liJIZiJOMPENDS Anatomy DR. POTTE MORRIS' ANATOMY. SECOND EDITION- 79 J Illustrations^ of which 2J4 are Gjlored. MEBICAL .SCMOOL UISMAmif eatise by Vari- . Surgical and Vestigial and )RRis, M.A. and liddlesex Hos- ondon ; Mem- lourt of Exam- jcond Edition. ;d throughout, hich are Orig- Royal Octavo. her, net, $7.00 and publishers The text has ten ; the editor iionious whole ; ed in the first in colors, while ved in several and excellence 2. The text is text-book on ars. surgical and topo- 1 is presented with :y of the book with ay safely be recom- tomy in the English I accurate. For the student, the surgeon, or Iof~tKe general practitioner who desires to review his anatomy, Morris' is decidedly the book to buy." A Descriptive Circular of Morris' ''Anatomy,'' with Sample Pages and Colored Illustrations, will be sent free to any address. H. A. STOCKWELL OPTOMETRIST BERKELEY, CAUF. COMPEND OF ANATOMY POTTER From The Southern Clinic, *' We know of no series of books issued by any house that so fully meets our approval as these ?Quiz-Compends ?. They are well arranged, full, and con- cise, and are really the best line of text-books that could be found for either student or practitioner." BLAKISTON'S ?QUIZ=COMPENDS? The Best Series of Manuals for the Use of Students. Price of each, Cloth, $0.80 net. Interleaved, for taking Notes, $1.00 net. >6®="These Compends are based on the most popular text-books and the lectures of prominent professors, and are kept constantly revised, so that they may thoroughly repre- sent the present state of the subjects upon which they treat. 4^The authors have had large experience as Quiz-Masters and attaches of colleges, and are well acquainted with the wants of students. 4S~They are arranged in the most approved form, thorough and concise, containing over 600 fine illustrations, inserted wherever they could be used to advantage. <8S=-Can be used by students of any college. ifi^They contain information nowhere else collected in such a condensed, practical shape. Illustrated Circular Free. No. I. POTTER'S ANATOMY. Sixth Revised and Enlarged Edition. Including Visceral Anatomy. Can be used with either Morris' or Gray's Anatomy. 117 Illus- trations and 16 Lithographic Plates of Nerves and Arteries, with Explanatory Tables, etc. No. 2. HUGHES. PRACTICE OF MEDICINE. Parti. Sixth Edition, Revised, Enlarged, and Improved. No. 3. HUGHES. PRACTICE OF MEDICINE. Part II. Sixth Edition, Revised, Enlarged, and Improved, These two books furnish a complete set of notes on the Practice of Medicine, including Nervous and Mental Diseases. No. 4. BRUBAKER. PHYSIOLOGY. Tenth Edition, with new Illustrations and a Table of Physiological Constants. Enlarged and Revised. No. 5. LANDIS. OBSTETRICS. Sixth Edition. Revised and Edited by Wm. H. Wells, m.d.. Instructor Jefferson Medical College, Philadelphia. 47 Illustrations. No. 6. POTTER. MATERIA MEDICA, THERAPEUTICS, AND PRESCRIP- TION WRITING. Sixth Revised Edition. No. 7. WELLS. GYNAECOLOGY. Second Edition. With many Illustrations. No. 8. GOULD and PYLE. DISEASES OF THE EYE AND REFRACTION. Including Treatment and Operations and a Section on Local Therapeutics. With Formulae and 109 Illustrations, several of which are in Colors. Second Edition. No. 9. HORWITZ'S SURGERY, Minor Surgery, and Bandaging. Fifth Edition, Enlarged and Improved. With 98 Formulae and 167 Illustrations. No. 10. LEFFMANN. CHEMISTRY. Inorganic and Organic. Fourth Edition. Including Urinalysis, Animal Chemistry, Chemistry of Milk, Blood, Tissues, the Se- cretions, etc. No. II. STEWART, PHARMACY. Fifth Edition. Based upon Prof. Remington's Text-Book of Pharmacy. No. 12. BALLOU. VETERINARY ANATOMY AND PHYSIOLOGY. With 29 graphic Illustrations. No. 13. WARREN. DENTAL PATHOLOGY AND DENTAL MEDICINE. Third Edition, Illustrated. Containing all the most noteworthy points of interest to the Dental Student, and a Section on Emergencies. No. 14. HATFIELD. DISEASES OF CHILDREN. Colored Plate. Third Edi- tion, Revised and Enlarged. No. 15. THAYER. GENERAL PATHOLOGY. With many Illustrations. No. 16. SCHAMBERG. DISEASES OF THE SKIN. Second Edition. Illus. No. 17. CUSHING. HISTOLOGY. With many Illustrations. No. 18. THAYER. SPECIAL PATHOLOGY. With many Illustrations. Price, each, $0.80 net. Interleaved, for taking Notes, $1.00 net. P. BLAKISTON'S SON & CO., PUBLISHERS, PHILADELPHIA. ? QUIZ-CO MPENDS? No. 1 A COMPEND HUMAN ANATOMY INCLUDING THE ANATOMY OF THE VISCERA SAMUEL O. L. POTTER, M.A., M.D.. M.R.C.P. (Lond.) PROFESSOR OF THE PRINCIPLES AND PRACTICE OF MEDICINE AND CLINICAL MEDICINE IN THE COLLEGE OF PHYSICIANS AND SURGEONS OF SAN FRANCISCO; MEDICAL SUPERIN- TENDENT OF ST. mark's hospital; author OF " H.\NDBOOK OF MATERIA MEDICA, PHARMACY, AND THERAPEUTICS," " QUIZ-COMPEND OF MATERIA MEDICA," " AN INDEX OF COMPARATIVE THERAPEUTICS," AND " SPEECH AND ITS DEFECTS"; BRIGADE SURGEON U. S. VOL, SIXTH EDITION, REVISE!^ AND ENLARGED WITH 117 WOOD ENGRAVINGS; ALSO AN APPENDIX CONTAINING NUMEROUS TABLES AND SIXTEEN LITHOGRAPHIC PLATES OF THE NERVES AND ARTERIES PHILADELPHIA P. BLAKISTOI^'S SON & CO. No. IOI2 Walnut Street 1902 TO THE MEMORY OF AN AMERICAN SURGEON AND ANATOMIST. WHOSE FAME IS ACKNOWLEDGED THROUGHOUT THB WHOLE CIVILIZED WORLD, JOSEPH PANCOAST, FORMERLY PROFESSOR OF ANATOMY IN JEFFERSON MEDICAL COLLEGE: AND TO WILLIAM H. PANCOAST, LATB PROFESSOR OF ANATOMY IN JEFFERSON MEDICAL COLLEGE, THE TALENTED AND COURTEOUS REPRESENTATIVE OF A GREAT NAME, JTHOSE ENTHUSIASTIC TEACHINGS, NO LESS THAN HIS GENIAL SALUTATIONS, ARE TREASURED IN LOVING REMEMBRANCE BY EVERY STUDENT WHO HAS HEARD HIM, THIS COMPEND OF HUMAN ANATOMY IS AFFECTIONATELY DEDICATED, BY ONB OF HIS "STAR ANATOMICAL MEN.' Copyright, i8qo, by P. Blakiston, Son &' Co. PREFACE THIS book contains the complete text of my two Compends of Anatomy, namely — the ''Human Anatomy," and the ''Visceral Anatomy," heretofore published as separate volumes in this series of students* manuals. The marked favor with which these Compends were first received, some three and a half years ago, has since been continuously extended to them by teachers and students, both in America and in England. This has been manifested by the sale of a new and large edition every year, and has been extremely gratifying to the author. Upon the exhaustion of the third edition, the publishers resolved to acknowledge the universal appreciation shown these books, by incorporating the two in one volume ; making this, the first of the now well-known " Quiz-Compends," a complete quiz-book on Human Anatomy. In carrying out this generous resolution, the original matter has not been curtailed anywhere ; but, on the contrary, much new matter has been introduced wherever greater detail seemed to be desirable, and the number of the illustrations has been increased by eighteen new cuts. Originally designed for the use of the medical student, in pre- paring for the exercises of the quiz-room and for his final exam- ination, the text is confined to the essentials of each structure treated of, which are arranged in such a manner as to facilitate their rapid acquirement. All superfluities of description have been studiously avoided, and only such matter inserted as should be thoroughly known in order to pass a rigid examination on any organ or structure of the human body. The descriptions will be found to closely follow Gray, though Quain and other recognized authorities have been freely consulted during the preparation of the text. For many of the special arrangements 85937 Vi PREFACE. the author is indebted to the lectures of Professor W. H. Pan^ coast, late of Jefferson Medical College, and to the quizzes of Dr. Henry Morris, formerly assistant to the Chair of Anatomy in the same school. While striving to carry out the object of this series in furnish- ing the medical student with a condensed Manual of Anatomy, the author has endeavored, from a strong appreciation of the importance of the subject, to make this volume deserving of first rank among its kind ; and believing that a judicious condensation, which does not slight the essential features of the subjects treated^ cannot fail to be of benefit in any department of science, he again commits his Compend to the teachers and students of Anatomy, in the hope that it may continue to be found worthy of a place alongside the more exhaustive and exhausting text- books. January, 1887. Preface to the Fifth Edition. Another edition of this Compend having been exhausted, the publishers have requested me to improve the book in any way which will keep it in the front rank among works of its class. I have therefore added an Appendix of forty-three pages, con- taining an original and complete set of Tables and Plates of the Arteries, the Cranial and Spinal Nerves and Plexuses, and the Sympathetic Nervous System. These have been prepared especially for this book, and will, I think, prove of very great value to the student in college, and the physician in practice, who desires a comprehensive view of these complicated parts of the human organism. Sam'l O. L. Potter. Cooper Medical College, San Francisco y July, 1 890. TABLE OF CONTENTS. ANATOMY. PAGE OSTEOLOGY 9 BONES OF THE HEAD ^. 12 The Okbits 29 The Foss^ 31 The Sutures and Fontanelles 33 The Wormian Bones 33 The Hyoid Bone 33 Table of the Foramina at the base of the Skull 34 BONES OF THE TRUNK 36 The Vertebral Column 36 The Thorax 38 The Sternum 38 The Ribs 38 THE PELVIS 40 BONES OF THE UPPER EXTREMITY 43 The Shoulder 43 The Arm 45 The Forearm 47 The Hand 48 BONES OF THE LOWER EXTREMITY 50 The Thigh 50 The Leg .. .. 51 The Foot 53 ARTICULATIONS 55 MUSCLES AND FASCI-ffi OF— The Head 68 The Ear 71 The Neck 71 The Larynx and Epiglottis 75 The Back 76 The Abdomen 80 The Thorax 82 The Perineum 83 vii WU CONTENTS. PAGB The Shoulder and Arm ^5 The Forearm 87 The Hand 9° The Hip and Thigh • 9^ The Leg 95 The Foot 97 rHE HEART 99 ARTERIES 102 THE CIRCLE OF WILLIS 106 ARTERIAL ANASTOMOSES ,. "4 VEINS "5 ABSORBENTS "9 NERVOUS SYSTEM 120 THE BRAIN "o THE SPINAL CORD 129 THE CRANIAL NERVES 129 THE SPINAL NERVES 133 THE SYMPATHETIC NERVE 136 VISCERAL ANATOMY. DIGESTIVE ORGANS I4» ALIMENTARY CANAL ". 141 TEETH 141 Structure 142 Development 143 MOUTH 144 Palate 144 Tonsils 144 Salivary Glands 145 Tongue 145 PHARYNX i4fi CESOPHAGUS 147 STOMACH 148 SMALL INTESTINE 150 Duodenum 150 Jejunum. 150 Ileum 150 LARGE INTESTINE 151 CiBCUM 151 Appendix Vermiformis xS* Colon 15a CONTENTS. IX PAGH Rectum 152 LIVER 153 Ligaments 154 Fissures 154 Lobes 154 Vessels 155 Capsule of Glisson 156 Gall-bladder 156 PANCREAS 157 DUCTLESS GLANDS 158 Spleen 158 Thyroid Gland 159 Thymus Gland .* 160 Supra-renal Capsules 160 ABDOMINAL CAVITY 161 Boundaries 161 Openings 162 Regions 162 PERITONEUM 163 Foramen of Winslow 163 Omenta 164 Mesenteries 164 ORGANS OF VOICE AND RESPIRATION 165 LARYNX 165 TRACHEA AND BRONCHI 170 LUNGS 171 PLEURA 174 Mediastinum 174 URINARY ORGANS 175 KIDNEYS 175 URETERS 177 BLADDER ^ 178 Male Urethra 179 Female Urethra iBi MALE GENERATIVE ORGANS 181 PROSTATE GLAND 181 COWPER'S GLANDS i8x PENIS 182 TESTES AND APPENDAGES 183 Descent of the Testes i8< X CONTENTS. PAGB FEMALE ORGANS OF GENERATION 187 VULVA 187 VAGINA 188 UTERUS AND APPENDAGES 188 Fallopian Tubes 190 Ovaries - 190 Parovarium 192 MAMMiE 192 ORGANS OF SENSE 193 SKIN AND ITS APPENDAGES 193 TONGUE 195 NOSE 195 Schneideria'n Membrane 19S EYE 197 Sclerotic and Cornea 19S Uveal Tract 200 Retina 202 Humors 204 Vessels and Nerves of the Eye 207 APPENPAGES of the EyE 209 EAR 212 External Ear 213 Membrana Tympani.. 214 Tympanum 216 Eustachian Tube 219 Internal Ear 219 HERNIA 226 INGUINAL HERNIA 226 Coverings 227 FEMORAL HERNIA 228 Coverings 229 PERINEUM 230 MALE PERINEUM 230 Lithotomy 231 FEMALE PERINEUM 232 ILPPENDIX » 835 THE ARTERIAL SYSTEM, Tables and Plates... 236 THE NERVOUS SYSTEM, Tables and Plates 951 \NDEX 277 LIST OF ILLUSTRATIONS. FlG. PAGH Base of the Brain xii 1. The Temporal Bone, external view, 15 2. The Temporal Bone, internal view, 16 3. The Sphenoid Bone, upper surface, 18 4. The Sphenoid Bone, lower surface.. 19 5. The Ethmoid Bone 21 6. The Superior Maxillary Bone 22 7. The Malar Bone 24 8. The Palate Bone 25 9. The Inferior Turbinated Bone 26 10. The Vomer 26 11. The Inferior Maxillaiy Bone 27 12. The Cavity of the Oibit 29 13. The Nasal Fossae - 31 14. The Base of the Sicull 34 15. A Vertebra 36 16. The Sternum 38 17. Ribs... 39 18. The First Rib 39 19. The Pelvis 40 20. The Sacrum 41 21. The Coccyx 41 22. The Innominate Bone 42 23. The Humerus 46 24. The Radius and Ulna 47 25. The Bones of the Carpus 48 26. The Femur 50 27. The Tibia and Fibula 52 28. Bones of the Tarsus and Foot 53 29. The Occipito-atloid Articulation, etc. 56 30. The Temporo-maxillary Articula- tion, 57 31. The Costo-vertebral Articulations... 58 32. The Sacro-ischiatic Articulation, etc. 59 33. The Shoulder-joint, etc 60 34. The Elbow-joint. .. 61 35. The Knee-joint, posteriorly 64 36. The Knee-joint, anteriorly 64 37. Muscles of the Face and Forehead.. 69 38. Muscles of the Neck 72 39. Muscles ot the Back 77 40. Muscles ot the Back, deep layers.... 79 41. Muscles of the Chest and Abdomen, 81 42. The Diaphragm 83 43. Muscles of the Perineum 84 44. Muscles of the Arm 86 45. Muscles of the Fore -arm and Hand .(0, 46. Muscles of the Fore-arm and Hand (2) 89 47. Muscles of the Thigh, anteriorly 92 48. Muscles of the Thigh, posteriorly,... 93 ^9. Muscles of the Hip joint 94 50. Muscles of the Leg, anteriorly 96 107 51. Muscles of the Leg, posteriorly 97 108. 52. Muscles of the Foot 98 109. 53. The Heart 101 54. The Aorta 103 55. Arteries of the Face and Head 104 112, 56. The Right Internal Maxillary Ar 113. tery 104 114. 57 The Subclavian Artery 106 115. 58. The Abdominal Aorta IC9 116, Sixteen Lithographic Plates xi PAGB The Femoral Artery iia The Venae Cavae and Azygos Veins 117 The Optic Nerves and Tract, etc. 130 The Fifth Cranial Nerve 130 The Sacral Plexus, and its branches 135 The Three Petrosal Nerves 138 A Tooth 142 The Salivary Glands 144 The Tongue and Fauces 145 The Muscles of the Pharynx 147 The Stomach 148 Arteries of the Stomach, Pancreas, etc 149 The Duodenum 150 The Colon and Rectum 152 The Liver 153 Structure of the Liver (vessels) 155 Structure of the Liver (cells) 156 The Pancreas 157 The Spleen 158 Regions of the Abdomen 162 The Peritoneum 164 The Thyroid Cartilage i66 The Cricoid Cartilage 166 The Arytenoid Cartilages 166 Muscles of the Larynx 169 The Lungs, Heart, etc 172 Lobules and Alveoli of the Lung.... 173 The Kidney 175 A Malpighian Tuft 176 The Bladder 178 The Male Urethra, etc 180 Section of the Penis 182 Section of the Testicle and Scro- tum 184 Ducts of the Testicle and Epididy- mis 185 The Vulva 187 The Uterus and its Appendages 189 The Mammae , 192 The Skin and its Appendages 193 The Nose 196 The Eye 198 The Iris 201 The Retina 203 The Crystalline Lens 205 The Muscles of the Eyeball 206 Appendages of the Eye 209 Structure of the Eyelids 210 The Lachrymal Gland 212 The Membrana Tympani 215 The Tympanum 217 The Internal Ear 220 The Cochlea 221 The Membranous Labyrinth 222 The Membranous Cochlea 223 Rods of Corti 224 Auditory Cells 224 Poupart's Ligament 227 Femoral Hernia 228 The Male Perineum 23a , in Appendix. THE BASE OF THE BRAIN. I. Olfactory Bulb. 2. Second, or Optic Nerves. 3. Anterior Perforated Space. 4. Optic Tract. 5. Crus Cerebri. 6. 3d Nerve. 7. 4th Nerve. 8. 5th Nerve. 9. 6th Nerve. 10. Pyramid. 11. Olivary Body. 12. Vertebral Artery. 13. Anterior Spinal Artery. 14. Anterior Cerebral Artery. 15. Lamina Cinerea. 16. Middle Cerebral Artery. 17. Tuber Cinereum. 18. Corpora Albicantia. 19. Middle Perforated Space. 20. Posterior Cerebral Artery. 21. Superior Cerebral Artery. 22. Pons Varolii. 23. Inferior Cerebellar Artery. 94. 7th and 8th Nerves. 25. 9th, loth and nth Nerves. 26. 12th Nerve. 27. Cerebellum. COMPEND OF ANATOMY. Define the term Anatomy. Derived from the Greek dva ana, through, and tifiveiv iemnein, to cut, it strictly means dissection, but is technically applied to that science which treats of the structure of organized bodies. What are the divisions of Descriptive Human Anatomy ? They are, — Osteology, the anatomy of the bones; Syndesmology, of the joints; Myology, of the muscles ; Angiology, of the vessels ; Neurology, of the nerves ; Splanch- nology, of the internal viscera ; Adenology, of the glands ; Dermatology, of the skin ; Genesiology, of the generative organs. State the number of Bones in the Adult Human Skeleton. It is variously stated by different anatomists. Excluding the teeth, the Wormian and sesa- moid bones, and the ossicles of the middle ear, the whole number would be 200 ; excluding also the 2 patellae, and the hyoid bone, would leave in the skeleton proper 197 bones. Describe the Long Bones. They number 90, act as supports, or levers, and are known by having a medullary canal in the centre of each, a shaft {diaphysis), and two extremities. They are developed by osseous deposit in cartilage. Describe the Short Bones. Numbering 30, they are found where strength is required, but limited motion. They also are developed by osseous deposit in cartilage. Describe the Flat Bones. They number 38, protect the viscera by forming Falls around them, and afford extensive attachment for muscles. They are developed by osseous deposit in membranes, and consists of 2 dense layers, separated by a cellular or cancellated osseous tissue, the diploe. What are the Irregular Bones ? They are 39 in number, and include the vertebrae, sacrum, coccyx, the temporal, ethmoid, and sphenoid bones, and the bones of the face, except the nasal, lachrymal, and vomer. 9 10 ANATOMY. Name the Bones of the Head. They number 22, and comprise the — Cranial Bones (8) — the frontal, 2 parietal, occipital, 2 temporal, the sphenoid and the ethmoid bones. Facial Bones (14) — 2 superior maxillary, 2 malar, 2 nasal, 2 lachrymal^ 2 palate, 2 inferior turbinated, vomer and inferior maxillary. Name the Bones of the Trunk. They number 53, as follows, viz.^ — Vertebrce (24) — 7 cervical, 12 dorsal, and 5 lumbar vertebrae. Thorax (25) — 7 pairs of true ribs, 3 pairs of false ribs, 2 pairs of floating ribs, (articulating with the bodies of the dorsal vertebrae,) and the sternum. pelvis (4) — the sacrum, the coccyx, and 2 ossa innominata; each os innomi- natum consisting of 3, — the ilium, ischium, and pubes. Name the Bones of each Upper Extremity. They number 32, as fol- lows : — Shoulder (2) — the clavicle and scapula. Arm (i) — the humerus. Forearm (2) — the radius and ulna. Hand (27) — 8 carpal bones, — the scaphoid, semilunar, cuneiform, pisiform, trapezium, trapezoid, os magnum, and unciform, — 5 metacarpal, and 14 phalanges. ' Name the Bones of each Lower Extremity. They number 29, viz. — Thigh (i)— the femur. Leg (2) — the tibia and fibula. Foot (26) — 7 tarsal bones, — the astragalus, os calcis, scaphoid, cuboid, external middle and internal cuneiform, — 5 metatarsal, 14 phalanges. Name the Unclassified Bones. They are the — PatellcB (2), which are sesamoid bones, each developed in the tendon of the quadriceps extensor femoris muscle. Hyoid Bone (i) — the tongue-bone, not articulated to the skeleton. Malleus, Incus, Stapes (3 pairs) — the bones of the middle ear. Sesamoid Bones, of variable number, situated in the tendons of the gastrocne- mius and peroneus longus muscles, and in the flexor tendons of the great toe and the thumb. Wormian Bones (ossa triqueta), sometimes found in the cranial sutures, are not constant in number or size. Name the principal Eminences on Bones. Heads, are convex and smooth, for articulation in movable joints. Condyles, are irregularly shaped heads. Trochanters, when for turning the bone. Tuberosities, are broad, uneven prominences. Tubercles, are small tuberosities. Spines, or Spinous processes, when sharp and slender. Apophysis, is a process xvhich has never BONES. 11 been separate from the bone. Epiphysis^ is a process developed as a separate piece and afterwards united to the bone by ossification of the intermediate tissue. What other names are given to Bony Prominences ? There are sev- eral adjectives applied to them from their fancied resemblances, such as — Azygos^ without a fellow; Clinoid, like a bed; Coracoid^ like a crow's beak; Coronoid, hooked like a crow's beak; Hamular^ hook-like; Malleolar, like a mallet ; Mastoid, like a nipple ; Odontoid, tooth-like ; Pterygoid, wing-like ; Rostrum, a beak ; Spinous, thorn-like ; Styloid^ pen-like ; Squamous, scaly ; Vaginal, ensheathing, etc. Name the Cavities of Bones. Articular cavities are called Cotyloid, cup- like; 67^«c/^, shallow ; Trochlear, puWey-like; /izr^. Internally, by the external plate of the pteryj^oid process. Abcrvey by the temporal fossa, the squamous portion of the temporal bone, and the greater wing of the sphenoid. Below, by the alveolar border of the inferior maxillary bone. What Fissures open into the Zygomatic Fossa. Two, the — Spheno-maxillary Fissure, between the greater wing of the sphenoid externally, and the superior maxillary and palate bones internally. It connects the orbit with the zygomatic, temporal, and spheno-maxillary fossae ; and trans- mits the infraorbital artery, the superior maxillary nerve and its orbital branches, and the ascending branches of Meckel's ganglion. Pterygo-m axillary Fissure, between the tuberosity of the superior maxillary bone and the pterygoid process of the sphenoid. It transmits branches of the internal maxillary artery, and connects the zygomatic fossa with the spheno-maxillary. Describe the Spheno-Maxillary Fossa. It is a triangular cavity be- tween the pterygoid process of the sphenoid bone and the tuberosity of the superior maxillary, and is situated at the junction of the spheno-maxillary, pterygo-maxillary, and sphenoidal fissures. Into it open — J FosscB, — the orl:)ital, zygomatic, and nasal. 2 Cavities, — the cranial, and buccal. ^ Foramina, — the Vidian and pterygo-palak.4ie canals, and the foramen rotundum, posteriorly; the spheno-palatine foramen on the inner wall; and the posterior palatine canal inferiorly ,— -occasionally also the acceS' scry palatine canals. THE SUTURES AND FONTANELLES. BS THE SUTURES AND FONTANELLES. Name the Sutures of the skull. There are 17. 4i the Vertex of the skull are 5, the — Sagittal, or interparietal. 2 Coronal, or fronto-parietal. 2 Lambdoid, or occipito-parietaL At the Sides of the skull are 4, the — 2 Spheno-parietal. 2 Temporo-parietal. At the Base of the skull are 5, the — 2 Temporo-occipital. Basilar, in the central line of the base. 2 Temporo-sphenoidal. In the Mesial line, besides the sagittal and basilar, are 3, the — Spheno-ethmoidal. Spheno-frontal. Ethmo- frontal. Describe the Facial Sutures. The most important are the following, but the sutures of the face are very numerous. Zygomatic Suture, at the temporo-malar articulation. Transverse Suture, extending from one external angular process of the frontal bone across to the other, and connecting that bone with the malar, sphenoid, ethmoid, lachrymal, superior maxillary, and nasal bones. Symphysis of the Chin, the site of a foetal suture. How are the Sutures formed ? By dentations of the external tables in- terdigitating with each other, the adjacent edges of the internal tables lying in unjoined proximity. The sutures are not formed until a long time after the formation of the skull, probably to permit of the marginal growth of the bones. What are the Fontanelles ? They are 6 membranous intervals in the in- fant's skull, corresponding in situation with the angles of the two parietal bones. They are as follows, viz. — Anterior, at the junction of the sagittal and coronal intervals. Posterior^ at the junction of the sagittal and lambdoid intervals. Lateral Fontanelles, 4, two at the anterior inferioi angles, and two at the posterior inferior angles of the parietal bones. Describe the Wormian Bones. They are supernumerary small pieces of bone, irregularly shaped, and developed by special centres in unclosed por- tions of the cranial sutures and fontanelles, being more frequent in the lamb doid suture. They are also called "ossa triqueta" from their triangular form. Describe the Hyoid Bone. It is shaped like a horse-shoe, has no articu- lation with the skeleton, but supports the tongue. It consists of a Body, two greater, and two lesser Cornua or horns. On the body is a Crucial Ridge, with a Tubercle at the centre. It is developed hy 5 centres, — one for the body and one lor each horn. Attached to it are lo muscles, 3 ligaments, and I membrane, as follows, viz. — c S4 ANATOMY. To the Body, — the genio-, mylo-, stylo-, sterno-, thyro-, omo-hyoid, the genio- hyo-glossus, and the hyo-glossus muscles; also the pulley of the digas- tric, the hyo-epiglottic ligament, and the thyro-hyoid membrane. To the Greater Cornu, — the hyo-glossus, middle constrictor muscles, and part of the thyro-hyoid ; — also the thyro-hyoid ligament. To the Lesser Cornu, — the stylo-hyoid ligament. TABLE OF THE FORAMINA AT THE BASE OF THE SKULL, with the various structures transmitted by each. Anterior Fossa contains i single foramen and 5 in pairs, viz. — Foramen Ccecum, — lodges a fold of dura mater, and transmits a vein to the longitudinal sinus from the nose, sometimes one from the frontal sinus. Ethmoidal Fissure, — the nasal nerve, and the anterior ethmoidal artery. Olfactory, — olfactory nerves, and nasal branches of the ethmoidal arteries. Anterior Ethmoidal, — anterior ethmoidal artery and the nasal nerve. Posterior Ethmoidal, — posterior ethmoidal artery and vein. Optic Foramen,— opXc nerve and ophthalmic artery. Middle Fossae contain 8 pairs, viz. — Foramen Lacerum Anterius,ox Sphenoidal Fissure, P — the 3d, 4th, oph- thalmic division of the 5th, ami the 6th cranial nerves, and filaments of pjg^ J ._ the sympathetic ; ophthalmic vein, a branch of the lachrymal artery, orbital branches of the middle meningeal artery, and a process of dura mater. Foramen Rotundum, — superior max- illary division of the 5th cranial nerve. Foramen Vesalii, — a small vein. This foramen is often absent. Foramen Ovale, t — inferior max- illary division of the 5th nerve, lesser petrosal nerve, and the small meningeal branch of the internal maxillary artery. Foramen Spinosum, ^ — middle men- ingeal artery, meningeal veins, and sympathetic filaments from the cavernous plexus. THE CRANIAL FORAMINA. 35 Foramen Lacerum Medium,q — internal carotid artery, carotid plexus, large petrosal nerve, and a branch from the ascending pharyngeal artery. ■ Small Foramen, — lesser petrosal nerve. Hiatus Fallopii, — large petrosal nerve, branch of middle meningeal artery. Posterior Fossa contains 6 pairs and i single, viz. — Meatus Auditorius Intermis, — facial and auditory nerves, auditory artery. Aqueductus Vestibuli, — small artery and vein, process of dura mater. Foramen Lacertitn Fosterius,''' — glosso-pharyngeal, pneumo-gastric, and spinal accessory nerves, internal jugular vein, meningeal branches of the ascend ing pharyngeal and occipital arteries. Mastoid Foramen (often absent), — small vein, occasionally the mastoid artery. Anterior Condyloid Foramen, — hypoglossal nerve, meningeal branch from the ascending pharyngeal artery. Posterior Condyloid Foramen^" (often absent), posterior condyloid vein. Foramen Magnum,k — medulla oblongata and its membranes, the vertebral arteries, and the spinal accessory nerves. Externally, at the base of the skull are lo pairs, viz. — Opening of the Eustachian Tube, — air to the middle ear. opening of Tensor Tympani Canal, — the tensor tympani muscle. Orifice of the Vidian Canal, — the Vidian nerve, and vessels. Glasserian Fissuve,n — laxator tympani muscle, tympanic artery, processus gracilis of the malleus. Orifice of the Canal of Hugier, — chorda tympani nerve. Foramen for Jacobson's Nerve, — tympanic branch of glosso-phaiyngeal. Foravien for Arnold's Nerve, — auricular branch of pneumogastric. Opening of the Aqueductus Cochlea, — vein to the cochlea. Stylo-mastoid Foramen^t — facial nerve, stylo-mastoid artery. Auricular Fissure, — exit of Arnold's nerve. Face presents 3 pairs, viz. — Supraorbital Foramen or Notch, — supraorbital artery, vein, and nerve. Infraorbital Foramen, — infraorbital artery and nerve. Mental Foramen, — mental artery and nerve. Palate presents, on each side at least 6 pairs, viz. — Incisive Foramina^ (one or two), — nerves and vessels to the incisor teeth. 2 Anterior Palatine, — anterior palatine vessels, naso-palatine nerves. Posterior Palatine, — posterior palatine vessels, anterior palatine nerve. Accessory Palatine Foramina (one or two), — posterior palatine nerves. Pterygo-palatine Foramen^ — pterygo-palatine vessels. 86 ANATOMY. Fig. is. THE BONES OF THE TRUNK. THE VERTEBRAL COLUMN. What Cnaracteristics are Common to the Vertebrae ? Each vcKtebra consists of a body and an arch, the latter being formed by 2 pedicles and 2 laminae, which support 7 processes. Body^ is thick and spongy, convex in front'' from side to side, concave verti- cally, and on the upper and lower surfaces, which are surrounded by a bony rim. Anteriorly are small foramina for nutrient vessels, posteriorly a large foramen for the exit of the vense basis vertebrarum. Pedicles, project backwards from the body, inclining outwards. They are notched above and below, thus forming, with the adjacent notches, the Intervertebral Foramina for the entrance of vessels and the exit of the spinal nerves. Lamina:^ are 2 broad plates, meeting in the spinous process behind, and rough on their upper and lower borders for the attachment of the liga- mentum subflava. Transverse Processes,^ one on each side, projecting outwards. Articular Processes, two on each side, superior ^ and inferior,* project from the junction of the laminae and pedicles, and articu- lating above and below with the articular pro- cesses of the adjacent vertebrae. Their superior facets look upwards in the cervical region, out- wards in the dorsal, and inwards in the lumbar. Spinous Process} projects backwards from the junc- tion of the laminae with each other, sometimes very obliquely. Spinal Foratnen^ is the space enclosed by the body, pedicles, and laminae ; and which, when the vertebrae are articulated, forms part of the spinal canal. THE VERTEBRAL COLUMN. 37 How are the Vertebrae distinguished? As cervical (7), dorsal (12), anu lumbar (5). Each of these divisions has several peculiar features, but their especial characteristics are as follows. The Cervical Vertebra; are pierced at the bases of their transverse processes by the vertebral foramina, which transmit the vertebral artery, vein, and plexus. The Dorsal Vertebra; have facets and demifacets on their bodies, for articula- tion with the heads of the ribs. The Ltimbar Vertebra are marked by the absence of the foramina and facets which distinguish the other two classes. What are the Peculiar Vertebrae? They are 9 in number, — the atlas or 1st cervical, the axis or 2d cervical, the vertebra prominens or 7th cervical, the 1st, 9th, loth, nth, and 12th dorsal, and the 5th lumbar. The Atlas is a bony ring supporting the head. A bony arch takes the place of a body, and its spinous process is a" mere tubercle. Its Lateral Masses form its chief bulk, supporting large Articular Processes which all look inwards, the superior articulating with the condyles of the occipital bone. The Axis is marked by its Odontoid Process projecting upwards from the body into the anterior part of the spinal foramen of the atlas, where it articulates with the anterior arch, and receives the occipito-axoid and the check ligaments. The Vertebra Prominens has a long and prominent spinous process which ends in a tubercle for the ligamentum nuchae. The Dorsal Vertebra. The 1st has one facet and ademifacet. The 9th has a demifacet only. The loth has but one facet on the body and one on the transverse process. The nth and 12th have each but one facet on the body, and none on the transverse processes. The 12th resembles a lumbar vertebra in size and shape. The £th Lumbar is much deeper in front than behind ; its spinous process is small, but its transverse processes are large and thick, and point slightly upwards. What important Relations have Certain Vertebrae? The jd Cervical corresponds to — the bifurcation of the common carotid artery, and the superior cervical ganglion. The^th Cervical, to — the junctions of the larynx with the trachea, and the phar- ynx with the oesophagus, and the middle cervical ganglion of the sympathetic. The 2d Lumbar, to — the junction of the duodenum with the jejunum, the commencement of the thoracic duct and the portal vein, the origin of the superior mesenteric artery, the lower margin of the pancreas, the opening of the ductus communis chol^dochus, the lower end of the spinal cord, and the crura of the diaphragm. [The false vertebrae are described as hones of the pelvis.] 4 S8 ANATOMY. Describe it. Fig. i6. THE THORAX. What is the Thorax? An osseo-cartilaginous cage formed by the bodit- of the dorsal vertebrae posteriorly, the ribs and costal cartilages laterally, and the sternum in front. Its shape is conical, the axis inclined forwards, the bast below and closed by the diaphragm. What Structures pass through its Apex? The trachea, oesophagus, large vessels of the neck, pneumogastric, phrenic and sympathetic nerves, thoracic duct, and in inspiration the apex of the lung. What Structures are contained in its Cavity? The trachea, bronchi and lungs, the heart and great vessels, internal mammary arteries, azygos and bronchial veins, pneumogastric, phrenic, and splanchnic nerves, oesophagus, thoracic duct, lymphatic vessels, and glands. THE STERNUM. The sternum, or breast-bone, consists of 3 parts, — the manu- brium,^ or handle; the gladiolus,'^ or sword; and the ensi- form or xiphoid appendix.^^ It presents the — Interclavicular Notch, on its superior border. Manubrium,'^ articulates with the clavicle,^ ist costal cartilage,^ and a part of the 2d./" Gladiolus, articulates with the costal cartilages from the 3d to the 6th inclusive, and partly with the 2d and 7th. Ensiform Appendix (the tip), articulates with the carti- lage of the false ribs, and in part with the 7th costal cartilage./ Describe its development and muscles. The ster- num is developed by 6 centres, I each for the manubrium and ensiform aooendix, and 4 for the gladiolus. The mus- cles attached to it are 9 pairs and one single muscle, — the sterno-cleido-mastoid, sterno-hyoid, and sterno-thyroid,. 3, to its upper part ; — the rectus abdominis, external and internal oblique, trans- versalis, and the diaphragm, 5, to its lower part; — the pectoralis major, i, an- teriorly ; — and the triangularis sterni, i, posteriorly. THE RIBS. Describe them. There are 12 ribs on each side, of which 7 are "trne ribs," being each connected to the sternum by a separate cartilage; — and 5 are " false ribs." Three of the latter are connected by their cartilages to the carti- lage of the 7th rib, while two are called " floating ribs," having each one ex- tremity free. What are the Characteristics Common to most of the Ribs ? They each consist of a head, neck, and shaft, and present the following points, viz. — THE RIBS. 39 IIead,a is divided by a ridge into 2 facets, which articulate with the facets on the bodies of the dorsal vertebrae ; the ridge giving attachment to the in- terarticular ligament. Neck, about an inch long, having attached to its upper border the anterior costo-transverse ligament, to its posterior surface the middle costo-trans- verse ligament ; its anterior surface is smooth. Tuber osity,^ at the June- a Fig. 17. tion of the neck with the shaft, has a facet for articula- t io n with the trans- verse pro- cess of the next lower vertebra, and a rough surface for the posterior costo-transverse ligament. Shaft, twisted on itself, is concave internally, convex externally, its uppef border round and smooth, its lower border grooved'^ for the intercostal 'vessels and nerves. At its external extremity^ is an oval depression for the insertion of the costal cartilage. Angle,e just in front of the tuberosity, is marked by a rough line, to which are attached the muscles of the deep layer of the back, Hov7 are they developed? Each rib has 3 centres, one each for the head, shaft, and tuberosity. The last 2 ribs, having no tuberosity, are devel- oped each by 2 centres. Describe the Peculiar Ribs. They are the ist, 2d, loth, nth, and 12th. They respectively present the following peculiarities, viz. — ist Rib, is broad, short, not twisted, has no angle, only one facet on the head \a. but on its upper surface are seen two grooves for the subclavian ar- tery*^ and vein,^ and between them a tubercles for the scale- nus anticus muscle. 2d Rib, is not twisted, its tuber- osity and angle are very close together, and its upper surface presents rough surfaces for the serratus magnus and scalenus posticus muscles. 40 ANATOMY. jotk Rib, has but one facet on its head. iiih Rib, has no neck, no tuberosity, and but one facet on its head. I2th Rib, has neither neck, angle, tuberosity nor groove, and but one facet THE PELVIS. Describe the Pelvis. It is formed by the sacrum, coccyx, and two ossa Innominata, and is divided into, — \\\& false pelvis, comprising the upper and expanded portion, — and the true pelvis, below the ilio-pectineal line. The false pelvis corresponds to the iliac fossae, and is marked by its walls being deficient anteriorly between the iliac borders, and posteriorly between the sacrum and the posterior iliac spines. The true pelvis has a — Brim, or inlet, bounded in front by the crest and spine of the pubes, benind by the promontory of the sacrum, laterally by the ilio-pectineal line, its axis corresponds to a line from the umbilicus to the middle of the coccyx. Its average diameters in the female are, — 4 inches antero-posteriorly,^ over 5 inches transversely,' under 5 inches obliquely.' In the male each of these measurements is about P^«- »9- Yz an inch less. Cavity, is a short curved canal, connecting the brim with the outlet. In nont its depth is about i>'^' inch, posteriorly 4 to 4^4 inches in the female, 4^ to 5^ inches in the male. Its diameter is about 4^" inches in the female, 4^^ inches in the male, all around. Outlet, is bounded by the pubic arch above, the tip of the coccyx behind, and the tuberosities of the ischii laterally. Its axis, if prolonged, would touch the promontory of the sacrum. Its diameters in the female are each about 4^4!' inches, in the male about 3^ inches. State the chief differences between the male and female pelves. The male pelvis is marked by strength of the bones, prominence of the muscular impres- sions, a deep and narrow cavity, and large obturator foramina. Th.Q female pel- z/zVhas lighter bones, broader iliac fossae, the spines being further apart, greater diameters at every point, the sacrum less curved, and the pubic arch wider. Describe the Sacrum. The '* sacred bone " is triangular, curved, with its convexity backwards, and is situated base upwards between the ossa innominata, forming with the coccyx the posterior wall of the pelvis. The bone is formed by the coalescence of 5 vertebrae, and presents the following points, viz — THE PELVIS. 