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AN ATLAS

OF

HUMAN ANATOMY

FOR STUDENTS AND PHYSICIANS

BY

CARL TOLDT, M.D.

ASSISTED BY

PROFESSOR ALOIS DALLA ROSA, M.D. a^apte^ to Englisb an^ American aiiD Jnternational XCermlnoloo^

BY

M. EDEN PAUL, M.D. Brux., M.R.C.S., L.R.C.P. THIRD SECTION

D. AIYOLOGY n-M(;i-iu-;s 4Q0 to (^o and ixdex)

REVISED EDITION

9t/oo'

NEW YORK

REBMAN COMPANY^

141, ] 13 Axn ] 1.5 WEST SOtii STREET

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AN ATLAS

HUMAN ANATOMY

FOR STUDENTS AND PHYSICIANS

CARL TOLDT, M.D.

ASSISTED BY

PROFESSOR ALOIS DALLA ROSA, M.D. a^apte^ to Engllsb an^ American att5 international TCermlnolog^

BY

M. EDEN PAUL, M.D. Brux., M.R.C.S., L.R.C.P. THIRD SECTION

D. AIYOLOGY

rFICl'liF.S 400 xn C>_^0 AND IXDEX)

REVISED EDITION

m

4'iv;'^'^<-

NEW YORK REBMAN COMPANY

141, 143 AND M.'i WEST 3GTII STREET

Copyright, 1919, by REBMAN COMPANY

V, ^'^

M YOLO GI A MYOLOGY

^3

MYOLOGY— GENERAL CONSIDERATIONS

260

Nuclei of the muscular fibre ^

MYOL OG Y^GENERAL CONSIDERA TIONS Sarcolemma

/

Perimysium of a primary fasciculus of

muscular fibres

Cross-striated contractile substance

Fig. 490. — A Portion of an Isolated Cross- striated Muscular Fibre.

-Sa. jojomA* a

.Cross-stnated contractile substance

Nuclei of the ; muscular fibre^

^Individual fibres of a primary fasciculus

1

mm^

Perimysium of a

fasciculus of muscular fibres

I Nuclei of the connective - -" [ tissue cells

I Nuclei of the |_ muscular fibres

~^^**^JIndomysium of the muscular fibres

Fig. 491. — A Portion of an Isolated Cross- striated Muscular Fibre in which for A Short Distance the Contractile Sub- stance HAS been removed FROM THE

Sarcolemma.

Muscular fibres^;-._

Fig. 492. — Fasciculus of Muscular Fibres FROM A Longitudinal Section of the Human Sartorius Muscle, hardened in Picric Acid Solution.

,.^Capillary bloodvessels

Perimysium; of a fasciculus

of muscular fibres

Bloodvessel...''-''

^^^^l^Jhr ~~— ^i^Endomysium of the

muscular fibres

Fig. 493. — Fasciculi of Muscular Fibres in Transverse Section. Some of the Fasciculi have fallen out of the Section. In the Perimysium of the Fasciculi numerous Capillary Bloodvessels are seen in Transverse Section. (From a Transverse Section of the Human Sartorius Muscle, hardened in Picric Acid Solution and Alcohol.)

Elementary Constituents and Structure of Muscle.

MYOLOG Y— GENERAL CONSIDER A TIONS

261

Capillary bloodvessels

Endomysiiun of the. muscular fibres

Sarcolemma-

Muscular fibres"^^

Endomysium undergoing transition to tendon

Perimysium of the muscular fibres

Thickening of the periosteum at the site of origin of a muscle

Direct origin of muscular fibres from the periosteum Periosteum I'eriosteum

- Muscular fibres

Bursa beneath the tendor,.

Bursa mucosa subtendinea

Indirect insertion of muscle by tendon

Fig. 494. — Diagrammatic Representation OF THE Relation of the Muscular Fibres to the Endomysium.

Fig. 495. — Diagrammatic Representation of the Relation of the Perimysium to the Origin and the Insertion of the Muscle (the In- sertion in this Case being by Tendon).

Perimysium of the <:;^--

secondary fasciculi \""

..-Nerve filament

Primary fasciculi

Perimysium of theism '"^'^^BSUK&B^bHUtlB^KMKB^'iSf^ Epimysium (the investment or

primary fasciculi ^^"VS^Si^^BK^WBi^^Si^^^^ -sheath of areolar tissue sur-

rounding the entire muscle)

Fig. 496. — Transverse Section through the Saktokius .\1uscli-; of a New-born Infant, showing the Primary and Secondary Fasciculi of Muscular Fibres.

Structure of Muscle.

262

MYOLOGY— GENERAL CONSIDERATIONS

. Tendon

" Tendo

^Head

Caput

Belly

"Venter

Fig. 497- — Musculus FusiFORMis ; Fusi- FCRM Muscle.

Fig. 498. — Musculus Fig. 499. — Musculus Unipennatus; Pen- Bipennatus; Bipen- NiFORM Muscle. niform Muscle.

Tendon

Tendo

Fig. 500. — Musculus Biceps ; Double- headed Muscle.

_ Belly

Venter

Fig. 501. — Broad Muscle.

Fig. 502. — Strap-shaped Muscle.

Fig. 503.^Musculus BivENXEEi Digastric Muscle.

The Principal Muscular Forms.

MYULOGV —GENERAL CONSIDERA TlONa

263

Common head for the coracobrachialis muscle anc' the internal or short head of the biceps muscle -

Antagonists in relation to the shoulder-joir

Biceps flexor cubiti muscle_ (acting on three joints) ~

In relation to the humero ulnar articulation

Antagonists -

Synergists (flexors)v .

Supinator radii brevis (acting on one joint) "~

radio ulnar articulation

Axis of the trochoid articulation or pivot joint (the radioulnar articulation)

Synergists in relation the shoulder -joint

Coracobrachialis muscle (acting on one joint)

Head acting on |

two joints I of the triceps extensoi Head acting on I cubiti muscle one joint I

Biachialis anticus muscle (acting on one joint)

Axis of the ginglymus or hinge-joint (the humero-ulnar articulation)

\^ Pronator radii teres muscle I (acting on two joints)

Synergists (supinators) "j

in relation to the radio-ulnar articulation

Synergists (pronators) ) ronator quadratus muscle (acting on one joint)

Fig. 504. — The Muscles ov the Akm and the Pronator and Supinator Muscles or the Forearm as Examples of the Relation of Various Muscles to One or Several Joints, and also ok the synergistic or antagonistic action of muscles in relation to a Particular Joint.

Relation of the Muscles to the Joints.

264

MYOLOGY— GENERAL CONSIDERA TIONS

Investing portion of the deep

fascia of the arm

Fascia brachii (Lamina

superficialis)

The internal cutaneous nerve piercing the deep fascia

Epimysium of the biceps

flexor cubiti muscle

Layer of the deep fascia of the arm between the biceps and the

brachialis muscle

Fascia bracliii (Lamina profunda)

Musculocutaneous nerve

N. cutaneus antibrachii lateralis Brachial artery with its accompanying veins and nerves

Basilic vein — Vena basilica

Internal intermuscular septum Septum intermusculare mediate

Ulnar nerve —

N. ulnaris

Investing portion of the deep fascia

of the arm Fascia bracliii (Lamina superficialis)

Skin

" Integumentum commune

Superficial fascia

' Fascia superficialis

Cutaneous vein (the cephalic vein)

■ Vena cutanea (V. cephalica)

_ Biceps flexor cubiti muscle

IVI. biceps brachii

Junction of the areolar septum be- tween the biceps and the brachialis muscle with the general investing portion of the deep fascia of the arm

Brachialis anticus muscle y\. bracliialis . Musculospiral nerve — N. radialis Supinator radii longus muscle M. brachioradialis The humerus — Humerus External intermuscular septum Septum intermusculare lateraie Triceps extensor cubiti muscle M triceps brachii Superficial fascia — Fascia superficialis Skin — Integumentum commune

Fig. 505. — Aponeurosis or Fascia. The Relation of the Deep Fascia to the Various Groups OF Muscles and to the Bone. The Intermuscular Septa. The Superficial Fascia. (Fascia of the Right Arm.)

The individual muscles with their investing fascia in the lower third of the arm have been divided transversely at varying levels.

Skin

Integumentum commune Superficial fascia Fascia superficialis Brachial artery with its accompanying -^. veins and nerves

Basilic vein

Vena basilica Ulnar nerve

N. ulnaris

Internal intermuscular septum Septum intermusculare mediale

The humerus

Humerus Triceps extensor cubiti muscle M. triceps brachii

Investing portion of the deep fascia of the arm

Fascia brachii (Lamina superficialis) N^ Biceps flexor cubiti muscle

_\^,— "' M. biceps brachii '^)^\ - Cephalic vein— Vena cephalica

Layer of the deep fascia of the arm between the biceps and the brachialis muscle (i) Brachialis anticus muscle — M. brachialis

_ Musculospiral nerve

N. radialis

Supinator radii longus muscle

M. brachioradialis

External intermuscular septum

' Septum intermusculare lateraie

(i) Fascin brachii (Lamina profunda)

Fig. 506.— The Grouping of the Muscles of the Arm, and the Relation of these Muscles to the Deep Fascia. (Transverse Section through the Right Upper Arm in the Neighbourhood of its Distal Extremity; Proximal Cut Surface. Semi-Diagrammatic.)

Aponeurosis or Fascia.

MUSCULI TRUNCI THE MUSCLES OF THE TRUNK

266

THE MUSCLES OF THE TRUNK

Auricularis superior, or attollens auriculam, muscle

Aurlcularia posterior, orretrahens auriculam, muscle

Transversus nuclise muscle cvar )

Complexus, or semispinalis capitis, muscle

Sternocleidomastoid muscle

Levator anguli scapulse muscle M. levator scapulae

-Occipitalis muscle

Deep cervical fascia

Fascia nuchae

Seventh cervical vertebra Vertebra cer\ icalis Vli.

Spine of the scapula

bpina scapulas

Deltoid muscle

Triceps extensor cubiti muscle (middle or long

head) M. triceps brachii (Caput longum)

Teres major muscle Latissimus dorsi muscle

External oblique muscle of the abdome/i

M. obliquus externus abdominis

Gluteal portion of the fascia lata of the thigh

Fascia glutaea

Triceps extensor cubiti muscle

M. triceps brachii ■~ Latissimus dorsi muscle

Twelfth dorsal vertebra

Vertebra thoracalis XII.

Superficial or posterior layer of the lumbar fascia^

External oblique muscle of ' the abdomen

~ M obliquus externus abdominis Triangle of Petit Trigonum lumbale (Petiti) Crest of the ilium

Crista iliaca

Posterior superior spine of the ilium

Spina iliaca posterior superior

' See notes to pp 267 and 285 for an account of the different portions of the lumbar fascia.

Fig. 507. — First (Superficial) Layer of the Muscles of the Back (Wide Muscles of the Back) : the Trapezius Muscle (Cucullaris) ; the Latissimus Dorsi Muscle. Super- ficial OR Posterior Layer of the Lumbar Fascia.

Musculi dorsi — Muscles of the back.

THE MUSCLES OF THE TJWNK

267

Highest Curved line I Suprema Linea rmchaej Supenor (.Superior Complexus, or semispinalis capitis, muscle

Sternocleidomastoid muscle (divided and turned aside) M. sternocleidomastoideub

Splenius capitis muscle Splenius colli, or splenius cervicis. muscle

Levator anguli scapulae muscle

M. levator scapula*

Serratus posticus superior muscle M. serratus posterior superior

Vertebral aponeurosis Fascia lumbodorsali-s

Lambdoid or occipitoparietal suture

feiitura lambcioidea

Ligamentum nucha:

Deep cervical fascia (deep layer) tascia nuchae (Lamina profunda)

Spinous process of the seventh cervical vertebra

Processus spinosus vertebrae cervicalis VII.

Serratus posticus superior muscle M serratus posterior superior

Rhomboideus minor muscle

Rhomboideus major muscle

Supraspinous fascia

Fascia supraspinata

Infraspinous fascia

Fascia infraspinata

External intercostal muscles Mm. intercostales e\terni

Serratus posticus inferior muscle

M. serratus posterior inferior

Latissimus dorsi muscle (arising from the superficial or posterior layer of • t^e lumbar fascia)

Internal oblique muscle of the abdomen M. obliquus internus abdominis

External oblique muscle of the abdomen M. obliquus externus abdominis

Superficial or posterior layer of the lumbar fascia

Fascia lumbodorsalis

Gluteus medius muscle M j;luta;us medius

Gluteus maximua muscle M. glutaius raaximus

Serratus magnus muscle

M, serratus anterior

Spinous process of the twelfth

dorsal vertebra

Processus spinosus vertebrae

thoracalis XII.

Latissimus dorsi muscle (arising from the three lowest ribs)

External oblique muscle of the abdomen

M. obliquus externus abdominis Triangle of Petit Trigonum lumbale (Petili) , Crest of the ilium Crista iliaca

Gluteal portion of the fascia lata

Fascia "luta'a

Fig. 50S. — SiicoND Layer of the Musclms of thf. Back (Wide Muscles of the Back), shown liY THE Removal of the Latissimus Doksi and the Tkai'e;^ius. Muscles; on the Left Side, the Rhomboideus Major and Rhomboideus Minor Muscles have also been removed. The muscles of the second layer arc: Rhomboideus major, rhomboideus minor, serratus posticus superior, serratus posticus inferior, and levator anguli scapui.e. 'I'he superficial or posterior layer of the lumbar fascia,' by means of which the latissimus dorsi and the serratus posticus inferior muscles are attached to the spines of the vertebra', and the vertebral aponeurosis, are also shown.

The name of lumbar /ascia 11 by wme anatomisls rcslriclcd to the deeper hiycrs uf this structure (s( here call Ihc superficial or poilirior layer 0/ the Imuliar fascia is in that case cither rcEarded as the Imi^rr puriion 11/ the a/omaroi// (with which it is conlinuoiu), or cIk is termed the ' '

I that case either regarded i : aponeurosis 0/ the latissimus dorsi muscle.

Musculi dorsi— Muscles of the back.

i'\—-

268

THE MUSCLES OF THE TRUNK

Complexus, or semispinalis capitis, muscle

Splenius capitis muscle

Scalenus posticus muscle

M. scalenus posterior

Splenius colli muscle M. splenius cer\icis

Serratus magnus muscle

Spinalis dorsi muscle

Musculus accessorius ad iliocostalem M. iliocostalis dorsi

Longissimus dorsi muscle

Serratus posticus inferior muscle M, serratus posterior inferior

Externa oblique muscle of the abdomen M. obliquus externus abdominis

Iliocostalis or sacrolumbalis muscle M. iliocostalis lumborum

Superficial or posterior layer of the

lumbar fascia' (turned outwards)

Fascia lumbodorsalis

Obliquus capitis superior muscle —Complexus, or semispinalis capitis, muscle

Trachelomastoid muscle

M longibsimus capitis

Transversalis cervicis muscle M longissimus cervicis Ligamentum nuchse

Spinalis cervicis muscle

Cemcalis ascendens muscle M iliocostalis cervicis

Serratus magnus muscla

Longissimus dorsi muscle " (outer row of insertions)

Spinalis dorsi nmscle

Musculus accessorius ad

iliocostalem

M. iliocostalis dorsi

External intercostal muscles

Mm. intercostales externi

Internal oblique muscle of the abdomen

M. obliquus internus abdominis

^ See note to p. 267.

Fig. 509.— Third Layer of the Muscles of the Back (Long Muscles of the Back), shown BY the Removal of the First and Second Layers of Muscles and of the Superficial or Posterior Layer of the Lumbar Fascia and the Vertebral Aponeurosis; on the Right Side the Musculus Accessorius ad Iliocostalem has been drawn Outwards.

The muscles of the third layer are: The erector spina, consisting of the iliocostalis (sacrolumbalis) and the longissimus dorsi, with their prolongations upwards— accessorius, spinalis, and splenius muscles.

Musculi dorsi— Muscles of the back.

THE MUSCLES OE THE TRUNK

Superior curved line Linea nucha? su] ei Complexus, or semispinalis capitis, muscle

Splenius capitis muscle

Levator anguli scapulsp muscle

M. le\ator scapula:- Cervicalis ascendens muscle (insertion! M- iliocostalis cervicis '^

Splenius colli muscle— M splenius cervici Scalenus posticus muscle — M. scalenus p sten i Hasculus accessorius ad iliocostalem (insertioni M. iliocostalis dorsi

Cervicalis ascendens muscle ( divided and the lower extremity turned inwardsi

M iliocostalis cervicis

"Insertion of the serratus posticus

superior muscle into the ribs

Musculus accessorius ad iliocostalem

(the tendons of insertion have been

divided, the uppermost excepted

jl. iliocostalis dorsi

Angle of the sixth rib Angulus costa:- VI, Iliocostalis or sacrolumbalis muscle (in-,. sertion) — M iliocostalis lumborum

Longissimus dorsi muscle - Iliocostalis or sacrolumbalis muscle (ten- dons of insertion, divided and turned — upwards)— M. iliocostalis lumborum Hasculus accessorius ad iliocostalem (origin) Iliocostalis or sacrolumbalis muscle (insertion by muscular slips into the eleventh and twelfth ribs; ~"

M. iliocostalis lumborum Serratus posticus inferior muscle : (insertion into the ribs) M. serratus posterior inferior External oblique muscle of the abdomen M. obliquus fcxternus abdominis

Transversalis abdominis muscle M. transversus abdominis

Iliocostalis or sacrolumbalis muscle .

M. iliocostalis

Internal oblique muscle of

the abdomen

M. obliquus internus

aljdominis

External oblique muscle of the

abdomen M. oblifjuus externus abdominis

G iuteus maximuB muscle M xlutxus maximus

Trapezius muscle

Ligamentum nuch% /Rhomboideus minor muscle

Spinous process of the first dorsal vertebra I icccssus sp 1 sus vertebrae thoracalis I.

Levator anguli scapulae muscle ■' \I Icvati r sc ipulae

Serratus posticus superior muscle M serratu p >sterior superior .Rhomboideus major muscle

==" Trapezius muscle

Deltoid muscle

"M. deltoideus -Infraspinous fascia Fascia inlraspinata Teres major muscle

Middle or long head of the triceps exten- sor cubiti muscle \Latissimus dorsi muscle (insertion) Serratus posticus inferior muscle M. serratus posterior inferior

*Latissimus dorsi muscle (origin)

The lowest slips of origin of the external oblique muscle

of the abdomen Internal oblique muscle of the abdomen M obliquus internus abdominis

External oblique muscle

of the abdomen

M. obliquus externus abdominis

Superficial or posterior layer of

the lumbar fascia'

Fascia lumbodorsalis

Gluteal portion of the fascia lata

Fascia gluta'a

' See note to p. 267.

Fig. 510.— The Divisions of the Iliocostalis ok Sacrolumbalis Muscle and its Accessory

Slii's of Origin, shown dy the Removal of Portions of the Muscle. The Levator

Anguli Scai'UL/E, the Splenius Capitis, and the Splenius Colli Muscles. The Serratus Posticus Superior and the Serratus Posticus Inferior Muscles.

The last-named muscle has, in respect of the width of its slips of insertion, a very different appearance from that shown in Kig. 508.

Musculi dorsi Muscles of the back.

270

THE MUSCLES OF THE TRUNK

Superior curved line

Linea nuchffi superior

Mastoid process

Processus mastoideus

Trachelomastoid muscle

M. longissiraus capitis

Complexus, or semispmahs _

capitis, muscle

Semispinalis colli muscle

M. semispinalis cervicis

Transversalis cervicis muscle with the accessory slip from - the longissimua dorsi muscle

Semispinalis dorsi muscle

External intercostal muscles J

Mm. intercostales externi j ^ u

Longissimus dorsi muscle

Multifidus spinse muscle M. multifidus

Longissimus dorsi muscle (inner row of insertions

[ntemal oblique muscle of the abdomen

M. obliquus internus abdominis

Obliquus capitis superior muscle _Eectus capitis posticus minor muscle

M. rectus capitis posterior minor -Rectus capitis posticus major muscle

_ M. rectus capitis posterior major

Obliquus capitis inferior muscle

Interspinales muscles

Scalenus medius muscle Semispinalis colli muscle

M. semispinalis cervicis Scalenus posticus muscle

M. scalenus posterior

TLevatores costarum muscles i Mm. levatores costarum [ breves

1 ^External intercostal muscles "J Mm. intercostales externi

.. r Levatores costarum longiores muscles

- \^Mm. levatores costarum longi

Maltifidus spinse muscle

M. multifidus

( Intertransversales laterales muscles Mm. intertransversarii posteriores laterales Middle layer of the lumbar fascia, forming the posterior aponeurosis of the transver- salis abdominis muscle — Lig. lumbocostale Transversalis abdominis muscle M transversus abdominis

Gluteus medius muscle

M. gluteus medius

Gluteus maximus muscle

M. glutseus maximus

Fig. 511. — Fourth Layer of the Muscles of the Back (Long Muscles of the Back); on the Left Side the Longissimus Dorsi and the Transversalis Cervicis have been drawn Outwards, showing the Connexion between the Two, and their Attachments to the Transverse "Processes of the Vertebra; on the Right Side the Erector Spin^ Muscle

HAS been entirely REMOVED ; THE SEMISPINALIS DORSI, SEMISPINALIS CoLLI, SEMISPINALIS

Capitis (Complexus), and the Multifidus Spin^ Muscles make up the Fourth Layer.

Regarding the insertion of the longissimus dorsi muscle into the lumbar vertebrae and the elventh and twelfth ribs, see also Fig. 592.

Musculi dorsi — Muscles of the back.

<.

THE MUSCLES OF THE TRUNK

271

Jomplexus, or semispinalis capitis, muscle -

Obiiqv.us capitis superior muscle - -

"3 jLiQuus capitis inferior muscle

interspinales muscles

^altifidus spinas muscle

^1. multitidus

External intercostal muscles f "' U Mm. intercostales externi j '

Middle layer of the lumbar fascia, forming

the posterior aponeurosis of the trans

versalis abdominis muscle

Lif; luTiibrjcostale

Interspinales muscles Mm. interspinales Transversalis abdominis muscle

M. transversus abdominis

Superior curved lino

l^inca nucluf superior

Bectus capitis posticus minor muscle

M. rectus capitis posterior minor Bectus capitis lateralis muscle Bectus capitis posticus major muscle M rectus capitis posterior major

Posterior mtertransversales muscles

I Mm intertransversarii posteriores

Seventh cervical vertebra

Vertebra cervicalis VII.

Botatores longi muscles

Levator costse longior muscle

M . levator costae lonsus

^Levatores costarum muscles

1 (Mm. levatores costarum breves

^ Botatores dorsi muscles

Mm. rotatores breves

Levator costse longior muscle

M. levator costae longus

Twelfth dorsal vertebra W-rtebia thoracalis XII. /"IntertransverEales mediates J or interaccesBorii muscles j Mm intertransversarii [ posteriores mediales

Intertransversales laterales muscles

. I\!m, intertransversarii posteriores [ laterales

i-iG. 512. — Fifth (Deepest) Layer of the Muscles of the Back (Short Muscles of the Back): Rotatores Longi, Rotatores Doksi ; Interspinales; Intertransversales; Levatores Costarum.

The short posterior cranioveitcbral or stiliorcipital muscles also belong to tlie fifth layer of the

muscles of the back.

Musculi dorsi Muscles of the Dack.

272

THE MUSCLES OF THE TRUNK

Rectus capitis posticus minor muscle (ongin) __ j^^^^ M. rectus capitis posterior minor r

Transverse process of the atlas ^Sc-^

Processus transversus atlantis ^"*\>™*.

Obliquus capitis inferior muscle (ongin)

Rectus capitis posticus major muscle

(origin)

M. rectus capitis posterior major

Spinous process of the axis Processus spinosus epistrophei

Multifidus spins muscle (insertions) M. multifidus

Semispinalis colli muscle (insertions) M. semispinalis cervicis

Rotatores longi muscles

Interspinales muscles

Spinous process of the seventh cervical vertebra — Processus spinosus ver- tebrae cervicalis VII.

Rotatores longi muscles

Rotatores dorsi

muscles Mm. rotatores

breves

Third rib

Os costale III.- —

Multifidus spinas muscle (insertions) M. multifidus Spinous process of the third

dorsal vertebra

Processus spinosus vertebrae

thoracalis III.

Rectus capitis lateralis muscle (origin) Obliquus capitis superior muscle (origini

Obliquus capitis inferior muscle (insertion)

Insertions of the transversalis cervicis (longissimus cervicis) muscle

Spmal dura mater Dura mater spinalis

The uppermost slips of origin of the com- plexus or semispinalis capitis, muscle

The uppermost slips of origin of the multifidus spinae muscle Slip of insertion of the transversalis cervicis (longissimus cervicis) muscle Slips of insertion of the cervicalis ascendens liliocostalis cervicis) muscl:

Posterior intertransversales muscles Mm mtertransversarii posteriores

Slips of origin of the complexus, or semispinalis capitis, muscle

Tubercle of the first rib Tuberculum costae I.

Outer row of insertions of the longissimus dorsi muscle

~_ Angle of the second rib Angulus costa; II.

Insertions of the museulus accessorius ad iliocostalem (iliocostalis dorsi)

Inner row of insertions of the longissimus dorsi muscle

Fig. 513. — Origin and Insertion of the Long and the Short Muscles of the Back in THE Cervical and Upper Dorsal Region. Origin of the Short Posterior Cranio- vertebral or Suboccipital Muscles. Interspinales Muscles. Posterior Intertrans- versales Muscles. Rotatores Longi and Rotatores Dorsi Muscles.

Musculi dorsi — Muscles of the back.

THE MUSCLES OF THE TRUNK

273

Mastoid process

Processus mastoideus

Trachelomastoid muscle

M. longissimus capitis

Multifidus spinse muscle

M. multifidus

Cervicahs ascendens muscle M, iliocostalib cerMcis Transversalis cervicis muscle

M. longisiimus cerMcis

Superior curved line

Linea nuchas superior Inferior curved line

Linea nucha; inferior

Complexus, or semispinalis capitis, muscle (outer portion)

Complexus, or semispinalis capitis, muscle (inner portion)

- Spinalis cervicis muscle

~ ^ Semispinalis colli muscle

M semispinalis cervicis

Longissimus dorsi muscle (outer row of insertions

Longissimus dorsi muscle row of insertions)

Angle of the seventh nb Angulus costae \\\

Slips of insertion of the iliocostalis (sacrolumbalis)

muscle M. iliocostalis lumborum

Musculus accessorius ad iliocostalem

M. ihocostalis dor^i

Rotatores longi and rotatores — dorsi muscles

Iliocostalis (sacrolumbalis) muscle

M. sacrospinalis

niocostalis (sacrolumbalis) muscle M. iliocostalis

Lumbar fascia Fascia lumbodorsalis

Longissimus dorsi muscle M. longissimus

Multifidus spinas muscle M. multifidus

Spinous process of the first

dorsal vertebra

Processus spinosus vertebrae

thoracalis I.

