295 - cerebelli305 - cochleares273,301 - cochlearis anterior 397,397 - - posterior300,397,397 - corporisgeniculatilateralis 295 ---medialis295 - - mamillaris294 - - trapezoidei 392 397 - c u n e a t u s3 5 3 , 3 5 3 , 3 9 7 - d e n t a t u s3 0 5 , 3 2 7 , 3 3 63,5 5 - dorsalisnervi vagi 274, 300-301 - dorsalis(-es)hypothalami 294 - - thalami 295 - dorsomedialis 294 - emboliformis+ Nucleusti) interpositusanterior - fastigii 305 - globosus+ Nucleusfi) interpositusposterior - g r a c i l i s3 5 3 , 3 5 3 - intermediolateralis 351 - interpositus anterior 305 - - posterior305 - interstitialis397 - lemniscilateralis397 - lentiformis 323, 323, 340 - lentis 370 r marginalis(Medullaspinalis)
Nucleus(i) - salivatoriusinlerlor 274,276, 300-30r - - superior272-273,276, 300-301 - sensoriusprincipalisnervi trigemini 300 - solitarius273-274,300-301 - spinalisnervi trigemini 271,274, 300-301 - subthalamicus323,355 - suprachiasmaticus294 - supraopticus294 - teSmentales 294 - thalami 323 - thoracicusposterior351,354, 354 - tuberales 294 - ventralis(€s)295,323 - - anterior 295 - - intermedius295 - - posterolateralis295 - - posteromedialis295 - ventromedialishypothalami 294 - vestibularis(€s) 273,300-301, 397 - - inferior 300,397 - - lateralis300,397 - - medialis300,397,397 - - superior300,397,397
o
Obex 299,342 Occipitalbone 61, 65 Occiput38 Oculus(-i)356 Oesophagus 13,22, 135,137-140, 160,163,349 Olecranon164,174,176- 178, 186-187,192,195,204-206,232, 236,238 Oliva 270, 275, 287,326-327 Operculumfa)290 - frontale 288,290 - parietale288,290 - temporale288 Opisthion40,65 Optic nerve+ Nenus opticus Ora serrata 366-369 oral 98-99 Oral cavity 95-96, lO7-1O8,ll7, Jf,I 122,123 - mediales295 Orbiculusciliaris 366,369 - mediani 295 Orbit + Orbita - - thalami 323 Orbita 57, 93-94, 102,122-123, - mesencephalicus nervi trigemini 3 5 7 ,3 6 0 , 3 7 6 - 3 8 0 - frontal section 380 27r, 297,300-301 - metathalami295 . MRT 373 -- motoriusnervi trigemini 271,297, - vertical section 380 300-301 Organof equilibrium 273 - nervi abducentis300-301,397 Organum(-a) - - a c c e s s o r 2i i 7 5 , 3 0 0 - 3 0 1 - genitaliafemininaexterna 14 - - f a c i a l i s2 7 3 , 3 0 0 - 3 0 1 ---interna14 - - h y p o g l o s s2i 7 5 , 3 0 0 - 3 0 1 - - masculinaexterna 14 - - lacrimalis300 ---interna14 - - o c u l o m o t o r2i i 7 0 , 2 9 7 , 3 0 0 - 3 0 1 , - s p i r a l e2 7 3 , 3 9 6 , 3 9 6 - urinaria 14 397 - - trigemini 353 - vestibulocochleare381 - - t r o c h l e a r i 3s 0 0 - 3 0 1 , 3 9 7 Origo,muscle 11 - olivarisinferior 323,397 Oropharynx140 - - superior397 Os(-sa) - parafascicularis - capitarum9, 179-182,184,214, 295 - paraventriculares 294 251,256 - pontinusnervi trigemini - - development8 - carpi 6, 165,180 300-301 - pontis 355 - coccygis6,342 - posteriorhypothalami 294-295 - coxae6 - preoptici294 - - development8 - c r a n i i3 3 , 3 5 , 4 1 , 4 8 proprius (Columnaposterior) 351 cuboideum,developmentI - pulvinares295 - cuneiformeinterrnedium, - reticulares295 developmentI - ruber 276,294,296-297,301,326, - - laterale,developmentI - mediale,development8 333-334,355,355,3497
Os(sa) - digitorum(Manus)6, 165,180 ---developmentS - - ( P e s )6 ---developmentS - ethmoidal3 e 3 ,3 5 , 4 1 , 4 35, f , 54-55,56, 57-59, 68,90, 357, 3 6 0 ,3 8 0 - f r o n t a l e3 3 , 3 5 , 3 9 ,4 3 , 4 5 , 4 7 - 4 9 , 50, 51,51, 54-55,57-58, 91,357, 360,362,364,380 - hamatum9, 179-182,214, 256 - - development8 - hyoideum47,73,79, 87,96, lO2, 1 0 9 - 1 1 1 ,1 31, 1 3 1, 1 41, 1 61, 1 8 , 120-121,125,125, 126,126, 127, r 2 7 , 1 2 8 ,1 3 0 - 1 3 11,3 4 ,1 3 4 , 136-138,r40-141,143,746,151, 1 5 8 ,1 6 0 -1 6 1 - Incae 37 - incisivum 48-49,52 - intgrparietale 37 - l a c r i m a l e3 3 ,3 5 - 3 6 , 4 8 5 , 4-55, 5 7- 5 9 , 3 5 7 , 3 6 0 - lunatum 9, 179-182,184,251 - - developmentI - manus 179-180 - metacarpi 6, 165,179-180, 183- 184,207,247,250-251, 256 - - development8 - metatarsi 6 - - deYelopment8 - nasale33, 35, 38, 41,47-45, 51, 5 4 - 5 5 ,5 7- 5 8 , 7 5 , 7 8 , 8 9 , 9 11, 6 0 , 357,359-360 - naviculare,development8 - occipitale37-39, 43, 45, 48-49, 55, 6r,61, 65, 136,144,160,341, 347,384,400 - palatinum 36, 47,45, 49, 52, 53, 54-55,57- 59,98, 98, 357, 3 6 0 ,3 9 0 - p a r i e t a l e3 3 ,3 5 - 3 9 , 4 3 , 4 5 , 48-49,58, 64, 264 - pisiforme 179-180, 184,202, 215, 2 1 7- 2 1 8 , 2 4 5 , 2 5 0 - - developmentI - s a c r u m6 , 3 4 2 - scaphoideum9, 179-182,222 - - development8 - s e s a m o i d e a ( M a n u1s7)9 - 1 8 1 , 1 8 3 -1 8 4 - sphenoidale33,36,42- 43,45, 48-49,52, 54-55,57-59, 60, 61, 6r, 68,93, 160,268,357,360,362, 3 6 4 - 3 6 53, 9 0 - suturalia37 - tarsi 6 - temporale33, 36-37,4l-43, 45-46,48-49,57-59, 62-63, 68,70-71,77, 139,258,381-382, 3 8 4 ,3 9 0 - 3 9 13, 9 5 ,3 9 8 , 4 0 0 - trapezium9, 179-180,182,184, 214,220,256 - - development8 - trapezoideum 9, 179-182,184, 214,256 - - development8 - triquetrum 9, 179-182,184,256 - - development8 - zySomaticum33, 36, 45, 48-49, 56, 57,59, 68-69,7r -72, 86-88, 94,357,359-360,364,380 joint 10 Osseous Ossiculaauditus 381,381,386, 400 Ossificationcentres - upper and lower limb 8 Ostium - pharyngeumtubaeauditivae 91, 136,140,160 - tympanicumtubaeauditivae 387, 388-389 Ovarium 14-15
i
P granulations+ PACcHroNr's Gmnulationesarachnoideae Painpathway+ protopathic sensibilitl Palate118 - hafi 52,707 - soft 107 Palatinebone+ Ospalatinum Palatum 118 - durum 46-47,52,91,95-96,102, 107,lo7 - molle 4Z 73, 91,95, 102,107,lO7, 1 0 8 ,1 3 6 , 1 6 0 - 1 6 1 - osseum44,98 Pallidum 323 Palma 5,164,244-246 Palmaraponeurosis+ Aponeurosis palmaris palmaris 1 Palpebra(-ae) 356,358-359 - i n f e r i o r3 5 6 , 3 6 0 , 3 7 3 , 3 8 0 - superior356,360,373,380 Pancreas13,22 Panniculusadiposus 77, 159 Papilla(-ae) - conicae 108 - ductusparoddei ll7, ll7 - filiformes 108 - f o l i a t a e1 0 8 , 1 1 0 - 1 1 1 - fungiforrnes 108 - incisiva 107 - lacrimalis 361 - - inferior 356 - - superior 356 - mammaria225,228 - vallatae108,110,118,131,136 Paranasalsinuses 9l-93, 94 Parapharyngealspace140 ganglia,head Parasympathetic 276 part of the Parasympathetic autonomicnervoussystem 25 Paries - caroticus 387 - externus 396 - inferior 93,357,365 - jugllaris 387 - labyrinthicus387,389,389 - lateralis357,360,365 - mastoideus387,389 - medialis357,360,365 - membranaceus (Cavitastympani) 387,388 - - (Trachea)125-128,130,135, 140,160 - posterior(Meatusacusticus externus) 384 - superior 365 - tegmentalis382 387 - tympanicus 396 - vestibularis 396 Parietalbone+ Osoccipitale Parotidgland+ Glandulaparotis Pars - abdorninalisaortae 16, 18,20, 25 - - (Ductusthoracicus)21 - - (M. pectoralismajor) 187,190, 226 - acromialis 173,l9l, 227 - alaris 74 - alveolaris 66 - anterior (Cerebellum)303 - - (Commissuraanterior) 318,320 - - (Dorsumlinguae)107-108,ll0, 118 - - (Lig.collateraleulnare) 176 - - (Lobusquadrangularisanterior) 303 - aryepiglottica 127,129, 134,140 - ascendensaortae 16,18,25, 158, - atlantica 155 - basilaris(Osoccipitale) 65, 145 - buccopharyngea 107,136,137-138