41 Fig. 20. ^ Ridges,^ transversely across both surfaces, mark the union of its original segments. 8 Anterior Sacral Foramina, for the anterior sacral nerves. 8 Grooves^ shallow and broad, for the aforesaid nerves. Promontory, at its junction with the last lumbar vertebrae. 8 Posterior Sacral Foramina, for the posterior sacral nerves. Tubercles^ representing the spinous processes of the segments. Groove, posteriorly, on each side of the spinous tubercles. 2 Cornua, at the posterior inferior portion of the bone. Auricular Surface^ on each side, articulates with the ilium. Notch, laterally and inferiorly, for the 5th sacral nerve. Base^ has all the characteristics of the lumbar vertebrae, with the last of which it articulates. Apex}^ has an oval surface for articulation with the coccyx. Sacral Canal, the continuation of the spinal, is incomplete posteriorly at its lower end. It transmits the Cauda Equina ; into it open the sacral fora- mina laterally. Fig. 21. Describe the Coccyx. It consists of 4 or 5 rudimentary vertebrae coalesced into a triangular bone, the base^ of which articulates with the apex of the sacrum. Its posterior surface is rough for muscles and liga- ments, its anterior surface is smooth and marked by ridges at the junction of its constituent vertebrae. It presents the fol- lowing points. — 2 Cornua^ superiorly, articulating with the sacral cornua to form foramina for the 5th sacral nerves. Apex, is sometimes bifid and turned to one side. Describe the Ossa Innominata. The unnamed bones are placed one on each side of the osseous pelvis, and are each formed by the union, about puberty, of 3 bones, — the ilium, ischium, and pubes. The innominate bone as a whole presents the following points, viz. — Acetabulum, or cotyloid cavity, receives the head of the femur. It is situ- ated at the junction of the 3 bones, the ilium and ischium each forming about two-fifths, and the pubes one-fifth of it. A depression in its centre lodges a mass of fat containing vessels for the nourishment of the synovial 4* 42 ANATOMY. membrane. The Cotyloid Notch is a deficiency in its lower anterioi margin, transmitting nutrient vessels to the joint ; to the edges of the notch is attached the ligamentum teres, and it is bridged over by the transverse ligament, a continuation of the cotyloid ligament which surmounts the brim of the acetabulum. Obturator^ or Thyroid Foramen^ on the anterior surface between the pubes and ischium, large and oval in the male, small and triangular in the female ; is closed by the obturator membrane, except above where the obturator nerves and vessels pass through it. Describe the Ilium. It is the superior part of the innominate bone, and presents the following points, viz. — Crest} along its upper border, having an outer and inner lip for muscular attachment, and ending in the superior spines. Anterior Superior Spine} to which is attached Fig- 22. the sartorius and tensor vaginas femoris mus- cles, and Poupart's ligament. Anterior Inferior Spine} for the straight tendon of the rectus femoris. Notch, between the above-named spines, trans- mitting the external cutaneous nerve, and lodging some fibres of the sartorius. Posterior Superior Spine}^ for the attachment of the erector spinse muscle, and the oblique part of the sacro-sciatic ligament. Posterior Inferior Spi?te}'^ for the great sacro- sciatic ligament. Great Sacro-sciatic Notch}^ below the last-named spine, transmits the great sciatic, superior gluteal, and pudic nerves, the pyriformis muscle, and the sciatic, pudic, and gluteal vessels, and a nerve supplying the obturator externus muscle. Curved Lines}^ superior middle and inferior, on the outer surface of the bone, from the spaces between which arise the glutei muscles. Groove, above the acetabulum, for the reflected tendon of the rectus femoris muscle. Linea Ilio-pectinea, in part ; on the inner surface, above which is a smooth surface, the Venter of the Ilium. Auricular Surface}^ rough, articulates with the sacrum. Describe the Ischium. It is the lowermost portion of the innominate bone, and presents the following points, viz. — Body^ forms two-fifths of the acetabulum, and the external margin of the BONES OF THE SHOULDER 43 obturator foramen ; on it is a broad groove for the tendon of the obturator externus muscle. Its posterior margin assists in forming the great sacro- sciatic notch. Spine^^ for the gemellus superior, coccygeus, and levator ani muscles, and the lesser sacro-sciatic ligament. Lesser Sacro-sciatic Notch}^ below the spine, transmits the obturator muscle, its nerve, and the pudic vessels and nerve as they re-enter the pelvis, hav- ing crossed the spine of the ischium. The sacro-sciatic notches are con- verted into foramina by the sacro-sciatic ligaments; the greater notch by the lesser ligament, the lesser notch by the greater ligament. Tuberosity}'^ the lowest and most prominent part, gives attachment to the greater sacro-sciatic ligament, and to several muscles. On it one rests when sitting. Ascending Ramus, bounds the obturator foramen inferiorly, articulates with the descending ramus of the pubes, and gives attachment to the obturator membrane and several muscles. Describe the Pubes. The pubic or pectineal bone forms the anterior portion of the innominate. It presents the following, viz. — Body, lies between the rami, with its fellow forms the Symphysis, giving origin to several muscles and ligaments. Crest,^ is the upper part of the body, terminates externally in the Spine, and internally in the Angle. Spine, affords attachment to one end of Poupart's ligament. Linea Iliopectinea, in part; gives attachment to the conjoined tendon, Gim- bernat's ligament, and the triangular ligament. Horizontal Ramus, forms part of the brim of the pelvis, of the margin of the obturator foramen, and of the acetabulum. On its under surface is a groove for the obturator vessels and nerve. Pectineal Eminence^ gives attachment to the psoas parvus muscle. Descending Ramus}"^ flat and thin, joins the ascending ramus of the ischium, and bounds the obturator foramen internally. What Muscles are attached to the Os Innominatum ? 36, comprising those of the abdomen, thigh, perineum, floor of the pelvis, and rotators of the hip-joint. BONES OF THE UPPER EXTREMITY. THE SHOULDER. What Bones form the Shoulder ? The clavicle and scapula connecting the arm with the trunk, and in this respect homologous to the innominate bone ia the lower part of the body. 44 ANATOMY. Describe the Clavicle. The collar- or key-bone, is a short bone by struct- ure, having no medullary canal; and is curved like the letter f, its inner two-thirds being cylindrical, and convex anteriorly ; its outer third flattened, and concave anteriorly. It is placed horizontally between the sternum and the scapula, and is the most elastic bone in the body. It presents, from within outwards, the following points, viz. — Facets y for articulation with the sternum and the cartilage of the ist rib, at its sternal end. Impression for the rhomboid, or costo-clavicular ligament. Groove, on the lower surface, for the subclavius muscle. Tubercle, for the conoid part of the costo-clavicular ligament. Oblique Line, for the trapezoid part of the same ligament. Facety on the acromial end, for articulation with the scapula. Nutrient Foramen, in the subclavian groove. Describe the Scapula. The shoulder-blade is a large, flat, and triangular bone, situated on the posterior and lateral portion of the thorax, from the 2d rib to the 7th, inclusive. The Venter, or anterior surface, presents from within outwards, — Ridges, giving attachment to the subscapularis muscle. Marginal Surface, along the inner border, for the attachment of the serratus magnus muscle. Subscapular Fossa, and Angle, for the subscapularis muscle. The Dorsum, or posterior surface, presents the following, viz. — Spine, a bony ridge, which affords attachment to the trapezius and deltoid muscles, and ends in the acromion process. Supraspinous Fossa, above the spine, for the supraspinatus muscle. Infraspinous Fossa, below the spine, larger than the supraspinous, convex at its centre, lodges the infraspinatus muscle, and the nutrient foramen. Marginal Surface, along the external border, to which are attached the teres minor muscle above, the teres major below, and sometimes a few fibres of the latissimus dorsi at the lower angle. Groove crossing the margin, for the dorsalis scapulae vessels. Smooth Surface, behind the root of the spine, over which the trapezius muscle glides. The Acromion process, or " summit of the shoulder," extends from the spine, and projects over the glenoid cavity, articulating with the clavicle by an oval facet. It affords attachment to the deltoid and trapezius muscles, and by its apex to the coraco-acromial ligament. The Coracoid process, or " crow's beak," projects from the upper border and neck of the bone over the inner and upper part of the glenoid cavity. BONES OF THE ARM. 45 Into it is inserted i muscle, the pectoralis minor; the coraco-brachialis, and the short head of the biceps arise from it by a common tendon ; and 3 ligaments are attached to it, — the conoid, trapezoid, and coraco-acromial. The Superior Border presents the — Suprascapular Notch, converted into a foramen for the suprascapular nerve by the transverse ligament, over which passes the suprascapular artery. The omo-hyoid muscle is attached to the border just internal to the notch. The Axillary Border is the thickest, and presents a — Rough Surface, for the long head of the triceps muscle, just below the glenoid cavity. Groove, the origin of a part of the subscapularis muscle. The Vertebral Border is the longest, and presents an — Anterior Lip, for the attachment of the serratus magnus. Posterior Lip, for the supra- and infra-spinatus muscles. Interspace, between the lips, for the levator anguli scapulae, the rhomboideus minor, and the fibrous arch of the rhomboideus major muscles. Other points of interest on the bone are the — Superior Angle, aflTords attachment to part of the serratus magnus, levator anguli scapulae, and supra-spinatus muscles. Inferior Angle, affords attachment to part of the serratus magnus and teres major muscles, and occasionally to a few fibres of the latissimus dorsi. Glenoid Cavity, at the external angle or head of the bone, a shallow cavity for the reception of the head of the humerus. It is deepened by the glenoid ligament which is attached around its margin ; and at its upper part gives origin to the long head of the biceps flexor cubiti muscle. Neck, is the contracted part of the bone behind the glenoid cavity ; from it arises the anterior root of the coracoid process. THE ARM. Describe the Humerus. It is the only bone in the arm, and articulates with the scapula above, and with the ulna and radius below. It presents the toUowing points, viz. — Head,b is nearly hemispherical, and smooth for articulation with a gle- noid cavity of the scapula. Anatomical Neck,c is a constriction in the bone, just below the head, for the attachment of the capsular ligament. Greater Tuberosity,^ has 3 small facets for the insertions of the supra- spinatus, infraspinatus, and teres minor muscles. 46 ANATOMY. Fig. 23. Lesser Tuberosity,' on the inner side of the bone, gives insertion to the subscapularis muscle. Bicipital Groove,/ lies vertically between the tuberosities for the upper third of the bone, and lodges the tendon of the long head of the biceps flexor cubiti. Into its inner or posterior lip h are inserted the teres major and latissimus dorsi muscles, while its outer or anterior lip^ receives the in- sertion of the tendon of the pectoralis major, which covers the groove. Surgical Neck, is situated immediately below the tuberosi- ties, and is a slight constriction in the upper part of the shaft. Shaft,^ is cylindrical above, prismatic and flattened below. Rough Surfaccyi for the insertion of the deltoid, muscle, about the middle of the external surface of the shaft. Musculo-spiral Groove, lodging the musculo-spiral nerve, and the superior profunda artery, is situated on the pos- terior surface of the shaft, separating the origins of the outer and inner heads of the triceps muscle. ?||fl, Orifice J of the nutrient canal, about the middle of the shaft. Condyloid Ridges op internal and external, arising from the respective condyles, extending upwards along the shaft. External Condyle,"^ gives attachment to the external lateral ligament and the extensor and supinator group of muscles. Internal Condyle,^ lower and more prominent than the other, gives attachment to the internal lateral ligament and the flexor and pronator group of muscles of the fore-arm. Radial Head,k forms the external part of the inferior articular surface ; for articulation with the radius. Trochlear Suifiace,l articulates with the greater sigmoid cavity of the ulna ; is a deep depression between two borders, and extends from the anterior to the posterior surface of the bone. Coronoid Fossa,, ball-and-socket joint ; Ginglymus,\i\xi^'om the inner surface of the tuberosity of the ischium, the crus penis, and pubic ramus, — into the crus penis laterally and inferiorly. Action, to maintain erection. Net^e, perineal. Transversus Perinei,-^ from the ascending ramus of the ischium, — into the central tendon of the perineum. Action, to drav^^ tense the central tendon. A^erve, perineal. Levator An\,^from the body and ramus of the pubes posteriorly, pelvic fascia, and the spine of the ischium, — into the tendinous centre of the perineum, sides of the rectum (and vagina), apex of the coccyx, and a fibrous raphe extending from the coccyx to the anus. Action, to support the lovs^er end of the rectum and vagina and the bladder, and assist in forming the floor of the pelvis. Nei-ves, inferior hemorrhoidal and 4th sacral. Compressor Urethrae, from the upper part of the ramus of the pubes, — into its fellow^ of the opposite side after encircling the membranous portion of th» urethra. Action, stop-cock muscle. Nerve, perineal. MUSCLES OF THE SHOULDER AND ARM. 85 Coccygeus,^/;--^?;^ the spine of the ischium and the lesser sacro-sciatic liga- ment, — into the margin of the coccyx and the side'of the last sacral segment. Action, to support the coccyx, and close the outlet of the pelvis posteriorly. Nerve, 5th sacral, anterior division. Sphincter Vaginae (in the female), fj'om the central tendon of the perineum, — into the corpora cavernosa and body of the clitoris. Represents the accel- erator urinae of the male. Erector Clitoridis (in the female), replaces the erector penis. MUSCLES OF THE SHOULDER AND ARM. Pectoralis Major, /r^z?? the sternal one-half of the clavicle, by an aponeu- rosis from the front of the sternum as low as the 6th or 7th rib, the cartilages of all the true ribs, and the aponeurosis of the external oblique, — the fibres converge, cross and are inserted by a flat tendon into the external bicipital ridge of the humerus, having crossed the bicipital groove. Action, to draw the arm forwards and downwards ; also to elevate the ribs in forced inspira- tion. Nerves, anterior thoracic. Pectoralis Miuov^ from the 3d, 4th, and 5th ribs, and the intercostal aponeu- rosis, — inro the coracoid process of the scapula. Action, to depress the point of the shoulder, also to elevate the ribs in forced inspiration. Nerves, anterior thoracic. SvhcXsiw'wxs, from the cartilage of the 1st rib, — into the under surface of the clavicle, in a groove about its middle 3d. Action, to draw the clavicle downwards. Nerve, a branch from the 5th and 6th cervical. Serratus Magnus, by 9 digitations/r^pw the 8 upper ribs (the 2d rib having 2) and from the intercostal aponeurosis, — into the whole length of the inner margin of the posterior border of the scapula. Action, to elevate the rihs in inspiration, also to raise the point of the shoulder. In lower animals the great sling-muscle, slinging the body between the upper extremities. Nerve, posterior thoracic. Deltoid, /rc';^ the outer one-third of the anterior and superior surfaces of the clavicle, the outer margin and upper surface of the acromion, and the whole lower border of the spine of the scapula, — into a prominence on the outer side of the shaft of the humerus, about its middle. Action, to raise the arm. Nerve, circumflex. Subscapularis, /rcw the inner two-thirds of the subscapular fossa, — into the lesser tuberosity of the humerus. Action, to rotate the head of the humerus inwards. Nerves, subscapular. Supra-spinatus,yr(7w the inner two-thirds of the supra-spinous fossa, — intf the upper facet of the greater tuberosity of the humerus. Action, to sup- port the shoulder-joint, and to raise the arm. Nerve ^ supra-scapular. 8 86 ANATOMY. Fig. 44. Infra-spinatus, frotn the inner two-thirds of the infra-spinous fossa, — inta the middle facet on the* greater tuberosity of the humerus. Action, to rotate the humerus outwards. Nerve, supra-scapular. Teres Minor, from the upper two-thirds of the dorsal surface of the axillary border of the scapula, — into the lowest facet on the greater tuberosity of the humerus, and the bone below. Actioji, to rotate the humerus outwards. Nerve, circumflex. Teres Major, from the dorsal aspect of the inferior angle of the scapula, — into the internal bicipital ridge of the humerus. Action, to assist the latis- simus dorsi. Nerve, subscapular, Coraco-brachialis," /rcw the apex of the coracoid process^ of the scapula, — into a ridge on the inner side of the shaft of the humerus, about its middle. Action, elevates the humerus forwards and inwards. Nerve, mus- culo-cutaneous, which perforates this muscle. Bicepses (Biceps Flexor Cubiti). Long head^ from the upper margin of the glenoid cavity, short head'^'^ from the apex of the coracoid process,^ in common with the coraco-brachi- alis, — into the back of the tuberosity of the radius, and the fascia of the forearm.^o Action, to flex and supinate the forearm, and to make tense its fascia. Nerve, the musculo- cutaneous. Brachialis Anti^'cus,^^ from the lower half of the shaft of the humerus anteriorly and later- ally, embracing the insertion of the deltoid,^ — into the base of the coronoid process of the ulna.19 Action, a flexor of the forearm. Nerves, musculo-cutaneous and musculo-spiral. Tricepsifi (Triceps Extensor Cubiti), by three heads, the outer and inner from the posterior surface of the shaft of the humerus, the outer above, the inner below the musculo-spiral groove; the middle or long head from a de- pression below the glenoid cavity of the scapula, — into the upper end of the olecranon process of the ulna. Action, to extend the forearm Nerve, musculo-spiral. MUSCLES OF THE FOREARM. 87 Subanconeus, from the humerus above the olecranon fossa, — into the poste- rior ligament of the elbow-joint. Action^ probably a tensor of the ligament Nerve^ musculo-spiral. MUSCLES OF THE FOREARM. Muscles of the forearm (20), arranged in groups of five and threes. (Pancoast.j Anteriorly, 5 flexors, 2 pronators, i tensor of palmar fascia : — Flexor Carpi Radialis. Pronator Radii Teres. Flexor Carpi Ulnaris. Pronator Quadratus. Flexor Longus Pollicis. Palmaris Longus. Flexor Sublimis Digitorum Perforatus Manis. Flexor Profundus Digitoru7?i Perforans Manis. Posteriorly (12), in 4 sets of threes: — Supinator Longus. Extensor Indicis. Extensor Carpi Radialis Longior. Extensor Communis Digitorum, Extensor Carpi Radialis Brevior, Extensor Minimi Digiti. Extensor Ossis Metacarpi Pollicis. Extensor Carpi Ulnaris. Extensor Primi Internodii Pollicis. Anconeus. Extensor Secundi Internodii Pollicis. Supinator Brcvis. Pronator Radii Teres,* by 2 heads, one from above the internal condyle of the humerus, the common tendon, fascia, and the intermuscular septum ; the other from the inner side of the coronoid process of the ulna, — into a rough ridge on the outer side of the shaft of the radius, about its middle. Action^ to pronate the hand. Nerve, median, which passes between the 2 heads of the muscle. Flexor Carpi Radialis,5yr^»? the internal condyle by the common tendon, the fascia, and intermuscular septa, — into the base of the metacarpal bone of the index finger. Action, to flex the wrist. Nerve, median. Palmaris Longus,syrf»/ the same origin as the flexor carpi radialis, — ijito the annular ligament and the palmar fascia.* Action, to make the palmar fascia tense. Nerve, median. Flexor Carpi Ulnaris,^ by 2 heads, one from the internal condyle by the common tendon, the other from the inner margin of the olecranon, the upper two-thirds of the posterior border of the ulna, and the intermuscular septum, — into the pisiform bone, the annular ligament, and the base of the 5th metacarpal bone. Action, to flex the wrist. Nerve, ulnar. Flexor Sublimis Digitorum (Perforatus),'' by 3 heads, one from the inner condyle by the common tendon, the internal lateral ligament, and the inter muscular septum; the 2d from the inner side of the coronoid process; the 3d from the oblique line of the radius, — into the lateral margins of the Siecon(( ANATOMY. ^^^- 45 phalanges by 4 tendons which are split for the passage of the deep flexor tendons. Aclion, to flex the second phalanges. Nerve, median. Flexor Profundus Digitorum (Perforans), from the upper two-thirds of the shaft of the ulna, a de- pression on the inner side of the coronoid process, and the interosseous membrane, — into the bases of the last phalanges, by 4 tendons which perforate the tendons of the superficial flexor. Action, to flex the phalanges. Nerves, ulnar, and anterior interosseous. Flexor Longus PoUicis, from the upper two-thirds of the shaft of the radius, and the interosseous membrane, — into the base of the last phalanx of the thumb, which it flexes. Nerve, anterior inter- osseous. Pronator Quadratus, from the oblique line on the lower one-fourth of the ulna, and the internal body of the ulna, — into the lower one-fourth of the ex- ternal border of the shaft of the radius. Action, to pronate the hand. A^erve, anterior interosseous. Supinator Longus,^' from the upper two-thirds of the external condyloid ridge on the humerus, and the intermuscular septum, — into the base of the styloid process of the radius. Action, to supinate the hand. Nerve, musculo-spiral. Extensor Carpi Radialis Longior,^ from the lower one-third of the external condyloid ridge on the humerus, and the intermuscular septum, — info the base of the metacarpal bone of the index finger,^ on its radial side. Action, to extend the wrist. Nerve, musculo-spiral. Extensor Carpi Radialis Brevior,/ from the external condyle by the common tendon, the external lateral ligament, and the intermuscular septa, — into the radial side of the base of the 3d metacarpal bone.i' Action, to extend the wrist. Nerve, posterior interosseous. Extensor Communis Digitorum,'^ from the external condyle by the common tendon, the deep foscia, and the intermuscular septa, — into the 2d and 3d phalanges of all the fingers, by 3 tendons, one of which divides into two. Action^ to extend the fingers. Nerve, posterior interosseous. MUSCLES OF THE FOREARM. 8fi Fig. 46. Extensor Minimi Digiti,i from the common tender and the intermusculai septa, — into the 2d and 3d phalanges of the little finger, with the tendon derived from the common extensor. Action, as named. Nerve, posterior interosseous. Extensor Carpi Ulna.ns,j from the common tendon, the middle one-third of the posterior border of the ulna, and the fascia of the forearm, — into the base of the 5th metacarpal bone. Action, to extend the wrist. Nerve, posterior interosseous. Anconeus,'^ yj-^w the external condyle of the humerus, posteriorly, — itito the side of the olecranon, and upper one-third of the posterior surface of the shaft of the ulna. Action, to extend the foreann. Nerve, the musculo-spiral. Supinator Brevis, from the external condyle of the humerus, the external lateral and orbicular liga- ments, and an oblique line on the ulna, — into the inner surface of the neck of the radius, the outer edge of its bicipital tuberosity, and the oblique line. Action, to supinate the hand. Nerve, posterior in- terosseous, which pierces it. Extensor Ossis Metacarpi PoUicis,^* from the pos- terior surfaces of the shafts of the radius and ulna, and the interosseous ligament, — into the base of the metacarpal bone of the thumb. Action, to extend the thumb. Nerve, posterior interosseous. Extensor Primi Intemodii Pollicis,« from the pos- terior surface of the shaft of the radius and the in- terosseous membrane, — into the base of the 1st phalanx of the thumb. Action, to extend the thumb, interosseous. Nerve ^ posterioi Extensor Secundi Intemodii Pollicis,^ from the shaft of the ulna poste- riorly and the interosseous membrane, — into the base of the last phalanx of the thumb. Action, to extend the thumb. Nerve, posterior inter- osseous. Extensor Indicis, from the shaft of the ulna posteriorly and the interosseous membrane, — into the 2d and 3d phalanges of the index finger with the tendon of the common extensor. Action, to extend the index finger. Neni, posterior interosseous. 8* 90 ANATOMY. FASCIA OF THE HAND. Anterior Annular Ligament, from the pisiform and unciform bones, — u the tuberosity of the scaphoid and the ridge on the trapezium. It is pierced by the tendon of the flexor carpi radialis, and beneath it pass the tendons of the superficial and deep flexors and the flexor longus pollicis, also the median nerve. It is continuous with the palmar fascia and the fascia of the forearm. Posterior Annular Ligament,^ froiii the ulna, cuneiform, and pisiform bones and the palmar fascia, — to the margin of the radius and the ridges on its posterior surface. It has 6 canals for the passage of the extensor tendons, each lined by a synovial membrane. It is continuous with the fascia of the forearm. Palmar Fascia, ensheathes the muscles of the hand, and divides into slips for the four fingers, each slip dividing and forming tendinous arches for the passage of the flexor tendons. MUSCLES OF THE HAND. Abductor Pollicis,^^ from the ridge of the trapezium and annular ligament, — into the radial side of the base of the 1st phalanx of the thumb. Action, to draw the thumb from the median line. Nerve, median. Opponens Pollicis, from the palmar surface of the trapezium and annular ligament, — into the radial side of the metacarpal bone of the thumb, for its whole length. Action, as a flexor ossis metacarpi pollicis. Nerve, median. Flexor Brevis Pollicis,^^ fro7}t the trapezium, annular ligament, trapezoid, os- magnum, base of the 3d metacarpal, and the sheath of the tendon of the flexor carpi radialis, — into both sides of the base of the 1st phalanx of the thumb, by two tendons, each of which has a sesamoid bone in it. Action, to flex the thumb. Nerves, median and ulnar. Adductor Y*o\\ic\s, from the whole palmar surface of the 3d metacarpal bone, — into the ulnar side of the base of the ist phalanx of the thumb, and the internal sesamoid bone. Action, to draw the thumb towards the median line. Nerve, ulnar. Thenar Eminence, or ball of the thumb, is formed by the above-named 4 muscles. The following first 4 form the Hypo-thenar Eminence. Palmaris Brevis,!" from the annular ligament and palmar fascia, — into the skin on the inner border of the palm of the hand. Action, to corrugate the skin of the hand. Nerve, ulnar. Abductor Minimi Digiti, from the pisiform bone and the tendon of the flexor carpi ulnaris, — into the ulnar side of the base of the ist phalanx of the little finger. Action, as named. Nerve,, ulnar. MUSCLES OF THE HIP AND THIGH. 91 Flexor Brevis Minimi "Digitiy/rom the tip of the unciform process and the annular ligament, — inio the base of the 1st phalanx of the little finger, wiih the preceding muscle. Action, as named. Nerve^ ulnar. Opponens Minimi Digiti, from the unciform process and annular ligament, — into the whole ulnar margin of the 5th metacarpal bone. Action^ a flexor of the 5th metacarpal bone. Nerve, ulnar. Lumbricales (4), from the tendons of the deep flexor, — into the expanded tendons of the common extensor, on the dorsi of the phalanges. Action, probably to flex the ist phalanges. Nerves^ median and ulnar. Dorsal Interossei (4), by 2 heads from the adjacent sides of the metacarpal bones, — into the bases of the 1st phalanges of the index, middle, and ring fingers, the middle finger having two. Action, abductors of the fingers from the median line. Nerve, ulnar. Palmar Interossei (3), from the palmar surfaces of the 2d, 4th, and 5th meta- carpal bones, — into the bases of the ist phalanges of the same fingers. Action, adductors of the fingers. Nerve, ulnar. MUSCLES OF THE HIP AND THIGH. * Psoas Magnus," /r<9OT the bodies, transverse processes, and intervertebral substances of the last dorsal and all the lumbar vertebrae, — into the lesser trochanter of the femur, by a common tendon with the iliacus. Action, to flex and rotate the femur outwards, also to flex the trunk and pelvis on the thigh. Nerves, anterior lumbar branches. Psoas Parvus, from the bodies of the last dorsal and first lumbar vertebrae, and the intervertebral substance, — into the ilio-pectineal eminence, and the iliac fascia. Action, when present it is a tensor of the iliac fascia. Nerves, anterior lumbar branches. Iliacus,'® from the iliac fossa, inner margin of the iliac crest, ilio-lumbar ligament, base of the sacrum, anterior spinous processes of the ilium and the notch between them, and from the capsule of the hip-joint, — into the outer side of the tendon of the psoas magnus. Action, the same as the psoas magnus. Nerve, anterior crural. Kascia Lata, the deep fascia of the thigh, extends from Poupart's ligament to the prominent points around the knee-joint, and from the margin of the sacrum and coccyx around the limb to the pubic arch and pectineal line. It sends two strong intermuscular septa down to the linea aspera, and con- tains the Saphenous Opening, which is foitned by the reflected margins of its pubic and iliac portions. Pouparf s Ligament is made by the knife, and is only the line of junction between the aponeurosis of the external oblique 92 ANATOMY. muscle and the fascia lata ; extending from the anterior superior spine of the ilium to the spine of the pubic bone. Fig. 47. Tensor Vaginae Femoris,* from the anterior part o( the outer lip of the iliac crest, and the anterioi superior spinous process, — info the fascia lata later- ally, for one-fourth down the thigh. Action, a tensor of the fascia lata. Nerve, superior gluteal. Sartorius,* from the anterior superior spine of the ilium 2 and half of the notch below it, — into the upper internal surface of the shaft of the tibia. Action, to flex and cross the legs. Nerve, anterior crural. Quadriceps Extensor, includes the rectus, vastus internus and externus, and the crureus muscles. Its tendon contains the patella. Rectus Femoris,^ by two tendons, the Straight from the anterior inferior spine of the ilium, the Reflected from a groove above the brim of the acetabulum, — into the tuberosity of the tibia by the tendon 9 common to this and the next 3 muscles. Action, to extend the leg. Nerve, anterior crural. Vastus Externus,' from the anterior border of the great trochanter and the whole length of the linea aspera, — into tlie tuberosity of the tibia, by the common tendon. Vastus Internus ^ and Crureus are one muscle, arising from the inner lip of the linea aspera and nearly the whole of the shaft of the femur in front and laterally from the trochanters down to within the lower one-fourth of the bone, — into the tuberosity of the tibia by the common extensor tendon. Action, to extend the leg. Nerve, anterior crural. Subcrureus, from the lower part of the femur anteriorly, — into the synovial pouch behind the patella. Action, to draw up the synovial sac. Nerve, anterior crural. QrsicWxs,^^ from the inner margin of the rami of the pubes and ischium, — into the inner surface of the shaft of the tibia below the tuberosity. Action, to flex and adduct the leg. Nerve, obturator. Pectineus,i2 fro7n the ilio-pectineal line, and the bone in front thereof, also from an expansion of Gimbernat's ligament, — into the rough line extending MUSCLES OF THE HIP AND THIGH. from the trochanter minor to the linea aspera. Action, to flex the thigh and rotate it outwards. Nerves^ obturator, accessory obturator, and anterior crural. Adductor Longus,^3/r;« the outer tuberosity of the tibia, the upper three-fourths of the shaft of the fibula anteriorly, interosseous membrane, deep fascia, and intermuscular septa, — into the 2d and 3d phalanges of AV «» 96 ANATOMY. 4 lesser toes, by 4 tendons which pass over the dorsum of the foot, from the outer canal in the anterior annular ligament. Ac- Hon, to extend the lesser toes. N^erve^ anterior tibial Fig. so. Peroneus Tertius^ (Flexor Tarsi Fibularis),/r^//z the. outer lower one-fourth of the fibula, interosseous membrane, and intermuscular septum, — into the base of the 5th metatarsal bone. This muscle is a part of the last named, and passes through the same canal in the annular ligament. Action, to flex the tarsus. Nerve, anterior tibial. Gastrocnemius, by 2 heads from the condyles of the femur, and the supra-condyloid ridges, — unites with the tendon of the soleus to form the tendo Achillis, into the posterior tuberosity of the os calcis. Action, to extend the foot. Nerve, internal popliteal. Soleus, from the head and upper one-half of the shaft of the fibula posteriorly, the oblique line of the tibia, and the tendinous arch, — unites with the tendon of the gastrocnemius as the tendo Achillis (see above). Action, to extend the foot. Nerve, internal popliteal. Plantaris, from the outer bifurcation of tlie linea aspera, and posterior ligament of the knee-joint, by a very long, delicate tendon, — into the posterior surface of the os calcis. Action, to extend the foot. Nerve, internal popliteal. Popliteus,^y>'^/« a depression on the external condyle of the femur, and the posterior ligament of the knee- joint, — into the inner two-thirds of the triangular surface on the shaft of the tibia posteriorly and above the oblique line. Action, to flex the leg- Nerve, internal popliteal. Flexor Longus Pollicis,^ from the lower two-thirds of the shaft of the fibula internally, the interosseous membrane, fascia, and intermuscular septum, — through grooves in the tibia, astragalus, and os calcis, — into the base of the last phalanx of the great toe. Action, to flex the great toe. Nerve, poste- rior tibial. Flexor Longus Digitorum,^ from the shaft of the tibia posteriorly and below the oblique line, and the intermuscular septum, — passes behind the inner malleolus in a groove^^ with the tibialis posticus, — into the bases of FASCIA OF THE FOOT. 91 the last phalanges of the lesser toes by 4 tendons which perforate the tendons of the flexor brevis digitorum. Action, to flex the phalanges and extend the foot. Nerve, posterior tibial. Tibialis Posti^cus,^ by two processes between which pass the anterior tibial vessels, frofn the upper one-half of shaft of the tibia posteriorly, the upper two-thirds of the shaft of the fibula internally, the interosseous membrane, deep fascia, and intermuscular septa, — passes behind the inner malle- olus in a groove ^^ with the long flexor, inio the tuberosity of the scaphoid and internal cuneiform bones. Action, to extend the tarsus, and invert the foot. Nerve, posterior tibial. Peroneus Longus,^" from the head of the fibula and the upper two-thirds of its shaft externally, the deep fascia, and intermuscular septa, — passes behind the outer malleo- lus in a groove with the peroneus brevis, through a groove in the cuboid bone, to the outer side of the base of the 1st metatarsal bone. Action, to extend and evert the foot. Nerve, musculo-cutaneous. Peroneus Brevis,^i from the middle one-third of the shaft of the fibula externally, and the intermuscular septa, — passes behind the external malleolus in a groove with the long peroneal, into the dorsum of the base of the 5th metatarsal bone. Action, to extend the foot. Nerve^ musculo-cutaneous branch of extei-nal popliteal. Fig. 51. FASCIA. OF THE FOOT. Anterior Annular Ligament, consists of vertical and horizontal portions, is attached to the lower ends of the fibula and tibia, the os calcis and the plantar fascia. It contains 5 sheaths lined by synovial membranes for the tendons of the extensor muscles, that of the extensor proprius pollicis pass- ing beneath it, as also the anterior tibial vessels and nerve. Internal Annular Ligament, from the inner malleolus to the os calcis, converting 3 bony grooves into canals lined by synovial membranes for the flexor tendons and the posterior tibial vessels and nerve. External Annular Ligament, from the outer malleolus to the os calcis, binding down the peronei tendons in one synovial sac. Plantar Fascia, the densest in the body, divided into a central and two lateral portions, and attached to the inner tuberosity of the os calcis, divides into 5 processes, i for each toe, and several intermuscular septa. 9 G 98 ANATOMY. MUSCLES OF THE FOOT. Extensor Brevis Digitorum, the only muscle on the dorsum of the foot, arises yr^z?/ the os calcis externally, the astragalo-calcanean and the anterior annular ligaments, — by 4 tendons, I into the ist phalanx of the great toe, and the others into the outer sides of the long extensor tendons of the 2d, 3d, and 4th toes. Action, to extend the toes. Nerve, anterior tibial. Muscles on the sole of the foot (19), by layers: — 1st Layer. 3d Layer. Flexor Brevis Digitorum. Flexor Brevis Pollicis. Flexor Brevis Minimi Digiti. -i Pancoast's Tri, Adductor Pollicis. \ angle, the low- Transversus Pedis. J est in the body. 4th Layer. Inter ossei [4 Dorsal,^ Plantar). Abductor Pollicis,<» from the inner tuberosity of the os calcis, the internal annular ligament, plantar fascia, and intermuscular septum, — into the inner side of the base of the ist phalanx of the great toe. Action, to abduct the great toe. Nerve, internal plantar. Flexor Brevis Digitorum,/ from the inner tuberosity of the os calcis, the plantar fascia and intermuscular septa, — into the sides of the 2d pha- Abductor Pollicis. Abductor Minimi Digiti. 2d Layer. Flexor Accessorius. Lumbricales {4). Fig. 52. langes of the lesser toes by 4 tendons which are perforated for the long flexor tendons. Action, to flex the lesser toes. Nej-ve, internal plantar. Abductor Minimi Digiti,^^ from the outer tuber- osity and under surface of the os calcis, the plantar fascia and the intermuscular septum, — into the base of the 1st phalanx of the little toe with the tendon of its short flexor. Action, to abduct the little toe. Nerve, external plantar. Flexor Accessorius, by 2 heads, froj)i the os calcis and the calcaneo-scaphoid and long plantar ligaments, — into the tendon of the flexor longus digitoi-um. Action, accessory flexor of the toes. Nerve, external plantar. Lumbricales^ [/\),from the long flexor tendons — into the inner side of the second phalanges of the lesser toes. Action, accessory flexors. Nerves, internal plantar to the two internal, external plantar to the others. THE HEART. 