Transverse process of the sixth

dorsal vertebra

Processus transversus vertebrae

thoracalis VI.

Semispinalis dorsi muscle

Levatoies costarum muscles Mm. levatores costarum breves

■-~^_Levatores costarum longiores muscles

Mm. levatores costarum longi

Spinalis dorsi muscle

Spinous process of the twelfth

dorsal vertebra Processus spinosus vertebrae thoracalis XII. Intertransversales laterales muscles Mm. intertransversarii posteriores laterales Intertransversales mediales or interaccessorii muscles Mm. intertransversarii posteriores mediales

Spinous process of the fifth lumbar vertebra

Processus spinosus vertebras lumbalis V.

Posterior superior spine of

the ilium

Spina iliaca posterior superior

Dorsal surface of the sacrum

Facics dorsalis ossis sacri

Fi'

514. — Diagram showing the Origins and Insertions of the Long and the Short

Muscles of the Back.

Musculi dorsi Muscles of the back.

35

274

THE MUSCLES OF THE TRUNK

Infraclaviculai triangle, oi Mohrenheinier's space Trigonum deltoideopectorali Deltoid muscle M deltoideus

Subclavius muscle

Clavicular portion Pars clavicularis

Pectoralis major muscle

Abdominal portion

Pars abdomiralib Serratus magnus muscle' M. serratus antei

External oblique muscle

of the abdomen

M. obliquusexternus

abdominis

Umbilicus

Poupart's ligament Lig- inguinale (Pouparti) External or superficial abdominal

ring Annulus inguinalis subcutaneus Spermatic cord Funiculus spermaticu Saphenous opening Fossa ovalis

Pectoralis minor muscle

Anterior or external intercostal aponeu- roses—Ligg. intercos-

Pectoralis major muscle

Biceps flexor cubiti

muscle M biceps brachii

} External intercostal muscles

j Mm intercostales externi

Aponeurosis of the external

oblique muscle of the

abdomen (turned inwards)

Vponeurosis m. obliqui

externi abdominis

Sheaih of the rectus abdominis muscle (anterior layer)

Internal oblique muscle of the abdomen

M. obliquu.s internus abdominis

Aponeurosis of the external

oblique muscle of the

abdomen (turned outwards)

Anoneurosis in. obliqui

externi abdominis

-Cremaster muscle Suspensory ligament of the penis

Lig. suspensorium penis

Fig. 515. — The Thoracic and Abdominal Muscles are shown, on the Right Side the MOST Superficial Layer, and on the Left Side the Layer immediately beneath this. Pectoralis Major and Pectoralis Minor Muscles ; Subclavius Muscle ; External and Internal Oblique Muscles of the Abdomen.

Musculi thoracis et abdominis — Muscles of the thorax and abdomen.

THE MUSCLES OF THE TRUNK

T75

Tendon of the subclavius muscle -^ i- \

Pectoralis major muscle I origin " \\\

of the clavicular portion)

Pectoralis major muscle (origin of the sternocostal portion)

Body of the second rib. Corpus costas II.

Pectoralis minor muscle (slips of origin)

Serratus magnus muscle / M serratus anterior

Pectoralis major muscle (Sternocostal portion)

Ensiform process

Processus xiphoideus

Cartilage of the seventh rib Cartilage costalis VII

Linea alba

Sheath of the rectus abdomici: muscle (posterior layer)

Transversalis abdominis mnscle M. transversus abdominis

Internal oblique muscle of the abdomen (partially removed) M. obliquus internum ahiloniini: Crest of the ilium Crista iliaca External oblique muscle

of the abdomen

M. obliquus externus abdominis Semilunar fold of Douglas Linea semicircularis — (iJouplasi) Anterior superior spine of the ilium Spina iliaca anterior superior Deep circumflex iliac artery A. circumflexa ilium profunda

Spermatic cord

l-'uniculus spermaticus

Cremaster muscle

Pyramidalis muacle'- Spiae of the pubis , ^

Tuberculum pubicum '

• By Englwh ai.atomi»l» the inferior or r'uhic altachmcnt of the rcctU! tuperinr or crwtal altachmeni :n its inirr/wn. — Tu. See p^f^es 386 and 387.

bundle of iTiuKu'ar fibres in the poolerior wall of the inguinn r superficial 10 tlial portion of the conjoined tendon known •lip is dc»cril,cil neither by Quain nor by Macalislcr. 1 1 i

and

3 Ai

work. —Til.

Fig. 516

Deltoid muscle (origin) M. deltoideus

Pectoralis minor muscle (insertion)

. Pectoralis major muscle (insertion)

Pectoralis major muscle (slips of origin of the sternocostal portion) External oblique muscle of the abdomen (slips of origin) M. obliquus externus abdominis

Rectus abdominis muscle (slips of origin)'

Internal intercostal muscle

M. intercostalis internus

Transversalis abdominis muscle (origin)

M. transversus abdominis

Internal oblique muscle of

the abdomen (cut edge)

M. obliquus internus

a.bdominis

Parietal layer of the

peritoneum leritonaum [ arietale

External oblique muscle of the abdomen (cut edge) — M. obli- quus externus abdominis * External umbilical ligamenf- Lig. umbilicale laterale

Transversalis fascia

Fascia transversalis

Poupart's ligament

Lig, inguinale (Pouparti) Internal or deep abdominal ring Annulus inguinalis abdominalis Deep or inferior epigastric artery A. epigastrica inferior M. interfoveolaris'

Pubic symphysis

Symph\sis ossium pubis

Tendon of the rectus abdominis muscle

i abdominis is regarded .-is the ,rj/j;m of that muscle, and the

I canal, running parallel with, but internal to, the spermatic cord, as the tif^nmrnlutn inler/oveoiarc or ligameHt 0/ Hcsselbtuh. s figured on a larger scale on p. 385, Section III., of the present

-OkKHNS AND iNSIiUTIONS Op THIC TnoHACIC AND AhDOMINAL MuSCLES.

Musculi thoracis et abdominis Muscles of the thorax and abdomen.

35-

276

THE MUSCLES OF THE TRUNK

Abdominal portion of the pectoralis major muscle

SerratuB magnus muscle ^

Tendinous intersections i Inscriptiones tendineae 1^

Internal oblique muscle of the abdomen

M. obliquus internus abdominis

Transversalis abdominis muscle

Rectus abdominis muscle

Internal oblique muscle

of the abdomen

M. obliquus internus abdominis

Pyramidalis muscle M. pyramidalis

Spermatic cord

Funiculus spermaticus

Suspensory ligament of the penis

Lig. suspensorium penis

Cremaster muscle M. cremaster

Rectus abdominis muscle

\Intemal intercostal muscles /Mm. intercostales interni

"1 External intercostal muscles /Mm. intercostales extern!

Linea alba

Sheath of the rectus abdominis muscle (posterior layer)

i\ ,\m^

gH- Tranversalis abdominis muscle

Lmea semilunaris (Spigelii)

Semilunar fold of Douglas, or plica semilunaris

Linea semicircularis (Douglasi)

Liaeaalba

Internal oblique muscle of the abdomen (i)

External oblique muscle of

the abdomen (2) Internal or deep abdominal ring (3) Poupart's ligament (4) Transversalis fascia

Saphenous opening Fossa ovalis

(i) M. obliquus internus abdominis

(2) M. obliquus externus abdominis

(3) Annulus inguinalis abdominalis ^/a (4) Lig. inguinale (Pouparti)

Fig. 517. — The Arrangeisient in Layers of the Abdominal Muscles as displayed by Partial Removal of the Superficial Layers. The Rectus Abdominis Muscle of the Left Side having been cut away, the Posterior Layer of the Sheath of that Muscle is exposed. Rectus Abdominis Muscle; Transversalis Abdominis Muscle; Pyramidalis Muscle.

Musculi abdominis— Muscles of the abdomen.

THE MUSCLES OE THE TRUNK

277

Styloid process

Sternocleidomastoid muscle

M. sternocleidomibtoideus Stylohyoid ligament Liy. style h\iiidcum Stylopharyngeus muscle

Splenius capitis muscle M. splenius capitis Levator anguli scapulae muscle M. levator scapula Omohyoid muscle — M. omohvoidens

Subscapularis muscle

Styloglossus muscle

Mylohyoid muscle Hyoglossus muscle Rectus capitis anticus major muscle M longiis capitis Thyropharyngeal portionof the inferior con-

■ stricter of the pharjraX-M. ihyreopharyngeus Thyrohyoid mUSCle-M- ihyreohyoldeus

Thyroid cartilage Cartilage tbyreoidea

- Scalenus medius muscle -ThjTToid body — Glandula tbyreoidea Sternothyroid muscle

' ' strrnothyrt-oideus

Scalenus posticus muscle Scalenus anticus muscle

Scalene space' Sternohyoid muscl; M sternohyoideus

_ I External intercostal muscles

I Mm. intercostales externi

Internal intercostal

muscles

Mm. intercostales interni

Rectus abdominis muscle

Latissimus dorsi muscle

Serratus magnus muscle Slips of origin of the latissimus dorsi muscle firom the tenth and eleventh ribs

External oblique muscle of the abdomen

M. obliquus externus abdominis

Fig. 518. — Serratus Magnus Muscle. Latissimus Dorsi and Subscapularis Muscle. The Three Scalene Muscles and the *Scalene Space.i Levator Anguli Scapula Muscle.

wnW by the scalenus nnticus

' Thi.* w a triangular xpace, the ba»c of which is formed by the upper surface of the first rib, the muKle, and the poKlerior wall by the Hcalenus medius muscle. It is occupied by the brachial plexus and the second part of the artery. ~T*t.

Musculi thoracis— Muscles of the thorax.

278

THE MUSCLES OF THE TRUNK

Superior curved line ^

Linea nucha: superior

Splenius capitis muscle (insertion) ~- /

Obliquus capitis superior muscle - Trapezius muscle (insertion)' Obliquus capitis inferior muscle

Levator anguli scapulae muscle (slips of origin) "Vy, M. levator scapulae "■"

Complexus muscle (inner portion)

M. semispinalis capitis

Complexus muscle (outer portion) M. semispinalis capitis

Occipitalis muscle

Sternocleidomastoid muscle (insertion) M. sternocieidomastoideus Mastoid process ■ rrocessus mastoideus

Trachelomastoid muscle 1 (insertion)

r AI. longissimus capitis

Stylohyoid muscle

M. stylohyoideus

-~'P

Longus colli muscle

Scalenus medius muscle

Scalenus posticus muscle (insertion) M. scalenus posterior

Serratus posticus superior muscle I slips of insertion) M. serratus posterior superior \\

Shaft of the fifth lil Corpus costae V

Scalenus anticus muscle

(slips of origin)

M. scalenus anterior

Scalenus anticus muscle (insertion)

M. scalenus anterior

Subclavius muscle (insertion)''

Serratus magnus muscle (the

^^ two uppermost slips' of origin)

M. serratus anterior

Pectoralis major muscle

(upper part of the origin

of the sternocostal portion)

Serratus magnus muscle (slips of origin) M. serratus anteiior External intercostal muscles , Mm. intercostales externi ^ ■

Internal intercostal muscles

Mm. intercostales interni

Serratus magnus muscle

(slips of origin)

M. serratus anterior

Serratus posticus inferior muscle (slips of insertion)

M. serratus posterior inferior

Latissimus dorsi muscle (slips of origin)

Pectoralis minor muscle (slips of origin)

Pectoralis major muscle (lo'wer part of . he origin of the sternocostal portion) Serratus magnus muscle (slips of origin) M. serratus anterior Rectus abdominis muscle (slips of origin)-'

External oblique muscle of the abdomen (upper slips of origin

M. obliquus externus abdominis

Internal intercostal muscles

Mm. intercostales interni

' Ot^Vk according to English anatomists. - li-nglish anatomists regard this as the oH

External oblique muscle of the abdomen

( lower slips of origin)

M obliquus externus abdominis

^\us muscle. — Tr.

Fig. 519.— Origins and Insertions of the Muscles on the Anterior and Lateral Walls OF THE Thorax. Seen from the Right Side.

Musculi thoracis et abdcminis-Muscles of the thorax and abdomen.

THE MUSCLES OE THE TRUNK

279

Rectus capitis lateralis muscle Obliquus capitis superior muscle

Rectus capitis posticus majoi muscle

M rectus capitis posterior nnj n Obliquus capitis inferior muscle

Rectus capitis posticus minor muscle

M. rectus capitis posterior minor

Spinous process of the axis

Processus spinosus epistrophei

Ligamentum nucha;

Transverse process of the sixth cemcal vertebra I'rocessus transversus vertebrae cervicilis \ I Scalenus posticus muscle

M. scalenus postc 1 1 i

'Scalene space'

Aponeurotic arch for the origin

of the uppermost digitation of

the serratus magnus muscle

Fifth rib Costa V.

External intercostal muscles I Mm. intercostales extern! i

interspinous ligament Lig. interspinale

Spinous process of the twelfth

dorsal vertebra

Processus spinosus vertebrx-

thoracalis XII.

Interspinales muscles |

Supraspinous ligament

I-iK supraspinale

Internal oblique muscle of the

abdomen M. obliquus internus abdominis

Mastoid process l'r"cessns mastoideus

Digastric muscle (posterior belly)

M digastiKiis (\ enter posterior)

Mylohyoid muscle

X M nnlohyoideus

Wj Digastric muscle (anterior belly)

'^T M di„istricus (venter anterior)

Accessory slip connecting

the anterior bellies of the

digastric muscles (var )

^ Slips of origin of the scalenus anticus muscle

Scalenus medius muscle

Scalenus pleuralis (var.)

M sLilenus minimus (var.)

Cervical pleura

Cupula pk ura;

Scalenus anticus muscle (insertion)

M scalenus anterior

Pectoralis minor (slips of origin)

I Internal intercostal muscles ) Aim. intercostales interni

External oblique muscle of the abdomen

M, obliquus e.xternus abdominis

Aponeurosis of the external oblique muscle of the abdomen

Aponeurosis m. obliqui extern! abdominis

Crest of the ilium Crista iliaca

Gluteal portion of the fascia lata Fascia glutxa

' See note to p. 277

Fig. 520.— Musculi Intkrcostales Extekni, the External Intercostal Muscles; Musculus Oruqvvs Externus Abpominis, the External Oblique Muscle of the Abdomen; the Scalene Muscles, with the Anomalous Scaij.nus Minimus or Scalenus Pleuralis.

Musculi thoracis et abdominis Muscles of the thorax and abdomen.

280

THE MUSCLES OF THE TRUNK

) Internal intercostal muscles

/Mm. intercostales interni

'^ External intercostal muscles

J Mm. intercostales externi

Anterior superior costotransverse

ligaments

Ligg. costotransversaria

anteriora

Subcostal muscles

Mm. subcostales

^ Posterior or internal intercostal I aponeuroses

j Ligg. intercostalia interna

Fig. 521. — The Muscles on the Inner Surface of the Lateral Wall of the Thorax, shown on the right side of the body, the diaphragm having been removed : Musculi Intercostales Intern Internal Intercostal Muscles; Musculi Sub- costales, Subcostal Muscles.

Musculi thoracis — Muscles of the thorax.

THE MUSCLES OF THE TRUNK

281

Interclavicular ligament

Lig intercla\ic»l in

Sternothyroid muscle /~J^\

M. sternothyreoideiii . -' - -

Sternohyoid muscle

M sternohyoideus The clavicle C lavicula First rib Costa I.

tntemal intercostal muscles

Mm. intercostales interni

Triangularis stemi muscle

M. transversus thoracis

Transversalis abdominis muscle

Sternal portion of the diaphragm /4

Pars sternalis diaphragmat

Sheath of the rectus

abdominis muscle

posterior layer)

Transversalis

abdominis

muscle

Costal portion of

the diaphragm

Pars costalis

diaphragmatis

Sheath of the rectus abdominis muscle (anterior layer) — Vagina m. recti abdominis (lamina anterior)

Internal oblique

muscle of the

abdomen

M. obliquus

internus abdominis

External oblique

muscle of the

abdomen

M. obliquus externus abdominis

Fig. 522. — The Muscles on the Inner Surface of the Anterior Wall of the Thorax.

The slips of origin of the diaphragm from the costal cartilages and the ensiform process have been retained, in order to show their relation to the slips of origin of the transversalis abdominis muscle. The anterior wall of the abdomen has been divided horizontally at the level of the anterior extremities of the tenth pair of ribs to show the relation of the anterior aponeuroses of the external oblique, internal obli((ue, and transversalis muscles of the abdomen to the sheath of the rectus muscle, and to display the two layers of this sheath. The transversus thoracis or triangularis stemi muscle and the origins of the sternohyoid and sternothyroid muscles are also shown.

Musculi thoracis et abdominis — Muscles of the thorax and abdomen.

36

282

THE MUSCLES OE THE TRUNK

Subcutaneous bursa of the laryngeal prominence

Bursa subcutanea prominentia; laryngea: Deep cervical fascia (superficial layer) Fascia colli (lamina superficialis' Platysma myoides

Subcutaneous bursa of the chin , Bursa subcutanea prsementalis

Infraclavicular triangle, or Mohrenheimer's space Trigonum deltoideopectorale Deltoideopeotoral groove Sulcus deltoideopectoralis

Costocoracoid membrane

Fascia coracoclavicularis

Cephalic vein

Vena cephalica

Deltoid muscle

M. deltoideus

Superficial layer

of the pectoral fascia

Stemalis muscle (var. )

Pectoralis major muscle

Deep layer of ^ the pectoral „ ■" 1 iciscia

Axillary fascia Fascia axillaris

Pectoralis major muscle Superficial layer of the pectoral fascia

F:g. 523 — /.'he Fascia of the Anterior Wall of the Thorax, Fascia Pectoralis, the Pectoral Fascia, and its Connexions with the Fascle of the Adjoining Regions of THE Body. The Anomalous Sternalis Muscle.

On the right side of the body, the skin and the superficial fascia having been removed, the superficial layer of the pectoral fascia is displayed, and its continuity with the aponeurosis of the arm is shown ; on the left side, the greater part of the pectoralis major muscle has been removed, in order to display the deep l;iycr of the pectoral fascia, with its specialized band the costocoracoid membrane, and to show the continuity of this deep layer with the axillary fascia.

Musculi thoracis — Muscles of the thorax.

THE MUSCLES OE THE TRUNK

283

Aponeurosis of the arm or brachial fascia

Fascia bracliii

The axilla, or armpit

Posterior fold (or wall)

of the axilla (Border of the latissimus

dorsi muscle 1 I'lica axillaris posterior

Fascia of the latissimus dorsi muscle

Pectoral fascia

Fascia pectoralis

Anterior fold (or wall)

of the axilla

Border of the pectoralis

major muscle)

Plica axillaris anterior

Foramina for the emergence

of the cutaneous vessels

and nerves

Axillary arch

Superficial layer of the pectoral fascia

Fascia pectoralis (lamina superficialis)

I'lG. 524. — The Axilla with the Anterior and Posterior Axillary Folds, Plica Axillaris Anterior et Plica Axillaris Posterior. Fascia Axillaris, the Axillary Fascia, with the "Axillary Arch of Langer.

The axillary fascia forms the base or inferior boundary of the axillary fossa, riie cutaneous vessels and nerves have been removed.

Mi'sculi thoracis Muscles of the thorax.

36-

284

THE MUSCLES OF THE TRUNK

Spinous process

Processus spinosus

Transverse process

Processus transversus

I Deep dorsal muscular layer of the trunk

. Superficial dorsal muscular layer of the trunk

Posterior primary division of spinal nerve

Ramus posterior nervi spinalis

Anterior primary division

of spinal nerve

Ramus anterior nervi spinalis

Ventral (subcostal) ,.. muscular layer of the trunk

Kib ..

Costa

..Ventral (intercostal) - muscular layer of the trunk

Muscular layer belonging to the extremities (or appendicular layer)

Skin

Integumentum commune

\ Ventral (subcostal) muscular layer of the trunk

Fig. 525. — Diagrammatic Representation of the Muscles of the Trunk and of the Distribution of the Segmental Nerves by which they are supplied, shown in a Thoracic Segment.

NOTE.

A brief explanation of this diagram seems needful, in the interest of students who have not made a special study of comparative anatomy. The muscles are grouped, first of all, into dorsal and ventral, the former being supplied by the posterior and the latter by the anterior primary divisions, respectively, of the spinal nerves. The dorsal muscles form the great mass lying chiefly in the hollow between the spinous processes and the angles of the ribs. They are classed in two groups— superficial and deep. These need not be further considered. The ventral muscles are shown to be arranged in three layers. In the abdominal region these are represented by three actual muscles, to name them from within outwards : the transversalis, the internal oblique, and the external oblique. Continuous with the deepest of these, the transversalis, for the purposes of this classification, are the triangularis sterni, the subcostals, the sternal and costal portions of the diaphragm and part of the levator ani — these form the s^tbcastal layer. Continuous with the internal oblique are the iuter- costals, the posterior serrati, the scalene muscles, and the quadratus lumborum— these form the intercostal layer. Continuous with the external oblique are all tire muscles connecting the scapula with the trunk, viz.: the trapezius, levator anguli scapulse, serratus magnus, and rhomboidei muscles, also the latissimus dorsi, the pectorals, the sternocleidomastoid, and the superficial perineal muscles — these constitute what may be called the afifiendicular layer. There is finally a more .superficial layer still (not shown in the figure), superficial indeed to the deep fascia, corresponding to the panniculosus carnosus of lower mammals, but represented in man only by the platysma myoides, the occipitofrontalis, and the muscles of the ear and face. — Tk.

Musculi trunci — Muscles of the trunk.

THE MUSCLES OF THE TRUNK

285

Posterior layer of the lumbar fascia' Kascia lumbodorsalis Middle layer of the lumbar fascia' Lig. lumbocostale ;

Ouadratus lumborum muscle Fatty tissue

Transversalis fascia

Latissimus dorsi muscle

Iliocostalis or sacrolumbalis muscle

Costal process of the fourth lumbar vertebra

Processus tostarius vertebra- himbalis IV.

Longissimus Multifidus spinse muscle

dorsi muscle ,,

bpinous process of the third

— niZCTT J lumbar vertebra

— ■ — ^^~o'L'T I'rocessus spinosus \ertebre lumbahs III.

Erector spinae muscle

Upper surface of the body of the fourth lumbar vertebra

Transversalis abdominis muscle M. transversus abil^munis Internal oblique muscle of the abdomen ; M- obliquus internus abdominis

External oblique muscle of the abdomen M. obliquus externus abdominis

Superficial fascia Skin Integumentum commune

Rectus abdominis muscle

Posterior layer

Lamina anterior '

Linea alba

Umbilicus

Sheath of the rectus abdominis muscle

Vagina m. recti abdominis

In

the

n with this figure, an account of the differ abdomen and_ the nomenclature commonly employed by English to most English authors, is regarded as consisting of three layers. The sufierficial tutttbodorsnlis, is the layer passing behind the composit^mass of the erector spina: (see note to p. 267). The micidU layer, called by Toldl (see Fig. 526 on this page passes in front of the erector spins, between that mu»clc and the qiiadratus lumbo' transverse^ prr>cesses of the lumbar vertebra:. At the outer edge of the

the posterior aponeurosis of the

author's nomenclature of the fasciae or the back and U suitably be given. The luttibar fascia, according ^posterior layer' ZiAWA by Toldt(see Fig. 526) /ama luscle to be attached to the tips of the spinous processes nd also Fig. 512 on p. 271) li^aincntuin lumbocostale, m, to be attached to the tips of the costal (o cle the posterior and middle layer:

1-called > form i abdominis mu.scle.~ T\\e anterior layer 0/ the liiinl>ar/ascia{cMeA by Toldt/<ir<r;Vi lumbalis) » the th-n membrane lying on the anterior surface of the quadratus lumborum muscle. At the inner edge of this muscle it is attached to the anterior surfaces of the costal processes ol the lumbar vertebra:, and at the outer edge of the muscle it is continuous with the trans- versalis fascia, the membrane lining the deep surface of the transversalis abdominis muscle. The term fascia himbalis is applied by Toldt also to the fascia covering the abdominal surface of the psoas muscle, but by English anatomists this membrane is regarded as a portion of the iliac fascia. — Tk.

\'\r,. 526. — The Stratification of the Muscles of the Trunk and of their Associated Fasci.*, displayed in A Horizontal Section of the Right Half of the Body-Wall. The Connexions hetween the Anterior Aponeuroses of the Wide Muscles of the Abdomen and the Sheath of the Rectus are shown.

Tlie strclion was made i

I a frozen body at the level of the navel, and passed posteriorly through the intervertebral disc between the third and fourth lumbar vertebra;.

Musculi trunci Muscles of the trunk.

286

THE MUSCLES OF THE TRUNK Sternal portion — Pais sternalis -^

Central tendon- y' Centrum tendmeum

Caval opening, or foramen quadratum

Foramen venae cavse

Inner cms, or pillar Crus mediale Intermediate crus, or pillar^ Crus intermedium

Outer crus. or pillar' Cruslaterale External archad ligament, or ligamentum arcuatum exter- num— Arcus lumbocostalis lateralis (Halleri)

Psoas magnus muscle M. psoas major

Quadratus lumborum muscle

_ Costal portion

Pars costalis _CEsopliageal opening

Hiatus cesophageus

Verteliral portion

Pars lumbalis

Aortic opening Hiatus aorticus Internal arched ligament, or ligamentum arcuatum internum Arcus lumbocoslalis medialis (Halleri) Twelfth rib Costa XII. Middle layer of the lumbar fascia Lig lumbocostale

Tourth lumbar vertebra — ^ ertebra lumbalis IV.

Fig. 527. — View of the Diaphragm with its Crura from Below. (Abdominal Aspect.;

Eleventh dorsal vertebra — Vertebra thoracalis XI.

Twelfth rib Costa XII. Vertebral portion

Pars lumbalis

Aortic opening Hiatus aorticus Central tendon- Centrum tendineum oesophageal opening Hiatus cesophageus Caval opening, or foramen quadratum Foramen vena; cavse Costal portion Pars costalis Base of the pericardium Basis pericardii Seventh rib Costa VII.

Sternal portion

Pais stcmalis

» The crwa, o^ pillars, of the diaphraain described by English anatomist!; are two onlv in number, a longer right cms and a shorter Itfl crus. Each of these is composed of all the fibres passing from the right and left sides, respectively, of the bodies of the lumbar vertebrae and the intervertebral discs to the central tendon. Thus, the cms of English authors corresponds to the combined iniu-r cms and inter- mediate crus of Toldt ; while the outer crus of the latter is in England not considered to belong to the crural portions of the diaphragm. — Tk.

= Called also the trefoil or cordi/orm tendon of the diaphragm. — Tr.

Fig. 528. — \'iEW OF the Diaphr.agm from Above, with the Basal Portion of the Pericardium.

