Appendix

Useful Anatomical Data of

Clinical Significance

Appendix Outline
Respiratory System

426

Table I. Important Airway Distances (Adult)

426

Table II. Important Data Concerning the Trachea

426

Musculoskeletal System

427

Table III. Summary of the Movements of the

Shoulder Joint and the Muscles Producing
Those Movements
Table IV. Summary of the Movements of the
Elbow Joint and the Muscles Producing
Those Movements
Table V. Summary of the Movements of the
Wrist Joint and the Muscles Producing
Those Movements
Table VI. Summary of the Movements of the
Hip Joint and the Muscles Producing
Those Movements

427

Table VII. Summary of the Movements of the

Knee Joint and the Muscles Producing
Those Movements

Table VIII. Summary of the Movements of the Ankle

Joint and the Muscles Producing Those
Movements
435

Digestive System

436

Table IX. Lengths and Capacities

436

Urinary System
429

436

Table X. Lengths and Capacities

436

Reproductive System
430

436

Table XI. Dimensions

436

Embryology
432

434

437

Table XII. The Size and Weight of the Developing

Human Embryo and Fetus

437

Respiratory System
Table I

Important Airway Distances

(Adult)a

Airway
Incisor teeth to the vocal cords
Incisor teeth to the carina
External nares to the carina
a

Average figures given
12 cm.

Table II

Distances
(approx.)
5.9 in. (15 cm)
7.9 in. (20 cm)
11.8 in. (30 cm)

Adults
Infants
a

Important Data Concerning

the Tracheaa

Length (approx.)

Diameter (approx.)

4.5 in. (11.4 cm)

1.62 in. (45 cm)

1 in. (2.5 cm)

As small as 3 mmb

Extension of the head and neck, as when maintaining

an airway in an anesthetized patient, may stretch the
trachea and increase its length by 25%. In the adult,
the carina may descend by as much as 3 cm on deep
inspiration. At the carina, the right bronchus leaves the
trachea at an angle of 25 from the vertical and the left
bronchus leaves the trachea at an angle of 45 from
the vertical. In children younger than 3 years, both
bronchi arise from the trachea at equal angles.
b
As children grow, the diameter in millimeters
corresponds approximately to their age in years.

Appendix

427

Musculoskeletal System
Table III

Summary of the Movements of the Shoulder Joint and the Muscles Producing
Those Movementsa
Muscles

Origin

Insertion

Flexion

Deltoid (anterior
fibers)

Clavicle

C5, 6

Pectoralis major
(clavicular
part)

Clavicle

Middle of lateral
Axillary nerve
surface of shaft
of humerus
Lateral lip bicipital
Medial and lateral
groove of humerus
pectoral nerves
from brachial
plexus
Tuberosity of
radius, deep fascia
of forearm

Musculocutaneous
nerve

C5, 6

Medial aspect of
shaft of humerus

Musculocutaneous
nerve

C5, 6, 7

Middle of lateral
surface of shaft
of humerus
Floor of bicipital
groove of
humerus

Axillary nerve

C5, 6

Thoracodorsal
nerve

C6, 7, 8

Medial lip of
bicipital groove
of humerus

Lower subscapular
nerve

C6, 7

Middle of lateral
surface of shaft
of humerus
Greater tuberosity
of humerus

Axillary nerve

C5, 6

Suprascapular
nerve

C4, 5, 6

Biceps brachii
Long head

Short head
Coracobrachialis
Extension

Deltoid
(posterior
fibers)
Latissimus dorsi

Teres major

Abduction

Adduction

Supraglenoid
tubercle of scapula
Coracoid process
of scapula
Coracoid process
of scapula
Spine of scapula

Iliac crest, lumbar

fascia, spines of
lower six thoracic
vertebrae, lower
three or four ribs,
and inferior angle
of scapula
Lower third lateral
border of scapula

Middle fibers
of deltoid

Acromion process
of scapula

Supraspinatus

Supraspinous fossa
of scapula

Pectoralis major
(sternal part)

Sternum and upper

six costal
cartilages
Iliac crest, lumbar
fascia, spines of
lower six thoracic
vertebrae, lower
three or four ribs,
inferior angle of
scapula

Latissimus dorsi

Nerve Supply

Segmental
Nerveb

Movements

Lateral lip of
Medial and lateral
bicipital groove
pectoral nerves
of humerus
Floor of bicipital
Thoracodorsal
groove of humerus
nerve

C5, 6

C7, 8; T1

C6, 7, 8

428

Appendix

Table III

Movements

Lateral
rotation

(continued)

