Atlas Human Anatobhnjklmy Ciba Netter

n rl f
AIIAS OI
Fourth Edition
FrankH.Netter,
MD
Atlasof
Human Anatomy
Gonsulting Editors
JenniferK. Brueckner,PhD NoelleA. Granger,PhD

AssistantProfessor Professor
Department of Anatomyand Neurobiology Department Biology
of Celland Developmental
of KentuckyCollegeof Medicine
University of NorthCarolinaSchoolof Medicine
University
Lexington,Kentucky ChapelHill,NorthCarolina
StephenW. Garmichael,PhD, DSc John T. Hansen,PhD

Professor and Anatomy
Professorof Neurobiology
Departments Surgery
of Anatomyand Orthopedic AssociateDeanfor Admissions
MayoClinic of Rochester
University Schoolof Medicineand Dentistry
Rochester,Minnesota Rochester,NewYork
ThomasR. Gest,PhD AnilH. Walji,MD,PhD

AssociateProfessor Professorand Director,Divisionof Anatomy
Divisionof AnatomicalSciencesand Department Professorof Radiologyand Diagnostic lmaging
of MedicalEducation Professorof Surgery
Universityof MichiganMedicalSchool Facultyof Medicineand Dentistry
AnnArbor,Michigan Universityof Alberta
Edmonton,Alberta,Canada
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Atlas of Human Anatomy Editionwith StudentConsultAccess: ISBN-13:978-1-4160-3385-1

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Professional
Edition: ISBN-13:978-1-4160-3699-9
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All rights reserved. No part of this book may be producedor transmittedin any form or by any
means,electronicor mechanical,includingphotocopying,recording,or any informationstorage
and retrievalsystem,without permissionin writingfrom the publishers.Permissionsfor Netter
Art figuresmay be sought directlyfrom Elsevier'sHealthScienceLicensingDepartmentin
Philadelphia, Pennsylvania,USA:phone1-800-523-1649, ext.3276,or215-239-3276; email:
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NOTICE
Neitherthe Publishernor the Editorsassume any responsibility for any loss or injuryand/or
damage to persons or property arisingout of or relatedto any use of the materialcontained in
this book. lt is the responsibility
of the treatingpractitioner,
relyingon independentexpertise
and knowledge of the patient, to determinethe best treatment and method of applicationfor
the oatient.
Previouseditionscopyrighted2003, 1997, 1989.
AcquisitionsEditor: Anne Lenehan

DevelopmentalEditor: Marybeth Thiel
Publishing Services Manager: Frank Polizzano
Senior Project Manager: Cecelia Bayruns
Design Direction: Louis Forgione
lllustrationManager: Cecilia Nuyianes
Cover Design Concept: Madelene Hyde
Marketing Manager: Megan Poles
'Working
togetherto grow
librariesin developingcountries
www.elsevier.com I wwwbookaid.org I wwwsabre.org
Printedin the UnitedStatesof America.
L a s t d i g i t i s t h e p r i n t n u m b e r 9: 8 7 6 5 4 3 2 1
To my dear wife, Vera
Head and Neck
Superficial Face Oral Region

Plates 23-26 Plates 5l-62
2s SuperficialArteries
andVeins
ofFace
andScalp 5r Inspection
of OralCavity
24 Cutaneous
Nerves
of Head
andNeck 52 Roofof Mouth
2s Facial
Nerve
Branches
andParotid
Gland 53 Floor
of Mouth
26 Muscles
of Facial
Expresssion:
LateralView Involved
s4 Muscles inMastication
Involved
55 Muscles (continued)
inMastication
Neck 56 Teeth
Plates 27-35 (continued)
s7 Teeth
27 Muscles
of NeckLateralView 58 Tongue
n Muscles
of Neck:Anterior
View (continued)
s9 Tongue
x, Infrahyoid
andSuprahyoid
Muscles andSalivary
60 Tongue Glands:Sections
30 Scalene
andPrevertebral
Muscles 6r Glands
Salivary
3r Superficial
Veins
andCutaneous
Nerves
of Neck Innervation
62 Afferent of MouthandPharynx
32 Cervical
Plexus
inSitu
33 Subclavian
Artery Pharynx
s4 Carotid
Arteries Plates 6$73
3s Fascial
Layers
of Neck 63 Pharynx:
Median
Section
64 Fauces
Nasal Region of Pharynr
65 Muscles (Sagittal)
Median Section
Plates 36*5O
66 Pharynx:
0pened View
Posterior
36 Nose of Pharynx
67 Muscles Partially Posterior
0pened View
s7 LateralWall
of Nasal
Cavity of Pharynx:
68 Muscles LateralView
3a LateralWall Cavig(continued)
ofNasal 69 Arteries
of OralandPharyngeal
Regions
3e MedialWall
ofNasal (Nasal
Cavity Septum) 7o Veins
of 0ralandPharyngeal
Regions
40 Maxillary
Artery 7r Nerves Regions
of 0ralandPharyngeal
4r Arteries
of Nasal
Cavity:
Nasal
Septum
Turned
Up 72 Lymph
Vessels
andNodes
of Head
andNeck
42 Nerves
of Nasal
Cavity:
Nasal
Septum
Turned
Up Vessels
73 Lymph andNodes andTongue
of Pharynx
4s Nerves
of Nasal (continued)
Cavity
44 Autonomic
Innervation
ofNasalCavity
(V,)andMaxillary
4s 0phthalmic (Vr)Nerves
46 Mandibular (V,)
Nerve
4z Nose
andParanasal
Sinuses:
Cross
Section
4g Paranasal
Sinuses
4s Paransal (continued)
Sinsues
so Paranasal
Sinuses:
Changes
withAge
Atlas of l{uman Anatomy

1 Head and Neck
Section
Topographic Anatomy
Plate I
HeadandNeck
Bones and Ligaments

Plales 2-22
z Anterior
Skull: View
s Skull:AnteroposteriorRadiograph
e LateralView
Skull:
s Skull:LateralRadiograph
e Midsagittal
Skull: Section
z Calvaria
e Base:
Cranial View
Inferior
g Bones Base:
ofCranial SuperiorView
to Base:
ofCranial
Foramina View
Inferior
rI Foramina Base:
ofCranial View
Superior
12 SkullofNewborn
13 BonyFramework andNeck
of Head
Fossae
Base:Pterygoid
14 Cranial
r5 Mandible
r6 TemporomandibularJoint
r7 CervicalVertebrae:AtlasandAxis
r8 Cervical (continued)
Vertebrae
i9 Vertebrae:
Cervical Joints
Uncovertebral
20 Degenerative
Changes Vertebrae
intheCervical
2r External Ligaments
Craniocervical
Ligaments
Craniocervical
22 Internal
Atlas of Human Anatomy

Frank H. Netter, MD
rank H. Netterwas born in New York City in 1906. He Dr.Netter'sworks are among the finest examplesof the use
studied ad at the Art Students League and the of illustrationin the teachingof medicalconcepts.The 13-book
NationalAcademy of Design before enteringmedical Netter Collection of Medical lllustrations, which includes the
school at New York University,where he receivedhis Doctor of greater part of the more than 20,000 paintings created by Dr.
Medicinedegree in 1931. During his student years, Dr. Netter's Netter.became and remainsone of the most famous medical
notebook sketches attracted the attention of the medical faculty works ever published. The Netter Atlas of Human Anatomy, first
and other physicians,allowinghim to augmenthis income by il- publishedin 1989, presentsthe anatomicpaintingsfrom the
lustratingadicles and textbooks. He continued illustratingas a Netter Collection.Now translated into 16 languages,it is the
sidelineafter establishinga surgicalpracticein 1933,but he ulti- anatomyatlas of choice among medicaland health professions
mately opted to give up his practicein favor of a full-timecom- studentsthe world over.
mitment to art. After service in the United States Army during The Netter illustrationsare appreciatednot only for their
World War ll, Dr. Netter began his long collaborationwith the aesthetic qualities,but, more importantly,for their intellectual
Company(now NovartisPharmaceuticals).content.As Dr. Netterwrote in l949 "clarificationof a subject is
CIBA Pharmaceutical
This 45-yearpartnershipresultedin the productionof the extra- the aim and goal of illustration.No matter how beautifully
ordinarycollectionof medical art so familiarto physiciansand painted,how delicatelyand subtly rendereda subject may be, it
other medicalprofessionalsworldwide. is of little value as a medical illustration if it does not serve to
lcon Learning Systems acquired the Netter Collection in make clear some medicalpoint." Dr. Netter'splanning,concep-
July 2000 and continuedto update Dr.Netter'soriginalpaintings tion, point of view, and approachare what inform his paintings
and to add newly commissionedpaintingsby artiststrained in and what make them so intellectuallyvaluable.
the styleof Dr.Netter.In 2005, ElsevierInc. purchasedthe Netter Frank H. Netter,MD, physicianand artist, died in 1991.
Collection and all publications from lcon Learning Systems.
Thereare now over 50 publicationsfeaturingthe art of Dr.Netter
availablethrough ElsevierInc.
Preface to the First Edition
have often said that my career as a medical artist for al- and even revisionof a number of them in order to make them
most 50 years has been a sort of "command performance" more pertinentto today's ever-expandingscope of medicaland
in the sense that it has grown in responseto the desires surgicalpractice.In addition,I found that there were gaps in the
and requestsof the medicalprofession.Over these many years, portrayalof medical knowledgeas pictorializedin the illustra-
I have producedalmost 4,000 illustrations,mostly for The CIBA tions I had previouslydone, and this necessitatedmy making a
(now Netfer) Collection of Medical lllustrations but also for numberof new picturesthat are includedin this volume.
ClinicalSymposla.These pictures have been concerned with the In creatingan atlas such as this, it is importantto achievea
varied subdivisionsof medical knowledge such as gross happy medium between complexity and simplification.lf the
anatomy, histology,embryology,physiology,pathology, diag- picturesare too complex,they may be difficultand confusingto
nostic modalities,surgicaland therapeutictechniquesand clin- read; if oversimplified,they may not be adequatelydefinitiveor
ical manifestationsof a multitudeof diseases.As the yearswent may even be misleading.I have thereforestriven for a middle
by, however,there were more and more requestsfrom physi- course of realism without the clutter of confusing minutiae. I
cians and students for me to produce an atlas purely of gross hope that the studentsand membersof the medicaland allied
anatomy.Thus, this atlas has come about, not through any in- professionswill find the illustrationsreadilyunderstandable,yet
spirationon my part but rather,like most of my previousworks, instructiveand useful.
as a fulfillmentof the desiresof the medicalorofession. At one point,the publisherand I thoughtit might be niceto
It involvedgoing back over all the illustrationsI had made include a foreword by a truly outstanding and renowned
over so many years,selectingthose pertinentto gross anatomy, anatomist,but there are so many in that categorythat we could
classifyingthem and organizingthem by system and region, not make a choice. We did think of men like Vesalius.Leonardo
adapting them to page size and space and arrangingthem in da Vinci,WilliamHunterand HenryGray,who of course are un-
logicalsequence.Anatomy of course does not change,but our fortunatelyunavailable,but I do wonder what their comments
understandingof anatomy and its clinical significancedoes might have been about this atlas.
change,as do anatomicalterminologyand nomenclature.
This
thereforerequiredmuch updatingof many of the older pictures Frank H. Netter.MD
(1906-1991)
Gontents
Section 1
Anatomy
Topographic Plate 1
Bones andLigamenb Plates 2
SuperficialFace Plates 23-26
Neck Plates 2 5
NasalRegion Plates 36-50
OralRegion Plates 51-62
Pharynx Plates 63-73
ThyroidGlandandLarynx Plates 74{;0
0rbitandGontenb Plates 81-91
Ear Plates 92-98
Meninges andBrain Plates 9S-115
Cranial Nerves
andCervical Plates 11ts135
CerebralVasculature Plates 136-148
RegionalScans Plates 14S-151
Section2
Anatomy
Topographic Plate 152
andLigamenb
Bones plates 1S3_159
SpinalCord Plates 160-173
andNerves
Muscles Pfates 171180
Section3
Anatomy
Topographic Plate 181
MammaryGland Pfates 182-184
Wall
Body Plates 18ts195
Lungs Plates 196-210
Heart Plates 211-229
Mediastinum Plates 23F241
Regional
Scans Pfate 242
Anatomy
Cross-Sectional Pfates 24T246
Section4
Anatomy
Topographic Pfate 247
BodyWall Plates 24V267
Peritoneal
Cavity Plates 26F274
(Gut)
Viscera Pfates 27Y285
(Accesory
Viscera Organs) Plates 28F299
Vasculature
Visceral Plates 300-317
lnnervation Plates 318-328
Kidneys Glands
andSuprarenal Pfates 32Y347
AbdominalSections Plates 34f349
Regional
Scans Plate 350
Section 5
TopographicAnabmy Plab 351
Bones andLigamenb Plates 3 55
PelvicFloorandContenb Platm 35F364
UrinaryBladder Plates 36S368
Vagina,
Uterus, andSupporting
Sfrncfures Plah 3f375
RegionalTransverceSection Hate 376
Perineum andExternalGenihlia:
Female Platc 377-379
Perineum andExtemal Male
Geniblia: Phtes 3flH87
Homologues of Geniblia Plates 388-389
Epididymis,
Testis, andDuctusDeferens Plate 390
Restum Hatos 391-396
Regional
Scans Plate 397
Vasculafure platc 399_409
Innervation Pfates 10/J-4.17
Section6
Topographic
Anabmy Plato 418
Shoulder
andAxilla Haho 419-430
Arm Plabs 431-435
ElbowandForearm Phbs 136-151
WristandHand Habs 452471
Neurcvasculature Pfatas 17243
Regional
Scans Hah 4U
Section 7
Topognaphic
ftrabmy i Plate 48s
HipandThigh Platc 48H05
Knee Plabs 5(H12
Leg Plabe 51 22
AnkleandFoot Plabs 52 37
Neurovasculature Plabs 5$tl6
Regional
Scans Plate il7
ion I
KeyFigure
forCross
Sections
References
lndex
Head and Neck
Thyroid Gland and Larynx Meninges and Brain

