PHYSICIANS’ AND STUDENTS’ READY REFERENCE 
SERIES. 
SYNOPSIS 
HUMAN ANATOMY 
OF 
BEING A COMPLETE COMPEND OF ANATOMY, INCLUDING THE 
ANATOMY OF THE VISCERA AND NUMEROUS 
TABLES. 
BY 
JAMES K. YOUNG, M.D., 
Instructor in Orthopaedic Surgery Demonstrator of Surgery in the 
University of Pennsylvania; Attending Orthopaedic Surgeon, Out- 
Patient Department, University Hospital; Fellow of 
the College of Physicians, etc., etc. 
Philadelphia and London: 
F. A. DAVIS, PUBLISHER. 
1889. Entered according to Act of Congress, in the year 1889, by 
F. A. DAVIS, 
In the Office of the Librarian of Congress, at Washington, D. C., U. S. A. 
All rights reserved. 
Philadelphia: 
The Medical Bulletin Printing House, 
1231 Filbert Street. TO 
JOHN ASHJIURST, Jr., M.D., 
JOHN RHEA BARTON PROFESSOR OF SURGERY, AND PROFESSOR OF 
CLINICAL SURGERY IN THE UNIVERSITY OF PENNSYL- 
VANIA, AS A SLIGHT TOKEN OF RESPECT AND 
ESTEEM, THIS LITTLE WORK IS 
INSCRIBED BY THE 
AUTHOR. PREFACE. 
The object of this little book is, as its title indicates, 
to furnish a concise though complete synopsis of human 
anatomy for the use of students of medicine and others. 
Appreciating, from a personal contact with students, 
the limited time at their disposal and the unlimited 
amount of medical material to be digested, the author 
has endeavored, by well-selected wood-cuts, typographi- 
cal arrangement, and numerous tables, to facilitate the 
acquisition of a subject as difficult as it is essential, and 
elegance of diction has therefore been sacrificed to con- 
ciseness and accuracy. 
In its preparation tlie last edition of Gray’s “ Anat- 
omy ” [edited by Keen], as the work most largely em- 
ployed, has been selected as the standard, but Leidy, 
Quain, Allen,Holden, Henle, Schaffer, Klein,Brown Aids, 
and others, have been freely used, and ou the special 
subjects Lusk, Spiegelberg, Savage, Scliroeder, Budin, 
Treve’s “Surgical Applied Anatomy,”and the“American 
System of Dentistry” have been consulted. Although 
prepared particularly for students, sufficient descriptive 
matter has been added to render it valuable to the busy 
practitioner, particularly the sections on the Viscera, PREFACE. 
Special Senses, Vascular System, and Surgical Anatomy. 
The aim throughout has been to make it as thoroughly 
complete and accurate as possible, and at the same time 
readily accessible for reference or study. 
The writer would acknowledge his obligations to 
Messrs. S. Z. Durborow and C. W. Holly, medical students 
at the University, for assistance in the correction of 
proof. J. K. Y. 
Philadelphia, 
March, 1889. TABLE OF CONTENTS. 
PAGE 
Introductory, 2 
Osteology, 3 
The Frontal Bone, 8 
Parietals, 10 
The Occipital Bone, 13 
Temporals, 15 
The Sphenoid, 20 
The Ethmoid, 24 
The Lachrymal, ...... 25 
The Malar, 26 
The Superior Maxilla, 27 
Palate Bones, 30 
The Inferior Turbinated Bones, . . .32 
The Yomer, ....... 32 
The Inferior Maxilla, 33 
The Sutures and Fontanelles, . . .36 
Fossae of Skull, 31 
The Orbits, 39 
Foramina at the Base of the Skull, . . 43 
The Sternum, 46 
The Ribs, 47 
The Spine, ....... 49 
The Upper Extremity, 54 
The Arm, 59 
The Forearm, 61 
The Hand, 64 
The Lower Extremity, 68 
The Thigh, 72 
The Patella, 75 
The Leg, 75 
The Foot, 78 
Table of Ossification, 83 
Articulations and Ligaments, . . . .88 
The Thorax, 93 
The Pelvis, 96 VIII 
TABLE OF CONTENTS. 
PAGE 
The Muscular System 112 
Muscles op the Head, 113 
Muscles op the Neck, 118 
Vertebral Region, 121 
Muscles of the Back, 123 
Muscles op the Abdomen, . . . .128 
Muscles op the Upper Extremity, . .133 
Muscles op the Forearm, .... 136 
Muscles of the Hand, 139 
Muscles op the Lower Extremity, . . 141 
Muscles of the Leg, 147 
Muscles op the Foot, 150 
The Fascias, 152 
The Heart and Vascular System, . . . 157 
The Circulation op the Blood, . . .165 
The Arterial System, . . . . 161,165 
Table of the Arterial System, . . .190 
The Venous System, 197 
The Lymphatic System, 207 
The Alimentary Apparatus, . . . .212 
The Teeth, 213 
The Pharynx, 221 
The (Esophagus, 221 
The Abdomen, 222 
The Peritoneum, 224 
The Stomach, 228 
The Small Intestine, 230 
The Large Intestine, 232 
The Pancreas, ...... 235 
The Liver, 236 
The Ductless Glands, . . . . .241 
Vocal and Respiratory Apparatus, . . . 246 
The Larynx, 246 
The Trachea and Bronchi, .... 252 
The Lungs, 254 
The Pleura, 257 
The Mediastinum, 257 
The Genito-Urinary Apparatus,. , . . 259 
The Kidneys, . . . . . . .259 TABLE OF CONTENTS. 
PAGE 
The Bladder, 264 
Male Organs, 266 
Female Organs, 275 
The Mammary Gland, 283 
The Nervous System, 285 
The Brain, 288 
The Cranial Nerves, 301 
The Spinal Cord and Nerves, . . . 309 
Table of Spinal Nerves, . . . .319 
The Sympathetic Nervous System, . . 326 
Organs of Special Sense, 331 
The Nose, 331 
The Eye, 332 
Appendages of the Eye, .... 344 
The Ear, 346 
The Tongue, 359 
The Skin and Appendages, .... 360 
Surgical Anatomy, 362 
Triangles of the Neck, .... 362 
Triangle in Front of Elbow-joint, . . 364 
Scarpa’s Triangle, 364 
Axilla, 365 
Anatomy of Hernia, 366 
Ischio-rectal Region and Perineum, . .371 
Anatomy of Lateral Lithotomy,. . .376 
Index, 377 INTRODUCTORY. 
The term “ anatomy,” derived from the Greek dvd, 
“through,” and ri/iuecu, “to cut,” signifies dissection, 
but has been appropriated to the science which treats of 
the apparent properties of organized bodies. It is the 
science of organization. Anatomy is divided into vege- 
table, which treats of the structures and properties of 
vegetal bodies; comparative, which treats of the 
anatomy of animals; human, which treats of the anat- 
omy of man in a physiological or healthy state; patho- 
logical, which treats of the anatomy of the diseased 
human body, etc. 
Human anatomy is subdivided into general, de- 
scriptive, and surgical. 
General anatomy treats of the minute structure or 
physical elements of the organs of the body. It is also 
called microscopical anatomy, or histology. It com- 
prises seven distinct classes :— 
Corpuscular, including the blood, spleen, etc. 
Epithelial, including mucous membranes, epidermis, glands, etc. 
Cartilaginous, including cartilage, fibro-cartilage, etc. 
Osseous, including all bony structures. 
Muscular, including flesh and muscle generally. 
Nervous, including the proper nerve elements. 
Connective, including white fibrous, elastic, adipose, and neuroglia. 
Descriptive or special anatomy treats of the various 
properties of the organs arranged into systems; hence 
the name systematic. It includes :— 
Osteology, the anatomy of the bones. 
Syndesmology, the anatomy of the joints. 
Myology, the anatomy of the muscles. 
Angiology, the anatomy of the vessels. 
Neurology, the anatomy of the nerves. 
Splanchnology, the anatomy of the viscera, etc., etc. 
Surgical or topographical anatomy treats of the 
relative position of organs to one another and to the 
surrounding parts in special regions of the body, as the 
axilla, neck, or groin. OSTEOLOGY. 
The frame-work of the body is composed of bones, 
which constitute the skeleton. This in the adult con- 
sists of 200 bones, excluding the ossicula auditus and 
the smaller sesamoid bones: Spine (including coccyx 
and sacrum) 26, cranium 8, face 14, ribs, sternum, and 
os hyoides 26, upper extremity 64, lower extremity 62; 
or, omitting patellae and adding ossicles, 204. 
The bones of the head number 22, consisting of 
Eight cranial bones, the frontal, 2 parietal, occipital, 2 temporal, 
the sphenoid and ethmoid bones; 14 facial bones, 2 lachrymal, 2 
nasal, 2 malar, 2 superior maxillae, 2 palate, 2 turbinal, 1 vomer, and 
1 inferior maxilla. 
The bones of the trunk number 52, comprising 
Twenty-six vertebrae, 7 cervical, 12 dorsal, 5 lumbar, 1 sacrum, 
and 1 coccyx. 
Twenty-six of the thorax, 7 pairs of true ribs, 3 pairs of false 
ribs, 2 pairs of floating ribs, the sternum and os hyoides. 
The bones of the upper extremity number 64, com- 
prising on either side 
Two shoulder, clavicle, and scapula ; 1 arm, humerus ; 2 forearm, 
radius and ulna ; 8 wrist (carpus), scaphoid, semi-lunar, cuneiform, 
pisiform, trapezium, trapezoid, os magnum, and unciform ; 19 hand, 
5 metacarpal and 14 phalanges. 
The bones of the lower extremity number 62, com- 
prising on either side 
One hip, divided into 3 portions, the ilium, ischium, and pubes; 
1 thigh, the femur; 2 leg, tibia and fibula; 1 knee, the patella; 26 
foot, 7 tarsal bones, the astragalus, os calcis, scaphoid, cuboid, exter- 
nal, middle, and internal cuneiform ; 5 metatarsal bones, and 14 
phalanges. 
They are divided into long, short, flat or tabular, and 
irregular. 
Long hones, such as femur, humerus, or radius, consist 
of shaft or diaphysis, and two extremities or epiphyses. 4 
HUMAN ANATOMY. 
The shaft or diaphysis is a cylindrical tube com- 
posed externally of compact tissue and internally of 
cancellous tissue, the centre being hollowed out by the 
medullary canal. 
The epiphyses, or extremities, are expanded for 
articulation, and are composed of a mass of solid can- 
cellous tissue with a thin coating of compact tissue. 
The short bones, as tarsus or carpus, are small, 
compact, irregular cubes. 
Flat bones, as those of skull and shoulder-blade, 
afford extensive surfaces for protection or muscular 
attachment. 
Under irregular or mixed bones are classed the 
vertebral, sphenoid, maxillary bones, and such that 
could not be placed under either of the other heads. 
The surfaces of the bones are marked by certain emi- 
nences and depressions, which have received the following 
names:— 
An apophysis is a prominent excrescence formed directly upon 
a bone, and is distinguished from 
An epiphysis, which has been formed from a distinct centre and 
separated by cartilage, but afterward united to the bone. 
A head is a rounded, smooth, articular eminence for articulation. 
A condyle is an irregular prominence for muscular attachment. 
A trochanter is a large prominence for the attachment of rotator 
muscles. 
A tuberosity is a broad, uneven eminence. 
A tubercle is a small tuberosity. 
A spine is a sharp-pointed eminence. 
A line, or ridge, is a rough, narrow elevation, extending some 
distance. 
Others, from their fancied resemblance to ordinary 
objects, have received the following names :— 
Coronoid, like a crown; coracoid, like a crow’s beak ; unciform, 
or hamular, hook-like; malleolar, like a mallet; mastoid, nipple- 
like; zygoma, yoke-like; pterygoid, wing-like; odontoid,tooth-like ; 
spinous, thorn-like; styloid, pen-like; rostrum, a beak; vaginal, 
ensheathing; squamous, scaly ; conoid, cone-like. 
The cavities of bones are divided into the articular 
and the non-articular. 
The articular are named acetabulum, measure-like; OSTEOLOGY. 
5 
glenoid, hollow; cotyloid, cup-like; facet, smooth; 
trochlear, pulley-like ; alveolar, socket-like. 
The non-articular cavities are named notches, fissures, 
grooves, furrows, fossse, hiatus, foramina, canals, sinuses, 
aqueducts, cells, depressions, meatuses, etc. 
Composition of Bone.—Adult human bones have a spe- 
cific gravity of 1.92, and are composed of about one-third 
(33.30) organic or animal matter, principally gelatin, and 
two-thirds inorganic or mineral matter, as follows :— 
Gelatin and blood-vessels, 33.30; phosphate, car- 
bonate, and fluoride of calcium, 64.34; soda, sodium 
chloride, and magnesium phosphate, 2.36 : total, 100. 
Structure of Bone.—In structure they consist of an 
ivory-like compact substance, inclosing a lamellar, reticu- 
lar cancellous substance. 
They are covered with periosteum, and their cavities 
are lined with endosteum and filled with medulla, or 
marrow. 
Periosteum is a fibro-vascular membrane, composed 
of two layers, the outer formed chiefly of connective 
tissue, the inner composed of several layers of elastic 
fibres, the deepest of which is the “ osteogenic,” or bone- 
producing layer. The tendons and ligaments are at- 
tached to the periosteum by a mutual interlacement of 
the fibres. 
Endosteum, medullary membrane or internal perios- 
teum, is a delicate, highly vascular membrane lining the 
cylindrical cavity of long bones. 
Medulla, or bone-marrow, is of two kinds, the red in 
the flat and irregular bones, and the yellow in the shafts 
of adult long bones. The red marrow has few blood- 
vessels, but many corpuscular elements. These may be 
divided into three groups : 1, red nucleated true “ mar- 
row-cells 2, large pinkish cells, “ myelo-plaques” of 
Robin, supposed to be the source of the red blood-cor- 
puscles ; and 3, giant cells, or “ osteoclasts.” 
The yellow marrow contains numerous blood-vessels, 
a few “marrow-cells,” and a large quantity of fat which 
imparts to it its color. 
Blood-vessels of Bone.—The arteries consist of three 6 
HUMAN ANATOMY. 
sets: The arteries of the (1) compact and (2) cancellous 
tissue are derived chiefly from the periosteum, the latter 
being larger and less numerous. The medullary canal 
of long bones has (3) one or more nutrient arteries, 
which penetrate the compact tissue obliquely and 
divide into two branches, one passing upward, the other 
downward, in the canal. All the arteries anastomose 
freely with each other. 
The veins consist of three sets also : 1. The veins of 
the compact substance are small and join the periosteum. 
2. The veins of the cancellous tissue do not accompany 
the arteries, but in certain localities form large, tortuous 
channels, as in the diploic veins of the cranium. In the 
long bones they emerge at the ends near the articular 
surfaces. 3. The nutrient arteries are accompanied by 
one or more large veins, which emerge at the nutrient 
foramen. 
Lymphatics and nerves are numerous in the perios- 
teum and are also found in the substance of the bone. 
Microscopic Appearance.—Microscopically, bone- 
tissue consists of concentric layers, or lamellae, arranged 
about the course of a vascular or Haversian canal. In 
and between these plates of bone-tissue are minute 
cavities, or lacunae, each containing a bone-cell, or 
“ osteoblast,” and from which diverge in every direction 
minute canals, or canaliculi, connecting the lacunae with 
each other and with the Haversian canals. Each canalicu- 
lus contains an artery, vein, and lymphatic (Schaffer). 
In this manner every part of the osseous substance com- 
municates. 
Development.—The development of bone is effected 
in two ways—(1) from cartilage, the intra-cartilaginous ; 
and (2) from membrane, the iutra-membranous; the 
former occurring at the base of the skull for the protec- 
tion of vital centres, or in the extremities to secure 
rigidity of the parts. 
In the intra-cartilaginous the parts are first formed 
in cartilage and then converted into bone. The process 
is as follows: The cartilage cells at the “centre of ossi- 
fication ” become enlarged and arranged into rows. The OSTEOLOGY. 
7 
cartilaginous matrix also increases and separates the 
cells. Lime salts are deposited between the rows of 
cells, inclosing them in oblong spaces called primary 
areolae. 
Blood-vessels from the deep or osteogenic layer of 
the periosteum, carrying numerous osteoblasts, pass into 
the structure, absorb the walls of the primary areolae, 
and convert them into larger cavities, or medullary 
spaces, which become filled with embryonic marrow. 
The walls of the spaces are gradually thickened by 
successive layers of osteoblasts, forming lamellae of 
bone, till nothing remains but a channel—the Haversian 
canal. 
The cartilage cells are probably converted into osteo- 
blasts. Thus, from the osteoblasts all the structures of 
bone are produced; the remains of a group of cells con- 
stitute an Haversian canal, the layers deposited by them 
and the adjacent cells, the lamellae, and the isolated, per- 
sistent cells form the contents of the lacunae, or “ true 
bone-cells,” with their nutrient canaliculi diverging from 
them. 
In the intra-membranous form the parts are first 
formed in membrane, and from one or more centres of 
ossification lime salts are deposited in radiating spiculae, 
or osteogenic fibres, inclosing the osteoblasts. 
From these fibres the process spreads, and vessels 
from the neighboring parts pass into it and form Haver- 
sian canals. 
The formation of the lamellae and the lacunae is essen- 
tially the same as in the intra-cartilaginous, and in most 
bones both processes go on simultaneously. 
Ossification appears first in the clavicle and inferior 
maxilla (from fifth to seventh week) and last in the pisi- 
form bone (twelfth .year). The epiphyses ossify from 
birth and unite from the age of puberty on to maturity, 
in reverse order to the appearance of ossification, being 
regulated, apparently, by the direction of the nutrient 
artery in the upper extremity toward the elbow and in 
the lower extremity from the knee. The only exception 
to this rule is the lower end of the fibula, which ossifies 8 
HUMAN ANATOMY. 
and also becomes united before the upper {vide Table of 
Ossification). In bones with only one epiphysis the 
artery is directed toward the other extremity. 
Growth of Bones.—Long bones grow in thickness 
from the periosteum and in length from the cartilage 
between the epiphyses and the shaft near the extremities. 
The medullary cavity is at first solid and grows by 
absorption of the cancellous tissue by the giant cells, or 
osteoblasts. 
Flat bones grow in thickness from the periosteum 
1, frontal eminence; 2. superciliary ridge; 3, supra-orbital arch; 4, external 
angular process; 5, internal angular process; 6, supra-orbital notch; 7, nasal emi- 
nence ; 8, temporal ridge; 9, nasal spine. 
Fig. 1. 
and in surface from the borders. Short bones grow from 
the centre or centres of ossification in all directions. 
The cranial bones are eight in number:— 
THE CRANIAL BONES. 
1 Frontal, 
2 Parietal, 
1 Occipital, 
2 Temporal, 
1 Sphenoid, 
1 Ethmoid. 
The frontal bone forms the anterior portion of the 
cranium and consists of two portions, a vertical or 
frontal portion and a horizontal or orbito-nasal portion. OSTEOLOGY. 
9 
The vertical portion consists of two surfaces, exter- 
nal and internal. 
The external surface is convex, and presents the 
frontal eminence on either side of the median line, the 
superciliary ridges, produced by the frontal sinuses, be- 
neath, below which is the supra-orbital arch, forming 
the upper boundary of the orbit, and terminating on 
either side in the external angular process, articulating 
with the malar bone, and the internal angular process, 
articulating with the lachrymal bone, and having at its 
Fig. 2. 
2, foramen caecum; 4, articulates with lesser wing; 6, articulates with ethmoid; 
7, anterior and posterior ethmoidal foramina; 9, lachrymal fossa; 10, depression for 
pulley of superior oblique ; 11, frontal sinus. 
inner third a notch or foramen, the supra-orbital fora- 
men, for passage of supra-orbital artery, nerve, and vein. 
Ascending from the external angular process is the 
temporal ridge for attachment of temporal fascia. Be- 
tween the internal angular processes is the vasal notch, 
for articulation with the nasal bone, and nasal process 
of superior maxilla, terminating below in the nasal 
spine, and above it projects the nasal eminence, or gla- 
bella, marking the location of the frontal sinuses. 10 
nUMAN ANATOMY. 
The posterior or internal surface is concave and 
lodges the anterior lobes of the brain. 
In the median line is the frontal crest, which gives 
attachment to the falx cerebri and terminates below in 
a foramen, the foramen caecum, for passage of a small 
vein from the nose to the longitudinal sinus. The crest 
is grooved for longitudinal sinus, and has on either side 
of it depressions for the Pacchionian bodies. This 
surface is also grooved for anterior meningeal arteries. 
The horizontal portion consists of an external and 
internal surface. 
The external surface is concave, to form the roof of 
the orbit, and separated from the opposite side by the 
ethmoidal notch. 
To the outer side is a deep depression for the lach- 
rymal gland, and to the inner side a slight one for the 
pulley of superior oblique. 
On the margin of the orbital plate are two notches 
converted into foramina by articulation with the 
ethmoid, the anterior ethmoidal canal, for passage of 
nasal nerve and anterior ethmoidal vessels, and the 
posterior ethmoidal canal, for passage of posterior 
ethmoidal vessels. 
The internal surface is marked by the convolutions 
of the anterior lobes of the brain. 
Between the two plates of the vertical portion are 
the frontal sinuses, two irregular cavities lined with 
mucous membrane and opening into the middle meatus 
of the nose on either side by the infundibulum. 
It articulates with twelve bones, two parietal, 
sphenoid, ethmoid, nasal, superior maxillary, lachrymal, 
and malar. 
Its muscular attachments are three pairs, corrugator 
supercilii, orbicularis palpebrarum, and temporal. 
It is developed from membrane by two ossific 
centres, one for each lateral half. 
Parietals.—These are two quadrilateral bones form- 
ing the superior and lateral walls of the cranium. Each 
bone consists of two surfaces, four borders, and four 
angles. OSTEOLOGY. 
11 
The external surface is convex and presents the 
parietal eminence a little above the middle, marking 
Fig. 3. 
1, superior border; 2, inferior border for squamous portion of temporal; 
3, anterior border for frontal bone; 4, posterior border for occipital; 5, parietal 
eminence; 6, parietal foramen; 7, anterior inferior angle. 
the original centre of ossification, the temporal ridge, 
crossing about the centre for attachment of the 
temporal fascia, and the parietal foramen, near the 
Fig. 4. 
1. 2, 3, 4, superior, inferior, anterior, and posterior borders; 5, superior longi- 
tudinal sinus; 6, parietal foramen ; 7, anterior inferior angle. 
superior border or sagittal suture, for passage of a vein 
to the longitudinal sinus. 12 
HUMAN ANATOMY. 
The internal surface is concave, and presents fur- 
rows for the branches of the meningeal arteries 
depressions for cerebral convolutions, and Pacchionian 
bodies ; 
A half groove along the superior border for longi- 
tudinal sinus, and 
A groove near the posterior inferior angle for the 
lateral sinus. 
The superior border articulates with its fellow of the 
opposite side, forming the sagittal suture ; 
Fig. 5. 
2, occipital protuberance; 3, crest; 4, inferior curved line; 5, foramen magnnm ; 
6, condyle; 7, posterior condyloid foramen; 8, anterior condyloid foramen; 9, jugular 
process; 11, basilar process; 12, tubercles for check ligaments. 
The inferior border articulates from before backward 
with the sphenoid, squamous, and mastoid portions of 
temporal bones; 
The anterior border forms with the frontal bone 
the coronal suture, and 
The posterior border forms with the occipital bone 
the lambdoid suture. 
Of the angles the anterior inferior is the only 
important one, being longer and grooved internally by 
the middle meningeal artery. 13 
OSTEOLOGY. 
It articulates with five bones—frontal, sphenoid, 
temporal, occipital, and opposite parietal bones. 
It has but one muscle attached—the temporal. 
It is developed from an ossific centre. 
The occipital forms the posterior inferior portion of 
the cranium. It presents two surfaces, four angles, 
and four borders. 
The external and posterior surface is irregularly 
convex, and presents 
The occipital protuberance (also called external to 
distinguish it), for insertion of ligamentum nucliae, 
descending from which to the foramen magnum is 
The occipital crest, for tendinous attachment, and 
diverging on either side, above and below, are 
The superior curved line, for attachment of occipito 
frontalis, trapezius, and other muscles ; and 
The inferior curved line for attachment of rectus 
capitis posticus, major and minor. 
Anteriorly it presents a large aperture, 
The foramen magnum, transmitting the medulla 
oblongata and its coverings, the vertebral arteries, and 
the spinal accessory nerves. 
A little in front and on either side of the foramen 
magnum are the condyles for articulation with the atlas, 
the inner border of each condyle presenting a tubercle 
for the check ligament. 
Externally to each condyle are the jugular processes, 
affording attachment for the rectus capitis lateralis, and 
forming by its articulation with the fibrous portion of 
the temporal bone the jugular foramen, or foramen 
lacerum posterius, transmitting the internal jugular vein, 
glosso-pliaryngeal, pneumogastric, and spinal accessory 
nerves, and meningeal branches of the ascending pharyn- 
geal and occipital arteries. 
In front of the condyles on either side are the openings 
of the anterior condyloid foramen, for passage of hypo- 
glossal nerve and meningeal branch from the ascending- 
pharyngeal artery; and behind, the posterior condyloid 
foramen, for passage of a small vein to the lateral sinus. 
In front of the foramen magnum is the basilar process, 14 
articulating with the sphenoid bone, and grooved on its 
under surface by the pharyngeal spine for the insertion 
of the tendinous raphe and superior constrictor of the 
pharynx. 
The internal surface is irregularly concave and 
divided by a crucial ridge, or occipital cross, into four 
fossae, the upper, for the posterior lobes of the cerebrum, 
and the lower, for the lateral lobes of the cerebellum. Its 
centre is marked by an eminence, the internal occipital 
protuberance, which is hollowed out to correspond to the 
torcular Herophili, or confluence of the sinuses. 
HUMAN ANATOMY. 
Fig. 6. 
1, cerebral fossa; 2, cerebellar fossa; 3, superior longitudinal sinus; 4, occipital 
sinuses; 5, lateral sinus; 6, torcular Herophili; 7, foramen magnum ; 8, jugular pro- 
cess; 9, posterior condyloid foramen; 13, jugular fossa; 14, inferior petrosal sinus. 
The upper division of the crucial ridge affords at- 
tachment for the falx cerebri, being grooved for the 
great longitudinal sinus; the lower extremity, called 
also the internal occipital crest, affords attachment for 
the falx cerebelli, being grooved for the occipital sinus ; 
and the lateral divisions afford attachment for the ten- 
torium cerebelli and are grooved for the lateral sinuses. 
The internal surfaces of the jugular processes are 
grooved for the lateral sinuses. OSTEOLOGY. 
15 
In front of the foramen magnum is the basilar groove, 
lodging the medulla oblongata and part of the pons 
Yarolii. Its lateral borders (the basilar process) are 
grooved for the inferior petrosal sinus. 
The superior angle articulates with the parietal 
bones, the inferior angle articulates with the sphenoid, 
and the lateral angles are wedged in between the mas- 
toid portion of the temporal and the posterior inferior 
angle of the parietal. 
This bone has four foramina—foramen magnum, an- 
terior and posterior condyloid, and foramen lacerum 
posterius. 
It articulates with six bones—two parietal, two tem- 
poral, the sphenoid, and the atlas. 
The muscular attachments are twelve (12) : occipito- 
frontalis, trapezius, sterno-mastoid, complexes, splenius 
capitis, obliquus superior, rectus capitis, posticus major 
and minor, rectus lateralis, rectus anticus major and 
minor, and superior pharyngeus constrictor. 
It is developed from seven (7) ossific centres : four for 
the tabular, orsupra-occipital,or occipital portion proper; 
one for each condyloid, or external occipital portion, 
and one for the basilar, or basi-occipital portion. 
Temporals.—These are situated at the side and base 
of the cranium, and consist of three portions—the 
squamous, mastoid, and petrous. 
The squamous portion is scale-like and overlaps the 
parietal bone. Its external surface, convex behind, 
concave in front, presents from before backward the 
following:— 
The zygoma, or zygomatic process, an arched process 
of bone articulating with the zygomatic process of the 
malar bone, and affording attachment above to the 
temporal fascia and below to the masseter muscle. It 
is connected to the body of the bone by three roots, the 
anterior root of which ends in the eminentia articularis, 
a process of bone in front of the glenoid cavity, and pre- 
sents at its junction a tubercle for the external lateral 
ligament; the middle root terminates at the Glaserian 
fissure, and the posterior root forms the posterior portion 16 
HUMAN ANATOMY. 
of temporal ridge and gives attachment to the retraliens 
aurem. 
The glenoid fossa is a marked depression hollowed 
out for articulation of the condyle of the lower jaw. 
It is bounded in front by the eminentia articularis, 
to the outer side by the middle root, and behind by 
the vaginal process. It is divided into two portions by 
the Glaserian fissure, the anterior being separated from 
1, temporal fossa; 2, squamous portion; 3, for masseter muscle; 4, zygoma; 5, 
tubercle of zygoma; 6, eminentia articularis; 7, glenoid fossa; 8, Olaserian fissure; 
9, petrous portion: 10, meatus auditorius externus; 11, stylo-hyoideus; 12, stylo- 
glossus; 13, styloid process; 14, mastoid portion; 15, sterno-inastoid ; 10, retraliens 
aurem ; 17, spl’enius capitus; 18, trachelo-mastoid; 19, mastoid foramen; 20, auditory 
process; 21, digastricus; 22, mastoid process ; 23, vaginal process. 
Fig. 7. 
the auditory process by the post-glenoid tubercle— 
rudimentary in man—and the posterior being formed 
by the tympanic plate, a thin plate of bone forming the 
front wall of the tympanum. 
The Olaserian fissure communicates with the tym- 
panum, transmits the laxator tympani muscle and tym- 
panic artery, and lodges the processus gracilis of the 
malleus. 17 
OSTEOLOGY. 
In the angle between the squamous and petrous 
portions the chorda tympani nerve passes from the 
tympanum through the canal of Hugier. 
The internal surface of the squamous portion pre- 
sents the markings of the convolutions, and grooves for 
the ramifications of the middle meningeal artery. The 
mastoid portion is convex, rough, and nipple-like, and 
presents, externally, the following :— 
The mastoid foramen, near the posterior border, 
1, lateral sinus; 2, mastoid foramen; 3, middle meningeal artery; 4, zygoma; 5, 
superior petrosal sinus ; 6, petrous portion ; 7, meatus auditorius internus; 8, carotid 
canal; 9, cochlea ; 10, aqueductus vestibuli; 11, stylo-pharyngeus. 
Fig 8. 
transmits a branch of the occipital artery to the dura 
mater and a small vein to the lateral sinus ; 
The mastoid process, a prominent projection, com- 
posed of the mastoid cells, and affording insertion for 
the splenius capitis, sterno-mastoid,and traclielo-mastoid 
muscles. 
To its inner side is a groove, the digastric groove, for 
attachment of the digastric muscle, and still more inter- 18 
HUMAN ANATOMY. 
nally the occipital groove, for the accommodation of the 
occipital artery. 
The internal surface is concave, and presents a 
groove, the fossa Sigmoidea, for the lateral sinus, in the 
bottom of which is the opening of the mastoid foramen. 
The petrous portion is pyramidal in shape, intensely 
hard, and contains the internal ear. It projects down- 
ward, forward, and inward, and presents for examina- 
tion a superior, posterior, and inferior surface. 
The superior or anterior surface is united to the 
squamous portion by the temporal suture and presents 
the following:— 
An eminence, marking the position of the superior 
semicircular canal; 
A depression, forming the roof of the tympanum ; 
The hiatus Fallopii, transmitting a branch of the 
middle meningeal artery and the petrosal branch of the 
Yidian nerve to the aqueduct of Fallopius; 
Foramen for the smaller petrosal nerve; 
Orifice of the carotid canal, transmitting the carotid 
plexus of the sympathetic and the internal carotid 
artery ; and 
Depression for Gasserian ganglion of the trifacial 
nerve. 
The posterior surface presents about its middle 
The meatus auditorius interims, at the bottom of 
which is the lamina cribrosa, a perpendicular plate of 
bone, and numerous foramina for the exit of the audi- 
tory nerve and the auditory branch of the basilar artery, 
one of which is the commencement of the aqueductus 
Fallopii for the facial nerve. 
Posteriorly to the internal meatus is the aquseductus 
vestibuli, lodging a process of dura mater,and transmit- 
ting an artery and vein, and between them another small 
depression for the same purpose. 
The inferior or basilar surface presents, from within 
outward, the following:— 
A rough, quadrilateral surface, for attachment of the 
tensor tympani and levator palati muscles ; 
The opening of the carotid canal, transmitting the OSTEOLOGY. 
19 
carotid plexus of the sympathetic and the internal ca- 
rotid artery ; 
Aquseductus cochlea, transmitting- a vein to the in- 
ternal jugular vein from the cochlea; 
Jugular fossa, forming the jugular foramen (foramen 
lacerum posterius) by articulation with the occipital 
bone, and transmitting the internal jugular vein, the 
glosso-pharyngeal, pneumogastric, and spinal accessory 
nerves, and meningeal branches of the ascending pharyn- 
geal and occipital arteries; 
Foramen for Jacobson's nerve, the tympanic branch 
of the glosso-pharyngeal; 
Foramen for entrance of Arnold’s nerve, the auricu- 
lar branch of the pneumogastric; 
The vaginal process, extending from the mastoid pro- 
cess to the carotid canal, and ensheathing 
The styloid process, affording attachment for the 
stylo-maxillary and stylo-hyoid ligaments and the stylo- 
liyoideus, stylo-pharyngeus, and stylo-glossus muscles; 
The stylo-mastoid foramen, for exit of facial nerve; 
The auricular fissure, for the exit of Arnold’s nerve, 
the auricular branch of the pneumogastric. 
The base of the petrous portion presents 
The external auditory meatus, the canal leading into 
the tympanum, and 
The auditory process, a lamina of bone forming the 
greater part of its walls. 
Borders.—The superior border affords attachment to 
the tentorium cerebelli, and has a groove for the superior 
petrosal sinus. The posterior border forms part of the 
jugular fossa. The anterior border articulates with the 
spinous process of the sphenoid. Between the squamous 
and petrous portions are two canals, separated by the pro- 
cessus cochleariformis, for the tensor tympani muscle 
above and the Eustachian tube below. 
Muscular attachments are fifteen :— 
To the squamous portion, 2—the temporal and masse- 
ter ; to the mastoid portion, 6—sterno-mastoid, occipito- 
frontalis, splenitis capitis, trachelo-mastoid, retrahens 
aurem, and digastricus ; to the styloid portion, 3—stylo- 
hyoideus, stylo-pharyngeus, and stylo-glossus ; and to 20 
HUMAN ANATOMY. 
the petrous portion, 4—levator palati, tensor palati, 
tensor tympani, and stapedius. 
Its ossific centres are ten (10), 1 for the squamous 
portion, including the zygoma, 1 for auditory process, 
6 for petrous and mastoid portions, and 2 for the styloid 
process. 
The sphenoid is wedged in between tlie bones at the 
base of the skull anteriorly and resembles a bat with 
extended wings. It consists of 
A body, 
2 Greater wings, 
2 Lesser wings, and 
2 Pterygoid processes. 
It presents 
12 Foramina, 
12 Articulations, 
12 Pairs of muscles, and 
14 Centres of ossification, 
and is in every respect the most important bone of the 
cranium, entering into the formation of 
5 Cavities— 
1 Anterior cerebral, 
2 Middle cerebral, 
3 Orbital, 
4 Pharyngeal, 
5 Nasal, 
4 Fossa?— 
1 Temporal, 
2 Zygomatic, 
3 Spheno-maxillary, 
4 Nasal, and 
3 Fissures— 
1 Spheno-maxillary, 
2 Pterygoid-maxillary, and 
3 Sphenoidal or foramen la- 
cernum anterior. 
The body is a hollow cube and presents an upper, 
lower, anterior, and posterior surfaces. 
The upper surface of the body presents from before 
backward the following points :— 
Ethmoidal spine, for articulation with the cribriform 
plate of the ethmoid ; 
Optic groove, lodging the optic commissure and ter- 
minating in the optic foramen ; 
Olivary process, a small, olive-like eminence behind 
the optic groove; 
Pituitary fossa, or sella tursica, for the pituitary 
body ; 
Middle clinoid process, one on either side bounding 
the pituitary fossa ; 
Dorsum sellse, or dorsum ephippii, a quadrilateral 21 
plate of bone, bounding the pituitary fossa behind, and 
notched on either side for the passage of the sixth 
cranial nerves; 
Posterior clinoid processes are the terminations of 
the dorsum sell* on either side and afford attachment 
to the tentorium cerebelli; 
Declivity, or clivus Blumenbachii, supporting the 
upper part of the pons Yarolii; 
Carotid or cavernous groove, lodging the cavernous 
sinus and the internal carotid artery; 
Lingula, a ridge of bone to the outer side of the 
cavernous sinus. 
OSTEOLOGY. 
Fig. 9. 
1, olivary process: 2, ethmoid spine; 3, optic foramen; 4, lesser wing; 5, ante- 
rior elinoid process; fi, posterior clinoid process ; 7, carotid groove; 8, Vidian canal; 9, 
hamular process; 10, pituitary fossa; 11, sphenoidal fissure; 12, foramen rotun- 
dum; 13, foramen ovale; 14, foramen spinosum; 15, spinous process; 16, pterygoid 
process. 
The lower surface presents :— 
Rostrum, the continuation downward of the ethmoidal 
crest, for articulation with the alae of the vomer; 
Vaginal processes, a thin plate of bone on either side 
articulating with the edges of the vomer; and 
Groove, converted into the pterygo-palatine canal by 
articulation with the sphenoidal process of the palate 
bone for transmission of the pharyngeal nerve and 
pterygo-palatine vessels. 22 
HUMAN ANATOMY. 
The anterior surface presents :— 
Ethmoidal crest, a thin plate of bone articulating 
with the ethmoid ; 
Openings of sphenoidal cells or sinuses partially 
closed by the sphenoidal turbinated bones or pyramids 
of Wistar, two curved plates of bone absent in infancy 
but derived as a pair of cones from the ethmoid. The 
sphenoidal cells open into the superior meatus of the nose, 
but occasional!}7 into the posterior ethmoidal sinuses. 
The posterior surface articulates with the basilar 
process of the occipital and becomes united to it between 
the eighteenth and twenty-fifth year. 
1, tensor palati: 2, Vidian canal; 3, pterygoidens internus : 4, pterygo-palatine 
canal; .r>. vaginal process ; 6, superior constrictor of pharynx ; 7, scaphoid fossa; 8, 
pterygoid fossa. 
Fig. 10. 
The superior surfaces of the great wing, deeply con- 
cave, forms part of middle fossa of skull and presents 
the following:— 
Foramen rotundum, for second division of fifth 
nerve ; foramen ovale, for third division of fifth, small 
meningeal artery, and small petrosal nerve ; foramen 
Vesalii, for small vein, and foramen spinosum, for 
passage of middle meningeal artery. 
The exterior surface is convex and presents :— 
Pterygoid ridge, dividing the bone into two portions; 
Spinous process, for attachment of tensor palati 
muscle, and the internal lateral ligament of the lower 
jaw. 
GREATER ’WINGS OF THE SPHENOID. OSTEOLOGY. 
23 
The anterior or orbital surface enters into the forma- 
tion of the orbit and presents numerous external orbital 
foramina for passage of branches of the deep temporal 
arteries. 
The circumference of the greater wing forms part of 
the sphenoidal fissure and articulates with the frontal 
bone in front and laterally with the parietal, squamous, 
and petrous portions of the temporal bone. 
The lesser wings, or processes of Ingrassias, project 
on either side from the superior surface of the body, to 
which it is attached by two roots. 
The upper surface forms part of the anterior fossa 
of the skull. The lower surface forms part of the orbit 
and the upper border of the sphenoidal fissure, or fora- 
men lacerum anterius, transmitting the third and fourth 
ophthalmic divisions of the fifth and sixth cranial nerves, 
orbital branch of the middle meningeal artery, a recur- 
rent branch of the lachrymal artery, the ophthalmic 
vein, and filaments from the cavernous plexus. 
The anterior clinoid process is formed by the inner 
extremity of the posterior border. 
Between the two roots is the optic foramen, trans- 
mitting the optic nerve and ophthalmic artery. 
The pterygoid pi'ocesses are two wing-like processes 
descending from the junction of the greater wings with 
the body. 
Each process presents the following:— 
An external pterygoid plate, for attachment of the 
external pterygoid muscle; 
The pterygoid fossa lies between the two plates and 
affords attachment for the internal pterygoid muscle; 
The internal pterygoid plate, terminating below in a 
hook-like process—the hamular process—for the tendon 
of the tensor palati muscle ; 
The scaphoid fossa, at the base of the internal plate, 
affording origin for the tensor palati muscle and present- 
ing just above it the posterior opening of the Yidian 
canal for the Yidian vessels and nerves ; 
An angular interval between the two plates articulates 
with tuberosity or pterygoid process of the palate bone. 24 
human anatomy. 
Tiie foramina are : Opticum, lacerum aiiterius, 
rotundum, Yesalii, ovale, spinosum, and two canals— 
Vidian and pterygo-palatine; articulate with twelve 
bones—two malar, two palate, vomer, and all of 
cranium. Its muscular attachments are twelve pairs— 
external and internal pterygoid, temporal, tensor palati, 
laxator tympanii, superior constrictor, levator palpebra, 
obliquus superior; superior, inferior, internal and exter- 
nal recti. Its ossific centres are fourteen, as follow: 
Body, 6, 6, 2 ; pre-sphenoid, 2 ; basi-sphenoid, 2 ; lingula, 
2 ; lesser wings, 2 ; greater wings, 2 ; internal pterygoid 
plates, 2 ; splieno-turbinals, 2 ; total, 14. 
The ethmoid is a spongy, cubical bone, consisting 
of a perpendicular lamella, a horizontal or cribriform 
plate, and two lateral masses. 
The horizontal or cribriform plate presents from 
before backward the following points :— 
Tivo projections completing the foramen caecum, the 
commencement of the longitudinal sinus ; 
Grusta galli, affording attachment to the falx 
cerebri; 
Foramina cribi'osa, three rows, transmitting fila- 
ments of the olfactory body ; 
Fissure for passage of the nasal branch of the oph- 
thalmic nerve. 
The perpendicular plate assists in forming the nasal 
septum, articulating in front with the crest of the nasal 
bones and the frontal bone and behind with the sphenoid 
and vomer. It is usually inclined to one side. 
The lateral masses are composed of the ethmoidal cells. 
The upper surface presents two notches, converted 
into foramina by articulation with the frontal bone— 
The anterior ethmoidal foramen, transmitting the 
anterior ethmoidal artery and nasal nerve, and 
The posterior ethmoidal foramen, transmitting the 
posterior ethmoidal artery and vein. 
The outer surface presents 
The os planum, a smooth plate of bone forming the 
inner wall of the orbit, and projecting downward from 
it is OSTEOLOGY. 
25 
The unciform process, a liook-like plate of bone 
closing the upper part of the opening of the antrum. 
The inner surface forms part of the nasal fossa, and 
presents 
The superior turbinated hone,, forming the upper 
boundary of the superior meatus, into which open the 
sphenoidal and posterior ethmoidal cells, and the 
Middle turbinated hone, forming the upper boundary 
of the middle meatus of the nose, into which open the 
anterior ethmoidal cells, the frontal cells through the 
infundibulum, and the antrum Highmorianum. 
It articulates with fifteen bones—two sphenoidal tur- 
binated, sphenoid, frontal, and eleven of the face, the 
two nasal, two lachrymal, two superior maxilla}, two 
palate, two inferior turbinated, and the vomer. 
It has no muscular attachments. 
Its ossific centres are three—one for the lamella and 
one for each lateral mass. 
BONES OF THE FACE 
The bones of the face are fourteen in number— 
six pairs and two single bones : Two lachrymal, two 
nasal, two malar, two superior maxillary, two palate, 
two turbinal, one vomer, and one inferior maxillary. 
The lachrymal are two small, thin bones forming 
part of the inner wall of the orbit and the lachrymo-nasal 
duct, and named from their resemblance to a finger-nail, 
the ossa unguis. 
Each presents externally :— 
The lachrymal crest affords attachment for the tensor 
tarsi and separates the anterior surface from the groove ; 
The groove forms part of the lachrymal groove and 
lodges tlie lachrymal sac ; 
The hamular process, or, when separate, called the 
lesser lachrymal hone, projects downward and articulates 
with the lachrymal tubercle of the superior maxilla. 
Internally :— 
A furrow, corresponding to the lachrymal crest on 
the external surface ; HUMAN ANATOMY. 
The internal surface enters into the formation of the 
middle meatus, closing in the anterior ethmoidal cells. 
It articulates with four bones—the frontal, ethmoid, 
superior maxilla, and inferior turbinated. 
The only muscular attachment is the tensor tarsi. 
It is developed from one ossifie centre. 
The nasal bones are two irregularly quadrate bones 
forming together the bridge of the nose. 
The outer surface, covered by the compressor nasi 
and pyramidalis muscles, presents 
A foramen, transmitting a small vein. 
The inner surface presents 
A groove or canal for a branch of the nasal nerve. 
The inferior border, the most important, has attached 
to it the lateral cartilage of the nose, and presents 
A spine, forming, with its fellow, the nasal angle, a 
notch for exit of the branch of the nasal nerve which 
grooves the posterior surface. 
It articulates with four bones—frontal, ethmoid, su- 
perior maxilla, and its fellow. 
It has no muscular attachments. It is developed 
from one centre. 
The malar bones are two quadrilateral bones forming 
the prominence of the cheek. They enter into the forma- 
tion of the orbit and the zj’gomatic and temporal fossae. 
Each bone has four processes—zygomatic, maxillary, 
frontal, and orbital. 
The external surface has attached to it the zygo- 
matic muscles (major and minor), and presents 
A foramen to its outer side for the malar branch of 
the temporo-malar nerve and a foramen to its inner side 
for the temporal branch of the temporo-malar. 
The internal surface articulates with the superior 
maxilla, has attached to it the masseter and temporal 
muscles, and presents the internal openings of the fora- 
mina given above. 
The zygomatic process forms, with the zygomatic 
process of the temporal bone, the zygoma. 
The maxillary process is triangular and roughened 
for articulation with the superior maxilla. OSTEOLOGY. 
The frontal process is articulated with the external 
angular process of the temporal bone. 
The orbital process, the most important, articulates 
by its upper surface with the greater wing of the sphe- 
noid, forming part of the outer wTall of the orbit; the 
under surface forms part of the temporal fossa, while 
the posterior margin forms part of the spheno-maxillary 
fissure. The superior surface presents two tempo ro- 
malar canals, transmitting temporo-malar branches of 
the superior maxillary nerve. 
It articulates with four bones—the frontal, sphenoid, 
temporal, and superior maxilla. 
Its muscular attachments are 
five—the masseter, temporal, 
zygomaticus major and minor, 
and the levator labii superioris. 
It is developed from one 
ossific centre. 
The superior maxilla is the 
largest bone of the face, except- 
ing the lower jaw, and one of the 
most important, assisting in the 
formation of three cavities, the 
mouth, nose, and orbit; two 
fissures, the spheno-maxillary 
and pterygo-maxillary; and two 
fossae, the spheno-maxillary and 
zygomatic. It consists of a body 
and four processes—the nasal, 
the malar, the palatine, and the alveolar (Fig. 11). 
The body is excavated to form the maxillary sinus 
or antrum Highmorianum, a large, irregular triangular 
cavity, with its base directed inward, its apex upward 
and outward, projecting into the malar process. 
Its posterior wall presents dental canals, 
transmitting the posterior dental vessels and nerves. 
The external or facial surface (Fig. 11) of the body 
presents the following points :— 
Incisive fossa, or myrtiform fossa, for the origin of 
the depressor alae nasi: 
Fig. 11. 
1, malar process; 2, nasal 
process; 3, orbital process; 4, infra- 
orbital foramen; 5, infraorbital 
groove; 6, lachrymal tubercle; i, 
incisor teeth; c, canine; b, bicuspid; 
m, molars. 28 
HUMAN ANATOMY. 
Canine fossa, for origin of levator anguli oris ; 
Canine eminence, over the position of the canine 
tooth ; 
Infraorbital foramen, for the exit of the infraorbital 
nerve and artery. 
The internal surface of the body presents :— 
Palate process, separating the mouth from the nasal 
fossae; 
Orifice of antrum Highmorianum, before alluded to ; 
Groove completing the 
posterior palatine canals be- 
hind ; 
Deep groove in front, form- 
ing, with the inferior turbi- 
nated bone and lachrymal, the 
lachrymal canal for laclirymo- 
nasal duct; 
Inferior turbinated crest 
for the turbinated bone. 
The superior orbital sur- 
face presents :— 
Infraorbital groove about 
the middle for the infraorbital 
artery and nerve ; 
Anterior dental canal, one 
of the divisions of the infra- 
orbital canal, transmitting 
the anterior dental vessels 
and nerve. 
The posterior or zygomatic surface presents :— 
Posterior dental canals, transmitting posterior dental 
nerves and vessels; 
Maxillary tuberosity, articulating with the tuberosity 
of the palate bone ; 
Groove, converted into posterior palatine canal by 
the palate bone for posterior palatine vessels and 
nerves. 
The nasal process projects upward to articulate with 
the frontal bone, its external surface smooth, affording 
attachment to several muscles, its internal surface form- 
Fig. 12. 
1, antrum; 2, nasal process; 3> 
superior turbinated bone; 4, middle 
meatus; 5, inferior crest; 6, inferior 
meatus; 11, posterior palatine canal; 
15, anterior nasal spine; 16, anterior 
palatine canal; 18, palate process. OSTEOLOGY. 
29 
ing part of the outer wall of the nose. It presents the 
following:— 
Superior turbinated crest, for the middle turbinated 
bone of the ethmoid ; 
Inferior turbinated crest below, for the inferior tur- 
binated bone ; 
Groove at the posterior margin, forming part of the 
lachrymal canal; 
Lachrymal tubercle, at the junction of the nasal 
process with the orbital surface. 
The malar process projects upward and outward to 
articulate with the malar bone. 
The palatine process projects from the internal sur- 
face of the bone to form part of the roof of the mouth 
and the floor of the nose. It presents :— 
Anterior palatine canal or fossa, divided into four 
canals ; 
Foramina of Stenson, one on either side, transmit the 
anterior branch of the descending palatine artery ; 
Foramina of Scarpa, one in front and behind, trans- 
mit the naso-palatine nerves; 
Suture in the anterior part showing original 
separation of the incisive or intermaxillary bone; 
Posterior palatine groove for the posterior palatine 
vessels, and anterior palatine nerves from Meckel’s 
ganglion ; 
Nasal crest for the vomer, and 
Anterior nasal spine projecting from the anterior 
extremity of the crest. 
The alveolar process forms the curved, spongy 
portion for the insertion of the upper teeth. It 
presents 
The alveoli or sockets of varying depths, eight in 
the adult, five in the child. 
It articulates with nine (9) bones—the ethmoid, 
frontal, lachrymal, nasal, malar, inferior turbinated, 
palate, vomer, and its fellow of the opposite side. 
Its muscular attachments are nine—the levator labii 
superioris alaeque nasi, levator labii superioris proprius, 
levator anguli oris, compressor naris, depressor alae 30 
HUMAN ANATOMY. 
nasi,orbicularis palpebrarum, inferior obliquus,masseter, 
and buccinator. 
It is developed from four centres: one for incisive 
bone, or pre-maxilla; one for palate process, or pre- 
palatine ; one for the maxillary portion, including the 
orbital and facial portion; and one for the malar 
portion. 
Each palate-bone is a thin, L-shaped bone, consisting 
of an inferior or horizontal plate and a superior or ver- 
tical plate. 
Each bone assists in forming three cavities—the outer 
wall and floor of the nose, the roof of the mouth, and the 
floor of the orbit; two fossae—the 
pterygoid and spheno-maxillary ; and 
one fissure—the spheno-maxillary. 
The horizontal plate is quadrilat- 
eral. Its inferior surface presents 
A ridge for the aponeurosis of the 
tensor palati muscle; 
A groove entering into the forma- 
tion of the posterior palatine canal; 
Accessory palatine foramina for 
posterior descending palatine nerves. 
Its posterior border presents 
The posterior nasal spine for the 
azygos uvulae muscles. 
The internal border articulates 
with its fellow and presents 
A crest for the vomer. 
The vertical plate projects upward and inward, 
terminating above in two well-marked processes—the 
orbital and sphenoidal processes. 
The internal surface forms part of the outer wall of 
the nasal fossa, and presents 
An inferior turbinated crest for the inferior turbi- 
nated bone ; 
A superior turbinated crest for the middle turbi- 
nated bone, separating the middle from the inferior 
meatus of the nose. 
The external surface forms part of the spheno- 
1, horizontal plate: 2, 
vertical plate; 3, tuberos- 
ity ; 4, crest: 5, post-nasal 
spine; 6, inferior turbinated 
crest; 7, spheno-palatine 
foramen; 8, zygomatic sur- 
face ; 9, sphenoidal surface. 
Fig. 13. OSTEOLOGY. 
31 
maxillary fossa and covers part of the orifice of the 
antrum. 
It presents at the posterior part 
A groove, converted by the superior maxilla into a 
canal, the posterior palatine, for the passage of the 
descending palatine vessels and the descending palatine 
branches from Meckel’s ganglion. 
The anterior border presents 
The maxillary process, closing part of the orifice of 
the antrum. 
The pterygoid process, or tuberosity of the palate, 
at its lower part wedged in between the pterygoid plates 
of the sphenoid, and giving origin to part of the superior 
constrictor and the internal pterygoid muscles. 
Foramina of accessory descending palatine canals, 
for posterior descending branches from Meckel’s gang- 
lion. 
The orbital process, a large, hollow, triangular pro- 
cess, is so called from its forming part of the orbit. 
It presents 
The anterior or maxillary articular surface for 
superior maxilla •, 
The posterior or sphenoidal articular surface for 
sphenoid ; 
The internal or ethmoidal articular surface for 
ethmoid ; 
A superior or orbital surface, a smooth portion 
entering into the formation of the orbit ; 
An external or zygomatic surface, also smooth, 
forming part of the zygomatic fossa. 
The sphenoidal process is a small, thin plate of bone 
which articulates by its upper surface with the 
sphenoidal turbinated bone; its inner surface forms part 
of the nasal fossa, and its outer surface articulates with 
the pterygoid process of the sphenoid and forms part 
of the spheno-maxillary fossa. 
The anterior border forms part of the spheno-palatine 
foramen, which passes between the orbital process and 
the sphenoidal process. 
It articulates with six (6) bones—ethmoid, sphenoid, 32 
superior maxillary, vomer, inferior turbinated, and fellow 
of opposite side. 
Its muscular attachments are azygos uvulae, tensor 
palati, internal and external pterygoid, and superior con- 
strictor. It has one ossific centre at the junction of the 
plates. 
The inferior turbinated bones are small, scroll- 
like bones, situated on the outer wall of the nasal fossa, 
separating the middle from the inferior meatus. Each 
presents two surfaces and three processes, the lachrymal, 
ethmoidal, and maxillary. 
The internal surface is lined in the recent state with 
the mucous membrane of the nose. 
The external surface is attached to the superior 
maxilla and palate-bone, and presents above the three 
processes. 
The lachrymal process forms part of the lachrymal 
canal, articulating with the superior maxilla and the 
lachrymal bone. 
The ethmoidal process articulates with the hook-like 
process of the ethmoid bone. 
The maxillary process projects outward and down- 
ward from the ethmoidal process, and narrows the orifice 
of the antrum. 
It articulates with four bones—ethmoid, palate, 
superior maxillary, and lachrymal. 
Muscular attachments, none. It has one ossific 
centre. 
The vomer is a thin, triangular plate of bone, con- 
tributing to form part of the septum nasi. It is usually 
bent to one side. 
The superior border presents a groove with overlap- 
ping laminae, or vaginal processes, for articulation with 
the rostrum and vaginal processes of the sphenoid. 
The inferior border articulates with the crests of the 
superior maxillae and palate-bones. 
The posterior border is smooth and free, forming the 
posterior nasal septum. 
The lateral surfaces present 
Furrows for blood-vessels, and 
HUMAN ANATOMY. 33 
OSTEOLOGY. 
Naso-palatine grooves for the naso-palatine nerves, 
which descend to the foramina of Scarpa. 
It articulates with six bones—the ethmoid, sphenoid, 
two palate, and two superior maxillae. 
It has no muscular attachments. It is developed from 
a single ossific centre, although it begins as two cartila- 
ginous laminae, which coalesce. 
The inferior maxilla is the largest bone in the 
face. It consists of a body and two rami. 
The body is the horizontal, horseslioe-like portion, 
containing the lower teeth. 
1, body; 2, ramus; 3, symphysis; 5, mental foramen; 6, external oblique line; 7, 
facial groove; 8, angle; 9, internal oblique line; 10, coronoid process; 11, condyle; 12, 
sigmoid notch ; 13, inferior dental foramen; mylo-hyoid groove; i, incisors; c, canine; 
b, bicuspids; m, molars. 
Fig. 14. 
The external surface presents from before back- 
ward :— 
Symphysis, a vertical median line indicating the 
junction of the vaginal halves ; 
Mental process, a triangular prominence forming the 
chin ; 
Incisive fossa, for the origin of the levator labii 
inferioris; 
Mental foramen, for the exit of the mental nerve and 
artery; 
External oblique line, running backward and upward 
from the mental process, for the attachment of the 
depressor anguli oris and depressor labii inferioris. 34 
HUMAN ANATOMY. 
The internal surface presents from before back- 
ward :— 
Genial tubercles, four in number, for attachment of 
the genio-hyoglossi muscles above and the genio- 
hyoidei below; 
Sublingual fossa, for the sublingual gland ; 
Internal oblique line (mylo-liyoidean), for the attach- 
ment of the superior constrictor, the mylo-liyoid mus- 
cles, and the pterygo-maxillary ligament; 
Submaxillary fossa, for the submaxillary gland. 
The superior or alveolar border presents sixteen cavi- 
ties (ten in childhood) for the teeth. 
The inferior border is grooved posteriorly for the 
facial artery. 
The ramus or horizontal portion on either side is 
somewhat quadrilateral, and presents the following 
points :— 
The internal surface of ramus; 
Foramen of inferior dental canal, for inferior dental 
vessels and nerve ; 
Mylo-liyoidean groove, described above ; 
Spine, for attachment of the internal lateral ligament 
of the lower jaw. 
The upper border is surmounted by two processes, 
the coronoid and the condyloid processes, separated by 
the sigmoid notch. 
The coronoid process is in front, and affords attach- 
ment for the temporal muscle. 
The condyloid process articulates writh the glenoid 
fossa of the temporal bone, being supported upon a 
constricted portion, the neck, which receives the inser- 
tion of the external pterygoid muscle, and presents to 
its outer side a tubercle for the external lateral ligament 
of the lower jaw. 
The sigmoid notch is crossed by the masseteric vessels 
and nerve. 
The lower border presents:— 
Angle of the jaw, the point of junction of the ramus 
with the body; 
Rough surface, for attachment of the stylo-maxillary OSTEOLOGY. 
35 
ligament, and on its inner side the internal pterygoid 
muscle, and on its outer side the masseter. 
It articulates with the two temporal bones. 
The muscular attachments are fifteen pairs ; to the 
external surface, six—depressor anguli oris, depressor 
labii inferioris, levator labii inferioris, orbicularis oris, 
platysma myoides, and buccinator; from the internal 
surface of the body, five—the genio-hyoglossus, genio- 
hyoid, mylo-hyoid, digastric, and superior constrictor ; 
and to the ramus, four—the masseter, internal and exter- 
nal pterygoids, and temporal. 
It has two ossific centres, one for each lateral 
half, developed partly from membrane, partly from 
cartilage, being preceded in time only by one bone—the 
clavicle. 
Changes in Lower Jaw.—Certain changes occur in 
the size and shape of the lower jaw as age advances. 
At birth the body is shell-like, containing sockets for 
the ten temporary teeth, the mental foramen is large and 
opens beneath first molar, and the coronoid process is 
large and at right angles to base. 
In adults the base and alveolar process are equal in 
size, the mental foramen opens midway between upper 
and lower borders, and the rami are at nearly right angles 
to base. 
In advanced age the loss of the teeth and alveolar 
borders greatly reduces the body, the mental foramen 
opens near the alveolar border, and the rami are united 
at very obtuse angles with the base. 
Tiie hyoid bone, or lingual bone, is a small U-shaped 
bone situated at the base of the tongue, consisting of a 
body, two greater and two lesser cornua. 
It is supported by the stylo-hyoid ligament from the 
styloid processes of the temporal bones. 
The anterior surface is divided by a crucial ridge 
into four depressions for muscular attachments, and its 
centre presents a tubercle. 
The posterior surface is in relation with the epiglottis, 
being separated by the thyro-hyoid membrane. 
The upper and lower borders afford attachment to HUMAN ANATOMY. 
muscles, and the lateral surfaces are mounted with car- 
tilage for articulation with the greater cornuae. 
The greater cornua, or thyro-hyals, project back- 
ward, afford attachment to the hyoglossus, thyro-hyoid, 
and middle constrictor of the pharynx, and terminate 
behind in a tubercle for the attachment of the thyro- 
hyoid ligament. 
The lesser cornua, or cerato-liyals, are two tuber-like 
projections attached at the junction of the body with the 
greater cornua, and receiving the insertion of the stylo- 
hyoid ligaments. It does not articulate with any bone. 
Its muscular attachments are ten—the lingualis, hyo- 
glossus, genio-hyoglossus, middle constrictor, stylo-, 
mylo-, genio-, sterno-, tliyro-, omo-hyoid ; also aponeu- 
rosis of digastric and stylo-hyoid ligament. 
Ossific centres, five—one for body and one for each 
horn. 
The Sutures and Fontanelles.—The sutures are 
divided into three sets, those of the vertex, side, and 
base of the skull. 
At the vertex of the skull there are three: — 
Sagittal, or inter-parietal; 
Coronal, or fronto-parietal; 
Lambdoid, or occipito-parietal. 
At the side of the skull are three :— 
Spheno-parietal; 
Squamo-parietal, or squamous; 
Masto-parietal. 
At the base of the skull are nine :— 
Basilar, in centre; 
Petro-occipital, 
Masto-occipital, 
Petro-sphenoidal, 
Squamo-sphenoidal, 
on either side. 
The sutures of the face are very numerous, but the 
most important are :— 
Zygomatic, at the temporo-malar junction ; 
Transverse, passes from one external angular process to the other, 
and connects the frontal with the malar ethmoid, sphenoid, lachrymal, 
superior maxillary, and nasal bones ; 
Intermaxillary, the median suture between the superior maxillae; 
Symphysis, the remains of a foetal suture. 37 
OSTEOLOGY. 
The fontanelles are six membranous intervals in the 
infant’s skull corresponding to the four angles of the 
parietal bones. The anterior, larger and lozenge-shaped, 
is at the junction of sagittal and coronal sutures; the 
posterior, smaller and triangular, is at the junction of 
sagittal and lambdoid sutures ; and the four lateral are 
at anterior and posterior inferior angles of parietal 
bones. 
The Wormian, or supernumerary, are irregular bones 
interposed in intervals between the cranial bones, chiefly 
in the course of the lambdoid suture. From their tri- 
angular form they are calledossa triqueta.” 
Congenital fissures from an arrest of ossification 
also occur, the most common being the parietal and 
sagittal fissures (Treves). 
FOSSAE OF SKULL. 
The fossae at the lateral region of the skull are tem- 
poral, zygomatic, and sphcno-maxillar}^. 
Temporal Fossa.—Deeply concave in front, convex 
behind, it is formed by parts of five bones—frontal,malar, 
sphenoid, temporal, and parietal. It is bounded above 
and behind by temporal ridge ; in front by the sphenoid, 
malar, and frontal; below and externally by zygoma and 
pterygoid ridge on greater wing of sphenoid. It is 
crossed by six sutures—spheno-malar, spheno-parietal, 
squamo-parietal, squamo-sphenoidal, coronal, and trans- 
verse facial. It opens below into the zygomatic fossa, 
is filled by the temporal muscle, and lodges the deep 
temporal vessels. 
Zygomatic Fossa.—This irregular cavity contains 
parts of temporal, external and internal pterygoid 
muscles, and is bounded above by pterygoid ridge of 
sphenoid and squamous portion of temporal, below by 
alveolar border of superior maxilla, in front by tu- 
berosity of superior maxillary, behind by border of 
pterygoid process, externally by zygoma and ramus of 
lower jaw, and internally by external pterygoid plate. 
It is traversed by two fissures—spheno-maxillary and 
ptery go-maxi llary. 38 
HUMAN ANATOMY. 
The splieno-maxillary fissure connects the zygomatic, 
temporal and spheno-maxillary fossae, and transmits the 
infraorbital artery, ascending branches of Meckel’s 
ganglion, the superior maxillary nerve, and its orbital 
branch. 
It is bounded above by great wing of sphenoid, 
below by superior maxilla and part of palate-bone; 
internally it opens into pterygo-maxillary fissure, and 
externally part of malar bone. 
Fig. 15. 
1, palatomaxillary suture; 2, anterior palatine fossa; 3, posterior palatine 
foramen; 4, posterior nasal spine; 5, vomer; 6, hamular process; 7, pterygo-palatine 
canal; 9, zy'gomatic fossa; 10, pharyngeal spine; 11, foramen magnum; 12, foramen 
ovale; 13, foramen spinosum; 14, glenoid fossa; 16, foramen lacerutn medium; 17, 
carotid foramen; 18, jugular fossa; 20, stylo-mastoid foramen; 23, posterior condyloid 
foramen. 
Ptery go-maxillary fissure connects the zygomatic and 
spheno-maxillary fossae, passing vertically between ptery- 
goid process of sphenoid and superior maxillary bone, 
and transmits branches of internal maxillary artery. 
Spheno-maxillary fossa is a triangular cavity, bounded 
above by body of sphenoid and orbital plate of palate- 
bone, within by vertical plate of palate, in front by OSTEOLOGY. 
39 
superior maxillary, and behind by pterygoid process of 
sphenoid. It has communicating with it 
Three fossae—orbital, nasal and zygomatic; 
Three fissures—sphenoidal, spheno-maxillary, and 
pterygo-maxillary; 
Two cavities—cranial and buccal; and 
Five foramina—foramen rotundum, Yidian, and 
pterygo-palatine posteriorly ; spheno-palatine, on inner 
wall, and posterior palatine canal, and (sometimes) 
accessory posterior palatine canals below. It contains 
FIG. 10. 
2, nasal eminence; 3, supraorbital ridge; 4, lachrymal bone; 5, ethmoid bone; 
6, infraorbital groove; 7, lachrymal groove; 9, infraorbital foramen; 10, malar 
foramina. 
internal maxillary artery, superior maxillary nerve, and 
Meckel’s ganglion. 
The orbits are two pyramidal cavities, situated 
between the nose and external angular processes, the 
forehead and face, their bases outward and forward, 
their apexes converging toward the body of the sphenoid 
bone. They contain the eye and its appendages, and are 
each formed by seven bones—frontal, ethmoid, sphenoid 
(entering into both cavities), and superior maxillary, 40 
HUMAN ANATOMY. 
lachrymal, malar, and palate (separate in each). The 
roof, concave, presents:— 
Externally, depression for lachrymal gland; 
Internally, depression for pulley of superior oblique, 
and 
Posteriorly, a suture between lesser wing and frontal 
bone. 
It is formed by the orbital plate of frontal and lesser 
wing of sphenoid. 
The floor is short and flat, and presents :— 
Internally, a depression for inferior oblique muscle; 
Middle, the infraorbital groove for nerve and artery ; 
Externally, suture of superior maxillary and malar, 
and 
Posteriorly, suture between palate and superior 
maxillary. 
It is formed by orbital processes of malar and 
superior maxilla and orbital surface of palate. 
Inner wall presents crest of lachrymal bone, lachry- 
mal groove, and sutures between ethmoid and sphenoid, 
and ethmoid and lachrymal. 
It is formed by lachrymal, parts of ethmoid, and 
sphenoid and nasal process of superior maxilla. 
The outer wall presents suture between malar and 
sphenoid and orifices of malar canals. It is formed by 
orbital plate of sphenoid and orbital process of malar. 
The angles of the orbit are four,—superior internal 
and external, inferior internal and external. 
They present the following :— 
Superior internal angle ; 
Foramen ethmoidal anterior, transmitting anterior 
ethmoidal vessels and nasal nerve ; 
Foramen ethmoidal posterior, transmitting posterior 
ethmoidal artery and vein ; 
Suture between frontal and ethmoid, and frontal and 
lachrymal; 
Superior external angle ; 
Sphenoidal fissure, or foramen lacerum anterius, 
transmitting third, fourth, ophthalmic division of fifth 
and sixth nerves; orbital branch of middle meningeal OSTEOLOGY. 
41 
artery, filaments of cavernous plexus of s}rmpathetic, 
recurrent branch of lachrymal artery, and ophthalmic 
vein and process of dura mater. 
Suture between great wing of sphenoid and malar 
bone. 
Inferior internal angle; 
Suture between superior maxillary and palate bones, 
uniting with lachrymal and os planum of ethmoid; 
Inferior external angle ; 
Spheno-maxillary fissure, for passage of superior 
maxillary nerve and its orbital branch, infraorbital ves- 
sels, and ascending branches from Meckel’s ganglion. 
The circumference is bounded :— 
Inner side by nasal process of superior maxilla and 
internal angular process of frontal; 
Outer side by external angular process of frontal 
and malar bone; 
Above by supraorbital arch ; 
Below by lachrymal, superior maxilla, and malar. 
It presents sutures malo-maxillary below ; 
Sutures fronto-malar to outer side ; 
Sutures fronto-maxillary to inner side ; 
Supraorbital notch or foramen above, for passage 
of supraorbital nerve, artery, and vein, and forms part 
of lachrymal groove. 
The apex presents:— 
Optic foramen, for passage of optic nerve and oph- 
thalmic artery. 
Each orbit presents nine (9) openings, as follows :— 
1. Supraorbital foramen for passage of supraorbital 
artery, vein, and nerve ; 
2. Infraorbital canal for infraorbital nerve and 
artery; 
3. Anterior ethmoidal foramen for anterior eth- 
moidal artery, vein, and the nasal nerve ; 
4. Posterior ethmoidal foramen for posterior eth- 
moidal artery and vein; 
5. Malar foramina, for malar and temporal branches 
of temporo-malar nerve; 
6. Lachrymal canal, for lachrymo-nasal duct; 42 
HUMAN ANATOMY. 
7. Spheno-maxillary fissure, for infraorbital vessels, 
superior maxillary nerve and its orbital branches, and 
ascending branches from spheno-palatine (Meckel’s) 
ganglion ; 
8. Foramen lacerum anterius (or sphenoidal fissure), 
for third, fourth, ophthalmic division of fifth and sixth 
nerves, ophthalmic vein, branches of lachrymal and men- 
ingeal arteries, filaments of the sympathetic nerve, and 
a process of dura mater for enslieathing of the nerve; 
9. Optic foramen, for optic nerve and ophthalmic 
artery. 
The nasal foss,® consist of two large cavities 
separated from each other b}' the septum nasi, and 
opening in front by the anterior nares, and behind into 
the pharynx by the posterior nares. 
They are formed by fourteen bones—the frontal, 
ethmoid, sphenoid, and all the bones of the face except 
the lower jaw and malar. 
They have each four sinuses opening into them—the 
ethmoidal and antrum of Highmore (maxillary) on 
either side, the sphenoidal behind and the frontal above, 
and communicate with the mouth by the anterior pala- 
tine canal, with the orbit by the lachrymal canal, with 
the spheno-maxillary fossae by the spheno-palatine 
foramen, and with the cranium by the olfactory fora- 
mina. 
They are each bounded by an outer, inner, upper, 
and lower wall. 
The outer wall is divided by the middle turbinated 
process of the ethmoid and the inferior turbinated bone 
into the superior, middle, and inferior meatuses of the 
nose. 
The superior meatus, the smallest, has three orifices 
opening into it— 
The posterior ethmoidal cells ; 
The sphenoidal sinuses, opening behind the superior 
turbinated bone, and 
The spheno-palatine foramen, for transmission of 
spheno-palatine vessels and superior nasal and naso- 
palatine nerves. OSTEOLOGY. 
43 
The middle meatus has two orifices— 
The infundibulum, communicating with the frontal 
sinuses, and the orifice of the antrum or maxillary 
sinus. 
The inferior meatus, the smallest, has two orifices— 
The lachrymal canal, for laclirymo-nasal duct, and 
the anterior palatine canals, for anterior branches of 
descending palatine arteries (foramina of Stenson) and 
naso-palatine nerves (foramina of Scarpa). 
The inner wall, or septum nasi, is formed by the 
vomer, vertical plate of the ethmoid, and the triangular 
cartilage of the nose, with portions of the following 
bones: nasal spine of the frontal, rostrum of the 
sphenoid, and the crests of the nasal, palate, and superior 
maxillary bones. It is grooved by the naso-palatine 
and other nerves. 
The upper wall or roof presents the following from 
before backward :— 
The nasal slit in the cribriform plate, for passage of 
nasal nerve, a branch of ophthalmic; 
The olfactory foramina, for olfactory filaments, and 
Openings or orifices posteriorly of the sphenoidal 
sinuses. 
The lower wall or floor presents from before back- 
ward :— 
The anterior nasal spine ; 
The anterior palatine canals, given above ; 
Crest or ridge for vomer ; 
Euture between superior maxillary and palate-bone, 
and 
Posterior nasal spine. 
FORAMINA AT THE BASE OF THE SKULL, 
Anterior fossa presents one single foramen and 
four in pairs :— 
Foramen caecum transmits a small vein to the 
superior longitudinal sinus ; 
Ethmoidal fissure transmits nasal branch of ophthal- 
mic nerve ; 
Olfactory foramina, for filaments of olfactory bulb; 44 
HUMAN ANATOMY, 
Anterior ethmoidal transmit anterior ethmoidal 
artery and nasal nerve ; 
Posterior ethmoidal transmits posterior ethmoidal 
artery and vein. 
Middle fossa presents nine (9) pairs :— 
Optic foramen transmits the optic nerve and oph- 
thalmic arter}^; 
Foramen lacerum anterius, or sphenoidal fissure, 
transmits third, fourth, three branches of the (third) 
1, anterior fossa; 2, lesser wing; 3, crista galli; 4, foramen caecum; 5, post- 
ethmoidal foramen : 6, olivary process; 7, optic foramen: 8, anterior clinoid process; 
9, post-clinoid process; 10, middle meningeal artery: 12, hiatus Fallopii; 13 fora- 
men lacerum posterius; 15, foramen rotundum ; 16, foramen ovale; 17, foramen spin- 
osum ; 18, posterior fossa; 20, occipital sinus; 21, foramen magnum. 
Fig. 17. 
ophthalmic division of the fifth and sixth nerves, orbital 
branch of the middle meningeal, recurrent branch from 
the lachrymal artery, filaments of the sympathetic and 
ophthalmic vein ; 
Foramen rotnndum transmits second division of fifth 
or superior maxillary ; 
Foramen Vesalii transmits a small vein; 
Foramen ovale transmits third division of fifth or OSTEOLOGY. 
45 
inferior maxillary nerve, small petrosal nerve, and small 
meningeal artery; 
Foramen spinosum transmits middle orgreat menin- 
geal artery ; 
Foramen lacerum medium transmits the internal 
carotid artery, carotid plexus, a branch of ascending 
pharyngeal artery, and the Vidian or large petrosal 
nerve; 
Foramen for lesser petrosal nerve, and 
Hiatus Fallopii transmits petrosal branch of middle 
meningeal artery and petrosal branch of the Vidian 
nerve. 
Posterior fossa presents six pairs and one single 
one :— 
Meatus auditorius internus transmits auditory artery, 
facial and auditory nerves; 
Aquae ductus vestibuli transmits small artery and vein 
and lodges a process of dura mater; 
Foramen lacerum posterius, or jugular foramen, trans- 
mits inferior petrosal sinus and lateral sinus, forming 
the internal jugular vein, glosso-pharyngeal, pneumo- 
gastric, and spinal accessory nerves, and meningeal 
branches of ascending pharyngeal and occipital arteries ; 
Mastoid foramen transmits small vein to the lateral 
sinus and small artery from occipital to the dura mater; 
Anterior condyloid foramen transmits meningeal 
branch from ascending pharyngeal artery and hypo- 
glossal nerve; 
Posterior condyloid foramen transmits posterior 
condyloid vein ; 
Foramen magnum transmits vertebral arteries, me- 
dulla oblongata and its membranes, and the spinal acces- 
sory nerves. 
The external surface of the base presents seven 
pairs :— 
Palatal portion :— 
Incisive foramina transmit nerves and vessels to the 
incisor teeth ; 
OTHER FORAMINA OF SKULL. 46 
HUMAN ANATOMY. 
Foramina of Stenson transmit the anterior branch of 
the posterior palatine vessels ; 
Foramina of Scarpa transmit the right and left 
naso-palatine nerve; 
Posterior palatine foramina transmit posterior pala- 
tine vessels and descending palatine nerve ; 
Accessory palatine foramina transmit posterior pala- 
tine nerves; 
Pterygo-palatine canals transmit pterygo-palatine 
vessels, and the 
Pterygoid or Vidian canal transmits the Vidian 
artery and nerve. 
Lateral portion presents nine pairs :— 
Opening of the Eustachian tube; 
Opening of the tensor tympani canal transmits the 
tensor tympani muscle; 
Glaserian fissure transmits the tympanic branch of 
the internal maxillary artery and lodges the processus 
gracilis of the malleus and laxator tympani muscle; 
Canal of Hugier transmits chorda tympani nerve ; 
Foramen for Jacobson’s nerve, the tympanic branch 
of the glosso-pliaryngeal nerve ; 
Foramen for Arnold’s nerve, the auricular branch of 
the pneumogastric nerve; 
Opening of aquseductus cochleae transmits a vein from 
the cochlea to internal jugular vein ; 
Auricular fissure transmits exit of Arnold’s nerve ; 
Stylo-mastoid foramen transmits the facial nerve and 
stylo-mastoid artery. 
Anterior region presents three pairs :— 
Supraorbital foramen, or notch, transmits supra- 
orbital artery, vein, and nerve ; 
Infraorbital foramen transmits infraorbital artery 
and nerve, and 
Mental foramen transmits mental nerve and artery. 
The sternum, orIbreast-boiie, is a long, narrow, sword- 
like bone occupying the anterior part of the thorax and 
consisting of three portions: manubrium (handle), 
BONES OF THE TRUNK. OSTEOLOGY. 
47 
gladiolus (blade), xyphoid or ensiform appendix (point). 
Its anterior surface is irregularly flat, posterior surface 
slightly concave. 
Manubrium is thick and triangular, and presents 
above the interclavicular notch, on either side of which 
are facets for articulation of clavicles. Laterally it pre- 
sents an articular facet for the cartilage of the first rib 
and a half of one for part of second costal cartilage. 
Gladiolus is the longest, narrowest portion, and pre- 
sents about its centre, between the third and fourth seg- 
ments, the sternal foramen, and laterally facets for half 
of the second and for the third, fourth, fifth, and sixth 
costal cartilages. 
Ensiform appendix is cartilaginous in youth and 
varies much in size and shape. 
It articulates with the clavicles and seven costal 
cartilages on side. 
Its ossific centres are six—one each for the manu- 
brium and appendix and four for the gladiolus, or body. 
Its muscular attachments are ten—sterno-mastoid, 
sterno-hyoid, sterno-thyroid, pectoralis major, triangu- 
laris sterni, obliquus externus and internus, transversalis, 
rectus, and diaphragm. 
The ribs, twelve on each side, form a series of narrow 
elastic arches on each side of the thorax, constituting 
the chief part of the thorax. They are divided into 
seven vertebrosternal, true or sternal, each of which 
join the sternum by a separate costal cartilage; three 
vertebrochondral, or false, the cartilages of which join 
each other and with the seventh before uniting with the 
sternum, and two vertebral, free or floating, which 
have no sternal attachment. 
Each rib consists of a head, neck, tubercle, and 
body. 
The head presents facet (except the first, tenth, 
eleventh, and twelfth) for articulation with the bodies 
of the contiguous dorsal vertebrae, separated by a ridge 
for the interarticular ligament. 
The neck or constricted portion is smooth in front 
and presents a rough surface behind for the middle 48 
HUMAN ANATOMY. 
costo-transverse ligament, and a rough crest above for 
the anterior costo-transverse ligament. 
The tubercle or tuberosity (wanting in eleventh and 
twelfth) presents an articular surface for articulation 
with the transverse process of the vertebra below, and a 
non-articular surface for attachment of the posterior 
costo-transverse ligament. 
The shaft or body is flat, thin, and twisted on itself. 
Its anterior extremity presents an oval depression for 
costal cartilage. 
The internal surface is smooth, concave, and pre- 
sents in front of the angle a ridge, forming the side of 
the groove on the inferior border. 
The external surface is rough, convex, and presents 
a little in front of the tubercle a bend or angle marked 
by a prominent line, and near the sternal extremity 
another bend, the anterior angle, marked by an oblique 
line. 
The superior border is round and thick, and presents 
an external and internal lip for external and internal 
intercostal muscles. 
The inferior border at its posterior third presents a 
groove for the intercostal vessels and nerve, and at its 
anterior two-thirds is sharp and thin. 
Peculiar Bibs.—The peculiar ribs are the first, second, 
tenth, eleventh, and twelfth. 
The first is short, broad, and flat, has no angle, and 
but one facet on the head. Its upper surface is marked 
by two parallel grooves, the anterior for the subclavian 
vein, the posterior for the artery, separated by a tubercle 
for insertion of scalenus anticus muscle,—an important 
guide in ligation of the subclavian artery. 
The second resembles the first in being flattened 
arid not twisted. The tubercle and angle are slight 
and almost coincide in position. The outer surface 
of the shaft presents near its middle a rough eminence 
for the second and third positions of the serratus 
magnus. 
The tenth rib has but one facet for articulation with 
the tenth dorsal vertebra. OSTEOLOGY. 
49 
The eleventh has single facet on head, slight angle, but 
no tubercle or neck. 
The twelfth, single facet, but no angle, tubercle, or 
neck. 
The ribs articulate with twelve vertebrae behind and 
twelve costal cartilages in front. 
Muscular attachments are twenty—scalenus anticus, 
medius, and posticus, pectoralis minor, intercostals, 
serratus magnus, obliquus externus, transversalis, quad- 
rat us lumborum, diaphragm, latissimus dorsi, serratus 
pasticus, superior and inferior; sacrolumbalis, musculus 
accessorius ad sacrolumborum, levatores costarum, 
longissimus dorsi, cervicales ascendens, infracostales. 
They are developed from thirty-four ossific centres, 
each rib having one centre each for its head, shaft, and 
tubercle, except the eleventh and twelfth, which have 
but two centres, not having any tubercles. 
VERTEBRAE. 
The spine, or vertebral column, is a flexible column 
composed of twenty-six bones (thirty-three vertebrae), as 
follows: seven cervical, 
twelve dorsal, five lumbar, 
sacrum, and coccyx. Each 
vertebra consists of a body, 
and an arch composed of two 
pedicles and two laminae, 
supporting seven processes— 
one spinous, two transverse, 
and four articular. 
The body (centrum), the 
large, solid, anterior portion, 
is generally half-cylindrical, 
concave behind, convex in 
front and sides. Its upper 
and lower surfaces are broad 
and rough, for attachment 
of interarticular cartilages. Its posterior surface has 
large foramen for exit of veins. 
The pedicles project backward (except the cervical, 
1, body; 2, demi-facet for rib; 3, 
superior articular processes; 5, interver- 
tebral notch; 6, spinous process; 7, 
facet for tubercle on transverse process; 
9, inferior articular processes. 
Fig. 18. 50 
HUMAN ANATOMY. 
which project obliquely outward), and present four in- 
tervertebral notches, two each, above and below. These, 
when articulated, form inter articular foramina for exit 
of spinal nerves and passage of blood-vessels. 
The laminee are two broad, flat plates of bone, pro- 
jecting backward and inward from the pedicles, to com- 
plete the vertebral arch and inclose the spinal foramen. 
Their upper and lower margins are rough for attachment 
of ligamenta subflaATa. 
The spinous processes vary much in size and shape in 
the different regions. They project backward from the 
junction of the laminae, and afford attachment for mus- 
cles. 
The transverse processes project, one on each side, 
from the junction of the laminae Avitli the pedicles, and 
in the cervical region from the sides of the body also, 
inclosing the foramen for the vertebral artery. 
The articular processes, four in number, project one 
above and below on each side, from the junction of the 
laminae and pedicles. The tAA’o superior project upward 
and more or less backward, the inferior downward and 
more or less forward, articulating with the corresponding 
processes of the adjoining vertebra. 
The spindl foramen is a large, triangular canal, in- 
closed by the body in front, the pedicles laterally, and 
the laminae behind for the passage of the spinal cord and 
its membranes. 
The cervical vertebra are characterized by small 
body, concave above, convex below, the anterior margin 
overlapping the one below ; short and bifid transverse 
process, perforated at base by foramen for vertebral 
artery; oblique articular processes—superior convex 
directed upward and backward, inferior concave down- 
ward and forward; short spinous process, bifid, placed 
horizontally; long and narrow lamina, inclosing large, 
triangular spinal canal. 
The peculiar cervical vertebrse are first, second, and 
seventh. 
or atlas is ring-like, without either body or 
spinous process, and consists of an anterior and poste- OSTEOLOGY. 
51 
rior arch and two lateral masses. The anterior arch, 
convex in trout, presents tubercle for longus colli mus- 
cles and behind articulates with odontoid process of axis. 
The posterior arch is deeply grooved above for trans- 
mission of vertebral artery and suboccipital nerves, and 
terminates behind in a rudimentary spine. It articu- 
lates above with condyles of occipital, below with axis. 
The transverse process is short and contains a foramen. 
Axis, so-called from the pivot-like odontoid process, 
which projects from the upper part of its to articu- 
late with the anterior arch and transverse ligament of 
atlas. 
The seventh resembles the dorsal series, its spinous 
process being long, not bifid, and prominent; hence its 
name, “ vertebra prominens.” To it is attached the liga- 
mentum nuchae. 
The dorsal vertebrae have large, heart-shaped bodies, 
flat above and below. Laterally are demi-articular facets 
for heads of ribs; long, strong, transverse processes, 
marked by facet, for tubercle of rib; vertical articular 
processes, superior backward, inferior forward; long, 
triangular, overlapping spinous process; small, and 
nearly circular, spinal canal. 
The peculiar dorsal vertebrae are : first, which resem- 
bles cervical, and have distinct facet for head of first rib, 
and half-one for half of second head ; tenth, eleventh, 
and twelfth, one facet for head of rib ; and eleventh and 
twelfth, no facet on transverse processes for tubercle of 
rib. 
The lumbar vertebrae are the largest, and have 
transversely oval body, flat above and below ; long, thin, 
transverse processes, representing ribs; vertical pro- 
cesses interlocking with adjacent vertebrae; large, tri- 
angular spinal canal. 
The last lumbar is peculiar in having body thicker 
in front, shorter and stronger transverse process, and 
inferior articular processes wider apart, and directed 
forward. 