Index
Pars - caecaretinae367 - canalis373 - cartilaginea (Tubaauditiva)391 - cavernosa260,261,266,268,277, 294,392 - centralis(Ventriculuslateralis) 284,306-307,308,310,311, 3 1 3 - 3 1 43, 2 3 ,3 2 5- 3 2 7 ,3 2 9 - 3 3 0 , 3 3 5- 3 3 6 - ceratopharyngea 110-111, 137, 137,138 cerebralis260, 261,266,268-2b9, 277,282,322,373 - cervicalis(A. carotisinterna) 260, 261 - - (Columnayertebralis) 6 - - (Ductusthoracicus)21,230 - - (Medullaspinalis)342,350 - chondropharyngea ll0-111, 118, 137,137, 138 - ciliarisretinae 366,367,369 - clavicularis(M. deltoideus)173, 191,227 - - (M. pectoralismajor) 141, 1 5 2 -1 5 3 ,1 8 6 ,1 9 0 ,1 9 72, 2 6 - 2 2 7 - compacta(Substantianigra) 296-297,323 - costalis(Pleuraparietalis)349 - cricopharyngea137, 138 - cuneiformisvomeris 54 - cupularis384,387 - descendens aortae 16,140,347 - distalis (Adenohypophysis)268 - duralis 342 - flaccida384 - glossopharynSea 107,110-111, 1 3 6 ,1 3 8 - inferior(N.vestibulocochlearis) 273 - infraclavicularis26, 153-154, 190-191,l9 6, 203, 209,2tt -214, 216,22t, 224,228-229,233-234 - i n s u l a r i s2 8 2 , 3 2 4 - intercartilaginea132-133 - intermedia(Adenohypophysis) 268 - intermembranacea 132-133 - intracranialis (A vertebratis)155, 265,283 - - (N.opticus)373 - intralaminaris372 - iridicaretinae367,368-369 - labialis 75,137,161 - lacrimalis 74 - laryngeapharyngis13,140,340 - lateralis(0s occipitale)48-49,61, o5 - libera(Fornix)318,325 - - membriinferioris 6 - - - superioris6, 165 - lumbalis(Columnavertebralis)6 - - (Medullaspinalis)342,350 - marginalis75,357 - motoria(N.trigeminus)258 - mylopharyngea136,137-138 nasalis(Osfrontale)50 - - pharyngis 13,140,340 - nervosa372 - obliqua 127,134,137 - opercularis290 - opticaretinae 366,367,372 - oralispharyngis 13,107-108,140, 340 - orbitalis(Glandulalacrimalis) 359-360,364-365,376-37I - - (Gyrusfrontalisinferior) 290 - - (M orbicularisoculi) 74,75, 7 7- 7 8 , 3 5 7 - - (N opticus)373 - - ( O s f r o n t a l e3) 3 , 4 7 , 5 0 , 5 7 , 3 5 7 , 360 - osseatubaeauditivae391 - palpebralis(Glandulalacrimalis) 359 - - (M orbicularisoculi) 74, 75, 7 7- 7 8 , 3 5 7- 3 5 8
Pars - parasympathica 25 parietalis(Stratumsynoviale)11 - patens(A umbilicalis)18 - petrosa(A. carotisinterna) 260, 261,267 (Ostemporale)43,46,48-49, 62, 258,384,391,395,398, 3 9 8 ,4 0 0 , 4 0 0 - postcommunicalis (A. cerebri anterior)266,269,282,284-285, 324 - - (A cerebriposteriorl266,282, 284 - posterior(Commissura anterior) 3 1 8 ,3 2 0 (Dorsumlinguae)108,110,140 - - (Lig.collaterale ulnare) 176 - postlaminaris372 - precommunicalis (A. cerebri anterior)266,282,322, 324 - - (A.cerebriposterior)266, 282-283,325 - prelaminaris372 - prevertebralis154-155 - profunda ( M .m a s s e t e r7)1 , 7 2 , 7 9 , 119 - pterygopharyngea 136,137-138 - recta 127,134,137 - reticularis296-297 - retrolentiformis 322 - sacralis350 - sensoria(N.trigeminus)258 - sphenoidalis282,284,322 - spinalis(M deltoideus)173,191 - squamosa36, 41,43, 49,57-58, 62-63,382 - sternocostalis 143,l9O,227 - sublentiformis322 - superficialis(Glandula parotidea) ll4 ( M .m a s s e t e r7l 1 , 7 2 , 7 5 , 7 9 , l l s - superior(N vestibulocochlearis) 273 - supraclavicularis26, 141, 149-150,154,158,190-191,224 - supratarsalis356 - sympathica 25 - tarsalis356 - tecta(Fornix)318,325 - tendinea(Stratumsynoviale)11 - tensa 384 - thalamolentiformis322 - thoracicaaortae 16,18,20,25, 274,349 - - (Columnavertebralis)6 - - (Ductusthoracicus)21 - - (Medullaspinalis)342,350 thyroepiglottica131 - thyropharyngea111,134,137,137, 138 - tracheopharyngea137 - transversa (M nasalis)74 - transversaria155-156 - triangularis290 - tuberalis(Adenohypophysis) 268 - t y m p a n i c a4 9 , 6 2 6 3 , 3 8 2 , 3 9 8 Patella 6 - development8 Patellartendonreflex 351 Pedunculusfi) - cerebellaris inferior 276,298-799, 3 5 4 ,3 5 4 - medius 273,276,298-299,304, 3 2 1 ,3 2 3 ,3 2 6 - 3 2 73, 3 5 - 3 3 6 - - superior276,298-299, 3 0 4 - 3 0 5 3, 2 7 , 3 5 4 , 3 5 4 - cerebri 269-270, 276-277,287, 2 9 1 ,2 9 5 - 2 9 93, 0 1 ,3 2 1 ,3 2 3 ,3 3 4 , 339, 374 f l o c c u l i2 9 8 , 3 0 4 P e l v i s2 , 6 - renalis l4 Penis 14 Pericardiumserosum349 Pericranium79
Periodontium 99 Perionyx 29 Periorbita362,364,373,380 Periosteum7, 162,252,345 Peripharyngealspace 140 Permanent teeth 100,101 P e s2 - 3 , 3 1 1 - h i p p o c a m p3i 1 8 , 3 2 23 2 3 , 3 3 4 Petiolusepiglottidis124- 126 Phalanx(-ges) - distalis(+s)(Manus)29, 165, 1 7 9 - 1 8 4 , 1 8 3 - 1 8245, 1 (Manus)+ Osfsa)digitorum (Manus) mediafae)(Manus) 11,165, 179-180,183-184,251 - proximalis(€s)(Manus) 165, 179 180,183-184,250-251 Pharynx 13,47,lO8,125,136, l?8-140, 160,272 - constrictormuscles136,137 - elevatormuscles138 - muscles,innervation274 - sensoryinnervation161 PHruppr-GorrrsAulr triangle 352 Phlebography19 of the sinuses316 Pia - matercranialis264,266,281,306 - - s p i n a l i s3 4 5 - 3 4 6 , 3 5 0 joint) PIP(proximalinterphalangeal 183 Placenta 20 Planesof the humanbody I Planta 5 Plantarreflex 351 plantaris 1 Planum - medianum168 - scapulare168 Platysma72-73, 75, 76, 77,ll4- 115, 122-123,135,137,141,145, 147 148,153,162,226 Pleuraparietalis156,349 Plexus - aorticusabdominalis25 - - thoracicus349 - b a s i l a r i s2 5 o ,2 5 9 ,2 6 3 ,2 6 5 ,2 8 4 , 294 - brachialis26, 26, 79, 141,143, 1 4 8 - 1 5 01, 5 2 - 1 s 41, 5 6 ,1 5 8 ,1 5 9 , 163,\73, 190-191,196,203,209, 2 t t - 2 1 4 , 2 1 6 ,2 2 1 ,2 2 4 ,2 2 8 2 2 9 , 233-234 - - innervationpatterns257 cardiacus25,274 - c a r o t i c u s c o m m u n1i s3 9 - 1 4 0 i n t e r n u s2 6 0 , 2 6 5 - 2 6 6 , 2 6 7 , 276,399 - c a v e r n o s u7s2 , 9 0 - cervicalis26, 26, 82-85, l4l-145, 148,149,153 154,157-158,275 - - innervationpatterns257 ventriculilateralis284, choroideus 2 9 6 ,3 0 6 ,3 1 0 ,3 1 3 3 1 4 ,3 1 7 , 325 327,329-333, 335-337,374 - - - quarti 282-283,287,298, 302,305-303 62 , 3 ,3 3 5 3 3 6 - - t e r t i i 2 7 6 , 2 8 42 8 5 , 2 9 4 , 3 0 2 , 3 0 6 , 3 1 33, 1 5 ,3 1 5 ,3 2 5 - 3 2 6 , 335 - coccygets 27,27 - coeliacus25 - dentalisinferior 88, 106,272 - - superior 106 hypogastricusinferior 25 - - superior25 intraparotideus84, 273 - lumbalis 27,27 lumbosacralis27,27 - lymphaticusaxillaris 225 - mesentericus inferior 25 - superior 25 - oesophageus 25, 274,349 ophthalmicus270 - pharyngeus(N vagus) 112