9$ Flexor Brevis Pollicis,'^ frotn the cuboid and external cuneiform bones, and the prolonged tendon of the tibialis posticus, — into both sides of the base of the 1st phalanx of the great toe, by 2 portions, of which one blends with the abductor pollicis, the other with the adductor pollicis. Action, to flex the great toe. Nerve, internal plantar. Adductor Pollicis, /r^w the tarsal ends of the three middle metatarsal bones, and the sheath of the tendon of the peroneus longus,— m/(? the base of the 1st phalanx of the great toe, externally. Action, to adduct the great toe. Nerve, external plantar. Flexor Brevis Minimi Digiti,^' from the base of the 5th metatarsal bone and the sheath of the tendon of the peroneus longus, — into the base of the ist phalanx of the little toe externally. Action, to flex the little toe. Nerve, external plantar. Transversus Pedis, from the under surface of the head of the 5th metatarsal bone, and the transverse ligament of the metatarsus, — into the outer side of the 1st phalanx of the great toe, blending with the tendon of the adductor pollicis. Action, to adduct the great toe. Nerve, external plantar. Dorsal Interossei (4), each by two heads /r^w the adjacent sides of two meta- tarsal bones, — into the base of the 1st phalanx of the corresponding toe. Action, to abduct the toes. Nerve, external plantar. Plantar Interossei/ (3), from the shafts of the 3d, 4th, and 5th metatarsal bones, — i^ito the bases of the ist phalanges of the same toes. Action, to adduct the toes towards the median line. Nerve, external plantar. THE HEART. What is the Pericardium "i It is a conical membranous closed sac, con- taining the heart and the roots of the great vessels. It lies behind the sternum and between the pleurae, its apex upwards, its base below and attached to the central tendon of the diaphragm. It is composed of an outer fibrous coat, and an inner serous one ; the latter consisting of two portions, a parietal layer, lining the inner surface of the fibrous coat, and a visceral layer, which is re- flected over the heart and vessels. The serous portion secretes a thin fluid, about I drachm in quantity normally, for the lubrication of its surfaces. The fibrous coat is prolonged on the outer surfaces of the great vessels, except the inferior vena cava, and becomes continuous with the deep layer of the cervical fascia. Describe the Endocardium. It is a serous membrane which lines the inner surface of the heart, forming by its reduplications the cardiac, aortic, and pulmonary valves, and continuous with the lining membrane of the grea' vessels. lOO ANATOMY. Describe the Heart. It is a hollow muscular organ, conoidal in shape, placed obliquely in the chest between the lungs, base upwards, apex towards the left and front, corresponding to the interspace between the 5th and 6th costal cartilages, one inch inside of and two inches below the left nipple. In the adult its size is about 5 inches by 3^^ by 2^, and from 8 to 12 oz. in weight. What are the Cavities of the Heart ? They are 4 in number, an auricle and a ventricle on each side of the heart, separated by a longitudinal muscular septum, and indicated on the external surface of the organ by grooves, named, from their contiguous cavities, as the Auriculo-ventricular Groove trans- versely, and the Inter- Ventricular Groove longitudinally. Describe the Right Auricle. It is larger than the left, can hold about 2 fluidounces, its walls being about i line in thickness. It receives the venous blood by the superior and inferior venae cava; and the coronary sinus, and presents interiorly the following points for examination: — Appendix Auriculw, a conical pouch projecting from the auricle to the front and left, its margins being dentated. Openings of the superior and inferior venae cavse and the coronary sinus, the latter having a valve in two segments. Foramina Thehesii, several minute orifices, the mouths of veins from the substance of the heart. Tubercle of Lower, a very small projection on the right wall, supposed to influence the direction of the blood-current. Eustachian Valve, at the anterior margin of the inferior vena cava; large if*- the foetus, to direct the blood to the foramen ovale. Fossa Ovalis, a depression on the inner wall, and the situation of the foramen ovale in the foetus. Annulus Ovalis, the oval margin of the fossa ovalis. Musculi PectinaU, muscular columns on the inner surface of the appendix and the inner wall of the auricle. Auriculo-ventricular Opening, communicates with the right ventricle, is oval, about an inch broad, surrounded by a fibrous ring, and is guarded by the tricuspid valve. Describe the Right Ventricle. Its form is conical, its cavity containing about 2 fluidounces, its apex above the apex of the heart, and it presents in- teriorly the following, viz. — Tricuspid Valve, consists of 3 triangular segments connected by their base* with the auriculo-ventricular orifice, and by their sides with each other, the largest being on the left side. Chordce Tendince, delicate tendinous cords which connect the margins and lower surfaces of the tricuspid valve with the columnse. THE HEART, 101 ColumtuB Carnea, muscular columns projecting from the surface of the ven- tricle, of which 3 or 4, called Columnce Papillares, give attachment to the chordae tendinae. Semilunar Valves, are 3 in number, and guard the orifice of the pulmonary artery, each about the middle of its free margin has a fibro-cartilaginous nodule, the Corpus Arantii, which more perfectly closes the orifice. Opening of the Pulmonary Artery, at the superior and internal angle of the ventricle, the Conus Arteriosus. It is circular in form, surrounded by a fibrous ring, and is guarded by the semilunar valves. Sinuses of Valsalva, are 3 pouches, one behind each valve, between it and the commencement of the pulmonary artery. Describe the Left Auricle. Its walls are about i}4. lines in thickness, its capacity rather less than 2 fluidounces, has an appendix auriculae, and receives the arterialized blood from the lungs. It presents the following in- ternally : — Openings of the Pulmonary Veins, are 4 in number, sometimes 3, as the two left veins frequently end in a common opening. Left Auriculo-ventricular Opening, is smaller than the right one. Musculi Pectinati, on the inner surface of the appendix. Depression, corresponding to the fossa ovalis in the right auricle. Describe the Left Ventricle. It is longer, thicker, and more coni- cal than the right, projecting towards the posterior aspect. Its walls« are the thickest of those in the heart, being twice as thick as those of the right ventricle. Its interior presents the following : — Aortic Opening, is small and cir- cular, placed in front and to the right of the auriculo-ven- tricular, a segment of the mitral valve being between them. It is surrounded by a fibrous ring, and guarded by semilunar valves. Mitral Valve,c consists of two unequal-sized segments, and is attached to the fibrous ring which surrounds the auriculo-ventricular opening. Its margins are connected with the ventricular walls by Chorda Tendin(B and the coc- cygeal I. The 1st cervical escapes above the ist vertebra, each of the others below the corresponding vertebra through the intervertebral foramina. Each nerve arises by 2 roots, an anterior motor root, and a posterior sensory one, the lattef having a ganglion on it. These unite, and the nerve then divides into 2 branches^ both having motor and sensory fibres. The posterior branches are small and generally unimportant ; they supply the muscles and integument of the back. The anterior branches supply the neck, front, and sides of the trunk, and the extremities, uniting in various regions to form plexuses from which important nerve-trunks originate. How is the Cervical Plexus formed and distributed ? It is formed by the anterior branches of the first 4 cervical nerves, and rests on the levator anguli scapulae and scalenus medius muscles. Its branches (10) comprise 4 superficial to the integument of the head and neck, and the following deep branches, viz. — Phrenic. Communicans Noni. 2 Muscular. 2 Communicating. Describe the Phrenic Nerve. It arises by 3 heads from the 3d, 4th, and 5th cervical, descends across the front of the scalenus anticus, crossing the sub- clavian and internal mammary arteries in the middle mediastinum, and is dis- tributed to the inferior surface of the diaphragm. It is often called the Inter- nal Respiratory Nerve of Bell. It sends filaments to the pericardium and pleura, and communicates with the plexuses of the sympathetic in the abdo- men. Describe the formation and distribution of the Brachial Plexus. It is formed by the union of the 4 lower cervical nerves and the ist dorsal. The 5th, 6th, and 7th unite into one trunk externally to the scalenus medius, as also do the 8th cervical and 1st dorsal behind the same muscle. Below the line of the clavicle both these trunks bifurcate ; the two adjacent branches unite be- hind the axillary artery making the Posterior Cord, and the remaining 2 form the Outer and Inner Cords, referred to the artery. Each of these cords bifur- cates, but the 2 adjacent branches of the outer and inner cords unite over the artery, to form the Median Nerve, leaving 4 other branches, the Ulnar, Mus- culo- cutaneous , Musculospinal, and Circumflex Nerves, the last 2 being de- rived from the posterior cord. The branches of the brachial plexus are as follows, viz. — Above the clavicle are given off 4, the — Communicating, completing the phrenic nerve. Muscular, to the longus colli, scaleni, rhomboidei, and subclavius muscles 12 134 ANATOMY. Posterior, or Long Thoracic, external respiratory nerve of Bell, to the ser«»<- tus magnus, arising from the 5th and 6th cervical. Suprascapular, from the 1st trunk of the plexus, to the scapular muscles. Below the clavicle are 12, the, — 2 Anterior Thoracic, from outer and inner cords to the pectoral muscles. J Subscapular, from the posterior cord, to the subscapularis, teres major> and latissimus dorsi muscles. Circumflex, from the posterior cord, to the muscles and integument of the shoulder, and the shoulder-joint. Musculo-cutaneous, from the outer cord, to the forearm externally, piercing the coraco-brachialis muscle. Internal Cutaneous, from the inner cord, to the arm and forearm. Lesser Internal Cutaneous (nerve of Wrisberg), from the inner cord to the inner side of the arm. Is sometimes wanting, sometimes connected with the intercosto-humeral. Median, from outer and inner cords, passes between the two heads of the pro- nator radii teres, supplying the pronators, flexors, first 2 lumbricales, and the integument of the thumb, 2^ fingers, and the radial side of the palm. Its branches are all in the palm, the — Muscular. Anterior Interosseus. Palmar Cutaneous. Ulnar, from the inner cord, passes between the two heads of the flexor carpi ulnaris at the inner condyle of the humerus, supplying the elbow- and wrist-joints, several muscles, and the palmar and dorsal integument of the little finger and half of the ring finger. Branches are the — 2 Articular. Cutaneous. Superficial Palmar. Muscular. Dorsal. Deep Palmar. Musculo-spiral, from the posterior cord, accompanies the superior profunda artery and vein in the spiral groove of the humerus, and at the external condyle it divides into the radial and posterior interosseus nerves. Its branches are — Muscular. Cutaneous. Radial. Posterior Interosseous. The Radial s,\\^\)\\Qs the outer side and ball of the thumb, and the dorsal integument of 2j4, fingers. The Posterior Interosseus supplies all the muscles on the back of the fore- arm except 3, and also sends a filament to the wrist-joint. "What is the Intercosto-humeral Nerve ? It is the lateral cutaneous branch of the 2d intercostal (anterior branch of the 2d dorsal) ; it pierces the external intercostal muscle and crosses the axilla, joining with a filament from the lesser internal cutaneous (nerve of Wrisberg), and supplying the skin of the upper half of the inside of the arm. THE SPINAL NERVES. 135 Fig. 63. Describe the Lumbar Plexus. It is formed by coromunicating loops from the anterior branches of the first 4 lumbar nerves, in the following manner. From the First lumbar nerve are given off the — IHo-hypogastric, to the abdominal and gluteal regions. Ilio-inguinal, to the inguinal region, and the scrotum. Communicating Loop, to the second lumbar nerve. From the Second lumbar nerve are given off the — External Cutaneous, to the integument of the outside of the thigh. Genito-crural, to the spermatic cord and front of the thigh. Communicating Branch, to the third lumbar nerve. From the Third and Fourth lumbar nerves are given off the following by a branch of origin from each, viz. — Obturator, through the obturator foramen to the ex- ternal obturator and adductor muscles and the hip- and knee-joints. Accessory Obturator (often absent), to the pectineus and hip-joint. Communicating, from the 3d lumbar to the 4th. Communicating, from the 4th lumbar to the 5th. Anterior Crural, which descends through the psoas muscle, and beneath Poupart's ligament to the thigh, where it divides into an anterior and pos- terior division. Its branches are, — To the Iliacus muscle. Long Saphenous. To the Femoral artery. Muscular. Middle and Internal Cutaneous. Articular. Describe the Sacral Plexus.'^ It is formed by the anion of the upper 4 sacral nerves'^ with the 5th lum- bar and a loop from the 4th, the two latter forming the Lumbosacral Cord a It lies upon the pyriformis muscle 4nd gives off the following 5 branches, viz. — Superior Gluteal,^ from the lumbo-sacral cord, sup- plies the glutei and tensor vaginae femoris. Muscular Branches, to the pyriformis, obturator internus, gemelli, and quad* ratus femoris muscles. Pudic,e escapes by the great sacro-sciatic foramen, crosses the ischiatifl 136 ANATOMY. spine, and re-enters the pelvis by the lesser sacro-sciatic foramen, supply ing the perineum, anus, and genitalia. Small Sciatic,/ to the gluteus maximus, and integument of the perineum, scrotum, and back of the thigh and leg. Great Sciatic,s the largest nerve ot the body, and the direct continuation of the sacral plexus, escapes by the great sacro-sciatic foramen, sends an Articular Branch to the hip-joint, Muscular branches to the adductor magnus, semimembranosus, semitendinosus, and biceps muscles, and ter- minates in the External^ and Internali Popliteal nerves, generally about the lower one-third of the thigh. Describe the External Popliteal Nerve. It passes from the bifurcation of the great sciatic along the outer side of the popliteal space, gives off Articular and Cutaneous branches, and about an inch below the head of the fibula it divides into the — Anterior Tibial,^ supplying the extensors, and the integument of the adja- cent sides of the great and 2d toes. Musculo-cutaneous^n by 2 branches (internal and external) to the peroneal muscles, the integument of the ankles, and the dorsal integument and sides of all the toes, except the outer side of the little toe and the ad- joining sides of the great and 2d toes. Describe the Internal Popliteal Nerve. It is the largest of the two, and descends along the middle of the back of the leg, becoming the Posterior Tibialk at the lower border of the popliteus muscle, and dividing into the External and Internal Plantarl below the inner malleolus. Its branches are as follows : — Articular, 3 in number, to the knee-joint. \ Muscular, to the gastrocnemius, soleus, plantaris, and popliteus. External or Short Saphenous,^ formed by a filament from both popliteal nerves, supplies the integument of the little toe and outer side of the foot. Muscular, to the tibialis posticus, flexor longus pollicis, and flexor longus digitorum. Plantar Cutaneous, to the skin of the heel and inner sole of the foot. Internal Plantar, to the inner plantar muscles, sole of the foot, and the plantar integument of the inner 3^ toes. External Plantar, to the external plantar muscles, and the plantar integu- ment of the outer i^ toes. THE SYMPATHETIC NERVE. What is the Sjnnpathetic Nerve ? It consists of a series of ganglia situated on each side of the vertebral column, connected together and to the cerebro- THE SYMPATHETIC NERVE. 137 spinal system by intervening cords, beginning in the ganglion of Ribes on the anterior communicating artery, and ending in the ganglion impar, in front of the coccyx. Name the Ganglia of the S5mnpathetic in the Cranium and its vicinity. They are 9 in number, as follows : — Ganglion of Ribes, on the anterior communicating artery. Ganglion of Laumonier, on the internal carotid artery. Ciliary, or Ophthalmic Ganglion, in the orbital cavity. Sphenopalatine [MeckePs) Ganglion, in the spheno-maxillary fossa. Otic [Arnold's] Ganglion, under the foramen ovale. Submaxillary Ganglion, above the submaxillary gland. Ganglion of Cloquet, in the incisive fossa, on the naso-palatine nerve. Ganglion of Bidder, below the foramen spinosum, on the middle meningeal artery. Ganglion of Bockdalek, on a branch between the spheno-palatine ganglion and the anterior dental nerve at their junction. Describe the Ganglia connected with the 5th Cranial Nerve. There are 4 such, each having a motor, a sensory, and a sympathetic root, viz. — Ciliary, or Ophthalmic Ganglion, is situated in the orbit, between the optic nerve and the external rectus muscle. Its sensory root is derived from the nasal branch of the ophthalmic, its motor root from the 3d nerve, its sympathetic root from the cavernous plexus. Its branches are the short ciliaiy nerves, and are distributed to the ciliary muscle and the iris. Spheno-palatine, or Meckel's Ganglion, is a large ganglion situated in the spheno-maxillary fossa. Its sensory root is derived from the superior maxillary, its motor root from the facial by the Vidian and large petrosal, its sympathetic root from the carotid plexus, by the carotid branch of the Vidian. Its branches are the — Ascending. Middle Palatine. Anterior Palatine. Superior Nasal. Pharyngeal, or Posterior Palatine. Naso-palatine. Pterygo-palatine. Otic Ganglion [Arnold* s), is situated on the inferior maxillary nerve, imme diately below the foramen ovale. Its sensory root is derived from the auriculo-temporal branch of the inferior maxillary; its motor root from the internal pterygoid branch of the same, also from the facial and glosso^ pharyngeal by the small petrosal ; its sympathetic root from the middle meningeal plexus. Its branches are distributed to the tensor palati and tensor tympani muscles. Submaxillary Ganglion, is situated above the submaxillary gland. Its sen- sory root is derived from the gustatory branch of the inferior maxillary, 12* 138 ANATOMY. Fig. 64. its motor root from the facial by the chorda tympani, its sympathetic root from the facial plexus. Its branches are distributed to the submaxillary gland, its duct, and the mucous membrane of the mouth. What Nerves appear on removing the Gasserian Ganglion ? The three Petrosal Ijranches of the 7th nerve (see page 131), lying on the petrous portion of the temporal bone, and communicating with the sympathetic system as follows, viz., the — Large Superficial Petrosal,^ (Great Petrosal),— a branch of the 7th nerve, from its geniculate ganglion, 2 (intu- mescentia gangliformis), which passes through the hiatus Fallopii, and thence through the foramen lacerum medium to the Vidian canal, where it joins the large deep petrosal from the carotid plexus, to form the Vidian nerve, as which it goes to Meckel's ganglion (page 137), forming its motor root. Small Superficial Petrosal,^ (Small Pe- trosal), immediately external to the preceding, going from the geniculate ganglion of the 7th to the otic gan- glion, and lying directly over the tensor tympani muscle. External Superficial Petrosal,'^ (External Petrosal), — going from the 7th to the sympathetic plexus on the middle meningeal artery.^ Describe the Cervical Ganglia. They are 3 in number on each side, of which the superior is the largest, communicate with each other, and are as fol- lows, viz. — Superior Cervical Ganglion^ lies behind the carotid sheath opposite the 2d and 3d cervical vertebras. Its branches are distributed to the carotid, cavernous, and pharyngeal plexuses, and one of its internal branches is the superior cardiac nerve going to the cardiac plexus. Middle Cervical Ganglion^ on the superior thyroid artery, opposite the 5th cervical vertebra, and gives off the middle cardiac nerve to the cardiac plexus, also communicating branches. Inferior Cervical Ganglion^ on the superior intercostal artery, between the neck of the 1st rib and the transverse process of the 7th cervical vertebra. It gives off several communicating branches and the inferior cardiac nerve to the cardiac plexus. THE SYMPATHETIC NERVE. 139 What are the other Ganglia of the Sympathetic ? There are on each side of the vertebral column ii or 12 dorsal ganglia, 4 or 5 lumbar, 5 sacral, besides the single coccygeal Ganglion Inipar in which terminates the double chain. Connected with the viscera are many ganglia, from which branches ramify around the arteries in plexuses named from their locations. Describe the Splanchnic Nerves. They are 3 in number on each side, and are derived from branches of the 6 lower thoracic ganglia, as follows, riz. — Great Splanchnic, from branches of the 6th to the loth, connecting with the upper six, passes through the posterior mediastinum, perforates the crus of the diaphragm, to the semilunar ganglion. Lesser Splanchnic^ from the loth and nth, passes through the diaphragm with the great splanchnic, to the coeliac plexus. Smaller or Renal Splanchnic^ from the last thoracic ganglion, also perforates the diaphragm, and ends in the renal and coeliac plexuses. Describe the Solar Plexus. This plexus, called also the " abdominal brain," is a network of nerves and ganglia, chiefly formed by the splanchnic nerves and the right pneumogastric. It lies behind the stomach, and in front of the aorta and the crura of the diaphragm, surrounding the coeliac axis and the root of the superior mesenteric artery. Its two largest ganglia are the Semilunar Ganglia situated in front of the crura of the diaphragm. From it are derived branches which form Plexuses over most of the abdominal arteries, as follows : — Phrenic. Gastric. Splenic. Renal. Superior Mesenteric. Coeliac. Hepatic. Suprarenal. Spermatic. Inferior Mesenteric. Describe the Carotid and Cavernous Plexuses. They are two plexuses of the sympathetic, situated on the internal carotid artery, the Carotid lying on the outer side of the artery, as it lies by the side of the body of the sphenoid bone ; and the Cavernous being on the inner side of the artery, below its last bend, in the upper portion of the cavernous sinus. The — Carotid Plexus, — is connected by numerous filaments with the 6th nerve " and the Gasserian ganglion, and furnishes the Large Deep Petrosal to unite with the large superficial petrosal of the facial, to form the Vidian nerve ; also the Small Deep Petrosal^ to join the tympanic plexus prob- ably. Cavernous Plexus, — communicates with the 3d and 4th nerves and the ophthalmic division of the 5th, and gives a branch to the Ciliary ganglion in the orbit. 140 ANATOMY. Mention some other Plexuses of the Sympathetic system. They are very numerous ; besides those already mentioned, the most important are the following : — Tympanic Plexus, — described under Nerves of the Tympanum. Meningeal Plexus, on the middle meningeal artery. Facial Plexus, surrounding the facial artery. Cardiac Plexuses, the deep in front of the bifurcation of the trachea, the superficial in front of the right pulmonary artery ; the first named lies behind the arch of the aorta, the latter beneath it. Coronary Plexuses, anterior and posterior, accompanying respectively the left and right coronary arteries. Aortic Plexus, on the sides and front of the aorta between the superior and inferior mesenteric arteries. Hypogastric Plexus, on and between the common iliac arteries ; supplying the viscera of the pelvic cavity. Inferior Hypogastric or Pelvic Plexuses, two in number, one on each side of the rectum and bladder. Their branches are the — Inferior Hemorrhoidal Plexus. Small Cavernous Nerve. Vesical and Prostatic Plexuses. Large Cavernous Nerve. Vaginal Plexus. Uterine Nerve. What is the Vidian Nerve ? It has generally been described as a branch of the spheno-palatine (Meckel's) ganglion (see p. 137), running backwards through the Vidian canal, and dividing into a Petrosal Branch to the P^acial nerve, and a Carotid Branch to the carotid plexus of the Sympathetic. It is now, however, more correctly described as a short nerve of communication, between the Facial and the Sympathetic on the one hand, and the Spheno- palatine Ganglion on the other, supplying that ganglion with its motor and vaso-motor roots. It is formed by the junction of the — Large Superficial Petrosal, Br. of the Facial (p. 138), with the — Large Deep Petrosal, Br. of the Carotid Plexus (p. 140), which occurs in the cartilage filling in the foramen lacerum medium (p. 35). It then enters the Vidian Canal (p. 20), in the pterygoid process of the sphenoid bone, pass- ing through which to finally join the posterior part of the spheno-palatine gan- glion (p. 137). Some filaments, the — Upper Posterior Nasal Branches, — are apparently given off from the Vidian in the canal, to the septum and roof of the nose ; but they are really branches from the ganglion-, bound up in the same sheath with the Vidian nerve. VISCERAL ANATOMY. What is a Viscus ? Viscus, gen. visceris, pi. viscera, is a term which is applied to any internal organ of the body. The Viscera are the organs con- tained in the three great cavities — cranium, thorax and abdomen — with their appendages. Of these the Heart and Brain have been described, with the circulatory and nervous systems respectively. \^See pp. 99, 120; alsG the CoMPEND OF Physiology in this series.] THE DIGESTIVE ORGANS. What is the Alimentary Canal ? A musculo-membranous tube, from 25 to 30 feet in length, extending from the mouth to the anus, lined throughout with mucous membrane, furnished with several accessory organs, and perform- ing the functions of ingestion, digestion, and egestion. Name its Subdivisions. They are the Mouth, Pharynx, (Esophagus, Stomach, Small Intestine (duodenum, jejunum and ileum) and Large Intestine (caecum, colon and rectum). The first three lie above the diaphragm, the rest below it. Name the Accessory Organs of Digestion. They are — the Teeth, Salivary glands (parotid, sub- maxillary, sub-lingual), Liver, Pancreas and Spleen. THE TEETH. What are the Teeth ? They are 32 organs of digestion (20 being tempo- rary, or milk-teeth), situated one-half in each jaw, imbedded in the alveolar processes, and partly surrounded by the Gumsy which are composed of fibrous tissue and covered with mucous membrane. In each half of each jaw there ire — Temporary Teeth (5) — 2 Incisors, i Canine, 2 Milk-molars. Per?nanent Teeth (8) — 2 Incisors, I Canine, 2 Bicuspids, 3 Molars. What are their General Characteristics "> Each tooth presents a — Crcnvn, or Body, — the part seen projecting above the gum. Neck, — the constricted portion between the crown and the fang. Fang, or Root, — imbedded in the alveolus ; and surrounded by the periodental membrane or periosteum lining the alveolus. 141 142 VISCERAL ANATOMY. Fig. 65. Pulp-cavity, — in the interior, opening at the apex of the fang for the entrance of vessels and nerves. State the Characteristics of each class of Teeth. Incisors, or Cutters. — Crown chisel-shaped, beveled posteriorly. Fang single, long, thickest antero -posteriorly. Canines, or Tearers, — Crown thick and conical. Fang longest and thickest of all the teeth, forming a projection on the alveolar arch. The 2 upper canines are the " eye-teeth." Bicuspids, — Crown has 2 cusps. Fang single but grooved deeply, showing a marked tendency to bifurcate. Molars, or Grinders, — Crown large, low and cuboid in shape, has 4 cusps on upper molars, 5 on the lower ones. Fangs multiple, usually 3 on the first two upper molars, 2 on the first two lower ones; the third molar of either jaw, having but one fang, is called the " wisdom tooth," and is the smallest of the three. The 2d or 3d Temporary Molar \s, larger than the first. Describe the Structure of a Tooth. Each consists of — Dentine or Ivory, "^ — composed of tubules sur- rounded by the inter-tubular tissue or Matrix, and opening into the pulp cavity. It resembles compact bone in appearance and in composi- tion, consisting of 28 parts Animal matter and 72 Earthy matter. The Tubules are delicate wavy canals, diameter about ^-^(5" ^^ ^'^ inch, which branch outwardly and anastomose with each other, forming concentric shadings or Schreyer''s Lines. Enamel,^ — covers the crown; consists of very dense tissue, which contains but 3)^ per cent, of animal matter. It is covered by a very delicate epithelial cuticle, Nasmyth's Membrane, which when intact withstands the action of acids. Crusta Petrosa or Cement,'^ — the enamel of the fang; is a layer of true bony tissue, containing lacunae, canaliculi, and Haversian canals. Pulp, — fills the pulp-cavity and is prolonged into the dental tubules; is soft, vascular, and sensitive; and consists of connective and fibrous tissue, THE TEETH. 143 nucleated cells, blood-vessels and nerves. The cells are caudate and anastomose with each other, those situated superficially being termed Odontoblasts. What Arteries and Nerves supply the Teeth ? The Arteries are derived from the inferior dental, and from the alveolar and infraorbital branches of the internal maxillary. The Nerves are derived from the inferior dental branch of the inferior maxillary division of the 5th, and also from the anterior and posterior dental branches of the superior maxillary divisii/ii of the same nerve. When do the Temporary Teeth appear ? Their eruption begins about the 7th month after birth, with the central incisors, and ends with the appearance of the second molars, about the age of two years. The lo\Srer teeth slightly antedate the upper. Their formula is as follows : — Mo. Mo. Ca. In. In. In. In. Ca. Mo. Mo. f Upper... iiiiiiiiii = lo'l (Lower... iiiiiiiiii = loj 24 12 18 9 7 7 9 18 12 24 months. When do the Permanent Teeth appear ? The first molars appear about the end of the 6th year, followed by the incisors about the 7th or 8th year, the bicuspids from the 9th to the loth year, the canines about the iith or 1 2th year, the second molars from the 12th to the 13th year, and the third molars from the 17th to the 25th year. Those of the lower jaw a^-e slightly in advance of the corresponding upper ones. Their formula is as follows : — Wis. Mo. Mo. Bi. Bi. Ca. In. In. In In. Ca. Bi. Bi. Mo. Mo.Wis. I" Upper. iiiiiiiiiiiiiiii = 16'^ \- _______ — ___ — — — __ U2. (^ Lower. iiiiiiiiiiiiiiii = 16) 18 12 6 10 9 II 8 7 7 8 II 9 10 6 12 18 years. What is the greatest Number of Teeth at one time in the jaws, and when ? Forty-eight, namely, all the temporary and permanent teeth except the third molars, — occurring between the 5th and 7th years of age. Describe the Development of the Teeth. They arise from the mucous membrane covering the maxillary arches, in which, about the 6ih foetal week, appears a depression, the Primitive Dental Groove^ from the floor of which arise papillce of mucous membrane to form the pulp of the milk-teeth. In the Follicular Stage^ membranous septa form across the groove, and its margins become thick and prominent. The Saccular Stage extends from the 13th week to the i6th, and is marked first by the projection of the papilloe from the follicles^ next by the growth of the follicular margins, the formation of processes or Opercula thereon, which meet and close in the papillae ; and finally by the closing in of the dental 144 VISCERAL ANATOMY. groove by the union of its margins. A Cavity of Reserve for each tooth is then formed by the closure of the secondary dental groove, from the floor of which another papilla arises to form the germ of the permanent tooth. The dental pulps now take the forms of teeth, a thin lamina of dentine appears and increases from without inward, the enamel organ and membrane are formed, and when calcification has advanced sufficiently, the pressure of the teeth causes the absorption of the gum above them, the septa ossify and the eruption of the teeth occurs. The Cement is formed from the periodental membrane, at a later period of life. THE MOUTH. Describe the Mouth. It is an oval cavity formed by the lips, cheeks, jaws, palate and, tongue, forming the superior portion of the alimentary canal, and opening posteriorly into the pharynx by the fauces. It presents the teeth (already described), the tongue (to be described), and also the — Hard Palate, formed by the palate processes of the superior maxillary and palate bones, and covered with mucous membrane ; forms the roof of the mouth. Soft Palate, formed by 5 muscles on each side, viz., the levator palati, tensor palati, palato-glossus, palato-pharyngeus, and the azygos uvulae;— the latter forming with its fellow the Uvula, a descending muscular projection. Anterior Pillars of the Fauces, — arch downwards and forwards to the base of the tongue, and contain the palato glossi muscles. Posterior Pillars of the Fauces,— zxch. downwards and backwards to the sides of the pharynx, and contain the palato-pharyngei muscles. isthmus Faucium, — the space bounded by the pillars, the free border of the palate, and the base of the tongue. Tonsils, — are small, elongated, glandular bodies, situate done on each side of the fauces, between the anterior and posterior pillars. Each has 12 or 15 Fig. 66. openings on its surface leading to follicular depressions within the gland, and lies close to the inter- nal carotid artery. Openings of Siena's Ducts, — from the parotid glands, are situated internally one on each cheek, opposite the 2d upper molar tooth. Openings of Wharton's Ducts, — from the sub-maxillary glands, one at each side of the frenum of the tongue. THE TONGUE. 145 Openings of the Ducts of Rivinus, — 8 to i8 on each side from the sublingual glands, near the frenum of the tongue. The longest is the Duct of Bartholine, which opens into the duct of Wharton, Where are the Salivary Glands ? The Parotid Gland'^ lies below and in front of the external ear, — the Sub -maxillary^ and Sub-lingual^ Glands lie in the corresponding fossae on the inner surface of the inferior maxillary bone. [See Fig. 66.] Describe the Tongue. The tongue consists of extrinsic and intrinsic muscles, a hyoglossal membrane and a mucous membrane, a median fibrous septum, vessels and nerves. Its Base is attached to the hyoid bone, the epi- glottis, the soft palate and the pharynx. Its Under Surface \^ attached to the hyoid bone and the inferior maxillary. Its mucous membrane is reflected over the floor of the mouth to the inner surface of the gums, forming in front a fold, the Frenum Lingutz. The Tongue presents — Filiform Papilla;, along its sides, closely packed in rows. Fungiform Papillce,"^ scattered over the anterior two-thirds of its dorsum. Circumvallate Papillcs,^ 7 to 12 in number, in two rows, forming a V at the base of the tongue, meeting at the Foramen Ccecum, which contains the central papilla. Fig. 67. Follicular Glands, posteriorly to the circum- vallate papillae. Racemose Glands, over the dorsum, sides, and under surface. Beneath the tip they form two small oblong m.asses. Extrinsic Muscles, are the stylo-, hyo-, genio- hyo-, and palato-glossus muscles. [See pp. 73, 74-] Intrinsic Muscles, are the several fibres of the lingualis muscle, — superior, inferior, trans- verse and perpendicular. Name the Arteries of the Tongue. They are the — /.ingual, branch of the external carotid, — with its branches, the — Dorsal is linguae. Sub-lingual. Ranine. Sub-mental, branch of the facial, — anastomoses with the sub-lingual. Ascending Pharyngeal, branch of the external carotid, — sends some small branches to the pharynx and tongue. J 148 VISCERAL ANATOMY. What Nerves are distributed to the Tongue ? The — Gustatory Branch of the §th, — to the mucous membrane of the sides and anterior two- thirds of the tongue, endowing it with general sensibiHty. Chorda Tympani Branch of the yth, — ^joins the gustatory, and is distributed to the same region, being the nerve of taste for the anterior two-thirds of the tongue. Lingual Branches of the gth or Glosso-pharyngeal, — to the mucous membrane of the base and sides of the tongue, being the nerve of taste for its poste- rior third. Hypoglossal, or 12th, — to the intrinsic and extrinsic muscles of the tongue, being its nerve of motion. Superior Laryngeal Branch of the loth or Pneumogastric, — sends a few fibres to the base of the tongue from its internal branch. What special Anatomical Features are presented by the Mouth? They are as follows, viz. — the — Hamular Process of the Sphenoid Bone, — may be felt behind the last upper molar tooth ; also the Internal Pterygoid Plate, and part of the Pterygoid Fossa. Coronoid Process,— o{ the lower jaw, its anterior border. Posterior Palatine Artery, — at inner side of the last upper molar tooth, and in front of the hamular process. Gustatory Nerve, — very near the last lower molar tooth. Pierygo-maxillary Ligament, — felt as a fold posteriorly to the last lower molar tooth. THE PHARYNX. Describe the Pharynx. It is a conical, musculo-membranous bag, about 4^ inches long, hung base up from the basilar process of the occipital bone, and extending to the lower border of the cricoid cartilage posteriorly, or the 5th cervical vertebra, where it becomes continuous with the oesophagus. ^ It forms the part of the alimentary canal which lies behind the mouth, being incomplete in front. What are its Relations ? It is connected with — Posteriorly, — the longus colli and recti capitis antici muscles, and by loose areolar tissue to the first 5 cervical vertebras. Laterally, — the styloid processes and their muscles, the pterygoid muscles, the internal carotid arteries, the internal jugular vein, the 8th, 9th, and the sympathetic nerves. Near its Apex, — the lobes of the thyroid gland, the common carotid and lingual arteries, the sterno-hyoid muscle, and the lingual nerves. THE CESOPHAGUS. 147 What are its Anterior Attachments ? The internal pterygoid plate, pterygo maxillary ligament, lower jaw, base of the tongue, cor- nua of the hyoid bone, stylo-hyoid ligament, thyroid and cricoid cartilages of the larynx. Name the Openings into the Pharynx. They are 7, viz. — 2 Posterior Nares, ^ , Larynx. 