Muscular attachments to atlas, ten—rectus anticus 
minor, rectus lateralis, rectus posticus minor, obliquus 52 
HUMAN ANATOMY. 
superior and inferior, splenius colli, levator anguli scap- 
ula;, interspinous, and intertransverse. To axis, ten— 
the last five of preceding, and obliquus inferior, rectus 
posticus major, semi-spinalis colli multifidus spinae, 
scalenus posticus, and transversalis colli. 
To the remaining vertebrae are attached anteriorly 
ten (10) muscles, and posteriorly twenty-two (22) [vide 
spinal muscles, p. 123]. 
Development.—The ossific centres for each vertebra 
are three primary, one for the body and one for each 
side, and five secondary epiphyses, as follows : one for 
tip of each spinous and transverse process, and the re- 
maining two are thin plates on articular surfaces. 
The exceptions to this rule are: atlas, with two pri- 
mary centres and one epiphysis ; the axis, with three 
extra centres for odontoid process ; the seventh cervical, 
with one extra centre for each transverse process,and the 
lumbar vertebrae, two additional centres for tubercles. 
The sacrum is a large, wedge-shaped, base above, 
apex below, with expanded lateral masses and alae, com- 
posed of five consolidated sacral vertebrae, and forming 
the posterior wall of pelvis. 
The base ai’ticulates with the last lumbar vertebra. 
Its anterior edge forms the promontory or sacro-vertebral 
angle, on each side of which is a smooth triangular sur- 
face, the ala. Behind the articulating surface is the 
sacral canal, and on either side are the superior articular 
processes. 
The apex is small and articulates with the coccyx. 
The anterior concave surface presents four ridges, 
indicating the original separations, which terminate ex- 
ternally in eight anterior sacral foramina, with wide, 
shallow grooves, for the exit of the anterior sacral nerves. 
To the outer side of these foramina is the lateral mass 
for origin of pyriformis muscle. 
The posterior surface presents rudimentary spinous 
articular and transverse processes, the laminae of the last 
two segments being deficient.* On the other side of the 
* The articular processes of the fourth and fifth unite to form the 
sacral cornua for articulation with the cornua of the coccyx. OSTEOLOGY. 
53 
spinous process is a broad, shallow concavity, the sacral 
groove, for the origin of the erector spin® muscle, and 
external to the articular processes are four posterior 
sacral foramina for the exit of posterior sacral nerves. 
The lateral surfaces have each a rough articular sur- 
face for articulation, with ossa innominata, and below 
presents a deep notch on each side of the apex, which is 
converted by articulation with the transverse process of 
the coccyx into the fifth sacral foramen, for exit of an- 
terior division of the fifth sacral nerve. 
The sacral canal, continuous above with the spinal 
foramen of the vertebrae, runs through the centre. Large 
and triangular above, small and flattened below, its lower 
posterior wall is deficient. It lodges the sacral nerves, and 
out of it pass the anterior and posterior sacral foramina. 
It articulates with four bones,—two ossa innominata, 
last lumbar vertebra, and coccyx. 
Muscular attachments are seven—iliacus, pyriformis, 
coccygeus, gluteus maximus, latissimus dorsi, multifidus 
spinse, and erector spinse. 
Its ossific centres are thirty-five, as follow: bodies, 
including interarticular plates, three each (15); arches, 
two each (10) ; lateral masses, six (6) ; epiphysal plates 
of lateral surfaces, four (4). Total, 35. 
The coccyx is a small triangular bone, resembling a 
cuckoo’s beak, and composed of four rudimentary ver- 
tebrae more or less co-ossified. 
The base articulates with the sacral apex, being pro- 
longed upward into two cornua to complete the fifth 
posterior sacral foramen for exit of posterior branch of 
fifth sacral nerve. 
Laterally the base is prolonged into rudimentary 
transverse processes, completing with the notch of the 
sacrum the fifth anterior sacral foramina for exit of the 
anterior branch of fifth sacral nerve. 
The anterior concave surface supports the rectum 
and gives attachment to levator ani muscle and anterior 
sacro-coccygeal ligament. 
The posterior convex surface presents rudimentary, 
articular processes and transverse grooves. 54 
The apex is rounded, occasionally bifid, or deviated 
to one side, and affords attachment to the levator ani 
and sphincter ani muscles. 
The muscular attachments are coccygei, gluteus maxi- 
mus, extensor coccj'geus (occasionally present), levator 
and sphincter ani. 
Its ossific centres are four—one for each segment. 
HUMAN ANATOMY. 
The upper extremity consists of the arm, forearm, 
and hand. It is attached to the trunk by the clavicle 
and contains the following bones: Clavicle, scapula, 
humerus, radius, ulna, eight carpus, live metacarpus, 
and fourteen phalanges. 
The clavicle, or collar- or key- bone, is a long bone, 
curved horizontally like the italic letter f, extending 
almost horizontally between the sternum and acromial 
THE UPPER EXTREMITY. 
Fig. 19. 
1, sternal extremity; 2, costal facet for first rib; 5, acromial extremity; 6, 6, deltoid 
muscle; 7,7, trapezius muscle. 
process of scapula. Its inner two-thirds are cylindrical 
and convex in front, its outer third flattened from above 
downward and concave in front. It consists of a body, 
or shaft, and outer, or acromial, and inner, or sternal 
extremities. 
The shaft presents in its outer third the following 
points :— 
Superior surface, rough impression in front for del- 
toid muscle, rough impression behind for trapezius ; 
Anterior border, occasionally deltoid tubercle about 
the centre for attachment of deltoid; 
Inferior surface, conoid tubercle at the posterior 
border for conoid ligament; oblique line extending out- 
ward and forward from this for attachment of trapezoid 
ligament. OSTEOLOGY. 
55 
The inner two-thirds is prismatic and presents three 
surfaces and three borders :— 
Anterior surface, divided by line into upper rough 
surface for sterno-mastoid muscle and lower for pec- 
toralis major; 
Posterior or cervical surface, gives attachment to 
sterno-h3roid muscle and presents foramen for nutrient 
artery. 
Inferior or subclavian surface presents :— 
Facet, continuous with sternal articular surface, for 
cartilage of first rib; 
Rhomboid impression for costo-clavicular or rhom- 
boid ligament; 
Subclavian groove for attachment of subclavian 
muscle; 
Longitudinal line, frequently dividing the groove into 
two parts, for intermuscular septum of the muscle. 
Anterior border separates the anterior and posterior 
surfaces and limits the attachment of the pectoralis 
major. 
Superior border gives attachment to the sterno- 
mastoid muscle. 
Posterior or subclavian border is short and concave, 
extending from the rhomboid impression to the conoid 
tubercle and giving attachment to the subclavian fascia. 
The acromial extremity presents an oval facet for 
articulation with the acromial process of the scapula 
and a rough circumference for acromio-clavicular liga- 
ments. 
The sternal extremity is triangular, and presents a 
facet for cartilage of sternal articulation and rough cir- 
cumference for sterno-clavicular ligaments. 
The clavicle articulates with three bones—the ster- 
num, scapula, and first costal cartilage. 
The muscular attachments are seven—subclavius, 
platysma, sterno-liyoid, sterno-mastoid, trapezihs, pec- 
toralis major, and deltoid. 
Its ossific centres are two—one each for body and 
sternal end. 
The scapula, or shoulder-blade, is a large, flat, tri- 56 
HUMAN ANATOMY. 
angular bone situated on the upper postero-lateral 
aspect of the thorax from the second to seventh rib, 
inclusive. 
It consists of a body, head, neck, acromion, and 
coracoid processes, and presents two surfaces, three 
borders, and three angles. 
The anterior surface, or venter, presents:— 
Subscapular fossa, a concave triangular surface for 
attachment of subscapular muscles, marked by 
1, supra-spinous fossa; 2, infra-spinous 
fossa: 3, superior border; 4, supra-seapu- 
lar notch ; 5, axillary border; 6, bead; 7. in- 
ferior angle; 8, neck; 9, vertebral border; 
10, spine ; 11, surface for trapezius ; 12, acro- 
mion process; 13, nutrient foramen; 14, 
coracoid process. 
Fig. 21. 
1, 1,1, oblique ridges; 3, superior bor- 
der; 4, superior angle; 5, supra-scapular 
notoh; 6. coracoid process; 7, acromial 
process; 10, glenoid fossa; 14, inferior angle. 
Fig. 20. 
Oblique ridges, for the tendinous intersections of the 
muscle; 
Marginal surface, for attachment of serratus magnus; 
Subscapular angle, a transverse depression at the 
upper part for the thickest part of the muscle. 
The posterior surface, or dorsum, presents:— 
Spine, a bony ridge passing upward, forward, and OSTEOLOGY. 
57 
outward, dividing it unequally into two fossae, afford- 
ing attachment to the trapezius muscle above and the 
deltoid below, and terminating above in the acromion 
process ; 
Supra-spinous fossa above the spine, for the origin 
of the supra-spinatus muscle ; 
Infraspinous fossa below, for the origin of the infra- 
spinatus muscle; 
Nutrient foramen, near the upper part of infra- 
spinous fossa, for nutrient artery. 
The marginal surface extends from the glenoid 
cavity downward and backward to an inch above inferior 
angle, its inner side formed by 
An elevated ridge, for the attachment of the aponeu- 
rosis between the infra-spinatus and two teres muscles ; 
its outer side by the axillary border. It is divided by an 
oblique line into two parts, the upper for the teres minor 
and the lower for the teres major muscles, and crossed 
by a groove near the upper part for the dorsalis scapulae 
vessels; 
A smooth, triangular surface at the root of the spine 
over which the trapezius glides. 
The superior border, shortest, presents :— 
Suprascapular notch at the base of the coracoid 
process, converted into a foramen [supra-scapular] by 
the transverse ligament, for the passage of the supra- 
scapular nerve (the artery passing above); 
Origin of omo-hyoid muscle from this border just 
internal to notch. 
External or axillary border, thickest, presents :—- 
Rough impression, just below glenoid cavity, for 
origin of long head of triceps muscle, and below, 
Longitudinal groove, for origin of part of sub- 
scapularis. 
Internal, vertebral border (base), longest, presents :— 
Anterior lip, for insertion of serratus magnus ; 
Posterior lip, for attachment above of supra-spinatus, 
below infra-spinntus. 
The superior angle, gives attachment to part of 
levator angulae scapulae; 58 
HUMAN ANATOMY. 
The inferior angle, for attachment of teres major, 
and sometimes part of latissimus dorsi. 
The anterior or external angle is thickest, and forms 
the head. 
The head is connected to the body of the scapula by 
a constricted portion, the neck, from the anterior surface 
of which arises the coracoid process. It presents 
The glenoid cavity or fossa, a shallow, pyriform, 
articular depression, deepened in the recent state by the 
glenoid ligament, for the head of the humerus. To its 
upper part or apex is attached the long head of the 
biceps muscle. 
The acromion process, forming the summit of the 
shoulder, is a triangular process, projecting forward, out- 
ward, and upward to overarch the glenoid cavit}7. It 
gives attachment by its upper surface to the platysma 
and deltoid and by its inner margin to the trapezius. 
It presents 
An apex, for attachment of coraco-acromial ligament; 
Articular facet, just behind the apex for the clavicle. 
The coracoid process (like a crow’s beak) arches 
forward, upward, and inward above the glenoid cavity. 
It presents:— 
Attachment for pectoralis minor muscle from the 
anterior border near the tip; 
Apex, for attachment of coraco-brachialis and short 
head of biceps; 
Rough impression at the inner side of the root for 
the conoid ligament, and from it 
A ridge running outward and forward for the 
trapezoid ligament. 
It articulates with the clavicle and humerus. 
Its muscular attachments are 18 : platysma, supra- and 
infra- spinatus, subscapular, deltoid, trapezius, omo-hyoid, 
serratus magnus, levator anguli scapulae, rhomboideus 
major and minor, triceps, teres major and minor, biceps, 
coraco-brachialis, pectoralis minor, and latissimus dorsi. 
Its ossitic centres are seven—one each for body, 
posterior border, and inferior angle, and two each for 
acromion and coracoid processes. 59 
The humerus, or arm-bone, the largest and longest 
bone of the upper extremity, consists of a shaft, head, 
neck, greater and lesser tuberosities, and lower extremity. 
The shaft, cylindrical above, flattened and prismoid 
below, becomes twisted in the middle, and presents 
A rough triangular surface 
about the middle of its outer 
surface for insertion of the del- 
toid muscle, and a 
Musculo-spiral groove for 
the musculo-spiral nerve and 
superior profunda artery, on 
each side of which arise the 
external and internal heads 
of the triceps muscle. 
The upper extremity pre- 
sents 
The head, forming nearly a 
sphere, projecting upward, back- 
ward and inward, articulating 
with the glenoid cavity ; 
The anatomical neck, imme- 
diately beneath, is slightly 
grooved for the attachment of 
the capsular ligament; 
Greater tuberosity, external 
to the head and lesser tuber- 
osity, with three facets from 
before backward for attachment 
of supra-spinatus, infra-spina- 
tus, and teres minor muscles ; 
Lesser tuberosity, smaller 
but more prominent than 
greater, is anterior to head, for 
the subscapular muscle; 
Bicipital groove, passes downward and inward be- 
tween the two tubei’osities and lodges the long tendon 
of biceps ; 
The anterior bicipital ridge, bounds the groove in 
front and receives insertion of pectoralis major muscle; 
OSTEOLOGY. 
1, shaft; 2, head; 3, neck; 4, 
greater tuberosity; 5, lesser tuberos- 
ity; 6, posterior bicipital groove; 7, 
impression for deltoid; 8, bicipital 
groove; 10, nutrient foramen; 11, 
capitellum; 12, trochlea ; 13, external 
condyle; 14, internal condyle; 15 and 
16, external and internal supra-con- 
dyloid ridges. 
Fig. 22. 60 
The posterior bicipital ridge, receives the latissimus 
dorsi and teres major ; 
The surgical neck, including the head, neck, and both 
tuberosities; 
A rough impression near the centre of the inner bor- 
der for the coraco-brachialis muscle ; 
Nutrient canal, below and directed toward the lower 
extremity. 
HUMAN ANATOMY. 
The lower extremity presents from within outward 
the following:— 
Internal condyloid ridge, extending upward from 
the condyle; 
Internal condyle, more prominent than external, gives 
origin to the flexors and pronator radii teres; 
Epitrochlea, an eminence separating the trochlea from 
the internal condyle ; 
Trochlea, a pulley-like articulating surface for greater 
sigmoid cavity of ulna; 
Coronoid fossa, a small depression bounding the 
trochlea in front, and receiving the coronoid of the ulna 
in flexion; 
Olecranon fossa, a larger depression behind, and re- 
ceiving the olecranon process of ulna in extension ; 
Supra-trochlear foramen, sometimes formed by per- 
foration of one fossa into the other; 
Radial head, or capitellum, a smooth, rounded emi- 
nence articulating with cup-like depression on head of 
radius ; 
External condyle, less prominent, gives origin to the 
extensors and supinators ; 
External condyloid ridge, extending upward on the 
shaft from the condyle. 
It articulates with three bones—scapula, radius, and 
ulna. 
Its muscular attachments are twenty-five—subscapu- 
laris, supra- and infra- spinatus, teres major and minor, 
pectoralis major, latissimus dorsi, deltoid, coraco-bracli- 
ialis, bracliialis anticus, triceps, pronators and flexors 
to inner condyle, pronator radii teres, flexor carpi 
radialis, palmaris longus, flexor sublimus digitorum, OSTEOLOGY. 
61 
flexor carpi ulnaris, supinators and extensors to outer 
condyle, supinator longus, extensor carpi radialis longior 
and brevior, extensor communis digitorum, extensor 
minimi digiti, extensor carpi ulnaris, anconeus and sub- 
anconeus, supinator brevis. 
Its ossific centres are seven—one each for head, shaft, 
tuberosities, condyles, radial 
head, and trochlear portion. 
The ulna is a long bone 
to the inner side of the forearm, 
and consists of a shaft and an 
upper and lower extremity. It 
forms the greater part of the 
articulation with the humerus, 
but does not enter into the 
formation of the wrist-joint, 
being excluded by the inter- 
articular fibro-cartilage. 
The shaft is prismatic above, 
smooth and rounded below, and 
presents:— 
Anterior surface, gives at- 
tachment to the deep flexors 
and pronator quadratus ; 
Nutrient foramen on an- 
terior surface, directed upward 
toward the elbow-joint; 
Posterior surface marked 
above by an oblique line for 
part of supinator brevis, above 
which is smooth triangular sur- 
face for anconeus muscle, and 
the lower third for extensor 
muscles of the thumb ; 
External border, sharp in middle two-thirds, for 
attachment of interosseus membrane. 
The upper extremity is large and irregular, and pre- 
sents :— 
Olecranon process (head of elbow), projects upward 
and forward, its apex being received into the olecranon 
1, shaft of ulna; 2, greater sigmoid 
cavity ; 3, lesser sigmoid cavity ; 4, 
olecranon; 5, coronoid process; 6, 
nutrient foramen; 7, interosseous 
borders ; 8, head of ulna ; 9, styloid 
process of ulna; 11, head of radius; 
12, neck of radius; 13, tuberosity of 
radius : 14, shaft of radius ; 15, carpal 
extremity of radius; 16, styloid 
process of radius. 
Fig. 23. 62 
HUMAN ANATOMY. 
fossa of the humerus in extension of the forearm ; its 
upper border has rough impression for the triceps mus- 
cle ; its lateral borders are grooved for external and 
internal lateral ligaments; 
Coronoid process, smaller than olecranon, projects 
forward from anterior surface, being received into coro- 
noid fossa of humerus in flexion. 
Its upper surface forms part of the great sigmoid 
cavity. 
Its under surface has rough impression for insertion 
of brachialis anticus, and has, at its junction with the 
shaft, the tubercle of the ulna for the oblique ligament. 
Its outer surface is the lesser sigmoid cavity. 
Its inner surface gives attachment to the internal 
lateral ligament, and the flexor digitorum sublimis, flexor 
profundus digitorum, and one head of pronator radii 
teres. 
Greater sigmoid cavity is a large, semi-lunar depres- 
sion between the olecranon and coronoid processes, 
divided into two unequal lateral parts by an elevated 
ridge. It is continuous on the outer side with the lesser 
sigmoid cavity and articulates with the trochlear surface 
of the humerus. 
Lesser sigmoid cavity is an oval, concave, articular 
depression, external to the coronoid process, for articula- 
tion with the head of the radius. Its prominent extrem- 
ities give attachment to the orbicular ligament. 
The lower extremity is small and cylindrical and pre- 
sents :— 
Head, an external, rounded, articular process, for the 
triangular fibro-cartilage below and the sigmoid cavity 
of the radius externally ; 
Styloid process, projects from the posterior and in- 
ternal part of the extremity, its apex gives attachment 
to the internal lateral ligament of the wrist, and it is 
marked at its root by a depression between it and the 
head, for attachment of the libro-cartilage; 
Groove, upon the posterior surface, for passage of 
extensor carpi ulnaris. 
It articulates with two bones—humerus and radius. OSTEOLOGY. 
63 
Its muscular attachments are sixteen—braclhalis 
anticus, triceps, anconeus, flexor and extensor carpi 
uinaris, pronator radii teres, flexor sublimus and profun- 
dus digitorum, pronator quadratus, supinator brevis, ex- 
tensor indicis,and extensor ossis metacarpi and extensor 
secundi internodii pollicis, flexor longus pollicis. 
Its ossific centres are three—one each for shaft, ole- 
cranon and inferior extremity. 
The radius is a long bone, shorter than the ulna, sit- 
uated on the outer side of the forearm, the upper end 
small, the shaft slightly curved, and the lower end ex- 
panded to form part of the wrist-joint. It consists of 
shaft, upper and lower extremity. 
The shaft is prismoid, slightly curved, and presents 
An internal border, sharp and prominent, for inter- 
osseous membrane; 
An anterior border, marked at its upper third by an 
oblique line, for attachment of flexor longus pollicis, su- 
pinator brevis, and flexor sublimis digitorum ; 
Anterior surface, affords attachment above for flexor 
longus pollicis, below for pronator quadratus, and pre- 
sents at the junction of middle and upper two-thirds a 
nutrient foramen directed upward ; 
Posterior surface gives attachment at upper third to 
supinator brevis, and at middle third to extensors of 
thumb. 
The upper extremity presents :— 
Head—a cup-like cylindrical cavity, for articulation 
with capitellum of humerus, and on its side an articulat- 
ing surface for lesser sigmoid cavity of ulna and orbicu- 
lar ligament, which nearly surrounds it; 
Neck, the constricted portion below the head; 
Bicipital tuberosity, below and to inner side, divided 
by a vertical line into a rough surface posteriorly, for at- 
tachment of biceps tendon, and smooth surface anteriorly 
for bursa. 
The lower extremity, large, expanded, and quadrilat- 
eral, presents:— 
Carpal articular surface, smooth, concave, tri- 
angular, depression divided by an antero-posterior 64 
HUMAN ANATOMY. 
ridge into an outer facet for scaphoid bone and inner 
for semilunar; 
Sigmoid cavity, a shallow concavity at inner side of 
carpal end, for articulation with ulnar head; 
Styloid process, projects obliquely downward from the 
external surface, for attachment by its apex to external 
lateral ligament of wrist-joint, and by its base to inser- 
tion of supinator longus muscle. Its outer surface is 
marked by two grooves for extensors of thumb; 
The posterior surface of the lower extremity is 
also marked by three grooves from without inward for 
the following: ext. carpi radi- 
alis longior and brevior in 
first, ext. secundi internodii in 
second, and ext. indicis, ext. 
communis digitorum, and ext. 
minimi digiti in third inner- 
most. This surface has also 
attachment of posterior liga- 
ment of wrist. 
It articulates with four 
bones — humerus, ulna, sca- 
phoid, and semi-lunar. 
Its muscular attachments 
are nine—biceps, supinator 
longus and brevis, flex, digi- 
torum sublimis, flexor longus 
pollicis, pronator quadratus, 
extensor ossis metacarpi pol- 
licis, ext. primi internodii 
pollicis, and pronator radii teres. 
Its ossific centres are three—one each for shaft and 
each extremity. 
The Hand.—The bones of the hand consist of eight 
carpus, five metacarpus, and fourteen phalanges ; total, 
twenty-seven bones. 
The carpus consists of eight small bones arranged in 
two rows—first, or proximal row, from the radial side in- 
ward are scaphoid, semi-lunar, cuneiform, and pisiform ; 
the second, or distal row, in same order are trapezium, 
traoezoid. os masrnum. and unciform. 
Fig. 24. 
1, ulna; 2, radius; 3, fibro-cartilage; 
4, 5. 6, 7, 8, metacarpal bones; S, sca- 
phoid; I,, semi-lunar; C, cuneiform; P, 
pisiform ; R, trapezium : T, trapezoid; 
M, os magnum; U, unciform. * OSTEOLOGY. 
65 
Scaphoid (boat-shaped), largest of first row, convex 
above, concave below, articulates with five bones, as 
follows: superior surface, with radius; inferior, with 
trapezium and trapezoid ; internal, with semi-lunar above 
and os magnum beneath. The external surface has 
attachment of external lateral ligament of wrist. 
Se>ii-lunar (half-moon), crescentic in outline, pre- 
sents articulating surfaces for five bones, as follows: 
superior convex surface with radius, inferior concave 
facet with os magnum and unciform, quadrilateral inter- 
nal facet with cuneiform, and external with scaphoid. 
Cuneiform is wedge-shaped, the base, directed out- 
ward, articulates with the semi-lunar, apex with the 
interarticular fibro-cartilage of wrist-joint, inferior sur- 
face with unciform, and anterior with pisiform; in all, 
three bones. 
Pisiform (pea-like) is a small, pea-shaped bone articu- 
lating with anterior surface of cuneiform, and affording 
attachment to annular ligament and two muscles, flexor 
carpi ulnaris, abductor minimi digiti. 
Trapezium (a table), a very irregular bone, articulates 
above by concave surface with scaphoid; below, by sur- 
face concave from side to side, convex from before back- 
ward, with first metacarpal, by internal surface with 
trapezoid, inferior with second metacarpal. Its dorsal 
surface is rough; its palmar grooved by flexor carpi 
radialis tendon. Muscular attachments are three—flexor 
ossis metacarpi, flexor brevis pollicis, and abductor 
pollicis. 
Trapezoid, smallest of second row, is wedge-shaped, 
apex palmar; articulates with four bones—superior sur- 
face with scaphoid, inferior with second metacarpal, ex- 
ternal with trapezium, internal with os magnum and 
interosseous ligament. 
It has one muscular attachment for flexor brevis 
pollicis. 
Os magnum, or capitate, the largest carpal bone, 
consists of a body, neck, and head. The latter projects 
from the superior surface and articulates with the 
scaphoid and semi-lunar. The inferior surface articu- 66 
HUMAN ANATOMY. 
lates with second, third, and fourth metacarpal bones; 
the external with trapezoid, and internal with unciform; 
in all seven bones. 
Muscular attachment for flexor brevis pollicis. 
Unciform (hook-like), a wedge-shaped bone, so 
named from the hook-like process, projecting from its 
anterior surface, below its articulation with fourth and 
fifth metacarpals, and above its articulation with semi- 
lunar. This process gives attachment to annular liga- 
ment, flexor brevis minimi digiti, flexor ossis metacarpi 
minimi digiti, and is grooved for passage of other flexor 
tendons. External surface articulates with os magnum 
and internal with cuneiform. 
Muscular attachments are those to unciform process. 
Each carpal bone is developed from a single ossitic 
centre. 
Table of Articulations of Carpal Bones.—Scaphoid, 
five; semi-lunar, live; cuneiform, three; pisiform, one; 
trapezium, four; trapezoid, four; os magnum, seven; 
unciform, five. 
The metacarpus are five long bones, resembling each 
other, and presenting a shaft and two extremities. 
Anterior surface is concave, posterior convex ; superior 
extremity irregular for articulation with carpal bones 
and with the adjoining bones; inferior extremity pre- 
sents rounded head for articulation with phalanges. 
The first metacarpal for thumb is supported on trape- 
zium, articulates with first phalanx, and has three 
muscles attached—first dorsal interosseus, flexor, and 
extensor ossis metacarpi pollicis; the second metacarpal 
by three, trapezium, trapezoid, and os magnum, articu- 
lates also with third metacarpal and second phalanx, 
and has five muscles attached—first and second dorsal 
interosseus, first palmar interosseus, flexor carpi radialis, 
and extensor carpi radialis longior ; the third metacarpal 
supported by os magnum, articulates also with second 
and fourth metacarpal and third phalanx, and has five 
muscles attached—flexor brevis pollicis, extensor carpi 
radialis brevior, Adductor pollicis, and second and third 
dorsal interosseus. The fourth metacarpal is supported OSTEOLOGY. 
67 
on os magnum and unciform, articulates with third and 
fifth metacarpal and fourth phalanx, and has three mus- 
cles attached—second palmar and third and fourth 
dorsal interosseus. The fifth metacarpal, supported on 
unciform, ai’ticulates with fourth metacarpal and fifth 
phalanx, and has five muscles attached—flexor ossis 
metacarpi minimi digiti, flexor and extensor carpi 
ulnaris, and fourth dorsal and third palmar interosseus. 
Ossific centres are two for each bone, one each for 
shaft and head, except thumb, which has one each for 
shaft and base, resembling the phalanges. 
Phalanges.—Each finger has three phalanges, except 
the thumb, w hich has but two. Palmar surface concave, 
dorsal convex; the superior extremity articulates with 
head of metacarpal, and the inferior, concave from side 
to side, convex from before backward, articulates writh 
second phalanx, which presents an opposite arrangement, 
except in the thumb, where it articulates with ungual or 
terminal phalanx. 
The second phalangeal articulation is the same, and 
the ungual phalanx presents a rough, arrow-shaped 
extremity. 
The muscular insertions to the first row are: to 
thumb four, flexor brevis, abductor and adductor 
pollicis, and extensor primi internodii; to index two, 
first palmar and dorsal interosseus; to middle two, 
second and third dorsal interosseus; to ring two,second 
palmar and fourth dorsal interosseus ; to little three, 
flexor brevis and abductor minimi digiti and third palmar 
interosseus. 
The insertions to second row are: extensor secundii 
internodii and flexor longis pollicis; and to each of the 
others four, extensor communis digitorum, flexor sub- 
limis digitorum, with the addition of extensor indicis 
to index and extensor minimi digiti to little. 
The insertions to third row are : extensor communis 
digitorum and flexor profundus. 
Ossific centres are two for each bone, one each for 
shaft and base. 68 
HUMAN ANATOMY. 
THE LOWER EXTREMITY. 
The lower extremity consists of the thigh, leg, and 
foot. It is connected to the trunk by the haunch, or hip- 
bone, and contains the following bones : os innominatum, 
femur, patella, tibia, fibula, seven tarsus, five metatarsus, 
and fourteen phalanges. 
Tiie os innominatum, or hip-bone, is a large, irregular 
bone forming the lateral and anterior walls of the pelvis, 
1, ilium ; 2, ischium; 3, pubes; 4, crest of ilium; 5, 6, and 7, middle, inferior, and 
superior curved lines; 8 and i), anterior superior and inferior spinous processes; 10 
and il, posterior superior and inferior spinous processes; 12, spine of ischium; 13, 
great sacro-sciatic notch; 14, lesser sacro-seiatic notch; 15, tuberosity of ischium ; 16, 
ramus of ischium and pubes; 17, horizontal ramus of pubes; 19, ascetabulum; 20, obtu- 
rator foramen. 
Fig. 25. 
and consisting of three bones, ilinm, ischium, and pubes, 
united about puberty. It presents 
The acetabulum or cotyloid cavity, a deep, cup-shaped 
cavity, for articulation of the head of the femur—the 
ischium forming a little more than two-fifths, the ilium 
a little less than two-fifths, and the pubes one-fifth. 
The bottom of the cavity presents a circular depression, OSTEOLOGY. 
69 
lodging a mass of fat, and giving attachment by its 
edges to the ligamentum teres, and continuous below 
with a deep notch, the cotyloid notch, for attachment 
of cotyloid and part of ligamentum teres, converted into 
a foramen by the transverse ligament for the entrance 
of the nutrient vessels and nerves. The margin of the 
acetabulum is deepened by a fibro-cartilaginous ring. 
The obturator', or thyroid foramen, is an aperture 
large and ovoidal in the male, small and triangular in the 
female, situated on the anterior inferior surface between 
the ischium and pubes. It is closed, in the recent state, 
by a strong membrane attached to its margins except 
above externally, where a foramen exists for obturator 
vessels and nerve. 
The ilium, broad, flat, and triangular, forms the 
greater part of the bone, its base above, its apex at the 
acetabulum. 
The external surface, or dorsum, concave in front 
and behind, presents from below upward 
A groove, just above the acetabulum, for the reflected 
tendon of the rectus femoris muscle; 
The inferior curved line, marking the lower border 
of the gluteus minimus; 
The middle curved line, the longest of the three, 
marking the lower border of the gluteus medius ; and 
The superior curved line, the shortest, marks the 
lower anterior border of the gluteus maximus,and from 
the surface below which arise a few fibres of the 
pyriformis. 
The upper expanded border forms the crest of the 
ilium, terminating in front in 
The anterior superior spinous process, giving origin 
to the sartorius and tensor vaginae femoris muscles and 
Poupart’s ligament, below which is 
The anterior inferior spinous process, for the ilio- 
femoral ligament, and the straight tendon of the rectus 
femoris muscle ; and behind in 
The posterior superior spinous process, for the oblique 
band of the sacro-iliac ligament, and part of the multi- 
fid us spinal muscle, below which is— 70 
HUMAN ANATOMY. 
The posterior inferior spinous process, for attachment 
of the great saero-sciatic ligament. 
Between the superior and inferior spinous processes, 
both anteriorly and posteriorly, is a notch, the former for 
partial attachment of the sartorius and passage of the 
external cutaneous nerve. 
The internal concave surface, or venter, presents 
The internal iliac fossa, lodging the iliacus muscle, 
and having a nutrient foramen at its lower part; 
llio-pectineal line, limiting the fossa below, and 
separating the false from the true pelvis; 
Rough surface, divided into two parts—an upper 
part for posterior sacro-iliac ligaments, and lower 
auricular surface for articulation with sacrum. 
The ischium forms the outer back part of pelvis, and 
consists of a bod}', tuberosity, and ascending ramus. 
The external surface of the body forms a little more 
than two-fifths of the acetabulum, and presents 
A groove below, for the tendon of the obturator 
externus. 
The internal surface is concave and smooth, and 
forms the lateral wall of the true pelvis. 
The posterior border presents 
The spine of the ischium, projecting downward, 
backward, and inward, from below the centre, for attach- 
ment of the gemelli superior, coccygeus and levator ani 
muscles, and lesser sacro-sciatic ligament; 
Great sacro-sciatic notch, a deep notch above the 
spine converted into a foramen by the lesser sacro- 
sciatic ligament, transmitting the pyriformis muscle, 
superior gluteal nerve, gluteal vessels, sciatic vessels 
and nerves, and the internal pudic vessels and 
nerves; 
Lesser sacro-sciatic notch, below the spine, and 
between it and the tuberosity, converted into a foramen 
by the great sacro-sciatic ligament, transmitting the 
obturator interims muscle and nerve, the internal pudic 
vessels and nerves. The lowest portion of the body 
presents:— 
Tuberosity (tuber iscliii), with OSTEOLOGY. 
71 
An outer lip, for attachment of part of adductor 
magnus, and quadriceps femoris ; 
Inner lip, for part of great sacro-sciatic ligament, 
erector penis, and transversus perinsei; 
Groove, on inner lip, for internal pudic vessels and 
nerve; 
Intermediate surface, for semi-membranosus, semi- 
tendinosus, biceps, adductor magnus, gemellus inferior, 
and great sacro-sciatic ligament. 
The ascending ramus passes upward and inward from 
the tuberosity to join the descending ramus of the pubes, 
forming part of the inner margin of the obturator 
foramen. It gives attachment to gracilis, obturator 
externus, partof adduct or magnus, erector penis, and 
transversus perinsei. 
The pubes forms the anterior part of the pelvis, and 
consists of a body, horizontal ramus, and descending 
ramus. 
The body is quadrilateral, and presents 
An anterior surface, for attachment of adductor 
longus and brevis, and part of gracilis, adductor magnus, 
and obturator externus; 
Posterior surface, forming anterior wall of true pelvis 
and giving attachment to levator ani and part of obtu- 
rator interims ; 
Spine, upon the upper border, for Poupart’s liga- 
ment and outer pillar of external abdominal ring; 
Ilio-pectineal line, continuous with that on ilium; 
Crest, along the upper border, internal to the spine; 
Angle, at the junction of the inner border with the 
crest and giving attachment to internal pillar of external 
ring; 
Symphysis, the internal oval border roughened by 
several ridges for articulation with opposite bone. 
The horizontal ramus joins the ilium, forming the 
upper part of the obturator foramen, and presents at its 
lower border a 
Groove, for the obturator vessels and nerve. 
The descending ramus is flat and thin, and joins the 
ascending ramus of the ischium. 72 
HUMAN ANATOMY. 
Each innominate bone articulates with three bones— 
the sacrum, femur, and its fellow of the opposite side. 
Its muscular attachments are thirty-three—[ilium], 
latissimus dorsi, tensor vaginae femoris, obliquus ex- 
tensor, erector spin®, trans- 
versalis, quadratus lumborum, 
gluteus minimus, medius and 
maximus, rectus, pyriformis, 
iliacus, multifid us spinae, sarto- 
rius; [ischium], obturator ex- 
ternus and internus, gemellus 
superior, coccygeus, levator ani, 
semi-membranosus and semi- 
tendinosus, biceps, quadratus 
femoris, adductor magnus, 
gemellus inferior, erector penis, 
and transversus perinaei; 
[pubes], pyramidalis, obliquus 
internus and externus, psoas 
parvus, pectineus, adductor lon- 
gus and brevis, gracilis, and 
compressor urethrae. 
Its ossific centres are eight 
—one primary for each division 
and five epiphyses, one each for 
crest of ilium, symphysis, tuber- 
osity of ischium, anterior spinous 
process, and acetabulum. 
The femur, or thigh-bone, is 
the largest, longest, and strongest 
bone in the body. In the erect 
position it inclines toward its 
fellow at the knee, being widely 
separated above, forming the 
sides of a triangle, the base of 
which is greater in females from 
the greater breadth of the pelvis. It consists of a 
shaft, an upper and lower extremity. 
The shaft, expanded above and below, curved and 
twisted, convex in front, concave behind, is nearly 
cylindrical throughout, and presents :— 
Fig. 26. 
1, shaft of femur; 2, head; 3, 
neck; 4. great trochanter; 5, an- 
terior trochanteric line; 6, lesser 
trochanter: 7 and 8, external and 
internal condyles: 10, groove for 
popliteus muscle: 9 and 11, external 
and internal tuberosity. OSTEOLOGY. 
73 
Smooth anterior surface, for origin of crureus and 
subcrureus muscles ; 
Lateral surfaces, covered by the vasti externus and 
internus ; 
The posterior surface, rough and prominent, has its 
Nutrient foramen between.the middle and lower two- 
thirds directed upward; 
Linea aspira, a rough, prominent, longitudinal crest 
descending from the trochanters along the middle third, 
bifurcating and diverging at the inferior extremity to 
the condyles, inclosing 
The popliteal space, a smooth, triangular space, on 
which rests the popliteal artery, and which is 
Gi'ooved at its inner margin by the femoral 
artery. 
The outer and inner lip of the linea aspera give 
attachment to the vasti externi and interni, three 
adductors, pectineus, biceps, and gluteus maximus. 
The upper extremity presents the following :— 
The head, forming two-fifths of a sphere, articulates 
with the acetabulum, having a central oval depression 
for the ligamentum teres ; 
Neck, pyramidal, with excavated surfaces, connects 
the head with the shaft, the angle of its obliquity to the 
shaft varying much from puberty to old age, being, in 
the adult, about 130° ; 
The great trochanter, a large, rough, quadrilateral 
eminence, directed upward, outward, and backward, its 
external surface marked by a diagonal line for insertion 
of gluteus medius tendon, its outer surface smooth for 
the passage of the gluteus maximus tendon, separated 
by a bursa, and its superior surface marked by three 
impressions, from behind forward, for pyriformis, obtu- 
rator internus, and gemelli muscles. The gluteus mini- 
mus is attached to the anterior border; 
Digital or trochanteric fossa, to the inner side of the 
great trochanter, for insertion of obturator externus 
tendon; 
The lesser trochanter, a small, conical projection at 
the base of the neck posteriorly, and giving attachment 74 
HUMAN ANATOMY. 
to the tendon of psoas magnus muscle, the iliacus being 
inserted below; 
Anterior intertrochanteric line, connects the tro- 
chanters in front and gives attachment at its upper part 
to the capsular ligament; 
Posterior intertrochanteric line, a much more promi- 
nent ridge, connects them behind ; 
Tubercle of the femur, a prominence at the junction 
of the neck with the great trochanter, is the meeting- 
place of five muscles—two gemelli, obturator internus, 
gluteus minimus, and vastus externus ; 
Tubercle of the quadratus, about the centre of the 
posterior intertrochanter line, for the quadratus femoris; 
Linea quadrati, passes vertically downward from the 
middle of the posterior line, and gives attachment to 
part of adductor magnus and quadratus femoris. 
The inferior extremity, large and cuboidal in form, 
presents:— 
External condyle, shorter and broader than the 
internal, has behind its centre the outer tuberosity for 
the external lateral ligaments of the knee, and a groove 
below the tuberosity for the tendon of the popliteus 
muscle. It also gives origin to the outer head of the 
gastrocnemius, above which arises the plantaris muscle ; 
The internal condyle, longer by half an inch and 
more prominent (so as to bring them on the same hori- 
zontal plane owing to the obliquity of the shaft), has 
on the inner surface the inner tuberosity for the internal 
lateral ligament; 
Adductor tubercle, at the summit of the internal 
condyle, marks the termination of the inner ridge of the 
linea aspera, and gives attachment to tendon of adductor 
magnus; 
Depression, above the articular surface of the inter- 
nal condyle posteriorly, for the origin of the inner head 
of gastrocnemius; 
Inter condyloid notch, separates the condyles behind, 
and lodges the crucial ligaments; 
Trochlea is a smooth surface between the condyles 
in front and articulates with the patella in front. The OSTEOLOGY. 
75 
inferior surfaces of both condyles are smooth, continu- 
ous in front, covered with cartilage in the recent state, 
for articulation with the head of the tibia. The femur 
articulates with three bones—innominatum, tibia, and 
patella. 
Its muscular attachments are twenty-three (23)— 
two vasti, three adductors, gluteus maximus, medius 
and minimus, pyriformis, obturator externus and inter- 
nus, two gemelli, quadratus femoris, psoas magnus, 
iliacus, biceps, pectineus, crureus, subcrureus, gastroc- 
nemius, plantaris, and popliteal. 
Its ossific centres are live—three primary, one each 
for shaft and each extremity, and one epiphysis for each 
trochanter. 
The patella is a flat, triangular bone, sesamoid in 
origin, developed in the tendon of the quadriceps exten- 
sor, forming the knee-cap, and entering into the 
formation of the knee-joint. 
The convex anterior surface is roughened by 
apertures for nutrient vessels. 
The posterior or internal surface is divided by a 
vertical and transverse ridge into three surfaces—two 
smooth, articular facets, for either condyle of femur 
above, the outer being deeper and broader, and a rough 
surface below (apex) for ligamentum patella?. 
The superior border gives attachment to the rectus 
and crureus muscles, the internal and external lateral 
borders to the vasti internus and externus. 
It articulates with the femur. 
Its muscular attachments are four muscles—rectus 
femoris, crureus, vastus externus, and vastus internus. 
It is developed from a single ossific centre. 
The tibia, or shin-bone, extends on the internal 
aspect of the leg from the knee to ankle, and consists 
of a shaft, upper and lower extremity. 
The shaft is triangular, prismoid, with the base above. 
Its anterior border and internal surface are subcuta- 
neous, the former forming the shin or crest of the tibia. 
The posterior surface presents above an oblique line 
for the lower border of the popliteal muscle and fascia, 76 
HUMAN ANATOMY. 
and origin of the soleus, and parts of flexor longus 
digitorum and tibialis posticus muscles. 
It presents just below the oblique line a nutrient 
canal, the largest in the skeleton, directed downward. 
Its external border, or interosseous ridge, is thin, for 
attachment of interosseous membrane. 
Fig. 27. 
Fig. 2§. 
Shaft of tibia, 2 and 3, inner and outer 
tuberosities; 4, spine ; 5, tubercle ; 6, crest 
or shin; 7, lower extremity; 8, internal mal- 
leolus ; 9, shaft of fibula; 10, head of fibula; 
11, external malleolus. 
2 and 3, articular surfaces; 3, insertion 
of semi-membranosus: 5, oblique line; 6, nu- 
trient foramen; 7, shaft of tibia; 9 and 14, 
grooves for flexors; 13, external malleolus. 
The external surface and internal borders are 
covered by muscles. 
The superior expanded surface presents :— 
Head, consisting of two lateral tuberosities, having 
each upon their upper surfaces a smooth, concave, ovoidal OSTEOLOGY. 
articulating facet for the condyles of the femur, sepa- 
rated by 
The spinous process of the tibia, in front and behind 
which is impression for crucial ligaments, and 
tubercles for the extremities of the semi-lunar cartilages ; 
Tubercle, on the anterior surface of the head, between 
the tuberosities, for the insertion of ligamentum patellae ; 
Popliteal notch, separating the tuberosities posteri- 
orly, for attachment of posterior crucial ligament; 
Transverse groove, on the posterior surface of the 
inner tuberosity, for insertion of semi-membranosus 
tendon; 
Facet, upon the posterior surface of the outer tube- 
rosity, for articulation of the head of the fibula. 
The inferior extremity, smaller than the superior, is 
quadrilateral, and presents in front a smooth surface 
for extensor tendons, behind a groove for flexor longus 
pollicis tendon, externally, a rough, triangular, articular 
surface, for fibula, and internally 
The internal malleolus, which projects downward, 
and articulates by its outer surface with the astragalus. 
Its inner surface is smooth and subcutaneous; its 
posterior border is grooved for the tendons of the 
tibialis posticus and flexor longus digitorum muscles, 
and to its tip is attached the internal lateral ligament. 
It articulates with three bones—femur, fibula, and 
astragalus. 
Its muscular attachments are twelve—ligamentum 
patellae, popliteus, soleus, flexor longus digitorum, 
tibialis posticus, semi-membranosus and tendinosus, 
gracilis, sartorius, tibialis anticus, and extensor longus 
digitorum, biceps. 
It is developed from three ossific centres, one each 
for shaft, upper and lower extremities. 
The fibula, or peroneal bone, is a long, slender bone 
on the outer aspect of the leg, and consists of a shaft, 
upper and lower extremity. 
The shaft is prismoidal, four-sided, twisted on itself, 
and arched backward. Its antero-internal border, or 
interosseous ridge, gives attachment to the interosseous HUMAN ANATOMY. 
membrane. The postero-internal border, called also 
oblique line, and the other surfaces and borders give 
attachment to all the muscles except the biceps. 
Nutrient foramen, about the middle of the anterior 
internal surface, is directed downward. 
The superior extremity presents a neck, supporting a 
rounded, irregular head, which articulates by a flattened 
facet on its inner surface with the tibia, and is prolonged 
upward on its outer side by the styloid process, giving 
attachment to the biceps tendon and the external lateral 
ligament of the knee. 
The inferior extremity expands into the external 
malleolus, with its convex internal surface for articula- 
tion with astragalus, outer convex surface subcutaneous, 
and posterior border deeply grooved for tendons of 
peroneus longus and brevis muscles. 
To the summit is attached the middle fasciculus of 
the external lateral ligament, and to rough depressions 
in front and behind the anterior and posterior fasciculi. 
It articulates with two bones, tibia and astragalus. 
Its muscular attachments are nine—soleus, biceps, 
three peronei, tibialis posticus, flexor longus pollicis, 
and extensor longus digitorum and pollicis. 
It is developed from three ossilic centres, one each 
for shaft, head, and malleolus. 
THE FOOT. 
The bones of the foot consist of seven tarsus, five 
metatarsus, and fourteen phalanges. 
The tarsal BONEsare—calcaneum, astragalus, cuboid, 
scaphoid, internal middle and external cuneiform. 
They may be arranged into two series, anterior and 
posterior, the calcis and astragalus behind, and all the 
others in front of the calcaneo-cuboid, astragalo- 
scaphoid joint [Cliopart’s]. 
Calcaneum, or os calcis, the largest, is irregularly 
cuboidal. 
The superior surface presents two articular surfaces 
for astragalus, separated by superior groove, and inter- 
nally a projecting process, the sustentaculum tali, for OSTEOLOGY. 
79 
calcaneo-cuboid ligament. The inferior surface, rough 
and excavated, presents two tubercles, an outer and 
inner tubercle, for muscles and ligaments. 
Internal surface is concave, for passage of flexor 
longus, and tibialis posticus tendons, and plantar vessels 
and nerves. 
External surface presents tubercle for external 
lateral ligament of ankle and 
grooves for peroneal tendons. 
Posterior surface, projecting 
behind, presents a smooth surface 
above for bursa and rough below 
for attachment of tendo Achillis. 
It articulates with astragalus 
and cuboid. 
Muscular attachments are 
eight—tendo Achillis, plantaris, 
tibialis posticus, abductor pollicis 
and minimi digiti, flexor brevis 
digitorum and accessorius, exten- 
sor brevis digitorum. 
Astragalus is an irregular, 
short bone, consisting of body, 
neck, and head. The quadrilat- 
eral body presents four articular 
surfaces, above for lower extrem- 
ity of tibia and internal malle- 
olus and external malleolus; 
below two surfaces for os calcis, 
separated by deep groove for 
interosseous calcaneo-astragaloid 
ligament; posteriorly it presents 
a deep groove for flexor longus 
pollicis tendon; and anteriorly, 
the rounded convex head supported on neck articulates 
with scaphoid, and rests upon calcaneo-scaphoid 
ligament. 
It articulates with four bones—tibia, fibula, scaphoid 
and os calcis. It has no muscular attachments. 
Cuboid (cube-like) is a small, pyramidal bone, between 
1, 09 calcis; 2, 2, outer and 
inner tuberosity; 3, groove for 
flexor longus pollicis; 4, head of 
astragalus; 6, tubercle of sca- 
phoid ; 7, 8, 9, internal, middle, 
and external cuneiform bones; 10, 
cuboid; 11, groove for peroneus 
longus; 12, 12, metatarsal bones; 
13, 14, 15, phalanges. 
Fig. 29. 80 
human anatomy. 
the os calcis and the fouttli and fifth metatarsal bones 
on the outer side of the foot. 
The upper or dorsal surface is rough for ligamentous 
attachment; the lower or plantar surface is grooved for 
tendon of peroneus longus, behind which is a ridge for 
the long calcaneo-cuboid ligament, terminating exter- 
nally in the tuberosity of the cuboid. 
The external surface has a deep notch, the outer ex- 
tremity of the peroneal groove. 
The posterior surface has triangular facet for os 
calcis, the anterior has two facets, separated by a ridge 
for the fourth and fifth metatarsals, and the internal 
surface has broad, square facet for external cuneiform, 
and sometimes a smaller facet for scaphoid. 
It articulates with four and occasionally with five 
bones. 
It has one muscular attachment—part of flexor 
brevis pollicis. 
Scaphoid, or navicular bone, is a boat-like bone placed 
between astragalus and three cuneiform bones. 
Its posterior concave surface articulates with head 
of astragalus, its anterior convex surface has three 
facets for cuneiform bones; its internal border presents 
the tuberosit}" of the scaphoid for insertion of tibialis 
posticus, the only muscular attachment. Its other 
borders are roughened for ligamentous attachment. 
It articulates with four bones—astragalus and three 
cuneiforms. 
The cuneiform hones are named from their position 
the internal, middle, and external. 
The internal cuneiform, the largest, lias its base 
below, and articulates anteriorly with first metatarsal, 
posteriorly with scaphoid, and externally with second 
metatarsal and middle cuneiform. The plantar surface 
presents tuberosity for insertion of part of tibialis pos- 
ticus and anticus tendons, the only muscular attach- 
ments. It articulates with four bones—scaphoid, 
middle cuneiform, first and second metatarsals. 
The middle cuneiform, the smallest, lias its base 
upward, and articulates posteriorly with scaphoid, OSTEOLOGY. 
81 
anteriorly by a triangular facet with second metatarsal, 
and laterally with internal and external cuneiforms. 
It has no muscles attached. 
The external cuneiform, intermediate in size, and 
more regular, articulates posteriorly with scaphoid, 
anteriorly with third metatarsal, internally with middle 
cuneiform and second metatarsal, and externally with 
cuboid and fourth metatarsal. 
Muscular attachments are for flexor brevis pollicis 
and tibialis posticus. 
The metatarsal bones have the same general form 
as the metacarpal bones of hand, each consisting of 
shaft, head, and base. 
The shaft is prismoid and curved, with concavity 
below, convexity above. 
The head is rounded for articulation with phalanges, 
and has tubercles laterally for ligaments and a groove 
below for tendon of long flexor. 
The base is wedge-shaped for articulation with the 
tarsus and with each other. 
The first and strongest articulates at base with inter- 
nal cuneiform, at head with phalanx and second meta- 
tarsal, and has three muscular attachments—for tibialis 
anticus, peroneus longus, and first dorsal interosseous. 
The second is wedged in by base between three cunei- 
form bones, articulates with second phalanx, first and 
third metatarsi, and has three muscular attachments— 
for adductor pollicis, first and second interosseous. 
The third articulates with external cuneiform below 
and second and third metatarsi and third phalanx, and 
has four muscular attachments— for adductor pollicis, 
first plantar, and second and third dorsal interossei. 
The fourth articulates at base with external cunei- 
form and cuboid and at extremity with third and fifth 
metatarsal and fourth phalanx, and has four muscular 
attachments—for adductor pollicis, third and fourth 
dorsal, and second plantar interossei. 
The fifth has marked tubercle on outer side. It 
articulates with cuboid, fourth metatarsal, and fifth pha- 
lanx, and has five muscular attachments—for flexor 82 
HUMAN ANATOMY. 
brevis minimi digiti, peroneus brevis and tertius, fourth 
dorsal, and third plantar interosseus. 
The phalanges have same general characteristics as 
in hand, but are compressed from side to side instead 
of from before backward. The muscular insertions to 
first row are—to great toe, transversus pedis, extensor 
brevis digitorum, adductor, abductor and flexor brevis 
pollicis ; to second, first and second dorsal interosseus ; 
to third, third dorsal and first plantar interosseus ; to 
fourth, fourth dorsal and second plantar interosseus; to 
fifth, abductor and flexor brevis minimi digiti and third 
plantar interosseus. To second row—to great toe, 
flexor and extensor longus pollicis; to remaining toes, 
extensor longus and brevis digitorum, flexor brevis digi- 
torum, and lumbricales. To third row, or ungual pha- 
langes—flexor longus and extensor longus and brevis 
digitorum. 
The ossific centres are one each for the tarsus, ex- 
cepting the os calcis, which has an epiphysis for pos- 
terior part, and two each for metatarsals and phalanges. 
These latter are arranged in phalanges, one each for 
shaft and base, and in metatarsals, one each for shaft and 
head, excepting great one, which has one each for shaft 
and base. 
Sesamoid bones are small, osseous masses, carti- 
laginous in early life, developed in the tendons to relieve 
pressure. They are of two kinds—those over articular 
surfaces of joints, as patella; and those applied to the 
surfaces of bones, as in tendon of peroneus longus in the 
groove of cuboid bone. OSTEOLOGY. 
83 
Name. 
Centres. 
Time of 
Appearance. 
Vertebrae. 
3 Primary:— 
1 for each lamina. 
6th week. 
1 for each process. 
1 for body. 
8th week. 
4 Secondary Centres:— 
1 for each transverse process. 
2 for end of spinous process. 
16th year. 
2 Additional Plates:— 
1 epiphyseal plate on upper and 
under surface of body. 
21st year. 
All unite by 30th 
year. 
Atlas (3). 
1 for each lateral mass. 
8th week. 
1 epiphysis for anterior arch. 
1st year. 
Axis (6). 
1 for lower part of body. 
1 for each lamina. 
6th month. 
2 for lateral processes. 
1 for apex of odontoid process. 
6th foetal month. 
Seventh Cer- 
1 for anterior and costal part of 
6th foetal month; 
vical. 
transverse process. 
joins 5th or 6th 
year. 
Lumbar Ver- 
1 for each tubercle of superior 
tebrae (2). 
Sacrum (35). 
articular process. 
15. 
3—1 for each body 
8th or 9th week. 
and upper and lower epiphy- 
seal plate. 
16th year, and 
unites 18th or 
20th year. 
10. 
2—1 for each arch. 
6th or 8th month; 
joins 2d to 6th 
year. 
6. 
2 for each lateral mass of the first 
three vertebrae. 
4. 
Each lateral surface has one epi- 
physeal articulation and ad- 
joining edge. 
18th to 25th year. 
Coccyx (7). 
1 for each piece. 
Birth. 
2. 
5th to 10th year. 
3. 
10th to 15th year. 
Cranial 
4. 
15th to 20th year. 
Bones. 
Occipital (7). 
4 for tabular or epi-occipital. 
8th foetal week. 
1 for each condylar portion. 
4th to 6th year; 
1 for basilar portion. 
joined to sphe- 
noid 18th to 
25th year. 
TABLE OF OSSIFICATION. 84 
HUMAN ANATOMY. 
Name. Centres. 
Time of 
Appearance. 
Parietal (1). From membrane. 
Single centre at parietal eminence. 
7th to 8th foetal 
week. 
Frontal (2). 1 for each lateral portion. 
7th to 8th week. 
From membrane. 
United by 4th 
year. 
Temporal (10). 1 for squamous process. 
2d month. 
1 for auditory process. 
Later. 
6 for petro-mastoid. 
2 for styloid process. 
8 for post-sphenoid. 
5th or 6th month. 
Sphenoid (14). 1 for each wing and external ptery- 
goid plate. 
1 for each internal pterygoid plate. 
2 for posterior part of body. 
1 for base ap- 
1 for each lingula. 
pears before 
birth and one 
after birth. 
6 for pre-sphenoid:— 
Appear from 8th 
1 for each lesser wing. 
week to third 
2 for anterior portion of body. 
1 for each spheno-turbinal. 
year,and union 
of all parts is 
accomplish ed 
by the 20th 
year, and with 
occipital, 18th 
to 25th year. 
Ethmoid (3). 1 for each lateral mass. 
4th to 5th foetal 
month. 
1 for lamella. 
Unite about 2<t 
year. 
Face. 
Nasal. 1 for each bone. 
Superior Max- 
6th week. 
illae (4). 1 pre-maxilla. 
Very early. 
1 pre-palatine portion. 
Antrum appears 
1 maxillary portion. 
about fourth 
1 malar “ 
foetal month. 
Lachrymal. A single centre. 
7th week. 
Malar. Single centre. 
6th week. 
Palate. Single centre at junction of plates. 
Inferior Tur- 
2d foetal month. 
binated. Single centre. 
Middle of foetal 
life. 
Vomer. Single centre, but two laminae. 
8th week. 
Inferior Max- Probably several centres ; at birth 
Very early, be- 
ilia. consists of two halves. 
ing second in 
order. OSTEOLOGY. 
85 
Name. 
Body. 
Centres. 
Time of 
Appearance. 
Ilyoid (5). 
1 for body and for each cornua. 
3 months after 
birth. 
Sternum (6). 
1 for manubrium. 
Middle of foetal 
4 for gladiolus. 
1 for ensiform appendix. 
life. 
Ribs (3). 
1 for each shaft, head, and tuber- 
cle, excepting the last two, 
Before vertebrae. 
Epiphysis for tu- 
which have but 2, the tuber- 
bercle appears 
cles being absent. 
from Kith to 
20th year, and 
unites about 
Upper 
25th. 
Extremity. 
Clavicle (2). 
1 for shaft. 
1 for sternal extremity. 
About 30th day. 
Scapula (7). 
1 for body. 
2 for coracoid process. 
2d month. 
2 for acromion process. 
1 for posterior border. 
Completed be- 
1 for inferior angle. 
tween 20th and 
25tli year. 
Humerus (7). 
1 for shaft. 
1 for head. 
8th week. 
1 for tuberosities. 
1 for radial head. 
Upper extremity 
ossifies 2d to 
4th year. 
1 trochlear portion. 
1 for each condyle. 
Complete about 
20th year. 
Ulna (3). 
1 for shaft. 
8th week. 
1 for olecranon. 
10th year. 
1 for lower extremity. 
4th year. 
Radius (3). 
1 for shaft. 
Soon after hu- 
merus. 
1 for upper extremity. 
5th year; unites 
17th to 18th 
year. 
1 for lower extremity. 
2d year; unites 
20th year. 
Upper extremity 
joins 16th year; 
lower, 20 th 
year. 86 
Name 
Centres. 
Time of 
Appearance. 
Carpus. 
Each has single centre:— 
1st year. 
Os magnum. 
Unciform. 
1st year. 
Cuneiform. 
3d year. 
Trapezium and semi-lunar. 
5th year. 
Scaphoid. 
6th year. 
Trapezoid. 
8th year. 
Pisiform. 
12th year. 
Metacarpus 
Centres for each:— 
(8). 
1 for shaft and 
8th or 9th week. 
1 for each distal extremity ex- 
3d year, and 
cept thumb, which has one 
unites about 
each for shaft and base. 
20th year. 
Phalanges (2). 
1 for each shaft and base. 
8th week, and 
unites 18th to 
20th year. 
Lower 
Extremity. 
Os Innomi- 
nata (8). 
3 Primary:— 
Ilium. 
Same as verte- 
brae, 6th week. 
Ischium. 
3d month. 
Pubes. 
5 Secondary:— 
4th or 5th month. 
1 crest of ilium. 
1 anterior inferior spinous pro- 
Puberty. 
(< 
cess. 
1 tuber ischii. 
« 
1 symphysis pubis. 
u 
1 acetabulum. 
13th or 14th year; 
completed 
25th year. 
Femur (5). 
1 for shaft. 
5th week. 
1 for upper extremity. 
End of 1st year. 
1 for lower extremity. 
9th foetal month. 
1 for great trochanter. 
4th year. 
1 for lesser trochanter. 
13th or 14th year. 
Inferior extrem- 
ity. The last 
is not united 
before the 20th 
year. 
Patella. 
Single centre. 
3d to 6th year; 
completed 
about puberty. 
HUMAN ANATOMY. OSTEOLOGY. 
87 
Name. 
Centres. 
Time of 
Appearance. 
Tibia (3). 
1 for shaft. 
7th week. 
1 upper extremity. 
Birth; unites 
20th year. 
1 lower extremity. 
2d year; unites 
18th year. 
Fibula (3). 
1 for shaft. 
8th foetal week. 
1 upper extremity. 
4th year. 
1 lower extremity. 
2d year; the 
lower unites 
first — about 
20th year. 
Tarsus. 
4 os calcis:— 
1 for body and 
1 for posterior extremity. 
6th foetal month. 
1 each for the following:— 
Cuboid. 
9th month. 
Astragalus. 
7th “ 
Scaphoid. 
4th year. 
Internal cuneiform. 
3d “ 
Middle “ 
4th “ 
External “ 
1st “ 
Metatarsus. 
1 for each shaft 
7th week. 
and digital extremity, 
except great toe, which is 
same as thumb. 
3d year. 
Phalanges (2). 
1 for each shaft and proximal ex- 
tremity. ARTICULATIONS AND LIGAMENTS. 
The bones of the skeleton are connected together by 
articulations or joints. 
These consist essentially of the expanded extremities 
of bones, covered with cartilage, often separated by 
interarticular fibro-cartilage, held together by ligaments, 
and lined by synovial membrane. 
The bone entering into the articular lamella differs 
from ordinary bone by its extreme density, without Ha- 
versian canals, its lacunae being much larger, and with- 
out canaliculi. It is not perforated by blood-vessels. 
Cartilage is a whitish, highly elastic, non-vascular 
structure, forming in the foetus the greater part of the 
skeleton, and found in the adult chiefly in the joints, the 
walls of the thorax, and certain orifices, as the nostrils, 
ears, etc. 
It is either temporary, becoming ossified later, or 
permanent, remaining unossified. The latter is divided 
into three varieties : articular, in joints covering the ends 
of the bones; costal, forming part of the thorax; and 
reticular, arranged in plates or lamellae to maintain the 
shape of parts. 
Fibro-cartilage consists of a mixture of cartilaginous 
with white fibrous tissue. There are four varieties :— 
(«) Interarticnlar, interposed between the joint surfaces; 
(l) Connecting, binding bones together as in pubes; 
(c) Circumferential, deepening cavities, as glenoid cavity of 
shoulder: and 
(d) Stratiform, lining grooves for tendons. 
Synovial membranes are of three kinds: articular, 
lining the cavities of movable joints throughout except 
the surface of the cartilage; bursal, irregular cavities 
interposed at convenient positions to alleviate friction; 
from their contents they may be either mucous or syno- ARTICULATIONS AND LIGAMENTS. 
89 
vial; and vaginal synovial membranes, or sheaths, sur- 
rounding tendons and diminishing friction. 
Synovia is a transparent, viscid liquid, albuminous 
in its nature. 
The articulations consist of three (3) classes: diar- 
throsis, movable ; synarthrosis, immovable ; and amplii- 
arthrosis, mixed. 
1. The diarthrosis are subdivided into :— 
Arthrodia, gliding-joint, as superior tibio-fibular; 
Enartlirosis, ball-and-socket-joint, as shoulder and hip; 
Ginglymus, binge-joint, as knee and ankle ; 
Diarthrosis rotatoria, a ring surrounding a pivot, as atlo-axoid 
joint. 
Condyloid, elliptical cavity receiving an ovoid head, as wrist- 
joint. 
2. Synarthrosis, surface, immovably connected by 
fibrous membrane without synovial membrane. 
They are divided into :— 
Sutura, bones interlocking with one another; 
Schindylesis, a fissure in one bone receiving a plate of bones, as 
between vomer and sphenoid ; 
Gomphosis, a socket with a pivot inserted, as in alveolar cavities 
for teeth. 
The sutura may be either true, sutura vera, or false, 
sutura notha, the former having three divisions: dentata, 
tooth-like processes, as interparietal suture; serrata, saw- 
like edges, as interfrontal suture; limbosa, dentated pro- 
cesses and beveled margins, as fronto-parietal; the latter 
two divisions:— 
Squamosa, overlapping beveled margins, and 
Harmonia, by union of roughened surfaces, as intermaxillary 
suture. 
3. Amphiarthrosis, bony surfaces connected by flbro- 
cartilage, with or without synovial membrane, as between 
vertebral bodies, and pubic symphysis. 
Motions in Joints.—Joints admit of four (4) dis- 
tinct varieties of motion :— 
(«) Gliding movement, between contiguous surfaces; 
(b) Angular movement, as flexion, extension, adduction, and ab- 
duction ; 
(e) Circumduction, as in true enarthrosis ; 
(cl) Rotation on its own axis, as between the atlas and axis. 90 
HUMAN ANATOMY. 
Temporo-maxillary is formed by condyle of lower 
jaw, below articulating with glenoid cavity of the tem- 
poral bone and eminentia articularis above. It is a 
double arthrodial joint. 
Ligaments.—External lateral—origin, tubercle on 
outer edge of zygoma; insertion, outer side of neck of 
condyle. Internal lateral—origin, spinous process of 
sphenoid; insertion, lower circumference of inferior 
dental foramen. 
Capsular—origin, circumference of articulation ; in- 
sertion, neck of condyle. 
Inter articular fibro-cartilage is within cavity ; ex- 
ternal pterygoid muscle attached to its inner edge. 
Synovial membrane is divided into two by cartilage. 
Intermaxillary ligament passes from external ptery- 
goid process to coronoid. 
Stylo-maxillary ligament—origin, styloid process; 
insertion, inner surface of angle of jaw. Nerves are de- 
rived from the auriculo-temporal and masseteric branches 
of the inferior maxillary. 
Articulations of Vertebral Column.—These are 
formed between the contiguous surfaces of the vertebral 
bodies and articular processes, inclosed in capsular 
ligaments, and connected with the following ligaments :— 
The anterior common ligament, extends from the 
front of the body of the axis down the anterior surface 
of the spine to the sacrum, being expanded opposite, 
and attached to each intervertebral connecting fibro- 
cartilage ; 
The posterior common ligament, descends along 
posterior surfaces of bodies from axis to sacrum within 
spinal canal. It also expands opposite and adheres to 
intervertebral substance ; 
Intervertebral substance, disks of varying size, 
twenty-seven in number, composed of decussating fibres 
of fibro-cartilage, arranged in crescentic laminae with 
central, semi-pulpy substance, separate the vertebrae; 
Ligamenta sub/lava, descend in pairs, twenty-three 
on either side, from one lamina to another, from axis to 
sacrum, inclosing spinal canal; ARTICULATIONS AND LIGAMENTS. 
91 
Supraspinous ligament, strong cord descending from 
one vertebra to another, from vertebra prominens 
(seventh cervical) to sacrum, Its continuation in 
cervical region forms ligament nucb.se; 
Interspinous, stretch between spinous processes 
throughout dorsal and lumbar regions ; 
Intertransverse, between transverse processes in 
lower dorsal and lumbar regions. 
The arteries are derived from ascending cervical and 
vertebral in cervical, intercostals in dorsal, and lumbars 
in lumbar regions. 
The nerves are from spinal nerves in each region. 
Atlo-axoid articulation consists of four joints, the 
two lateral joints being arthrodia, and that between 
the odontoid process and arch of atlas and transverse 
ligament—a diarthrosis rotatoria—being double, one in 
front, atlo-odontoid, and one behind, odonto-transverse. 
The ligaments are :— 
Anterior atlo-axoid, two—superficial and deep, con- 
necting anterior borders together; 
Posterior atlo-axoid, connecting the arches of the 
atlas and axis posteriorly, and pierced laterally by the 
second spinal nerve; 
Capsular, two, connecting the articulating processes 
laterally, and lined with s37novial membrane ; 
Transverse, or cruciform, arises from the tubercle 
on one side of the lateral mass, passes across the back 
of odontoid process to be inserted into the opposite 
tubercle. 
The arteries are from vertebral, nerves from second 
cervical, or from loop between it and suboceipital. 
Occipito-atloid.—Anterior occipito-atloid—two, su- 
perficial and deep, connecting the tubercle and upper 
border of anterior arch of atlas with basilar process and 
margin of foramen magnum of occiput. 
Posterior occipito-atloid (membranous), connects 
the upper border of posterior arch of atlas with posterior 
margin of foramen magnum. 
Lateral ligaments, two bands connecting transverse 
process of atlas with jugular process of occipital. 92 
HUMAN ANATOMY. 
Capsular ligaments connect the articular processes 
of atlas with condyles of occiput. 
The arteries are from vertebral; nerves, from sub- 
occipital. 
Occipito-axoid.—Occipito-axoid is a broad band, the 
continuation of posterior common ligament, extending 
from the body of the axis to basilar groove of occipital. 
Odontoid, or check, pass upward and outward from 
the summit of the odontoid process, to be inserted into 
the inner side of the occipital condyles. 
Ligamentum suspensorium, or central occipito- 
odontoid, arises from the centre of the transverse 
ligament at the apex of the odontoid process, and passes 
upward, to be inserted into the anterior margin of the 
foramen magnum. 
Occipito-cervical, or cervico-basilaris, arises from the 
bodies of the third cervical and axis, and is inserted 
into the basilar groove of occipital. 
The arteries are from vertebral; the nerves from 
suboccipital. 
Capsular ligaments.—Throughout the spine the 
articulations between the facets of the articular processes 
are surrounded by capsular ligaments, making twenty- 
five pairs in all. 
Costo-vertebral Articulations.—The costo-vertebral 
have each a double arthrodia between the head of the 
rib and the bodies of the two adjacent vertebrae, except 
the first, tenth, eleventh, and twelfth ribs, which have 
each but a single joint. 
Anterior costo-vertebral, or stellate ligament—origin, 
head of the rib; insertion, into body of vertebra above 
and below, and interarticular cartilage between. 
Inter articular costo-vertebral is within the capsular 
ligament, from the crest on the head of the rib to the 
intervertebral substance. 
Capsular ligament surrounds the articular surfaces. 
Costo-transverse articulations are united by three 
ligaments—anterior, middle, and posterior costo-trans- 
verse ligaments—extending between the tubercles of the 
ribs to the transverse process below. ARTICULATIONS AND LIGAMENTS. 
93 
Costo-sternal Articulations.—These are connected 
by arthrodia excepting the first, which is a synarthrodia. 
Anterior chondro-sternal ligaments connect the chon- 
dral and sternal surface in front; 
Posterior chondro-sternal connect them behind. 
Capsular ligaments surround all, and synovial mem- 
branes are present in all but the first, while the second 
has an interarticular cartilage interposed. 
The chondro-xiphoid ligament connects the cartilage 
of the seventh, and sometimes the sixth rib with the 
xiphoid appendix. 
Interchondral and costo-chondral articulations. The 
ribs are connected with their cartilages by the perios- 
teum covering them. The cartilages of the sixth, 
seventh, and eighth ribs, and sometimes the fifth and 
ninth, are connected by anterior and posterior inter- 
chondral ligaments, held together by capsular ligaments 
and lined with synovial membrane. 
Ligaments of Sternum.—The first and second por- 
tions of the sternum are articulated by an amphiar- 
throdial joint, sometimes a diarthrodial joint, connected 
by the anterior intersternal and posterior intersternal 
ligaments, and lined with synovial membrane. 
The third portion, or ensiform cartilage, is united to 
the gladiolus by a synarthrodial joint. 
THE THORAX. 
The thorax is a conical osteo-cartilaginous frame-work, 
formed by the dorsal vertebrae behind, the ribs, intercos- 
tal muscles, and costal cartilages laterally, and the 
sternum in front. 
The apex, or superior opening, is bounded behind by 
the first dorsal vertebra, laterally by the first rib, and 
in front by the upper border of tiie sternum. 
It transmits the following structures :— 
(Esophagus, trachea, thoracic duct (on left side), lymphatic ves- 
sels of right side of chest and of surface of liver, innominate artery 
(right side), left common carotid artery, left subclavian artery, right 
and left superior intercostal arteries, right and left internal mammary 
arteries, thyroidea ima artery (if present), right and left inferior thy- 
roid veins, right and left innominate veins, right and left phrenic 94 
HUMAN ANATOMY. 
nerves, right and left pneumogastric nerves and their cardiac branches, 
left recurrent laryngeal nerve, right and left first dorsal nerves, right 
and left sympathetic nerves and their cardiac branches, apices of 
lungs and pleurae, remains of thymus, and deep cervical fascia pass- 
ing to pericardium. 
The longus colli, sterno-liyoides, and sterno-thyroides on both 
sides also pass through it. 
The inferior opening is formed by the last dorsal 
vertebra behind, the last rib laterally, and the ensiform 
cartilage in front. It is filled in by the diaphragm. 
1, manubrium; 2, gladiolus; 3, xiphoid appendix; 4, first dorsal vertebra; 5, 
last dorsal vertebra; 6, first rib. 
Fig. 30. 
The cavity of the thorax contains the following 
structures : the heart and great vessels, trachea, bronchi, 
and lungs, azygos and bronchial veins, internal mammary 
arteries, pneumogastric, phrenic, and splanchnic nerves, 
thoracic duct, (esophagus, lymphatic vessels, and glands 
(vide mediastinum). 
Spine and Pelvis.—Sacro-verlebral articulation. In 
addition to those of the spine, given above, there are 
two ligaments connecting the last lumbar vertebra with 
the sacrum:— 95 
Lumbosacral ligament, arising from the transverse 
process of the last lumbar vertebra, and inserted into the 
base of the sacrum; 
Ilio-lumbar ligament, arising from the apex of the 
transverse process of the last lumbar vertebra, and in- 
serted into the crest of the ilium. The arteries are from 
last lumbar, ilio-lumbar, and lateral sacral. The nei-ves 
are branches of fourth and fifth lumbar and sympathetic. 
Sacro-iliac articulation, between the articular surfaces 
of the sacrum and ilium, is an amphiarthrodial joint con- 
nected by 
The anterior sacro-iliac ligament, crossing between 
anterior surfaces of the two bones ; 
Posterior saci’o-iliac ligament, the stronger, passes in 
different directions between the posterior surfaces of the 
two bones, firmly binding them together. One of these, 
stronger than the others, passes from the posterior supe- 
rior spinous process to the third sacral transverse pro- 
cess. It is called 
The oblique sacro-iliac ligament. 
The arteries are from gluteal, sacral, spinal, and ilio- 
lumbar ; the nerves from lumbo-sacral and posterior 
sacral cords. 
Sacro-ischiatic Articulation.—The os innominatum 
and sacrum are united by two important ligaments—the 
great sacro-sciatic (posterior) ligament, and the lesser 
sacro-sciatic ligament (or anterior). 
The great sacro-sciatic ligament arises from the 
fourth and fifth transverse tubercles of the sacrum, from 
spine of ilium, sacrum, and coccyx, and passes down- 
ward, outward, and forward, to be inserted into the 
inner margin of the tuberosity of the ischium, being 
prolonged forward as the falciform ligament protecting 
the internal pudic veins and nerves. 
It converts tiie sacro-sciatic notch into the lesser 
sacro-sciatic foramen, transmitting the obturator in- 
terims muscle and nerve, the internal pudic vessels and 
nerves. 
The lesser sacro-sciatic ligament arises from the 
lateral margin of the sacrum and coccyx, and is inserted 
ARTICULATIONS AND LIGAMENTS. 96 
HUMAN ANATOMY. 
into the spine of the ischium. It converts the sacro- 
sciatic notch into the greater sacro-sciatic foramen, 
transmitting the pyriformis muscle, gluteal vessels, 
superior gluteal nerve, sciatic vessels and nerves, and 
the internal pudic vessels and nerves. 
Sacro-coccygeal articulation is an amphiarthrodial 
joint, resembling the vertebral, having an interarticular 
libro-cartilage, and connected together by 
An anterior sacro-coccygeal ligament, and 
A posterior sacro-coccygeal ligament, continuations 
respectively of the anterior and posterior common 
ligaments. 
Lateral sacro-coccygeal, intertransverse, and inter- 
cornual ligaments connecting the rudimentary transverse 
processes and the cornua together. 
Tiie arteries are from lateral and median sacral; 
The nerves branches of coccygeal, fifth sacral, and 
posterior divisions of fourth sacral. 
Pubic Articulation.—This is an amphiarthrodial 
joint, known also as the symphysis pubis. 
It is connected by the 
Anterior pubic ligament in front; 
Superior pubic ligament above; 
Posterior pubic ligament behind ; 
Subpubic ligament below, forming the boundary of 
the pubic arch. 
Within the joint an interposed fibro-cartilage separates 
the bones. 
The obturator membrane, or ligament, closes the obtu- 
rator foramen, and affords attachment for the external 
and internal obturator muscles and allows passage at 
its upper outer part, for the obturator vessels and nerves. 
THE PELVIS. 
The pelvis is a strong, bony basin, formed at the lower 
end of the vertebral column by the articulation of the 
sacrum and coccyx posteriorly with the ossa innominata 
laterally. 
It is divided into a false and true pelvis by the ilio- 
pectineal line. ARTICULATIONS AND LIGAMENTS. 
The false pelvis is situated above the ilio-pectineal 
line, and corresponds to the expanded iliac fossae, being 
bounded laterally btr the ossa ilii, and having in front 
and behind wide intervals. 
The true pelvis includes all that portion below' the 
linea ilio-pectinea, and presents a cavity, superior cir- 
cumference or inlet, and an inferior circumference or 
outlet. 
The inlet is heart-shaped, being bounded behind by the 
promontory of the sacrum, laterally by the linea ilio- 
pectinea, and in front by the crest and spine of the 
pubes. 
A A, antero-posterior diameter; BB, transverse diameter; CC, oblique diameter; 
1, sacro-iliac ligament; 2, anterior or lesser sacro-sciatic ligament; 3, posterior or 
great sacro-sciatic ligament. 
Fig. 31. 
Its principal diameters in the female are :— 
Antero-posterior, from symphysis to vertebral angle, four and 
three-fourths inches; transverse, across the widest part, live and one- 
fourth inches; and oblique, from the ilio-peetineal eminence in 
front to the sacro-iliac symphysis behind, five inches. In the male, 
these measurements are about three-fourths of an inch less in every 
diameter. 
It transmits the following structures :— 
Viscera and Ducts. 
1. Small intestine. 
2. Rectum. 
3. Vasa deferentia (in male), 
round ligaments (in female). 
4. Ureters. 
5. Urachus and obliterated hypo- 
gastric arteries. 
6. Uterus (pregnant). 
7. Bladder (distended). 
8. Peritoneal coverings. 98 
HUMAN ANATOMY. 
Vessels. 
1. Superior haemorrhoidal. 
2. Internal iliac. 
3. Sacra media. 
4. Ilio-lumbar. 
5. Branches of vasa intestini ten- 
uis. 
6. Obturator (from deep epigas- 
trie). 
7. Ovarian. 
8. Pubic branches from external 
epigastric arteries. 
9. Lymphatic vessels. 
Nerves. 
1. Sympathetic. • 
2. Branches from hypogastric 
plexus. 
3. Obturator. 
4. Lumbo-sacral cord. 
The cavity of the pelvis is bounded behind by the 
sacrum and coccyx, in front by the symphysis, and 
laterally by the body of the ischium, forming a curved 
canal, widest in the middle. It contains, in the recent 
state, the organs of generation, rectum, bladder, and 
their vessels, nerves, ducts, etc. Its axis corresponds 
to the concavity of the sacrum and coccyx. 
Its depth in front, at the symphysis, is about one 
and a half in the middle axial line, three and a half 
behind, in males four and a half to possibly five and a 
half. 
The outlet of the pelvis is bounded by three promi- 
nences, the tuber iscliii laterally and the coccyx behind; 
separated by three notches, the subpubic arch in front 
and the sacro-sciatic notches posteriorly. 
Its principal diameters are: transverse, three and a 
half in male, four and three-fourths in female; antero- 
posterior and oblique, three and one-fourth in male, five 
in female. 
Iii the erect position the pelvis is placed at an angle 
of from sixty degrees to sixty-five degrees with the 
ground. 
Differences of Sex.—The male pelvis is character- 
ized by the strength of the bones, by prominent mus- 
cular impressions, by the depth and narrowness of the 
cavity, the large obturator foramen, and the acute angle 
of the subpubic arch. 
The female pelvis is characterized by the lightness of 
the bones, the slight muscular impressions, by the 
expanded iliac fossae, the increased size of the cavity in ARTICULATIONS AND LIGAMENTS. 
99 
every diameter, and the obtuse angle of the subpubic 
arch. 
ARTICULATIONS OF THE UPPER EXTREMITY. 
The sterno-clavicular articulation is an arthrodial 
joint, formed between the sternal end of the clavicle and 
the sternum and first rib, being divided into two cavi- 
ties by an interarticular fibro-cartilage. Its ligaments 
are:— 
Anterior sterno-clavicular, is a broad band passing 
between the articular mar- 
gins, attached to the inter- 
articular cartilage and two 
synovial membranes, and 
forming the front part of the 
capsular ligament; 
Posterior sterno-clavicu- 
lar , passes over the posterior 
aspect of the joint and corre- 
sponds to the former; 
Inter clavicular, passes 
from the sternal end of the 
clavicle on one side across the 
supra-sternal notch to the 
clavicle of the opposite side ; 
Costo-clavicular,ov rhom- 
boid, passes from the rhom- 
boid impression on the infe- 
rior surface of the clavicle to 
the upper surface of the first 
costal cartilage. 
The synovial membranes form two sacs separated by 
the interarticular cartilage. 
The arteries are from muscular branch of supra- 
scapular and contiguous muscular branches ; 
The nerves, from descendens noni. 
Aoromio-clavicular articulation is au arthrodial 
joint formed between the acromial extremity of the 
clavicle and the acromial process of the scapula. Its 
ligaments are:— 
The superior acromio-clavicular, connect the adjoin- 
1, superior acromio-clavicular liga- 
ments; 2, coraco-clavicular ligaments; 3, 
coraco-acromial ligaments; 4, transverse 
ligament; 5, capsular ligament; 6, coraco- 
humeral ligament; 7, tendon of biceps. 
Fig. 32. 100 
HUMAN ANATOMY. 
ing parts of the superior surfaces of the clavicle and 
acromion process; 
Inferior acromio-clavicular, connecting the inferior 
surfaces; 
Coraco-clavicular, consists of two parts :— 
Trapezoid, broad, square, arises from upper surface 
of coracoid process, and is inserted into oblique line on 
under surface of clavicle ; and 
Conoid, behind and internal, arises from base of 
coracoid process, and is inserted into conoid tubercle on 
under side of clavicle and a line internal to it. 
The capsular ligament covers the anterior and pos- 
terior surfacesof the joint, uniting above and below with 
the superior and inferior acromio-clavicular ligaments. 
The arteries are from anterior circumflex, acromial 
thoracic, and supra-scapular. 
The nerves are anterior circumflex and supra-scapular. 
The scapula has, also, 
The coraco-acromial, arising from the outer border of 
the coracoid process and inserted into the summit of the 
acromion, and 
Transverse, a ligamentous band bridging the supra- 
scapular notch, converting it into a foramen for supra- 
scapular nerve. 
The shoulder-joint is an enarthrodial joint, formed 
above by the glenoid cavity of the scapula and below 
by the head of the humerus. Its ligaments are—glenoid, 
coraco-humeral, and capsular. 
The glenoid surrounds the edge, deepens the glenoid 
cavity, and is continuous above with the long head of 
the biceps tendon. 
The capsular ligament, extensive and loose, arises 
above it from circumference of glenoid cavity behind the 
ligament, is attached below to the anatomical neck of 
humerus, and is pierced by tendons of two or three 
muscles. 
The coraco-humeral, or accessory, is a fibrous band 
which extends obliquely downward and outward from 
the coracoid process to the anterior part of great tuber- 
osity, strengthening the capsular ligament. ARTICULATIONS and ligaments. 
101 
The synovial membrane is extensive and reflected 
upon the tendons of biceps, infra-spinatus, and sub- 
scapularis muscles. 
Its arteries are derived from the subscapular, supra- 
scapular, dorsalis scapulae, anterior and posterior cir- 
cumflex ; 
Its nerves, from the subscapular, 
supra-scapular, and circumflex. 
The elbow-joint is a ginglymoid ar- 
ticulation formed above by the lower 
extremity of humerus, below by upper 
extremities of ulna and radius. Its liga- 
ments are external and internal lateral, 
anterior and posterior ligaments. 
External lateral arises from exter- 
nal condyle of humerus and is inserted 
into outer margin of ulna. Internal 
lateral, much stronger, consists of two 
portions : anterior arises from fore part 
of internal condyle to be inserted into 
coronoid process, and posterior from 
back part of condyle to inner margin of 
olecranon. 
Anterior ligament arises above 
coronoid fossa, and is inserted into 
coronoid process of ulna and orbicular 
ligament.. 
Posterior ligament, attached above 
olecranon fossa, and below to olecranon 
process of ulna. The anterior and pos- 
terior ligaments become continuous 
with the lateral to encircle the joint. 
The arteries are derived from supe- 
rior and inferior profunda,anastomatica inagna, posterior 
interosseous recurrent, anterior and posterior ulnar re- 
current, and radial recurrent. 
The nerves, from median, ulnar, musculo-cutaneous, 
and musculo-spiral. 
The radio-ulnar articulations are three—the su- 
perior, middle, and inferior. 
1. anterior liga- 
ment; 2 and 2, anterior 
and posterior portions 
of internal lateral; 3, 
orbicular ligament: 4, 
oblique: 5, interosseous 
membrane. 
Fig. 33. 102 
HUMAN ANATOMY. 
The superior radio-ulnar is a diarthrosis rotatoria, 
formed by the inner side of the head of radius and lesser 
sigmoid cavity of ulna. Its synovial cavity communi- 
cates with the elbow-joint and it is held together by the 
orbicular, or annular ligament, attached in front and 
behind to the lesser sigmoid cavity and surrounding the 
head of radius. Its arteries and nerves are the same as 
for elbow. 
The middle radio-ulnar articulation consists of the 
oblique or round ligament, passing from tubercle of ulna 
to below tuberosity of radius, and the interosseous pass- 
ing between the bones, deficient above for passage of 
posterior interosseous vessels, and perforated below for 
anterior vessels. Its arteries are from anterior inter- 
osseous ; its nerves, from anterior and posterior interos- 
seous. 
Inferior radio-ulnar consists of anterior and pos- 
terior radio-ulnar ligaments, passing from one to the 
other in front and back of wrist, and triangular inter- 
articular fibro-cartilage, interposed between head of 
ulna and cuneiform bone, and binding the radius and 
ulna firmly together. Its arteries are from anterior 
and posterior interosseous and carpal; its nerves, from 
median and posterior interosseous. 
The radio-carpal, or wrist-joint, is a condyloid joint 
consisting of an elliptical cavity formed by the radius 
and triangular cartilage, into which fits the convex sur- 
faces of the scaphoid, semi-lunar, and cuneiform below. 