Plexus pterygoideus81,88, 262 - pulmonalis(N vagus) 274 r e n a l i s2 5 - sacralrs 27,27 thyroideusimpar 135 - tyinpanicus 274,274, 399 vasalisdermalis29 - - epifascialis29 subcutaneus29 - - subdermalis29 - venosuscanalishypoglossi262, 267 - - caroticusinternus 260, 262, 266,267,391 - - f o r a m i n i s o v a l i2s6 2 , 2 6 2 , 2 6 3 , 266,267,391 - - pharyngeus132 - - vertebralisexternusanterior 348 posterior 348 - - - i n t e r n u s1 6 2 , 2 6 7 - - - anterior 345,348-349 - - - - posterior345-346,348 Plicafae) - aryepiglottica 128, 133,136,140 - axillaris anterior 164 - - posterior 164 - ciliares 369 - fimbriata 109,111,ll7,120-121 - glossoepiglottica lateralis 108 - mediana108 - iridis 368-369 - lacrimalis360, 361 - mallearisanterior 384,387-388 - - p o s t e r i o 3r 8 4 , 3 8 8 - nervilaryngeisuperioris136,140 - palatinaetransversae107 - petroclinoidea anterior 258,258, 269,276 - posterior 258,258 pharyngoepiglottica136 136 salpinBopalatina 108,136,140, salpingopharyngea 160 semilunarisconjunctivae356,361 sublingualis117,120 triangularis108 vestibularis128,130,132-134, 160 v o c a l i s1 2 8 ,1 3 0 ,1 3 2 - 1 3 41, 6 0 Pollex 164,179 Polus - anterior(Bulbusoculi) 366 - ( L e n s )3 6 6 ,3 6 8 , 3 7 0 - frontalis 286-288,290-291,309, 3 1 8 ,3 3 1- 3 3 2 - occipitalis286 288,290-291, 3 0 9 ,3 1 8 ,3 3 1- 3 3 2 - posterior(Bulbusoculi) 366 - - ( L e n s )3 6 6 , 3 7 0 - temporalis287-288,290-291, 311,324,338 351 Polysynapticreflex Pons 24-25, 270-274, 277, 284- 285, 2 8 8 , 287 2 9 4 ,2 96 , 2 9 9 ,3 0 1- 3 0 2 , 3 3 6 ,3 4 0 , 3 0 8 ,3 2 1 3, 2 5 - 3 2 6 , 3 3 5 342,347 Porus - acusticusexternus35, 68-69, 137, 3 8 4 ,4 0 0 - internus 41,43,63, 266,392, 400 20 Postnatalcirculation Precuneus289,321,327,329-330 Primaryregion - acoustic293 motor 293 - optic 293 s e n s o r y2 9 3 ProcessusFus) - a l v e o l a r i(sM a x i l l a )3 3 , 5 1 ,5 7 - 5 8 , 72,98 - anterior(Malleus)385-386 - articularisinferior(Vertebra)36 - - superior(vertebra)346,349
Index
Processus(us) - c i l i a r e s3 6 7 , 3 6 8 , 3 6 83, 6 9 - c l i n o i d e u s a n t e r i4o3r , 4 7 , 6 0 - 6 1 , 258,258,266,268 - - medius 61,268 - posterior43,47,60-61,258, 258,266 387-389, 399 cochleariformis - c o n d y l a r i s3 5 ,6 6 - 6 8 , 7 0 , 7 19, 4 , 102 - coracoideus141,168,170-173, 1891 , 93,233 (Mandibula)35, 66, coronoideus 68-70,71,94 ( U l n a )1 7 4 , 1 7 6 - 1 7 8 - ethmoidalis55 - f r o n t a l i s( M a x i i l a )3 3 , 4 8 , 5 1 , 5 3 - 5 4 ,8 9 ,3 5 7 ,3 5 9 - 3 6 1 - - ( O sz y g o m a t i c u m5)6 , 9 4 , 3 5 7 intratugularis(Osoccipitale)41, 61 (Ostemporale)63 - j u g u l a r i s4 3 , 6 1 , 6 5 lateralis(Malleus)385-386,388 - lenticularis385,388 - mastoideus36-37,44-46,62-63, 6 9 , 7 2 ,1 3 6 ,1 4 0 ,1 4 4 , 3 8-13 8 2 , 389,398,400 m u s c u l a r i s1 2 4 ,1 2 6 - I 2 7 - o r b i t a l i s5 3 , 5 8 - 5 9 , 3 5 23 6 0 - p a l a t i n u s3 6 ,4 1 ,4 5 ,4 9 ,5 2 - 5 5 ,5 7 , 9 0 ,9 3 ,9 8 - posterior(Cartilago septinasi) 90 - pterygoideus36, 41,45, 49,52, , 37, 5 4 - 5 5 ,5 8 6 0 ,6 8 , 7 1 ,9 6 ,1 1 9 1 3 6 0 ,3 9 0 pyramidalis45, 52-53,59,7l, 98, 360 - sphenoidalis53 - spinosus36,47,162-163,346 (Osmetacarpi)179 styloideus - - ( O st e m p o r a l e3) 5 3 Z 4 1 , 4 5 , 6 2 - 6 3 ,6 8 6 9 ,7 2 ,7 9 ,8 2 ,9 6 , 1 1 1 1, 3 6 - 1 3 91, 4 4 1 4 5 , 3 8 1- 3 8 2 ,3 8 9 ,3 9 8 - - r a d i i 1 6 4 , 1 7 5 , 1 7188, 0 - 1 8 2 u l n a e 1 6 4 , 1 7 4 , 1 7 8 , 1 8108 2 , 184,186,215 - t e m p o r a l i 3s 6 , 5 6 , 7 1 - transversus36,144,156 uncinatus(Osethmoidale)55-56 - vocalis 124-126,132 z y g o m a t i c u( M s a x i l l a )3 6 ,4 5 , 5 t - 5 2 ,5 8 (os frontale)33, 50-51,352 364 ( O st e m p o r a l e3l 6 , 4 5 , 6 2 - 6 3 , 68 fibres 321 Protection Prominentia canalisfacialis387,389 - - semicircularis lateralis387,389 laryngea124,134,157 - mallearis384 - spiralis 396 - styloidea387 (Cavitastympani) Promontorium 3 8 7 ,3 8 7 ,3 8 8 - 3 8 93, 9 8 3 9 9 Pronatio(Articulatiocubiti, Articulatioradioulnarisdistalis) 208-209 285,288 Prosencephalon Prostata14 sensibility(painpathway) Protopathic 353 Protuberantia - mentalis 35, 47, 66, 113 - occipitalisexterna37,41,45,65, l!9,277 i n t e r n a4 3 , 6 1 ,6 5 proximalis1 Pterion 34 fossa 59 Pterygopalatine P\lmo 22-23 - dexter 13 - sinister 13
Ramus(i) - alveolaressuperioresanteriores 82,106 m e d i i 8 2 ,1 0 6 - - posteriores82,86-87,106 radialis) anterior(A collateralis 240-241 - (A recurrensulnaris) 224,241 (N auricularismagnus)147,383 - ( N . c e r v i c a l i s1)5 2 - 1 5 3 - - (N cutaneusantebrachii medialis)223,231,238 - - (N.sacralis)27 (Sulcuslateralis)290 - (Truncusn. spinalis)345-346, 3 4 8 -3 4 9 (Sulcuslateralis)290 ascendens - auricularis(A auricularis posterior)84 - - anterior (A temPoralis superficialis)84 - - (N. auricularisposterior) 383 space 189,193,195 Ouadrangular - vagus)84, 86-88, 139,274, {J.,1. 3 8 3 ,3 9 e - bronchiales (N vagus)274 R - buccales83-84, 122,273 calcarinus284,374 radialis 1 - cardiacicervicalesinferiores 274 Radiatiofnes) - - superiores274 - acustica 295, 321,322, 397,397 - c o r p o r i s c a l l o s3i2 0 , 3 2 3 3 2 4 , 3 2 8 thoracici(N vagus) 274 - o p t i c a2 9 5 ,3 2 1 , 3 2 2 , 3 3 1 - 3 3 3 , cardiacuscervicalissuperior 135, 1 3 9 -1 4 0 ,1 5 4 374 375 - carpalisdorsalis(A. radialis) 247, - thalami 295 - - anteriores295,322 249 - - centrales295,321,322 (A. ulnaris) 224,239 240, - - posteriores295,322 243,249 - - palmaris(A radialis)224,243, joint Radioulnar - distal + Articulatio radioulnaris 246 - - - (A. ulnarisl 224,243,246 distalis - proximal+ Articulatio chiasmaticus282 - choroideus posterior317 radioulnarisproximalis - clavicularis (A. thoracoacromialis) Radiusti) 6, 9, 165,175, 176-l7 8, 227 180-182,182,184,187,201, - coeliaci(N vagus) 274 204 208,215,220,251 - colli 83, 115,148-149,273 - developmentI communlcans (Lens)370 - - albus 348 Radix(-ces) - cum nervoUlnari 224,245 - anterior(N spinalis)24,299, cum ganglio ciliari 271 345 347,355 - cum nervo glossopharYngeo - clinica 99 - craniales275,283,299 273-274 - - cum nervolacrimali 272 - dentis 99 - inferior(Ansacervicalis)26, 26, cum nervovago 273 - - cum nervozySomatico 271, 1 5 2 , 2 5,72 7 5 - lateralis(N.medianus)26,224 