2 Eustachian Tubes. (Esophagus. Describe its Structure. The pharynx is composed of 3 coats, — a mucous, a muscular and a fibrous, the latter lying between the other two, and sometimes called the Pharyn- geal Aponeurosis. The mucous coat is covered with ciliated columnar epithelium above the level of the floor of the nares — below that level by squamous epithelium ; and contains simple follicular glands, also compound folli- cular and racemose glands, the latter being most numerous in the upper part, between the two Eustachian tubes. Name its Muscles, Arteries and Nerves. Its— Muscles, 5, — are the Superior, Middle and Inferior Constrictors, Stylo-pharyngeus, and Palato- Pharyngeus. [See pages 73, 74.] Arteries number 4, as follows, — Superior Thyroid Branches. ") Branches of Ascending Pharyngeal. / Ext. Carotid. Pterygo-palatine. 1 ^^ , r , -r , ,, .„ T^ 1 • T^ , • >- Branches of the Internal Maxillary. Descendmg Palatme. J ^ Nerves, — Branches of the Pharyngeal Plexus, which is formed by the pharyngeal branches of the pneumogastric, glosso-pharyngeal, superior laryngeal, and superior cervical ganglion of the sympathetic. THE CESOPHAGUS. Describe the (Esophagus. It is a musculo-membranous tube, about p inches long, extending from the 5th cervical vertebra and the lower border of the cricoid cartilage of the larynx, through the oesophageal opening in the 148 VISCERAL ANATOMY. diaphragm to the cardiac orifice of the stomach, opposite the 9th dorsal vertebra, where it terminates. It lies in the neck, between the trachea and the vertebral column, resting in part on the longus colli muscle; then inclining to the left side it reaches the posterior mediastinum behind the left bronchus. Describe its Structure. The CEsophagus has three coats, a — Mucous, — in thick longitudinal folds, containing compound racemose glands, and covered with a thick layer of squamous epithelium. Cellular, — forms a loose connection between the other two coats, and con- tains the CESophageal vessels. Muscular, — having longitudinal fibres externally, circular fibres internally, which are continuous with the fibres of the stomach below, and with those of the inferior constrictor muscle above. Name its Vessels and Nerves. The CEsophageal — Arteries^ are chiefly branches from the thoracic aorta. VeinSf empty into the vena azygos minor. Nerves, are branches of the pneumogastric and the cervical sympathetic, form- ing the CEsophageal Plexus. THE STOMACH. Describe the Stomach. It is the principal organ of digestion, pyriform in shape, of musculo-membranous structure, about 12 inches long by 4 inches in average diameter, held in position by the lesser omentum, and situated diagonally across the upper abdomen, in the epigastric and right and left hypo- chondriac regions, above the transverse colon, below the liver and diaphragm. It presents for examination a — Fundus or Splenic End, c — connected to the spleen by the gastro-splenic omentum. (See under Peritoneum.) Pylorus or Lesser End, — lies in contact with the anterior wall of the abdomen, the under surface of the liver, and the neck of the gall- bladder, its position being near the end of the carti- lage of the 8th rib. Greater Curvature,^ — is con- vex, and is connected to the colon by the gastro-colic omentum. (See under Peri- toneum.) THE STOMACH. 149 Lesser Curvature, i — is concave, and connected to the liver by the gastro- hepatic omentum, and to the diaphragm by the gastro- phrenic ligament. (Esophageal Orifice, ^ — is situated between the fundus and the lesser curva- ture. It is funnel-shaped, and the highest part of the organ. Pyloric Orifice, k — opens into the duodenum, ^and is guarded by the circu- lar muscular fibres of the pylorus, w^hich are aggregated into a circular ring, projecting into the cavity, and with its covering fold of mucous membrane, forming the Pyloric Valve. Describe its Structure. The Stomach has 3 coats, a — Mucous Coat, g — lined with columnar non-ciliated epithelium, covered with polygonal Alveoli, j^q of an inch in diameter, containing the orifices of the Gastric Follicles. When the stomach is contracted the mucous membrane lies in longitudinal folds or Rugce, ^ one of which aids in forming the valve at the pyloric orifice. Cellular or Sub-mucous Coat, — contains the gastric vessels. Muscular coat,f—cor&^s^.% of longitudinal, circular, and oblique fibres. The Longitudinal are continuous with those of the oesophagus and small intes- tine, and are the most superficial. The Circular lie deeper, and over the whole organ ; they form a sphincter valve around the pyloric orifice. (See Fig. 70. above.) The Oblique Fibres lie deepest, forming two sets around the oesophageal open- ing, in continuation of the circular fibres of the oesophagus. The Serous Invest- ment of the stomach is derived from the perito- neum, and covers the whole external surface, excepting the points where the gastro- splenic, greater and lesser omenta are attached. It is usu- ally, but incorrectly, described as a fourth coat of the stomach. Describe the Gastric Glands. They are of 3 kinds, the — Peptic Follicles, — situated all over the stomach, but most numerous towards the splenic end, — are tubules lined with columnar epithelium in their upper one-fourth, and filled with nucleated cells in their deepest parts. 150 VISCERAL ANATOMY. Simple Solitary Glands are found scattered along the lesser curvature, and nv:ar the pyloric tnd. Name the Vessels and Nerves of the Stomach. Its Arteries are the Pyloric^ ^ \ Branches of the Hepatic Artery ' Right Gastro-epij>loic'>^ ' ^ -epiploic^ '^ ^ I J Left Castro- ^ ' \ Branches of the Splenic Artery. ^ "* Vasa Brevia ' " Veins, terminate in the splenic and portal veins. Nerves, are terminal branches of the right and left pneumogastrics, and branches of the semilunar ganglia of the sympathetic, forming the Gastric Plexus. THE SMALL INTESTINE. Describe the Small Intestine. It is a convoluted, tubular, digestive organ, about 20 feet in length, held to the spinal column by the mesenteric portion of the peritoneum, and divided into 3 parts, the — Duodenum, — about 12 fingers (10 inches) long, ascends for 2^ inches to f. the under surface of the liver and the r IG. 71. neck of the gall-bladder, — descends for 2i% inches in front of the right kidney, — and passes transversely for 4 inches to the left, across the spinal column, to the left side of the second lumbar vertebra, where the superior mesenteric artery crosses its junction with the jejunum. The duodenum has no mesentery, is partially covered with peritoneum, and surrounds the head of the pancreas. Into its descending portion open the ductus communis chol6dochus/ and the pancreatic duct. fejunum, — about two- fifths of the rest of the small intestine, its coils lying around the umbilical region. It is named from the fact that it is tisually found empty {Jejunus) after death. Ileum, — comprises the remainder of the small intestine ; is named from its twisted course, lying below the umbilicus, and terminating in the right iliac fossa, at the ileo-csecal valve, or valve of Bauhin. What Coats has the Small Intestine ? Three, a mucous, a sub-mucous or cellular, and a muscular coat. Its peritoneal investment is sometim.es da- scribed as a fourth coat, but incorrectly. The — THE LARGE INTESTINE. 161 Mucous Membrane, — is covered with columnar non-ciliated epithelium, and thrown into crescentic transverse folds, the Valvulce Conniventes, or valves of Kirkring. It also presents numerous vascular projections or Villi, each formed of basement membrane, epithelium, a lacteal vessel, a capillary plexus, granular corpuscles, and longitudinal muscular fibres, and number- ing about four millions in the whole length of the intestine. Cellular Coaly — contains the vessels of the intestine, and connects the other two coats together. Muscular Coat, — consists of external longitudinal and internal circular fibres, the former being thinly distributed along the bowel, the latter form- ing a thick layer, but not making complete rings. Describe the Glands of the Small Intestine. The mucous membrane of the small intestine contains — Crypts of LieberkUhUy or Simple Follicles, — are minute tubular depressions, found all over the intestine and also in the stomach. B runner' s Glands, — are small conglomerate glands, found only in the duo- denum and the first part of the jejunum, being most numerous near the pylorus. In structure they resemble the pancreas. Solitary Glands, — are lymphoid organs, situated throughout the intestine, though most numerous at the lower portion of the ileum. They are agmi- nated into some 20 or 30 oval patches, named — i'eyer's Patches,— on the surface opposite to the mesenteric attachme its, some of which are as much as 4 inches in length. They are most numer- ous and largest in the ileum, and are most developed during digestion. THE LARGE INTESTINE. Describe the Large Intestine. It is about five feet long, of large calibre, sacculated, consists of the same coats as the small intestine, the mucous being smooth, and without villi, the muscular having its longitudinal fibres collected into 3 narrow bands, producing a pouching of the tube. It presents the fol- lowing PARTS Q.ndipointSf viz. — CfECUM, or Caput Ccecum Coli,c — a dilated blind pouch behind the entrance of the small intestine.* It is the beginning of the large intestine, lies in the right iliac fossa, and is two-thirds covered by peritoneum. Appendix Vermiformis, ^ — a blind prolongation about 3 to 6 inches long, narrow and worm-like, directed backwards and" upwards from the lower part of the caecum, being retained by a fold of the peritoneum. lleo-ccecal Valve, or Valve of Bauhin, — guards the entrance of the small intestine, being formed by two crescentic folds of the mucous and cellular coats and circular muscular fibres, each covered with villi on the side toward the ileum, but smooth on the caeca! side. 162 VISCERAL ANATOMY. Ascending Colon, — extends upwards to the under surface of the liver, where it forms the Hepatic Flexure of the Colon. Transverse Colon, d— crosses the abdominal cavity just below the liver, gall- bladder, stomach and spleen, to the left hypochondrium, where it ter- minates in the Splenic Flexure oj the Colon. Descending Colon, e — passes down- wards in front of the left kidney to the left iliac fossa, where it forms the— Sigmoid Flexure of the Colon,/ — curved like an/j first upwards, then downwards; extending from the crest of the left ileum to the left sacro-iliac synchondrosis. Rectum,-^ — from the last-named point to the anus ; is 6 to 8 inches long, not sacculated, and, though not straight, is straighter than the rest of the gut. It curves laterally to the middle of the sacrum, and back- wards aboui an inch above its ter- mination at the Anus, i where it is distended into a pouch. This lower inch has no peritoneal investment. Appendices Epiploicce, — are small pouches of peritoneum containing fat, and found along the colon and part of the rectum. They are due to the incom- pleteness of the investment of the gut by peritoneum. Sphincters of the Rectum are 3,— the sphincter ani, internal sphincter and sphincter tertius of Hyrtl, (See ante, pp. 83, 84.) Folds of Houston, — three semilunar transverse folds, one in the upper part of the rectum on the right side, another about the middle on the left side, and the third in front, opposite the base of the bladder. What Glands are found in the Large Intestine ? The Follicles of Lieberkiihn are more numerous here than elsewhere, also a few Solitary Glands and Beyer's Patches in its upper portion. The glands of Brunner are absent, the villi and valvuise conniventes are almost wanting. State the Principal Relations of each of the three parts of the Rectum. They are as follows, viz. — Upper Part (4 inches), — lies on the left pyriformis muscle and the left THE LIVER. 153 sacral plexus ; and to its left lie the left ureter and branches of the left internal iliac artery. Middle Part (3 inches), in the male subject lies just behind the trigonum vesicae and the vesiculie seminales, and close below the under surface of the prostate gland. In the female it is adherent to the central portion of the posterior wall of the vagina. Lower Part (i inch), — is surrounded by the 3 sphincters and the levator ani muscle, and is separated by the perineum from the membranous por- tion and bulb of the urethra in the male, from the vagina in the female. THE LIVER. Describe the Liver. It is the largest gland in the body, weighing from 3 to 4 pounds, measuring transversely about 12 inches, antero-posteriorly 6 inches, in greatest thickness 3 inches. It is situated in the right hypochon- driac, epigastric and part of the left hypochondriac regions ; has 5 fissures, 5 lobes, 5 ligaments, and 5 sets of vessels, and is invested by peritoneum, except for a small space at the attachment of the coronary ligament. It is also sur- rounded by a fibrous coat which is continuous at the transverse fissure with the capsule of Glisson. Its — Upper Surface, — is convex, in relation with the under surface of the dia- phragm and 6 or 7 lower ribs, and is divided into two lobes by the sus- pensory or broad ligament. Under Surface (Fig. 73), is concave, covers the stomach, duodenum, hepatic flexure of colon, right kidney and supra-renal capsule, and is divided into 5 lobes by 5 fissures. Anterior Border yC — sharp and notched opposite the fundus of the gall-bladder and the round and falciform ligaments. It corresponds to the lower border of the ribs and costal carti- lages, descending a little lower during deep inspiration and in the upright posture. Posterior Border,^ — rounded, and deeply grooved ("sometimes channeled) for the inferior vena cava.^'': 154 VISCERAL ANATOMY. Describe the 5 Ligaments of the Liver. Four are folds of peritoneum ; one, the round ligament, is the obliterated umbilical vein and ductus venosus of the foetus. The — Suspensory or Falciform Ligament,j — called also the Broad and the Lon- gitudinal Ligament, — is a sickle-shaped double fold reflected over the round ligament, and is attached to the sheath of the right rectus muscle as low as the umbilicus, and to the diaphragm. Coronary Ligament, ff^\% a double fold, containing firm areolar tissue in its interspace, and extending from the posterior border of the liver to the diaphragm. Lateral LJgaments, 2, — are the triangular extremities of the coronary ligament. Round Ligament,^ — ascends in the free margin of the suspensory ligament from the umbilicus to the longitudinal fissure, in which it is continued to the vena cava. Describe the 5 Hepatic Fissures. They are all situated on its under surface, and separate the 5 lobes, one from another. They are the — Longitudinal Fissure,^ — its anterior two-thirds, in front of the transverse fissure^ is called the Umbilical Fissure^ from containing the umbilical vein ; its posterior one-third is the Fissure of the Ductus Venosus, lodg- ing the slender cord which represents that foetal vessel. Transverse Fissure,^ — about 2 inches long, running from the longi- tudinal towards the right ; and transmit the portal vein, hepatic artery, bile-duct, lymphatics and nerves, surrounded by the Capsule of Glisson. Fissure of the Gall bladder,^ — on the right of the longitudinal fissure, and nearly parallel with it, extending from the anterior border, backwards to near the right end of the transverse fissure. fissure for the Vena Cava, — extends inwards from the posterior border, where it joins the fissure for the ductus venosus; and gives exit to the hepatic veins which here join the v6na cava. This fissure is occasionally a complete foramen. Describe the 5 Hepatic Lobes. Three are mere lobules, formed from Ae right lobe by the smaller fissures. The — Right Lobe,a — is much the largest, and presents the three small fissures and two depressions, one anteriorly for the colon, the other posteriorly for the kidney. Left Lobe,i — is divided from the right by the longitudinal fissure, and rests upon the stomach. Z-obulus Quadratus,^ — in front of the transverse fissure, and between the umbilical fissure and that for the gall bladder. THE LIVER. 155 Lobular Plexus. (Fig- 74.) Lobtdus Spigelii,y — behind the transverse fissure, and between the fissure for the ductus venosus and that for the vena cava. Lobtdus CaudatuSyZ — a connecting ridge from the lobulus Spigelii to the right lobe ; it separates the transverse fissure from the fissure for the vena cava, and forms the roof of the foramen of Winslow. Describe the 5 Hepatic Vessels. They are the — portal vein,^ hepatic artery ,f hepatic duct,/ and lymphatics, situated in the transverse fissure, and surrounded by the capsule of Glisson, — also the hepatic veins in the fissure for the vena cava. The — Portal Vein,s — formed by the superior and inferior mesenteric, splenic and gastric veins (all the main veins of the abdomen except the renal), is about 4 inches long. It enters the transverse fissure of the liver, where it divides into two branches, and these again divide and subdivide to ramify throughout the gland. Its branches are the — Right Portal. Inter-lobular Veins. ^ Left Portal. Lobular Veins. » Vaginal Branches. Intra-lobular Veins.* Hepatic Veins, — are the continuations of the intra-lobular, beginning as the Sub-lobular Veins beneath each lobule, and entering the inferior vena cava in the fis- sure for that vessel. Hepatic Artery,g — the nutrient vessel of the liver; arises, from the coeliac axis, enters' the transverse fissure, and di- vides into branches which supply the cellular tissue, the ^. walls of the vessels, and the investing membranes of the liver, also forming a plexus in each lobule which anasto- moses with the terminal branches of the portal vein. Hepatic Duct, — about i ^ inch long ; is formed in the trans- verse fissure by the union of the two main biliary ducts, from the right and left lobes. It joins the cystic duct from the gall-bladder to form the Ductus Communis Chol6do- chus. (See next page.) 156 VISCERAL A^fATOMY. Lymphatics, — accompany the blood vessels in two sets, a superficial set anH a deep one. What Nerves supply the Liver? Branches of the Hepatic Plexus, which is formed by branches derived from the left pneumogastric, right phrenic and solar plexus. Describe the Structure of the Liver. The substance of the liver is composed of numerous Lobules,'^ of polygonal shape, and about -^-^ of an inch in diameter, clus- tered around the sub- lobular branches of the hepatic veins, and con- nected together by con- nective tissue, 3 blood vessels, ducts, ^ and lym- phatics. Each lobule consists of — Hepatic Cells, — each about the j^^^^ of an inch in diameter, having a nucleus and nucleolus, yellow coloring matter, glycogen granules, and oil globules. Lobular Veins, ^ — forming a plexus in the lobule. 1 , . Intra-lobular Vein,^ — in the centre of each lobule, j Plexuses, — of lymphatics, nerves, and bile-ducts. What is the Capsule of Glisson ? The areolar tissue which surrounds the hepatic vessels in the transverse fissure, and accompanies them in their course throughout the substance of the liver. It is continuous with the fibrous covering of the organ. How may the Portal Veins be distinguished from the Hepatic, on section of the Liver ? The portal veins remain closed, being surrounded by the capsule of Glisson. The hepatic veins gape open, being adherent to the liver substance. Describe the Gall-bladder. It is a pear-shaped bag, 3 to 4 inches long, an inch in greatest diameter, holding from 8 to 12 fluid drachms, invested by peritoneum on its under surface and fundus, formed of a fibro- muscular coat and lined by a mucous one, lying in a fissure on the undei surface of the liver, dose to its anterior border, and directed obliquely down- wards, forwards, and to the right. Its — THE PANCREAS. 157 Fundus, — touches the abdominal wall immediately below the 9th costal cartilage, and is completely invested by peritoneum. Neck, — coils twice upon itself, and empties into the Cystic Duct, which is about an inch long, and joins with the Hepatic Duct to form the Ductus Communis Chol6dochus. What is the Ductus Communis Choledochus ? A fibro- muscular tube, covered by peritoneum and lined with mucous membrane, about 3 inches in length, formed by the junction of the Cystic and Hepatic ducts, and emptying its contents (bile) into the descending part of the duodenum at a point about 3 inches from the pyloric orifice of the stomach, generally in common with the duct of the pancreas. The three ducts above-named are often called the Biliary Ducts. THE PANCREAS. Describe the Pancreas. The Pancreas is a racemose gland, about 7 inches long, of a grayish-white color, situated behind the stomach and in front of the first lumbar vertebra. Its structure resembles that of the salivary glands, being composed of reddish-yellow lobules, united by cellular tissue, vessels and ducts, and ending in closed pouches surrounded by a capillary plexus. The — Pancreatic Duct, or Duct of Wirsung, ^ — extends the whole length of the gland, and opens into the P^^ g duodenum about 3 inches below the pylorus, by an orifice common to it and the ductus communis chole- dochus. Head, or Right Extremity, ^ I is surrounded by the curve of the duodenum, the ductus communis chole- dochus and the pancreatico-duodenal arteries. Tail, or Left Extremity, * — lies above the left kidney and in contact with the lower end of the spleen. Body 3— is in relation anteriorly with the ascending layer of the transverse mesocolon, the posterior wall of the stomach and the transverse colon ■ posteriorly with the aorta, portal vein, inferior vena cava, splenic vein, origin of the superior mesenteric artery, crura of the diaphragm, left kid- ney and supra-renal capsule, and the left quadratus lumborum muscle. Arteries, are the — Pancreatica Magna, and Pancreaticae Parvae, from the splenic. Pancreatico-duodenalis, — branch of the hepatic artery. Inferior Pancreatico-duodenalis, — branch of the sup. mesenteric. 158 VISCERAL ANATOMY. Veins, — open into the splenic and mesenteric veins. Nerves, — from the solar plexus, forming a Splenic Plexus. What is the Lesser Pancreas ? A lobe of the head of the pancreas; sometimes detached therefrom, in which case it opens by a duct into the duodenum about an inch above the orifice of the pancreatic duct. THE DUCTLESS GLANDS. Name the so-called Ductless Glands. They are the Spleen, Supra- renal Capsules, Thyroid and Thymus Glands. The first two are in the abdo- minal cavity, the thyroid gland is in the front of the trachea, and the thymus gland is in the anterior mediastinum of the thorax. These organs have no excretory ducts, and their functions are unknown. THE SPLEEN. Describe the Spleen. The spleen is a soft, spongy and very vascular organ, about 5 by 3 by 2 inches, from 6 to 10 ounces in weight, and situated deeply in the left hypochondrium, embracing the cardiac end of the stomach, to which it is connected by the gastro- splenic omentum. Its — Outer Surface,— Ss, convex, corresponds to the 9th, loth and nth ribs, and is in relation with the inferior surface of the diaphragm. Inner Surface, — is concave, and embraces the cardiac or splenic end of the stomach. Borders, — the anterior is thin and often notched ; the posterior is thick and lies on the left kidney. Suspensory Ligament, — attaches the upper extremity to the diaphragm, and is a fold of peritoneum. Hilum, — a vertical fissure about the middle of the con- cave surface . It is pierced by the vessels, lymphatics and nerves. Peritoneal, or Serous Coat, — covers the whole organ, except at the attach- ments of the suspensory ligaments and the gastro- splenic omentum, Fibro-elastic Coat, or Tunica Propria, — is reflected at the hilum upon the vessels, and gives off numerous bands [trabeculce'), which bound the lacunar spaces [areolce) of the organ. Malpighian Corpuscles, — are lymphoid sphenoidal expansions of the outer coat of the small arteries, and average in diameter about the -^^ of an inch. They are attached to the arterioles of the organ in groups of 6 or 8, and are usually pierced by an artery. Their reticulum is slender and open, densely filled with lymphoid corpuscles, and well supplied with capillaries. They have no capsule. THE THYROID GLAND. 159 Splenic Substance or Pulp, — a soft, pulpy, brown-red mass, surrounding the Malpighian corpuscles, and contained in the areolae. It consists of a delicate net-work of connective-tissue corpuscles, containing pigment- granules (disintegrated blood-corpuscles), granular albuminous matter, nucleated and non-nucleated cells, and free nuclei, also red blood- corpuscles in every stage of metamorphosis. These are denominated the colored and colorless elements. Splenic Artery, — is large and tortuous, and divides at the hilum into 5 or 6 branches, each supplying a segment of the organ, and terminating either directly in the venous radicles, or in the lacunar spaces. Splenic Vein, — arises by radicles partly from the capillaries, partly from the lacunar spaces, and empties into the portal vein. Nerves, — are derived from the semi-lunar ganglion of the solar plexus and the right pneumogastric, forming the Splenic Plexus. THE THYROID GLAND. Describe the Thyroid Gland. It is a bi-lobed organ, about 3 inches in length, situated on the sides of the upper 2 or 3 rings of the trachea, and con- sisting of minute closed vesicles containing a yellow-colored fluid, surrounded by a dense plexus of capillaries, and connected together by areolar tissue. Its — Isthmus, — connects the lower third of each lobe together, passing in front of the trachea. It is occasionally absent. Pyrafuid, — is a third lobe, which sometimes arises from the left lobe, or from the left upper border of the isthmus. Levator Glandules Thyroidece, — are muscular bands occasionally found extending from the body of the hyoid bone to the isthmus of the gland or its pyramid. Name the Arteries of the Thyroid Gland. They are very large, anas- tomose freely, and are the — Superior Thyroid, — branch of the external carotid, arising therefrom below the greater cornu of the hyoid bone, and giving off the following branches^ viz. — Muscular. Hyoid. Superior Laryngeal. Glandular. Superficial Descending. Crico-thyroid. Middle Thyroid, Artery of Neubauer^ or Arteria Thyroidea ImUy — ig occasionally found arising from the innominate artery or directly from the arch of the aorta, passing upwards along the front of the trachea. Inferior Thyroid, branch of the thyroid axis, gives off — Laryngeal Branch. (Esophageal Branches. Tracheal Branches. Ascending Cervical. 160 VISCERAL ANATOMY. Enumerate the Veins and Nerves of the Thyroid Gland. The Veins form a plexus in front of the gland and the trachea, giving rise to the — Superior Thyroid Vein. i , , ^ , ^ •, ,. . Middle Thyroid Vein. I °P'" '"'° "^^ ^"'''"''' J'S"'"' ^''"- Inferior Thyroid Vein, opens into the Innominate Vein. Nerves — are branches of the pneumogastric, and of the middle and inferior ganglia of the sympathetic. THE THYMUS GLAND. What is the Thymus Gland 7 It is a temporary organ, attaining its full size about the age of 2 years, then being about 2 inches long, ij4. inch broad, 3 lines thick, and weighing about half an ounce. It subsequently atrophies, and has almost disappeared at puberty. It is situated in the anterior mediastinum and the neck, behind the sternum and the sterno-hyoid and sterno-thyroid muscles, extending from the level of the 4th costal cartilage to the lower border of the thyroid gland. In the mediastinum it rests upon the pericardium, and is separated by the thoracic fascia from the arch of the aorta and the great vessels. Describe its Structure. The Thymus gland consists of two lateral lobes (sometimes a third), together forming a pyramidal mass. It is surrounded by a (ibrous capsule and is divided by Trabecules into primary and secondary lobules, which consist of meshes of delicate retiform tissue closely packed with lymph-corpuscles, and pervaded with capillaries. The so-called Central Cavity and Primitive Linear Tube, are deceptive appearances of the multi- plying cells in the interior of the gland. Name its Vessels and Nerves. The Thymus — Arteries, — are derived from the internal mammary, superior and inferior thyroid, subclavian and carotid. They ramify on the surface of each lobule, having smaller twigs converging toward the centre. Veins,— open into the left innominate and the thyroid. Lymphatics, — consist of intralobular and interlobular plexuses, and open into the anterior mediastinal glands. Nerves, — are very minute and derived from the pneumogastric and the sym- pathetic. THE SUPRA-RENAL CAPSULES. What are the Supra^Renal Capsules ? They are two small, crescentic shaped bodies, situated one on each kidney. Each presents a small fissure or Hilum anteriorly, from which its vein emerges, and consists of a — Fibrous Capsule, — which is very thin, closely adherent, and sends numerous septa inwards. Tttfe ABDOMINAL CAVITY. 16l Cortical Substance, — composed of columnar and rounded cells, held together in layers by a fibrous stroma. Medullary Substance,— \s darker than the cortical portion, and pulpy. Consists of cells in groups, supported by a delicate stroma, and believed by some anatomists to be prolonged into nerve fibres. What are their Relations ? Their bases rest on the upper front parts of the kidneys, their posterior surfaces on the crura of the diaphragm, about the level of the loth dorsal vertebra. The — Anterior Surface, — of the right capsule is covered by the liver; that of the left one by the spleen and pancreas, Superior Surface, — of each is in relation internally with the great splanchnic nerve and semilunar ganglion. Name their Vessels and Nerves. The Lymphatics of these bodies open into the lumbar glands, but are very imperfectly known. Their — Arteries, — are the Supra-renal Branches of the aorta, renal, and inferior phrenic arteries, forming a dense capillary plexus in the cortical portion of the organ. Veins, — of each open into a single trunk, the Supra-renal Vein, which on the right side of the body empties into the inferior vena cava, on the left side into the left renal vein. Nerves, — are chiefly derived from the solar and renal plexuses, with some filaments from the phrenic and pneumogastric nerves, forming a compli- cated network in the medullary substance of the organ, and having numerous small ganglia developed upon them. THE ABDOMINAL CAVITY. What is the Abdomen ? An oval cavity, situated between the thorax above and the pelvis below, invested by peritoneum internally, and containing the — Stomach. Pancreas. Abdominal Aorta. Intestines. Kidneys and Ureters. Inferior Vena Cava. Liver. Supra-renal Capsules. Receptaculum Chyli. Gall-bladder. Bladder (when distended.) Thoracic Duct. Spleen. Uterus (during pregnancy.) Solar Plexus, etc. Name the Boundaries of the Abdomen. Above, it is bounded by the diaphragm; — below, by the brim of the -^^i-^'vi',— posteriorly, by the vertebral column, and the fasciae covering the psose and quadrati luvnborum muscles ; — anteriorly and laterally, by the transversalis fascia, the lower ribs, and the venter of the ilium, K 162 VISCERAL ANATOMY. What Openings are found in its Walls ? They are the — Opening for'the Vena Cava,— in the diaphragm. Aortic Openings — behind the diaphragm, for the aorta, vena azygos minor, the thoracic duct, and occasionally the left sympathetic nerve. (Esophageal Opening, — in the diaphragm, for the oesophagus, and the pneumo- gastric nerves. Umbilical Opening, — in the anterior wall, transmitting the umbilical vessels in the foetus, but obliterated after birth, leaving a puckered depression, the Umbilicus. Internal Abdominal Ring, — on each side, half an inch above Poupart's liga- ment, for the passage of the spermatic cord in the male, and the round ligament of the uterus in the female. Femoral or Crural Ring, — on each side, just below Poupart's ligament; for the passage of the femoral vessels. This opening is closed by the Septum Crurale. (See Femoral Hernia.) Name the Regions of the Abdomen. The Abdomen is divided into 9 regions, by two horizontal lines, — one between the cartilages of the 9th ribs, another between the crests of the ilia, — and 2 vertical lines from the cartilages of the 8th ribs to the centre of Poupart's ligament. The 9 regions thus formed are named the — Epigastric. Umbilical. Hypogastric. What Parts Region "> Right Hypochondriac Region,- the right lobe of the liver, gall-bladder, duodenum, hepatic flexure of the colon, upper part of the right kidney, and the right supra-renal capsule. Epigastric Region, — contains the right two-thirds of the stomach, left lobe and lobus Spigelii of the liver, hepatic vessels, coeliac axis, solar plexus, pan- creas, and parts of the aorta, inferior vena cava, vena azygos, and thoracic duct. \Left Hypochondriac Region, — contains the splenic end of the stomach, spleen, tail of the pancreas, splenic flexure of the colon, upper half of the left kidney and its supra-renal capsule. Right Hypochondriac. Right Lumbar. Right Inguinal, Fig. 78. Left Hypochondriac. Left Lumbar. Left Inguinal. are contained in each ;ontams THE PERITONEUM. 163 Right Lumbar Region, — contains the ascending colon, lower half of the right kidney, and part of the small intestine. Umbilical^ — contains the transverse colon, transverse duodenum, part of the great omentum and mesentery, and part of the small intestine. Left Lumbar Region, — contains the descending colon, low^er half of the left kidney, and part of the small intestine. Right Inguinal Region, — contains the right ureter, caecum, appendix vermi formis, and the spermatic vessels of that side. Hypogastric Region, — contains part of the small intestine, the bladder in children and vi'hen distended in adults, and the uterus during pregnancy. Left Inguinal Region, — contains the left ureter and spermatic vessels, and the sigmoid flexure of the colon. THE PERITONEUM. What is the Peritoneum ? A serous membrane, forming a closed sac, \\s, parietal layer lining the v^^alls of the abdomen and pelvis, its visceral layer being reflected more or less completely over all the abdominal and pelvic viscera. Its free surface is covered with squamous epithelium, and is smooth, moist, and shining Its attached surface is connected to the viscera and the parietes of the abdomen by the sub-peritoneal areolar tissue. Is the Peritoneum always a closed sac ? No ! In the female it is con- tinuous with the mucous lining of the Fallopian tubes, which at their free extremities open into its cavity. Name the Divisions of the Peritoneum. The — Greater Sac^ — extends over the anterior two-thirds of the liver, behind and above the stomach, below, behind, and in front of the great omentum, and below the meso-colon. Lesser Sac, or Cavity of the Great Omentum, — extends behind and below the liver and stomach, above the meso-colon, and within the great omentum. What is the Foramen of Winslow ? A constriction of the peritoneal cavity connecting the two sacs, situated behind the right free border of the gastro- hepatic or lesser omentum, and formed by the gastric and hepatic arteries as they curve around to the coeliac axis. Its boundaries are as follows, viz. — - Anteriorly, — the lesser omentum, containing the duodenum, hepatic artery, portal vein, and the ductus communis choledochus. Posteriorly, — the inferior vena cava, and the right crus of the diaphragm. Superiorly, — the lobus SpigSlii of the liver. Inferiorly, — the hepatic artery, curving forwards from the coeliac axis What passes through the Foramen of Winslow .' Nothing. 164 VISCERAL ANATOMY. Fig. 79. What are the Omenta or Epiploa ? They are folds of peritoneum con. necting the stomach with other organs, and are 3 in number, namely, the — G astro- colic or Great Omentum,^ ^ — consists of four layers of peritoneum, the most anterior and posterior of which belong to the greater sac, the two inter- nal to the lesser sac. The two anterior layers descend from the stomach and the spleen, over the small intestines, and then ascend as the posterior layers, to enclose the transverse colon. Gastro- hepatic or Lesser Omentum, — con- sists of two layers of peritoneum, the upper belonging to the greater sac, the lower to the lesser sac. It extends from the transverse fissure of the liver to the lesser curvature of the stomach, and con- tains in its right free margin the — Hepatic Artery. Portal Vein. Lymphatics. Ductus Communis Chol6dochus. First part of the Duodenum. Hepatic Plexus of Nerves. Gastro- splenic Omentum, — connects the • stomach with the spleen, and is con- tinuous by its lower border with the great omentum. It contains the Splenic Vessels and the Vasa Brevia. What are the Mesos or Mesenteries ? Folds of peritoneum connect- ing the various parts of the intestinal canal (except the duodenum) to the abdominal walls. Each one contains the vessels of the part which it sup- ports. They are the — Mesentery proper. ^^ Meso-ccecum. Meso-colon.^^ Meso-rectum. What Ligaments are formed by the Peritoneum ? They are 17 folds of peritoneum which support certain organs, viz. — I G astro-phrenic, — from the stomach to the diaphragm. 4 Hepatic — the longitudinal, coronary, and 2 lateral ligaments of the hver. 5 Vesical, — the false ligaments of the bladder. 6 Uterine, — 2 vesico-uterine, 2 recto-uterine, and 2 lateral or broad liga- ments of the uterus. I Splenic, — the suspensory ligament of the spleen. THE LARYNX. 166 Name the Viscera covered by Peritoneum. They are the — Liver^ (almost wholly). Transverse Colon.^ Stomach"^ (almost wholly). Sigmoid Flexure. Spleen. Rectum (upper y^). Duodenum^ (first part). Ovaries. Small Intestine.^ Uterus.^ Name the Viscera partially invested by Peritoneum. The — Duodenum^ (descending and Descending Colon. transverse portions). Rectum'^ (middle third). Ccecum. Vagina^ (upper part). Ascending Colon. Bladder^'^ (posterior wall). What Viscera have no Peritoneal Investment ? The — Rectum'' (lower third). Pancreas.^ Bladder"^ o (neck, base and Kidneys. anterior surface). Supra-renal Capsules. Vagina^ (lower part). What are the Appendices Epiploicae ? Pouches of peritoneum situated along the colon and upper third of the rectum, and filled with fat. They are chiefly found along the transverse colon. A Demonstration of the Peritoneum is best made with a large bag of mosquito- netting, sewn up along all four sides, and having a central slit to represent the incision usually made in the laparotomy operation. Sponges of various sizes will represent the various organs, and may be pushed into folds of the bag and tied in by string, wholly covered or partially covered, as the ex,'^^ — projecting into the neck about an inch above the 1st rib, where U is in relation with the subclavian artery and the scaleni muscles. BasCy^^ — is broad, concave, and directed obliquely downwards and back wards, resting on the upper convex surface of the diaphragm. External Surface, — is convex, smooth, marked by the fissures, and corre.. sponds in form to that of the thorax. Inner Surface, — is concave, the left lung excavated for the heart, thf sur. face forming part of the walls of the middle mediastinum. Fig. 84. Root, — is where the bronchi, vessels, and nerves enter the lung, bound together by areolar tissue. In front of the root is the phrenic nerve, behind it the pneumogastric nerve. Its chief structures are arranged in the following manner : — r Pulmonary veins. Prom before, backwards. X Pulmonary artery. ^ ^N . K. B. (^ Bronchus, etc. THE LUNGS. 