Plates 74-80 Plates 99-l 15
74 Thyroid View
Gland:Anterior 99 Veins
andDiploic
Meninges
7i Thyroid
Gland
andPharynx:
Posterior
View Arteries
too Meningeal
?6 Parathyroid
Glands lol Hematoma
Epidural
of Larynx
7z Cartilages to2 Meninges Veins
Cerebral
andSuperficial
zs Intrinsic
Muscles
ofLarynx t03 Venous
Dural Sinuses
7s Actions
ofIntrinsic
Muslces
ofLarynx Venous
t 0 4 Dural (continued)
Sinuses
Bo Nerves
of Larynx t05 Lateral
Cerebrum: Views
t06 MedialViews
Cerebrum:
Orbit and Gontents View
Inferior
t 0 7 Cerebrum:
Plates 8l-9t t08 of Brain
Ventricles
Br Eyelids r09 Fluid
ofCerebrospinal
Circulation
s2 LacrimalApparatus t t o Basal
Nuclei(Ganglia)
so Fascia
ofOrbit
andEyeball tll Thalamus
EyeMuscles
a4 Extrinsic 112 andFornix
Hippocampus
85 Arteries
andVeins
ofOrbit
andEyelids r'rs Cerebellum
86 Nerves
of 0rbit r re Brainstem
s7 Eyeball andCerebellum
Ventricle
r rs Fourth
80 Anterior
andPosterior of Eye
Chambers
8e LensandSupporting
Structures Granial and Gervical Nerves
90 Intrinsic
Arteries
andVeins
of Eye Plates ttFl35
er Vascular
Supply
ofEye Ir6 Nerve
Cranial inBrainstem:
Nuclei Schema
117 Cranial Nuclei
Nerve Schema
inBrainstem: (continued)
Ear (Motor
Nerves
t t 8 Cranial Distribution):
andSensory Schema
Plates 92'8 tt9 Nerve
0lfactory (l):Schema
92 Pathway
ofSound
Reception 12|' 0pticNerve(ll)(Visual Pathway):Schema
93 EarandTympanic
External Cavity 121 Oculomotor (lll),Trochlear (Vl)Nerves:
(lV),andAbducent
94 Tympanic
Cavity Schema
95 BonyandMembranous
Labyrinths 122 TrigeminalNerve (V):Schema
96 BonyandMembranous (continued)
Labyrinths 123 Facial
Nerve(Vll):
Schema
g7 Orientation
ofLabyrinth
inSkull Nerve
124 Vestibulocochlear (Vlll):
Schema
98 (Pharyngotympanic,
Auditory Tube
Eustachian) 125 Glossopharyngeal (lX):
Nerve Schema
126 Vagus (X):Schema
Nerve
nerve(Xl):Schema
127 Accessory
Nerve
l 4 Hypoglossal (Xll):
Schema
14, Plexus:
Cervical Schema
inNeck
Nerves
r 3 0 Autonomic
t 3'l Nerves
Autonomic inHead
Atlas of l{uman Anatomy

Head and Neck
roz Ciliary
Ganglion:
Schema rlz Arteries
ofBrain:
Lateral
andMedialViews
rse Pterygopalatine
andSubmandibular
Ganglia:
Schema reo Arteries
of Posterior
Cranial
Fossa
r34 0ticGanglion:
Schema rs Veins
of Posterior
Cranial
Fossa
rss TastePathways;
Schema rru Deep
Veins
ofBrain
rrc SubependymalVeins
ofBrain
Gerebral Vasculature rlz Hypothalamus
andHypophysis
Plates 136-148
rre Arteries
andVeinsof Hypothalamus
andHypophysis
r se Arteries
to Brain
andMeninges
rsz Veins
oftheVertebral
Column-Vertebral
Veins Regional Scans
rse Arteries
to Brain:
Schema Plates l4$-l5l
rss Arteries
ofBrain:
Inferior
Views res Head
Scans:
Sagittal
MRlmages
reo CerebralArterial (ofWillis)
Circle r50 Head
Scans:Axial
CTlmages
rer Arteries
ofBrain:
Frontal
ViewandSection rsr Head
Scans: CTlmages
Coronal

Foreword
he Fourth Edition of Atlas of Human Anatomy by the uncovertebraljoints of the cervicalvertebrae,the vertebral
Frank H. Netter, MD, has been updated by our veins, and the intricate vasculatureof the eye, to mention a few,
Consulting Editor team of Jennifer K. Brueckner, with artistic brilliance,anatomicalprecision,and visual appeal
Stephen W. Carmichael,Thomas R. Gest, Noelle A. Granger, that is unsuroassed.The sectionincludesa concisetreatmentof
John T. Hansen,and Anil H. Walji.We haveeach reviewed,mod- the centralnervoussystem,includingthe cranialnervesand im-
ified, and updated a section of the Atlas. Throughoutthe book, portant central pathways.
new radiographs,computed tomographic(CT) images,CT an- In the Back section, a new plate illustrates the proper
giograms, and magnetic resonance (MR) images have been placementof a lumbar epiduralanestheticagent,as well as the
added, which reflectsthe importanceof diagnostic imaging in locationfor lumbarpunctureor "spinaltap." Autonomicsare tra-
clinicalanatomyand medicine.In this edition,45 plates have ditionallythe bane of many students,and excellentnew draw-
been revised to show corrected anatomicalrelationships,290 ings of the autonomicnervoussystem by Dr.Machadowill serve
plates have been relabeled,and there are 17 completelynew as a new educationalresourcefor these difficultconcepts.
plates.Wonderfulnew artworkfor this edition has been created The Thorax section underwent minor editorial corrections
by Carlos A. G. Machado, MD, who has contributed to the of terminologyand subtle artwork modificationsto more accu-
Netter illustrationsfor over ten years.Anatomicalnomenclature rately reflect the most common anatomical patterns. For in-
has been broughtup to date, and clinicalterms and eponymsin stance, the representationof the azygos venous system pat-
common usage have been included parenthetically.
The genius tern was altered to reflect the most common arrangementof
of Dr. Netter'spaintingsis that the anatomyis portrayedclearly, thesehighlyvariableveins.The inclusionof the thoraciccross-
realistically,
and in a clinicallyrelatablefashionwhile maintaining sectional images at the end of the section, rather than in the
the balance between complexity and oversimplification.We later section, reinforcesthe importanceof knowledgeof cross-
have tried to adhere to these principlesin the creation of the sectional anatomy in the interpretationof cross-sectionalMR
new plates for this edition. Finally,some of the plates were re- and CT images.
arrangedas page-pairs,whereappropriate,to facilitateside-by- The Abdomen section has had the most extensiverevision
side comparisonsof commonly illustratedelements.This fourth for labelchangesand positioningof leaderlines.By popularre-
edition owes much to the consultingeditors of the earlieredi- quest,the plateshowingthe common variationsin the branches
tions, Drs.SharonColacino(Oberg)(firstedition),ArthurF.Dalley of the celiac artery which appearedin the first editionAbdomen
ll (secondedition),and John T. Hansen(thirdedition),who shep- section,has been reinstated.
herded their editions with great skill and uncompromisingpro- The anatomy of the pelvis is a particularlydifficult area to
fessionalism,making our task significantlyeasier. teach and, becauseof the depth and tight organizationof the in-
The head and neck is a particularlychallengingareafor stu- ternal structures,difficultto illustrate.The Netter illustrationsof
dents, residentsand facultyto master,due not only to the sheer pelvic anatomy are outstandingbecause of the clarity of their
numberof structurespacked in this relativelysmall regionof the presentationand their scope of coverage.A very small number
human body, but also the complexityof their three-dimensional of plates were eliminatedto permit the inclusionof the illustra-
anatomical organization.The age-old aphorism that "there is tion of pelvic fascia, a parasagittalview of the broad ligament,
more anatomy above the hyoid bone than below it" presentsa and normal imaging (male and female radiographs,cys-
uniquechallengeto anyonetrying to portraythe anatomyof this tourethrograms,and a hysterosalpingogram).
Comparativeim-
region in a simple, visually appealing, and clinically relevant ages of male and female pelvicanatomywere reorganizedto al-
manner.More than ten new plateshave been added to this sec- low their side-by-sidecomparison.
tion. For the first time, spectacularoriginalpaintingscreatedby New CT angiogramshave been includedin the Upper Limb
CarlosMachadoillustrateclinicallyimportantstructuressuch as and Lower Limb sections.This new technologynot only clearly
Foreword
demonstratesblood vessels,but vividlyshows bony landmarks help you better understandanatomy and its applicationto the
to which the blood vessels are related.The ligamentsof the practice of clinical medicine.More informationabout the web-
wrist have been illustrated in more detail to reflect their in- site, includingthe PIN code for access,can be found on the in-
creasedimportancein arthroscopicproceduresand other appli- side front cover of the Aflas.
cations of new technologyto this joint. JenniferK. Brueckner,PhD
We hope you enjoy this new edition of the Aflas of Human StephenW. Carmichael,PhD, DSc
Anatomy and that you find it usefulfor learningand for your ca- Thomas R. Gest, PhD
reer.For the standardeditionand enhancedinternationaledition NoelleA. Granger,PhD
of the Aflas, we have included access to the website www. John T. Hansen,PhD
netteranatomy.com.By registeringon this website, you will be Anil H. Walji,MD, PhD
able to accesssupplementalmaterialthat has been organizedto
Acknowledgments
It has been my pleasureto work with the other membersof the I would liketo thank MarybethThiel,Developmental
Editor,our
editorial board, Carlos Machado, MD, and the Elsevierstaff. superb medical illustratorDr. Carlos Machado, and the entire
Specialthanks go to John Hansen,PhD, for the opportunityto Editorial,Production,Design,lllustration,and Marketingstaff at
work on this editorialteam. I am indebtedto my family for the Elsevierfor shepherdingthis edition to completion.For all our
support and encouragementthat they have provided. students,past, presentand future,this Aflas is for you. Finally,
to my wife, Paula,thank you for your love and encouragement
-Jennifer K. Brueckner PhD throughoutthe years.
-John T Hansen, PhD

I would like to thank the specialistsat the Mayo Clinic who
helped review the art, especiallyRichardA. Berger,MD, PhD,
Shawn W. O'Driscoll,MD, PhD, EnriqueA. Sabater,MD, and I would like to thank my wife, Parviz,and my daughters,Amreen
RobertJ. Spinner,MD. and Farah,for their patienceand constant support and encour-
agement during my involvementwith this project. My special
-Stephen W. Carmichael,PhD, DSc thanks go to Dr. Carlos Machado,who has my utmost admira-
tion for his brilliantartwork and who was an absolutedelight to
work with. I would also like to expressmy sincereappreciation
I must thank my family and especiallymy daughter,Madison, to all the wonderfulstaff at Elsevier,in particularLinda Belfusfor
and son, Taylor,for their support and understandingof my ef- her exemplaryleadership,and Anne Lenehan,MarybethThiel,
fofts on this editorialtask. lt was a pleasureto work with my col- and Cecelia Bayruns for all of their hard work, patience,and
leagueson the editorial board and with the staff of Elsevier.lt dedication,without which this atlas would not have been possi-
has been my sincerepleasureto work with Dr. Carlos Machado ble. Finally,I would like to thank my fellow coeditorsand all of
on the artwork changesfor the 4th edition. my colleagueswho helpedwith reviewingthe plates,in particu-
lar PierreLemelin,PhD,and DanielLivy,PhD,whosemeticulous
-Thomas R. Gest, PhD examinationof the artwork has helped greatly in ensuringthe
accuracyof the head and neck sectionin this edition.
I am deeply grateful to my colleaguesat Universityof North -AnilH. Walji, MD, PhD

CarolinaSchoolof Medicine:JamesScatliff,MD, formerChairof
the Departmentof Radiology,
for his help with the imaging,and
O.W Henson, PhD, ProfessorEmeritusof Anatomy,for his in-
put. I especiallythank Carlos Machado, the exceptionalartist
whose talent made any change requiredin the originalplates
both seamlessand beautiful.
-Noelle A. Granger,PhD
Head and Neck
Frontal
bone
Supraorbital Zygomatic bone

notch
Superciliary
arcn
Helix
Tragus
Antihelix
Nasal
oone
Antitragus
Ala of nose
A n t e r i o rn a r e s
(nostril) Lobule
C o m m i s s u roef l i p s
Philtrum
A n g l eo f j a w ( m a n d i b l e )
Nasolabial
s ut c u s S u b m a n d i b u lgalra n d
T u b e r c loef
s u p e r i olri p E x t e r n aj lu g u l a rv e i n
Mental l n f e r i o rb e l l vo f o m o h v o i d m u s c l e
protuberance
Brachialplexus
T h y r o i dc a r t i l a g e
Trapeziusmuscle
-"*r
. l u g u l anr o t c h C l a v i c u l a hr e a d o f
s t e r n o c l e i d o m a s t o im
du s c l e
S t e r n ahl e a do f
s t e r n o c l e i d o m a s t o im
du s c l e
C/Fd4g/*
Topographic Anatomy Plate I

Skull: Anterior View
Frontal bone C o r o n a ls u t u r e
Clabell.r
Parietalbone
Supraorbital
notch(foranren)
S p h e n o i db o n e
O r b i t a ls u r f a c e e s s e rw r n g
Nasal bone C r e a t e rw l n g
Temporalbone
L a c r i m a lb o n e
E t h m o i db o n e
Zygomatic bone O r b i t a lp l a t e
P e r p e n d i c u l aprl a t e
Frontap
l rocess
O r b i t a ls u r f a c e M i d d l e n a s a lc o n c h a
Tenrporal process
Inferior nasal concha
Zygom at icofac iaI
toramen Vomer
*;o
Maxilla
Z y g o m a t i cp r o c e s s
rl
'\
Mandible
Ramus
4{r
O r b i t a ls u r f a c e Body
^.,,
I n f r a o r b i t aflo r a m e n { M e n t a lf o r a m e n
\,,
Frontap
l rocess M e n t a lt u b e r c l e
A l v e o l a rp r o c e s s M e n t a lp r o t u b e r a n c e
A n t e r i o rr r a s asl p i n e
R i g h t o r b i t : f r o n t a l a n d s l i g h t l yl a t e r a lv i e w
O r b i t a l s u r f a c eo f f r o n t a lb o n e P o s t e r i oar n d
Anterior
O r b i t a ls u r f a c eo f l e s s e r e t h m o i d a lf o r a m i n a
w i n g o f s p h e n o i db o n e
O r b i t a lp l a t eo f
S u p e r i o ro r b i t a lf i s s u r e e t h m o i db o n e
( ) p t i c c a n a l( f o r a m e r . r )
L a c r i m a bl o n e
O r b i t a ls u r f a c eo f g r e a t e r
w i n g o f s p h e n o i db o n e F o s s af o r l a c r i m a sl a c
O r b i t a ls u r f a c eo f O r b i t a l p r o c e s so f
z y g o n r a t i cb o n e p a l a t i n eb o n e
I n f e r i o ro r b i t a lf i s s u r e
O r b i t a ls u r f a c e
Infraorbital!lroove of maxilla
Plate 2 Bones and Ligaments

Skull: Anteroposterior Radiograph
A Angleof mandible
C Cristagalli
E Ethmoidair cells(sinuses)
F Frontalsinus
G Createrwingof sphenoid
L Lesser wing of sphenoid
M Maxillarysinus
R R a m u so f m a n d i b l e
Bones and Ligaments Plate 3