271-272,360 - - (Tractusopticus)374,374 cum plexu tympanico 273 - - cum ramoauricularinervivagi - l i n g u a e1 0 8 ,1 0 8 ,1 0 9 - 1 1 01,1 6 , 274 1 1 8 ,1 3 0 ,1 3 1 ,1 3 6 - - griseus 348 - medialis(N.medianus)26, 224 - (N spinalis)24 (Tractusopticus)374,374 - motoria+ anterior(N.spinalis) u l n a r i s2 2 3 - (N trigeminus)106,269, (Truncusn. communicantes spinalis3 ) 45-346 271-272,287,299 - (Truncussympathicus)25, 154, - parasympathica (Ganglion ciliare) 349 271,276,378 - corporiscallosidorsalis284 (N.oculomotorius) 276 - cricothyroideus - (N trigeminus)106 (A.thyroidea - posterior(N spinalis)24,299, superior) 160 (V thyroideasuPerior)160 3 4 1 , 3 4 2 , 3 4 43 4 6 , 3 5 0 - cutanei(A. circumflexahumeri - sensoria(Ganglion ciliare) 378 - - (N. nasociliaris)276 posterior)232 - anteriores(Nn thoracici)24 ( N t r i g e m i n u s1 ) 06,269, - - pectorales 2 7 2 , 2 8 7 , 2 9 9 , 3 7 8 (N intercostalis) 271 - spinales267,275-276,299,301 157,223,226,229 (Nn thoracici)24,27, laterales superior(Ansacervicalis)26,26, 226,341 149,151 152,154,157 158,257, - - pectorales (N intercostalis) 275 ' - sympathica 223,226,228-229 (Ganglionciliare) 378 - - posteriores (Nn thoracici)223 (N trigeminus)106 - - (V.circumflexahumeri - (Plexuscaroticusinternus)271, posterior)232 276 cutaneuslateralis(N.spinalis)346 Ramusfi) - - medialis(N.spinalis)346 acromialis(A suprascapularis) - deltoideus (A profundabrachii) 233 236-237 154,222 (A. thoracoacromialis) (A thoracoacromialis\149,227 229
Pulpa - coronalis99 - dentis 99 - radicularis99 Pulvinar thalami 295-296, 298- 299, 316,327 Punctum(-a) - l a c r i m a l i a3 5 6 ,3 6 0 , 3 6 1 - nervosum26,148 Pupilla 356, 363, 367-368, 369 Putamen284,322-323,323, 324-326, 330-333,336-337 Pyramidaltract 321,323,355 Pyramis - medullaeoblongatae 270 271, 287,299,321 - vermis 302-304
o
Ramus(i) - dentales(A alveolarissuperior posterior)86 - digastricus 85, 87,142, 400 - dorsalis(N.ulnaris) 223-224, 238-240,242,248,255 - externus(N.accessorius) t39-140,275 - - (N.laryngeussuperior)139 - femoralis 27 - frontalis (A. meningeamedia) 260, 278,284 - - (A. temporalissuperficialis) 72 - 73 , 8 0 ,8 3 - 8 5 ,8 8 ,2 6 0 - - anteromedialis284 - - intermediomedialis284 - - posteromedialis 284,328 - - (V.temporalissuperficialis) 83 - ganglionares(Ganglion pterygopalatinuml272, 272 - - (Ganglionsubmandibulare) 272 - - (Radixsensoria,N. trigeminus) 106 - Sastricianteriores 274 - - posteriores274 - genitalis 27 - glandularisanterior 121 - gyri angularis 279 - hepatici 274 - hypothalamicus282 - inferior(N.oculomotorius) 271, 3 6 2 ,3 7 8 - 3 8 0 - inferiores(N. transversuscolli) 147 - infrahyoideus 149 - interganglionaris 156 - internus(N.accessorius) 139-140, 275 - - (N.laryngeussuperior) 121, r27-12a, 131- 132,139 - - (Truncusnervi accessorii)140 - lateralis(N.spinalis)345,348 - - (N.supraorbitalis)82,84-86, 88, 122,271,376-377 - - nasi 84 - linguales(N. facialis) 273 - - (N.glossopharyngeus) 118,131, 274 - - (N. hypoglossus)275 - - (N.lingualis)272 - mammarii laterales 229 - - - (Nn.thoracici)228 - mandibulae33,46-47,66, 68-70, 1 ,1 31, 3 9 1 , 45 72,79,85,88,96 - marginalismandibularis 83-84, 151,273 - mastoideus (A.occipitalis)80, 154 - medialis(N.spinalis)345,348 - - (N supraorbitalis)82,84-86, 88, 122,271,376-377 - membranaetympani 383 - meningeus(A occipitalis)265 - - (A vertebralis) 265 - - anterior (A ethmoidalis anterior) 265,376,378-379 - - (N.mandibularis)265-266, 267,272,376 - - (N maxillaris\272,376 - - (N.vagus)274 - - (Truncusn. spinalis) 24, 345-346,348-349 - mentalis80,86 - musculares(Plexusbrachialis) 257 - - (Plexuscervicalis) 257 - musculistylopharyngei138,274 - nasalis(-€s) externus(N. ethmoidalis anterior)85-86 - - (GanglionpterySopalatinum)82 - - interni (N ethmoidalisanterior) 82 - - posterioressuperioreslaterales 271 - - - - mediales2Tz - nervi cochlearis396 - - oculomotorii 282
Inde::
Ramus(i) Ramus(t,l occipitalis(€s) (A auricularis tentorit 271,37C, posterior)8C - terminales(A cerebrimedia) 284, - (A occipitahs)80 330 - occipitotemporalis - thyrohyoideus274 284 oesophageales (N laryngeus tonsillarisfes)(A palatina recurrens)13i a s c e n d e n s1)1 8 1 , 31 - - (Parsthoracicaaortae)349 (N glossopharyngeus) 118,131, - orbitales(N. maxillaris) 271 274 - orbitalis (A meningeamedial 267 - tracheales (A thyroideainferior) - palmaris(N medianus)223, 131 - trapezius(Plexuscervicalis)26 238-240,244-245,255 - - ( N . u l n a r i s )2 2 3 - 2 2 4 , 2 3 9 - 2 J 9 , ventrales(Plexuscervicalis)144 - zygomatici72, 83-84, 122,273 244-246 - - protundus243,245-246 - zygomaticofacialis 83-85, 272 - - superficialis224,240,243, - zygomaticotemporalis 83-85,272 245-247 Raphe - paracentralis279, 284 - mylohyoidea113 - parietalis(A meningeamedia) - palati 107 - palpebralis 260,265,278,328 lateralis356,359 - - (A occipitalismedialis)284, - pharyngis 138 - pterygomandibularis 328 96, 107,137 - - (A temporalissuperficialis) 80, Recessus - articularis 10 83-88,260 - - (V.temporalissuperficialis) 83 - axillaris 170,172,189 - parietooccipitalis279, 284 - cochlearis393 - pectorales226-227,229 - ellipticus 393 - perforans(-tes)(A radialis) 249 - epitympanicus384,386-387,387, - - (A thoracicaintenal 157,226 388 - - (V.thoracicainternal157,226 - intundibuli 294,302,302315, - peridentales (A.alveolarissuperior 325,334 posterior) 86 - lateralisventriculiquarti 298, - petrosus265 304,307 - pharyngeales(A. thyroidea - membranae tympanicae superior inferior) 139 387 - - (A. thyroideasuperior) 139 - p h a r y n g e u 9s 1 ,1 3 6 ,1 6 0 , 3 9 1 - - (N. glossopharyngeus) - pinealis 294, 307,315,332 - piriformis 132-133,136,140,162 136-138,139,274 - - (N.vagus)137,139,274 - sacciformis(Articulatio - pharyngeus(N. glossopharyngeus) radioulnarisdistalis)255 - sphericus393 136-137,138-139 - posterior(A. collateralisradialis) - supraopticus294,307,315, 325, 237 334 - - (A recurrensulnaris) 224,241 - suprapinealis294,298,307,315, - - (N.auricularismagnus)147, 331 - triangularis298,315,325 383 - - (N cervicalis)83,85 R e c t u m1 3 , 2 2 - 2 3 - - (N. cutaneusantebrachii Reflexes - abdominalwall 351 medialis)223,231,238 - - (Sulcuslateralis)290,328 - Achillestendon351 - - (Truncusn. spinalis) 24, - cremasteric351 - monosynaptic351 345-346,348-349 - posteriores - patellartendon351 (Nn thoracici)223, - plantar 351 341 - precunealis 279, 284, 328 - polysynaptic351 - - (A.cerebrianterior)327-329 - spinalcord 351 - profundus(A. transversacolti) Regio(-nes) - abdominalis 149,152 lateralis4 - - (N radialis) 202,208,224, - analis 5 239-242,249 antebrachii anterior 4-5, 164, - - (N ulnaris) 211,214,216,224, 238-240 - - p o s t e r i o 4r - 5 , 1 6 4 , 2 3 8 , 2 4 2 245-246 - pubicus(A. epigastricainferior; - axillaris 4-5, 164 - brachiianterior 4, 164,231, A. obturatoria)l8 - radicularisanterior(A spinalis 234-235 , anterior) 349 - - p o s t e r i o5 r ,164,232,236-237 - renales(N. vagus) 274 - buccalis30 - sinuscarotici 274 - calcanea + Calx - spinales(A intercosralis posterior) - capitis 30-31 347,349 cervicalisfes)30-31 - spinalis(A verrebralis)347 - - a n t e r i o r4 , 3 0 - 3 1 , 1 4 7 , 1 4 9 - sternocleidomastoideus - - l a t e r a l i s4 , 3 0 - 3 1 ,1 4 7 - 1 4 9 , (A. occipitalis)80, 153 152-154,159 - - (A. thyroideasuperior) 152 - - posterior5, 3l - stylohyoideus85, 142, 400 - corporis4-5 - superficialis(A transversa - c r u r i sa n t e r i o r4 - 5 colli) - - posterior4-5 1 4 9 ,r 5 2 , 1 5 4 , 2 3 0 - - (N.radialis) 186,223-224, - c u b i t a l ia s n t e r i o r4 , 2 3 1 , 2 4 1 238-242,247-248, 254- 255 p o s t e r i o5 r ,232 - - (N.ulnaris) 213,224,245-246 - d e l t o i d e a4 - 5 , 3 1 ,1 6 4 - superior(es)(N.oculomotorius) epigastrica4 - femorisanterior 4 271,377-378, 380 - - (N transversus - - posterior5 colli) 147 - suprahyoideus149 - frontalis 30-31 - temporales273 - genusanterior 4 - - ( N f a c i a l i s )7 2 , 8 3 - - posterior5
Regio(nes) - glutealis5 hypochondriaca 4 - inframammaria4 - infraorbitalis30-31 infrascapularis5 - inguinalis4 lumbalis 5 - mammana4 - m e n t a l i s3 0 - 3 1 - n a s a l i s3 0 - 3 1 - o c c i p i t a l i s5 , 3 1 - o r a l i s3 0 - 3 1 , 9 5 - orbitalis 30-31 parietalis5, 31 - pectoralis4 - presternalis4 - pubica 4 sacralis5 - scapularis5 - sternocleidomastoidea 4, 30-31 - surae 5 - temporalis30-31 - umbilicalis4 - urogenitalis 4 vertebralis 5 - zygomatica30-31 Regionsofthe humanbody 4 REISSNER's membrane+ Paries vestibularis(Ductuscochlearis) Ren14-15,22-23,341 Respiratory system,medialand ventralview 13 Rete - a c r o m i a l e2 2 6 - 2 2 7 , 2 3 2 - articularecubiti 224,236-237, 242 - carpaledorsale242,247,249 - - palmare251 - venosumdorsalemanus 248,256 Reticulumtrabeculare 366, 368-369 Retina 123,366-367,367 - vessels371 Rctinacula - musculorumextensorum(Manus) 186-187,198,204-207,219-220, 242,247,249,255 - - flexorum(Manus)202, -218,239, 213-215,217 244-246,250-251,256 Retroversio - (Articulatiohumeri) 191 REXED's laminarorganisation351 Rhombencephalon 285,288 - arteries283 Rhornboidfossa 299 Rima g l o t t i d i s1 3 2 - 1 3 4 oris 13 - palpebrarum 3 5 6 ,3 5 8 - 3 5 9 - vestibuli 134 R o dc e l l s 3 6 7, 3 7 4 , 3 7 4 RoLANDo's fissure 290 ROLLER'S nucleus397 RoSENIHAL's vein+ Vena(-ae) basalis R o s t r u m3 1 8 ,3 2 0 ,3 2 4 , 3 3 23, 3 5 ,3 4 0 - (Corpuscallosum)285,294,302, 3 1 3- 3 t 4 - sphenoidale60 Rotatio - externa(Articulatiohumeri) 191 - interna(Articulatiohumeri) 191 R o t a t o r c u f1f 7 1 ,1 8 8
S Sacculus - l a r y n g i s1 3 2 ,1 3 4 v e s t i b u l a r i3s 9 5 - 3 9 6 Saccus - endolymphaticu 3 s8 1 , 3 9 5 l a c r i m a l i s3 5 9 ,3 6 0 ,3 6 t - vestibularis + Sacculus vestibularis Sagittalaxis I
Sagittalplane 1, 1 Salivaryglands+ Gtandula(-ae) salivariae Salpinx+ Tubauterina Scala - t y m p a n i3 8 1 , 3 9 3 - 3 9 6 v e s t i b u l 3i 8 1 , 3 9 3 - 3 9 6 gap 159 Scalene Scapha382 Scapula6, 163,165,168,168, t 72 - 1 7 3 Scapularplane 168 ScHLEMM's canal+ Sinusvenosus sclerae ScHULTzE's bundle+ Fasciculus(-i) interfascicularis ScHwersE's nucleus397 Sclera366-362 367,368,380 Scrotum14 Secondaryregion - acoustic293,293 - motor 293 - optic 293 - sensoric293 Segmenta - cervicalia342-343,344 - coccygea343 - lumbalia 342-343,344 - medullaespinalis 343 - sacralia343 - thoracica342-343,344 Segmentalcutaneousinnervation (=dermatomes), upperlimb 223 Sellaturcica 41-42,61.,91, 268,269 Semicanalis - musculi tensoristympani 389, 391,399 - tubaeauditivae390-391,394,399 Septum - canalismusculotubarii388-389, 391,399 - intermusculare29 - - brachiilaterale186-182192, 195,197,204 206,236,253 - - mediale 177,186,193-194, 198-202,210,234,239,241, ZJJ
- interventriculare 20 - linguae 109,111,120 - nasi 46, 90, 93-94, 102,122-123, 1 3 6 ,1 6 0 - - o s s e u m3 3 , 4 8 , 5 4 , 6 8 - orbitale359,364,380 - pellucidum276,285,294,298, 307,314-315,318,323,325, 329 331,335,339-340 sinuumsphenoidalium268 Shouldergirdle 168 Shoulderjoint + Articulatiohumeri StneprurLt's membrane+ Pars flaccida Sinus c a r o t i c u s2 6 0 , 2 7 4 , 2 7 4 - cavernosus259,259-260, 262-263,263,265,268,268-272, 277,340,373,387 duraematris 259, 263, 265, 316 - ethmoidales380 fronralis41,46 47,54-55, 57,83, 9 0 - 9 2 , 9 41, 2 2 , 3 7 3 - - development93 intercavernosus(-\ 259,259,263, 263,265,268,294 - - anterior 268 - - posterior268 marginalis259,259, 263,267 - maxillaris 46-47,52, 53,57-58, 72,91-941 , 0 2 ,1 0 6 ,1 2 2 , 1 2 2 , 2 7 2 , 3 6 0 - 3 6 13, 6 4 - 3 6 53, 7 3 ,3 8 0 development93 - o c c i p i t a l i s2 5 4 ,2 5 9 ,2 6 3 ,2 6 6 -- paranasales13,91-94 - petrosquamosus 259 - petrosusinferior 259,259,263, 267 s u p e r i o r2 5 9 , 2 5 9 , 2 6 3 , 2 6 5 , 2 7 7
tndex
I Slnus posterior265,389 - rectus 259,259, 262,265,276, 3 0 6 ,3 1 6 - sagittalisinferior 259,259,262, 2 6 5 ,2 8 4 , 3 0 63, 1 6 - 31 7 - - superior 122-123,259,259, 2 6 2 - 2 6 52, 7 6 ,2 7 8 - 2 79 , 2 7 9 , 284,306,3t6-317,340 - sigmoideus139-140,259, 26 2- 2 6 3 ,2 6 5- 2 6 6 ,2 6 7 ,2 77 , 3 1 6 , 387 - sphenoidalis41,47,54-55, 58, 68, 90- 94, 160,268,268,271-27 2, 340,373 - sphenoparietalis 259,259, 262-263,265 - transversus139-140,259,259, 263,265,277,316,400 - tympani 389,399 - valvulae 19 - venosussclerae366-367,367 ,368 Skeletalsystem - bonemarrow,distributtonof haematopoiesis7 - Bonesthat can be touchedthrough the skin 7 Skeletonof the hand 180 Skin 29 - tensionlines 28 Skull 32-38, 40-41, 46-49 Space - quadrangularf89, 193,195 - triangular f89, 193,195 Spatium(-a) - anguliiridocornealis368 - axillarelaterale189,193,195 - Fediale189,193,195 - epidurale160,162,345-346 - intervaginalesubarachnoidale 366,372 - lateropharyngeum140 - oelophagotracheale 130,160 - perichoroideum366 - perilymphaticum381 - re[ooesophageum 135,160 - retropharyngeum160 - subarachnoideum122, 162,264, 2M, 306,307,345-346, 349 - subdurale306,345-346 - zonularia367,368-369 Sphepoidbone+ Ossphenoidale Spinafae) - helicis 382 - mentalis67 - - superior 113 - nasalis 50 - - a n t e r i o r3 3 , 3 5 - 3 6 , 4 6 , 5 1 - 5 3 , 5 5 ,9 0 - - posterior45,52-55 - ossissphenoidalis43,45, 59-60, 68,390 - palatinae52 - scapulae168,170-171,186-189, 233 - suprameatica62 trochlearis50 - tympanicamalor 388 - - minor 388 Spinalcord - + Medullaspinalis - reflexes351 - segments343 Spinalnerves- Nervusfi)spinales Spiralorgan 396 Splen 22 23 Splenium276, 285,291,294,313, 3 1 8 - 3 2 13, 2 7 ,3 3 0- 3 3 1 ,3 3 5 ,3 4 0 , 374 Squama - f r o n t a l i s3 3 , 3 5 , 4 9 - 5 15, 4 ,5 8 , 360 - o c c i p i t a l i s3 8 ,4 1 , 4 8 - 4 96, 5 SSA(specialsomato-afferent nuclei) 2 6 7 , 3 0 03 , 01 N vestibulocochlearis [VIII] 273