173 „ , , - r Bronchus, etc. From above, downwards, on > ^ , • 1-. -J r 1. J i Pulmonary artery, right side of body. i ^ ■, . V. Pulmonary vems. T, , , , r Pulmonary artery, rrom above, downwards, on i ^ , , ,, . , ^ , , \ Bronchus, etc. left sid£ of body. y t^ , i^ Pulmonary vems. B. A, V. A. B. V. Fig. 85. Describe the Structure of the Lung. The lung has a serous coat (the pleura) ; a sub-serous, elastic areolar tissue, investing the entire organ, and ex- tending inwards between the lobules ; and the parenchyma, or true lung-tissue, composed of — Lobules, — each consisting of several air- cells or compartments, arranged around the termination of a bronchiole, and surrounded by 6 plexuses of pulmon- ary and bronchial arteries and veins, lymphatics and nerves. Each lobule is a miniature lung, pyramidal in form, with base outwards, and about -^^ inch in diameter. Alveoli, or Air-cells, — are separated from each other by thin septa, are lined with pavement epithelium on a base- ment membrane, and vary in diam- eter from y^^ to Tj?^ inch. [See Fig. 85.] Name the Vessels and Nerves of the Lungs. The lungs are nour- ished by the bronchial arteries, and supplied with blood for oxygenation by the pulmonary arteries. Bronchial Arteries, — are derived from the thoracic aorta. Pulmonary Arteries, — are derived from the right heart. Bronchial Veins, — open on the right side into the vena azygos, on the left side into the superior intercostal vein. Pulmonary Veins, — open by 4 large orifices into the left auricle of the heart, carrying oxygenated blood from the lungs to the heart. Lymphatics, — terminate in the bronchial glands. Nerves, — are branches from the pneumogastric and the sympathetic, form- ing the Anterior and Posterior Pulmonary Plexuses, from which filaments are distributed to each lobule. 174 VISCERAL ANATOivIY. THE PLEURiE. What are the Pleurae ? Two delicate serous sacs, one surrounding each lung and reflected over the pericardium, the diaphragm, and the inner surface of the thorax. Where do the Pleurae meet ? For a short space behind the middle of the sternum, at the approximation of the anterior borders of the lungs. What Names are given to the parts of the Pleurae ? The — Pleura Pulmonalis, or Visceral Layer, — covers the lung, and invests that organ as far as its root. Pleura Costalis, or Parietal Layer, — lines the inner surface of the parietes of the chest. Cavity of the Pleura, — is the space between the two layers. W^hat is the Ligamentum Latum Pulmonis ? The Broad Ligament of the Lung is a triangular fold or reflection of pleura, which descends from rhe root of the lung posteriorly to the upper surface of the diaphragm. State the Differences between the Pleurae. The right sac is shorter, wider, and reaches higher into the neck than the left. Enumerate the Parts in Relation with the Left Pleura. Its — Visceral Layer, — is in contact with the left lung. Parietal Layer, — is in relation with the vertebral column, the ribs, intercostal muscles and vessels, the sternum, the left sympathetic nerve, the diaphragm, the arched portion of the subclavian artery, and the origin of the left carotid, the left pneumogastric, phrenic and cardiac nerves, the trachea, oesophagus, aorta and the pericardium. What is the Mediastinum ? It is the space between the two pleurae in the median line of the thorax, extending from the sternum to the vertebral column, and containing all the thoracic viscera except the lungs. Enumerate the Contents of each of its Divisions. The — Anterior Mediastinum, contains the — Origins of the Sterno-hyoid and Sterno-thyroid Muscles. Triangularis Sterni Muscle. Thymus Gland. Left Internal Mammary Vessels. Lymphatics. Middle Mediastinum, contains the — Heart and Pericardium. Bifurcation of the Trachea. Ascending Aorta. Pulmonary Arteries and Veins. Superior Vena Cava. Phrenic Nerves. Posterior Mediastinum, contains the — Descending Aorta. Pneumogastric Nerves. Azygos Veins. Splanchnic Nerves. Superior Intercostal Veins. Thoracic Duct. Lymphatic Glands, THE KIDNEYS. 176 THE URINARY ORGANS. THE KIDNEYS. Where are the Kidneys situated ? Posteriorly in the abdomen, one on each side of the spinal column, behind the peritoneum, and extending from the level of the nth rib to near the crest of the ileum. The right kidney is lower than the left. State their Dimensions. Each one is about 4 inches by 2 by i, and weighs from 4 to 6 oz. Enumerate their Relations. The — Anterior Surface of the Right Kidney, — is in relation with the right lobe of the liver, descending duodenum, and the ascending colon. Anterior Surface of the Left Kidney, — with the tail of the pancreas, descen-:/- ing colon, and part of the spleen. Posterior Surface, — with the crus of the diaphragm, nth and 12th ribs, psoas magnus, quadratus lumborum, and the aponeurosis of the transversalis muscle. Superior Extre?nity, — is capped by the supra-renal capsule. Describe the Hilum of the Kidney. The Hilutn is a fissure on the inner or concave border, leading into the Sinus or cavity of the gland. It contains the-^ Renal Vein, — in front. Renal Artery, — next in order. Ureter, or Excretory Duct, — ^behind and below. Describe the Kidney-structure. A vertical section presents the — Pelvis or Sinus, ^ — the cavity, forming the beginning of the ureter ^ or ex' cretory duct of the gland. Its divisions are the 3 Infundibula ^, and these are again divided into Calices * or pouches, into which open the orifices of the pyramids, looo orifices situated on each Papilla. Medullary Substance ^^ — consists chiefly of the tubes of Bellini and Henle, arranged in Pyra- mids of Malpighi, whose apices project into the calices of the pelvis. Cortical Substance,'^ — forms the surface of the gland, and consists of uriniferous tubules (straight and convoluted), Malpighian bodies, blood-vessels, nerves, lymphatics, connective tissue, and a granular matrix. It is of a red color, and is prolonged down to the pelvis be- tween the pyramids, these prolongations being named the Columns of Bertin. Fig. 86. 176 VISCERAL ANATOMY. Describe the Tubuli Uriniferi. The uriniferous tubes begin at the Mai- pighian corpuscles in the Capsules of Miiller, and end at the orifices on the surfaces of the papillae. Their various portions are the — Convoluted Tubes of Ferrein, — in the cortical substance. Looped Tubes of Henle, — descending from the former and ascending into the next mentioned. Straight Tubes of Bellini, — in the medullary substance, arranged in pyra- mids, the Pyramids of Malpighi. What are the Pyramids of Ferrein ? They are pyramidal arrangements of the tubes of Ferrein at the bases of the pyramids of Malpighi. What are the Malpighian Bodies ? They are small red bodies found in the cortical substance, each formed by the dilated extremity of a tube of Fer- rein, about the yi^ inch in diameter, and consisting of the — Malpighian Tuft, — a tuft of capillary vessels, the termination of some branches of the renal artery « and y€\n.v Capsule of Muller,c — the dilated extremity of a tube of Ferrein,^ investing the Malpighian tuft probably by two layers, similar to the pleural investment of the lungs. How is the Kidney invested 7 By a dense fibrous Capsule, which is continued inwards at the hilum, to line the sides of the sinus and form sheaths around the vessels. The kidney is also surrounded by a large quantity of fat. Enumerate the various Divisions of the Renal Vessels. They are all derived from the Renal Artery and the Renal Vein, but in their course have received different names, as follows, viz. — Renal Artery, — branch of the abdominal aorta. Divides into the — Primary Branches, 4 or 5, — arising just external to the hilum, again sub- divide and enter in the columns of Bertin as the Arterise Proprias Renales, which form — Arterial Arches, — over the bases of the pyramids, and divide into ascend- ing and descending branches. Interlobular Arteries, or Ascending Branches, — supply the cortical sub- stance, and end in the Stars of Verheyen. (See next page.) Arterioles RectcE, or Descending Branches, — supply the medullary pyra- mids, ending in venous plexuses therein. Afferent Vessels, — to the Malpighian bodies, from the ascending branches. THE URETERS. . l77 Malpighian Tufts, — are capillary plexuses within the Malpighian bodies. From them arise the — Efferent Vessels, — whether arterial or venous, is undecided. They form Venous Plexuses, — on the convoluted uriniferous tubes. Stars of Verheyen, — are venous plexuses of stellate form, situated on the surface of the kidney, beneath its capsule, joining to form the — Interlobular Veins, — from the cortical portion ; which with the VencE RectcB, — from the medullary pyramids, making Venous Arches, — over the bases of the pyramids, finally meet in the— • VencB Propric? Renales, — and they end in the Renal Vein, — which empties into the inferior vena cava. Whence are the Nerves of the Kidney derived ? From the Renal Plexus, which is formed by filaments from the solar plexus and the lesser splanchnic nerve. THE URETERS. What is the Ureter "i The excretory duct of the kidney, forming, by Its upper expanded portion, the cavity of that gland. It is a musculo-membra- nous tube, i6to i8 inches long, as large as a small goose-quill; and ends at the base of the bladder, into which it opens obliquely by a constricted orifice, about 2 inches from the orifice of its fellow. The ureter commences in the — Calices,—'] to 13 small tubes, embracing the papillae of the kidney, and joining to form the — Infundibula, — 3 or 4 in number, which unite in the — Pelvis, — a funnel-shaped dilatation of the upper portion of the ureter. Describe its Course. It descends obliquely inwards along the posterior wall of the abdomen, enters the posterior false ligament of the bladder in the male, and that of the uterus in the female, through which it passes forwards and inwards to the posterior angle of the trigone vesicae, lying between the muscular and mucous coats of the bladder, for about three-fourths of an inch. What are its Relations ? It lies upon the psoas muscle, behind the peri- toneum and below the spermatic vessels, over the common iliac or the external iliac artery, behind the ileum on the right side, behind the sigmoid flexure on the left. The right ureter lies close to the outer side of the inferior vena cava. Describe its Structure. The ureter has 3 coats — a fibrous, a muscular, and a mucous ; the epithelium of the mucous coat is different from that of the urethra, the bladder, or the uriniferous tubes, being spheroidal in shape. L 178 . VISCERAL ANATOMY. THE BLADDER. What is the Bladder ? It is the urinary reservoir, a musculo-membra nous sac, situated in the anterior portion of the pelvis, behind the pubes. When moderately distended it measures about 5 by 3 inches, and holds about a pint. Its — Summit, — is connected to the umbilicus by the Urachus and the obliterated Hypogastric Arteries of the foetus, forming three fibrous cords, the Superior Ligament of the bladder. Body, — is in relation in front with the triangular ligament, the symphysis pubis, and the in- ternal obturator muscles, — behind it is cov- ered by peritoneum, and is in relation with the rectum in the male, with the uterus and upper part of the vagina in the female. Each side is crossed obliquely by the obliterated hypogastric artery and the vas deferens,^ the first passing from below for- / wards, the latter from below backwards. Fundus or Base, — rests on the second portion of the rectum in the male, on the lower part of the cervix uteri and adherent to the anterior wall of the vagina in the female. It is partly covered by peritoneum. Cervix or Neck, — is constricted and continuous with the urethra.*' It is sur- rounded in the male by the prostate gland/ and is directed downwards and forwards. Name the Ligaments of the Bladder. They number 10, of which 5 are true ligaments, and 5 are false, the latter being folds of peritoneum. They are named as follows, — True Ligaments. False Ligaments. 2 Anterior (pubo- prostatic). 2 Posterior. 2 Lateral. 2 Lateral. Superior (the Urachus, etc.). Superior. What is the Urachus ? It is the obliterated remains of a canal, which in the embryo connects the bladder with the allantois. It is situated between the two obliterated hypogastric arteries, and with them forms the superior liga- ment of the bladder, connecting the summit of that organ with the umbilicus. What is the Trigonum Vesicae ? C^, Fig. 89.) The Vesical Trigone is a triangular space, of pale color, at the base of the bladder interiorly, charac- terized by its smooth surface and the intimate adhesion between its mucous and muscular coats. Its boundaries are — THE URETHRA. 179 In Front, — the urethral opening. Posteriorly, — a line connecting the orifices ^ of the ureters. Laterally, — two ridges of mucous membrane, which extend from the ure- thral orifice back to th- orifices of the ureters. What is the Uvula Vesicae ? (^, Fig. 89.) A small elevation of mu- cous membrane projecting from the floor of the bladder into the urethral orifice. It is said to be Hfted by the anterior fibres of the levator ani muscle. Describe the Structure of the Bladder. It has a partial peritoneal in- vestment, and its walls are composed of 3 coats, — a muscular, a cellular, and a mucous. The — Muscular Coat, — consists of 5 sets of fibres, as follows, — External and Internal Longitudinal fibres. Intermediate Circular fibres, forming a Sphincter Vesicce at the neck of the bladder. Transverse fibres, connecting the orifices of the ureters. Muscles of the Ureters, connecting their orifices with the middle lobe of the prostate gland. Cellular Coat, — connects the other two coats together, and is closely attached to the mucous coat. Mucous Coat, — is covered with epithelium intermediate in form between the columnar and the squamous ; is loosely connected to the muscular coat, except at the trigone vesicale and the uvula vesicae, where it is closely adherent. What Nerves supply the Bladder } Branches from the hypogastric plexus supply its upper part, — from the sacral plexus its base and neck. The Male Urethra. What is the Urethra ? It is the urinary canal from the neck of the bladder to the meatus urinarius ; in the male it is chiefly within the penis, and from 8 to 9 inches in length. Enumerate its Divisions. The male urethra is divided into 3 parts, — the prostatic, membranous and spongy. Describe the Prostatic portion of the Urethra. ^^ It is that part of the canal which pierces the prostate gland,i2 is about i^ inch in length, of spindle-shape, and is the widest and most dilatable part of the urethra. Its floor presents the — Veru Montanum, or Caput Gallinaginis,^ — an elevation of the mucous membrane and its adjacent tissue, 3^ inch long, and supposed to contain muscular and erectile tissue. 180 VISCERAL ANATOMY. pjg g^^ Prostatic Sinus, ^"^ — one on each side of the veru montanum, containing the orifices of the prostatic ducts. Sinus Pocularis, or Uterus Masculinus,^ — a small cul-de-sac situated at the front part of the veru montanum. It extends for ^ inch upwards and back- wards into the prostate gland, beneath its middle lobe. Orifices of the Seminal Ducts, — open on the margins of the sinus pocularis. Describe the Membranous portion of the Urethra. 15 it is ^ inch long above, and ^ inch along its floor, being that part of the canal lying between the layers of the triangular ligament of the perineum. Its walls are very thin, and almost destitute of erectile tissue. It is surrounded by the compressor urethrse mus- cle, and except the orifice, is the narrowest part of the urethral canal. On its sides are the— Ducts of Cowper's Glands, "^^—ow their way to open into the bulb of the urethra. (See p. 182.) Describe the Spongy portion of the Urethra. It is about 6 inches long, and has two dilatations, one at each end, named respectively the Bulb and the Fossa Na- vicularis. The — Bulb of the Urethra,^ ^ — is the upper end of the spongy portion, projects backwards for ^ inch, and contains the orifices of Cowper's glands. Fossa Navicular's, — is the lower dilatation of the urethra, and is situated within the glans penis. Lacuna Magna, — the largest of several orifices of mucous follicles, situated on the roof of the fossa navicularis. Glands of Littri, — are numerous mucous glands and follicles, opening into the urethral canal, their orifices being directed forwards. THE URETHRAL GLANDS. 181 Describe the Structure of the Urethra. It has 3 coats, a mucous, a muscular, and an erectile. The — ■ Mucous Coat, — is continuous with that of the whole urinary tract and the ducts of the glands opening therein. Its epithelium is columnar, except in the fossa navicularis, where it is squamous. Muscular Coat, — consists of a layer of longitudinal fibres of the unstriped variety. [For the voluntary muscles of the urethra, see the Compressor Urethroe and Accelerator Urinae, page 84.] Erectile Coat, — is the corpus spongiosum of the penis, and a thin layer con- tinued therefrom around the membranous and prostatic portions. The Female Urethra, Enumerate the Characteristics of the Female Urethra. It is about I j^ inch long, imbedded in the anterior wall of the vagina, perforating the triangular ligament, and surrounded by the fibres of a compressor urethrge muscle. Its diameter is about ]^ inch, but it is capable of considerable dilatation, being surrounded by softer structures than those around the male urethra. THE MALE GENERATIVE ORGANS. THE URETHRAL GLANDS. Where is the Prostate Gland ? It encircles the neck of the male bladder, its apex touching the deep perineal fascia, its under surface resting on the rectum. It is perforated by the urethra and the common seminal ducts, and its ducts open into the prostatic portion of the urethra. State its Dimensions and Characteristics. It measures about ij^ inch by I inch by |^ inch, weighs about ^y^ oz., resembles a horse-chestnut in size and shape, and consists of three lobes, two being lateral and of equal size, the third or middle lobe being a small prominence situated in the notch between the lateral lobes. Describe its Structure. The prostate gland is composed of glandular substance and muscular tissue, inclosed in a fibrous capsule. How is it Held in Position ? By the pubo prostat'C ligaments of the bladder, the posterior layer of the deep perineal fascia, and by the anterior portion of the levator-ani muscle. Where are Cowper's Glands ? They are situated between the two layers of the deep perineal fascia, one on each side of the membranous portion of the urethra, close behind the bulb, and inclosed by the transverse fibres of the compressor urethroe muscle. 182 VISCERAL ANATOMY. Where do their Ducts open ? On the floor of the bulbous part of the spongy portion of the urethra, after traversing the wall of the urethra for about one inch, between its mucous and muscular coats. THE PENIS. Of what is the Penis composed ? Of a mass of erectile tissue arranged in three compartments of cylindrical shape, each surrounded by a fibrous sheath which is prolonged inwards, forming numerous bands (trabeculse), which divide the compartment into a number of spaces. The compartments are named the Corpora Cavernosa i and the Corpus Spongiosum, 2 the latter lying between and beneath the former, like the ramrod of a double barreled gun. Describe the Corpora Cavernosa. (i9, Fig. 89.) They lie side by FiG.-go. side, forming the upper and lateral parts of the ^ ^ 3^ 4 S penis, are joined together along their anterior iM^^.®.^ three- fourths, their posterior one-fourth form- ing the Crura, which arise from the tuberosi- ties of the ischia and their descending rami, and meet beneath the symphysis pubis, forming two grooves, one above for the dorsal vessels ^, * and nerves, 5 the inferior one for the corpus spongiosum. 2 Bu/d of the Corpus Cavernosum, — is a slight enlargement on each crus, near its junction with its fellow. Suspensory Ligament,— z. fibrous membrane which connects the root of the organ to the symphysis pubis. Septum Pectiniforme, — is a portion of the fibrous septum between the corpora cavernosa. This septum extends but two-thirds along the penis, and is wanting for its anterior third. Describe the Corpus Spongiosum. It is an erectile tube lying in the inferior groove between the two corpora cavernosa, having within it the urethra, and being expanded at both ends to form the glans penis and the bulb. It is composed of trabecular (band-like) structure, derived from a fibrous sheath, and containing erectile tissue. The— Bulb of the Corpus Spongiosum, — receives the urethra and is surrounded by the accelerator urinse muscle. Glans Penis, — is the external expansion of the corpus spongiosum, and covers by its base the ends of the two corpora cavernosa. Its base pre- sents a rounded border, called the Corona Glandis, behind which is a deep sulcus, the Cervix. THE TESTES AND THEIR APPENDAGES. 183 Meatus Urinartus, — the external orifice of the urethra, is situated at the summit of the glans penis. Prepuccy — a prolongation of the integument of the penis, covering or partly covering the glans penis. Frenum Preputii, — a fold of mucous membrane lying along the raph6 of the glans penis, and connecting the prepuce thereto. Glands of Tyson, — small lenticular sebaceous glands opening on the corona and cervix of the glans, and secreting an odorous sebaceous matter, which is easily decomposed. Of what does Erectile Tissue consist ? Of an intricate venous plexus, supplied by afferent arteries and emptied by efferent veins. Such are the essential features of the erectile tissue of the penis, which is lodged in the interspaces between the trabeculse of the fibrous structure. What are the Helicine Arteries ? They are peculiar vine-like arterial branches, which project in a convoluted manner into the venous plexuses in the posterior portion of the penis. Enumerate the Vessels and Nerves of the Penis. Its — Arteries, — are derived from the internal pudic, and are the — Artery of the Bulb, — to the corpus spongiosum. Artery of the Corpus Cavernosum, — to that structure. Dorsal Artery of the Penis, — to the glans, prepuce and skin. Veins, — empty into the Dorsal Vein of the Penis, the prostatic plexus and the pudic vein. The venous plexuses of the erectile tissue are very intricate, and remarkably developed. Lymphatics, — the superficial terminate in the inguinal glands ; the deep set joins the deep lymphatics of the pelvis. Nerves, — are derived from the internal pudic nerve, and the hypogastric plexus of the sympathetic. THE TESTES AND THEIR APPENDAGES. What are the Testes ? The Testes or Testicles are the glandular organs which secrete the seminal fluid, — two oval bodies suspended obliquely in the scrotum by the spermatic cords, each measuring about an inch in diameter, and weighing |^ oz. to an ounce. What is the Scrotum ? A cutaneous pouch, consisting of 2 layers — the integument and the Dartos, — the latter being a contractile vascular tunic, con- tinuous with the superficial fascia of the thighs and perineum, and forming a septum in the scrotum between the two cavities for the testes. Describe the Essential Coats of the Testis. They are 3 in number, as follows, viz. : the — - 184 VISCERAL ANATOMY. Tunica Vaginalis, the Serous Covering, — having a visceral layer (tunica vaginalis propria) and a parietal layer (tunica vaginalis reflexa). It was Fig. 91. originally derived from the peritoneum, and the upper part being obliterated, it remained a closed sac. (See « Fig. 91.) Tunica Albuginea, the Fibrous Covering, — formed of white fibrous tissue, and forming an incomplete vertical septum within the gland, the Corpus Highmorianum or Medi- astinum Testis,^ from which fibrous bands (trabeculae) cross the gland, dividing its inte- rior into spaces for the lobules of the organ. Tunica Vasculosa, the Pia Mater Testis, — is the vascular tunic, lying beneath the tunica albuginea, and giving off numerous pro- cesses between the lobules. Name the Coverings of the Testicle. From without inwards they are 6 in number, as follows, the — (i) Skin, — of the scrotum, closely adherent to the dartos. (2) Dartos, — or superficial fascia. (3) External Spermatic Fascia, Intercolumnar Fascia, — derived from the margins of the external abdominal ring. (4) Cremasteric Fascia, — derived from the lower border of the internal oblique muscle. [Called also the Cremaster Muscle.] (5) Internal Spermatic Fascia, or Fascia Propria, — the infundibuliform process of the transversalis fascia. (6) Tunica Vaginalis,^ — originally a process of peritoneum. [Shown by dots in Fig. 91.] Describe the Structure of the Testicle. The glandular structure is composed of small, convoluted tubes, the Tubuli Seminiferi,^ (Fig- 92), which are collected into Lobules, about 300 in number, from which straight ducts, the Vasa Recta,^ enter the mediastinum and form an ascending plexus of anastomosing tubes, the Rete Testis,^ which gives off some 12 to 20 ducts, the Vasa Efferentia; ^ these perforate the tunica albuginea of the testis, and form a number of conical masses, the Coni Vasculosi,'^ which together con- stitute the Globus Major ^ of the Epididymis. ^ What is the Epididymis ? ^ It is an appendix to the testicle, lying along its posterior border, and consists of a single duct about 20 feet in length when unraveled, but which is wound upon itself so as to occupy a very small space. The — THE TESTES AND THEIR APPENDAGES. 185 Globus Major,'' — is formed by the coni vasculosi, Fig. 92. or efferent ducts of the testis, which therein open into the single duct which forms the epi- didymis. JBody,^ — is formed by the convolutions of the tube, held together by fine connective tissue, and is the central portion. Globus Minor, ^ — the lower expanded portion, similarly formed, and connected to the testis by fibrous tissue. Vasculum Aberrans,'^'^ — a narrow tube, sometimes found opening into the canal of the epididymis near its lower end, and ending in a blind ex- tremity. Hydatids o/Morgagni, — small pedunculated bodies, found attached to the epididymis or to the upper end of the testicle. One of them is beheved to be the remains of the duct of Muller. (See CoM- PEND OF Physiology, page 131.) Describe the Vas Deferens.^" It is the continuation of the epididymis, and is the excretory duct of the testicle. Beginning at the globus minor it ascends along the back of the spermatic cord to the external abdominal ring, where it enters the inguinal canal, and penetrates the abdominal cavity through the internal abdominal ring. Descending into the pelvis it passes between the bladder and the rectum, along the inner side of the vesicula seminalis, and at the base of the prostate gland it joins with the duct of the vesicula seminalis to form the ejaculatory duct. The vas deferens is about 2 feet long, and has a canal of only half a line in diameter. Its walls are very dense, making it feel like a piece of wire or whip-cord when grasped between the fingers. (2 Fig. 91.) Name the Arteries of the Testicle. The Spermatic Artery ^ supplies the gland itself; but the coverings of the testicle are supplied by the — Superficial External Pudic, ~| , , . . ^ . ^ -^ ^ , _, ,. \ — branches of the remoral. Deep External Fudic, J Superficial Perineal,— hr. of the Internal Pudic, from the Int. Iliac. Cremasteric, — branch of the Epigastric, from the External Iliac. Name the Nerves of the Testicle. They are the — ^ . .^ * . I —branches of the Lumbar Plexus. Ilio- hypogastric, \ Superficial Perineal,— hrzYich. of the Internal JPudic nerve.. 186 VISCERAL ANATOMY. Inferior Pudendal, — ^branch of the Small Sciatic nerve. Genital, — branch of the Genito-crural nerve. Describe the Spermatic Cord. It extends from the internal abdominal ring to the globus minor of the epididymis, and is about 4 inches long. It consists of the following-named 10 structures, bound together by areolar tissue and invested by its coverings. These structures are the — Vas Deferens. ^ Fig. 91. Spermatic Plexus of Nerves. Spermatic Artery ?■ Branch of the Ilio- inguinal Nerve. Cremasteric Artery. Branch of the Genito-crural Nerve. Artery of the Vas Deferens.^ Vasculum Aberrans. Spermatic Veins. Lymphatics. What is the Pampiniform Plexus ? A venous plexus formed by the spermatic veins and branches from the epididymis. It forms the chief mass of the spermatic cord, and unites into a single trunk, which on the right side empties into the inferior vena cava, On the left side into the left renal vein. Describe the Vesiculae Seminales. They are two sacculated, membra- nous pouches, serving as reservoirs for the semen, and are filled by the back- ing up of that fluid from the vasa deferentia. They are about 2}4, inches in length, and are situated between the base of the bladder and the rectum. Their— Ejaculatory Ducts, — one on each side, are formed by the junction of the vasa deferentia with the ducts of the vesiculae seminales. They are about ^ inch in length, and terminate in the prostatic portion of the urethra, by orifices on the sides of the veru montanum. Describe the Descent of the Testes. In early foetal life the testes are situated in the abdominal cavity, just below and in front of the kidneys, and are each connected to the dartos of the scrotum and the tissues about the in- guinal canal by the 3 processes of a cord named the Gubernaculuju TestiSy which is supposed to gradually shorten itself and draw the testis down. At the beginning of the 5th month the descent begins; during the 7th month the testicle enters the inguinal canal, and ordinarily arrives in the scrotum by the end of the 8th month. A process of peritoneum is supposed to be carried down in front of the testis ; which process, by obliteration of the canal, be- comes a separate structure, the Tunica Vaginalis. The structures of the inguinal canal are also supposed to be brought down vi^ith the testicle, and to constitute some of its coverings. THE VULVA. 187 FEMALE ORGANS OF GENERATION. THE VULVA. Enumerate the Organs comprised in the Vulva. They are the Mons Veneris, the Labia Majora, Labia Minora, Clitoris, Meatus Urinarius, and the Orifice of the Vagina. Describe the Labia Majora. They are two prominent folds formed of skin, mucous membrane, areolar and dartoid tissues; — are joined together at the mons veneris, forming the Anterior Commissure^ and also in front of the perineum, where they form the Posterior Commissure. What are the Labia Minora ? The Labia Minora or Nymphae are two folds of mucous membrane, lost posteriorly in the labia majora, but anteriorly they vjmbrace the clitoris, forming the Prepuce of that organ. Dt?«cribe the other Parts comprised in the Vulva. The — Mons Veneris, — is the eminence in front of the pubes. It is formed of adi- pose tissue, and at puberty becomes covered with hair. Clitoris,'^ — is situated beneath the anterior Fig. 93. commissure, its Glans only appearing as a small rounded tubercle between the anterior extremities of the labia minora. It is a diminutive penis in all but the urethra, hav- ing a body, two crura, a glans, prepuce, suspensory ligament and muscles, the erec- tores clitoridis. Bulbi Vestibuli,^ — are two oblong masses extending from the clitoris along the sides of the vestibule, and consisting of a venous plexus surrounded by a fibrous membrane. Pars Intermedia, — is a small venous plexus situated between the glans clito- ridis and the bulbi vestibuli. Vestibule, — is a triangular depression in front of the vaginal orifice, bounded laterally by the labia minora. Meatus Urinarius, "^ — situated in the vestibule, about an inch below the cli- toris, and close to the vaginal orifice. Orifice of the Vagina,"^ — is surrounded by the sphincter vaginae muscle, and in the virgin is sometimes partly closed by the hymen. Hymen, — a fold of mucous membrane situated across the lower part of tbe vaginal orifice, of various shapes, but usually semilunar, the concavity upwards. It is frequently absent in virgins, and after sexual intercourse its rupture and cicatrization give rise to small eminences along the margin of the vaginal orifice, named the Carunculce Myrtiformes. 188 VISCERAL ANATOMY. Fourchett^^—z small transverse fold just behind the posterior margin of the vaginal orifice. Fossa Navicularis, — the space between the fourchette and the posterior com- missure of the vulva. Glands of Bartholine, — one on each side of the vaginal orifice, their ducts opening on the inner sides of the labia minora. They are the analogues of Cowper's glands in the male. THE VAGINA. Describe the Vagina. It is a curved canal extending from the vulva to the uterus, placed between the bladder and the rectum. Its length is about 4 inches along its anterior wall, an inch longer posteriorly, and its walls are usually in contact with each other. It is very dilatable, especially at its upper part. Describe its Structure. The vaginal wall consists of a muscular coat externally, a layer of erectile tissue, and a mucous lining covered with squa- mous epithelium, and furnished with mucous glands and follicles. The — Columns of the Vagina, — are two longitudinal raphes situated along its mucous surface, connected by numerous transverse ridges, or RugcB. What are the Relations of the Vagina ? They are — Anteriorly^ — the urethra and the base of the bladder. Posteriorly^ — the anterior wall of the rectum, and the recto-uterine fold of peritoneum which forms Douglas^ cul-de-sac behind its upper fourth. Laterally, — are attached the broad ligaments of the uterus, the levatores ani muscles, and the recto- vesical fascia. Stiperiorly, — it is attached to the cervix uteri above the os, and higher on the posterior wall than anteriorly. THE UTERUS AND ITS APPENDAGES. Where is the Uterus situated ? In the pelvic cavity, between the bladder and the rectum, and above the vagina. Describe the Uterus. It is a hollow, pear-shaped, muscular organ, meas- uring about 3 inches long, 2 inches broad, and T inch thick, flattened from before backwards, placed base upwards, and forming an angle with the vagina, which partially receives its cervix. The — Fundus,^ — is broad, convex, having walls ^ inch thick, and is covered by peritoneum. Body, — is about i j^ inch long, walls j4 inch thick, flat anteriorly, convex posteriorly, concave laterally, and joined to the bladder by its lower ante- THE UTERUS AND ITS -APPENDAGES. 189 rior fourth. It is invested by peritoneum posteriorly, and in front for its upper three- fourths. Cervix, or Neck^ — is the lower constricted portion, about i^ inch long, walls ]^ inch in thickness, and is embraced for }4 ^^ ^ inch by the upper extremity of the vagina. Cavity of the Body^B — is small and Uriangular, flattened from before back- wards, about I y% inch in length, and has two lateral Cornua above, and a constricted orifice — the Os Internum Uteri — at its lower angle, opening into the cavity of the cervix. Cavity of the Cervix, — is spindle-shaped, about l^ inch long, and presents on its inner surface transverse folds of mucous membrane proceeding from a longitudinal fold, giving an appearance named the Arbor Vitae.*' Os Uteri or Os Tincte^ — is a transverse orifice at the lower jsnd of the cervical cavity, opening into the vagina, and having an anterior and a posterior lip. Fig. 94. I S Enumerate the Ligaments of the Uterus. The proper ligaments of the uterus are 6 in number, — 2 Anterior, or Utero-vesico-pubic, 2 Posterior, or Utero-recto-sacral, and 2 Lateral, or Broad Ligaments, all composed of peri- toneum. The — Broad Ligaments,— ^a&s from the sides of the uterus to the lateral walls of the pelvis, and form a septum across the pelvic cavity. They contain, between the two folds of peritoneum of which they are composed, the Fallopian tubes, the Ovaries, and the so-called Round Ligaments. What are the Round Ligaments of the Uterus ? They are two cords, composed of areolar and fibrous tissue, muscular fibres, vessels and nerves, extending one on each side, from the lateral aspects of the fundus uteri, through the inguinal canals, to the labia majora, where they are lost. Each ligament lies, for a part of its course, between the two layers of the broad ligament, and is covered by a process of peritoneum. (^ Fig. 94.) 190 VISCERAL ANATOMY. Canal of Nuck^ — is the extension of the above-named process of perito- neum into the inguinal canal. It exists in the foetus, and is usually ob- literated in the adult. Describe the Uterine Structure. The uterine wall has 3 coats — perito- neal, muscular and mucous. Its — Peritoneal or Serous Coal, — invests the body of the organ, excepting on its lower anterior fourth. Muscular Coat, — constitutes the chief bulk of the uterus. It consists of bundles of unstriped muscular fibres, disposed in 3 layers interlaced together ; circular fibres predominating in the cervix, longitudinal fibres in the body of the organ. Mucous Coat, — is very thick, -^^ to ^ inch, and closely adherent to the rauscufer tissue, having no basement layer of connective tissue. It is covered with ciliated columnar epithelium, and studded with mucous follicles and glands, which are most numerous in the cervix. The latter, when distended by their own secretions, form sacs, which Naboth mistook for human ova, and hence were named the Ovules of Naboth. Enumerate the Uterine Vessels and Nerves. ItS' — Arteries, — are the Uterine, from the anterior trunk of the external iliac, anas- tomosing with twigs from the Ovarian — (spermatic branch of the abdominal aorta). Veins, — accompany the arteries, and in the impregnated state become sinuses. They end in the uterine plexuses. Lymphatics, — those of the cervix end in the sacral and internal iliac glands, those of the fundus in the lumbar glands. Nerves, — are derived from the inferior hypogastric and ovarian plexuses, and from the 3d and 4th sacral nerves. Describe the Fallopian Tubes or Oviducts. They are two tubes, i ^ .^ ^ , . ^ ,. , ^. ^, , . ^ ^„ V In the Sub- cutaneous Cellular Tissue. Sebaceous Glands.