Skull: Lateral View
S p h e n o i db o n e Parietalbone Temporalfossa Iemporal bone
C r e a t e rw i n S q u a n r o u sp a r t
Frontal bone Z y g o m a t i cp r o c e s s
C o r o n a ls u t u r e
Supraorbital A r t i c u l a rt u b e r c l e
notch(foramen) Pterion
Croovefor posterior
Clabella d e e p t e m p o r a la r t e r y
E t h m o i db o n e E x t e r n aal c o u s t i c
meatus
O r b i t a lp l a t
M a s t o i dp r o c e s s
L a c r i m a lb o n e
F o s s at o r L a m b d o i ds u t u r e
l a c r i m a sl a c
Occipital bone
Nasal bone L')
Sutural (wormian)
bone
Maxilla
External
----)a-
Frontalprocess occipital
I n fr a o r b i t a l protuberance
foramen
Anterior
Mandible
H e a d o f c o n d y l a rp r o c e s s
Zygomatic bone M a n d i b u l a rn o t c h
Zygom aticofacial C o r o n o i dp r o c e s s
foramen Ramus
T e m p o r a lp r o c e s s O b l i q u el i n e
Body
M e n t a lf o r a m e n
Z y g o m a t i ca r c h
lnfratemporalfossaexposedby C r e a t e rw i n g
removalof zygomaticarchand mandible*- I n f r a t e m p o r acl r e s t
L a t e r a pl l a t eo f
P t e r y g o m a x i l l a rfyi s s u r e p t e r y g o i dp r o c e s s
P t e r y g o i dh a m u l u s
I n f e r i o ro r b i t a lf i s s u r e ( o f m e d i a lp l a t eo f
p t e r y g o i dp r o c e s s )
I n f r a t e m p o r asl u r f a c eo f m a x i l l a
Temporal bone
A l v e o l a rf o r a m i n a
Forame E x t e r n aal c o u s t i c
ovale meatus
T u b e r o s i t yo f m a x i l l a
./.1 M a n d i b u l a rf o s s a
.-*F
n '.
_a*-
'";*-"t A r t i c u l a rt u b e r c l e
P t e r y g o p a l a t i nfeo s s a
S t y l o i dp r o c e s s
S p h e n o p a l a t i nfeo r a m e n
* S u p e r f i c i a l l ym, a s t o i dp r o c e s sf o r m s p o s t e r i o r
bourrcrary

Skull: Lateral RadiograPh
Anterior arch of atlas C Creater wing of

(Cl vertebra) sphenoid
c C o n d y l eo f m a n d i b l e H Hypophysealfossa(sellaturcica)
C P Coronoid processof L L a m b d o i ds u t u r e
mandible M M a x i l l a r ys i n u s
cs Coronal suture MS Mastoid air cells
D D e n s o f a x i s( C 2 P Palatineprocessof
vertebra) maxilla
F r o n t a ls i n u s S S p h e n o i ds i n u s

Skull: Midsagittal Section
Sphenoidbone Temporalbone
Parietalbone
Creater wing part
Coronal Croovesfor
Lesser wing sutur branches Petrouspart
of middle
Anteriorclinoid meningealvessels lnternalacousticmeatus
process '?t'zt*
tr.M,I:ltg Groovefor superior
Optic canal petrosalsinus
Sellaturcica
Externalopeningof
S o h e n o i d sa il n u s vestibularaqueduct
Body
Croove for
Medialand lateral s i g m o i ds i n u s
platesof
pterygoid
process
Lambdoidsuture
Frontalbone
Frontalsinus
Ethmoidbone Occipital bone
Cristagalli
for
Cribriformplate sinus
transverse
Perpendicular
plate(bony ;'--- Externaloccipital
nasalseptum) protuberance
foramen
Jugular
Nasalbone
Croove for inferior
Inferior nasal petrosalsinus
concha
Hypoglossal
canal
Maxilla
Foramenmagnum
Anterior
nasalspine Occipitalcondyle
Palatinebone
Nasalsu
Vomer(bonynasalseptum) part
Incisivecanal
Palatine
Alveolar process
Frontalbone
Openingof sphenoidal
sinus
Nasalbone 1l':
Ethmoidbone foramen
Sphenopalatine
Cribriformplate
Superior nasalconcha
Middle nasalconcha
Sphenoidbone
Lacrimalbone
Body
Inferior nasalconcha Medial I -.
Platesof PterYgoidProcess
1;il i
Maxilla Pterygoidhamulus
Nasalsurf
Palatineprocess
Perpendicularplate
Alveolar process
Horizontalplate
View of lateral nasalwall with nasalseptum removed

I
euluttn"
non"
*{r
Galvaria
Superiorview
Frontalbone
Coronalsuture
Bregma
Parietalbone
Sagittal
suture
Parietalforamen (for emissaryvein)
Lambdoidsuture
Sutural(wormian)
bone
Occipital
Inferior view
Frontalbone
Frontalcrest
Croovefor superiorsagittalsinus
Coronalsuture
Parietal
bone
Cranularfoveolae
(forarachnoidgranulations)
Diplod
Croovesfor branches of
m i d d l em e n i n g e av le s s e l s
Croovefor superiorsagittal
sinus
suture
Sagittal
ambdoidsuture
ipitalbone 4{tr

Granial Base: Inferior View
Maxilla
I n c i s i v ef o s s a
Palatineprocess
Intermaxillary
suture
Zygomaticprocess
Zygomatic bone
Frontal bone
Palatomaxillary
suture
Sphenoidbone
Pterygoidprocess .b
Uit
Hamulus Palatinebone
M e d i ap
l late Horizontal plate
Pterygoidfossa ir C r e a t epr a l a t i n feo r a m e n
Lateralplate Pyramidal process
Scaphoidfossa L e s s epr a l a t i n feo r a m i n a
C r e a t e rw i n g
Posterior nasalspine
Foramenovale
F o r a m e ns p i n o s u m
Spine
Choanae
Temporalbone
Zygomaticprocess Vomer
A r t i c u l atru b e r c l e
Mandibularfossa Ala
Styloidprocess
for auditory
Petrotvmoanic fissure (pharyngotympanic,
C a r o t i dc a n a l( e x t e r n aol p e n i n g Eustachian)tube
Tympaniccanaliculus
Externalacousticmeatus Foramenlacerum
M a s t o i dc a n a l i c u l u s
Mastoid process
Stylomastoidforamen
Petrous
part
Mastoid notch (for
d i g a s t r i cm u s c l e )
Occipital groove
(for occipital artery)
J u g u l a fr o s s a
(jugularforamen in its depth
Mastoid foramen
Parietalbone
Occipitalbone
Hypoglossal canal
O c c i p i t acl o n d y l e
Condylar canal and fossa
Basilarparl
Pharyngeal
tubercle
F o r a m e nm a g n u m
I n f e r i o rn u c h a ll i n
Externaloccipital crest
S u p e r i o rn u c h a ll i n e
Externaloccipital protuberance
Nr
Bones of Granial Base: Superior View
Frontalbone
C r o o v e f o r s u p e r i o rs a g i t t asl i n u s
Frontalcrest
C r o o v e f o r a n t e r i o rm e n i n e e a l
F o r a m e nc e c u m
Superiorsurfaceof orbital part
Ethmoidbone
C r i s t ag a l l i
Cribriform plate
*
tr Anterior
t
Sphenoidbone
L e s s ewr ing ,rr t fossa
A n t e r i o rc l i n o i dp r o c e s s ,{
*
C r e a t e rw i n g
C r o o v e f o r m i d d l em e n i n s e a l
v e s s e l s( f r o n t a lb r a n c h e s )
Body
Jugum
I
Prechiasmaticgroove Middle
t
: cranial
tl
fossa
I
I
Carotid g r o o v e ( f o r i n t . c a r o l i da . t
Clivus
Temporal bone
S q u a m o upsa r t
Petrous part
Croove for lesseroetrosalnerve
Croove for greaterpetrosalnerve
A r c u a t ee m i n e n c e
T r i g e m i n ailm p r e s s i o n Posterior
C r o o v e f o r s u p e r i o rp e t r o s a sl i n u s cranial
C r o o v e f o r s i g m o i ds i n u s fossa
Parietalbone
C r o o v e f o r m i d d l em e n i n g e a l
v e s s e l s( p a r i e t ahl r a n c h e s r
M a s t o i da n g l e
Occipitalbone
Clivus
Croove for inferior oetrosal
Basilap r art
Croove for posterior m e n i n g e a vl e s s e l s
Condyle
Croove f o r t r a n s v e r s e sinus
Croove f o r o c c i p i t a ls i n u s
Nr
I nternal occipital crest
l n t e r n a loccipital protuberance
C r o o v e f o r s u p e r i o rs a g i t t asl i n u s

Foramina of Granial Base: lnferiot View
Nasopalatinenerve)
sph";;pi;il;" Incisivefossa
""tldtil
Greaterpalatinenerveandvessels ------ Greaterpalatineforamen
Lesserpalatinenerveandvessels ------ Lesserpalatineforamen
Createrpetrosalnerve------ Foramenlacerum
Lesserpetrosalnerve)
Mandibularnerve(Vr)t----- Foramen
ovale
Accessorymeningealartery)
Middle menineealvessels
I -----
Meningealur"n.h o?-minii"di;?;r;;u;j Foramenspinosum
I
Internalcarotidarteryl------Larotlo
Carotidautonomicplexusf canal
Chordatympaniof facialnerve(Vll)------ Petrotympanic

Tympanicbranchof glossopharyngealnerve(lX)------Tympanic canaliculus
Auricularbranchof vagusnerve(X)------ Mastoidcanaliculus
Facialnerve(Vll)------ Stylomastoid
for
Glossopharyngeal nerve(lX)\
Vagusnerve(X)/
Spinalrootsofaccessorynerves(Xl))----- Jugular
InternaliugularveinI
Inferiorp6trosalsinus)
Mastoidemissary
vein) -- - -Mastold
Posterior
meningeal
irtery|-- roramen
nerve(Xll)-------
Hypoglossal Hypoglossal
canal
Plate I O Bones and Ligaments

Foramina of Granial Base: Superior View
Foramencecum----- vein to superiorsagittalsinus

Emissary
Nasalslit I J Anteriorethmoidalartery,vein,
Anteriorethmoidalforamen t I and nerve
of cribriformplate-----Olfactory nervebundles
Foramina
ethmoidalforamen----
Posterior ethmoidalartery,
Posterior vein,
and nerve
opric
canar ljl".,
I 3Bilt.n:i#:
Foramenrotundum--- Maxillarynerve(Vz)
( Mandibularnerve(Vr)
amenovale-- - { Accessorymeningealartery
( Lesserpetrosalnerve(occasionally)
Foramen
spinosum I M:11i"rg:tffi?13?'fl1"Tfl,j3',".",
foramen(of Vesalius)
Sphenoidemissary (inconstant)
Carotidcanalfor - { Internalcarotidartery
I Internalcarotidnerveplexus
Hiatusfor Lesserpetrosalnerve
Hiatusfor Createrpetrosalnerve
{ Facialnerve(Vll)
Internalacousticmeatus------{ Vestibulocochlearnerve(Vlll)
( Labyrinthineartery
Externalopeningof
-----
vestibular'aqueduct Endolymphatic
duct
--- Emissary
Mastoidforamen(inconstant) vein(andoccasional
branchof occipitalartery)
meningeal
''(' - - - - I tl:1:t::.:and pharyngeal branch
condylarcanal(inconstant)
I of ascending artery
canal------
Hypoglossal nerve(Xll)
Hypoglossal
4{F
Bones and Ligaments Plate I t

Skull of Newborn
Lateralview
Anteriorfontanelle Parietal bone
Tuber(eminence)
Sphenoidal
fontanelle
Frontalbone suture
Squamous
Squamous part
notch(foramen)
Supraorbital Posteriorfontanelle
Ethmoidbone Lambdoidsuture
Anteriorethmoidal
foramen bone
Orbitalplate
Mastoidfontanelle
Temporalbone
Maxilla
Infraorbital
foramen part
fissure
Petrosquamous
Zygomaticbone Sphenoid
Zygomaticofacial
foramen bone Petrouspart
(mastoidprocessabsent)
Greaterwing
Palatinebone Lateralplateof Tympanicpart (bony external
Pyramidal pterygoidprocess acousticmeatusabsent)
Hamulusof medial
plateof pterygoid al (vestibular)
window
process
Round(cochlear)window
Styloidprocess
Mandibularfossa
Zygomaticprocess
Frontalbone
Anteriorfontanelle
Coronalsuture
Parietalbone
Sagittal
suture
Posteriorfontanelle
Occipital bone Lambdoidsuture
*{r
Bony Framework of Head and Neck
Temporalbone
Temporalfossa
Zygomatic arch
C o n d y l a rp r o c e s so f m a n d i b l e
M a n d i b u l a rn o t c h
Coronoid orocessof mandible
Lateralpterygoid plate (broken line)
Hamulusof medialpterygoidplate(broken/ine)
Mastoid
process
raphe(brokenli ne)
Pterygomandibular
External
a c o u s t imc eatus
( Ramus
M a n d i b l e{ A n g l e A t l a s( C 1 )
( Body- Styloidprocess
A x i s( C 2 )
S t y l o h y o i dl i g a m e n t
Stylomandibular
( Bodv ligament
H v o i db o n e{ L e s s bhro r n-
( C r e a t ehr o r n C3 vertebra
Epiglottis C7 vertebra
Thyroid cartilage
C r i c o i dc a r t i l a g e
Trachea
Tl vertebra
1st rib
2nd cervicalto 1stthoracicvertebrae:

right lateralview
a.
Dens*
Suoeriorarticularfacet
Foramen
um
transverSafl
Spinous
processes Intervertebral
f o r a m i n af o r
spinalnerves
Articularpillarformed by for spinal

articularprocessesand nerve In transverse
interarticularparts process
(parsinterarticularis)
Zygapophyseal Cervical vertebrae (spine): lateral radiograph
(facet)joints
S SpinousProcess(axis)
T Transverseprocess
V P S p i n o u sp r o c e s so f C Z
Spinousprocessof C7 ( v e r t e b r aP r o m i n e n s )
(vertebraprominens) Z Zygapophyseal(facet)joint
Costalfacets
(for l st rib) 1-7 Bodieso{ cervicalvertebrae
... Cervicalcurvature
r-r Vertebral canal
Bones and Ligaments Plate t 3

Granial Base: Pterygoid Fossae
Posteriorview
External
occipitalprotuberance
S u p e r i onr u c h alli n e
External
occipitalcrest
Nasalseptum
lnferior nuchal line Choana(posteriornasal
aperture)
F o r a m e nm a g n u m
lnferior orbital fissure astoid foramen
Occipitomastoid
suIUre
al condyle
Mastoid proCss-
Styloidprocess Lateralpterygoidplate
Pterygoidfossa Medialpterygoidplate
Zygomaticarch Scaphoidfossa
Horizontal plate of palatinebone Pyramidalprocessof
oalatinebone
Inferior concha
Tuberosity
of maxilla Pterygoidhamulus
processof maxilla
Palatine Alveolar orocessof maxilla
lncisivefossa
Cfd4/*
Inferolateral view
S p i n eo f s p h e n o i db o n e
Foramenovale \ _,
Sphenopalatineforamen
Pterygopalatinefossa
Choanae (posteriornares)
*{r
Tuberosityof maxilla
Infratemporalfossa
Pyramidalprocessof palatinebone
Alveolar processof maxilla