Its ligaments are external and internal lateral, anterior 
and posterior radio-carpal. 
External lateral passes from the styloid process of 
radius to the scaphoid, os magnum, and trapezium. 
Internal lateral passes from the styloid process of 
ulna to the cuneiform, pisiform, and annular ligament. 
The anterior radio-carpal is a broad membrane 
attached above to the anterior margin of the radius, its 
styloid process and ulna, and below to cuneiform, semi- 
lunar, scaphoid, and os magnum, strengthened by a band 
extending from styloid process of ulna to semi-lunar and 
cuneiform. ARTICULATIONS AND LIGAMENTS. 
103 
The posterior radio-carpal is attached to dorsal 
margin of radius, and below to cuneiform, semi-lunar, 
and scaphoid. The anterior and posterior radio-carpal 
belong to the annular ligament (vide fascias). 
Its arteries are the anterior and posterior carpal, 
derived from the radial and ulnar, anterior and posterior 
interosseous, and ascending branches from the deep 
palmar arch. 
Its nerves are derived from the median, ulnar, and 
posterior interosseous. 
The carpal articulations are arthrodial, and consist 
of three sets. The first row is held together by two 
palmar, two dorsal, and two interosseous; the second 
row by three dorsal, three palmar, and three inter- 
osseous ; and the two rows are held together by a 
palmar, dorsal, internal and external lateral ligament. 
First Row.—The palmar and dorsal ligaments con- 
nect the scaphoid and semi-lunar, and semi-lunar and 
cuneiform together on the front and back. 
The interosseous connect the semi-lunar with the 
scaphoid and cuneiform. 
The pisiform bone has a separate capsular ligament 
and an interosseous ligament connecting it to the fifth 
metacarpal bone and cuneiform. 
Second Row.—The palmar and dorsal ligaments 
connect the trapezium with the trapezoid, and the os 
magnum with the trapezoid and unciform, on the front 
and back of the wrist. 
The interosseous connect the adjacent surfaces of 
the trapezium and trapezoid, and the os magnum with 
the trapezoid and unciform. 
Two Rows Together.—The palmar and dorsal con- 
nect the bones of the first with the second rows on the 
front and back of the wrist. The internal lateral passes 
on the ulnar side between the cuneiform and unciform. 
The external lateral, stronger, passes on the radial side 
between the scaphoid and trapezium. 
The anterior annular ligament contributes strength 
to these joints. 
The arteries are: Carpal of anterior interosseous, 104 
HUMAN ANATOMY. 
anterior an,1 posterior carpals of radial and ulnar, carpal 
of deep palmar arch, interosseus recurrent, and termi- 
nal branches of anterior and posterior interosseous. 
The nerves are from median, ulnar, and posterior 
interosseous. 
The carpo-metacarpal articulations are each ar- 
throdial joints, held together by dorsal, palmar, inter- 
osseous, and capsular ligaments, except the thumb, which 
has only capsular. 
The capsular ligament of the thumb surrounds the 
margins of the articular surfaces of the first metacarpal 
and trapezium, and is lined by a separate synovial sac. 
The palmar and dorsal carpo-metacarpal connects 
the carpus and metacarpus on the palmar and dorsal 
surface. 
The interosseous connect the adjoining inferior 
angles of os magnum aud unciform with the contiguous 
surfaces, fourth and fifth metacarpal bones. 
The synovial membranes of the wrist consist of five 
distinct sacs : First, membrana sacciformis lines lower 
end of ulna, sigmoid cavity of radius, and upper sur- 
face of triangular cartilage ; second, lower surface of 
radius and cartilage and upper surface of first row of 
carpus ; third, between margins of carpus and carpo- 
metacarpal joints; fourth, between earpo-metacarpal 
joint of thumb; and fifth, between pisiform and cunei- 
form. 
Inter metacarpal Articulation.—The bases of the 
metacarpal bones, except the thumb, articulate with 
one another by arthrodial joints, lined by synovial mem- 
brane continuous with the carpal sac and connected 
together by palmar, dorsal, and interosseous ligaments. 
The digital extremities are connected by a transverse 
ligament across the anterior surface, continuous with 
anterior metacarpo-phalangeal ligament. 
Tiie metacarpo-phalangeal and phalangeal are of 
the condyloid variety, like the wrist-joint, allowing of 
motion in every direction except laterally. They are 
each connected by one anterior and two lateral liga- 
ments, the posterior ligament being substituted by ARTICULATIONS AND LIGAMENTS. 
105 
the extensor tendon, which crosses the dorsum of tire 
joint. 
The arteries and nerves are from the digitals. 
ARTICULATIONS OF THE LOWER EXTREMIY. 
The hip-joint is a true enarthrodial articulation, 
formed above by deep cup-like cavity of acetabulum, 
below by prominent spherical head of femur. Its liga- 
ments are the capsular, ilio-femoral, teres, cotyloid, and 
transverse. 
The capsular ligament, dense and strong, is attached 
above to margin of acetabulum and cotyloid ligament, 
and below to the spiral line in front and to the neck be- 
hind. It is strengthened by several accessor}' bands, the 
pubofemoral, ilio-trochanteric, ischio-capsular, and ilio- 
femoral. Of these the latter is the most important, 
arising above from anterior inferior spine, and attached 
below to spiral line, and has received the name of 
Y-ligament of Bigelow. 
The ligamentum teres, or round ligament, is a strong 
triangular band, its base arising from the bottom of 
acetabulum and margins of cotyloid notch externally, 
its apex inserted below and behind centre of head of 
femur. 
The cotyloid ligament encircles and deepens the ace- 
tabulum, and at the inner side, under the name of the 
transverse ligament, it bridges over the cotyloid notch, 
converting it into a foramen for the passage of nutrient 
vessels to the joint. 
There are numerous bursa about the joint, with one 
of which, beneath the ilio-psoas muscle, the synovial 
membrane often communicates. 
Its arteries are derived from the sciatic, internal and 
external circumflex, obturator, and gluteal. 
Its nerves are derived from the great sciatic, obtura- 
tor, accessory obturator, and the sacral plexus. 
The knee-joint is a ginglymoid articulation, f rmed 
above by condyles of femur, below by head of tibia, and 
in front by patella. 106 
HUMAN ANATOMY. 
Tts ligaments are divided into two sets, the external, 
consisting of anterior, posterior, internal lateral, two 
external laterals, and capsular; and internal, consisting 
of anterior, posterior, two semi-lunar fibro-cartilages, 
transverse, coronary, ligamentum mucosum, and liga- 
menta alaria. Its joint surface is the most extensive in 
the body. 
External Set.—Anterior, or ligamentum patella, is 
the tendinous portion of extensors of thigh between 
Fig. 34. 
2. quadriceps extensor; 3, patella; 4, 
ligamentum patellse; 6, bursa; 7, 8, 9, syno- 
vial membrane of knee-joint; 10, anterior 
crucial ligament. 
Fig. 35. 
2, anterior crucial ligament; 3, posterior 
crucial ligament: 4, transverse ligament; 
6, 7, internal and external semi-lunar carti- 
lages : 8, ligamenta patella;; 9. bursa patellae; 
10, anterior superior tibio-fibular liagment. 
patella and tubercle of tibia. The posterior, or liga- 
mentum posticum Winslowii, derived principally from 
the tendon of semi-membranosus, arises from inner 
tuberosity of tibia, passes upward and outward to be 
inserted into external condyle of femur. 
The internal lateral is a flat and broad ligament 
arising from back part of inner condyle of femur, de- 
scends forward to be inserted into inner tuberosity of 
tibia, covering in its course the inferior internal articu- 
lar artery and nerve, part of tendon of semi-mem- 107 
branosus, and attaching itself to the internal semi lunar 
fibro-cartilage. 
The long external lateral ligament, round and strong, 
arises from tuberosity on outer part of external condyle, 
and descends forward to the head of fibula. The 
short external lateral ligament is an accessory, not 
very constant, band, descending posteriorly to the pre- 
ceding. 
The capsular ligament fills up the intervals between 
the preceding ligaments, and is strengthened by bands 
from fascia lata, vasti, crureus, semi-membranosus, biceps, 
and sartorius tendons. 
Internal Set.— Crucial ligaments are two strong, 
short, interosseous, crossing each other from before back- 
ward. The anterior, or external, arises from inner pos- 
terior part of condyle of femur, and descends forward and 
inward to be inserted into front of spine of tibia and 
internal semi-lunar cartilage. 
The posterior, or internal, arises from outer fore part 
of inner condyle of femur, descends downward, back- 
ward, and outward to spine of tibia. 
The semi-lunar fibro-cartilages consist of two cres- 
centic laminae of interarticular cartilage, resting upon 
the upper articular surface of tibia, which serve to 
deepen its surface. 
The internal is attached by its inner border to inter- 
nal lateral ligament and to head of tibia by coronary 
ligaments, its extremities attached in front of anterior 
crucial ligament and behind the spine. 
The external, more circular, is connected to edge of 
tibial head by coronary ligaments, its extremities being 
inserted behind and in front of the tibial spine. 
In other words, the ends of the semi-lunar carti- 
lages are all, except the anterior end of internal, 
attached to the tibia between the crucial ligaments. 
A band of fibres passing from the anterior margin 
of external cartilage to the internal has received the 
name of transverse ligament. 
The knee is lined by the most extensive synovial 
membrane in the body, covering both surfaces through- 
ARTICULATIONS AND LIGAMENTS. 108 
HUMAN ANATOMY. 
out and extending up between quadriceps tendon and 
surface of femur. 
Below the patella in front is a duplicature of synovial 
membrane, inclosing some adipose tissue, which has 
received the name of ligamentum mucosum, and extend- 
ing from it are two fringes—the ligamenta alaria. 
On either side in the popliteal space behind are bursae, 
which often communicate with joint. 
There are also bursae over the patellae, above and 
beneath the ligamentum patellae, and between the inner 
hamstring and head of tibia. 
The arteries of the knee-joint are derived from the 
anastomatica magna,the articular branches of the popli- 
teal (five), and the recurrent branch of the anterior 
tibial. 
Its nerves are derived from the anterior crural, 
obturator, external and internal popliteal nerves. 
The TiBio-FiBULAR articulations are three—superior, 
middle, and inferior. The superior is arthrodial joint 
between fibular head and outer tuberosity of tibia, and 
consists of anterior and posterior ligaments stretching 
on either side of the outer tuberosity, downward and 
backward, to the head of the fibula. The arteries are 
some of the knee; the nerves, from external popliteal. 
The middle consists of an interosseous membrane 
between the bones, connecting them firmly together, 
deficient above, for passage forward of anterior tibial 
artery and below for anterior peroneal vessels. 
The inferior is an arthrodial joint between con- 
tiguous inferior surfaces of tibia and fibula, and consists 
of four : the interosseous, continuous with that above ; 
the anterior inferior tibio-fibular, extending downward 
and outward between tibia and fibula in front; the pos- 
terior inferior tibio-fibular, occupying a similar position 
behind ; and the transverse, a long, narrow band, passing 
between external malleolus and tibia. The synovial 
membrane is continuous with that of ankle-joint. The 
arteries and nerves are the same as those to the ankle. 
The ankle-joint is a ginglymoid articulation, formed 
between the lower extremity and malleolus of tibia on 109 
ARTICULATIONS and ligaments. 
the inner side, the malleolus of the fibula on the outer 
side, and the astragalus below. Its ligaments are anterior, 
posterior, external, and internal lateral. 
The anterior tibio-tarsal ligament consists of broad 
set of irregular fibres, attached above to lower margin 
of tibia, below to astragalus. The posterior tibio-tarsal 
ligament passes transversely between back part of tibia 
and astragalus. 
The internal lateral, or deltoid, has two layers—the 
superficial triangular, its apex arising from malleolus, 
its base spread out from before backward to be attached 
to scaphoid and inferior calcaneo-scaphoid ligament, the 
sustentaculum, and inner side of astragalus; and the 
deep, a short, round cord passing from internal malleolus 
to astragalus. 
The external lateral ligament consists of three dis- 
tinct fasciculi, anterior, middle, and posterior, arising 
from near summit of external malleolus, and being 
inserted respectively into the front of astragalus, the 
outer surface of os calcis, and the back of astragalus. 
The arteries of the ankle-joint are derived from the 
malleolar branches of the peroneal and anterior tibial. 
Its nerves are branches of the anterior and posterior 
tibial nerves. 
The articulations of the tarsal bones consist of 
those of the first row, those of the second row, and of 
the two rows with each other. 
First Row.—The astragalus articulates with the 
ealcaneum by two distinct surfaces separated by the 
interosseous groove, and firmly connected by the exter- 
nal and posterior calcaneo-astragaloid ligaments, and the 
interosseus. The external calcaneo-astragaloid ligament 
passes vertically downward from the outer surface of 
astragalus to outer surface of ealcaneum. The posterior 
is a short, narrow, oblique band connecting the poste- 
rior border of astragalus to the os calcis. 
The interosseus is a strong, short ligament passing 
vertically and obliquely downward between the two 
bones, the principal bond of union. 
The arteries of the first row are tarsal from dorsalis 110 
human anatomy. 
pedis, external malleolar from anterior tibial, and 
branches of peroneal from posterior tibial. 
Nerves, from posterior tibial, or plantar. 
The second row are firmly held together by dorsal, 
plantar, and interosseous ligaments. The two former 
unite the dorsal and plantar surfaces and the interosse- 
ous, four strong bands connect the scaphoid and cuboid, 
the internal and middle, the middle and external cunei- 
forms, and the external cuneiform and cuboid. 
The arteries of the second row are from plantars 
and metatarsals. Nerves, from anterior tibial, and in- 
ternal and external divisions of posterior tibial nerves. 
The two rows of the tarsus are connected with 
each other by three sets of ligaments, first between os 
calcis and cuboid, consisting of superior and internal 
calcaneo-cuboid, long and short calcaneo-cuboid ; second, 
between os calcis and scaphoid, consisting of superior 
and inferior calcaneo-scaphoid; and third, between 
astragalus and scaphoid, consisting of a single superior 
astragalo-scaphoid ligament, a band passing from neck 
of astragalus to upper surface of scaphoid. 
Calcaneo-cuboid.—The superior passes between dor- 
sal surfaces of os calcis and cuboid. The internal, pass- 
ing from os calcis to inner side of cuboid, is one of the 
main bonds of union between the two rows of tarsus. 
The inferior firmly connects the bones below, the 
ligamentum longse plantse passing from os calcis for- 
ward to the plantar surface of the cuboid, and sending 
fibres forward to bases of second, third, and fourth met- 
atarsal bones; the ligamentum breve plantse passing 
from fore and under surface of os calcis to under surface 
of cuboid. The two preceding are important in preserv- 
ing the arch of the foot. 
The superior and inferior calcaneo-scaphoid pass 
above and below these bones, firmly connecting them. 
The arteries of the mediotarsal joints are derived 
from the anterior tibial, tarsal, metatarsal, or external 
plantar. 
Nerves, from external branch of anterior tibial. 
The tarso-metatarsal articulations are firmly ARTICULATIONS and ligaments. 
held together by dorsal and plantar ligaments, and con- 
nected with one another by interosseous bands, three in 
number, passing between internal cuneiform and second 
metatarsal bone, external cuneiform and second meta- 
tarsal, and external cuneiform and third metatarsal. 
The arteries are from metatarsal, dorsalis pedis, 
and deep plantar arch ; 
The nerves, from anterior tibial, and internal and 
external plantars. 
Inter metatar sal Articulations.—The bases of all ex- 
cept the first are connected by dorsal plantar and 
interosseous ligaments, and the distal extremities are 
connected by the transverse metatarsal ligament. 
The synovial membranes concerned in these 
articulations are six: (1) between calcaneo-astragaloid 
articulation, posterior to interosseous membrane; (2) 
anterior calcaneo-astragaloid and astragalo-scaphoid ; (3) 
calcaneo-cuboid; (4) between middle and external cunei- 
form, scaphoid, and three cuneiforms, middle and external 
cuneiform, and second and third metatarsal, and between 
cuboid and external cuneiform and scaphoid; (5) be- 
tween internal cuneiform and first metatarsal; and (6) 
between cuboid and fourth and fifth metatarsal bones. 
The metatarsophalangeal articulations are each 
connected by two lateral and a plantar ligament, and the 
phalangeal articulations are the same, the extensor ten- 
dons acting as dorsal ligaments. They resemble in 
every respect the articulations in the hand {vide hand). THE MUSCULAR SYSTEM. 
The muscles constitute 45 per cent, of the bod}r- 
weight and are the active agents of locomotion. 
They consist of two kinds—the non-striped and the 
Striped. The latter, being usually under the control of 
the will (the heart being a notable exception), have also 
received the name of voluntary, and the former, not 
under the control of the will, involuntary. 
Microscopically, their structure is as follows:— 
Non-striped muscular tissue is made up of elongated, 
contractile, nucleated cells. They consist of minute 
fibres in bundles, inclosed in extremely delicate sheaths 
of elastic tissue. 
They are held together b}' an albuminous cement and 
collected by connective tissue, into groups or masses, 
one-tenth to one five-hundredth of an inch in length. 
Non-striped muscular tissue is highly vascular and 
is supplied with nerves from the sympathetic. 
Striped muscular tissue is made up of cylindroid 
fibres of from one and a half to two inches in length 
and one two-liundredth to one six-hundredth of an inch 
in diameter. They are held together in bundles by the 
endomysium, a delicate fibro-conneetive tissue. These 
bundles are collected into groups by the perimysium, a 
stronger connective-tissue band, forming the fasciculi of 
the fully formed muscle. Striped muscular tissue is also 
highly vascular. 
The parts of an individual fibre are—first, the sarco- 
lemma, a very delicate, transparent, elastic sheath; 
second, the membranes of Krause, which appear as dark 
lines stretching across the fibre at regular intervals, 
forming the third, or the compartments of Krause, which 
contain the muscular substance. The latter contain the 
nucleated muscle-corpuscles. TIIE MUSCULAR SYSTEM. 
113 
The striped muscular fibres of the heart differ some- 
what from the preceding, being branched, and dividing 
and subdividing to form an intricate net-work. 
The muscles are connected to cartilages, ligaments, 
bones, and skin, either directly or by aponeuroses or 
tendons. 
Aponeuroses are dense, white, fibrous membranes, 
serving to connect the muscles with the structures to be 
acted upon. 
Tendons are white, fibrous, glistening cords. They 
are composed of white, fibrous tissue, arranged into 
bands or bundles. They are attached to the perichon- 
drium, periosteum, ligaments, and subcutaneous tissue 
by a mutual interlacement of fibres. 
Names of Muscles.—They have received their 
names:— 
1. From the arrangement of their fibres they have received the 
names of radiated, penniform, bipenniform, etc. 
2. From their uses they are called extensors, adductors, etc. 
3. From their direction, oblique, rectus, transversalis, etc. 
4. From the number of insertions, as triceps, biceps, etc. 
5. From their form, as rhomboid, deltoid, etc. 
6. From their attachment, as occipito-frontalis, sterno-hyoid, etc. 
The origin refers to the fixed extremity; the inser- 
tion, to the movable point. 
Muscles op the Head. 
CRANIAL REGION. 
Occtpito-frontalis.—Origin, from outer two-thirds 
of superior curved line of the occipital hone and base 
of the mastoid process of the temporal, also from cor- 
rugator supercilii, orbicularis palpebrarum, and pyra- 
midalis nasi fibres; insertion, into fibrous aponeurosis 
covering the vertex of the skull; action, raises the eye- 
brows and used chiefly as a muscle of facial expression ; 
nerves, supraorbital, small occipital, facial, and posterior 
auricular branch of facial. 
AURICULAR REGION. 
Attollens Aurem.— Origin, from aponeurosis of 114 
HUMAN ANATOMY. 
occipito-frontalis; insertion, into the surface of the 
pinna ; action, raises the ear ; nerve, occipitalis minor. 
Attrahens Aurem.—Origin, from edge of occipito- 
frontalis aponeurosis; insertion, into anterior part of 
helix ; action,draws the ear upward and forward; nerve, 
facial. 
Retraiiens Aurem.—Origin, from mastoid portion 
of temporal bone; insertion, into lower part of concha; 
action, draws the ear backward ; nerve, posterior auricu- 
lar branch of facial. 
Orbicularis Palpebrarum.—Origin, from nasal pro- 
cess of superior maxilla, internal angular process of 
frontal, and from front and sides of tendo-palpebrarum ; 
insertion, into skin of the cheek, eyelids, forehead, and 
temple, blending with the corrugator supercilii and the 
occipito-frontalis; action, sphincter of the eyelids; 
nerve, facial. 
Tendo-palpebrarum (Tendo-oculi).—Origin, nasal 
process of superior maxilla; insertion, inner part of 
tarsal cartilage. 
Corrugator Supercilii.—Origin, superciliary ridge; 
insertion, into orbicularis about the middle of the orbital 
arch ; action, draws eyebrows inward and downward and 
wrinkles the forehead ; nerve, facial. 
Tensor Tarsi.—Origin, from crest and orbital sur- 
face of lachrymal gland ; insertion, into tarsal cartilages 
near the puncta lachrymalia ; action, draws the lachrymal 
canals inward and against the globe of the eye; nerve, 
facial. 
PALPEBRAL REGION. 
Levator Palpebras Superioris.—Origin, from lesser 
wing of the sphenoid, near the optic foramen ; insertion, 
superior border of tarsal cartilage; action, elevates the 
upper eyelid ; nerve, third cranial, or motor oculi. 
Rectus Superior.—Origin, sheath of the optic nerve 
and upper margin of optic foramen ; insertion, into upper 
surface of sclerotic coat; action, rotates the eyeball up- 
ward ; nerve, third cranial. 
ORBITAL REGION. 115 
TIIE MUSCULAR SYSTEM. 
Rectus Inferior.— Origin, from lower and inferior 
part of optic foramen (ligament of Zinn) ; insertion, 
into lower surface of sclerotic; action, rotates the eye- 
ball downward ; nerve, third cranial. 
Rectus Internus.—Origin, same as rectus inferior; 
insertion, into inner surface of sclerotic; action, rotates 
the eyeball inward ; nerve, third cranial. 
External Rectus.—Origin, by two heads—lower 
from ligament of Zinn and lower margin of sphenoidal 
fissure, upper from outer margin of optic foramen; 
insertion, into outer surface of sclerotic; nerve, abdu- 
cens, or sixth cranial. Passing between the two heads 
are the ophthalmic vein, the third, nasal branch of fifth, 
and sixth nerves. 
Superior Oblique.—Origin, from inner margin of 
optic foramen : its tendon passes through a pulley near 
the internal angular process of the frontal bone; inser- 
tion, into sclerotic, between external and superior recti, 
midway between entrance of optic nerve and the cornea; 
action, rotates the eyeball on its axis ; nerve, fourth, or 
patheticus. 
Inferior Oblique.—Origin, orbital plate of superior 
maxilla ; insertion, near that of superior oblique, between 
external and superior recti; action, rotates the eyeball 
on its axis ; nerve, third cranial. 
nasal region. 
Pyramidalis Nasi.— Origin, from the occipito- 
frontalis ; insertion, into the compressor nasi; ac- 
tion,, lowers the inner angle of the eyrebrows; nerve, 
facial. 
Levator Labii Superioris Nasi.—Origin, 
nasal process of superior maxilla; insertion, the ala of 
the nose and upper lip, blending with the levator labii oris 
proprius and orbicularis; action, dilates the nostril and 
elevates the upper lip ; nerve, facial. 
Dilator Naris Posterior.—Origin, nasal notch of 
superior maxilla; insertion, into skin at the margin 
of the nostril. 
Dilator Naris Anterior.—Origin, from cartilage of 116 
HUMAN ANATOMY. 
the ala; insertion, into the skin of nose; action, dilates 
the nostrils ; nerve, facial. 
Compressor Nasi.—Origin, superior maxilla, near 
the incisive fossa; insertion, into fibro-cartilage of the 
nose, continuous with the pyramidalis nasi aponeurosis 
and its fellow; action, dilates the nostril; nerve, facial. 
Compressor Narium Minor.—Origin, from alar car- 
tilage; insertion, into the skin of the end of the nose; 
action, dilates the nostril; nerve, facial. 
Depressor Ala: Nasi.—Origin, incisive fossa of 
superior maxilla; insertion, into the lip; action, con- 
tracts the nostril; nerve, facial. 
MAXILLARY REGION. 
Levator Labii Superioris (Proprius).—Origin, 
above infraorbital foramen to malar and superior 
maxilla; insertion, into the upper lip; action, elevates 
the upper lip; nerve, facial. 
Levator Anguli Oris.—Origin, from canine fossa; 
insertion, into the angle of the mouth, blending the 
depressor anguli oris, orbicularis, and zygomatici; 
action, draws the angle inward and raises it; nerve, 
facial. 
Zygomaticus Major.—Origin, from malar bone; 
insertion, into angle of mouth, blending with depressor 
anguli oris and orbicularis. 
Zygomaticus Minor.—Origin, from malar bone ; 
insertion, at the angle of the mouth, blending with the 
levator superioris; action, draws the lip outward and 
upward ; nerve, facial. 
Levator Labii Inferioris.—Origin, from incisive 
fossa of lower jaw; insertion, into skin of the chin; 
action, raises the lower lip ; nerve, facial. 
Depressor Labii Inferioris.—Origin, from external 
oblique line of lower jaw; insertion, into skin of lower 
lip, blending with its fellow and the orbicularis; action, 
lowers the angle of the mouth; nerve, facial. 
Depressor Anguli Oris.—Origin, external oblique 
line of lower jaw ; insertion, into the angle of the mouth, 
continuous with the orbicularis and risorius at its inser- THE MUSCULAR SYSTEM. 
117 
tion and the platysma at its origin; action, depresses 
the angle of the mouth; nerve, facial. 
Orbicularis Oris.—Origin, by accessory fibres 
(accessorii orbicularis superioris and inferioris and naso- 
labialis), from superior and inferior maxillary borders 
and nasal septum ; insertion, into the buccinator and 
adjoining muscles, forming the sphincter of the mouth; 
action, closes the lips; nerve, facial. 
Buccinator.—Origin, from pterygo-maxillary liga- 
ment and the posterior alveolar processes of the upper 
and lower jaw ; insertion, into orbicularis oris; action, 
compresses and contracts the cheeks; nerves, facial, and 
buccal branch of the inferior maxillary nerve. 
Risorius (Santorini).—Origin, from fascia of mas- 
seter muscle; insertion, at angle of the mouth; action, 
draws back the angles of the mouth,—the “smiling” 
muscle; nerve, facial. 
Masseter : Superficial Portion.— Origin, inner sur- 
face of zygoma and malar process of superior maxilla; 
insertion, into the ramus and angle of the lower jaw. 
Deep Portion.—Origin, posterior border and inner 
surface of the zygoma; insertion, into the ramus and 
coronoid process of the jaw ; action, raises the lower 
jaw, and the superficial portion assists in drawing it 
forward ; nerve, inferior maxillary. 
Temporal.—Origin, from the temporal fascia and 
the temporal fossa ; insertion, into the coronoid process 
of the lower jaw ; action, raises and draws backward the 
lower jaw ; nerve, inferior maxillary. 
Internal Pterygoid.—Origin, from pterygoid fossa 
and the tuberosity of the palate-bone ; insertion, into 
the inner side of the ramus and angle of the lower jaw; 
action, draws forward and raises the lower jaw; the 
accessory triturating muscle of mastication; nerve, 
inferior maxillary. 
External Pterygoid.—Origin, by two heads—the 
lower from the tuberosities of the palate and superior 
maxilla and from the external pterygoid plate, the 
upper from the pterygoid ridge on the greater wing of 
the sphenoid ; insertion, into the front of the neck of 118 
HUMAN ANATOMY. 
the lower jaw and inner side of interarticular cartilage; 
action, draws the jaw forward; triturating muscle of 
mastication ; nerve, inferior maxillary. 
Muscles of the Ear {vide Ear). 
Muscles of the Neck, 
superficial cervical region. 
Platysma Myoides.— Origin, from the deep fascia 
over the trapezius, deltoid, and pectoral muscles, and 
from the clavicle and acromion; insertion, into the 
lower jaw and skin of the face ; action, wrinkles the skin 
of the neck and protects the air-passages and blood- 
vessels from external pressure,—rudimentary in man ; 
nerves, branch of superficial cervical plexus and the 
facial. 
Sterno-cleido Mastoid.—Origin, by two heads— 
sternal portion from the fore and upper part of the 
manubrium sterni, the clavicular portion from the 
inner third of the upper border of the clavicle, leaving 
a triangular interval; insertion, into the mastoid process 
and outer two-thirds of the superior curved line of the 
occipital bone ; action, rotates and depresses the head ; 
nerves, spinal accessory and branches of the cervical 
plexus. 
infra-hyoid region. 
Sterno-hyoid.—Origin, from upper and back part 
of the manubrium sterni and inner extremity of the 
clavicle; insertion, into the lower border of the os 
hyoides; action, depresses the hyoid bone ; nerve, branch 
from the loop of communication between the descendens 
and communicans noni. 
Sterno-tiiyroid.—Origin, posterior surface of manu- 
brium sterni; insertion, into oblique line of the surface 
of the thyroid cartilage; action, depresses the larynx ; 
nerve, branch from the communicating loop above. 
Tiiyro-iiyoid.— Origin, from the oblique line on the 
surface of the thyroid cartilage; insertion, into the 
greater cornu and body of the hyoid bone; action, ele- 
vates the larynx ; nerve, hypoglossal. THE MUSCULAR SYSTEM. 
119 
Omo-iiyotd.—Origin, from the upper border of the 
scapula and the transverse ligament; insertion, into the 
lower border of the os hyoides; its centre is tendinous 
and bound down to the cartilage of the first rib by a 
process of the deep cervical fascia; action, depresses the 
hyoid bone and draws it backward; nerve, from the 
communicating loop above. 
Digastric.—Origin, bj" two bellies—posterior from 
digastric groove of mastoid process of the temporal 
bone, anterior from a depression in the lower border 
of the jaw near the symphysis ; the tendon is held to 
the hyoid bone by an aponeurotic loop and pierces the 
stylo-hyoid ; action, raises the tongue and hyoid bone ; 
nerve, mylo-hyoid branch of the inferior dental and 
facial. 
SUPRA-HYOID REGION. 
Stylo-hyoid.—Origin, from outer surface of styloid 
process; insertion, into the body of the bone; 
action, retracts and elevates the hyoid bone; nerve, 
facial: near its insertion it is perforated by the tendon 
of the digastric. 
Mylo-hyoid.—Origin, from the ridge of 
the inferior maxilla from last molar to symphysis; 
insertion, into a fibrous raphe in the median line, ex- 
tending from the hyoid bone to the chin and into the 
body of the hyoid bone; action, draws forward and ele- 
vates the hyoid bone and forms part of the floor of the 
mouth ; nerve, mylo-hyoid branch of the inferior dental. 
Genio-uyoid.—Origin, from inferior genial tubercle 
of the internal surface of the symphysis of the jaw ; 
insertion, into the front of the body of the hyoid bone; 
action, same as the mylo-hyoid ; nerve, hypoglossal. 
MUSCLES OF THE TONGUE. 
Genio-hyoglossus.—Origin, from superior genial 
tubercle of the internal surface of the symphysis of the 
jaw; insertion, by fan-like expansion into the whole 
length of the inferior surface of the tongue, the side of 
the pharynx, and the body of the hyoid bone; action, 120 
HUMAN ANATOMY. 
retracts and protrudes the tongue; nerve, the hypo- 
glossal. 
Hyoglossus.— Origin, body and greater cornu of the 
hyoid bone; insertion, between the lingualis and stylo- 
glossus into the side of the tongue ; action, renders the 
tongue convex from side to side ; nerve, hypoglossal. 
Styloglossus.—Origin, from stylomaxillary ligament 
and styloid process of the temporal; insertion, into the 
side of the tongue, blending with the hyoglossus and 
lingualis; action, retracts and elevates the tongue; 
nerve, hypoglossal. 
Lingualis.—Consists of four portions—superficial, 
inferior, transverse, and vertical. It lies between the 
genio-hyoglossus and the hyoglossus, extending from 
the apex to the base of the tongue; action, renders the 
tongue convex from before backward; nerve, the chorda 
tympani. 
Palato-glossus (Constrictor Istiimi Faucium) (vide 
Palatal Region). 
PHARYNGEAL AND PALATAL REGION. 
Constrictor Inferior.—Origin, from the sides of 
the thyroid and cricoid cartilages ; insertion, into the 
fibrous raphe of the pharynx; action, contracts the 
pharyngeal canal; nerves, external laryngeal, glosso- 
pharyngeal, pharyngeal plexus. 
Constrictor Medius.— Origin, from the stylo-hyoid 
ligament, greater and lesser cornua of the hyoid bone; 
insertion, into the median librous raphe, blending with its 
fellow of opposite side; action, constricts the pharynx; 
nerves, pharyngeal plexus and glosso-pharyngeal. 
Constrictor Superior.—Origin, from margin of 
internal pterygoid and its hamular process ; from pterygo- 
maxillary ligament, part of the alveolar process of the 
lower jaw and side of the tongue, tendon of the tensor 
palati, and part of the palate-bone; insertion, into the 
median raphe and the pharyngeal spine of the basilar 
process of the occipital bone; action, constricts the 
pharynx; nerves, pharyngeal plexus and glosso- 
pharyngeal. THE MUSCULAR SYSTEM. 
121 
Stylo-pharyngeus.—Origin, from base of the styloid 
process; insertion, into the constrictor muscles, palato- 
pharyngeus, and posterior border of the thyroid cartilage; 
nerves, pharj'ngeal plexus and glosso-pharyngeal. 
Levator Palati.— Origin, cartilaginous portion of 
Eustachian tube and apex of the petrous portion of the 
temporal bone; insertion, into the back part of the soft 
palate, blending with its fellow of the opposite side; 
action, elevates the soft palate; nerve, descending- 
palatine from Meckel’s ganglion, from the facial. 
Tensor Palati, or Circumflexus.—Origin, from 
spine of the sphenoid, vaginal portion of temporal bone, 
cartilage of Eustachian tube, and scaphoid fossa at 
base of internal pterygoid; insertion, into palate-bone 
and the soft palate; action, renders tense the palate; 
nerve, a branch from the otic ganglion. 
Azygos Uvulae, or Levator.— Origin, from aponeu- 
rosis of soft palate and posterior nasal spine; insertion, 
into the uvula ; action, raises the palate; nerves, de- 
scending palatine branches and Meckel’s ganglion, from 
the facial. 
Palato-glossus (Constrictor Isthmi Faucium).— 
Origin, from soft palate on either side of the uvula; 
insertion, into the dorsum and side of the tongue, 
blending with the fibres of the styloglossus; action, 
constricts the fauces; nerves, palatine branches of 
Meckel’s ganglion. 
Palato-pharyngeus.—Origin, by two portions, from 
soft palate; insertion, into posterior border of thyroid 
cartilage and pharynx; this muscle forms the posterior 
pillar of the fauces; action, closes the posterior naves; 
nerves, palatine branches from Meckel’s ganglion. 
VERTEBRAL REGION. 
Rectus Capitis Anticus Major.—Origin, by four 
tendons from transverse processes of the third, fourth, 
fifth, and sixth cervical vertebrae; insertion, basilar 
process of occipital bone; action, flexes the head; 
nerves, suboccipital and deep internal branches of cer- 
vical plexus. 122 
HUMAN ANATOMY. 
Rectus Capitis Anticus Minor.—Origin, from root 
of transverse process and anterior part of the lateral 
mass of the atlas; insertion,basilar process of occipital, 
behind the former; action, flexes the head; nerves, sub- 
occipital and deep branches of the cervical plexus. 
Rectus Lateralis.—Origin, superior surface of the 
transverse process of the atlas; insertion, inferior 
surface of the jugular process of the occipital; action, 
draws the head laterally ; nerves, suboccipital and deep 
internal branches of the cervical plexus. 
Longus Colli.—Origin, from three portions, supe- 
rior oblique portion from anterior tubercles of the 
transverse processes of the third, fourth, and fifth 
cervical; insertion, tubercle on the anterior arch of 
atlas; inferior oblique portion, origin, from anterior- 
surface of the bodies of the first two or three dorsal 
vertebrje ; insertion, anterior tubercles of the transverse 
processes of the fifth and sixth cervical; vertical portion, 
origin, from the anterior surface of the bodies of the 
lower three cervical and upper three dorsal vertebra?; 
insertion, anterior surface of the bodies of the second, 
third, and fourth cervical vertebrae; action, rotates 
and flexes the cervical portion of the vertebrae; nerves, 
anterior branches of the lower cervical nerve. 
Scalenus Anticus.—Origin, from the tubercle of 
the first rib; insertion, into the anterior tubercles of 
the transverse processes of the third, fourth, fifth, and 
sixth cervical vertebrae; action, flexes and rotates the 
vertebral column; nerves, anterior branches of the lower 
cervical nerve. 
Scalenus Medius.— Origin, upper surface of the first 
rib, behind the groove for the subclavian artery; insertion, 
into the transverse processes of the lower six cervical 
vertebrae; action, rotates and flexes the vertebral 
column; nerves, the anterior branches of the lower 
cervical nerve: the posterior thoracic, long thorae'e 
nerve, or external respiratory nerve of Bell, has its 
origin in the substance of this muscle, by union of two 
roots from fifth and sixth cervical nerves. 
Scalenus Posticus.— Origin, from the outer surface THE MUSCULAR SYSTEM. 
123 
of the second rib, behind the serratus magnus; insertion, 
into the posterior tubercles of the transverse processes 
of the low'er twro or three cervical vertebrae; action, 
flexes and rotates the spine; nerves, anterior branches of 
the lower cervical nerves. 
Of these muscles the scalenus medius is the longest 
and largest, and the scalenus posticus the smallest. 
Muscles of the Larynx and Epiglottis (vide Larynx.) 
Muscles of the Trunk. 
MUSCLES OF THE BACK. 
First Layer. 
Trapezius.—Origin, from inner third of superior 
curved line of the occipital bone, the ligamentum nucliae, 
the spinous processes of the seventh cervical, and all the 
dorsal vertebrae; insertion, into the outer third of the 
posterior border of the clavicle, the inner margin of the 
acromion process, and the crest of the spine of the scap- 
ula ; action, draws the head backward; nerves, cervical 
plexus and spinal accessory. 
Ligamentum Nuch^e.—Origin, from external occipital 
protuberance; insertion, spinous processes of the cer- 
vical vertebrae, from the second to the seventh. This 
ligament is rudimental in man, and in the lower animals 
sustains the head. 
Latissimus Dorst.— Origin, by an aponeurosis from 
the spinous processes of the six lower dorsal, the lumbar 
and sacral vertebrae, the supraspinous ligament, the 
crest of the ilium, and the three or four lower ribs; 
insertion, into the inner lip of the bicipital groove of the 
humerus, in front of the teres major, and a little above 
the pectoralis major; the tendon of this muscle twists 
completely on itself, so that the superior fibres become 
the inferior; action, draw's the arm backward and down- 
ward, or, fixing the arm, raises the lower ribs and draws 
the trunk forward ; nerve, subscapular. 
Levator Anqult Scapulae.— Origin, from three to five 
tendons from the posterior tubercles of the transverse 
Second Layer. 124 
HUMAN ANATOMY. 
processes of the three or five upper cervical vertebrae; 
insertion, into posterior border of the scapula, at the root 
ot the spine ; action, elevates the angle of the scapula ; 
Fig. 36. 
Muscles of the hack : 1, trapezius; 2, 4, latissimus dorsi; 10, levator anguli scap- 
ula; : 11, rhomboideus minor; 12, rhomboideus major; 13, 14, splenius capitis etcolli; 
15, vertebral aponeurosis; 10, serratus posticus inferior. 
verve, interior division of the third and fourth cervical 
nerves. 
Rhomboideus Minor.— Origin, from spinous processes 
of seventh cervical and first dorsal vertebrae and the TIIE MUSCULAR SYSTEM. 
125 
ligamentum nucliae; insertion, into root of the spine of 
the scapula; action, draws the inferior angle upward 
and backward ; nerves, branches from the fifth cervical 
nerve. 
RiioMiloideus Major.— Origin, from supraspinous 
ligament and spinous processes of four or five upper 
dorsal vertebrae ; insertion, by a tendinous arch attached 
above near the spine and below to the inferior angle of the 
scapula; action, draws the inferior angle upward and 
backward ; nerves, branches of the fifth cervical. 
Third Layer. 
Serratus Posticus Superior.— Origin, from spinous 
processes of the two or three upper dorsal and last 
cervical vertebrae, and from the ligamentum nucliae; 
insertion, into upper borders of the second to the fifth 
ribs inclusive ; action, assists in respiration; nerves, ex- 
ternal branches of the posterior division of the cervical. 
Serratus Posticus Inferior.— Origin, from spinous 
processes and interspinous ligaments of two or three 
upper lumbar and two lower dorsal vertebrae; insertion, 
into lower borders of the four lower ribs, external to 
their angles; action, elevates the ribs; assists in respi- 
ration ; nerves, external branches of the posterior divis- 
ions of the lower dorsal. 
Splenius.— Origin, from spinous processes of last 
cervical and six upper dorsal vertebrae, the lower half 
of the ligamentum nucliae, and the supraspinous ligament; 
insertion, by two heads—splenitis capitis into the occip- 
ital bone, just below the superior curved line and the 
mastoid process of the temporal bone; splenitis colli 
into posterior tubercles of the transverse processes of 
the three or four upper cervical vertebrae ; action, sepa- 
rately, rotates the head and draws it to the other side; 
together, draw the head backward ; nerves, external 
branches of the posterior divisions of the cervical. 
Fourth Layer. 
Erector Spin^e.— Origin, from sacro-iliac groove 
and from a broad tendon attached internally to the 126 
HUMAN ANATOMY. 
spinous processes of the lumbar and two or three lower 
dorsal vertebrae and supra-spinous ligament; externally, 
the crest of the ilium and the posterior part of the 
sacrum; insertion, by two parts—1, sacro-lumbalis (ilio- 
costalis), inserted into the angles of the six or seven 
lower ribs; this muscle has two accessory portions, (a) 
musculus accessorius ad sacro-lumbalem : origin, from 
angle of six lower ribs; insertion, angles of six upper 
ribs; (b) cervicalis ascendens : origin, angles of the four 
or five upper ribs ; insertion, into the posterior tubercles 
of the fourth to the sixth cervical vertebrae, inclusive; 
2, longissimus dorsi; insertion, into the transverse pro- 
cesses of all the dorsal vertebrae, and from the seventh 
to the eleventh ribs, inclusive, between their angles and 
tubercles ; action, bends the trunk backward and erects 
the spine; nerves, external branches of the posterior 
divisions of the lumbar and dorsal. 
Tiiansversalis Colli (or Cervicis).—Origin, trans- 
verse processes of six upper dorsal vertebrae; insertion, 
into the posterior tubercles of the transverse processes of 
the second to the sixth cervical vertebrae inclusive ; nerves, 
external branches of the posterior divisions of the cervical. 
Traciielo-mastoid.—Origin, from articular processes 
of three or four lower cervical, and from the transverse 
processes of the third to the sixth dorsal vertebrae; 
insertion, into the posterior margin of the mastoid 
process, below the sterno-mastoid and the splenius; 
action, steadies the head; nerves, external branches of 
the posterior divisions of the cervical. 
Spinalis Dorsi.—Origin, spinous processes of last 
two dorsal and first two lumbar vertebrae; insertion, 
into spinous processes of the dorsal vertebrae, blending 
with the semi-spinalis dorsi; action, erects the spinal 
column; nerves, external branches of the posterior 
divisions of the cervical. 
Spinalis Colli.—Origin, from the spinous processes 
of the fifth to the seventh cervical vertebrae; insertion, 
into the spinous process of the axis; action, steadies the 
neck; nerves, same as above; this muscle is absent in 
20 per cent, of the subjects. THE MUSCULAR SYSTEM. 
127 
Complexus.— Origin, by seven tendons from trans- 
verse processes of the upper three dorsal and seventh 
cervical and articular processes of the fourth, fifth, and 
sixth cervical; insertion, into the occipital bone, 
between the curved lines ; action, separately, rotates and 
draws the head to one side; together, draw the head 
directly backward; nerves, suboccipital, great occipital, 
and internal branches of the posterior divisions of the 
cervical. 
Fifth Layer. 
Semi-spinalis Dorst.— Origin, from transverse pro- 
cesses from the fifth to eleventh dorsal vertebrae; 
insertion, into the spinous processes of the lower two 
cervical and upper four dorsal vertebrae; action, erects 
the spinal column; nerves, internal branches of the 
posterior divisions of the cervical. 
Semi-spjnalis Colli.— Origin, from transverse pro- 
cesses of lower four cervical and upper four dorsal 
vertebrae; insertion, into spinous processes of the second 
to the fifth cervical vertebrae; action, erects the spinal 
column; nei'ves, same as above. 
Multifidus Spinas.— Origin, from the transverse 
processes of the dorsal region, the articular processes in 
the cervical and lumbar region, the posterior superior of 
the ilium, posterior saero-iliac ligaments, and from the 
aponeurotic arch of the erector spinae; insertion, each 
fasciculus is attached to the lamime and spinous process 
of the vertebrse above; action, preserves the erect con- 
dition of the spine; nerves, internal branches of the 
posterior divisions of the cervical,1 dorsal, lumbar, and 
sacral nerves. 
Rotatores Sptn^e.—Eleven on either side. Origin, 
from upper part of transverse process; insertion, into 
outer surface and lower border of the lamime of the 
vertebrae above, from the first and second dorsal to the 
eleventh and twelfth ; action, rotates the spinal column ; 
nerves, anterior branches of the posterior divisions of 
the dorsal. 
Supraspin ales.— Origin and insertion, the spinous 128 
HUMAN ANATOMY. 
processes in'the cervical region of the vertebrae; action, 
extends cervical spine ; nerves, internal branches of the 
posterior divisions of the cervical. 
Interspinales.—Consist of muscular bands in pairs 
between the spinous processes of the adjoining vertebra;: 
six pairs in the cervical region, three pairs in the dorsal, 
four or five in the lumbar; action, extend the spine; 
nerves, internal branches of the posterior divisions of the 
cervical, dorsal, and lumbar. 
Extensor Coccygis.—Origin, from the first piece of 
the coccyx, or last bone of the sacrum; insertion, into 
the lower extremity of the coccyx; action, rudimental 
in man. 
Intertransversales.—Are small, muscular bands 
between the transverse processes: in the cervical region 
seven pairs, in the dorsal twelve pairs, in the lumbar 
region four pairs; action, flex the spine laterally; nerves, 
internal branches of the posterior division of the cervi- 
cal, dorsal, and lumbar. 
Rectus Capitus Posticus Major.—Origin, from the 
spinous process of the axis; insertion, into inferior 
curved line of the occipital bone; action, rotates the 
atlas and the cranium ; nerve, the suboccipital. 
Rectus Capitus Posticus Minor.—Origin, from the 
tubercle of the posterior arch of the atlas ; insertion, 
below the inferior curved line of the occipital bone; 
action, draws the head backward; nerve, suboccipital. 
Obliquus Capitus Inferior.— Origin, spinous pro- 
cess of the axis; insertion, lower back portion of the 
transverse process of the atlas; action, rotates the atlas 
and the cranium; nerves, suboccipital and great occipital. 
Obliquus Capitus Superior.—From upper surface of 
the transverse process of the atlas ; insertion, between 
the curved lines of the occipital bone to the outer side of 
the complexus; action, rotates the atlas; nerves, sub- 
occipital and great occipital. 
MUSCLES OF TIIE ABDOMEN. 
Obliquus Externus.—Origin, lower borders of the 
eighth lower ribs ; insertion, into the crest of the ilium THE MUSCULAR SYSTEM. 
129 
and by a broad aponeurosis (Poupart’s ligament) into 
the anterior superior spine of the ilium, the spine of the 
pubis, and the linea ilio-peetinea, blending above with 
the pectoralis major and (in median line) with its fellow 
of the opposite side; insertion, into the spine of the 
Muscles of abdomen: 12, external oblique: 16, rectus abdominis; 18, internal 
oblique; 17, pyramidalis; 19, quadratus lumborum. 
Fro. 37. 
pubis by two divisions, forming the external abdominal 
ring; action, flexes the pelvis on the thorax, or vice 
versa, and compresses the viscera; nerves, lower inter- 
costal, ilio-hypogastric, and ilio-inguinal. 
Obliquus Internes.—Origin, from the outer half of 130 
HUMAN ANATOMY. 
Poupart’s ligament, from the anterior two-thirds of the 
crest of the ilium, and the posterior lamellae of the 
lumbar fascia; insertion, above to the lower four costal 
cartilages, below, conjointly with the tendon of the 
transversalis,into the os pubis and linea ilio-pectinea, to 
form the conjoined tendon, and into the median line 
(linia alba) by an aponeurosis extending from the 
sternum and seventh and eighth costal cartilages to the 
pubis. This aponeurosis at its lower fourth consists of 
two united laminae passing in front of the rectus muscle, 
but in its upper tliree-fourtlis it divides, one lamina 
passing in front of the rectus and joining the aponeu- 
rosis of the external oblique, the other passing behind 
and joining the aponeurosis of the transversalis; action, 
same as the externus ; nerves, same as externus. 
Transversalis.— Origin, from outer third of Pou- 
part’s ligament and anterior three-fourths of the crest of 
the ilium, from the inner surface of the cartilages of the 
six lower ribs, and from the spinous and transverse 
processes of the lumbar vertebrae; insertion, by the 
conjoined tendon into the linea ilio-pectinea and crest of 
the os pubis; action and nerves, same as the externus. 
Rectus Abdominis.— Origin, by two tendons—the 
outer from the crest of the pubis, the inner interlacing 
with its fellow of the opposite side; insertion, into the 
cartilages of the fifth, sixth, and seventh ribs; action, 
depresses the thorax, flexes the vertebral column, and, 
acting from above, flexes the pelvis upon the vertebral 
column. 
Pyramtdalis.— Origin, from the os pubis and anterior 
pubic ligament; insertion, into the linea alba, midway 
between the os pubis and umbilicus. 
Quadratus Lumborum.—Origin, by two portions— 
posterior portion, from crest of the ilium and ilio-lumbar 
ligament; insertion, into lower border of the last rib and 
transverse processes of the three lower lumbar vertebrae; 
anterior portion, from upper border of the transverse 
processes of the lumbar vertebrae, from the third to the 
fifth; insertion, into one-lialf the lower margin of the 
last rib and apices of upper four lumbar vertebrae ; action, THE MUSCULAR SYSTEM. 
131 
draws down and fixes the last rib and assists in inspira- 
tion and expiration. 
Intercostalis Externi.—Eleven pairs on either side. 
Origin, from the outer border of the groove on the 
lower border of each rib, from the cartilage to the 
tubercle; insertion, into upper border of the rib below; 
action, raises the ribs ; nerve, intercostal. 
muscles op the thorax 
Intercostalis Interni.—Origin, inner lip of the 
groove on the lower border of each rib; insertion, into 
the upper border of the rib below; action, pulls the ribs 
upward; nerve, intercostal. 
Ineracostalis (Subcostalis).—Origin, inner surface 
of rib ; insertion, into the inner surface, from the first to 
the third rib below; action, inspiratory muscles ; nerve, 
intercostal. 
Triangularis Sterni.—Origin, lower part of the 
sternum and ensiform cartilage and inner surface of 
sternal end of the costal cartilages of the three or four 
lower ribs; insertion, into the border and inner surfaces 
of the costal cartilages, from the second to the fifth rib 
inclusive; action, draws down the costal cartilages; 
nerve, intercostal. 
Levatores Costarum.— Twelve on either side. 
Origin, from transverse processes of seventh cervical 
and eleven upper dorsal vertebrae ; insertion, into upper 
surface of the rib below, between the angle and tubercle; 
action, raises the ribs; nerve, the intercostal. 
DIAPHRAGMATIC REGION. 
Diaphragm.— Origin, inner surface of ensiform carti- 
lage, cartilages and bony portions of six or seven lower 
ribs in front, and from two aponeurotic arches, the 
ligamentum arcuatum externum and internum and the 
lumbar vertebrae behind ; insertion, into the circumfer- 
ence of the central or cordiform tendon ; action, the 
principal muscle of inspiration and expulsion; nerves, 
the phrenic, and phrenic plexus of the sympathetic. 132 
HUMAN ANATOMY. 
THE OPENINGS IN THE DIAPHRAGM. 
The aortic opening is placed posteriorly between the 
two crura, in front of the spine. It transmits the aorta, 
thoracic duct, and vena azygos major, and sometimes 
the left sympathetic nerve. 
The oesophageal opening is in front of the decussation 
of the crura, a little to the left and in front of the aortic 
opening. It transmits the oesophagus and pneumo- 
gastric nerves. 
Diaphragm: 1, 2, 3, central cordiform tendon; 4, middle leaflet; 5, ligamentum 
arctuatum externum; 6, ligamentum arctuatum internum; 8, right crus; 10. left 
crus; 11, aortic opening; 12, oesophageal opening; 13, opening for vena cava; 14, psoas 
inagnus, quadratus lumborum. 
Fig. 38. 
The foramen quadratum, or opening for the vena 
cava,, is placed at the highest part of the central tendon, 
a little to the right. It transmits the vena cava and 
maintains its patency. The crus on each side transmits 
the sympathetic and greater and lesser splanchnic nerves, 
and in addition the left transmits the vena az3’gos 
minor. THE MUSCULAR SYSTEM. 
133 
Muscles of the Perineum (vide Perineum) 
Muscles of the Upper Extremity. 
Pectoralis Major.—Origin, from the sternal half of 
the clavicle and anterior surface of the sternum, as low 
as the sixth or seventh rib ; insertion, into the anterior 
bicipital ridge of the humerus ; action, draws the arm 
across the chest. 
MUSCLES OF THE SHOULDER. 
Pectoralis Minor.—Origin, upper and outer surface 
of the third to the fifth rib, inclusive, and the aponeu- 
rosis of the intercostal muscles ; insertion, into anterior 
border of the coracoid process of the scapula; action, 
draws the scapula inward and downward; nerve, the 
anterior thoracic. 
Subclavius.— Origin, from cartilage of the first rib; 
insertion, under surface of the clavicle, about its middle 
third; action, depresses the shoulder, and draws clavicle 
forward and downward ; nerve, branch from the union 
of the fifth and sixth cervical. 
Serratus Magnus.— Origin, by nine muscular por- 
tions, from the outer surface of the eight upper ribs 
(two divisions being from the second rib) and from 
the upper intercostal aponeurosis; insertion, by three 
’divisions—upper portion into superior angle of the 
scapula, middle portion into posterior portion of the 
scapula between the inferior and superior angles, lower 
portion into the inferior angle of the scapula; action, 
raises the vertebral border and carries the scapula 
forward ; nerve, the posterior thoracic. 
Deltoid.—Origin, from the outer third of the clavicle 
and from the outer part of the acromion process and 
the lower border of the scapular spine; insertion, into 
the outer side of the shaft of the humerus, about its 
middle ; action, raises the arm ; nerve, the circumflex. 
Subscapularis.—Origin, from the internal two-thirds 
of the subscapular fossa ; insertion, into the lesser tuber- 
osity of the humerus; action, rotates the head of the 
humerus inward ; nerves, upper and lower subscapular. 134 
human anatomy. 
Supraspinatus.—Origin, from inner two-thirds of 
supraspinous fossa; insertion, into the uppermost facet 
of the great tuberosity of the humerus; action, assists 
in raising the arm and fixing the head of the humerus; 
nerve, the suprascapular. 
Infraspinatus.—Origin, from the inner two-thirds 
of the infraspinous fossa; insertion, into the middle 
facet of the great tuberosity; action, rotates the head 
of the humerus outward ; nerve, supra-scapular. 
Teres Minor.—Origin, posterior surface of the upper 
two-thirds of the axillary border of the scapula; inser- 
tion, into the lowest facet of the great tuberosity ; action, 
rotates the head of the humerus outward; nerve, the 
circumflex. 
Teres Major—Origin, posterior surface of the 
inferior angle of the scapula; insertion, into the poste- 
rior bicipital ridge of the humerus; action, draws the 
humerus backward and downward, assisting the latissi- 
mus dorsi; nerve, the lower subscapular. 
HUMERAL REGION. 
Coraco-brachiALTs.— Origin, from apex of the cora- 
coid process of the scapula; insertion, into the inner 
side of the middle of the shaft of the humerus, between 
the origin of the braehialis anticus and triceps; action, 
draws the humerus inward and forward; nerves, the' 
musculo-cutaneous and a branch of the musculo-spiral. 
Biceps (Flexor Cubiti).—Origin, by two heads; 
short head from the apex of the coracoid process, along 
with the coraco-brachialis ; the long (glenoid) head from 
the upper margin of the glenoid cavity ; insertion, into 
the posterior part of the tuberosity of the radius; 
action, flexes the forearm ; nerve, the musculo-cutaneous. 
Brachialis Anticus.—Origin, inner and outer sur- 
faces of the shaft of the humerus, embracing the inser- 
tion of the deltoid; insertion, into the anterior surface 
of the coronoid process of the ulna; action, flexes the 
forearm; nerve, the musculo-cutaneous. 
Triceps (Extensor Cubiti).— Origin, by three heads 
—middle, or scapular head, below the glenoid cavity of THE MUSCULAR SYSTEM. 
135 
the scapula ; external head, from the posterior aspect of 
the shaft of the humerus, between the upper part of the 
musculo-spiral groove and the insertion of the teres 
minor, and from the external intermuscular septum; 
the internal head, from the posterior aspect of the shaft 
of the humerus, below the insertion of the teres major, 
Fig. 39. 
Muscles of shoulder and arm: 4, sub- 
scapularis; 5, teres major; 6, coraco-bra- 
chialis; 7, biceps. 
Triceps muscle: 1, external head; 2, 
scapular head; 4, insertion. 
Fig. 40. 
and below the groove for the musculo-spiral nerve; 
insertion, by a common head, into the posterior part of 
the under surface of the olecranon process of the ulna; 
action, extends the forearm; nerve, the musculo-spiral. 
Subanconeus.—Origin, from the posterior surface 
of the humerus, above the olecranon process; insertion, 136 
HUMAN ANATOMY. 
above the posterior ligament of the elbow-joint; action, 
flexes the arm; nerve, the musculo-spiral. 
Muscles of the Forearm. 
anterior superficial layer. 
Pronator Radii Teres.— Origin, by two heads.—the 
smaller from the coronoid process of the ulna, the 
larger from the humerus, above the internal eondjle, 
and from the common tendon and intermuscular septum; 
insertion, into the outer aspect of the shaft of the 
radius; action, pronates the hand; nei-ve, the median. 
Flexor Carpi Radialis.— Origin, from the common 
tendon of the inner condyle from the intermuscular 
septum between it and the pronator teres; insertion, 
into the base of the metacarpal bone of the index linger; 
action, flexes the wrist; nerve, the median. 
Palmaris Longus.— Origin, from the inner condyle 
of the humerus and the intermuscular septum and the 
deep fascia; insertion, into the annular ligament, 
spreading out in the palmar fascia; action, renders tense 
the palmar fascia; nerve, the median. 
Flexor Carpi Ulnaris — Origin, by two heads—one 
by the common tendon from the inner condyle of the 
humerus, the other from the inner margin of the ole- 
cranon, the intermuscular septum, between the ulna and 
the flexor sublimis digitorum, and from the upper two- 
thirds of the posterior aspect of the ulna; insertion, 
pisiform bone; action, flexes the wrist; nerve, the ulnar. 
Flexor Sublimis Pigitorum (Perforatus).—Origin, 
by three heads—one from the coronoid process of the 
ulna, above the pronator radii teres, another from the 
common tendon from the internal condyle of the 
humerus, and the third from the oblique line of the 
radius, from the insertion of the pronator radii teres, to 
the tubercle; each tendon divides at the base of the 
first phalanges to allow the passage of the tendon of 
the flexor profundus digitorum; insertion, into the lateral 
margins of the second phalanges by four tendons; 
action, flexes the second phalanges ; nerve, median. THE MUSCULAR SYSTEM. 
137 
Flexor Profundus Digitorum (Perforans).— Origin, 
from the inner side of the coro- 
noid process, and from the upper 
two-thirds of the front and in- 
ner aspect of the shaft of the 
ulna, between the brachialis anti- 
cus above and the pronator 
quad rat us below ; insertion, by 
four tendons into the bases of the 
last phalanges, perforating the 
tendons of the flexor sublimis; 
action, flexes the phalanges; 
nerves, the anterior interosseous 
and the ulnar. 
Flexor Longus Pollicis.— 
Origin, from the upper two- 
thirds of the shaft of the radius 
and from the interosseous mem- 
brane; insertion, into the base 
of the last phalanx of the 
thumb ; action, flexes the thumb ; 
nerve, anterior interosseous. 
Pronator Quadratus.— Ori- 
gin, anterior border of the ulna 
and from the oblique line of the 
lower fourth of the anterior as- 
pect of the ulna ; insertion, into 
the lower fourth of the front and 
outer border of the shaft of the 
radius; action, pronates the 
hand; nerve, anterior interos- 
ANTERIOR DEEP LAYER. 
fig. 41. 
RADIAL REGION. 
Muscles of forearm : 1, biceps; 
2, brachialis anticus; 3, triceps; 
4, supinator longus; 5, extensor 
carpi radial is longior; 6, extensor 
carpi radialis brevior; S, extensor 
communis digitorum ; 12, extensor 
carpi ulnaris; 13,14, extensors of 
thumb. 
Supinator Longus.— Origin, 
from the upper two-thirds of the 
external condyloid ridge of the 
humerus and the external intermuscular septum ; inser- 
tion, into the styloid process of the radius ; action, supi- 
nates the hand ; nerve, musculo-spiral. 138 
Extensor Carpi Radialis Longior.—Origin, from 
the lower third of the external condyloid ridge of the 
humerus and the intermuscular septum ; insertion, into 
the radial side of the base of the metacarpal bone of 
the index finger; action, extends the wrist; nerve, 
musculo-spiral. 
Extensor Carpi Radialis Brevior.—Origin, from 
the common tendon, from the external condyle of the 
humerus, the external lateral ligament, and the inter- 
muscular septum; insertion, into the base of the meta- 
carpal bone of the middle finger on its radial side; 
action, extends the wrist; nerve, posterior interosseous. 
HUMAN ANATOMY. 
POSTERIOR SUPERFICIAL LAYER. 
Extensor Communis Digitorum.— Origin, from the 
external condyle of the humerus, the deep fascia, and 
the intermuscular septa; insertion, by three tendons 
into the second and third phalanges of all the fingers, 
one of them, the inner tendon, dividing into two ; action, 
extends the fingers ; nerve, posterior intei*osseous. 
Extensor Minimi Digiti.—Origin, from the common 
tendon of the external condyle and the intermuscular 
septum; insertion, into the second and third phalanges 
of the little finger; action, extends the little finger; 
nerve, posterior interosseous. 
Extensor Carpi Ulnaris.—Origin, from the middle 
third of the posterior border of the ulna, from the ex- 
ternal condyle of the humerus, and from the fascia of 
the forearm; insertion, into the base of the metacarpal 
bone of the little finger, on the ulnar side; action, ex- 
tends the wrist; nerve, posterior interosseous. 
Anconeus—Origin, from the outer condyle of the 
humerus ; insertion, into the upper fourth of the poste- 
rior aspect of the shaft of the ulna and the side of the 
olecranon ; action, extends the forearm ; nerve, musculo- 
spiral. 
POSTERIOR DEEP LAYER. 
Supinator Brevis.— Origin, from the external lateral 
ligament of the elbow-joint, from the external condyle THE muscular system. 
139 
of the humerus, from the ridge of the ulna, and from 
the orbicular ligament of the radius; insertion, into the 
neck, bicipital tuberosity and oblique line of radius; the 
posterior interosseous nerve pierces this muscle; action, 
supinates the hand ; nerve, posterior interosseous. 
Extensor Ossis Metacarpi Pollicis.—Origin, mid- 
dle third of posterior surface of radius, posterior surface 
of lower three-fourths of shaft of ulna, and interosseous 
ligament; insertion, into base of metacarpal of thumb; 
action, extends metacarpal of thumb; nerve, posterior 
interosseous. 
Extensor Primi Internodii Pollicis.— Origin, from 
the interosseous membrane and from the posterior as- 
pect of the shaft of the radius ; insertion, into the base 
of the first phalanx of the thumb; action, extends the 
thumb ; nerve, posterior interosseous. 
Extensor Secundi Internodii Pollicis.— Origin,from 
the posterior aspect of the shaft of the ulna and from 
the interosseous membrane; insertion, into the last 
phalanx of the base of the thumb; action, extends the 
thumb; nerve, posterior interosseous. 
Extensor Indicis.— Origin, from the posterior aspect 
of the ulna and from the interosseous membrane ; inser- 
tion, into the second and third phalanges of the index 
finger, along with the tendon of the extensor communis; 
action, extends the index finger; nerve, posterior inter- 
osseous. 
Muscles of the Hand. 
These are divided into three groups—the radial re- 
gion, the ulnar region, and the palmar region. 
RADIAL REGION. 
Abductor Pollicis.—Origin, from the annular liga- 
ment and ridge of the trapezium; insertion, into base of 
the first phalanx of the thumb on its radial side ; action, 
abducts the thumb from the median line; nerve, median. 
Opponens Pollicis.— Origin, from annular ligament 
and palmar surface of the trapezium ; insertion, into meta- 
carpal bone of the thumb throughout the whole length 
of its radial side ; action, flexes the thumb; nerve, median. 140 
HUMAN ANATOMY. 
Flexor Brevis Pollicis.—This muscle consists of 
two portions, divided by tendon of flexor longus pollicis; 
origin, superficial portion from outer two-tliirds of annu- 
lar ligament and trapezium, deeper portion from sheath 
of flexor carpi radialis, the trapezoid, os magnum, and 
base of third metacarpal bone ; insertion, into either side 
of base of first phalanx of thumb, the inner portion joining 
the adductor and the outer portion the abductor; each ten- 
don has a sesamoid bone developed in it; action, adducts 
thumb toward mediau line; nerves, ulnar and median. 
Adductor Pollicis.— Origin, from lower two-thirds 
palmar surface of middle metacarpal bone; insertion, into 
ulnar side of base of first thumb-phalanx and internal 
sesamoid bone ; action, adducts thumb ; nerve, ulnar. 
Palmarts Brevis.— Origin, from palmar fascia and 
annular ligament; insertion, into skin of palm of hand ; 
action, wrinkles skin of hand ; nerve, ulnar. 
Abductor Minimi Digiti.— Origin, from pisiform 
bone and from tendon of flexor carpi ulnaris ; insertion, 
into base of first phalanx of little finger on its ulnar side; 
action,abducts little finger from median line; nerve,ulnar. 
Flexor Brevis Minimi Digiti.—Origin, from an- 
nular ligament and tip of unciform process of unciform 
bone; insertion, into the first phalanx of little finger; 
action, flexes little finger; nerve, ulnar. 
Opponens Minimi Digiti.—Origin, from annular liga- 
ment and from unciform process of unciform bone; in- 
sertion, into ulnar border of whole length of metacarpal 
bone of little finger; action, flexes little finger; nerve, 
ulnar. 
ULNAR REGION. 
PALMAR REGION. 
Lumbrtcales.— Origin, by four fleshy tendons from 
the tendons of the deep flexors—the first and second 
from the palmar surface and radial side of the tendons of 
the index and middle fingers, the third from the adjoin- 
ing sides of the tendons of the middle and ring fingers, 
and the fourth from the adjoining sides of the tendons THE MUSCULAR SYSTEM. 
141 
of the ring and little fingers; insertion, on dorsal aspect 
of each finger into the expansion of the extensor com- 
munis digitorum; action, abduct the fingers to either 
side of the median line; nerves, ulnar and median. 
Interossei muscles consist of two groups, the dorsal 
and palmar. 
Dorsal Interossei.—Origin, from two heads from 
the adjacent sides of the metacarpal bones, four in num- 
ber ; insertion, the first into the radial side of the base 
of the first phalanx of the index finger, the second into 
the radial side of the middle finger, the third into the 
ulnar side of the middle finger, and the fourth into the 
ulnar side of the ring finger, the middle finger having 
two, one on either side; action, abducts the fingers from 
the median line ; nerve, ulnar. 
Palmar Interossei.—Three in number. Origin, the 
first from the entire length of the metacarpal bone of 
the index finger on its ulnar side, the second from the 
ring finger on its radial side, and the third from the little 
finger on its radial side ; insertion, into the base of the 
first phalanx and into the expansion of the extensor com- 
munis tendon of the same finger from which they arise; 
action, adducts the fingers toward the median line; 
nerve, ulnar. 
Muscles of the Lower Extremity. 
ILIAC REGION. 
Psoas Magnus.—Origin, from the sides and anterior 
surfaces of the transverse processes and bodies of the 
last dorsal and all the lumbar vertebrae and the inter- 
vertebral substances between them; insertion, into the 
lesser trochanter of the femur, uniting with the tendon 
of the iliacus; this muscle is in relation behind with the 
capsular ligament of the hip, being separated from it by 
a synovial bursa; action, flexes and rotates the femur 
outward, and also flexes the trunk and pelvis on the 
thigh; nerves, anterior branches of the lumbar nerves. 
Psoas Parvus.—Origin, from the lateral surfaces of 
the bodies of the last dorsal and first lumbar vertebrae 142 
HUMAN ANATOMY. 
and from the intervertebral substances between them ; 
insertion, into the ilio-pectineal eminence, joining the 
iliac fascia ; action, assists the psoas magnus and renders 
tense the iliac fascia; nerves, anterior branches of the 
lumbar. 
Iliacus.— Origin, from the base of the sacrum and 
the ilio-lumbar ligament behind, from the iliac fossa and 
inner margin of the crest of the ilium and the anterior 
superior and anterior inferior spinous processes of the 
ilium ; insertion, into the oblique or intertrochanteric 
line of the femur to the outer side of the insertion of 
the psoas; action, flexes and rotates the femur outward 
and flexes the trunk and pelvis on the thigh; nerves, 
anterior crural and the anterior branches of the lumbar. 
Tensor Vaginae Femoris.— Origin, from the anterior 
superior spinous process between the sartorius and the 
gluteus medius, and from the fore part of the outer lip 
of the crest of the ilium; insertion, into the fascia lata, 
about the upper fourth of the outer side of the thigh; 
action, renders tense the fascia lata; nerve, superior 
gluteal. 
Sartorius.—Origin, from the anterior superior 
spinous process of the ilium and the upper part of the 
notch below; insertion, into the inner and upper part 
of the shaft of the tibia; action, flexes the leg upon the 
thigh and the thigh upon the pelvis ; nerve, branches 
of the anterior crural. 
femoral and gluteal region. 
Quadriceps Extensor.—This extensive muscle covers 
the front and sides of the femur and consists of four 
portions—the rectus femoris, the vastus externus, the 
vastus intern us, and the crureus. 
Rectus Femoris.—Origin, by two heads—one, the 
long head, from the groove above the brim of the 
acetabulum ; the other, the short head, from the anterior 
inferior spinous process of the ilium; insertion, by the 
common tendon into the patella; action, extends the 
leg upon the thigh ; nerves, branches of the anterior 
crural. THE MUSCULAR SYSTEM. 
143 
Vastus Externus.—Forms the greater part of the 
quadriceps extensor. Origin, by an extensive aponeu- 
rosis extending from the tubercle 
of the femur along the anterior 
border of the great trochanter and 
the whole length of the outer lip 
of the linea aspera; insertion, into 
the outer portion of the patella, 
joining the common tendon; ac- 
tion, extends the leg on the thigh; 
nerves, branches of the anterior 
crural. 
Vastus Internus and Cru- 
reus.— Origin, by a tendinous 
aponeurosis extending from the 
neck of the femur throughout the 
whole length of the inner lip of 
the linea aspera; insertion, into 
the common tendon, together with 
the rectus femoris and the vastus 
externus ; action, extends the leg 
on the thigh; nerves, branches 
of the anterior crural. 
Subcrureus.—Origin, from the 
anterior aspect of the lower part 
of the shaft of the femur; inser- 
tion, into the synovial sac behind 
the patella. 
Gracilis.—Origin, from the 
inner margin of the ramus of 
the ischium and the pubes; in- 
sertion, into the inner aspect of 
the shaft of the tibia, below the 
tuberosity; action, flexes the leg 
and draws it inward, assisting 
the sartorius; nerve, the obtu- 
rator. 
Pectineus.— Origin, from the tendinous prolongation 
of Gimbernnt's ligament and the linea ilio-pectinea; 
insertion, into the rough line leading to the linea aspera 
Fig. 42. 
Anterior femoral region: 4, 
tensor vaginae femoris; 5, sarto- 
rius; 6, rectus; 7, vastus exter- 
nns; 8, vastus internus; 10, 
iliacus; 11, psoas; 12, pectineus; 
13. adductor longus; 14, adductor 
magnus; 15, gracilis. 144 
HUMAN ANATOMY. 
from the lesser trochanter; action, adducts the thigh; 
nerves, obturator, the accessory obturator, and branches 
of the anterior crural. 
Adductor Longus.—Origin, from the junction of the 
crest of the pubis; insertion, into the middle 
third of the linea aspera, between the adductor magnus 
and the vastus interims; action, adducts the thigh ; 
nerve, obturator. 
Adductor Brevis.—Origin, from the outer aspect of 
the descending ramus of the pubes, between obturator 
externus and the gracilis; insertion, into the upper part 
of the linea aspbra; action, adducts the thigh; nerves, 
branches of the obturator. 
Adductor Magnus.—Origin, from the tuberosity of 
the ischium, the ascending ramus of the ischium, and 
from the descending ramus of the pubes; insertion, 
into the rough line leading to the linea aspera from 
the great trochanter to the inner side of the gluteus 
maximus; action, adducts the thigh; nerves, the obtu- 
rator and a branch from the great sciatic. 
Gluteus Maximus.—Origin, from the superior curved 
line of the ilium, the posterior aspect of the last segment 
of the sacrum, the border of the coccyx, and the surface 
of'the great sacro-sciatic and posterior sacro-iliac liga- 
ment; insertion, into the rough line leading to the linea 
aspera from the great trochanter, between the adductor 
magnus and the vastus externus, and into the fascia lata ; 
action, abducts the thigh; nerves, the inferior gluteal and 
a branch from the sacral plexus. 
Gluteus Medius.— Origin, from the outer lip of 
the crest and the outer aspect of the ilium, betiveen 
the middle and superior curved lines, and from the 
gluteal aponeurosis; insertion, into the oblique line 
on the outer surface of the great trochanter; action, 
rotates the thigh outward; nerve, from the superior 
gluteal. 
Gluteus Minimus.—Origin, from the border of the 
great sacro-sciatic notch and between the inferior and 
middle curved lines of the outer aspect of the ilium ; in- 
sertion, into a depression on the front border of the great THE MUSCULAR SYSTEM. 
145 
trochanter; action, rotates the thigh inward; nerve, 
superior gluteal. 
Pyriformis.—Origin, from the anterior surface of the 
sacrum, between the first to the 
fourth anterior sacral foramen, 
and from the margin of the great 
sacro-sciatic foramen, and from 
the anterior aspect of the great 
sacro-sciatic ligament; insertion, 
into the upper border of the great 
trochanter, with the tendon of the 
obturator internus ; action, rotates 
femur outward; nerve, obturator. 
Obturator Internus.—Origin, 
from the inner side of the obtura- 
tor foramen and the internal sur- 
face of obturator membrane and 
the anterior and external wall 
of the pelvis it passes out of the 
pelvis through the lesser sacro- 
sciatic notch and receives the ten- 
dons of the gemelli muscles; in- 
sertion, into the upper border of 
the great trochanter in front of 
the pyriformis ; action, rotates the 
thigh outward; nerves, branches 
from the sacral plexus. 
Gemelli consist of two mus- 
cles—gemellus superior and ge- 
mellus inferior. 
Gemellus Superior.— Origin, 
from the outer aspect of the spine 
of the ischium; insertion, into the 
tendon of the obturator internus. 
Gemellus Inferior.—Origin, 
from the outer border the tuber- 
osity of the ischium; insertion, into the lower portion 
of the tendon of the obturator internus ; action, rotates 
the thigh outward ; nerves, branches of the sacral plexus. 
Quadriceps Femoris.—Origin, from the external bor- 
Fig. 43. 
Posterior femoral region: 1, 
gluteus medius; 2, gluteus maxi- 
mus; 3, vastus externus; 4, bi- 
ceps ; 6, semitendinosis ; 7, serai- 
membranosis; 8, gracilis. 146 
HUMAN ANATOMY. 
der of the tuberosity of the ischium ; insertion, into the 
upper part of the linea quadrati, on the posterior aspect 
of the trochanter major; action, rotates the thigh out- 
ward ; nerves, branches of the sacral plexus. 
Obturator Externus.—Origin, from the inner side 
of the obturator foramen and the inner two-tliirds of the 
outer aspect of the obturator membrane and the tendi- 
nous arch covering the canal for the obturator vessels 
and nerves; insertion, into the digital fossa of the femur; 
action, rotates the thigh outward ; nerve, the obturator. 
Biceps.—Origin, arises by two heads—the long head, 
from the lower and inner facet of the tuberosity of the 
ischium by a common tendon to the long head of the 
semitendinosus; the short head, from the outer lip of 
the linea aspera, between the vastus externus and the 
adductor magnus; insertion, outer side of head of fibula, 
by two portions, on either side of the external lateral 
ligament of the knee-joint, sending a band forward to 
the outer tuberosity of the tibia. This tendon forms the 
outer hamstring; action, flexes the leg upon the thigh; 
nerve, the great sciatic. 
Semitendinosus.—Origin, from a common tendon, to- 
gether with the long head of the biceps, from the tuber- 
osity of the ischium ; insertion, into the inner and upper 
part of the shaft of the tibia ; action, rotates the leg in- 
ward ; nerve, the great sciatic. 
Semimembranosus.—Origin, from the outer and upper 
facet of the tuberosity of the ischium to the outer side 
and above the origin of the semimembranosus and the 
biceps; insertion, into the posterior inner aspect of the 
inner tuberosity of the tibia, under the internal lateral 
ligament by three portions—the internal portion into 
the inner side of the internal tuberosit}'', the posterior 
portion into the posterior part of the outer condjde of 
the femur, forming the principal part of the posterior 
ligament of the knee-joint, and middle portion into the 
posterior aspect of the inner tuberosity; action, flexes 
the leg upon the thigh; nerve, the great sciatic. 
These two tendons (semimembranosus and semiten- 
dinosus), together with the gracilis and sartorius, form 
the inner hamstring. THE MUSCULAR SYSTEM. 
147 
MUSCLES OF THE LEG. 
Tibialis Anttcus.—Origin, from the upper and outer 
two-thirds of the shaft of the tibia, the interosseous 
Anterior Set. 
Fig. 44. 
Fig. 45. 
Anterior muscles of leg: 3, tibialis an- 
ticus; 4, extensor longus digitornm; 5, ex- 
tensor proprius pollicis; 6, peroneus tertius; 
7, peroneus longus ; 8, peroneus brevis. 
Posterior muscles of left: 4, popliteus; 
5, gastrocnemius; 6, tendo Achillis; 8, ten- 
dons of peroneus longus and brevis; 9, tibia- 
lis posticus and flexors. 
membrane, and the intermuscular septum between it 
and the extensor longus digitorum; insertion, into the 
lower and inner aspect of the internal cuneiform bone 148 
nUMAN ANATOMY. 
and base of the first metatarsal bone; action, flexes the 
foot; nerve, the anterior tibial. 
Extensor Proprtus Pollicis.—Origin, from the 
anterior aspect of the fibula and the interosseous mem- 
brane and the intermuscular septum between it and the 
extensor longus digitorum; insertion, into the base of 
the last phalanx of the great toe; action, extends the 
great toe ; nerve, the anterior tibial. 
Extensor Longus Digitorum.—Origin, from the 
upper two-thirds of the anterior aspect of the shaft of 
the fibula and the outer tuberosity of the tibia, from the 
deep fascia of the interosseous membrane and the 
intermuscular septum, between it and the perinei on the 
outer and the tibialis anticus on the inner side ; insertion, 
by three tendons into the bases of the first and second 
phalanges of the four lesser toes, the innermost tendon 
dividing into two; each tendon (except the fourth) is 
joined opposite the metatarso-phalangeal joint by the 
tendon of the extensor brevis digitorum, and receives 
an expansion from the lumbricales and interossei; at 
the first interphalangeal articulation the tendons divide 
into three slips—the middle one for insertion into the 
second phalanges, and the other two uniting to be in- 
serted into the bases of the third; action, extends the 
phalanges and, continuing, flexes the foot upon the leg; 
nerve, the anterior tibial. 
Peroneus Tertius.—Origin, from the lower front 
part of the fibula on its outer side, from the interosseous 
membrane, and the intermuscular septum between it 
and the peroneus brevis ; insertion, into the metatarsal 
bone of the little toe; action, flexes the tarsus upon the 
leg; nerve, the anterior tibial. 
Posterior Superficial Set. 
Gastrocnemius.—Origin, from the upper and back 
part of the external and internal condyles of the femur 
on either side, above the origin of the popliteus, and from 
the supracondyloid ridges ; insertion, by joining with the 
tendon of the soleus to form thetendo Acliillis; action, 
extends the foot; nerve, from the internal popliteal. THE MUSCULAR SYSTEM. 
149 
Soleus.—Origin, from the oblique line of the tibia, 
from the middle third of the internal border and from 
the posterior surface of the head of the fibula; insertion, 
by joining with the tendon of the gastrocnemius to form 
the tendo Acliillis ; action, extends the foot; nerve, the 
internal popliteal. 
Tendo Achillis.—Origin, from the union of the 
gastrocnemius and soleus; is the largest and strongest 
tendon in the body; it is inserted into the inferior sur- 
face of the posterior tuberosity of the os calcis, having 
a synovial bursa between it and the bone. 
Plantaris.—Origin, from the posterior ligament of 
the knee-joint and the lower portion of the outer division 
of the linea aspera ; insertion, into the posterior part of 
the os calcis to the inner side of the tendo Achillis; 
action, the rudiment of a muscle intended to render 
tense the plantar fascia ; nerve, the internal popliteal. 
Posterior Deep Set. 
Popliteus.—Origin, from the outer side of the ex- 
ternal condyle, from the posterior ligament of the knee- 
joint; insertion, above the oblique line on the posterior 
aspect of the shaft of the tibia ; action, assists in flexing 
the leg; nerve, the internal popliteal. 
Flexor Longus Pollicis.—Origin, from the lower 
two-thirds of the internal surface of the fibula, from the 
lower part of the interosseous membrane, fascia covering 
tibialis posticus, and from the intermuscular septum; it 
passes behind the internal malleolus; insertion, into the 
base of the last phalanx of the great toe ; nerve, posterior 
tibial. 
Flexor Longus Digitorum (Perforans).— Origin, 
from the posterior aspect of the tibia, below the oblique 
line ; it passes behind the internal malleolus ; insertion, 
into the bases of the last phalanges of the four lesser 
toes, passing through the division in the tendons of the 
flexor brevis digitorum; action, flexes the phalanges 
and, continuing, extends the foot on the leg ; nerve, the 
posterior tibial 
Tibialis Posticus.—Origin, from the posterior aspect 150 
HUMAN ANATOMY. 
of the shaft of the tibia, and from the upper two-tliirds 
of the shaft of the fibula, and from the whole length of 
the interosseous membrane and the intermuscular septa 
on either side of it; it passes behind the inner malleolus; 
insertion, into the internal cuneiform bone and the 
tuberosity of the scaphoid ; it contains a sesamoid bone 
in its tendon ; action, extends the tarsus upon the leg; 
nerve, the posterior tibial. 
Fibular Region. 
Peroneus Longus.—Origin, from the upper two- 
thirds of the shaft of the fibula, the head of the fibula, 
the intermuscular septa, and the deep fascia; it passes 
behind the outer malleolus along with the peroneus 
brevis; insertion, into the base of the metatarsal bone 
of the great toe; this tendon changes its course twice, 
first at the external malleolus, second at the cuboid 
bone, and usually has a sesamoid bone developed in its 
tendon ; action, extends and everts the foot upon the 
leg; nerve, musculo-cutaneous branch of the external 
popliteal. 
Peroneus Brevis.—Origin, from the outer and 
middle third of the fibula and the intermuscular septa 
on either side; insertion, into the upper surface of the 
base of the metatarsal bone of the little toe; action, 
extends the foot upon the leg; nerve, musculo-cutaneous 
branch of the external popliteal. 
MUSCLES OF THE FOOT. 
Dorsal Region. 
Extensor Brevis Pigitorum.—Origin, from the 
external calcaneo-astragaloid ligament, from the annular 
ligament, and from the outer side of the os calcis; 
insertion, by four tendons—the first one into the first 
phalanx of the great toe, the other three into the long 
extensor tendons of the second, third, and fourth toe on 
their outer sides ; action, extends the phalanges of the 
four inner toes and the first phalanx of the great toe; 
nerve, the anterior tibial. THE MUSCULAR SYSTEM. 
151 
Plantar Region. 
The muscles of this region are divided into four sets. 
Abductor Pollicis.—Origin, from the internal annu- 
lar ligament, from the inner tubercle of the os calcis, 
from the intermuscular septum on its outer side; 
plantar fascia ; insertion, into the base of the first phalanx 
of the great toe on its inner side; action, abducts the 
great toe; nerve, branch of the internal plantar. 
Flexor Brevis Digitorum (Perforatus).— Origin, 
from the inner tubercle of the os calcis, from the plantar 
fascia and the intermuscular septa between it and the 
muscles on either side; insertion, into the second 
phalanges by a process on either side, allowing the 
passage of the tendon of the flexor longus digitorum; 
action, flexes first lesser toes; nerve, from the internal 
plantar. 
First Set. 
Abductor Minimi Digitl—Origin, from the plantar 
fascia, from the os calcis in front of the tubercle, and 
from the intermuscular septum on its inner side; inser- 
tion, into the first phalanx of the little toe on its outer 
side ; action, abducts little toe ; nerve, external plantar. 
Second Set. 
Flexor Accessorius.—Origin, by two heads, one 
from the os calcis in front of the outer tubercle, the 
other from the inner surface of the os calcis and the 
calcaneo-scaphoid ligament; insertion, by a common 
tendon into the tendon of the flexor longus digitorum ; 
action, accessory to the long flexor; nerve, external 
plantar. 
Lumbricales. —Four small muscles. Origin, from the 
tendons of the flexor longus digitorum, after their di- 
vision, each one arising from two tendons; insertion, 
into the base of the first phalanx of the same toe and 
the tendinous expansion of the extensor longus digito- 
rum ; nerves, the external plantar nerve supplies the two 
external, the internal plantar nerve the two internal, 
muscles. 152 
HUMAN ANATOMY. 
Third Set. 
Flexor Brevis Pollicis.—Origin, from the external 
cuneiform bone, and the internal border of the cuboid 
bone, and the tendinous expansion of the tibialis posti- 
cus ; insertion, into the first phalanx of the great toe on 
either side; action, flexes first phalanx of great toe; 
nerves, the internal plantar and sometimes a branch from 
the external plantar. 