* Fat Cells.' J Ducts of the Sweat-glands. Hair-follicles, — into which most of the seba- ceous ducts open. Ducts of the Sebaceous Glands, — occasionally. Describe the Structure of the Epidermis. It is an unorganized epithe- lial structure, having no vessels or nerves. The cells of which it is composed are agglutinated together in a lami- Perforate both the Dermfl and the Epidermis. nated arrangement, are flat and dry on the surface, round and softer in the central portion, columnar and softest in the deepest layers. The lowest and softest layers are named the — Rete Mucosum, — which is closely moulded upon the papillary layer of the derma, and contains pig- ment cells, to which the color of the skin is due. Describe the Structure of the Derma. The true skin is a highly organized, tough yet elastic tissue, and serves to protect the parts beneath, to perform the functions of excretion and absorption, and as the chief seat of the sense of touch. It consists of fibro-areo- Ur tissue, vessels and nerves. The — Fig. 96. 194 VISCERAL ANATOMY. Papillary Layer, — situated next to the rete mucosum, is covered with minute conical elevations (papillae), ■^\-^ inch high ^\-^ inch in diameter at their base, very numerous and arranged in parallel curved lines wherever sen- sibility is greatest. Each papilla contains a capillary loop or plexus, the termination of one or more sensory nerves, — and in highly sensitive parts, an oval shaped body, the Tactile Corpuscle. Corium, — the lower layer of the derma, is composed chiefly of interlacing bundles of white fibrous tissue, in which are mingled some yellow elastic fibres, also plain muscular fibres wherever hairs are found, — and lym- phatic vessels, blood-vessels and nerves, in plexiform arrangement. Describe the Nails. They are flat, horny structures, a modification of the epidermis, molded upon the derma at the dorsal surface of the terminal phalanges of both fingers and toes. Each nail is convex on its outward surface, and is imbedded by its Root into a fold of the skin. Its — Matrix, — is that portion of the derma directly beneath the nail. It is covered with highly vascular papillae. The — Lunula, — is a white crescentic portion of the nail nearest to its root, pro- duced by the diminution in number and size of the papillae beneath. What are the Hairs ? They are also a modified form of the epidermis, found over nearly the whole surface of the body, much varied in size and color. Each hair consists of a Root and a Shaft. The — Root, — is lodged in an involution of the epidermis called the Hair-follicle, which sometimes extends into the subcutaneous cellular tissue. The root rests on a vascular papilla at the bottom or Bulb of the follicle, which supplies it with the material for its growth. Shaft, — is the projecting portion of the hair. It consists of a medulla in the centre, next a fibrous portion, externally a cortex of thin, flat scales. The finest hairs have no medulla. /*(?/■«/,— consists of the fibrous portion and the cortex, the medulla being wanting. Where are the Sebaceous Glands most abundant 7 In the scalp, the face, around the anus, and the apertures of the nose, mouth and external ear. The largest are the — Meibomian Glands, — situated in the eyelids (see Fig. 104). Describe the Sebaceous Glands. They are small, glandular bodies situated in the corium or in the subcutaneous cellular tissue over most of the body, but not in that of the palmar surface of the hands nor on the plantar surface of the feet. Each gland consists of a single sacculated duct, usually opening into a hair follicle, but sometimes ending on the surface of the in* tegument. THE NOSE. 19^ Describe the Sweat-glands. Ench gland consists of a single convoluted tube, situated usually in the subcutaneous cellular tissue, and opening on the surface of the integument by a spiral duct which pierces the derma and the epidermis. It is formed of two coats, an external fibro -cellular, which is con- tinuous with the corium, and an epithelial lining, continuous with the epidermis. State the probable number of Sweat-glands and their Evaporating area. They are estimated as varying, in different parts of the integument, from 417 to 2800 to the square inch, giving for the whole body a total of nearly two millions and a half, representing an evaporating surface of about 8 square inches. ORGANS OF TASTE. What are the special Organs of Taste ? The Taste-buds, small, flask- shaped bodies, each about 3^^ inch long, situated in the fungiform and cir- cumvallate papillae of the tongue. The seat of the sense of taste lies, how- ever, in the mucous membrane covering the dorsum of the tongue, the upper portion of the pharynx, the soft palate and the fauces. Name the special Nerves of Taste in the Tongue. The — Chorda Tytnpani Branch of the Facial, — for its anterior two-thirds; perceiv- ing saline, acid and styptic qualities (Flint). Lingual Branch of the Glosso-pharyngeal, — for its posterior third; apprecia- ting alkaline, metallic, sweet and bitter tastes (Flint). What is Sapolini's view of the Chorda Tympani Nerve "> From re- peated dissections. Dr. Sapolini, of Milan, believes the chorda tympani to be a separate cranial nerve, having its proximal end in the so-called intermediary nerve of Wrisberg, originating in the floor of the 4th ventricle, and termina- ting in a dense plexus with the lingual branch of the 5th nerve, in the mus- cles of the tongue. He further concludes that the chorda tympani is the nerve governing the movements of the tongue in speech, and that the nerves of taste are the Lingual Branches of the 5th and 9th nerves. THE NOSE. [For an osteological description of the Nasal Fossae and Septum, see page 31.] Where is the Organ of Smell situated ? In the mucous lining of the upper portion of the nasal fossae, which is the seat of distribution of the ter- minal filaments'^ of the Olfactory Nerve,d the special nerve of the sense of smell. What is the Schneiderian Membrane "> The Schneiderian or Pituitary Membrane is the mucous membrane of the nasal fossae. It is continuous with 196 VISCERAL ANATOMY. the mucous lining of the pharynx, Eustachian tube, tympanum and mastoid cells; also with that of the frontal,^ ethmoidal and sphenoidal sinuseSj-^ the antrum, nasal duct, and the conjunctiva. It is covered with columnar epithe- lium, ciliated throughout most of its extent, provided with mucous glands, and in YiQ 97, ^'^^ deeper layer with the — J Olfactory Cells ofSchullze, — spindle-shaped, epi- thelial structures grouped around and between the columnar epithelial cells, and joined together by their anastomosing pro- cesses, to form an intri- cate plexus on which the terminal fibres of the ol- factory nerve are sup- posed to be distributed. Name the Arteries of the Nose. They are the — Lateralis JVasi, — branch of the facial, to the alae of the nose. Nasal of the Septum, — from the superior coronary artery, to the septum. Nasal, — branches of the ophthalmic and infra- orbital, to the dorsum and sides of the nose. Name the Arteries of the Nasal Fossae. They are the — Anterior and Posterior Ethmoidal, — from the ophthalmic. Spheno-palatine, — branch of the internal maxillary. Alveolar, — branch of the internal maxillary, to the antrum. What Nerves supply the Nose ? Branches from the facial, infra- orbital and infra-trochlear, and a filament from the nasal branch of the ophthalmic nerve. What Nerves supply the Nasal Fossae ? They are the — Olfactory or jst Cranial,e — over the upper third of the septum nasi, And over the superior and middle turbinated bones. Nasal Branch of the Ophthalmic, S — to the septum and outer walls. Anterior Dental Branch of the Superior Maxillary, J— io the inferior meatus of the nose and the inferior turbinated bone. Sphenopalatine Ganglion, — sends branches to the septum and the superior turbinated bone, — the Superior Nasal Br. to the same parts,— the Naso- palatine to the middle of the septum, — and the Anterior Palatine to the middle and lower turbinated bones. THE EYE. 197 THE EYE. [For an osteological description of the Orbit, see page 29.] What is the Visual Apparatus ? It comprises the eyeballs and their appendages, which collect the luminous impressions, — and the optic nerves, which convey these impressions to the brain. Describe the Eyeball. It is a spherical organ, situated in the anterior part of the orbital cavity, on a cushion of connective tissue and fat, where it is retained by its muscles, the optic nerve, the conjunctiva, etc., and protected in front by the eyelids and eyebrows. Projecting from its anterior surface is the segment of a smaller, transparent sphere, the Cornea. The eyeball has the following — Diameters, — Antero-posterior, about .95 inch, — Transverse, .92 inch, — Vertical, .90 inch, — in the adult. Anterior Fole,—'\s the geometric centre of the cornea. Posterior Pole, — is the geometric centre of the fundus. Optic Axis, — is an imaginary straight line connecting the poles. Visual Axis, — an imaginary straight line from the yellow spot to the object, through the nodal point. It cuts the cornea above the optic axis, at an angle therewith of 3° to 7°, the Visual Angle. Nodal Point, — the centre of curvature of the refracting surfaces. Equatorial Plane, — an imaginary plane through the centre of the eyeball, perpendicular to the axis, dividing the ball or globe into the anterior and posterior hemispheres. The Equator is the line where this plane cuts th^ surface of the globe. Meridional Planes, — are imaginary planes coinciding with the axis of the eyeball. Meridians are the lines where these planes intersect the surface of the globe. Describe the Tunica Vaginalis Oculi. It is a fibrous capsule, sur- rounding the eyeball and the intra -orbital portion of the optic nerve ; arising from the optic foramen and being lost anteriorly on the sclerotic. It consists of two layers (parietal and visceral) enclosing a lymph-space which communi- cates with the lymph- space between the sclerotic and choroid coats. The tendons of the ocular muscles pierce it. The — Capsule of Bonnet, — is the portion of tunica vaginalis posterior to the point where the tendons pass through it. This part is loosely attached to the eyeball, which rotates in it. Capsule of Tenon, — is the portion of the tunica vaginalis anterior to the passage of the tendons. [The whole capsule or Tunica Vaginalis is by many anatomists named the Capsule of Tenon.] 198 VISCERAL ANATOMY. Name the Tunics of the Eyeball. They number 3, and are named as fol lows: the — Sclerotic ' and Cornea,'^ — the exter- nal and protective tunic. Uveal Tract, — or vascular tunic, comprising the Choroid,* Ciliary body and the Iris,^ within which is the — Retina,^'^ — the innermost, nervous tunic. Name the Humors of the Eyeball. They also number 3, as follows : — Aqueous,"^ — in the anterior 2 and middle ^ chambers. Crystalline, — iorramg the crystal- line lens. 1 5 Vitreous y'^^ — in the posterior chamber of the eyeball. The Sclerotic and Cornea. Describe the Sclerotic. The Sclerotic or hard coat is the posterior five- sixths of the external tunic of the eyeball, the anterior one-sixth being the Cornea. Externally it is of a white color, covered anteriorly by the conjunc- tival mucous membrane, posteriorly being continuous with the sheath of the optic nerve. Internally its color is brown, and its surface marked by grooves for the ciliary nerves. The optic nerve pierces it posteriorly, also the long and short ciliary arteries, posterior ciliary veins and short ciliary nerves. In the equatorial region it is pierced obliquely by the venae vorticosae, and around the corneal border by the anterior ciliary arteries and veins. It is composed oi connective tissue with elastic fibres, intermixed with pigment cells, and cells resembling the corneal corpuscles. It presents for consideration the following points, viz. : — Thickness, — ^^^ inch posteriorly, -^^ inch anteriorly. Lamina Fusca, — a layer of very fine connective tissue, connecting the sclerotic with the outer surface of the choroid. Lamina Cribosa, — the posterior perforated portion of the sclerotic, which at this point is a thin, cribriform lamina. Its largest opening transmits the arteria centralis retinae, and is named the Porus Opticus, or Optic Canal. Sub-conjunctival Tissue, — connects the conjunctiva with the outer surface of the sclerotic. THE CORNEA. 199 Sulcus, — a slight circular depression around the junction of the sclerotic with the cornea. Arteries, — from the Ciliary, are few and in a coarse net- work, uniting at wide intervals, but forming, however, the — Posterior Vascular Zone, or Zone of Zinn, — an arterial zone around the optic nerve entrance, formed by twigs of the short ciliary going to the optic nerve to anastomose with branches of the central artery of the retina, forming the only connection between the cihary and retinal systems. Anterior Vascular Zone, — around the cornea, formed by sub- conjunctival branches of anterior ciliary vessels. Nerves, — none have been yet found in the sclerotic. What is the Cornea ? The Cornea, or horny body, is the anterior trans- parent projecting portion of the external tunic of the eyeball, forming about one-sixth thereof. It is set into the sclerotic as a watch-crystal into its case, is of ellipsoidal base, the transverse diameter being the longest, and slightly more convex vertically than horizontally. Its — Thickness, — is ^^ inch at centre, ^^ inch at periphery. Index of Refraction,— i .■^^2. Vessels, — none, except the peripheral zone, ^^ inch wide, formed of capil- lary loops from Episcleral branches of the anterior ciliary, which termi- nate at its circumference ; so that it is practically a non-vascular structure. Nerves, — are numerous ; 20 or 30 twigs from the Ciliary nerves form an intricate plexus throughout its laminated substance. Describe the Structure of the Cornea. It consists of five layers, — cen- trally the true corneal tissue, having in front an anterior elastic lamina and the conjunctival epithelium ; behind, a posterior elastic lamina and the epithelial lining of the aqueous chamber. The — Layer of Conjunctival Epithelium -g\-^ inch thick, consists of two or three layers of transparent nucleated cells. Anterior Elastic Lamina, also named the Anterior Limiting Layer, the Membrane of Bowman or Membrane of Reichert, — is -^^'^^ to ^J^^ inch thick, a firm, elastic and transparent homogeneous membrane, consisting of closely-interwoven fibrils, similar to those in the corneal tissue proper. True Corneal Tissue, — -^^ inch thick, a transparent, fibrous structure, formed of five connective-tissue fibrillae, united in bundles, and these in laminae, between which is a semi-fluid cement, filled with Corneal Corpuscles and wandering cells. Posterior Elastic Lamina, Membrane of Descemet, or Demours, — is, like the anterior elastic lamina, a structureless basement membrane, of extreme thinness, resisting the action of water, alcohol or acids ; very brittle, ex- 200 VISCERAL ANATOMY. ceedingly elastic, and curls up inwardly upon itself, when detached from the true cornea. At the corneal margin it breaks up into fibres, which are continuous with the ligamentum peclinatum of the iris. Posterior Epithelial Layer, — a single layer of flattened, polygonal, trans- parent, nucleated cells, forming the endothelium of the membrane of Descemet or Demours, and the epithelial lining of the aqueous chamber. The Uveal Tract. Describe the Choroid. It is the posterior portion of the middle tunic of the eyeball, -^\-q to ■^\-^ inch thick, and extends from the optic nerve entrance to the ora serrata, a little in front of the equator. It is highly vascular, of dark- brown color, connected to the sclerotic by the Lamina Fusca, terminates anteriorly in the Ciliary Processes, and is composed of four layers, as follows : — Tunica Vasculosa, — externally, consists of the venae vorticosae and the larger arterial branches. . Membrana Ruyschiana, or Chorio-capillaris, the middle layer — consists of a fine capillary plexus, formed by the short ciliary vessels. Limiting Membrane^ — a structureless hyaline membrane, covering the inner surface of the capillary layer. Pigmentary Layer, internally, — a single layer of hexagonal nucleated cells, loaded with pigment of a brown black color, which is absent in albinos, and of slight amount in blondes. [Considered by many anatomists the loth layer of the retina,] Arteries of the Choroid, — are the short posterior ciliar}% and recurrent branches from the long posterior and anterior ciliary. (See p. 105.) Veins, "^ — unite into 4 or 6 Venae Vorticosse,* which pass out through the sclerotic near its equator. Nerves,^ — derived from 3d, 5th, and sympathetic, through the long and short ciliary nerves. (See p. I37-) What are the Ciliary Processes ? They are 70 or 80 folds, formed by the anterior prolongation of the middle and internal layers of the choroid on the inner surface of the ciliary muscle, being received into corresponding folds on the suspensory ligament of the lens. They are about -^^ inch in length, and form a curtain-like expansion behind the iris. Describe the Ciliary Body.^ It is the portion of the uveal tract between the choroid and the iris,^ and consists of ciliary muscle covered by choroidal stroma and the ciliary processes. The— Ciliary Muscle or Muscle of Bowman,— \% a ring of involuntary muscular fibres, supphed by the 3d nerve ; is thickest anteriorly, thin posteriorly. Its fibres arise from the corneo-sclerotic junction, and pass backwards to THE UVEAL TRACT. 201 be attached to the choroid in front of the retina. Consists of meridional fibres drawing the choroid forwards, and circular fibres which relax the zonula and permit the lens to become more convex, from its own elasticity. Annular Muscle of Milller, — consists of separate circular bundles at the anterior internal angle of the ciliary body. Circulus Arteriosus Major and Minor, — are arterial circles on the ciliary muscle, formed by branches of the long posterior ciliary and anterior ciliary arteries. What is the Iris ^ ? It is a perforated c.urtain, suspended in the aqueous humor behind the cornea and in front of the lens, and is the anterior portion of the middle tunic of the eyeball, being continuous with the ciliary muscle and the choroid coat. It is about \ inch wide, y^^ inch thick, and is com- FlG. 99. posed of radiating and circular muscular fibres, a fibrous stroma and pigment cells, covered by a layer of irregular cells continuous with those of the mem- brane of Descemet. The — Pupil, — is the central opening in the iris, situated a little to the nasal side of the centre, diameter -^^ to \ inch. Ligamentum Pectinatum Jridis, or Bollinger's band, — is the suspensory ligament of the iris, connecting its ciliary margin with the corneo- sclerotic junction. It is formed of strong fibrous prolongations firom the membrane of Descemet and the posterior surface of the cornea. Fontana^s Spaces, — are spaces between the prolongations which form the ligamentum pectinatum. In some animals, as the ox, they fornt regular canals. 202 VISCERAL ANATOMY. Uvea^ or Tapetum, — a layer of purple pigment-cells on the posterior surface of the iris, continuous with the pigment layer of the ciliary processes. Sphincter Pupilla, — a layer of circular muscular fibres around the pupillary margin, supplied by the 3d nerve. dilator Pzipillce, — radiating muscular fibres from the pupillary margin toward ^ije ciliary border, supplied by fibres of the sympathetic, from the ciliary ganglion. [See p. 137.] Menibrana Pupillaris, — a vascular membrane which covers the pupil in the foetus, disappearing about the eighth month, — occasionally permanent. It is nourished by the Hyaloid Artery, through the Canal of Stilling (de- scribed under the Vitreous Humor). Arteries, — are derived from the long and anterior Ciliary, forming the Cir- culus Major Iridis at the ciliary border, and the Circulus Arteriosus Iridis Minor near the pupillary margin. Veins, — empty into those of the ciliary processes and the anterior ciliary veins Sinus Circularis Iridis, Canal of Schlemm, or Canal of Fontana, — is z minute canal at the internal corneo-sclerotic junction, extending arounc the circumference of the attached border of the iris. It is lined by endo thelium and encloses a venous plexus, receiving veins from the sclerotic and the ciliary plexus. It communicates with the chamber of the aqueous humor and with the anterior ciliary veins. Nerves of the Iris, — are derived from the 3d, 5th and the sympathetic, through the long and short ciliary nerves. The 3d supplies the circular fibres, the sympathetic the radiating ones, the 5th being nerves of common sensation. The Retina. What is the Retina ? It is the innermost or nervous tunic of the eye, — a delicate, grayish, transparent membrane, about i^-^ of an inch thick at the fundus, 2^^ ii'^ch at the anterior margin. It is formed by a membranous ex- pansion of the optic nerve elements, and extends from the termination of that nerve nearly as far forwards as the ciliary processes, terminating in a jagged margin, the Ora Serrata, though its fibrous stroma is continued as the Pars Ciliaris RetincB over the ciliary body. The Retina presents for examination the following points, viz., the — Macula Lutea,or Yellow Spot, — situated on the retina, exactly in the visuai axis ; is an elevated oval spot where vision i« very acute, the retina being very thin and full of nerve elements closely packed together at the ex- pense of its connective tissue. No rods, no nerve-fibre layer here, but me cones and ganglion-cells are very numerous. Fovea Centralis, — a depression at the centre of the macula lutea, ji^ to -^^ inch in diameter, in which the sense of vision is most acute. THE RETINA. 203 Fig. loo. optic Disc or Papilla, — the point where the optic nerve enters, the central artery of the retina piercing its centre. It lies about -^-^ inch internal to and -^^ inch below the posterior pole of the eye, and is often called the Blind Spot, being the only part of the fundus oculi from which the power of vision is absent. Pars Ciliaris RetincB, — the part of the retinal stroma which is prolonged over the ciliary body. It is destitute of nerve-elements. Arteries of the Retina, — arise from the Arteria Centralis Retinoe (br. of the ophthalmic), just behind the optic disc; run chiefly upwards and down- wards, accompanied by veins, to terminate in capillary network. No vessels exist in the fovea centralis, and only the finest capillaries in the macula lutea. Describe the Structure of the Retina. It is composed of nervous elements, blood-vessels, and modified connective tissue resembling the neuroglia of the brain, arranged in 9 or lO layers, from within outwards, as follows, viz. — Membrana Limitans Interna, — a perfectly transparent membrane, made up of the retinal connective tissue, and lining the inner surface of the retina (shown in the cut by the lowest line). Optic Nerve Fibres,'^ — composed of the ter- minal fibres of the optic nerve radiating from the papilla in all directions. They consist of the axis-cylinder only. Ganglionic Layer,"^ — a very thin layer of large ganglion cells, having large nuclei and nucleoli, with branching processes to the optic nerve fibres of next layer. Internal Molecular Layer,^ — fine granules intersected by finest nerve fibres and con- nective tissue elements. Internal Granular Layer,^ — small, round cells with large nuclei, their processes uniting with the ganglion cells. External Molecular Layer,^ — a very thin layer of fine granules and nerve-fibrillae. External Granular Layer,^ — consists of ellipsoid cells, forming a nucleated en- largement of Jacob's membrane. 204 VISCERAL ANATOMY. External Limiting Membrane, — a membranous expansion of radial con. nective tissue, perforated by foramina (shown in the cut by a line between 6 and "'). Rods and Cones, or Jacob's Membrane,*^ — the perceptive layer of the retina, composed of rods and cones closely packed together, like palisades, the termini, probably, of the optic nerve fibres. [A tenth layer is described by some anatomists, the pigmentary layer of the choroid. 8 See a'«/<», p. 200.] Name the Essential Elements of the Retinal Structure. Principal Elements, are three, as follows, viz. — Nerve fibres, — which in the molecular layers break up into very delicate plexuses. In their course are found — Nerve-cells, — ordinary bipolar or multipolar, and modified ones, the so-called granular layers of the retina. Terminal Organs, — the rods and cones of Jacob. Subordinate Elements, are two, the — Modified Connective Tissue,— oi spongy nature. Vessels, — blood-vessels and lymphatics. The Humors. What is the Aqueous Humor ? It is a clear, alkaline, serous fluid, com- posed of water 96.7, albumen o.i, chloride of. sodium and extractive matters 3.2, weighing 4 to 5 grains, and filling the anterior and posterior aqueous chambers, which communicate with each other when the pupil is dilated sufficiently to remove the pupillary margin of the iris from the surface of the lens. The— Anterior Chamber of the Aqueous Humor, — has the cornea in front and the iris behind. Posterior Chamber of the Aqueous Humor, — has the iris in front, the lens, zonula and ciliary body behind. [The existence of any such space is denied by many authorities.] Describe the Crystalline Lens. It is a biconvex, elastic, transparent body, enclosed in a capsule, held in place by a suspensory ligament, and situ ated between the posterior aqueous chamber and the chamber of the vitreous humor, immediately behind the pupil. Its posterior surface is the most convex, ftnd rests in the Hyaloid Fossa of the vitreous. Its — Dimensions and Weight, — diameter, about ^ inch, — axis about ^ inch, — weight, 4 to 4^ grains, — index of refraction, 1.44. Composition, — water 60, soluble albuminous matter 35, insoluble albuminous matter 2.5, fat and cholesterine 2 per cent. THE HUMORS OF THE EYE. 205 Capsule, — is transparent, elastic, ^^^^ ^^^^^ thick anteriorly, -^-^^-^ inch pos- teriorly ; has a layer of flat cells between its anterior portion and the lens, which, after death, break down into a fluid, the Liquor Morgagni. Zonula of Zinn, or Suspensory Ligament, — connects the capsule with the ciliary body. It is formed by a splitting of the, hyaloid membrane into two layers, one going in front of the lens, the other behind. It is shown exaggerated in the cut. Canal of Petit, — is a triangular space around the circumference of the lens, formed by the sepa- ration of the two portions of the suspensory ligament (shown inflated in the cut). Processus Zonules, — are small radiating folds on the anterior surface of the suspensory ligament, which are received be- tween the ciliary processes. Describe the Structure of the Crystalline Lens. It consists of flattened hexagonal fibres, united laterally into lamellse, by serrated edges, and curving around the borders of the organ. Its centre or Nucleus is unstratified, and denser than the surrounding portion or Cortex. It is unorganized, having no vessels or nerves, but receives its nutriment by imbibition from the uveal tract, and possibly from the other humors of the eye. What is the Vitreous Humor ? The Vitreous Humor or Hyaloid Body is an apparently structureless substance, of gelatinous consistence, consisting of water with a little albumen and salts, and containing cells, nuclei, and con- nective-tissue filaments. It has no vessels or nerves, and is situated in the posterior chamber of the eye, behind the lens, which it supports, as also the retina. The — Canal of Stilling, Canal of Cloquet, or Hyaloid Canal, — traverses the vit- reous humor antero-posteriorly, being the channel for the transmission in the foetus of the Hyaloid A7'tery to the membrana pupillaris. [See ante^ p. 202,] Hyaloid Fossa, — a depression on the anterior surface of the vitreous, receiv- ing the posterior convexity of the lens. What is the Hyaloid Membrane ? It is a delicate capsule investing the vitreous, and supposed to send delicate septa into the substance of that humor. It divides anteriorly into two layers, which enclose the Canal of Petit and the Lens, forming the suspensory ligament of the latter, or Zonula of Zinn. [See above.] The foregoing is the view of most anatomists, but some assert that this membrane is identical with the internal limiting membrane of the retina, extending only to the ora serrata. [Henle, IwanofF, etc.] ??0(5 VISCERAL ANATOMY. Others admit a hyaloid membrane surrounding the vitreous, but deny that it sphts to enclose the lens, and assign but one layer to the suspensory ligament, namely, that in front of the Canal of Petit. [Gray, etc.] Describe the Muscles of the Eyeball. They number 6, of which 4 are Recti and 2 Oblique, as follows : — Rectus Superior,'^ — from the upper margin of the optic foramen and the sheath of the optic nerve, — into the sclerotic coat. Action, to rotate the eyeball upwards. Nerve, 3d cranial. Rectus Inferior,^ — from the ligament of Zinn, — into the sclerotic coat. Action, rotates the eyeball downwards. Nerve, 3d cranial. Rectus Internus,^ — from the ligament of Zinn, — into the sclerotic coat. Action, rotates the eyeball inwards. Nerve, 3d cranial. Rectus Externus,"^ — by two heads, the upper from the outer margin of the optic foramen, the lower from the ligament of Zinn and a bony process Fig. 102. at lower margin of the sphenoidal fissure, — into the sclerotic coat.^o Action, to rotate the eyeball outwards. Nerve, 6th cranial, or abducens. Between the two heads of the external rectus pass the 3d, nasal branch of the 5th, and the 6th cranial nerves, and the ophthalmic vein. Obliquus Superior,'^ — from about a line above the inner margin of the optic foramen, its tendon passing through a " pulley " ^ 2 near the internal an- gular process of the frontal bone and thence beneath the rectus superior, — into the sclerotic coat, at right angles ^ to the insertion of the rectus superior. Action, to rotate the eyeball on its antero-posterior axis. Nerve, 4th cranial, or patheticus. Obliquus Inferior,^ — from the orbital plate of the superior maxillary, — into the sclerotic coat below the insertion of the external rectus and at right angles thereto. Action,io rotate the eye on its antero-posterior.axis. Nerve, 3d cranial. ^ THE EYE. 207 Vessels and Nerves of the Eye. What Nerves supply the Muscles of the Eye ? The — 3d Cranial, or Motor t9(r«//,— supplies the superior, inferior and internal recti, and the inferior oblique muscles. 4th Cranial, or Trochlear, — supplies the superior oblique muscle. 6th Cranial, or Abducens, — supplies the external rectus. Describe the Arteries of the Eye. The Eye is supplied by the Oph- thalmic and Anterior Cerebral branches of the internal carotid artery, and the Infra- orbit alhxdMch of the internal maxillary (from the external carotid). The— Ophthalmic, — arises from the cavernous portion of the Internal Carotid, and enters the optic foramen, giving off the follovi^ing-named branches : — Lachrymal,— to the lachrymal gland, the upper eyelid, and the conjunctiva, anastomosing v^'ith the palpebral arteries. 5'«/ra;^r3// Anteriorly y — the Skin, Superficial fascia. External oblique muscle, and the Internal oblique for its outer one-third. Posteriorly, — the Conjoined tendon, Transversalis fascia, Triangular ligament, Sub- peritoneal tissue, and Peritoneum. Above, — the arched fibres of the Internal oblique and Transversalis muscles. Below, — Poupart's ligament, and the Transversalis fascia. INGUINAL HERNIA. 227 The Crural Arch or Poupart's Liga- Fig, 114. What is Poupart's Ligament ? ment is that portion of the aponeu- rosis of the external oblique muscle \ which extends from the anterior superior spine of the ilium to the spine of the pubes. Its lower por- tion 3 forms the external pillar of the external abdominal ring,i and its reflection along the pectineal line is called Gimbernafs Ligament.'^ Other fibres, reflected behind the internal pillar of the ring,* upward to the linea alba, are termed the Triangular Ligament. What is the Relation of the Epigastric Artery to the Internal Abdominal Ring ? The Epigas- tric artery lies between the trans- versalis fascia and the peritoneum, passing obliquely upwards and in- wards along the lower and inner margins of the internal ring.^ What is the Cremasteric Fascia ? It consists of a series of muscular loops, united by areolar tissue, and forming a thin covering over the spermatic cord. The muscular fibres (Cremaster muscle) are supposed to have been originally part of the Internal oblique muscle, but carried down by the testicle in its descent to the scrotum. It does not exist in the female. Name the Coverings of Inguinal Hernia. In the oblique form of Inguinal Hernia the coverings are — 1. Skin. 2. Superficial Fascia^ — 2 layers. 3. Intercolumnar Fascia, — from the external abdominal ring. 4. Cremasteric Fascia, — from the inguinal canal. 5. Infundibuliform Process of the transversalis fascia, — from the internal abdominal ring. 6. Peritoneum, — the proper hernial sac. In the direct form of Inguinal Hernia, the coverings are precisely the same, except that the Conjoined Tendon is substituted for the Cremasteric fascia, and the Transversalis Fascia for its Infundibuliform process. A 7th covering is sometimes enumerated, viz. : the Sub-serous Areolar Tissue, 228 VISCERAL ANATOMY. which would come before the peritoneum in the above list. It is not suffi- ciently dense to make an appreciable covering. FEMORAL HERNIA. Where and What is the Femoral Canal ? The Femoral or Crural Canal lies beneath Poupart's ligament, i close to the inner side of the femoral vein * ; and extends from the Femoral Ring to the Saphenous Opening in the fascia lata of the thigh. It is a narrow interval between the femoral vein and the inner wall of the Crural Sheath or sheath of the vessels. The canal is }4 to }4 inch in length ; is closed above by the Septum Crurale, below by the Cribriform Fascia ; and contains only some loose areolar tissue and a few lymphatic vessels. The — Femoral or Crural Ring,—\s an oval-shaped opening, about yi inch in Fig. 115. diameter (larger in the female), situated below the internal abdo- minal ring ' and Poupart's liga- ment, ^ and between the inner side of the femoral vein and the mar- gin of Gimbernat's ligament. ^ It is closed by the Septum Crurale and a small lymphatic gland. The arrow in the figure goes into the femoral ring. Saphenous Opening,^ — is an oval- shaped structure, ij4. inch long, ^ inch wide, situated below the inner third of Poupart's ligament, and formed by a reflection inwards of the fascia lata around the end of the internal saphenous vein.^ The outer margin curves over to the spine of the pubes, and is named the Falci- form Process^ or Ligament of BurnSy its pubic end being often called the Ligament of Hey. The inner margin curves upwards behind the saphenous vein and under the outer margin, and is blended with the pubic portion of the fascia lata over the pectineus muscle. The opening is covered by the Cribriform Fascia. What are the Boundaries of the Femoral Canal ? Anteriorly, — Poupart's ligament, Transversalis fascia, and the Falciform Pro- cess of the fascia lata. Posteriorly, — Iliac fascia, and Pubic portion of the fascia lata. Externally, — the Septum covering the femoral vein. FEMORAL HERNIA. 229 gttternallyy — Transversalis fascia, Iliac fascia, Gimbernat's lijjament, and the deep Crural arch. Name the Structures in relation with the Femoral Ring. The — Spermatic Cord, — in the male, lies directly above its anterior margin, replaced by the round ligament in the female. Femoral Vein,^ — lies next on its outer side. Epigastric Artery^ — crosses its upper and outer angle. Obturator Arteryy — when arising from a common trunk with the epigastric, as it does once in 3^^ subjects, may lie close along its internal and superior margins. What is the Septum Crurale ? A layer of condensed cellular tissue, supporting a lymphatic gland, and perforated for the passage of lymphatic vessels. It lies across the femoral ring, and forms one of the coverings to any hernia escaping thereby. It is sometimes named the Fascia of Cloquet, or Fascia of Cooper. Describe the Crural Sheath. It is the sheath which invests the femoral vessels below Poupart's ligament, and is formed by a prolongation of the transversalis fascia anteriorly, and the iliac fascia posteriorly. It is divided by two septa into 3 compartments, the exterior of which contains the Femoral Artery, the middle one the Femoral Vein, while the one most internal is the Femoral Canal. The sheath is perforated anteriorly by the genito-crural nerve, internally by the internal saphenous vein, and forms one of the coverings of a femoral hernia. What is the Deep Crural Arch ? It is the lower thickened border of the transversalis fascia, which arches across the front of the crural sheath, and is intimately connected therewith. It seems to be attached externally to the centre of Poupart's ligament ; internally it is inserted into the pectineal line behind the conjoined tendon. Name the Coverings of Femoral Hernia. From without inwards its coverings are the — 1. Skin. 2. Superficial Fascia, — 2 layers. 3. Cribriform Fascia, — from the saphenous opening. 4. Crural Sheath, — from the transversalis fascia. 5. Septum Crurale, — from the femoral ring. 6. Peritoneum, — the proper hernial sac. VISCERAL ANATOMY. THE PERINEUM. What is the Perineum ? It is a triangular space containing the structures which close the pelvic outlet anterior to a line drawn between the tuberosities of the ischia. Posteriorly to this line the corresponding space is named the Ischio-rectal Fossa. The Perineum is bounded laterally by the rami of the pubes and ischia, anteriorly by the symphysis pubis, and posteriorly by the line above mentioned, which averages about 2^ inches in length. [For the Muscles of the Perineum, see antCy p. ^2>-\ THE MALE PERINEUM. What Fasciae are met with in the Perineum ? The — Superficial Layer of the Superficial Fascia, — is thick, loaded with fat, and continuous with the subcutaneous fascia of the thighs. Deep Layer of the Superficial Fascia, — is thin but strong, continuous in front with the dartos of the scrotum, (?), attached on each side to the rami of the pubes and ischium ; posteriorly it joins the deep perineal fascia under the transversus perinei muscle. It sends inwards a vertical septum which is incomplete in front. [This fascia is called by Professor Pancoast the " anterior leaflet of the triangular ligament."] Anterior Layer of the Deep Perineal Fascia, — is triangular in shape, and extends from the pubic arch and the sub-pubic ligament, laterally to the rami of the pubes and ischia, and posteriorly to the central tendinous portion of the perineum, where it becomes blended with the deep layer of the superficial fascia. It embraces the anterior part of the membranous portion of the urethra. [Called by Professor Pancoast, the " middle leaflet of the triangular ligament."] Posterior Layer of the Deep Perineal Fascia, — has the same attachments as the anterior layer above described, but in its course it embraces the posterior part of the membranous portion of the urethra, and is in connection with the apex of the prostate gland. [Called by Prof. Pancoast, the " posterior leaflet of the triangular ligament."] Obturator Fascia, — is the part of the pelvic fascia which covers the obturator internus muscle, and is continued on to the levator ani muscle as the Ischio- rectal or Anal fascia. Recto-vesical Fascia, — is the portion of the pelvic fascia which invests the internal surface of the levator ani muscle, and the prostate gland, bladder, rectum, and vesiculae seminales. What is Buck's Fascia ? It is a continuation of the Deep Layer of the Superficial Fascia of the Perineum, extending forwards upon the penis, and investing that organ completely as far as the glans. It is continuous above THE MALE PERINEUM. 