Mandible
Head
Attachmentsfor major Condylar process Lateralpterygoid

musclesof mastication Pterygoidfovea
Coronoid process Neck
Attachmentsfor Temporalis M a n d i b u l a rn o t c h
accessorvmusclesof Lingula
mastication Mylohyoid groove
Mandibular,,TemPoralis
O b l i q u el i n e
Buccinator
S u b m a n d i b u lfaors s a
Mylohyoid line
S u b l i n g u faol s s a
Interalveolar
sepra Masseter
Alveolar part (crest)

Mental foramen
Mental protuberance
M e n t atl u b e r c l e
B a s eo f m a n d i b l e
Mandibleof adult:
Body anterolateralsuperiorview
l-ateralpterygoid
Coronoid process
Head C o n d y l apr r o c e s s
Neck
L i n g ul a
M a n d i b u l a rn o t c h
M a n d i b u l a rf o r a m e n
Pterygoidfovea
Temporalis
groove
4{F
M y l o h y o i dl i n e
\Angle
Medialpterygoid
S u b m a n d i b u lfaors s a
Digastric fossa
Digastric,anteriorbelly
M e n t asl p i n e s( g e n i atlu b e r c l e s )
Mandibleof adult: Mandibleof aged

left posteriorview person(edentulous)

Temporomandibular Joint
Lateralview
Jointcapsule
Lateral(temporomandibular)
ligament
S p h e n o m a n d i b ulliagra m e n t
Sphenomandibular ligamen t (phantom\
Styloidprocess
Stylomandibular
ligament
Mandibularnerve
Jointcapsule
M i d d l em e n i n g e a l
artery
Auriculotemporal
nerve
Maxillaryartery
Inferioralveolar
Lingualnerve
S t y l o m a n d i b ul iagra m e n t
Mandibularfossa
Articulardisc
Articulartubercle
Medialview
l o i n tc a p s u l e and mylohyoidnerve
faws closed
faws widely
openeo
( h i n g ea n dg l i d i n g
actioncombined) 4{tr
Gervical Vertebrae: Atlas and Axis
t e r i o ra r t i c u l a r
Articularfacet facet (for anterior
for dens arch of atlas)
Transverse Pedicle
process S u p e r i o ra r t i c u l a r
facet for atlas Interarticular
parr
Transverse Vertebral
foramen foramen
Posteriorarch
Suoeriorarticularsurface
of lateralmassfor Posterior
tubercle lnferior articular
o c c i p i t a lc o n d y l e facet for C3
Croove for vertebralartery
Atlas(C1):superiorview Axis(C2):anteriorview
Posteriorarch Dens
Posterior
tubercle P o s t e r i oarr t i c u l a r
facet(fortransverse
Vertebral Superiorarticular ligamentof atlas)
Transverse foramen facet for atlas
process Transverse
lnterarticular
parl
Transverse
foramen Articularfacet
for dens lnferior
l n f e r i o ra r t i c u l a r articular Spinousprocess
surfaceof lateral
Anteriorarch Anteriortubercle process
massfor axis
Atlas(Cl): inferiorview A x i s ( C 2 ) : p o s t e r o s u P e r i o vr l e w
Superior
a r t i c ul a r A t l a s( C 1 )
surface
for occipital
condyle
Posterior
articularfacet
(fortransverse
ligament
of atlas)
Radiosraphof atlantoaxialioint
n{r (openlnduth odontoidview)

masses
A Lateral of atlas(C1vertebra)
D Dens of axis (C2 vertebra)

Gervical Vertebrae (continuedl
Inferioraspectof C3 and superioraspectof C4 showine

the sitesof the facetand uniovertebialarticulations "
c3 Bifidspinousprocess
lnferior aspect
Lamina
Inferiorarticularprocessandfacet Vertebral
foramen
Pedicle
Foramentransversarium
Costallamella
Area for articulationof left uncinate processof C4
Vertebralbody
.{
Left uncinate process
Articularsurfaceof rightuncinateprocess
Superiorarticularprocessand facet
Groove for spinal nerve (C4)
c4
Superioraspect Inferiorarticularprocess
7th cervicalvertebra:anteriorview
Reduplicated
foramentransversarium
lamella ncrnateprocess
Articularsurface
Inferior Articularsurface
articular B o n ys p i c u l e
facet dividingforamen
Body
Posterior tubercle) -
Foramentransversarium ( | ransverse
Anteriortubercle( process
( r n c o n s p r c u o u s) )
7th cervicalvertebra(vertebraprominens):superiorview
Body Articularsurfaceof uncinateorocess

Uncinate orocess
Costallamella Foramen (reduplicated)
transversarium
Foramen t
transversarium
Croovefor C7
I n c o n s p i c u oa
uns t e r i otru b e r c l e
(transverse process)
process(posteriortubercle)
Transverse
Pedicle Superiorarticularprocessandfacet
Inferiorarticularprocess
Lamina
Vertebral
foramen
Spinousprocess
*The foramina
transversariaof C7 transmit vertebral
veins,but notthe vertebral artery,and areasymmetricalin this specimen
eh4s/*
Plate | 8 Bones and Ligaments

Gervical Vertebrae: Uncovertebral Joints
Cervicalvertebrae:antenorvrew
Densof axis
Anteriortubercleof atlas
Anterior arch of atlas
Foramen m
transversariu
foramen
Intervertebral (forC3 spinalnerve)
disc
lntervertebral
A x i s( C 2 ) Vertebralbody
lnferiorarticularprocess(C3)
S u p e r i oar r t i c u l aprr o c e s (sC 4 )
Groovefor spinalnerve
joint (cleft)of Luschka
Siteof uncovertebral
Transverseprocess
Articularcartilageon dens for median
Carotidtubercle atlantoaxialjoint complex
Lateralatlantoaxial
ioint
Uncinate processes Facet(zygapophyseal)
joint between C2 and C3
Vertebra prominens
Firstthoracic vertebra (T1) Axis (C2)
Foramentransversarium
Uncinate processes
A n u l u sf i b r o s u s
joints(clefts)of Luschka
Uncovertebral
N u c l e u sp u l p o s u s
process
lransverse
foramen(forC7 spinalnerve)
lntervertebral
Vertebralbody (C7)
joints of the cervicalspine:anteriorview

The uncovertebral
(C3 to C7 havebeensectionedcoronallyto exposethe loints)
|\
C(d4/* \

Degenerative Ghanges in the Gervical vertebrae
Degenerativechangesin the cervical spine

A t l a s( C 1 ) (ankylosingspondylitis)
A x i s( C 2 )
C3 vertebralbody
(sectioned
in coronalplane)
Complete transversecleft Uncovertebraljoint

i n i n t e r v e r t e b r adli s c with cleft formation
Spreadof cleft formation into

centralportion of intervertebral
disc with age leadingto progressive
degenerativechangesin the disc
Spondylophytes(osteophytes)
Deformed vertebralbodies on uncinateprocesses
a n d l i p p i n go f v e r t e b r a m
l argins
6/Fd4*/*
Narrowine of intervertebralforamen
C7 vertebra
S u p e r i oar r t i c u l aprr o c e s s
Advancedankylosingspondylitiswith
uncovertebral
arthrosisin C4 and C5 Facetjoint ossified
due to advanced
osteoarthriticchange
Advanced spondylophyte(osteophyte) Markedly narrowed

formation on uncinateprocesses intervertebralforamen
may lead to compression
of spinal nerve
Inferiorarticular
processwith facet
Vertebralbody
Uncovertebra.ljoint fused due to extensivespondylophytei Croove for spinal nerve

formation and ossification on transverseprocess
Potentialfor compressionof vertebralartery within foramen transversarium S p i n o u ps r o c e s s
Plate 2O Bones and Ligaments

External Graniocervical Ligaments
Anteriorview
partof occipitalbone
Basilar
Pharyngeal
tubercle
membrane
Anterioratlantooccipital
Capsuleof atlantooccipital
.ioint
A t l a s( C 1 ) Posterior membrane
atlantooccipital
joint (openedup)
Lateralatlantoaxial
Caosuleof lateral A n t e r i o lro n g i t u d i n lai g
l ament
atlantoaxialjoint
Posterioratlantooccipitalmembrane
Posteriorview
A x i s( C 2 )
Capsuleof
zygapophyseal
joint (C3-4)
Capsuleof
atlan tooccipital
Anterior atlantooccipitalmembrane Transverse

process
o f a t l a s( C 1 )
Capsuleof Capsuleof lateral

atlantooccipital joint
atlantoaxial
joint
A x i s( C 2 )
Posterior
atlantooccipital Suboccipitalnerve (dorsal
memDrane artery
r a m u so f C l s p i n a ln e r v e )
Ligamentaflava
o f a x i s( C 2 )
L i g a m e n t u mn u c h a e -
discs(C2-3 and C3-4)
Intervertebral
Zygapophysealjoints (C4-5 and cs-6)
Anterior tubercle of C6 vertebra (carotidtubercle)

S p i n o ups r o c e s s
of C7 vertebra Vertebralartery
( v e r t e b rpar o m i n e n s )
T1 vertebra
4{tr
Rightlateralview

lnternal Graniocervical Ligaments
Clivus(surface feature)
of basilarpartof occipitalbone
Upper part of vertebralcanalwith spinousprocesses
and partsof vertebralarchesremovedto expose
ligamentson posteriorvertebralbodies:posteriorview
Tectorialmembrane
Capsuleof
Deeper(accessory)
partof tectorialmembrane
joint
A t l a s( C 1 ) Posterior ligament
longitudinal
Capsuleof lateral
atlantoaxialjoint
Axis(C2) Alarligaments
Capsuleof
zygapophyseal
joint
(c2-3\
A t l a s( C 1 )
Superiorlongitudinal
band
Cruciate
ligament Transverse
ligamentof atlas
Inferiorlongitudinal
band
Deeper(accessory)
partof tectorialmembrane
Principal part of tectorial membrane removed

to expose deeper ligaments: posterior view
Apicalligamentof dens
Alarligament
A t l a s( C 1 )
Posteriorarticularfacetof dens(for transverse
ligamentof atlas)
Anteriortubercleof atlas
Alarligament Svnovialcavities
Axis(C2)
Cruciateligamentremovedto show
deepestligaments:posteriorview
ligament
Transverse
of atlas
*{r Median atlantoaxialjoint: superiorview

Superficial Arteries and Veins of Face and Scalp
S k i na n d
subcutaneou t is s u e
Scalp E p i c r a n iaapl o n e u r o s i s Parietalemissaryvein
t (galea poneurotica)
(cut to revea/skull)
Middle temporal artery and
Zygomaticoorbitalartery
Transversefacial
artery and vein
Supraorbital
arteryand vein
Supratrochlear
a r t e r ya n dv e i n
Nasofrontalvein
Dorsal nasal
artery and vein
Zygomaticotemporal
a r t e r ya n d v e i n
Angular
arrery
a n dv e i n
Zygomatico-
facialartery Mastoidemissary
and vein v e i na n dm e n i n g e a l
branchof occipital
artery(posterior
Infraorbital
meningeal artery)
a r t e r ya n d
ipitalartery
Deep facialvein and vein (cut)
(from pterygoid
plexus)
Posterior
auricular
arteryand vein
Facialartery and
jugularvein(cut)
External
vein
Retromandibular
Common facial vein
I n t e r n aj ul g u l avr e i n
lnternalcarotidartery
Externalcarotid artery
Common carotid arterY
Lingualartery and vein
Sourcesof arterialsupplyof face

Black: from internalcarotid artery (via ophthalmic artery)
Red: from externalcarotid artery
Nr
Superficial Face Plate 23
Gutaneous Nerves of Head and Neck
SeealsoPlates 32, 36, 45,46,122
Fromophthalmicdivision A u r i c u l a rb r a n c h
o f v a g u sn e r v e ( X )
of trigeminalnerve(V,)
S u p r a o r b i tnael r v e
Supratrochlearnerve
Medial branches
Palpebralbranch of of dorsalrami
lacriman
l erve of cervicalspinal
I n f r a t r o c h l e anr e r v e
nerves
External nasalbranchof Creater occipital

a n t e r i oer t h m o i d anl e r v e n e r v e( C 2 )
3rd occipital
n e r v e( C 3 )
Frommaxillarydivision F r o m4 t h , 5 t h ,
of trigeminalnerve(Vr) 6th, and 7th
nervesIn
I n f r a o r b i tn
ael rve successton
below
Zygomaticofacialnerve
Zygomaticotemporalnerve
Branchesfrom
cervicalplexus
Lesseroccipital
Frommandibulardivision n e r v e( C 2 )
of trigeminalnerve(Vr)
Creatauricular
Mentalnerve n e r v e( C 2 ,3 )
Transversecervical
Buccalnerve n e r v e( C 2 ,3 )
Auriculotemporal
nerve Supraclavicular
n e r v e s( C 3 , 4 )
i Dorsalrami of
Ophthalmicnerve(V,)- i cervicalspinal
nerves
;'1
*\:" N o t e : A u r i c u l a rb r a n c h
of vagus nerve to
Trigeminal externaa l coustic
nerve(V) Maxillarynerve(Vr) m e a t u sa n d s m a l l
a r e ao n p o s t e r o m e d i a l
s u r f a c eo f a u r i c l e
Branchesfrom
Mandibularnerve(Vr) cervicalplexus
4{tr
Plale 24 Superficial Face

Facial Nerve Branches and Parotid Gland
Temporalbranches
Zygomatic branches
Parotidduct
M a i n t r u n ko f
facial nerve Buccalbranches
emerging from
stylomastoidforamen
M a r g i n a lm a n d i b u l a rb r a n c h
Nerve to posterior
belly of digastric
m u s c l ea n d t o
stylohyoid muscle
Cervical branch
Medial pterygoid muscle

Horizontalsection
R a m u so f m a n d i b l e
Main trunk of facial ner Massetermuscle
Mastoid process
Parotidgland
Temoorofacialdivision Temporalbranch
Posteriorauricularnerve
Zygomatic branches
Main trunk of facial nerve
Nerve to posterior belly

o f d i g a s t r i cm u s c l ea n d Buccalbranches
t o s t y l o h y o i dm u s c l e -
Cervicofacialdivision
M a r g i n a lm a n d i b u l a rb r a n c h
*{r Cervicalbranch
Superficial Face Plate 25

Muscles of Facial Expression: Lateral View
S k i na n d
s."re subcutaneous
tissue
{ Epicranial (galeaaponeurotica)
aponeurosis Auricularis
anteriormuscle
Temporalfascia Auricularis
superiormuscle
orbicularisoculimuscle{ o'0""' o"u posteriormuscle
Auricularis
Palpebralpa
I
Occipitalbelly
Frontalbelly(frontalis)
of epicranius
muscle (occipitalis)of
epicranius muscle
Corrugatorsupercilii muscle(frontalis
and orbicularisoculi,partiallycut awa'
Procerus
muscle
Levatorlabiisuperioris
muscle
Levatorlabiisuperioris
alaequenasimuscle
(partiallycut away)
NasalisJ Trrnru"rr"p.rt
muscle( Alarnarty Parotid
fascia
Depressorsepti
nasimuscle Massetericfascia
Orbicularis
orismuscle
Zygomaticus
minormuscle
Investing
layerof
(deep)cervicalfascia
Zygomaticus
majormuscle
Orbicularis
orismuscle
Mentalismuscle
Depressor
labiiinferiorismuscle Deltoid
fascia
Depressor
anguliorismuscle
Buccinator
Risorius
Platvsma
muscle
4{F Sternum
Clavicle
Pectoralismajorfascia
Plate 26 Superficial Face