(Thoracic Aspect.)

Diaphragma — The diaphragm, or midriff.

^HE MUSCLES OF THE TRUNK

28;

Base of the pericard:

Basis pericardii

Body of the sternum (manubriumj Corpus sterni

Sternal portion

Pars sternalis

Costal portion

Pars costalis

Twelfth rib ( osta \1I Vertebral portion

Pars luinbalib

' Caval opening, or foramen quadratura

Foramen verice cavse

Central tendoa

Centrum tendineuSi

(Esophageal opening

Hiatus oesophageus

Aortic opening Hiatus aorticus First lumhar vertebra Vertebra lumbalis I

Fig. 529. — The Diaphragm in Median-Sagittal Section, the Right Half seen from Within. Drawn from a Dry Preparation.

The abdominal surface of the diaphragm was first cleaned by dissection and then given a coating of liquid plaster of Paris. When this had been allowed to harden, the thoracic surface of the muscle was exposed and similarly coated with plaster of Paris. In this manner the natural shape was as far as possible preserved.

Diaphragma — the diaphragm, or midriff.

288

THE MUSCLES OF THE TRUNK

Fourth sacral vertebra

Vertebra sacralis IV.

Coccygeus or levator coccygis muscle Sacrococcygeus anticus or curvator coccygis muscle M. sacrococcygeus anterior First coccygeal vertebra \ ertebra coccygea I.

Fig. 530.— Musculus Sacrococcygeus Anterior, Sacrococcygeus Anticus or Curvator

Coccygis Muscle.

First coccygeal vertebra

\ ertebra coccygea I.

Sacrococcygeus posticus or extensor coccygis muscle

M sacrococcygeus posterior

Posterior or great sacrosciatic

ligament

Lig. sacrotuberosum

Coccygeus or levator coccygis muscle

-Levator ani muscle

Obturator fascia Fascia obturatoria Tuberosity of tie

ischium Tuber ischiadicum

Fig. 531. — Musculus Sacrococcygeus Posterior, Sacrococcygeus Posticus or Extensor Coccygis Muscle ; Coccygeus or Levator Coccygis Muscle.

Musculi sacrococcygei — Sacrococcygeal muscles.

MUSCULI COLLI ET CAPITIS

THE MUSCLES OF THE HEAD AND NECK

290

THE MUSCLES OF THE HEAD AND NECK

^^ Zygomaticus major muscle

M z>gomaticus

Buccal fat-pad^

c orpus adiposum buccas

Eisorius muscle Depressor anguli oris or - triangularis menti muscle M. triangularis

bometimes, but inappropriately, named the sucking-pad. — Tr

Fig. 532. — The Platyswa Myoides of the Right Side.

Musculi colli— Muscles of the neck.

THE MUSCLES OF THE HEAD AND NECK

291

Parotideomasseteric fascia'

i-ascia parotideomasseterica

Sternocleidomastoid muscle

M. sternocleidomastoideub

Deep layer of the deep cervical fascia

Lamina profunda fasciae colli

Sternocleidomastoid muscle M. sternocleidomastoideus

Trapezius muscle Deep layer of the deep cervical fascia Lamina profunda fascia colli

Superficial layer of the pectoral fascia ~

Platysma myoides Platysma

Platysma myoides

Platysma

Deep layer of the deep

cervical fascia

Lamina profunda

fasciae colli

Superficial layer of the deep cervical fascia

Anterior region of the neck Regio colli anterior

Jeep layer of the deep cervical fascia

Lamina profunda fasciae colli

' In England, the portion of the deep cervical fascia covering the parotid gland is usually distineuished as the parotid fascia ; that covering the masseter muscle, as the masseteric fascia. — Tr.

Fig. 533.— Fascia Colli, the Deep Cervical Fascia, displayed on the Right Side of the Neck by the Removal of the Platysma Myoides.

In those places in which the deep layer of the fascia is clearly differentiated from the superficial layer, the latter has been partially removed. The submaxillary gland has been taken away, and the middle portion of the sternocleidomastoid muscle has been cut out, to lay bare in each case the deep layer of the fascia ; between the cut ends of the sternocleidomastoid, and between the lower portion of this muscle and the trapezius, the anterior and posterior bellies respectively of the omohyoid muscle are visible beneath the deep layer of the fascia.

Musculi colli — Muscles of the neck.

37-

292

THE MUSCLES OF THE HEAD AND NECK

Stylohyoid ligament .

Lig. stylohyoideum

Stylohyoid muscle

M. stylohyoideus

Digastric muscle (posterior belly)

M. digastricus (venter posterior)

Prevertebral fascia

Fascia prae\ ertebrahs

Sternocleidomastoid muscle

M. sternocleidomabtoideus

Deep layer of the deep cervical fascia

Fascia colli (lamina profundri) Trapezius muscle

Mylohyoid muscle

'SI. mylohyoideus

Styloglossus muscle ^' Digastric muscle (anterior belly) — !\I. digastricus (venter anterior) Hyoid bone— Os hyoideum Thyiohyoid mUSOle-M. thyreoliyoideus Thyropharyngeal portion of the inferior con- strictor of the pharynx— M. thvreopharyngeus Omohyoid muscle (anterior beUy)

JI oniohyoidriis (venter superior)

Thyroid body Glandula thyreoidea Sternothyroid muscle iSI sternothyreoideus Sternohyoid muscle M sternohyoideus

Fig. 534. — The Muscles of the Front of the Neck, shown on the Right Side of the Body. M. Sternocleidomastoideus, Sternocleidomastoid Muscle ; M. Digastricus, Digastric Muscle ; the Relations of the Latter to the Stylohyoid and Mylohyoid Muscles. Portions of the Muscles arising from the Styloid Process, of the Lower Muscles of the Tongue, and of the Trapezius Muscle, are displayed.

In the preparati 'n of the muscles both the superficial and the deep layers of the deep cervical fascia have been removed, except in the posterior triangle of the neck, where the deep layer has been leh. iatact.

Musculi colli— Muscles of the neck.

THE MUSCLES OF THE HEAD AND NECK

293

Scalenus medius muscle —

Scalenus anticus muscle M, scalenus anterior

Trapezius muscle

Deep layer of the deep

cervical fascia

Lamina profunda

fasciae colli

Deltoid muscle -£

Infraclavicular tnangle, or Mohrenheimer'a space

Trigonum deltoideopectorale

Sternocleidomastoid muscle —

Stylopharyngeus muscle

Stylohyoid ligament

Lig. stylohyoideum

Splenius capitis muscle

Middle constrictor of the pharynx M. constrictor pharyngis medius Rectus capitis anticus major muscle M. longus capitis

Levator anguli scapulae muscle M, levator scapulae

Masseter muscle

Depressor anguli oris

or triangularis menti

muscle

M triangularis "Styloglossus muscle

-Mylohyoid muscle Hyoglossus muscle

Thyrohyoid muscle

M. thyreohyoideus Omohyoid muscle (anterior bellyXi) Thyropharyngeal portion of the in- ferior constrictor of the pharynx M thvreopharyngeus Sternohyoid muscle— M. sitrnuhyuidtu> Sternothyroid muscle ternotliyreoideus

Longus colli muscle

(i) M. omohyoideus (v

Sternothyroid muscle

M steiroth\reoideus

Sternocleidomastoid muscle

superit/r)

fiG. 535._The Muscles of the Neck, displayed on the Right Side, the Sternocleido- mastoid, Digastric, and Stylohyoid Muscles having been removed. The Infrahyoid Group of Muscles, Sternohyoid, Sternothyroid, Thyrohyoid, and Omohyoid. The ^ Mylohyoid Muscle, the Anterior and Middle Scalene Muscles, and the Levator Anguli Scapula ; Portions of the Muscles of the Face, and of the Deep Lateral AND Prevertebral Muscles of the Neck.

Musculi colli — Muscles of the neck.

.$■. --i *

292

THE MUSCLES OF THE iEAD AND NECK

Stylohyoid ligament

Lig. stylohyoideum

Stylohyoid muscle -

M. stylohyoideus

Digastric muscle (posterior belly)

M. digastricus (venter posterior)

Prevertebral fascia

Fascia praevertebralis

Sternocleidomastoid muscle _

M. sternocleidomastoideus

Deep layer of the deej cervical fascia

Fascia colli (lamina profunda) Trapezius muscle

Mylohyoid muscle

W. mylohyoideus

Styloglossus muscle Digastric muscle (anterior belly) — M. digastricus (venter anterior) Hyoid bone— Os liyoideum Thyrohyoid muscle— M. iiiyreohyoideus -: - Thyropbaryngeal portion of the inferior con-

:[ Stricter Of the pharynx— M. thvreopharyngeus

'" Omohyoid muscle (anterior beUy) M. oniohyoidrus (senler superior)

Thyroid body

Glandula thyreoidea - Sternothyroid muscle

M. sternothvreoideus

Fig. 534. — The Muscles of the Front of the [eck, shown on the Right Side of the Body. M. Sternocleidomastoideus, Sternoleidomastoid Muscle ; M. Digastricus, Digastric Muscle; the Relations of the Lh-ter to the Stylohyoid and Mylohyoid Muscles. Portions of the Muscles arisi| from the Styloid Process, of the Lower Muscles of the Tongue, and of thi Trapezius Muscle, are displayed.

In the preparati m of the muscles both the superficial ai the deep layers of the deep cervical fascia have been removed, except in the posterior trianglof the neck, where the deep layer has been leh latact. r /

Musculi colli— Muscle of the neck.

r^,- ■.» . • «

y

A'ili

THE MU

OF THE HEAD AND NECK

293

X WOWK ON THE RIGHT W

'■in Mi'scle; I. Cw

11 SniOHVOlDASDlE

it SnioiD PwE&i"

- MlSClE, ARE BISPUia

Scalenus medius muscle

Scalenus anticus muscle

M. scalenus anterior

Trapezius muscle

Deep layer of the deep

cervical fascia

Lamina profunda

fasciae colli

Deltoid muscle

Sternocleidomastoid muscle-

Stylopharyngeus muscle Stylohyoid ligament Lig. stylohyoideuni

Splenius capitis muscle

middle constrictor of the pharynx

M. constrictor pharyngis medius BectUB capitis anticus major muscle M. longus capitis

Levator anguli scapulae muscle

M. levator scapalrt

Masseter muscle

Depressor anguli oris

or triangularis menti

muscle

M. triangularis

Styloglossus muscle

-^ Mylohyoid muscle •^ - Hyoglossus muscle

_ Thyrohyoid muscle

M. thyreohyoideus Omohyoid muscle (anterior bellyKO Thyropharyngeal portion of the in- ferior constrictor of the pharynx M. thyreopharyngeus Sternobyold muscle— W. !.iernohycideii> Sternothyroid muscle sternothyreoideus

Longus colli muscle

Infraclavicular triangle, or , ' i^/^^^^^L ' Sternothyroid muscle

Mohrenheimer's space "■ 1 ^fc^S^^^^ "^1 sterrothyreoideus

Trigonum deltoideopectorale ~ WHM^r ^

Sternocleidomastoid muscle

(i) X oaiohyoideus (venter superior)

Fig. 535. — The Muscles of the Nkci displayed on the Right Side, the Sternocleido- mastoid, Digastric, and Stylohycd Muscles having been removed. The Infrahyoid Group of Muscles, Sternohyoii Sternothyroid, Thyrohyoid, and Omohyoid. The ^ Mylohyoid Muscle, the Anterk and Middle Scalene Muscles, and the Lev.\tok Anguli Scapula ; Portions 01 : 1 Mua^iM&J[H£ Face, and of the Deep L.atekal AND Prevertebral Muscles 01 7 i

li

the neck.

Mo^ettii

till'

i.iil'r

294

THE MUSCLES OF THE HEAD AND NECK

Internal oblique line, or mylohyoid ridge

Linea ravlohyoidea

Mylohyoid muscle

M. mylohyoideus Geniohyoid muscle

M. geniohyoideus

Small cornu ~\

Cornu minus , ^. . . , ,

I of the hyoid bone

_, . I ossis hyoidei

.Great cornu I -'

Cornu majusj

Fig. 536. — M. Mylohyoideus, the Mylohyoid Muscle, the Muscles of the Right and Left Side together forming a Floor below the Anterior Part of the Mouth, the

DiAPHRAGMA ORIS, AND THE GENIOHYOID MuSCLE, SEEN FROM AbOVE AND BeHIND

Small cornu of the hyoid bone, Cornu minus ossis hyoidei '

Stylohyoid ligament_-

Lig. stylohyoideum

Great cornu of the hyoid bone

Cornu majus ossis hyoidei

Thyrohyoid membrane, or middle thyrohyoid ligament

Membrana hyothyreoidea

Bursa of the thyrohyoid muscle' ,*--'" Bursa musculi thyreohyoidei

Thyrohyoid muscle (lower portion)-- M. thyreohyoideus

Inferior constrictor of the pharynx M. constrictor pharyngis inferior

/Thyrohyoid muscle (divided and turned upwards)

' M thYreohyoideus

Body of the hyoid bone

Corpus ossis hyoidei

Sternohyoid muscles (turned upwards)

Mm. sternohyoidei

Bursa of the sternohyoid muscle-

Bursa musculi sternohyoidei

Thyroid cartilage Cartilago thyreoidea

Cricothyroid membrane, or middle

cricothyroid ligament Lig cricothyreoideum (medium)

Cricothyroid muscle

M. cricothyreoideus

Trachea Trachea

"■'■ /I

m„JlJo*L%t"Jft°/"'"^"''Tl'TJ^'\"'-''/"'"?'^°'''^°"'''=(',''^'^''" '" "== ?<■==="' instance), is situate beneath the thyrohyoid

muscle on the antener sunace of the thyrohyoid membrane, external to the bursa of the sternohyoid muscle.— Tr.

membrane clme to the mli^ V '"% '^ situate beneath the upper extremity of the sternohyoid muscle and in front of the thyrohyoid

Fig. 537._The Burs.e below the Hyoid Bone. The Sternohyoid and Thyrohyoid Muscles

HAVE BEEN DIVIDED TRANSVERSELY, AND THE PORTIONS OF THESE MuSCLES LEFT ATTACHED

TO THE Hyoid Bone have been turned upwards. Seen obliquely from the Right Side AND Before,

Musculi colli-Muscles of the neck.

IHE MUSCLES OF THE HEAD AND NECK

295

Sphenoidal sinus

Sinus sphenoidalis Eustachian cartilage

Cartilage tubae auditivse

Carotid canal

Canalis caroticus

Levator paiati muscle

(origin) M levator veli palatini Circtunflexua or tensor paiati muscle (origim M tensor veli prd.itjni Pterygoid process Processus pterygoidcu

Hamular process

Hamulus pterygoideu

Interartloular disc, or meniscus

Capsular ligament (i) Head of the condyle Capitulum maridibula:

— External pterygoid muscle M. pterygoideus externus

Internal pterygoid muscle

M pterygoideus internus

Genioglossus or geniohyoglossus muscle Geniohyoid muscle

M geniohyoideus

Mylohyoid muscles

Median raphe of the mylohyoid

muscles

Raphe m, mylohyoidei

(i) Capsula articularis

Body of the hyoid bone

Corpus ossis hyoidei

Fig. 538.— M. Mylohyoideus, the Mylohyoid Muscle, the Right and Left Muscles

FORMING the DiAPHRAGMA OrIS, SEEN FROM AbOVE AND BEHIND. ThE PTERYGOID

MuscLF.s, External and Internal, are displayed, both Intact on the Right Side, WHILE on the Left Side the Internal Pterygoid Muscle has been removed in order to lay bare in its Whole Extent the Posterior Surface of the External Pterygoid Muscle.

The levator paiati and the circumflexus or tensor paiati muscles have been cut away close to their

respective origins.

Muscull colli et capitis -Muscles of the head and neck.

296

THE MUSCLES OF THE HEAD AND NECK

Styloglossus muscle

Hyoglossus muscle

/ Lmgualis inferior or inferior lingual muscle

longitudinalis inferior

Genioglossus or '■^'' 1 geniohyoglossus muscle

Geniohyoid muscle

M geniohyoideus

Cricothyroid muscle

M. cricothyreoideus

Fig ■i^Q— The Muscles of the Tongue, with the Geniohyoid Muscle, seen from the Right Side: the Hyoglossus, the Styloglossus, and the Genioglossus or Geniohyoglossus Muscles. Also the Thyro- hyoid AND Cricothyroid Muscles.

Body of the mandible Corpus mandibulae

Edge of the tongue """

Margo lateralis lingua; ~

Genioglossus or geniohyoglossus muscle

M. genioglossus

Iiingualis inferior or inferior lingual muscle M. longitudinalis inferior

Hyoglossus muscle

(cut away)

M. hyoglossus

Styloglossus muscle

Middle constrictor of the pharynx

M. constrictor pharyngis medius

/ Ceratopharyngeus

muscle M. ceratopharyngeus

Chondrophaiyngeus muscle ' I IVI. chondropharyngeus

Great comu — Cornu majus

Transversalis linguae muscle or transverse muscle of the tongue

M. transversus linguae

--.Chondroglossus muscle

Membranous connexion of the geniohyoglossus muscle with the body of the hyoid bone -- Body of the hyoid bone

Corpus ossis hyoidei

Stylohyoid ligament '

Lig. stylohyoideum

j Small comu

Cornu minus

Fig. 540.— The Muscles of the Tongue seen from the Right Side and Below, displayed by the Removal OF THE Hyoglossus Muscle : M. Longitudinalis Inferior, the Inferior Lingual Muscle ; M. Transversus (vel Transversalis) Lingua, thk Transverse Muscle of the Tongue, and its Relation to the Genio- hyoglossus Muscle; the Chondroglossus Muscle.

Musculi colli et capitis— Muscles of the head and neck.

THE MUSCLES OF THE HEAD AND NECK

Levator anguli oris muscle, or musculus

caninus

Parotid duct or duct of

Stenson

Ductus parotideus

Zygomaticus major

muscle (cut away)

M. zygomaticus

Buccinator muscle .

M, buccinator

Depressor anguli oris or

triangularis menti muscle

(cut away)

M. triangularis

iicumflexus or tensor palati muscle M tensor \ ell palatini Levator palati muscle M le\ator veil palatini Stylopharyngeus muscle Digastric muscle (posterior belly)

(\t liter p( sterior)

Hamular process Hamulus pterygoideus Superior constrictor of the pharynx

istrittoi ] iiai)nt,ib superior

PterygomaxiUary or ptery; omandibular

ligament— Raplie pteijgomandibulari

Styloglossus muscle Stylohyoid muscle

M btylohyoideus

, Middle constrictor of the pharyn

M. constrictor pharyngis mediiis

Digastric muscle (anterior belly) M. digastricus (venter anterior)

Mylohyoid muscle

M. mylohyoideus

Fig. 541.— The Muscles arising from the Styloid Process with the Digastric Muscle; the Circumflexus OR Tensor Palati, the Levator Palati, and the Buccinator Muscle; seen from the Left Side.

The ramus of the jaw has been removed.

Spinous process of the sphenoid bone

Spina annularis

Pterygoid process Processus pterygoideus

Sphenomaxillary fossa Fossa pterygopalatina Circur-.flerus or tensor palati muscle (origin|--M. tensor veli palatini

Tuberosity of the superior maziUary bone ..,

Tuber maxillare

Out edge of the external pterygoid plate

Bursa of the hamular process

liursa m tensoris veli palatini

Circumflexus or tensor palati (insertion) M tensor veli palatini

Vestibule of the labyrinth

-'' Vestibulum labyrinthi

Tympanic orifice of the Eustachian tube

""Ostium tympanicum tuba;- auditiva;

— Foramen ovale

Petrous portion of ths temporal bone Pars petrosa ossis temporalis Levator palati (origin) M. levator veli palatini

Fascia salpingopharyngea, ormembranous portion of the Eustachian tube — Lamina membranacea tub^^auditi\a3 Eustachian cartilage -Cartilage tuba; auditivae Pharyngeal orifice of the Eustachian tube Ostium pharyngeum tubas auditivai

Levator palati muscle (insertion)

M. levator veli palatini

- Soft palate Velum palatinum

/,

, Hamular process

Hamulus pterygoideus

Fig. 542.— Origin and Insertion of the Circumflexus or Tensor Palati Muscle and of the Levator Palati Mu.scle, wijh the Synovial IUjrsa of the Hamular Process, seen from the Left Side.

Musculi colli et capitis — Muscles of the head and neck.

38

298

THE MUSCLES OF THE HEAD AND NECK

Basilar portion of Petrous portion of the occipital bone the temporal bone

Pars basilaris Pars petrosa

Styloid process 1

Processus styloideus ^ Mastoid process Processus mastoideus

Rectus capitis anticus major muscle

M. longus capitis

Cervical pleura

Cupula pleura

Rectus capitis lateralis muscle Digastric muscle (posterior belly)

M. digastricus (venter posterior)

Anterior tubercle of the atlas Tuberculum anterius atlantis

Rectus capitis anticus major muscle

M longus capitis

Levator anguli scapulae muscle

M. levator scapulae

Longus colli muscle

Scalenus medius muscle

Scalenus anticus muscle

\I. scalenus anterior

Scalenus posticus muscle

M. scalenus posterior

Scalene space^

Eminence for the attach- ment of the serratus

magnus muscle Tuberositas costae II.

Fig. 543. — The Deep Lateral and Prevertebral Muscles of the Neck, displayed by THE Removal of the Facial Portion of the Skull and the Cervical Viscera. Seen FROM Before. Scalenus Anticus, Medius, and Posticus Muscles ; Longus Colli Muscle ; Rectus Capitis Anticus Major Muscle. The Relation of the Scalene Muscles and the Longus Colli Muscle to the Cervical Pleura. The Scalene Space.^

^ See note to p . 277.

Musculi colli— Muscles of the neck.

THE MUSCLES OF THE HEAD AND NECK

299

Basilar portion of Petrous portion of the occipital bone the temporal bone Pars basilaris ossis c

Hectos capitis anticus minor muscle M. rectus capitis anterior

Rectus capitis lateralis muscle

Posterior intertransversales muscles Mm. intertransversarii posteriores 1

Anterior intertransversales muscles Mm. intertransversarii anteriores

Insertion of the scalenus medius muscle

Groove for the subclavian artery Sulcus subclavicx-

Insertion of the scalenus anticus muscle

Insertion' of the .- subclavius muscle

First costal cartilage

Cartilago costalis 1.

\ Anterior intertransversales muscles l\lm intertransversarii anteriores

Longus colli muscle

Scalenus medius muscle

Scalenus posticus muscle

Vt scalenus posterior

' English anatomists regard this as the nn'gin of the subclavius muscle. — Tk.

Fig. 544. — The Deep Latekal and Pkevektebkal Muscles of the Neck, the Rectus Capitis Anticus Major and Scalenus Anticus Muscles having been removed. On the Right Side the Longus Colli and the Scalenus Medius and Posticus Muscles

HAVE also been REMOVED. SeEN FROM BEFORE. INTERTRANSVERSALES MuSCLES ;

Rectus Capitis Anticus Minor and Rectus Capitis Lateralis Muscles.

Musculi colli — Muscles of the neck.

38-

300

THE MUSCLES OF THE HEAD AND NECK

Pericranium Orbicularis palpebrarum muscle (orbital portion) M. orbicularis oculi (pars orbital Corrugator superoilii muscle .

Orbicularis palpebrarum (palpebral

portion) M. orbicularis oculi (pars palpebralis) Internal tarsal or palpebral ligament Lig. palpeljrale mediale

Pyramidalis nasi muscle' .

M. procerus

/■Levator labii superioris

alseque nasi

Caput angulare

Levator labii superioris -

propius

Caput infra-orbitale

M.quadratus

labii

superioris-

Zygomaticus minor Caput zygomaticum

Depressor labii infenoris or .

quadratus menti muscle M. quadratus labii inferioris

Epicranial or occipitofrontal aponeurosis

Frontalis muscle

Skin

Integumentum

commune

Auricuiaris superior or - attoUens auriculam muscle

Auricuiaris anterior or

attrahens auriculam

muscle

Parotideomasseteric fascia' Levator anguli oris muscle,

or musculus caninus Zygomaticus major muscle

M zygomaticus

Eisorius muscle

Depressor anguli oris or triangularis menti muscle

"\I triangularis

Platysma myoides Platysma

Transversus menti (var.)''

1 The pyramidalis «fls/ muscle {Musculus pvocenis) is regarded by the author as a portion of the occipitofrontalis muscle. — Tr.

- In England the levator labii superioris altrqiie nasi, the levator labii superioris prot'rius, and the :ygo?iiaiicus minor, are regarded as three separate muscles, not, as in the nomenclature of the German Anatomical Society, as the three heads, the angular head, the infra-orbital head, and the zygomatic head, respectively, of a single muscle, the quadratus labii superioris. — Tr.

'■' See note to p. 291.

Fig. 545. — The Superficial Layer of the Muscles of Facial Expression and their Relation to the Platysma Myoides. Depressor Anguli Oris or Triangularis Menti Muscle ; Risorius Muscle ; Zygomaticus Major Muscle ; Levator Labii Superioris Al^que Nasi, Levator Labii Superioris Proprius, and Zygomaticus Minor Muscles (see note ^ above) ; Orbicularis Palpebrarum Muscle. The Anterior Portions of the Occipitofrontalis Muscle — the Frontalis and the Pyramidalis Nasi Muscles {see note 1 above). Auricularis Superior or Attollens Auriculam and Auricularis Anterior OR Attrahens Auriculam Muscles. The Epicranial Aponeurosis ; the Pericranium ; the Parotideomasseteric Fascia {see note ^ above). Seen obliquely from the Left Side and Before.

Musculi faciei— Muscles of the face.*

'' See note ' on page 303.

THE MUSCLES OF THE HEAD AND NECK Corrugator supercilii musclei

301

Orbital portion of the orbicularis palpebrarum muscle

Palpebral portion of the orbicularis palpebrarum muscle

Levator anguli oris muscle, or musculus caninus

M. caninus

Pyramidalis nasi muscle

M. procerus

Internal tarsal or palpebral ligament

Lig. palpehrale mediale

Fasciculus of the orbicularis palpebrarum

muscle inserted into the skin beneath the

inner commissure of the eyelids Nasalis muscle' M. nasalis

Levator labii superioris

alaeque nasi muscle'

Caput angulare m. quadrati

labii superioris

1 This consists of the compressor natis muscle and of the outer fart of the depressor ala nasi muscle of English anatomists. — Tr.

2 See note - to p. 300.

Fig. 546.— The Attachment of the Orbicularis Palpebrarum Muscle in the Neighbourhood OF the Inner Canthus, and its Relation to the Corrugator Supercilii Muscle, seen FROM Before. Right Side.