231 with the suspensory ligament of the penis, and is held by some anatomists to prove that the deep layer aforesaid is not continuous in front with the dartos of the scrotum. This fascia was named from Dr, Buck, an American surgeon, who, in 1846, first insisted on the importance of this structure. It modifies the direction of urinary infiltration of the perineum, until perforated. What is the Triangular Ligament of the Urethra ? According to some authorities it is the anterior layer of the deep perineal fascia ; according to others it includes the posterior layer also. Prof. Pancoast includes in the term " Triangular Ligament''^ all three layers which are united at the central tendinous portion of the perineum, including, therefore, the deep layer of the superficial perineal fascia. Name the Structures which lie between the Layers of the Deep Perineal Fascia. In this space, which by some writers is termed the Cavity of the Triangular Ligament, are the — Membranous Portion of the Urethra. Compressor Urethm Muscle. Artery of the Bulb. Pudic Vessels and Nerve. Nerve of the Bulb. Cowper's Glands and Ducts. Plexus of Veins. What Structures lie behind the Posterior Layer of the Deep Perineal Fascia ? They are the — Bladder. Rectum. Prostate Gland. Levator Anti Muscle. Ischio-rectaly or Anal Fascia. Enumerate the Structures situated between the Anterior Layer of the Deep Perineal Fascia and the Deep Layer of the Superficial Perineal Fascia. They are as follows, the — Crura of the Penis. Erector Penis Muscle. 2 Corpus Spongiosum. Transversus Perinei Muscle.^ Bulb of the Urethra. Transversus Perinei Artery. Accelerator Urince Muscle.^ Superficial Perineal Vessels. Enumerate the Structures which are divided in the Lateral Opera- tion of Lithotomy. If the knife is inserted i ^ inch above the verge of the anus, and carried to a point "^ inch below that orifice, and about half-way outwards to the tuber ischii {^Gross)^ it will divide the Skin and Superficial Fascia (ist Layer). Inferior Hemorrhoidal Vessels and Nerves. Deep Layer of the Superficial Fascia. Superficial Perineal Vessels and Nerves. Accelerator Urincz Muscle ^ (posterior fibres). Transversus Perinei Muscle ^ and Artery, 232 VISCERAL ANATOMY. Anterior Layer of the Deep Perineal Fascia. Compressor Urethm Muscle (a few fibres). Levator Ani Muscle ^ (anterior fibres). Membranous and Prostatic Portions of the Urethra. Posterior Layer of the Deep Perineal Fascia. Prostate Gland (in part only). Neck of the Bladder. What Parts are to be avoided in the Lateral Operation of Lith- otomy ? Tliey are the — Bulb and its Artery, — in front. Rectum, — inwardly and posteriorly. Pudic Artery, — outwardly. Fig. ii6. Prostate Gland and Veins, — by not carrying the deep incision too far back- wards, the entire division of the left lobe of this gland will be avoided. THE FEMALE PERINEUM. What especial Function does the Female Perineum Perform ? That of supporting the posterior wall of the vagina, and thereby aiding materially in the support of the whole vagina, uterus and bladder. The — Perineal Body, — is the pyramidal-shaped prolongation of the female peri- neum upwards between the vagina and rectum. Enumerate the chief points of Difference between the Female Perineum and that of the Male. The— Orifice of the Vulva, including the vaginal orifice, — ^perforates the female THE FEMALE PERINEUM. 233 perineum, its posterior commissure approaching the anal margin within about an inch. Superficial Fascia, — is incomplete, by reason of its perforation by the orifice of the vulva, but consists of two layers, as in the male. Deep Perineal Fascia, — being also perforated by the vagina, is less apparent than in the male, though presenting two layers, with the urethra perforating them, as in the other sex. Muscles, — the Sphincter Vaginae takes the place, in the female, of the A.ccelerator Urinse of the male. Prostate Gland is wanting, — but its place is occupied by a number of minute glands disposed around the neck of the bladder. APPENDIX TO POTTER'S ANATOMY. TABLES AND PLATES OF THE ARTERIAL AND NERVOUS SYSTEMS. ABBREVIATIONS. Anas Anastomoses. Inf. Inferior. Ant Anterior. Int Internal. Art. or A. . . . Artery. L Left. Asc Ascending. M Middle. Br Branch. N Nerve. Cerv Cervical. PI Plexus, Com Common. Post Posterior. Commun. . . . Communicating. R Right. Desc Descending. Sup Superior. Ext External. Superf. .... Superficial. Trans Transverse. Note —The arteries in the following plates should be colored red, by painting them over with ordinary crimson ink, or water-color paint, using a fine camel's- hair brush for the purpose. Copyright, 1890, by P. Blakiston, Son & C: Pulmonary Artery, (Plate I.) ARTERIAL SYSTEM. THE ARTERIAL SYSTEM. {•: Pulmonary Art. (Plate Pulmonary Art. (Plate J Nu J c merous branches through- out the pulmonary tissue, carrying Venous blood. R. Coronary K^ ^j^^ muscular tissue of the heart. L. Coronary J r R. Common Carotid | ^■^'- <^^^oitd{3). ^Int. Carotid {/[). Innominate -! f Vertebral (5). R. Subclavian I Thyroid Axis {6). becomes ^;rz7/ar)' (9)] ^«^- Mammary (7). \ Sup. Intercostal (8). L. Common Carotid, . . Same as R. Common Carotid. L. Subclavian, . . Same as R., continuing as Axillary (9). Arch of Aorta. (Plate I.) External Cairotid. (Plate I.) Lingual. {Hyoid, along lower border of os hyoides. Super/. Descending, crosses Com. Carotid. Sup. Laryngeal, to larynx and epiglottis. Inf. Laryngeal, crosses Crico-thyroid membr. [' Hyoid, along upper border of bone. Dorsalis LingucE, to tongue, tonsil, palate, etc. Sublingual, to gland, mouth, gums. Ranine, under surface of tongue, to tip. Inf. {Asc.) Palatine, {f ''• *° ^°^ P^^^*^" ^Br. to tonsil. Tonsillar, to tonsil and root of tongue. Submaxillary, to gland, skin, muscles. ^ , . ASuperf. Br. anas. inf. labial. u men a ^ ^^^^ ^^ ^^ ^^^ ^.^ Muscular, to pterygoid, masseter, buccinator. Inf. Labial, anas, with br. of 7th and 5th N. Inf. Coronary, anas, with br. of inf. dental art. „ ^ _ { Art. of Septum Nasi. Sup. Coronary, -J _ ^ , r •" K Br. to ala of nose. Lateralis Nasi, to ala and dorsum of nose. Angular, termination of facial trunk. Muscular, to digastric, stylo-hyoid, sterno' mastoid, etc. Auricular, to back part of concha. Inf. Meningeal, to dura mater in post, fossa. {Superf. Br. anas, superf. cervical. Deep Br. anas, vertebral, and deep cerv. br. of sup. intercostal. Facial. Occipital. - Plate.l. ,:^atemiu l/'^H^^ Pottei; de 238 ARTERIAL SYSTEM. THE ARTERIAL SYSTEM. -Continued. External Carotid. {Continued.) Post. Auricular. Ascending Pharyngeal. Temporal. Internal Maxillary Divisions : /. Maxillary. 2. Pterygoid. 3. Spheno- maxillary. Branches (small), to muscles and glands. {anas, with Tympanic of Int. Maxil. forming vascular cir- cle around tympanum. Auricular, to cartilage of ear. External Branches, to muscles and nerves. Meningeal Branches, to dura mater. Pharyngeal Branches, 3 or 4 in number. Transverse Facial, lies on the masseter. Anterior Auricular Branches, to pinna, etc. Middle Temporal, supplies that muscle. Anterior Temporal. Its brs. directed backward. Posterior Temporal, along side of head. r ^ , . (tomemb.tympani, anas. with Stylo« Tympantc\ . ■. K^j.\. t mastoid and Vidian arteries. Mid. Meningeal, to dura and cranial bones. Small Meningeal, to dura and Gasserian gang. I Mylo-hyoid, in that groove. Inferior DentalX Incisor X^^,^^^^^ grs. ^-Mental, > Deep Temporal (2), under temporal muscle. Pterygoid Brs., to pterygoid muscles. Masseteric, to deep surface of masseter. Buccal, a small br. to buccinator. f6w/n Z) ^ T-41. -J , S Metiingeal, io dura.. Post. Ethmoidal i ^, , „ ' ^^ Nasal Brs., to nose. Ant, Ethmoidal, has same branches. Sup. Palpebral, arch on margin of lid. Inf. Palpebral, margin of lower lid. Frontal, to muscles, skin| ^^^.j^j^^^j Nasal \ Dorsalis Nasi, ) Branches. Ophthalmic. Groups, 1. Orbital, 2. Ocular. (Plate 4.) Fig. 2. Muscular f Superior, to ocular muscles. V Inferior, to ocular muscles. Ant, Ciliary, to circle on the iris. Short Ciliary, 12 or 15, around optic n. Long Ciliary, to circles on iris. Art. Centralis Retincs, to retina. Anterior Cerebral \ Ant. Communicating, 2 lines long. { Anterior, to anterior lobe of brain. Middle Cerebrals Posterior, to middle lobe of brain. ^Median, to the island of Reil. _, ^ . ^ . ,. /anas, with Post. Cerebral of Basilar, to Posterior Communicating, \ . ^u • 1 r Txrn- <- form the circle of Willis. Anterior Choroid, to the choroid plexus, etc. THE CIRCLE OF WILLIS. {Post. Cerebral \ Post. Commun. [ Middle | ^„^ Cerebral "I i I Cerebral J VAnt. Commun. ( Middle ■> . , Post. Cerebral S Post. Commun. j cerebral J Cerebral J 240 ARTERIAL SYSTEM. THE ARTERIAL SYSTEM. -Continued. Vertebral. - (Plate I.) L t l^h' I i^^' *° spinal cord and membranes. I Br. to bodies of Vertebrae posteriorly. Muscular Branches, to deep cervical muscles. Post. Meningeal, ramify between dura mater and skull. At ' r Si>' I |J°'"^ ^^^ fellow to form Ant. Median Artery of tht ' t spinal cord. Posterior Spinal, to spinal cord and membranes, laterally. r ^ ■ ^ 1. 77 i Internal \ to cerebellum, and choroid plexus Inferior Cerebellar ■{ ^ ^ A ., ,,' .. ^ ■^ ^External) of the 4th Ventre e. Basilar. - _ „ i Auditory, to that canal. Transverse BrsA . . , r r ■ -, ^ i „ (Ant. {Inferior) Cerebellar. Superior Cerebellar, to pia mater, pineal gland, etc. {Post. Choroid,\.o choroid plexus. ^ra«.A.., to posterior lobes of cerebrum, anas, with Ant. and Mid. Cerebral Arteries. 6. Thyroid Axis. (Plate I.) Inferior Thyroid. . Transversalis Colli. . Supra-scapular. {Laryngeal, to posterior muscles of larynx. J Tracheal Brs. to trachea, anas. Bronchial. 1 CEsophageal Brs. to oesophagus. yAscending Cervical, to muscles, spinal cord. {Superficial Cervical, beneath Trapezius. Posterior Scapular, along post, border. {Supra-acromial, anas. Acromial Thoracic. I Communicating, across neck of scapula. ' Comes Nervi Phrenici {Superior Phrenic), to'Diaphragm. Mediastinal Brs. to connec. tissue, ant. mediastinum. Pericardiac Brs. to upper part of pericardium. Sternal Brs. to sternum and Triangularis sterni. Anterior Intercostals, to 5 or 6 upper intercostal spaces. Perforating, to Pectoralis major, mammarv gland, etc. , ,, . ( Ant. Intercostals, to lower spaces. Musculo-phrentc ■{ „ ^ , • j- ta- u * ^ t Brs. to lower pericardium, Diaphragm, etc. anas. Epigastric of Ext. Iliac. Internal Mammary. (Plate I.) L Superior Epigastric supplies Rectus abdominis, etc. 8. r Profunda Cervicis, ascends along back of neck, to axis ; anas, with Superior J Art. princeps cervicis of Occipital. Intercostal. | Brs. to ist and 2d intercostal spaces, giving br. to post, spinal mus- (Plate I.) L cles. and one to spinal cord, and anas, with Aortic Intercostals. ARTERIAL SYSTEM. kl Axillary. (Plate 2 ) 1 from I St part. 2 " 2d " 3 " 3d " THE ARTERIAL SYSTEM .-Continued. f Superior Thoracic, to Pectoral muscles and wall. {Thoracic Brs. to Pectorals. Acromial Brs. to Deltoid. Descending, to both these muscle*. Thoracica Longa, to Serratus, Pectorals and gland. Thoracica Alaris, to glands of axilla. {Subscapular. Infra-spinous. Median. Main trunk to inf. angle of the scapula. f around neck of humerus, to Deltoid. Anterior Circumflex, Posterior Circumflex i Br. to shoulder-joint. /around neck of humerus, to Deltoid muscle and shoulder-joint. Becomes Brachial (io), at lower margin of tendon of the Teres major muscle. zo. Brachial. (Plate 2.) Superior Profunda, Post. Articular, to elbow, and inner side of arm. Main trunk, in spiral groove of the L humerus, to Deltoid, Triceps, etc. Nutrient, to nutritious canal of humerus. InfetHor Profunda, to inner condyle and olecranon. Anastomotica Magna, transversely inwards on Brachialis an- ticus muscle, anas, with several arteries. Muscular, 3 or 4, to muscles in course of artery. Bifurcates into Radial (ii) and Ulnar (12), about % inch below the bend of the elbow. II. Radial. (Plate 2.) In forearm. In wrist. In hand. Radial Recurrent, anas, branches of Sup. profunda. Muscular Brs. to muscles on radial side of arm. Superficialis Voles, |^° muscles of thumb, anas, with Ulnar «- Art. completing Superf. Palmar Arch. Ant. Carpal, to wrist-joints, anas. Ant. Carpal of Ulnar. Post Carpal |*° wrist-joints, anas. Post. Carpal of Ulnar. ^ Dorsal Interosseous, for 3d and 4th spaces. Metacarpal, is the First Dorsal Interosseous Branch. Dor sales Pollicis (2), laterally on dorsum of thumb. Dorsalis Indicts, on radial side of index dorsum. Princeps Pollicis, \ 2 Brs. forming arch on last phalanx. Radialis Indicis, along radial side of index finger. Perforantes (3) between heads of last Dorsal Interossei. Palmar Interossecs [ ^3 o"" 4) along Interossei muscles, given <- off by Deep Palmar Arch. Forms Deep Palmar Arch in the hand, by inosculating with the Communicating from the Ulnar, at the base of the metacarpal bone of the little finger. ^3 ARTERIAL SYSTEM. THE ARTERIAL SYSTEM.-Continued. 13. Ulnar. (Plate 2>. In forearm. In wrist. In hand. 3- i Interosseous Anterior Interosseous Anterior Ulnar Recurrent, ascends in front of inner condyle Posterior Ulnar Recurrent, ascends behind inner condyle, pierces Interosseous niera* brane, descending to back of wrist. Muscular Branches. Nutrient, of both bones. Br. on Pronator quadratus. Median, along median n. to back of wrist. Post. Interosseous Recur^ rent, to ext. condyle of • [ humerus. Muscular, to muscles on ulnar side of arm. Anterior Carpal, to joints, anas. Carpal of Radial. Posterior Car>a/, j'^J^^"*^ of wrist, anas. Carpal of Radial. ^Br. {oxm\x\% Post. Carpal Arch. /■anas, with termination of Radial Deep {Communicating) < Artery, forming the Deep Palmar Posterior Interosseous Arch. Digital (4), (from convexity of Superf. Palmar Arch, to ulnar side of little finger, and adjoining sides of ring, middle, and index fingers (rest supplied by radial). Forms- Superficial Palmar Arch in palm of hand, by inoscu- lating with Superficialis Volae of Radial Artery. Bronchial Arteries (3) nutrient vessels of the lungs. CEsophageal, (4 or 5) anas. brs. Inf. Thyroid, Phrenic, Gastric. Pericardiac, Brs. distributed to the pericardium. 13. Thoracic Aorta. (Plate 3.) Intercostal J (20) I r Anterior {Proper)\^''- ^1°"^ lower border of rib. y Br. alone UDoer border of nb. Br. along upper border of rib. ^ Spinal, to vertebrae, cord, etc. Posterior {Dorsal) \ ^^,,^1^^^ to tissues of back. . Posterior Mediastinal, (several) to glands, etc., in mediastinum. Plate 2 ■s~^ Totter <3el. 244 ARTERIAL SYSTEM. THE ARTERIAL SYSTEM Phrenic -Continued. 14. Abdominal Aorta. (Plate 3.) / Internal, to front of thorax and Diaphragm. I External, to side of thorax. CCEUAC Axis. Gastric, Hepatic - Gastro-duodenalis, to cardiac orifice of stomach, cardiac end, then along lesser curvature to pylorus, where it anas, with Pyloric Br. of Hepatic Art. ' Pyloric, to pylorus, anas. Gastric Art. G astro- epiploic a Dextra, along greater curva- ture. Pancreatico-duo- denalis, to those L organs. . Cystic, br. R. Hepatic, to gall-bladder. Pancreaticce ParvcB \ .^ .. ^ ^„„^..^„o „ > to the pancreas. Pancreattca Magna J Gastric (l^asa Previa), 5 to 7, to the Splenic i greater curvature of stomach. Gastro-epiploica Sinistra, along the greater curvature, from left to right. Terminal Brs enter hilum of Spleen. Inferior Pancreatico-duodenal, to those organs. Vasa Intestini Tenuis (12 to 15) form arches in mesentery, in several series, from terminal arches branches ramify on intestines. Ileo-colic I ^^f^^^o*'^ anas. Vasa intes. ten. I Superior, anas. Colica dextra. Colica Dextra j^^^^' ^''- 1 Arches branching to (■Asc. Br. ) ascending colon. Colica Media \ ^'^^^ \ Arches, branching to trauR- ^ Left ) verse colon. Supra-Renal, to supra-renal capsule. Renal i^*"^- 1° substance of kidney. ^ Small Brs. to capsule, ureter, etc. Spermatic (or Ovarian) to testes or ovaries. r Colica Sinistra \^J'- \ ^'"^^^ branching to de- Superior Mesenteric ^Desc. ) scending colon. 1 Sigmoid, across Psoas to that flexure of colon. Sup. Hemorrhoidal, \ ^J' ^° "^^' } side of rectum. ^ ^Br. to left J {fto muscles, etc., of back. Dorsal < , ( Br 1 ^ , [Sptnal, to canal j | Arches. Abdominal, between abdominal muscles. Middle Sacral, to coccyx, anas. Lateral Sacral. Bifurcates /Right Com. Iliac, R. Int. and Ext. Iliac (15, 16). 1. Left Com. Iliac, L. Int. and Ext. Iliac (15, 16). Bifurcation occurs at 4th Lumbar Vertebra, opposite Umbilicus. Inferior Mesenteric Lumbar (4) Plate 3 246 ARTERIAL SYSTEM. THE ARTERIAL SYSTEM.-Continued. 15- Internal Iliac. Anterior Trunk. (Plate 4.) r Superior Vesical j^^^' ""^ ^""^ Deferens, to that organ, t Middle Vesical, to base of bladder. Inferior Vesical, to base of bladder, prostate gland, etc. Middle Hemorrhoidal, to rectum, anas, other hem. arteries. UteHne, to neck of uterus j ^^^- ^^ bladder. <• Brs. to ureter. Vaginal, analogous to Inf. Vesical in male. ■ In the female. Obturator. Internal PUDIC. Sciatic. Iliac, to iliac bone and Iliacus muscle. Vesical, backwards to the bladder. Pubic, on the back of pubic bone. Internal, inner margin obturator foramen. External J^"^^*" "largin obturator foramen. I- ^r. to hip-joint by cotyloid notch. Inf. {Ext.) Hemorrhoidal, 2 or 3 to anus. Sup erf. Perineal, to scrotum, etc. Transverse Perineal, to muscle of same name. Artery of the Bulb, large but very short. Art. of Corpus Cavernosum, to that body. , Dorsal Artery of the Penis, thereto. Muscular Brs. within the pelvis. Hemorrhoidal Brs. to the rectum. Ve.iical Brs. to base and neck of bladder. Coccygeal, to back of coccyx. Inf. Gluteal (3 or 4) to Gluteus maximus. Comes Nervi Ischiadici, along sciatic nerve. Muscular Brs. to back of hip. Articular Brs. to capsule of joint. Plate 4 FIG. 1. ^oLachynwl Gland FIG. 2. BRANCHES OF OPHTHALMIC ARTERY. "^ r \ 1 1 yyJhfJntSuraC MExtArtirjtlar =^ '^ In/MS^ Potter, del. 248 ARTERIAL SYSTEM. THE ARTERIAL SYSTEM. -Continued. 15. Internal Iliac. Posterior Trunk. {Muscular Br s. within the pelvis. Nutrient, of the Ilium. Superficial, to Gluteus maximus, etc. Deep ^Superior, to ant. sup. spine of Ilium. I Inferior, to glutei and hip-joint. r Iliac, to Iliacus internus and Ilium. 1 Lumbar |*° Psoas and Quad, lumborum. \ Spinal Br. to cord and membranes. Superior Lateral Sacral, to dorsum of sacrum. Inferior Lateral Sacral, to front of sacrum, and coccyx, anas with Sacra media, etc. Ilio-Lumbar . ' Muscular Brs. several, to Psoas and glands. /■ Cremasteric, to cremaster muscle. Epigastric -< Pubic, to inner side of femoral ring. ^Muscular, to abdominal muscles and skin. x6. External Iliac. (Plate 4.) Circumflex Iliac /^etw. Transversalis and Int. oblique. •^ Br. anas, with Lumbar and Epigastric. Becomes Femoral (17) at Poupart's Ligament. Superficial Epigastric, in superf. fascia, to umbilicus. Superf. Circumflex Iliac, outwards to iliac crest. Superf. Ext. Pudic, inwards to skin of penis, scrotum, etc. Deep Ext. Pudic, inwards to skin of perineum, etc. {Asc. Brs. outer side of hip. Transverse, to back of hip. Descending, as far as knee. {Ascending, to Adductors, etc. Descending, to Adductors, etCv Articular, to head of femur. (Superior, pierces Adductor magnus, Middle | Nutrient of Femur. Inferior, pierces Adductor magnus. Muscular (2 to 7), along course of the artery. X7. Femoral. (Plate 4.) Profunda Femoris Anastomotica Magna. [Superficial Br. io\n^.^^x^^n^. ^ Deep Br. to mner side of Knee and jomt. Becomes Popliteal (18), at opening in Adductor magnus. Plate 5. Potter, del. 250 ARTERIAL SYSTEM. THE ARTERIAL SYSTEM. -Continued. 18. Popliteal. (Plate 4.) Muscular [^^P^^or Brs. to Vastus ext. and flexor muscles. ^ Inferior or Sural (7)^ to Gastrocnemius and Flantans, Cutaneous Brs. to integument of calf. Superior Internal Articular, to Vastus int. and joint. Superior External Articular, to Vastus ext. and joint. Azygos Articular, to synovial membrane of joint. Inferior Internal Articular, to head of tibia and joint. Inferior External Articular, to front of knee-joint. Bifurcates into /Anterior Tibial (19) | at lower border t Posterior Tibial (20) / Popliteus muscle. Recurrent Tibial, on front and sides of knee-joint. Muscular Brs. numerous to muscles of leg. Internal Malleolar, beneath tendon of Tibialis anticus. External Malleolar, to outer ankle. Tarsea, to tarsal joints and Ext. brev. digit. 19. Anterior Tibial, (Plate 5.) DoRSALis Pedis . Metatarsea \ 3 InterossecB, \ °^^^ ^' y \ Dorsal Br. Dorsalis Hallucis \ ^''- '° ^""^^ «^ ^^^^ t^^' '^ Br. to great and 2d toes. Communicating, j^"^^- ^^t. Plantar (Arch). U Digital Brs. Ends in the Plantar Arch. / Anterior Peroneal, pierces interosseous membrane. Peroneal X Nutrient of Fibula, to that bone. y Muscular Brs. in its course. Muscular, to Soleus, etc., on back of leg. Nutrient of Tibia, the largest nutrient artery of bone. Communicating Br. to the Peroneal, near its end Internal Calcanean Brs. to the heel, and sole of foot. Internal Plantar, along inner side of foot. Brs. to muscles, fascia and skin. Posterior Perforating (3) Branches. 4 Digital, \ Ant. Perforating Branches. Ends as the Plantar Arch, anas, with Commun. Br. of Dorsalis Pedis. TO. Posterior Tibial. (Plate 5.) External Plantar, TABLES AND PLATES NERVOUS SYSTEM Note. — These Tables are of original arrangement, and are designed to show the origin, formation and distribution of each nerve. They are generally self-explanatory. That for the 2d Cranial (Optic Nerve) is too long for the width of the page, and breaks at the Optic Commissure, which is repeated again where the table continues below. Sam'l O- L. Pqttkr, 251 252 NERVOUS SYSTEM. THE CRANIAL NERVES. r Ethmoidal foramina, 20, ist NERVE,— Olfactory. Funciton,— smell. Exit,—< in cribriform plate of Eth- C moid bone. ^,W. /?oo/,Temp.-sphen. lobe,\ .. /-£jr/.i^//azw^«^j, to outer wall of nasal cavity. Mid. Root, Olfac. tubercle, > • r ih 1 ^^^' Filaments, to root of cavity. Int. Root, Gyrus fornicat. -' ^Int. Filaments, to Septum nasi. 2d NERVE,— Optic. Function,— %\^\.. Exit,— O^W^ foramen }' Optic thalamus -v r Longitudinal Corp. geniculata > Fibres -< Decussating ^Left Optic Tract Corp. quad. ant. ^ ^Inter-cerebral Corp. quad. ant.\ (Inter-cerebral-^ Corp. geniculata [-Fibres X Decussating > Right Optic Tract Optic thalamus ^ ^ Longitudinal j Optic .COMMISSURE^gi^^ or Chiasm. ^^ Optic Commissure or Chiasm. J {Longitudinal, to temporal J4 ot retina >| Decussating, fr. opp. tract to nasal Yi of ret. > L. Eye. Inter-retinal, fr. opp. retina to retina •' (Longitudinal, to temporal ^ of retina opp. opp. 2d i Inter-retinal, fr. opp. retina to retina Optic N.^ Decussating, fr. opp. tract to nasal Y^. of ret. >- R. Eye. ^Longitudinal, to temporal Y^ of retina. 3d NERVE,— Motor Oculi. Function— vaoWon. .Ejtrw,— Sphenoidal fissure. Corp. quadrig. ~| Valve of Vieus. I . ^ {Sup. Branch, to Lev. palp, sup., Rectus superior. Aqued. ofSyl. | ^ ' \lnf. Branch /to Rectus int., Rect. inf., Inf. oblique. Crus cerebri. J '^ motor root to Ciliary Ganglion. Supplies all the Ocular muscles, including iris, except Sup. oblique and Ext. Rectus. 4th NERVE,— Trochlear. Function,— moMxon. ^'.rzV,— Sphenoidal fissure. Aq. of Sylvius, -v „ , . Valve of Vieus. \ 4th N. |*° ^"P" Oblique on upper (orbital) surface. Crus cerebri i Branch to Cavernous Plexus of Sympathetic. Is the smallest cranial nerve, with the longest nerve-course in the cranial cavity. Plate B. I^JVervPr Oifiwtffry. Bu2b ^ OlTcmtoty Ti^ict OtfetctoryTilanije rtts 2\*^^\ert^ei-(^tir Corp. rtrochleuT- 254 NERVOUS SYSTEM. THE NERVOUS SYSTEM.-Continued. 5th NERVE,— Trigeminus. (See Page 131, ante.) Functions, Sensation, Motion, Special sense. Origin. Nucleus in floor of 4th Ventri- cle, and side of Pons, for Sensory Root, and the Gang- lion of Gasser. Nucleus in floor of 4th Ventri- cle, and side of Pons, for Motor Root. 5th N. Trigeminus, (i) Ophthalmic . by Sphenoidal fissure. (2) Superior Maxillary' by For. rotund. ^ro«/a/j^"P''^°''b'tal. <■ Supratrochlear. Lachrymal. Ganglionic. Long Ciliary. Nasal. \ Infratrochlear. Int. Nasal. Ext. Nasal. Temporo-malar. . inSpheno- Spheno-palatine. V max. Post. Dental. i Foramen.- Mid. Dental. Ant. Dental. Palpebral. Nasal. Labial. In Canal. Infra- orbital /-Palpebral, -v \ Nasal. \ ^Labial. 3 On face. (3) Inferior Maxillary. by For. Ovale. Ant. Div. Mid. Div. Masseteric* Deep Temporal* |^"^- ^''•* 1 Post. Br.* Buccal. yPterygotd*\^''^-^''* \ Ext. Br.* Br. of Communic'n. Br. of Distribution. fMylo-hyoid. Dental Brs. f Incisor. LingualX '-Terminal •^ Mental. Post. \ Auriculo- Div. I Temporal. 'Ant. Temporal. Post. Temporal. Sup. Auricular. Inf. Auricular. Br. of Commun'n. to Meat. Auditor, to articulation. Parotid. * Motor Branches, going to the muscles of mastication. Plate 7, The Cranial ^erve s . 5t> Nerve,-Trige minus. 256 NERVOUS SYSTEM. THE NERVOUS SYSTEM .-Continued. 7th NERVE,— Facial, or Portio Dura. Func Hon, —Motion. (See ante, p. 131.) In auditory canal. Br. to Auditory N. Origin. Nucleus in floor of the 4th Ventricle and groove between Olivary and restiform bodies of medulla oblongata. 7th N. Facial In Aqueduct of Fallopius . . . (Large Petrosal,\.o Meckel's Ganglio.; Small Petrosal, to Otic ganglion. Ext. Petrosal, to meningeal plexus. Tympanic Br. to ear. At exit from the Stylo - mastoid Foramen On the face . . . In Aqueduct of Fallopius . . . Br. to Great Auricular (Cerv. Plex.) Br. to Auriculo-Temporal (5th), Br. to Pneumogastric. Br. to Glosso-pharyngeal. Br. to Carotid Plexus (Symp.). Brs. to 5th Nerve. {Tympanic Nerve. Chorda Tympani Nerve. Near Stylo -mas- toid Foramen. ^On the face* Post. Auricular ' Auricular. ^ Occipital. Br. to Digastric. Br. to Stylo-hyoid. . Lingual. {Temporal. Malar. Infra-orbital. r Buccal. Cervico-facial X Supra-maxillary. y Infra-maxillary. • Forming the Pes Anserinus, or Goose-foot, as these branches are named. Plate 8 The GptAisriAi. Serves. 7^^ Nerve -Facial, or Portia Dura. O.A.F iTvfriLorb. JPy REFERENCES. (.GREAT PETROSAL,™ FORM VJOIAN WITH N?5. 2. SMALL PETROSAL, TO OTIC GANGLION, 3. EXTERNAL PETROSAL JO PLEXUS ON MID. MENINGEAL ARTERY. 4. TYMPANIC BR. TO STAPEDIUS, ETC. 5. BR. FROM CAROTID PLEXUS, MAKING VIDIAN, WITH N9 I 6.7. BRS.TOAURICULO-TEMPORAL OF STV 8.BR TOAURICULAR OFVAGUS. M. THE GANGLION OF MECKEL. O.A.F. ORIFICE OFAQUEDUCTUS FALLOPK. iioLS^ 258 NERVOUS SYSTEM. THE NERVOUS SYSTEM. -Continued. The Eighth Pair (Willis) includes the 9th Glosso-pharyngeal, loth Pneumo* GASTRIC, and nth Spinal Accessory,— all of which Exit by i\\^ Jugular Foramen, of Foramen Lacerum Posterius. gtb NERVE, — Glossopharyngeal. Functions, — Motion, Sensation, Special Sense, (See ante, page 132.) Origin. A Gray nucleus in floor of 4th Vent. and medulla oblong. behind the olivary body. gth Nerve Glosso- pharyngeal. Tympanic. (Jacobson's N.) Communica f Large Petrosal. < Small Petrosal. ting Brs. to (carotid Plexi Distributing [ Fenestra ovalis. Brs. to Fenestra rotunda. Eustachian tube. Carotid Branches. Pharyngeal Brs. — to Pharyngeal Plexus. Muscular Brs. — to muscles of pharynx. Tonsillar Brs.— to Tonsillar Plexus. Lingual Brs.— to post. % of tongue, giving taste thereto. loth NERVE,— Pneumogastric, or Vagus. (See ante, page 132.) /^««c^wM J, (Sensation, t Motion. Origin. A nucleus in the floor of 4th Vent- ricle below that of 9th nerve and groove between olivary and restiform bodies of medulla. loth Nerve Vagus. ' Auricular {Arnold's Nerve). Pharyngeal. Sup. Laryngeal \^^^- ^^• I Int. Br. Recurrent or Inf. Laryngeal Cervical Cardiac. Thoracic Cardiac. Ant. Pulmonary. Post. Pulmonary. Gastric. Intestinal. Hepatic. Renal. Splenic. ' Probably comes from the Spinal Accessory, and supplies all the laryngeal muscles except crico-thyroid. Terminal Brs. Gives sensation to external ear and larynx, motion to other parts, also vaso-motorial, inhibitory, trophic and secretory influences. A nerve of deglutition, phonation, respi- ration, circulation, and digestion. The Auriculo-Laryngo-Pharyngo-CEsophago- Tracheo-Pulmono-Cardio-Gastro-Hepatic-Intestinal-Renal-Splenic Nerve. nth NERVE,— Spinal Accessory. Function, — Motion. (See ante, page 132.) Origin. The floor of 4th Ventricle, and gray horn in cord, down to 6lh Cervical N. nth Nerve Branch to Vagus, ganglion of root. Internal, anastomosing with Vagus, is probably the Recurrent Laryngeal Br. of the latter nerve. ExternaL or Muscular, to f Sterno-mastoid. ^^Trapeziur. A motor nerve to the muscles named, also probably to the laryngeal also. Plate 9. The Cranial Xep^ves. ■r The 8tti Pair of Nerves, ^sy comprising the 9^'^ or Glosso- pharyngeal, 10^^ or Pneumogastric, ll^'^or Spinal Accessory ,ft-^^^-^^^ ffuscles ofjjaiynx toOmUaein. /nmCTKirunlJC REFERENCES. 1. JUGULAR GANGLION OF S^r HERVE. 2. PETROUS GANGLION OF 9^" NERVE. 3. GANGLION OF THE VAGUS ROOT. '». GANGLION 0FTHEVA6US TRUNK. 5. MEDULLARY PART OFIIT" NERVE. 6.SPINALPART0F II^h NERVE. 7. SUP CARDIAC BR. JOINING CARDIAC OF SYMPATHETIC. 8 SUBCLAVIAN ARTERY, ON RICHTSIDE,ARCH OF THE AORTA.ON LEFTSIDE OFTHF BODY. 9. FORAMEN MAGNUNI,RECE1VIN6 SPINAL PART OF THE SPINAL ACCESSORY. 10. JUGULAR FORAMEN TRANSMITTING AILTHREE NERVES ^ fingers. Muscles of little finger Interossei. 2 inner Lumbricales. Adduc. pollicis. Flex. brev. poll, (inner head). (8) Subscapular (3). (9) Circumflex (10) MUSCULO- Spiral. ist upper, to Subscapular muscle, 2d Long, to Latiss. dorsi. 3d Lower, to Teres major. Superior Br . toj^^^toid. '^Skin of shouldw. f Teres minor. Inferior Br. . to -< Deltoid (post ). ''Skin ef shoulder. Muscular, . {Triceps, Anconeus. Brach. anticus Supin. long. Ext. carpi, rad. long. Cutaneous, to skin of arm. Radial. Internal Br. External Br. to skin of thumb. to skin of z% fingers on radial side of dorsum. {to all muscles on back of forearm, except Anconeus, Sup. long, and Ext. carpi radialis long. Filaments to wrist-joints. NERVOUS SYSTEM. 269 THE NERVOUS SYSTEM .-Continued. THE DORSAL NERVES. N. B.— Read front the Black Types outwards to left and right. Transv. colli. Longis. dorsi. Trachelo-raast. Levat. costar. Sacro-lumbal. Accessorius. Semi-sp. dorsi. Multif Spinae. Skin of back. Ext. Brs. «-« to \lnt. Brs. to Each ■ Post. Div. 6 Upper Dorsal .Nerves.^ Ant. Div. Thoracic Intercostals Muscular. Lateral Cutaneous. Intercos. Tri. Ster. f Skin of Chest, Breast, Side, Back. Anterior Cutaneous Skin of Chest, Breast. Same as above. •» Skin of back. J Ext. Brs. Same as above. % No br. to skin. \ Int. Brs. (Each 6 Lower Dorsal Nerves. Muscular. f Intercos. t^Abdom.M f . . , , Skin of Lateral ' auj _ ^ < Abdomen, Cutaneous, i '■ etc. , , <■ Recti M. Antertor \ ^^^.^ ^^ Cutaneous.\^^^^^ 270 NERVOUS SYSTEM. THE LUMBAR AND SACRAL NERVES. (Distribution shown on next Table.) An External Branch, sending filaments to the Erector spinae and Intertransversales muscles, and the skin of the gluteal region, posteriorly. An Internal Branch, sending filaments to the Multifid. spinae, and skin over vertebrae of spinal column. An External Branch, forming loop on sacrum and great Sac-Sciat. lig. to supply skin over glutei. An Internal Branch, to Multifidus Spinae and back part of coccyx. (the two lower nerves.) 1st Lumbar. 2d Lumbar. c ^ 3d Lumbar. ■4th Lumbar. •R Uth Lumbar, ist Sacral. 2d Sacral. Are below the' Multifid. Spinae, join together in loops over back of sacrum, sending fila- ments to skin. Post Div ;] Post. Div. 3d Sacral. 4th Sacral. 5th Sacral. Coccygeal. {Nos. I, 2, 3, Comm. Br. to 2d Lum. iNos. 3, 4, 5, Comm. Br. to 3d Lum. {Part of 5, 6, 7, Comm. Br. to 4th Lum. Ant. Div. Part of 5, 6, 7, Lumbo- sacral Cord to 5th Lum. {Joins the Lumbo- SacralCord Joins the Lumbo- sacral Cord and 2d Sacral. (i) nio-hypogastric (2) Ilio-inguinal . (3) Genito-crural. (4) Ext. Cutaneous. (5) Ant. Crural. (6) Obturator. (7) Accessory Obturator, (when present.) Ant, Div. Ant Div ..{! oins with I St Sacral. {Joins with 2d Sacral and part of the 4th. Br. to Plexus, Vise. Brs. Mus. Brs. . Fil. to 5th. /-Br. to skin of coccyx. .' -< Br. to Coccygeus M. i-Br. toCocc. Nerve. Ant. Div. (i) Super. Gluteal. (2) Muscular Brs. (3) Small Sciatic. (4) Great Sciatic. (5) Pudic. (6) Articular. Ant. Div {' delicate filament, going to skin, over coccyx. from /^^/^Donsal THE SPINAL SERVES. Lumbar 6c Sacral Plexuses Plate 14 THE LUMBAR PLEXUS lies in the substance of the psoas muscle, ILIES UPON THE PYRIFORMIS MUSCLEINTHE PELVIS, THE SACRAL PLEXUS < and is covered by the pelvic fascia, and the I SCIATICAND PUDIC ARTERIES Pot:tv-i„dfci, 272 NERVOUS SYSTEM. THE NERVOUS SYSTEM —Continued. DISTRIBUTION OF THE BRANCHES From the 7 Great Trunks of the LUMBAR PLEXUS. (A Continuation of the Table on Page 288.) (i). Ilio-hypogastric . . («). Ilio-inguinal, . . . . , (3). Genito-crural . . . . (4). External Cutaneous (5). Anterior Crural. (6). Obturator. Ant. Div. {Hiac, to skin of gluteal region. Hypogastric, to skin of that region. f to Internal Oblique Muscle. Ito skin of upper and inner thigh, scrotum, penis. f Genital, to Cremaster, scrotum, round ligament. I Crural, to skin of upper and front thigh. (Ant. Br. to skin of ant. and outer thigh, above knee. \Post. Br. to skin of post, aud outer thigh, above knee, to Sartorius, and skin of ant. thigh above knee. /Ext. Br. to skin, lateral of knee. Int. Cutaneous. < Post. Br. to skin of inner thigh '. and leg. to Skin of knee and of front and inner leg and foot. Mid. Cutaneous. Long Saphenous. Post. (Muscular Brs. to muscles on front of thigh, all but 2. Div. <■ Articular Brs. (2) to capsules of knee- and hip-joints. . f Articular Brs. ioh\^-)o\ni. " ' < Muscular Brs. to Adductors, Gracilis and Pectineus. ^' ^Anastomotic Brs. with Int. Cutan. and Int. Saphenous. Post. (Articular Brs. to knee-joint. Br. \ Muscular Brs. to Adduc. mag. and Obturator externus. f Muscular Br. to Pectineus. (7). Accessory Obturator. -< Articular Br. to hip-joiut. y Cutaneous Br. to skin of thigh and leg. I Occasionally r present. The Lumbar Plexus lies in the substance of the Psoas muscle, in front of the trans- verse processes of the lumbar vertebrae. Plate 15 The Spinal Nerves. £o>ter,aiil. 274 NERVOUS SYSTEM. THE NERVOUS SYSTEM. -Continued. DISTRIBUTION OF THE BRANCHES OF THE SACRAL PLEXUS. [Continuation of Table on Page 288.] (i). Superior Gluteal (Su '{In Sup. Br. to the Gluteus medius and minimus, to the Gluteus medius and minimus, to the Tensor vaginae femoris. Inf. Br. (2). Muscular Branches, to I Py"^°™'^' Obturator internus, the two Gemelli, and I the Quadratus femoris muscles. (3). Articular Branches, to the hip-joint. ( Gluteus maximus muscle. (4). Small Sciatic. /«/. Gluteal, I Skin of side of penis, or vulva. Inf. Pudendal |^^'" of upper and inner thigh, and of scrotum * I or labium. (5). Great Sciatic. Cutaneous, Articular, . /Ascending, to Skin over Glutei. I Descending, to Skin of post, thigh. . to the hip-joint. Muscular, to (Adductus magnus. Biceps. I Semi-membranosus, Semi-tendinosus. External Popliteal or Peroneal. Internal Popliteal Nerve. Terminal Branches. {^See next page.) (6). PUDIC. Perineal, {/•to Skin of anus, scrotum. Superficial Perineal, \ penis and labia, and the ^ Sphincter ani muscle. Muscular, to perineal muscles. Inferior Hemorrhoidal, to Sphincter ani muscle. to Skin of anal region. Dorsal of Penis, | Skin of dorsum of penis. I Br. to Corpora cavernosa. The Sacral Plexus lies in the pelvis upon the Pyriformis muscle, and is covered bjr the Pelvic fascia, and the Sciatic and Pudic Arteries. NERVOUS SYSTEM. JTiJ THE NERVOUS SYSTEM .-Continued. External Popliteal or Peroneal Nerve. DISTRIBUTION OF THE NERVES OF THE LEG AND FOOT. [Terminal Branches of the Great Sciatic] f (i). Articular {i), distributed to the knee-joint. (2). Cutaneous (2 or 3), to skin of leg, exteriorly and posteriorly. Muscular, to 1^°"^ muscles of leg. I Peroneus tertius. (3). Anterior Tibial. (4). Musculo- cutaneous. c ^ 7 D / Extensor brevis digitorum. External Br. \ ^ , . , . *. Tarsal articulations. // IR f Skin of contiguous sides of great and ^ 2d toes. Muscular, . . \ Peroneus longus and brevis. External Br. f Skin, outer side of foot and ankle. Skin, contig. sides, 3d, 4th, 5th toes. /Skin, inner side of foot and ankle. Internal Br. X Skin, contig. sides, 2d and 3d toes, '^ and inner side of great toe. (i). ^r//cM/ar (3), to knee-joint. (2). Muscular, to Gastrocnemius, Plantaris, Soleus, and Popliteus. (•formed by a filament from each of the Popli- Internal Popliteal - Nerve. (3). Ext. Saphenous, ■< teal nerves, to skin of outer side of the '- foot and little toe. Muscular, to (flexor longus poUicis, Flexor longuis I digitorum. Tibialis posticus. Plantar Cutaneous, to skin of heel and sole. {Digital, to skin, zV^ inner toes. Muscular, to flexors, etc. Articular, to tarsus. Cutaneous, to sole of foot. r Muscular, to Flexor accessorius. f\.oi% outer toes. External ^ Superficial, < Flexor brevis min. mg Plantar. 1 ( ^^^ Interosseous. {Deep Br. {^^ ^"^ ^^^ Lumbricales. ' 1. Rest of Interossei. Posterior Tibial. 276 NERVOUS SYSTEM. THE NERVOUS SYSTEM. -Continued. THE SYMPATHETIC SYSTEM, ron the Anterior Communicating Artery. Ganglion of Ribes-< In it begins the double chain of gangliated cords enumcK '^ ated below. fSome to Pneumogastric, Glossopharyngeal, and Hypoglossal Nerves. External Braytches to join the Superior ISt, 2d, Cervical 3d, 4th Ganglion Cervical Nerves. Ext.BrsXo Middle 5th and 6th * Cervical Cerv. N. Ganglion Ext. Br. forms Carotid Plexus. yAscend, BrA Int. Br. forms Cavernous Plex. V along Int. Carotid Artery. Anterior Branches, to Plexus on Ext. Carotid Artery. ( Pharyngeal, to Pharyngeal Plexus. Superior Cardiac Nerve, to Cardiac Plexus; goes to Deep PI. on right side, to Superficiaf PI. on left side of body. Int. Bts. Filaments along Inf. Thyroid Art. to Thyroid ltd. Brs. A body and Larynx. 1 Mid. Cardiac Nerve, to Deep Cardiac Plexus. Ext. Brs. to I Inferior i J Filaments along Vertebral Art. to cranium. 7th and 8th, \ Cervical \ Int. Brs. < ^^^ Cardiac Nerve, to Deep Cardiac Plexus. Cerv. N. Ganglion '- Ext.Brs.to 12 Dorsal N. 13 Thoracic Ganglia. Int. Brs. ■ Upper 5 or 6 to Aorta and Vertebral column. 2d, 3d and 4th to Post. Pulmonary Plexus. Lower 6 from the 3 Splanchnic Nerves, thus — 6-10, Great Splanchnic, to Semi-lunar Gang. 10, II, Small Splanchnic, to Cceliac Plexus. 12, Smallest Splanchnic, to Renal Plexus. Ext. Brs. to Lumbar N Ext. Brs. Sacral ^< Lumbar > ■ '^ Ganglia. J ^•*°| Sacral \ Int. Brs. \ ^' ( Ganglia. } ^ f Some to Aortic Plexus. Int. Brs. |g^^g Jo Hypogastric Plexus. 