Muscles of Neck Lateral View
Parotidgland (cut) Massetermuscle
Ramusof mandible S u b m a n d i b u lgalra n d
muscle
Hyoglossus
muscle
Styloglossus
Mylohyoidmuscle
Mastoidprocess
Styloidprocess
muscle
Stylohyoid
Body of
D i g a s t r im
c uscle mandible
(posterior belly)
Middlepharyngeal
muscle
constrictor Digastric
muscle
Longuscapitismuscle (anterior
belly)
S p l e n i um
s uscle
muscl
Sternocleidomastoid Hyoid bone
Levatorscapulaemuscle Thyrohyoidmuscle
/
\ Posterior Omohyoidmuscle
Scalenemuscles{ Middle - (superiorbelly)
( Anterior
muscte
Brachialplexus
Inferiorpharyngeal
muscle
Trapezius muscle
constrictor
Acromion Sternothyroid
muscle
Deltoidmuscle
Omohvoidmuscle(inferiorbelly) of sternum
Manubrium
Clavicle Sternalhead )
muscle
) Sternocleidomastoid
head
Clavicular )
maiormusclei
Pectoralis
*{r
Neck Plate 27
Muscles of Neck Anterior View
Masseter
muscle gastricmuscle(anteriorbelly)
Mylohyoidmuscle
Parotidgland
S u b m a n d i b u lgalra n d
Platysma
muscle Fibrousloopfor
(cutaway) intermediate
digastrictendon
Mastoidprocess Stylohyoid
muscle
Hyoid bone
Digastricmuscle
(posterior
belly)
Carotid sheath External

carotidarterv
Internaljugularvein
Fasciaof infrahyoid
musclesand cut edge Thyrohyoidmuscle
muscle
Thyroidcartilage (superiorbelly)
Sternohyoid
muscle
Investinglayerof (deep)
cervicalfasciaand cut edge Sternothyroid
muscle
Scalenemuscles
Cricoid
cartilage
Trapezius
muscle
Deltoidmuscle
icle
Omohvoidmuscle
(inferiorbelly)
Pretracheal
layerof
(deep) cervicalfasciaover Pectoralismajor muscle
thyroidglandand trachea
Clavicular
head Sternocleidomastoid
space(of Burns)
Suprasternal Sternalhead muscle
Manubriumof sternurh
Jugularnotch
4{r
Plate 28 Neck
lnfrahyoid and Suprahyoid Muscles
Digastricmuscle(anteriorbelly)
Mylohyoidmuscle
Thyrohyoidmembrane
muscle
Hyoglossus
External
carotidartery
muscle
Stylohyoid
Internal.iugular
vein
Digastricmuscle
Thyrohyoidmuscle (posteriorbelly)
Fibrousloopfor
Thyroidcartilage intermediate
tendon
digastric
O m o h y o i dm u s c l e
(superiorbelly) Sternohyoidandomohyoid
muscles(cut)
muscle
Sternohyoid
Thyrohyoidmuscle
Median cricothyroid
ligament
thyroidcartilage
Cricoid cartilage
muscle
Cricothvroid
Scalene muscle
Sternothyroid
muscles
mohyoid
muscle
(superior
Trapezius belly)(cut)
muscle
Thyroidgland
Omohyoidmuscle
(inferiorbelly) muscle(cut)
Sternohyoid
Clavicle
Nr Styloidprocess
Mastoid process
muscle
Stylohyoid
Mylohyoidmuscle
Digastricmuscle(posteriorbelly)
Digastricmuscle(anteriorbelly) Thyrohyoidmuscle
Ceniohvoid muscle ue lineof thyroidcartilage
muscle
Sternohyoid
Omohyoidmuscle Omohyoidmuscle(inferiorbelly)
(superiorbelly)
Sternothyroid
muscle
Infrahyoidand
suprahyoidmusclesand Sternum
their action:schema
Plate 29
Scalene and Prevertebral Muscles
Basilarpartof
occipitalbone Longuscapitismuscle(cut)
condyle
process
Jugular of
occipital bone Rectuscapitis
anteriormuscle
Mastoidprocess Rectuscapitis
lateralis
muscle
Styloidprocess
processof atlas(C1)
Transverse
L o n g u sc a p i t i sm u s c l e
Posteriortubercle of
processof axis(C
transverse
Longuscollimuscle Slipsof originof anterior

scalenemuscle(cut)
Slipsof originof posterior

scalenemuscle
Anterior
Scalene Middle
muscles Middle I S."t"n"
Posterior PosteriorI muscles
Phrenic
plexus
Brachial
4{tr
+
f:i'
Subclavian
artery
Rightcommoncarotidartery
Subclavianveiri Posterior
tubercleof transverse
processof C7 vertebra
Plate 3O Neck
Superficial Veins and Gutaneous Nerves of Neck
muscle(cut)
Platysma
Facialarteryand vein muscle
Digastric
(anterior
belly)
Marginalmandibular
gland
Submandibular
branch offacial nerve
Mylohyoidmuscle
Hyoid bone
Parotid gland
Retromandibularvein Omohyoidmuscle(cut)
I n t e r n a l j u g u l avre i n Externalcarotid artery
muscle
Thyrohyoid
Externaljugularvein
muscle(cut)
Sternocleidomastoid
Anteriorjugularvein thyroidarteryandvein
Superior
Communicatingvein lnternaljugularvein
Common carotid artery

Great auricularnerve
muscle
Sternohyoid
Thyroidcartilage id muscle
cervicalnerves
Transverse Ansa cervicalis
Omohyoidmuscle
Thyroid gland belly)(cut)
(superior
Omohyoidmuscle
(inferiorbelly)
muscle
Trapezius plexus
Brachial
muscle(cut)
Platysma
Pectoralismajor muscle
nerves
Supraclavicular
Clavicle
muscle
Sternocleidomastoid
muscle(cut)
Sternocleidomastoid
Sternothyroidmuscle
4{tr
Neck Plate 31
Gervical Plexus in Situ
SeealsoPlates 127-129.199
Parotidgland Creatauricular
nerve
Facialarterv and vein
Lesseroccipital
S u b m a n d i b u lgalra n d nerve
Mylohyoidmuscle Sternocleidomastoid
muscfe (cut, turned up)
Hypoglossalnerve (Xll)
Stylohyoid
muscle
Digastricmuscle
( a n t e r i obr e l l y ) Digastricmuscle
(posterior
belly)
Lingualartery
C2 spinalnerve
Externalcarotid art (ventralramus)
Internalcarotid artery Accessory nerve (Xl)

C 3 s p i n anl e r v e
Thyrohyoidmuscle (ventralramus)
Superiorthyroidartery Levatorscapulae
muscle
O m o h y o i d m u s c l e( s u p e r i o rb e l l y ) M i d d l e s c a l e n em u s c l e
Anterior scalenemuscle
(ventralramus)
Sternohyoidmuscle
ialcervical
Sternothyroidmuscle
artery
I n t e r n ajlu g u l a rv e i n Phrenicnerve
Common carotid artery Omohyoid
muscle
Inferiorthvroid arterv (inferior
Vagusnerve (X) belly)(cut)
Brachialplexus
Vertebral artery
Dorsalscapular
artery
Thyrocervical
trunk
Subclavianartery and vei
Suprascapular
Accessory
artery
Nr
Hypoglossal
nerve
Cervicalplexus:schema Creat auricularnerve
(S= grayramus
fromsuperior
cervicalsympatheticganglion) Lesseroccioital nerve
Torectuscapitislateralis,
To geniohyoid muscle longuscapitis,
andrectus
caoitisanteriormuscles
To thyrohyoid muscle
C o m m u n i c a t i o nt o v a g u sn e
Transversecervical nerves
To omohyoid muscle
To longuscapitisand
l o n g u sc o l l i m u s c l e s
Ansa cervicalis
To sternothyroidmuscle
To sternohyoidmuscle
To omohyoid muscle (inferior bellv)
To scaleneand levator
Supraclavicularnerves s c a p u l a em u s c l e s
P h r e n i cn e r v e
Plate 32 Neck
Subclavian Artery
Rightanteriordissection
Thyroidgland(reflected)
l n t e r n a jl u g u l a rv e i
Common carotid artery ganglion
Middlecervicalsympathetic
Ascendingcervicalartery
P h r e n i cn e r v e Vagusnerve(X)
A n t e r i o rs c a l e n em u s c l e
Vertebralartery
Inferior thvroid arterv
Commoncarotidartery
Superficialcervical artery
S u p r a s c a p ual ar rt e r y laryngeal
Recurrent nerve
Dorsalscapularartery
trunk
Brachiocephalic
Costocervical
Thyrocervical
trunk jugularvein(cut)
Internal
Subclavianartery and vei
cervicalartery(-30%)
Commonorigin of superficialcervicaland dorsalscapulararteriesfrom transverse
Superficialbranch of transversecervical artery (superficialcervical

Inferiorthyroid artery
Deep branch of transversecervical artery (dorsalscapularartery)
Transversecervicalartery
Thyrocervical
trunk
artery
Suprascapular
Rightobliqueschematicview
Vertebralartery
Rightexternalcarotidartery
Deep cervical artery (ascending
to anastomosewith descending Rightinternalcarotidartery
branch of occipital artery)
Ascending cervicalartery
Suoerficialcervical arte
Inferiorthyroid artery
Costocervical
trunk
S u p r e m (es u p e r i o r ) Superficialcervicalartery
intercostal artery Right common carotid artery
trunk
Thyrocervical
S u p e r i o ra n d i n f e r i o r t
transversescapularligaments Right subclavianartery (1st part medial to, 2nd part
posterior to, 3rd part lateralto anterior scalenemuscle)
Acromion 6
B r a c h i o c e p h atlriuc n k
Dorsalscapularartery Suprascapular artery
S u p r a s c a p u l aar Aorticarch
Axillaryartery
Internalthoracic(mammary)
artery
1 s ta n d2 n d p o s t e r i o r
intercostal arteries
4{tr
C/Fd4/^
1 s t , 2 n da,n d3 r d a n t e r i oirn t e r c o s t a rl t e r i e s
S u b s c a p u laarrt e r y
Circumflex
scapularartery horacodorsalartery
Neck Plate 33
Garotid Arteries
Parotidspace Superficialtemporal artery

(bed):right lateral
dissection Transverse
facialarterv
Maxillaryartery
Mastoid process
External
carotidarterv
Styloidprocess
Posterior
auriculararterV
Facialnerve (Vll) (cut
Clossopharyngealnerve (lX)
muscle(cut)
Sternocleidomastoid
Stylohyoid
muscle
Digastricmuscle(posterior
belly)(cut)
Occipital artery and
sternocleidomastoidbrancn Facialartery
Accessory nerve (Xl) Lingualartery
Mylohyoidmuscle
H y o g l o s s umsu s c l e
Vagus nerve (X)
Digastricmuscle
(anteriorbelly)
Ascending
pharyngeal
artery
Carotidbranchof glossopharyngeal Hyoid bone
nerve (lX) and carotid body
Branchto
Internalcarotid thyrohyoidmuscle
(fromansacervicalis)
Internaljugular vein
Superiorlaryngeal
artery
Superiorthyroidartery
External
carotidartery
Superficialtemporal artery
Transversefacial artery Commoncarotidarterv
Disastricmuscle Maxillaryartery
(phantom)
Posterior
auricularartery
Occipitalartery
Facialartery
Descending branch/
Sternocleidomastoid branch Lingualartery
Ascendingpharyngealartery
Internalcarotid artery
Superiorthyroidarteryand
Externalcarotid superiorlaryngeal
branch
Omohyoid muscle (phantom)
Common carotid arter
Externalcarotidbranches:
schema
Thyrocervicaltrunk
4{tr
Plate 34 Neck
Fascial Layers of Neck
ofcarotid
Forcontents seePlates 69-71
sheath
Superficial layer of deep ce.rvicalfascia P l a t v s m am u s c l e

S t e r n o h y o i dm u s c l e
Infrahyoidfa Trachea
Sternothyroidmuscle
T h y r o i dg l a n d
Pretracheal(visceral)fascia
Esophagus
Omohyoid muscle
Buccopharyngeal
( v i s c e r a lf)a s c i a 'Sternocleidomastoid
muscle
Carotid sheath Recurrentlaryngeal
nerve
S u b c u t a n e o tui s s u e
\ -----'-\ Common carotid artery
Superficial I n t e r n a l u g u l a rv e i n
(investingl a)y e r Vagus nerve (X)
of deep cervical
fasciaroofing P h r e n i cn e r v e
p o s t e r i o rt r i a n g l e Anterior scalenemuscle
Fatin S y m p a t h e t i ct r u n k
posterior S p i n a ln e r v e
triangle
Middleand posterior
s c a l e n em u s c l e s
PrevertebralIayer L o n g u sc o l l i m u s c l e
of (deep)
Levatorscapulaemuscle
cervicalfascia
Trapeziusmuscle
Alar fascia Deeo cervical muscles
Crosssection Retropharyngeal Subcutaneous Cervicalvertebra (CZ)