Corrugator supercilii muscle

Palpebral portion of the

orbicularis palpebrarum

muscle

Frontal sinus Sinus frontalis

Orbital arch, or supra- orbital margin

Margo orbitalis superior

Puncta lachrymalia Tensor tairsi muscle ' Parslacrimalis(M. Horneri)

— - Lachrymal sac Saccus lacrimalis

Lachrymal groove

Fossa sacci lacrimalis

Maxillary sinus, or -antrum of Highmore

Sinus maxillaris

Orbital portion of the orbicularis palpebrarum muscle

Fig. 547. — The Three Portions^ of the Orbicularis Palpebrarum Muscle, and the Relation OF this Muscle to the Corrugator Supercilii Muscle, seen from Behind. Left Side. The soft parts in the neighbourhood of the eyelids, with the exception of the origin of the orbicularis palpebrarum muscle, have been detached from the bone ; and by the removal of the conjunctiva, the tarsal cartilages and the palpebral fascia (septum orljitale). t'le orbicularis muscle has been laid bare from behind.

" Called also/crs lachrymalis musculi orbicularis palpebrarum , Horner's muscle, or musculus sacci lachrymalis. — Tr. ■* These three portions being the orbital, palpebral and lachrymal portions; the last-mentioned, however, is by English anatomists usually described as a distinct muscle, the tensor tarsi (see also note ■•). — Tr.

M. orbicularis oculi Orbicularis palpebrarum and tensor tarsi muscles.

^02

THE MUSCLES OF THE HEAD AND NECK

.Pericranium

Tensor tarsi muscle- Pars lacnmalis M. orbicularis oculi (M. Kornen

Levator labii superioris proprius-

Caput infra-orbitale M. quadrat! labii superiorly Compressor naris muscle M. nasalis (pars transversa) -, Zygomatious major muscle M. zygomaticus _ i

Depressor alse nasi f muscle (outer part) M. nasalis (pars alaris) L3vator anguli oris muscle,

or musculus caninus Parotidductorductof Sten- . son— Ductus parotideus Buccopharyngeal fascia — Fascia buccopharyngea

Depressor labii inferioris or

quadratus menti muscle

M. quadratus labii

inferioris

Epicranial or occipito- — frontal aponeurosis

Galea aponeurotica

Superficial layer of the temporal fascia

Occipitalis muscle

Auricularis posterior or re- traheus auriculam muscle Transversus nuchse muscle (var.)

Masseter muscle (superficial portion)

Sternocleidomastoid muscle

M . sternocleidomastoideus

Spleuius capitis muscle

Buccal glands Glandulae buccales

Platysma myoides Platysma

' See notes ^ and * on p. 301.

- See note ^ on p. 300.

Fig. 548. — The Deep Layer of the Muscles of Facial Expression with the Masseter Muscle, displayed by the Removal of the Levator Labii Superioris Al^que Nasi, Levator Labii Superioris Proprius, Zygomaticus Minor, and the Depressor Anguli Oris or Triangularis Menti Muscles, of the Parotideomasseteric Fascia, and of THE Parotid Gland : Levator Anguli Oris Muscle, or Musculus Caninus ; Depressor Labii Inferioris or Quadratus Menti Muscle ; Compressor Naris and Depressor PiLM Nasi Muscles. Occipitalis Muscle. Epicranial or Occipitofrontal Aponeurosis; Pericranium; Temporal Fascia and Anterior Portion of Buccopharyngeal Fascia. Left Side.

Musculi faciei— Muscles of the face.s

» See note' on page 303.

i

THE MUSCLES OF THE HEAD AND NECK

303

Compressor naris muscle M. nasalii pars transversa' Inciaivus superior muscle /j(

M iaci3i\'us labii superioris ^}m Depressor alae nasi muscle (outer " "

parti — M. ni^jlli (pars alaris)

Depressor alae nasi muscle (inner

part)— M. depressor septi

Orbicularis oris muscle

Levator labii inferioris or levator menti muscle

M. mentalis

Incisivus inferior muscle

M. incisivus labu infenons'

Superficial layer of the temporal fascia

Deep layer of the temporal fascia

Levator anguli oris muscle, or musculus caninus

Masseter muscle (deep portion)

Zygomaticus major muscle

(cut away) M. zygomaticus

Buccinator muscle

Eisorius muscle (cut away)

Depressor anguli oris or triangularis menti muscle (cut away)

M triangularis Pepressor labii inferioris or quadratus menti muscle (cut away) M. quadratus labii inferioris

Fig. 549.— The Deep Layer of the Muscles of Facial Expression, and the Relation of THE Orbicularis Oris Muscle to the Adjoining Muscles. Seen obliquely from Before and the Left Side. Buccinator Muscle, the Buccopharyngeal Fascia having been dissected off; Accessory Slips of the Orbicularis Oris Muscle known respectively as Incisivus Superior and Incisivus Inferior Muscles; Levator Labii Inferioris or Levator Menti Muscle; Compressor Naris Muscle^; Depressor Ale Nasi Muscle^ ; Levator Anguli Oris Muscle, or Musculus Caninus. The Deep Portion of the Masseter Muscle, displayed by the Partial Removal of the Larger Superficial Portion. Pericranium ; Temporal Fascia.

i The principal differences between tlie autnor's grouping of the lacia! muscles ana tnat usual in lingland M saown in the following table :

Toldt's (Jfetng the nometictature o/the German A nalamical Soiie/y).

= pars transversa | ^^^^^^,5 ^^^^y^^

= pars alaris j

= musculus depressor septi. I-evator labii superioris alaeque nasi muscle = caput angulare \

I,evator labii superioris proprius muscle = caput infra-orbitale V musculi quadrati labii superioris. Zygomaticus minor muscle = caput zygomaticum J

— Tr.

English.

Compressor naris muscle

Depressor alae nasi muscle { °" ^^ P^"^, •^ I inner part

Musculi faciei — Muscles of the face {see nole above).

304

THE MUSCLES OF THE HEAD AND NECK

Depressor sXse nasi muscle (outeT- part) M. nasalis (pars alans) Depressor ala3 nasi muscle (inner part)

M. depressor septi i~j»-

Buccinator muscle

Incisivus superior muscle

M incisivub labii superioris

Depressor labii inferioris or quadratus

menti muscle ^

Levator anguli oris

muscle, ai musculus caninus M. caninus - Orbicularis oris muscle

'^\oY — Euccinator'musele

Orbicularis oris muscle

Transversus menti muscle (var )

M. transversus menti (var.) Levator labii inferioris or levator menti muscle

M. mentalis

Mucous membrane of the moutli

I Tunica mucosa oriB

' Incisivus inferior muscle

M. incisivus labii inferioris

Fig. 550.

-Orbicularis Oris Muscle, and its Relation to the Adjoining Muscles, seen

FROM Behind.

The soli parLS m tne iieignbourhood of the mouth and the cartilag-inous portion of the nose were together detached from the bone, and the muscles laid bare from behind by the removal of the mucous membrane of the mouth. On the right side, a narrow strip of mucous membrane, passing outwards from the angle of the mouth, has been retained, to show the partial attachment thereto of the buccinator and orbicularis oris muscles.

M. orbicularis oris — Orbicularis oris muscle.

THE MUSCLES OF THE HEAD AND NECK

305

Inner part of the depressor

ala; nasi muscle

j\I. depressor septi

Orbicularis ons muscle — -

Labial glands Glandulae labiales'

Hucous membrane of the mouth .

Tunica mucosa oris ''^

Sebaceous glands Glandulae sebacess

Skin

Integumenlum commune

Scattered fasciculi of the orbicularis oris muscle

Fig. 551. — Sagittal Section through the Middle of the Upper Lip, showing i'he Situation in the Lip of the Okbicularis Oris, and the Shape of that Muscle in Cross-Section.

Numerous thin fasciculi of the muscle are shown radiating to the skin.

M. orbicularis oris — Orbicularis oris muscle.

39

306

THE MUSCLES OF THE HEAD AND NECK

Temporal fascia (superficial layer) Fascia temporalis (lamina superficialis)

Jfrontal bone-

Parietal bone

i-m Temporal musoie

Occipital bone

1 Temporal fascia (deep layer) Fascia temporalis (lamina profunda)

Zygoma

Processus zygomaticusi ossis temporalis

Fig. 552. — Temporal Muscle, displayed on the Left Side of the Head, after Partial Removal of the Zygomatic Arch, by dissecting off the Superficial and Deep Layers of the Temporal Fascia.

Tip of the coronoid process, seen through the tendon of insertion of the temporal muscle Slip to the temporal muscle from the zygomatic arch

External oblique line Linea obliqua mandibulse

Buccinator muscle

M buccmatoi

Temporal muscle

M temporalis

Incisivus superior

M. incisivus labii inferioris -"-

Levator labii inferioris or levator menti muscle

M. mentalis

Mental foramen Foramen mentale

Head of the condyle

Capitulum mandibute . Sigmoid notch Incisura mandibular

-j/ Masseter muscle (deep portion)

M. masseter (pars profunda)

Masseter musoie (superfi^'al portion)

M masseter (pars superficialis)

Platysma myoides

1 latysma

Depiessor anguli oris or triangularis menti muscle \ M. triangularis Depressor labii inferioris or quadratus menti muscle M. quadratus labii inferioris

Fig. 553.— Attachment of Muscles to the Outer Surface of the Inferior Maxillary

Bone. Left Side.

Musculi masticatorii— Muscles of mastication.

THE MUSCLES OF THE HEAD AND NECK

307

Infratemporal crest

"Crista infratemporalis

Capsular ligament

Capsula articularis

Interaxticalardisc or meniscus

"Discus articularis

Superior and inferior neads of the external pterygoid muscle

, Internal pterygoid muscle

M. pterygoideus internus

Fig. 554. — MuscuLi Pterygoidei, iixternus et Internus, External and Internal Pterygoid Muscles, displayed by the Removal of the Zygomatic Arch and of a Portion of the Ramus of the Inferior Maxillary Bone. Seen from the Left Side.

Vhts temporomandibular articulation has been opened, in order to show the insertion of scwe of the fibres of the superior head of the external pterygoid muscle into the anterior border of ;he inter- articular fibiocartilage and the capsular ligament of the articulation.

Temporal muscle

.^M. temporalis

Interarticular disc or meniscus

Discus articularis

Head of the condyle Capitulum mandibula:- External pterygoid muscle M. pterygoideus externus

Mandibular or inferior dental foramen Foramen mandibulare

Mylohyoid groove

Sulcus mylohyoidcu:

Internal pterygoid muscle M. pterygoideus inlcrnui

'Buccinator crest

•Crista biiccinatoria

Pterygomaxillary or pterygomandibular ligament

^ Raphe pterygomandibularis

y Buccinator muscle

Genioglossus or geniohyoglossus muscle

Mental spine

•'Spina mentalis

Mylohyoid muscle

M. myloliyoideus

Geniohyoid muscle

M. geniohyoideus

7:,

Digastric muscle (anterior belly)

M. digastricus (venter anterior)

f^'f-- 555- — Attachment of Muscles to the Inner Surface of the Inferior Maxillary Bone.

Right Side.

Musculi masticatorii Muscles of mastication.

39—2

308

THE MUSCLES OF THE HEAD AND NECK

Masseter muscle (superficial portion) Masseter muscle (deep portion)

Slip to the temporal muscle from the zygomatic arch

Temporal muscle M. temporalis

External pterygoid muscle

M. pterygoideas externus

Internal pterygoid muscle

M. pterygoideus internus

Circumflexus or tensor

palati muscle M. tensor veli palatini Levator palati muscle M. levator veli palatini

Styloglossus muscle Stylohyoid muscle

M. stylohyoideus _ Stylopharyngeus muscle

Eectus capitis -■ lateralis muscle

Sternocleidomastoid muscle

M. sternocleidomastoideus Digastric muscle (posterior belly) M. digastricus (venter posterior)

Trachelomastoid muscle

M. longissimus capitis ]

Splenius capitis muscle'

Obliquus capitis superior muscle'

Rectus capitis posticus major muscle < M. rectus capitis posterior major

Eectus capitis posticus minor muscle M. rectus capitis posterior minor

Complexus, or semispinalis capitis, muscle'

M. semispinalis capitis

Trapezius muscle

Internal pterygoid plate

Processus pterygoideus (lamma medialis)

External poerygoid plate

Processus pterygoideus (lamina lateralis) Infratemporal crest Crista mfratemporalis

Membranous portion of the Eustachian tube

Lamina membranacea tubse auditivas

Eustachian cartilage (outer

fold) — Cartilago tubs auditivEe (lamina lateralis)

Eustachian cartilage (inner fold) — Cartilago tubae auditivas (lamina medialis) Spmous process of the sphenoid bone Spina angularis Styloid process Processus styloideus Mastoid process Processus mastoideus

Digastric fossa Incisura mastoidea Crest for the rectus capitis posticus major muscle Crista m. recti capitis posterioris majoris '-^ Inferior curved line

Lmea nuchas inferior Crest for the rectus capitis posticus minor muscle — Crista m. recti capitis posterioris minoris Superior curved Ime Linea nuchse superior

i

Rectus capitis anticus major muscle

\ M. longus capitis 'Rectus capitis anticus minor muscle

M. rectus capitis anterior

External occipital protuberance

Protuberantia occipitalis externa

Fig. 556. — Basis Cranii Externa, External Aspect of the Base of the Skull. Areas of Origin and Insertion of the Muscles attached to the Base of the Skull.

The muscular attachments are shown on the right side only of the base of the skull ; the bony prominences, etc., on the left side.

Attachment of Muscles to the External Aspect of the Base of the Skull.

MUSCULI EXTREMITATIS SUPERIORIS

THE MUSCLES OF THE UPPER EXTREMITY

310

THE MUSCLES OF THE UPPER EXTREMITY

SupraspinatuB mascle

Spine of the scapula i _^^^P}^^^ bcdpula

Infraspinatus muscle

Teres minor muscle Teres major muscle

?Mceps extensor cubiti muscle M. triceps brachii

TlieeteVlcle

Aoroimoil

Deltoid muscle

Biceps flexor cubiti muscle

M. biceps brachii

Brachialis anticus muscle

M. brachialis

Fig. 557. — M. Deltoideus, Deltoid Muscle, of the Right Side, Dorso-External Aspect, SHOWING ITS Relations to the Adjoining Muscles of the Shoulder and of the Upper Arm.

Musculi articulationis humeri— Muscles of the shoulder.

THE MUSCLES OF THE UPPER EXTREMITY

311

Subcutaneous bursa of the acromion

Burbd subcutanea acromialib Acromion

\ciomion

Integumentura commune

Subdeltoid or subacromial bursa / Bursa subdeltoidea /

Infraspinatus muscle

Acromial or scapular extremity of the claTicla

E\tremitas acromialis claviculae

Deltoid muscle (origin) — M. deitoideus

Coraco-acromial ligament

Lig. coraco-acromiale

The clavicle

Subclavlus muscle Pectoralis minor muscle

Teresnninor muscle -

Teres major muscle

Middle or long head of the

triceps extensor cubiti muscle

M. triceps brachii

External head of the triceps extensor cubiti muscle M. triceps brachii External intermuscular septum

Septum intermusculare laterale

Tendon of the pectoralis major muscle

Deltoid muscle (insertion)

M deitoideus

Biceps flexor cubiti muscle

M biceps brachii

Brachialis anticus muscle (outer process of origin)

M brachialis

Fig. 558.— Arrangement of the Muscles adjoining the Right Shoulder-Joint and in THE Proxima' Portion of the Upper Arm, as seen from the Outer Side, after the Removal of the Greater Part of the Deltoid Muscle. Subdeltoid or Subacromial Bursa and Subcutaneous Bursa of the Acromion.

Musculi articulationis numeri— Muscles of the shoulder.

312

THE MUSCLES OF THE VPPER EXTREMirY

Supraspinatus muscle

Spine of the scapula Spina scapulas

'Internal axillary space'

Teres major muscle — V'/C^"-' ~— ~

_,-- Infraspinatus muscle

Great tuberosity of the humerus

Tuberculum majus humeri

Teres minor muscle

" External axillary space'

Middle or long head of the triceps extensor cubiti muscle

External head of the triceps extensor cubiti muscle

Deltoid muscle

M. deltoideus

Brachialis anticus muscle M. brachialis

Internal or deep head of the triceps extensor cubiti muscle ' Caput mediale m. tricipitis brachii

I Intcrjial and External Axillary Spaces. — Between the lower horder of the teres minor muscle, the upper part of the humerus, and the axillary border of the scapula, covered in front by the subscapularis muscle and behind by the teres minor muscle, is a triangular space, divided, as shown in the figure, by the middle or long head of the triceps into an outer, quadrilateral, and an inner, triangular, compart- ment, called respectively by Toldt the internal and the external axillary space. These names are not in use in England, but are suitable, and may well be adopted. Through the external axillary space the posterior circumflex nerve and vessels pass backwards; and through ternal axillary space the dorsal branch of the subscapular artery passes round the margin of the scapula into the infraspinous

-Te.

Fi<^' 559- — Muscles of the Right Shoulder, seen from Behind: Supraspinatus and Infraspinatus Muscles; Teres Major and Teres Minor Muscles; the Adjoining Parts of the Triceps Extensor Cubiti Muscle. The *Internal and the *External Axillary Space (see note above).

Supraspinatus muscle

Spine of the scapula

Spina scapulas

Bursa of the infraspinatus muscle- Bursa m. infraspinati

Infraspinatus muscle

Acromial or scapular extremity of the clavicle Extremitas acromialis claviculse

Subdeltoid or subacromial bursa

Bursa subacromialis

Capsular ligament

Capsula articularis

Teres major muscle.

Middle or long head of the triceps extensor cubiti muscle i Caput longum m. tricipitis brachii

External head of the triceps

extensor cubiti muscle

Caput laterale m. tricipitis

brachii

= The bursa of the infraspinatus muscle lies between the infraspinatus muscle and the capsular ligament of the shoulder-joint.— Te.

Fig. 560. — In a Preparation similar to that last described, the Origin of the Infraspinatus Muscle ■WAS detached from the Spine of the Scapula, to show the Bursa between that Muscle and the Capsule of the Shoulder-Joint. The Subdeltoid or Sub-i^cromial Bursa has also been opened.

Musculi articulationis humeri — Muscles of the shoulder.

THE MUSCLES OF THE UPPER EXTREMITY

313

Bursa of the subscapularis muscle' Bursa m siibscip'i'aris

Ooracoid process (cut away at its base)

Processus coracoidcus

Acromion

/Acromion Supraspinatus muscle

Gr£at tuberosity _

Tuberculum majus Small tuberosity Tuberculum minus

•fextemal axillary space- Latissimus dorsi muscle

Fectoralis major muscle

Long head of the biceps flexor cubiti muscle

Caput longum m. bicipitis brachii

Coracoscapular or suprascapular ligament Lig transversum scapulae superius

Subscapularis muscle

•Internal axillary space-

Teres major muscle

Middle or long head of the triceps extensor cubiti muscle

Caput longum m. tricipitis brachii

Internal or deep head of the triceps

extensor cubiti muscle Caput mediale m. tricipitis brachii

Brachialis anticus muscle

M. brachialis

' The bursa of the subscapularis muscle is situate between the upper border and posterior surface of the subscapularis muscle and the coracoid process and neck of the scapula. — Tr. - See note ' on p. 312.

Fig. 561. — Muscles of the Right Shoulder, seen from Before. Subscapularis Muscle, WITH ITS Bursa; Supraspinatus Muscle; Teres Major Muscle. Adjoining Portions of the Muscles of the Upper Arm and of the Muscles passing from the Trunk TO THE Upper Limb. The *Internal and the *External Axillary Space {see note * on p. 312).

Musculi articulationis humeri — Muscles of the shoulder.

40

314

THE MUSCLES OF THE UPPER EXTREMITY

Subclavius muscle

Pectoralis minor muscle Coracoid process Processus coracoideus Bursa of the subscapularis muscle' Bursa m. subscapularis Bursa of the coracobrachialis muscle'^ Bursa m. coracobrachialis

Subscapularis muscle

Bursa of the latissimus dorsi muscle' — Bursa m. latissimi dorsi Latissimus dorsi muscle Teres major muscle '

Bursa of the teres major muscle^ - Bursa m. teretis majoris

Coracobrachialis muscle

Biceps flexor cubiti muscle M. biceps brachii

Omohyoid muscle (posterior belly)

M. omohyoideus (venter inferior) Coracoscapular or suprascapular ligament — Lig. transversura scapulas superius

\ . Subscapular fossa Teres minor muscle

Teres major muscle

of the triceps extensor

cubiti muscle

M. tricipitis brachii

'Deep fascia of the arm

Internal intermuscular septum Septum intermusculare mediate

Internal condyle

Epicondylus medialis Deep fascia of the forearm

Subcutaneous bursa of the olecranon Bursa subcutanea olecrani

: See note ", p. 313.

» The />itr-sa of the coracobrachialis muscle is situate between the anterior surface of the subscapularis muscle and the upper ends ot the biceps and the coracobrachialis muscles. — Tr.

3 1 he bursa 0/ the latissi/ints dorsi muscle is situate between the tendon of the latissimus dorsi muscle and that of the teres major muscle. — Tk.

4 The bursa of the teres major muscle is situate between the tendon of the teres major muscle and the humerus. — Tr.

Fig. 562. — Arrangement of the Muscles in the Proximal Portion of the Right Upper Arm, AND THE Relation of these Muscles to the Insertions of the Muscles of the Shoulder AND of the Muscles passing from the Trunk to the Upper Limb. Seen from the Inner Side. Burs^ of this Region. Distal Portion of the Deep Fascia of the Upper Arm AND Proximal Portion of the Deep Fascia of the Forearm. Subcutaneous Bursa of the Olecranon.

Musculi brachii — Muscles of the upper arm.

THE MUSCLES OF THE UPPER EXTREMITY

315

Coracoscapular or suprascapular ligament

Lif . transversum scapula; superius j

Pectoralis minor muscle Coracoid process Processus coracoideuo

Pectorali; iiiajor muscle

<joracobracliiaIi3 muscle

Biceps flexor cubiti muscle (long head) M. biceps brachii (caput longum)

Biceps flexor cubiti muscle (internal or short head) M. biceps brachii (caput breve)

Brachialis antious muscle M. brachialis

Supinator radii longus muscle M. brachioradialis

Extensor carpi radialis longior muscle M. extensor carp, radialis longus

\ Subacapularis muscle

Teres major muscle

Triceps extensor cubiti muscle (middle or long head)

M triceps brachii (caput longum)

Triceps extensor cubiti muscle (internal or deep head)

M triceps brachii (caput mediale)

Internal intermuscular septum

Septum mtermusculare mediale

Inner bicipital furrow

Sulcub bicipitalis medialis Brachialis anticus muscle M brachialis

Semilunar or bicipital fascia

Lacertus fibrosus

Pronator radii teres muscle

-M. pronator teres

Flexor carpi radialis muscle

Fig. 563.-B1CEPS Flexor Cubiti Muscle, of the Right Side, and its Relations to the OTHER Muscles on the Flexor Side of the Upper Akm, to the Muscles of the Shoulder, to the Muscles passing from the Trunk to the Upper Limb, and to THE Muscles of the Forearm.

Musculi brachii— Muscles of the upper arm.

40-

316

THE MUSCLES OF THE UPPER EXTREMITY

Coracoid process

Processus coracoideus Pectoralis minor muscle

Coracoscapular or suprascapular ligament

Lig tranb\ ersum scapulse superius

Biceps flexor cubiti muscle (internal or short head) i\I. biceps brachii (caput breve) Biceps flexor cubiti muscle (long

head) M. biceps brachii (caput longum)

Pectoralis major muscle

Deltoid muscle M. deltoideus

Brachialis anticus muscle

M. brachialis

Subscapularis muscle

Teres major muscle Latissimus dorsi mascle

*Bicipitoradial bursa^ Bursa bicipitoradlalis

'' Internal intermuscular septum

Septum intermusculare mediale

Tendon of insertion of the biceps flexor cubiti muscle

1 This bursa is situate between the tendon of insertion of the biceps muscle and the anterior smooth portion of the tuberosity of the radius. — Tr.

Fig. 564. — The Muscles of the Anterior (Flexor) Side of the Right Upper Arm, after Removal of the Biceps Flexor Cubiti Muscle. Coracobrachialis Muscle; Brachialis Anticus Muscle.

The tendon of insertion of the biceps flexor cubiti muscle has been turned downwards, in order to display the "bicipitoradial bursa {see note above).

Musculi brachii — Muscles of the upper arm.

THE MUSCLES OF THE UPPER EXTREMITY

317

Subclavius muscle (insertion) Coracoclavicular ligament Li^ corac LliMCulire Coracoid process trccebbUb coracoideus Pectorahs minor muscle

Deltoid muscle - Common tendon of the coracobrachialis muscle and the internal or short head of the biceps flexor cuhiti muscle Biceps flexor cublti muscle (long head — tendon of origin) — M. biceps brachii (caput longum) Glenoid fossa Cavitas slenoidalis

Great tuberosity

Tuberculum majus

Small tuberosity Tuberculum minus Subscapularis muscle

Latissimus dorsi muscle

Teres major muscle

Pectoralis major muscle

Deltoid muscle M. deltoideus

Supinator radii longus

muscle origin I

M. brachioradialis

Extensor carpi radialis

longior muscle

M. extensor carpi

radialis longus

Extensor carpi radialis brevior

muscle M. extensor carpi radialis brevis Annular or orbicular ligament of the radius Lig. annvilare radii . Supinator radii brevis muscle 'origin)— M supinator Supinator radii brevis muscle 'deep Insertions) — M supinator

Bicep|8 flexor cubiti muscle 'insertion) . M biceps brachii

Bupinatorradiibrevis muscle 'super- ,,. ficial insertion)— M. supinator

Sternocleidomastoid muscle (clavicular head)

M. sternocleidomastoideus (caput claviculare)

— Pectoralis major muscle (clavicular portion)

IVI. pectoralis major (pars clavicularis)

Omohyoid muscle (insertion)- M. omobvoideus

Serratus magnus muscle (insertion) M. serratus anterior

Subscapularis muscle (origin from the subscapular fossa)

Serratus magnus muscle (insertion)

M. serratus anterior

Triceps extensor cubiti muscle (middle or long head) M. triceps brachii (caput longum) Coracobrachialis muscle (insertion)

Internal intermuscular septtun

-Septum intermusculare mediale

Capsule of the elbow -joint

'Capsula articularis

Pronator radii teres muscle (humeral head) , M. pronator teres (caput humerale) Internal condyle Epicondylus medialis Common tendon of the pronator radii teres, flexor -; carpi radialis, palmaris longus, flexor carpi ulnaris, '' and flexor sublimis digitorum' muscles

Pronator radii teres (ulnar head)

M. pronator teres (caput ulnare)

Flexor sublimis digitorum' (humeral head)

' M. flexor di^'itorum sublimis (caput humerale)

Flexor carpi ulnaris muscle Brachialis anticus muscle (insertion) M brachialis Oblique ligament— Chorda obliqua

■ Tins Icrm,

cparatelydevn'ibed, xs the

» 'rht ttcapular allachin

3 Or JItxor per/oralus

cular ligaiiKnt. is seldom used in KnKlaiid onoiil ligamcnl and the trapezoid li^-amcnt, :nl of the omohyoid is by Knglish anatomists regarded

here thctw respectively.