S t a p e s3 8 4 3 8 5 ,3 8 5 ,3 8 7 - 3 8 8 , 3 9 5 , 3 9 8 ,4 0 0 STENoN's duct+ Ductustus) parotideus joint + Articulatio Sternoclavicular sternoclavicularis Sternum6, l4l Stratum - basale29 corneum29 - - (strictusensu)29 - fibrosum (Capsulaarticularis) + Membranafibrosa - - (Vaginatendinis) 11,219 - germinatiurm 29 - granulosum(Cerebellum)305 - - ( C u t i s )2 9 - griseumcolliculisuperioris297 - lucidum 29 - moleculare (Cerebellum) 305 - nervosum366,372 - papillare29 - pigmentosum361,366,372 - reticulare29 - spinosum29 - synoviale(Capsulaarticularis) + Membranasynovialis - - (Vaginatendinis)11,219 Striafae) - longitudinalis lateralis309,318, 326 - - m e d i a l i s3 0 9 , 3 1 8 , 3 2 6 - mallearis384 - medullares ventriculiquarti 299, 307 - medullaristhalami 294,298, 325-326 - olfactorialateralis270,287 - t e r m i n a l i s2 9 8 ,3 1 0 , 3 1 3 - 3 1 5 , 325-326,329-330 - vascularis396 Stromairidis 368 Subarachnoid space306 Subcutis29 Subiculumpromontorii389 Subintimal0 Sublingualgland+ clandulatae) sublingualis gland+ Submandibular Glandula(-ae) submandibularis Substantia - a l b a2 6 4 , 3 1 2 , 3 2 7 , 3 5 0 - compacta7 - gelatinosa350-351 - - centralis350 - grisea 264,312,327,350 - - centralis 296-297 - intermediacentralis351 - lentis 370 nigra 269,291,296-297,323,334, 3 5 5 ,3 s 5 .. perforataanterior 287,296 - - posterior282,291,296 - propria 368 - sclerae372 - spongiosa7 Sulcus(-i) - anterolateralis 342,350 - - (Medullaoblongata\ 267,275, 275 - arteriaemeningeae mediae64,266 - - occipitalis63 - - temporalismediae62 - arteriosi39, 41,43, 60,63 - bulbopontinus302 - calcarinus285,288,291,293,310, 3 1 8 ,3 2 1 ,3 2 7 ,3 3 1 3 3 2 , 3 3 5 - 3 3 6 , 339-340,374,374,375 - caroticus43, 60-61,266 - centralis(Cerebrum)285 286, 2 8 8 - 2 9 03, 0 8 - 3 0 93, 2 1 ,3 2 8 - 3 3 0 , 3 3 5 - 3 3 83, 4 0 - i n s u l a e2 9 0 - c e r e b r ahl e m i s p h e r e2s9 0 , 2 9 1 - cinguli 286,288,318,324,329, 335
Sulcus(t) circularisinsulae 324 - collateralis288,291,312,332-334 corporiscallosi 321,324 - frontalisinferior 286 - - superior 286 - hippocampalis288,2el, 312. 3 3 3- 3 3 4 - hypothalamicus285,294,326, 333 - infraorbitalis51,57-59, 357 - intermediusposterior299,350 - intertubercularis169-170,173 - intraparietalis286,289-290 - lacrimalis(Maxilla) 53 - - (Oslacrimale)357 - lateralis288-290,290,308, 323-324,326,328 - limitans 299 - l u n a t u s2 9 0 , 3 3 0 - 3 3 2 - medianuslinguae 108 - - posterior(Medullaoblongata) 299,342,344,350 - - (Ventriculus quartus) 298-299, 307 - musculi subclavii 167 mylohyoideus 36,66-68 - nervipetrosimajoris43,394 ---minoris43 - - radialis 169,195 - - ulnaris 169,177 - occipitotemporalis291 - olfactorius 270, 287,291 - orbitales282 291 - palatini 52 - p a l a t i n um s a j o r5 3 , 9 8 - palpebralisinferior 356 - - superior356 - palpebronasalis356 - parietooccipitalis284-286, 288- 291,318,321,327,329-330, 3 3 5 ,3 4 0 - postcentralis286,290 - posterolateralis 267,299,342, 3 4 4 ,3 5 0 - precentralis286,290 - prechiasmaticus 61,268 - promontorii389 - rcftoolivaris 267,274 - sclerae356 - sinuspetrosiinferioris43,394 - - - superioris41,43 - - sagittalissuperioris 39,43,65 sigmoidei(Osoccipitale)61,65, 266 - - - (Osparietale)64 - - - (0stemporale)41,43,63, 392,394,398,398 - - transversi41,43,61,65 - spiralisexternus396 - - internus 396 - subparietalis327,329-330 - temporalisrnferror 287,290-291 - - superior286,290,327,330-333 - terminalis(Lingua)108,140 - tubaeauditivae 60 - tympanicus389 - vomeris 54 Supercilium 77, 356, 380 Supinatio(Articulatiocubiti) 208-209 Suprahyoid muscles142 Surfaceanatomy female3 - male 3 Surfaceof the body,proiectionof the internalorgans22, 23 Sutura - c o r o n a l i s3 3 ,3 5 ,3 8 - 3 9 , 4 1 , 4 7 - 4 9 , 264 - ethmoidolacrimalis 58 frontalis 48 49, 123 - frontoethmoidalis43 - frontolacrimalis33,35 frontomaxillaris33, 5Z 89 - f r o n t o n a s a l3 i s3 , 5 4 , 8 9 - 9 0 frontozygomatica 33, 35, 94, 123
Sutura - lncisiva 52 - intermaxillaris33 - internasalis 33 - lacrimomaxillaris 35 lambdoidea35,37-39, 41,46-48 - nasomaxillaris33.35.89 - occipitalistransversa37,49 - occipitomastoidea35, 37, 43, 45 - palatinamediana 45, 52, 98 - - transversa45,52-53.90 - palatomaxillaris 98 - parietomastoidea35, 37 - petrosquamosa387 - sagittalis 37-38, 46, 49, 264 - sphenofrontalis 33,35,43, 58 - sphenoparietalis33 - sphenosquamosa 35,43 - sphenozygomatica33, 35, 360 - squamomastoidea35 - squamosa35,37,41 - temporozygomatica35 - vornerornaxillaris90 - zygomaticofrontalis57 - zygomaticomaxillaris 33,35, 5Z 59,123 SVA(specialviscero-afferentnuclei) 267,300,301 - N. facialis[VIII 273 - N. glossopharyngeus UXI 274 - N vagus [X] 274 S\rE(specialvisceroefferentnuclei) 267,300,301 - N. accessoriuslKll 275 - N. facialis MII 273 - N. glossopharyngeus [IX] 274 - N. trigeminus [Vl 271 - N. vagus [X] 274 SYLVTS canal+ Aqueductuscerebri Srurus fissure+ Sulcus(-i)lateralis (Cerebrum) Sympatheticpart - of autonomicnervoussystem 156 - of the autonomicnervoussystem 25 Sympathetictrunk 25, 156 Symphysis - mandibulae48,67 - manubriosternalis167 Synchondrosis - petrooccipitalis 119,136,138,394 - sphenooccipitalis43, 55, 60-61, of,
- sphenopetrosa392,394 - - + Fibrocartilagobasalis Synovialjoint l0 Synovialsheathsoftendon,hand 11, 213
T Tactilepath + epicritic sensibility Taenia - choroidea298,314 - fornicis 314-315.318 - thalami 314-315 Talus,developrnent8 Tapetum 3lO, 320, 327,329-330 Tarsus - inferior 358-359,380 - superior358-359,380 Tectum 335 - mesencephali27l, 285, 291,294, 297,302,333-334,339- 340,374 Tegmen - tympani 387 - ventdculi quarti 304-305 Tegmentummesencephali294, 296-297,302,326,333-335,339 Tela - choroideaventriculi quarti 298 - - - tertii 285,294,302,313-315, 315,317,325- 327,330-331, 335 - subcutanea253-255
Index