space tissue
Sagittal section
Mandible
Pharynx
C e n i o h y o i dm u s c l e
Buccopharyngeal(visceral) Ceniohyoid fascia
fascia
lnvestinglayer of (deep)
Retropharyngeal
cervicalfascia
space
F a s c i ao f i n f r a h y o i dm u s c l e s
Alar fascia
Pretracheal(visceral) fascia
Prevertebralfascia
Thyroid gland
Trachea
S u b c u t a n e o u tsi s s u e
Esophagus
asternalspace (of Burns)
' M a n u b r i u mo f s t e r n u m
:w'-'-
Aorta
Pericardium
4{F
Neck Plate 35
Nose
Anterolateralview Inferiorview
Major alar cartilage
Frontalbone
N a s a lb o n e s
Lateral Medial
Frontalprocessof maxilla crus
Lateralprocessof
septal nasalcartilages
Septalcartilage
M i n o r a l a rc a r t i l a g e
Accessory nasalcartilage
Alar Anterior
Nasalseptalcartilage fibrofatty n a s asl p i n e
trssue of maxilla
A n t e r i o rn a s a ls p i n eo f m
Nasalseptal
Alarfibrofattytis cartilage Intermaxillary
suture
Infraorbitalforamen
F r o n t a l i sm u s c l e
Supraorbital
arteryand ner
Supratrochleararterv and
P r o c e r um
s uscle
C o r r u g a t osru p e r c i lm
ii uscle
Dorsal nasalarl
Infratrochlearnerve
Angular artery
Externalnasalartery and nerve
Nasalismuscle (transversepart
Infraorbitalartery and nerve
Lateralnasalartery
Transversefacial artery
N a s a l i sm u s c l e( a l a rp a r t )
Depressorsepti nasi muscte
O r b i c u l a ro
i sr i sm u s c l e
Facialartery
Nry
Plate 36 Nasal Region
Lateral Wall of Nasal Gavity
Sohenoethmoidal recess
F r o n t asl i n u s
of
S u p e r i o rn a s a lc o n c h a s il n u s
sphenoida
Superior nasalmeatus Hypophysis
( p i t u i t a rgyl a n d )
M i d d l e n a s a lc o n c h a
i n s e l l at u r c i c a
Agger nasi S p h e n o i d sa il n u s
Atrium of middle nasalmeatus Pharyngeal tonsil
(adenoidif enlarged)
M i d d l e n a s a lm e a t u s
Basilarpartof
Inferior nasalconcha occipitalbone
(turbinate)
Pharyngeal
L i m e nn a s i raphe
Nasalvestibule
Torustubarius
lnferior nasalme
O p e n i n go f a u d i t o r y
Palatineprocessof maxilla (pharyngotympanic,
I n c i s i v ec a n a l E u s t a c h i atnu)b e
Pharyngeal recess
Tongue
Horizontalplateof
palatinb
eone
Softpalate
M i d d l e n a s a lc o n c h a
M i d d l e n a s a lm e a t u s
Bulging
septum
rway to nasopharynx
*{ry
Inferior nasalconcha
Inferior nasalmeatus
Floor of nasalcavity
F r o n t a sl i n u Cribriform plate of ethmoid bone
P r o b e p a s s i n gf r o m s e m i l u n a r P r o b e i n o p e n i n go f s p h e n o i d asl i n u s
h i a t u si n t o f r o n t a ls i n u sv i a
S p h e n o i d sa il n u s
frontonasalduct
Suoeriornasalmeatus
Middle nasalconcha (cut surface) w i t h o p e n i n go f p o s t e r i o r
E t h m o i d ablu l l a e t h m o i d acle l l s
part
Basilar
O p e n i n g so f m i d d l ee t h m o i d a lc e l l s of occipitalbone
S e m i l u n ah r i a t u s( o s t e o m e a t aul n i t )
Torustubarius
w i t h o p e n i n go f a n t e r i o r
e t h m o i d a la i r c e l l s ingof auditory
(pharyngotympanic,
U n c i n a t ep r o c e s s
E u s t a c h i atnu)b e
l n f e r i o rn a s a lc o n c h a
(cut surface) Anterior arch
of atlas(C1vertebra)
O p e n i n go f n a s o l a c r i m a l Densof axis
(C2vertebra)
lnferior nasalmeatus O p e n i n go f
m a x i l l a r ys i n u s
Nasal Region Plate 37

Lateral Wall of Nasal Gavity (continuedf
Lacrimalbone
Middlenasalconcha
Uncinate process Ethmoid bone
Cribriformplate
S u p e r i o rn a s a lc o n c h a
Highest nasalconcha
Nasalbone recess
Sohenoethmoidal
Agger nasi
Sphenopalatine
foramen
partof
Basilar
Lateralprocessof occipitalbone
nasalseptalcartilage
Major alar cartilage
Alarfibrofattytissue Sphenoidal
sinus
Medial
Frontalprocess and
Lateral S p h e n o i db o n e
Anteriornasalspin platesof
pterygoid
Maxilla Incisivecanal process
Pterygoid
Palatineprocess hamulus
Inferior
Alveolar process nasalconcha
E t h m o i d ablu l l a
Frontalsi O p e n i n go f m i d d l ee t h m o i d a lc e l l s
periornasalconcha(cutaway)
Opening of frontonasalcanal
gs of posteriorethmoidal cells
Middle nasalconcha (cutaway)
ingof sphenoidal
sinus
I n f u n d i b u l u ml e a d i n gt o
frontonasalcanal O p e n i n g si n t o m a x i l l a r ys i n u s
hiatus(osteomeatal
Semilunar unit) foramen
Sphenopalatine
with opening of anterior
e t h m o i d a la i r c e l l s
Uncinate process
Ethmoidal processof
lnferior nasalconcha (cut away) inferiornasalconcha
Lesserpalatineforamen
O p e n i n go f n a s o l a c r i m a l
Creater palatineforamen 4{tr
Medial Wall of Nasal Gavity (Nasal Septum|
Falxcerebri
Frontal m plateof ethmoidbone
Dura mater
Sphenoidal
sin
Sellaturcica
Nasal
Choanae(posteriornasalapertures
)
Lateralprocessof nasalseptalcartilage
alarcartilage
Torustubarius
Nasalvestibule
Anteriornasalspi
Incisivecanal
Oral cavity
Tongue
Soft
4{tr
Cristagalli
Cribriformplate Ethmoidbone
Nasal
Vomer
Vomerine groove
(for nasopalatine nerve
andvessels)
Septalcartila
Majoralar
cartilage(medialcrus)
Anteriornasal
Nasalcrest-
Incisivecanal,
Palatine
oroce
Createrpalatineforamen

Maxillary Artery
A n t e r i o r Deeptemporalarteriesand nerves
Lateralpterygoid artery and muscle Posterior
Masseteric
arteryand nerve
Supraorbital
artery
Lateralligament of
Supratrochlear
artery joint
temporomandibular
Ophthalmicartery Middle meningealartery
Dorsalnasalartery Auriculotemporal
nerve
Angularartery Maxillaryartery
\ temporalartery
Superficial
Infraorbital
arterv
Posterior
auricular
artery
Facialnerve
Inferioralveolar
Buccalarteryand nerve artery and nerve
Medial pterygoid
artery and muscle Mylohyoid nerve and branch
P t e r y g o m a n d i b urlaapr h e of inferior alveolarartery
Lingualnerve
muscle
Stylohyoid
Facialartery
External
carotidarterv
Mentalbranchof
inferioralveolararl Facialartery
S u b m e n t a lr t e r y Lingualartery
Anterior I Oeeptemporalarteries
Sphenopalatine
artery Arteryof pterygoidcanal I and nerves
Posterior
Pharyngealartery Accessory meningeal
artery
Posterior
lateralnasalbranch
Sphenopalatineforamen M i d d l e m e n i n g e a al r t e r y
Infraorbital
artery Anteriortympanicartery
Deepauricularartery
Posteriorsuoerior
alveolarartery Auriculo-
temporal
Sphenopalatine
artery nerve
Posterior
septalbranches
Creater (descending)
palatineartery
Buccalartery
Superficial
Anastomosis
in
temporalartery
incisivecanal
pharyngeal
Ascending
Left and right artery
greaterpalatinearteries Ascendingpalatineartery
Tonsillarbranches
Leftand right
lesserpalatinearteries Tonsillar
artery
Externalcarotidartery
Pterygoidarteries
Facialartery
4{tr Masseteric
artery
Inferior alveolarartery
Superiorpharyngeal
muscle
Styloglossus
muscle
constrictor

Arteries of Nasal Gavity: Nasal Septum Turned Up
Nasalseptalbranchof superiorlabialbranch
(of facialartery)
Nasalseptum(turnedup
Anastomosis betweenposterior
septalbranchof sphenopalatine
arteryand greaterpalatineartery
i n i n c i s i v cea n a l
Schematichinge.
Septaland lateralnasal
branchesof posterior
ethmoidalartery
Anterior septal branch,
Anterior lateralnasalbr
Posteriorseptal
Externalnasalbranch ti. branchof
of anterior
ethmoidal
artery
N, sphenopalatine
artery
Sphenopalatine
artery
Sphenopalatine
foramen
Alarbranches of
lateralnasal
branch
(of facialartery)
Posterior
lateralnasal
b r a n c h eosf
sphenopalatine
artery
Maxillary
artery
Anastomosisbetween
posterior septal branch External
carotid
of sphenopalatineartery artery
and greaterpalatine ,/
artery in incisive
Lesserpalatineforamenand artery
Creater palatineartery
Createrpalatineforamenandartery
Lateralwall of nasalcavity
Nr
Nerves of Nasal Gavity: Nasal Septum TUrned Up
SeealsoPlates 44,45,119
Olfactory
Nasafseptum(turned up)
I n c i s i v ec a n a l
Schematic hinge
M e d i a l i n t e r n a ln a s a l , n e r v e( V z )
Nasopalatine
L a t e r a il n t e r n a ln a s a l ,
E x t e r n anl a s a l
b r a n c h e so f
a nteflor
ethmoidal
n e r v e( V 1 )
S p h e n o p a l a t i nfeo r a m e n
(dlssectedaway)
I n t e r n a ln a s a l Pterygopalatine
b r a n c h e so f ganglion
i n fr a o r b i t a l
n e r v e( V 2 )
Nerve(Vidian)
o f p t e r y g o i dc a n a l
P o s t e r i o sr u p e r i o rl a t e r a ln a s a l
b r a n c ho f m a x i l l a r yn e r v e ( V 2 )
I
.I
N a s a lb r a n c ho f a C r e a t e ra n d l e s s e rp a l a t i n en e r v e s
j
a n t e r i o rs u p e r i o r
a l v e o l a rn e r v e ( V 2 )
P o s t e r i o irn f e r i o rl a t e r a ln a s a l
b r a n c ho f g r e a t e rp a l a t i n en e r v e ( V 2 )
L e s s e rp a l a t i n en e r v e s
C o m m u n i c a t i o nb e t w e e n
g r e a t e rp a l a t i n ea n d n a s o p a l a t i n e C r e a t e rp a l a t i n en e r v e
n e r v e sa t i n c i s i v ec a n a l
Lateral wall of nasal cavitv
4{tr
Nasal Region
Nerves of Nasal Gavity (continuedf
Distribution of olfactory
mucosa(shadedblue)
Nasal
septum
lateral wall
of nasal cavitv
nasalbranchof anteriorethmoidalnerve(Vr)
External
Lateralinternalnasalbranchof anteriorethmoidalnerve(Vr)
Olfactorybulb
m Dlateof ethmoid bone
Olfactorytract
superiorlateralnasalbranches
Posterior
from maxillarynerve(Vz)
Maxillarynerve(V2)(sphenopalatine
foramendissectedaway)
Pterygopalatineganglion
Createrpetrosalnerve
Deep petrosalnerve
Nerve(Vidian)of pterygoidcanal
branchof maxillarynerve(V2)
Pharyngeal
nerve(Vz)passingto septum(cut)
Nasopalatine
inferiorlateralnasalbranch
Posterior
from greaterpalatinenerve(V2)
Lateral
wall of
nasal bulb
cavity
Cribriformplate
Olfactorynerves(l)
Createi
Palatinenerves(Vz)
{
Medialinternalnasalbranch
of anteriorethmoidalnerve(Vr
Nr Olfactorvnerves(
Nasopalatinenerve (V2
Incisivecanal
Nasalseptum

Autonomic lnnervation of Nasal Gavity
Superiorsalivatorynucleus(parasympathetic)
Facialnerve(Vll)
Geniculum(geniculate
ganglion)of facialnerve
Createrpetrosalnerve(parasympathetic)
Deep petrosalnerve(sympathetic)
Nerve(Vidian)of pterygoidcanal
Maxillarynerve(Vz)enteringforamenrotundum
ganglionin
Pterygopalatine
Lateraland medialposteriorsuperior
nasalbranchesin pterygopalatine
fossa
nerve
lnfraorbital
Posteriorsuperior
and inferiorlateral
nasalnerves
(cut ends)
Tympaniccavity
ternalcarotid
n e r v ea n d p l e x u s
Posterior
supenor Maxillary
alveolar sinus
nerves
cervicalganglion
Postsynapticfibersto
vessels(sympathetic) and
glands(parasympathetic)
of nasalcaviry maxillary
sinus,and palate
Preganglionicparasympatheticfi bers
Postganglionicparasympatheticfi bers
Preganglionicsympatheticfi bers
Presynaptic sympatheticcell Postganglionicsympatheticfi berc
bodiesin intermediolateral
nucleus
*{r
(lateralhorn)of graymatter(T1-T5)
Plate 44 ]laoal Region

Ophthalmic (Vrl and Maxillarv (V"l Nerves
C o m m u n i c a t i n gb r a n c h Anterior ethmoidal nerve
Posteriorethmoidal nerve
nerve
Supraorbital
Supratrochlearnerve
Long and short ciliary nerves
Lacrimalgland
C i l i a r yg a n g l i o n
Infratrochlearnerve
(from nasociliarynerve)
Lacrimalnerve
Cutaneous branchof
N a s o c i l i a r yn e r v e lacrimalnerve
Zygomaticotemporal
Frontalnerve nerve
Tentorialbranch Zygomaticofacial
nerve
O p h t h a l m i cn e r v e ( V r )
External
nasal
Trigeminal branchof
( s e m i l u n a rg) a n g l anterior
ethmoidal
Trigeminal nerve
Meningeal
branch
Foramen
rotundum lnfraorbital
nerve
Foramen
ovare Anteriorsuperior
alveolarnerve
M a n d i b u l a rn e r v e ( V 3 )
Nasal
branch
Maxillary nerve (V2)
Mucousmembrane
Zygomatic nerve of maxillarysinus
Nerve (Vidian)of pterygoid canal Dental and gingivalbranches
Pterygopalatineganglion S u p e r i odr e n t apl l e x u s
Createrand lesserpalatinenerves Infraorbitalnerve entering

infraorbitalcanal
Canglionic branchesto pterygopalatineganglion
Middlesuperioralveolarnerve
superioralveolarnerve
Posterior
4{tr

Mandibular Nerve (V"l
SeeafsoPlates 71,122,
A n t e r i o rd i v i s i o n Temporalfascia
t e m p o r a l i sm u s c l e Posterior
Lateral view Posteriordivision o""o temporal
nerves
Anterior I
Foramenovale
Massetericnerve
M e n i n g e a lb r a n c h
ateral pterygoid
nerve and muscle
Middle
meningealartery
Auriculotemporal
nerve
Posterior
a u r i c u l anre r v e
l e r v e( V l l )
F a c i an
C h o r d at y m p a n i
nerve Buccalnerve
and buccinator
L i n g u a ln e r v e
muscle(cut)
Inferioralveolarnerve (cut) Submandibular

ganglion
Nerve to mylohyoid
Sublingual
Medialpterygoidmuscle(cut) gland
Digastricmuscle (posteriorbelly)
Mylohyoid
muscle(cut)
muscle
Stylohyoid
*{r Hypoglossalnerve
S u b m a n d i b u l aer l a n d
Inferior alveolarnerve (cut)
Mentalnerve
Sublingua
n le r v e D i g a s t r i cm u s c l e( a n t e r i o rb e l l y )
Trigeminal
ganglion Ceniculum (geniculate
r$'
{ ganglion)
of facialnerve
O p h t h a l m i cn e r v e ( V r) rl,
d Tympaniccavity
Maxillary nerve (V2
Chordatympaninerve
M a n d i b u l a rn e r v e ( V t )
F a c i anl e r v e( V l l )
Anterior division
l e n s o rt y m p a n i
Tensorveli palatini m u s c l ea n d n e r v e
nerve and muscle
Lesseroetrosalnerve
Otic ganglio
Chorda tympani nerve nerve