Adductor Pollicis.— Origin, from the bases of the 
second, third, and fourth metatarsal bone and from the 
sheath of the tendon of the peroneus longus; insertion, 
into the base of the first phalanx of the great toe on the 
outer side; nerve, external plantar. 
Flexor Brevis Minimi Digiti.—Origin, from the 
sheath of the peroneus longus and the base of the meta- 
tarsal bone of the little toe ; insertion, into the outer 
side of the base of the little toe ; nerve, external plantar. 
Transversus Pedis.—Origin, from the inferior sur- 
face of the head of the fifth metatarsal bone, from the 
transverse metatarsal ligament; insertion, into the first 
phalanx of the great toe, on its outer side ; action, adducts 
the great toe; nerve, the external plantar. 
Fourth Set. 
Dorsal Interossei.—Four in number. Origin, by 
two heads from the adjoining bases of the metatarsal 
bones; insertion, into the bases of the first phalanges of 
the second, third, and fourth toe, the second having two, 
one on either side, and the third and fourth on their 
outer side; action, abducts the toes from the middle 
line of the second toe; nerve, external plantar. 
Plantar Interossei.—Three in number. Origin, 
from the bases of the inner side of the third, fourth, and 
fifth metatarsal bones; insertion, into the bases of the 
first phalanges on the same side; action, adducts the 
toes toward the middle line of the second toe; nerve, 
the external plantar. 
Tiie Fascias. 
The fascias are strong, fibrous (fibro-areolar) invest- THE MUSCULAR SYSTEM. 
153 
ments protecting and binding together the muscles, and 
in places forming ligaments and intermuscular septa. 
They consist for the most part of two layers, a super- 
ficial and a deep. 
Fascias of the Head and Face.—The superficial 
fascia of the head and face is everywhere intimately 
connected to the skin, except over the temporal region, 
where it forms a distinct lamina, inclosing the superficial 
temporal vessels and auricular muscles. 
The deep temporal fascia is a dense, fibrous mem- 
brane, attached to the margins of the temporal fossa and 
zygoma, and from which in part the temporal muscle 
arises. 
Fascias of the Neck.—The superficial fascia is 
continuous below with that covering the pectoral muscles 
and deltoid, and above invests the parotid gland and 
masseter, and blends with the facial muscles and fascia. 
The deep fascia adheres below to the clavicle and 
sternum, and is continuous with the thoracic fascia. As 
it ascends the neck it ensheaths the great vessels of the 
neck, sends processes to the larynx, trachea, pharynx, 
and oesophagus, and above ensheaths the submaxillary 
and parotid glands, and forms the stylo-maxillary 
ligament. 
Fascias of the Trunk.—The superficial fascia con- 
sists everywhere of two layers, continuous above with 
the fascias of the neck and upper extremity, and below 
with the thigh. Over the pectoral region the mammary 
glands are inclosed between its laj’ers. It is attached 
to the crest of the ilium and Poupart’s ligament. 
The deep fascia forms intermuscular septa and 
aponeuroses. 
The lumbar fascia divides into three layers, inclosing 
the quadratus lumborum, multitides spin®, and erector 
spin® muscles, and giving attachment to the internal 
oblique. Its anterior and middle layers are attached to 
the transverse processes, and its posterior layer to the 
spinous processes. Above its anterior layer is attached 
to the lower border of the last rib, forming the ligamen- 
tum arcuatum externum. (The ligamentum arcuatum 154 
human anatomy. 
internum extends from the body of the first or second 
lumbar vertebra to the transverse process, inclosing the 
psoas magnus muscle.) 
Abdominal and Pelvic Fascia.—The transversalis 
fascia is a thin aponeurosis between the peritoneum and 
transversalis muscle. It is attached below to the pubes, 
pectineal line, Poupart’s ligament, and the femoral 
vessels, and becomes continuous with the iliac and 
pelvic fascia. The pelvic fascia lines the pelvic cavity 
throughout, attached to the symphysis pubis, margin of 
obturator foramen, and the sacrum, and becomes con- 
tinuous with the iliac and transversalis fascias. Below 
it forms the arcus tendinve, for the origin of muscles and 
the division into the recto-vesical and obturator fascias 
(vide Perineum). 
The iliac fascia is a thin, fibrous membrane investing 
the psoas and iliacus muscles. Above it is attached to 
the ligamentum arcuatum internum, laterally with the 
bodies of the vertebrae and sacrum, and below it is 
attached to Poupart’s ligament, the femoral vessels, 
pectineal eminence, and the capsule of the hip-joint. 
Upper Extremity.—The superficial fascia is a thin 
membrane, inclosing the parts throughout, and adherent 
to the deep fascia beneath. 
The deep fascia is very dense and strong. It gives 
off numerous intermuscular septa, and is attached to 
the olecranon and back part of ulna, and becomes con- 
tinuous below with the anterior and posterior annular 
ligaments of the wrist-joint, both of which it forms. 
The anterior annular ligament is attached to the 
ridge of the trapezium, the tuberosity of the scaphoid, 
the unciform process of the unciform, and the pisiform 
bone, forming a strong, fibrous arch, under which the 
flexor tendons of the fingers pass. 
The posterior annular ligament is attached to the 
radius, ulna, cuneiform, and pisiform bones, and the 
palmar fascia, forming a fibrous arch for the passage of 
the extensors of the fingers. 
The palmar fascia is an exceedingly dense, triangular 
mass of adipose and fibrous tissue, attached behind to THE MUSCULAR SYSTEM. 
155 
the anterior annular ligament, and in front divides into 
four fasciculi, each of which subdivides into two, inserted 
into the lateral ligaments of the metacarpo-phalangeal 
articulations. These digitations allow the passage of 
the flexor digitorum tendons, the digital vessels, and 
nerves. It is attached above to the skin, and laterally 
gives off vertical septa, which separate the middle from 
the lateral groups of palmar muscles. 
FASCIA OF THE LOWER EXTREMITY. 
The superficial fascia resembles that in other locali- 
ties, except over the saphenous opening, where it is thick, 
contains several lymphatic glands, and is perforated by 
numerous lymphatic vessels and blood-vessels; hence its 
name, cribriform fascia. 
The deep fascia of the thigh, or fascia lata, is a dense 
fibrous aponeurosis attached to the pubes, Poupart’s 
ligament, crest of the ilium, sacrum, and coccyx, in- 
closing the gluteus maximus and tensor vaginae femoris 
between its layers, attached to the linea aspera, and 
below to all the bony points about the knee-joint, being 
attached to the head of the fibula and tuberosities of the 
tibia by the ilio-tibial band. 
At its upper and inner part it presents a large open- 
ing—the saphenous opening—the lateral portions of 
which form the iliac and pubic portions. The iliac por- 
tion becomes continuous at the pectineal line with Gim- 
bernat’s ligament, and its free border forms the falci- 
form border (vide Femoral Hernia). 
The pubic portion is continuous above with the iliac 
fascia. 
The deep fascia of the leg is attached above to the 
bony points about the knee, continuous with the fascia 
lata, invests the leg completely, except the inner sur- 
face of the tibia, sends in a deep transverse fascia be- 
tween the superficial and deep muscles on the posterior 
aspect of the leg, and below becomes continuous with 
the annular ligament of the ankle-joint. 
The annular ligament of the ankle-joint consists of 
three portions—the internal, external, and anterior. It 156 
HUMAN ANATOMY. 
is attached to the bony points about the ankle-joint, the 
external and internal malleoli, surfaces of the os calcis, 
and allows the passage of the muscles to the foot. 
The dorsal aponeurosis of the foot covers the back of 
the foot, uniting with the plantar fascia at the sides, and 
terminating anteriorly at the heads of the metatarsal 
bones. 
The plantar aponeurosis consists of three portions, 
a central and two lateral portions. 
The middle commences at the inner tubercle of the os 
calcis and proceeds, gradually becoming broader, to the 
heads of the metatarsal bones, where it divides into four 
branches, each of which nearly surrounds the corre- 
sponding flexor tendon to which it gives passage, and is 
inserted into the edges of the dorsal expansion of the 
first phalanges. 
The inner portion arises from the internal annular 
ligament, covers the abductor pollicis muscle, and joins 
the dorsal aponeurosis internally and the internal sep- 
tum externally. 
The outer portion, much stronger, arises from the os 
calcis, covers the abductor minimi digiti muscle, and 
joins the external plantar septum internally and the 
dorsal aponeurosis externally, and is firmly attached to 
the base of the fifth metatarsal bone. 
Numerous septa pass from the upper surface of the 
plantar fascia between the plantar muscles and tendons 
to be inserted into the metatarsal and tarsal bones. THE HEART AND VASCULAR SYSTEM. 
The pericardium is a conical, membranous closed 
sac, surrounding the heart and the roots of the great 
vessels. It occupies the greater part of the middle me- 
diastinum, its apex upward, its base downward and 
attached to the central tendon of the diaphragm. It is 
a fibro-serous membrane, consisting of an outer fibrous 
coat and an inner serous coat. The latter is composed 
of a visceral layer reflected over the heart and vessels, 
and a parietal layer lining the inner surface of the fibrous 
sac. It secretes a thin, serous fluid. 
The fibrous coat becomes continuous above with the 
deep layer of the cervical fascia, being prolonged up- 
ward on the outer surfaces of all the great vessels, 
except the inferior vena cava. 
THE HEART. 
The heart is a hollow, muscular organ, placed ob- 
liquely within the chest, and inclosed within the peri- 
cardium. Its base is directed upward and backward, 
opposite the fifth to eighth dorsal vertebrae; its apex 
downward to the left, opposite the interspace between 
the fifth and sixth costal cartilages. Its weight is about 
ten to twelve ounces in male, eight to ten in female; 
length five inches, breadth three and a half inches, thick- 
ness two and a half inches. 
It is divided into four parts :— 
Right auricle, 
Right ventricle, 
Left auricle, 
Left ventricle, 
an auricle and ventricle on each side. This division is 
indicated on both surfaces of the organ by two grooves 
crossing each other and named, from their position, the 
longitudinal the inter-ventricular, the transverse the 
auriculo-ventricular grooves. 158 
HUMAN ANATOMY. 
Right Auricle.—The right auricle consists of two 
portions—a sinus and an appendix auriculae, which pro- 
jects to the outer side of the origin of the aorta. The 
walls at the fore and outer part and in the auricular ap- 
pendage are thickened by musculae pectinati. Its inte- 
rior presents the following parts :— 
Openings of the superior and inferior venae cavae, 
neither of which are protected by valves ; 
Opening of coronary sinus, protected by a valve of 
two unequal segments—the coronary valve; 
Fig. 46. 
Eight side of heart: a. apex; h, right ventricle; d, pulmonary artery; e, f, 
chordae tendinae; p, aorta; 3, superior vena cava; 5, inferior vena cava. 
Foramina thebesii, minute foramina returning the 
blood from the heart-muscle; 
Eustachian valve, the remains of a foetal structure, 
extending from the right of the orifice of the inferior 
vena cava to the outer border of the oval foramen; 
Fossa ovalis, the obliterated foramen ovale of foetal 
life; 
Tubercle of Lower, a small rudimental projection on 
the right wall, directing the blood toward the auriculo- 
ventricular opening ; THE HEART AND VASCULAR SYSTEM. 
159 
Annulus ovalis, the oval margin of the preceding 
structure; 
Musculi pectinati, elevated muscular columns before 
referred to; 
Auriculo-ventricular opening, an oval aperture about 
one inch in diameter, surrounded by a fibrous ring, and 
protected by the tricuspid valve. 
The Left Auricle.—The left auricle is smaller, and 
its walls somewhat thicker, than the right, and consists of 
a cuboidal sinus and an elongated appendix auriculae. Its 
interior surface is smooth, except the auricular append- 
age, 'which is provided with musculi pectinati, and 
presents the following openings :— 
Pulmonary veins, four in number, two on either side ; 
they are without valves ; 
Auriculo-ventricular opening, an oval aperture, rather 
smaller than the right, and protected by the bicuspid or 
mitral valve. 
The Right Ventricle.—The right ventricle is tri- 
angular, with thick walls (one-quarter inch), and occupies 
the anterior part of the organ. Its capacity is about 
three fluid ounces. It presents the following:— 
Infundibulum, or conus arteriosus, a conical pouch, 
from which the pulmonary artery arises; 
Columnse carnese, muscular columns projecting from 
the inner surface, three or four of which (musculi 
papillares) give attachment to the chordae tendineae; 
Chordae tendineae, delicate tendinous cords, connecting 
the margins and central portions of the tricuspid valve 
with the columnae carneae ; 
Tricuspid valve, consists of three triangular dupli- 
cations of endocardium, strengthened by fibrous tissue; 
they are attached by their bases to the auriculo- 
ventricular orifice, and their free margins give attach- 
ment to the chordae tendineae; 
Semilunar valves,consist of three semicircular folds, 
guarding the orifice of the pulmonary artery; their 
free margins are thickened by nodules, the corpora 
Arantii; 
Opening of the pulmonary artery, at the apex of the HUMAN ANATOMY. 
conus arteriosus, is circular in outline and protected by 
the semilunar valves; 
Sinuses of Valsalva, three pouches, situated one 
behind each semilunar valve. 
The Left Ventricle.—The left ventricle is longer, 
more conical, and its walls three times as thick as the 
right. It forms most of the posterior portion of the 
heart. It presents the following parts in its interior:— 
Golumnse carneae, and 
Chordae tendineae, much the same as the right; 
Auriculo-ventricular opening, a little smaller than 
the corresponding orifice on the right side, similarly 
formed,and protected by the mitral valve; 
The mitral valve consists of two unequal segments, 
attached the same as the tricuspid, and also affording 
attachment to the chordae tendineae; 
Aortic opening, a circular opening to the right of the 
auriculo-ventricular opening; 
The semilunar valves, three in number, surround the 
aorta, and are larger and stronger than those on the 
right side; 
Sinus aortici, are depressions situated behind each 
valve, corresponding to the sinuses of Valsalva, on the 
right side. 
Structure of the Heart.—The heart is composed 
of finely striated muscular walls, with external serous 
covering from pericardium and internal serous lining the 
endocardium, continuous with that of blood-vessels. 
The latter is a thin, translucent membrane, consisting 
of tessellated epithelium, or a fine basement membrane, 
beneath which is a fibro-elastic layer. The doublings of 
these layers constitute the valves. The tricuspid and 
mitral valves, as well as the aortic and pulmonary, are 
surrounded by a fibro-elastic ring, which furnishes a 
“ punctum fixum ” for the various muscles of the heart. 
The muscular structure consists of an intricate inter- 
lacement of fibrous bands. Of these there are two 
groups—those of the auricles and those of the ven- 
tricles. 
The former consist of a superficial transverse set THE HEART AND VASCULAR SYSTEM. 
161 
and the internal or deep set, of which there are the 
looped and the circular. 
The fibres of the ventricles consist of seven layers 
in a general oblique and circular manner, and terminating 
in a whorl or vortex at the apex, some of the fibres 
terminating in the column* carneae, musculi pectinati, 
while others ascend, forming in their course a twisted 
loop like 8. The arteries of the heart are the right 
and left coronary. The veins are—great, anterior, 
middle, and posterior cardiac, and venae Thebesii. The 
lymphatics end in thoracic and right lymphatic ducts. 
The nerves are derived from the cardiac plexus of 
pneumogastric, spinal, and great sympathetic. 
THE VASCULAR SYSTEM. 
The vascular system consists of four sets of vessels— 
arteries, capillaries, veins, and lymphatics. Anastomoses 
are common. 
The arteries, for the most part, are composed of 
three coats:— 
Tunica adventitia, or external coat, consists of fibrous 
tissue, thinnest on the largest trunks, and disappears in 
those which merge into capillaries. 
The tunica media, or middle coat, is thickest in the 
large trunks, mainly elastic tissue, with small portion 
unstriated muscular tissue and some connective tissue ; 
in smallest arteries it consists alone of muscular tissue. 
The elastic tissue in layers forms nets, constituting so- 
called perforated or fenestrated membranes. 
The tunica intima, or internal coat, thinnest, most 
transparent, and elastic, is composed of lining epithe- 
lium, basement membrane, and layers of elastic tissue. 
It becomes continuous with capillaries. The walls of 
larger arteries are supplied by blood-vessels from neigh- 
boring arteries, not the same trunk they supply. 
Nutrient arteries form a net-work of capillaries, and 
returning veins empty into contiguous veins. The 
nerves are from the sympathetic, but to what extent the 
walls are supplied is not determined. 162 
HUMAN ANATOMY. 
Arteries dilate and contract with the action of the 
heart, constituting the pulse. 
The Yeins.—Larger, more numerous, and more 
capacious than the arteries. With one exception (the 
portal vein) they terminate in the heart by seven 
branches :— 
Four pulmonary; 
Superior and inferior venae cavae; 
Coronary vein from heart. 
The larger arteries have each one companion vein, 
the medium arteries two. In some positions they form 
venous plexuses, corresponding to arterial anastomoses. 
Many large veins have valves, usually in pairs, 
attached by convex border. 
There are, however, no valves in the pulmonary, 
superior and inferior cavae, portal vein and branches, 
hepatic, renal, uterine, and spinal, and most of those of 
head or neck. 
In certain membranes and organs channels exist, 
lined by internal coat of blood-vessel, termed venous 
sinuses, as in the dura mater, bones, and uterus. 
The coats are similar to those of the arteries, and 
differ chiefly in the weakness of the middle or muscular 
coat, which allows them to remain open. 
The external fibrous coat has also longitudinal, un- 
striated muscular tissue in veins of abdominal cavity :— 
The middle, unstriated muscular and fibrous tissue ; 
The internal, no fenestrated membrane. 
The walls also have nutritive vessels, and a few 
nerves have been traced into larger veins. 
Both arteries and veins are insensitive in health. 
The capillaries communicate with the terminations 
of the arteries and veins, and do not communicate with 
tissue proper, which is supplied by imbibition. They 
are remarkable for their general uniformity of size. 
They vary in different organs, all admitting passage of 
blood-corpuscle, one five-hundredth to one one-hundredtli 
line diameter. Their form is dependent on the form of 
tissue supplied. 
Composition of the Blood.—Blood within the vessels THE HEART AND VASCULAR SYSTEM. 
is a perfect fluid, of alkaline reaction, saline taste, 
average specific gravity 1055, and feeble, peculiar odor. 
Within the arterial vessels it is bright-red color, becom- 
ing in the veins (particularly the venae portae and pul- 
monary arteries) a deep maroon or reddish-black color. 
It constitutes about one-twelfth or one-fourteenth of 
the body-weight, and consists of the liquor sanguinis 
and the corpuscles, red, white, etc. 
The red corpuscles are elastic, of specific gravity 1088, 
and average about one three-thousandth line in diameter. 
A cubic millimetre contains between four and five 
millions. On evaporation they become stellate, and 
swell up with water. They vary much in size and shape 
in different animals. They consist chiefly of haemoglobin. 
The colorless or white blood-corpuscles are free nucle- 
ated protoplasmic masses, capable of amoeboid move- 
ment. They contain fat-corpuscles, myosin, cholesterin, 
protogbn, glycogen, and nuclein. They are one to 
several hundred red, or in one cubic millimetre from 
four thousand to seven thousand. 
The liquor sanguinis is a pale, amber-colored fluid, 
holding the corpuscles in suspension, and very prone to 
coagulate. The coagulation of the blood results in the 
formation of a clot, or crassamentum, and the serum, in 
the following manner:— 
Corpuscles. 
Colorless 
corpuscles. 
Clot. 
Crassamentum. 
Fluid blood, 
Plasma or 
Liquor 
Sanguinis. 
! Fibrin, 
i Serum. 
Serum. 
The composition of the blood is about as follows:— 
Corpuscles, 328, . 
Water, . 200 
Solids, . 128 
f Salts, 
' Haemoglobin, 
{Other organic compounds. 
Water, . 604 
r Fibrin, 
Albumen, 
Fat, 
Other organic compounds, 
Sodium and potassium salts, 
. Calcium and magnesium salts. 
Plasma, 672, 
Solids, 
. 68 
1000 164 
HUMAN ANATOMY. 
Fig. 47. 
Diagram of the fetal circulation: 1, umbilical cord, with veins and arteries; 
2, placenta; 3, divisions of umbilical vein; 4. hepatic branches; 5, ductus venosus; 
6, inferior vena cava: 7, portal vein; 8, right auricle; 9, left auricle; 10, left ventricle; 
11, arch of aorta; 14, superior vena cava; 15, right ventricle; 16, pulmonary artery; 
17, ductus arteriosus; 18, descending aorta; 19, umbilical arteries. THE HEART AND VASCULAR SYSTEM. 
165 
THE CIRCULATION OE THE BLOOD. 
Foetal Circulation.—The fresh arterial blood return- 
ing from the placenta through the umbilical vein enters 
the foetus at the umbilicus, passes along the suspensory 
ligament to the under surface of the liver, where a portion 
passes directly into the inferior vena cava by the junction 
of the ductus venosus with the left hepatic vein, a 
portion enters the liver and reaches the inferior vena 
cava through the hepatic veins, and the larger portion 
mixes with the portal venous blood before reaching the 
vena cava through the hepatic veins. It ascends in the 
inferior vena cava along with the venous blood from the 
trunk and lower extremities to enter the right auricle of 
the heart (Fig. 47). Here it is directed by the Eustachian 
valve through the foramen ovale into the left auricle, 
into the left ventricle, and so through the aorta, chiefly 
to the head and upper extremities, a small portion only 
entering the descending aorta. It is returned by the 
superior vena cava to the right auricle, passes over the 
Eustachian valve to the right ventricle, and so through 
the pulmonary artery toward the lungs, but (the lungs 
being almost impervious) most of it passes through 
the ductus arteriosus into the descending aorta (mixing 
with the small quantity from the left ventricle before 
mentioned) to supply the lower extremities, abdominal 
and pelvic viscera, and as venous blood to return through 
the umbilical arteries to the placenta. 
Circulation After Birth and in Adult.—The dark 
venous blood from the entire body is received through 
the superior and inferior venae cavae and sinus 
into the right auricle, from whence it passes into the 
right ventricle, to be sent through the pulmonary artery 
into the lungs. Here it becomes oxygenated, and as 
bright arterial blood it returns to the left auricle by the 
pulmonary veins, and passes into the left ventricle, from 
whence it is distributed through the aorta and its 
branches to the entire body. 
This is the main trunk of the systemic arteries. 
AORTA. 166 
HUMAN ANATOMY. 
Commencing at the upper part of the left ventricle, it 
ascends for a short distance, arches backward over the 
root of the left lung, and descends as the thoracic aorta 
through the thorax a little to the left side of the verte- 
bral column to the fifth dorsal vertebra, where it passes 
through the diaphragm and becomes the abdominal 
aorta. It then descends to the lower border of the 
fourth lumbar vertebra, where it terminates by dividing 
into the left and right common iliac arteries. In its 
course it is divided into the arch, the thoracic aorta, and 
the abdominal aorta, the arch being subdivided into the 
ascending, transverse, and descending portion. 
Relations.—The ascending portion of the arch is in relation on 
the right side with the superior cava and right auricle; on the left 
side with the pulmonary artery; in front, with the pulmonary artery, 
the pericardium, the right appendix auriculae, and the thymus gland ; 
and behind, with the root of the right lung and the right pulmonary 
vessels. 
The transverse portion of the arch is in relation in front with the 
left lung and pleura, the left pneumogastric and phrenic nerves, the 
superficial cardiac nerves, the left superior intercostal vein, and the 
thymus gland; behind, with the trachea, the oesophagus, the thoracic 
duct, the deep cardiac plexus, and the left recurrent nerve; above, 
with the arteria innominata, the left innominate vein, the left sub- 
clavian, and the left carotid; and below, with the left bronchus, the 
bifurcation of the pulmonary artery, the left recurrent nerve, and the 
remains of the ductus arteriosus. 
The descending portion of the arch is in relation in front with the 
root of the left lung and the pleura; behind, with the left 6ide of the 
body of the fifth dorsal vertebra; on the right side with the thoracic 
duct and oesophagus; and on the left side with the pleura. 
The branches of the aorta are, from the arch :— 
Two coronary, 
Innominate, 
Left common carotid, 
Left subclavian. 
The coronary arteries supply the heart and are 
two in number—the right and the left. The right arises 
from the aorta, above the right semilunar valve, and 
passes downward in a groove between the right auricle 
and ventricle on its posterior surface, dividing into two 
branches, one of which anastomoses with the left coro- 
nary. The left coronary arises above the left semilunar 
valve and descends between the anterior interventricular THE HEART AND VASCULAR SYSTEM. 
167 
groove, where it divides into two branches, one of which 
anastomoses with the right coronary. 
Arteria Innominata.—This is the largest branch 
from the arch of the aorta. It ascends to the upper 
border of the right sterno-clavicular articulation, where 
it divides into the right common carotid and the right 
subclavian arteries. It is a short vessel, from one and 
a-lialf to two inches long. 
Relations.—It is in relation in front witb the sternum, the sterno- 
hyoid and sterno-thyroid muscles, the left innominate and right 
inferior thyroid veins, the thymus gland, and the cardiac branch from 
the right pneumogastric; behind, with the trachea; on the right side, 
with the pleura and right vena innominata and right pneumogastric 
nerve; on the left side, with the left carotid and the thymus gland. 
The Common Carotid Arteries.—The left common 
carotid, arising directly from the arch of the aorta, is 
longer and ascends more obliquely and is more deeply 
placed than the right. 
From the sterno-clavicular articulation to their di- 
vision at the upper border of the thyroid cartilage the 
common carotid on either side pursue the same course. 
At the lower part of the neck the two vessels are sepa- 
rated by a very short interval, which is occupied by the 
trachea, but at the upper part they diverge widely, the 
larynx, pharynx, thyroid body, and several muscles 
being interposed between them. It ascends the neck in 
a direction indicated by a line drawn from the sterno- 
clavicular articulation to midway between the mastoid 
process and the angle of the lower jaw. 
Relations.—It is in relation in front with the sterno-mastoid, 
sterno-thyroid, sterno-hyoid, and omo-hyoid muscles, the anterior 
jugular and the superior and middle thyroid veins, the sterno-hyoid 
artery and the descendens and communicans noni nerves ; behind it 
rests upon the longest colli and rectus capitis anticus major muscles 
and is in relation with the sympathetic nerve, the recurrent laryngeal 
nerve, and the inferior thyroid artery; on the outer side, with the 
pneumogastric and the internal jugular vein ; to the inner side, the 
larynx, trachea, pharynx, thyroid gland, inferior thyroid artery, and 
the recurrent laryngeal nerve. 
THE EXTERNAL CAROTID ARTERY. 
From its commencement at the superior border of 
the thyroid cartilage ascends upward and forward and 168 
HUMAN ANATOMY. 
then backward, beneath the anterior margin of the 
sterno-mastoid muscle, in a direction indicated by an 
imaginary line drawn from the superior border of the 
Arteries of face and head: 1, common carotid; 2, internal carotid; 3, external 
carotid; 4, occipital; 5, superior thyroid; 7, lingual; 9, facial; 10, temporal; 11, sub- 
mental ; 12, transverse facial; 13, inferior labial; 15, 17, inferior and superior coro- 
nary ; 19, lateral nasal; 21, angular. 
Fig. 48. 
thyroid cartilage to a point midway between the meatus 
and the neck of the condyle of the lower jaw. It 
ascends through the space known as the superior triangle 
of the neck. THE HEART AND VASCULAR SYSTEM. 
169 
Relations.—It is in relation in front with the parotid gland and 
the facial nerve and temporo-maxillary passing through it, covered by 
the 6kin, superficial platysma, and deep fascia, and is crossed by the 
digastric and stylo-hyoid muscles, hypoglossal nerve, lingual and 
facial veins; behind it is separated from the internal carotid by the 
parotid gland, stylo-glossus and stylo-pharyngeus muscles, and the 
glosso-pharyngeal nerve, and at its lower part the superior laryngeal 
nerve ascends behind it; to its inner side it is in relation with the 
pharynx, hyoid bone, superior laryngeal nerve, and the ramus of the 
lower jaw, from which it is separated by the parotid gland. 
The branches of the external carotid are eight:— 
1. Superior thyroid, 
2. Lingual, 
3. Facial, 
4. Occipital, 
5. Posterior auricular, 
6. Ascending pharyngeal, 
7. Temporal, 
8. Internal maxillary. 
1. Superior thyroid arises below the great cornu of 
the hyoid bone, passes beneath the sterno-hyoid, omo- 
hyoid, and sterno-tliyroid muscles to the upper part of 
the thyroid gland, where its terminal branches anasto- 
mose with its fellow of the opposite side. Its branches 
are:— 
а. Hyoid, to the lower border of the hyoid bone ; 
б. Superficial descending branch, crosses the common carotid 
artery to supply the skin and sterno-mastoid muscle ; 
c. Superior laryngeal, passes beneath the thyro-hyoid muscle with 
the superior laryngeal nerve ; 
d. Crico-thyroid, crosses the crico-thyroid membrane. 
2. The lingual artery arises from the anterior part 
of the external carotid, between the superior thyroid 
and the facial. It passes inward and upward to the 
greater cornu of the hyoid bone, and, descending, reaches 
the under surface of the tongue and runs along its 
under surface as far as its tip, where it terminates as the 
ranine. 
In its course it passes through a triangle bounded on 
two sides below by the two bellies of the digastric, and 
above by the hypoglossal nerve, passing under the liyo- 
glossus muscle. Its branches are :— 
Hyoid, to the hyoid bone; 
Dorsalis linguae, supplies the epiglottis, soft palate, tonsil, and 
the mucous membrane of tongue; 
Sublingual, supplies mylo-hyoid and genio-hyoglossus muscles 
and sublingual gland; 
Ranine, the terminal branch, ends at the tip of the tongue. 170 
HUMAN ANATOMY. 
3. The facial artery arises from the anterior por- 
tion of the external carotid artery above the lingual. 
It ascends forward through the submaxillary gland, 
crosses the lower jaw at the anterior border of the masse- 
ter muscle, and crosses the cheek to the angle of the 
mouth and the side of the nose, where it terminates as 
the angular artery. Its branches are in the neck:— 
Inferior or ascending palatine, supplies the soft palate, palatine 
glands, tonsil, and Eustachian tube; 
Tonsillar, supplies the root of the tongue and tonsil; 
Submaxillary, supplies the submaxillary gland and neighboring 
lymphatics, muscles, and skin ; 
Submental, supplies the chin, lower lip, and neighboring struc- 
tures ; 
Muscular, to the buccinator, masseter, internal pterygoid muscles. 
In the face :— 
Muscular, to the same muscles given above ; 
Inferior labial, to the skin of the lower lip ; 
Inferior coronary, to the mucous membrane, muscles and glands 
of the lower lip ; 
Superior coronary, to the structures of the upper lip and nasal 
septum ; 
Lateralis nasi, to the skin of the nostrils, anastomoses with the 
nasal branch of ophthalmic; 
Angular, supplies lachrymal sac and 6kin. All of these branches 
anastomose freely with the neighboring arteries. 
4. The occipital artery arises from the posterior 
portion of the external portion of the lower carotid, 
about the lower border of the digastric muscle. It 
passes beneath the stylo-hyoid muscle, the digastric 
muscle, and part of the parotid gland, and, ascending, 
grooves the surface of the mastoid portion of the tem- 
poral bone and distributes itself over the occiput as 
high as the vertex. Its branches are :— 
Muscular, to splenius, digastric, stylo-hyoid, etc.; 
Sterno-mastoid, crosses the hypoglossal to the sterno-mastoid 
muscle ; 
Auricular, is distributed to the back part of the concha ; 
Meningeal, passes through the foramen lacerum posterius to the 
dura mater ; 
Arteria princeps cervicis, anastomoses with the deep cervical 
branch from the superior intercostal. 
Cranial branches are distributed to the scalp over 
the occiput. THE HEART AND VASCULAR SYSTEM. 
171 
5. The posterior auricular artery arises from the 
posterior portion of the external carotid, on a level with 
the apex of the styloid process. It ascends beneath the 
parotid gland to a point between the mastoid process and 
the cartilage of the ear, where it divides into two branches, 
one going to the ear and the other to the occiput. Its 
branches are:— 
Stylo-mastoid, supplies the mastoid cells, tympanum, and semi- 
circular canals, entering the cranium through the stylo-mastoid 
foramen; 
Auricular, supplies the cartilage of the ear ; 
Muscular, supply the sterno-mastoid, digastric, and stylo-hyoid 
muscles; 
Glandular, to parotid gland. 
6. The ascending pharyngeal artery arises about the 
commencement of the external carotid artery and 
ascends to the base of the skull upon the rectus capitis 
anticus major. Its branches are :— 
Pharyngeal, supplies the three constrictors of the pharynx and 
the stylo-pharyngeus muscles; 
External, to the neighboring muscles, glands, and hypoglossal 
and pneumogastric nerves; 
Meningeal, enter the skull through the posterior and middle 
lacerated foramina and the anterior condyloid foramen. 
7. The temporal arteiy is the smaller of the two 
terminal branches. It arises in the parotid gland, crosses 
the root of the zygoma, ascends forward a couple of 
inches, and divides into the anterior temporal and the 
posterior temporal. Its branches are :— 
Transverse facial, supplies the masseter muscle, parotid gland, 
and skin; 
Middle temporal, crosses the face to supply the temporal muscle 
and fascia; 
Anterior auricular, supplies the lobule, external meatus, and 
front part of pinna. 
8. The internal maxillary is the larger of the two 
terminal branches of the external carotid, It arises in 
the parotid gland about the level of the lower part of 
the lobe of the ear, passing close to the inner side of 
the neck of the condyle of the lower jaw to be dis- 
tributed to the deep structures of the face. Its course 
is divided into three portions : the maxillary portion, 172 
HUMAN ANATOMY. 
passing inward and forward between the internal lateral 
ligament and the ramus of the jaw; the pterygoid por- 
tion, passing upward and forward upon the external 
pterygoid muscle ; and the third part, or spheno-maxil- 
lary, enters the splieno-maxillary fossa. Its branches 
are, from the maxillary portion :— 
Tympanic (anterior), supplies the tympanum through the Gla- 
serian fissure, forming a capillary plexus on the tympanic membrane; 
Middle meningeal, enters the cranium through the foramen 
spinosum, supplies the dura mater, and gives off a petrosal branch to 
facial nerve in hiatus fallopii * 
Internal maxillary artery: A, third portion; B, second portion; C, first portion. 
Fig. 49. 
Small meningeal, or meningea parva, enters foramen ovale to 
supply dura mater and Gasserian ganglion; 
Inferior dental, accompanies the dental nerve through the lower 
jaw to the mental foramen, supplying the structures. 
The pterygoid portion :— 
Deep temporal, supply the temporal muscle; 
Pterygoid, to pterygoid muscles ; 
Masseteric, to the masseteric muscle; 
Buccal, to the buccinator muscle. 
Splieno-maxillary portion :— 
Alveolar or posterior dental branch, supplies the upper molar 
and bicuspid teeth and gums ; THE HEART AND VASCULAR SYSTEM. 
173 
Infraorbital, passes through infraorbital canal to face ; 
Posterior or descending palatine, descends posterior palatine 
canal and runs forward to foramen of Stenson ; 
Vidian, accompanies the Vidian nerve; 
Pterygo-palatine, supplies Eustachian tube and pharynx ; 
Nasal, or spheno-palatine, descends through spheno-palatine fora- 
men to antrum, sphenoidal, and ethmoidal cells. 
THE INTERNAL CAROTID ARTERY 
arises about the upper border of the thyroid carti- 
lage from the bifurcation of the common carotid. It 
ascends in front of the transverse processes of the cer- 
vical vertebrae to the carotid foramen in the petrous 
portion of the temporal bone to supply the anterior 
part of the brain, the eye with its appendages, and send 
branches to the nose and forehead. It gives off no 
branches until it passes through the carotid canal, 
where, after piercing the dura mater at the anterior 
elinoid process, it divides into its terminal branches— 
the anterior and middle cerebral. 
Relations.—The internal carotid artery in the neck is in relation 
in front with the parotid gland, the glosso-pharyngeal nerve, the 
stylo-glossus and stylo-pharyngeal muscles, and is covered by the 
skin, superficial and deep fascia; behind it rests upon the rectus 
capitis anticus major and has resting upon it the superior laryngeal 
nerve and the sympathetic; internally it is in relation with the 
pharynx, tonsil, superior laryngeal nerve, and ascending pharyngeal 
artery; externally it is in relation with the internal jugular vein and 
the pneumogastric nerve. 
Its brunches are, in the petrous portion:— 
Tympanic (internal or deep), supplies tympanum. 
In the cavernous portion :— 
Arterice receptaculi, supply the Gasserian ganglion and pituitary 
body; 
Anterior meningeal, a branch from the preceding vessel to the 
dura. 
Ophthalmic arises about the position of the anterior 
elinoid process and passes through the optic foramen to 
the outer side of the optic nerve to reach the orbit. At 
the inner angle of the eye it divides into its two termi- 
nal branches—the fronta'l and the nasal. It supplies the 
muscles and the globe of the eye, and its branches may 
be divided into two groups—the orbital and the ocular. 174 
HUMAN ANATOMY. 
Orbital group:— 
Lachrymal, supplies the lachrymal gland and gives off a malar 
branch which passes through the malar bone to the temporal fossa; 
Supraorbital, passes out through the supraorbital foramen to 
supply the surrounding structures ; 
Posterior ethmoidal, descends through the posterior ethmoidal 
foramen to the cells and adjacent parts ; 
Anterior ethmoidal, through the anterior ethmoidal foramen to 
the nose; 
Palpebral, supply the eyelids ; 
Frontal, supplies the skin and muscles of the forehead. 
Nasal, supplies the lachrymal sac and bridge of the nose. 
Ocular group:— 
Muscular, supply the muscles of the eye ; 
Anterior ciliary, supply the iris, piercing the sclerotic near the 
cornea; 
Short ciliary, supply the choroid and ciliary processes, piercing 
the sclerotic near the optic nerve; 
Long ciliary, enter with the short ciliary, but run forward to 
the iris; 
Arteria centralis retinae, supplies the optic nerve and the retina. 
In the cerebral portion:— 
Anterior cerebral, supplies the anterior part of the cerebrum, the 
optic and olfactory nerves, and communicates with its fellow by the 
anterior communicating; 
Middle cerebral, or Sylvian artery, ascends in the Sylvian fissure, 
and supplies the middle lobes of the cerebrum ; 
Posterior communicating, runs backward to join the posterior 
cerebral; 
Anterior choroid, supplies the choroid plexus. 
THE CIRCLE OF WILLIS 
is an anastomotic circle formed at the base of the 
brain about the pituitary body, between the branches of 
the internal carotid and the vertebral arteries, for the 
purpose of equalizing the cerebral circulation. The an- 
terior cerebrals, from the internal carotids, pass forward 
and are united in front by a short trunk, the anterior com- 
municating. The posterior communicating unites the 
internal carotid with the posterior cerebral, the latter 
being the terminal branches of the basilar, which in its 
turn is formed by the union of the two vertebrals. THE HEART AND VASCULAR SYSTEM. 
175 
on the right side arises from the arteria innominata, 
opposite the right sterno-elavicular articulation, and on 
the left side directly from the arch of the aorta. They 
pass outward to the outer margin of the first rib, where 
they become the axillary, being divided in their course 
by the scalenus anticus muscle into three portions—the 
first portion to its inner side, second portion behind it, 
and the third portion between its outer margin and the 
border of the first rib. The vessels differ only in their 
first portions, the left ascending more vertically. 
THE SUBCLAVIAN ARTERY 
Relation.—The first portion of the right subclavian is in relation 
in front to the internal jugular and vertebral veins, the sterno-hyoid 
and sterno-thyroid and the clavicular portion of the sterno-mastoid 
muscles, and the pneumogastric, phrenic, and cardiac nerves; behind 
it is in relation with the longus colli muscle, the transverse process 
of the first dorsal or seventh cervical vertebrae, the sympathetic nerve, 
and the recurrent laryngeal nerve beneath with the pleura. 
The first portion of the left subclavian artery is in relation in 
front with the left internal jugular and innominate veins, the left 
carotid artery, the sterno-thyroid, sterno-hyoid, and sterno-mastoid 
muscles, the pleura and left lung, and the pneumogastric, phrenic, 
and cardiac nerves; behind, with the vertebral column and longus colli 
muscle, the oesophagus and thoracic duct, and the inferior cervical 
ganglion of the sympathetic; on the inner side with the (Esophagus, 
thoracic duct and trachea, and on the outer side with the pleura, 
The second portion of the subclavian artery on either side is in rela- 
tion with the subclavian vein, the scalenus anticus muscle, and the 
phrenic nerve ; behind with the middle scalenus muscle and pleura ; 
above by brachial plexus, and below by the pleura. The third portion 
of the subclavian artery on either side is in relation in front with the 
external jugular vein and its branches, the clavicle, subclavius muscle 
and suprascapular artery, the descending branches of the cervical 
plexus and the cervical fascia; behind with the scalenus medius, 
above with the omo-hyoid muscle and the brachial plexus, and below 
with the first rib. 
Its branches are :— 
1. Vertebral, 
2. Thyroid axis, 
3. Inferior thyroid, 
4. Suprascapular, 
5. Transverse cervical, or 
transversalis colli, 
6. Internal mammary, 
7. Superior intercostal. 
These branches are all given off from the first portion, 
except the superior intercostal, which arises on the right 
side, from the second portion. 176 
HUMAN ANATOMY. 
1. The vertebral artery passes upward, enters the for- 
amen in the transverse process of the sixth cervical ver- 
tebra, and ascends through the foramina until it reaches 
the atlas, when it runs backward, pierces the posterior 
occipito-atloid ligament and dura mater to enter the 
skull through the foramen magnum. After entering the 
cranium, it passes forward to the lower border of the 
pons Yarolii, where it unites with its fellow of the oppo- 
site side to form the basilar artery. Its branches are— 
Cervical branches :— 
Lateral spinal, supply the spinal cord and its membranes, enter- 
ing the spinal canal through the intervertebral foramina; 
Muscular, supply the deep muscles of the neck. 
Cranial branches:— 
Posterior meningeal, supply the falx cerebelli; 
Anterior spinal, supplies the cord; uniting with branches from the 
inferior thyroid, intercostals, and lateral sacral, descend to the cauda 
equina; 
Posterior spinal, descends in the same manner as the anterior; 
Posterior inferior cerebellar, supplies the inferior surface of the 
cerebellum and the choroid plexus of the fourth ventricle. 
The branches of the basilar artery are:— 
Transverse, to the pons Yarolii and inferior surface of the cere- 
bellum ; 
Anterior inferior cerebellar, a branch of the transverse; 
Superior cerebellar, supplies pia mater, pineal gland, and velum 
interpositum; 
Posterior cerebral, to posterior lobes of cerebrum and choroid 
plexus. 
2. The thyroid axis consists of three branches—the 
inferior thyroid, the suprascapular, and the transversalis 
colli. 
3. The inferior thyroid artery is distributed to the 
thyroid gland, its branches being :— 
Laryngeal, to muscles and mucous membrane of larynx; 
Tracheal, to the trachea, anastomosing with the bronchial arte- 
ries ; 
(Esophageal, to oesophagus ; 
Ascending cervical, supplies the spinal cord and membranes, ver- 
tebrae, and muscles of neighborhood; 
Muscular, to inferior constrictor of pharynx, scalenus anticus, 
and other muscles. THE HEART AND VASCULAR SYSTEM. 
177 
4. The suprascapular artery (transversalis humeri) 
passes beneath the posterior belly of the omohyoid to 
the upper border of the scapula, passing over the trans- 
verse ligament of the scapula to the supraspinous fossa, 
where it is distributed to the supraspinatus, sterno- 
mastoid, and other muscles, and by means of the supra- 
acromial branch to the skin over the acromion, anasto- 
mosing with the posterior circumflex and acromial 
thoracic arteries. 
5. The transversalis colli passes outward to the tra- 
pezius muscle, where it divides into 
The (a) superficial cervical, an important branch passing beneath 
the trapezius to anastomose with the superficial branch of the arteria 
princeps cervicis; 
And the (6) posterior scapular, the larger passing to and along 
the upper and posterior border of the scapula, beneath the levator an- 
guli scapulae, rhombodei, latissimus dorsi and trapezius, to anas- 
tomose with the subscapular, suprascapular, and posterior branches 
of the intercostals. 
6. The internal mammary arises from the subclavian, 
opposite the thyroid axis, and descends upon the inter- 
nal surfaces of the costal cartilages to between the sixth 
intercostal space, where it divides into the musculo- 
phrenic and the superior epigastric. Its branches are :— 
Comes nervi phrenici (superior phrenic), supplies diaphragm, 
passing between the pleura and pericardium; 
Mediastinal, to the anterior mediastinum; 
Pericardiac, to upper portion of pericardium; 
Sternal, to posterior surface of sternum ; 
Anterior intercostal, to fifth or sixth upper intercostal spaces; 
Perforating, perforate the intercostal spaces to supply the mam- 
mary gland; 
Musculo-phrenic, supplies lower part of pericardium, diaphragm, 
and upper part of abdominal muscles; 
Superior epigastric, supplies the rectus muscle, and anastomoses 
with the deep epigastric from the external iliac. 
7. The superior intercostal artery arises from the 
subclavian, behind the anterior scalenus, and descends 
behind the pleura and anastomoses with the first aortic 
intercostal artery. It gives off branches in the inter- 
costal spaces to the spinal cord and its membranes and 
the posterior spinal muscles. Its principal branch is 
the deep cervical (profundus cervicis). 178 
HUMAN ANATOMY. 
THE AXILLARY ARTERY 
is the continuation of the subclavian, extending out- 
ward from the edge of the first rib to the lower margin 
of latissimus dorsi and teres major muscles, where it 
becomes the brachial. It is divided by the pectoralis 
minor into three parts—the first portion above, the sec- 
ond portion behind, and the third portion below that 
muscle. It passes through the space known as the axilla 
{vide Regions). 
Relations.—First portion: The first portion of the subclavian is 
in relation in front with the subclavius and pectoralis major muscles, 
costo-coracoid membrane, and acromial thoracic and cephalic veins, 
and the external anterior thoracic nerve; the axillary vein to its inner 
side, the brachial plexus to its outer side, and the posterior thoracic 
nerve and serratus magnus behind. Second portion: The relations 
of the second portion are much the same as the first, with the addition 
of the pectoralis minor in front and the division of the brachial 
plexus surrounding the vessel. Third portion : The third portion is 
in relation in front with the inner head of the median nerve and the 
pectoralis major muscle; to the inner side with the axillary vein, 
internal cutaneous and ulnar nerves; to the outer side, the median 
and musculo-cutaneous nerves and coraco-brachialis muscle; and, 
behind, the circumflex and musculo-spiral nerves and the subscapu- 
laris, latissimus dorsi, and teres major muscles. 
Its branches are:— 
Superior thoracic, supplies the pectoralis major and 
minor muscles; 
Acromial thoracic, gives off three branches—acro- 
mial, thoracic, and descending, supplying the pectoralis 
major, minor, serratus, and deltoid; 
Thoracica longa, follows the lower border of the pec- 
toralis minor to supply the serratus, pectoralis major 
and minor, and mammary glands; 
Thoracica alaris, supplies the axillary glands; 
Subscapular, arises from the axillary artery about 
the level of the lower border of the subscapularis 
muscle. It passes backward and downward to the 
inferior dorsum of the scapula. Its branches anasto- 
mose with the posterior scapular and the suprascapular. 
They are:— 
Subscapular, supplies the subscapularis muscle; 
Dorsalis scapulae, is distributed to the infraspinous fossa, anasto- 
mosing with the posterior scapular and suprascapular arteries; THE HEART AND VASCULAR SYSTEM. 
179 
Median branch, descends the axillary border of the scapula to 
supply teres muscles. 
Posterior circumflex, encircles the neck of the hu- 
merus to supply the shoulder-joint and the deltoid 
muscle; 
Anterior circumflex, descends beneath the short 
head of biceps and coraco brachialis muscles to supply 
the shoulder-joint. 
commences at the lower border of the latissimus 
dorsi and teres major muscles, and descends the front 
and inner aspect of the arm, to half an inch below the 
middle of the elbow, where it terminates by dividing 
into the radial and ulnar artery. 
THE BRACHIAL ARTERY 
Jtelations.—It Is covered in front by the skin, superficial, and deep 
fascia, and is crossed by the median nerve; behind it rests upon the 
triceps, brachialis anticus, and coraco-brachialis muscles ; 
And is in relation with the musculo-spiral nerve and the superior 
profunda artery; to the outer side above it is in relation with the 
biceps and coraco-brachialis muscles and the median nerve ; and on 
the inner side with the internal cutaneous and ulnar nerve, and the 
basilic vein and median nerve below. 
At the bend of the elbow it is crossed by the bicipital 
fascia. Its branches are:— 
Superior profunda, accompanies the musculo-spiral 
nerve to supply the triceps, deltoid, and coraeo- 
brachialis muscles ; 
Nutrient artery, supplies the shaft of the humerus; 
Inferior profunda, accompanies the ulnar nerve to 
supply the triceps muscle and structures about the 
internal condyle; 
Anastomotica magna, forms an anastomosis on the 
lower posterior aspect of the arm, with branches from 
the inferior profunda and recurrent ulnar vessels. It 
supplies the triceps; 
Muscular, supply the muscles on the anterior aspect 
of the arm. 
THE RADIAL ARTERY 
descends from the bifurcation of the brachial below 
the bend of the elbow to the wrist, where it winds 180 
HUMAN ANATOMY. 
around the carpus beneath the extensor tendons of the 
thumb, passes between the two heads of the first dorsal 
interosseous muscle and into the palm of the hand, 
where it forms the deep palmar arch, anastomosing with 
the deep branch of the ulnar artery. Its branches are, 
in the forearm :— 
Radial recurrent, supplies the brachialis anticus and supinator 
longus and brevis; 
Muscular, supply the radial muscles ; 
Superficialis volas, supplies the muscles of the thumb and anasto- 
moses with the ulnar to form the superficial palmar arch ; 
Anterior carpal, supplies the wrist-joint. 
In the wrist:— 
Posterior carpal, supplies the wrist-joint, forms the posterior 
carpal arch, and gives off the dorsal interosseous arteries; 
Metacarpal, is called the first dorsal interosseous ; it supplies the 
index and middle finger ; 
Dorsales pollicis, supply the back of the thumb ; 
Dorsalis indicis, supplies the outer and dorsal side of the index 
finger. 
Princeps pollicis, supplies the sides of the palmar aspect of the 
thumb; 
Radialis indicis, supplies the radial side of index finger; 
Perforating, anastomose with dorsal interosseous arteries ; 
Interosseous, anastomose with digital branches of superficial 
palmar arch. 
In the hand :— 
descends from the bifurcation of the brachial below 
the bend of the elbow to the ulnar border of the wrist, 
passing beneath all the superficial flexors excepting the 
flexor carpi ulnaris, crosses the annular ligament to 
radial side of pisiform bone, and enters the palm to form 
the superficial palmar arch, anastomosing with the super- 
ficialis volse from the radial. Its branches are, in the 
forearm:— 
THE ULNAR ARTERY 
Anterior ulnar recurrent, supplies the pronator radii teres and 
brachialis anticus muscles; 
Posterior ulnar recurrent, supplies the joint and neighboring 
muscles, and anastomoses freely : THE HEART AND VASCULAR SYSTEM. 
181 
Interosseous, passes backward to the upper border of the inter- 
osseous membrane, where it divides into 
Anterior branch, descends on the front of the interosseous 
membrane; 
Posterior, descends on the posterior aspect of the foramen and 
gives off a recurrent interosseous branch ; 
Muscular, to muscles on ulnar side of forearm. 
In the wrist 
Anterior carpal, supplies the front of wrist and anastomoses with 
the carpal branches of radial artery ; 
Posterior carpal, passes beneath the tendon of flexor carpi ulnaris 
and forms posterior carpal branch. 
In the hand :— 
Deep, or communicating branch, passes between the flexor and 
abductor minimi digiti to form part of deep palmar arch ; 
Digital, supply the ulnar side of the little finger and adjoining 
sides of the little, ring, middle, and index fingers. 
THE DESCENDING AORTA. 
The thoracic aorta extends from the lower border of 
the fifth dorsal vertebra on the left side to about the 
last dorsal vertebra, where by passing through the 
aortic opening in the diaphragm it becomes the abdomi- 
nal aorta. 
Relations.—It is in relation in front with the left bronchus, 
oesophagus, pericardium, and left pulmonary artery; behind it rests 
upon the vertebral column and is in relation with the vena azygos 
minor; on the right side it is in relation with the thoracic duct, the 
oesophagus at its upper part, and the vena azygos major; on the left 
side with the left lung, the pleura, and the oesophagus below. 
The branches of the thoracic aorta are:— 
Pericardiac, supply the pericardium ; 
Bronchial, two or three in number, supply the 
bronchi; 
(Esophageal, supply the oesophagus ; 
Posterior mediastinal, supply the neighboring pleura 
and lymphatic glands; 
Intercostal, ten on each side, supply the intercostal 
spaces. They divide into—anterior branch, to intercostal 
and pectoral muscles ; posterior branch, to spinal col- 
umn and dorsal muscles. 182 
HUMAN ANATOMY. 
descends from the last dorsal vertebra at the aortic 
opening of the diaphragm, to opposite the fourth lumbar 
vertebra, a little to the left of the median line, where it 
divides into the two common iliac arteries. 
THE ABDOMINAL AORTA 
Relations.—The abdominal aorta is 
in relation in front with the pancreas, 
transverse duodenum, stomach, and 
lesser omentum, the mesentery, splenic 
vein, left renal vein, coeliac, solar, and 
aortic plexuses ; behind it is in relation 
with the vertebral column, the thoracic 
duct, the left lumbar veins, and the re- 
ceptaculum chyli; on the right side with 
the inferior vena cava, vena azygos, 
thoracic duct, the right crus of the dia- 
phragm above, and the right semilunar 
ganglion ; on the left side with the left 
semilunar ganglion and the sympathetic 
nerve. 
The branches of the abdomi- 
nal aorta are:— 
Phrenic, two in number, sup- 
ply the diaphragm ; 
Coeliac axis, divides into 
three large branches, the gastric, 
hepatic, and splenic; 
1. Gastric, or coronaria ven- 
triculi, is the smallest, and sup- 
plies the lesser curvature of the 
stomach; 
2. Hepatic, enters the trans- 
verse fissure of the liver, and di- 
vides into two branches to sup- 
ply the lobes of the liver. It 
gives off:— 
Abdominal aorta: 1, phrenic; 
2, coeliac axis; 3, superior mesen- 
teric : 4, suprarenal; 5, renal; 6, 
spermatic: 7, inferior mesenteric; 
8, lumbar; 9, sacra media. 
Fig. 50. 
Pyloric, to lesser curvature of stomach ; 
Gastro-duodenalis, which descends behind the pylorus, and divides 
into 
Pancreatico-duodenalis superior branch to supply the pancreas 
and duodenum; 
Gastro-epiploica dextra, along the greater curvature of the 
stomach from right to left. 
Cystic, supplies the gall-bladder. THE HEART AND VASCULAR SYSTEM. 
183 
3. Splenic, the largest of the three, supplies the spleen 
and gives off the 
(a) Pancreatic—to the pancreas ; 
(b) Gastro-epiploica sinistra, runs from left to right, along the 
greater curvature, to join the gastro-epiploica dextra ; 
(c) Gastric (vasa brevia), supply the fundus of the stomach. 
Superior mesenteric, supplies the small intestine 
(except first part of the duodenum) and the large intes- 
tine as far as the splenic flexure, and part of the de- 
scending colon. It gives off:— 
(а) Duodenal inferior pancreatico, supplies duodenum and 
pancreas; 
(б) Vasa intestini tenuis, Supply nearly the whole length of the 
small intestine (ileum and jejunum) ; 
(c) Ileo-colic, descends to the right iliac fossa, between the 
layers of the mesentery, and divides into two branches ; 
(d) Colica dextra, passes to the middle of the ascending colon, 
to divide into two branches ; 
(«) Colica media, ascends in the layers of the transverse meso- 
colon, to divide into two branches. 
Suprarenal, supply the suprarenal bodies; 
Renal, supply the kidneys, a large trunk on each side 
springing directly from the aorta ; 
Spermatic, descend to supply the testicles, and in 
their passage form one of the constituents of the sper- 
matic cord; 
Inferior mesenteric, gives off:— 
(a) Colica sinistra, supplies the descending colon; 
(b) Sigmoid, supplies the sigmoid flexure of the colon; 
(c) Superior hemorrhoidal, the continuation of the inferior 
mesenteric, supplies the mucous and muscular coats of the rectum on 
its posterior aspect. 
Lumbar branches, four or five on each side, pass 
backward and outward and divide into the 
Dorsal branches, supply the spinal cord, muscles, and 
skin of back; 
Spinal branches, divide within the spinal canal, as- 
cend and descend, and form an arterial net-work through- 
out the whole length of the spinal canal; 
A bdominal branches, supply the abdominal walls ; 
Middle sacral, is the continuation of the abdominal 
aorta, descending in the middle of the sacrum to the 
upper part of the coccyx. 184 
HUMAN ANATOMY. 
descend from the bifurcation of the abdominal aorta, 
opposite the body of the fourth lumbar vertebra, to a 
point midway between the last lumbar vertebra and the 
sacrum, where they divide into the external and internal 
iliac arteries. The right common iliac is a little larger 
than the left, and passes more obliquely outward. 
THE COMMON ILIAC ARTERIES 
Relations.—The right common iliac is in relation in front with the 
small intestine, the ureter, the peritoneum, and the sympathetic 
nerves ; behind, with the left and right common iliac veins, and to its 
outer 6ide it rests upon the psoas muscle, and is in relation with the 
vena cava and the right common iliac vein. The left common iliac is 
in relation in front with the ureter, the peritoneum, the superior 
luemorrlioidal artery, and the sympathetic nerves; behind with the 
left common iliac vein, to its outer side the psoas muscle, and to its 
inner side the left common iliac vein. 
The common iliac arteries give off a few unimportant 
branches to the ureters, peritoneum, etc. 
THE INTERNAL ILIAC ARTERY 
is about an inch and a half in length, extending from 
the bifurcation of the common iliac, about the sacro- 
lumbar junction, to the upper border of the great sacro- 
sciatic. foramen, where it divides into the anterior and 
posterior trunks. 
The branches from the anterior trunk are :— 
Superior vesical, is the pervious remains of the foetal 
hypogastric artery. It supplies the apex and body of 
bladder, ureter, and vas deferens ; 
Middle vesical, supplies the base of the bladder and 
part of vesicules seminales ; 
Inferior vesical, supplies the prostate land, base 
of bladder, and vesiculae seminales; 
Middle h senior rhoidal, supplies part of the rectum ; 
Obturator, passes along the side of the pelvis to the 
obturator foramen, through which it passes. It gives 
off within the pelvis, the iliac, vesical, and pubic branch ; 
Internal pudic, supplies the external organs of gen- 
eration. It passes out of the pelvis through the great THE HEART AND VASCULAR SYSTEM. 
185 
sacro-sciatic foramen, winds around the ischial spine, 
and re-enters the lesser sacro-sciatic foramen. 
It gives off the following branches in the peri- 
neum :— 
(а) Inferior hcemorrhoidal, supplies the muscles and skin of the 
anus; 
(б) Superficial perineal, supplies the erector penis and accelerator 
urinoe muscles and the scrotum ; 
(c) Transverse perineal, crosses the perineum on the trausversus 
muscle, which, together with the structures between the bulb and 
anus, it supplies; 
(d) Bulbo-urethral, supplies the bulb of the spongy body and 
Cowper’s gland; 
(e) Cavernous, supplies the corpus cavernosum, and is one of the 
terminal branches; 
(/) Dorsal artery of penis, or clitoris, runs forward on the 
dorsum and supplies the glans and prepuce. 
The distribution of the internal pudic artery is much 
the same in the female as in the male, supplying analo- 
gous structures—the superficial artery to the labia, the 
artery of the bulb to the bulb of the vagina, the artery 
of the corpus cavernosum and dorsal artery to the clitoris. 
Sciatic artery supplies the muscles at the back of 
the pelvis, coccygeus, pyriformis, and levator ani, and 
passes out of the great sacro-sciatic foramen to follow 
the course of the sciatic nerve. Its branches external 
to the pelvis are :— 
Coccygeal, supplies back part of coccyx ; 
Inferior gluteal, to the gluteus maximus muscle ; 
Comes nervi ischiadici, runs in the substance of the great sciatic 
nerve; 
Muscular, to the back part of the hip; 
Articular, to supply the capsule of the hip-joint. 
Uterine, is distributed to body of uterus, giving 
branches to the ureter and bladder; 
Vaginal, supplies the mucous membrane of the va- 
gina, giving branches to the rectum and neck of the 
bladder. It is analogous to the male inferior vesical. 
From the posterior trunk 
llio-lumbar gives off two branches :— 
Lumbar, supplies quadratus lumborum and psoas 
muscles; 
Iliac, supplies iliacus, gluteal, and abdominal muscles. 186 
HUMAN ANATOMY. 
Lateral sacral, are two in number—the superior and 
inferior—supplying the contents of the sacral canal; 
Gluteal, gives off a superficial and deep branch to 
supply the gluteus maximus, medius, and minimus mus- 
cles. 
extends from the bifurcation of the common iliac to 
Poupart’s ligament, under which it passes to become the 
femoral. 
THE EXTERNAL ILIAC ARTERY 
Relations.—It is in relation in front with the peritoneum and 
intestines, circumflex iliac vein, spermatic vessels, genito-crural nerve, 
and the lymphatic vessels and nerves ; behind it rests upon the psoas 
muscle, and is in relation with the external iliac vein, which, together 
with the vas deferens, is also in relation to it on its inner side, beneath 
Poupart’s ligament. On its outer side it is in relation with the psoas 
magnus and iliac fascia. 
Its branches are :— 
The deep epigastric, arises above Poupart’s ligament 
and ascends obliquely inward between the transversalis 
fascia and peritoneum to the rectus muscle, in which it 
ascends to anastomose with the termination of the in- 
ternal mammary artery. It gives off:— 
Cremasteric branch, to supply the cremaster muscle; 
Pubic, crossing Poupart’s ligament to descend to the inner side of 
the femoral ring, and 
Muscular, to supply abdominal muscles and the peritoneum. 
The deep circumflex iliac ascends outwardly behind 
Poupart’s ligament to the crest of the ilium, where it 
gives off 
Muscular branches, to supply the abdominal muscles. 
THE FEMORAL ARTERY 
extends from Poupart’s ligament down the inner side of 
the thigh to the opening in the adductor magnus (Hun- 
ter’s canal), where it becomes the popliteal. Its course 
corresponds to an imaginary line drawn from a point mid- 
way between the anterior superior spine of the ilium and 
the symphysis pubis to the inner tuberosity of the inter- 
nal condyle. In the upper part of its course it is super- 
ficial, where it passes through Scarpa’s triangle, but in THE HEART AND VASCULAR SYSTEM. 
187 
the lower part it passes backward and becomes very 
deep. Where it passes under Poupart’s ligament the 
femoral vein is to the inner side, and the anterior crural 
nerve to the outer side; thus, from within outward, 
Y. A. N. 
Relations.—It is in relation in front with the sartorius, the long 
saphenous nerve, a branch of the anterior crural nerve, and is covered 
by the fascia lata; behind it is in relation with the psoas magnus, 
adductor longus, adductor magnus and pectineus, and the profunda 
vein, and about the middle with the femoral vein; at its inner side it 
is in relation with the sartorius and adductor longus muscles, and at 
its upper part with the femoral vein; on the outer side, with the 
vastus internus, and at its lower part, the femoral vein. 
The branches of the femoral artery are:— 
Superficial epigastric, descends through the saphe- 
nous opening in the fascia lata, and ascends in abdomen, 
supplying the skin, inguinal glands,and superficial fascia ; 
Superficial circumflex iliac, passes outward to the 
skin of the groin and over crest of ilium; 
Superficial external pudic, supplies the skin on the 
lower part of the abdomen ; 
Deep external pudic, supplies the scrotum in the 
male, the labia pudendi in the female; 
Profunda, arises about two inches below Poupart’s 
ligament, and passes beneath the adductor longus, giving 
off the following :— 
External circumflex, gives off ascending, transverse, 
and descending branches, supplying the muscles on the 
front of the thigh as low as the knee ; 
Internal circumflex, passes internally, supplying the 
adductor muscles and the hip-joint; 
Three perforating, pierce the adductor magnus and 
brevis, and supply the flexor muscles of the thigh, and 
give off the medullary nutrient artery. The vessel ter- 
minates by a fourth perforating. 
Muscular, vary in number, and supply the sartorius 
and vastus internus; 
Anastomotica magna, gives off two branches—super- 
ficial, accompanying the long saphenous nerve, and deep 
branch, to the inner side of knee, and supplies knee- 
joint. 188 
HUMAN ANATOMY. 
descends from the opening in the adductor magnus 
to the lower border of the popliteus muscle, passing 
behind the knee-joint, where it divides into the anterior 
and posterior tibial arteries. Its branches are:— 
Muscular, gives off two principal branches :— 
Superior, to flexors of thigh and vastus externus 
muscles; 
Inferior, or sural, to heads of gastrocnemius and 
plantaris. 
Cutaneous, supplies the skin of the calf; 
Superior external articular, supplies knee-joint and 
vastus externus; 
Superior internal articular, supplies knee-joint and 
vastus internus; 
Azygos articular, supplies the synovial membrane 
and ligaments of joints; 
Inferior external articular, supplies knee-joint and 
fibular head; 
Inferior internal articular, supplies knee-joint and 
head of tibia. 
THE POPLITEAL ARTERY 
THE ANTERIOR TIBIAL ARTERY 
descends from the bifurcation of the popliteal at the 
lower border of the popliteus muscle; passes through 
the upper part of the interosseous membrane, between 
the two heads of the tibialis posticus, and descends on 
the anterior part of the interosseous membrane and 
lower part of the tibia to the ankle-joint, where it ter- 
minates as the dorsalis pedis. 
In the upper third of its course it lies between the tibialis anticus 
and extensor longus digitorum, resting upon the interosseous mem- 
brane, in the middle third, between the tibialis anticus and extensor 
proprius pollicis, and at the lower third it becomes more superficial, 
and lies between the extensor proprius and extensor longus digitorum 
tendons. 
Its branches are :— 
Recurrent tibial, ascends to supply the front and 
sides of the knee-joint and anastomose with the anasto- 
motica magna and popliteal; THE HEART AND VASCULAR SYSTEM. 
189 
Muscular, supplying the muscles and skin of the 
neighboring parts; 
Internal malleolar, arises two inches above the ankle- 
joint, and supplies it and the structures on its inner 
side; 
External malleolar, supplies the outer side of the 
ankle. 
The dorsalis pedis artery extends from the bend of 
the ankle, where it is continuous with the anterior tibial, 
to the first interosseous space, where it divides into the 
dorsalis hallucis and the communicating. Its branches 
are:— 
Tarsal, supplies the tarsal articulations and the 
extensor brevis digitorum muscle; 
Metatarsal, passes to the outer side of the foot, and 
gives off three interosseous branches to supply the 
adjacent sides of the toes; 
Dorsalis pollicis, or hallucis, passes along the outer 
border of the great toe, supplying it; 
Communicating, descends between the two heads of 
the first dorsal interosseous to complete, with the exter- 
nal plantar, the plantar arch ; 
Interosseous, branches of the tarsal branch, three in 
number. 
THE POSTERIOR TIBIAL ARTERY 
descends along the posterior and tibial side of the leg 
to the space between the heel and the inner ankle, where 
it passes beneath the abductor pollicis and divides into 
the internal and external plantar arteries. 
Relations.—In the upper part of its course it lies deeply, being 
covered by the gastrocnemius and 6oleus muscle, but in the lower 
part it becomes more superficial, being covered only by the 6kin and 
the fascia. 
Its branches are:— 
Peroneal, descends the inner border of the fibula, 
supplying the muscles and skin of that region and the 
back of the ankle ; 
Anterior peroneal, a branch of the peroneal, pierces the 190 
HUMAN ANATOMY. 
lower part of the interosseous membrane to supply the 
dorsum and outer side of the tarsus; 
Muscular, supplies the posterior muscles ; 
Nutrient, supplies the tibia, being the largest nutrient 
arterjr in the body; 
Communicating, passes to the peroneal; 
Internal calcanean, supplies the inner side of the 
sole and heel. 
The internal plantar artery, the smaller of the two, 
passes along the inner side of the foot between the 
abductor pollicis and the flexor brevis digitorum to the 
inner border of the great toe, anastomosing with its 
digital branch. 
The external plantar artery passes across the foot 
to the base of the fifth metatarsal bone, where it turns 
inward and crosses the foot to the first interosseous 
space, where it anastomoses with the communicating 
branch of the dorsalis pedis to form the plantar arch. 
Its branches are:— 
Posterior perforating, are three branches which pass 
between the heads of the dorsal interossei muscles; 
Digital branches—these are four branches which 
supply the adjacent sides of the three outer toes, and 
the outer sides of the second and little toes. 
Table of the Arterial System. 
Right coronary, 
Left coronary. 
AORTA. 
f Right common 
carotid, 
Right 
subclavian. 
External carotid, 
Internal carotid. 
Arch 
of 
aorta, 
Innominate, 
External carotid, 
Internal carotid. 
Left common carotid, 
Left subclavian. THE HEART AND VASCULAR SYSTEM. 
191 
Superior 
thyroid, j 
Hyoid, 
Superficial descending branch, 
Superior laryngeal, 
Crico-thyroid. 
Hyoid, 
Dorsalis linguae, 
Sublingual, 
Ranine. 
Lingual, 
In the Inferi°r or ascending palatine 
neck i tonsillar, submaxillary, sub- 
’ ( mental, muscular. 
On the ( Muscular, inferior lab’l, inferior 
face ) coronary, superior coronary, 
. ’ ( lateralis nasi, angular. 
Facial, 
' Muscular, 
Sterno-mastoid, 
Auricular, 
Meningeal, 
Arteria princeps cervicis, 
. Cranial branches. 
Occipital, 
External 
carotid, 
Posterior 
auricular, 
{Stylo-mastoid, 
Auricular, 
Muscular, 
Glandular. 
Ascending 
pharyngeal, 
(Transverse facial, 
Middle temporal, 
Auricular, 
Anterior temporal, 
Posterior temporal. 
Pharyngeal, external, meningeal. 
Temporal, 
Maxillary 
portion, 
{Tympanic (anterior), 
Middle meningeal, 
Small meningeal, 
Inferior dental. 
Internal 
maxillary, 
Pterygoid 
portion, 
{Deep temporal, 
Pterygoid, 
Masseteric, 
Buccal. 
Spheno- 
maxillary 
portion, 
' Alveolar, 
Infraorbital, 
Post., or ascend’g palatine, 
Vidian, 
Pterygo-palatine, 
. Nasal, or spheno-palatal. 192 
HUMAN ANATOMY. 
Petrous 
portion, 
Tympanic (internal, or deep). 
Arteriae receptaculi, 
Anterior meningeal. 
Internal carotid, 
Cavern- 
ous 
portion, 
Lachrymal, 
Supraorbital, 
Post, ethmoidal, 
Ant. ethmoidal 
Palpebral, 
Frontal, 
Nasal. 
Orbital 
group, 
Ophthalmic, 
Cerebral 
portion, 
Anterior cerebral, 
Posterior cerebral, 
Anterior choroid, 
Ocular 
group, 
Muscular, 
Ant. ciliary, 
Short ciliary, 
Long ciliary, 
Arteria centralis 
retinae. 
Posterior commun’g. 
Cervical Branches, 
Lateral spinal, 
Muscular. 
Cranial Branches, 
Transverse, 
Anterior inferior 
cerebellar, 
Sup. cerebellar, 
Post, cerebral. 
Verte- 
bral, 
Basilar, 
Posterior meningeal, 
Anterior spinal, 
Posterior spinal. 
Laryngeal, 
Tracheal, 
(Esophageal, 
Ascend, cervical, 
Muscular. 
Inferior thyroid, 
Subclavian, 
Thyroid 
axis, 
Superior scapular, 
(Transversalis humeri), 
Muscular, 
Supra-acromial. 
Transversalis colli, 
Superfic. cervic’l 
Post, scapular. 
Comes nervi phrenici (superior 
phrenic), 
Mediastinal, 
Pericardiac, 
Sternal, 
Anterior intercostal, 
Perforating, 
Musculo-phrenic, 
Superior epigastric. 
Internal 
mam- 
mary, THE HEART AND VASCULAR SYSTEM. 
193 
Superior thoracic, 
Acromio-thoracic, 
Thoracica longa, 
Thoracica alaris. 
Subscapular, 
Dorsalis scapulae, 
Median branch, 
Posterior circumflex. 
Axillary, 
Subscapular, 
Anterior circumflex 
' Superior profunda, 
Nutrient artery, 
Inferior profunda, 
Anastomotica magna, 
Muscular, 
Radial, 
. Ulnar. 
Brachial 
In forearm, 
Radial recurrent, 
Muscular, 
Superficialis volae, 
Anterior carpal. 
Radial, 
Posterior carpal, 
Metacarpal, 
Dorsalis pollicis, 
Dorsalis indicis. 
In the wrist, 
Princeps pollicis, 
Radialis indicis, 
Perforating, 
Interosseous. 
In the hand, 
In the forearm, 
( Anterior ulnar recurrent, 
J Posterior ulnar recurrent, 
I Interosseous, 
l Muscular. 
Ulnar, 
In the wrist, 
$ Anterior carpal, 
( Posterior carpal. 
In the hand, 
\ Deep, or communicat’g branch, 
( Digital. HUMAN ANATOMY. 
DESCENDING AORTA. 
Thoracic 
aorta, 
C Pericardiac, 
Bronchial, 
(Esophageal, 
Posterior mediastinal, 
[ Intercostal. 
Two phrenic. 
Gastric. 
Pyloric, 
Pancreatico- 
duodenalis, 
Hepatic, 
Gastro- 
duodenalis, 
Gastro- 
epiploica 
dextra. 
Cceliac axis, 
Cystic, 
Splenic, 
Pancreatic, 
Gastro-epiploica sinistra, 
Gastric (vasa brevia). 
Superior 
mesenteric, 
Suprarenal, 
Renal, 
Duodenal, 
Vasa intestini tenuis, 
Ilio-colic, 
Colica dextra, 
Colica media. 
Abdominal 
aorta, 
Spermatic. 
Inferior 
mesenteric, 
’ 
Colica sinistra, 
| Sigmoid, 
Superior haemorrhoidal. 
Lumbar (four or five branches), 
Dorsal branch, 
Spinal branch, 
Abdominal branches, 
Middle sacral, 
Common ilii. THE HEART AND VASCULAR SYSTEM, 
195 
Branches to 
ureter, peritoneum, etc. 
Superior vesical, 
Middle vesical, 
Inferior vesical, 
Middle haemorrhoidal 
Within 
pelvis, 
Iliac, 
Vesical, 
Pubic. 
Obturator, 
Without 
pelvis, 
External 
and 
internal 
branches. 
Anterior 
trunk, 
Inferior hsemorrhoidal, 
Superficial perineal, 
Transverse perineal, 
Bulbo-urethral, 
Cavernous, 
Dorsal art’y of the penis. 
Common iliac, 
Internal 
pudic, 
Internal 
iliac, 
Sciatic, 
' Coccygeal, 
Inferior gluteal, 
Comes nervi ischiadieis, 
Muscular. 
k Articular. 
(Bifurcation.) 
In the 
female, 
Uterine, 
Vaginal. 
Posterior 
trunk, 
Ilio-lumbar, 
Lateral sacral, 
Gluteal. 
Deep 
epigastric, 
Cremasteric, 
Pubic, 
Muscular. 
External 
iliac, 
Deep 
circumflex 
iliac, 
Muscular branches. 196 
Superficial epigastric, 
Superficial circumflex iliac, 
Superficial external pudic. 
Deep external pudic. 
HUMAN ANATOMY. 
Femoral 
(continuat’n), 
Profunda, 
External circumflex, 
Internal circumflex, 
Three perforating. 
Muscular, 
Anastomotica magna, 
Popliteal (continuation). 
Muscular, 
Cutaneous, 
Superior external articular, 
Superior internal articular, 
Azygos articular, 
Inferior external articular, 
Inferior internal articular, 
< Superior, 
( Inferior, 
Popliteal, 
Anterior tibial, 
. Posterior tibial, 
| Bifurcation. 
Recurrent tibial, 
Muscular, 
Internal malleolar, 
External malleolar. 
Anterior 
tibial, 
r Tarsal, 
Metatarsal, 
Three 
interosseous, 
Dorsalis pedis 
(continuat’n), 
Dorsalis pollicis or hallucis, 
Communicating, 
. Interosseous. 
' Peroneal, 
Muscular, 
Nutrient, 
Anterior peroneal, 
Posterior 
tibial, 
Communicating, 
Internal calcanean, 
Internal plantar, ) 
. External plantar, $ 
Bifurcation. 
Plantar arch 
(from external 
plantar), 
Three Posterior Perforating, 
Four diSitaL THE HEART AND VASCULAR SYSTEM. 
197 
Pulmonary Artery.—The pulmonary artery carries 
venous blood from the right ventricle to the lungs. It 
is about two inches in length, ascends backward, up- 
ward, and to the left side to the under surface of the 
transverse portion of the arch of the aorta, where it di- 
vides into the right and left pulmonary arteries. It is 
attached to the under portion of the arch by a fibrous 
cord, the remains of the ductus arteriosus of foetal life. 
The right pulmonary artery is larger and longer than 
the left, and passes behind the ascending aorta and 
superior vena cava to the root of the right lung, where 
it divides into two branches. The left pulmonary artery 
passes in front of the descending aorta and left bronchus 
to the root of the left lung, where it divides into two 
branches. 
The Venous System. 
The venous system, like the arterial, consists of two 
distinct sets, the systemic and pulmonary. It is com- 
posed of seven (7) main trunks and their branches :— 
Systemic. 
1. Coronary vein; 
2. Superior vena cava ; 
3. Inferior vena cava. 
Pulmonary. 
Four pulmonary veins. 
The systemic veins return the venous blood from the 
body, head, and extremities to the right auricle. 
The portal vein, with its branches and capillaries, is 
an appendage to the systemic set, collecting the venous 
blood from the organs of digestion and carrying it to the 
liver, where it breaks into capillaries, and finally reaches 
the inferior vena cava by means of the hepatic veins. 
The pulmonary veins are peculiar in carrying arte- 
rial blood from the lungs to the left auricle. 
Systemic Veins.—The coronary sinus returns all the 
blood from the substance of the heart, except that re- 
turned directly from the walls of the right auricle by 
the venae Thebesii. It is a dilatation of the great cardiac 
vein, about one inch in length, situated in the posterior 
part of the left auriculo-ventricular groove. It opens 198 
HUMAN ANATOMY. 
into the right auricle, its orifice being protected by the 
coronary valves, and receives the following:— 
Great cardiac, or coronary vein ; 
Anterior cardiac; 
Middle cardiac; 
Posterior cardiac; 
Small cardiac; 
Oblique vein. 
The superior vena cava is a short trunk formed by 
the union of the right and left innominate veins. It re- 
ceives the vena azygos, has no valves, and is smaller in 
size than the aorta. It ends in the right auricle, receiv- 
ing the blood from the whole upper half of the body 
and the right lymphatic and thoracic ducts. The left 
innominate passes to join the superior cava in front of 
the great arteries of tiie arch. The inferior thyroid, the 
internal mammary, and vertebral veins follow closely the 
courses of the corresponding arteries, and terminate in 
the innominate vein. The jugular veins are formed by 
the junction of the external and internal jugular veins. 
All the veins of the neck and head, except the jugular, 
are destitute of valves. 
The Sinuses of the Dura Mater.—These are venous 
channels analogous to veins between the layers of the 
dura mater. They are destitute of valves, follow no 
vessels, and their inner coat is continuous with the lining 
membrane of the veins. They are fifteen in number, 
divided into two sets, those at the back and upper part 
of the skull five in number :— 
Superior longitudinal, 
Inferior longitudinal, 
Straight sinus, 
Lateral sinuses (2), 
Occipital sinus. 
And those of the base five also :— 
Cavernous (2), 
Circular, 
Transverse (anterior occipital. Leidy). 
Inferior petrosal (2), 
Superior petrosal (2), 
The superior longitudinal sinus arises at the foramen 
caecum, passes backward along the margin of the falx 
cerebri to the crucial ridge of the occipital bone, where 
it terminates in the torcular herophili (confluence of the 
sinuses). THE HEART AND VASCULAR SYSTEM. 
199 
The inferior longitudinal sinus passes in the free 
margin of the falx cerebri. 
The straight sinus passes backward from the junction 
of the tentorium witli the falx cerebri to enter the con- 
fluence of the sinuses. 
The lateral sinuses pass horizontally outward from 
the confluence of the sinuses, torcular heropliili, along 
the temporal bone to the jugular foramen, where they 
terminate in the internal jugular vein. 
The occipital sinus, the smallest of all the sinuses, com- 
mences at the margin of the foramen magnum on either 
side and passes backward to the confluence of the 
sinuses. 
The cavernous sinuses pass from the sphenoidal 
fissure along either side of the sella Turcica to the apex 
of the petrous portion of the temporal bone, where they 
join the petrosal sinuses. They are crossed by fibrous 
bands or offsets of the dura mater, and inclose the pa- 
thetic, motor oculi, abducens, and ophthalmic nerves, 
and the internal carotid artery, from which they are 
separated by the lining membrane. 
The circular sinus is formed by two small vessels 
passing in front of and behind the pituitary body, and 
connecting the cavernous sinuses. 
The inferior petrosal sinus on each side runs in a 
groove between the petrous portion of the temporal bone 
and the basilar portion of the occipital, connecting the 
cavernous sinuses with the lateral sinuses. 
The superior petrosal sinus on each side passes along 
the upper border of the petrous portion of the temporal 
bone, connecting the cavernous with the lateral sinuses 
above. 
The transverse sinus is a small, straight sinus, con- 
necting the inferior petrosal and cavernous sinuses. 
Cerebral Yefns.—The cerebral veins consist of two 
sets—the superficial, on the surface, and the deep, within 
the substance. They include :— 
Superficial- 
Superior cerebral veins, 
Inferior cerebral veins. 200 
HUMAN ANATOMY. 
Deep— 
Ventricular veins, or venae 
Galeni, 
Veni corporis striati, 
Choroid vein. 
The cerebellar veins consist of the superior, inferior, 
and lateral. 
Diploic and Meningeal Veins.—The diploic veins 
communicate with the sinuses of the brain and with the 
veins of the dura mater, the scalp, and orbit. 
The meningeal veins follow the course of the cor- 
responding arteries, two accompanying each vessel 
through its course, and open into the sinuses of the dura 
mater. 
The great meningeal veins terminate either in the 
cavernous sinuses or by emptying into the internal 
maxillary vein. 
The ophthalmic vein commences at the internal can- 
thus of the eye in an anastomosis with the facial, passes 
backward along the inner part of the orbit, through the 
sphenoidal fissure, to empty into the cavernous sinuses. 
The external jugular vein, smaller than the internal 
jugular, is formed by the union of the posterior auricular 
with the temporo-maxillary veins ; or it may be formed 
by union with the facial. It descends beneath the 
platysma muscle from the angle of the jaw to the middle 
of the clavicle, where it terminates by emptying into the 
subclavian. It receives the following veins :— 
Anterior jugular, 
Posterior jugular, 
Suprascapular, 
Transverse cervical. 
The facial vein pursues the same course as the artery. 
It commences as the angular at the internal canthus of 
the eye, where it anastomoses with the ophthalmic vein, 
and receives the frontal vein. About the angle of the 
jaw it usually ends in the internal jugular, but some- 
times empties into the external jugular or unites with 
the temporo-maxillary, to enter the external jugular. It 
receives— THE HEART AND VASCULAR SYSTEM. 
201 
Supraorbital and superior 
palpebral, 
Nasal veins, 
Inferior palpebral, 
Buccal and masseteric, 
Labial, 
Submental, 
Submaxillary, 
Palatine. 
The temporal vein is formed by the anterior temporal, 
which anastomoses with the frontal, and the posterior 
temporal, which anastomoses with the occipital. It 
penetrates the parotid gland and forms the temporo- 
maxillary vein by uniting with the internal maxillary. 
It receives 
Articular veins, 
Anterior auricular, 
Middle temporal, 
Transverse facial, 
Parotid 
The internal maxillary vein follows the course of 
the corresponding- artery, and receives veins correspond- 
ing to the branches of that vessel. Some of these 
branches form the pterygoid plexus. It passes back- 
ward and unites with the temporal vein to form the 
temporo-maxillary. 
The temporo-maxillary vein, formed by the junction 
of the internal maxillary in part or whole with the tem- 
poral, passes through the parotid gland and receives the 
posterior auricular, to form the external jugular vein. 
The occipital veins follow the course of the artery, 
and terminate, usually, in the internal jugular ; occasion- 
ally, in the external jugular. The mastoid vein, passing 
through a foramen in the mastoid portion, connects it 
with the lateral sinus. 
Veins of the Tongue and Throat.—The dorsal 
lingual, formed by branches from the tonsils, epiglottis, 
and tongue, follow the course of the lingual nerve to 
empty into the facial, either jugular, or the pharyngeal. 
The ranine pursues the course of the hypoglossal 
nerve, and terminates either in the facial or in one of 
the jugulars. 
The pharyngeal, commencing in the pharjmgeal 
plexus, receives branches from the brain, and terminates 
about on a level with the hyoid bone in the internal 
jugular. 202 
HUMAN ANATOMY. 
The superior thyroid conveys the blood from the 
larynx, trachea,and thyroid gland to the internal jugular. 
Veins of the Upper Extremity.—Superficial and 
deep. 
The subclavian vein, the continuation of the axillary, 
unites with the external jugular to form the innominate. 
In its passage over the first rib it is separated from 
the artery by the scalenus anticus muscle. 
Deep Set.—The deep veins accompany the correspond- 
ing arteries and form the venae comites, one on either 
side, except the axillary, which lias a single vein. The 
valves are more numerous in the deep set. About the 
middle of the arm one of the brachial veins receives the 
basilic vein, one of the larger veins of the superficial 
set. The two brachial veins unite with the basilic to 
form the axillary vein, which in turn becomes the sub- 
clavian vein, receiving in its course beneath the clavicle 
the cephalic vein, a branch of the superficial set. 
Superficial Set.—The anterior ulnar vein commences 
on the inner surface of the hand and wrist, and termi- 
nates by uniting with the posterior ulnar or the median 
vein. The posterior ulnar vein commences on the inner 
back portion of the hand, anastomosing with the radial 
cutaneous vein, and ascends to the bend of the elbow, 
where it becomes the basilic vein ; 
The basilic vein, from its formation at the bend of 
the elbow, ascends the inner side of the biceps, pierces 
the fascia, to join the brachial vein. 
The radial cutaneous commences on the radial, dorsal 
aspect of the hand, and at the bend of the elbow unites 
with the median cephalic, to become the cephalic. 
The cephalic vein ascends along the outer border of 
the biceps, and above in the groove between the deltoid 
and pectoralis major, and passes beneath the clavicle, to 
end in the axillary. 