Telencephalon 285,288 Temporalbone+ Ostemporale Temporomandibular.joint + Articulatio temporomandibularis Tendo(-ines) 11 - intermedius151 Tensionlines of the skin 28 Tentoriumcerebelli 258, 258, 259, 265,27t, 276-277, 317,340 Testis 14-15 Thalamus 284-285, 288, 294,295, 2 9 8 ,3 0 2 , 3 1 33, 1 5 - 3 1 63,1 8 3 , 22, 3 2 5 - 3 2 63, 3 0 - 3 3 23, 3 5 - 3 3 6 , 3 3 9 - 3 4 03, 5 3 ,3 5 5 ,3 5 5 , 3 9 7 - corticalprojections 295 nuclei 295 Thenar 164,212,216,250,256 Thoracicaperture,upper 158 Thorax 2,6 T h y m u s1 5 , 1 6 0 Thyroidcartilage+ Cartilago thyroidea Thyroidgland+ Glandulathyroidea Tibia 6 - developmentI tibialis 1 Tong:re+ Lingua Tonsilla(-ae) - cerebelli 285, 287,302-305, 327 - lingualis 108,118 - palatina95, 107 108,108,111, 118,1313 , 6 1, 4 0 1 , 60,272,274 - pharyngea91,96,136,140, 160-161 Torus - levatorius136,160 - mandibularis66 palatinus44 - tubarius 91,96, 136,140,160 Touchpath+ epicriticsensibility Trachea13,22,121,125,125,126, 1 2 6 ,1 2 7- 1 2 8 ,1 3 0 -l 3 t , 1 3 4 ,1 3 4 , 135,138,140-14r,145-146, r54, 1 6 0 ,1 6 3 Tracheotomy146 - lower 146, 160 - upper 146,160 Tractus - bulboreticulospinalis 355 - cerebellorubralis 326,355 - corticospinalis anterior 321,352, Jtc
l a t e r a l i s3 2 1 , 3 5 2 , 3 5 5 - frontopontinus 295, 321-322, 322 - hypothalamohypophysialis 294 olfactorius91,270, 276,281- 282, 287,3\8-319,324,374 - o p t i c u s2 7 0 , 2 7 62 7 7 , 2 9 5 - 2 9 6 , 299,319,321,323,325,334, 373-374,374,375 - paraventriculohypophysialis 294 pyramidalis321,321,323,326 . r e t i c u l o s p i n a3l i5s2 , 3 5 5 , 3 5 5 - rubrospinalis352,355,355 rubrothalamicus355 - spinocerebellaris anterior 352, 352,354,354 - - p o s t e r i o3 r 52,354,354 spinoolivaris352-353 - spinoreticularis353,353 - spinotectal3 i s5 2 - 3 5 33, 5 3 - spinothalamicus anterior 352-353,353 - - l a t e r a l i s3 5 2 3 5 3 , 3 5 5 spiralis foraminosus394 - supraopticohypophysialis 294 - t e c t o s p i n a l3i s5 2 , 3 5 5 , 3 5 5 - vestibulospinalis 355,397 - lateralis 355 - - m e d i a l i s3 5 2 , 3 5 5 - vestibulothalamicus397 Tragusci)382,384 Transversalaxis 1 Transversalplane l, I Triangularspace 189,193,195
Trigonum - c a r o t i c u m3 0 - 3 1 , 2 6 0 - clavipectorale 4, 153-154, 226-ZZ7 - collaterale310-314,332 - femoris 4 - habenulare298 - lemnisci 298 - musculare[omotracheale]30 31 - nervi h)?oglossi 299 - - vagi 299 - olfactorium291,296,319,374 - omoclaviculare 30-31,145 - submandibulare 30-31,151 - submentale30 Trochlea - humeri 169,176-177,202 - (M. obliquussuperior)362,365, 379 T r u n c u s ( - i2) - 3 , 6 - brachiocephalicus 16,18,20,140, 144,155-156,160,274 - bronchomediastinalis 21,230 - coeliacus16,18,20,25,274 - - branches 18 - (Corpuscallosuml 276,284-285, 3 1 0 - 311,3 1 8 - 3 2, 1 323-326,329, 3 3 s ,3 4 0 - costocervicalis 18,155 - encephali 285, 287, 296, 298-299 - inferior 26,26,156 - intestinalis21 - jugularis 21,135,230 - lumbalis 21 - lumbosacralis27 - m e d i u s2 6 , 2 6 , 1 5 6 -- nervi accessorii140,275 spinalis 24,345-349 - pulmonalis20 - s u b c l a v i u2 s1,230 - superior26, 26, 149,152,156 - sympathicus25, 139-140,154, 't62,267 156, , 3 4 6 ,3 4 9 thyrocervicalis18,140,153 156, 229 - vagalisanterror25,274,349 - - p o s t e r i o 2r 5 , 2 7 4 , 3 4 9 Tuba - a u d i t i v a1 0 6 , 2 7 4 , 3 8 1 3 ,8 8 ,3 9 1 , 391,400 - uterina 14 Tuber - cinereum287,291,296,374 - frontale38,48, 50 - m a x i l l a e5 1 ,7 l parierale35, 38, 48-49,64 - vermis 302-304 Tuberculum(-a) anteriusthalami 298 (Vertebracervicalis)36, 144 - a r t i c u l a r e3 6 , 4 5 , 6 2 6 3 , 6 9 7 1 , 102 auriculare382 - CenAenrlr99 caroticum+ TuberculumCa) anterius(Vertebra cervicalis) - conoideum167 corniculatum128,130,136,140, 160 - crJneatrm276,299 - cuneiforme127,130,136,140,160 dentis 99 - d o r s a l e1 7 5 , 1 7 8 , 1 8 2 - epiglotticum128 gracile276,298-299 - infraglenoidale168,'170, 173 - j u g u l a r e4 3 , 6 1 , 6 5 m a j u s 1 6 9 - 1 7 11,7 3 - mentale66, 113 - minus 169,173 ossisscaphoidei179,184 - - trapezii 179-180 - pharyngeum 3 6 , 4 5 ,1 3 6 - posterius(Vertebracervicalis)36, 47 - s e l l a e4 3 , 6 1
Tuberculum(t) - supraglenoidale 168 - thyroideuminferius 111,124 superius124 Tuberositas(-tes) - deltoidea169 - masseterica 66,68 - phalangisdistalis(Manus) 179-180,219 - pterygoidea66-68,71 - radii U5-i78 - ulnae 174,176,178 Tunica coniunctivabulbi 356,361, 363-364,366 . palpebrarum 356,358,361 - fibrosabulbi 367 internabulbi 367 - mucosa(Larynx) 132 - - l i n g u a e1 0 9 , 1 3 1 - - o r i s 9 8 ,1 1 0 - 1 1 1 (Pharynx)125 - - (Sinusmaxillaris)361 - - (Trachea)130,135 - muscularis(Oesophagus) 138,140 (Pharynx)132 - vasculosabulbi367,368 Tunicsof the eye - external 367 - intermediate367 - internal 367 Tympaniccavity384,387-389, 400 Tympanicmembrane+ Membrana tympani
U Ulna 6, 9, 165,174,176 178, 180-181,182,184,204-206,208, 215,218,220,254-255 - development8 Ulnartunnel 256 Ulnartunnelsyndrome256 ulnaris 1 tympanicae384, Umbomembranae 387 U n c u s2 8 7 ,2 8 9 ,2 9 1 ,3 1 2 ,3 1 8 - 3 1 9 , 321,334,336 + Maxilla Upper.jaw Upperlimb 165 arteries224 - cutaneous nerves223 centres8 enchondral ossification - epiphyses8 innervation222 - - segmental343 - joints 166 m u s c l e s1 8 8 - 2 2 2 - muscularoriginsand insertions 197, Zr0,211 - nerves 224 ossificationI - s e g m e n t ac lu t a n e o ui n s nervalion (=dermatomes) 223 Ureter 14 Urethra - feminina 14 m a s c u l i n a1 4 Urinarytractand genitalorgans female 14 - male 14 Uterus 14 U t r i c u l u s3 8 1 , 3 9 5 - 3 9 6 Uvea+ Lamina(-ae) vasculosa Uvula p a l a t i n a9 5 , l l 8 , 1 3 6 - v e r m i s3 0 2 - 3 0 4
V Vagina(-ae) 14 - communis tendinum musculorum flexorum 213-214