Origin

Insertion

Nerve Supply

Teres major

Lower third lateral

border of scapula

Lower subscapular
nerve

C6, 7

Teres minor

Upper two thirds

lateral border of
scapula

Medial lip of
bicipital groove
of humerus
Greater tuberosity
of humerus

Axillary nerve

C5, 6

Infraspinatus

Infraspinous fossa
of scapula
Upper two thirds
lateral border of
scapula
Spine of scapula

Greater tuberosity
of humerus
Greater tuberosity
of humerus

Suprascapular
nerve
Axillary nerve

C5, 6

Middle of lateral
surface of shaft
of humerus

Axillary nerve

C5, 6

Upper and lower

subscapular
nerves
Thoracodorsal
nerve

C5, 6

Teres minor

Deltoid
(posterior
fibers)
Medial
rotation

Subscapularis

Subscapular fossa

Lesser tuberosity
of humerus

Latissimus
dorsi

Iliac crest, lumbar

fascia, spines of
lower three or
four ribs, inferior
angle of scapula
Lower third lateral
border of
scapula
Clavicle

Floor of bicipital
groove of
humerus

Teres major

Deltoid (anterior
fibers)

a
b

Segmental
Nerveb

Muscles

Medial lip bicipital

groove of
humerus
Middle of lateral
surface of shaft
of humerus

Circumduction is a combination of all the movements described.

The predominant segmental nerve supply is indicated by boldface type.

C5, 6

C6, 7, 8

Lower subscapular
nerve

C6, 7

Axillary nerve

C5, 6

Appendix

429

Musculoskeletal System
Table III.

Table IV

Summary of the Movements of the Elbow Joint and the Muscles Producing
Those Movements
Segmental
Nervea

Movements

Muscles

Origin

Insertion

Nerve Supply

Flexion

Brachialis

Front of lower
half of humerus

Coronoid process
of ulna

Musculocutaneous
nerve

C5, 6

Supraglenoid
tubercle of
scapula
Coracoid process
of scapula
Lateral
supracondylar
ridge of humerus

Tuberosity of
radius, deep
fascia of forearm

Musculocutaneous
nerve

C5, 6

Styloid process
of radius

Radial nerve

C5, 6, 7

Medial epicondyle
of humerus
Coronoid process
of ulna

Lateral aspect of
shaft of radius

Median nerve

C6, 7

Infraglenoid tubercle
of scapula
Posterior surface of
shaft of humerus
Lower half of
posterior surface
of shaft of humerus
Lateral epicondyle
of humerus

Olecranon
process of ulna

Radial nerve

C6, 7, 8

Olecranon
process of ulna

Radial nerve

C7, 8; T1

Biceps brachii
Long head

Short head
Brachioradialis

Pronator teres
Humeral head
Ulnar head
Extension

Triceps
Long head
Lateral head
Medial head

Anconeus

The predominant segmental nerve supply is indicated by boldface type.

430

Appendix

Musculoskeletal System
Table V

Summary of the Movements of the Wrist Joint and the Muscles Producing Those
Movements

Movements

Muscles

Origin

Insertion

Nerve Supply

Segmental
Nervea

Flexion

Flexor carpi
radialis

Medial epicondyle
of humerus

Bases of second
and third
metacarpal bones

Median nerve

C6, 7

Medial epicondyle
of humerus

Pisiform bone,
hook of hamate,
base of fifth
metacarpal bone

Ulnar nerve

C7, 8

Flexor
retinaculum,
palmar
aponeurosis

Median nerve

C7, 8

Middle phalanx
of medial four
fingers

Median nerve

C7, 8; T1

Distal phalanx
of medial four
fingers

Ulnar half
ulnar nerve,
radial half
median nerve
Anterior
interosseous
branch of
median nerve
Radial nerve

C8; T1

Deep branch
of radial nerve
Deep branch
of radial nerve
Deep branch of
radial nerve

C7, 8

Flexor carpi
ulnaris
Humeral head

Ulnar head

Palmaris longus

Flexor digitorum
superficialis
Humeroulnar
head

Flexor pollicis
longus

Medial epicondyle
of humerus,
coronoid process
of ulna
Oblique line anterior
surface shaft of
radius
Anterior surface
shaft of ulna,
interosseous
membrane
Anterior surface
shaft of radius

Extensor carpi
radialis longus
Extensor carpi
radialis brevis
Extensor carpi
ulnaris
Extensor
digitorum