4 Sacral Ganglia Coccygeal G,, or Ganglion Impar. to Pelvic Plexus. to Plexus on Middle Sacral Artery. In which ends the double chain of gangliated cords enumer- ated above, and called The Sympathetic Nervous System. [For the various connected Ganglia, etc., see ante, pages 137 to 140.] Glosso-ph. The Sympathetic SVSTEM OfXeRVES. JrOryhon (ff/Hdes ~7 Zarae S-PetrosoL 7*^ Plate 16. G.= GANGLION. P.= PLEXUS. A.= ARTERY. 2,3.4. BRAN CHES. rROM PNEUMOGASTRIC. NERVE TO THE CARDIAC. PLEXUS. 9astro-tUiactenai Si'? irotnCowyyoai 3 SapMemorrhoidaL. 6 SpermaticI'lejcus. JPe I xas P. or In t'lh/yjocfo^tric . ' SUPPLIES ALL THE PELVIC VISCERA AND THE PENIS. frcLngUan JntjHw. INDEX Note. — Titles which contain the name of a person are entered twice, one entry being under the person's name, the other under that of the structure. PAGE ABDOMEN i6i Abdominal Cavity i6i Regions 162 Absorbents 119 Acervulus cerebri 127 Acetabulum 41 Adenology 9 Alveoli II, 23 of the lungs 173 Alveolus 141 Amphiarthrosis 55 Ampulla of semi-circ. canals 221 of the milk-ducts 192 Anastomoses 114 Anastomosis, The Stirrup 113 Anatomy 9 Angiology 9 Angle of the jaw 28 Visual 197 Angulus vestibularis 224 Annulus ovalis loo Anti-helix 213 Anti-tragus 213 Antrum of Highmore 22 Anus 152 Aorta 102 Apparatus ligam. coUi 57 Appendices epiploicae 152, 165 Appendix auriculae 100 Ensiform 38 vermiformis 151 Aponeuroses 67 Aponeurosis, Pharyngeal 147 Apophysis 10 Aqueduct of Sylvius 124 Aqueductus cochleae 17, 35, 222 Fallopii 216 vestibuli ifi, 35, 220 Arachnoid of brain 121 of spinal cord 129 Arbor vitae 129 Arch, Crural 227, 229 Palmar 108 Plantar • 113 Areola of mammae 192 Arm 45 Arnold's ganglion 137 , n^rve 35, 132 Arteriae propriae renales 176 Arterial anastomoses 114 Arteries 102 Helicine 182 Hepatic 155 Lingual 145 PAGE Arteries, Pharyngeal 145 Sub-lingual 145 Arteries of the— ankle-joint 65 auditory canal 214 auricle 214 bone 12 choroid 200 elbow-joint 61 Eustachian tube 219 eye 206 eyelids 210 hip-joint 63 iris 202 kidney 176 knee-joint 63 labyrinth 225 larynx 170 lung 173 mammae 192 membrana tympani 215 nasal fossae 196 nose 196 oesophagus 148 ovaries 191 pancreas 157 penis 183 pharynx 147 retina 203 shoulder-joint 60 stomach 150 supra-renal capsules i6i testicle 185 thymus gland 160 thyroid gland 159 tympanum 218 uterus 19Q wrist-joint 62 Arteriolae rectae 176 Artery . . 102 Anastomotica magna 108, 112 Aorta 108, 109 Art. receptaculi 105 Auricular 105 Axillary 107 Basilar 106 Brachial 107 Carotid 103, 104, 105 Cerebral, Anterior 105, 207 Middle 106 Choroid, Anterior 106 Circumflex, Anterior 107 Posterior 106 Communicating, Anterior 106 277 278 PAGE Artery, Communicating, Posterior io6 Coronary 103 Digital 114 Dorsalis hallucis 113 pedis 113 Epigastric 11 1, 227 Superficial 112 Facial 104 Femoral iii Gastric 109 Gluteal Ill Hemorrhoidal no Hepatic 109 Iliac, Circumflex in External ni Internal no Ilio-lumbar ni Infra-orbital 207 Innominate 103 Intercostales 107, 108 Lingual 104 Lumbar no Mammary 107 Maxillary, Internal 105 Meningeal, Anterior 105 Mesenteric, Inferior no Superior 109 of Neubauer 103, 159 Obturator 110,229 Occipital 105 Ophthalmic 105,206 Palmar arches 108 Peroneal 113 Pharyngeal, Ascending 105 Phrenic 109 Plantar 113 Popliteal 112 Profunda femoris 112 inferior 108 superior 107 Pudic ni External 112 Pulmonary 114 Radial 108 Renal no Sacral, Lateral , in Middle no Sciatic ni Spermatic no Splenic 109,159 Subclavian 106 Sub-scapular 107 Supra-renal no Supra-scapular 107 Temporal 105 Thoracic, Acromial 107 Superior 107 Thoracica alaris 107 longa 107 Thyroid 104, 159 Inferior 107 Thyroidea ima 159 Tibial, Anterior 112 Transversalis colli 107 Tympanic 105,218 Ulnar 108 Uterine 110 PACK Artery, Vaginal no Vertebral 106 Vesical no Arthrodial joints 55 Articulation 55 Atlo-axoid 57 Carpal 62 Carpo-metacarpal 62 Costo-sternal 58 Costo-transverse 58 Costo-vertebral 58 Metacarpo-metacarpal 63 Metatarso-metatarsal 66 Occipito-atloid 56 Occipito-axoid 57 Phalangeal of foot 66 of hand 63 Radio-ulnar 59, 61 Sacro-coccygeal 59 Sacro-iliac 59 Sacro-ischiatic 59 Sacro-vertebral 59 Scapulo-clavicular 60 Sterno-clavicular 60 Tarsal 53,65 Tarso-metatarsal 66 Temporo-maxillary 57 Tibio-fibular 65 Vertebral 56 Arytenoid cartilages 166 Atlas 37 Auricle 213 Axis 37 Coeliac 103, 109 Optic 197 Thyroid 107 Visual 197 Azygos n uvulae 74 BAND, DoUinger's 201 Bartholine, Duct of. 145 Glands of. 188 Bauhin, Valve of. 150, 151 Bell, Nerve of 133 Bellini, Tubes of 176 Bertin, Columns of. 175 Bladder 178 Blastema 12 Bodies, Malpighian 176 Pacchionian 121 Body, Ciliary aoo Hyaloid 205 Olivary 128 Perineal 232 Pituitary 123 Restiform 128 Bone II Astragalus 53 Clavicle 44 Coccyx 41 Cuboid 54 Cuneiform 49» 54 Ethmoid 21 Femur 50 Fibula 52 Frontal " INDEX. 279 PAGB Bone, Humerus 45 Hyoid 53 Ilium 42 Incus 217 Innominate 41 Ischium 42 Lachrymal 24 Malar 24 Malleus 217 Maxillary, Inferior 27 Superior 22 Nasal 22 Occipital 14 Os calcis 53 Os magnum 49 Palate 25 Parietal 13 Pectineal 43 Peroneal 52 Phalanges of foot 54 of hand 50 Pisiform 49 Pubic 43 Sacral 40 Scaphoid 49, 54 Scapula 44 Semilunar 49 Sphenoid 18 Stapes 217 Sternum 38 Temporal 15 Tibia 51 Trapezium 49 Trapezoid 49 Turbinated 19 Inferior 26, 31 Ulna 47 Unciform 49 Vomer 26 Bones of the — Body 9 Carpus 48 Foot 53 Hand 48 Head 12 Leg 51 Lower extremity 50 Metacarpus 49 Metatarsus 54 Tarsus S3 Trunk 36 Upper extremity 43 Bones, Unclassified lo Wormian 10, 33 Bonnet, Capsule of 197 Bowman's membrane 199 Muscle 200 Bowman and Todd's muscle 224 B/ain 120 Commissures of Brain 124 Divisions 121 Points on surface 123 Ventricles 124 Weights of average 121 Bronchi 170, 171 Brunner's glands 151 Bulb of corpus cavernosum 183 PAGB Bulb of corpus spongiosum 182 Bulbi vestibuli 187 Bulbs, Olfactory 123 Burns, Ligament of 228 Bursae of knee-joint 65 CJECVM 151 Calamus scriptorius 128 Calices of the kidney 175 Canal, Alimentary 141 Auditory, External 214 Internal 225 Carotid 17 Central of the Cord 129 Crural 228 Dental 22, 28 Femoral 228 Hunter's 93 Hyaloid 205 Infraorbital 22, 29 Inguinal 226 of the modiolus 221 Nutrient 52, 53 Palatine 23 Sacral 41 Spiral of the cochlea 221 for tensor tympani 35 Vidian 20, 35 Canal of— Cloquet 205 Fontana 202 Hugier 16, 35, 215 Nuck 190 Petit 204 Schlemm 202 Stilling 205 Canaliculi 11. 212 CanaHs reuniens 223 Canals, Semicircular 221 Membranous 223 Canthus 210 Capillaries 102 Capsule of Bonnet , 197 of Glisson 150 of the lens 204 of Miiller 176 of Tenon 197 Capsules, Supra-renal 160 Caput caecum coli 151 gallinaginis 179 Carpus 49 Cartilage 56 Cartilages of the larynx 165 of Santorini .. 167 Tarsal 210 of Wrisberg 167 Cartilage triticea 167 Caruncuia lachrymalis 211 Carunculae myrtiformes 187 Cauda equina 41, 129 Cavity, Cotyloid 41 Glenoid of scapula 45 of the omentum 163 Orbital 29 of reserve 144 Sigmoid 47 of the radius 4S 280 PACB Celk, Auditory 224 Ethmoid 21 Hepatic 156 Mastoid 16, 216 Olfactory of Schultze 196 Cement 144 Cerebellum 128 Cerebrospinal system 120 Cerebrum 121 its convolutions 122 its lobes, fissures, etc 121 Cervix of the penis 182 uteri 189 Chopart's operation 53 Chordae tendinae 100 Choroid tunic 200 plexus 125 Cilia 210 Circle of Willis 106 Circulus arteriosus 201 iridis minor 202 major iridis 202 venosus 192 Clavicle 44 Clinoid II Clitoris 187 Cloquet, Canal of 205 Fascia of 228 Coccyx 41 Cochlea, Membranous — 223 Osseous 220 Cceliac Axis 103, 109 Collar-bone 44 Colon 152 Flexures of. 152 Columnse cameae loi papillares loi Columns of Bertin.... 175 of spinal cord 129 Commissure, Optic... 123, 208 Concha 213 Condyles 10 of femur 51 of humerus 46 Coni vasculosi _ 184 Conjunctiva 211 Conus arteriosus loi Convolutions of cerebrum 122 Cooper, Fascia of. 229 Coracoid ii Corium 194 Cornea 199 Cornicula laryngis 167 Comua of thyroid cartilage 166 uteri 189 of the ventricles 125 Corona glandis 182 radiata 127 Coronoid 11 Corpora albicantia 123, 125 cavernosa 182 quadrigemina , 124, 127 striata 123 Corpus Arantii loi tallosum 123, 125 dentatum 128, 129 fimbriatum xt5 PAGB Corpus Highmorianum 184 luteum 191 spongiosum 182 Corpuscles, Malpighian 158 Tactile 194 Corti, Organ of. 224 Cortical substance 175 Cotunnius, Liquor of. 219 Cotyloid II Coverings of the testicle 184 of hernia 227, 229 Cowper's glands 181 Crest of the ilium 42 lachrymal 30 nasal 23 of the pubes 43 of the tibia 52 turbinated 23, 25 Cricoid cartilage 166 Crista galli 21 vestibuli 220 Crura cerebri 123, 127 of penis 182 Crusta petrosa 142 Crypts of Lieberkiihn 151 Cuneiform cartilages 167 Cuneus 122 Cupola of cochlea 221 Cuticle 193 T^ARTOS 183 *^ Dentine 142 Derma 193 Dermatology 9 Descemet, Membrane of 199 Diaphragm 83 Diarthrosis 55 Digestion, Organs of. 141 Disc, Optic 202 Discus proligerus 191 DoUinger's band 201 Dorsum of scapula 44 Douglas' cul-de-sac 188 Duct of Bartholine 145 Cystic 157 of Gaertner 192 Hepatic 155, 157 Lymphatic 120 of Miiller 185 Nasal 212 Pancreatic 157 of Rivinus 145 of Steno 144 Thoracic 119 of Wharton 144 of Wirsung 157 Ducts, Biliary 157 Ejaculatory 186 Seminal 180 Ductus cochlearis 223 communis choledochus 157 Duodenum 150 Dura mater of cerebrum 120 of spinal cord 129 EAR - 212 Internal aif INDEX. 281 PAGB Earstones 223 Eminence, Hypothenar 90 Thenar ,. 90 Eminentia coUateralis 125 Enamel 142 Enarthrosis 55 Endocardium 99 Endolymph 220 Endosteum 11 Epidermis 193 Epididymis 184 Epigastric region 162 Epiglottis 167 Epiphysis n Epiploa 164 Equator of eye-ball 197 Eustachian tube 219 Eye 197 Its appendages 209 Eyeball 197 Eyebrows 209 Eyelashes 210 Eyelids 209 PACET ■^ Fallopian tubes Fallopius, Aqueduct of. Hiatus of. Falx cerebelli cerebri Fascia, Anal Buck's of Cloquet of Cooper Cremasteric Cribriform Dentata Intercolumnar Ischio-rectal Lata Lumbar Obturator Palmar Perineal 230, Plantar Recto-vesical Tarso-orbital of Testis Fasciae of the perineum Fasciculus cuneatus gracilis Fauces Femur Fenestra ovalis 216, rotunda Ferrein, Pyramids of Tubes of. Fibro-cartilage Fibula Fimbriae Fimbriated extremities Fissure, Auricular 17 Ethmoidal Glaserian ic, qc. Palpebral f..... II 190 216 35 121 120 230 230 229 229 227 228 125 226 230 ?' 82 230 90 232 97 230 211 184 67 230 128 128 144 50 220 2X6 176 56 52 190 190 ,35 216 209 PAGE Fissure Pterygo-maxillary 32 of Rolando 122 Spheno-maxillary 30, 32 Sphenoidal 20, 30, 34 ofSylvius 122 Transverse 125 Fissures of cerebellum 128 of cerebrum 122 of liver 154 of spinal cord, 129 Folds, Retro-tarsal 211 Semi-lunar 211 Fon tana. Canal of 202 Spaces of 201 Fontanelles 33 Foot 53 Foramen for Arnold's nerve 17, 35 Caecum 12, 34 Condyloid 35 Ethmoidal 30, 34 Incisive 23,35 Infra-orbital 22, 35 Inter-vertebral 36 for Jacobson's nerve 17, 35 Lacerum anterius 20, 30, 34 medium 35 posterius 35 Magnum 14. 35 Mastoid 16, 35 Mental 27, 35 of Munroe 124 Nutrient 47, 48 Obturator 42 Olfactory 34 Ovale 19, 34 Optic 20, 30, 34 Orbital 19 Palatine 25, 35 Petrosal 35 Pterygo-palatine 35 Rivinian 215 Rotundum 19, 34 Sacral 41 of Scarpa 23 Spheno-palatine 25 Spinal 36 Spinosum 19, 34 of Stenson 23 Stylo-mastoid 17, 35 Supra-orbital 30, 35 Supra-scapular 45 Thyroid 4a Vesalii ,...19, 34 of Winslow 163 Foramina at the base of the skull 34 Olfactory 31 Orbital 29 Spheno-maxillary 32 Thebesii 100 Fore-arm 47 Fornix 125 Fossa, Canine 22 Coronoid 46 Di-gastric 28 Digital 50 Glenoid 15 Hyaloid 204, 205 INDEX. PAGE Fossa, Incisive 22, 27 Infra-spinous 44 Ischio-rectal 230 Jugular 17 Lachrymal 29 Navicularis of vulva 188 of penis 180 of auricle 213 Olecranon 46 Ovalis 100 Pterygoid 20 Scaphoid 20 Spheno-maxillary ,. 32 Sublingual 28 Sub-maxillary 28 Subscapular 44 Supraspinous 44 Temporal 32 Triangularis 213 Zygomatic 32 Fossae, Nasal 31 of the Skull 34, 35 Fourchette 188 Fovea centralis 202 hemispheric a 220 semi-elliptica 220 Frenulum 127 Frenum preputii 183 GiERTNER, DHct of, 192 Gall-bladder 156 Ganglia, Basal 123 Cervical 138 of Fifth nerve 137 of the Sympathetic 137 Ganglion, Arnold's 137 Gasserian 131, 138 Impar 137, 139 Meckel's 137, 196 of Ribes 137 Spheno-palatine 196 Spirale 225 Gasser, Ganglion of. 131, 138 Genesiology 9 Gimbernat's ligament 227 Ginglymus 55 Gladiolus 38 Gland, Lachrymal 211 Mammary 192 Pineal 127 Prostate 181 Thymus 160 Thyroid 159 Stands of Bartholine 188 Brunner's 151 Cowper's 181 Ductless 158 Gastric I49 Intestinal 152 Lachrymal 211 Littre's 180 Lymphatic 119 Meibomian 194, 210 Sebaceous 194 Solitary.... 151 Sweat 195 of Tyson 183 PAGB Glans clitoridis 187 penis 182 Glenoid n Glisson's capsule 156 Globus major 184, 185 minor 185 Glottis 168 Gomphosis 55 Graafian vesicle 191 Groove, Bicipital 46 Infraorbital . ...23, 29 Musculo-spiral 46 Mylo-hyoid 28 Naso-palatine 27 Optic 18 Pterygo-palatine 19 Gubernaculum testis 186 Gums 141 Gyrus, Angular 122 Fornicatus 122 "LJAIRS 194 ^^ Hamstrings 94 Hamular 11 Hand 48 Haversian canals 11 system 11 Head of the humerus 45 of the ulna 47 Heart 99, loo Heel 53 Helicotrema 331 Helix 313 Henle, Tubes of 176 Hernia 326 Femoral 228 Inguinal 326 Hey, Ligament of. 228 Operation of. 54 Hiatus Fallopii 16, 35 Hihon, Sac of. 168 Hilum of kidney 175 Hippocampus Major 125 Minor 125 Horner's muscle 68 Houston, Folds of ... 152 Hugier, Canal of. 16, 35, 216 Humerus 45 Humor, Aqueous 304 Vitreous 205 Humors of the eyeball 198 Hunter's Canal 93 Hydatids of Morgagni 185 Hymen 187 Hypochondrium 162 Hypogastrium 163 TLEUM 150 •*■ Ilium 42 Incisura intertragica 213 Infundibula of kidney 175 Infundibulum. 13 of brain 123 of cochlea 321 Inguinal regions 163 Intestine, Large 151 Small iS$ INDEX. 283 PAGE Intumescentia gangliformis Scarpse 225 of 7th nerve.... 138 Iris 201 Ischium 42 Island of Reil 122 Iter chordae anterius 216 Iter chordae posterius 216 Iter e tertio ad quartam ventriculum 124 Ivory 142 JACOB'S MEMBRANE 203 Jacobson's nerve 35, 132, 216, 218 Jejunum 150 Joint, Ankle 65 Elbow 61 Hip 63 Rotators of the hip-joint 95 Knee 63 Shoulder 60 Wrist 62 Joints, Motion in 55 Structures of 55 IDNEYS 17s Kirkring's valves 151 K T ABIA MAJORA •^-^ minora Labium tympanicum vestibulare Labyrinth 219, Membranous Lacteals Lacuna magna.., Lacunae Lacus lachrymalis Lamina cinerea cribrosa fusca reticularis spiralis Laminae Lancisi, Nerves of Larynx Layer, Dermoid Ganglionic Granular Molecular Leg.-V Lens, Crystalline Lieberkuhn, Crypts of. Ligament, Annular Annular of foot of Burns Canthal, External Conoid Coronary Costo-xiphoid Cotyloid Crucial of knee-joint Cruciform Deltoid Falciform Gimbernat's Glenoid of Hey Ilio-femoral or Y Q .64, 187 187 224 224 220 222 119 180 II 209 123 198 198 224 221 36 125 165 215 203 203 203 51 204 151 90 97 228 210 60 154 58 64 57 65 154 227 60 228 63 PAGE Ligament, Orbicular 61 Poupart's 91,227 Rhomboid 6j Round of the liver 154 cf the uterus 189 Sacro-sciatic 59 Stellate 58 Stylo-mastoid 57 Suspensory of lens 204 of liver 154 of penis 182 of spleen 158 Transverse 57 of hip-joint 63 Trapezoid » 6j Triancular 227 of perineum 230 of Zinn 205 Ligaments 56 of the Bladder 178 Broad 189 Canthal 210 Check 57 of the Knee-joint 64 of the Larynx 167 of the Liver 154 of the Ossicles 217 of the Ovaries 190 Peritoneal 164 of the Scapula 60 of the Sternum 58 Tarsal 210 of the Uterus 189 Ligamentum latum pulmonis 174 mucosum , 64 nuchae 76 patellae 64 pectinatum iridis 201 spirale 224 suspensorium 57 teres 63 Winslowii „. 64 Ltmbus laminae spiralis 223 Line, Inter-trochanteric 50 Popliteal 52 Linea aspera 51 ilio-pectinea 42 quadrati 50 Liquor Cotunnii 220 Morgagni 204 Scarpae 220 Lithotomy, Structures affected 231 Littre, Glands of. 180 Liver 153 Structure of liver 156 Lobe of the ear 213 Lobes of the cerebellum 128 of the cerebrum 121 of the liver « 154 Optic 124, 127 Lobule, of the ear 213 Paracentral 122 Lobules of the liver 156 of the lung 173 Lobulus caudatus 155 quadratus .°. 154 Spigelii , 155 284 INDEX. PAGB Locus niger 127 Lower, Tubercle of. 100 Lumbar regions 163 Lung, Broad ligament of 174 Lungs 171 Lunula 194 Lymphatics 119 Hepatic 156 of Lung 173 of Penis 183 of Supra-renal capsules i6i of Thymus gland 160 of Trachea and Bronchi 171 of Uterus 190 Lymph-spaces of eyeball 207 Lyra 125 TUTACULA ACOUSTICA 223 *••■• Macula lutea 202 Maculae cribrosae 220 Malleolar n Malleolus 52, 53 Malpighi, Bodies of 176 Pyramids of. 176 Malpighian Corpuscles 158 Tuft 176 Mammae 192 Manubrium 38 of the malleus 217 Marrow of bone 12 Masses, Lateral of Ethmoid 21 Mastoid u Meatus auditorius externus 16 internus 35 nasi 31 urinarius 183, 187 Meckel's ganglion 137 Mediastinum 174 testis 184 Medulla oblongata 127 Medullary substance 175 Membrana basilans 224 granulosa 191 Supillaris 202 Luyschiana 200 sacciformis 61,62 tectoria 224 tympani 214 secundaria 216 Membrane of Bowman 199 of Descemet 199 Hyaloid 205 Interosseous 61,65 {acob's 203 limiting 203 Pituitary 195 of Reichert 199 of Reissner 223 Schneiderian 195 Shrapnell's 215 Vitelline 191 Membranes of Brain 120 of the Spinal Cord 129 Synovial 56 Tarsal synovial 66 Wrist synovial 62 Meridians of eyeball 197 Mesenteries 164 Meso-cephalon 127 Mesos j6.) Metacarpus 49 Metatarsus 5^ Modiolus 221 Mons veneris 187 Morgagni, Hydatids of. 183 Sinus of 168 Mouth 144 Miiiler, Capsule of. 176 Duct of. 185 Muscle of. 201 Munroe, Foramen of. 124 Muscle of Bowman 200 Ciliary 200 Cremaster 227 Dilator papillae 202 Horner's 68 Kerato-cricoideus 169 Levator glandulae thyroideae 159 of Miilier 201 Sphincter papillae 202 of Todd and Bowman 224 Triticeo-glossus 169 Muscles 67 of the abdomen 80-82 of the arm 85 of the auricle 213 of the back 76-80 Double-bellied 67 of the ear 71 of the epiglottis 75, 169 of the eustachian tube 219 of the eyeball 68, 205 of the face 69, 70 of the forearm 87 of the foot 98 of the hand 90 of the head 68 of the hip 91 of the larynx 75, 168 of the leg 95 of the neck 7i-75 of the palate 74 of the perineum 83, 231 of the pharynx 73, 147 of the shoulder 85 of the stomach 149 of the thigh 91 of the thorax 82 of the tympanum 218 Muscular fibre 67 Musculi pectinati 100 Myology 9 NABOTH, Ovules of 190 Nails 194 Nates of cerebrum 127 Nasmyth's membrane 142 Neck of humerus 45, 46 Neubauer, Artery of 103 Nerve 120 Abducens 131 Arnold's 17, 35. 132 Auditory 131, 225 Bell's respiratory 133 INDEX. 285 PAGE Nerve, Chorda tympani 131, 195, 218 Circumflex 134 Cochlear 225 Crural anterior 135 Facial 131 Genito-crural 135 Glosso-pharyngeal 132 Hypo-glossal 132 Ilio-hypogastric 135 Ilio-inguinal 135 Intercosto-humeral 134 Interosseous 134 ti;obson's 17, 35, 132, 215, 218 ryngeal 170 Maxillary, Inferior 131 Superior 131 Median 133, 134 Motor oculi 130 Musculo-spiral 134 Nonus or 9th pair 132 Obturator 135 Olfactory 130 Ophthalmic div. of 5th 131 Optic 130, 209 Parvagum 132 Patheticus 130 Phrenic 133 Pneumogastric 132 Portio dura 131 Portio mollis 131 Pudic 13S Radial 134 Spinal accessory 132 Sympathetic 136 Thoracic 134 Trigeminus 130 of tongue movements 195 Tympanic 218 Ulnar 134 Vestibular 225 Vidian 140 of Wrisberg 134 Nerve-fibres, Optic 203 Nerves of ankle-joint 65 of auditory canal 214 of auricle 214 of bladder 179 of choroid 200 Cranial 129 of elbow-joint : 6i of eustachian tube 219 of eye 207 of eyelids. 210 of eye-muscles 206 Hepatic 156 of hip-joint 63 of iris 202 of kidney 177 of knee-joint 63 of Lancisi 125 oflarynx 7. 170 of lung 173 of membrana tympani 216 of nasal fossa 196 of nose 196 of oesophagus 148 of ovaries 191 PAGE Nerves of pancreas 158 of penis 183 Petrosal. ..- 131, 138, 140 of pharynx 147 Popliteal 136 Sciatic 136 of shoulder-joint 60 Spinal 133 Splanchnic 139 of spleen 159 of stomach 150 of supra-renal capsules 161 of taste 195 of testicles 185 of thymus gland 160 Thyroid 160 of tongue 146 of trachea and bronchi 171 of tympanum 218 of uterus 190 of wrist-joint 02 Nervous system 12c Neurilemma 120 Neurology 9 Nipple 192 Nose 19s Notch, Cotyloid 42 Inter-clavicular 38 Inter-condyloid 51 Pophteal 52 Sacro-sciatic 42, 43 Sigmoid 28 Supra-orbital 30, 35 Supra-scapular 45 Nuck, Canal of. 190 Nymphse 187 QDONTOBLASTS 12,143 ^^ Odontoid 11 CEsophagus 147 Omentum 163, 164 Opening, Saphenous 91, 229 Opercula 143 Optic thalami ....'. 123 Ora serrata 202 Orbit 29 Organ of Corti 224 of hearing 212 of Rosenmiiller 192 of sight 197 ofsmell 19S Organs of generation 181, 187 of sense 193 of taste 195 Urinary 175 of voice and respiration 165 Os orbiculare 217 planum , 21 tincae 189 uteri 189 Ossa innominata 41 triqueta 33 Osteology 9 Ossification 12 Ossicles of tympanum 217 Otoliths 223 Ovaries 190 ddd INDEX. PAGE Oviducts 190 Ovisacs 191 Ovules of Naboth 190 Ovum 191 PACCHIONIAN BODIES 13 ■^ Palate 144 Palpebrae 209 Pampiniform plexus 186 Pancoast, W. H 49, 50,95,230 Pancoast's triangle 98 Pancreas 157 Lesser 158 Papilla, Lachrymal 209 Oplic 202 Papillae of skin. 194 Parovarium 192 Pars ciliaris retinae 203 intermedia 187 Peduncles of cerebellum 128 Pelvis 40 of the kidney 175 Penis 182 Pericardium 99 Perilymph 220 Perineum 230 Female 232 Periosteum 11 Peritoneum 163, 165 Peroneus 52 Pes accessorius 125 hippocampi 125 Petit, Canal of 204 Peyer's patches 151 Phalanges 50 Pharynx 146 Pia mater of brain 121 of spinal cord 129 of the testes 184 Pinna 213 Plane, Equatorial 197 Meridional 197 Plantar arch.'. 113 Plate, Cribriform 21 Orbital 21 Perpendicular 21 Pleurae 174 Plexus, Brachial 133 Carotid 139 Cavernous 139 Cervicnl 133 Choroid 125 Gastric 150 Lumbar 135 Lobular 155 Pampiniform i?6, 191 Sacral I35 Solar 139 Splenic 159 Tympanic 218 Plexuses of the sympathetic 140 Pli courbe 122 Plica semilunaris 211 Point, Nodal 197 Poles of the eyeball 197 Pomum Adami 166 PAGB Pons Varolii 127 Tarini 123 Portal system 118 Porus opticus 198 Pouches of membrana tympani 215 Poupart's ligament 227 Precuneus 122 Prepuce 183 of the clitoris 187 Process, Acromion 44 Alveolar 23 Articular 36 Auditory 16 Basilar 14 Clinoid 18 Condyloid 28 Coracoid 44 Coronoid 28, 47 Ethmoidal 26 Falciform 228 Hamular 20, 24 of cochlea 221 Lachrymal 26 Malar 23 Mastoid 16 Maxillary 26 Mental.. 27 Nasal 23 Odontoid..... * 37 Olecranon ..." 47 Olivary 18 Orbital 24,26 Palate 23 Pterygoid 20, 25 Sphenoidal 26 Spinous 36 Styloid 17, 47, 48, 52 Transverse 36 Turbinated 21, 31 Unciform 21 Vaginal 17, 19 Vermiform 128 Zygomatic 15, 24 Processes, Ciliary 200 Clinoid 20 of Ingrassias 20 Processus cochleariformis 17,217 e cerebeilo ad medullam 128 ad pontem 128 ad testes 127, 128 gracilis 217 zonulae 205 Promontory ol tympanum 216 Prostate gland 181 Prostatic urethra 179 sinus 180 Pterygoid n Pubes 43 Punctum lachrymale 209 Pupil 201 Pylorus .-. 148, 149 Pyramid, Anterior 127 Posterior 128 of tympanum 216 Pyramids of Ferrein 176 of Malpighi 176 of Wistar 19 287 PAGE •pADIUS 48 ■■^ Rami of Inferior Maxillary 28 Ramus of ischium 43 of the pubcs 43 Receptaculum ch>li 119 Rectum » 152 Regions of abdomen 162 Reichert, Membrane of. 199 Reil, Island of 122 Reissner, Membrane of. 223 Renal vessels 176 Rete mucosum 193 testis 184 Retina 202, 204 Ribes, Ganglion of. 137 Ribs 38 Ridge, Mylo-hyoid 27 Pterygoid 19 Rima glottidis 168 Ring, Abdominal 162, 226 Crural 229 Femoral 228 Rings and phalanges 225 Rivinus, Duct of. 145 Segment of 214 Rods and cones 203 of Corti 224 Rolando, Fissure of. 122 Rosenmiiller, Organ of 192 Rostrum II of the sphenoid 19 OAC OF HILTON 168 ^ Lachrymal 212 Saccule , 223 Sacculus laryngis 168 Sacs of the peritoneum 163 Sacrum 40 Santorini, Cartilages of. 167 Sapolini 195 Scala media 222 tympani 222 vestibuli 222 Scapula 44 Scarpa, Foramen of. 23 Intumentesciagang. of. 225 Liquor of. 220 Scheyer's lines 142 Schindylesis 55 Schlemm, Canal of. 202 Schultze, Olfactory cells of. 196 Schwann, Substance of. 120 Sclerotic 198 Scrotum 183 Se.E;ment of Rivinus 214 Sella Turcica 18 Septum crurale 228 lucidum 125 nasi ji pectiniforme 182 tubae 17, 216 Sheath, Crural 228,229 Shin 52 Shoulder 43 Shoulder-blade 44 Shrapnell's membrane 215 Sight, Organ of. 197 PAGE Sigmoid flexure ,.. , 152 Silvius, Aquedu tof. 124 Fissure of. 122 Sinus aortici 102 circularis iridis 202 of the kidney 175 of Morgagni 168 pocularis 180 Sinuses 115 Sphenoidal 19 of Valsalva lox Skin 193 Slit, Nasal 31 Smell, Organ of 195 Space, Inter-peduncular- 123 Anterior perforated 123 Posterior perforated 123 Spaces, Fontana's 201 Spermatic cord 186 Sphincter vesicae 179 Spinal cord 129 Spine, Ethmoidal 18 of the ischium 43 Nasal 23j25, 31 of .he pubes 43 of the scapula 44 of the sphenoid 19 of the tibia 51 Spines of the ilium 42 Spina tympanica 214 Spinous II Splanchnology 9 Spleen 158 Spot, BHnd 20a Germinal 191 Light 215 Yellow 202 Squamous ii Stars of Verheyen 177 Steno's ducts 144 Stenson's foramen 23 Sternum 38 Stilling, Canal of. 205 Styloid II Stomach 148 Substance of Schwann 120 Sulci 122 Sulcus spiralis internus 224 tympanicus 214 Surface, Auricular 4i)42 Trochlear 46 Sustentaculum tali 53 Sutura 55 Suture, Coronal 13 Lachrymo-ethmo-frontal 30 Lambdoidal 13 Palato-maxillary 29 Sagittal 13 Spheno-malar 30 Sutures, Facial , 33 of the orbit 30 of the skull 33 Sympathetic system 120 Symphysis 55 of inferior maxillary 27 Synarthrosis 55 Synchondrosis 55 288 INDEX. PAGE Synovia 56 Synovial membranes 56 Syndesmology 9 nnAPETUM 201 •*■ Tarsus 53 Taste, Nerves of. 195 Taste-buds 195 Taenia hippocampi 125 semicircularis 125 Teeth 141, 143 Tendo oculi 210 Tendons 67 Tenon, Capsule of. 197 Tentorium cerebelli 121 Testes 183 of the cerebrum 127 Descent of. 186 Thebesius, Foramina of. 100 Thigh 50 Thorax 38 Thyroid axis 107 cartilage 166 Todd and Bowman's muscle 224 Tongue 145, 195 Tonsils 144 Torcular Herophili 14 Trachea 170 Tract, Lateral 128 Optic 208 Uveal 200 Tracts, Olfactory 123 Tractus spiralis forminosus 225 Tragus 213 Triangle, Fancoast's 98 Trigonjim vesicae 178 Trochanters 10 of femur 50 Trochlear 11 Tube, Eustachian 17, 35,216, 219 Tuber annulare 124 cinereum 123 Tubercle 10 Genial 27 of Lower 100 Tubero-sities 10 of femur 51 of humerus 45 of ischium 43 Maxillary 23 Tubes of Bellini 176 of Ferrein 176 of Henle 176 Tubuli galactopheri 192 lactiferi 192 seminiferi 184 uriniferi 176 Tuft, Malpighian 176 Tunica albuginea 184 vaginalis 184 oculi 197 vasculosa 184,200 Tunics of eyeball 198 Tutamina oculi 209 Tympanum 216 Tyson, Glands of. 183 PAGH TJLNA 4, ^^ UmbiHcal region 163 Umbilicus 162 Umbo 215 Urachus 178 Uretfers 177 Urethra 179 Bulb of. 180 Uterus 188 masculinus 180 Utricle 222 Uvea 201 Uvula 144 vesicae 179 TTAGINA 188 ^ Vaginal 11 Vallecula cerebelli 128 Valsalva, Sinuses of. loi, 102 Valve of Bauhin 150, 151 Eustachian 100 Ileo-csecal 150, 151 Mitral lor Tricuspid 100 of Vieussens 127 Valves of Kirkring 151 Semilunar loi, 102 Valvulae conniventes 151 Vas deferens 185 Vasa efferentia 184 recta 184 vasorum 102 Vasculum aberrans 185 Vein, Axillary 116 Basilic 116 Cephalic 116 Femoral 118 Median 116 PopHteal 118 Portal 118, 15s Radial 116 Splenic 159 Sub-clavian 117 Supra-renal 161 U]«ar 116 Vena Cava 117, 118 Vertebral 116 Veins 115,202 Azygos 116 ofbone 12 Cardiac 119 Choroid 200 of the eye 207 of head and neck 115 Hepatic 155 Iliac... 118 Innominate 117 Jugular no of the kidney 177 of the larynx 170 Lobular 155 of lower extremities 117 of the lung J73 of oesophagus 148 of the pancreas 158 Pulmonary 119 of the penis 183 INDEX. 289 Veins, Saphenous ii8 1 Spinal ii6 j of the stomach 150 of supra-renal capsules 161 ' •f the thorax 116 of thymus gland 160 Thyroid 160 of trachea and bronchi 171 Uterine 190 without valves 115 '. Velum interpositum 125 j Venae comites 115 j proprise renales 177 ! rectae 177 vorticosae 200 j Venter of the ilium 42 I of the scapula 44 Ventricle of the cord 129 Fifth 126 Fourth 126 of the larynx 168 Third 126 Ventricles, Lateral 124 Verheyen, Stars of. 177 Vertebra prominens 37 Vertebrae 36 Veru montanum 179 Vesalius, Foramen of. 35 Vesical, Germinal 191 Graafian 191 Vesiculae seminales 186 Vestibule 187 of the ear 220 Vidian canal 20 n*rv« 140 PACK Vieussens, Valve of. 127 ViUi 151 Viscera 141 covered by peritoneum 165 Vitellus 191 Vocal chords 168 Vomer 26 Vortex of the heart ir2 Vulva 187 Orifice of 232 TX7ALLS OF THE TYMPANUM... 216 VV Wharton's ducts 144 Willis, Circle of 106 Wings of the sphenoid 19 Winsiow, Foramen of. 163 Ligament of 64 Wirsung, Duct of. 157 Wistar, Pyramids of 19 Wormian bones 10 Wrisberg, Cartilages of. 167 Nerve of. 134 Y^LK 191 ^-INN, LIGAMENT OF 205 ^ Zone of 199 Zonula of. 204 Zona pellucida 191 Zone, Peripheral 199 of Zinn 199 Vascular 199 Zonula of Zinn j»4 Zygoma ij A Classified Catalogue of Books on Medicine and the Collateral Sciences, Phar- macy, Dentistry, Chemistry, Hygiene, Microscopy, Etc. ^ P. Blakiston's Son & Company, Pub- lishers of Medical and Scientific Books, IOI2 Walnut Street, Philadelphia No, 8. 1-18-02. SUBJECT INDEX. Special Catalogues of Books on Pharmacy, Dentistry, Chemistry, Hygiene, and Nursing will be sent free upon application. All inquiries regarding prices, dates of edition, terms, etc., will receive prompt attention. SUBJECT. PAGE Alimentary Canal (see Surgeiy) 19 Anatomy 3 Anesthetics 14 Autopsies (see Pathology) 16 Bacteriology (see Pathology).. 16 Bandaging (see Surgery) 19 Blood, Examination of 16 Brain 4 Chemistry. Physics 4 Children, Diseases of 6 Climatology , 14 Clinical Charts 20 Compends 22, 23 Consumption (see Lungs) 11 Cyclopedia of Medicine 8 Dentistry 7 Diabetes (see Urin. Organs).. 21 Diagnosis 6 Diagrams (see Anatomy) 3 Dictionaries, Cyclopedias 8 Diet and Food 14 Dissectors 3 Ear 9 Electricity 9 Embryology 3 Emergencies 19 Eye 9 Fevers 9 Food 14 Gynecology 21 Hay Fever 20 Heart 10 Histology 10 Hydrotherapy 14 Hygiene 11 Hypnotism 14 Insanity 4 Intestines (see Miscellaneous) 14 Latin, Medical (see Miscella- neous and Pharmacy) 14, 16 Life Insurance 14 Lungs II Massage 12 Materia Medica 12 Mechanotherapy 12 Medical Jurisprudence 13 SUBJECT. PAGB Mental Therapeutics 4 Microscopy 13 Milk Analysis (see Chemistry) 4 Miscellaneous 14 Nervous Diseases 14 Nose 20 Nursing 15 Obstetrics 16 Ophthalmology 9 Organotherapy 14 Osteology (see Anatomy) 3 Pathology 16 Pharmacy 16 Physical Diagnosis 6 Physical Training 12 Physiology 17 Pneumotherapy 14 Poisons (see Toxicology) 13 Practice of Medicine 18 Prescription Books 18 Refraction (see Eye) 9 Rest 14 Sanitary Science 11 Skin 19 Spectacles (see Eye) 9 Spine (see Nervous Diseases) 14 Stomach (see Miscellaneous)... 14 Students' Compends 22, 23 Surgery and Surgical Dis- eases 19 Technological Books 4 Temperature Charts 6 Therapeutics 12 Throat 20 Toxicology 13 Tumors (see Surgery) 19 U. S. 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Interleaved, for taking Notes, $1.00. 49* These Compends are based on the most popular text-books and the lectures of prominent professors, and are kept constantly re- vised, so that they may thoroughly represent the present state of the subjects upon which they treat. 4S^ The authors have had large experience as Quiz-Masters and attaches of colleges, and are well acquainted with the wants of students. 4^ They are arranged in the most approved .form, thorough and concise, containing over 6oo fine illustrations, inserted wherever they could be used to advantage. JtS" Can be used by students of any college. 4^ They contain information nowhere else collected in such a condensed, practical shape. Illustrated Circular free. No. I. POTTER. HUMAN ANATOMY. Sixth Revised and Enlarged Edition. Including Visceral Anatomy. Can be used with either Morris's or Gray's Anatomy. 117 Illustrations and 16 Lithographic Plates of Nerves and Arteries, with Explanatory Tables, etc. By Samuel O. L. Pottbr, m.d.. Professor of the Practice of Medicine, College of Physicians and Surgeons, San Francisco ; Brigade Surgeon, U. S. Vol. No. 2. HUGHES. PRACTICE OF MEDICINE. Part I. Sixth Edition, Enlarged and Improved. By Daniel E. Hughes, m.d., Physician-in-Chief, Philadelphia Hospital, late Demonstrator of Clinical Medicine, Jefferson Medical College, Phila. No. 3. HUGHES. PRACTICE OF MEDICINE. Part II. Sixth Edition, Revised and Improved. Same author as No. 2. No. 4. BRUBAKER. PHYSIOLOGY. Tenth Edition, with Illustrations and a table of Physiological Constants. Enlarged and Revised. By A. P. Brubaker, m.d.. Professor of Physiology and General Pathology in the Pennsylvania College of Dental Surgery; Adjunct Professor of Physiology, Jefferson Medical College, Philadelphia, etc. No. 5. LANDIS. OBSTETRICS. Seventh Edition. By Henry G. Landis, m.d. Revised and Edited by Wm. H. Wells, m.d.. Demonstrator of Clinical Obstetrics, Jefferson Medical College, Philadelphia. 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Illustrated. By same Author as No. 15. Price, each, Cloth, .80. Interleaved, for taking Notes, $1.00. Careful attention has been given to the construction of each sentence, and while the books will be found to contain an immense amount of knowledge in small space, they will likewise be found easy reading ; there is no stilted repetition of words ; the style is clear, lucid, and dis- tinct. The arrangement of subjects is systematic and thorough ; there is a reason for every word. They contain over 600 illustrations. THE STANDARD TEXT-BOOK Morris^ Anatomy SECOND EDITION Rewritten. Revised. Improved WITH MANY NEW ILLUSTRATIONS Has been recommended as a text-book at more than seventy of the most prominent medical schools in the United States and Canada, and is considered by all anatomists as a standard authority. It contains many features of special advantage to students. A complete Text-book. Edited by Henry Morris, f.r.c.s., Surgeon to, and Lecturer on Anatomy at, Middlesex Hospital, assisted by J. BlaniJ Sutton, f.r.c.s., J. H. Davies-Colley, f.r.c.s., Wm. J. Walsham, f.r.c.s., H. St. John Brooks, m.d., R. Mar- cus GuNN, f.r.c.s., Arthur Hensman, f.r.c.s., Fred- erick Treves, f.r.c.s., William Anderson, f.r.c.s., Prof.W. H. a. Jacobson, and Arthur Robinson, m.r.c.s. Octavo. With 790 Illustrations, of which a large number are printed in colors CLOTH. $6.00; LEATHER. $7.00 ** The ever-growing popularity of the book with teach- ers and students is an index of its value, and it may safely be recommended to all interested." — From 7'he Medical Record, New York. "Of all the text-books of moderate size on human anatomy in the English language, Morris is undoubtedly the most up-to-date and accurate." — From The Philadel- phia Medical Journal. THUMB INDEX IN EACH COPY Eighth Revised Edition* POTTER'S MATERIA MEDICA, PHARMACY, AND THERAPEUTICS. Eighth Edition, Enlarged and Revised* A Handbook, including the Physiological Action of Drugs, Special Therapeutics of Disease, Official and Practical Pharmacy, Prescription Writing, etc. By Samuel O. L. Potter, m.a., m.d., formerly Professor of the Practice of Medicine, Cooper Medical College, San Francisco; late Major and Brigade Surgeon, U. S. Vol., etc. Octavo. 950 pages. Thumb Index. Cloth, net, ^5.00; Leather, net, %(>.oq A UNIQUE BOOK. The present edition contains material gathered from the writer's experience in active professional practice in a tropical climate, among soldiers and civilians, men, women, and children, during a period of nearly two years' duration. The text throughout the book has again been subjected to a thorough and critical revision, has been largely rewritten, and has been expanded by the introduction of much new matter. The latter has to some extent taken the place of material consid- ered obsolete or comparatively unimportant, so that the increased size of the book over the previous edition is only twenty pages. In the section on Materia Medica twelve articles have been rewritten and thirty-eight new articles have been inserted. The rewritten ones are those on Argen- tum, Cinchona, Coca, Coffea, Digitalis, Dulcin, Ergot, Ferrum, Ipecacuanha, Myrrha, Saccharinum, and Veratrum Viride. The new matter includes paragraphs on Actol, Airol, Argentamin.Argentol, Argonin,Chinosol, Creosotal, Dionine, Eucaine, Eudoxin, Glycero-phosphates, Heroine, Holocaine, lodothyrin, Itrol, Largin, Nosophen, Orphol, Orthoform, Passiflora, Pellotine, Peronine, Phloridzin, Piperidin, Protargol, Tuber- culin-R, Urotropin, and Xeroform. In the section on Therapeutics new articles are inserted on Local Anesthesia, Beriberi, Dhobie Itch, Tropical Fevers, Heat-stroke, Hemoglobinuric Fever, Lymph- adenoma, Miliaria, Bubonic Plague, Sprue, Tinea Imbricata, Tinea Versicolor, and Toxemia. Twenty-eight articles in this portion of the book have been rewritten, including those on Amenorrhea, Asthma, Boils, Cholera, Diabetes, Dysentery, Dysp- nea, Gonorrhea, Insomnia, Leprosy, Lucocythemia, Lichen, Myxedema, Pemphigus, Phthisis, Remittent Fever, Typhoid Fever, Septicemia, Shock, Suppuration, Ulcers, Uremia, Variola, and Wounds. The text of many other articles has been expanded by the incorporation of more than two hundred items from current medical literature and from the author's personal experience in practice. Arrangement of Contents. Introduction. — Administration of Drugs, Classification, Dosage, etc. Part I. — Materia Medica and Therapeutics, arranged alphabetically ; under each drug is given its Synonym, Description, Preparations, Analogous Compounds, Deriva- tives, and Doses, official and unofficial ; Physiological Action ; Antagonists, Anti- dotes ; Therapeutics. Part II.— Pharmacy and Prescription Writing ; Constituents of Vegetable Drugs ; Weights and Measures ; Incompatibility; Extemporaneous Pharmacy, etc. Written for the physician who prefers to, or must from necessity, dispense his own medicines. Part III. — Special Therapeutics. Consists of 280 pages, in which diseases are taken up in alphabetical order and the treatment indicated in each concisely stated. This section contains a vast number of suggestions and over 650 Prescriptions, For- mulae, etc. Appendix, containing many useful Tables of Differential Diagnosis, Lists of Latin Phrases, Hyperdermic and Patent Medicine Formulae, etc. Index, 38 pages, double column, very carefully prepared. FOR MEDICAL STUDENTS. TAYLOR AND WELLS. DISEASES OF, CHILDREN. Illus- THE LIBRARY UNIVERISTY OF CALIFORNIA, SAN FRANCISCO (415) 476-2335 THIS BOOK IS DUE ON THE LAST DATE STAMPED BELOW Books not returned on time are subject to fines according to the Library Lending Code. A renewal may be made on certain materials. For details consult Lending Code. 28 DAY M 2 2 1995 RETURNEd AUG 3 1995 Series 4128 P. BLAKISTON'S SON &. CO., Publishers and Booksellers, 1012 WALNUT STREET, PHILADELPHIA. FOR MEDICAL STUDENTS. KIRKES' PHYSIOLOGY. Seventeenth Edition. {The Authorized Edition. i2?no. Dark Red Cloth.) Revised and Enlarged. By W. D. Halliburton, m.d., f.r.s., Professor of Physiology, King's College, London. 68i Illustrations, a number of which are printed in Colors. Cloth, net^ ^3.00 STOHR. TEXT-BOOK OF HISTOLOGY, INCLUDING THE MICROSCOPICAL TECHNIC. By Dr. Philip Stohr, Professor of Anatomy at University of Wiirzburg. Authorized Translation. Edited, wiUi Additions, hv Dr. AlF£.1<1D Schapf.R. Profejisor _£if_ Anainmy, Uni- Ql!28 Potter, S.O, L. 85937 "tflt HAL] DI H H G P( WIL] \\ P' \\ TYSC F TY5 la P86 mA compend of human anatomy-' ^3- oo Rfl SV B^ B/ P. 0202 6th fid^ s:l± ♦J J 6 i 631644 3 1378 00631 6445 By F. "minster 1 ; and 'ospital, ;^ondon '', ^2.75 ERT U. cal De- ilarged. ', ^1.50 te 5 1 1012 Walnut Street, Philadelphia.