The median vein receives the blood from the palmnr 
surface of the hand and the front of the forearm, and 
usually divides into two branches—the median cephalic, 
passing outward to join the cephalic, and the median 
basilic, passing inward to join the basilic. The median 203 
basilic vein, the larger, is the one usually selected for 
phlebotomy. 
Veins of the Trunk.—The azygos vein commences on 
the right side of the vertebral column, opposite the first 
or second lumbar vertebra, by a branch from the right 
renal, the right lumbar, the inferior vena cava, or by an 
anastomosis formed by these. It passes through the 
aortic opening of the diaphragm, or through an aperture 
in the right crus, ascends on the dorsal vertebrae, arches 
over the root of the right lung, and empties into the 
superior vena cava. It is in relation on its right side 
with the aorta, thoracic duct, and oesophagus. It 
receives 
THE HEART AND VASCULAR SYSTEM. 
Right intercostal veins (2 or 3), 
(Esophageal, 
Right bronchial, 
Hemi-azygos veins. 
The hemi-azygos veins are two in number:— 
The inferior hemi-azygos vein arises on the left side, 
similarly to the azygos, and like it passes through the 
diaphragm and about the middle dorsal vertebrae crosses 
beneath the aorta to join the azygos vein ; 
The superior hemi-azygos vein returns the blood of 
the upper left intercostal vein, and terminates either in 
the inferior hemi-azygos, the azygos, or the left innomi- 
nate. 
The inferior cava formed by the junction of the 
common iliac veins, at the sides of the fourth lumbar 
vertebra, ascends on the right of the aorta, grooves the 
posterior border of the liver, and passes through the 
quadrate foramen in the central tendon of the dia- 
phragm, and ends in the right auricle. It receives 
Middle sacral, 
Lumbar, 
Spermatic (from spermatic 
plexus), 
Ovarian (from ovarian plexus), 
Renal veins—the left, the 
longer, crosses in front 
of the aorta, 
Suprarenal, 
Phrenic, 
Hepatic (2 or 3) . 
The portal vein, about three inches in length, is 
formed by the inferior and superior mesenteric, the 204 
HUMAN ANATOMY. 
gastric, splenic, and pancreatic veins. It ascends in the 
right border of the lesser omentum to the transverse 
fissure of the liver, where it divides into the right and 
left. Its blood is distributed through the liver, mixing 
with the arterial blood from the hepatic artery, to be 
returned to the inferior cava by the hepatic veins. It 
receives 
The superior mesenteric, 
Splenic, 
Coronary, 
Cystic, 
Inferior mesentery, 
Right gastro-epiploic. 
The portal vein and its branches are destitute of 
valves. 
Yeins of the Vertebral Column.—1. The dor si spinal 
veins commence in an intricate net-work surrounding the 
vertebral arches and their processes. They communi- 
cate with the intercostal, vertebral, intraspinal plexus, 
lumbar, sacral, and the superficial veins of the back. 
2. The intraspinal or meningo-rachidian veins form 
an intricate plexus between the vertebrae and dura mater 
within the spinal canal. They consist of four longitudi- 
nal veins—two in front and two behind. The anterior 
longitudinal spinal veins, two in number, extend along 
the sides of the vertebral bodies and opposite the bodies 
communicate bytransverse trunks, which, in their passage 
beneath the vertebral ligament, receive the diploic veins, 
or venae basis vertebrarum, from the interior of the body 
The posterior longitudinal veins, also two in number, 
smaller than the anterior, extend down the vertebral 
arches and are connected by transverse branches oppo- 
site the latter. 
They receive the veins from the spinal cord and its 
membranes. 
3. The venae basis vertebrarum return the blood from 
the bodies of the vertebrae into the anterior intraspinal 
plexuses. 
The venae medulli spinalis are the essential veins of 
the cord, situated between the arachnoid and pia 
mater. THE HEART AND VASCULAR SYSTEM. 
205 
Formed by the internal and external iliac veins, 
uniting opposite the sacro-iliac articulation, pass beneath 
the right common iliac artery to a point a little to the 
left of the body of the last lumbar vertebra, where they 
unite to form the inferior vena cava. The right is 
shorter and more vertical in its course, and both are 
without valves. 
The internal iltac vein corresponds to the distribu- 
tion of the corresponding artery. 
It receives the following vense comites :— 
COMMON ILIAC VEINS. 
Gluteal, 
Sciatic, 
Obturator, 
Internal pudic, 
Lateral sacral, and 
Middle sacral; 
and the following plexuses: 
V esico-prostatic, 
Hsemorrhoidal, 
in male; 
Uterine and 
Vaginal, 
in female. 
The lateral and middle sacral form a small plexus— 
the plexus sacralis. 
The veins of the rectum, bladder, and generative or- 
gans anastomose freely and form three plexuses :— 
1. Haemorrlioidal plexus encircles the lower part of 
the rectum, communicates with the sacral and prostatic 
plexuses, and veins from it join the inferior mesenteric, 
internal iliac, and pudic veins. 
2. Vesico-prostatic plexus surrounds the membranous 
portion of the urethra, neck of bladder, prostate body, 
and seminal vesicles. It communicates behind with the 
hsemorrhoidal. 
3. Utero-vaginal plexuses.—These correspond in the 
female with the prostatic, and communicate with the 
vesical and hsemorrhoidal plexuses, the ovarian, pudic, 
and through the uterine veins join the internal iliac 
veins. 
During pregnancy these veins or plexuses become 
greatly distended and enlarged, forming the uterine 
sinuses, but retain a straight course. 206 
HUMAN ANATOMY. 
The pudic vein follows the same course as the artery, 
communicates with the prostatic and hemorrhoidal plex- 
uses, and terminates in the internal iliac vein. 
In the female it originates from the clitoris and peri- 
neum, and communicates with the vaginal plexus. 
The dorsal vein of the penis returns the blood from 
the body of that organ. It commences as two venae 
comites of the dorsal artery, which unite on the dorsal 
surface of the root of the penis, perforates the triangular 
ligament, and again divides to terminate in the prostatic 
plexus. 
The veins of the corpus cavernosum emerge at the 
lower groove, and turn round their outer side to join the 
dorsal vein. 
The dorsal vein of the clitoris has a corresponding 
origin and course, and empties into the vaginal plexus. 
The external iliao vein, the continuation of the 
femoral, commences below Poupart’s ligament, and joins 
the internal iliac opposite the sacro-iliac symphysis, to 
form the common iliac vein. It receives at its com- 
mencement the venae comites of the epigastric artery 
and the circumflex iliac. 
Lower Extremity.—The deep veins of the lower ex- 
tremity pursue the exact course of the corresponding 
arteries, anastomosing across the vessels they accompany, 
except the popliteal and its continuation, the femoral, 
which has but one vein. 
The popliteal vein, formed by the junction of the an- 
terior and posterior tibial veins, ascends to the lower 
margin of Hunter’s canal, where it becomes the femoral. 
It receives the articular veins, sural veins, and the exter- 
nal saphenous. 
The femoral vein, at first behind the artery, inclines 
to the inner side as it ascends, and at Poupart’s liga- 
ment becomes the external iliac. It receives the pro- 
funda femoris,the internal saphenous vein, and numerous 
muscular veins. 
The superficial veins of the lower extremity consist 
of two principal trunks : the external short saphenous, or 
vein, commences on the dorsum of the foot, passes THE HEART AND VASCULAR SYSTEM. 
207 
behind the outer malleolus, ascends the leg, and pierces 
the deep fascia in the popliteal space, to terminate in the 
popliteal vein. The Jong saphenous vein, and the larger, 
arises from the dorsum and inner side of the foot, as- 
cends the front and inner side of the leg and thigh, and 
passes through the saphenous opening to join the femoral 
vein. 
The Pulmonary Yeins.—The pulmonary veins are 
four short, venous trunks, two from the base of each 
lung passing to the left auricle, returning arterial blood. 
They differ from other veins in the following 
respects:— 
1. They are without valves; 
2. They carry arterial blood ; 
3. They accompany the arteries singly ; 
4. They are a little larger only than their arteries. 
The right are longer than the left, and pass from the 
root of the lung, on a lower level than the artery,behind 
the aorta, superior cava, and right auricle, to enter the 
left auricle. 
THE LYMPHATIC SYSTEM. 
The lymphatic system includes the lymphatic vessels 
and glands and the lacteals, and forms an important 
accessory to the sanguiferous system, collecting the 
transuded, unappropriated fluids of the body and the 
nutritive material derived from the food and conveying 
it into the venous system. 
It consists of two main trunks:— 
(a) Thoracic duct; 
(6) Right lymphatic duct; 
and five smaller trunks :— 
1. Jugular lymphatic trunk ; 
2. Subclavian lymphatic trunk ; 
3. Broncho-mediastinal lymphatic trunk; 
4. Lumbar lymphatic trunk ; 
5. Intestinal lymphatic trunk. 
Lymphatics have been found in nearly every organ 
and texture in the body except the brain, the spinal 
cord, cartilage, tendon, eyeball, placenta, umbilical cord, 208 
HUMAN ANATOMY. 
membranes of the ovum, hair, cutis, and the labyrinth 
of the ear. They appear to originate as fine capillary 
nets interwoven among the blood-vessels and proper 
elements of the tissues, or, more minutely, in the lymph, 
perivascular, and perineural spaces. In the villi they 
commence as closed, club-like tubes. 
The lymphatic capillaries are somewhat larger than 
the vascular capillaries and destitute of valves. Their 
main trunks pass through lymphatic glands lying in 
their course, before doing which, however, they divide 
into afferent vessels, which, on emerging, unite into a 
smaller number of larger vessels, the efferent. 
In structure, they are composed of three coats—the 
external fibro-areolar, middle muscular, and internal or 
endothelial and elastic. 
The lymphatic glands are generally situated in the 
course of the blood-vessels, lymphatic vessels, or lacteal 
vessels, being accumulated together in certain localities, 
as the neck, abdomen, axilla, etc. 
The lymphatic glands and vessels are named from 
the regions they occupy or the vessels they accompany, 
and consist usually of a superficial and deep set. Thus, 
we have cervical, axillary, mediastinal, lumbar, inguinal, 
etc., and the lymphatic vessels corresponding. 
The lacteals, or chyliferous vessels, are the lymphatic 
vessels of the small intestine, and differ only from the 
others in carrying chyle during digestion from the 
intestines to the thoracic duct. 
The thoracic duct is formed by the junction of the 
two lumbar lymphatic trunks with the intestinal lym- 
phatic trunk, in front of the second lumbar vertebra, 
between the aorta and inferior vena cava, as the recep- 
taculum chyli, or cistern of Pecquet. This receptacle is 
about one to two inches long and a quarter of an inch 
wide. From its origin the thoracic duct ascends through 
the abdomen, passes through the aortic orifice in the 
diaphragm, and ascends behind the oesophagus between 
the aorta and azygos vein to the fourth dorsal vertebra, 
where it passes to the left beneath the aorta, and ascends 
between the sesophagus and the left subclavian artery to 209 
THE HEART AND VASCULAR SYSTEM. 
the last cervical vertebra, where it arches forward, out- 
ward, and downward to enter the junction of the sub- 
clavian and the left internal jugular vein. Its orifice is 
protected by a pair of valves. It receives all the 
lymphatic vessels below the diaphragm, those of the left 
side of the head, neck, and left upper extremity. 
The right lymphatic duct is about half an inch long 
and one-twelfth inch wTide. It empties in a correspond- 
ing manner on the right side to the thoracic duct. It 
receives all the lymphatics of the right side of the 
thorax, neck, head, and right upper extremity. 
Lymphatics of the Head and Neck.—The substance 
of the brain is probably destitute of lymphatics, but 
they are very numerous in the pia mater and choroid 
plexuses of the lateral ventricles, and pursue the same 
course as the principal veins, to emerge at the base 
through the various foramina, to terminate in the deep 
cervical glands. The occipital lymphatic vessels termi- 
nate in the posterior auricular and occipital glands. The 
temporal lymphatic vessels terminate in the anterior 
or auricular glands. The lymphatics of the face are 
superficial and deep. The superficial lymphatics are 
numerous, and terminate in the submaxillary glands, 
six or more in number; the deep lymphatics accompany 
the branches of the internal maxillary artery, and ter- 
minate in the deep cervical and deep parotid glands 
about the ramus of the jaw. 
Lymphatics op the Upper Extremity.—Lymphatics 
of the upper extremity are composed of two sets, the 
superficial and deep. The superficial lymphatic glands 
are few in number, one or two onty being situated at 
the internal condyle of the humerus. The deep lym- 
phatic glands lie along the course of the vessels, and 
communicate with the axillary glands. All of these 
glands unite in the deep axillary glands, about eight to 
ten in number, which communicate with the deep 
cervical glands, and through them empty into the sub- 
clavian lymphatic trunk, to end finally in the thoracic or 
right lymphatic duct. The superficial and deep vessels 
of the thorax, the former in the skin, the latter from the 210 
HUMAN ANATOMY. 
mammary glands, pectoral and other muscles, for the 
most part, pass to the axilla, a few only terminating in 
the glands below the clavicle. 
The Cavity of the Thorax.—The intercostal lym- 
phatic vessels, derived from the side of the abdomen and 
thorax, pleurae, diaphragm, spinal canal, muscles of the 
back, etc., follow the course of the veins, traverse fifteen 
to twenty intercostal glands near the heads of the ribs, 
and terminate in the thoracic duct. The posterior medi- 
astinal glands are between the intercostal glands, and 
communicate with them. They receive vessels from the 
pericardium, oesophagus, and diaphragm. Some of the 
efferent vessels end in the bronchial glands, others in the 
thoracic duct. The anterior mediastinal lymphatic 
vessels are derived from the anterior wall of the abdomen 
and thorax, the diaphragm, pericardium, upper surface 
of the liver, heart, and thymus gland. They traverse 
about eighteen to twenty anterior mediastinal glands, 
situated in the course of the internal mammary vein, 
pericardium, and great vessels of the heart, and termi- 
nate in thoracic and right lymphatic ducts. The pul- 
monary lymphatic vessels consjst of a superficial and 
deep set, traversing in the last part of their course the 
pulmonary glands. The bronchial glands are twenty or 
more glands at the bifurcation of the trachea and root 
of the lungs, and receive the lymphatic vessels of the 
lungs and bronchi. They become pigmented, and often 
the seat of disease. Their efferent vessels terminate on 
the right side in the right lymphatic duct, either directly 
or by forming the broncho-mediastinal trunk, and on the 
left side into the thoracic duct. 
Lower Extremity and Pelvis.—The superficial 
lymphatic vessels from the back of the foot follow the 
course of the long saphenous vein, passing to the super- 
ficial inguinal glands; and those from the sole of the 
foot follow the short saphenous vein joining the deep set 
in the popliteal space. The deep lymphatic vessels fol- 
low the deep veins, traverse two to four popliteal glands, 
and join the deep inguinal glands. The deep lymphatic 
glands in the pelvis consist of three sets: the external 211 
THE HEART AND VASCULAR SYSTEM. 
iliac,around the external iliac vessels; the internal iliac, 
around the internal iliac vessels ; and the sacral glands, 
on the anterior surface, and in the mesorectal folds. 
Lymphatics op the Abdomen.—The lymphatic vessels 
of the external and internal iliac glands enter the lumbar 
glands, twenty-five or more in number, situated upon the 
vertebrae, the origin of the diaphragm, the psoas and 
quadratus lumborum muscles,and the great blood-vessels. 
They receive vessels from the kidneys, ureters, loins, 
suprarenal bodies, ovaries, and testicles, and form lum- 
bar lymphatic trunks, which ascend to join the thoracic 
duct or receptaculi cliyli. The lymphatic vessels of the 
stomach follow the general course of the blood-vessels. 
They consist of three groups: the first, along the lesser 
curvature, passing to the glands along the pylorus ; the 
second, at the great end of the stomach, passing to the 
splenic lymphatic glands; and the third, at the greater 
curvature, passing to one of the principal lacteal vessels. 
The lymphatics of the small intestine are called also lac- 
teals. They pass between the layers of the mesentery 
and traverse a large number of mesenteric glands, ar- 
ranged irregularly into three rows. The lymphatic ves- 
sels of the large intestine traverse the mesoeolic glands, 
about thirty in number, and pass into the superior mesen- 
teric glands. The vessels from the spleen and pancreas 
follow the course of the splenic vein, traverse a number 
of the glands, to end in the coeliac glands. The lym- 
phatics of the liver consist of superficial and deep, and are 
very extensive, both on the upper and lower surfaces. 
They terminate in the right lymphatic duct, the glands 
of the gastro-hepatic omentum, the anterior mediastinal 
glands, the oesophageal glands, the glands of the lesser 
curvature, and of the thoracic duct. The deep tymphatics 
follow the course of the portal vein and hepatic artery and 
duct, and, emerging, join one of the lacteal vessels before 
it enters into the thoracic duct. The coeliac glands, fifteen 
or twenty in number, are situated behind the pancreas and 
duodenum, the aorta, portal vein, coeliac, and superior 
mesenteric vessels. Their efferent vessels form the intes- 
tinal lymphatic trunk and empty into receptaculum chyli. THE ALIMENTARY APPARATUS. 
The alimentary apparatus consists of the alimentary 
canal and of certain accessory organs. 
The former is a musculo-membranous canal about 
thirty feet in length, extending from the mouth to 
the anus, and comprises: first, the organs of degluti- 
tion, consisting of the mouth, pharynx, and cesophagus ; 
and, second, the organs of digestion, consisting of the 
stomach and small and large intestines. It is lined 
throughout by mucous membrane. The accessory organs 
comprise the teeth, salivary glands, liver, pancreas, and 
spleen. 
Alimentary Apparatus. 
Mouth, 
( Pharynx, 
{ (Esophagus. 
Organs of deglutit’n, 
Alimentary 
canal, 
Stomach, 
r Duodenum, 
: Jejunum, 
’ Ileum. 
Organs of digestion, 
Small intestine, 
Large intestine, 
Caecum, 
Colon, 
Rectum. 
Teeth, 
Accessory 
organs, 
Salivary glands, 
Parotid, 
Submaxillary, 
Sublingual. 
Liver, 
Pancreas, 
„ Spleen. 
The mouth is an oval cavity in which mastication 
takes place preparatory to deglutition. It is placed at 
the entrance of the alimentary canal, is bounded laterally 
by the alveolar processes of the upper and lower jaws 
and cheeks ; above by the upper teeth and hard palate; 213 
THE ALIMENTARY APPARATUS. 
below by the tongue, the lower jaw, the mucous mem- 
brane between, and the lower teetli; in front by the lips ; 
and behind by fauces and soft palate. It terminates 
posteriorly at the anterior pillars of the fauces, through 
the fauces into the pharynx. 
It is invested throughout (except on the teeth) with 
highly vascular mucous membrane covered with strati- 
fied squamous epithelium containing conical papillae. 
It presents for examination the following parts :— 
The Teeth.—The teeth are firmly implanted within 
the alveoli of the jaws and surrounded by the gums. 
The gums are composed of dense fibrous tissue, cov- 
ered by smooth, vascular, mucous membrane of slight 
sensibility. This fibrous tissue is continuous with the 
periosteum of the jaws, and forms about the neck of the 
teeth a constricted ring—the dental ligament. 
There are four kinds of teeth—incisors, canines or 
cuspids, premolars or bicuspids, and molars. Man is 
provided with two sets of teeth, the temporary, decidu- 
ous, or milk teeth, which appear in childhood, and the 
permanent, which appear after the shedding of the milk 
teeth and last until old age. 
The temporary or deciduous teeth are twenty in num- 
ber, ten in each jaw, or five in each side of each jaw:— 
Two incisors, one canine, and two molars. 
The permanent teeth are thirty-two in number, six- 
teen in each jaw, or eight in each side of each jaw:— 
Two incisors, one canine, two bicuspids, three molars. 
Each tooth consists of three parts :— 
Crown, or body, the enameled portion above the 
gum; neck, the constricted portion between the crown 
and root; root, or fang, within the alveolus, and covered 
with cement. 
Characteristics.—Incisors, or cutting, are so called 
from their wedge-shaped, chisel-like crown,being adapted 
for biting or cutting the food. The fang is long, single, 
conical, and compressed at the sides. 
Cuspids, or canines, have been so named from their 
conspicuous character in the canine or dog tribe. 
The crown is large, conical, convex in front, and 214 
HUMAN ANATOMY. 
beveled behind. The fang is single, longest, and thickest 
of all the teeth. The upper canines are commonly known 
as “eye teeth,” the lower as “ stomach teeth.” 
Bicuspids, or premolars. The crown has a pair of 
projecting tubercles or cusps. Fang is conical, single, 
but deeply grooved, indicating a disposition to bifurcate. 
Molars, commonly known as grinders or jaw teeth. 
Crown, broad, quadrilateral, with four cusps in upper, 
live in lower molars. Lower molars have usually a pair 
of fangs placed laterally, the upper three fangs, two 
external and one internal. 
The last or third molar has but one fang (with a 
tendency to divide into the same number of roots as the 
other molars), and is known as the dens sapientise, or 
“ wisdom tooth,” from its late appearance. 
Structure.—On section a tooth consists of two por- 
tions, the pulp cavity and the solid portion surrounding 
it. 
The solid portion consists of three structures, dentine, 
or ivory, which forms the principal mass of the tooth ; 
enamel, which covers the crown, and cement, which covers 
the surface of the fang. 
Dentine, or ivory, resembles bone, but differs from it 
in composition and structure, consisting of twenty-eight 
parts animal and seventy-two parts mineral matter, and 
being made up of minute tubuli held together by the 
intertubular substance. 
The dental tubuli are minute cylindrical canals 
of an inch in diameter. They pass in a spiral direction 
from the pulp cavity to the periphery. 
Enamel, the hardest and densest of all organized 
bodies, contains but 3.5 per cent, animal matter, and is 
composed of minute hexagonal rods °f an inch in 
diameter, placed at right angles to the surface of the 
dentine. The external surface of unworn enamel can be 
separated as a thin, homogeneous membrane, Nasmyth's 
membrane. 
Cement, or crusta petrosa, is a tliin of true bone 
with canaliculi and lacunae, disposed on the surface of 
the fang. 215 
The pulp cavity is a cavity within the base of the 
crown, continuous with a canal in the centre of the fang, 
and open at the apex of the fang for the entrance of ves- 
sels and nerves. It is filled with dental pulp. 
THE ALIMENTARY APPARATUS. 
Dental pulp consists of two kinds of cells, the fusi- 
form and the columnar, or odontoblasts of Waldeyer, 
held together by loose connective tissue. It is soft, 
vascular, and highly sensitive. The nerves are both 
medullated and non-medullated, and form a rich plexus 
beneath the odontoblastic layer. The terminal fibrils 
probably unite with these cells, but the exact distribution 
is still unsettled. 
Development—Temporary.—They are formed very 
early, seven to eleven weeks, in the primitive dental groove 
by an involution of the epithelium of the oral cavity cover- 
ing the maxillary arches into the blastema or corium 
and connective tissue below, the former forming the 
enamel, the latter the cement and dentine. 
The enamel is formed by the enamel germ (a mass 
of epithelial cells) descending into the dental groove 
until it meets the papilla, a vascular growth extending 
upward from the connective tissue, upon which it forms 
a cap. A vascular membrane inclosing the enamel germ 
then extends itself—as the dentinal sac—upon the united 
papilla and enamel germ and cuts the latter off from its 
former epithelial structure. The cells become differen- 
tiated and finally calcify. 
The dentine is formed by the development of odonto- 
blasts in the periphery of the papilla in a similar manner 
to the development of osteoblasts in bone. 
The cement is developed from the wall of the dental 
sac by the intramembranons process of ossification. 
Permanent.—The successional permanent teeth, or 
those replacing the temporary, are formed in a different 
manner from the superadded, or three molars in each 
side of each jaw. 
The former are developed similarly to the temporary 
teeth, but in a secondary dental groove, from which after 
their formation they recede behind the germs of the 
temporary teeth, inclosed in sacs. The molars, or super- 216 
HUMAN ANATOMY. 
added teeth, however, are formed by extensions backward 
of a portion of the enamel germ of the tooth immediately 
in front. 
Eruption, or “cutting of the teeth,” takes place by 
the growth of the fang, the gums being absorbed by the 
pressure of the advancing crown. The development of 
the fangs of the permanent causes the absorption of the 
fangs of the temporary teeth through the agency of the 
odontoclasts, multinueleated cells corresponding to the 
osteoclasts of bone. 
The eruption of the temporary teeth takes place in 
months in the following order, the lower preceding by 
a short time the upper (according to Dr. C. N. Pierce, 
in “ American System of Dentistry ”) :— 
Fiq. 51.—'Temporary Teeth. 
The order of the eruptions being, first the lower central 
incisors, the upper central incisors, lateral incisors, 
upper and lower, first molars, followed by the canines 
or cuspids, and ending with the second molars. 
The eruption of permanent teeth takes place in years 
as on page 217, the order of the eruptions being, first the 
“ first or sixth year molar,” followed by the first central 
incisors, four lateral incisors, four first bicuspids, four THE ALIMENTARY APPARATUS. 
217 
second bicuspids, the first canines or cuspids, the four 
second molars, and ending with the four third molars or 
“wisdom teeth.” 
About the sixth year the jawTs contain the temporary 
teeth fully erupted, and the crowns of all the permanent 
teeth excepting the four wisdom teeth, in all forty-eight. 
It should be noted that the first permanent or “ sixth- 
year ” molar is erupted before any of the permanent 
teeth, and that the second bicuspid takes the place of 
the second temporary molar. 
Fig. 52.—Permanent Teeth. 
Vessels and Nerves of the Teeth.—The arteries of 
the upper teeth are derived from the anterior dental 
branches of infraorbital and posterior or alveolar dental 
branches of the internal maxillary; of the lower teeth, 
from the inferior dental branch of the internal maxil- 
lary. 
The nerves are distributed to the upper teeth from 
the anterior and posterior dental brandies of the su- 
perior maxillary (first division of fifth cranial nerve), 
and to the lower teeth from the inferior maxillary (third 
division of fifth cranial nerve). 218 
HUMAN ANATOMY. 
Soft palate is a movable fold of mucous membrane 
suspended from the posterior border of the hard palate, 
and inclosing an aponeurosis, vessels, nerves, glands, 
and the following muscles on each side: tensor palati, 
levator palati, palatoglossus, palatopharyngeus, and azy- 
gos uvulae, the latter uniting with its fellow to form 
the uvula. 
Hard palate is formed b}T the palatal process of the 
superior maxillary and the palate-bone, and covered by 
a thick, dense structure composed of mucous membrane 
and periosteum combined. It forms the roof of the 
mouth, and presents a median raphe and corrugated 
surface. 
Anterior pillars of the fauces are folds of mucous 
membrane arching downward and forward from the base 
of the uvula to the base of the tongue, and inclosing 
the palatoglossus muscles. 
Posterior pillars of the fauces are similar folds arch- 
ing downward and backward from the base of the uvula 
to the sides of the pharynx, and inclosing the palato- 
pharyngeus muscles. 
The tonsils, or amygdalae, are small, almond-shaped, 
glandular bodies situated on each side of the fauces be- 
tween the anterior and posterior pillars. They rest upon 
the superior constrictor of the pharynx, which separates 
them from the ascending pharyngeal and internal carotid 
arteries. They are composed of numerous follicles (lined 
by closed capsules containing adenoid tissue), which 
contain a thick, grayish secretion and open on the sur- 
face of the gland by a dozen or more orifices. 
The arteries to the tonsil are from the tonsillar and 
ascending palatine of the facial, dorsalis lingual from 
the lingual, ascending pharyngeal from external carotid, 
branch from small meningeal, and descending palatine 
branch of internal maxillary. 
The nerves are from glossopharyngeal and Meckel’s 
ganglion. 
The Salivary Glands.—The salivary glands com- 
municating with the month are three: the parotid, sub- 
maxillary, and sublingual. 219 
THE ALIMENTARY APPARATUS. 
The parotid gland, so called from its location near 
the ear, is the largest, weighing from a half to one 
ounce. It occupies the space in front of the ear, 
bounded below by the angle of the jaw, and a line ex- 
tended from it to the mastoid process, above by the 
zygoma, in front by the masseter muscle, and behind by 
the mastoid process, the external meatus, and the digas- 
tric muscle. 
The external carotid artery passes through its struc- 
ture and divides into its terminal branches. The facial 
nerve and the great auricular both pass through it. 
Tiie duct of the parotid gland, Steno’s or Stenson’s 
duct, empties its secretion into the mouth. It is about 
two and a half inches in length, of the diameter of a 
crow’s quill, and crosses the face upon the masseter 
muscle, through the substance of the buccinator muscle, 
in the direction of an imaginary line drawn about a 
finger’s breadth below the zygoma, from the lower part 
of the ear to midway between the ala of the nose and 
the margin of the upper lip, to open about the position 
of the second molar tooth of the upper jaw. 
Its arteries are branches of the external carotid. 
The veins empty into the external jugular. The lym- 
phatics empty into the superficial and deep cervical 
glands, and the nerves are derived from the facial, from 
the superficial temporal branches of the great auricular, 
the auriculo-temporal, and sympathetic. 
The submaxillary gland occupies the submaxillary 
fossa on the inferior surface of the inferior maxilla, 
within the submaxillary triangle of the neck. The 
facial artery grooves its upper and posterior border, and 
it is separated behind from the parotid gland by the 
stylomaxillary ligament. The duct of the submaxillary 
gland, or Wharton’s duct, about two inches in length, 
passes forward between the hyoglossus, geniohyoglos- 
sus, and mylohyoid muscles, to open at the side of the 
frenum linguae. 
Its arteries ai*e from the facial and lingual; the veins 
follow the course of the corresponding arteries; the 
nerves are from the submaxillary ganglion, the sym- 220 
HUMAN ANATOMY. 
pathetic, and the mylohyoid branch of the inferior 
dental. 
The sublingual gland, the smallest, lies on the floor 
of the mouth, at the side of the frenum linguse, beneath 
the mucous membrane. Its ducts, called the ducts of 
Rivini, from eight to twenty, open on the mucous mem- 
Fig. 53. 
Pharynx laid open from behind: 1, styloid process ; 2, body of occipital; 3, sep- 
tum nasi; 4, middle turbinated bone: 5, posterior naris: 6, inferior turbinated bone; 
7, soft palate; 9, uvula; 10, tonsil; 11. back of tongue; 12. epiglottis; 13, arytaeno-epi- 
glottidean fold ; 14, tip of arytaenoid cartilage; 15, oesophagus; 16, back of cricoid 
cartilage. 
brane. One of them, the longest, called the duct of 
Bartholin, joins Wharton’s duct. Its arteries are from 
the submental and sublingual. The nerves are branches 
from the gustatory. 
Besides these glands, the mucous membrane of the 
mouth is plentifully supplied with mucous glands. 221 
The pharynx is a musculo-membranous sac, extend- 
ing from the basilar process of the occipital bone above 
to the level of the fifth cervical vertebra or the cricoid 
cartilage below. It is about four and a half inches in 
length. It has communicating with it seven openings: 
THE alimentary apparatus. 
Two posterior nares, 
Two Eustachian tubes, 
Mouth. 
Larynx, 
(Esophagus, 
It is composed of three coats :— 
1. Fibrous coat, or pharyngeal aponeurosis, attached 
above to the pharyngeal spine of the basilar process of 
the occipital bone; it affords attachment in the median 
line to the constrictor muscles of the pharynx. 
2. Mucous coat, continuous with that of the various 
openings. It is covered in its upper part with columnar 
ciliated epithelium, as low as the floor of the nares, be- 
low which it is squamous. It contains numerous race- 
mose glands, crypts, and lymphoid structure similar to 
the tonsils, a mass of which, between the Eustachian 
tubes, has been called the “ pharyngeal tonsil.” 
3. Muscular coat, consists of the three pharyngeal 
constrictors, the palatopharyngeus, and the stylopha- 
ryngeus. ( Vide Muscles.) 
Arteries are from the inferior palatine, pharyngeal, 
and thyroid arteries. Nerves are branches of the pneu- 
mogastric, glossopharyngeal, and sympathetic. 
The (esophagus, or gullet, is a musculo-membranous 
tube about nine inches long and less than one inch in 
diameter, flattened from before backward, and extend- 
ing from the pharynx to the stomach or from the level 
of the fifth cervical to the ninth dorsal vertebra. 
Relations,—In the neck the trachea is in front, the principal 
carotids on either side, and in the chest the pericardium, the left 
carotid, left subclavian, the aorta, and the left bronchus are in front; 
the loiigus colli and intercostal vessel and the vertebral column are 
behind. The pleura covers it laterally, the descending aorta lying on 
the left and the vena azygos major on the right. 
Its structure consists of three coats:— 222 
HUMAN ANATOMY. 
Muscular coat, consisting of two layers, the longitu- 
dinal and the circular, continuous both with the inferior 
constrictor; 
Areolar or fibrous coat, connecting the two ; 
Mucous coat, covered with stratified pavement epithe- 
lium, and having beneath it some non-striated muscular 
Fig. 54. 
1, left hypochondriac region; 2, epigastric; 3, right hypochondriac; 4, left 
lumbar; 5, umbilical; 6, right lumbar; 7, left iliac; 8, hypogastric; 9, right iliac. 
fibres, the muscularis mucosae. It also contains numer- 
ous compound racemose glands, the oesophageal glands. 
The abdomen, the largest cavity in the body, is 
bounded in front and laterally by the abdominal mus- 
cles, the lower ribs, the ilii,and above by the diaphragm, 
THE ABDOMEN. THE ALIMENTARY APPARATUS. 
223 
below by the brim of the pelvis, and behind by the ver- 
tebral column, quadratus lumborum, and psoas muscles. 
It is lined throughout by peritoneum, inclosing the 
greater portion of the alimentary canal. It has six 
openings, as follow :— 
Aortic opening, for the vena azygos, aorta, and thoracic duct; 
(Esophageal opening, for the oesophagus and pneumogastric 
nerves; 
Quadrate opening, for the vena cava inferior; 
Umbilicus, in front, for the foetal umbilical vessels; 
Femoral canal (vide femoral hernia) ; 
Inguinal canal, for the round ligament in the female, and the 
spermatic cord in the male. 
Regions of the Abdomen.—For convenience of study, 
the cavitjr of the abdomen is divided into nine regions 
by four imaginarj7 lines, two circular lines drawn around 
the body, one at the lower margin of the thorax (Leidy) 
or on a level with the cartilages of the ninth ribs, the 
second at the highest point of the crest of the ilium ; 
and two vertical lines, drawn from the cartilage of the 
eighth rib on each side through the centre of Poupart’s 
ligament, or from the anterior inferior spinous process 
of the ilium, drawn upward (Leidy). These regions are 
named as follows :— 
Right hypochondriac, 
Right lumbar, 
Right inguinal (iliac), 
Epigastric region, 
Umbilical region, 
Hypogastric region, 
Left hypochondriac, 
Left lumbar, 
Left; inguinal (iliac). 
Contents of Regions. 
Eight Hypochondriac. 
Hepatic flexure of 
colon, right lobe of 
liver, gall-bladder, and 
upper part of right 
kidney. 
Epigastric. 
Left lobe of liver, 
lobulus spigelii, 
greater part of stom- 
ach, duodenum, and 
pancreas, portions of 
the kidneys and su- 
prarenal capsules, 
vena cava, aorta, tho- 
racic duct, semilunar 
ganglia. 
Left Hypochondriac. 
Splenic flexure of 
colon, spleen, tail of 
pancreas, splenic end 
of stomach, and upper 
part of left kidney. 224 
HUMAN ANATOMY. 
Right Lumbar. 
Greater part of right 
kidney, ascending co- 
lon, and portions of the 
small intestine. 
Umbilical. 
Transverse portions 
of colon and duode- 
num, jejunum, and 
ileum, part of mesen- 
tery and great omen- 
tum, receptaculum 
chyli, and portions of 
both kidneys. 
Left Lumbar. 
Part of left kidney, 
descending colon, 
some convolutions of 
small intestine, and 
part of the omentum. 
Right Inguinal (Iliac). 
Right ureter, caecum, 
spermatic vessels, and 
appendix caeci,. 
Hypogastric. 
Portions of the 
small intestine un- 
der certain circum- 
stances, the uterus 
(pregnant), bladder 
(distended), some- 
times the caecum, sig- 
moid flexure, and 
appendix. 
Left Inguinal (Iliac). 
Left ureter, sigmoid 
flexure of colon, and 
spermatic vessels. 
Peritoneum.—The peritoneum is a closed serous sac, 
its parietal layer lining the cavity of the abdomen, its 
visceral hiymr inclosing more or less completely all the 
abdominal and pelvic viscera. It is not in all cases a 
closed sac, for in the female it is continuous with the mu- 
cous membrane of the Fallopian tubes. It consists essen- 
tially of two sacs of unequal size, the greater and lesser 
peritoneal sacs, united by a central constriction—the 
foramen of Winslow:— 
The greater sac is located in front of the viscera, one 
layer lining the internal abdominal wall, the other re- 
flected upon the viscera. Its cavity is known as the 
greater peritoneal cavity. 
The lesser sac covers the upper part of the posterior 
abdominal wall, and is reflected upon the posterior sur- 
face of the liver and stomach. Its cavity is called the 
lesser peritoneal cavity. It also gives off three pro- 
cesses, one of which is a broad, loose fold,—the great 
omentum,—passes downward from the greater curvature 
of the stomach between the two layers of the greater 
sac, and is reflected upon itself back to the under sur- 
face of the transverse colon. 
The foramen of Winslow is a narrow canal, large THE ALIMENTARY APPARATUS. 
225 
enough to admit one finger, between the greater and 
lesser peritoneal cavities, located behind the right border 
of the lesser omentum, and formed by the hepatic and 
gastric arteries, constricting the sac at this point as they 
ascend from the coeliac axis. It is bounded as follows :— 
Fig. 55. 
D, diaphragm; L, liver; S, stomach; P, pancreas; D, duodenum; C, colon; I, 
small intestine; D, bladder; R, rectum; 3, posterior surface of liver; 4, foramen of 
Winslow: 5, great omentum; 6, lesser omentum; 7, mesocolon; 8-9, lesser cavity of 
peritoneum; 10, mesentery; 11, recto-vesical fold. 
Tu front, by the lesser omentum, containing the hepatic artery, 
portal vein, duodenum, and the ductus communis choledochus; 
Behind, by the right crus of the diaphragm and the inf. vena cava; 
Above, by the lobus Spigelii; 
Below, by the hepatic artery. 226 
HUMAN ANATOMY. 
Reflections.—The reflections of the peritoneum viewed 
in an antero-posterior section (the greater ami lesser 
sacs together) may be traced as follows: From the 
diaphragm it is reflected to the upper surface of the 
liver. Enveloping this organ, it then presents a doubling 
or fold—the gastro-hepatic omentum—extending down- 
ward from the transverse hepatic fissure to the lesser 
curvature of the stomach. Inclosing the stomach, it is 
reflected upon itself in front of the intestines as a broad 
apron—the great omentum—making a quadruple fold of 
peritoneum. 
The two layers then embrace the transverse colon, 
unite, and pass back to the vertebral column, forming 
the transverse mesocolon. From here the layers sepa- 
rate, the upper one ascending in front of the pancreas 
to the starting point. The lower layer descends in front 
of the duodenum and aorta, incloses the small intestine 
(forming the mesentery proper), is reflected upon the 
rectum (forming the mesorectum) and the bladder, and 
ascends upon the anterior abdominal wall to the starting 
point. 
In the female, from the rectum it envelops the 
uterus and upper part of the vagina before reaching the 
bladder. 
In addition to the folds seen in the antero-posterior 
section, the peritoneum passes between the various 
organs, and also laterally to the sides of the abdominal 
and pelvic cavities. In this manner are formed the 
right, left, and suspensory ligaments of the liver, the 
suspensory ligament of the spleen, the broad ligament 
of the uterus, and the three great ligaments or omenta 
of the stomach—the gastro-hepatic, gastro-splenic, and 
gastro-colic (already described) and the mesenteries. 
The latter, the mesenteries, include the mesentery 
proper, mesocaecum; ascending, transverse, and descend- 
ing mesocolon; sigmoid mesocolon, and mesorectum. 
The mesentery proper is a broad fold, reflected from 
the vertebral around the jejunum and ileum. Its base, 
attached obliquely from the left side of the second lum- 
bar vertebra to the right iliac region, measures about THE ALIMENTARY APPARATUS. 
227 
six inches, wdiile its expanded extremity is quite con- 
siderable. 
In the male the recto-vesical folds, one on each side, 
pass from the rectum to the bladder, including between 
them the recto-vesical pouch. In the female, however, 
this pouch is divided into two—the recto-uterine and 
vesico-uterine pouches, the recto-vesical folds being 
called recto-uterine and vesico-uterine folds. Folds of 
peritoneum (superior false ligaments of the bladder) 
ascend from the bladder to the umbilicus, inclosing the 
remains of the foetal urachus and hypogastric arteries, 
and also a fold on each side, follows the course of the 
epigastric arteries toward the umbilicus, dividing the 
inguinal region into the internal and external inguinal 
fossae, corresponding to the external and internal ingui- 
nal rings, respectively. The peritoneum at the external 
inguinal fossa (corresponding to the internal abdominal 
ring) is continuous in the male foetus with the tunica 
vaginalis testis, and in the female forms a blind sac 
about the round ligament—the canal of Nuck. 
Viscera Partly Invested by Peritoneum. 
Vagina—upper part; 
Bladder—posterior wall; 
Duodenum—descending and transverse portions ; 
Caecum; 
Colon—ascending and descending; 
Rectum—middle portion. 
Viscera Entirely or Almost Entirely Covered. 
Stomach, 
Spleen, 
Ileum, 
Jejunum, 
Colon—transverse, 
Sigmoid flexure, 
Rectum—upper part, 
Liver, 
Uterus, 
Ovaries. 
Viscera Without Peritoneal Investment. 
Bladder—except posterior wall; 
Rectum—lower third ; 
Vagina—lower part of posterior wall; 
Pancreas; 
Suprarenal capsules; 
Kidneys. 228 
HUMAN ANATOMY. 
THE STOMACH. 
The stomach is a musculo-membranous sac, pyriform 
in shape, situated below the diaphragm in an oblique 
position across the upper abdomen, where it is held in 
position by the lesser omentum and the gastro-splenic 
ligament. It measures about nine to twelve inches long, 
four to five inches in its greatest diameter, and has a 
capacity of from one to two quarts. It occupies the 
epigastric, right and left hypochondriac regions, and is 
in relation above with the diaphragm and liver, below 
with the transverse colon, in front the abdominal walls, 
and behind with the pancreas. It presents for exami- 
nation a greater and lesser extremity, greater and lesser 
curvatures, anterior and posterior surfaces, and cardiac’ 
and pyloric orifices. 
The greater extremity, or fundus, occupies the left 
hypochondriac region, in contact with the spleen, with 
which it is attached by the gastro-splenic omentum, and 
behind the lower rib. 
The lesser or pyloric end is smaller, and lies in con- 
tact with the under surface of the liver and the wall of 
the abdomen in the right hypogastric region. 
The greater curvature extends between the pyloric 
and oesophageal orifices, along the lower border of the 
stomach, and to it is attached the great omentum. 
The lesser curvature extends between the same two 
points along the superior border of the organ. 
The oesophageal or cardiac orifice occupies the highest 
part of the stomach, behind the left seventh costal carti- 
lage, and receives the oesophagus. 
The pyloric orifice occupies the right extremity, and 
opens into the duodenum,being protected b}T a muscular 
valve, the pylorus, or pyloric valve. 
The anterior surface is in contact with the under 
surface of the left lobe of the liver, the abdominal walls, 
and the diaphragm. 
The posterior surface is in contact with the pleura 
of the diaphragm, solar plexus, the pancreas, and the 
abdominal vessels. THE ALIMENTARY APPARATUS. 
229 
The structure of the stomach consists of four coats, 
a serous, muscular, fibrous or areolar, and mucous. 
The serous coat is derived from the peritoneum, which 
completely covers it, except along the lesser and greater 
curvature, where the vessels and nerves enter. 
The muscular coat consists of three sets of fibres :— 
The longitudinal, the most superficial, are continuous 
below with the longitudinal fibres of the small intestine 
below, and the oesophagus above ; 
The circular fibres, the second layer, are most abun- 
dant at the pyloric extremity, where they form the py- 
loric valve; 
The oblique fibres are distributed over both sur- 
faces, passing obliquely from right to left and left to 
right. 
The areolar or submucous coat connects the muscu- 
lar with the mucous layer, and is sometimes named the 
vascular coat. 
The mucous membrane is of a pale pinkish-ash color, 
thickened toward the pylorus, where it presents numer- 
ous rugae, or pleats, and at the pyloric end it helps to 
form the pyloric valve. It is lined throughout with 
columnar epithelium, and is studded with three kinds 
of minute tubes, the gastric follicles, and lenticular 
glands. The gastric follicles consist of two kinds, the 
pyloric and the peptic glands, the former most abundant 
at the pyloric end and the latter distributed all over the 
surface of the stomach. 
The pyloric or mucous glands consist each of from 
two to four blind tubes opening into a common duct, 
and lined throughout by columnar epithelium. 
The peptic glands are similar in structure, but have a 
much shorter duct, and contain in addition peculiar 
large, spheroidal, granular peptic cells. 
The lenticular or simple solitary glands are small 
masses of lymphoid tissue scattered throughout the 
connective-tissue frame-work of the stomach between 
the gastric follicles. 
The arteries are derived from the gastric, pyloric, and 
right gastro-epiploic branches of the hepatic artery, and 230 
HUMAN ANATOMY. 
the left gastro-epiploic and vasa brevia branches of the 
splenic artery (vide Arterial System). 
The veins terminate in the portal and splenic veins. 
The nerves are derived from the gastric plexus, 
formed by the terminal branches of the right and left 
pneumogastric, and the branches of the semilunar gan- 
glion of the sympathetic. 
THE SMALL INTESTINE. 
The small intestine is a convoluted tube about twenty 
to twenty-five feet in length, for the cliylification of the 
food, occupying the lower and central portions of the 
abdominal and pelvic cavities, and held in position to 
the spinal column by the mesentery. It is divided into 
three portions—the duodenum, jejunum, and ileum. 
The duodenum, so called from being about the twelve 
fingers’ breadth in length, is about eight to ten inches in 
length. It consists of three portions, from the position 
of its course—ascending, descending, and transverse:— 
The_/ir.s‘£ or ascending portion is about two inches in 
length, and ascends to the neck of the gall-bladder; 
The second or descending portion, about three inches 
in length, descends in front of the right kidney as far as 
the second or third lumbar vertebra, and has attached 
to it the head of the pancreas, and into its lower part 
the duct of the pancreas and the common biliary duct 
opens; 
The third or transverse portion is attached to the 
crura of the diaphragm and the vessels in front of the 
vertebral column, passes behind the transverse meso- 
colon, and has the pancreas above it, and the superior 
mesenteric blood-vessels cross from beneath the latter 
over its termination or between the two. 
The arteries are derived from the inferior pancreatico- 
duodenal branch of the mesentery and the pylorus and 
pancreatico-duodenal branch of the hepatic. The veins 
terminate in the superior mesentery and splenic veins. 
The nerves are from the solar plexus. 
The jejunum, named from jejunus, empty, includes 
the upper two-fifths of the small intestine, is continuous THE ALIMENTARY APPARATUS. 
231 
above with the duodenum and below with the ileum. It 
occupies chiefly the left iliac and umbilical region. 
The ileum, so called from its twisted condition, in- 
cludes the remaining three-fifths, is continuous above 
with the jejunum, and below with the caput caecum of 
the large intestine. It occupies the right iliac, hypo- 
gastric, and umbilical regions. 
The structure of the small intestine consists of four 
coats—the serous, muscular, fibrous or areolar, and mu- 
cous :— 
The serous coat is the peritoneal covering; 
The muscular coat consists of two sets—a longitudi- 
nal and a circular; 
The areolar or submucous coat connects the muscular 
with the mucous coat; 
The mucous coat is thinner and redder than that of 
the stomach, and is thrown into numerous transverse 
folds—the valvul* coniventes—most numerous in the 
upper part; they diminish as it descends and finally 
disappear in the ileum. They increase the secreting and 
absorbing surface of the mucous membrane and retard 
the passage of the food. 
The mucous membrane also contains the villi and four 
kinds of glands:— 
Simple follicles, or crypts of Lieberkiihn; 
Duodenal glands, or Brunner’s glands ; 
Solitary glands; 
Agminate, or Peyer’s glands. 
The villi are minute vascular projections of the mu- 
cous membrane scattered throughout the surface of the 
small intestine. Their structure consists of a pouch- 
like termination of a lacteal in the centre surrounded by 
a minute plexus of capillary vessels inclosed in a base- 
ment membrane and covered with columnar epithelium. 
The simple follicles, or crypts of Lieberk'uhn, are 
scattered throughout the mucous membrane of the en- 
tire small intestine. They consist of minute tubes of 
basement membrane, lined with columnar epithelium and 
surrounded by a capillary net-work. 232 
HUMAN ANATOMY. 
The duodenal or Brunner's glands are distributed to 
the duodenum and jejunum only. They are largest and 
most numerous in the vicinity of the pylorus. They 
are composed of tubular alveoli, lined by epithelium, 
and having a small duct opening on the mucous mem- 
brane. 
The solitary glands are distributed throughout the 
small intestine, being most numerous in the last portion 
of the ileum. They consist of lymph follicles, and com- 
municate with the lacteal system by means of lymph 
spaces. 
Peyer's glands, or Peyer's patches, consist of an ag- 
gregation of the solitary glands into oval groups of 
twenty or thirty along the small intestine at a point op- 
posite the attachment of the mesentery. The patches 
are about fifteen to thirty in number, each measuring 
about one-half to two inches in length and one-half inch 
in breadth. Their axes are parallel with the length of the 
intestine. In the duodenum they are few and small 
in size, and the mucous membrane of the valvuhe coni- 
ventes over them is reduced in size and much distorted. 
The arteries are derived from the pyloric, pancre- 
atico-duodenal, and superior mesenteric. They reach 
the intestines inclosed in and along the course of the 
mesenteries. In the intervals of the coats they form 
three vascular nets, which supply the serous, muscular, 
and mucous coats. The veins accompany the arteries 
and join the portal vein. 
The lymphatics follow the course of the superior 
mesentery vessels to enter the mesentery glands. 
The nerves are derived from the solar plexus of the 
sympathetic. 
TIIE LARGE INTESTINE. 
The large intestine is about five feet long and extends 
from the ileum to the anus. 
It commences in the right iliac fossa, ascends through 
the right lumbar and right hypochondriac regions, passes 
transversely between the epigastric and umbilical regions 
to the left hypochondriac region, where it descends THE ALIMENTARY APPARATUS. 
233 
through the left hypochondriac, lumbar, and iliac 
regions, and through the pelvis on its posterior wall to 
terminate at the anus. 
It consists of three divisions :— 
1. Caecum, 
Ascending, 
Transverse, 
Descending, 
Sigmoid flexure. 
2. Colon, 
The c.*cum is a blind poucn measuring about two 
and one-half inches in every diameter, lying free in the 
right iliac region. 
3. Rectum. 
It has opening into its lower back part the appendix 
vermiformis, and into its inner back part the ileum, 
guarded by the ileocaecal valve. 
The appendix vermiformis is a long, narrow, twisted 
tube, the rudiment of the prolonged caecum in all mam- 
malia. It terminates in a blunt extremity. Its mucous 
membrane is continuous with that of the caecum, and 
contains many solitary glands. 
*/ «/ cj 
The ileocsecal valve, or valve of Bauhin, protects the 
opening of the ileum into the caecum, and consists of 
two valve-like semilunar folds of mucous membrane, 
strengthened by bands of circular fibres. The upper 
one is attached to the junction of the ileum with the 
colon, the lower one to the junction of the ileum with 
the caecum. On each side where the folds coalesce, a 
ridge of mucous membrane continuous for a short dis- 
tance around the canal, forming the frsena or retinacula, 
of the valve. The mucous membrane on either side of 
the valves corresponds to that of the large and small 
intestines respectively, being covered with villi on the 
side toward the ileum, and being destitute of villi, and 
containing numerous tubular glands or crypts of Lie- 
berkiihn,on the side toward the caecum. This difference 
occurs abruptly at the free margin of the valves. 
The colon consists of four portions—ascending, 
transverse, and descending colon, and sigmoid flexure: 
The ascending portion begins opposite the ileocecal 234 
HUMAN ANATOMY. 
valve, ascends through the right lumbar and hypochon- 
driac regions, and terminates beneath the under surface 
of the liver at the hepatic flexure in the transverse por- 
tion. Its posterior surface is destitute of peritoneum, 
and is attached to the quadratus lumborum muscle by 
loose areolar tissue. 
The transverse portion, or transverse arch of the 
colon, passes from the hepatic flexure, through the ad- 
joining portions of the epigastric and umbilical re- 
gions, to terminate at the splenic flexure in the de- 
scending portion. It is attached by the transverse 
mesocolon, and is the most movable portion of the 
colon. 
The descending portion begins at the splenic flexure, 
descends through the left lumbar and iliac regions to 
terminate in the sigmoid flexure. Like the ascending 
colon, its posterior surface is destitute of peritoneum. 
The sigmoid flexure is a narrow, twisted portion of 
the colon, occupying the left iliac fossa, between the 
descending portion of the colon and the rectum. It is 
held in position by the sigmoid mesocolon. 
The rectum—the terminal portion—extends from 
the sigmoid flexure to the anus. It is from six to eight 
inches in length, not sacculated, but club-shaped, with 
its large extremity downward, and consists of three por- 
tions—the upper, middle, and lower:— 
The upper portion, about four inches in length, rests 
upon the sacral plexus of nerves and the pyriformis 
m uscle; 
The middle portion, about three inches, is in relation 
in the male with the bladder, prostate gland, and vesicuhe 
seminalis; in the female with the uterus and vagina, 
being adherent to the latter; 
The lower portion, about one and one-quarter inches, 
turns backward and terminates in the anus. It is sup- 
ported by the levator ani muscle, and is surrounded by 
the internal and external sphincters of the anus. 
The structure of the large intestine consists of four 
coats—serous, muscular, cellular, and mucous :— 
The serous coat, derived from the peritoneum, invests THE ALIMENTARY APPARATUS. 
235 
completely the transverse portion and upper portion of 
the rectum, but only partially the others, being absent in 
the posterior surfaces of the ascending and descending 
portions, and on the middle portion of the rectum. 
The lower portion of the rectum is without peritoneal 
covering. The appendices epiploicse are folds of serous 
membrane filled with fat and attached chiefly to the 
transverse colon, depending from it. 
The muscular coat consists of longitudinal fibres ar- 
ranged into three flat bands, shorter nearly one-half 
than the intestine itself, and the circular, distributed 
more evenly, but accumulated at points, producing with 
the former a saccidated condition. 
The cellular coat connects the mucous with the 
muscular coat beneath. 
The mucous coat is smooth, destitute of villi and 
valvulse coniventes, and thrown into numerous folds, 
two to four of which, situated in the rectum, have 
received the name of Houston's folds. 
It contains crypts of Lieberkiihn, more numerous 
here than in the small intestine, and solitary glands scat- 
tered throughout, but most numerous in the appendix 
and csecum, where some of them are accumulated into 
Pejmr’s patches. 
The arteries of the csecum and colon are from the 
mesenteric. The lymphatics empty into the mesenteric 
glands, and the nerves are derived from,the mesenteric 
plexus of the sympathetic system. 
The arteries of the rectum are the hsemorrhoidal 
branches of the inferior mesenteric, internal iliac, and 
internal pudic. The veins form hsemorrhoidal plexus, 
and empty into inferior mesenteric and internal iliac 
veins. 
The lymphatics go to the sacral and lumbar glands, 
and the nerves are from the hypogastric plexus of sym- 
pathetic and contiguous spinal nerves. 
THE PANCREAS. 
The pancreas is an oblong compound racemose gland, 
about six to eight inches in length, one and one-half 236 
HUMAN ANATOMY. 
inches in breadth, and one-half to one inch in thickness, 
situated across the back part of the epigastric and left 
hypochondriac regions. Its weight varies from two to 
six ounces. 
It consists of a head, body, and tail:— 
The head, or right extremity, is received into the 
concavity of the duodenum. The lesser pancreas, a de- 
tached portion of the gland, lies behind it. 
The tail, or lesser end, terminates above the left kid- 
ney and suprarenal capsule, in contact with the spleen. 
The body is in relation in front with the stomach and 
transverse mesocolon; behind it rests upon the first 
lumbar vertebra, having interposed the crura of the dia- 
phragm, vena cava, left renal vein, aorta, superior mesen- 
teric artery and vein, the inferior mesenteric vein, and 
commencement of portal vein. 
The splenic artery and vein are lodged in a groove on 
its upper border. 
The pancreatic duct, or canal of Wirsung, runs 
throughout the substance of the organ, to emerge at the 
head, and open into the duodenum by an orifice in com- 
mon with the ductus communis choledochus. The 
lesser pancreas, when it exists, empties by the ductus 
pancreaticus minor. 
The structure resembles that of the salivary glands, 
but is softer and looser. 
Arteries are from the splenic and pancreatico-duode- 
nal branches of the hepatic and superior mesenteric. 
The veins join the splenic or superior mesenteric. 
The nerves are from splenic plexus of the sympa- 
thetic. 
The lymphatics empty into the lumbar glands. 
THE LIVER. 
The liver is the largest gland in the body, measuring 
in its transverse diameter from ten to twelve inches, and 
its antero-posterior six to seven, and its thickest part 
about three inches, and weighing about from three to 
four pounds. It occupies the upper part of the abdomi- 
nal cavity, and the right hypochondriac, epigastric, THE ALIMENTARY APPARATUS. 
237 
and a portion of the left hypochondriac regions. Its 
upper surface is oonvex and rests against the diaphragm 
and a small portion of the abdominal parietes in front. 
Its lower surface is in contact with the duodenum and 
stomach, the right kidney and suprarenal capsules, and 
the hepatic flexure of the colon. It is divided by the 
longitudinal fissure into the right and left lobes. The 
liver has five fissures, five lobes, five ligaments, five 
sets of vessels, and is inclosed in a fibrous coat, contin- 
uous at the transverse fissure with the capsule of Glis- 
son. It is also invested by the peritoneum, except at 
the attachment of the coronary ligament. 
Undersurface of liver: 1. longitudinal fissure; 2, fissure for ductus venosns; 3, 
transverse fissure; 4, gall-bladder; 5, vena cava; 6, right lobe; 7, left lobe; 8, lobu- 
lus spigelii; 9 , lobulus caudatus; 10, lobulus quadratus. 
Fig. 56. 
Structure.—The liver is made up of lobules, which are 
small, granular bodies about one-fifteenth of an inch in 
diameter, held together by delicate connective tissue and 
the branches of the five sets of vessels (to be de- 
scribed) and nerves, the whole being inclosed in a serous 
and fibrous coat. 
Each lobule is made up of a mass of polyhedral, nu- 
cleated cells, inclosed in a capillaty plexus derived from 238 
HUMAN ANATOMY. 
the hepatic artery and portal vein, and giving origin to 
the hepatic vein and biliary duct. 
The five fissures of the liver are all situated on its 
under surface. They separate the five lobes from one 
another. They are— 
1. Longitudinal fissure extends from before backward, 
from the notch in front to the posterior border. It is 
sometimes called the umbilical fissure, and lodges the 
round ligament, the remains of the foetal umbilical vein. 
2. Fissure for the ductus venosus is the posterior 
Transverse section of lobules of liver: a, interlobular vein; b, intralobular 
central vein. 
Fig. 57. 
portion of the longitudinal fissure, and lodges the re- 
mains of the ductus venosus of foetal life. 
3. Transverse fissure, or portal fissure, crosses the 
inferior surface of the liver and joins the 
longitudinal. It transmits the portal vein, hepatic ar- 
tery and nerves, and the hepatic duct and lymphatics. 
4. Fissure for the gall-bladder is a shallow depres- 
sion beneath the right lobe, running parallel with the 
longitudinal fissure in front. 
5. Fissure for the vena carta runs obliquely upward 
along the inferior surface near its posterior margin to 
the left side, joining the fissure for the ductus venosus THE ALIMENTARY APPARATUS. 
239 
behind, and separated from tlie transverse fissure in 
front by the lobulus caudatus. It lodges the inferior 
cava, which, within this fissure, receives the hepatic 
veins. 
The five lobes of the liver ai-e— 
Right lobe, much the largest, is somewhat quadrilat- 
eral in outline, and presents three fissures and two de- 
pressions, the latter one for the right kidney and its 
suprarenal capsule, and the other for the hepatic flexure 
of the colon. 
Left lobe, smaller, is separated from the right lobe 
by the longitudinal fissure, and is in contact with the 
stomach. 
Lobulus quadratus, or square lobe, occupies the an- 
terior border of the under surface of the right lobe, be- 
tween the umbilical fissure and the fissure for the gall- 
bladder, and in front of the transverse fissure. 
Lobulus Spigelii occupies a similar position to the 
quadrate lobe, along the posterior border, immediately 
back of it, from which it is separated by the transverse 
fissure. It is bounded laterally by the fissures for the 
ductus venosus and vena cava. 
Lobulus caudatus, or tailed lobe, unites the lobus Spi- 
gelii with the right lobe, and separates the transverse 
fissure from the fissure for the vena cava. 
The five ligaments of the liver are folds of peri- 
toneum except one, the round ligament, which is the 
remains of the umbilical vein and ductus venosus of 
the foetus. 
The}r are— 
1. Longitudinal ligament consists of two laj’ers of 
peritoneum, attached by one margin to the under sur- 
face of the diaphragm, and the sheath of the right rec- 
tus muscle, and is attached to the liver along its ante- 
rior margin, from the notch to its posterior border. 
2 and 3. The lateral ligaments, one on either side, are 
triangular layers of peritoneum, attached to the lateral 
edges of the liver toward its posterior margin. 
4. The coronary ligament is formed of two layers, 
continuous with the lateral ligament and with the 240 
HUMAN ANATOMY. 
longitudinal ligament, connecting the posterior border of 
the liver to the diaphragm. 
5. The round ligament is a fibrous cord, the remains 
of the obliterated umbilical vein and ductus venosus, 
extending from the umbilicus to the longitudinal fissure, 
extending as far back as the inferior vena cava. 
The five sets of vessels are the hepatic artery, portal 
vein, hepatic veins, hepatic ducts, and lymphatics:— 
The hepatic artery, the nutrient vessel of the liver, 
one of the branches of the coeliac axis, enters the trans- 
verse fissure, and after giving off" branches to the capsule 
of Gllisson, and to the capsule, divides into interlobular 
branches, which form plexuses around each lobule, and 
terminate in capillaries between the cells, anastomosing 
with the capillaries of the portal vein. 
The portal vein enters at the transverse fissure, di- 
vides into two branches, and finally terminates in the 
interlobular plexuses, already described. These all unite 
into one vein—intralobular vein—traversing the centre 
of the lobule to join the sublobular vein, the latter end- 
ing in the hepatic veins. These latter finally terminate 
in the inferior vena cava. 
The hepatic ducts originate between the hepatic cells 
as bile capillaries, minute canals without walls, and form 
a plexus between the lobules. From these plexuses 
ducts converge and unite to finally form the hepatic 
duct. 
The lymphatic vessels form twro sets—the superficial, 
those upon the surface of the organ ; and deep, those ac- 
companying the branches of the hepatic arteries and 
portal vein. 
The gall-bladder is a conical membranous sac at- 
tached to the under surface of the right lobe of the 
liver, and partly covered by peritoneum. It measures 
about four inches by one, and has a capacity of about 
nine drachms. It consists of a fundus or rounded ex- 
tremity, a body and neck, and has three coats—a fibrous, 
muscular, and mucous—the latter lined with columnar 
epithelium. 
The neck terminates in the cystic duct, the mucous THE ALIMENTARY APPARATUS. 
241 
membrane of which is thrown into a series of folds, 
forming a spiral valve. 
The ductus communis choledochus, or common biliary- 
duct, about three inches long and the diameter of a goose- 
quill, is formed by the union of the hepatic, about two 
inches in length, and the cystic, about one inch in length. 
It empties into the descending portion of the duodenum 
in common with the pancreatic duct, about three and 
one-half inches below the pylorus. 
The following group includes the glands without 
ducts, of unknown function, which resemble each other 
in structure:— 
THE DUCTLESS GLANDS. 
Spleen, 
Thyroid, 
Pituitary body, 
Thymus, 
Suprarenal capsules, 
Glandula coccygea, 
The Spleen.—The spleen is a soft, very vascular, 
sponge-like organ, situated deeply in the left hypochon- 
driac region. Its function is unknown, but it is classed 
among the ductless, or blood-making glands. It varies 
much in size and weight, measuring about five inches in 
length, three in width, one and one-half in thickness, and 
weighing between seven and ten ounces. 
Outer surface, smooth and convex, corresponds to 
the ninth, tenth, and eleventh ribs, and is adapted to the 
inferior surface of the diaphragm, to which it is con- 
nected by the suspensory ligament. 
Glandula intercarotica. 
Inner surface is concave and adapted to the cardiac 
end of the stomach, to which it is attached by the gastro- 
splenic omentum. 
Hilus is a vertical fissure on the concave inner sur- 
face, admitting the passage of blood-vessels, tymplmtics, 
and nerves. The structure consists of two coats—a 
serous and fibro-elastic coat, inclosing in its interior the 
spleen pulp. 
Serous coat, derived from the peritoneum, covers the 
entire organ, except at the hilus, where it forms the 
gastro-splenic omentum. 242 
HUMAN ANATOMY. 
Fibro-elastic coat, or tunica propria, surrounds the 
organ, and from the hiius and periphery sends numerous 
fibrous bands, or trabeculae, into the substance of the 
organ, dividing it into small trabecular spaces, or 
areolae. 
Splenic substance, or spleen pulp, is a soft, reddish- 
brown mass, consisting of a fine reticulum of connective- 
tissue corpuscles, inclosing red and white blood-corpus- 
cles, nucleated and non-nucleated cells, granular matter, 
etc. 
Malpighian corpuscles, or bodies, are spheroidal liy- 
perplasim of lymphoid tissue from the outer coat of the 
arterioles. They are not encapsuled, vary from one- 
sixtieth to one-twenty-fifth of an inch, and are visible in 
the fresh specimens to the naked eye. 
Splenic artery, remarkable for its size and tortuosity, 
divides in the hiius into four or five branches, each dis- 
tributed to a segment, terminating in a capillary plexus 
without anastomoses, or opening directly into the areolae 
of the splenic pulp. 
Splenic vein commences in the same manner as the 
arterioles end, and empties into the portal vein. The 
smaller veins anastomose freely. 
Nerves are from the splenic plexus, formed from the 
right pneumogastric, and left semilunar ganglia of the 
solar plexus. 
Thyroid Gland.—The thyroid is a vascular, gland- 
like body, situated on the sides of the upper part of the 
trachea, and consists of two lateral lobes connected by a 
transverse portion, the isthmus. 
A third lobe—the pyramid—sometimes arises from 
the left lobe or upper margin of the isthmus. 
Levator glandulse thyroideae are muscular bands 
sometimes found passing from the isthmus to the body 
of the hyoid bone. 
Structure.—This is similar to other glands, being 
made up of a capsule and radiating septa inclosing 
alveoli—the closed vesicles—each of which is lined with 
one layer of columnar epithelium, and contains more or 
less viscid, transparent fluid—the colloid substance. The THE ALIMENTARY APPARATUS. 
243 
closed vesicles are abundantly supplied with blood by 
meshes of capillaries, while penetrating the septa are 
lymphatic net-works, and lymph sinuses are found in the 
tissue between the vesicles and septa. 
Arteries are the superior thyroid, a branch of exter- 
nal carotid, and inferior thyroid, a branch of the thyroid 
axis, and sometimes a branch from the arch of the aorta 
or innominate artery, the middle thyroid, or arteria thy- 
roidea ima. All the vessels anastomose freely. 
Veins form plexus about the gland and give off the 
superior and middle thyroid to internal jugular, and 
inferior thyroid to innominate vein. 
Nerves, from middle and inferior cervical ganglia 
and from pneumogastric. 
Thymus Gland.—The thymus gland is a temporary 
organ of unknown function which attains its full size at 
the end of two years and at puberty has almost disap- 
peared. It occupies the upper part of the anterior 
mediastinum, and is in relation in front with the sternum, 
and below with the pericardium, aorta, left innominate, 
and trachea. It is a flat, triangular body, composed 
of a pair of lateral unequal lobes, about two inches in 
length, one and one-half inches at the widest part, and 
one-quarter inch thick, and weighing about one-half 
ounce. 
Structure.—It is composed of a frame-work of fibro- 
connective tissue, consisting of a capsule and septa, and 
the gland substance, which is divided into lobes, these 
into lobules, and these into units or follicles. 
The follicles vary in shape, present for study a cortex 
and medulla, and consist of adenoid tissue. 
The cortical meshes of the reticulated adenoid tissue 
are filled with lymph-corpuscles, while in the medulla 
the meshes are less numerous and filled with large endo- 
thelioid plates and giant cells. 
The capillary blood-vessels surround the follicles. 
Arteries are from superior and inferior thyroid and 
internal mammary. 
Veins join thyroid and left innominate veins. 
Nerves are from sympathetic and pneumogastric. 244 
HUMAN ANATOMY. 
Suprarenal Capsules.—The suprarenal capsules are 
two small, triangular bodies, situated upon the upper and 
front part of either kidney. They measure from one 
and one-quarter to two inches in length, and less in 
breadth, two to three lines in thickness, and weigh about 
two drachms. 
Structure.—Like the kidneys, they consist of a corti- 
cal and medullary portion, inclosed in a capsule which 
sends septa into the substance of the body. 
The cortex is composed of three zones of epithelial 
cells—outer, middle, and inner—the middle being the 
largest. 
The medulla consists of streaks of small, transpa- 
rent cells, separated by connective-tissue and capillaries. 
These streaks are continuous with the inner zone of the 
cortex. The nerve supply is rich, consisting of non- 
medullated fibres connected with small ganglia. 
Relations.—The inferior concave border rests upon the upper 
surface of the kidney. The inner border rests against the inferior 
vena cava on the right side, the aorta on the left, and is in relation 
with semilunar ganglion and great splanchnic nerves. 
The anterior surfaces touch on the right the under surface of the 
liver and on the left side the pancreas and spleen. The posterior 
surface lies upon the crus of the diaphragm, about opposite the ten 
dorsal vertebrae. 
Arteries are suprarenal, and from the renal and 
phrenic arteries. 
Veins on the right joins vena cava, on left renal vein. 
Nerves, from renal and solar plexus. 
Pituitary body (hypophysis cerebri) is a small, vas- 
cular mass on the inferior surface of the cerebrum, but 
resembling in structure the ductless glands. 
Structure.—The upper lobe is part of the central 
nervous system. The lower and larger lobe has a 
fibrous capsule which sends processes into the interior, 
forming minute septa; these divide and reunite around 
spaces called alveoli. The alveoli contain epithelial 
cells of various shapes, between which are small irregu- 
lar cells having flattened nuclei. THE alimentary apparatus. 
245 
Tiie glandula coccygea, lying near the tip of the 
coccyx and the intercarotica, at the angle of bifur- 
cation of the common carotid, have been recently in- 
cluded among the ductless glands. They were both dis- 
covered by Luscha. The frame-work of their bodies is 
identical with that of other glands, except that the septa 
contain non-striped muscular tissue. The alveoli are 
filled with gland substance, consisting of connected 
masses of epithelial cells, having in their centre a 
twisted capillary blood-vessel. VOCAL AND RESPIRATORY APPARATUS. 
Tiie larynx is a musculocartilaginous box at the 
top of the trachea, below the root of the tongue and the 
liyoid bone, and is the organ of the voice. It is com- 
posed of cartilages connected 
by ligaments, provided with 
muscles, blood-vessels, and 
nerves, and lined with mucous 
membrane. The cartilages are 
nine in number, three single 
and three pairs :— 
Thyroid, 
Cricoid, 
Epiglottis, 
Two arytenoid, 
Two cornicula laryngis, 
Two cuneiform. 
The thyroid, the largest car- 
tilage, consists of two quadri- 
lateral halves, united in front 
in the median line, or entering 
angle of the thyroid, the upper 
part of which is the pomum 
adami. The outer surface is 
marked by an oblique ridge 
for the attachment of muscles. 
The inner surface is smooth 
and covered by mucous mem- 
brane, and has in front at- 
tached the true and false vocal 
cords. The posterior angles are prolonged into superior 
and inferior horns, the superior giving attachment to the 
thyro-liyoid ligament, the inferior articulating with the 
sides of the cricoid cartilage. 
Vertical section of larynx: 1, body 
of hyoid bone; 2, epiglottis; 3, thyro- 
hyoid membrane; 4, great cornu of hy oid; 
5, false vocal cord; 6, thyro-hyoid liga- 
ment ; 7, ventricle of larynx ; 8, thyro- 
hyoid membrane; 9, true vocal cord; 
lit, aryteno-epiglottidean fold; 11, thy- 
roid cartilage; 12, superior cornu of 
thyroid; 14, arytenoides muscle; 16, 
arytenoid cartilage; 18, cricoid cartilage. 
Fig. 59. VOCAL AND RESPIRATORY APPARATUS. 
The cricoid cartilage resembles a seal ring, narrow in 
front, the back part of the upper border articulates with 
the arytenoid cartilage, and on each side externally are 
two facets for the articulation of the inferior horns of 
the thyroid. 
The epiglottis is a spoon-shaped, fibro-cartilaginous 
plate, large above, its narrow inferior extremity is pro- 
longed and attached by a band of fibro-elastic tissue of 
thyro-epiglottic ligament to the thyroid cartilage. It is 
also attached to the posterior surface of the hyoid bone 
by the hyo-epiglottic ligament. The anterior or lingual 
surface has three reflections of mucous membrane be- 
tween it and the tongue, called the glosso-epiglottidean 
ligaments. 
The arytenoid cartilages each resembles the mouth of 
a pitcher, from which they are named. They are smaller 
than the other two, and are situated on the summit of 
the cricoid cartilage posteriorly. They are three-sided, 
the apex extends backward, and is surmounted by the 
supra-arytenoid, cornicula laryngis, or cartilages of San- 
torini. 
The posterior surface has attached to it the arytenoid 
muscle. The anterior surface has attached to it the 
thyro-arytenoid muscle and the false vocal cord. The 
internal surfaces are opposed to each other and sup- 
plied with mucous membrane. Of the three angles at 
the base, the outer gives attachment to the crico-aryte- 
noid muscle, lateral and posterior. The anterior is pro- 
longed for attachment of the true vocal cord. 
The cuneiform cartilages, or cartilages of Wrisberg, 
are two small rod-shaped bodies extending upward from 
the arytenoid cartilages into the aryteno-epiglottidean 
fold. 
The cartilages of the larynx, with the exception of 
the epiglottis, are composed of true cartilage. 
The ligaments of the larynx are divided into two 
sets—the extrinsic, those connecting the epiglottis and 
thyroid cartilage with the hyoid bone, and the intrinsic, 
those which connect the various cartilages together. 
The extrinsic consist of three:— 248 
HUMAN ANATOMY. 
1. Thyro-hyoid membrane, connecting the upper border of the 
thyroid cartilage with the inner surface of the hyoid bone; 
2 and 3. The two lateral thyro-hyoid ligaments, fibro-elastic cords 
connecting the superior horns of the thyroid cartilage with the ex- 
tremities of the great horns of the hyoid bone. They contain a small 
nodule, the cartilago-triticea. 
The intrinsic ligaments are sixteen in number, as 
follows:— 
Hyo-epiglottic ligament; 
Crico-thyroid membrane; 
Two crico-thyroid capsular ligaments ; 
Two crico-arytenoid ligaments; 
Two crico-arytenoid capsular ligaments ; 
Two superior thyro-arytenoid ligaments (in false cords) ; 
Two inferior thyro-arytenoid ligaments (in true cords) ; 
Thyro-epiglottic ligament; 
Three glosso-epiglottic folds. 
The hyo-epiglottic ligament is a fibro-elastic band, 
connecting the anterior surface of the epiglottis with the 
upper border of the hyoid bone. The ligaments con- 
necting the cricoid to the thyroid cartilage are three 
also—the crico-thyroid ligament, capsular ligaments, and 
synovial membranes. 
The crico-thyroid membrane, a yellow, elastic band, 
connects the adjacent margins of the cricoid and thyroid 
cartilages, and extends from the upper border of the 
cricoid cartilage to the lower margin of the true vocal 
cords. 
The two crico-thyroid capsular ligaments surround 
the articulations between the inferior horns of the thy- 
roid and the cricoid cartilage. 
The synovial membrane lines the capsular ligaments, 
forming a true enarthrodial joint. 
The ligaments of the epiglottis are the thyro-epiglottic, 
the hyo-epiglottic, and the three glosso-epiglottic folds of 
mucous membrane before described. 
The superior aperture of the larynx is a triangular 
opening with the apex in front. It is bounded behind 
by the apices of the arytenoid cartilages and cornicular 
laryngis, in front by the epiglottis, and laterally by the 
aryteno-epiglottidean folds. From this, as its superior VOCAL AND RESPIRATORY APPARATUS. 
249 
boundary, the cavity of the larynx extends as low as to 
the lower border of the cricoid cartilage. The true 
vocal cords and the thyro-aryrtenoid muscle divide it 
into two parts, the narrow fissure between the two cords 
being called the glottis, or rima glottidis. 
The superior or false vocal cords are two folds of 
mucous membrane inclosing the superior thyro-arytenoid 
ligaments. 
The inferior or true vocal cords are two folds of 
mucous membrane inclosing the inferior thyro-aryte- 
noid ligaments, composed of elastic tissue, from the 
sides of the upper border of the cricoid cartilage, ex- 
tending upward to the bases of the arytenoid cartilages, 
and lower portion of the angle of the thyroid. Their 
upper margins correspond to the lower edges of the 
ventricles of the larynx. 
The ventricle of the larynx is a deep fossa on either 
side of the larynx, bounded above by the false vocal 
cords, below by' the inferior or true vocal cords, and ex- 
ternally by the thyro-arytenoideus muscle. 
The sacculus laryngis, or laryngeal pouch, is a mem- 
branous sac lined with mucous membrane, opening into 
its anterior portion. Its inner or laryngeal surface is 
covered by the aryteno-epiglottideus inferior, and the 
outer side by the thy ro-epiglottideus and thyro-aryteno- 
ideus muscles. It is compressed by these muscles, dis- 
charging its mucous secretion upon the true vocal cords. 
Muscles.—The intrinsic muscles of the larynx con- 
sist of two sets, five connected with the vocal cords and 
rima glottidis, and three with the epiglottis. The five 
muscles of the vocal cords are:— 
Crico-thyroid.— Origin, from the front and sides of 
the cricoid cartilage ; insertion, into anterior border of 
the inferior cornua, and lower margin of the thyroid car- 
tilage ; action, elongates and renders tense the vocal 
cords ; nerve, superior laryngeal. 
Grico-arytsenoideus Posticus.— Origin, from the sides 
and posterior surface of the cricoid cartilage ; insertion, 
into the outer angle of the base of arytenoid cartilage; 
action, rotates the arytenoid cartilages outward, opening 250 
HUMAN ANATOMY. 
the glottis, and rendering tense the vocal cords; nerve, 
recurrent laryngeal. 
Orico-arytsenoideus Lateralis.—Origin, from upper 
and outer side of the cricoid cartilage; insertion, in 
front of the preceding into the outer angle of the base 
arytenoid; action, rotates the arytenoids inward, closing 
the glottis ; nerve, recurrent laryngeal. 
Arytsenoideus.—Origin, from outer border and pos- 
terior surface of one arytenoid cartilage ; insertion, into 
the same part of the other—its fibres are oblique and 
transverse; action, by approximating the arytenoids 
closes the back part of the glottis ; nerves, superior and 
recurrent laryngeal. 
Thyro-arytsenoideus.—Origin, from the crico-thyroid 
membrane and lower half of the entering angle of the 
thyroid cartilage; insertion, into anterior surface and 
base of the cartilage—it consists of inferior 
and superior portions, the former entering into the for- 
mation of the true vocal cords ; action, mainly relaxes 
the true vocal cords by drawing the arytenoids forward ; 
nerve, recurrent laryngeal. 
Kerato-cricoideus, a small muscular slip, only occa- 
sionally found; origin, posterior surface of cricoid carti- 
lage; insertion, into inferior cornu of thyroid cartilage; 
action, pulls inferior cornu downward and backward. 
Triticeo-glossus.—Origin, from the cartilago-triticea 
and thyro-hyoid ligament; insertion, with the liyoglossus 
into the tongue; action, unknown. 
The muscles of the epiglottis are:— 
Thyro-epiglottideus.—Origin, from the inner surface 
of thyroid cartilage; insertion, into the margin of epi- 
glottis and aryteno-epiglottidean fold ; action, compress 
the sacculus laryngis and depress the epiglottis ; nerve, 
recurrent laryngeal. 
Arytseno-epiglottideus superior.—Origin, from apex 
of arytenoid; insertion, into aryteno-epiglottidean folds; 
action, constricts the superior laryngeal aperture; nerve, 
recurrent laryngeal. 
Arytseno-epiglottideus Inferior.—Origin, from middle 
of internal portion of the arytenoid; insertion, into VOCAL AND RESPIRATORY APPARATUS. 
251 
upper and inner part of epiglottis ; action, compresses 
the sacculus laryngis; nerve, recurrent laryngeal. 
The lining mucous membrane of the larynx is contin- 
uous with that of the pharynx and trachea. It forms 
the glosso-epiglottie and arytieno-epiglottic folds, ad- 
heres tightly to the epiglottis, vocal cords, and the inte- 
rior of the cricoid cartilage, but is more loosely attached 
to other parts. It contains numerous racemose glands, 
particularly along the posterior margin of the arytseno- 
epiglottidean fold, and in front of the aiytenoid carti- 
lages, where they are called the arytenoid glands. Its 
epithelium is of the ciliated, columnar variety below the 
true vocal cords, and above this point in front as high 
as the middle of the epiglottis. The other portions are 
covered by squamous epithelium. 
The arteries are the laryngeal branches from the 
superior and inferior thyroid, and the crico-thyroid 
branches of the superior thyroid. 
The veins join the inferior, middle, and superior thy- 
roid veins. 
The lymphatics enter the deep cervical glands. 
The nerves are the inferior or recurrent laryngeal, 
the superior laryngeal branches of the pneumogastric, 
and branches from the sympathetic nerve. 
The superior laryngeal supplies sensation to the 
larynx. It descends from the inferior ganglion of the 
pneumogastric, behind the internal carotid at the side 
of the pharynx, and divides into two branches— 
the internal laryngeal pierces the thyro-hyoid mem- 
brane to supply the mucous membrane and arytenoid 
muscle, the external laryngeal supplies the crico-thyroid 
muscle. 
The inferior or recurrent laryngeal, from its origin, 
winds around the subclavian on the right side and 
around the arch of the aorta on the left side, and as- 
cends by the side of the trachea to the larynx, of which 
it is the motor nerve, supplying all the muscles of the 
larynx except the crico-thyroid, giving off in its course 
cardiac, oesophageal, tracheal, and pharyngeal branches, 
and anastomosing with the superior laryngeal nerve 252 
HUMAN ANATOMY. 
The trachea, or windpipe, is a membrano-cartilagi- 
nous tube, about four and a half inches in length, three- 
quarters to one inch in width, extending from the fifth 
cervical to the third dorsal vertebra. It divides into 
two bronchi, the right, about an inch long and nearly at 
right angles, passing behind the right pulmonary artery 
on a level with the fourth dorsal vertebra ; the left, nar- 
rower, about twice as long, passes beneath the arch of 
the aorta on a level with the fifth dorsal vertebra, be- 
hind the left pulmonary artery. The trachea and 
bronchi are formed of a series of cartilaginous rings, 
incomplete at their posterior third, connected by fibro- 
elastic membrane, and lined by columnar ciliated epithe- 
lium. The last ring is triangular, so as to fit the rings 
of the twro bronchi. The mucous membrane contains 
numerous racemose glands, the largest on the posterior 
surface, called the tracheal glands. The muscular fibres 
consist of two layers, longitudinal, the most external 
and transverse internal, both unstriated. 
Relations.—The trachea has the following relations in 
the neck:— 
TRACHEA AND BRONCHI. 
Lobes of the thyroid body; 
Carotid arteries; 
Inferior thyroid arteries. 
Laterally. 
Anteriorly. 
Skin, superficial and deep fascia; 
Anterior jugular veins; 
Left innominate vein; 
Inferior thyroid plexus of veins ; 
Isthmus of thyroid body; 
Arteria thyroidea iina (sometimes). 
CEsophagus, 
Vertebral column; 
Recurrent and inferior laryngeal nerves. 
Posteriorly. 
The following in the thorax :— VOCAL AND RESPIRATORY APPARATUS. 
253 
Laterally. 
Pleura; 
Pneuinogastric nerves. 
Anteriorly. 
Sternum; 
Remains of thymus; 
Arch of aorta; 
Right and left innominate veins; 
Left carotid artery; 
Deep cardiac plexus. 
Posteriorly. 
(Esophagus. 
The arteries are derived from the inferior thyroid 
and bronchial. 
The veins empty into the thyroid and bronchial 
plexuses. 
The nerves are from the pneumogastric and sympa- 
thetic. 
The lymphatics empty into the mediastinal glands. 
The bronchi are the continuation of the trachea from 
its bifurcation to the hilus of the lung. 
Right bronchus is shorter, about one inch in length, 
placed more horizontally, and wider. It divides at the 
hilus into three short branches, corresponding to the 
divisions of the right lung. 
Left bronchus is longer, nearly two inches in length, 
placed more obliquely, and narrower than the right. It 
divides into two long branches corresponding to the 
number of lobes :— 
Relations.—The right bronchus has the right auricle and the 
superior vena cava in front of it, the right pulmonary artery at first 
below, then passing also in front, and the vena azygos arching over it 
from behind; 
The left bronchus has the arch of aorta above, the left pulmonary 
artery at first above, then in front, and the oesophagus, thoracic duct, 
and descending aorta behind. 
The arteries, veins, nerves, and lymphatics are the 
same as for the trachea. 
The two bronchi subdivide into the bronchial tubes, 
or bronchioles, which ramify throughout the lungs, di- 
viding and subdividing, to end finally in the primary 254 
HUMAN ANATOMY. 
lobules, where they communicate with the intercellular 
air-passages. Their cartilages consist of thin plates, 
distributed irregularly along the tubes, and in the finer 
tubes disappearing entirely. The mucous membrane of 
the bronchi and bronchial tubes is lined throughout 
with columnar ciliated epithelium. 
THE LUNGS. 
The lungs, the organs of respiration, are two in num- 
ber, occupying the lateral cavities of the chest, separated 
from each other by the heart and structures within the 
mediastinum. They accurately fill the cavity of the 
chest at all times, and are covered Ity the pleura. They 
are conical in shape, presenting each a base, apex, two 
borders, and two surfaces. The apex extends upward 
above the level of the first rib; the base occupies the 
convex surface of the diaphragm ; the external, or thora- 
cic surface is accurately applied to the wall of the tho- 
rax ; the inner surface is in contact with the pericar- 
dium, and is marked by a depression or liilus, or hilum 
pulmonis, at the root of the lungs. The posterior border 
rests on either side of the spinal column, and the ante- 
rior border is thin and overlaps the pericardium. 