Lateral supracondylar
ridge of humerus
Lateral epicondyle of
humerus
Lateral epicondyle
of humerus
Lateral epicondyle
of humerus

Radial head

Flexor digitorum
profundus

Extension

Olecranon process,
posterior border
of ulna
Medial epicondyle
of humerus

Distal phalanx
of thumb

Base of second
metacarpal bone
Base of third
metacarpal bone
Base of fifth
metacarpal bone
Middle and distal
phalanges of
medial four
fingers

C8; T1

C6, 7

C7, 8
C7, 8

Appendix

Table V

Movements

(continued)

Origin

Insertion

Nerve Supply

Extensor indicis

Shaft of ulna and

interosseous
membrane
Lateral epicondyle
of humerus

Extensor
expansion of
index finger
Extensor
expansion of
little finger
Base of distal
phalanx of thumb

Deep branch of
radial nerve

C7, 8

Deep branch of
radial nerve

C7, 8

Deep branch of
radial nerve

C7, 8

Median nerve

C6, 7

Radial nerve

C6, 7

Bases of third
metacarpal bone
Base of first
metacarpal bone
Base of distal
phalanx of thumb

Deep branch of
radial nerve
Deep branch of
radial nerve
Deep branch of
radial nerve

C7, 8

Base of proximal
phalanx of thumb

Deep branch of
radial nerve

C7, 8

Pisiform bone,
hook of
hamate, base
of fifth
metacarpal bone

Ulnar nerve

C7, 8

Base of fifth
metacarpal
bone

Deep branch of
radial nerve

C7, 8

Extensor pollicis
longus

Shaft of ulna and

interosseous
membrane

Flexor carpi
radialis

Medial epicondyle
of humerus

Extensor carpi
radialis longus

Lateral
supracondylar
ridge of humerus
Lateral epicondyle
of humerus
Shafts of radius
and ulna
Shaft of ulna and
interosseous
membrane
Shaft of radius and
interosseous
membrane

Extensor carpi
radialis brevis
Abductor pollicis
longus
Extensor pollicis
longus
Extensor pollicis
brevis
Adduction

Flexor carpi
ulnaris
Humeral head

Ulnar head
Extensor carpi
ulnaris

Segmental
Nervea

Muscles

Extensor digiti
minimi

Abduction

431

Medial
epicondyle of
humerus

Olecranon process
of ulna
Lateral epicondyle
of humerus

Bases of second
and third
metacarpal bones
Base of second
metacarpal bone

The predominant segmental nerve supply is indicated by boldface type.

C7, 8
C7, 8

432

Appendix

Musculoskeletal System
Table VI

Summary of the Movements of the Hip Joint and the Muscles Producing
Those Movementsa

Movements

Muscles

Origin

Insertion

Nerve Supply

Segmental
Nerveb

Flexion

Iliacus

Iliac fossa

Femoral nerve

L2, 3

Psoas

Body of twelfth
thoracic vertebra,
transverse
processes, bodies
and intervertebral
discs of the five
lumbar vertebrae

Lesser trochanter
of femur
Lesser trochanter
of femur

Lumbar plexus

L1, 2, 3

Patella

Femoral nerve

L2, 3, 4

Upper medial
surface of shaft
of tibia

Femoral nerve

L2, 3

Inferior gluteal
nerve

L5; S1, 2

Rectus femoris
Straight head
Reflected head
Sartorius

Extension
Gluteus
(a posterior
maximus
movement
of the flexed
thigh)
Biceps femoris
Semitendinosus

Anterior inferior
iliac spine
Ilium above
acetabulum
Anterior superior
iliac spine

Outer surface of
Iliotibial tract,
ilium, sacrum,
gluteal
coccyx, sacrotuber- tuberosity of
ous ligament
femur
Long head: ischial
tuberosity
Ischial tuberosity

SemimembraIschial tuberosity
nosus
Adductor magnus Ischial tuberosity
Abduction

Gluteus medius

Outer surface of
ilium

Gluteus minimus

Outer surface of
ilium

Sartorius

Anterior superior
iliac spine

Tensor fasciae
latae
Piriformis

Iliac crest
Anterior surface of
sacrum

Head of fibula

Tibial nerve
(sciatic nerve)
Upper part of
Tibial nerve
medial surface of
(sciatic nerve)
shaft of tibia
Medial condyle of
Tibial nerve
tibia
(sciatic nerve)
Adductor tubercle
Tibial nerve
of femur
(sciatic nerve)

Greater
trochanter of
femur
Greater
trochanter of
femur
Upper medial
surface of shaft
of tibia
Iliotibial tract
Greater
trochanter of
femur