) parts of which the ligament consists are more often See Section II. of this work, p. 202, I''ig. 435.— Tr. the origin of that muscle. — Tk.

Fig. 565.— Attachment of Muscles to the Anterior Surfaces of the Scapula, the Humerus,

AND THE Elbow.

Musculi brachii — Muscles of the upper arm.

318

THE MUSCLES OF THE UPPER EXTREMITY

Teres major muscle

Middle or long head

Caput longum

Internal or deep head

Caput mediale

Internal or deep head Caput mediale

Internal condyle

Epicondylus medialis

Aperture for the ulnar nerve,

between the two heads of the'

flexor carpi ulnaris muscle

Flexor carpi ulnaris muscle

Acromion

t— Infraspinatus muscle

Great tuberosity of the humerus

Tuberculum majus humeri Teres minor muscle

-Trioeps extensor cubiti muscle

Internal or deep head

\ "Caput mediale

Olecranon

Olecranon

Anconeus muscle

M. anconasus

Posterior border of the ulna

Margo dorsalis ulnae

Extensor carpi ulnaris muscle

M. extensor carpi ulnaris

Fig. 566. — Triceps Extensor Cubiti Muscle, of the Right Side, seen from Behind; THE Relations of its Proximal Extremity to the Muscles of the Shoulder, and OF ITS Distal Extremity to the Muscles of the Forearm. Anconeus Muscle.

Musculi brachii — Muscles of the upper arm.

TJIF. MUSCLES OF THE UPPER EXTREMITY

319

Trapezius muscle (clavicular origin)' AI. trapezuis Omohyoiu n.us'ile M. omohyoideus -

/I he claviclo

Clavicula

Supraspinatus muscle ( origin _ from the supraspinous fossa^

Levator anguli scapulae muscle M. levator scapulx-

Spine of the scapula

Spina scapula?

Trapezius muscle (scapular origin' M. trapezius

Rhomboideus minor muscle

Deltoid muscle (scapular origin M. deltoideus

Rhomboideus major muscle -^

Infraspinatus muscle (origin from the infraspinous fossa

Teres minor muscle

Teres major muscle

Serratus magnus muscle M. serratus anterior

, Deltoid muEiole (clavicular origin)

M 1. Itciidcus

Acromion \i romion Capsule of the shoulder-joint

ipsula articularis

jupraspinatus muscle Infraspinatus muscle

Teres minor muscle

Triceps extensor c"biti muscle

(external ijt<ad) r. triceps brachii (caput )aterale)

Deltoid muscle

M. deltoideus

Brachialis anticus muscle

i\I. brachialis

rxternal intermuscular septum

,-i-ptum intermusculare laterale

Triceps extensor cubiti muscle (origin of the internal or deep head)

M. triceps brachii (caput mediale)

Internal intermuscular septum

Septum intermusculare mediale

Capsule of the elbow-joint-^

Capsula articularis

i'licepe extensor cubiti muscle (insertion) lA. triceps brachii

Internal condyle Hpicondyius medialis Olecranon (Olecranon

Flexor carpi ulnaris muscle

Anconeus muscle (origin ) M. anconanis

Posterior border of the ulna Margo dorsalis ulna;

' Inurtion of the trapezius muM:Ie, according to Eneli<;h anatomists. » EnKlish anatcmistK regard ihe humeral attachment of the : of thai muscle.— Tk.

Triceps extensor cubiti muscle (external head)

M. triceps brachii (caput laterale)

Supinator radii longus muscle \1. brachioradialis

Extensor carpi radialis longior muscle

M. extensor carpi radialis longus

External condyle — Epicondylus lateralis

Anconeus muscle (insertion") " M. aconaius . Annular or orbicular ligament of the rauiu:

Lin. annulare radii Neck of the radius C.'ollum radii Supinator radii brevis muscle (origin) M, supinator Supinator radii brevis muscle (insertion) M supinator

\perture for the posterior Interosseous

nerve, between the two layers of the

supinator radii brevis muscle

Fig. 5O7. — Attachment ok Muscles to the Posterior Surfaces oe the Scapula, the Humerus,

AND THE EluOW.

Musculi brachii — Muscles of the upper arm.

320

7:he muscles of the upper extremity.

Bracliialis anticus mnscle

M iDrachiahs

Subcutaneous bursa of the internal condyle

Bursa subcutanea epicondvli medialis

/"Humeral head Caput humerale\ Flexor carpi J Ulnar \

ulnarls muscle I head \ \

Caput \ I ulnare ^

Deep fascia of the forearm Fascia antibrachii \

Triceps extensor cubiti muscle /\ M. triceps brachii

Internal or deep head

Caput mediale

Middle or long head

"Caput longum

Subtendinous bursa of the olecranon'

Bursa subtendinea olecrani

Epitrochleo-anconeus muscle (var. )-

Intratendinous bursa of the olecranon'

Bursa intratendinea olecrani

Subcutaneous bursa of the olecranon

Bursa subcutanea olecrani

1 Concerning these bursas Quain writes (" Elements of Anatomy," loth ed., vol. ii., Part II., p. 221): " In many cases there is a small bursa above the olecranon, either between the tendon of the triceps and the posterior ligament, or more frequently in the deep part of the tendon itself. A bursa behind the internal condyle, beneath the inner edge of the triceps and the ulnar nerve, is of rare occurrence." — Tr.

^ The epitrochleo-anconeus is a small muscle often found, which arises from the posterior surface of the internal condyle of the humerus, and is inserted into the olecranon. It is superficial to the ulnar nerve. When absent, it is represented by a band of transverse fibres in the deep fascia of the arm. — Tr.

Fig. 568. — The Inner Side of the Right Elbow with the Distal Extremity of the Triceps Extensor Cubiti Muscle, the Anomalous Epitrochleo-anconeus Muscle,

AND the BuRS^ of THIS REGION.

In order to display the intratendinous and the subtendinous bursas of the olecranon t'O longitudinal incisions have been made in the distal e.xtremity of the triceps extensor cubiti muscle, and the posterior margins of the incisions have been retracted with hooks. In the region of the forearm the deep fascia has been left intact.

Musculi brachii— Muscles of the upper arm.

THE MUSCLES OF THE UPPER EXTREMITY

321

Delioid mu3cle

M deltoideus

Triceps extensor cubiti muscle (external head) M. triceps brachii (caput laterale)

Supinator longus muscle

M. brachioradialis

Extensor carpi radialis longior muscle

M. extensor carpi radialis Idiisus

Capitellum of the humerus Capitulum humt-ri Annular or orbicular ligament of the radius Lig- annulare radii

Tendon of the biceps flexor cubiti muscle Bicipitoradial bursa' Bursa bicipitoradialis - 'Interosseous bursa of elbow- (i) Supinator radii brevis muscle — M. supinator

Flexor longus pollicis muscle

M. flexor pollicis longus Extensor carpi radialis brevioi muscle

M. extensor carpi radialis brevis

Pronator radii teres muscle

M. pronator teres

(■)Bu

ubitalts ioterossea

Triceps extensor cubiti muscle (internal or deep head)

M. triceps brachii (caput mediale)

Brachialis anticus muscle

M. brachialis

Common tendon of the pronator

radii teres, palmaris longus, and

flexor carpi radialis muscles

■Flexor sublimis digitorum' muscle (humeral head)

M. flexor digitorum sublimis (caput humerale)

Flexor profundus digitorum'' muscle

M, flexor digitorum profundus

Flexor sublimis digitorum^ muscle (radial head)

M, flexor digitorum sublim's (caput radiale)

» See Rote (©"p. 316.

' /nUrossems Bursa 0/ the jS^oiu.— This bursa is situate in the bicipital hollow of the ulna, which lies below the small sigmoid cavity, bounded behind by the supinator ridge and in front by the upper extremity of the interosseous border. In pronation of the hands, the bicipital hollow lodges the tuberosity of the radius and the distal extremity of the biceps tendon ; and the interosseous bursa forms a s>-novial cavity between the two boi es. Behind, the sac is in contact with the interosseous membrane and the oblique ligament: projecting forward, it separates the.tendon of the brachialis amicus on the inner side from the tendon of the biceps and the upper part of the insertion of the supinator radii hrevis on the outer side. Thus the tendon of the biceps at its insertion lies between the bicipitoradial bursa and the interosseous bursa of the elbow. The condition known as " lawn-tennis elbow "depends on inflammation of one or both of these bursas. — Tr.

3 Ot Jlcxor perforatus mu^K.

* Ot /lexor per/orans muscle. •

Fig. 569. — The Origin of the Palmar and Radial Muscles of the Right Forearm, and THEIR Relations to the Brachialis Anticus Muscle in the Neighbourhood of the Antecubital Fossa. Anterior Aspect, the Forearm being supinated. The Bicipito- radial Bursa (see note ^ above) and the Interosseous Bursa of the Elbow {see note ^ above).

The brachialis anticus muscle has been drawn slightly inwartJs. The two superficial muscles of the radial group, the supinator radii longus and the extensor carpi radialis longior, have been cut away, except for their proximal extremities, which have been turned outwards, in order to lay bare the deep layer of muscles of the radial group : these arc the extensor carpi radialis brcvior and the supinator radii brevis. The superficial layer of the palmar group of muscles has also been removed.

Musculi antibrachii -Muscles of the forearm.

4»

rf22

THE MUSCLES OF THE UPPER EXTREMITY

Biceps flexor cubiti muscle M. biceps brachii

Supinator radii brevis muscle M. supinator

Supinator radii longus muscle

M. brachioradialis

Extensor carpi radialis longior muscle^ M. extensor carpi radialis longus

Flexor sublimis digitorum muscle'

(radial head)

M. flexor digitorum sublimis

(caput radiale)

Flexor longus pollicis muscle

M. flexor pollicis longus

*Radial furrow of the forearm

Sulcus antibrachii radialis

Anterior annular ligament of the wrist (superficial layer)

Sec note -'■' oil l^agc 7281 Lig. carpi volare Aperture for the ulnar artery

Thenar eminence ' Thenar

n

Brachialis anticus muscle

AI bracliialis

Semilunar or bicipital fascia

Lacertus fibrosus Antecubital fossa Fossa cubitalis

Pronator radii teres muscles

M. pronator teres

Flexor carpi radialis muscle Palmaris longus muscle

Flexor sublimis digitorum muscle'

M. flexor digitorum sublimis

Flexor carpi ulnaris muscle

Ulnar furrow of the forearm

Sulcus antibrachii ulnaris

Palmaris brevis muscle

Hypothenar eminence

Hvpothenar

Palmar fascia

Aponeurosis palmaris

' Or Jlexor/ierforatusmmde.

- English anatomists group the pronator and flexor muscles of the fori pronator radn teres, flexor carpi radialis, palmaris longus, and flexor suUimi profundus digitorum, flexor longus pollicis, and pronator quadratus muscle, as enumerated in the description at the foot of Figs. 570, 571, and 572. — Tr.

onim muscle luthor, howe

nly: a svperficia^^ comprehending the ; and a deep, comprehending the flexor ;r, groups these muscles in y2>wr layers,

Fig. 570.— The Superficial Layer (see note " above) of the Palmar Group of Muscles of THE Right Forearm: Pronator Radii Teres Muscle, Flexor Carpi Radialis Muscle, Palmaris Longus Muscle, Flexor Carpi Ulnaris Muscle. The Superficial Layer of the Radial Group of Muscles : Supinator Radii Longus Muscle, and a Portion of the Extensor Carpi Radialis Longior Muscle. The Antecubital Fossa, and the Ulnar and Radial Furrows of the Forearm. Ligamentum Carpi Volare, the Anterior Annular Ligament of the Wrist, and the Palmar Fascia wiTh the Palmaris Brevis Muscle.

Musculi antibrachii— Muscles of the forearm.

THE MUSCLES OF THE UPPER EXTREMITY

323

Biceps flexor cubiti muscle

M. biceps brachii

Supinator radii brevis muscle M. supinator

Pronator radii teres muscle

M. pronator teres

Flexor sublimis digitorum muscle'

(radial head)

M. flexor digitorum sublimis

(caput radiale)

Pronator quadratus muscle

Supinator radii longus muscle M. brachioradialis

Flexor carpi radialis muscle M. flexor carpi radialis Ridge or tuberosity of the trapezium Tuberculum ossis muitaii^^uli majoris Bursa of the flexor carpi radialis muscle-

Bursa m. flexoris carpi radialis

Opponens pollicis muscle - j M- opponens pollicis "

First dorsal interosseous or

abductor indicis. muscle

M. interosseus dorsalis 1.

#

Internal condyle

lipicondylus medialis

Brachialis anticus muscle

M. brachialis

Flexor sublimis digitorum muscle' (humeral head)

M. flexor digitorum sublimis (caput humerale)

Flexor carpi ulnaris muscle

Abductor minimi digiti muscle

M. abductor digiti quinti

' Ox Jlexor prrforatus muscle. _ .

* This bursa .ics beneath the tendon of the flexor carpi radialis muscle as it crosses the scaphoid bone and the trapezium. — Tr.

Fig. 571.— The Sfxond Layer (sec note'' tn p. 2,21) of the Palm.\r Group of Muscles of the Right Forearm: Flkxok .Sublimis Dkjitorum or Flexor Ferforatus Muscle. The Ulstal Attachments (Insertions) OF THE Tendons of the Flexor Carpi Ulnaris, Flexor Carpi Radialis, and Supinator Radii Longus Mu.scLES. The Superficial Musclks of the Hypothenar Eminence, and the Interosseous MuscLts

of the H*NIJ that are VISIIiLE FRO.M THE PaLMAR SIDE. THE I'jURSA OF I'HE FLEXOR CaRPI RADIALIS

Muscle isee note = above).

After the removHl of the muscles of the superficial layer and the anterior annular ligament of the wrist, the flexor sublimis rligiiorum mu-cle was laid bare. In order to show clearly the disposition of the tendons of the flexor sublimis digitorum muscle, the flexor profundus digitorum muscle was removed.

Musculi antibrachii — Muscles of the forearm.

41— a

324

THE MUSCLES OF THE UPPER EXTREMITY

Brachialis anticus muscle -

M. brachialis

Tendon of the biceps flexor cubiti muscle '

Internal intermuscular septum

beptura intermusculare mediale

Internal condyle

Epicondylus medialis

Supinator radii brevis muscle M. supinator

Flexor sublimis digitorum muscle'

(radial head)

M. flexor digitorum sublimis

(caput radiale)

Flexor profundus digitorum muscle^

M. flexor digitorum profundus

Flexor longus poUiois muscle

M. flexor pollicis longus

Interosseous membrane or ligament of the forearm

Membrana interossea antibrachii

Pronator quadratus muscle

M. pronator quadratus

Remains of the anterior annular ligament of the wrist (Deep layer)

See note -^^ on page 7281

Abductor pollicis muscle M. abductor pollicis brevis-

Flexor brevis pollicis muscle'^ -

M. flexor pollicis brevis

Adductor pollicis muscle'^ - '

First dorsal interosseous or abductor indicis muscle M. interosseus dorsalis I.

1 rwTi-wtfe

Pisiform bone

Os pisiforme

Unciform process of the unciform bone

Hamulus ossis hamati

Flexor brevis minimi digiti muscle M flexor digiti quinti brevis

Abductor minimi digiti muscle

M abductor digiti quinti _ \Lumbricales muscles ^-/Mm. lumbricales

\Vaginal ligaments'* , /Ligg. vaginalia

' OrJ7exor per/oratus muscle.

= The aut.nor adheres to the old nomenclatu adopted by English anatomists. Following this used to be called the dee/> head of the flexor obliquus pollicis, the largest of the thumb muscle bones, the os magnum, the anterior carpal 1'

of the short muscles of the thumb, but that introduced by Cunningham is now generally titer, the former addjtctor pollicis is called the adductor pollicis traits^'crsiis, and what :z'is pollicis muscle is divided into two parts. The larger part, known as the adductor consists of several slips arising from the upper ends of the second and third metacarpal .. and the sheath of the flexor carpi radialis muscle ; the muscle is inserted, i

'ith the adductor transversns and the deep head of the flexor brevis, into the inner side of the bL_ Vhat is now termed the deep head of t\\& flexor brevis pollicis is a very small slip, deeply placed bet nd the outer head of the abductor indicis. It arises from the ulnar side of the upper part of the first Iready described.— Tr. See also Figs. 573, 585, and 586.

3 Ot flexor per/bratis muscle.

4 See note 3 to p. 334.

of the first phalanx of the thumb, veen the adductor obliquus pollicis netacarpal bone, and is inserted as

Fig. 572.— The Third Layer of the Palmar Group of Muscles of the Right Forearm, after the First AND Second Layers and the Anterior Annular Ligament of the Wrist have been removed : Flexor Profundus Digitorum or Flexor Perforans Muscle, and Flexor Longus Pollicis Muscle. In the Fourth Layer we see a Portion of the Pronator Quadratus Muscle. Lumbricales Muscles, and THE Superficial Muscles of the Thenar and Hypothenar Eminences : Abductor Brevis Pollicis, Adductor Pollicis {see note ^ above), Flexor Brevis Pollicis, Flexor Brevis Minimi Digiti and Abductor Minimi Digiti Muscles.

Musculi antibrachii— Muscles of the forearm.

THE MUSCLES OF THE UPPER EXTREMITY

325

Supinator radii longus muscle M. brachioradialis

V Extensor carpi radialis longior muscle -

M. extensor carpi radialis longus

Extensor carpi radialis brevior muscle-^

M. extensor carpi radialis brevis Annular or orbicular ligament of the radius ,_

Lig. annulare radii

Supinator radii brevis muscle (origin) — M. supinator' Supinator radii brevis muscle (deep insertion - M. supinator

Tendon of insertion of the

biceps flexor cubiti muscle

Supplementary origin of the,-

flexor longus poUicis muscle

Supinator radii brevis muscle (superficial insertion) '

M. supinator

Pronator radii teres muscle M. pronator teres Flexor sublimis digitorum muscle' (radial head) - M. flexor digitorum sublimis (caput radiale)

Fleshy origin of the flexor - longus poUiois muscle

Accessory slip from the radius to the flexor profundus digitorum muscle- <

Pronator quadratus muscle""

Styloid process of the radius — .

Tuberosity of the scaphoid bone

Tuberculum ossis navicularis

Deep head of the flexor brevis poUicis muscle ■ Opponens pollicis muscle (insertion)

Tendon of insertion of the/ flexor carpi radialis muscle Carpal head of the adductor pollicis muscle'' , Metacarpal head of the adductor pollicis muscle^

Brachialis anticus muscle M. brachialis Internal intermuscular septum

Septum intermusculare mediale

Fasciculi of the brachialis anticus

muscle attached to the anterior

ligament of the elbow-joint

Internal condyle ,■ Epicondylus medialis

L^ Common tendon of the pronator radii teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, and flexor sublimis digitorum' muscles

Flexor sublimis digitorum muscle' (humeral head)

M. flexor digitorum sublimis (caput humerale) -Pronator radii teres muscle ( ulnar head)

M. pronator teres (caput ulnare)

Tendon of insertion of the brachialis anticus muscle

Aponeurotic origin of the flexor carpi ulnaris muscle from the ulna

~ Fleshy origin of the flexor sublimis digitorum muscle-

Interosseous membrane or ligament of the forearm

Membrana interossea anlibrachii

-Pronator quadratus muscle

Inferior radio-ulnar articulation

- Articulatio radio-ulnaris distalis

Tendinous insertion of the flexor carpi ulnaris muscle Pisiform bone /Os pisiforme ,Pisi-imcinate ligament — Lig. pisohamatura — Pisimetacarpal ligament— Lig. pisometacarpeum ,^ Tendinous insertion of the extensor

carpi ulnaris muscle ^-Unciform process of the unciform bone

lamulus ...si- h.iii.ali

Flexor brevis minimi digiti and opponens mmimi digiti

muscles (origin)— Mm Hexor digui quinti brevis el npponers dij^iti L]uinti

Opponens minimi digiti muscle (insertion)

M. opponens digili quinti

' Or Jlexor per/oratusTn^iw:\t:,

=• Or Jlexor per/orans muscle.

' .'^cc nole 2 lo p. 324.

4 What the author calls the carpal head 0/ the adductor pollicis muscle is part of the adductor pollicis obliijuus according to Cunningham, whilst what he calls the metacarpal head 0/ the adductor pollicis is the adductor pollicis transversus of Knglish anatomists. See nole ^ 10 p. 324.

Fig. 573. — Attachment of Muscles to the Palmar Surface of the Forearm and the Hand.

Musculi antibrachii— Muscles of the forearm.

326

THE MUSCLES OE THE UPPER EXTREMITY

Triceps extensor cubiti muscle

(external head)

M. triceps brachii (caput laterale

External intermuscular septum Septum intermusculare laterale

Supinator radii longus muscle

M. brachioradialis

External condyle Epicondylus lateralis Extensor carpi radialis longior muscle M. extensor carpi radialis longus

Anconeus muscle - M. anconaeus

Extensor communis digitorum muscle M. extensor digitorum communis

Extensor carpi ulnaris muscle

Extensor minimi digiti muscle M. extensor digiti quinti proprms

Extensor indicis muscle

M. extensor indicis propnub

Head of tlie ulna

Capitulum uln;e

Posterior annular ligament of the wrist

Brachialis anticus muscle

^M. brachialis

Outer bicipital furrow

Sulcus bicipitalis lateralis

Biceps flexor cubiti muscle "IVI. biceps brachii

Extensor carpi radialis brevior muscle

M. extensor carpi radialis brevis

Extensor ossis metacarpi poUicis' or

abductor longus poUicis muscle

M. abductor pollicis longus

Extensor primi intemodii pollicis' or

extensor brevis pollicis muscle

RI. extensor pollicis brevis

Extensor secundi intemodii pollicis' or

extensor longus pollicis muscle

M. extensor pollicis longus

1 have given the preference to the old names as more distinctive and therefore more suitable, of the three extensor muscles of the thumb, ejtrrcnsor OSSIS mi:/iuar/'i/'ol/ic/s, xt }i\n primi int > no iti pollicis ;iXiA. txUnsorsccundiintcriiodii pollicis. QuainC* Anatomy," loth ed.) has, however, adopted the Coiumciual n :)mencWtur<. in the case of the two latter muscles, which he terms respectively extensor brevis pollicis and exicnsor longus pollici ^\ hil t ^ et )ther names have been adopted by Macalister, who terms the extensor of the iirst phalanx, extensor pollicis minor, attd the e\len or of the st-cond phalin\ t xttnsor pollicis major. The names used in the text are, however, more familiar to students, both in England and America and there seems no good reason for any change.

While speaking oi| these muscles, it maj be mentioned that their tendons viz those of the extensor ossis metacarpi pollicis and extensor primi intemodii pollicis on the radial side, and that of the extensor secundi intemodii pollicis on the ulnar side, bound the deep hollow to be seen on the outer (radial) side of the wrist and behind the metacarpal bone of the thumb, when this member is fully extended. This hollow is known as the tabatiirc anatomique, or anatomical snvff.box (called by Toldt foveola radialis, see Fig. 575). Beneath the tendons of the extensors of the thumb, and across the intervening hollow, the radial artery passes from the front to the back of the wrist, its direction being indicated by a line from the front of the styloid process of the radius to the proximal end of the first interosseous space ; and the artery is crossed by the superficial radial vein, which usually forms a distinct prominence in the hollow between the tendons.— Tk.

2 By English anatomists the supinator and extensor muscles are, like those of the front of the forearm, divided simjjlv into two layers : a superficial, containing seven muscles, viz., the supinator radii longus, extensor carpi radialis longior, extensor carpi radialis brevior, extensor communis digitorum, extensor minimi digiti, extensor carpi ulnaris, and anconeus muscles ; and a deep layer, containing five muscles, viz., the supinator radii brevis, extensor o-ssis metacarpi pollicis, extensor primi internodii pollicis, extensor secundi intemodii pollicis, and extensor indicis muscles. The author's classification of these muscles is to he found in the description at the foot of Figs. 574, 575, and 576.— Tr.

Fig. 574. — The Superficial Layer {see note -above) of the Dorsal Group of Muscles of the Right Forearm: Extensor Communis Digitorum, Extensor Carpi Ulnaris, and Anconeus Muscles. The Radial Group OF Muscles seen from the Dorsal Side, and the Deep Layer of Muscles of the Dorsal Group that are visible in the Distal Portion of the Forearm between the Superficial Layer of Dorsal Muscles nd the Radial Muscles : Extensor Carpi Radialis Longior and Extensor Carpi Radialis Brevior (Muscles of the Radial Group); Extensor Ossis Metacarpi Pollicis, Extensor Primi Internodii Pollicis, and Extensor Secundi Internodii Pollicis (Muscles of the Deep Dorsal Layer). Ligamentum Carpi Dorsale, the Posterior Annular Ligament of the Wrist.

Musculi antibrachii — Mnsrlpt; nf thp fn

THE MUSCLES OF THE UPPER EXTREMITY

327

Brachialis anticus muscle M. brachialis

Supinator radii longus muscle 11. brachioradialia

Extensor carpi radialis longior muscle: M. exteusor carpi radialis longus

Aperture for the posterior interosseous nerve,

between the two layers of the supinator

radii brevis muscle

Extensor carpi radians brevier muscle M. extensor carpi radialis brevis

Supinator radii brevis muscle M. supinator

Intermuscular septum

Septum intermusculare

Extensor carpi radialis brevior muscle M. extensor carpi radialis brevis

Extensor carpi radialis longior muscle

M. extensor carpi radialis longus

Deep fascia of the forearm

Fascia antibrachii

Posterior annular ligament of the wnst Lig. carpi dorsale

Fascia of the dorsum of the band Fascia dorsalis manus

Ox Jlexor perforatum muscle.

Biceps flexor cubiti muscle

M. biceps brachii

Semilunar or bicipital fascia

Lacertus fibrosus

Pronator radii teres muscle ' humeral head) M. pronator teres (caput humeralej

— Aperture for the median nerve between the two heads of the pronator radii teres muscle Pronator radii teres muscle (ulnar head) M. pronator teres (caput ulnare)

Flexor carpi radialis muscle

M. flexor carpi radialis

Flexor sublimis digitorum muscle' (radial

head) M. flexor digitorum sublimis (caput radiale) Supinator radii longus muscle

M. brachioradialis

Tabatiere anatomique, or anatomical snufl-box-

Foveoia radialis

Dorsal metacarpophalangeal subcutaneous bursa

Bursa subcutanea metacarpo- phalangea dorsalis

Dorsal subcutaneous bursa of the index finger

1-lursa subcutanea digiti II. dorsalis

%

' See second paragraph of note ' to p. 326,

^^^- 575- — The Akkange.mknt of the Muscles in the Deeper Part of the Antecuuital Fossa when the Hand is hkonated.