Auriculotemooral
Medial pterygoid Maxillaryartery

nerve and muscle (cut)
Mylohyoidnerve
P t e r y g o ihda m u l u s
Inferior alveolarnerve enterinq
L i n g u anl e r v e
m a n d i b u l a rf o r a m e n

Nose and Paranasal Sinuses: Gross Section
Major alar
cartilage
Nasalvestibule
Nasalseptalcartilage lnferior nasalconcha

Facialartery
Facialvein
M a x i l l a rby o n e
M a x i l l a rsyi n u s
S p h e n o i bd o n e
Massetermuscle
Coronoid Medialpterygoid
processof
muscle
mandible
{ Lateralpterygoid
Lateral
J. plate
pterygoid
m u s c l e\
Levatorveli
Cartilage p a l a t i nm
i uscle
of
auditory recess
Pharyngeal
tube
Neck of Longuscapitis
mandible muscle
Parotid Rectuscapitis
gland
anterior
muscte
Retroman-
dibular ! /_\ \ Superficial
vetn .\'i
temporal
\.\ arrery
Closso-
pharyngeal + I Sympathetic
nerve trunk
Styloid
proceSs Styloglossus
muscle
Stylohyoid
muscre
Medullaoblongata
lnternalcarotid
M a s t o i da i r c e l l s artery
Internal Vagusnerve
j u g u l a rv e i n
Facialnerve
Hypoglossalnerve
c4#
Nasal Region Plale 47

Paranasal Sinuses
Olfactorybulbs
Falx
Brain F r o n t asl i n u s
Nasalcavities
Orbitalfat
N a s a ls e p t u m
E t h m o i d ac le l l s
Middle
nasalconcha
O p e n i n go f
m a x i l l a rsyi n u s
Middle
nasalmeatus
Infraorbital Recesses
of
Zygomatic maxillary
M a x i l l a rsyi n u s s tn u s
Alveolar
Inferior
nasalmeatus Buccinatormuscle
ar processof maxilla
Inferior nasalconcha
of tongue
Hard palate
Sublingug
aland
Oral cavit
M a n d i b l e( b o d y )
*^--J
Nasalcavities
Nasal septum
E t h m o i d acl e l l s
M e d i a lw a l l
of orbit
Orbitalfat and muscles
O p t i c n e r v e( l l )
S p h e n o i d asl i n u s e s
Brain
4{r Optic chiasm
Horizontalsection

Paranasal Sinuses (continuedl
Sagittalsection
Ethmoidal air cells
( sni u s e s )
F r o n t asl i n u s
O p e n i n go f
sphenoida s il n u s
O p e n i n g o f f r o n t o n a s adl u c
S e m i l u n ah
r iatus
(osteomeatalunit)
M i d d l en a s a l
U n c i n a t ep r o c
concha(cutaway)
O p e n i n go f
m a x i l l a rsyi n u s
lnferior nasalconcha
F r o n t a sl i n u s
n i n g i n t o m i d d l e n a s a lm e a t u s
Pterygopalatinefossa
M a x i l l a r ys i n u s
Lateraldissection
Roots of teeth
*{r
Paranasal Sinuses: Ghanges with Age
Bonesof nasalcavity
Sinrs.r"p.resents
one or moreanteriorethmoidalcells
and paranasalsinus6s I
openinginto semilunar
hiatusof middlenasalmeatus
at birth I
! Sinw represents
one or moremiddleethmoidalcells
1 openinginto middlenasalmeatus
Partof nasolacrimal
duct two or moreposteriorethmoidalcells
Sinur",represent
that formedin depthsof I
\ openinginto superiornasalmeatus
nasoopticfurrow
! sinuswithinbonyshell(sphenoidal
Spfr"noidal concha)
1 locatedanteriorand lateralto body of sphenoidbone
Nasal (brokenlineindicatessinuslateralto sphenoidbody)
\
Lacrimalbone Bodyof sphenoidbone
Nasolacrimal
foramen(becomes Vestigialremnant
bonycanal) of Rathke'spouch
Medialplateof
Partof nasolacrimal pterygoidprocess
ductwithinnasal
cavitywith slit-like Lowerborderof highestnasalconcha
openingin inferior
nasalmeatus Lowerborderof superiornasalconcha
Palati Superiornasalmeatus
bone
Middle nasalconcha(cut edge)(inferior
Uncinateprocessof ethmoidbond Pterygoid nasalconchacompletelyremoved)
Semilunar hiatus(striped
Maxillarysinuswith openinginto semilunar
arearepresentsmembraneformingmostof medialwall of sinus)
Grorythof frontal and maxillary

sinu"ses
throughout life
Frontalsinus
withinfrontal
I Birth
Middlenasalconcha
Leftorbit
I 1 year
r 4 years Nasal
I 7 years Nasalcavity
Maxillarvsinus
withinmaxilla
ffi 12years
I Adult Inferiornasalconcha
Molar tooth
I Old age
Nr
lnspection of Oral Gavity
F r e n u l u mo f u p p e r
l i n o r s a l i v a r yg l a n d
L i n g u am
D e e p l i n g u a la r t e r ya n d v e r n s
a n d l i n g u a ln e r v e
F i m b r i a t e df o l d
S u b m a n d i b u l ad ru c t
lff-- S u b l i n g u agll a n d
F r e n u l u mo f t o n g u e
S u b l i n g u aflo l d w i t h o p e n i n g s
o f s u b l i n g u adl u c t s
S u b l i n g u acla r u n c l ew i t h o p e n i
L# o f s u b m a n d i b u l adru c t
Nr
Oral Region Plate 51
Roof of llouth
I n c i s i vpea p i l l a
Incisivefossa
palatine
Transverse
folds Createrpalatinearteryand nerve
Palatineraphe Createrpalatineforamen
Palatineprocess Lesserpalatineforamen
of maxi
Lesserpalatinearteryand nerves
Palatine
glands
'endon
of tensorveli
Horizontalplate palatinimuscle
of palatinebone
Pterygoidhamulus
Palatine
aponeurosis Interdigitating
fibersof
(fromtensor levatorveli palatinimuscle
velipalatini
muscle) Buccinator
muscle
Uvularmuscle Pterygomandibular
raphe
M o l a rm i n o r Superiorpharyngeal
salivaryglands constrictor
muscle
Palatopharyngeus Palatoglossus
muscle
muscle
Palatine
tonsil
Anterior view partof

Basilar
occipitalbone
part
Cartilaginous
of auditorv
(pharyngotympanic,
Eustachian)
tube
Levatorvelipalatinimuscle(cut)
Pharyngobasilar
lascta
Tensorvelipalatinimuscle
Levatorveli palatinimuscle
Medialpterygoidmuscle(
Medialpterygoidplate
Pterygoid Pterygoidhamulus
Tendonof tensorvelipalatini Superiorpharyngeal

muscle(cut)
constrictor
Levatorveli palatinimuscle(cut
Palatopharyngeus
muscle
muscle(
Palatopharyngeus
*{r Posteriorview
Plate 52 Oral Region

Floor of Mouth
Lateral, slightly inferior view
Hyoglossus
muscle
Mylohyoidmuscle
Fibrousloop for intermediate
digastrictendon
Medianraphebetweenmylohyoidmuscles
Anteroinferior
view
Mylohyoidmuscle
muscle
Stylohyoid
muscle(posterior
Digastric belly)
Hyoglossus
muscle digastrictendon
Fibrousloopfor intermediate
Posterosuperior
view
Inferioralveolarnerveand arterv
Mylohyoidnerveand artery
glandandduct
Submandibular
Ceniohyoid muscle
Superiormentalspine(genialtubercle)
for originof genioglossus
muscle
*{r Createrhorn Hyoglossus

muscle(cut)

Muscles Involved in Mastication
Forfacial
muscles
seePlate26
muscle
Temporalis
Temporalfascia
Superficial
layer
Deeplayer
Levatorlabii
supenons
alaequenasi
Tygomatic arch
muscre
Levatorlabii
Articulardisc of
supenons
t e m p o r o m a n d i b u l aj ro i n t
muscte
Zygomaticus Deeppart I Masseter

minormuscle S u p e r f i c ipaal r t muscle
I
Zygomaticus
major muscle Parotidduct
Levator B u c c i n a t o rm u s c l e
anguli
ons
muscle
Orbicularis
o r i sm u s c l e
Mentalis
muscle
D e p r e s s ol ar b i i
inferiorismuscle D e p r e s s oarn g u l i
o r i sm u s c l e
T e m p o r a l i sm u s c l e
I n s e r t i o no f t e m o o r a l i sm u s c l et o
coronoid orocessof mandible
Parotidduct
B u c c i n a t o rm u s c l e
Orbicularo
i sr i sm u s c l Lateralpterygoid
muscte
Massetericnerve
and artery
Maxillary artery
*{r I n s e r t i o no f
massetermuscle

Muscles Involved in Mastication (continuedl
,,ti;ij
j*i
Articulardiscof
t e m p o r o m a n d i b u l aj ro i n t
A r t i c u l a rt u b e r c l e
Lateralpterygoid muscle
Parotidduct
Pterygomandibularraph
S u p e r i opr h a r y n g e a
col n s t r i c t omr u s c
Lateralview
Choanae
Otic ganglion C a r t i l a g i n o ups a r t o f a u d i t o r y
'(pharyngotympanic,
S p h e n o m a n d i b u l al irg a m e n
Eustachian)tube
M a s s e t e n cn e r v e
Lateralpterygoidplate
Middle meningealartery 2q
T e m p o r o m a n d i b u l aj or i n t
A u r i c u l o t e m p o r anl e r v e
teralpterygoidmuscle
Massetericartery
Medialpterygoidmuscle
Maxillaryartery
lnferior alveolarnerve
M e d i a l p t e r y g o i dm u s c l e
Medial pterygoid Tensorveli palatini muscle (cut)
P t e r y g o ihda m u l u s Levatorveli palatini muscle (cut)
Nerve to mylohyoid Pterygoidhamulus
4{tr Posteriorview

Teeth
Permanent
(coloredblue)
Usualageof
eruption
Centralincisor Centralincisor(7thyear)
( B - 1 0m o n t h s ) Lateralincisor(Bthyear)
Lateralincisor C a n i n e( c u s p i d()11 t h - 1 2 t hy e a r )
( B - 1 0m o n t h s
st premolar(9thyear)
C a n i n e( c u s p i d )
(16-20months) 2 n d p r e m o l a r( 1 O t hy e a r )
1 s tm o l a r 1 s tm o l a r( 6 t h y e a r )
( 1 5 - 2 1m o n t h s )
2 n dm o l a r( 1 2 t h - 1 3 t yhe a r )
2 n dm o l a r
(20-24 months)
l---3rd molars(.17th-25thyear)
2 n dm o l a r
( 2 0 - 2 4m o n t h s )
2 n d m o l a r( 1 2 t h - 1 3 t yhe a r )
1 s tm o l a r
( 1 5 - 2 1m o n t h s ) 1 s tm o l a r( 6 t hy e a r )
C a n i n e( c u s p i d ) 2 n dp r e m o l a(r1 O t h
year)
(16-20months)
1 s tp r e m o l a(r9 t hy e a r )
Lateralincisor
( 1 5 - 2 1m o n t h s ) e ( c u s p i d()11t h - 1 2 t hy e a r )
Centralincisor Lateralincisor (Bth year)
(6-9 months)
Central incisor(7th year)
Central incisors
Lateralincisors
Palatineprocess Canines
of maxilla
l st premolars
Horizontal 2 n dp r e m o l a r s
plate of
palatine 1 s tm o l a r
oone\
2nd molars
3 r dm o l a r s
Greater and lesser

palatineforamina
Upperpermanentteeth Lowerpermanentteeth
4{r
Teeth (continuedl
Enamel
Dentineand dentinaltubules
sPaces
Interglobular
Odontoblastlayer
InterproximalsPaces
Dentalpulp containingvessels
and nerves
ival (gum)epithelium(stratified)
Cingivalgroove
Laminapropriaof gingiva(gum)
(mandibular
or maxillaryperiosteum)
Periodontium
(alveolarperiosteum)
Root (central)canals
containingvesselsand nerves
Bone
Apicalforamina
Leftupper
permanent
teeth:
labiobuccal
Leftlower
permanent
teeth:
labiobuccal
vtew
Central Lateral 12
lncisors Canines Premolars

4{tr (cuspids)

Tongue
Epiglottis
Medianglossoepiglottic fold
teralglossoepiglotticfold
Vallecula
topharyngeal archand muscle(cut)
Palatinetonsil(cut)
Lingualtonsil(lingualnodules)
archand muscle(cut)
Palatoglossal
Foramen cecum
Terminal sulcus
Vallatepapillae
'Foliatepapillae
Filiformpapillae
Fungiformpapilla
Midlinegroove(mediansulcus)
Dorsumof tongue
Lingualtonsil
4{tr
Filiformpapillae
Fungiform
papilla
Keratinizedtip
of papilla
I n t r i n s im
c uscle
Duct of gland
Crypt
Lymphfollicles
Stratified
squamous Mucousglands
epithelium
Sustentacular
cell Vallatepapilla
Tastebuds
Sensorycell
Tastepore
Lingualglands(serousglandsofvon Ebner)
Laminapropria
Schematic stereogram: area indicated above

Section of
taste bud

Tongue (continued|
Palatopharyngeus
muscle
Palatoglossus
I n f e r i o rl o n g i t u d i n am
l u s c l eo f
Mastoid process
/ Digastricmuscle(posterior
belly)(cut)
process
Pharyngobasilar fascra
Superior pharyngeal constrictormuscle
Stylohyoid ligament
S t y l o g l o s sm
u su s c l e
Clossopharyngeal partof superior
pharyngealconstrictor
Stylopharyngeus muscle
Stylohyoid muscle
Middle pharyngealconstrictormuscle
gastricmuscle(posteriorbelly)(cut)
H y o g l o s s umsu s c l e
msu s c l e !
Cenioglossu lntermediatetendon of digastricmuscle (cut)
Mylohyoidmuscle(cut) loop for intermediatedigastrictendon
Lateralview
Superiorpharyngeal
c o n s t r i c t omr u s c l e
S u b m a n d i b u l agr a n g l i o n Styloglossus muscle
muscle(cut)
Palatoglossus
D e e pl i n g u aal r t e r y
andvenaecomitantes ligament
Stylohyoid
muscle
Stylopharyngeus
muscle(cut)
Hyoglossus
ngual artery
Arteryto fren
jugularvein
R e t r o m a n d i b u l avre i n
S u b m a n d i b u l adr u c t Facialvein
C o m m o n t r u n kf o r f a c i a l ,
r e t r o m a n d i b u l aar n d
l i n g u a lv e i n s( c o m m o n
facial vein)
I vein
S u b l i n g u aal r t e r ya n d artery
Suprahyoid
Ceniohyoid muscki Hyoid bone Dorsal lingual artery and vein
Hypoglossalnerve Vena comitans of hypoglossalnerve