The root of each lung, situated near its middle, is 
composed of the following structures, surrounded by a 
reflection of pleura :— 
Bronchus; 
Pulmonary artery; 
Pulmonary veins ; 
Bronchial glands; 
Bronchial vessels; 
Posterior and anterior pulmonary plexuses of nerves; 
Connective tissue. 
The root of the right lung is behind the right supe- 
rior cava and the vena azygos arches over it. The root 
of the left lung lies below and in front of the arch and 
descending aorta. The relative positions of the pulmo- 
nary veins, pulmonary artery, and bronchus on either 
side are:— VOCAL AND RESPIRATORY APPARATUS. 
255 
Both sides, from before backward :— 
V. Pulmonary veins, 
A. Pulmonary artery, 
B. Bronchus. 
Right side, from above downward :—. 
B. Bronchus, 
A. Pulmonary artery, 
V. Pulmonary veins. 
Left side, from above downward:— 
A. Pulmonary artery, 
B. Bronchus, 
V. Pulmonary veins. 
Fig. 59. 
Heart and lungs: 1, right ventricle; 3, right auricle; 5, pulmonary artery; 9, 
aorta; 10, superior cava; 20, root of lung ; 21, 22, 23, upper, middle, and lower lobes 
of right lung; 24, 25, upper and lower lobes of left lung. 
The weight of the lungs varies according to many 
conditions. In the adult the approximate weight is 
about forty-two ounces, the right being two ounces 
heavier than the left, and their total capacity about three 
hundred cubic inches. The right lung has three lobes, 
the left but two, of which the lower is the larger. The 
lungs in infancy are of a pale-rose color, but later 256 
HUMAN ANATOMY. 
become of a leaden hue, variegated with dark slate and 
bluish-black. They are highly elastic, crackle on press- 
ure, and float in water, having a specific gravity of 
0.345 to 0.t46. In the fcetus before birth, and also in 
certain diseases, they sink in water. The structure of 
the lung consists of an external serous coat, the visceral 
layer of the pleura, a subserous areolar tissue, highly 
elastic, and the parenchyma, or proper substance of the 
lungs. The latter is made up of small polyhedral pri- 
mary lobules, which unite to form secondary lobules, 
the latter giving rise to the markings on the sur- 
face. Both the primary and secondary lobules are 
held together by connective tissue. A primary lobule 
represents the structure of the entire organ, consisting 
of a bronchiole and infundibula, or air-passage, com- 
municating with numerous air-cells. 
The air-cells are minute polyhedral cavities, from one 
two-hundredths to one-seventieth of an inch in diameter, 
separated from each other by a thin lamina, and com- 
municating freely with the infundibula. They vary much 
in size, being largest on the surface, the thin borders, 
and the apices. Each air-cell is composed of the base- 
ment membrane, lined with squamous epithelium, and 
surrounded by a minute capillary net-wrork of blood- 
vessels, which intervene between the terminal branches 
of the pulmonary artery and the commencement of the 
pulmonary veins. Between the cells the capillary net- 
work forms a single layer. 
The pulmonary artery conveys the venous blood to 
the lungs and terminates in the capillary net-work about 
the air-cells, from which proceeds the pulmonary vein, 
which proceeds along the bronchial tubes to the left 
auricle of the heart. The bronchial arteries supply the 
structure of the lungs. They are derived from the 
aorta, and follow the course of the bronchial tubes, 
the bronchial veins returning the blood to terminate 
in the hemiaz3,'gos major on the right and the superior 
hemiazygos or superior intercostal vein on the left. 
The lymphatics are numerous and consist of a super- 
ficial set converging to the root and a deep set along VOCAL AND RESPIRATORY APPARATUS. 
257 
the course of the tubes, and both enter the bronchial 
glands. 
The nerves are derived from the anterior and pos- 
terior pulmonary plexuses of the pneumogastric and 
sympathetic, the latter the larger. Ganglia are found 
upon these nerves. 
THE PLEURA. 
Each lung is invested by a delicate serous membrane, 
the pleura, which lines the internal wall of the thorax 
and is reflected at the root of the lung over that organ. 
It consists essentially of two layers, a parietal, or pleura 
costalis, and visceral, or pleura pulmonalis. It adheres 
accurately to the subjacent structures, and is called, 
from its position, costal, diaphragmatic, mediastinal, and 
pulmonary. The space between the two layers of each 
pleura, known as the cavity of the pleura, contains a thin, 
serous secretion. 
A fold extending downward from the root of the lung 
to the diaphragm forms the so-called pulmonary liga- 
ment, or ligamentum latum pulmonis. 
Each pleura is a closed sac; the right is wider, 
shorter, and extends higher in the neck than the left. 
They do not meet in the median line, except opposite 
the upper part of the gladiolus, but have a space be- 
tween them known as the mediastinum. 
The arteries are from the intercostal, bronchial, peri- 
cardiac, internal mammary, musculo-phrenic, and thymic. 
The veins accompany the arteries. 
The lymphatics are numerous, and empty into the 
intercostal and posterior mediastinal glands. 
The nerves are from the phrenic and sympathetic. 
MEDIASTINUM. 
The mediastinum is the space left between the two 
pleurae in the median line between the sternum and 
vertebral column, and contains the heart within its peri- 
cardium and all the thoracic viscera except the lungs. 
The intervals in the mediastinum from their position 
are named anterior, middle, posterior, and superior 258 
HUMAN ANATOMY. 
mediastinal cavities. The boundaries and contents of 
the four mediastinal cavities are as follow :— 
Anterior mediastinum, bounded in front by the ster- 
num; laterally, pleura; behind, the pericardium. It 
contains :— 
Origin of the sterno-thyroideus muscle ; 
Origin of the sterno-hyoideus muscle; 
Triangularis sterni muscle; 
Remains of thymus gland ; 
Left internal mammary artery and venae comites; 
Lymphatic vessels from convex surface of the liver; 
Areolar connective tissue. 
Middle mediastinum, bounded in front by the ante- 
rior mediastinum ; laterally, by the pleura ; behind, pos- 
terior mediastinum. It contains :— 
Ascending portion of aorta ; 
Superior vena cava; 
Heart, inclosed in the pericardium ; 
Bifurcation of trachea; 
Pulmonary artery and veins; 
Phrenic nerves; 
Arteriae comites nervi phrenici, from the internal mammary. 
Posterior mediastinum, bounded in front by the peri- 
cardium and root of the lungs ; behind, vertebral column ; 
laterally pleura. It contains :— 
CEsophagus; 
Thoracic duct; 
Descending aorta; 
Lymphatic glands and vessels ; 
Vena azygos major; 
Vena azygos minor; 
Superior intercostal veins; 
Pneumogastric nerves; 
Great splanchnic nerves. 
The superior mediastinum is hounded in front by the 
manubrium sterni; behind, by the upper dorsal verte- 
bra ; laterally, by the pleura. It contains:— 
Origin of sterno-thyroid muscle; 
Origin of sterno-hyoid muscle; 
Lower end of the longus colli 
muscle; 
Innominate artery; 
Left carotid artery; 
Subclavian artery; 
Transverse portion of the aorta; 
Innominate veins; 
Superior vena cava; 
Left superior intercostal vein; 
Left recurrent laryngeal nerves ; 
Cardiac nerves; 
Pneumogastric nerves; 
Phrenic nerves; 
(Esophagus; 
Trachea; 
Thoracic duct; 
Remains of the thymus gland; 
Lymphatics. THE GENITO-URINARY APPARATUS. 
The genito-urinary apparatus consists of the urinary 
organs and the male and female generative organs. 
THE URINARY ORGANS, 
The urinary organs consist of the kidneys, ureters, 
bladder, and urethra. 
The kidneys are two glandular organs, situated 
deeply in the lumbar region, opposite the second or third 
lumbar vertebra and last dorsal, the right a little lower 
than the left. They are surrounded by fat and held in 
position by the blood-vessels and loose connective tissue. 
The right kidney is in relation in front with the liver, 
descending portion of the duodenum and ascending colon. 
The left is in relation with cardiac end of stomach, lower 
end of spleen, tail of pancreas, and descending colon. 
Each kidney measures about four inches in length, two 
in width, and one in thickness, and weighs from four and 
one-half to six ounces in male, four to five and one-half 
in female. Their shape is characteristic. The notch at 
the inner side is called the hilus, and communicates with 
the interior cavity, the sinus, at which the blood-vessels, 
nerves, and ureter have their passage. The kidneys have 
a special fibrous coat, slightly adherent, which extends 
into the hilus and becomes continuous with the fibrous 
coat of the blood-vessels and ureters. The relative po- 
sition of the arteries, veins, and ureter at the hilus are, 
from above downward :— 
A. Artery, 
Y. Vein, 
U. Ureter; 
from before backward :— 
V. Vein, 
A. Artery, 
U. Ureter. 260 
HUMAN ANATOMY. 
The general structure of the kidney consists of a cor- 
tical substance and a medullary substance, the latter ar- 
ranged into conical masses called renal pyramids, with 
Longitudinal section of kidney: l, cortex; 2, medulla; 3, section of tubules in 
boundary layer; 4, fat of renal sinus ; 5, renal arteriole; A, branch of renal artery; 
C, renal calyx ; U, ureter. 
Fig. 60. 
their bases in the cortical substance, and their apices, 
the renal papillae, projecting into the calices of the pelvis 
within the sinus of the kidney. The renal pyramids of THE GENITO-URINARY APPARATUS. 
261 
Malpighi, about ten to fifteen in number, corresponding to 
the foetal lobules, are arranged into three irregular rows. 
The substance, or parenchyma of the kidney, is com- 
posed of uriniferous tubules, held together by compara- 
Diagram of uriniferous tubules: 1, Malpighian capsule; 2, proximal convoluted 
tubule: 2 b, distal convoluted tubule; 3, descending limb of Ilenle's loop; 4, ascend- 
ing limb of Ilenle's loop; 5, irregular tubule; 6, collecting tube; a, apex of pyramid ; 
b, base of pyramid; c, cortical portion. 
Fig. 61. 
tively little connective tissue. The terminal orifices of 
these, several hundred to each papilla, open on its 
summit. 
Course of the Tubuli Uriniferi.—Beginning at the 262 
HUMAN ANATOMY. 
Malpighian capsule within the cortex, each tubule pur- 
sues a very tortuous and complicated course before it 
terminates in the renal papillae, the outline of which is 
as follows (after Gray) :— 
(a.) Neck—the constricted portion below the capsule, before it 
terminates in the renal papillae 
(&.) Proximal convoluted tube, 
(c.) Spiral tubule of Schachowa, 
(d.) Descending limb of Henle’s loop, 
(e.) Henle’s loop, 
Within the cortical 
structure. 
Within the medullary 
structure. 
(/.) Ascending limb of Henle’s loop, 
(ff.) Irregular tubule, 
(h. ) Distal convoluted tubule, 
(i.) Curved tubule, 
Cortical structure. 
(j.) Straight collecting tubule—descends through the medullary 
structure to open by an orifice in a renal papilla. 
The straight, collecting or receiving tubes converge 
as they descend, and unite and reunite until their num- 
bers are reduced from sixteen to twenty, one opening 
on the summit of each papilla. In the cortical portion 
they form groups, or medullary rays, giving the appear- 
ance of conical masses in the cortical substance with 
their bases toward the periphery—the so-called pyra- 
mids of Ferrein. The tubules are composed of a base- 
ment membrane, lined wTith pavement epithelium. In 
the neck the epithelium becomes continuous with that of 
the Malpighian capsule, and at the glomerule the wall is 
reflected upon the inclosed tuft, or Malpighian corpuscle. 
In other situations the epithelium varies much in shape 
and size. The renal arteries subdivide at the hilum, 
cross the sinus, and enter the renal substance between 
the renal papillae. They terminate in the renal glom- 
erules, or Malpighian corpuscles. Each one of these 
remarkable convolutions of ipillaries is about one 
one-hundredth of an inch in ammeter and inclosed in a 
pouch-like dilatation of the uriniferous tubules or Mal- 
pighian capsule, or capsule of Bowman. The efferent 
vessels form, together with others, a capillary net-work 
between and around the uriniferous tubules. They are 
made up of three sets: (a) the plexuses around the THE GENITO-URINARY APPARATUS. 
263 
tubuli contorti; (b) the veins beneath the capsule ; and 
(c) the plexuses about the apices of the pyramids of 
Malpighi. These form the venae interlobulares, which 
join the venae rectae, and together form the renal veins, 
venae propriae renales. Those in the sinus unite together 
to form the renal vein, and open into the inferior vena 
cava, the left crossing in front of the abdominal aorta. 
The ureter commences as a compressed pouch, the 
pelvis. Within the sinus the pelvis divides and subdi- 
vides into several small funnels, or calyces, each one of 
which receives one or two projecting renal papillae. The 
calyces, pelvis, and ureter are all of the same structure, 
consisting of a fibrous and unstriated muscular and a 
mucous coat. The fibrous coat becomes continuous 
with the capsule above and below in the fibrous struc- 
ture of the bladder. The muscular coat ceases at the 
base of the renal papillae, but the mucous membrane be- 
comes continuous with that of the uriniferous tubules. 
Its epithelium is of the “ transitional ” variety, consist- 
ing of several layers of cells of varying shapes, resting 
upon a basement membrane. 
The nerves are derived from the renal plexus of tlie 
sympathetic, formed by branches in the semilunar 
ganglion, the solar plexus, and the lesser and smallest 
splanchnic nerve. 
The lymphatics communicate with the lumbar glands. 
The ureter proper is a musculo-membranous tube, 
sixteen to eighteen inches in length, about the diameter 
of a goose-quill, extending from its origin in the pelvis 
of the kidney to the basal or posterior angle of the vesi- 
cal trigone, which it enters by passing obliquely through 
the muscular and mucous walls of the bladder. 
Course.—It descends upon the psoas magnus mus- 
cle, beneath the peritoneum, being crossed by the sper- 
matic vessels. About the first division of the sacrum it 
crosses the external or common iliac artery, passing be- 
hind the sigmoid flexure on the left and the ileum on the 
right side, to enter the pelvis, where it reaches the 
bladder within its posterior false ligament. 
In the male it passes behind the vas deferens. 264 
HUMAN ANATOMY. 
In the female it lies close to the cervix uteri in the 
upper part of the vagina (vide Vagina). 
Muscles of the Ureters. — Two oblique muscles. 
Origin, behind the orifices of the ureters ; insertion, 
into the middle lobe of the prostate gland ; action, they 
guard the orifices of the ureters, and prevent the reflex 
of urine. 
Suprarenal capsules (vide Ductless Glands). 
THE BLADDER. 
The bladder is a musculo-membranous sac, the reser- 
voir for the urine, situated in the anterior part of the 
pelvis, behind the pubes, in front of the uterus and 
vagina in the female, and the rectum in the male. 
It measures, moderately distended, five inches in 
length, three in width, and holds about one pint. It 
consists of a body, summit, base, and neck. 
The body is partially invested with peritoneum be- 
hind, but in front it is wanting, the body being in rela- 
tion with the symphysis pubis, triangular ligament, and 
internal obturator muscles. 
The summit, or apex, is rounded, and directed up- 
ward and forward, being connected to the umbilicus by 
the urachus, the remains of the foetal allantois, and also 
by the obliterated hypogastric arteries, one on either side. 
The base, or f undus, in the male is situated upon a 
triangular space upon the second portion of the rectum, 
its base formed behind by the recto-vesical fold, its apex 
by the prostate gland, and its sides by the vas deferens 
and vesiculse seminales. 
In the female it is situated in contact with the cervix 
uteri and anterior wall of the vagina, adhering closely to 
the latter. Its upper portion has a peritoneal covering. 
The neck, or cervix, is the contracted portion, con- 
tinuous with the urethra. It is encircled in the male 
by the prostate gland, and is directed in both obliquely 
forward and downward. 
The ligaments of the bladder consist of five true 
ligaments and five false ligaments, and are derived from 
the peritoneum. THE GENITO-URINARY APPARATUS. 
265 
The true ligaments are :— 
Two anterior (pubo-prostatic), two folds of recto- 
vesical fascia passing from the pubic symphysis to the 
cervix and upper surface of prostate gland ; 
Two lateral folds of recto-vesical fascia connecting 
the lateral surfaces of prostate gland with sides of base 
of bladder; 
The urachus, an obliterated foetal structure, passing 
as a fibro-muscular cord from the apex of the bladder to 
the umbilicus. 
The false ligaments are :— 
Two posterior ligaments are peritoneal folds passing 
between sides of rectum in male, sides of uterus in 
female, to postero-lateral surface of bladder, inclosing 
obliterated hypogastric arteries, ureters, vessels, and 
nerves; 
Two laterals are folds of peritoneum passing from 
iliac fossae to sides of bladder ; 
The superior is a single peritoneal fold inclosing the 
obliterated hypogastric arteries from apex of bladder to 
umbilicus. 
The structure consists of four coats, a serous, muscu- 
lar, submucous, and mucous. 
The serous coat is derived from the peritoneum. It 
covers the posterior surface from the ureters to the 
summit, and is reflected from the sides to the walls of 
the pelvis and abdomen. 
The muscular coat is made up of unstriated fibres 
arranged into three layers:— 
(a) Longitudinal external layer, named the detrusor 
urinse muscle ; 
(b) Circular middle layer, forming at the neck the 
sphincter vesicm ; 
(c) Longitudinal internal layer. 
The submucous or cellular coat, made up of fibrous 
and elastic tissue, supports the mucous coat and unites 
it with the muscular. 
The mucous membrane is smooth and of a palo-rose 
color. Its epithelium is continuous with that of the 
ureters and pelvis of kidneys; its superficial layer, HUMAN ANATOMY. 
large, tessellated, polyhedral cells, its deep layer of club- 
shaped and spindle-shaped cells. 
The inner surface of the base presents a triangular 
space, the vesical trigone, or trigonum vesicse apex in 
front, formed by the orifice of the urethra, its basal an- 
gles behind about two inches apart, and each about one 
and one-half inches behind the urethral orifice, formed 
by the orifices of the ureters : 
U 
IX IX" 
U U 
2" 
The uvula vesicse is an elevation of mucous mem- 
brane projecting from the floor near the apex of the tri- 
gone into the orifice of the urethra. 
The arteries are the superior, middle, and inferior 
vesical, with branches from the obturator and sciatic in 
the male, and branches from the vaginal and uterine in 
the female. 
The veins from the vesico-prostatic empty into the 
internal iliac vein.' 
Lymphatics follow the course of the vessels and 
enter the lumbar glands. 
The nerves to the base and neck are from the third 
and fourth sacral, and to the summit from the hypo- 
gastric plexus of the sympathetic. 
GENERATIVE APPARATUS. 
The male organs of generation consist of the testes, 
vasa deferentia, vesical® seminales, and penis. 
The testicles (testes) are two glandular bodies 
which secrete the spermatic fluid, and are suspended by 
the spermatic cords within the scrotum, the left a little 
larger and lower than the right. They are oval, com- 
pressed laterally, measure one and a half to two inches 
in length, one inch in breadth, one and one-fourth inches 
in their antero-posterior diameter, and weigh from six 
to eight drachms. 
They each consist of a body, or testicle proper, and 
an epididymis. The latter consists of a head, body, and 
tail. 
Male Organs. THE GENITO-URINARY APPARATUS. 
267 
The scrotum consists of the skin marked in the me- 
dian line by the raphe, formed by the union of the geni- 
tal folds, and the dartos, a reddish, contractile tissue 
which surrounds the testes and extends from the raphe 
to the under surface of the penis, forming the septum 
scroti, which divides it into two cavities for the testes. 
Diagram of male organs: 1, symphysis pubis; 2, corpus cavernosum; 3, glans 
penis; 4, corpus spongiosum urethrae; 5, bulb of corpus spongiosum; 6, Cowper's 
gland; 7, membranous part of urethra; 8, prostate gland; 9, ureter; 10, vas deferens; 
11, vesicula seminalis. 
Fig. 62. 
The spermatic cord is made up of the following 
structures:— 
External spermatic, or intercolumnar fascia ; 
Cremaster muscle; 
Internal spermatic fascia, or fascia propria ; 
Yas deferens; 
Spermatic artery; 
Deferential artery from superior vesicle ; 
Cremasteric artery, from epigastric; 
Yasa spermatica; 
Lymphatic vessels; 
Spermatic plexus of nerves [from renal and aortic plexuses] ; 
Genital branch of genito-crural; 
Scrotal branch of the ilio-inguinal. 268 
HUMAN ANATOMY. 
It commences at tlie internal abdominal ring, passes 
obliquely through the inguinal canal, emerges at the ex- 
ternal abdominal ring, descends into the scrotum, and 
terminates at the posterior border of the testes. 
The external spermatic fascia, continuous with the 
superficial and transversalis fascia of the abdomen, 
envelops the cord and testicle and involves between its 
Layers the cremaster muscle. This muscle arises within 
the inguinal canal from Poupart’s ligament and pubic 
spine, and descends along the cord in loops. Its fibres 
are striated. 
The cremasteric fascia is derived from the lower 
border of the internal oblique muscle. 
The internal spermatic fascia, or fascia propria, is the 
infundibuliform process of the transversalis fascia. 
The proper coverings or tunics of the testicle are 
three—tunica vaginalis, tunica albuginea, and tunica 
vasculosa:— 
The tunica vaginalis is a serous membrane surround- 
ing the testes, and at the posterior portion is reflected on 
itself to form a sac. The outer portion of the latter is 
loosely attached, except at the lower part of the testicle, 
where the gubernaculum testis binds it down. 
The tunica albuginea is a dense, white, fibrous struc- 
ture, continuous at the upper part with a similar 
structure on the epididymis. At the back part it 
projects into the glandular substance of the testicle to 
form the mediastinum testis (or corpus Highmorianum), 
from which numerous septula (trabecuhe) diverge, and 
with similar cords from the tunica albuginea serve to 
maintain the shape of the gland and divide it into 
lobules. 
The tunica vasculosa (pia mater testis) lies within 
the tunica albuginea, and is the source and termination 
of the blood-vessels to the secretory substance of the 
gland, resembling the pia mater of the brain. 
The glandular structure of the testis is divided into 
several hundred (two hundred and fifty to four hundred) 
pyramidal lobules (lobuli testis), each one of which con- 
sists of from one to three tubuli seminiferi. THE GENITO-URINARY APPARATUS. 
269 
At the conical extremity of the lobules the tubules 
end in straight tubes, vasa recta, which enter the medi- 
astinum to form the plexus retiformis. From the upper 
part of this the vessels unite into from twelve to twenty 
vasa efferentia, which pass out of the testicle to the 
epididymis. Within the epididymis these efferent 
canals form a series of spermatic cones, the coni vascu- 
losi. These end in a coarse, convoluted tube, about 
twenty feet in length, forming the body and tail of the 
epididymis, and ending in the spermatic duct, or vas 
deferens. These tubes are lined with columnar ciliated 
epithelium. 
The vas aberrans of Haller is a spermatic cone join- 
ing the epididymis, but unconnected with the testicle. 
The hydatids of Morgagni are one or two pedicu- 
lated bodies attached to upper part of testis or head of 
epididymis, and supposed to be the remains of Muller’s 
duct. 
Structure of the Tubules.—The tubuli seminiferi are 
minute convoluted tubules, closed at one extremity, 
consisting of a hyaline membrana propria lined with 
several layers of epithelial polylxedral cells, the seminal 
cells, from which the seminal or spermatic fluid is 
directly elaborated. 
These cells undergo a process of indirect division to 
form the spermatoblasts, which are arranged into bundles, 
and are converted into spermatozoids, the nuclei becom- 
ing the head, and the tail, or ciliary appendages, being 
afterward developed. These cells are constantly cast off 
and replaced. 
Descent of the Testes.—In early foetal life the testes 
are placed at the back part of the abdomen, below and 
in front of the kidneys, and behind the peritoneum. 
About the third month a peculiar structure, the 
gubernaculum testis, appears, attached to the lower end 
of the epididymis, and extending as a cord to the 
bottom of the crotum. It is supposed to cause the 
descent of the testicle. It reaches its full development 
between the fifth and sixth month, at which time the 
testicle reaches the iliac fossa. It enters the internal HUMAN ANATOMY. 
abdominal ring by seventh month, and the scrotum by 
the eighth month, carrying before it a fold of peritoneum, 
which is afterward shut off, forming the tunica vaginalis 
testis. Other coverings of the testicles are also derived 
in this manner. In the female a structure similar to 
the gubernaculum forms the round ligament. 
The vas deferens has three coats—(1) an external 
fibrous coat, (2) an unstriated muscular coat, and (3) a 
lining membrane of columnar epithelium. It is about 
one and one-half feet long and one line in diameter. 
From the tail of the epididymis it ascends in the cord, 
forming an important part, and lying behind the blood- 
vessels. It ascends through the inguinal canal, and at 
the internal ring descends on the bladder, crosses the 
ureter and obliterated hypogastric artery, and runs for- 
ward to form with the duct of the seminal vesicle the 
ejaculatory duct. 
The walls of the vas are very thick and the canal 
very small. Its course for the most part is straight,but 
beneath the bladder it becomes enlarged, tortuous, and 
snore capacious, but again contracts near its termination. 
The arteries of the cord are :— 
The spermatic, to the testicle from the aorta; 
The vas deferens, or deferent artery, from the superior vesical; 
The cremasteric, from the deep epigastric. 
The veins from the testis—spermatic veins—unite 
with branches from the epididymis to form the pampini- 
form plexus, which terminates on the left side, passing 
beneath the sigmoid flexure in the left renal vein,on the 
right side in the inferior vena cava. 
The lymphatics are numerous, and terminate in the 
lumbar glands. 
The nerves are from the sympathetic system, and 
form the spermatic plexus. 
The arteries of the scrotum are derived from the 
Cremasteric branch of epigastric; 
Superficial external pudic, from the femoral; 
Deep external pudic, from the femoral; 
Superficial perineal, branch of internal pudic, from internal iliac. THE GENITO-URINARY APPARATUS. 
271 
The seminal vesicles are two membranous pouches, 
closely adhering to the under surface of the bladder. 
Their size varies, but they usually measure two and 
one-half inches in length, one-half inch in breadth, and 
two to three lines in thickness. 
Each consists of a tube closed at one end, about four 
to six inches long, the diameter of a quill, convoluted 
into a mass. Its structure is analogous to that of the 
ducts, but thinner. 
The ejaculatory ducts, two in number, are formed by 
the union of the vasa deferentia with the duct of the 
vesiculae seminales. Each duct is three-fourths to one 
inch in length, and passes through the prostate gland to 
terminate at the margin of the sinus pocularis by a slit- 
like orifice. 
The arteries are derived from the inferior vesical and 
middle hemorrhoidal. The veins and lymphatics cor- 
respond, and the nerves are from the hypogastric plexus 
of the sympathetic. 
The seminal vesicles are not only reservoirs, but 
secrete a fluid to dilute the spermatic liquid. 
The semen is a viscid, whitish liquid, composed of a 
colorless liquid, the liquor seminis, and the spermatozoa 
and seminal granules. 
The seminal granules are about one four-thousandth 
of an inch in diameter. 
The spermatozoa are the essential elements, and con- 
sist of an oval head, a body or middle piece, and a tail. 
The penis is composed of three columnar bodies, two 
corpora cavernosa and one corpus spongiosum, invested 
with skin, and filled with a peculiar, vascular, sponge- 
like structure. 
It is attached to the pubic arch and symphysis by its 
root, has a free expanded extremity, the glans penis, or 
head, and an intermediary portion, the body. 
The upper surface is the dorsum, or back. The glans 
is a blunt, cone-like body, expanded at its base, the 
corona, and attached by its cervix, or neck. 
The summit has a slit-like aperture, the meatw;, or 
orifice of the urethra. 272 
HUMAN ANATOMY. 
The skin adheres loosely to the organ, and has a 
loose, cup-like fold over the glans, called the prepuce, 
after which it is reflected into the cervix and glans, 
becoming continuous with the mucous membrane of the 
urethra at the meatus, to which it is attached below by 
a band or bridle—fraenum preputii. 
The skin covering the glans resembles mucous mem- 
brane, is very vascular and sensitive, but about the 
cervix and corona has numerous preputial glands— 
glandulse Tysoni odoriferi, which secrete the smegma. 
The superficial fascia is thin, free from adipose tissue, 
and continuous with that of the abdomen and scrotum. 
From the front of the pubis a fibro-elastic fasciculus 
descends to the root of the penis, called the suspensory 
ligament. ' 
The corpora cavernosa, or cavernous bodies, con- 
stitute more than two-thirds of the bulk of the organ. 
They spring as crura from the rami of the ischium and 
pubis, swell out into the bulb of the cavernous body, or 
corpus cavernosum, join each other in the median line, 
to terminate in a conical extremity, which receives the 
glans. 
They are grooved above for the dorsal vein, and 
below for the corpus spongiosum. 
They each have a strong outer fibrous membrane, 
which, on uniting, forms a thick partition, complete 
behind, but incomplete and comb-like in front—septum 
pecliniforme. 
From this septum fibro-elastic bands diverge in all 
directions and form trabeculae, which, witli the blood- 
vessels occupying their intervals, form the erectile tissue 
of the corpora cavernosa. 
The corpus spongiosum commences as a bulb below 
the crura and in front of the triangular ligament. It 
expands anteriorly into the glans penis, which fits upon 
the conical termination of the corpora cavernosa. 
The urethra enters above and anteriorly to the bulb, 
and traverses its entire length to the summit of the 
glans, opening at the meatus. 
The corpus spongiosum consists of an external THE GENITO-URINARY APPARATUS. 
273 
fibrous coat, thinner and more elastic than that of the 
corpora cavernosa, and an interior erectile tissue. A 
thin, muscular layer lines the external fibrous coat, and 
another is found beneath the mucous membrane of the 
urethra. 
The corpora cavernosa get their blood from the 
arteries of the corpora cavernosa, and branches from the 
dorsal artery of the penis, from the internal pudic. 
The corpus spongiosum is supplied by the artery of 
the bulb. 
The arteries of all three bodies terminate finally in 
the erectile tissue. Many arterial branches, especially 
at the root of the penis, form short convolutions—the 
helecine arteries, which terminate in finer vessels, and 
subsequently open into the spaces of the erectile tissue. 
Others open directly. 
From these spaces the veins begin; some wind 
around the side of the organ to the dorsal vein, while 
others pass under the pubis to join the prostatic plexus. 
The lymphatics are numerous; the superficial join 
the inguinal glands, the deep join the lymphatic plexus 
about the prostate and other deep lymphatics of the 
pelvis. 
The male urethra is the common canal for the emis- 
sion of semen and urine, extending from the neck of the 
bladder to the meatus urinarius. It is from eight to 
nine inches in length, and consists of three portions— 
the prostatic, membranous, and spongy. 
The prostatic portion extends from the neck of the 
bladder to the anterior border (apex) of the prostate 
gland. It is one and one-quarter inches in length, and 
is the widest and most dilatable part. 
Its floor is raised, and presents:— 
Veru montanum, or caput gallinaginis, an elevated 
ridge; 
Prostatic sinus, on each side of the veru montanum; 
Orifices of the prostatic ducts, in the floor of the 
prostatic sinuses; 
Sinus pocularis, a depression in the median line in 
front of the veru montanum, presenting the slit-like open- 274 
HUMAN ANATOMY. 
ings of the ejaculatory ducts. This cul-de-sac is one- 
quarter of an inch in length. It is homologous with the 
uterus, and has received the name of utricle, or uterus 
masculinus. 
The membranous portion is about three-quarters of 
an inch in length, extending from the apex of the pros- 
tate gland to the corpus spongiosum above and in ad- 
vance of the bulb. It passes out of the pelvis beneath 
the symphysis pubis, traversing the triangular ligament. 
It is the least dilatable portion and has four coats:— 
Fibrous, continuous with both layers of the triangu- 
lar ligament; erectile, continuous with that of the 
spongy body ; an unstriated muscular layer, and a mu- 
cous coat. 
The spongy portion extends from the membranous 
portion through the corpus spongiosum to the meatus 
urinarius on the summit of the glans. 
The portion within the bulb has received the name 
of bulbous portion of the urethra. The spongy portion 
diminishes gradually in size to near the orifice, where it 
suddenly dilates into the fossa navicularis, contracting 
again at the meatus, the narrowest part of the urethra. 
The mucous membrane is provided with columnar 
epithelium,except near the meatus, where it is tessellated, 
a fibro-elastic submucous layer with unstriated muscular 
fibres, and numerous minute racemose glands, the glands 
of Littre. These latter open forward into the urethra 
by good-sized orifices, especially one in the upper part 
of the fossa navicularis, called the lacuna magna. Into 
the bulbous portion of the urethra the ducts of Cowper’s 
glands open. 
The prostate gland is a glandular body which re- 
sembles in size and form a chestnut, and surrounds the 
first portion of the urethra between the neck of the 
bladder and the triangular ligament. It measures one 
and one-half inches in length and breadth and three- 
quarters in depth. Its weight, about six drachms. Its 
flat, under surface rests on the rectum. 
It has two lateral lobes, and one middle lobe which 
corresponds in position to the vesicle uvula, and is held in THE GENITO-URINARY APPARATUS. 
275 
position by the anterior ligaments of the bladder, by a 
portion of the deep perineal fascia, and of the levator 
ani muscle. 
It is perforated by the urethra and the common 
seminal ducts. 
Its structure consists of a mass of fibro-muscular 
(unstriated) tissue with imbedded follicular pouches, the 
whole inclosed in a firm fibrous capsule, continuous in 
front with the triangular ligament, behind with the pos- 
terior layer of the deep perineal fascia. 
The muscular fibres are longitudinal and circular, the 
latter surrounding the urethra, continuous behind with 
the bladder, in front with the fibres about the mem- 
branous portion. 
The glands open into the floor of the prostatic sinuses 
by twelve to twent}r ducts. 
The arteries are from the vesical, haemorrhoidal, and 
internal pudic. 
The veins enter into the formation of the prostatic 
plexus, receive the dorsal vein of the penis, and empty 
into the internal iliac vein. 
The nerves are from the hypogastric plexus. 
Cowper’s glands, or suburethral glands, are two 
small lobular bodies, about one-quarter of an inch in 
diameter, inclosed between the two layers of the deep 
fascia, situated behind the bulb of the corpus spongi- 
osum, below the membranous portion of the urethra. 
They are racemose glands and empty their secretion 
by a long duct into the bulbous portion of the urethra. 
Female Organs. 
The female organs of generation are divided into the 
external, termed the vulva, or pudendum, consisting of 
the mons veneris, labia majora and minora, clitoris, 
meatus urinarius, and orifice of the vagina; and the in- 
ternal, consisting of the uterus, ovaries, Fallopian tubes, 
and vagina, with certain accessories. 
The uterus is a hollow, muscular organ for the re- 
ception of the fecundated ovum and the development 
and expulsion of the foetus. HUMAN ANATOMY. 
The virgin uterus holds an oblique anterior position 
in the pelvis, being supported by attachments to the va- 
gina, rectum, bladder, and sides of the pelvis. 
It is in contact with the bladder in front, the rectum 
behind, and above the small intestine. 
Its shape is pyriform, compressed from before back- 
ward, and measures three inches in length, two in 
breadth, one in thickness, and weighs from one to one 
and a half ounces. 
It consists of a neck, fundus, and body. 
Internal female genitals: IT, uterus; O O', ovaries: PPI, fimbria*; C, intervagi- 
nal portion of cervix; ERI, round ligaments ; V VI, vagina laid open; L LI, broad 
ligaments; M, ovarian ligament; T Tl, Fallopian tubes. 
Fig. 63. 
The mouth, os uteri, or os tincse, opens into the 
vagina, being protected by two lips, an anterior thick 
lip, and a posterior, long and narrow. 
The cavity of the uterus is triangular V from side to 
side, but a mere slit from before backward, and meas- 
ures two and one-half inches in its longitudinal diameter. 
The two upper angles are prolonged to communicate 
with the Fallopian tubes; the lower angle forms the 
ostium internum uteri, communicating with the cavity 
of the cervix. 
Its structure consists of three coats :— THE GENITO-URINARY APPARATUS. 
277 
Serous coat, derived from the peritoneum and invest- 
ing all but the lower anterior quarter; 
Muscular coat, about one-half inch thick, composed 
of unstriped muscular fibres arranged into three layers ; 
Mucous coat, has numerous tubular follicles, is lined 
with ciliated columnar epithelium, and has no submu- 
cous coat to connect it with the muscular coat. 
The mucous membrane of the cervix is thrown into 
folds, or rugae, which assume on the anterior and poste- 
rior walls a branched arrangement, or arbor vitae uterina. 
It is lined by squamous epithelium, and presents numer- 
ous follicular glands—the ovula of Naboth, or glandulae 
Nabothi. 
The arteries are brandies of the ovarian from the 
aorta, and the uterine from the internal iliac, remarkable 
for their tortuosity and anastomoses. 
The veins form plexuses or uterine sinuses, the 
branches of which correspond to the uterine arteries 
and terminate in the uterine plexuses. 
The lymphatics are very numerous and terminate in 
the lumbar and pelvic glands. 
The nerves are from the ovarian and hypogastric 
plexuses of the sympathetic. 
The ligaments of the uterus are folds of peritoneum 
arranged into four pairs :— 
Two anterior, or vesico-uterine, passing one on either side from 
the posterior surface to the cervix uteri; 
Two posterior or recto-uterine, passing between the sides of the 
rectum and uterus, and inclosing a cul-de-sac, the recto-vaginal pouch, 
or Douglas’ pouch ; 
A prolongation of this ligament upward to the second sacral 
vertebra, with some unstriated muscularflbres derived from the uterus 
and vagina, forms the so-called utero-sacral ligaments ; 
Two lateral, or broad, extending from the uterus to the sides of 
the pelvis, dividing it into two portions, and inclosing the Fallopian 
tubes, ovary, ovarian ligament, uterine blood-vessels, lymphatics, and 
nerves, and some unstriated muscular fibres; 
Two round ligaments, are cords of unstriated muscular and 
fibrous tissue, extending from the side of the fundus uteri to the 
inguinal canal, where it is lost in the subcutaneous tissue of the pubes. 
The canal of Nuch, a pouch of peritoneum, incloses the ligament 
in the young subject, but is usually obliterated later. 
The ovaries correspond to the male testicles, and HUMAN ANATOMY. 
are suspended behind the broad ligament inclosed in its 
posterior layer. 
They are largest from puberty to adidt age, and meas- 
ure one and one-half inches in length, three-quarters of 
an inch in width, and one-third of an inch in thickness, 
and weigh from one to two drachms. The inner border 
is attached to the fundus uteri by the ovarian ligament, 
and its outer border to the fimbriated extremity of the 
Fallopian tube by a cord (tubo-ovarian ligament). 
The structure of the ovary is made up of a reddish, 
spongy stroma, well supplied with blood-vessels, contain- 
ing numerous ovisacs, or Graaffian vesicles inclosed in a 
serous covering derived from the peritoneum. 
The serous coat differs from the peritoneum in having 
a single layer of columnar cells, the germinal epithelium 
of Waldeyer. 
The tunica albuginea is a dense, white, fibrous kyer 
inclosing the ovary, and consisting of a condensation of 
the stroma. It is perforated at its upper border, hilus 
ovarii, to admit the passage of blood-vessels. 
The Graaffian vesicles, or ovisacs, containing the 
human ova, vary in size from microscopic bodies to one- 
quarter of an inch in diameter, and are most abundant 
in the periphery. 
In structure they consist of a fibrous coat—the ovi- 
capsule—lined by a basement membrane—membrana 
propria—and a layer of cells, the membrana granulosa. 
The interior is filled with a transparent albuminous fluid, 
liquor folliculi. 
The epithelial lining nearest the ovary presents an 
accumulation of cells—the germinal eminence, or discus 
proligerus, within which is the ovum or egg. 
Discharge.—The Graaffian vesicles approach the sur- 
face of the ovary and burst, their contents passing into 
the opened aperture of the tube, the fimbriated ex- 
tremity apparently applying it to the region of the 
bursting ovisac.* 
* The fimbriated extremity contains no erectile tissue, and the 
ovum probably falls into the peritoneal cavity and is swept into the 
tube by the action of the cilia. (Spigelberg.) THE GEN1TO-UR1NARY APPARATUS. 
279 
The rupture occurs periodically and corresponds to 
the menstrual flow. 
The ovum is surrounded by the tunica vasculosa and 
some additional epithelial structures (retinacula). It is 
one-tenth line in diameter, and represents all the elements 
of an organized cell, being composed of a 
Cell-wall, or vitelline membrane, or zona pellucida; 
Cell-coutents, or vitelltis ; 
Nucleus, or germinal vesicle ; 
Nucleolus, or germinal spot. 
At the seat of the rupture the walls collapse, and the 
vesicle immediately becomes filled with a blood-tinged 
fluid, which, together with the hypertrophy of the walls, 
forms the false corpus luteum, which remains and 
develops for two to three months and gradually disap- 
pears. 
Under the influence of pregnancy it enlarges for some 
time, forms the true corpus luteum of pregnancy, and dis- 
appears two to three months after parturition. 
The arteries are the ovarian from the aorta. 
The veins form an intricate plexus from which emerge 
vessels corresponding to the arteries ; they form a plexus 
near the ovary—the pampiniform plexus—which commu- 
nicates with the uterine and terminates as in the male. 
The lymphatics are numerous and of large size in the 
impregnated uterus, and terminate in the lumbar and 
pelvic glands. 
The nerves are from the ovarian and hypogastric 
plexuses of the sympathetic. 
The Parovarium consists of a series of tortuous tubes 
extending from the ovary to a main transverse trunk 
(the epoophoron), near the Fallopian tubes. It is also 
called the organ of Rosenmuller, and is the remains of 
the Wolffian body of embryo life, and corresponds to the 
origin of the epididymis in the male. 
The Fallopian tubes, or oviducts, are the passageways 
for the ovum from the ovaries to the uterus. They are 
trumpet-shaped tubes about four inches long, with the 
largest extremity outward. 280 
HUMAN ANATOMY. 
Its ovarian extremity is fimbriated ; hence its name, 
fimbriated extremity. It is also called morsus diaboli, 
from its supposed erectile action. 
One of these fimbriae extends along the border of the 
broad ligament to the outer extremity of the ovary, 
forming the tubo-ovarian ligament. 
The ovarian orifice—ostium abdominale, or pavillion 
—is much larger than the uterine, or ostium internum. 
The tube has three coats :— 
Serous, derived from the peritoneum ; 
Fibro-muscular, from the uterine walls; 
Mucous coat, with ciliated columnar epithelium, con- 
tinuous with the uterine. 
The remains of the duct of Muller form the hydatid 
of Morgagni, a small vesicle, attached by a long pedicle 
near the fimbriated extremity. 
The arteries are from the ovarian, the veins follow the 
same course, and the lymphatics and nerves are the same 
as the ovarian and uterine. 
The vagina is a cylindrical membranous canal ex- 
tending from the vulva to the uterus. It is formed by 
the coalescence of two symmetrical tubes in foetal life. 
Relations.—It is in relation in f ront with the base of the bladder 
and urethra, behind its upper fourth with Douglas’ pouch, its lower 
three-fourths connected loosely with the rectum, and laterally with 
the broad ligaments, pelvic fascia, and levator ani muscles. 
On the posterior wall just below the cervix uteri the 
ureters approach each other, leaving a space of only 
three-quarters of an inch between them,—important in 
lithotomy. 
In the virgin adult it measures about four inches in 
length, one inch in width, somewhat larger in its middle. 
Its anterior and posterior walls are in contact. 
Its lower orifice, or entrance, is constricted by a cres- 
centic or circular fold of mucous membrane, the hymen. 
The upper extremity, or fundus, receives the cervix 
uteri,extending higher up posteriorly (five to six inches), 
making the anterior lip apparently the longest. 
The mucous membrane has numerous transverse 
folds, or rugae, passing to either side of a median ridge, THE GENITO-URINARY APPARATUS. 
281 
both anterior and posterior, the columnse vaginae, formed 
by the coalescence of the two tubes in foetal life. Some 
of these rugse present wart-like eminences,most numerous 
about the entrance of the vagina, where they form the 
carunculee myrtiformes, the remains of the hymen after 
intercourse (or after par- 
turition—Budin). 
The walls of the vagina 
are about one line thick and 
consist of three coats :— 
Fibro-elastic coat; 
Muscular coat, of un- 
striated fibres, elastic tis- 
sue and blood-vessels, con- 
sisting of two layers, exter- 
nal longitudinal and inter- 
nal circular, and about the 
entrance the internal circu- 
lar fibres form the sphincter 
vaginae (vide Perineum); 
Mucous or internal coat, 
containing numerous con- 
ical papillm, and covered 
by squamous epithelium. 
The arteries are from 
the vaginal, uterine, vesi- 
cal, and internal pudic. 
The veins form an intri- 
cate plexus on each side 
with the returning vessels, 
corresponding to the pros- 
tatic plexus, and join the 
internal iliac veins. 
The nerves are from 
the hypogastric plexus of the sympathetic, also the 
fourth and fifth sacral and internal pudic nerves. 
The vulva, or pudendum, consists of the mons ven- 
eris, labia majora and minora, clitoris, and meatus urina- 
rius. 
The mons veneris is the prominence of skin over the 
External female genitals: 1, labia majora; 
2, fourchette: 3, labia minora ; 4, clitoris; 5, 
meatus urinarius; 6, vestibule; 7, orifice of 
vagina; 8, hymen; 9. orifice of duct of vulvo- 
vaginal gland; 10, anterior commissure; 11, 
anus. 
Fig. 64. 282 
HUMAN ANATOMY. 
symphysis pubis, supported upon a mass of adipose 
tissue, and covered with hair. 
The labia niajora are two folds of skin bounding the 
vertical fissure of the labia, the junctions of which in 
front and behind form the anterior and posterior com- 
missures. The labia correspond to the scrotum in the 
male. 
Within the posterior commissure is a depression, 
fossa navicularis, which separates it from a fold of mu- 
cous membrane—the fourchette. 
The triangular space between the anus and the pos- 
terior commissure is termed the perineum. 
The clitoris corresponds to the penis in the male, 
resembling it also in form, structure, and connections. 
It is about one and one-half to two inches in length, 
and consists of a pair of corpora cavernosa,and a double, 
spongy body, surmounted by a glans clitoridis. 
The corpora cavernosa arise by two crura attached 
to the rami of the pubes and ischium like the penis, and 
united in front by the septum pectiniforme. They 
curve abruptly down, being attached to the pubic sym- 
physis by a suspensory ligament. The body and crura 
represent a tripod. 
The glans corresponds to that of the male penis, but is 
not perforated by the urethra. It is covered by the 
praeputium clitoridis, a hood-like fold of skin continuous 
with the nymphse. 
The corpus spongiosum consists of an intermediate 
portion and semibulbs. The former consist of a plexus 
of veins, inclosed in a fibrous membrane. 
The semibulbs, or bulbi vestibuli, are about the size 
of large almonds, and are situated beneath the vestibule, 
embracing the orifices of the urethra and vagina. In 
front of the bulbs, between them and the clitoris, is a 
smaller plexus called the pars intermedia. 
The arteries, nerves, and veins are the same as those 
of the penis. 
The nymphse, or labia minora, are two folds of 
mucous membrane diverging from the praeputium clito- 
ridis to the labia, where they are lost. At their superior THE GENITO-URINARY APPARATUS. 
283 
extremity they divide into two folds, the upper forming 
the preeputium clitoridis, the lower one the frsenum. 
These diverging labia inclose a triangular space, the 
vestibule, at the middle of the base of which is situated 
the orifice of the urethra, or meatus urinarius. 
The bladder in the female is larger and broader than 
in the male. It is situated behind the pubes, in front of 
the uterus, from which it is separated by the small 
intestine, and rests upon the anterior wall of the vagina 
and cervix uteri. 
The urethra is a short but capacious canal, one and 
one-half inches in length, one-quarter inch in diameter, 
extending beneath the pubic symphysis from the neck 
of the bladder to the meatus. It lies in the anterior wall 
of the vagina, and perforates the triangular ligament 
precisely as does the male urethra (vide Urethra). 
Below the vestibule is the entrance or orifice of 
the vagina. The mucous membrane of the labia is re- 
flected continuously to the clitoris, nympliae, prepuce, and 
vestibule, and becomes continuous with the vagina and 
urethra. 
Its epithelium is squanums, and its glands racemose, 
mucous, and sebaceous glands or glandulse odoriferi 
Tysoni. 
The Bartholine or suburethral glands are two race- 
mose glands about one-third inch in diameter, situated 
just behind the semibulbs of the spongy body. The 
ducts, about three-fourths inch long, open between the 
nymphae and the vaginal orifice, or the hymen, if 
present. They secrete mucous. 
The blood-vessels and nerves of the vulva correspond 
to those of the penis and scrotum (vide Internal Pudic 
Artery). 
The mammae, or breasts, are the milk-secreting 
organs of the female (being rudimentary in the male). 
They consist of two large, hemispherical bodies, in the 
antero-lateral region of the thorax, resting upon the 
pectoralis major muscle, between the third and seventh 
MAMMARY GLAND. 284 
HUMAN ANATOMY. 
ribs, inclosed between the two layers of the superficial 
fascia. 
The nipple (mammilla) is roseate or brownish, and 
surrounded by an areola of the same color, the skin of 
which contains numerous sebaceous glands, the tubercles 
of the areola, or the glands of Montgomery. The skin 
of the nipple is thin, vascular, and erectile. On its 
summit are the orifices of the fifteen to twenty milk- 
ducts, or lactiferous ducts. 
Its structure is firm and pinkish-white, consisting of 
fifteen or twenty lobes forming a racemose gland, held 
together and invested with fibrous tissue. 
Each lobe ends in one of the tubuli lactiferi, or 
galactophori, which beneath the areola dilates into a 
lactiferous sinus, or galactophorous sinus, or ampulla, 
and terminates on the summit of nipple in an orifice. 
The arteries are, the long thoracic, with other 
branches of the axillary, the internal mammary, and 
intercostals. 
The veins follow the corresponding arteries to end in 
the internal mammary and axillary veins. They form 
about the base of the nipple a venous circular anasto- 
mosis, the circulus venosus. 
The lymphatics terminate in the axillary glands, a 
feAV also entering the anterior mediastinal glands. 
The nerves are from the anterior and lateral cutaneous 
branches of the intercostals. 
Milk, the secretion of the mammary gland, is an 
emulsion, consisting of a colorless fluid, the milk- 
plasma, holding in suspension the milk-globules. It has 
a specific gravity of 1.028 to 1.034, and slightly alkaline 
reaction. 
The milk is secreted by the swelling and bursting of 
the cells in the vesicles. 
The first secretion at the commencement of lactation 
is a thin, yellowish fluid, the colostrum, the peculiarity 
consisting in the large, granular colostrum-corpuscles, 
or corpuscles of Gluge, the entire, unruptured, secreting 
cells. THE NERVOUS SYSTEM. 
The nervous system is composed of four grand di- 
visions :— 
Cerebro-spinal axis, 
Nerves, 
Ganglia, 
Organs for special senses. 
These may also be divided into two divisions : Cere- 
brospinal system, that controlling animal life, and sym- 
pathetic system, presiding over organic life. 
Structure.—Nervous tissue consists of three distinct 
substances, combined together in the organs in different 
proportions—white, or fibrous substance ; gray, or vesic- 
ular substance, and neuroglia. 
(a) White substance is found in the cortex of the 
cord, the interior of cerebrum, in nerves, etc., and is made 
up of medullated nerve-fibres. These are smooth, round 
fibres, measuring one two-thousandth to one twelve- 
thousandth of an inch in diameter, and have each three 
parts :— 
1. Axis cylinder is a round or band-like striated 
structure consisting of fibrilla?; 
2. The medullary sheath., or white substance of 
Schwann, which is made up of fatty substance and prob- 
ably insulates the axis cylinder ; and 
3. The neurilemma, or sheath of Schwann, a delicate, 
structureless membrane, closely surrounding the medul- 
lary sheath, and forming the surface of the nerve-fibres. 
Near their termination the nerve-fibres lose their 
medullary sheath and become non-medullated, or Re- 
mak’s fibres. Such are the olfactory and most of the 
sympathetic nerves. 
(b) Gray substance, found in the middle of the spinal 
cord, in the cortex of the bra n, in ganglia, etc., consists 
of three elements : (1) nerve-fibres ; (2) nerve-cells ; and 
(3) blood-vessels and connective tissue 286 
HUMAN ANATOMY. 
Nerve-fibres. — These are medullated ner.ve-fibres, 
identical with those in the white substance, with which 
they are continuous. 
Nerve-cells are of two kinds—large branched cells, 
bipolar and multipolar, etc., and small round cells re- 
sembling free nuclei. 
(c) Neuroglia, or nerve-glue, is made up of a matrix 
of delicate, fibrillar net-work and small neuroglia cells, 
and forms an imbedding substance for the other elements. 
Nerves are round, white, shining cords, belonging 
either to the cerebro-spinal or the sympathetic sys- 
tems. They are made up of bundles of nerve-fibres held 
together by fibro-connective tissue, the epineurium. 
The individual fibres are held together within the bun- 
dles by connective tissue, the endoneurium. 
The nerve-fibres have a two-fold function—sensory 
and motor. 
Sensory, or afferent, transmit impressions from the 
periphery to the centres. 
Motor, or efferent, transmit impressions from the 
centres to the periphery. 
Ganglia form independent nerve-centres, similar to 
but less complex than the brain. They are connected 
with the cranial nerves, spinal nerves, and form an im- 
portant part of the sympathetic system. 
Terminations.—The motor nerves end in the volun- 
tary and involuntary muscles, the former having special 
endings called the motorial end plates. 
The sensory nerves terminate in the peripheral 
organs, to which they are distributed by first becoming 
non-medullated, and then dividing and joining one an- 
other to form a minute plexus or by means of one of the 
three special endings, called “peripheral end organs:'1'1 
(1) tactile corpuscles of Wagner; (2) end bulbs of 
Krause; or (3) the Pacinian corpuscles. 
CEREBRO-SPINAL AXIS. 
The cerebro-spinal axis is divided into two grand 
divisions:— 
The encephalon, or brain, and spinal cord. THE NERVOUS SYSTEM. 
287 
Membranes of the Brain.—The membranes of the 
brain are three—dura mater, arachnoid, and pia mater. 
Dura mater is a dense, white, fibrous membrane lining 
the interior of the skull, and forming its internal perios- 
teum, to which it is adherent at the sutures. 
It contains the sinuses or venous channels (already- 
described), and forms three partitions for the support 
of the brain—the falx cerebri, falx cerebelli, and tento- 
rium. 
Falx cerebri is an arched or sickle-shaped process re- 
ceived into the longitudinal fissure. It contains in its 
upper and lower margins the superior and inferior lon- 
gitudinal sinuses. 
Tentorium cerebelli is a lamina, arched across, be- 
tween the superior borders of the petrous portion of 
temporal on either side, the anterior and posterior cli- 
noid processes in front, and the transverse ridge of the 
occipital behind, for the support of the posterior lobes 
of the cerebrum. It incloses the superior petrosal and 
lateral sinuses. 
Falx cerebelli is a small median partition descending 
from the tentorium to the foramen magnum, and sepa- 
rating the lateral lobes of the cerebellum. 
Pacchionian bodies are white granular bodies found 
in the pia mater, inner and outer surface of the dura, and 
are most numerous near the great longitudinal sinus. 
They are hypertrophied normal villi of the arachnoid 
which have perforated the dura mater. They are of un- 
known function, and occur from childhood to advanced 
age. 
Arachnoid is a thin serous sac lying between the 
dura and pia mater. It invests the dura, from which it 
is separated by a space, the subdural space. It also 
invests the brain, from which it is separated by the pia 
mater and some loose connective tissue—the subarach- 
noidean; and also at the base by two spaces, the an- 
terior and posterior subarachnoidean spaces. It con- 
sists of a net-work of white fibrous and elastic tissue, 
covered on its outer surface with a layer of endothelium 
cells, and contains a rich plexus of nerves. 288 
HUMAN ANATOMY. 
Anterior subarachnoidean space lies between the two 
middle lobes of the cerebrum. 
Posterior subarachnoidean space lies between the me- 
dulla below and the two hemispheres of the cerebellum 
above. They are filled with cerebro-spinal fluid, and 
communicate across the crura cerebri and also with the 
ventricles by an opening in the fourth ventricle. 
Pia mater, the investing membrane of the brain, is 
composed of a net-work of blood-vessels derived from 
the vertebral and internal carotid arteries, held to- 
gether by delicate connective tissue. It dips into the 
sulci, and is prolonged into the ventricles through the 
transverse fissure, forming the choroid plexus and velum 
interpositum. It contains nerves and lymphatics. 
The encephalon, or brain, consists of four distinct 
portions—the cerebrum, cerebellum, pons Varolii, and 
medulla oblongata. The average weight of the brain in 
the male adult is forty-nine and a half ounces, in the 
female forty-four ounces, of which the cerebrum is about 
seven-eighths. The maximum male brain weighs sixt}'- 
five ounces ; minimum, thirty-four ounces. The maximum 
female brain weighs fifty-six ounces ; minimum, thirty- 
one ounces. The brains of idiots seldom weigh more 
than twenty-three ounces. Excepting the whale and 
elephant, the human brain is heavier than that of all the 
lower animals. 
The Encephalon, or The Brain. 
The medulla oblongata is the upper expanded por- 
tion of the spinal cord, extending between the lower 
border of the pons and the upper border of the atlas. 
It is divided by two fissures—the anterior and posterior 
median fissures—into two halves, each one of which is 
subdivided into four columns, from before backward, 
the following:— 
(a) Anterior pyramids, or corpora pyramid alia, are 
two pyramidal masses of white nervous matter, placed 
between the anterior median fissure and the olivary 
body, and continuous with the anterior columns of the 
cord below; THE NERVOUS SYSTEM. 
289 
(b) Lateral tract and olivary body, are continuous 
with the lateral columns of the cord below ; 
(c) Restiform bodies, are continuous below with the 
posterior columns of the cord ; 
(d) Posterior pyramids, are continuous below with 
the posterior median columns of the cord. 
Leftside of human brain : F, frontal; P, parietal; O, occipital; T, temporo-sphenoi- 
dal lobes; S, fissure of Sylvius; horizontal, Sff, ascending ramus of S; c, fissure of 
Bolando; A, ascending frontal, B, ascending parietal convolutions; Fj, superior, F2, 
middle, and F3, inferior frontal convolutions; Pi, superior parietal lobule; P2, inferior 
parietal lobule; Oi, first, 02, second, O3, third occipital convolutions ; Tj, first, T2, 
second, T3, third temporo-sphenoidal convolutions. 
Fig. 65. 
The structure of the medul'a oblongata consists of 
both white and gray matter, the former arranged into 
four columns, the latter contained in the interior. 290 
HUMAN ANATOMY. 
The gray matter of the medulla is partly arranged 
into masses and partly continuous with the gray matter 
of the cord. The posterior horns are called here “ the 
tubercles of Rolando.” On the floor of the fourth ven- 
tricle the ganglion-cells sire arranged into nuclei, from 
which several of the cranial nerves have their origin. 
The Pons Varolii connects the cerebrum above with 
the cerebellum behind and the medulla oblongata below. 
On its under surface it presents a groove for the passage 
of the basilar artery. The upper surface forms a portion 
of the floor of the fourth ventricle, and on either side, 
under the name of the crus cerebelli, it passes to the 
cerebellum, forming its middle peduncle. 
consists of a large, ovoidal mass, divided into two lateral 
halves, or hemispheres, by the great longitudinal fissure, 
connected together by a white, transverse commissure— 
the corpus callosum. The surface is marked 
by convolutions, or gyri, separated from each other by 
irregular depressions, fissures, or sulci. The outer sur- 
face is composed of gray matter, which, from its location, 
is called the cortical substance. The interior surface, 
for the most part, is white. 
The principal fissures of the brain are five, as fol- 
lows :— 
THE CEREBRUM 
1. The great longitudinal fissure, separating the two hemispheres 
from one another. 
2. The great transverse fissure of Bichat, between the cerebellum 
and the cerebrum, admitting the pia mater to form the velum inter- 
posit um. 
3. The fissure of Sylvius, beginning at the anterior perforated 
6paee and ascending obliquely. 
4. Theyisswre of Rolando, descends from near the middle of the 
great longitudinal fissure to join the fissure of Sylvius. 
5. The parieto-occipital fissure, on the postero-lateral aspect of 
the cerebrum. 
The principal lobes of the brain are five, as follows :— 
1. Frontal lobe, lies above the fissure of Sylvius and in front of 
the fissure of Rolando, and is divided into :— 
(a) Superior lobe; 
(b) Middle lobe; 
(c) Inferior lobe. THE NERVOUS SYSTEM. 
291 
2. Parietal lobe, lies between the fissure of Rolando, the parieto- 
occipital, and the fissure of Sylvius, and consists of five lobes :— 
(a) Ascending parietal; 
(b) Superior parietal; 
(c) Supramarginal; 
(d) Angular: 
(e) Paracentral. 
3. Occipital lobe, lies at the posterior aspect of the cerebrum and 
is divided into first, second, and third occipital convolutions. 
4. Temporo-sphenoidal lobe, occupies the middle fossa of the 
skull. 
5. Island of Reil, or central lobe, lies within the fissure of 
Sylvius. It consists of six convolutions—the gyri operti. 
Fig. 66. 
Convolutions and fissures of the median and tentorial surfaces of the right cere- 
bral hemisphere: CC, corpus callosum; AF, ascending frontal convolution; AP, 
ascending parietal convolution; PO, parieto-occipital fissure; PC, prsecuneus, or 
quadrate lobe; C, cuneus; cy calcarine fissure; elf, collateral fissure; GF, forni- 
catus ; cm, calloso-marginal fissure ; ft, superior frontal convolution; OT, optic thala- 
mus; P, pituitary body; dcy dentate convolution. 
The inner or median surface of the hemispheres pre- 
sents five fissures, as follows :— 
1. Calloso-marginal. 
2. Parieto-occipital. 
3. Calcarine. 
4. Occipito-temporal or collateral. 
5. Dentate fissure, or sulcus hippocampi. 
The lobes on the internal surface are six in number, 
as follows:— 292 
HUMAN ANATOMY. 
1. Gyrus fornicatus, or convolution of the corpus callosum, 
descends as the gyrus hippocampi and terminates as the uncinate 
gyrus. 
2. Marginal, or first frontal convolutions. 
3. Quadrate, or prsecuneus. 
4. Cuneus, or occipital lobule. 
5. Uncinate gyrus. 
6. Temporo-sphenoidal lobe. 
The inferior surface of each hemisphere is divided 
into three lobes—the anterior, middle, and posterior. 
The two former occupy the anterior and middle fossa of 
the skull and the posterior rests upon the cerebellum, 
separated from it by the tentorium. This surface pre- 
sents for study from before backward the following 
points:— 
The longitudinal fissure, separates the two hemispheres; 
Corpus callosum,, the great transverse commissure of the cere- 
brum, extending by means of its peduncles to near the Sylvian fissure ; 
Lamina cinerea, is a thin, gray layer, forming the anterior part of 
the inferior boundary of the third ventricle; 
Olfactory nerve, with its bulb; 
Fissure of Sylvius, between the anterior and middle lobes of the 
cerebrum, and lodges the middle cerebral artery ; 
Anterior perforated space, transmits vessels to the corpus striatum ; 
Optic commissure, is formed by the junction of the optic tracts ; 
Tuber cinereum, is a gray eminence between the corpora albicantia 
and optic tracts, and forms part of the floor of the third ventricle; 
Infundibulum, is a tube of gray matter connecting the pituitary 
body with the third ventricle; 
Pituitary body, is a small, vascular, bilobed body, connected by 
the infundibulum and occupying the sella Tursica; 
(For histology vide “ Ductless Glands.”) 
Corpora albicantia, or mammillaria, are two white, rounded 
masses, formed by the folding of the anterior crura of the fornix, and 
are sometimes called the bulbs of the fornix; 
Posterior perforated space, allows the passage of blood-vessels to 
the optic thalami; 
Crura cerebri, or cerebral peduncles, connect the cerebrum with 
the medulla, cerebellum, and spinal cord; it consists of the super- 
ficial portion, or crusta, and the deep portion, or tegmentum, between 
which is a mass of gray matter—the locus niger ; 
Pons Varolii, covers up the posterior portion of the cerebral 
lobes. 
Interior of the Cerebrum.—The interior of the cere- 
brum, viewed above the level with the corpus callosum, 
presents a white surface—the centrum, ovale minus, the 
margins of which are convoluted gray matter, and are TIIE NERVOUS SYSTEM. 
293 
called labia cerebri. It is studded throughout with 
minute blood-vessels—puncta vasculosa. 
The hemispheres, viewed on a level with the corpus 
callosum, present a large white mass—the centrum 
ovale majus—in the centre of which is the connecting 
band, the corpus callosum. 
Corpus Callosum.—This connecting band forms the 
roof of the lateral ventricles. It is about four inches in 
length and varies from an inch and a half to two inches 
in width, presenting in front a bend, or genu, below which 
it terminates in the tuber cinereum through the lamina 
cinerea. 
Posteriorly it forms a thick, rounded fold—the 
splenium, or pad—which is continuous with the fornix. 
The peduncles of the corpus callosum are two reflected 
bundles of white matter given off near the anterior 
termination of the corpus, and each passing backward 
across the anterior perforated space of its own side to 
the fissure of Sylvius. 
The superior surface of the corpus callosum shows a 
depression—the raphe—bounded on each side by elevated 
bands, the strise longitudinales, or nerves of Lancisi. 
External to these are the striae longitudinales laterales. 
On either side of the raphe are many transverse lines— 
the lineae transversae, which indicate the direction of the 
fibres of the corpus. 
The cerebral commissures are connecting bands of 
gra}r and white matter, pursuing either a transverse or 
antero-posterior course. 
Transverse:— 
Anterior, middle, and posterior commissures ; 
Corpus callosum ; 
Optic chiasm; 
Fornix; 
Pons Yarolii; 
Posterior medullary velum. 
A ntero-posterior:— 
Corpus callosum (nerves of Lancisi); 
Fornix; 
Fasciculus uncinatus; 
Taenia semicircularis; 294 
HUMAN ANATOMY. 
Gyrus fornieatus; 
Fasciculus longitudinales inferior; 
Olfactory tracts; 
Crura cerebri; 
Peduncles of pineal gland ; 
Processus a cerebello ad testes. 
The interior of the brain contains five distinct 
cavities, named the ventricles of the brain, situated as 
follows: Two lateral ventricles in the upper part, within 
the substance of the hemispheres, the third ventricle 
between the optic thalami at the base of the brain, the 
fourth ventricle between the medulla oblongata and the 
cerebellum, and the fifth ventricle within the septum 
lucidum between the two lateral ventricles. 
VENTRICLES OF THE BRAIN. 
The ventricles intercommunicate—the two lateral 
ventricles with the third by means of the foramen of 
Monro, the third with the fourth ventricle by means of 
the iter a tertio ad quartum ventriculum, and, in the 
foetus, with the fifth, and through the infundibulum with 
the cavity of the pituitary body. 
The lateral ventricles are bounded as follows:— 
The roof, the corpus callosum; the floor is formed by the follow- 
ing parts from before backward: corpus striatum, tsenius semi- 
circularis, optic thalamus, choroid plexus, corpus fimbriatuin and 
fornix; internally, by the septum lucidum; externally, in front and 
behind by the brain-substance. Each lateral ventricle presents three 
cornua—the anterior cornu, posterior cornu, or digital cavity, and the 
middle cornu. 
The anterior cornu curves outward and forward over 
the corpus striatum and into the anterior lobe. 
The middle cornu passes into the middle lobe, as- 
cending to the transverse fissure at the base of the brain. 
Its course is backward, outward, downward, forward, 
and inward (B., O., D., F., I.). 
The posterior cornu runs backward into the posterior 
lobe, its course being backward, outward, and inward 
(B., 0., I.). 
Parts of Lateral Ventricle—Corpus Callosum.— 
Described above. 
Septum Lucidum.—Forms the internal boundary of THE NERVOUS SYSTEM. 
295 
the lateral ventricle. It consists of two layers of white 
and gray matter, and is attached above to the under sur- 
face of the corpus callosum, below to the fornix, and an- 
teriorly to the prolongation of the corpus callosum. 
Between the laminse forming the septum is a narrow 
interval—the fifth ventricle. 
The Corpus Striatum.—Situated in the lateral ven- 
tricle, its broad end directed forward into the fore part 
of the body and anterior cornu of the ventricle, its nar- 
row end directed outward and backward, and separated 
from its fellow by the thalami optici. 
The intraventricular portion is called the caudate 
nucleus, the extraventricular the lenticular nucleus, the 
two separated by the internal capsule. 
The internal capsule is a large layer of white fibres, 
derived from the medulla and crura cerebri, separating 
the lenticular nucleus from the caudate nucleus an- 
teriorly, and the lenticular nucleus from the optic 
thalamus posteriorly. 
The external capsule is a small layer of white fibres 
on the outer surface of the corpus striatum, between 
the lenticular nucleus and the claustrum. 
The claustrum is a convoluted layer of gray fibres 
between the external capsule and the island of Reil. 
The Tsenia Semicircularis, or Horny Band of Tari- 
nus.—A band of medullary substance in the furrow be- 
tween the corpus striatum and the optic thalamus. Its 
anterior portion descends with the anterior pillar of the 
fornix, its posterior portion passes into the descending 
horn. Beneath it is the vena corporis striati. 
The choroid plexus, a vascular membrane, occupying 
the margin of a fold of pia mater, known as the velum 
interpositum. It runs across the floor of the lateral 
ventricle, and communicates with its fellow of the oppo- 
site side through the foramen of Monro. Posteriorly it 
descends into the middle horn of the lateral ventricle. 
The corpus fimbriatum (tsenia hippocampi), a narrow 
white band behind the choroid plexus. It is the lateral 
edge of the posterior pillar of the fornix. 
The fornix, a lamella of white fibrous matter, beneath 296 
HUMAN ANATOMY. 
the corpus callosum, continuous with it posteriorly, but 
separated from it anteriorly by the septum lucidum. It 
consists of two symmetrical halves which join to form 
the body, each half having an anterior and posterior crus 
where they do not join. 
The anterior crura curve down to the base of the 
brain, where each crus spreads out and curves upon 
itself to form the corpus albicans of that side. From 
this point it passes to the corresponding optic thalamus. 
The posterior crura, at their commencement, are 
joined to the under surface of the corpus callosum. 
They pass downward into the descending horns of the 
lateral ventricles, being continuous with the concave 
borders of the hippocampi majores. 
The lateral edge of the posterior crus is called the 
corpus fimbriatum. 
The lyra is a series of lines, some transverse, others 
longitudinal and oblique, on the under surface of the 
fornix, between the diverging posterior crura. 
Optic Thalamus.—The thalami optici are two large 
ganglionic masses, situated between the diverging por- 
tions of the corpora striata. Each thalamus rests upon 
the corresponding crus cerebri. 
The thalamus is bounded externally by the corpus 
striatum and taenia semicircularis, and internally forms 
the lateral boundary of the third ventricle. 
Its upper surface is partly covered by the fornix. 
Its under surface forms the roof of the descending horn 
of the lateral ventricle. 
Its posterior and inferior part exhibits two rounded 
eminences, the external and internal geniculate bodies. 
Its anterior extremity forms the posterior boundary of 
the foramen of Monro, which foramen connects the two 
lateral ventricles with the third. 
Velum interpositum, a vascular membrane, reflected 
from the pia mater into the interior of the brain through 
the transverse fissure. It passes beneath the posterior 
border of the corpus callosum and fornix, and above the 
corpora quadrigemina, the pineal gland, and the optic 
thalami. It forms the roof of the third ventricle. Its THE NERVOUS SYSTEM. 
297 
anterior extremity passes on each side into the corre- 
sponding lateral ventricle, forming the anterior ex- 
tremity of the choroid plexus. The vascular fringes 
of the velum interpositum projecting into the third 
ventricle are called the choroid plexuses of the third 
ventricle. 
It has two veins, the venae Galeni, which run along its 
under surface and are formed by the veins of the choroid 
plexuses and the venae corporis striata. The venae Galeni 
unite to form a single trunk and empty into the straight 
sinus. 
The posterior cornu runs into the substance of the 
posterior lobe. On the floor of this horn is an eminence 
corresponding to a sulcus between two convolutions, and 
called the hippocampus minor. 
Between the posterior and middle horns is another 
eminence—the eminentia collateralis, or pes accessorius. 
The hippocampus major, or cornu ammonis, a white 
eminence running the entire length of the floor of the 
middle horn. This eminence is the doubled-in surface 
of the gyrus fornicatus. 
The lower extremity of the hippocampus major is 
called the pes hippocampus. 
The fascia dentata, the gray and serrated edge of the 
middle lobe. It is really external to the cavity of the 
middle cornu. 
The third ventricle is a mere fissure in the median 
line of the cerebrum, situated between the optic thalami. 
It communicates with the lateral ventricle by the fora- 
men of Monro and with the fourth ventricle by the iter 
a tertio ad quartum ventriculum. The cavity is crossed 
by three commissures—the anterior commissure, a white, 
rounded cord ; the middle or soft commissure, composed 
of gray matter; and the posterior commissure, a white 
band connecting the two optic thalami. It is bounded 
by the following structures :— 
The roof, by the velum interpositum, suspending the choroid 
plexuses of the third ventricle, and laterally the peduncles of the 
pineal gland ; floor, by the parts inclosing the interpeduncular space 
at the base of the brain, viz.: the lamina cinerea, tuber cinereum and 298 
HUMAN ANATOMY. 
infundibulum, corpora albicantia and the posterior perforated space; 
laterally, by the optic tlialami; in front, by the anterior commissure 
and anterior crura of the fornix ; behind, the posterior commissure 
and the iter a tertio ad quartam ventriculum. 
The fourth ventricle is a diamond-shaped cavity 
between the cerebellum behind and the posterior surface 
of the medulla oblongata and pons in front. It is in- 
closed behind by the pia mater, which contains an open- 
ing for the exit and entrance of the subarachnoid fluid 
from the subarachnoidean space of the brain and spinal 
cord, and a vascular fold of pia mater—the choroid 
plexus. It communicates in front with the third ven- 
tricle by the iter a tertio ad quartam ventriculum. It is 
bounded as follows :— 
The roof, valve of Vieussens and the cerebellum, containing in 
front the foramen of Magendie, by which it communicates with the 
subarachnoidean space; the floor, the posterior median fissure of the 
medulla and pons, the fovea posterior, the orifice [ventricle of the cen- 
tral canal of the cord] of Aurantius,the locus cseruleus, and the taenia 
violacea, the calamus scriptorius and the fasciculi teretes; anteriorly, 
the pons Varolii and medulla oblongata; posteriorly,the cerebellum; 
laterally, the processus a cerebello ad testes, the restiform bodies, and 
posterior pyramids of the medulla. 
Its lining membrane is continuous with that of the 
third ventricle. The gray matter of the floor of the 
fourth ventricle presents masses for the origin of certain 
cranial nerves. 
The fifth ventricle is a narrow fissure, formed 
within the two laminae of the septum lucidum, being 
originally a part of the great longitudinal fissure. It 
is bounded:— 
Above, by the under surface of the corpus callosum; 
Below, by the anterior part of the fornix; 
Laterally, by the lateral ventricles, from which it is separated 
by the septum lucidum. 
It is not lined with epithelium. 
The mesocepiialon includes those portions of the 
brain substance which connect the cerebrum, cerebellum, 
and medulla oblongata together, and comprises the fol- 
lowing structures :— 
Pons Varolii, already described. THE NERVOUS SYSTEM. 
299 
Crura cerebri, before described {ante, p. 292). 
The valve of Vieussens, or anterior medullary velum, 
is a thin layer of white matter stretched between the 
processus e cerebello ad testes, and forming the roof of 
the iter a tertio ad quartum ventriculum. It presents 
an elevated ridge descending on its upper part from the 
corpora quadrigemina—the frsenulum. 
Corpora or tubercula quadrigemina, or optic lobes, 
are four spherical eminences, placed in pairs above the 
valve of Yieussens, and behind the third ventricle, be- 
neath the posterior border of the corpus callosum. 
The two anterior are called the nates, the two poste- 
rior the testes. The brachia (anterior and posterior) are 
two white cords connecting them with the optic thalamus 
and beginning of the optic tracts. 
The processus a cerebello ad testes connect them with 
the cerebellum. 
To the outer side of the optic lobes are two small 
masses called the corpus geniculatum externum and 
internum. 
The pineal gland, or epiphysis cerebri, is a small, 
reddish, conical body resting upon and between the nates. 
It represents the rudiment of a median eye of certain 
extinct lizards and amphibia (Spencer). It is attached 
to the cerebrum by its two peduncles, and is held in po- 
sition by a fold of the pia mater. It contains a cavity, 
filled with a viscid fluid and secretory matter composed 
of phosphates of lime, magnesia, and ammonia—the 
acervulus cerebri. 
The cerebellum, or little brain, occupies the inferior 
occipital fossae beneath the great cerebral lobes, from 
which it is separated by the tentorium. Its average 
weight is a little over five ounces in the male, and is 
proportioned to the greater brain about one to twenty. 
It is oblong, flattened from above downward, and divided 
into two lateral hemispheres connected by a central por- 
tion, the vermiform process. 
It is composed of gray and white matter—the former 
CEREBELLUM. 300 
HUMAN ANATOMY. 
upon the surface. It is not convoluted, like the cere- 
brum, but consists of a number of thin plates, folia, 
arranged in a series of crecentric curves, with the con- 
cavity forward. 
The fissures of the cerebellum are three in number, 
two vertical and one horizontal, as follows :— 
Incisura cerebelli anterior, separates the hemispheres 
in front, and rests against the corpora quadrigemina; 
Incisura cerebelli posterior, separates the hemispheres 
behind,and receivesthe upper portion of the falx cerebelli; 
Great horizontal fissure, vallecula, or valley, separates 
the hemispheres on the inferior surface, into which project 
part of the middle lobe—the inferior vermiform process. 
The upper surface of each hemisphere presents the 
following:— 
Anterior or square lobe, in front, and extending back 
to the 
Posterior or semilunar lobe, on a level with the pos- 
terior margin of the vermiform process. 
On the under surface of each hemisphere are the fol- 
lowing points from before backward :— 
Flocculus, subpeduncular lobe, or pneumogastric 
lobule, is below and behind the middle peduncle of the 
cerebellum ; 
Amygdala lobe, or tonsil, on either side of the valley, 
and projects forward into the fourth ventricle ; 
Posterior medullary velum, or valves of Tarini, a 
white, valve-like fold on either side of the tonsil; 
Digastric lobe, on the outer side also, partly connected 
with the pyramid, and situated external to the tonsil; 
Slender lobe, also connected with the pyramid ; 
Posterior inferior lobe, rests against the medulla ob- 
longata, and joins the commissura brevis in the valley. 
The vermiform process presents superiorly:— 
Lobulus centralis, or anterior eminence, within the 
incisura anterior; 
Monticulus cerebelli, or middle eminence, projection 
from the centre; 
Commissura simplex, or posterior eminence, near the 
incisura posterior. 301 
Inferiorly, called also inferior vermiform process, 
presents from behind forward :— 
Commissura brevis, within the incisura cerebelli pos- 
terior ; 
Pyramid, a prominent conical projection, forming the 
posterior limit; 
Uvula, a large eminence in front, between the pyra- 
mid and nodule; 
Nodule, a small projection in front. 
The cerebellum is connected with the encephalon 
by the peduncles of the cerebellum, three in number, 
from above downward, as follows :— 
Superior, or processus e cerebello ad testes, pass to 
the cerebrum; 
Middle, or processus ad pontem, the transverse fibres 
of the pons Yarolii, connect the hemispheres; 
Inferior, or processus a cerebello ad medullam, the 
restiform bodies of the medulla oblongata, connect with 
medulla oblongata. 
The internal structure of the cerebellum consists of 
an arbor vitae arrangement of gray matter, inclosing a 
white mass. In the centre of the latter is found a 
grayish, dentated mass, the corpus dentatum, an irreg- 
ular capsule of gray matter opening anteriorly. 
TIIE NERVOUS SYSTEM. 
The cranial nerves consist of twelve pairs, according 
to the division of Soemmering, or nine, according to 
Willis, the former being now generally adopted :— 
CRANIAL NERVES. 
Soemmering. 
1. Olfactory, 
2. Optic, 
3. Motores oculorum, 
4. Pathetici, 
5. Trifacial, 
6. Abducentes, 
7. Facial (portio dura), 
8. Auditory (portio mollis), 
9. Glosso-pharyngeal, 
10. Pneumogastric (vagus, or 
par vagum), 
11. Spinal accessory, 
12. Hypoglossal. 
1. Olfactory, 
2. Optic, 
3. Motores oculorum, 
4. Pathetici (or trochleares), 
5. Trifacial (ortrigemini), 
6. Abducentes, 
Willis. 
7. 
i Facial, 
i Auditory, 
8. 
Glosso-pharyngeal, 
Pneumogastric, 
Spinal accessory. 
9. Hypoglossal. 302 
HUMAN ANATOMY. 
1. Olfactory nerve, special nerve of smell; super- 
ficial origin by three roots : internal from anterior lobe, 
Base of brain and cranial nerves: 1, olfactory bulb; 2, optic nerves; 4, tractus 
opticus ; 5, crus cerebri; 6, third pair of nerves; 7, fourth pair of nerves ; 8, fifth pair 
of nerves; 9, sixth pair of nerves: 10, pyramid; 11, olivary body; 22, pons Varolii; 
24, seventh and eighth pairs of nerves: 25, ninth, tenth, and eleventh pairs of nerves; 
26, twelfth pair of nerves; 27, cerebellum. 
Fig. 67. 
middle or gray root from the caruncula mammillaris in 
anterior lobe also, and external from the middle lobe; TIIE NERVOUS SYSTEM. 
303 
deep origin, from gyrus fornicatus, corpus striatum, and 
temporo-sphenoidal lobe ; course, roots unite, pass for- 
ward, and form bulbus olfactorius; exit, foramina of 
cribriform plate of ethmoid; distribution, by three 
groups to mucous (Schneiderian) membrane of nares, 
inner to septum nasi, middle to roof of nasal fossa, outer 
to superior and middle turbinated bones. 
2. Optic nerve, special nerve of sight; superficial 
origin, optic chiasma or commissure formed by union of 
the optic tracts. The fibres in the commissure cross and 
recross, being connected in front by inter-retinal fibres, 
behind by inter-cerebral fibres, and laterally by cerebro- 
retinal fibres, continuing directly from the tract to the 
optic nerve. Deep origin, the optic tracts arise from 
optic thalamus, corpora quadrigemina, and corpora gen- 
iculati, and are also attached to the lamina cinerea and 
the tuber cinereum; course, diverge and pass forward ; 
exit, optic foramen ; distribution, to retina. 
3. Motor oculi, motor nerve; superficial origin, 
inner surface of crus cerebri; deep origin, from pons 
Yarolii, crus cerebri, corpora quadrigemina, valve of 
Yieussens, and a nucleus in floor of aqueduct of Sylvius; 
course, from inner side of crus cerebri passes forward, 
descends along external wall of cavernous sinus; exit, 
sphenoidal fissure between two heads of external rectus 
muscle ; distribution, by superior and inferior divisions, 
to all the ocular muscles (including the iris) except the 
external rectus and superior oblique. 
4. Pathetic (trochlear), motor nerve; superficial 
origin, from valve of Yieussens, on outer side of crus 
cerebri; deep origin, from floor of aqueduct of Sylvius 
and floor of fourth ventricle; course, outer side of crus 
cerebri, through outer wall of cavernous sinus ; exit, 
sphenoidal fissure; distribution, to superior oblique 
muscle. 
5. Trifacial, or Trigeminus, common sensation, taste 
and motion; superficial origin, by two roots, like a 
spinal nerve from tlie side of the pons Yarolii; deep 
origin, the anterior or motor root, from the gray tubercle 
of Rolando and pyramidal body, the posterior or deep 304 
HUMAN ANATOMY. 
root, from gray tubercle of Rolando, posterior gray horn 
of medulla, and lateral tract; course, passes forward to 
apex of petrous portion of temporal bone, where the 
sensory root enters Gasserian ganglion,the motor passing 
beneath, and later joins a branch of the ganglion. It 
divides into three branches—ophthalmic, superior max- 
illary, and inferior maxillary; exit, ophthalmic 
sphenoidal fissure, superior maxillary by foramen ro- 
tundum, inferior maxillary by foramen ovale. 
Fig. 68. 
Diagram of superior maxillary nerve: 1, trunk of fifth nerve; 2, Gasserian 
ganglion; 3, facial nerve; 4, chorda tympani; 5, submaxillary ganglion ; 6, frontal, 
nasal, and lachrymal nerves : 7, orbital branch; 8, infraorbital; 9, anterior dental 
nerve; 10, naso-palatine ; 11, palatine; 12, gustatory nerve. 
Ophthalmic nerve, entirely sensory, supplies lachry- 
mal gland, upper eyelid, skin and muscles of forehead, 
eyebrow, nose, eyeball (ciliary muscle, iris, etc.), mucous 
membrane of e}relids and nose, and the ciliary ganglion. 
Its branches are :— 
Lachrymal, 
Frontal, 
Nasal. 
Superior maxillary nerve, entirely sensory also; 
supplies sensation to upper jaw, teeth, hard and soft THE NERVOUS SYSTEM. 
305 
palates, tonsils, gums, antrum Highmorianum, muscles, 
skin and mucous membrane of lower eyelid, muscles 
and skin of cheeks and upper lip, and mucous membrane 
of floor of nares. 
Its branches are:— 
Orbital, 
Spheno-palatine, 
Posterior dental, 
Middle dental, 
Anterior dental, 
Palpebral, 
Nasal, 
Labial. 
Fig. 69.—Diagram of Inferior Maxillary Nerve. 
Inferior maxillary nerve consists of two portions: 
anterior, or motor, and posterior, or sensory, haying 
a threefold function. It supplies motion to all the 
muscles of mastication (except to buccinator), anterior 306 
HUMAN ANATOMY. 
belly of digastric, and mylo-hyoideus ; sensation to skin 
of ear, lower part of face, lower lip, and tongue, and is 
one of the special nerves of taste. Its branches are :— 
Anterior Portion. 
Masseteric, 
Deep temporal (2), 
Buccal, 
Pterygoid (2). 
Posterior Portion. 
Auriculo-temporal, 
Inferior dental, 
Gustatory, or lingual. 
The fifth nerve has four ganglia connected with it:— 
(a) Ophthalmic, or lenticular; 
(b) Spheno-palatine, or Meckel’s; 
(c) Otic, or Arnold’s; 
.(d) Submaxillary (wide Sympathetic System). 
6. Abducens, motor; superficial origin, pyramidal 
body and pons Varolii; deep origin, posterior part of 
medulla and floor of fourth ventricle; course, passes 
forward in cavernous sinus; exit, sphenoidal Assure; 
distribution, to external rectus muscle. 