Vagina(ae) - externanervi optici 362,366, 372 373,379-380 - fibrosaet synovialisdigiti manus 2t8 - internanervi optici 372-373 musculirectiabdominisl8Z 226 - nervioptici 267 processus styloidei36, 62-63, 398 - synovialis10 - - digitorummanus 213 - tendinis 11,1l - - intertubercularis 170-172, 1 8 8 -1 8 9 ,1 9 4 - - musculi extensoriscarpi ulnaris 2 1 9 2, 5 6 - - - - d i o i i im i n i m i? 1 O - - pollicislongi2l9,24T - - - flexoris carpi radialis 213-215,247 - - - - pollicislongi 183,213-215, 256 - tendinumdigiti (Manus)252 - - ( M a n u s )2 1 3 , 2 1 4 - - musculorumabductorislongi et extensorispollicis brevis 213, 215,219,247 extensorisdigitorum et extensorisindicis 219,247 ---extensorum24T - - - - carpiradialium219,247 Vallecula - cerebelli304 - epiglottica108,131 Vallumunguis 29 Valwlae venosaa19 Vasa - lymphaticumta, 21 - - profundum 29 - - superficialia29,150,225 sanguinearetinae 362 371 Vascularsystem arteries 16 - s u r v e y1 6 - 1 7 , 2 1 - veins 17 Veins - head 262 - vascularsystem 17 Velum - medullareinferl,us276,299, 304 305 - - superius276,294,298-299, 3 0 2 , 3 0 43 0 5 , 3 2 7 - palatinum+ Palatummolle Vena(-ae) - alveolarisinferror 122-123 - anastomoticasupeilor 279 - angularis72, 81,83,262 - anteriorseptipellucidi 316-3lZ 324,331 auricularisposterior147 149 - axillaris 17,19,153-154,157,225, 228-230 - azygos17-18,349 basalis262,284,316 - basilica17,186,225,231,232, 234,238-239,248,253,255-256 - basivertebralis 348 - brachiales17,19,228,230,232, 233-234,253 229 brachiocephalica - - d e x t r al 7 1 8 ,1 4 0 ,1 5 6 ,1 5 8 - - s i n i s t r a1 7 - 1 8 , 1 4 0 , 1 4 4 , 1 5 3 -1 5 4 ,1 5 6 ,1 5 8 ,1 6 0 - cavainferior17 18,20,349 tributaries 18 s u p e r i o r1 7 - 1 8 2 , 0 ,1 4 0 ,1 4 4 , 1 5 6 ,1 5 8 ---tributarieslS - centralisrelinae 122,367,372, 379 - cephalica17,19,l4l,149, 152,154,157-158,186,225-227, 229 232,232, 234,238-239,248, 253-256
rndex 4I7 Vena(te) Vena(ae) - laryngeasuperior 111,115,120, - cerebelli 277 - cerebri 284 132,137,140 - lateralisventriculi lateralis 316 - cervicalisprofunda 81, 156 - - superficialis 157 l i n g u a l i s1 2 1 - 1 2 2 - lumbales 18 - choroideainferior 316 - - superior 316 lumbalisascendens18,348 - magnacerebri 258, 262, 265, 276' - ciliares 265 - ciliaris anterior 367 285, 302,306, 314-317,327,332, - circumflexahumeri Posterior 228, 335,374 - maxillaris72,81,88 232 - mediaprofundacerebri 284, 316 - - scapulae228 - - superficialiscercbri 279,284, - comitansnervi hypoglossi81, 120, 324 157 - medianaantebrachii 231,232, - conjunctivalisanterior 367 - diploicae 264,264 238,254 - - basilica231,232,238 - - frontales81,264 - - cephalica 231,232,238 - - occipitales81,264 - - cubiti 17,177,186,231,232, - - temporalesanteriores 81,264 - - - posteriores81,264 238 - meningeamedia 263 - emissaria(-ae)262 - mesentericainferior 17 - - condylaris81,262,267 - - superior 17 - - hontalis 262 - nasofrontalis81,265 - - mastoidea81,262,262 - occipitalis 81,83, 147-149, - - occipitalis262,262 - - parietalis81,262,262,264 157-158,262,279 - oesophageae349 - episcleralis 367 - ophthalmicasuperlot 26?-263, - f a c i a l i s8 1 , 8 3 - 8 5 , 8 81, 1 4 - 1 1 5 , 265-266,267,380 t22, r4l, r48- 149,151- 152, - ovarica 17, 18 t57-158,262 parietales 279-280, 284 - femoralis 17 - pericardiacophrenica349 - frontales 279 - pharyngeae81,139 - hemiazygos18,349 - phrenicainferior 18 - - accessoria18 - poplitea 17 - hepaticae 17-18,20,349 - portaehepatis 17 - iliacacommunis17-18,2O - protundafaciei 88 - - externa 17-L9 - - femoris 17 - - interna 17-18 - - linguae 121 - iliolumbalis 18 - profundaecerebri 316 - inferiorescerebri' 284 - renalis 17-18 - infraorbitalis 380 - retromandibularis81,83-85, 88, - intercapitulares(Manus) 232, 1 1 5 1, 4 8 - 1 4 91, 5 1 - 1 5 31, 5 7 - 1 5 8 , 248 - intercostalesposteriores 18 262 - sacralismediana 18 - intercostalisposterior 349 - saphenamagna 17 - interna cerebri 262, 284,284, - - parva 17 317,326-327,331 314-317, - spinalisposterior 346 - interossea posterior201,254 - splenica17 - intervertebralis 348 - subclavia 17-18, 21,f4O, 144,152, - intramuscularis 29 - intraseptales29 158-159, 159, 227 - subfascialis29 - jugularis 316 - sublingualis ll5, 120-121 - - anterior 17,135,146,148, - s u b m e n t a l i8s1 , 8 5 , 8 8 1 , 1 5 1, 5 2 , 1 5 7 - 1 5 81, 6 3 ,2 3 0 - - e x t e r n al Z 8 1 , 8 4 - 8 5 1 t)/ , 1 5 1, 4 5 , - subscapularis228 r47-149,151-154, 157-158, - superiorvermis 316 162-163,230 - superiores - - i n t e r n a1 7 - 1 8 , 2 1 , 7 2 , 7 9 , 8 1 , cerebri 262,279-280, 284,316 8 1 , 1 3 5 ,1 3 9 ,1 4 1 1, 4 9 - 1 5 1 , - suprarenalis 18 153-154,157- 159,162-163, - suprascapularis230 262,263 - supratrochlearis81 - labialisinferior 81 - temporalismedia 85,88 - - superior 81 - - superficialis72,77,81,83-84, - labyrinthi 267 - lacrimalis 265 88
Vena(4e) - testicularis 18 - - dextra 17 - - sinistra 17 - thalamostriatasuperior 262, 284' 310,313-312326-327,329-33r' 335 - thoracicainterna 1Z 144, 156-158,226 - - lateralis 154,228-230 - thoracoacromialis19,152,157, 226 - thoracodorsalis228-229 - thoracoepigastricae 154,225-226' 228-229 -'thymicae 158 - thyroideainferior 136' 154' 1 5 7 - 1 5 81, 6 0 ,1 6 3 - - media 135,158 - - superior81,134,152,154, 1 5 7 -1 5 8 ,1 6 0 - tibialis anterior 17 - - posterior 17 - transversacolli148,157-158' 230 - ulnares 254 - umbilicalis 20 - vertebralis135,154,156'163 - vorticosa 367 Venography19 Venousvalves 19 Venter - a n t e r i o r7 2 , 7 8 - 7 9 , 8 58, 7 - 8 8 , 113,115-116,119- 120,122-123' 137,141,142,143,145,149-153' 157-159,272 - frontalis 74,75,77-79, 85,88, 357 - inferior 141,142,143,145, 149-150,152-153,157,187-189' 197,233 - muscles 11 - occipitalis74,77-79, 147 - p o s t e r i o 7r 9 , 8 5 , 8 7 - 8 81' 1 3 1 ' 15, 119,136-141,142,143-145,159, 273,400 - superior ll5, 120,142, 143' l4i, 149- 150,153-154,159,188' 230 Ventricle+ Ventriculus(-i) Ventriculus(-i) - dexter 20 - encephali306-308 - - MRT 307 - laryngis 109,128,130,132,134, 160 - lateralis 270,284-285, 295-296, 299, 307,310,310, 311,3ll' 312' 312,313,313,314,314,315,315, 323- 327,329- 337,339- 340 - - walls 310 - quartus 276,285, 302, 302, 305-308,326-327,335,340 - - walls 299 - sinister 20
Venficulus(i) - tertius 276,254-285, 294, 298, go2,302,306-308,313,315'323' 325-326,331-332, 334,339-340 - - walls 315 Venula(-ae) - macularisinferior 371 - - superior371 - medialisretinae 371 - nasalisretinaeinferior 371 ---superior371 - temporalisretinaeinferior 371 ---superior37l Vermiscerebelli 276,285, 287,302, 303,309,313-314,327,332-335' 339-340,354,355 Vertebratae) - cervicales 135,155-156,162 - coccygeae342 - - +Ostsa)coccygis - lumbales 346 - thoracicae 144,155,163 Vertebralcanal+ Canalisvertebralis vertex 38,40 - corneae366 Vesica - biliaris 13,20,23 - urinaria 14,20 vestibular 98-99 Vestibularpath 397 Vestibulum - lablrinthi 38f , 393-394 - laryngis 130,134 - n a s i 1 3 , 9 11 , 60 - oris 13,108-109 Vibrissae 96 Vinculum(-a) - breve 217-218 - lonBa 217-218 - tendinum 212 219 viscerocranium 57 -59, lO4 Visual pathway 374,375 - primary region 293 - secondaryregion 293 Vocalcord+ Ligamentumvocale Vola + Palrna Vomer 33, 36, 41,45,49, 54,54, 57, 68,90
w centre 397 WERNIcKx's
Y Yellowspot+ Maculalutea
z Zonula - ciliaris 366,367,368,368 - Znnt+ Zonulaciliaris Zygapophysis 36