L5; S1, 2
L5; S1, 2

L5; S1, 2
L2, 3, 4

Superior gluteal L5; S1

nerve
Superior
gluteal nerve

L5; S1

Femoral nerve

L2, 3

Superior gluteal L4, 5

nerve
Sacral plexus
L5; S1, 2

Appendix

Table VI

433

(continued)

Movements Muscles

Origin

Insertion

Nerve Supply

Segmental
Nervea

Adduction

Body of pubis

Posterior surface
of shaft of femur
Posterior surface
of shaft of femur
Posterior surface
of shaft of femur,
adductor tubercle
of femur
Upper end of
shaft of femur
Upper part of
shaft of tibia on
medial surface

Obturator nerve

L2, 3, 4

Obturator nerve

L2, 3, 4

Obturator nerve

L2, 3, 4

Femoral nerve

L2, 3

Obturator nerve

L2, 3

Sacral plexus

L5; S1, 2

Sacral plexus

L5; S1

Obturator nerve

L3, 4

Sacral plexus

L5; S1

Sacral plexus

L5; S1

Sacral plexus

L5; S1

Inferior gluteal
nerve

L5; S1, 2

Adductor longus
Adductor brevis

Inferior ramus of
pubis
Adductor magnus Inferior ramus of
(adductor fibers)
pubis, ramus of
ischium, ischial
tuberosity
Pectineus
Superior ramus of
pubis
Gracilis
Inferior ramus of
pubis, ramus of
ischium
Lateral
rotation

Piriformis
Obturator
internus
Obturator
externus
Superior
gemellus
Inferior gemellus

Medial
rotation

a
b

Anterior surface of
sacrum
Inner surface of
obturator membrane
Outer surface of
obturator membrane
Spine of ischium
Ischial tuberosity

Greater trochanter
of femur
Greater trochanter
of femur
Greater trochanter
of femur
Greater trochanter
of femur
Greater trochanter
of femur
Quadrate tubercle
on upper end of
posterior
surface of femur
Iliotibial tract,
gluteal tuberosity
of femur

Quadratus
femoris

Ischial tuberosity

Gluteus maximus

Outer surface of
ilium, sacrum,
coccyx,
sacrotuberous
ligament

Gluteus medius

Outer surface of
ilium

Greater trochanter
of femur

Superior gluteal L5; S1

nerve

Gluteus
minimus

Outer surface of ilium

Greater trochanter
of femur

Superior gluteal L5; S1

nerve

Tensor fasciae
latae

Iliac crest

Iliotibial tract

Superior
gluteal nerve

Circumduction is a combination of all the movements described.

The predominant segmental nerve supply is indicated by boldface type.

L4, 5

434

Appendix

Musculoskeletal System
Table VII

Summary of the Movements of the Knee Joint and the Muscles

Producing Those Movements
Segmental
Nervea

Movements

Muscles

Origin

Insertion

Nerve Supply

Flexion

Biceps femoris
Long head
Short head

Ischial tuberosity
Shaft of femur

Head of fibula

L5; S1, 2

Semitendinosus

Ischial tuberosity

Semimembranosus
Gastrocnemius

Ischial tuberosity

Upper part of
medial surface
of shaft of tibia
Medial condyle of
tibia
Via Achilles tendon
into calcaneum

Tibial nerve
Common
peroneal
nerve
Tibial nerve

Tibial nerve

L5; S1, 2

Tibial nerve

S1, 2

Patella

Femoral nerve

L2, 3, 4

Patella

Femoral nerve

L2, 3, 4

Patella

Femoral nerve

L2, 3, 4

Patella

Femoral nerve

L2, 3, 4

Femoral nerve

L2, 3

Interior ramus of
pubis, ramus
of ischium

Upper medial
surface of shaft
of tibia
Upper part of shaft
of tibia on medial
surface

Obturator nerve

L2, 3

Ischial tuberosity
Shaft of femur

Head of fibula

Tibial nerve
Common
peroneal
nerve

L5; S1, 2
L5; S1, 2

Extension

Quadriceps
femoris: rectus
femoris
Straight head
Reflected head
Vastus lateralis
Vastus medialis

Medial
rotation

Vastus intermedius
Sartorius

Gracilis

Lateral
rotation

Biceps femoris
Long head
Short head

Medial, lateral
condyles of
femur

Anterior inferior
iliac spine
Ilium above
acetabulum
Upper end and
shaft of femur
Upper end and
shaft of femur
Shaft of femur
Anterior superior
iliac spine

The predominant segmental nerve supply is indicated by boldface type.