The muscles of the radial group, with the exception of the deepest of these, the supinator radii brevis, have been partly removed. The semilunar or bicipital fascia has been cut across, and its distal extremity has been drawn inwards together with the pronator radii teres muscle, in order to display the ulnar head of this muscle. In this distal half of the forearm and on the back of the hand we see the deep fascia and the posterior annular ligament of the wrist.

Musculi antibrachii — Muscles of the forearm.

328

THE MUSCLES OF THE UPPER EXTREMITY

Triceps extensor cubiti muscle (internal

or deep head) //j

M- triceps brachii (caput mediale) i

Anconeus muscle

M. anconaeus

Ulna

Ulna

Extensor seoundi internodii pollicis or

ejrtensor longus pollicis muscle'

M. extensor pollicis longus

Extensor indicts muscle -

M. extensor indicis proprius

Styloid process of the ulna

Processus styloideus ulnae '

Posterior annular ligament of the wrist

Extensor carpi ulnaris muscle M. extensor carpi ulnaris

Capitellum of the humerus

Capitulum humeri

External condyle— Epicondylus lateralis

_ External lateral ligament of the elbow-Joint

Li:; collaterals radiale

Annular or orbicular ligament of the radius Lig. annulare radii Supinator radii brevis muscle

"M. supinator

Pronator radii teres muscle

M. pronator teres

Radius

Radius

Extensor ossis metacarpi pollicis or

abductor longus pollicis muscle'

M abductor pollicis longus

Extensor primi internodii pollicis or extensor brevis pollicis muscle'

M. extensor pollicis brevis

Extensor carpi radialis brevier muscle

M. extensor carpi radialis brevis

Extensor carpi radialis longior muscle

M. extensor carpi radialis longus

1

I

1

' See note to p. 326.

Fig. 576. — The Deep Layer of the Dorsal Group of Muscles of the Right Forearm, displayed by the removal of the extensor communis digitorum and the extensor Carpi Ulnaris Muscles : Extensor Ossis Metacarpi Pollicis, Extensor Primi Inter- nodii Pollicis, Extensor Secundi Internodii Pollicis, and Extensor Indicis Muscles.

In the proximal segment of the pronated forearm, the supinator radii brevis muscle and the anconeus

muscle are seen.

Musculi antibrachii — Muscles of the forearm.

THE MUSCLES OF THE UPPER EXTREMITY

329

Triceps extensor cubiti muscle (internal . or deep head)

M. triceps brachii (caput mediale)

Posterior ligament of the elbow-joint Capsula articularis Triceps extensor cubiti muscle (tendon of insertion) M. triceps brachii

Olecranon . Olecranon

Flexor carpi ulnaris musole (ulnar head) - M. flexor carpi ulnaris (caput ulnare)

Intermuscular septum -

Septum intermusculare

Anconeus muscle (origin')'' M. ancona;us

Posterior border of the ulna"

Margo dorsalis ulnae

Extensor carpi ulnaris muscle

Intermuscular septum

Septum intermusculare

Supinator radii longus muscle

M brachioradialis

Extensor carpi radialis lougior muscle

M extensor carpi radialis longus Anconeus muscle (insertion' ) -' M, ancona:us — External condyle — Epicondylus lateralis _ Extensor carpi radialis brevier

M. extensor carpi radialis brevis Annular or orbicular ligament of the radius I ig, annulare radii Neck of the radius — Collum radii Extensor communis digitorum muscle M txtensiir digitorum communis ~ Supinator radii brevis muscle M supinator

-^ Aperture for the posterior interosseous nerve, between the two layers of the supinator radii brevis muscle _ Extensor ossis metacarpi poUicis or abductor longus poUicis muscle- M. alxluctor pollicis longus Interosseous membrane or ligament of the forearm Membrana interossea antibrachii

Extensor indicis muscle

M. extensor indicis proprius

^ Extensor primi intemodii pollicis or extensor brevis pollicis muscle-

M. extensor pollicis brevis

-Extensor secundi intemodii pollicis or extensor

longus pollicis muscle-

M. extensor pollicis longus

Styloid process of the ulna

Processus styloideus ulnae

Tendon of insertion of the extensor carpi ulnaris muscle Posterior or dorsal proximal intermetacarpal, ligaments -Ligg basium dorsalia Fotirth dorsal interosseous muscle (origin) - Third dorsal interosseous muscle (origin) -

Third and fourth dorsal interosseous — =i muscles (distal extremities)

Dorsal aponeuroses of the extensor — - tendons

' Sec note 2 to p. 319.

Tendon of insertion of the supinator radii

longus muscle Styloid process of the radius

P'rocessus styloideus radii

Extensor carpi radialis brevier muscle

M- extensor carpi radialis brevis

Extensor carpi radialis longior muscle M. extensor carpi radialis longus Insertion of the extensor ossis metacarpi

follicis muscle- interosseous or abductor indicia muscle (origin) M. interosseus dorsalis I.

Second dorsal interosseous muscle (origin)

Partial insertion of the first dorsal interosseous or abductor indicis muscle into the dorsal aponeurosis of the extensor tendon Partial Insertion of the dorsal aponeurosis of the extensor

tendon Into the base of the proximal phalanx Dorsal aponeurosis of the extensor tendon divided longitudinally

%

' See note '

) p. 336.

Fig. 577. — Attachment of Muscles to the Dorsal Surface of the Forearm and the Hand.

Musculi antibrachii — Muscles of the forearm.

330

THE MUSCLES OF THE UPPER EXTREMITY

Extensor Tninimi digiti muscle

M. extensor digiti quinti proprius Extensor communis digitorum muscle . M. extensor digitorum communis Extensor indicis muscle M. extensor indicis proprius__ Extensor carpi ulnaris muscle

Head of the ulna Capitulum ulnse

Synovial sheath of the tendon of the extensor

carpi ulnaris muscle u'

Synovial sheath of the tendons of the extensor

communis di^torum and extensor indicis

muscles t ; i

Synovial sheath of the tendon of the extensor

minimi digiti muscle ( j)

Vincula of the extensor tendons Juncturae tendinum

Dorsal subcutaneous meta- carpophalangeal bursa Bursa subcutanea meta- carpophalangea dorsalis

Dorsal subcutaneous bursae of the fingers Bursas subcutaneae digitorum dorsales

(i) Vagina tendinU in. extensoris carpi ulnaris

(2) Vagina tendinum mm. extensoris digitorum

et extensoris indicis

(3) Vagina tendinis m. extensoris digi

igiti quinti

Extensor ossis metaoarpi pollicis and extensor

primi internodii pollicis muscles' Mm. abductor longus et extensor brevis pollicis Extensor secundi internodii pollicis muscle'

M. extensor pollicis longus

Tendons of the extensor carpi radialis longior

and extensor carpi radialis brevior

muscles

1

Posterior annular ligament of the wrist

Synovial sheath of the tendons of the ex- .-— — tensor ossis metacarpi pollicis and extensor primi Internodii pollicis musclesMj> Synovial sheath of the tendons of the ex- tensor carpi radialis longior and extensor

carpi radialis brevior muscles ts) — Synovial sheath of tlie tendon of the extensor secundi internodii polUcis muscle' (6)

Dorsal interosseous muscles Mm. interossei dorsales

— Dorsal subcutaneous meta- carpophalangeal bursa Bursa subcutanea meta- carpophalangea dorsalis

Intermetacarpophalangeal bursas Bursae intermetacarpophalang^ae

(4) \ psina tendinum mm. abductoris longi et

extensoris bre\-is pollicis (3) Vagma tendinum mm. extensorum carpi

(6) Vagina tendinis m. e.xteiisoris poliicis longi

Fig. 578. — The Disposition of the Extensor Tendons at the Back of the Wrist and Hand, and the Synovial Sheaths of these Tendons. Right Hand. The Connexions between the Extensor Tendons (Vincula) on the Dorsum of the Hand, and the Dorsal Aponeuroses of the Extensor Tendons. The Intermetacarpophalangeal BuRS.E, the Dorsal Subcutaneous Metacarpophalangeal Burs.e, and the Dorsal Subcutaneous Burs^ of the Fingers. The Dorsal Interosseous Muscles.

The synovial sheaths of the tendons were injected with strong alcohol before dissection. A portion of the posterior wall has been removed from the sjTiovial sheath of the tendons of the extensor communis di.gitorum and extensor indicis muscles.'

Musculi manus — Muscles of the hand.

THE MUSCLES OF THE UPPER EXTREMITY

331

The radius

Radius

Canals for the tendons—

of the extensor secundi intemodii poUicis muscle'

of the extensor communis digitorum and extensor indicis muscles

of the extensor "I'Tiimi digiti muscle of the extensor carpi ulnaris muscle —

Tendon of the extensor carpi ulnaris muscle

Dorsal interosseous muscles Mm. interossei dorsales

Dorsal aponeuroses of the extensor tendons

Aponeuroses tendinum extensorum digitorum

Canals for the tendons—

of the extensor carpi radialis longior and

extensor carpi radialis brevier muscles of the extensor ossis metacarpi poUicis and

extensor pnmi intemodii poUicis muscles^

Cansular ligament

Bursa of the extensor carpi radialis brevior muscle-

Tendon of the extensor carpi radialis longior muscle

Dorsal aponeurosis of the extensor tendons of the thumb

Aponeurosis tendinum extensorum pollicis

Adductor pollicis muscle'^

■ See note ■ to p. 326. ' This bursa !s situate beneath the tendon close to its insertion.— Tr. 3 See note » to p. 324.

Fig. 579.— The Dors.\l Aponeuro.sks of thk Extensor Tenuon.s. Right Hand. Dorsal Interosseous Muscles.

The osseo-fibrous canals for the extensor tendons have been opened by the removal of the posterior annular ligament of the wrist. The distal extremity of the tendon of the extensor carpi radialis brevior muscle has been turned down- wards, in order to display the bursa that lies beneath it.

Dorsal aponeurosis

Tendon of the flexor sublimis digitonur muacle-

Metacarpal bone Os metacarpale Dorsal interosseous muscle

M. interosseus dorsalis Lumbricalis muscle

Tendon of the flexor profundus digitorum muscle ■

■ Viruula Tendinum— 'XW'ai are folds of syi Their nome.iciaturc \% Munewhat v.iriable. Macalister write"! ififi. cit. the two tendons al first, and the deep tendon is tied to the l>one bv on** tt.ey are generally free, but when the deep tendon has passefl through round cord ' ' - • "

e another and to ihe phalanges.

le of the digital sheath enwraps

tinaaila). Where the tendons, pass each c

: synovial s (retinae

1o8):

A-o flat band:. ^ - -,- ..... ,

is lied to the superficial tendon, now underlying it, by a soft OTd (vinculum). Finally the deep tendon is tied 10 the distal end of the second ph:.lanx by a flat retinacuum in/trius.' Accord- Quain (op. cil.. vol. ii.. p. 22?.), '' The synovial m'mbrane 'orms small folds (viruula accessorta tendi, and Ihe bonen. There ate two sets of these : ihe one, linninen'a hrnia, broad and membranous, passing bet insertion and the lower part of the phalanx immediately above ; the other. l!/;amfnta Inncn, slendi

tendo laimm), . bi the finger*."-

') between the the tendonsnear their id less constant hands, joining the hgamentum breve of the deep flexor is a small band of yellow elastic tissue {vinculum iub- the head of the second phalanx, and may assist in drawing down Ihe tendon after flexion of

I O, flexor p,r/o,

» Ox Jlexor per/oratus muscle.

Fk;. 580.— The Distal Kxtre.mities of the Flexor anij Kxtensor Tendons of the Right Middle Finger seen FRO.M THE Radial Side. The Relation of the Lu.mhricai.is and of the Inteko.sseous Mu.sclk to the Dorsal Aponeurosis of the Kxtensor Tendon. Vincula Tendinu.m (see note ' abmie).

Musculi manus Muscles of the hand.

42 — 2

333

THE MUSCLES OF THE UPPER EXTREMITY

First lumbricalis muscle

M. lumbricalis I.

— Tendon of the palmaris longus muscle

Deep fascia of the forearm

Fascia antibrachii

Anterior annular ligament of the wris (Superficial layer)

Lig. carpi volare

See note -" on page 7281

— Talmaris brevis muscle

Palmar fascia

Aponeurosis palmaris

Fourth lumbricalis muscle

M. lumbricalis IV.

Superficial transverse ligament of the fingers

Fasciculi transversi aponeurosis palmaris

Fig. sSi.^Aponeurosis Palmaris, Deep Fascia of the Palm, or Palmar Fascia ; the Insertion of the Tendon of the Palmaris Longus Muscle into this Fascia; the Processes passing from the Palmar Fascia to the Digital Sheaths ; the Super- ficial Transverse Ligament of the Fingers. Palmaris Brevis Muscle.

Musculi manus — Muscles of the hand.

THE MUSCLES OF THE UPPER EXTREMITY

333

Tendon of the flexor longus pollicis muscl

Synovial sheath of the tendon of the flexor longus pollicis muscle Vagina m. flexoris pollicis longi

Digital synovial sheaths of ~

the flexor tendons Vaginae tendinum digitales

'^Tendons of the flexor sublimis digitorum^ and flexor profundus digitorum' muscles Tendon of the flexor carpi ulnaris muscle

Synovial sheath of the tendons of the flexor

sublimis digitorum' and flexor profundus

digitorum- muscles

Vagina tendinum mm. flexorum

ccmmunium

Fig. 582.— The Synovial Sheaths of the Flexor Tendons,^ prepared after injecting them with

Alcohol. Right Hand.

The palmir fascia and the anterior annular ligament of the wrist have been removed.

Flexor sublimis digitorum muscle' M. flexor digitorum sublimis "^

Flexor longus pollicis muscle M. flexor pollicis longub Tendon of the flexor carpi radialis muscle

Synovial sheath of the tendon of the flexor

longus pollicis muscle

Vagina tendinis m. flexoris pollicis longi

Synovial sheath of the tendon of the flexor

carpi radialis muscle Vagina tendinis m. flexoris carpi radiafis

Remains of the anterior annular - ligament of the wrist Synovial sheath of the extensor ossis metacarpi.'-'' pollicis and extensor primi intemodii pollicis muscles' — Vagina tendinum mm. abductoris longi et extensoris brevis pollicis

Tendon of the supinator radii long^us muscle

The radius Radius

f Flexor profundus digitorum muscle-

( M. flexor digitorum profundus

. Flexor carpi ulnaris muscle

Btirsa of the flexor carpi ulnaris muscle'

"-- Bursa m flexoris carpi ulnaris

Synovial sheaths of the tendons of the flexor sublimis digitonun' and flexor profundus digitorum- muscles

Vagina tendinum mm. flexorum communium '■Mesotenon''

-Pronator quadratus muscle

Interosseous membrane or ligament of the forearm

"Membrana interossea antibrachii

The ulna

Ulna

■ Or yfexar /er/oralus muscle. 0\ flex(n- ferforans muscle. _ , . . .

3 The synovial sheath of the common flexors in the canal of the carpus beneath the anterior annular liRamcnt of (he wnst is sometimes known as the prial carpal bursa. It extends upwards to the level of the radiocarpal articulation, and downwards about halfway along the metacarparii"nes endini; in blind pouches in the case of the index, middle, and ring fingers, the digital sheaths of which are separ.-ite : in the case of the little finger, however, the digital sheath of the flexor tendon is continuous with the great carpal bursa. The sheath of the flexor longu« pollicis is entirely distinct in the carpal canal from the sheath of the common flexors. — Tk.

< See note ' to p. 126. 5 This bursa is situate heneath the tendon close to its insertion.— TR.

' Mitolcnon.—TWv. term is not used hy English anatomists. The synovial sheath of the common flexors beneath the anterior annular ligament i> in most cases divided by an incomplete septum attached to the middle finger tendon of the deep flexor. It is to this structure that the term mtiotenon is applied.— Tk.

Fig. 583.— The Synovial Sheaths ok the Flexor Tendons, displayed, after the Removal of the Anterior AsNLLAR Ligament of the Wrist, by turning down the Flexor Tendons into the Palm of the Hand. Left Hand.

The synovial sheaths and bursic have all been opened.

Musculi manus — Muscles of the hand.

334

THE MUSCLES OF THE UPPER EXTREMITY

Tendon of the supinator radii longus muscle Pronator quadratus muscle

Tendon of the flexor carpi radialis muscle ' ;$

Tendon of the extensor ossis metacarpi poUicis muscle^

Opponens pollicis muscle Abductor pollicis muscle M. abductor pollicis brevis Flexor brevis pollicis muscle (superficial

head)- M. flexor pollicis brevis (caput superficiale) Flexor brevis pollicis muscle (deep head)--^-" M. flexor pollicis brevis (caput

profundum) J

Adductor pollicis muscle---"" / ^^

First dorsal interosseous or — jibductor indicis muscle

Lumbricales muscles

M. lumbricales

Middle vaginal band^ Lig. vaginale

Tendon of the flexor carpi ulnaris muscle

Anterior annular ligament of the wrist (Deep layer)

Lig. carpi transversum

See note =" on page 7281 Abductor minimi digiti muscle ~ M. abductor digiti quinti

Opponens minimi digiti muscle M. opponens digiti quinti Third and fourth dorsal

interosseous muscles

Second and third palmar

interosseous muscles Flexor brevis minimi digiti muscle

M. flexor digiti quinti brevis

Transverse metacarpal ligament (anterior or palmar distal intermetacarpal ligaments)

Ligg. capituloriim (ossiiiin metacarpalium) t"""'-"

Superior vaginal bands^ Fibrae annulares

JB Tendon of the flexor sublimis

digitorum^ muscle ~" Superior crucial bands'' Fibrae cruciatae

Middle vaginal band^

Lig. vaginale

;^J ~- — Tendon of the flexor profundus ^^ digitorum muscle*

^ See note i to p. ^z6. = See note = to p. 324.

3 The author does not enumerate all the component parts of the anterior wall of the digital sheaths of the flexor tendons. These are : (i) Superior vaginat band (called by Toldt fibne annulares), strong transverse fibres crossing the tendon at the level of the upper half of the proximal pha'anx (to the rough margins of the anterior surface of which bone the fibres are attached) ; {:i) mlterlor crucial ^a«(f (called by Toldt fibres cruclatcs), X-shaped bands at the level of the distal end of the r'roxinial phalanx ; (3) inldd'e vaginal band, a slight transverse slip at the level of the proximal interphalangeal articulation (called by Toldt lleavicnhnn vagi'iale) ; (4) oblique band, passing downwards and inwards across the proximal extremity of the medial phalanx ; (5) inferior vaginal band, across the middle of the medial phalanx ; (6) Inferior cnictal band, in front of the distal interphalangeal articulation. — Tr.

4 Or fie.vor/ierforatus muscle.

5 Or fiexar pe^firans m\xic\<i.

Fig. 584. — The Superficial Layer of Muscles of the Thenar Eminence : Abductor Pollicis Muscle ; the Superficial Head and a Portion of the Deep Head of the Flexor Brevis Pollicis Muscle {see note - to p. 2,2^). The Superficial Muscles of the Hypothenar Eminence : Abductor Minimi Digiti and Flexor Brevis Minimi Digiti Muscles. Adductor Pollicis Muscle {see note ^ to p. 324). Third and Fourth Dorsal Interosseous and Second and Third Palmar Interosseous Muscles. Pronator Quadratus Muscle. Vaginal Ligaments {see note ^ above^. Right Hand.

I

Musculi manus — Muscles of the hand.

4

THE MUSCLF"^ OF THE UPPER EXTREMITY

335

Tendon of the flexor carpi radialis muscle

Tendon of the extensor ossis metacarpi pollicis muscle' Abductor pollicis muscle M. abductor pollicis brevis

Fiexor brevis pollicis muscle^

;superficial head) d ) ' ^^ Opponens pollicis muscle ~ ■'^*

Flexor brevis pollicis muscle- ideepheadK ) Adductor pollicis muscle-

Abductor minimi digiti muscle

M. abductor digiti quinti -Pisi uncinate ligament — Lig. pisohamatum .Pisimetacarpal ligament — Lig. pisometacarpeum —Unciform process of the unciform bone

Hamulus ossis hamati

Opponens minimi digiti muscle

JI. opponens digiti quinti Flexor brevis minimi digiti muscle M Ik'xor digiti (jumti brevis First, second, and third palmar

interosseous muscles (3) First, second, third, and fourth dorsal interosseous muscles^

Mm.

ales 1. — IV.

'Commissure of the tendons

Chiasma tendinuin*

(i) M. flexor pollicis brevis (caput superficiale) (2) M. flexor pollicis brevis (caput profundum)

See note ' to p. 326. ' Set note = to p. 324. \ Ot /Itxar fer/oratus mu^\e. ■ t kiasma Temiinnin. — This term is no hich the two divisions of the tendon of the s

short space ; below this commissure the :s of the medial phalanx. — Tr. ' The first dorsal interosseous muscle is al ' Or Jltxar per/orans muscle.

Vaginal ligaments, divided longitudinally

Ligg. vaginalia

^Tendons of the flexor sublimis digitorum muscle'

(.Insertions of the tendons of the flexor profundus digitorum muscle"

ly e.nployed by English anatomists. It is applied by the author t ficial flexor, after splitting for the passage of the tendon of the deep fle

ndon of the superficial flexor divides ( called the abductor indicis muscle. — Tr.

: into two parts, which pass to the lateral

Fig, 585. — The Deep Layer of Muscles of the Thenar and Hypothenar Eminences,

DISPLAYED BY THE REMOVAL OF THE AbDUCTOR POLLICIS AND AbDUCTOR MiNIMI DlGITI

Muscles, and also of the Superficial Head of the Flexor Brevis Pollicis Muscle: Opponens Pollicis Muscle; Deep Head of the Flexor Brevis Pollicis Muscle (.sw «o/e 2 /o />. 324) ; Opponens Minimi Digiti; Flexor Brevis Minimi Digiti.

By the removal of that portion of the adductor polHcis musrlc which arist-s from the third metacarpai bone, the portion of this muscle arising froin the carpal ligaments, and the dorsal and palmar interosseous muscles, are exposed to view. The vaginal ligaments of the fle.xor tendons have been opened, and in the index and middle fingers the commissure of the tendons (see note '^ above) of the superficial flexor is shown.

Musculi manus— Muscles of the hand.

336

THE MUSCLES OF THE UPPER EXTREMITY

Scaphoid bone

Os naviculare

Tendon of the flexor carpi radiahs muscle

Abductor pollicis muscle M abductor polhcis bre\ IS Opponens poUieis muscle Extensor ossis metacarpi poUicis muscle' M. abductor pollicis longus Flexor brevis pollicis muscle' (superficial — bead)

M. flexor pollicis brevis i caput superficnl'-^l

Flexor brevis pollicis muscle- (deep bead

M. flexor pollicis brevis (caput profuntbun)

First dorsal interosseous or abductor indicis muscle

M.

Flexor brevis pollicis muscle' (in-«i-

SertiOn)— M. flexor pollicis brevis

Abductor pollicis muscle- (insertion)

M. abductor pollicis brevis

Adductor pollicis muscle--— (insertion) M. adductor pollicis

Flexor longus pollicis muscle (insertion) IM. flexor pollicis longus First palmar interosseous' muscle M. interosseus volaris I. /'

Partial insertion of the first dorsal interosseous

or abductor indicis muscle and of the first lumbricalis muscle into the dorsal aponeurosis

of the extensor tendon of the index finger /

Tendon of the flexor sublimis digitorum or' flexor perforatus muscle Attachment of the vaginal ligament

Insertion of the flexor sublimis digitorum or'' ) flexor perforatus muscle

Insertion of the flexor profundus digitorum or flexor perforans muscle

Lunar (or semilunar) bone Os lunatum

I Pyramidal or cuneiform bone I Os triquetrum

Tendon of the flexor carpi ulnaris muscl" Anterior annular ligament of the wrist Lig carpi transversum

Pisiform bone— Os pisiforme Tendon of the extensor carpi

ulnaris muscle Abductor minimi digiti muscle ~ M abductor digiti quinti - Flexor brevis minimi digiti muscle M. flexor digiti quinti brevis Opponens minimi digiti muscle M. opponens digiti quinti Second and third palmar interosseous muscles (origin) Mm interossei volares II. et III. Third and fourth dorsal interosseous muscle

afe III.

. IV.

Ilexor brevis minimi digiti muscle

M. flexor di.^iti quinti brevis

Abductor minimi digiti muscle

(partial insertion into the dorsal

aponeurosis of the extensor

tendon) (i)

Third and fourth lumbricales

muscles

Mn

III.

: IV.

Partial insertion of the third

palmar interosseous muscle

into the dorsal aponeurosis of

the extensor tendon

Insertion of the flexor sublimis

digitorum or flexor perforatus

muscle

Insertion of the flexor pro- fundus digitorum or flexor perforans muscle

Insertion of the flexor sublimis

digitorum or flexor perforatus

muscle

Insertion of the flexor profundus

digitorum or flexor perforans

muscle

(i) M. abductor digiti quinti

See note ' to p. 326.

See note 2 to p. 324.

Fig. 586. — Attachment of Muscleb to the Palmar Surface of the Hand.

Musculi manus — Muscles of the hand.

MUSCULI EXTREMITATIS INFERIORIS

THE MUSCLES OF THE LOWER EXTREMITY

43

338

THE MUSCLES OF THE LOWER EXTREMITY

Gluteus maximus muscle

M. glutjeus maximus

Crest of the ilium Crista iliaca

Anterior superior spine of the ilium

Spina iliaca anterior superior

Tensor vaginse femoris or tensor fasciae femoris muscle

M. tensor fasciae latas

Deep fascia of the thigh, or fascia

lata (superficial layer) Fascia lata (lamina superficialis)

Deep fascia of the thigh, or fascia -

lata (superficial layer) Fascia lata (lamina superficialis)

Iliotibial band or ligament

Fig. 587. — Deep Fascia of the Thigh, or Fascia Lata, seen from the Outer Side, with THE Thickened Portion of this Fascia, known as the Iliotibial Band or Ligament; Insertion of the Tensor Vagina Femoris (Tensor Fasciae Femoris, Tensor Fascia Lat^) Muscle and Partial Insertion of the Gluteus Maximus Muscle into the Iliotibial Band or Ligament. Right Thigh.

Musculi coxae et femoris — Muscles of the hip and thigh.