7. Facial, or portio dura of the seventh, motor 
nerve ; superficial origin, lateral tract of medulla and 
pons Yarolii; deep origin, from gray tubercle of 
Rolando, and fasciculus teres, in floor of fourth ventricle; 
course, forward and outward, through internal auditory 
meatus, aquseductus Fallopii, and inner wall of tym- 
panum; exit, stylo-mastoid foramen; distribution, to 
muscles of expression, buccinator, and platysma, poste- 
rior belty of digastric, stylo-hyoid, attraliens and retra- 
hens aurem muscles, to laxator tympani and stapedius 
through tympanic branch, lingualis muscle through 
chorda tympani, and levator palati, and azygos uvulae 
muscles through Vidian. In its course through the 
temporal bone it communicates with- many important 
nerves; in the internal auditory meatus, with auditory ; 
in aquseductus Fallopii, with otic ganglion,by the small 
petrosal; Meckel’s ganglion, by the large petrosal nerve; 
the sympathetic of the great meningeal, by the external 
petrosal nerve; and at its exit from the stylo-mastoid 
foramen, with the glosso-pharyngcal, pneumogastric, THE NERVOUS SYSTEM. 
307 
auriculo-temporal, auricularis magnus, and the carotid 
plexus. Its branches are :— 
In Aqnceductus Fallopii. 
On the Face. 
Tympani, 
Chorda tympani. 
Temporo-facial, 
' Temporal, 
Molar, 
' Infraorbital. 
After Exit from Stylo-mastoid Foramen. 
Posterior auricular, 
Stylo-hyoid, 
Digastric. 
Cervico-facial, 
Buccal, 
Supramaxillary, 
| Inframaxillary. 
8. Auditory, or portio mollis of the seventh, special 
nerve of hearing; superficial origin, from groove be- 
tween olivary and restiform bodies ; deep origin, from 
white transverse striae in floor of fourth ventricle, pos- 
terior pyramid and restiform body, and superior vermi- 
form process of the cerebellum; course, winds around 
restiform body, and passes forward to internal auditory 
meatus, with the facial; distribution, to internal ear by 
two branches:— 
Vestibular, and Cochlear (vide Ear, p. 346). 
9. Glosso-pharyngeal, or first portion of eighth, 
nerve of common sensation and taste ; superficial origin, 
from medulla oblongata, between olivary and restiform 
bodies; deep origin, gray nucleus in floor of fourth 
ventricle; course, passes outward across flocculus; exit, 
jugular foramen, in separate sheath, in front of pneumo- 
gastric and spinal accessory, having two gangliform 
enlargements upon it—-jugular and petrosal, petrous, 
or ganglion of Andersch ; distribution, to mucous mem- 
brane of fauces, tonsil, pharynx, and middle ear, muscles 
of the pharynx, and special sense of taste to the base 
and sides of the tbngue. Its branches are :— 
Tympanic (Jacobson), 
Carotid branches, 
Muscular branches, 
Pharyngeal branches, 
Tonsillar branches, 
Lingual branches. 
10. Pneumogastric (vagus, or par vagum), secoud 
portion of eighth, motor and sensory ; superficial origin, 
from groove between olivary and restiform bodies by a 308 
HUMAN ANATOMY. 
dozen filaments; deep origin, from nucleus in floor of 
fourth ventricle; course, passes outward across the 
flocculus ; exit, jugular foramen in a common sheath with 
the spinal accessory nerves ; distribution, motor nerve to 
the organs of respiration and voice, and a motor and 
sensory nerve to heart, oesophagus, pharynx, and 
stomach. Its branches are:— 
Auricular (Arnold’s), 
Pharyngeal, 
Superior laryngeal, 
Recurrent laryngeal, 
Cervical cardiac, 
Thoracic cardiac, 
Anterior pulmonary, 
Posterior pulmonary, 
(Esophageal, 
Gastric. 
It also communicates with the left hepatic sympa- 
thetic plexus. 
11. Spinal accessory, third portion of eighth, motor 
nerve; superficial origin, from lateral tract of medulla 
and spinal cord as low as sixth cervical nerve; deep 
origin, spinal portion from anterior horn of gray matter, 
accessory portion from gray nucleus in floor of fourth 
ventricle; course, the spinal portion enters the skull 
through the foramen magnum, and joins the accessory 
portion in the jugular foramen ; exit, jugular foramen in 
sheath with the pneumogastric; distribution, to sterno- 
cleido-mastoid and trapezius muscles, communicating 
with the cervical plexus and pharyngeal and laryngeal 
branches of pneumogastric. • 
12. Hypoglossal, or ninth nerve, motor nerve of 
tongue; superficial origin, from groove between olivary 
and pyramidal bodies by about a dozen filaments; deep 
origin, from gray nucleus at lowest part of floor of fourth 
ventricle; exit, anterior condyloid foramen ; distribution, 
to the omo-hyoid (both bellies), sterno-hyoid, sterno- 
thyroid, thyro-hyoid, and muscles of the tongue—stylo- 
glossus, hyoglossus, genio-liyoid, genio-hyoglossus, com- 
municating with the pneumogastric, sympathetic, first 
and second cervical, and gustatory nerves. Its branches 
are:— 
Descendens noni, 
Thyro-hyoid, 
Muscular, 
Meningeal. 
Membranes of the Cord.—Tlie membranes of the THE NERVOUS SYSTEM. 
309 
spinal cord are three—the dura mater, arachnoid, and 
pia mater. 
Dura mater is a loose fibrous sheath, continuous with 
the dura of the brain, and from which it differs in not 
inclosing the venous sinuses, not dipping into the 
fissures of the cord, and not being adherent to the bony 
canal. From the latter it is separated by the venous 
plexuses and some connective tissue. 
It extends the whole length of the canal, from the 
foramen magnum (to which it is attached) to the top of 
the sacrum. 
Arachnoid is a delicate serous sac, continuous above 
with the cerebral arachnoid, inclosing the pia mater, 
from which it is separated by an interval—the subarach- 
noidean space. It is filled wTith the cerebro-spinal fluid. 
The outer surface of the arachnoid is in contact with the 
dura, the space between them being called the subdural 
space. 
Pia mater is a fibrous membrane, closely adhering to 
the cord and forming its neurilemma. Over the anterior 
median fissure it is strengthened by a fibrous band—the 
tinea splendens—and laterally has the ligamentum den- 
ticulatum. It terminates below the cord as the filum 
terminate—a slender filament. 
THE SPINAL CORD. 
The spinal cord (medulla spinalis) is the elongated 
portion of the cerebro-spinal axis contained in the 
spinal canal. Its length is about sixteen to eighteen 
inches, extending from the medulla above to the lower 
border of the first lumbar vertebra below, where it ter- 
minates in the cauda equina by a slender prolongation 
of gray substance, called the conus medullaris. 
It presents two enlargements, the upper or cervical, 
extending from the third cervical to the second dorsal 
vertebra, and the lower about the position of the second 
or third dorsal vertebra. It is divided into two lateral 
halves by the anterior and posterior median fissures, 
united in the centre by the commissure. The lateral 
portions are again subdivided by the antero-lateral and 310 
HUMAN ANATOMY. 
postero-lateral fissures into the anterior lateral and pos- 
terior lateral columns, and posteriorly a narrow fissure 
separates the posterior median column from the posterior 
median fissure. The gray substance occupies the centre 
of the cord, and is arranged into two crescentic masses 
connected together by the gray commissure. The pos- 
terior horn forms the apex cornu, from which arises the 
posterior root of the spinal nerves. The anterior horn 
is thick and short, and affords origin to the anterior 
root of the nerve. The gray commissure contains 
throughout its whole length a minute canal—the central 
Fig. 70. 
Section of spinal cord and membranes: 1, dura mater; 2, arachnoid membrane; 3, 
fanglion on posterior root; 4, anterior root of spinal nerve ; 5, 5, subarachnoid space; 
, posterior branch of spinal nerve; 7, anterior branch of spinal nerve. 
canal, or ventricle of the cord, continuous above with 
the fourth ventricle. 
SPINAL NERVES. 
The spinal nerves consist of thirty-one pairs, arranged 
in the following order: cervical, eight pairs; dorsal, 
twelve pairs; lumbar, five pairs; sacral, five pairs; 
coccygeal, one pair. 
Each of the spinal nerves arises by two roots, an an- 
terior or motor and a posterior or sensory. The fibres 
of the anterior root arise from the antero-lateral col- 
umns, originating deeply in the gray matter of the cord. 
The posterior roots arise at the postero-lateral fissure, 
also originating deeply in the gray matter of the cord. 
The posterior roots have each a ganglion developed 
upon it—except sometimes the first cervical. These 
roots unite and the nerve then subdivides into twTo THE NERVOUS SYSTEM. 
311 
branches, both having motor and sensory fibres. The 
posterior branches are smaller and unimportant; they 
supply the skin and muscles of the back. 
The anterior branches supply the neck, front and 
sides of the trunk, and the extremities. 
Cervical Plexus.—The cervical plexus is formed by 
the anterior divisions of the first to the fourth cervical 
nerves. It is covered by the sterno-mastoid muscle, and 
rests upon the scalenus medius and levator anguli 
scapulae muscle. It gives off:— 
Superficial. 
Superficialis colli, 
Auricularis magnus, 
Occipitalis minor, 
Supraclavicular. 
Deep. 
Communicating, 
Muscular, 
Phrenic, 
Communicans noni, 
Communicating, 
Muscular. 
The phrenic nerve, or internal respiratory of Bell, is 
derived from the third and fourth cervical nerves, with 
a branch from the fifth. It descends into the chest be- 
tween the subclavian artery and vein, between the peri- 
cardium and the pleura, to the diaphragm, to which it is 
distributed. The course of the two nerves differs in the 
thorax (vide Mediastinum). 
The brachial plexus is formed by the anterior 
branches of the four lower cervical and the first upper 
dorsal nerves—the fifth, sixth, and seventh forming one 
cord, and the eighth cervical and first dorsal another cord. 
Below the line of the clavicle, both these trunks divide, 
the adjacent cords of the two upper uniting to form the 
posterior, and the remaining cords forming the outer 
and inner cords respectively, receiving their names from 
their relative position to the subclavian artery. Each 
of these cords again bifurcates, the adjacent divisions at 
the outer ending of the cords uniting over the artery to 
form the median nerve, the other divisions forming the 
musculo-cutaneous, ulnar, circumflex, and musculo- 
spiral, the two latter being the divisions of the posterior 
cord. Its branches are:— 312 
HUMAN ANATOMY. 
Above the clavicle : 
Communicating, arises from the fifth cervical, and 
passes to the phrenic ; 
Muscular, supply the scaleni, rliomboidii, longus 
colli, and subclavius; 
Posterior thoracic, long thoracic, or external respira- 
tory of Bell, arises by five roots from the fifth to seventh 
cervical nerves, which unite within the scalenus medius 
muscle and descend to supply the serratus magnus; 
Suprascapular, passes beneath the trapezius, through 
the suprascapular notch, to supply the shoulder-joint 
and supraspinatus muscle. 
Below the clavicle: 
The anterior thoracic nerve consists of two—an ex- 
ternal or superficial branch and an internal or deep 
branch. The former supplies the pectoralis major and 
the latter the pectoralis minor, and sending branches to 
the pectoralis major. 
The subscapular nerves are three in number. The 
upper subscapular supplies the subscapular muscle, the 
lower subscapular nerve supplies the teres major and 
subscapularis, the middle or long subscapular supplies 
the latissimus dorsi. 
The circumflex nerve accompanies the posterior cir- 
cumflex artery, passing through the space formed be- 
tween the teres major, teres minor, and long head of the 
triceps to supply the shoulder-joint and skin over the 
shoulder and the neighboring muscles. It gives off two 
branches, an upper and a lower branch. 
The musculo-cutaneous nerve pierces the coraco- 
brachialis muscle and descends the arm to supply the 
brachialis anticus, biceps, coraco-brachialis, and the skin 
of the forearm. At the outer border of the tendon of 
the biceps, above the elbow, it becomes superficial and 
divides into two branches—the anterior descending the 
radial side of the forearm to the wrist and supplying the 
skin of that part, the posterior branch descending the 
back part of the radial side of the forearm to the wrist 
to supply that part. 
The internal cutaneous nerve descends the inner side THE NERVOUS SYSTEM. 
313 
of the arm together with the basilic vein to about its 
middle, where it becomes cutaneous, supplying the skin 
of this region. It has an anterior and a posterior branch. 
The lesser internal cutaneous nerve of Wrisberg is 
derived from the inner cord, and receives filaments from 
the eighth cervical, first dorsal, and the intercosto- 
humeral nerve, and is distributed to the skin on the 
inner side of the arm. 
The median nerve, formed by a root from the outer 
and inner cord of the brachial plexus, descends the arm, 
crossing the brachial artery from its outer to its inner 
side to the bend of the elbow. Its branches are:— 
Muscular branches, supply all the superficial anterior muscles 
except the flexor carpi ulnaris ; 
Anterior interosseous, supplies all the deep anterior muscles 
except the inner half of the flexor profundis digitorum ; 
Palmar cutaneous, crosses above the annular ligament, divides into 
two branches to supply the ball of the thumb and the palmar surface 
of the hand; 
Branches to the muscles of the thumb, supplies the opponens, 
cuter head of the small flexor, and the abductor; 
Digital branches, supply both sides of the thumb, index and 
middle and the radial side of the ring finger. 
The ulnar nerve descends the inner side of the 
axillary artery to the middle of the arm, where it crosses 
the internal head of the triceps, and accompanies the 
inferior profunda artery to the elbow, where it passes 
between the heads of the flexor carpi ulnaris. Its 
branches are, in the forearm :— 
Articular (elbow), supplies the elbow-joint; 
Muscular, to inner half of the deep flexors and flexor carpi 
ulnaris; 
Cutaneous, supplies the skin of the palm ; 
Dorsal cutaneous, supplies both sides of the little finger and the 
ulnar side of the ring finger; 
Articular (wrist), supply the wrist-joint. 
In the hand :— 
Superficial palmar, supplies the skin of both sides of the little and 
the ulnar side of the ring finger and palmaris brevis muscle; 
Deep palmar, supplies the interossei, lumbricales, adductor 
pollicis, and inner head of flexor brevis pollicis. 
The musculo-spiral nerve, derived from the posterior 
cord of the brachial plexus, descends the arm in front 314 
HUMAN ANATOMY. 
of the teres major and latissimus dorsi muscle, accom- 
panies the superior profunda artery through the musculo- 
spiral groove to the outer side of the elbow, between the 
supinator longus and the brachialis anticus, where it 
divides into the radial and posterior interosseous nerves. 
Its branches are:— 
Muscular, supply the supinator longus, external carpi radialis 
longior, triceps, anconeus, and brachialis anticus ; 
Radial, descends in the course of the radial artery to three inches 
above the wrist, where it becomes superficial, and supplies the adjoin- 
ing sides of the thumb and index, index and middle, middle and ring 
fingers. 
Cutaneous, supply the outer side of the arm, elbow, and radial 
side of forearm and wrist; 
Posterior interosseous, passes through the supinator brevis muscle, 
and supplies, as it descends, all the posterior brachial and radial 
muscles, except those supplied by the muscular branches of the ulnar 
(vide page 313). It has a ganglion upon it. 
Dorsal Nerves.—The posterior divisions of the 
dorsal nerves subdivide into the external and internal 
branches to supply the muscles of the skin of the back. 
The anterior divisions of the dorsal nerves (intercostal 
nerves), twelve in number, supply the walls of the 
abdomen and thorax. They are divided into two sets— 
the six upper, distributed for the most part to the walls 
of the chest, and the six lower, to the walls of the chest 
and abdomen. The upper six dorsal nerves run between 
the two sets of the intercostal muscles, accompanied by 
the intercostal vessels, to supply the skin over the front 
of the chest and the mammae. Their branches are:— 
Lateral cutaneous, divide into two branches, anterior and pos- 
terior ; 
Anterior branches, to the skin of the chest and mamma principally; 
Posterior branches, to the skin over the scapular and lower dorsal 
regions. 
The first intercostal nerve is not distributed to the 
skin, but crosses the axilla under the name of the inter- 
costo-humeral nerve, to join the nerve of Wrisberg. The 
six lower dorsal nerves have received the name of lower, 
or abdominal intercostal nerves, from their distribution. 
The last dorsal one is of large size, and gives off a 
branch, the dorsi lumbar nerve, to supply the quadratus 
lumborum muscle. THE nervous system. 
315 
Lumbar Nerves.—The posterior divisions of the 
lumbar nerves have the same distribution as the other 
spinal nerves. The anterior divisions of the upper four 
lumbar nerves unite to form the lumbar plexus. The 
fifth, with a branch from the fourth, joins the sacral 
nerves to form the lumbo-sacral cord. 
The lumbar plexus is formed by the communicating 
loops from the anterior branches of the first four lumbar 
nerves and a branch from the last dorsal. 
Its branches are :— 
1. llio-hypogastric, divides into two branches :— 
(a) Iliac branch, supplies the skin of the gluteal region and 
the oblique muscles of the abdomen ; 
(b) Hypogastric branch, supplies the skin of the hypogastric 
region and the oblique muscles. 
2. Ilio-inguinal, supplies the skin of the inner and 
upper part of the thigh, the scrotum, and labium (in 
female). 
3. Genito-crural, passes through the psoas muscle 
and divides into two branches :— 
(«) Genital branch, follows the spermatic cord to supply the 
cremaster muscle; in female, supplies round ligament; 
( f>) Crural branch, descends in the sheath of the femoral vessels 
to supply the skin in front of the thigh. 
4. External cutaneous, emerges below the anterior 
superior spine of ilium and divides into :— 
(а) Anterior branch, to skin of outer and front aspect of thigh ; 
(б) Posterior branch, to skin of outer and back aspect of thigh. 
5. Obturator, follows the brim and outer wall of 
pelvis to foramen (obturator), which it pierces to enter 
thigh. 
(а) Anterior branch, supplies the femoral artery ; 
(б) Posterior branch, supplies the adductor muscles ; 
(c) Articular branch, supplies the synovial membrane of knee- 
joint. 
6. Accessory obturator, sends a branch to the hip- 
joint and one to join the anterior branch of the obturator 
nerve. 
7. Anterior crural, the largest branch of the lumbar 
plexus, descends through the psoas muscle, beneath 
Poupart’s ligament, into the thigh, where it divides into 316 
HUMAN ANATOMY. 
an anterior or cutaneous branch, and a posterior or 
muscular branch. It supplies all the muscles and the 
front of the thigh, excepting the tensor vaginae femoris, 
gives branches to the knee, and supplies the skin of the 
inner side in front of the thigh, and to the leg and foot. 
Its branches are, from the anterior division 
(а) Middle cutaneous, to sartorius muscle and skin of front of 
thigh; 
(б) Internal cutaneous, supplies the skin in the inner aspect of 
the leg; 
(e) Long saphenous, or internal saphenous, passes through 
Hunter’s canal, accompanies the internal saphenous vein, to supply 
the skin of the inner side of the foot. 
From the posterior division :— 
(a) Muscular, to tlie muscles of the anterior and lateral aspects 
of the thigh; 
(b) Articular, to the knee-joint. 
The sacral nerves, five in number, divide into 
anterior and posterior nerves. The four upper sacral 
nerves, with the fifth lumbar, and a filament from the 
fourth, the two latter forming the lumbo-sacral cord, 
together form the sacral plexus. It lies upon the ante- 
rior surface of the pyriformis muscle, and is separated 
from the viscera, the sciatic and pudic branches of the 
internal iliac artery, by the pelvic fascia. Its branches 
are:— 
1. Muscular, supply the obturators, gemelli, quad- 
rat us femoris, and pyriformis. 
2. Superior gluteal, supplies the glutei muscles and 
tensor vaginae femoris. 
3. Pudic, accompanies the internal pudic artery, 
passing out of the great sacro-sciatic foramen, around 
the spine of the ischium to re-enter the lesser sacro- 
sciatic foramen. It gives off:— 
(a) Inferior haemorrhoidal, supplies the skin of the anus ; 
(b) Perineal, follows the course of the superficial perineal artery 
to supply the perineal structures generally ; 
(e) Dorsal nerve of the penis, follows the course of the corre- 
sponding1 artery to supply the skin of the glans, prepuce, and penis 
generally. 
4. Small sciatic, supplies the skin of the thigh, leg, THE NERVOUS SYSTEM. 
317 
perineum, and the gluteus maximus muscle. Its branches 
are :— 
(а) Inferior gluteal, to the gluteus maximus ; 
(б) Internal cutaneous branches, to the skin of the inner and 
upperpartof the thigh,and onebranch,the inferior pudendal, supplies 
the skin of the scrotum in the male and labium in the female ; 
(c) Ascending, cutaneous branches supply the skin over the 
gluteus maximus. 
5. The great sciatic nerve, the largest in the body, 
passes out of the great sacro-sciatic foramen, and de- 
scends between the tuberosity of the ischium and the 
great trochanter to the lower third of the thigh, where 
it divides into the internal and external popliteal. It 
gives off:— 
(а) Muscular branches, to the muscles on the inner and posterior 
aspect of the thigh ; 
(б) Articular branches, to the hip-joint. 
The internal popliteal, descends through the popliteal 
space to the arch of the soleus muscle, where it becomes 
the posterior tibial. It gives off:— 
(a) Articular branches, to knee-joint; 
(b) Muscular branches, to the muscles on the posterior aspect 
of the leg; 
(c) External, or short saphenous nerve, passes between the two 
heads of the gastrocnemius muscle, and descends the leg, receiving 
the communicans peronei branch from the external popliteal, around 
the outer malleolus to supply the skin of the outer side of the foot. 
The posterior tibial nerve descends the leg in com- 
pany with the posterior tibial vessels to below the inner 
ankle, where it divides into the external and internal 
plantar nerves. It gives off:— 
1. Muscular branches, to the deep muscles of the calf; 
2. Plantar, cutaneous branch, supplies the skin on the inner side 
of the sole and heel; 
3. Articular branch, to ankle-joint. 
The internal plantar accompanies the corresponding 
artery to the inner side of the foot and gives off:— 
1. Cutaneous branches; 
2. Muscular branches; 
3. Articular branches; 
4. Four digital branches, supplying both sides of the first three 
toes and the inner side of the fourth. 318 
HUMAN ANATOMY. 
The external plantar supplies by a superficial branch 
the outer side of the fourth and both sides of the fifth 
toes, and gives off a deep, or muscular branch. 
The external popliteal or peroneal nerve descends to 
the inner side of the biceps tendon, pierces the peroneus 
longus about one inch below the head, and divides into 
the anterior tibial and musculo-cutaneous. It gives off:— 
1. Articular branches to knee-joint; 
2. Cutaneous branches, one of which is the communicant peronei, 
which joins the short saphenous. 
The anterior tibial accompanies the corresponding 
artery on its outer side to the ankle, where, after giving 
olf an articular branch, it divides into :— 
1. External or tarsal branch, to the tarsal and metatarsal joints, 
and 
2. Internal, to the inner and dorsal adjoining sides of the great 
and second toes. 
The musculo-cutaneous gives off:— 
1. Internal branches, supply skin of inner side of foot and ankle; 
2. External branch, to the dorsum of the adjacent sides of the 
third, fourth, and fifth toes. THE NERVOUS SYSTEM. 
319 
Table of the Spinal Nerves. 
Posterior 
division 
(suboccipital), 
Complexus, recti, andobliqui. muscles. 
First 
cervical 
nerve, 
Anterior 
division 
(occipital), 
i Unites with the second cervical nerve, 
and supplies the anterior recti and 
• rectus lateralis muscles. 
External 
branch, 
> Splenius, complexus, 
) trachelo-mastoid muscles. 
Posterior 
division 
Internal 
branch 
(great 
occipital), 
With branch from third 
cervical, supplies the 
skin of the scalp. 
Second 
cervical 
nerve, 
Anterior 
division, 
Small occipital, 
Branch to great auricular, 
Branch to superficial cervical, 
Branch to communicans noni. 
Posterior 
division, 
External 
and 
internal 
branches, 
Splenius, semispinalis, 
complexus, traehelo- 
mastoid muscles. 
Third 
cervical 
nerve, 
Anterior 
division, 
Branches to form the great auricular, 
superficial cervical, and communi- 
cantes minor. 
Posterior 
divisions, 
External 
branches, 
Muscles of the 6ide of the 
neck. 
Internal 
branches, 
Skin and larger muscles 
of the neck. 
Fourth 
to 
eighth 
cervical 
nerves, 
Branch to phrenic, 
Branches to the trapezius, scalenus 
medius, levator anguli scapulae 
muscles. 
Anterior division 
of fourth, 
Anterior 
divisions, 
fifth to eighth, 
Unite with the first dorsal nerve to 
form tile brachial plexus. 320 
HUMAN ANATOMY. 
Table of the Spinal Nerves.—(Continued.) 
Superficialis colli, 
Auricularis magnus, 
Occipitalis minor. 
Superficial 
branches, 
Ascending, 
i. Descending, 
> Supraclavicular. 
Cervical plexus 
(formed by the ante- 
rior divisions of the 
first to the fourth 
cervical nerves), 
Communicating, 
Muscular, 
Recti 
muscles. 
Deep 
branches, 
( Internal set, 
[ Phrenic, 
l Communicans noni. 
External set, 
Muscular, 
Communicating. 
Communi- 
cating, 
Tophrenic. 
Above 
the 
clavicle, 
Muscular, 
Posterior 
thoracic, 
Scaleni., rhomboidei, lon- 
gus colli, subclavius. 
Serratus magnus. 
(External respiratory 
nerve of Bell.) 
Supra- 
„ scapular, 
Shoulder-joint and supra- 
spinatus muscle. 
' External 
branch, 
Pectoralis 
major. 
Brachial plexus 
(formed by the ante- 
rior branches of four 
lower cervical and 
first dorsal nerves), 
Anterior 
thoracic, 
Pectoralis 
minor, 
Internal 
branch, 
Pectoralis 
major. 
Upper, 
Subscapular 
muscle. 
Three sub- 
scapular, 
Lower, 
Teres major. 
Below 
the 
clavicle, 
Middle, 
Latissimus 
dorsi. 
Circum- 
flex, 
Upper, 
Lower, 
Shoulder- 
joint, and 
muscles and 
skin about it. 
Anterior 
branch, 
Integument 
of palmarsur- 
face of the 
wrist. 
Musculo- 
cutaneous, 
Posterior 
branch, 
Integument 
of dorsal sur- 
face of the 
wrist. THE NERVOUS SYSTEM. 
321 
Table of the Spinal Nerves.—( Continued.) 
Internal 
cutaneous, 
f Anterior ' 
and 
posterior 
, branches, , 
Integument 
of inner side 
of the arm. 
Lesser internal 
cutaneous 
(Wrisberg’s), 
Integument of the inner 
side of the arm. 
Muscular, 
Superficial anterior mus- 
cles, except flexorcarpi 
ulnaris. 
Deep anterior muscles, 
except the inner half of 
flexor profundus digi- 
torum. 
Anterior 
interosseous, 
Palmar 
cutaneous, 
Ball of thumb and palmar 
surface of the hand. 
Median, 
Branch to 
the muscles of 
the thumb, 
Opponens, outer head of 
small flexor and ab- 
ductor. 
Brachial 
plexus, 
below the 
clavicle, 
con till’d, 
Both sides of thumb, in- 
dex and middle fingers, 
and radial side of ring 
finger. 
Digital 
branches, 
Articular, 
(Elbow). 
Muscular 
uscuiar, 
Inner half of deep flexors, 
and flexorcarpi ulnaris. 
Ulnar, 
in forearm 
Cutaneous, 
Skin of the palm. 
Dorsal 
cutaneous, 
Both sides of little finger, 
and ulnar side of ring 
finger. 
Articular, 
(Wrist). 
Superficial 
palmar, 
' Skin of both sides of little 
finger, and ulnar side of 
ring finger, and pal- 
maris brevis muscle. 
Ulnar, 
in hand, 
Deep 
palmar, 
Interossei lumbricales, 
adductor pollicis, inner 
head of flexor brevis 
pollicis. 322 
HUMAN ANATOMY. 
Table of the Spinal Nerves.—(Continued.) 
Supinator longus, extensor 
carpi radial is longior, tri- 
ceps, anconeus, brachialis 
anticus. 
Muscular 
branches, 
Supplies adjoining sides of 
thumb and index finger, 
index and middle, middle 
and ring fingers. 
Brachial 
plexus, 
below the 
clavicle, 
contin’d, 
Radial, 
Musculo- 
spiral, 
Inner side of arm, elbow, 
radial side of forearm, and 
wrist. 
Cutaneous, 
Posterior 
interosseous, 
Posterior brachial and radial 
muscles, except those sup- 
plied by ulnar (muscular 
branches). 
Posterior 
divisions, 
External 
branches, 
Internal 
branches, 
Muscles and skin of the back. 
First intercostal crosses the 
axilla to join the lesser in- 
ternal cutaneous (Wris- 
berg’s). 
Dorsal 
nerves, 
Ante- 
rior, 
Skin of 
chest and 
mammae. 
Upper six 
(thoracic 
intercostals) 
Lateral 
cutane- 
ous, 
Poste- 
rior, 
( Skin over 
I scapula 
<j andlower 
I dorsal 
[ region. 
Anterior 
divisions 
(to the walls 
of chest and 
abdomen), 
Lower six 
(thoracieo- 
abdominal 
intercostals) 
The last dorsal gives off the 
dorsi lumbar to the quad- 
ratus lumborum muscle. 
External 
branches, 
Posterior 
divisions, 
Internal 
branches, 
Muscles of the skin of the 
back. 
Lumbar 
nerves, 
Anterior 
divisions, 
The four upper unite to form the lumbar 
plexus. The fifth, with a branch from the 
fourth, joins the sacral nerves to form the 
lumbo-sacral cord. THE NERVOUS SYSTEM. 
323 
Table of the Spinal Nerves.—(Continued.) 
Iliac, 
Skin of gluteal region, ob- 
lique muscles of abdomen. 
Ilio- 
hypogastric, 
Hypo- 
gastric, 
Skin of hypogastric region 
and oblique muscles. 
Ilio- 
inguinal, 
Skin of inner and upper part of thigh, 
scrotum, labium (in female). 
Genital, 
Cremaster muscle, round 
ligament (in female). 
Genito- 
crural, 
Crural, 
Anterior, 
Skin of front of thigh. 
Skin of outer front aspect 
of thigh. 
External 
cutaneous, 
Skin of outer back aspect 
of thigh. 
Posterior, 
Lumbar 
plexus, 
Anterior, 
Posterior, 
Femoral artery. 
Obturator, 
Articular, 
Adductor muscles. 
Synovial membrane of knee- 
joint. 
Accessory 
obturator, 
Branch to hip-joint, branch to anterior 
branch of obturator nerve. 
Middle 
cutaneous, 
Sartorius 
muscle, 
skin of 
thigh 
(ant.). 
Anterior 
division, 
Internal 
cutaneous, 
Skin of 
inner 
aspect of 
leg. 
Long 
saphenous, 
Skin of 
inner side of 
foot. 
Anterior 
crural, 
Muscles 
of the an- 
terior and 
lateral 
aspect of 
thigh. 
Muscular, 
Posterior 
division, 
Articular, 
Knee-joint. 324 
Table of the Spinal Nerves.—(Continued.) 
HUMAN ANATOMY. 
External 
and internal 
branches, 
Sacral 
nerves, 
Posterior 
divisions, 
Muscles and skin of the 
back. 
Anterior 
divisions, 
The four upper joining with the lumbo- 
sacral cord form the sacral plexus. 
Muscular, 
Obturators, gemelli, quadratus femoris, 
and pyriformis. 
Superior 
gluteal, 
Glutei muscles, and tensor vaginae femoris. 
Inferior 
hsemorrhoidal, 
Skin of the anus, 
Pudic, 
Perineal, 
Perineal structures. 
Dorsal nerve of 
the penis, 
Skin of the penis. 
Articular, 
To hip-joint. 
Sacral 
plexus, 
Inferior 
gluteal, 
Gluteus maximus. 
Branch to skin of inner 
and upper part of thigh. 
Inferior pudendal, skin 
of scrotum, labium in 
female. 
Small 
sciatic, 
Internal 
cutaneous, 
Ascending 
cutaneous, 
Skin over gluteus maxi- 
mus. 
Articular, 
Hip-joint. 
Great 
sciatic, 
Muscular, 
Muscles of inner and pos- 
terior part of thigh. 
External, 
Internal, 
Bifurcation, 
Popliteal. THE NERVOUS SYSTEM. 
325 
Table of the Spinal Nerves.—(Continued.) 
0S2SZ 
Muscular 
branches, 
External 
(short) 
saphenous, 
To knee-jpint. 
To muscles of the posterior aspect of 
the leg. 
Internal 
popliteal, 
Skin of outer side of the foot. 
Muscular, 
Deep muscles of the 
calf. 
Posterior 
tibial (con- 
tinuation), 
Plantar 
cutaneous, 
Skin of inner side of 
sole and heel. 
Articular, 
To ankle-joint. 
Bifur- 
cation, 
Internal plantar, 
External plantar. 
' Cutaneous, 
Muscular, 
Articular, 
„ Four digital. 
Internal 
plantar, 
Supplies the outer side 
of the fourth and 
both sides of the 
fifth toes. Muscular 
branch. 
External 
plantar, 
Articular, 
To knee-joint 
Two 
cutaneous, 
One communicates with the short 
saphenous. 
Bifurcation, 
Anterior tibial, 
Musculo-cutaneous. 
External 
or tarsal 
branch, 
External 
popliteal 
(peroneal), 
Anterior 
tibial, 
Tarsal and metatarsal 
joints. 
Internal 
branch, 
Inner and dorsal, ad- 
joining sides of great 
and secoud toes. 
Musculo- 
cutaneous, 
Internal 
branches, 
To skin of inner side 
of foot and ankle. 
External 
branch, 
To dorsum of adjacent 
sides of third, fourth 
and fifth toes. 326 
HUMAN ANATOMY. 
THE SYMPATHETIC'NERVOUS SYSTEM. 
The sympathetic system, like the cerebvo-spinal axis, 
is double, consisting of a gangliated cord on each side, 
extending the entire length of the vertebral column, and 
numerous nerve-fibres, both communicating, by which it 
anastomoses with the cerebro-spinal axis, and distribu- 
tory, by which the blood-vessels and viscera are supplied. 
Branches of the ganglionated cords ascend through 
the carotid canal to communicate with the ganglia of the 
fifth cranial nerve, and also with each other through the 
ganglion of Ribes, situated upon the anterior communi- 
cating artery. They also communicate below in the 
ganglion impar, located in front of the coccyx. 
The ganglia of each cord correspond very nearly in 
position and number to the vertebrae, except in the cer- 
vical region, where there are but three: cervical three, 
dorsal twelve, lumbar four, sacral five. 
From the ganglionated cords three important plex- 
uses are given off—the cardiac, solar, and hypogastric— 
situated in the thoracic, abdominal, and pelvic cavities 
respectively. 
Cranial Ganglia—Ganglia Connected with the Fifth 
Cranial Nerve.—Besides the Gasserian ganglion upon 
the root there are four—ophthalmic, spheno-palatine, 
otic, and submaxillary—each of which have three 
branches of communication or roots—motor, sensory, 
and sympathetic—besides several branches of distribu- 
tion. 
Ophthalmic, or ciliary, is situated in the orbit be- 
tween the external rectus muscle and optic nerve upon 
the first division of the fifth cranial nerve. 
Sensorj' root from the nasal branch of ophthalmic, 
motor root from the motor oculi or third, sympathetic 
from the cavernous plexus. 
Its branches are the short ciliary nerves (vide Eye). 
Spheno-palatine, or Meckel's, the largest, is situated in the 
spheno-maxillary fossa upon the superior maxillary, or 
second division of the fifth. 
Sensory root, from the superior maxillary. THE NERVOUS SYSTEM. 
Motor root, from the facial, through means of the 
Vidian, sympathetic from the carotid plexus. Its 
branches are:— 
1. Ascending; 
2. Descending, or 
palatine, 
Anterior, or large palatine, 
Middle, or external palatine, 
Posterior, or small palatine; 
3. Internal, 
Superior nasal, 
Naso-palatine; 
Vidian, 
Large superficial petrosal, 
Deep petrosal, 
Pharyngeal branch. 
4. Posterior, 
The Vidian nerve passes from the back part of 
Meckel’s ganglion through the foramen lacerum medium, 
where it divides into the large superficial and deep 
petrosal nerves. It gives off the upper posterior nasal 
branches to the mucous membrane of septum, orifice 
of Eustachian tube, and roof of the nose. Or, more 
correctly, the Vidian is formed by the union of great 
petrosal (large superficial petrosal) from the facial and the 
large deep petrosal from the carotid sympathetic, runs 
forward through the Vidian canal, and joins the spheno- 
palatine ganglion (Meckel’s). In this description, the 
nerves given off to the nasal mucous membrane must be 
considered branches from the ganglion inclosed in the 
same sheath. 
The large superficial petrosal branch enters the 
cranium through the foramen lacerum medium, passes 
beneath the dura mater and Gasserian ganglion, enters 
the hiatus Fallopii, receives a branch from the tympanic 
branch of the glosso-pharyngeal (Jacobson’s), and through 
the aquaeductus Fallopii to terminate in the geniculate 
ganglion of the facial nerve. 
The large deep petrosal branch crosses the foramen 
lacerum medium to the carotid canal, where it joins the 
carotid plexus of the sympathetic. 
The pharyngeal or pterygo-palatine nerve descends 
from the back part of the ganglion through the pterygo- 
palatine canal, to supply upper back part of pharynx. 
Besides the Vidian and its branches there are two 328 
HUMAN ANATOMY. 
other petrosal nerves (vide Facial Nerve), the small and 
external petrosal. 
The small petrosal connects the geniculate ganglion 
of the facial, within the aquaeductus Fallopii, with the otic 
ganglion. 
The external petrosal connects the geniculate gan- 
glion of the facial, within the same canal, with the sym- 
pathetic plexus of the middle meningeal plexus. 
Otic ganglion (Arnold’s) is placed below the fora- 
men ovale upon the inferior maxillary nerve, or third 
division of the fifth. 
Sensory root, from the auriculo-temporal branch of 
the inferior maxillary; motor root, from the internal 
pterygoid branch of the same. 
Sympathetic root, from the plexus on the middle 
meningeal artery. Branches distributed to the tensor 
palati and tensor tympani muscles. 
Submaxillary ganglion, placed above the deep por- 
tion of the submaxillary gland. 
Sensory root, from gustatory branch of inferior 
maxillary; 
Motor root, from the facial nerve through a branch 
of the chorda tympani ; 
Sympathetic, from plexus of facial artery. 
Beside these ganglia, situated upon branches of the 
trifacial nerve, the following are found within the cavity 
of the cranium:— 
Ganglion of Ribes, on the anterior communicating artery ; 
Ganglion of Bidder, on the middle meningeal artery; 
Ganglion of Laumonier, on the internal carotid artery ; 
Ganglion of Cloquet, on the naso-palatine nerve in the incisor 
fossa ; 
Ganglion of Bochdaleck, near the spheno-palatine ganglion. 
Cervical Ganglia.—The cervical ganglia consist of 
three,—superior, middle, inferior,—of which the supe- 
rior is the largest and the middle the smallest. These 
are connected above with the cranial ganglia, below with 
the thoracic ganglia, and communicate with each other. 
Superior cervical ganglion lies opposite the second 
or third cervical vertebra, behind the internal carotid THE NERVOUS SYSTEM. 
329 
artery. It is connected with the middle ganglion, the 
upper four cervical, and tenth and twelfth cranial 
nerves, distributes branches to the carotid (internal), 
cavernous, and pharyngeal plexuses, and gives off" the 
superior cardiac nerve to the cardiac plexus. 
Middle cervical ganglion lies upon inferior thyroid 
artery, opposite fifth cervical vertebra. It is connected 
with the upper and lower ganglia and spinal nerves, and 
gives off the middle cardiac nerve to cardiac plexus. 
Inferior cervical ganglion lies internal to the supe- 
rior intercostal artery, below the last cervical vertebra. 
It is connected to the middle ganglion, first thoracic, 
lower cervical nerves, forms the vertebral plexus, and 
gives off the inferior cardiac nerve to cardiac plexus. 
Thoracic ganglia lie upon the heads of the ribs on 
each side of the vertebral column. They are connected 
with the inferior cervical ganglion above, the lumbar 
ganglion below, the dorsal spinal nerves behind, and 
give off internal branches divided into two sets of six 
each—upper and lower. 
Internal branches from upper set are distributed to 
the pulmonary and aortic plexuses, and internal branches 
from lower set unite to form the three splanchnic nerves,— 
great splanchnic, lesser splanchnic, renal splanchnic,— 
distributed respectively to the semilunar ganglion, renal 
and suprarenal plexuses, and to renal and cceliac plexuses. 
Lumbar ganglia lie along inner margin of the psoas 
muscle. They communicate above and below with the 
other ganglia and with the lumbar spinal nerves, and give 
off internal branches which form the hypogastric plexus. 
Sacral ganglia are situated internal to the anterior 
sacral foramina. They unite below in front of the coc- 
cyx in the coccygeal ganglion, or ganglion impar. They 
communicate with the sacral nerves, join the pelvic 
plexus, and send branches on the middle sacral artery. 
Cardiac Plexus.—The cardiac plexus, formed from 
the superior, middle, and inferior cardiac nerves from the 
cervical ganglia, and the cardiac branches from the pneu- 
mogastric and recurrent laryngeal, consists of two por- 
tions—the superficial and deep. 330 
HUMAN ANATOMY. 
Superficial cardiac plexus, situated beneath the arch 
of the aorta, is formed by the left superior cardiac nerve 
and the left inferior cervical cardiac nerve, and contains 
the cardiac ganglion of Wrisberg. It forms part of the 
anterior coronary plexus, and sends branches to the left 
anterior pulmonary plexus. 
Deep cardiac plexus lies between the arch of the 
aorta and trachea, and receives all the cardiac nerves 
except the two mentioned above. It forms part of the 
anterior coronary and posterior coronary plexuses. 
Solar plexus, or “ abdominal brain,” consists of 
ganglia and a net-work of nerve branches, formed 
chiefly from the branches of the two great splanchnic 
nerves and branches from the right pneumogastric. It 
is situated between the aorta and the crura of the dia- 
phragm and the stomach, and surrounds the superior 
mesenteric artery and coeliac axis. 
Its ganglia are two crescentic ganglionic masses— 
the semilunar ganglia (the largest in the body)—situ- 
ated in front of the crura of the diaphragm. They are 
composed of smaller ganglia aggregated together. From 
the solar plexus and semilunar ganglion are derived 
numerous branches which are distributed as plexuses 
over all the abdominal arteries, as follows :— 
Coeliac, 
Gastric, 
Hepatic, 
Splenic, 
Phrenic, 
Suprarenal, 
Renal, 
Spermatic, 
Aortic, 
Superior mesenteric, 
Inferior mesenteric, 
Ovarian. 
Hypogastric plexus is situated below the bifurca- 
tion of the aorta, in front of the sacrum, and is formed 
by branches from the lumbar ganglia and aortic plexus. 
It divides into two parts which, with branches from the 
sacral ganglia and nerves, become the pelvic plexuses. 
The inferior hypogastric or pelvic plexus on each 
side gives off the following branches :— 
Vesical plexus, 
Prostatic nlexus 
l rostatic plexus, 
Vaginal plexus, 
( Small cavernous nerves, 
( Large cavernous nerves, 
Inferior haemorrlioidal, 
Uterine plexus. 
to penis, ORGANS OF SPECIAL SENSE. 
The nose, the special organ of smell, consists of two 
parts,—the external prominence, or nose proper, and the 
internal cavities, or nasal fossae. 
The nose proper is made up of a cartilago-osseous 
frame-work covered with muscles (vide Muscles) and 
skin, and lined with mucous membrane. The osseous 
portion is formed by the margins of the anterior meatus 
(vide Osteology). 
The cartilaginous portion consists of an upper and 
lower lateral cartilage on either side, and the nasal 
septum dividing the nasal cavity into two nasal fossae. 
Arteries are from nasal branch of ophthalmic and 
infraorbital, nasal artery from superior coronary, and 
branches of the lateralis nasi. 
Veins empty into the ophthalmic and facial veins. 
Nerves from infratrochlear, infraorbital, and facial. 
The nasal fossae are the two bony cavities already de- 
scribed (vide p. 42). They are lined throughout with 
mucous membrane called Schneiderian membrane, which 
is continuous with the antrum of Highmore, frontal, 
ethmoidal, and sphenoidal sinuses, with the conjunctiva 
through the lachrymo-nasal duct, with the pharynx 
through the posterior nares, and with cavity of the 
tympanum through the Eustachian tube. Its epithelium 
is columnar, ciliated in the lower part and the sinuses, 
and is columnar but not ciliated in the membrane to 
which the olfactory nerve is distributed. 
Arteries are anterior and posterior ethmoidal from 
the ophthalmic to the roof, frontal and ethmoidal sinuses, 
spheno-palatine from the internal maxillary to the 
mucous membrane of the spongy bones, septum, and 
meatuses, and alveolar from the internal maxillary to the 
antrum. 
THE NOSE. 332 
Veins empty into facial, ophthalmic, and beginning 
of great longitudinal sinus. 
Nerves are:— 
HUMAN ANATOMY. 
Olfactory, or first cranial, the special nerve of smell, 
is distributed over the upper third of the septum, and 
superior and middle turbinated bones. 
Anterior dental branch of superior maxillary to the 
inferior turbinated bone and inferior meatus. 
Nasal branch of ophthalmic, to the outer walls and 
septum. Besides these, the spheno-palatine ganglion, 
the superior nasal branch, naso-palatine, and anterior 
palatine also send branches to the parts. 
The organs of sight comprise the eyeballs and 
their appendages and the optic nerves. 
THE EYE. 
The eye is a spherical organ, situated in the anterior 
part of the skull, protected in front by several append- 
ages, acted upon by muscles, and supplied by blood- 
vessels and nerves. 
Within the orbit it rests upon a bed of fat, from 
which it is separated by a membranous sac—the capsule 
of Tenon. 
Diameters.—Antero-posterior, in the adult, .950 inch ; 
transverse, .925 ; vertical, .915 ; oblique, .943. 
Anterior and posterior poles are the geometric centres 
of the cornea and fundus respectively. 
Optic axis is a straight line passing through the 
cornea and posterior pole of the eye. 
Line of vision, or visual axis, is an imaginary line 
which connects the point of fixation with the fovea cen- 
tralis, through the nodal point, usually to the outer side 
of the centre of the pupil. It forms with the optic axis, 
as it cuts the cornea, the visual angle—an angle of from 
3° to 7°. 
It presents the following :— 
Nodal point is an imaginary point—the centre of 
curvature of the refracting media—where all the lumi- 
nous rays pass without deviation. 
Equatorial plane, an imaginary plane passing through ORGANS OF SPECIAL SENSE. 
333 
the centre of the eyeball at right angles to the optic 
axis, dividing the globe into two hemispheres—the ante- 
rior and posterior. 
Equator is the line upon the surface of the globe 
where the equatorial plane cuts it. 
Meridional planes are imaginary antero-posterior 
planes coinciding with the axis. 
Horizontal section of human eye: 1. cornea: It, conjunctiva; 2, sclerotic; 3, cho- 
roid; 4, ciliary processes; 4t, ciliary muscle: 5, suspensory ligament of lens; 7, iris; 
8, optic nerve; 8tt, macula lutea; 10, canal of Petit; 11, anterior chamber; 12, crys- 
talline lens; 13, vitreous humor; a a, antero-posterior, and b b, transverse axis of 
ball. 
Fig. 71. 
Meridians are the lines upon the surface where these 
meridional planes cut it. 
The capsule of Tenon, tunica vaginalis oculi, is a 
fascia between the and the walls of the orbit, 
isolating the eyeball and allowing free movement. It 334 
HUMAN ANATOMY. 
is continuous in front with the subconjunctival connect- 
ive tissue, and behind with the dura mater, through the 
sphenoidal fissure and optic foramen, and consists of 
two layers—a visceral layer investing the posterior por- 
tion of the eyeball, and a parietal layer lining the 
cushion of fat on which the eye rests. 
The inner aspect is lined with flattened endothelial 
cells, and incloses a lymph space communicating with 
subdural and subarachnoidean lymph spaces of the optic 
nerve-slieatli. It supports the lachrymal gland, is 
strengthened by numerous fibrous bands, and is pierced 
by the ocular muscles, inclosing them in imperfect 
sheaths. 
The capsule of Bonnet is the name given to the por- 
tion posterior to the passage of the tendons, and 
The capsule of Tenon is then applied to the anterior 
socket-like half. 
Tiie eyeball is composed of a large, opaque segment 
of a sphere, forming about five-sixths of the globe, for 
the protection of its contents, and a smaller transparent 
segment of a sphere, implanted upon and continuous with 
it in front. The optic nerves enter the eyeballs to their 
nasal side, in the direction of the axis of the orbit. 
It is composed of three tunics or coats:— 
1. Sclerotic and cornea, 
2. Choroid, iris, and ciliary processes, 
3. Retina; 
And three humors, or refracting media :— 
1. Aqueous humor, 
2. Crystalline lens (and capsule), 
3. Vitreous humor, or body. 
The sclerotic coat, so called from its extreme hard- 
ness, is thicker behind (one twenty-fifth of an inch) than 
in front (one-sixtieth of an inch), and presents two sur- 
faces for studjr—the external and internal. 
The external surface is smooth and ivliite, and has 
attached to it the various muscles of the eye. 
The internal surface is grooved for the passage of ORGANS OF SPECIAL SENSE. 
335 
the ciliary nerves, and connected to the choroid by a 
fine areolar laj^er—the lamina fusca. 
Behind, and a little to the nasal side, where the optic 
nerve enters, it presents a perforated appearance—the 
lamina cribrosa — the larger opening of which—the 
porus opticus—transmits the arteria centralis retinae; 
the others transmit the ciliary vessels and nerves. It 
is continuous in front with the cornea, overlapping it 
a little on its outer margin. 
In structure it is made up of white, fibrous tissue, 
with a small quantity of elastic fibres, and connective- 
tissue corpuscles. It probably contains no nerves. 
The cornea is the convex, transparent, nearly circular 
tissue forming the anterior one-sixth of the globe. It is 
from one twenty-second to one thirty-second of an inch 
in thickness. Its thickness at the periphery is 1.12 
millimetres, hence its posterior surface is more curved 
than the anterior. Its transverse diameter is a little 
greater than the vertical, owing to the overlapping of 
the sclerotic above and below. It is composed of four 
layers :— 
1. Conjunctival epithelium; 
S. Cornea proper, 
Anterior elastic lamina, 
Cornea proper; 
3. Posterior elastic lamina, 
4. Epithelial lining, 
Membrane of Descemet. 
The conjunctival epithelium consists of several layers 
of cells (columnar, polyhedral and squamous) covering 
the anterior surface of the cornea, continuous with the 
conjunctiva. 
The anterior elastic lamina is the name given to the 
outer epithelial layer of the cornea proper. 
The cornea proper is made up of a transparent fibrous 
structure, identical with the sclerotic, and consisting of 
about sixty layers or lamina, connected by a cement sub- 
stance inclosing corneal spaces, each of which contains 
a corneal corpuscle. 
The posterior elastic lamina consists of an elastic 336 
HUMAN ANATOMY. 
homogeneous membrane, internal to the proper structure 
of the cornea, and constituting, with the epithelial lining, 
the membrane of Descemet, or Demours. 
The structure of the cornea is non-vascular, being 
nourished by channels representing lymphatic vessels, 
and continuous with the corneal spaces. The nerves de- 
rived from the ciliary nerves are numerous, and form be- 
tween the outer surface of the cornea proper and the 
epithelial covering the subepithelial plexus, from which 
is given off the intraepithelial plexus. 
The second tunic consists of the choroid, lining the 
sclerotic coat throughout; the iris, the circular curtain 
suspended in the aqueous humor and perforated by the 
pupil; and the ciliary ligament and muscle at the junc- 
tion of the two. 
The choroid is a dark, reddish-brown, highly vascu- 
lar membrane, lining the sclerotic coat from the optic 
nerve to the ciliary ligament, where it projects backward 
in a number of processes, the ciliary processes. It is in 
contact externally with the sclerotic, to which it is at- 
tached by the membrana fusca, and internally with the 
retina. 
The structure consists cliiefty of a dense capillary 
net-work. 
The choroid proper consists of an external and an 
internal layer, and is separated from the sclerotic by the 
lamina supra choroidea, continuous with the lamina 
fusca of the sclerotic, and from the pigmentary layer of 
the retina by the lamina vitrea. 
The external layer consists of a capillary net-work, 
derived from the larger branches of the short ciliary ar- 
teries, inclosing between the meshes large, star-shaped 
pigment cells, which are connected together by a delicate 
stroma. They terminate in the venae verticosae, which 
emerge through the sclerotic midway between the optic 
nerve and the margin of the cornea. 
The internal layer is also composed of a fine capil- 
lary net-work, derived from the short ciliary arteries, 
and continuous in front with the vessels of the ciliary 
processes. It is called the tunica Ruyschiana. ORGANS OF SPECIAL SENSE. 
337 
The vitreous membrane lamina vitrea is a thin, struc- 
tureless layer, separating the pigmentary layer of the 
retina from the membrana Ruyschiana. 
The arteries are from posterior ciliary, short ciliary 
(principally in the external layer), and recurrent 
branches of long and anterior ciliary. 
The veins converge from the venae verticosae to form 
four or five trunks, which pierce the sclerotic midway 
between the optic nerve and corneal margin to join the 
cavernous sinus. 
The nerves are the long and short ciliary. 
The ciliary processes are a series of sixty to eighty 
pigmented vascular processes arranged circularly around 
the lens behind the iris, and composed of the two inter- 
nal of the choroid folded inward. They are con- 
tinuous in front with the iris, and are connected behind 
with the suspensory ligament of the lens. 
The structure is similar to that of the choroid. 
The iris is a thin, circular curtain, suspended in the 
aqueous humor, between the lens and cornea, and per- 
forated by a circular aperture—the pupil. 
Its circumference is connected with the choroid, and 
also by means of the ciliary ligament with the sclerotic 
and cornea. The sclerotic contains in this position, 
near its junction with the cornea, a circular canal 
(lymph canal, or venous sinus), the sinus circularis 
iridis, or canal of Schlemm. 
The circumference of the iris is also connected in 
front with the cornea by ligamentum pectinatum iridis, 
derived from the membrane of Descemet. 
The structure is composed of four elements:— 
1. A basement membrane and polyhedral cells, continuous with 
the membrane of Descemet; 
2. Stroma, consisting of bundles of fibrous tissue and cells ; 
Circular fibres, forming the sphincter of the 
pupil; 
Radiating fibres, forming the dilator of the 
pupil; 
3. Muscular fibres, 
4. Pigment, consisting of polyhedral or round pigment cells, dis- 
tributed for the most part to the posterior surface, which, from its 
deep-purple tint, has been called the uvea. 338 
HUMAN ANATOMY. 
The arteries are from the long and anterior ciliary 
and from the ciliary processes 
(from the short ciliary). 
The veins join those of the 
ciliary processes and anterior 
ciliary veins. 
The nerves are the long 
ciliary from the nasal branch 
of the ophthalmic (first di- 
vision of fifth), and ciliary 
branches from the lenticular 
or ophthalmic ganglion. 
The circular fibres are 
supplied by the fibres from 
the third or motor oculi, the 
radiating fibres are supplied 
by the sympathetic. 
The membrana pupillaris 
is a delicate, vascular mem- 
brane, closing the pupil in the 
foetus, continuous at its mar- 
gin with the iris. It usually 
disappears about the eighth 
month, but occasionally per- 
sists. 
The ciliary muscle is a 
grayish, circular band of un- 
striated fibres, attached to 
the fore part of the choroid. 
It consists of two sets of 
fibres—the external radiating 
fibres, dilator pupillse—aris- 
ing from the junction of the 
sclerotica and cornea, and is 
inserted into the choroid op- 
posite the ciliary processes ; 
the internal circular fibres, 
sphincter pupillse, pursue a circular course around the 
insertion of the iris. 
It is the muscle of accommodation, its contraction 
Fig. 72. 
Layers of the retina: 1, membrana 
limitans interna and layer of nerve- 
fibres; 2, layer of nerve-cells; 3, inner 
molecular layer; 4, inner nuclear layer; 
5, outer molecular layer; 6, outer nu- 
clear layer; 7, membrana limitans and 
Jacob’s membrane; 8, layer of pigment 
cells. ORGANS OF SPECIAL SENSE. 
339 
drawing on the ciliary processes, relaxing the circular 
fibres described as the ligament of the lens, and allowing 
the anterior surface of the lens to become more convex 
by its inherent elasticity. 
The retina is a delicate, white, nervous membrane, 
the expansion of the optic nerve. It lines the eyeball, 
being in contact externally with the choroid and inter- 
nally with the vitreous body. It terminates in front 
near the ciliary ligament in an irregular margin, the ora 
serrata, but is prolonged forward as the pars ciliaris to 
the iris. Its internal posterior surface presents at a 
point corresponding to the axis of the eyeball a small, 
round, elevated spot of yellowish color, the macula lutea, 
or yellow spot of Sommering, in the centre of which is 
the fovea centralis, a central depression, the region of 
most acute vision, and about one-tenth of an inch to its 
nasal side, at a point corresponding to the axis of the 
orbit, the entrance of the optic nerve, an oval, bluish- 
white depression, with distinct, often pigmented margins, 
a region destitute of vision and called the optic disk. 
Its centre presents the arteria centralis retinae, giving 
branches to the nasal upper and lower side of the macu- 
lar region. 
The structure of the retina is exceedingly complex, 
consisting microscopically of ten distinct layers from 
within outward, as follows:— 
1. Membrana limitans interna, the most internal layer of the 
retina, forms the base of the connective-tissue frame-work of the 
retina, from which it is derived. 
2. The fibrous layer consists of nerve-fibres, the termination of 
the optic nerve-fibres. 
3. The vesicular layer, composed of a layer of large, flask-shaped 
ganglionic cells. It is wanting in the muscular region. 
4. The inner molecular layer is composed of a layer of glandular- 
like structure, forming a reticulum inclosing minute granules. 
5. The inner nuclear layer is composed of three sets of nuclear 
bodies, the first resembling bipolar nerve-cells, the second without 
branches, and the third continuous with the radiating fibres, or fibres 
of Muller. 
6. The outer molecular layer resembles closely the inner molecular 
layer, from which it differs only by containing branched stellate cells. 
7. The outer nuclear layer is composed of several layers of nuclear 
cells, separable into two kinds, the rod grannies and cone granules, 
both continuous with the rods and cones of Jacob’s membrane. 340 
HUMAN ANATOMY. 
8. The membrana limitans externa Is, like the internal limiting 
membrane, derived from the radiating fibres, or fibres of Muller. 
9. Jacob's membrane, or the layer of rods and cones, consists of 
two distinct kinds of cells—the rods and cones, distributed alternately 
throughout this layer, the rods being much more numerous. 
The rods are solid, staud perpendicularly to the surface, and 
consist of two portions—an outer striated and an inner granular. 
The cones are flask-shaped, with their pointed extremities toward 
the choroid. They also consist of two portions—an outer striated 
and an inner granular. 
10. The pigmentary layer was formerly described as a layer of the 
choroid. It has received the name of tapetum nigrum, consisting of 
a layer of pigmented hexagonal epithelial cells. 
In many of the lower animals, this layer on the posterior surface 
is destitute of pigment, and is called from its iridescent lustre the 
tapetum lucidum. 
The radiating fibres, or fibres of Muller, consist of connective-tissue 
fibres, connecting all the layers together, and forming the membrana 
limitans interna and the membrana limitans externa. 
The structure of the retina at the macula lutea differs 
in the following manner: the cones only of Jacob’s 
membrane are present; the vesicular layer consists of 
several layers, and in the outer nuclear layer only the 
cone-fibres are present. 
At the fovea centralis only the cones of Jacob’s 
membrane, the outer nuclear layer, and the internal 
granular layer are present. 
The arrteria centralis retina supplies only as far as the 
inner nuclear layer. 
The aqueous humor is a transparent, alkaline, serous 
fluid, small in quantity, weighing four to five grains, and 
filling the anterior and posterior chambers of the eye. 
It is composed of water, 96.7 ; extractive matters, princi- 
pally chloride of sodium and albumen, 0.1. 
The anterior chamber is the space (about 2.7 milli- 
metres in depth) between the iris and the cornea. 
The posterior chamber is the space between the 
anterior surface of the lens and the iris. It amounts to 
a space only at the circumference, the two being in 
contact at the posterior surface. 
The crystalline lens is a biconvex, transparent, 
elastic body, suspended within its capsule, surrounded 
THE HUMORS OF THE EYE. ORGANS OP SPECIAL SENSE. 
341 
by the ciliary processes. It is more convex on its pos- 
terior surface (anterior surface has an average radius of 
ten millimetres, the posterior six millimetres), and is re- 
ceived into a hollow depression in the hyaloid membrane. 
It measures about one-tlxird inch in diameter, one- 
fourth inch in axis, and weighs from four to four and 
one-half grains. 
Its index of refraction increases from the periphery 
to the centre, wdth an average of 1.4371. 
Its composition consists of about 60 per cent, water ; 
soluble albuminous matter, 35 per cent.; insoluble albu- 
minous matter, 2.5 per cent.; cholesterine and fat, 2 per 
cent. 
The structure of the lens consists of concentric 
laminae, made up of hexagonal prisms, about one live- 
thousandth inch in breadth, united laterally by dentated 
margins, and curving round the borders of the lens. The 
laminae are ari’anged into three triangular segments. 
The central portion, or nucleus, is unstratitied, while 
the outer layers, or cortex, each contain a nucleus, form- 
ing a nuclear layer. 
The capsule of the lens is a clear, elastic, brittle 
membrane, inclosing the lens, and held in position by 
the suspensory ligament. Its anterior laj’er is thicker, 
and is attached to the lens by a layer of polygonal 
nucleated cells, which break down post-mortem to form 
the liquor Morgagni. 
The canal of Petit is about one-tenth of an inch in 
diameter, encircling the capsule of lens. Its base is 
formed by the capsule, and it is bounded in front by 
suspensory ligament, behind by the vitreous humor. 
The suspensory ligament, or zonula of Zinn, is a thin, 
transparent structure, extending from the margins of 
the hyaloid fossa, where it is continuous with hyaloid 
membrane, to the anterior margin of the lens. 
The vitreous humor, or body, is a clear, albuminous 
fluid, filling the cavity of the retina, hollowed out in 
front—hyaloid fossa—for the lens, and inclosed in the 
hyaloid membrane. It is composed of water, with a few 
salts, and a little albumen. 342 
HUMAN ANATOMY. 
Its structure is finely reticular, particularly in the 
foetus. 
The canal of Stilling, canal of Cloquet, or hyaloid 
canal, is a canal extending in the foetus from the entrance 
of the optic nerve to the lens, containing fluid, and 
lined by a fold of hyaloid membrane. 
In the foetus a canal extends parallel but independent 
of this, and transmits a minute artery to the capsule of 
the lens. 
The hyaloid membrane is a delicate capsular mem- 
brane, investing the vitreous body, excepting its anterior 
surface, sends fibrous septa into the structure of the 
vitreous, and is continuous in front with the posterior 
capsule, and with the anterior capsule through the sus- 
pensory ligament. 
MUSCLES OF THE EYEBALL. 
Rectus Superior.— Origin, sheath of the optic nerve 
and upper margin of optic foramen; insertion, into 
upper surface of sclerotic coat, three or four lines from 
corneal margin ; action, rotates the eyeball upward; 
nerve, third cranial. 
Rectus Inferior.— Origin, from lower and inferior 
part of optic foramen (ligament of Zinn); insertion, into 
lower surface of sclerotic; action, rotates the eyeball 
downward ; nerve, third cranial. 
Rectus Internus.—Origin, same as inferior rectus; 
insertion, into inner surface of sclerotic ; action, rotates 
the eyeball inward ; nerve, third cranial. 
Rectus Externus.—Origin, by two heads—lower, 
from ligament of Zinn and margin of sphenoidal 
fissure; upper, from outer margin of optic foramen; 
insertion, into outer surface of sclerotic; ner ve, abducens, 
or sixth cranial. Passing between the two heads are 
the ophthalmic vein, the third, nasal branch of fifth, and 
sixth nerves. 
Superior Oblique.—Origin, from inner margin of 
optic foramen. Its tendon passes through a pulley near 
the internal angular process of the frontal bone ; inser- ORGANS OF SPECIAL SENSE. 
343 
tion, into sclerotic between external and superior recti, 
midway between entrance of optic nerve and the cornea; 
action, rotates the eyeball on its axis ; nerve, fourth, or 
patheticus. 
Inferior Oblique.—Origin, orbital plate of superior 
maxilla; insertion, near that of superior oblique, between 
external and superior recti; action, rotates the eyeball 
on its axis ; nerve, third cranial. 
The arteries of the globe of the eye are :— 
1. The short ciliary, enter through the sclerotic 
around the optic nerve, to supply the choroid and ciliary 
processes. 
2. The long ciliary arteries, two in number, pierce 
the sclerotic, run forward between the choroid and 
sclerotic to the ciliary muscle, which they supply, and 
where they form an anastomotic circle about the iris. 
3. The anterior ciliary arteries, five or six in number, 
enter the sclerotic in front, supply the ciliary processes, 
and anastomose about the iris. 
4. The arteria centralis retina, supplies the retina, 
dividing into four or five branches, which enter as deeply 
as the inner nuclear layer. 
The other arteries supplying the eye and its append- 
ages are derived from the ophthalmic branch of the in- 
ternal carotid (the same source as the ciliary arteries), 
the anterior cerebral branch of the internal carotid, and 
the infraorbital branch of the internal maxillary. 
The branches of the ophthalmic are the 
Lachrymal; 
Supraorbital; 
Anterior and posterior ethmoidal; 
Palpebral; 
Frontal; 
Nasal. (For description see Arterial System.) 
The veins of the eyeball emerge as the venae vorticosae, 
unite with the other veins to form two main trunks—the 
ophthalmic and inferior ophthalmic veins—to terminate 
in the cavernous sinus. The ophthalmic vein anasto- 
moses freely with the angular vein, the commencement 
of the facial at the inner angle of the orbit. 344 
HUMAN ANATOMY. 
The nerves of the eye and its appendages are nerve 
of special sense, the optic or second cranial; motor nerves, 
the third and fourth; branches of the fifth and sixth, and 
filaments from the sympathetic. 
Sensory nerve, ophthalmic division of the trifacial, or 
fifth cranial (vide Cranial Nerves). 
Sympathetic branches, derived chiefly from the ciliary 
ganglion, Meckel’s ganglion, and the cavernous and 
carotid plexuses (vide Cranial Sympathetic Ganglion). 
appendages op the eye, 
The appendages of the eye, or the tutamina oculi, 
include:— 
The eyebrows (supercilia'), 
The eyelids (palpebrce), 
Conjunctiva, 
Lachrymal gland, 
Lachrymal sac, 
Nasal duct. 
The eyebrows are the elevated arches of skin sur- 
mounting the upper margins of the orbits, covered with 
short, thick hairs. 
The eyelids are two movable folds, covering and 
protecting the front of the eye. The upper lid is larger, 
longer, and most movable, being supplied with a special 
muscle—the levator labii superioris. 
The lids are separated by an elliptical fissure—the 
fissura palpebrarum—and connected at their angles of 
junction by the outer and inner canthi. 
On the nasal side the lids are separated by a triangu- 
lar space—the lacus lachrymalis—at the outer angles of 
which are the lachrymal papillae, surmounted by the 
puncta lachrymalia, the commencements of the lachry- 
mal canal. The lacus lachrymalis is filled by the corun- 
cula lachrymalis, a mass of follicles resembling the 
Meibomian glands, and covered by the conjunctiva. 
The structure of the eyelids, from without inward, 
is as follows :— 
Skin, subcutaneous areolar tissue, fibres of the orbicularis muscle, 
tarsal cartilage, fibrous membrane, Meibomean glands, vessels, and 
nerves; 
The skin is thin, and attached by a very loose areolar tissue to the 
muscle beneath; ORGANS OP SPECIAL SENSE. 
345 
The fibres of the orbicularis are pale, thin, and act involuntarily ; 
The tarsal cartilages are two plates of firm connective tissue; 
the superior, the larger, is semilunar in shape, the inferior is elliptical. 
The inner margins are fixed to the orbit by tendo oculi; 
The fibrous membrane of the lids, or tarsal ligament, passes over 
the anterior surface of the tarsal cartilage, being attached to its free 
margin below and to the margin of the orbit externally; 
The Meibomian glands, about thirty in number in the upper, a few 
less in the lower lid, are arranged vertically on the inner surface of 
the cartilages; they are straight, sebaceous follicles, into which 
open a number of secondary follicles, terminating above in a blunt 
extremity, and opening below on the free margin of the lids by small 
foramina, corresponding to the number of tubules; 
The eyelashes, or cilia, are arranged on the free border of the lids 
in two or three rows. 
The conjunctiva is the mucous lining membrane of 
the front of the eye. It consists of two portions—the 
ocular, reflected over the sclerotic and cornea, and the 
palpebral portion, lining the internal surface of the lids. 
The ocular portion is loosely connected with the 
sclerotic, but over the cornea it becomes very thin, con- 
sisting only of the epithelial layer. 
The palpebral portion is thick, highly vascular, and 
contains many papillae. At the inner angle of the eye it 
forms a semilunar fold, the plica semilunaris—the rudi- 
ment of the nictitating membrane of birds, the mem- 
brana nictitans. 
The point of reflection is called the fornix conjunc- 
tivse, and the reflected portions the superior and inferior 
palpebral folds. 
The lachrymal apparatus consists of the lachrymal 
gland, canals, sac, and nasal duct. 
The lachrymal gland is an oval, glandular body, 
about the shape and size of an almond, situated in a 
depression in the upper surface of the orbit near the 
external angular process. 
The anterior portion of the gland is sometimes de- 
scribed as a separate lobe—the palpebral portion of the 
gland, or accessory gland of Rosenmuller. 
The gland is attached to the bony roof of the orbit 
by the tarso-orbital fascia. 
The ducts, seven to ten in number, open upon the 346 
HUMAN ANATOMY. 
conjunctiva near its point of reflection by minute ori- 
fices arranged in a row. 
The lachrymal canals commence at the puncta lach- 
rymalia, at the summits of the papillm lachrymales, and 
descend by two canaliculi to empty into the lachrymal 
sac. 
The superior canal descends obliquely inward and 
downward, while the inferior descends at first and then 
passes nearly horizontally inward. 
The lachrymal sac is the oval, dilated, upper por- 
tion of the nasal duct, lodged in a deep groove formed 
by the nasal process of the superior maxilla and the 
lachrymal bone. It is crossed by the tensor tarsi 
muscle, which acts as a compressor, and receives a 
fibrous expansion from the tendo oculi. 
Its structure is made up of a fibrous elastic coat, 
lined by mucous membrane continuous with the nose 
and conjunctiva. 
The nasal duct is a membranous tube about three- 
quarters of an inch in length, extending from the lach- 
rymal sac to the inferior meatus of the nose, and lining 
the bony lachrymo-nasal canal. It passes backward, 
downward, and outward, and is protected at its inferior 
extremity by a valve of mucous membrane—the valve 
of Hasner. 
The mucous lining is continuous with that of the sac, 
but instead of having squamous epithelium it is ciliated 
in the duct. 
The ear—the organ of hearing—is contained in the 
petrous and mastoid portions of the temporal bone, and 
consists of three divisions,—external ear, middle ear or 
tympanum, and internal ear or labyrinth :— 
THE EAR. 
1. External ear, 
Auricle, or pinna, 
External auditory canal, or meatus ; 
2. Middle ear, or 
tympanum, 
f Membrana tympani, 
| Tympanic cavity, 
I Mastoid sinuses, 
[ Eustachian tube ; ORGANS OF SPECIAL SENSE. 
347 
f Osseous portion, 
Vestibule, 
Semicircular canals, 
Cochlea; 
3. Internal ear, or 
labyrinth, 
Utricle, 
Saccule, 
Semicircular canals, 
Cochlea. 
Membranous portion, 
The external ear includes two parts, the auricle and 
the external auditory canal. 
The external prominent portion is composed of carti- 
laginous segments, connected together by ligaments and 
muscles richly supplied with blood-vessels, nerves, and 
lymphatics, and covered with skin. It presents the 
following elevations and depressions :— 
Fossa of the helix, a depression between the helix 
and antihelix; 
Fossa of the antihelix, a depression above the bifur- 
cation of the antihelix; 
Tragus, the prominence in front of the concha, 
usually covered with hair; 
Antitragus, a small, conical eminence behind the 
tragus, from which it is separated by the incisura inter- 
tragica; 
Lobule, the soft, rounded portion depending below 
the antitragus; 
Concha, a deep cavity, surrounded by the helix, and 
leading into the external meatus. 
Muscles.—The muscles of the auricle include two sets, 
the extrinsic muscles, already described (vide Muscles), 
of which there-are three—the attolens aurem, attrahens 
aurem, and retrahens aurem—and the intrinsic muscles, 
but slightly developed, of which there are two sets, four 
on the anterior surface of the auricle—the tragicus, anti- 
tragicus, helicis major, and helicis minor—and two on the 
posterior surface, transversus auriculae and obliquus 
auriculae. 
Arteries, auricular branch, from the occipital; pos- 
terior auricular, from the external carotid; and anterior 
AURICLE, OR PINNA. 348 
HUMAN ANATOMY. 
auricular, from the temporal. The veins correspond to 
the arteries. 
Nerves, auricular branch, from the pneumogastric; 
aurieulo-temporal branch, from the inferior maxillary ; 
occipitalis major and occipitalis minor; auricularis mag- 
nus, from the cervical plexus; and posterior auricular, 
from the facial. 
Auditory canal, or meatus auditorius externus, is an 
osseo-cartilaginous canal, about one and one-fourth 
inches in length, extending from the concha to the 
tympanic membrane. 
The osseous portion forms about two-thirds of the 
passage, and consists in greater part (anterior and lower) 
of a curved plate of bone—the annulus tympanicus. 
The anterior and upper part of the ring present two 
spines—spina tympanica, major and minor, for the liga- 
ments of the malleus. 
The sulcus tympanicus is a furrow on the inner edge 
of the ring,for the attachment of the tympanic membrane. 
The cartilaginous portion forms about one-tliird of 
the passage, and consists of the inverted cartilage of 
the tragus and concha, the upper and back part of which 
is deficient, the cleft being filled with fibrous tissue. 
The canal,including the tympanic membrane, is lined 
throughout with skin, containing short hairs, vascular 
papillae, sebaceous and ceruminous glands. 
Arteries—branches of the internal maxillary, pos- 
terior auricular, and temporal branches of external 
carotid. 
Nerves—from the aurieulo-temporal branch, the in- 
ferior maxillary, and auricular branch of the pneumo- 
gastric. 
MIDDLE EAR, OR TYMPANUM, 
is an irregular cavity, situated between the auditory 
canal and the labyrinth, communicating with the pharynx 
through the Eustachian tube, and also with the mastoid 
cells. It contains a chain of movable bones, part of the 
chorda tympani nerve, and is filled with air. Its average 
diameters are about half an inch in height and width, ORGANS OF SPECIAL SENSE. 
349 
and a line or two in depth from without inward. It is 
lined with mucous membrane, continuous with that of 
the Eustachian tube and mastoid cells, and which is 
reflected over all the tympanic contents. It is bounded 
by a roof, floor, and four walls, which present the follow- 
ing points:— 
Roof, a very thin plate of bone, separates the tym- 
panum from the cranial cavity, and corresponds to a 
depression on the anterior wall of the petrous bone; 
Floor, forms the bottom of the jugular fossa, and 
presents:— 
The opening for Jacobson’s nerve, the tympanic branch of the 
glosso-phary ngeal. 
Outer wall, formed by the tympanic membrane and 
the annulus tympanicus surrounding it:— 
Inter-chordae posterius, gives entrance to chorda tympani nerve; 
Inter-chorda anterius, or canal of Hugier, gives exit to same; 
Olaserian fissure, above and in front of annulus tympanicus, 
receives the anterior ligament of the malleus, the long process of the 
malleus, and the tympanic artery; 
Pouches of the mernbrana tympani, ax-e two or three pockets formed 
by the doubling of the mucous membrane around the chorda tympani 
nerve. 
Inner wall, separates the tympanum from the laby- 
rinth :— 
Fenestra ovalis, an oval window, leading to the vestibule, closed 
by the membrane to which the base of the stapes is attached ; 
Fenestra rotunda, a round window, leading to the scala tympani, 
but closed also by a membrane—mernbrana tympani secundaria. 
Promontory, two grooves, marking the first turn of the cochlea, 
and separating the fenestra ovalis and rotunda; 
Pyramid, a small conical eminence behind the fenestra ovalis, 
which contains within it the stapedius muscle, and communicates 
with the aquseductus Fallopii. 
Posterior wall:— 
Openings of the mastoid cells, three or four in number, connect 
these 6inuses with the tympanum. 
Anterior wall, is a thin plate of bone, which sepa- 
rates the tympanum from the carotid canal. 350 
HUMAN ANATOMY. 
Openings of the canal for tensor tympani, lies above and parallel 
with the canal for the Eustachian tube, and transmits the tensor 
tympani muscle; 
Opening of Eustachian tube, the larger of the two, is separated 
from the former by a thin plate of bone, the processus cochlear iformis. 
The tympanum is divided into two parts—the attic 
of the tympanum and the atrium. The former is situated 
on a plane directly above the atrium, and is bounded 
above by the tegmen, externally by auditory plate, and 
internally by prominence of the tympanum. On the 
outer part of the attic is a smooth surface called the 
scute (Leidy). 
The Eustachian tube is an osseo-cartilaginous canal, 
one and one-half to two inches in length, extending from 
the tympanum to the pharynx. 
It is about one-third osseous and two-thirds carti- 
laginous, and lined with ciliated epithelium continuous 
with the pharynx and tympanum. Its pharyngeal orifice 
is trumpet-shaped, and opens at the side of the pharynx, 
behind the inferior meatus. 
Muscles of the Eustachian tube:— 
Tensor palati (tensor veli), the most important has 
been described (vide Palatal Region). Its action is to 
pull the anterior wall of the tube outward and down- 
ward, and widen the canal. 
Internal Pterygoid (vide Muscles).—Some fibres are 
inserted into the floor of the tube. It acts as tensor of 
the fascia. 
Ligamenta salpingo-pharyngeal, arises from the su- 
perior and middle constrictors of the pharynx, and is 
inserted by three to five tendinous cords into the phar- 
yngeal orifice of the tube. Action, opens the tube. 
Arteries of Eustachian Tube.—Pharyngeal from the 
external carotid, middle meningeal from the internal 
maxillary, and small branches from the internal carotid. 
Nerves, by branches from the glosso-pharyngeal, in- 
ferior maxillary, otic ganglion, and facial nerve. 
Membrana tympani is a thin, parchment like mem- 
brane, stretched upon the annulus tympanicus, forming 
the bottom of the external auditory canal, and separating ORGANS OP SPECIAL SENSE. 
351 
it from the t}rmpanum. It is placed obliquely downward 
and inward at an angle of 45°. 
Structure.—Its three layers are :— 
External or cuticular, derived from the skin of the 
meatus ; 
Middle or fibrous, consisting of two sets of fibres, 
radiating and circular, the latter forming a tendinous 
ring around the margin; 
Internal or mucous, continuous with the mucous 
membrane of the tympanum. 
Its outer surface presents :— 
Manubrium of malleus, projecting downward and 
backward; 
Processus gracilis of malleus, projecting outward 
above the manubrium; 
Umbo, a depression of the membrane formed by the 
lower end of the manubrium ; 
Yellow spot, the cartilaginous end of the manubrium; 
pyramid of light, a triangular cone of reflected light in 
the antero-inferior quadrant of the membrane. 
Inner surface (vide Outer Wall of Tympanum). 
Arteries, tympanic branch of inferior, branch from 
the internal carotid. 
Nerves, from the superficial temporal branch of the 
trifacial, and from the tympanic plexus. 
The small bones of the are three in num- 
ber, and connect the membrana tympani with the mem- 
brane closing the fenestra ovalis. They are the 
1. Malleus, or hammer, consists of a head, neck, 
manubrium or handle, processus gracilis, and processus 
brevis. The manubrium is attached to the membrana 
tympani, and has the tendon of the tensor tympani 
attached. Processus gracilis is lodged in the Glaserian 
fissure. 
2. Incus, or anvil, consists of a body and long and 
short processes. The body articulates with the malleus 
and the long process by means of a rounded process. 
The os orbiculare articulates with the head of the stapes. 
OSSICLES OP THE TYMPANUM 352 
HUMAN ANATOMY. 
3. Stapes, or stirrup, has a head, neck, two branches 
(or crura) 'which unite into a cross-piece or base. The 
neck has inserted into it the stapedius muscle, and the 
base is fitted to the fenestra ovalis. 
Ligaments of the Ossicles:— 
Lig. mallei anterius, extends from the neck of the malleus to the 
outer wall of the tympanum ; 
Lig. mallei suspensorium, suspends the head of the malleus to 
the roof; 
Lig. incudi posticum, attaches the short process to the posterior 
wall; 
Lig. incudi suspensorium, suspends the incus to the roof; 
Lig. stapedi annularum, connects the base to the margin of the 
fenestra ovalis. 
Muscles.—The tensor tympani, laxator tympani, sta- 
pedius. 
Tensor tympani (already described). 
Laxator tympani (already described). 
Stapedius arises from the hollow of the pyramid on 
the inner wall, and its tendon is inserted into the neck 
of the stapes. Nerve from the tympanic branch of 
facial. 
Arteries:— 
Tympanic branch of internal maxillary ; 
Stylo-mastoid branch of posterior auricular; 
Petrosal branch of middle meningeal; 
Tympanic branch from internal carotid; 
Branch from ascending pharyngeal. 
Veins accompany the corresponding arteries and 
empty into middle meningeal and pharyngeal. 
Nerves:— 
Chorda tympani, from the facial, enters the iter 
chordae posterius, crosses the tympanum between the 
long process of the incus and the handle of malleus, and 
makes its exit at the iter chordae arterius; 
Tympanic branch of glosso-pharyngeal (Jacobson’s 
nerve) enters the floor, supplies the fenestrae and mu- 
cous membrane of tympanum and Eustachian tube; 
Tympanic branch from facial to the stapedius ; 
Branch from the otic ganglion to the tensor tympani. ORGANS OF SPECIAL SENSE. 
353 
The tympanic plexus is formed upon the surface of 
the promontory, from the following nerves:— 
Jacobson’s nerve, tympanic branch of the glosso-pharyngeal; 
Branch of the superficial petrosal, from the facial; 
Branches from the carotid plexus of the sympathetic. 
INTERNAL EAR, OR LABYRINTH. 
The internal ear, the essential part of the organ of 
hearing, consists of three complex cavities within the 
petrous portion of the temporal bone, filled with fluid, 
the perilymph, and containing a membranous sac filled 
also with fluid, the endolymph, which receives the dis- 
tributions of the auditory nerve. 
Its divisions are :— 
Osseous portion, 
Vestibule, 
Semicircular canals, 
Cochlea; 
Membranous portion, 
Utricle, 
Saccule, 
Semicircular canals, 
Cochlea. 
Vestibule, is a common cavity of communication be- 
tween the bony parts of the internal ear. It is situated 
between the tympanum without, the cochlear behind, 
and the semicircular canals in front, and measures one- 
fifth of an inch in its antero-posterior and vertical diam- 
eters, and less from without inward. It presents:— 
Fenestra ovalis on its outer wall, closed by the stapes 
and its ligament; 
Fovea hemispherical a circular depression on its inner 
wall for the saccule, and perforated by the macula crib- 
rosa, for the vestibular filaments of the auditory nerve; 
Orifice of the aquseductus vestibulse, on the inner wall 
for the transmission of a small vein ; 
Eminencia pyramidalis, a vertical ridge on the inner 
wall separating the two forae ; 
Fovea semi-elliptica, in the roof lodges the utricle. 
Semicircular canals are three canals, forming each 
two-thirds of a circle one-twentieth of an inch in diame- 354 
HUMAN ANATOMY. 
ter, and named, from their position, the superior, pos- 
terior, and external. They are placed nearly at right 
angles to each other, and open into the vestibule by five 
apertures—two extremities uniting to form one. 
The superior and posterior are both vertical, the 
former being more anterior. 
I. Transverse section of a turn of the cochlea. II. Schema of the human labyrinth: 
U, utricle; S, saccule; Cs, semicircular canal; Cr, canalis reunions. 
FlO. 73. 
The external is placed horizontally, its arch directed 
backward. 
Ampullae, are the dilated, flask-shaped extremities of 
the tubes, and are about one-tenth of an inch in diameter. 
The cochlea resembles closely a common snail’s shell, 
placed with the base corresponding to the bottom of the 
meatus auditorius internus, and its apex directed out- ORGANS OF SPECIAL SENSE. 
355 
ward and forward. It consists of two parallel tubes one 
and one-half inches in length, one-tenth of an inch in 
diameter, wound spirally for two and one-half turns 
around a central pillar—the modiolus. 
The modiolus, or columella, is broad at the base, but 
tapers gradually toward the apex, where it terminates 
within the last turn or cupola in the infundibulum, a 
funnel-shaped lamina of bone. Its interior is traversed 
by numerous canals for vessels and nerves, one of which 
—the canalis centralis modioli—runs nearly the whole 
length, and transmits the arteria centralis modioli. 
Lamina spiralis, the partition between the two tubes, 
consists of two thin laminae of bone filled with cancel- 
lous tissue—lamina spiralis ossea—projecting from the 
modiolus half-way to the outer wall, the lamina being 
completed by the membrana basilaris. The osseous 
lamina terminates in the cupola in a hook-like process— 
the hamulus. 
The spiral canal, between the modiolus and the outer 
wall, is divided by the lamina spiralis ossea and mem- 
brana basilaris into two canals, or scalse—the upper 
scala vestibuli, and the lower scala tympani. 
The first turn of the spiral canal presents three open- 
ings :— 
1. Fenestra rotunda, a circular aperture communi- 
cating with the tympanum, and closed by the membrana 
tympanum secondaria. 
2. Fenestra ovalis, an oval opening, communicating 
with the vestibule. 
3. Aquseductus cochlearis, a small foramen opening 
on the inferior surface of the petrous portion of the 
temporal bone, and transmitting a small vein from the 
cochlea to the jugular vein. 
Scala vestibuli, begins at the fenestra ovalis, and as- 
cends in a spiral course above the lamina spiralis and 
membrana basilaris, to communicate with the scala tym- 
pani, through the helicotrema within the vestibule. It 
contains perilymph. 
Scala tympani begins at the fenestra rotunda, and as- 
cends in a spiral course below the scala vestibuli, from 356 
human anatomy. 
which it is separated by the osseo-membranous lamina. 
It also contains perilymph. 
Helicotrema is an opening within the cupola, by 
which the two scala communicate. It is formed by a 
deficiency of the osseous lamina. 
Canalis spiralis modioli, is a small canal which winds 
around the modiolus at the attachment of the osseous 
laminae. It contains a gangliform swelling—ganglion 
spirale—from which nerves pass to the organ of Corti. 