L5; S1, 2

Appendix

435

Musculoskeletal System
Table VIII

Summary of the Movements of the Ankle Joint and the Muscles Producing
Those Movements
Nerve
Supply

Segmental
Nervea

Deep peroneal
nerve

L4,5

Deep peroneal
nerve

L5, S1

Deep peroneal
nerve

L5, S1

Deep peroneal
nerve

L5, S1

Via Achilles tendon

into calcaneum

Tibial nerve

S1,2

Via Achilles tendon

into calcaneum
Calcaneum

Tibial nerve

S1,2

Tibial nerve

S1,2

Movements

Muscles

Origin

Insertion

Dorsiflexion

Tibialis anterior

Medial cuneiform,
base of first
metatarsal bone
Base of distal
phalanx of great
toe
Dorsal extensor
expansion of
lateral four toes
Base of fifth
metatarsal bone

Peroneus longus

Shaft of tibia,
interosseous
membrane
Shaft of fibula,
interosseous
membrane
Shaft of fibula,
interosseous
membrane
Shaft of fibula,
interosseous
membrane
Medial, lateral
condyles of
femur
Shaft of tibia
and fibula
Lateral supracondylar ridge
of femur
Shaft of fibula

Peroneus brevis

Shaft of fibula

Tibialis posterior

Shaft of tibia,
fibula, interosseous
membrane
Shaft of tibia

Extensor hallucis
longus
Extensor digitorum
longus
Peroneus tertius

Plantarflexion

Gastrocnemius

Soleus
Plantaria

Flexor digitorum
longus
Flexor hallucis
longus
a

Shaft of fibula

Base of first
metatarsal and
medial cuneiform
Base of fifth
metatarsal bone
Tuberosity of
navicular

Distal phalanges
of lateral four toes
Base of distal
phalanx of big toe

The predominant segmental nerve supply is indicated by boldface type.

Superficial
L5; S1,2
peroneal nerve
Superficial
L5; S1,2
peroneal nerve
Tibial nerve
L4,5

Tibial nerve

S2,3

Tibial nerve

S2,3

436

Appendix

Digestive System
Table IX

Lengths and Capacities

Region (approx.)

Lengths (approx.)

Capacities (Approx.)

Esophagus
Stomacha
Duodenum
Jejunum
Ileum
Appendix
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Anal canal
Gallbladder
Cystic duct
Bile duct

10 in. (25 cm)

Lesser curvature 4.85.6 in. (1214 cm)
10 in. (25 cm)
8 ft (2.4 M)
12 ft (3.7 M)
35 in. (813 cm)
5 in. (13 cm)
15 in. (38 cm)
10 in. (25 cm)
1015 in. (2538 cm)
5 in. (13 cm)
1.5 in. (4 cm)
2.83.9 in. (710 cm)
1.5 in. (3.8 cm)
3 in. (8 cm)

1,500 mL

3050 mL

The curved course taken by a nasogastric tube from the cardiac orifice to the pylorus is usually
longer, 610 in. (1525 cm).

Urinary System
Table X

Reproductive System

Lengths and Capacities

Organ

Lengths (approx.)

Ureter
Bladder
Male urethra
Penile
Membranous
Prostatic
Female urethra

10 in. (25 cm)

8 in. (20 cm)

6 in. (15.7 cm)
0.5 in. (1.25 cm)
1.25 in. (3 cm)
1.5 in. (3.8 cm)

Capacity
(approx.)

500 mL

Table XI
Organ
Male
Testis
Vas deferens
Penis (erect)
Female
Ovary
Uterine tube
Uterus
Vagina

Dimensions
Dimensions (approx.)
2  1 in. (5  2.5 cm)
18 in. (45 cm)
6 in. (15 cm)
1.5  0.75 in. (4  2 cm)
4 in. (10 cm)
3  2  1 in. (8  5  2.5 cm)
3 in. (8 cm)

Appendix

Embryology
Table XII

The Size and Weight of the

Developing Human Embryo
and Fetus

Age of
Conception
(weeks)

CrownRump
Length (mm)

Weight (g)

4
5
8
12
16
20
24
28
32
36
Full term

5
8
23
56
112
160
203
242
277
313
350

0.02

1
14
105
310
640
1,080
1,670
2,400
3,300

Reprinted with permission, Arey 1966.

CD Figure APP-1 Critical times in the maturation of the human fetus during which
mutant genes, drugs, or environmental factors may alter normal development of specific
structures.

437