THE MUSCLES OF THE LOWER EXTREMITY

339

Spinous process of the twelfth dorsal vertebra

Processus spinosus vertebrae thoracalis XII, Intertransversales mediales or inter- ^ accessoril muscles I

Mm. intertransversani posteriores mediales

Interspinales muscles

Iliolumbar ligament

Lig. iliolumbale

Gluteus mazimuB muscle M. glutaeus maximus

Uppermost portion of the middle layer of the lumbar fascia, which forms the posterior aponeurosis of the transversalis abdominis muscle

Lig. lumbocostale

I Intertransversales laterales muscles J Mm intertransversarii posteriores laterales

Quadratus lumborum muscle

Semitendinosus muscle —

Biceps flexor cruris muscle (long head) M. biceps femoris (caput longum)

Fig. 588.— Gluteus Maximus Muscle, seen obliquely from I^ehind and Without, con- stituting THE Superficial Layer of the External Muscles of the Hip. Quadratus Lumborum Muscle; Interspinales, Intertransversales Laterales, and Intertrans- versales Mediales or Interaccessorii Muscles of the Lumijar Region ; seen from Behind. Right Side.

Musculi coxae— Muscles of the hip.

43—2

340

THE MUSCLES UF THE LOWER EXTREMITY

Quadratus lumborum muscle

M quadratus lumborum

Crest of the ilium

Crista iliaca

Gluteus maximus muscle

(proximal portion)

M. glutaeus maximus

Pyriformis muscle M. piriformis Posterior or great sacrosciatic ligament Lig. sacrotuberosum Anterior or small sacrosciatic ligament Lig. sacrospinosum Gemellus superior muscle^ "

Obturator intemus muscle'

Gemellus inferior muscle' —

Quadratus femoris muscle -

Trochanteric bursa of the gluteus __

maximus muscle'^

Bursa trochanterica m. glutasi

maximi

Biceps flexor cruris muscle (long head)

M. biceps femoris (caput longum)

Semimembranosus muscle

Gluteus maximus muscle

(distal portion)

M. glutaeus maximus

Vastus extemus muscle

M. vastus lateralis

'-Gluteus medius muscle

-Iliotibial band or ligament

»« 1^ gemelh muscles may be regarded as portions of the obturator internus muscle arising outside the pelvis, and for this reason Macaliister has given to the three muscles the name of iria-/>s rotator femoris muscle, but the term is rarely used.— Tr.

f i he trochanteric lursa of tli^gtuteus inaxiiims muscle is situate, as its name implies, between the fascial insertion of the gluteus ma.\imus muscle and the great trochanter of the femur. In most cases it is a large compound or multllocular bursa, but is occasionally represented by several distinct smaller bursa.— Tr.

Fig. 589. — Second Layer of the External Muscles of the Hip, displayed by the Division OF THE Gluteus Maximus Muscle and the Posterior Portion of the Fascia Lata: Gluteus Medius Muscle; Pyriformis Muscle; Obturator Internus and Gemellus Superior and Inferior Muscles; Quadratus Femoris Muscle. Origin and Femoral Insertion of the Gluteus Maximus Muscle. Trochanteric Bursa of the Gluteus Maximus Muscle. Right Hip, seen from the Outer Side.

Musculi coxae — Muscles of the hip.

THE MUSCLES OF HIE LOWER EXTREAUTY

341

Quadratus lumborum muscle

Crest of the ilium

Crista iliaca

Posterior superior spine of the ilium

Spina iliaca posterior superior ^Ju M

Pyriformis muscle

M. piriformis Posterior or great sacrosciatic ligament Lig. sacrotuberosum ) I J Anterior or small sacrosciatic ( ' ligament — Lis sacmspinrjsum \^S' Gemellus superior muscle' Obturator intemus muscle' Bursa of the obturator intemus

muscle-'— Bur>a m. uLlurat jri- inlcrni

Gemellus inferior muscle

Tuberosity of the ischium Tuber ischiadicum

Gluteus medius muscle

Gluteus minimus muscle

Anterior superior spine

of the ilium

Spina iliaca anterior

superior

— Obturator extemus muscle

_ Great trochanter Trochanter major Quadratus femoris muscle

> Sec note ' lo p. 340. , J , •■ A

' The buna o/the ohturntor intemus muscle is situate between (he tendon of the obturator internus muscle and the cartilage-covered

irothlcar surface or groove of the ischium (i.e., the hollowed portion of the bone between the s[>ine and the tuberosity) ; r •■ ■-

loHK and narrow, lies between the tendon of the muscle and the capsule of the hipjoint : often,

combine to form a single structure. — Tr.

econd burs: in Fig. 590, these two bursa:

Fig. 590. — Deep External Muscles ok the Right Hip, displayed hy the Removal of the Gluteus Maxi.mus and Gluteus Medius Muscles: Gluteus Minimus Muscle; Pyri- formis Muscle. Seen obli(,)Uely from the Right Side and Behind.

The tendon of the obturator internus muscle has been divided, and the inner half has been turned inwards over the posterior or ^'reat sacrosciatic lit,'ament, in order to display the bursa of the obturator internus muscle. The quadratus femoris muscle has been drawn downwards a little, and slightly separated from the },'<-'nie"us inferior muscle, in order to bring into view between them a portion of the obturator externus muscle.

Musculi coxae- Muscles of the hip.

342

THE MUSCLES OF THE LOWER EXTREMITY

Subcntaaeoiis bursa of the

posterior superior spinE

of the iliiim

Bursa subcntanea spia=E iliaca postericiis

SubcutaiieDUE bursa of the

sacnnn Bursa snbcutanea sacral^;

SubcutaJioous bursa of ti coecjx

Bursa snbcmtanea coccygea

Superior bursa of the Weep flexor cruris muEde^

Bursa m. bicjpitis femoiis superior

Semimembranosus muscle

Adductor magnus muscle.

Biceps flexor cruris muscle

M. biceps femcris

SeimtendiiiDEUs muscle

- Tbe .vx^rripr fwrtra ■of i^ IHcips _0£XBr trwris matsaic is aEcBM (bsrv -■- of tbe senmnembranDSns masdle. — Ts- , _ . _

= The fipstcripr trpdhwKltrnr ^rursa pfihc g'^cus rrfscjBus mjxs^Ir as a smBll bursz it zmd tbe inseraon of the tendon of the jrj-iifonms inrasde. — ^Tk-

3 See DOie = 10^1. 340.

* The gixtaifcmKnal licma is sJtlBle ibcitweEn ihe festial msKrtioa laT !|4ie gtatcy ej'ternns musdt. — Tr.

5 See mote ' to p. 31^0.

: nn ^t&at inmRtQ^ ftiStncBBB

Fig. 591. — Deep External Mtjsci-Es of the Right Hep seen fkom Beeekd, showtog thei?. Relation to the Posteeiok Femokal ok Hamstkimg Muscues A3BD TO THE Addhctc?.

Magnus Muscle. Insektion of the Gluteus Maslmchs esto toe Glipteal Ridge of THE Femur and into the Fascia Lata. Burs^ of the Sacral amd Gluteal Regions.

The g^emelli musdes have bees kit nmdktiiiiljed in Aor dk^e pnaxiinitf to idbe abffiimatar

Moscoli cozs — Muscles of the hip.

THE MUSCLES OF THE LOWER EXTREMITY

343

Outer row of insertions of the longissimus dorsi muscle Slips of origin of the multifidus spinae muscle Twelfth dorsal i Mamillary process vertebra I Processus mamillaris \ertebra | Accessory process thoracalis XII. Ij'rocessus accessorius

Inner row of insertions of the longissimus dorsi muscle

Accessory process of the first lumbar vertebra I'rocessus accessonus vertebrae lumbalis I. Intertransversalis medialis or inter- accessorius muscle M Intertransversarius posterior medialis Origins of the multifidus spinae muscle

Isolated slip of the multifidus spinae muscle

Spinous process of the third lumbar vertebra processus spinosus vertebrse lumbalis III.

Mamillary process of the fourth lumbar ver

tebra-Prucessu.-. mamillaris vertebra: Kimljali, I\'.

Insertions of the multifidus spinae muscle Tendon of the origin of the longissimus dorsi muscle

Eleventh rib

Costa XI

Uusculus accessonus ad iliocostalem (origin)

Middle layer of the lumbar fascia, forming the u'Vv. posterior aponeurosis of the transversaus " " abdominis muscle— Lig- lumiocosiale

Slips of insertion of the iliocostalis or sacrolumbalis muscle

- Serratus posticus inferior muscle

M , serratus posterior inferior

— Intertransversalis

lateralis muscle

M intertransvcrsarius

posterior lateralis

Outer row of insertions of the

longissimus dorsi muscle

. - Iliocostalis or sacrolumbalis muscle

M. iliocostalis lumborum ..Inner row of insertions of the longissimus dorsi muscle

Intertransversalis medialis or interaccessorius muscle M intertrans\ersarius posterior medialis

Costal process of the fourth lumbar vertebra

Processus costarius vertebra:- lumbalis IV.

Origin of the iliocostalis. or sacrolumbalis muscle

Crest of the iliiun

Crista iliaca

Holtifidus spinae muscle - M. multifidus

Origin of the longissimus dorsi muscle

Dorsal orposterior surface of the first sacral vertebra

fa..iv->d.r^!isverlel.ri sa.rah, I.

Posterior superior spme of the Uium

.Spina il,aca i,.,l„i jr supcn.jr

Surface of origin of the multifidus spins muscle

Surface of origin of

the gluteus maximus '

muscle

Gemellus superior muscle ^origin

Posterior or great sacrosciatic ligament Lig. sacr')tuberosum

Gemellus inferior muscle (origin;

Common tendon for the long head of the biceps flexor cruris muscle and for the semitendinosus muscle

Crest of the ilium Crista iliaca

Surface of origin of the gluteus medius muscle

Su-fice of origin of the

gluteus minimus muscle

Proximal portion of the pyriformis muscle in the great sciatic or ilio- sciatic notch Anterior i uferior spine of the ilium

^pina iliaca anterior inferior

Origin of the rectus femoris muscle

Tendon of insertion of the pyriformis muscle

Tendon of the obturator intemus muscle

Tendon of the obturator extemus muscle

'--• Insertions of the quadratus femoris muscle

Posterior intertrochanteric ridge

or line

Crista intertrochanterica

Quadratus femoris muscle (origin)

I'IG. 5fj2. — ATTACIlMliNT OF MlSCLBS TO THE POSTERIOR SURFACE OF THE LUMBAR VERTEBKJi

ANO OF THE HiP-BoNE.

Musculi coxae — Muscles of the hip.

344

THE MUSCLES OF THE LOWER EXTREMITY

Quadratus lumborum muscle

Psoas magnus muscle M. psoas major Psoas parvus muscle (var.) .

M. psoas minor (var.)

Iliacus muscle

M. iliacus

Anterior superior spine of the ilium

Spina iliaca anterior superior

Iliac fascia Fascia iliopectinea^

Transversalis fascia

Fascia transversalis

Vascular compartment —

Lacuna vasorum Poupart's ligament (superiicial femoral arch) Lig. inguinale (Pouparti)

First lumbar vertebra Vertebra lumbalis I.

Sacral promontory f romontorium

Fyriformis muscle ~M piriformis Sacrococcygeus anticus or cuivator coccygis muscle

Obturator internus muscle Coccygeus or levator

coccygis muscle lliopectineal eminence Eminentia iliopectinea Pubic ligament of Astley Cooper, or Cooper's ligamenf- Lig pubicum (Cooperi)

Pubic symphysis

Symphysis ossium pubis

Spine of the pubis

, Tuberculum pubicum

I Gimbemat's ligament Ijg, lacunars (Gimbernati) Internal or deep abdominal ring^' Annulus inguinalis abdominalis

» See note > to p. 390. ^ See note = to p. 390. ■> Or internal ivguinat aperture.

Fig. 593. — Internal Muscles of the Region of the Hip, seen somewhat obliquely from Before : Iliopsoas Muscle, consisting of Two Parts — the Iliacus Muscle and the Psoas Magnus Muscle; Psoas Parvus Muscle, the Tendon of which becomes incorporated with the Iliac Fascia. Obturator Internus Muscle. Pyriformis and Quadratus Lumborum Muscles. Lacuna Vasorum, or Vascular Compartment, of the Space between Poupart's Ligament (Superficial Femoral Arch) and the Concave Iliopubic Margin of the Hip-Bone. Right Side.

Musculi coxae — Muscles of the hip.

THE MUSCLES OF THE LOWER EXTREMITY

345

Psoas magnus muscle (slips of origin from the bodies of the vertebrje I M y \ niiJLi Quadratus lumborum muscle i insertion into the twelfth rib)

Twelfth rib Costi \II Psoas magnus muscle (slips of origin from the costal processes! M. p^oas majDr Quadratus lumborum muscle (slips of origin from the costal processes;

Slips of origin of the internal

oblique muscle of the

abdomen

Costal process

Processus costarius

Middle layer of the lumbar fascia, forming

the posterior aponeurosis of

the transversalis abdominis muscle

Lii; lumli.jcostale Psoas magnus muscle ( slips of origin from the costal processes) M. psoas major Quadratus lumborum muscle (insertion into the crest of the ilium)

Iliolumbar ligament

Lig. iliolumhale

Transversalis abdominis muscle M. trans\ersus abdominis Internal oblique muscle of the

abdomen

M. obliquusinternus abdominis

External oblique muscle of the -

abdomen M. obliquusexternusabdominis Surface of origin of the'' iliacus muscle Surface of origin of the gluteus '' medius muscle

Surface of origin of the gluteus minimus- muscle

Margin of the acetabulum

Surface of origin of the iliopsoas muscle from the capsule of the hip-joint

Tendon of insertion of the pyriformis muscle

Insertion of the gluteus.

medius muscle

Great trochanter '' Trochanter major

Insertion of the gluteus ' minimus muscle

Partial insertion of the gluteus -

maximus muscle into the gluteal ridge of the femur

Origin in layers of the vastus extemus muscle

Twelfth dorsal vertebra

\ eitebra thoracal is XII.

'Intermediate crus of the vertebral portion of the diaphragm'

*Crus intermedium partis lumbalis

diaphragmatis

Portion of the internal arched

ligament

"Internal crus of the vertebral portion of the diaphragm'

*Crus mediale partis lumbalis diaphragmatis Intervertebral foramen Foramen intervertebrale

Psoas magnus muscle (slips of origin from the bodies of the vertebrse and from the intervertebral discs)

iM. psoas major

Sacral promontory

Promontorium

Anterior superior spine of the ilium

Spina iliaca anterior superior Tensor vaginse femoris or tensor fasciae femoris muscle M. tensor fascije latas ' Sartorius muscle (origin) ...Poupart's ligament (superficial femoral arch) Lig. inguinale (Pouparti) Eectus femoris muscle (origin)

Pubic portion of the iliopectineal

line

Pecten ossis pubis

Pectineus muscle (origin)

.. Spine of the pubis

Tuberculum pubicum

- Adductor longus muscle (origin) Adductor brevis muscle (origin)

' -^Gracilis muscle (origin)

'^ Obturator extemus muscle (origin) ^^ Adductor minimus muscle (origin)'-

Obturator membrane or ligament

Membrana obturatoria

'Adductor magnus muscle (origin)'- ' Quadratus femoris muscle (origin)

Fk;. 594.— Attachment ok Muscles to thk Antekior Suki'ack ok ihk Luin:.\i< Vektkhk.I'; and ok the Hip-Bone

Musculi coxae- Muscles of the hip.

44

346

THE MUSCLES OF THE LOWER EXTREMITY

Promontory of the sacrum Promontorium

Psoas magnus muscle. M. psoas major

Iliacus muscle

*Linea arcuata' Iliac fascia

Fascia iliaca Poupart's ligament (superficial femoral archXi) Obturator canal Canalis obturatorius White line of the pelvic fascia Arcus tendineus m. levatoris am Pubic symphysis Symphysis ossium pubis

Inferior or descending ramus of the pubis Ramus inferior ossis pubis Adductor longus muscle -

Gracilis muscle

Adductor magnus muscle

(i) Lig. inguinale (Pouparti

\ -. Sacro-iliac articulation ' Articulatio sacro-iliaca ' Pyrif ormis muscle M. piriformis v -. Fifth sacral vertebra (2)

[S-j Sacrococcygeus anticus or

■ curvator coccygis muscle (3)

-— First coccygeal vertebra

Vertebra coccygea I. Anterior or small sacrosciatic ligament Lig. sacrospinosum Obturator fascia Fascia obturatoria - Posterior or great sacrosciatic ligament Lig. sacrotuberosum

Falciform process

Processus falciformis Tuberosity of the ischium

Tuber ischiadicum

Semitendmosus muscle

( ) Vertebra sacralis V.

(j) M. sacrococcygeus anterior

I The *Unea arcuata marks the attachment of the iliac fascia along the brim of the pelvis to the iliopectineal line, where it is insepar- ably blended with the obturator fascia. — Tr.

Fig. 595. — Internal Muscles of the Region of the Hip, seen from the Inner Side, with THE Obturator Fascia and a Portion of the Iliac Fascia : Pyriformis Muscle ; the Two Parts of the Iliopsoas Muscle, viz.. Psoas Magnus and Iliacus Muscles. Proximal Extremities of the Internal Femoral or Adductor Muscles, showing their Mutual Relations. White Line of the Pelvic Fascia. Right Side.

Musculi coxae— Muscles of the hip.

THE MUSCLES OF THE LOWER EXTREMITY

347

Psoas magnus muscle

M. Dsoas major

Iliacus muscle -

Obturator canal " T Canalis obturatorius-

niopsoas muscle

Small trochanter

Trochanter minor

Bursa of the pectineus muscle Bursa musculi pectinei

Promontory of the sacrum

Pi omen tori um

Sacro-iliac articulation

''\ * ■ \ " Articulatio sacro-iliaca

Pyriformis muscle

M. piriformis

Coccygeus or levator coccygis muscle

Obturator intemus muscle

Posterior or great sacrosciatic

ligament

Lig. sacrotuberosum

Pectineus muscle

'riy to the tendon of the pectli

its insertion, betw

Fig. 596. — The Internal Muscles of the Region of the Hip, seen from the Inner Side, THE Obturator Fascia having been removed, and the Iliopsoas Muscle fully

exposed UP TO ITS INSERTION INTO THE SMALL TROCHANTER: PyKIFORMIS AND OBTURATOR

Inteknus Muscles. Bursa of the Pectineus Muscle.

Musculi coxae--Muscles of the hip.

44—2

348

THE MUSCLES OF THE LOWER EXTREMITY

Pyriformis muscle (divided and turned outwards)

M. pirilormis

Bursa of the pyriformis muscle' Bursa musculi piriformis

Gluteus minimus muscle

M. glutaeus minimus

Troclianteric bursa of the gluteus minimus muscle-

Bursa trochantenca m. glutaii ■

Anterior trochanteric bursa of the gluteus meaius muscle ^

Baiaa trochanLerica m. glut^ei

Gluteus medius muscle

(divided and

turned outwards)

M. gluteus medius

Vastus intemus muscle

M. vastus medialis

Kectus femoris muscle (divided and turned upwards)

rectus femoriS muscle^

sculi recti femoris

I

Iliopectineal bursa'"' Bursa iliopectinea

Iliopsoas muscle (divided

and turned downwards

and inwards)

Bursa of the iliopsoas tendon"

Bursa iliaca subtendinea

Mass of adductor muscles

* The bursa of the pyriformis jiuiscle is situate beneath the tendon of that muscle clos

2 The trochanteric bursa of tlie gluteus inijtijiius inuscte is situate beneath the tendon

3 The anterior troclianteric bursa of the gluteus tncdius nnisclc is situate beneath the the front of the outer surface of the great trochanter. — Tr.

'' The bursa of the rectus femoris muscle is situate between the anterior tetidinou: anterior inferior spine of the ilium.— Tr.

^ The iliopectineal bursa is situate beneath the iliopsoas muscle as it passes c of the hip-joint. It frequently communicates with the joint. — Tr.

6 The bursa of the iliopsoas tendon is situate between the tendon of the iliopsoas muscl -Tr.

luscle close to its insertion. — Tr. part of the tendon of that muscle and

IS head of the muscle and the lower part of the

liopectineal eminence and the capsular ligament

id the femur immediately above its

Fig. 597. — The Burs^ situate beneath the Tendons of the Muscles of the Hip adjacent TO their Insertions. Iliopectineal Bursa. Right Side. Seen from Before.

The distal extremities of the muscles have been drawn away from the bone to e.xpose the bursas, which

have been ooened.

Musculi coxae — Muscles of the hip.

THE MUSCLES OF THE LOWER EXTREMITY

349

Anterior superior spine of the ilium Spina iliaca anterior superior Aponeurosis of the external oblique muscle of the abdomen Aponeurosis m. obliqui externi

abJominis

Poupart's ligament superficial

femoral arch)

Lig. inguinale (Fouparti

Superiorcornu'— Cornu supi luia

Vascular compartment

Lacuna vasorum

Falciform border ^Iargo falcifoimi^ Saphenous opening (publc portion

of the fascia lata x 1 1 Pectineal fascia, or pubic portion of the fascia lata i j)

Inferior cornu Cornu inferius

Deep fascia of the thigh, or fascia lata superficial layer)-

Superficial fascia

1 ascia superficialis

External or superficial abdominal ring* \nnulus inguinalis subcutaneus Upper or internal pillar (3) Lower or external pillar (4) Gimbernat's ligament iji; lacunare (Gimbernati) Spine of the pubis Tuberculum pubicum

Supensory ligament of the penis

Lig. suspensorium penis

(3) Crus superius

(4) Crus inferius

(i) Fos'ia ovflIis(LaiT

fasctz latx) (2) Fascia prctinea

' The superior cornu o/llic saphenous opening passes completely to the inner side nf the femoral sheath to be attached to Gimbernat's ligament. This inner partof the superior cornu is termed the femoral ligament or Hey's ligament. — Tr.

2 The upper part of this portion of the fascia lata, lying to the outer side uf the saphenous opening, is termed the iliac portion of the /ascia tata.—'VK.

'Or external inguinal aperture.

Fig. 598. — Deep Fascia of the Thigh or F"ascia Lata of the Right Side, seen from Before ; ITS Connexion with the Aponeurosis of the External Oblique Muscle of the Abdomen through its Attachment to Poupart's Ligament (Superficial F^emoral Arch). The External or Superficial Abdominal Ring (the External Inguinal Aperture), lying immediately above the Inner Extremity of Poupart's Ligament, which f"orms the Lower or External Pillar of the Ring. The Saphenous Opening (Fossa Ovalis) which forms the Femoral Aperture of the Femoral or Crural Canal. The Pubic Portion OF the Fascia Lata, or Pectineal Fascia, attached above to the Iliopectineal Line, forms the Floor of the Saphenous Opening, and, passing outwards, dips deeply beneath the Falciform Border of the Iliac Portion of the Fascia Lata and behind the Femoral Vessels to form the Back of the Femoral or Crural Sheath, by Means of which it is continued into the Iliac Fascia.

The vessels that descend through the vascular comparlment or lacuna vasorimi benc.itli Poupart's ligament (femoral artery and femoral vein) have been removed.

Musculi coxae et femoris— Muscles of the hip and thigh.

350

THE MUSCLES OF THE LOWER EXTREMITY

'IhJ

Iliacus muscle

Anterior superior spine of the ilium Spina iliaca anterior superior

Tensor vaginae femoris or tensor fasciae femoris muscle

M. tensor fascia; latse

Sartorius muscle

Rectus femoris muscle

Vastus internus muscle M. vastus medialis

Deep fascia of the thigh, or fascia lata

Prepatellax subcutaneous bursa Bursa pr^patellaris subcutanea

Infrapatellar subcutaneous bursa

Bursa infrapatellaris subcutanea

Psoas magnus muscle

W. psoas major

Poupart's ligament (superficial femoral arch)

Lig. inguinale (Pouparti)

Iliopectineal fossa

Fossa iliopectinea

Pectineus muscle

— Adductor longus muscle

Gracilis muscle

ill Internal intermuscular septum

Septum intermusculare mediale

Fig. 599. — Anterior and Internal Muscles of the Right Thigh, as seen from Before with THE Limb rotated outwards : Sartorius Muscle ; Portions of the Quadriceps Extensor Cruris Muscle, of the Internal Femoral or Adductor Muscles, and of the Iliopsoas Muscle. *Iliopectineal Fossa. The Triangular Area, the Base of which is formed BY Poupart's Ligament, the Sides by the Sartorius and Adductor Longus Muscles, respectively, and the Floor by the Iliopsoas and Pectineus Muscles, is known as Scarpa's Triangle (Fossa Scarpa Major, Trigonum Femorale). Prepatellar and Infra- patellar Subcutaneous Burs^e.

In the region of the knee the fascia lata has not been removed.

Musculi femoris— Muscles of the thigh.

THE MUSCLES OF THE LOWER EXTREMITY

351

Anterior superior spine of the ilium

Spina iliaca anterior superior

Iliopsoas muscle Sartorius muscle

Tensor vaginsB femoris or tensor fascisB femoris muscle il. tensor fascia; latae

Rectus femoris muscle

Vastus intemus muscle M. vastus medialis

^Poupart's ligament (superficial femoral arch) Lig. inguinale (Pouparti) Pubic symphysis

bymphysis ossium pubis

Inferior or descending ramus of the pubis

Ramus interior ossis pubis -Pectineus muscle

-Adductor maguus muscle Adductor brevis muscle Gracilis muscle

Adductor longus muscle

Semimembranosus muscle Semitendinosus musciD

Entrance to the lower part of Hunter's canal

Canalis adductorius (Hunteri)

Internal intermuscular septum

Septum intermusculare mediale

Semimembranosus muscle

Sartorius muscle

Aponeurotic expansion of the tendon of the gracilis muscle Aponeurotic expansion of the tendon of insertion of the sartorius muscle

Pes anserinus'

■ Pts /I /iserinus.— The tendon of insertion of the sartorius muscle sends off from its upper border an aponeurotic expansion to join tiiat of Ihc common extensor over the front of the capsule of the knee-joint, and Irom its lower border another to the deep fascia of the leg ; immediately below and behind this latter is a similar aponeurotic expansion from the ic'.don of insertion of the gracilis mufcle to the deep fascia of the leg. From the resemblance of the aponeurotic expansions of the sartorius tendon to the foot of a goose, it is called by the author /« anserinus, but it is to he noted that this name is given by English anatomists to an entirely different strnclure— to wit, the plexus formed in the substance of the parotid gland and on the side of the face by the freely communicating twigs of the temporofacial and cervicofacial branches of the facial nerve, known also as the " parotid plexus " (see l''ig. 1314, p. 871, sect. vi. of this work).— Tr.

Fig. 600.— Anterior and Internal Muscles of the Right Thigh, as .seen from Hefore with the Limb

ROTATED outwards, 'IHE SARTORIUS MUSCI.E HAVING BEEN REMOVED. OF THE QUADRICEPS EXTENSOR

Cruris Mu.scle, we see the Long Head, the Rectus Femoris Muscle, and the Inner Head, the Vastus Internus Muscle: of the Internal Femoral or Adductor Mu.scle.s, we seethe Gracilis, Adductor Longus, Adductor Urevis, and Pectineus Muscles. Behind the Gracilis Mu.scles we see Portions of the Posterior Femoral or Hamstring Mu.scles: Skmimemhranosus Muscle and Semi- tendinosus Muscle. Benfath the Sartorius Muscle and between the Vastus Internus Muscle, ON THE Outer Side, and the Adductor Longus (auovr) and the Adductor Magnus (below), on the Inner Side, lies Hunter's Canal (Canalis Adductorius Huntkri), the Fa.scial Roof of which has

BEEN removed EXCEPT FOR A SHORT SFACE AT THE LOWER END OK THE CANAL.