The membranous labyrtntii corresponds closely to 
the osseous, the vestibule consisting of two membranous 
sacs—the utricle and saccule—communicating with each 
other, and the former receiving the five openings of the 
membranous semicircular canals, the latter communi- 
cating with the membranous cochlea through the canalis 
reuniens. The membranous labyrinth is surrounded 
everywhere with perilymph, filled with endolymph, and 
is composed of three coats—an outer fibrous layer, 
middle or tunica propria, and inner epithelial layer. 
Utricle, the larger of the two, is an elliptical sac 
lodged in the fovea liemi-elliptica. The semicircular 
canals communicate with it by five openings. Its wall 
is the thickest near the crista vestibuli, where the fila- 
ments of the nerve enter, the macula acoustica. 
Saccule, is a hemispherical sac lodged in the fovea 
hemispherica. It communicates with the cochlea 
through a small duct—the canalis reuniens. 
The otoliths, or otoconia, are small masses of crystals 
of lime carbonate, contained in the inner wall of the 
utricle and saccule opposite the distribution of the 
nerves. 
Semicircular Canals.—These are three membranous 
tubes corresponding exactly in shape, number, and form 
to the bony canals in which they are contained. They 
are surrounded everywhere with perilymph, except at 
the ampullae, where they are in contact with the bony 
canals. The inner, or epithelial layer of the membrane 
in the ampullae, is covered with columnar ciliated epithe- 
lium—auditory hairs. 
The membranous cochlea begins at the base and ORGANS OF SPECIAL SENSE. 
357 
ascends in a spiral course within the osseous cochlea to 
terminate in the cupola. It includes only the canalis 
cochleae—a part of the scala vestibul®. As before 
stated, the membrana basilaris extends from the margin 
of the lamina spiralis ossea to the outer wall of the 
cochlea, dividing the cavity into the two seal®—the 
scahe vestibul® above, the seal® tympani below. The 
former is again subdivided by the membrane of Riessner 
into two parts, the outer of which forms the canalis 
cochlea, or scala media—the membranous cochlea proper 
—on the floor of which is the organ of Corti covered by 
the membrana tectoria. The seal® are lined with peri- 
ostium, and filled with perilymph. The scala tympani 
ends at the fenestra rotunda, but the scala vestibula 
communicates freely with the vestibula. 
Limbus laminse spiralis is the periosteal margin of 
the lamina spiralis ossea, and consists of an upper lip— 
the labium vestibulare—and a lower lip—the labium 
tympanicum—separated by a groove—the sulcus spiralis. 
Membrana basilaris extends from the labium tym- 
panicum to the outer cochlear wall, to which it is at- 
tached by the ligamentum spirale of Henle. 
Membrane of Reissner arises from the middle of the 
vestibular lamina and passes obliquely at an angle of 
40° to the outer cochlear wall, separating the canalis 
cochle® from the scala vestibula. 
Canalis cochlea extends as a spiral sac closed at both 
ends through the osseous cochlea, and contains the most 
important part of the labyrinth—the ultimate distribu- 
tion of the auditory nerve in the organ of Corti. It is 
triangular on section, the membrana basilaris forming the 
base, the membrane of Riessner the inner side, and the 
periosteum of the cochlea its outer side. 
Membrana tectoria, or membrane of Corti, commences 
as a delicate membrane, at a point between the origin of 
the membrane of Riessner and the labium vestibule, and 
arches over to the outer cochlear wall, inclosing the 
organ of Corti, but not in contact with it. 
Organ of Corti consists of two sets of pillars—the 
inner and outer rods of Corti—extending upward upon 358 
HUMAN ANATOMY. 
the vestibular surface of the membrana basilaris, and 
forming a series of arches. Between the bases of the 
arches is the zona arctuata. There are over three thou- 
sand arches, and within them is formed a tunnel ex- 
tending the entire length of the lamina spiralis termi- 
nating at the hamular process. 
Inner rods of Gorti, rest upon the basilar membrane. 
Their upper extremities resemble the proximal extremity 
of the ulna, and each has on its inner side a row of epithe- 
lial cells—the inner hair-cells. 
Outer rods of Gorti, are attached in a similar manner 
at the bases, and their extremities each resemble the 
head and bill of a swan, the former fitting into the cavity 
in the inner rods. On the outer side are four rows of 
ciliated cells—the outer hair-cells. 
Reticular membrane, or lamina reticularis, is a deli- 
cate complex net-work of phalanges—flddle-sliaped struc- 
tures—extending from the inner rods to the external 
row of the outer hair-cells. 
The internal auditory canal, is a short canal about 
one-third of an inch in length, extending outward from 
the meatus auditorius interims, on the posterior surface 
of the petrous portion of the temporal bone to termi- 
nate at a vertical, perforated plate—the lamina cribrosa. 
This plate is divided by a horizontal ridge into a lower 
and upper portion. The lower is perforated by numer- 
ous foramina for passage of the auditory artery and 
branches of the auditory nerve, some of which are ar- 
ranged into a spiral-shaped depression, called the tractus 
spiralis foraminulentus ; the upper has one large open- 
ing—the commencement of the aquueductus Fallopii for 
portio dura, or seventh nerve. 
Auditory Nerve.—The auditory nerve enters the in- 
ternal auditory meatus in company with the facial, and at 
the bottom divides into two branches—the vestibular and 
cochlear. 
Vestibular nerve subdivides into three branches, as 
follows :— 
Superior, distributed to the utricle and ampullae of the superior 
and external semicircular canals ; ORGANS OF SPECIAL SENSE. 
359 
Middle, enters the bottom of the fovea hemispherica, and is dis- 
tributed to the saccule; and the 
Inferior, is distributed to the ampulla of the posterior semicircular 
canal. 
Cochlear nerve, ascends in the canals in the modiolus, 
and divides into numerous branches which pass between 
the plates of the lamina spiralis ossea, forming a plexus 
which contains the ganglia spirale, from which filaments 
are distributed to the outer and inner hair-cells of the 
organ of Corti. 
Arteries of Labyrinth:— 
Internal auditory, from the basilar, divides into ves- 
tibular and cochlear branches, which accompany the 
corresponding nerves; 
Stylo-mastoid, from the posterior auricular, enters 
through the stylo-mastoid foramen. 
THE TONGUE (vide LINGUAL MUSCLES, p. 119). 
The tongue is the organ of the sense of taste, and lies 
in the floor of the mouth. It is composed of a mass of 
muscles, the free surface of which is entirely invested 
with mucous membrane. It consists of three parts :— 
Base, or root, attached behind to the hyoid bone, the 
epiglottis and the soft palate; 
Body, the back or dorsum of which is marked by a 
median line or raphe, terminating behind in a cavity— 
the foramen caecum; 
Apex, or tip, narrow and pointed, directed forward. 
The mucous membrane resembles skin, consisting of 
a corium, or mucosa, containing numerous papillae, and 
covered with epithelium. The papillae are most numer- 
ous over the anterior two-thirds of the dorsum, and con- 
sist of three varieties :— 
Circumvallate, or largest, about ten in number, 
about one-twelfth inch wide, are arranged at the back 
part of the dorsum like the letter V, with the apex di- 
rected backward; 
Fungiform, or medium, are scattered over the organ, 
especially at the tips and sides; 360 
HUMAN ANATOMY. 
Filiform, conical, or smallest, are distributed over 
the anterior two-thirds of the dorsum. 
Mucous and serous glands and simple papillae, such 
as are found in the skin, are also present. 
Taste bulbs, or taste goblets, minute, flask-shaped 
bodies, about one three-hundredths of an inch in length, 
are situated in the circumvallate and fungiform papillae. 
Arteries, are branches of the lingual, facial, and as- 
cending pharyngeal. 
1. Nerves.—Hypoglossal, the principal motor nerve. 
3. Lingual branch of glosso-pharyngeal, the special 
nerve of taste. 
3. Gustatory branch of the trifacial, to sides and 
anterior part; sensation and possibly sense of taste also. 
4. Chorda tympani, to the lingual muscle. 
5. Superior laryngeal, filaments from its internal 
branch to the base. 
THE SKIN AND APPENDAGES. 
The skin, besides being the special organ of the sense 
of touch, is an absorbing and excretory organ, and pro- 
tects the underlying structures. 
It consists of two layers—the epidermis or cuticle, 
and the derma or true skin. The appendages are the 
nails, hair, sudoriferous and sebaceous glands, and their 
ducts. 
The epidermis, or cuticle, is an epithelial structure 
consisting of four layers :— 
1. Jtete Malpighii, the deepest layer, in contact with the corium, 
is composed of several layers of round or polyhedral epithelial cells. 
This layer is pigmented in the negro and other dark races. 
2. Granular layer, is a single layer of compressed, spindle-shaped 
cells. 
3. Stratum lucidum, are still more compressed into scales. 
4. Stratum corneum, several layers of horny scales. 
The derma, or true skin, has two layers, the reticular 
or deeper, and the papillary or superficial. 
Reticular layer is composed of interlacing bands of 
white fibrous tissue, mixed with yellow elastic fibres, 
and some unstriated muscular fibres where hairs are ORGANS OF SPECIAL SENSE. 
361 
found, together with blood-vessels, lymphatics, and 
nerves. 
Papillary layer is covered with minute, vascular, 
highly sensitive elevations—the papillae—from one one- 
hundredth to one two-hundred-and-fiftieth of an inch in 
diameter. These papillae are in places arranged into 
parallel curved ridges, and have in the most sensitive 
situations some one of the “ peripheral end organs ” 
(already described) added to their structure. 
Nails are horny plaques of modified epidermis,firmly 
adapted to the derma on the dorsal surfaces of the ter- 
minal phalanges. Each nail is firmly implanted by its 
root into a fold of skin. 
The matrix is the derma beneath the body, which is 
vascular and highly sensitive. 
The lunula is the white, less vascular portion of the 
matrix near the root. 
Hairs are a cylindrical modification of the epi- 
dermis, and consist of a root imbedded in the skin, a 
shaft, and a point. 
Root is lodged in a poucli-like involution of epidermis 
—the hair-follicle. This is composed of an inner or 
cuticular and an outer or dermic layer, and presents at 
the bottom a vascular papilla, on which the hair rests, 
and from which it grows. 
Shaft, consists of a pith or medulla in the centre, 
surrounded by a fibrous part containing pigment, and 
covered with a layer of scaly epithelium. 
Point, contains the two latter elements, but has no 
medulla. 
Sebaceous glands are minute, glandular bodies, situ- 
ated in the substance of the corium, and each opening 
by a single duct into a hair-follicle, or upon the surface 
of the skin. They are most abundant where hairs are 
found. The Meibomian glands in the eyelids are the 
largest. 
Sudoriferous or sweat glands are minute, reddish, 
glandular bodies, situated usually in the subcutaneous 
connective tissue, each consisting of a single convoluted 
tube. Each gland opens on the surface of the skin. SURGICAL ANATOMY. 
THE TRIANGLES OP THE NECK. 
The general outline of the neck is somewhat quadri- 
lateral. Bounded in front by the median line, behind 
by the trapezius muscle, above by the lower border of 
the body of the maxilla, and below by the clavicle. 
It is divided by the sterno-mastoid muscle running 
obliquely through it into two large triangles, an anterior 
and a posterior triangle. These are again subdivided 
by the crossing of the omo-liyoid muscle into two smaller 
triangles each. The anterior into the superior and infe- 
rior carotid triangles, and the posterior into the occipital 
and subclavian triangles. The digastric muscle, at the 
upper part of the anterior triangle, separates a triangular 
space called the submaxillary triangle. 
The anterior triangle of the neck is bounded as fol- 
lows :— 
Front, median line of the neck; 
Behind, anterior border of the sterno-mastoid muscle ; 
Above, lower border of thebody of the lower jaw, and a line from 
its angle to the mastoid process, forming the base of the triangle; 
Below, the top of the sternum, forming the apex. 
The floor is formed by the sterno-hyoideus, sterno-thyroideus, 
thyro-hyoideus, inferior and middle constrictors of the pharynx, the 
anterior belly of the digastricus, the mylo-hyoideus, stylo-hyoideus, 
and hyoglossus muscles. The roof is formed by the skin, superficial 
fascia, platysma myoides, and deep fascia. 
The inferior carotid triangle is the most inferior 
subdivision of the anterior triangle, and is bounded as 
follows:— 
Front, median line of the neck ; 
Behind, anterior border of the sterno-mastoideus | 
Above, anterior belly of the omo-hyoideu6 ; 
Below, the apex of the anterior triangle. 
It contains the following structures:— SURGICAL ANATOMY. 
363 
Thyroid gland and lower part of the trachea and larynx ; 
Inferior thyroid and common carotid arteries ; 
Inferior thyroid and internal jugular veins ; 
Pneumogastric, recurrent laryngeal, descendens noni, communi- 
cans noni, and sympathetic nerves. 
The superior carotid triangle is the middle subdi- 
vision of the anterior triangle of the neck, and has the 
following boundaries:— 
Above, posterior belly of the digastricus; 
Below, anterior belly of the omo-hyoideus ; 
Behind, anterior border of the sterno-mastoideus. 
Termination of the common carotid; 
The internal carotid; 
The external carotid, and the following branches :— 
Superior thyroid, lingual, facial, ascending pharyngeal, and 
occipital; 
The internal jugular vein, and the following tributaries :— 
Lingual, facial, superior thyroid, pharyngeal, and occasionally the 
occipital; 
The pneumogastric, superior laryngeal, external laryngeal, de- 
scendens noni, spinal accessory, hypoglossal, and sympathetic nerves. 
It contains the following structures :— 
The submaxillary triangle is the most superior of 
the subdivisions of the anterior triangle, and has the 
following boundaries:— 
Above, the lower border of the body of the jaw, and the imaginary 
line behind; 
In front, the median line of the neck; 
Behind, the posterior belly of the digastricus. 
It contains the following structures:— 
External carotid, internal carotid, facial, submental, mylo- 
hyoidean arteries; 
The internal jugular, the commencement of the external jugular, 
branches of the anterior jugular, and the facial vein and its branches ; 
The inframaxillary branches of the facial nerve, the ascending 
branches of the superficial cervical nerve, and the pneumogastric and 
glosso-pharyngeal and mylo-hyoid nerves; 
Portions of the parotid and submaxillary glands, and also sub- 
maxillary lymphatic glands and vessels. 
The posterior triangle of the neck occupies the space 
behind the posterior border of the sterno-mastoideus, 
and is bounded as follows :— 364 
HUMAN ANATOMY. 
Front, posterior border of the sterno-mastoideus ; 
Behind, anterior border of the trapezius ; 
Below, upper border of the middle third of the clavicle, forming: 
its base; 
Above, the occiput, forming the apex. 
Its floor is formed from above downward, by the following 
muscles :— 
Splenius capitis, levator anguli scapuli, scalenius medius, scale- 
nius posticus, and the upper portion of the serratus magnus. 
Its roof is formed by the superficial and deep fascia, and below 
by the platysma myoides. 
It contains the following structures :— 
The transversalis colli artery and vein; 
Spinal accessory and superficial plexus of the cervical nerve ; 
Lymphatic glands and vessels. 
The subclavian triangle, or the inferior division of 
the posterior triangle, is bounded— 
In front by the margin of the sterno-mastoideus, behind by the 
posterior belly of the omo-hyoideus, below by the clavicle. 
It contains the following structures :— 
The subclavian, transversalis colli, and transversalis humeri 
or suprascapular arteries ; 
The transversalis colli, suprascapular, and external jugular veins; 
The descending branches of the superficial cervical plexus, and 
the brachial plexus of nerves ; 
Lymphatic nerves and vessels. 
Triangle in Front of the Flbow-joint. 
Bounded— 
Externally, by supinator longus ; 
Internally, by pronator radii teres; 
Base, above, by a line (imaginary) two inches above the condyles ; 
Apex, below, by crossing of supinator longus and pronator radii 
teres. 
It is covered in by skin, superficial fascia, and bicipital fascia; the 
floor is formed by oblique fibres of the supinator brevis and lower 
part of brachialis anticus muscles. 
It contains:— 
From within outward, median nerve, brachial artery, and venae 
comites, triceps tendon, and musculo-spiral nerve. 
Scarpa's Triangle 
is a large triangular space situated in the upper part of SURGICAL ANATOMY. 
365 
the anterior surface of the thigh, through the femoral 
vessels descend. It is bounded— 
Externally by sartorius, internally by adductor longus, above 
Poupart’s ligament; below, apex is formed by crossing of bounding 
muscles. 
It is covered in by skin, superficial fascia, fascia lata, and cribri- 
form fascia, and its floor is formed by the following from without 
inward : iliacus, psoas, pectineus, and portion of adductor brevis 
muscles. 
It contains:— 
The femoral artery (with its profunda and cutaneous branches), 
inclosed in the femoral sheath, femoral vein (joined by profunda and 
long saphenous veins), anterior crural nerve and its branches [from 
within outward being vein, artery, and nerve], deep lymphatic glands 
and vessels, and adipose tissue. 
This is a pyramidal space between the upper and 
lateral part of the chest and the inner side of the arm. 
It is bounded— 
Axilla. 
In front, by the pectoralis major and minor muscles ; behind, by 
latissimus dorsi, teres major, and subscapularis; internally, by the 
upper four ribs and intercostal and upper part of serratus magnus 
muscles, and its apex is directed upward, and is formed by the 6pace 
between the first rib, clavicle, and upper border of the scapula, and 
its base by the skin and axillary fascia stretched across between the 
lower borders of the pectoralis major and latissimus dorsi muscles. 
It contains:— 
The axillary artery and vein, and their branches; the brachial 
plexus of nerves, and the branches given off below the clavicle; 
branches of the intercostal nerves; ten or twelve lymphatic glands, 
and a quantity of loose adipose and areolar tissue. 
Popliteal Space. 
The popliteal space is a lozenge-shaped space situ- 
ated at the back of the knee, and forms the ham. It is 
bounded— 
Externally, above the joint, by the biceps; below the joint, by 
outer head of gastrocnemius and plantaris; internally, above the 
joint, semitendinosis, semimembranosis, gracilis, and sartorius ; below 
the joint, by inner head of the gastrocnemius. 
It is covered in by the skin, superficial fascia, and fascia lata. 366 
It?, floor is formed by the lower part of the posterior surface of the 
femur, the ligamentum posticum Winslowii, and the popliteus muscle 
and its fascia. 
HUMAN ANATOMY. 
It contains:— 
The popliteal artery and branches; popliteal vein receiving the 
external saphenous vein (vein to the outer side) ; internal and external 
popliteal nerves and branches ; articular branch of obturator nerve; 
branch of 6mall sciatic nerve ; four or six lymphatic glands, and a 
quantity of adipose and areolar tissue. 
ANATOMY OP HERNIA. 
Hernia is the protrusion of any part of a viscera from 
its natural cavity through an abnormal opening. As 
usually understood, it refers to the protrusion of the 
intestine or mesentery, or both, from the abdominal 
cavity. The most common forms are:— 
External or oblique inguinal hernia ; 
Internal or direct inguinal hernia ; 
Femoral hernia; 
Umbilical hernia. 
1. Oblique inguinal hernia escapes from abdominal 
cavity at the internal abdominal ring, carrying before it 
a pouch of peritoneum, descends along the inguinal canal 
in front of the cord, and emerges at the external open- 
ing. The anatomical parts concerned are the inguinal 
canal, with its internal and external abdominal rings, 
the transversalis fascia {vide Fascia), the peritoneum (vide 
Peritoneum), and Poupart’s ligament. 
The inguinal or spermatic canal is about one and a 
half inches in length, extending from the internal ab- 
dominal ring to the external abdominal ring. It serves 
for the passage of the spermatic cord in the male, and 
the round ligament with its vessels in the female. Its 
boundaries are:— 
In front, the tendon of the external oblique muscle, the lower 
border of the internal oblique, and a small portion of the cremaster 
muscle; 
Behind, the fascia transversalis, the conjoined tendon of the trans- 
versalis and internal oblique muscles, and the transversalis fascia ; 
Above, by the arched border of the internal oblique and trans- 
versalis muscles; 
Below, by Poupart’s ligament. SURGICAL ANATOMY. 
367 
The internal abdominal ring is an oval opening in 
the transversalis fascia about half an inch above Pou- 
part’s ligament, midway between the symphysis pubis 
Fig. 74. 
Dissection of the inguinal canal: A, external oblique; B B, internal oblique; C, 
transversalis: D, conjoined tendon ; E, rectus abdominis with sheath opened; F, fascia 
transversalis; II, cremaster; I, infundibular fascia. 
and tlie anterior superior spinous process of the ilium. 
It is bounded— 
Above and externally by the arched fibres of the transversalis 
muscle ; below and internally by the epigastric vessels. 368 
HUMAN ANATOMY. 
It transmits a funnel-shaped fascia from its margins, 
the infundibuliform fascia. 
The external abdominal ring is a triangular opening 
between the two pillars in the aponeurosis of the exter- 
nal oblique muscle, to the outer side and just above the 
crest of the pubes. It is about a half an inch wide and 
one inch long, and is bounded— 
Above, by the intercolumnar fascia; below, by the crest of the os 
pubis, and on either side by the pillars or columns of the ring formed 
by the free margins of the aponeurosis of the external oblique. 
From the margins of the external abdominal ring 
arises the intercolumnar fascia. 
PouparVs ligament, or the femoral arch, is the rounded 
fibrous margin of the external oblique muscle, extending 
between the anterior superior spine of the ilium and the 
spine of the pubes. The portion of the aponeurosis 
which is inserted into the pectineal line has received 
the name of Gimbernat’s ligament. 
The epigastric artery holds a very important ana- 
tomical relation to the inguinal canal and internal ab- 
dominal ring. It ascends between the peritoneum and 
transversalis fascia to reach the sheath of the rectus 
muscle along the inner and lower margin of the internal 
ring and beneath the spermatic cord. 
The coverings of oblique inguinal hernia are :— 
1. Skin ; 
2. Superficial fascia; 
3. Intercolumnar fascia; 
4. Cremaster muscle ; 
5. Fascia transversalis, or infundibuliform fascia; 
6. Subserous tissue; 
7. Peritoneal sac. 
2. Direct inguinal hernia escapes through the ab- 
dominal wall, within Hesselbach’s triangle, internal to 
the epigastric artery, and through the external abdom- 
inal ring, pushing before it a pouch of peritoneum. 
Hesselbach’’s triangle is a space situated at the lower 
anterior part of the abdominal wall on either side. It is 
bounded as follows:— SURGICAL ANATOMY. 
369 
Externally, epigastric artery; 
Internally, the outer margin of the rectus abdominis 
muscle; 
Below, Poupart’s ligament, forming its base. The 
structures forming the abdominal wall at this cavity are, 
from without inward :— , 
1. Skin; 
2. Superficial fascia; 
3. Intercolumnar fascia; 
4. Conjoined tendon of the transversalis and oblique; 
5. Fascia transversalis; 
6. Subserous tissue; 
7. Peritoneum. 
The anatomical parts concerned in direct inguinal 
hernia are the same as those in the indirect, already 
given. The coverings of direct inguinal hernia are those 
just given. 
3. Femoral hernia escapes through the femoral ring, 
carrying before it a pouch of peritoneum, descends 
through the femoral canal and emerges through the 
saphenous opening in the fascia lata. The anatomical 
parts concerned in this hernia are:— 
The femoral ring, the femoral or crural canal, the 
septum crurale, crural sheath and deep crural arch, and 
the saphenous opening. 
The femoral or crural ring is an oval opening, about 
an inch and a half in diameter, larger in the female and 
situated below Poupart’s ligament and the internal ab- 
dominal ring, between the inner side of the femoral vein 
and the margin of Gimbernat’s ligament. It is closed 
in the recent state by the septum crurale and a small 
lymphatic gland. It is bounded— 
In front, by the deep femoral arch and Poupart’s ligament; 
Behind, by the pubes, covered by the pubic portion of the fascia 
lata and the pectineus muscle ; 
Externally, by the femoral vein, from which it is separated by a 
fibrous septum; 
Internally, by the deep femoral arch, Gimbernat’s ligament, the 
transversalis fascia, and the conjoined tendon. 
The femoral canal is a space from a quarter to a half 
an inch in length, extending from Grimbernat’s ligament 370 
HUMAN ANATOMY. 
to the upper margin of the saphenous opening. Bounded 
above by the femoral ring and below by the saphenous 
opening. 
Anterior wall—transversalis fascia, covered by the falciform 
process of the fascia lata; 
Posterior wall—iliac fascia and pnbic portion of the fascia lata; 
External wall—fibrous septum of the femoral vein; 
Internal wall—Gimbernat’s ligament, deep crural arch, and the 
junction of the iliac and transversalis fascia. 
The septum crurale is a layer of dense areolar tissue, 
supporting small lymphatic glands and closing in the 
femoral ring. It is perforated by numerous lymphatic 
vessels, and forms a barrier to the escape of hernia at 
this point. 
The crural or femoral sheath is a prolongation down- 
ward of the fascia lining the abdomen, closely adhering 
to the femoral vessels to about an inch below the saphe- 
nous opening. Its upper part is funnel-shaped and its 
lower part continuous with the sheath of the vessel. Its 
outer border is pierced by the genito-crural nerve, its 
inner by the internal saphenous vein. 
The deep femoral arch is a fibrous thickening of the 
transversalis fascia, arching over the femoral vessel from 
its attachment at the centre of Poupart’s ligament to its 
insertion at the pectineal line behind the conjoined ten- 
don. It is divided into separate compartments by septa, 
which unite behind with the continuation of the iliac 
fascia forming sheaths for the femoral vessels. Below 
it, from without inward, are the following structures: 
the anterior crural nerve, the femoral artery, the femoral 
vein, and the femoral canal, filled by a small gland. 
The saphenous opening is an oval aperture of half 
an inch in width, an inch and a half in length in the 
upper and inner part of the fascia lata, between its two 
divisions, the iliac and pubic portions. It is bounded 
externally by the falsi form process of Burns, internally 
by the pubic portion of the fascia lata, which curves 
upward behind the saphenous vein. The opening is 
covered externally by the cribriform fascia and the skin. SURGICAL ANATOMY. 
371 
The coverings of femoral hernia are:— 
1. Skin ; 
2. Superficial fascia; 
3. Cribriform fascia; 
4. Femoral sheath, or fascia propria; 
5. Septum crurale; 
6. Peritoneal sac. 
ISCHIO-RECTAL REGION AND PERINEUM. 
The outlet of the pelvis is a lozenge-shaped space 
divided by an imaginary line drawn in front of the anus, 
transversally between the front part of the tuber ischii, 
into two parts, the ischio-rectal region behind and the 
perineum in front. 
The ischio-rectal region contains the external and in- 
ternal sphincters, the corrugator cutis ani and the ischio- 
rectal fossa. The latter is a pyramidal cavity, its apex 
reaching to the junction of the obturator and anal fascia, 
and its base formed by the skin. It is bounded— 
Behind, by the edge of the great sacro-sciatic ligament and gluteus 
maximus and coccyghus muscles; internally, by the levator ani, 
covered by the anal fascia, sphincter ani, and coccygeus muscle ; ex- 
ternally, by the tuber ischii and obturator fascia. 
It contains:— 
The internal pudic artery, nerve, and veins ; 
The inferior haemorrhoidal vessels and nerves; 
The perineal and fourth sacral nerves; and 
A mass of areolar tissue. 
PERINEUM. 
The perineum is the triangular space between the 
anus and scrotum in the male, and between the anus 
and vulva in the female. The skin is dark, thin, and 
supplied with sebaceous and sudoriparous glands, and 
is marked by middle line or raphe. 
Pelvic and perineal fascia at the brim of the pelvis 
is continuous with transverse and iliac fascia; covers 
sacrum and pyriformis muscle, external iliac, transverse 
and sacral nerves. It forms the anterior and lateral 
ligament of bladder (true). It forms arcus tendinse, 
Fascise of the Perineum. 372 
HUMAN ANATOMY. 
corresponding to division of pelvic fascia into two layers, 
the obturator and recto-vesical, extending from pubis to 
spine of ischium, from which originates the levator ani 
muscle, with recto-vesical and ischio-rectal or anal fasciae 
on either side. 
The obturator fascia, the continuation of the iliac 
and transversalis fascia, incloses the pudic vessels and 
nerve in a sheath, covers the internal obturator muscle, 
and forms the posterior layer of the triangular ligament. 
Male perineum: 1, inferior pudendal nerve; 2, urethra; 4, crus penis: 8, accel- 
erator urinae; 9, muscular branches of pudic nerve; 10, erector penis; 11, pudic 
artery and nerve; 12, triangular ligament; 13, inferior hsemorrlioidal artery and 
nerve; 16, sphincter ani; 18, levator ani; 20, gluteus maximus. 
Fig. 75. 
Recto-vesical or visceral layer of the pelvic fascia, 
the continuation of the, pelvic fascia, descends into the 
pelvis investing the prostate gland with the vesico-pros- 
tatic plexus of veins, the bladder forming the anterior 
lateral true ligaments and the rectum. It is perforated 
in the female by the vagina. 
Superficial perineal fascia consists of superficial fat 
layer and deep membranous layer. The former is con- 
tinuous with subcutaneous layer of buttocks, thigh, and SURGICAL anatomy. 
373 
labia, and posterior to anus becomes continuous with 
tissue of ischio-rectal fossa. The superior layer passes 
from rami of pubis and ischium to the tuberosity of 
ischia, covering ischio-cavernosus and bulbo-urethral 
muscles, and becomes continuous with the deep perineal 
fascia. 
The deep perineal fascia (triangular ligament) is a 
strong triangular membrane extending between the rami 
iscliii et pubis, its apex attached to the under surface of 
the symphysis. It is often described as consisting of 
two layers, the anterior and posterior, the latter being 
the triangular ligament. It is pierced by the membran- 
ous urethra, and sends a fascia surrounding the urethral 
glands to the spongy body. In the female it is weaker, 
the urethra also pierces it, and it is continuous with the 
fascia of the vagina. 
Ischio-cavernosus (erector penis) arises in the inner 
surface of the tuberosity of the ischium, and is inserted 
into the side and under surface of the crus penis. In 
the female there is a similar insertion into the clitoris. 
It serves to maintain the organ erect. Nerve, perineal. 
Bulbo-cavernosus (accelerator urinae, ejaculator sem- 
inis) arises from central tendon of perineum and from 
median raphe in front. It spreads out and is inserted 
from behind forward to anterior surface of triangular 
ligament, bulb and adjacent part of corpus spongiosum, 
to join fibres of opposite side, and to sides of corpus 
cavernosa; anterior to erector penis and in fibrous ex- 
pansion over dorsal blood-vessels of penis. 
Muscles of the Perineum. 
It accelerates the flow of urine and semen and con- 
tributes to erection of the penis. Nerve, perineal. 
Vaginal constrictor (sphincter vaginae), analogous 
to foregoing muscle, surrounds the orifice of vagina. It 
arises from the central tendon and passes forward on 
either side of vagina to he inserted into the corpora cav- 
ernosa and body of clitoris. It compresses the dorsal 
vein of the clitoris. 374 
HUMAN ANATOMY. 
Erector clitoridis corresponds to erector penis 
muscle in the male, but smaller. 
Transverse perineal arises from inner part of 
ramus of ischium, and is inserted into perineal centre in 
male, into the side of sphincter vaginae in the female. It 
steadies the perineal centre. Nerve, perineal. 
Depressor urethra, or Jarjavay’s muscle, arises from 
the rami ischii, and joins the constrictor and its fellow 
of the opposite side over the urethra. Nerve, perineal. 
Pelvic floor and muscles of female perineum: A, anus; B, bulbo-vaginal; C, coc- 
cyx ; G, gluteus maximus; P, perineal body; U, urethra; V, vagina; G, vulvo-vagi- 
nal gland; 1, clitoris; 2, its suspensory ligament; 3, crura clitoridis; 4, erector clito- 
ridis; 5, bulbo-eavernosus; 7, transversus perinasi; 8, sphincter ani; 9 and 10, levator 
ani; 11, coccygeus; 12, obturator externus. 
Fig. 76. 
External sphincter ani muscle arises from the apex 
of the coccyx and the superficial fascia, and is inserted 
into the perineal centre, blending with the levator ani, 
accelerator urinae, and transversus perinei. It closes the 
anus. Nerve, fourth sacral. 
Internal sphincter ani is an aggregation of circular 
fibres of the intestine, forming a muscular ring one inch 
in breadth, surrounding the lower portion of the rectum. SURGICAL ANATOMY. 
375 
Sphincter tertius is a ring of fibres described by 
Ilertyl and others, arising from the sacrum and sur- 
rounding the rectum about four inches above the anus. 
Anal elevator (levator ani) arises in front from body 
and ramus of pubis and symphysis, posteriorly from spine 
of ischium, and on either side from angle of arcus ten- 
ding. It is inserted by posterior fibres into coccyx, 
and anterior fibres into the muscle of opposite side in a 
median raphe extending from coccyx to anus; middle 
fibres into rectum,joining with sphincter; anterior to 
prostate, blending with external sphincter and trans- 
verse fascia. In the female it is inserted into the vagina 
instead of the prostate. 
It helps with its fellow to form the floor of the pelvis, 
and supports the vagina, rectum, and pelvic viscera. 
Nerves, inferior haemorrhoidal and fourth sacral. 
Coccygeal muscles (coccygei) are derived from the 
levator ani as an offshoot arising from the spine of the 
ischium and lesser sacro-sciatic ligament, and inserted 
into the margin of coccyx and side of lowest segment of 
sacrum. It raises the coccyx and forms the posterior 
part of the pelvic floor. Nerve, anterior division of 
the fifth sacral. 
The muscles of the female perineum are:— 
Sphincter vaginae, or bulbo-cavernosue; 
Erector clitoridis; 
Transversus perinsei; 
Sphincter ani; 
Levator ani ; 
Coccygeus. 
Superficial Set. 
Deep Set. 
Transversus perinaei (deep) ; 
Constrictor vaginae; 
Depressor urethral, or Jarjavay’s muscle. 
The structures beneath the deep layer of the super- 
ficial fascia are:— 
Erector penis muscle; 
Accelerator urinse muscle; 
Transversus perinaei muscle and arteries; 
Superficial perineal vessels. 376 
HUMAN ANATOMY. 
The structures between the two layers of the deep 
perineal fascia are :— 
Compressor urethrae muscle; 
Membranous urethra; 
Subpubic ligament; 
Dorsal vein of penis; 
Pudic vessels and nerves ; 
Venous plexus; 
Cowper’s glands and ducts; 
Arteries and nerves of bulb. 
ANATOMY OP LATERAL LITHOTOMY. 
The incision is made through a triangular interval 
formed by the transversus perinaei, accelerator urinae, 
and erector penis muscles, and divides the following 
structures in the order named:— 
Skin and superficial fascia ; 
Inferior haemorrhoidal vessels and nerves ; 
Accelerator urinae muscle; 
Superficial perineal vessels and nerve (sometimes) ; 
Deep perineal fascia; 
Anterior part of levator ani; 
Part of compressor urethrae; 
Membranous and prostatic positions of urethra ; 
Left lobe of prostate gland. 
The structures to be avoided are :— 
In median line, rectum and bulb of corpus spongiosum ; 
Externally, internal pudic artery ; 
Forward, artery of the bulb ; 
Backward, posterior part of prostatic gland and neck of the 
bladder. CRANIAL NERVES. 
Willis 
Sommering 
Superficial Origin 
Deep Origin 
Exit 
Divisions 
Distribution 
Termination Function 
1. Olfactory. 
1. Olfactory. 
( Short, 
Short, anterior lobe. 
Inner group—nasal septum. 
Schneiderian mucous mem- 
Three roots -J Middle, 
Middle— 
three groups of filaments, . j Outer* 
Middle group—roof of nasal fossa. 
brane of the nose. 
(Long. 
v, f caruncula, 
\ mamellaris. 
Outer group—superior and middle turbinated bones. 
Nerve of special sense of 
smell. 
white, corpus stri- 
atum. 
Long, anterior commis- 
Foramina of the cribri- 
sure and exterior white 
form plate of ethmoid 
substance of the optic 
thalamus. 
bone. 
2. Optic. 
2. Optic. 
Optic commissure, form- 
Optic thalami, corpora 
Optic foramen. 
Passes as single trunk through the sclerotic 
Expands to form the retina of the eye. 
In the retina after receiv- 
ed hy the tracti optici. 
geniculata, corpora 
and choroid coats, a little to nasal side of 
ing a sheath from the 
These portions are con- 
nected with the crus 
and tuber cinereum. 
quadrigemina. 
centre. 
dura mater at the optic 
foramen. 
Nerve of special sense of 
sight. 
In the muscles mentioned. 
3. Motor oculi. 
3. Motor oculi. 
Inner side of crus close 
Crus, motor tract of 
Sphenoidal between 
In the external wall of the cavernous sinus 
Superior—to the superior rectus and levator palpebrse muscles. 
to the pons Varolii. 
pons, corpora quadri- 
two heads of rectus 
divides into two branches—superior, and 
( 1st branch—to inferior rectus muscles. 
Nerve of motion 
gemina, aqueduct of 
Sylvius, valve of Vi- 
muscle. 
inferior. 
Inferior < 2d branch—to internal rectus muscles. 
( 3d branch—to the lenticular ganglion. 
4. Pathetici 
4. Pathetici. 
Valve of Vieussens 
GUSS011.&. 
Aqueduct of Sylvius, 
Sphenoidal fissure. 
In the cavernous sinus it sends a branch to 
To the superior oblique or trochlearis muscle. 
In the superior oblique 
(trochleares). 
around the outer side 
floor of fourth ven- 
ophthalmic nerves and a recurrent branch 
muscle. 
of crus cerebri. 
tricle. 
to the tentorium cerebelli. 
Enters muscle on its orbital side. 
Nerve of motion (smallest 
5. Trifacial (tri- 
cranial nerve). 
5. Trifacial. 
From sides of pons Va- 
Sensory root, from lat- 
Ophthalmic division 
Ophthalmic- 
gemini). 
rolii by two roots—an- 
eral tract of the me- 
through sphenoidal 
' Lachrymal. 
Lachrymal gland, conjunctiva, integument of upper eyelid. 
In mucous membrane, in- 
terior or motor, pos- 
dulla oblongata. 
fissure. 
Branches 
Frontal $ Supratrochlear, 
Corrugator supercillii, occipito-frontalis, integument of forehead. [cranium. 
tegument, glands, mus- 
terior or sensory. 
Motor root, from the 
Superior maxillary di- 
oniai £ Supraorbital. 
Corrugator supercillii, orbicularis palpebrarum, occipito-frontalis, integument of cranium, peri- 
cles, ganglia. 
Opposite the internal 
pyramidal body. 
vision through fora- 
[ Nasal. 
Mucous membrane of nose, integument of wings and tip of nose. 
auditory meatus the 
men rotundum. 
C Ganglionic, 
Ciliary ganglion. 
sensory root enters the 
Inferior maxillary di- 
Nasal < Ciliary, 
Ciliary muscle and iris. 
Casserian ganglion. 
vision through fora- 
( Infratrochlear. 
Integument of eyelids and nose, orbicularis palpebrarum, caruncula lachrymalis, lachrymal sac, 
The motor root passes 
men ovale. 
Superior maxillary, three groups— 
conjunctiva. 
beneath and, later, 
1 n.mioi 5 Temporal, 
Integument of temple and side of forehead. 
joins a branch of the 
ganglion. 
Splieno-max. fossa j Bphmo^SaUM. 
Joins facial nerve. 
Two branches to spheno-palatine ganglion. 
(The trifacial is the largest 
of the cranial nerves.) 
( Posterior dental. 
Anterior branch to gums and buccinator muscle ; posterior branch to molar and second bicuspid 
teeth, antrum, and gums. 
Infraorbital canal—Ant. dental. 
Incisor, canine, and first bicuspid teeth and inferior meatus. 
Orbicularis palpebrarum, conjunctiva and integument of lower eyelids. 
Palpebral, 
On the face 
Nasal, 
Muscles and integument of inner side of nose. 
Labial. 
Labial glands, muscles, integument, and mucous membrane of upper lip. 
Inferior maxillary, two divisions— 
To the muscles of mastication the branches are : temporal (deep), buccal, masseieric, pterygoid. 
In muscles. Nerve of mo- 
Anterior, principally motor fibres. 
Posterior, principally sensory fibres. 
tion. 
f 
( Communicating 
Auriculo-temporal < branches, 
Facial nerve and otic ganglion—two branches to the meatus, branches to parotid gland. 
( Two auricular. 
To integument of the ear, temporo-maxillary articulation. 
Gustatory -j 
Communicating branches, 
Communicating with submaxillary ganglion and hypoglossal nerve. 
Branches of distribution. 
Supply the papillae and mucous membrane of tongue, mucous membrane of mouth, gums, com- 
Nerve of special sense of 
municating at tip of tongue with the hypoglossal nerve. 
taste. 
[inferior denial {Mylojyoid, 
Upper surface of the mylo-hyoid muscle, anterior beily of the digastric muscle. 
Nerve of motion. 
Molar and bicuspid teeth. 
Nerve of common sensa- 
tion. 
In external rectus muscle. 
6. Abducentes. 
6. Abducentes. 
Pyramidal body and 
Posterior part of me- 
Sphenoidal fissure. 
Passes in one trunk to— 
The external rectus muscle. 
pons Varolii. 
dulla and floor of 
fourth ventricle. 
Nerve of motion. 
7. Facial (portio 
Lateral tract, medulla, 
Floor of fourth ven- 
Internal auditory me- 
Branches before its exit are— 
dura). 
and pons Varolii. 
tricle. 
atus, facial canal, and 
f Tympanic, 
To the stapedius and laxator-tympani muscles. 
In muscles. 
stylomastoid foramen. 
( Chorda tympani. 
Communicates with and accompanies the gustatory nerve to the submaxillary gland. Joins sub- 
Branches at its exit— 
maxillary ganglion. To muscles of tongue. 
f Posterior auricular, 
< Digastric, 
Retrateus aurem, occipito-frontalis (occipital portion). 
Posterior belly of digastric, filament to glosso-pharyngeal nerve. 
Nerve of motion. 
( Stylo-hyoid. 
Stylo-hyoid muscle, communicates with sympathetic or carotida. 
Nerve of facial expression. 
7. Facial and 
auditory. 
Branches after its exit— 
( Temporal, 
Attrahens aurem, occipito-frontalis (frontal portion), orbicularis palpebrarum. 
Temporo-facial < Malar, 
Orbicularis, corrugator supercilii, lower eyelid. 
( Infraorbital. 
Superficial branches to skin and muscles of face, up branches levator muscles of mouth. 
C Buccal, 
Buccinator and orbicularis oris muscles. 
Cervico-facial < Supramaxillary, 
Platysma, muscles of chin and lip, depressors of angle of mouth. 
(Inframaxillary. 
Platysma. One branch joins the superficial cervical nerve. 
8. Auditory (por- 
tio mollis). 
Winds around the resti- 
White striae in floor of 
Internal auditory me- 
J 
Cochlear, 
Cochlea. 
Internal ear. 
form body. 
fourth ventricle. 
atus. 
1 
Vestibular. 
Vestibule and semicircular canals. 
Nerve of special sense of 
hearing. 
r 
9. Glosso-pharyn- 
geal. 
Three or four filaments 
Gray nucleus in floor of 
Jugular foramen in a 
f Tympanic (Jacobson’s), 
Distributed to fenestra rotundum, fenestra oralis, tympanum, Eustachian tube, communicating 
In mucous membrane and 
from the medulla pos- 
fourth ventricle. 
sheath of its own and 
with greater superficial petrosal, carotid plexus, otic ganglion. 
muscle. 
terior to the olivary 
in front of the pneu- 
Carotid, 
Trunk of internal carotid artery, communicates with pneumogastric and sympathetic. 
Nerve of special sense of 
body. 
mogastric and spinal 
Pharyngeal, 
Mucous membrane of pharynx. 
taste. 
accessory. 
Muscular, 
Stylo-pharyngeus muscle. 
Nerve of motion. 
Two gangliform en- 
Tonsillar, 
Tonsil, soft palate, and fauces. 
Nerve of common sensa- 
largements in jugular 
. Lingual. 
One branch to mucous membrane surface and base of tongue ; one branch to mucous membrane 
tion. 
foramen—jugular and 
petrosal. 
and papillae of sides of tongue. 
10. Pneumogastric 
(vagus, or 
par vagum). 
About a dozen filaments 
Gray nucleus in floor of 
Jugular foramen in a 
In jugular fossa—Auricular. 
(Arnold’s) communicates with auricular branch of facial. To integument of Pinna. 
In muscles, mucous mem- 
8. Glosso-phar- 
yngeal, 
immediately below the 
origin of the glosso- 
fourth ventricle. 
common sheath, with 
f Pharyngeal, 
With a filament from spinal accessory to pharyngeal plexus on middle constrictor. 
brane, vessels, gland 
the spinal accessory! 
Superior laryngeal, 
Mucous membrane of interior of larynx and arytenoideus muscle. Exterior laryngeal nerve, to 
(thyroid). 
pharyngeal. 
Two ganglia—ganglion 
In neck 
Recurrent laryngeal, 
superior constrictor, crico-thyroid muscles, branch pharyngeal plexus. 
Nerves of motion, sensa- 
Pneumogas- < 
of the root, ganglion 
To all muscles of larynx except the crico-thyroid. 
tion, and sympathy. 
trie, 
of nerve. 
Cervical cardiac. 
Two or three branches to cardiac plexuses; inferior cardiac branch to deep plexus on right; super- 
Spinal acces- 
f Thoracic cardiac, 
ficial cardiac plexus on left. 
To deep cardiac plexus. 
sory. 
In thorax - 
Anterior pulmonary, 
Anterior pulmonary plexus. 
Posterior pulmonary, 
Posterior pulmonary plexus. 
(Esophageal. 
Plexus guise, around the msophagus. 
In abdomen—Gastric. 
Stomach, communicating with solar, splenic, and hepatic plexuses. 
II. Spinal acces- 
By filaments from spinal 
Accessory portion from 
Enters skull by fora- 
Accessory portion. 
Sends communicating branches to pharyngeal and superior laryngeal branches of the pneumo- 
In muscles. 
sory. 
cord as low as sixth 
gray nucleus in floor 
men magnum ; exit by 
jugular foramen in 
gastric. 
cervical vertebrae ; ac- 
of fourth ventricle. 
Spinal portion. 
To sterno-mastoid, trapezius, cervical plexus, occasionally great auricular nerve. 
Nerve of motion. 
cessory portion from 
sheath with pneumo- 
. 
lateral tract. 
gastric. 
9. Hypoglossal. 
12. Hypoglossal. 
About a dozen filaments 
from the space between 
Gray nucleus in floor 
of fourth ventricle. 
Anterior condyloid 
foramen. 
J 
' Descendens noni, 
Thyro-hyoid, 
Omo hyoid (both bellies), sterno-hyoid, sterno-tliyroid. 
Thyro-hyoicl muscle. 
In muscles. 
Nerve of motion. 
the pyramidal and oli- 
Muscular, 
Styloglossus, liyoglossus, genio-hyoid, genio-hyoglossus. 
vary bodies. 
Communicating. 
With pneumogastric, sympathetic, first and second cervical and gustatory nerves. INDEX. 
Abdomen, 222 
muscles of, 128 
regions of, 223 
Acervulus cerebri, 299 
Acetabulum, 68 
Alveoli of lower jaw, 34 
of upper jaw, 29 
of the lungs, 256 
Amphiarthrosis, 89 
Anastomoses, 161 
Anatomy, descriptive, 1 
general, 1 
of hernia, 366 
of lateral lithotomy, 376 
surgical, 362 
Angle of jaw, 34 
of subscapular fossa, 56 
Annulus ovalis, 159 
Antrum of Highmore, 27 
Anus, 234 
Aorta, 165, 181, 182 
Appendices epiploicae, 235 
Appendix auriculae, 158, 159 
ensiform, 47 
vermiformis, 233 
Aponeuroses, 113 
pharyngeal, 221 
Apophysis, 4 
Aqueduct of Sylvius (iter e tertio, 
etc.), 297, 299 
Fallopii, 18, 306 
vestibuli, 18 
Arachnoid membrane of brain, 287 
of spinal cord, 308 
Arbor vitae, 277, 301 
Arch, deep palmar, 180 
plantar, 190 
Areola of mammae, 284 
Arm, 54 
Arnold’s ganglion, 328 
Arteriae propriae renales, 262 
Arterial anastomoses, 161 
system, table of, 190 
Arteries, helicine, 273 
hepatic, 182, 240 
lingual, 169 
pharyngeal, 171 
sublingual, 169 
Arteries of the ankle-joint, 109 
auditory canal, 348 
auricle, 347 
bone, 6 
choroid, 337 
elbow-joint, 101 
Eustachian tube, 350 
eye, 343 
eyelids, 344 
hip-joint, 105 
iris, 338 
kidney, 262 
knee-joint, 108 
labyrinth, 352 
larynx, 251 
lung, 256 
mammae, 284 
membrana tympani, 351 
nasal fossae, 331 
nose, 331 
oesophagus, 181 
ovaries, 279 
pancreas, 236 
penis, 273 
pharynx, 221 
retina, 339 
shoulder-joint, 99 
spleen, 242 
stomach, 229 
suprarenal capsules, 244 
testicle, 270 
thymus gland, 243 
thyroid gland, 243 
tympanum, 351 378 
INDEX, 
Arteries of the uterus, 277 
wrist-joint, 103 
Artery, anastomotica magna, 179 
aorta, 165, 181, 182 
arteria receptaculi, 173 
auricular, 170 
axillary, 178 
basilar, 176 
brachial, 179 
carotid (external), 167 
(internal), 173 
cerebral, anterior, 174 
middle, 174 
posterior, 176 
choroid, anterior, 174 
communicating, anterior, 174 
posterior, 174 
coronary, 166 
digital, 181-190 
dorsalis hallucis, 189 
pedis, 189 
epigastric, deep, 186 
superficial, 187 
facial, 170 
femoral, 186 
gastric, 182 
gluteal, 186 
bsemorrhoidal, 183 
hepatic, 182 
iliac, circumflex, 186 
external, 186 
internal, 184 
ilio-lumbar, 185 
infraorbital, 173 
innominate, 167 
intercostal, 181 
lingual, 169 
lumbar, 183 
mammary, internal, 177 
maxillary, internal, 171 
meningeal, anterior, 173 
mesenteric, superior, 183 
inferior, 183 
obturator, 184 
occipital, 170 
ophthalmic, 173 
palmar arches, 180 
peroneal, 189 
Artery, pharyngeal, ascending, 171 
phrenic, 182 
plantar, external, 190 
internal, 190 
popliteal, 188 
profunda femoris, 187 
inferior, 179 
superior, 179 
pudic, deep external, 187 
superficial external, 187 
internal, 184 
pulmonary, 197 
radial, 179 
renal, 183 
sacral, lateral, 186 
middle, 183 
sciatic, 185 
spermatic, 183 
splenic, 183 
subclavian, 175 
subscapular, 178 
suprarenal, 183 
suprascapular, 177 
temporal, 171 
thoracic, acromial, 178 
superior, 178 
thoracica alaris, 178 
longa, 178 
thyroid, inferior, 176 
superior, 169 
thyroidea ima, 252 
tibial, anterior, 188 
posterior, 189 
transversalis colli, 177 
tympanic, 173 
ulnar, 180 
uterine, 185 
vaginal, 185 
vertebral, 176 
vesical, 184 
Arthrodial joints, 89 
Articulations, 88 
atlo-axoid, 91 
carpal, 103 
carpo-metacarpal, 104 
costo-sternal, 93 
costo-transverse, 92 
costo-vertebral, 92 379 
Articulations, occipito-atloid, 91 
occipito-axoid, 92 
phalangeal, of foot, 111 
of hand, 104 
radio-ulnar, 101 
sacro-coccygeal, 96 
sacro-iliac, 95 
sacro-ischiatic, 95 
sacro-vertebral, 94 
scapulo-clavicular, 99 
scapulo-humeral, 100 
sterno-clavicular, 99 
tarsal, 109 
tarso-metatarsal, 110 
temporo-maxillary, 90 
tibio-fibular, 108 
vertebral, 90 
Arytenoid cartilages, 247 
Atlas, 50 
Auricle, 347 
Axilla, 365 
Axis, 51 
cceliac, 182 
optic, 332 
thyroid, 176 
visual, 332 
Azygos veins, 203 
uvulae, 121 
Bartholin, duct of, 220 
Bartholin, glands of, 283 
Bauhin, valve of, 233 
Bell, external nerve of, 312 
internal nerve of, 311 
Bladder, 264 
Bodies, Malpighian, 262 
Pacchionian, 287 
Body, ciliary, 338 
olivary, 289 
perineal, 372 
pituitary, 292 
restiform, 289 
Bone, astragalus, 79 
calcaneum, 78 
clavicle, 54 
coccyx, 53 
cuboid, 79 
cuneiform, 80 
INDEX. 
Bone, ethmoid, 24 
femur, 72 
fibula, 77 
frontal, 8 
humerus, 59 
hyoid, 35 
ilium, 69 
incus, 351 
innominate, 68 
ischium, 70 
lachrymal, 25 
malar, 26 
malleus, 351 
maxillary, inferior, 33 
superior, 27 
nasal, 26 
occipital, 13 
os calcis, 78 
os magnum, 65 
palate, 30 
parietal, 10 
peroneal, 77 
phalanges of foot, 82 
of hand, 67 
pisiform, 65 
pubic, 71 
sacral, 52 
scaphoid, 65 
scapula, 55 
semilunar, 65 
sphenoid, 20 
stapes, 352 
sternum, 46 
structure, microscopic, 5 
temporal, 15 
tibia, 75 
trapezium, 65 
trapezoid, 65 
turbinated, inferior, 32 
middle, 25 
superior, 25 
ulna, 61 
unciform, 66 
vomer, 32 
Bones of the body, 46 
of the carpus, 64 
of the foot, 78 
of the hand, 64 380 
INDEX. 
Bones of the leg, 75 
of the lower extremity, 68 
of the metacarpus, 66 
of the metatarsus, 81 
of the tarsus, 78 
of the trunk, 46 
of the upper extremity, 54 
Wormian, 37 
Bonnet, capsule of, 334 
Bowman, capsule of, 262 
Brain, commissures of, 293 
divisions of, 288 
points on base, 292 
on surface, 290-293 
ventricles, 292 
weights, average, 288 
Bronchi, 252 
Brunner’s gland, 232 
Bulb of corpus cavernosum, 272 
of corpus spongiosum, 272 
Bulbi vestibuli, 282 
Bulbs, olfactory, 302 
Burns, process of, 370 
Bursae of hip, 105 
of knee, 108 
of shoulder, 101 
of wrist, 102 
Caecum, 233 
Calamus scriptorius, 298 
Calices of kidney, 263 
Canal, alimentary, 212 
auditory, external, 348 
internal, 18, 358 
carotid, 18 
central, of the cord, 310 
crural, 369 
dental, 28 
femoral, 370 
for tensor tympani, 350 
Hunter’s, 186 
hyaloid, 342 
infraorbital, 28 . 
inguinal, 367 
nutrient, 7 
of Huguier, 349 
of Nuck, 227 
of Petit, 341 
Canal of Schlemm, 337 
of Stilling, 342 
of the modiolus, 355 
palatine, 30 
sacral, 53 
spiral, of the cochlea, 355 
Vidian, 23 
Canaliculi, 346 
Canalis reuniens, 356 
Canals, membranous, 356 
semicircular, 353 
Canthus, 344 
Capillaries, 162 
Capsule, internal, 295 
of Bonnet, 334 
of Glisson, 237 
of Tenon, 333 
of the lens, 341 
Capsules, suprarenal, 244 
Caput caeci, 233 
gallinaginis, 273 
Carpus, 64 
Cartilages of the larynx, 246 
of Santorini, 247 
of Wrisberg, 247 
tarsal, 345 
Cartilago-triticea, 248 
Caruncula lachrymalis, 344 
myrtiformes, 281 
Cauda equina, 309 
Cavity, cotyloid, 68 
glenoid, of scapula, 58 
of the omentum, 224 
orbital, 39 
sigmoid, greater, 62 
lesser, 62 
of radius, 64 
Cells, auditory, 358 
ethmoid, 24 
hepatic, 237 
mastoid, 17,349 
Cement, 214 
Cerebellum, 299 
Cerebro-spinal system, 285 
Cerebrum, 290 
convolutions of, 290 
fissures of, 291 
lobes of, 290 381 
Cervix of penis, 271 
of uterus, 276 
Chordae tendinse, 159,160 
Choroid plexus, 336 
tunic, 295 
Cilia, 345 
Circle of Willis, 174 
Circulus arteriosus iridis, 337 
venosus, 284 
Claustrum, 295 
Clavicle, 54 
Clinoid processes, 20, 21 
Clitoris, 282 
Clivus Blumenbachii, 21 
Cloquet, canal of, 342 
Coccyx, 53 
Cochlea, membranous 356 
osseous, 354 
Cceliac axis, 182 
Collar-bone, 54 
Colon, 233 
flexures of, 234 
Columnse carneae, 159,160 
papillares, 159 
Columns of spinal cord, 310 
Commissure, optic, 292 
Concha, 347 
Condyles of femur, 74 
of humerus, 60 
Coni vasculosi, 269 
Conjunctiva, 345 
Conus arteriosus, 159 
medullaris, 309 
Convolutions of cerebrum, 290 
Coracoid process, 58 
Corium, 361 
Cornea, 335 
Cornicula laryngis, 247 
Cornua of thyroid cartilage, 246 
of ventricles, 294 
Corona glandis, 271 
Coronoid process, 34 
Corpora albicantia, 292 
cavernosa, 272 
quadrigemina, 299 
striata, 295 
Corpus Arantii, 159 
callosum, 293 
INDEX 
Corpus dentatum of cerebellum, 301 
of olivary body, 289 
fimbriatum, 295 
Highmorianum, 268 
luteum, 279 
spongiosum, 272 
Corpuscles, Malpighian, 262 
of Gluge, 284 
tactile, 286 
Corti, organ of, 357 
Cortical substance of kidney, 260 
Cotyloid cavity, 68 
Coverings of the testicle, 268 
Cowper’s glands, 275 
Crest, lachrymal, 25 
nasal, 29 
of the ilium, 69 
of the pubes, 71 
of the tibia, 75 
turbinated, 28 
Cricoid cartilage, 247 
Crista galli, 24 
Crura cerebri, 292 
of clitoris, 282 
of penis, 272 
Crusta petrosa, 214 
Crypts of Lieberkiihn, 231 
Cuneiform cartilages, 247 
Cuneus, 291 
Cupola of cochlea, 355 
Cuticle, 360 
Dartos, 267 
Declivity, 21 
Dentine, 214 
Derma, 360 
Descemet, membrane of, 335 
Diaphragm, 132 
Diarthrosis, 89 
Digestion, organs of, 212 
Discus proligerus, 278 
Disk, optic, 339 
Dorsum of scapula, 56 
Douglas’ cul-de-sac, 227-280 
Duct, cystic, 240 
hepatic, 240 
lymphatic, 209 
nasal, 346 382 
INDEX, 
Duct of Bartholin, 220 
of Muller, 269 
of Rivini, 220 
of Steno, 219 
of Wharton, 219 
of Wirsung, 236 
pancreatic, 236 
thoracic, 208 
Ducts, biliary, 240 
ejaculatory, 271 
Ductus cochlearis, 357 
communis choledochus, 241 
Duodenum, 230 
Dura mater of cerebrum, 287 
of spinal cord, 308 
Ear, 346 
internal, 353 
Earstones, 356 
Eminentia (pes accesso- 
rius), 297 
Enamel, 214 
Enarthrosis, 89 
Endocardium, 160 
Endolymph, 356 
Endosteum, 5 
Epidermis, 360 
Epididymis, 266 
Epigastric region, 223 
Epiglottis, 247 
Epiphysis, 4 
Equator of eyeball, 333 
Eustachian tube, 350 
Eye, 332 
appendages of, 344 
Eyebrows, 344 
Eyelashes, 345 
Eyelids, 344 
Fallopian tubes, 279 
Fallopius; aqueduct of, 18 
hiatus of, 18 
Falx cerebelli, 287 
cerebri, 287 
Fascia, cremasteric, 268 
cribriform, 155 
dentata, 297 
intercolumnar, 267 
Fascia, lata, 155 
lumbar, 153 
obturator, 154 
palmar, 154 
plantar, 156 
recto-vesical, 154 
Fasciae, 152 
Fauces, 218 
Femur, 72 
Fenestra ovalis, 349 
rotunda, 349 
Ferrein, pyramids of, 262 
Fibro-cartilage, 88, 90, 107, 247, 
347 
Fibula, 77 
Fimbriae, 280 
Fimbriated extremity, 280 
Fissure, auricular, 19 
calcarine, 291 
calloso-marginal, 291 
collateral, 291 
dentate, 291 
Glaserian, 16 
of Rolando, 290 
of Sylvius, 290 
palpebral, 344 
paracentral, 291 
parieto-occipital, 291 
pterygo-maxillary, 38 
spheno-maxillary, 38 
sphenoidal, 23 
transverse, 290 
Fissures of cerebellum, 300 
of cerebrum, 290 
of liver, 238 
of spinal cord, 309 
Folds, palpebral, 345 
Fontanelles, 36 
Foot, 78 
Foramen for Arnold’s nerve, 19 
caecum, 10 
condyloid, 13 
ethmoidal, 24 
for Jacobson’s nerve, 19 
infraorbital, 28 
intervertebral, 50 
lacerum anterius, 23, 44 
magnum, 13, 45 INDEX. 
383 
Foramen, mastoid, 17 
medium, 45 
mental, 33 
nutrient, 6 
obturator, 69 
of Monro, 297 
of Scarpa, 29 
of Stenson, 29 
of Winslow, 224 
olfactory, 24 
optic, 20 
orbital, 23 
ovale, 22 
palatine, 31 
petrosal, 18 
posterius, 45 
pterygo-palatine, 21 
rotunaum, 22 
sacral, 53 
spheno-palatine, 31 
spinal, 50 
spinosum, 22 
stylo-mastoid, 306 
supraorbital, 9 
suprascapular, 57 
thyroid, 69 
Yesalii, 22 
Foramina at the base of the skull 
43 
Thebesii, 158 
Forearm, 61 
Fornix, 295 
Fossa, canine, 33 
coronoid, 60 
digastric, 17 
digital, 73 
glenoid, 16 
hyaloid, 341 
incisive, 27 
infraspinous, 57 
ischio-rectal, 371 
jugular, 19 
lachrymal, 10 
navicularis of penis, 274 
of vulva, 282 
olecranon, 60 
ovalis, 158 
pterygoid, 23 
Fossa, scaphoid, 23 
spheno-maxillary, 38 
sublingual, 34 
submaxillary, 34 
subscapular, 56 
supraspinous, 57 
temporal, 37 
zygomatic, 37 
Fossse, nasal, 42 
of the skull, 37 
Fourchette, 282 
Fovea centralis, 339 
hemispherica, 353 
semi-elliptica, 353 
Frsenulum, 299 
Freenum preputii, 272 
Gall-bladder, 240 
Ganglia, basic, 296 
cervical, 328 
of fifth nerve, 326 
of the sympathetic, 328 
Ganglion, Arnold’s, 328 
Gasserian, 304 
impar, 326 
Meckel’s, 326 
of Ribes, 328 
spheno-palatine, 326 
spirale, 356 
Gasser, ganglion of, 304 
Ginglymus, 89 
Gladiolus, 47 
Gland, lachrymal, 345 
mammary, 283 
pineal, 299 
prostate, 274 
thymus, 243 
thyroid, 242 
Glandula coccygea, 245 
intercarotica, 245 
Glands, Brunner’s, 232 
Cowper’s, 275 
ductless, 241 
gastric, 229 
intestinal, 231 
lachrymal, 345 
lymphatic, 208 
Meibomian, 345 384 
INDEX, 
Glands of Bartholin, 283 
of Tyson, 272, 283 
sebaceous, 361 
solitary, 232 
sweat, 361 
Gians clitoridis, 282 
penis, 271 
Glenoid, 58 
Glisson’s capsule, 237 
Glottis, 249 
Gomphosis, 89 
Graafian vesicle, 278 
Groove, bicipital, 59 
infraorbital, 28 
musculo-spiral, 59 
mylo-hyoid, 34 
naso-palatine, 33 
optic, 20 
Gubernaculum testis, 269 
Gums, 213 
Gyrus, angular, 291 
fornicatus, 292 
Hairs, 361 
Hamstrings, 146 
Hamular process, 23 
Hand, 64 
Haversian canals, 7 
system, 6 
Head of the humerus, 59 
of the ulna, 62 
Heart, 157 
Helicotrema, 355 
Helix, 347 
Henle, tubes of, 262 
Hernia, anatomy of, 366 
femoral, 369 
inguinal, 366 
Hiatus Fallopii, 18 
Hilus of kidney, 259 
Hippocampus major, 297 
minor, 297 
Hasner, valve of, 346 
Houston, folds of, 235 
Huguier, canal of, 17 
Humerus, 59 
Humor, aqueous, 340 
vitreous, 341 
Humors of the eyeball, 340 
Hunter’s canal, 186 
Hydatids of Morgagni, 280 
Hymen, 280 
Hypochondrium, 223 
Hypogastrium, 223 
Ileum, 233 
Ilium, 69 
Incisura intertragica, 347 
Infundibula of kidney, 263 
Infundibulum of brain, 292 
Inguinal regions, 223 
Intestine, large, 232 
small, 230 
Internal capsule, 295 
Intumescentia ganglioniformis 
Scarpse of seventh nerve, 327 
Iris, 337 
Ischium, 70 
Iter chordae anterius, 349 
posterius, 349 
e tertio ad quartum ventricu- 
lum, 298 
Ivory, 214 
Jacob’s membrane, 340 
Jacobson’s nerve, 307 
Jejunum, 230 
Joint, ankle-, 108 
elbow-, 101 
hip-, 105 
rotators of the, 146 
knee-, 105 
shoulder-, 100 
wrist-, 102 
Joint, motion in, 89 
structures of, 88 
Kidneys, 259 
Labia majora, 282 
minora, 282 
Labium tympanicum, 357 
vestibulare, 357 
Labyrinth, membranous, 356 
osseous, 353 
Lacteals, 208 385 
INDEX 
Lacuna magna, 274 
Lacunae, 6 
Lacus lachrymalis, 344 
Lamellae, 6 
Lamina cinerea, 292 
cribrosa (of sclerotic), 335 
fusca, 335 
reticularis, 358 
spiralis, 355, 357 
Laminae of cornea, 335 
Lancisi, nerves of, 293 
Larynx, 246 
Layer, dermoid, 360 
ganglionic, 339 
molecular, 339 
Leg, 75 
Lens, crystalline, 340 
Lieberkuhn, crypts or follicles of, 
231 
Ligament, annular, of foot, 155 
of hand, 154 
chondro-xiphoid, 93 
conoid, 100 
coronary, 107 
cotyloid, 105 
crucial, of knee-joint, 107 
deltoid, 109 
falciform, 370 
Gimbernat’s, 368, 369 
glenoid, 100 
ileo-femoral or Y, 105 
of Burns, 370 
of Hey, 368 
of Zinn, 341 
orbicular, 102 
Poupart’s, 129, 368 
rhomboid, 99 
round, of the liver, 240 
of the uterus, 277 
sacro-sciatic, 95 
stellate, 92 
stylo-maxillary, 90 
suspensory, of lens, 341 
of liver, 239 
of penis, 272 
of spleen, 241 
transverse, of hip-joint, 105 
trapezoid, 100 
Ligament, triangular, of perineum, 
373 
Ligaments of the bladder, 264 
broad, of uterus, 277 
check, 92 
of the knee-joint, 105 
of the larynx, 247 
of the liver, 239 
of the ossicles, 352 
of the ovaries, 277 
of the sternum, 93 
of the uterus, 277 
peritoneal, 226 
tarsal, 345 
Ligamentum latum pulmonis, 257 
mucosum, 108 
nuchae, 91 
patellae, 106 
pectinatum iridis, 337 
suspensorium, 92 
teres, 105 
Winslowii, 106 
Limbus laminae spiralis, 355 
Line, intertrochanteric, 74 
Linea-aspera, 73 
ilio-pectinea, 70 
quadrati, 74 
Lingula, 21 
Liquor Morgagni, 341 
Lithotomy, structures affected, 376 
Liver, fissures of, 238 
lobes of, 239 
structure of, 237 
vessels of, 240 
Lobes of the cerebellum, 300 
of the cerebrum, 290 
of the liver, 239 
optic, 299 
Lobule of the ear, 347 
Lobules of the liver, 237 
of the lung, 256 
Lobulus caudatus, 239 
quadratus, 239 
Spigelii, 239 
Lower, tubercle of, 158 
Lumbar regions, 224 
Lung, broad ligament of, 257 
Lungs, 254 386 
INDEX 
Lunula, 361 
Lymphatics, 207 
hepatic, 211, 240 
of lung, 256 
of penis, 271 
• of trachea and bronchi, 253 
of uterus, 279 
Lymph spaces of eyeball, 334 
Lyra, 296 
Membranes of brain, 287 
of the spinal cord, 308 
synovial, 88 
tarsal synovial, 111 
wrist synovial, 104 
Meridians of eyeball, 333 
Mesenteries, 226 
Mesocephalon (pons Varolii), 298 
Metacarpus, 66 
Metatarsus, 81 
Modiolus, 355 
Monro, foramen of, 296 
Mons veneris, 281 
Montgomery, glands of, 284 
Morgagni, hydatids of, 280 
liquor, 341 
Mouth, 212 
Muller, duct of, 269, 280 
Muscle, ciliary, 338 
cremaster, 267 
dilator pupillae, 338 
kerato-cricoideus, 250 
levator glandulse thyroideas, 
242 
of the arm, 134 
of the auricle, 347 
of the back, 123 
sphincter pupillse, 338 
tritico-glossus, 250 
Muscles of the abdomen, 128 
of the ear (external), 113 
of the epiglottis, 250 
of the Eustachian tube, 350 
of the eyeball, 342 
of the face, 115-117 
of the forearm, 136 
of the foot, 150 
of the hand, 139 
of the head, 115 
of the hip, 142 
of the larynx, 249 
of the leg, 147 
of the neck, 118 
of the palate, 120 
of the perineum, 373 
of the pharynx, 121 
of the shoulder, 133 
of the stomach, 229 
Macula acoustica, 356 
cribrosa, 353 
lutea, 339 
Malleolus, 77, 78 
Malpighi, bodies of, 242 
pyramids of, 262 
Malpighian corpuscles, 262 
tuft, 262 
Mammae, 283 
Manubrium of the malleus, 351 
of the sternum, 47 
Marrow of bone, 5 
Masses, lateral, of ethmoid, 24 
Mastoid process, 17 
Meatus auditorius externus, 19 
internus, 18, 358 
nasi, 43 
urinanus, 273, 283 
Meckel’s ganglion, 326 
Mediastinum, 257 
testis, 268 
Medulla oblongata, 288 
Medullary substance, 260 
Membrana basillaris, 355 
granulosa, 278 
pupillaris, 338 
Kuyschiana, 336 
tectoria, 357 
tympani, 350 
secundaria, 349 
Membrane, hyaloid, 341 
interosseous, 102, 103, 108 
Jacob’s, 340 
limiting, 339, 340 
of Descemet, 335 
of Reissner, 357 
Schneiderian, 331 
vitelline, 279 INDEX, 
387 
Muscles of the thigh, 142 
of the thorax, 131 
of the tympanum, 352 
Muscular fibre, 112 
Musculi pectinati, 159 
Naboth, ovules of, 277 
Nails, 361 
Nates of cerebrum, 299 
Neck of humerus, 59 
triangles of, 362 
Nerve, abducens, 306 
Arnold’s, 308 
auditory, 307 
Bell’s external respiratory, 312 
internal respiratory 311 
chorda tympani, 307, 352 
circumflex, 312 
cochlear, 359 
crural anterior, 315 
facial, 306 
genito-crural, 315 
flosso-pharyngeal, 307 
ypoglossal, 308 
ilio-hypogastric, 315 
ilio-inguinal, 315 
intercosto-humeral, 314 
interosseous, 314 
Jacobson’s, 307, 352 
laryngeal, 251, 308 
maxillary inferior, 305 
superior, 304 
median, 313 
motor oculi, 303 
musculo-spiral, 313 
nonus or ninth pair, 308 
obturator, 315 
of Wrisburg, 313 
olfactory, 302 
ophthalmic division of fifth, 
304 
optic, 303 
par vagum, 307 
patheticus, 303 
phrenic, 311 
pneumogastric, 307 
portio dura, 306 
portio mollis, 307 
Nerve, pudic, 316 
radial, 314 
spinal accessory, 308 
sympathetic, 326 
thoracic, 312 
trigeminus, 303 
tympanic, 307 
ulnar, 313 
vestibular, 307, 358 
Vidian, 327 
Nerve-fibres, optic, 303 
tissue, 285 
Nerves, cranial, 301 
table of, 395 
hepatic, 330 
of ankle-joint, 109 
of auditory canal, 348 
of auricle, 348 
of bladder, 266 
of choroid, 337 
of elbow-joint, 101 
of Eustachian tube, 350 
of eye, 344 
of eyelids, 344 
of eye-muscles, 342 
of hip-joint, 105 
of iris, 338 
of kidney, 263 
of knee-joint, 108 
of Lancisi, 293 
of larynx, 251, 308 
of lung, 257 
of membrana tympani, 350 
of nasal fossae, 332 
of nose, 332 
of oesophagus, 221 
of ovaries, 279 
of pancreas, 236 
of penis, 273 
of pharynx, 221 
of shoulder-joint, 100 
of spleen, 242 
of stomach, 229 
of suprarenal capsules, 244 
of taste, 360 
of testicles, 270 
of thymus gland, 243 
of tongue, 360 388 
INDEX. 
Nerves of trachea and bronchi, 253 
of tympanum, 350 
of uterus, 277 
of wrist-joint, 103 
petrosal, 327 
popliteal, 317 
sciatic, 316, 317 
spinal, 310 
splanchnics, 329 
thyroid, 243 
Nervous system, 285 
Neurilemma, 285 
Nipple, 284 
Nose, 331 
Notch, cotyloid, 69 
interclavicular, 47 
intercondyloid, 74 
popliteal, 77 
sacro-sciatic, 70 
sigmoid, 62 
supraorbital, 9 
suprascapular, 57 
Nuck, canal of, 227 
Nymphse, 282 
Odontoblasts, 215 
Odontoid ligaments, 91 
process, 51 
(Esophagus, 221 
Omentum, 226 
Opening saphenous, 155, 370 
Optic thalami, 296 
Ora serrata, 339 
Orbital cavities, 39 
Organ of Corti, 357 
of hearing, 346 
of Rosenmuller, 279 
of sight, 332 
of smell, 331 
Organs of generation, female, 275 
male, 266 
of sense, 331 
of taste, 359 
of voice and respiration, 246 
peripheral end, 286, 361 
urinary, 259 
Os calcis, 78 
orbiculare, 351 
Os planum (orbital of ethmoid), 
24 
tincse, 276 
uteri, 276 
Ossa innominata, 68 
triquetra, 37 
Ossification, 7 
table of, 83 
Ossicles of tympanum, 351 
Osteology, 3 
Otoliths, 356 
Ovaries, 277 
Oviducts, 279 
Ovisacs, 279 
Ovules of Naboth, 277 
Ovum, 279 
Pacchionian bodies, 287 
Palate, 218 
Palpebrse, 344 
Pampinaform plexus, 270, 279 
Pancreas, 235 
lesser, 236 
Papilla, lachrymal, 344 
Papillae of skm, 361 
Parovarium, 279 
Pars ciliaris retinae, 339 
intermedia, of vulva, 282 
Peduncles of cerebellum, 301 
Pelvis, 96 
of the. kidney, 263 
Penis, 271 
Pericardium, 157 
Perilymph, 356 
Perineum, 371 
female, 375 
Periosteum, 5 
Peritoneum, 225 
Peronei muscles, 150 
Pes accessorius, 297 
hippocampi, 297 
Petit, canal of, 341 
Peyer’s patches, 232 
Phalanges of ear, 358 
of foot, 82 
of hand, 67 
Pharynx, 221 
Pia mater of brain, 288 INDEX, 
389 
Pia mater of spinal cord, 309 
of the testes, 268 
Pinna, or auricle, 347 
Plane, equatorial, 332 
meridional, 333 
Plantar arch, 156 
Plate, cribriform, 24 
perpendicular, 24 
Pleurae, 257 
Plexus, brachial, 311 
carotid, 326 
cavernous, 326 
cervical, 311 
choroid, 295 
of fourth ventricle, 298 
gastric, 330 
lumbar, 315 
pampiniform, 270, 279 
sacral, 316 
solar, 330 
splenic, 330 
tympanic, 353 
Plexuses of the sympathetic, 330 
Plica semilunaris, 345 
Point, nodal, 332 
Poles of the eyeball, 332 
Pomum Adami, 246 
Pons Varolii, 290 
Portal system, 165, 197, 240 
Porus opticus, 335 
Pouches of membrana tympani, 349 
Poupart’s ligament, 129, 368 
Prepuce of clitoris, 282 
of penis, 272 
Process, acromion, 58 
alveolar, 29, 34 
articular, 88 
auditory, 19 
basilar, 13 
clinoid, 20, 21 
condyloid, 13, 34, 60 
coracoid, 58 
coronoid, 34, 62 
ethmoidal, 32 
falciform, 370 
hamular, of cochlea, 355 
of pterygoid plate of sphe- 
noid, 23 
Process, Ingrassias, 23 
lachrymal, 32 
malar, 29 
mastoid, 17 
maxillary, 32 
mental, 33 
nasal, 28 
odontoid, 51 
olecranon, 61 
olivary, 20 
orbital, 24, 27, 28, 31 
palate, 28 
pterygoid, 23 
sphenoidal, 31 
spinous, 22, 50 
styloid, 19 
transverse, 50 
turbinated, 25 
unciform, 25 
vaginal, 19 
vermiform, 233 
zygomatic, 15 
Processes, ciliary, 339 
clinoid, 20, 21 
of Ingrassias, 23 
Processus, cochleariformis, 19 
cerebello ad medullam (infe- 
rior peduncles), 301 
ad pontem (middle pedun- 
cles), 301 
ad testes, 301 
gracilis, 351 
Promontory of sacrum, 52 
of tympanum, 349 
Prostate gland, 274 
Prostatic sinus, 273 
urethra, 273 
Pterygoid processes, 23 
Pubes, 71 
Punctum lachrymale, 345 
Pupil, 337 
Pylorus, 228 
Pyramid, anterior, 288 
posterior, 289 
of tympanum, 349 
Pyramids of Ferrein, 262 
of Malpighi, 263 
of Wistar, 22 390 
INDEX. 
Radius, 63 
Rami of inferior maxillary, 33 
Ramus of ischium, 71 
of the pubes, 71 
Receptaculum chyli, 208 
Rectum, 234 
Regions of abdomen, 223 
Reil, island of, 291 
Reissner, membrane of, 357 
Renal vessels, 262 
Retina, 339 
Ribes, ganglion of, 328 
Ribs, 47 
Ridge, mylo-hyoid, 34 
pterygoid, 22 
Rima glottidis, 249 
Ring, abdominal, 367, 368 
crural, 369 
femoral, 369 
Rings and phalanges, 358 
Rivinus, duct of, 220 
Rods and cones (Jacob’s), 340 
of Corti, 357 
Rolando, fissure of, 290 
Rosenmiiller, organ of, 279 
Rostrum of the sphenoid, 21 
Sac, lachrymal, 346 
Saccule, 356 
Sacculus laryngis, 249 
Sacrum, 52 
Sacs of the peritoneum, 224 
Santorini, cartilages of (cornicula 
laryngis), 247 
Scala media, 357 
tympani, 355 
vestibuli, 355 
Scapula, 55 
Scarpa, foramen of, 29 
intumescentia ganglionifor- 
mis, 327 
Schindelysis, 89 
Schlemm, canal of, 337 
Schwann, substance of, 285 
Sclerotic, 334 
Scrotum, 267 
Scute, 350 
Sella turcica, 20 
Septum, crurale, 370 
lucidum, 298 
nasi, 43 
pectiniforme, 272 
Sheath, crural, 370 
Shin, 75 
Shoulder-joint, 100 
blade, 55 
Sight, organs of, 332 
Sigmoid flexure, 234 
Sinus aortici or sinus of Valsalva, 
160 
circularis iridis, 337 
of kidney, 263 
of Morgagni (sacculus laryn- 
gis), 249 
pocularis, 273 
Sinuses, 10 
of Valsalva, 160 
sphenoidal, 22 
Skin, 360 
Slit, nasal, 24 
Smell, organ of, 331 
Space, anterior perforated, 292 
popliteal, 365 
posterior perforated, 292 
Spermatic cord, 267 
Sphincter vesicas, 266 
Spinal cord, 309 
Spine, ethmoidal, 20 
nasal anterior, 29 
posterior, 30 
of the ischium, 70 
of the pubes, 71 
of the scapula, 56 
of the sphenoid, 22 
of the tibia, 77 
Spines of the ilium, 69 
Spinous processes, 4, 60 
Spleen, 241 
Spot, blind, 339 
germinal, 279 
light, 351 
yellow, 339 
Squamous, 15 
Steno’s ducts, 219 
Stenson’s foramina, 29, 46 
Sternum, 47 INDEX. 
391 
Stilling, canal of, 342 
Stomach, 228 
Styloid, 19 
Substance of Schwann, 285 
Sulci, 290 
Sulcus spiralis, 357 
tympanicus, 348 
Surface, articular, 88 
trochlear, 60 
Sustentaculum tali, 78 
Sutura, 36 
Suture, baso-sphenoidal, 36 
coronal, 36 
lachrymo-ethmo-frontal, 36 
lambaoidal, 36 
masto-occipital, 36 
masto-parietal, 36 
petro-occipital, 36 
petro-sphenoidal, 36 
sagittal, 36 
spheno-parietal, 36 
squamo-parietal, 36 
squamo-sphenoidal, 36 
Sutures, facial, 36 
of the orbit, 36 
of the skull, 36 
Sylvius, fissure of, 290 
Sympathetic system, 326 
Symphysis, 71 
of inferior maxillary, 33 
Synarthrosis, 89 
Synovial membranes, 88 
Tarsus, 78 
Taste, nerves of, 360 
Taste goblets, 360 
Tsenia hippocampi, 295 
semicirculans, 295 
Teeth, 213 
Tendo-oculi, 345 
Tendons, 113 
Tenon, capsule of, 333 
Tentorium cerebelli, 287 
Testes, 266 
of the cerebrum, 299 
descent of, 269 
Thebesius, foramina of, 158 
Thigh, 72 
Thorax, 93 
Thyroid axis, 176 
cartilage, 246 
Tongue, 359 
Tonsils, 218 
Trachea, 252 
Tract, lateral, 289 
optic, 292 
uveal, 337 
Tracts, olfactory, 292 
Tractus spiralis foraminulentus,358 
Tragus, 347 
Triangle, Hesselbach’s, 368 
Trigonum vesicae, 266 
Trochanters of femur, 73 
Trochlea, 60 
Tube, Eustachian, 350 
Tuber annulare (pons Varolii), 290 
cinereum, 292 
Tubercle, 4 
genial, 34 
of Lower, 158 
Tuberosities, 4 
of femur, 72 
of humerus, 59 
of ischium, 70 
maxillary, 28 
Tubes of Henle (convoluted tubes), 
262 
spiral, of Schachowa, 262 
Tubuli lactiferi, 284 
seminiferi, 269 
uriniferi, 262 
Tuft, Malpighian, 262 
Tunica albuginea, 268 
Ruyschiana, 336 
vaginalis, 268 
vasculosa, 268 
Tunics of eyeball, 334 
Tutamina oculi, 344 
Tympanum, 350 
Tyson, glands of, 272, 282 
Ulna, 61 
Umbilical region, 223 
Umbilicus, 223 
Umbo, 351 
Urachus, 265 INDEX. 
Ureters, 263 
Urethra, 273 
bulb of, 274 
Uterus, 275 
masculinus, 274 
Utricle, 274, 356 
Uvea, 337 
Uvula, 218 
vesicm, 266 
Vagina, 280 
Vaginal, 4 
Valley of cerebellum, 300 
Valsalva, sinuses of, 160 
Valve, Eustachian, 158 
Hasner, 346 • 
ileo-csecal, 233 
mitral, 160 
of Bauhin, 233 
of Vieussens, 299 
tricuspid, 159 
Valves of Kirkring (valvulae con- 
niventes), 231 
semilunar, 159, 160 
Valvulm conniventes, 231 
Vas aberrans, 269 
deferens, 270 
Vasa efferentia, 269 
recta, 269 
vasorum, 161 
Vein, axillary, 202 
basilic, 202 
cephalic, 202 
cerebral, 199 
cerebellar, 200 
jugular, 200 
femoral, 206 
iliac, 206 
median, 202 
popliteal, 206 
portal, 203 
radial, 202 
splenic, 204 
subclavian, 202 
suprarenal, 203 
ulnar, 202 
vena cava, 203 
vertebral, 204 
Veins, 162 
azygos, 203 
cardiac, 198 
choroid, 200 
hepatic, 203 
iliac, 205 
innominate, 198 
interlobular, 240 
jugular, 200 
of bone, 6 
of head and neck, 201 
of lower extremities, 206 
of oesophagus, 203 
of suprarenal capsules, 203,244 
of thymus, 243 
of trachea and bronchi, 253 
of the eye, 343 
of the kidney, 262 
of the larynx, 251 
of the lung, 256 
of the pancreas, 236 
of the penis, 273 
of the stomach, 228 
of the thorax, 203 
pulmonary, 207 
saphenous, 206 
spinal, 204 
thyroid, 202 
uterine, 277 
without valves, 162, 207 
Velum interpositum, 296 
Vense comites, 162, 205 
proprise renales, 263 
rectse, 263 
vorticosse, 337 
Venter of the ilium, 70 
of the scapula, 56 
Ventricle of the cord, 298, 310 
fifth, 298 
fourth, 298 
of the larynx, 249 
third, 297 
Ventricles, lateral, 294 
Vertebra prominens, 51 
Vertebrae, 49 
Verumontanum, 273 
Vesalii, foramen, 22 
Vesical, germinal, 279 INDEX, 
393 
Vesical, Graafian, 278 
Vesiculae seminales, 271 
Vestibule, 283 
of the ear, 353 
Vidian canal, 23 
nerve, 327 
Vieussens, valve of, 299 
Villi, 231 
Viscera, covered by peritoneum 
227 
partially, 227 
wholly, 227 
Vitellus, 279 
Vocal cords, 249 
Vomer, 32 
Vortex of heart, 161 
Vulva, 281 
Walls of the tympanum, 349 
Wharton’s ducts, 219 
Whorl of heart, 161 
Willis, circle of, 174 
Wings of the sphenoid, 22, 23 
Winslow, foramen of, 224 
ligament of, 106 
Wirsung, duct of, 236 
Wistar, pyramids of, 22 
Wormian bones, 37 
Wrisberg, cartilages of, 247 
nerve of, 313 
Zinn, zonula of, 341 
Zona pellucida, 279 
Zonula of Zinn, 341 
Zygoma, 15, 37 August, 1894. 
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