Musculi femoris Muscles of the thigh.

352

THE MUSCLES OF THE LOWER EXTREMITY

Surface of origin of the gluteus medius muscle

Surface of origin of the gluteus minimus muscle

Rectus femoris muscle

(proximal extremity)

Tendon of the gluteus medius muscle

Tendon of the gluteus minimus muscle

Vastus intemus muscle ivi. vastus raedialis

Crureus muscle

M. vastus intermedius

vastus extemus muscle-

M. vastus lateralis

Quadriceps extensor cruris muscle

Rectus femoris muscle - (distal extremity) \

Biceps flexor cruris muscle

M. biceps femoris

Crest of the ilium

Crista iliaca

Anterior superior spine of

the ilium

Spina iliaca anterior superior

_ Iliopsoas muscle M. iliopsoas

Poupart's ligament (superficial

femoral arch)

Lig. inguinale (Pouparti)

Pubic symphysis

Symphysis ossium pubis -Pectineus muscle

Adductor brevis muscle

Adductor longus muscle

Adductor magnus muscle

Fig. 6oi. — Anterior and Internal Muscles of the Right Thigh, with the Limb in the Normal Position, the Sartorius, Gracilis, and Rectus Femoris Muscles having been Removed. Seen from Before. Vastus Externus, Crureus, and Vastus Internus Muscles, the Outer, Middle, and Inner Heads of the Quadriceps Extensor Cruris Muscles; Adductor Longus and Adductor Brevis Muscles, and the Inner Portion of the Adductor Magnus Muscle ; Pectineus Muscle.

Musculi femoris — Muscles of the thigh.

THE MUSCLES OF THE LOWER EXTREMITY

353

Crest of the ilium

Crista iliaca Tensor vaginae femoris or tensor fasciae femoria muscle (origin) — M. tensor fasciae lata;

Gluteus minimus muscle M. glutafus minimus Rectus femoris muscle (tendon of origin) M. rectus ienirtris

Capsular ligament of the hip-joint Capsula articularis

Gluteus medius muscle (insertion)

M. glutaeus medius

Great trochanter Trochanter major

Upper limit of the origin of the vastus extemus muscle

Quadriceps extensor cruris

muscle ■ M. quadriceps

femoris

Quadriceps

extensor cruris

muscle

Upper limit of the origin of the crureus muscle

Superficial layers of the vastus extemus muscle

Deep layers of the vastus externus muscle

Outer surface of the femur Facies lateralis femoris

/ Aponeurosis of insertion of the

vastus extemus muscle Bundles of muscular fibres passing from the crureus to the vastus extemus muscle (divided)

M. quadriceps femoris

I Tendonof insertion of the rectus \ femoris muscle

Fascia lata (iliotiblal band or ligament) Fascia lata (tractus ihotibialis)

Head of the fibula

Capitulum fibul i

, Body of the fifth lumbar vertebra

' Corpus vertebra; lumbalis V. —Anterior superior spine of the ilium

Spma iliaca anterior superior

~ Sartorius muscle (origin)

Iliopsoas muscle

Pubic ligament of Astley Cooper, or Cooper's ligament'

1-ig. piibicum ((■ooperi) Pectineus muscle (origin)

Spine of the pubis

Tuberculum pubicum Obturator canal Canalis obturatorius Obturator extemus muscle

-Adductor brevis muscle Adductor longus muscle

Crureus muscle \

M, vastus intermedins Vastus intemus muscle

M. vastus medialis

Common tendon for the crureus and vastus intemus muscles

Vastus intemus muscle

M. vastus medialis

Bundles of muscular fibres passing from the vastus intemus muscle to the tendon of the rectus femoris muscle (which has been dividedl /

Patella

Patellar ligament, or infrapatellar tendon

r ig. patelhc

Tubercle of the tibia — Tuberositas tibi;e

Quadriceps extensor cruris muscle

M. quadriceps femoris

Fig. 602.— Stratification of the Vastus Externus Muscle, as seen after the Removal OF the Rectus Femoris Muscle, the Layers of the Vastus Externus Muscle having been well separated from the Femur. Outer Limit of Origin of the Crureus ^Vastus Intekmedius) Muscle. Stratification of the Tendons (Aponeuroses) of the Vastus Externus, Crureus, and Rectus Fi:moris Muscles above the Knee-Joint.

The thigh, which has been rotated inwards, is seen from before. The bundles of the vastus externus muscle that arise from the fascia lata are shown in Fig. 616.

Musculi femoris — Muscles of the thigh.

45

854

THE MUSCLES OF THE LOWER EXTREMITY

Capsular ligament of the hip-joint v-

Capsula articularis

Upper limit of the origin o the crureus muscle

Crureus muscle

M. "astus intermedin

Vastus internus muscle (divided and turned forwards)

Common tendon for the vastus internu: and crureus muscles

Adipose tissue of the internal alar ligament (plica alaris medialis)

Patella ligament, or infrapatellar tendon Lig. patellae

Tendon of the sartorius muscle

Tubercle of the tibia Tuberositas tibiae

— Head of the femur

Caput femoris

Tendon of insertion of the iliopsoas muscle

Small trochanter Trochanter minor

Insertion by muscular fibres of the iliopsoas muscle

Upper limit of the origin of the vastus internus muscle

Vastus internus muscle (line of origin from the inner lip of the linea aspera)

Inner surface of the femur Facies medialis femoris

Deep fascia of the leg

Fascia cruris

Fasciculus of the subcrureus muscle

Fasciculus m. articularis genu

,Tendon of insertion of the adductor

magnus muscle with the internal

intermuscular septum

,\ .Capsule of the knee-joint ''Capsula articularis genu

jinsertion and aponeurotic expansion of the semimembranosus muscle

_, Tendon of the gracilis muscle Tendon of the semitendiuosus muscle

'/'JF B^"- ^"'''^^'^^1 surface of the tibia /^*^^jH Facies medialis tibiae --Popliteus muscle

-^ Soleus muscle

FiG. 603. — Inner Limit of the Origin of the Crureus (Vastus Intermedius) Muscle, and THE Blending of the Fasciculi of that Muscle with those of the Vastus Internus (Vastus Medialis) Muscle in their Insertion into the Deep Aponeurosis of the Quadriceps Extensor Cruris Muscle. Right Thigh, seen from Within.

The vastus internus muscle has been divided longitudinally throughout its entire length, and has been

turned fcrvards.

Musculi femoris — Muscles of the thigh.

VHE MUSCLES OF THE LOWER EXTREMITY

355

t^adriceps extensor cruris — muscle M. quadriceps femoris

Subtendinous prepatellar — \ bursa '

Bursa prspatellaiis subtendinea

Subfascial prepatellar bursa'

Bursa prspatellaris subfascialis

Patellar ligament, or infrapatellar tendon

Lig. pateilse

Subcutaneous bursa of the — tubercle of the tibia

Bursa subcutanea tuberositatis tibiae

Deep fascia of the thigh, or fascia lata

Sartorius muscle

Bursa propria of the sartorius muscle'

Bursa musculi sartorii propria

Deep fascia of the leg

Fascia cruris

' The htrsa propria of the sartorius muscle is situate between the sartorius muscle at the point where the muscle become*; tendinous. U is to be distinguished from a mc - -I of the tendon of the sartorius, called by the autlior bttrsa anserina. See not'

nd the upper part of the capsule of the knee-joint e distally situate bursa beneath the aponeurotic I to p. 362.-TR.

Fig. 604.— Demonstration of Certain Burs^ in the Anterior Region of the Knee. Bursa Propria of the Sartorius Muscle. Subcutaneous Bursa of the Tubercle of THE Tibia. Region of the Right Knee, seen obliquely from Before and Within.

The subfascial prepatellar Durs.i was opened by a longitudinal incision through the fascia lata over the front of the patella, and the subtendinous prepatellar bursa was opened by a longitudinal incision through the common tendon of the quadriceps extensor cruris muscle ("suprapatellar tendon) immediately above the patella.

Musculi femoris — Muscles of the thign.

4S— 2

356

THE MUSCLES OF THE LOWER EXTREMITY

Iliopsoas muscle Eectus femoris muscle

Iliopectineal bursa- Bursa iliopectmea

Iliopsoas muscle Pectineus muscle Grureus muscle

Vastus extemus muscle

Bsctus femoris muscle

Patellar ligament, or

infrapatellar tendon

Lig. patellsE

'-Peotineus muscle

Gracilis muscle ■ Obturator extemus musde

> Adductor brevis muscls

Adductor longus muscle Adductor magnus muscle

Opening in the adductor magnus muscle through ■which the femoral vessels pass into the popliteal space, forming the inferior orifice of Hunter's canal

Hiatus adductorius

--Internal intermuscular septum Septum intermusculare mediale

.Vastus intemus muscle M. vastus medialis

Bursa of the aponeurotic _expansion of the sartorius muscle^

Bursa anserina

V4

Fig. 605. — Internal Femoral or Adductor Muscles, displayed by the Removal of the Sartorius, Gracilis, Pectineus, Rectus Femoris, and Vastus Internus Muscles, the Limb being rotated outwards. Right Thigh, seen from Before. Adductor Brevis and Adductor Longus Muscles ; Inner Portion of the Adductor Magnus Muscle,' WITH the Internal Intermuscular Septum, and the Opening (Hiatus Adductorius) through which the Femoral Vessels pass into the Popliteal Space. (This Opening constitutes the Inferior Orifice of Hunter's Canal.) Obturator Externus Muscle. Bursa of the Aponeurotic Expansion of the Sartorius Muscle (Bursa Anserina) (see note ^ to p. 362)-

Musculi femoris — Muscles ot the thign.

THE MUSCLES OF THE LOWER EXTREMITY

357

Pectineus muscle Obturator canal

I Canalis obturatorius

Obturator extemus muscle

Iliopsoas muscle

Pectineus muscle —

Adductor brevis muscle

Subcrureus muscle

M. articularis

genu

Vastus intemus muscle

M. vastus medialis

Adductor longus muscle

-Adductor brevis muscle

-Inferior or descending ramus of the pubis

Ramus inferior ossis pubis

Quadratus femoris muscle

Adductor brevis muscle

Adductor magnus muscle

Adductor longus muscle

Openmg in the adductor magnus muscle

through which the femoral vessels pass

into the popliteal space, forming the

inferior orifice of Hunter's canal

Hiatus adductorius

Internal intermuscular septum

Septum intermusculare mediale

Fig. 606. — Adductor Magnus Muscle with the Internal Intermuscular Septum and the Opening (Hiatus Adductorius) through which the Femoral Vessels pass into the Popliteal Space. (This Opening constitutes the Inferior Orifice of Hunter's Canal.) Right Thigh, seen from Before. Obturator Externus Muscle. Subcrureus Muscle.

The quadriceps extensor cruris, pectineus, adductor longus, and adductor brevis muscles have been removed. The limb is in the position of external rotation.

Musculi femoris— Muscles of the thigh.

358

THE MUSCLES OF THE LOWER EXTREMITY

Posterior or great sacrosciatic

ligament

Lig. sacrotuberosum

Tuberosity of the ischium Tuber ischiadicum

Semitendinosus muscle.

Pyntormis muscle— M piriformis

Gemellus superior muscle'

M gemellus superior

^.Obturator intemus muscle*

M. obturator internus

Great trochanter

Trochanter major

Gemelliis inferior muscle'

M . gemellus inferior

Quadratus femoris muscle

Adductor minimus muscle'^ Adductor magnus muscle'^

..Vastus extemus muscle

M. vastus lateralis

_.„Linea aspera of the femur

Linea aspera femoris

Biceps flexor cruris muscle (long head)

M. biceps femoris (caput longum) —Biceps flexor cruris muscle (short head) M. biceps femoris (caput breve)

Semimembranosus muscle

Popliteal space (the ham)^.

Fossa poplitea , „ .r n _. , .

'^ ^ '"' ■ »'^ » Plantans muscle

Gastrocnemius muscle (outer head)

M. gastrocnemius (caput laterale)

_Head of the fibula

Gastrocnemius muscle (inner head) ( 1/ Capitulum fibulae

M. gastrocnemius (caput mediale)

I See note * to p. 340. = See note 2 to p. 345.

Fig. 607. — Muscles on the Posterior and Outer Sides of the Right Thigh, the Limb

BEING ROTATED INWARDS. SEEN FROM BEHIND. BlCEPS FlEXOR CRURIS MUSCLE ; SEMI- TENDINOSUS MuSCLE ; DiSTAL PORTION OF THE SEMIMEMBRANOSUS MuSCLE. RELATIONS OF

THE Gastrocnemius Muscle to these Muscles. Popliteal Space (the Ham). Quad- ratus Femoris Muscle, with the Adductor Magnus Muscle {see note ^ above) in Contact WITH its Lower Border. Adductor Minimus Muscle (see note ^ above), not clearly SEPARABLE ABOVE FROM THE ADDUCTOR Magnus Muscle (see note ^ ubove). Vastus Externus Muscle, the Outer Head of the Quadriceps Extensor Cruris Muscle.

Musculi femoris — Muscles of the thigh.

THE MUSCLES OF THE LOWER EXTREMITY

359

Gemellus superior muscle

Obturator intemus muscle'—

Gemellus inferior muscle

Obturator extemus muscle

Biceps flexor cruris muscle (long head). M. biceps (emoris (caput longum)

Semitendinosus muscle-

Adductor magnus muscle

Semimembranosus muscle-

Internal intermuscular septum ...

Septum intermusculare mediale

Internal condyle of the femur-

Condylus medialis femoris

Gastrocnemius muscle

' See note • to p. 340.

Pynformis muscle

M piriformis

Great trochanter Trochanter nia'or Quadratus femoris muscle Small trochanter Trochanter minor

Adductor minimus muscle-

Adductor magnus muscle-

Vastus extemus muscle

M. vastus lateralis

Linea aspera of the femur

Linea aspera femoris

Biceps flexor cruris muscle (short head) M. biceps femoris (caput breve)

Biceps flexor cruris muscle (long head)

M. biceps femoris (caput longum)

Popliteal surface of the femur Planum popliteum femoris

Plantaris muscle

Head of the fibula

('apitiilum fibulae

Fig. 608. — Muscles at the Back of the Right Thigh, the Limb being rotated inwards, THE Long Head of the Biceps Flexor Cruris and the Semitendinosus Muscle having been removed. Seen from Behind. Semimembranosus Muscle; Short Head of the Biceps Flexor Cruris Muscle ; Adductor Magnus {see note - above) and Adductor Minimus {see note ^ above) Muscles; Vastus Externus Muscle.

By the removal of the quadratus femoris muscle, the outer portion of the obturator extemus muscle

has been exposed.

Musculi femoris — Muscles of the thigh.

360

THE MUSCLES OF THE LOWER EXTREMITY

Surface of origin of the gluteus maximus muscle Posterior or great sacrosciatic ligament I^ig. sacrotuberosum

Tuberosity of the ischium Tuber ischiadicum

Adductor magnus muscle' (origin^

Adductor minimus muscle' (origin) y Gracilis muscle (origin! ^ Adductor brevis muscle (origin)

Pubic symphysis -

Adductor loagas muscle (tenion of origin) ''

Pectineus muscle (origin) Iliopsoas muscle (insertion)

Pectineus muscle (tendon of insertion)'

Adductor brevis muscle (tendon of insertion) '

Adductor longus muscle (tendon of insertion

Adductor magnus muscle' (insertion)

Vastus intemus muscle M. vastus medialis

Opening In the adductor magnus muscle

through which the femoral vessels pass

into the popliteal space, forming the

inferior orifice of Hunter's canal

Hiatus adductorius

Popliteal surface Planum popliteum

Internal intermuscular septum

(tendon of the adducbor

magnus muscle)

Septum intermusculare mediale

Inner head of the — gastrocnemius muscle

Tendon of the semimembranosus muscle —

Posterior ligament of 'the knee-joint Lig. popliteum obliquum

Common tendon of origin for the semitendinosus muscle and the long head of the biceps flexor cruris muscle ^ Tendon of origin of the semimembranosus muscle Quadratus femoris muscle (origin)

,- Gluteus medius muscle

M. gluteus medius

Gluteus maximus muscle (divided and turned outwards) M. glutreus maximus — Obturator externus muscle

— Great trochanter

Trochanter major

—-Quadratus femoris muscle (insertion)

Small trochanter

Trochanter minor

Adductor minimus muscle' (tendon of insertion)

Tendmous insertion of the gluteus maximus muscle into the gluteal ridge

Partial insertion of the gluteus maximus muscle into the fascia lata

Deep fascia of the thigh, or fascia lata

Vastus externus muscle

M \ astus lateralis

Short head of the biceps flexor cruris muscle (origin)

Lmea aspera of the femur

Lmea aspera femoris

External intermuscular septum Septum intermusculare laterale

-Plantaris muscle

-Tendon of insertion of the biceus flexor cruris muscle

■ Outer head of the gastrocnemius muscle

Head of the fibula Capitulum fibulae Popliteus muscle , Soleus muscle

M. soleus

Fig. 609. Attachment of Muscles (Origins and Insertions) to the Outer Aspect of the

HiP-BONE AND TO THE POSTERIOR AsPECT OF THE FeMUR. RiGHT SiDE, SEEN FROM BeHIND.

Musculi femoris — Muscles of the thigh.

I

THE MUSCLES OF THE LOWER EXTREMITY

361

Great sacrosciatic foramen Foramen ischiadicum maji s ^v^-^-^"

Posterior or great sacrosciatic x-^'^ ligament

Lig. sacrotuberosum

Extremity of the coccyx

Ape\ ossis coccygis

Tuberosity of the ischium Tuber ischiadicum

Surface of origin of the obturator extemus muscle

Obturator canal

Canalis obturatorius"

Pubic symphysis .J^

Symphysis ossium pubis

Spine of the pubis-'' y

Tuberculum piibicum ^'- - —

Insertion of the iliopsoas muscle'

Insertion of the pectineus muscle into'' the pectineal line of the femur Upper limit of the origin of the vastus intemus muscle

'"-Deep fasciculi of origin of the vastus extemus muscle

Lower limit of the origin of the vastus intemus muscle

Internal intermuscular septum . Septum intermusculare medial

Inner head of the gastrocnemius muscle (origin)

Posterior ligament of the knee-joint— ^ Lig. popliteum obliquum

Semimembranosus muscle (tendon of insertion; Internal lateral ligament of__ the knee-joint Lig collaterale tibiale PopUteus muscle — M. popliteus

Posterior superior spine of the ilium bpin-i ihici posterior superior

Middle gluteal line /U S Middle curved line

1 1I1C1 ^'luti-a anterior

Ma of the ilium

\la ossis ilium'

Great trochanter

1 rochanter major

Upper limit of the origin of the vastus extemus muscle

Small trochanter

Trochanter minor

Tendinous insertion of the gluteus maximus muscle into the gluteal ridge

Inner surface of the femur Facies medialis femoris

Origin of the vastus intemus

muscle from the inner lip of

the liuea aspera

Outer surface of the femur

Facies lateralis femoris

Linea aspera of the femur

Linea aspera femoris

Origin of the vastus extemus muscle from the outer lip of the linea aspera

Lower limit of the origin of the vastus extemus muscle

_. Popliteal surface

Planum popliteum

Plantaris muscle (surface of origin)

Outer head of the gastrocnemius muscle (origin)

External lateral ligament of the knee-joint

Lig. collaterale fibulare

-Biceps flexor cruris muscle (tendon of insertion)

Head of the fibula Capitulum fibula;

The

as an indeclinable nou English anatomists, h<

nd I have followed him he when using Latin tern

as in the section on Osteology, in writing aia c ology, generally decline iiiuin, speaking oi dor.

Fig. 6io. — Attachment of Muscles

OF

(Origins and Insertions) to the Posterior Aspect THE Right Femuh.

Musculi femoris- Muscles of the thigh.

46

362

THE MUSCLES OF THE LOWER EXTREMITY

Semitendinosus muscle — Gracilis muscle—

Sartoriua muscle ^=;

Bursa of the aponeurotic expansion — of the sartorius muscle' Bursa anserina

Popliteus muscle

Deep fascia of the leg

Fascia cruris

Biceps flexor cruris muscle M. biceps femoris

-Semimembranosus muscle

Gastrocnemius muscle (inner head)

Bursa of the imier head of the

gastrocnemius muscle" Bursa m. gastrocnemii medialis

Bursa of the semimembranosus muscle'

Bursa m. semimembranosi

Plantaris muscle

Gastrocnemius muscle (outer head)

■ The l>m the aponeuroti note ' on sam passes more dt

= The iur and the tendo tendon of ihe communicate ■

3 The iui

sa of ihe aponeurotic expansion of the sartorius muscle (called by the author bursa, anserina) is situate between the root of : expansion of the tendon of insertion of the sartorius muscle (^pes anserintts, according to Toldt, see Fig. 600, p. 35I; t page) and the subjacent tendons of insertion of the gracilis and semitendinosus muscles. A prolongs epiy between these latter tendons and the subjacent internal lateral ligament of the knee-joint. — Tr. !ao/ tlic inner head of the gastrocnemius muscle is situate between the inner head of origin of the gast 1 of the semimembranosus muscle. This bursa frequently communicates with the knee-joint. Higher inner head of the gastrocnemius muscle and the femur, there is usually a second, smaller synovial bursa nth the knee-joint.— Tr.

of the semimembranosus muscle is situate between the tendon of insertion of the semimembranosus muscle and the

1 of the bursa

nuscle p. between the which may also

prominent upper margin of the gr( inserted. — Tr.

the internal tuberosity of the tibia into which the

ainly

Fig. 611. — Region of the Knee, seen obliquely from Behind and Within. Right Limb. BuRS^ (Subtendinous Mucous Burs^) in the Inner Part of the Posterior Region OF the Knee, as seen after Division of the Inner Head of the Gastrocnemius Muscle : Bursa of the Inner Head of the Gastrocnemius Muscle, Bursa of the Semi- membranosus Muscle, Bursa of the Aponeurotic Expansion of the Sartorius Muscle (Bursa Anserina).

Bursse mucosae regionis genu posterioris — Bursse of the posterior region of the knee.

THE MUSCLES OF THE LOWER EXTREMITY

363

Semimembranosus muscle

Inner head of the gastrocnemius muscle—

Bursa of the inner head of the -

gastrocnemius muscle' Bursa m. gastrocnemii medialis

Popliteus muBcle-

BuTsa of the popliteus muscle Bursa m. poplitei

'Popliteal canal'

*Canalis popliteu

Short head of the biceps flexor cruris muscle

Caput breve m. bicipitis femoris

Long head of the biceps flexor

cruris muscle

Caput longum m. bicipitis femoris

Plantaris muscle Bicipitogastrocnemial bursa*

I ursa bicipitOKastrocnemialis Outer head of the gastrocnemius muscle C iput laterale m. gastrocnemii Bursa of the outer head of the

gastrocnemius muscle^ Bursa m. gastrocnemii lateralis

Inferior bursa of the biceps flexor

cruris muscle" Bursa m. bicipitis femoris inferior

Tendinous arch of the soleus muscle'

Arcus tendineus m. solei

PeroneuB longus muscle

M perona;us longus

Soleus muscle

' See note = to p. 362.

» The liursa 0/ the popliteus muscle (so-called) is an expansion of the synovial cavity of the knee-joint passing downwards between the tendon of origin of the popliteus muscle and the back of the outer tuberosity of the tibia. —Tk.

3 •Popliteal Canal. — Wni name is not used by English anatomists. It is given by the author to the space beneath (anterior to) the tendinous arch of the soleus muscle (see note 7 on this page) through which the posterior tibial vessels and nerve pass from the popliteal space tieneath the soleus muscle. — Th.

■I The bicipitogastrocnemial bursa is situate between the biceps flexor cruris muscle and the outer head of the gastrocnemius muscle. — Tr. . . ^ , L J r u

i The bursa 0/ tlu outer head 0/ the gastrocnemius muscle is situated beneath the tendon of origin of the outer head ol the gastroc- nemius muscle, between that tendon and the femur. — Tk.

' The inferior bursa of the iicefs fle;cc lateral ligament of the knee-joint. — Fk.

7 The tendinous arch of the soleus muscle, passing from the upper part of the back of the fibula obliquely downwards and inwards to the upper part of the back of the tibia, arches over the tibial vessels and i ' ^ ., - • _•- -^ -1- jji..

muscle. -Tk.

: muscle is situate between the tendon of insertion of that muscle and the external

; for the origin of the middle fibres of the soleus

Fig. 612.— Region of the Knee, seen from Behind. Right Limb. Burs^i (Subtendinous Mucous BuRs.E) IN the Outer Part of the Posterior Region of the Knee, as seen AFTER Removal of Both Heads of the Gastrocnemius Muscle and of the Plantaris Muscle: Bicipitogastrocnemial Bursa, Bursa of the Outer Head of the Gastrocnemius Muscle, Inferior Bursa of the Biceps Flexor Cruris Muscle, Bursa of the Popliteus Muscle, Bursa of the Inner Head of the Gastrocnemius Muscle. Tendinous Arch of the Soleus Muscle, and beneath it (anteriorly) the Entrance to the •Popliteal Canal.

Bursae mucosse regionis genu posterioris— Bursae of the posterior region of the knee.

46 — 2

364

THE MUSCLES OF THE LOWER EXTREMITY

Head of the fibula Capitulum fibulx

Anterior (peroneal) intermuscular septum Septum intermusculare (fibulare) anterius

Deep fascia of the leg

Fascia cruris

Tubercle of the tibia

Tuberositas tibise

— - Internal surface of tlie tibia Facias medialis tibise

Anterior border of the tibia

Crista anterior tibiae

Tibialis anticus muscle M. tibialis anterior

Extensor longus digitorum pedis muscle M. extensor digitorum longus

I

Extensor longus vel extensor proprius hallucis muscle-

M. extensor hallucis longus

Anterior annular ligament of the ankle, or ligameutum lambdoideum

Lig. cruciatum cruris

Extensor brevis hallucis muscle-

M. extensor hallucis brevis

Peroneus tertius muscle IVI peronseus tertius

External malleolus . Malleolus lateralis

*Bursa of the sinus of the tarsus *Bursa sinus tarsi "Inferior retinaculum of the peronei tendons' -' "Retinaculum mm. peronaiorum inferius

Extensor brevis digitorum pedis muscle^ M. extensor digitorum brevis

Peroneus longus tendon ' M. peronseus longus

Peroneus brevis tendon M. peronaeus brevis

Abductor minimi