4{tr
Tongue and Salivary Glands: Sections
Horizontalsection Orbicularo
i sr i sm u s c l e
below lingulaof
mandible(superiorview) Buccinatormuscle
demonstratingbed Buccopharyngeal fascia
of parotid gland Facialartery and vein
P t e r y g o m a n d i b u l ar ra p h e
Linguan
l e r v e a n d s u p e r i o rp h a r y n g e acl o n s t r i c t o rm u s c l e
Masseter
muscle
Palatoglossus
muscle in palatoglossalarch
Palatinetonsil
Palatopharyngeus
muscle in palatopharyngealarc
R a m u so f m a n d i b l
Inferior alveolarartery,vein, and nerve
Styloglossus
muscle
Facialnerve
R e t r o m a n d i b u l avre i n
4{r
Parotidgland
Stylopharyngeus
muscle
Stylohyoidmuscle
Sternocleidomastoidmuscre
Internaljugular vein, internalcarotid artery L o n g u cs a p i t i sm u s c l e

a n d n e r v e sl X , X , a n d X l l i n c a r o t i d
Prevertebralfascia
Superiorcervical sympatheticganglion
Buccopharyngeal fascia
and retropharyngealspace
S u p e r i o rl o n g i t u d i n am l uscle
Verticaland transversemusctes ortonsu"
I n f e r i o rl o n g i t u d i n am
Styloglossus muscle
l uscle I
B u c c i n a t omr u s c l e
Musclesof facialexpression
Hyoglossus muscle
Cenioglossu msu s c l e
S u b l i n g u saal l i v a rgyl a n d
S u b m a n d i b u ldaur c t
andibularcanal,inferior alveolarartery,vein, and nerve
Lingualnerve
Nerve to mylohyoid
V e n a c o m i t a n so f h y p o g l o s s anl e r v e ( t o l i n g u a lv e i n )
Linguaa l rtery
. F a c i aal r t e r y
Submandibularsalivarygland
S u b m a n d i b u llay rm p hn o d e Frontalsection
Mylohyoidmuscle
F a c i avl e i n
behindl st molartooth
(anteriorview)
I n t e r m e d i a t ed i e a s t r i ct e n o o n
Platysmamuscle
demonstrating
bedsof sublingualand
Hyoid bone submandibularglands

Salivary Glands
Superficialtemporal artery and vein

and auriculotemporalnerve
Branchesof facial nerve
facial artery
Transverse
Accessoryparotid gland
Parotidduct
B u c c i n a t o rm u s c l e( c u t )
Massetermuscle
L i n g u a ln e r
S u b m a n d i b u l agr a n g l i o n
Tongue
F r e n u l u mo f t o n g u e
S u b l i n g u aflo l d w i t h o p e n i n g s
d lu c t s
of sublingua
Parotid gland
S u b l i n g u acl a r u n c l ew i t h o p e n i n g Retromandibular
o f s u b m a n d i b u l adr u c t vein (anteriorand
posterior branches)
gland
Sublingua
Digastricmuscle
S u b m a n d i b u ldaur c t (posteriorbelly)
muscle
Sublingualartery and vein Externaljugular vein
Mylohyoidmuscle(cui) Sternocleidomastoidmuscle
Common trunk receivingfacial,
Digastricmuscle (anteriorbelly) anterior branch of retromandibular,
Hyoid bone a n d l i n g u a lv e i n s( c o m m o n f a c i a lv e i n )
S u b m a n d i b u lgalra n d
4{F Facialartery and vein
Parotidgland: S u b m a n d i b u lgalra n d : S u b l i n g ug
al a n d :
totally serous mostlyserous,partiallymucous almostcompletelymucous

Afferent Innervation of Mouth and pharynx
SeealsoPlates45, 52, Sg,64, 1n,1?fg,,l25, ig3, lgs
Trigeminal(V) (maxillaryV2) Trigeminalnerve(V) :

V i a s u p e r i o ra l v e o l a r Glossopharyngealnerve 0n {,fffi
nerves
Via pterygopalatine Vagus nerve (Xl ;-/"7.//.'r
g a n g l i o na n d n a s o p a l a t i n e
Facialnerve(Vll)
and greaterand lesser
palatinenerves
Facial(Vll) (intermediate
nerve)
Via greater petrosalnerve, pterygopalatine
g a n g l i o na
, n d g r e a t e ra n d l e s s e rp a l a t i n en e r v e s
(lX)
Glossopharyngeal
Via pharyngealplexus
V i a t o n s i l l a rb r a n c h e s
Tasteplus generalsensation
v i a l i n g u a lb r a n c h e s
Trigeminal(V) (maxillaryV2)
a pharyngealbranch of
pterygopalatineganglion
tr
Facial(Vll) (intermediate
nerve)
Via greaterpetrosalnerve and
pterygopalatineganglion
Vagus(X) Trigeminal (V)

(lX)
Glossopharyngeal (maxillary V2)
Via internalbranchof
s u p e r i olra r y ng e a ln e r v e Via pharyngeal
plexus Via pterygopalatine
V i a t o n s i l l a rb r a n c h e s g a n g l i o na n d
Tasteplus general nasopalatineand
s e n s a t i o nv i a g r e a t e ra n d l e s s e r
l i n g u a lb r a n c h e s p a l a t i n en e r v e s
V i as u p e r i o r
Vagus(X) and alveolarnerves
glosso-
pharyngeal(lX)
Via pharyngeal Trigeminal(V)
prexus (mandibularV3)
Via buccal nerve
Vagus(X) Via inferior
V i ai n t e r n a l a l v e o l a rn e r v e
branchof
supenor
laryngeal
nerve
Trigeminal(V)
(mandibularV3)
ia lingual
nerve
Facial(Vll) (intermediate nerve)

Tastevia chorda tympani and lingual nervt:
*{r
Oral Region
Pharynx: Median Section
Sellaturcica Pharyngealopening of auditory

(pharyngotympanic,Eustachian) tube
Frontalsinus
S p h e n o o c c i p i t asly n c h o n d r o s i s
S p h e n o i d asl i n u s tonsil
Pharyngeal
Nasalseptum Pharyngealtubercle of occipital bone
Nasopharynx aryngealraphe
Soft palate A n t e r i o rl o n g i t u d i n allig a m e n t
terior atlantooccipitalmembrane
Palatineglands
A p i c a ll i g a m e n to f d e n s
Hard palate.- !
Oral cavity Anterior
arch of
I n c i s i v ec a n a l atlas(C1
Palatinetonsil-..- vertebra)
Dens of
Body of tongue axis (C2
Oropharynx vertebra)
Foramencecum Pharyngeal
constrictor
L i n g u a tl o n s i l muscles
Cenioglossus Bucco-
muscle pharyngeal
fascia
Root of tongue
Retro-
Epiglottis pharyngeal
Mandible space
Prevertebral
Ceniohyoid muscle
Hyoid bone
i i!:rj"r, fasciaand
anterior
longitudinal
Hyoepiglottic ligament ligament
Thvrohvoid membrane Vertebral
bodies
Laryngopharynx
Laryngealinlet (aditus)
Thyroid cartilage
Vocalfold
Transversearytenoid
Cricoid cartilage
Trachea
Esophagus
muscles
Esophageal
Thyroidgla
Superficial(investing)layer of deep cervicalfascia
Pretrachealfascia
space(of Burns
Suprasternal
of sternum
Manubrium
4{tr
Pharynx Plate 63
Medialview
Median (sagittal)section
S o h e n o i d sa il n u s
Pharyngeal tonsil
Torustubarius
Pharyngeal tubercle(basilarpartof occipitalbone)
Pharyngeal raphe
Pharyngealopening of auditory
(pharyngotympanic,Eustachian)tube
Hard palate
Pharyngealrecess
Salpingopharyngealfold
Soft oalate
Palatineglands
Uvula
S e m i l u n a fro l d
Supratonsillarfossa
Palatinetonsil
Palatopharyngeal arch
Palatoglossal arch
Oropharynx
Triangularfold
Tongue (drawn forward and downward)
L i n g u a tl o n s i l
Epiglottis
Vallecula
Pharyngealmucosaremoved
C a r t i l a g i n o ups a r t o f a u d i t o r y( p h a r y n g o t y m p a n i cE,u s t a c h i a nt )u b e
Medial pterygoid plate
Tensorveli palatini muscle and tendon
L e v a t o rv e l i p a l a t i n im u s c l e
Ascendingpalatineartery
Pharyngealbranch of ascendingpharyngealartery
Lesserpalatineartery
S a l p i n g o p h a r y n g e umsu s c l e
Pterygoid hamulus
Pterygomandibularraphe
Tonsillarbranch of lesserpalatineartery
Superiorpharyngealconstrictor muscle
Tonsillarbranch of ascendingpharyngealartery
Palatoglossus muscle
Palatopharyngeus muscle
Tonsillarbranch of ascendingpalatineartery
Tonsillarbranch of facial
Tonsillarbranch of dorsal lingualartery
Glossopharyngealnerve (lX) and tonsillarbranch
S t y l o h y o i dl i g a m e n t
Hyoglossusmuscle
4{tr Middle pharyngealconstrictor muscle

S t y l o p h a r y n g e um s uscle
Plate 64 Pharynx
Muscles of Pharynx: Median (Sagittall Section
Medial pterygoid plate

Cartilaginouspart of auditory (pharyngotympanic,Eustachian)tube
Tensorveli palatinimuscle
Pharyngobasilarfascia
Levatorveli oalatinimuscle
P a l a t i n ea o o n e u r o s i sa n d t e n d o n o f
t e n s o rv e l i o a l a t i n im u s c l e
P h a r y n g etaul b e r c l e( b a s i l apra r to f o c c i p i t abl o n e )
P h a r y n g e arla p h e
A n t e r i o rl o n g i t u d i n alli g a m e n t
Anterior atlantooccipitalmembrane
A p i c a l l i g a m e n to f d e n s
lpingopharg
yne u sm u s c l e
Musclesof soft palate
Palatopharyngealsphincter(Passavant's
ridge)
Superiorpharyngealconstrictormuscle
Pterygomandibularraphe
muscle
Palatopharyngeus
Clossopharyngealpart ol
superior pharyngealconstrictor
Stylopharyngeusmuscle
Stylohyoidligament
Styloglossusmuscle
ibers to pharyngoepiglotticfold
B u c c o p h a r y n g e af al s c i aa n d
retropharyngealspace
Hyoglossus Prevertebralfasciaand anlenor
muscle l o n g i t u d i n alli g a m e n t
Ceniohyoid I n t e r n abl r a n c ho f s u p e r i olra r y n g e anle r v e
muscte
L o n g i t u d i n apl h a r y ng e a lm u s c l e s
Mylohyoid
muscte I n f e r i o rp h a r y n g e acl o n s t r i c t o rm u s c l e
Hyoid bone P h a r y n g e aal p o n e u r o s i s
Thyrohyoid C r i c o p h a r y n g e um
s uscle
memDrane (part of inferior pharyngealconstrictor)
T h y r o i dc a r t i l a g e
r i c o i d a t t a c h m e n to f l o n g i t u d i n a l
Median e s o p h a g e am l uscle
cricothyroid ligament
C i r c u l a re s o p h a g e am
l uscle
C o r n i c u l a t ea n d
arytenoid cartilages l s o p h a g e am
o ng i t u d i n ae l uscle
Cricoid cartilage #r
Trachea
. . . M a r g i n so f m i d d l ep h a r y n g e a l
c o n s t r i c t o rm u s c l e
- Margins and attachmentsof inferior
pharyngeal constrictormuscle
Plate 65
Pharynx: Opened Posterior View
B a s eo f s k u l l( b a s i l a p
r a r t o f o c c i p i t a lb o n e )
Pharyngealtonsil
\
Nasalseptum
Torustubarius
Pharyngeal opening
of auditory(pharyngotympanic,
Nasopharynx Eustachian)tube
recess
Parotidgland
Toruslevatorius(fold
causedby levator
velipalatinimuscle)
Salpingopharyngealfold
Soft palate
A n g l eo f m a n d i b l e
bulargland
Uvula
Oropharynx Palatinetonsil
Root of tongue
Palatopharyngeal
arch
Prominencecaused by greaterhorn
of hyoidbone
Epiglottis
Laryngealinlet (aditus)
P r o m i n e n ccea u s e db y s u p e r i ohr o r n
of thyroid cartilage
Laryngopharynx
ielotticfold
Piriformfossa(recess)
Cuneiformtubercle
Foldover internalbranch
of superiorlaryngealnerve
Corniculatetubercle
Interarytenoidnotch
overlamina
of cricoid cartilage
Esophagus
4{tr
Trachea
Plate 66 Pharynx
Muscles of Pharynx: Partially Opened Posterior View
Basilarpart of occipital bone P h a r y n g e atlu b e r c l e

't\
}i,ilri:l, *-
* Pharyngeal
tonsil
\: Cartilaginouspart
Styloid of auditory
process ( p h a r y n g o t y m p ainc ,
Eustachian)tube
Digastric
muscle Pharyngobasilar
(Posterlor fascia
belly)
Choana
Stylohyoid
muscte Levatorveli
p a l a t i n im u s c l e
Stylopharyngeus
muscre Superiorpharyngeal
constrictormuscle
Accessory muscle
b u n d l ef r o m Salpingopharyngeus
muscte
Petrouspart of
t e m p o r a lb o n e
Uvula
Medial Palatopharyngeus muscle
p t e r y g o i dm u s c l e
Middlepharyngeal
Pharyngobasilar
fascia constrictor muscle
Pharyngealraphe muscle
Stylopharyngeus
Superiorpharyngeal goepiglotticfold
Pharyn
c o n s t r i c t o rm u s c l e
fold
Aryepiglottic
Hyoid bone (tip of greater
lnferiorpharyngeal
constrictor muscle (cut edgeJ
Middle pharyngealconstrictormusc
L o n g i t u d i n apl h a r y n g e am
l uscles
Epiglottis
S u p e r i ohr o r no f
Inferior pharyngealconstrictormuscle thyroidcartilage
Cuneiformtubercle Thyrohyoid membrane
C o r n i c u l a t eu b e r c l e lnternal branch of
superior laryngealnerve
(Transverse and oblique)
a r y t e n o i dm u s c l e s P h a r y n g e aal p o n e u r o s i s
Posteriorcricoarytenoidmuscle s u s c l e( p a r to f
C r i c o p h a r y n g e um
inferior pharyngealconstrictor)
C r i c o p h a r y n g e aml u s c l e( p a r to f Posteriorborder of thyroid cartilagelamina
inferior pharyngealconstrictor)
id attachment of longitudinal
L o ng i t u d i n a e
l s o p h a g e am
l uscle esophagealmuscle
muscle
ularesophageal
4{tr
Pharynx Plate 67
Muscles of Pharynxl Lateral View
Pharyngobasilar
fascia
T e n s o rv e l i p a l a t i n im u s c l e
Levatorveli palatini muscte
Lateralpterygoid plate
B u c c i n a t o rm u s c l e( c u t )
P t e r y g o m a n d i b u l ar ra p h e
igastricmuscle
(posterior
belly)(cut)
Buccinatorcrest yloidprocess
of mandible
Superiorpharyngealconstrictor muscle
Styloglossusmuscle
Obliqueline
of mandible Stylohyoidligament
M i d d l e p h a r y n g e acl o n s t r i c t o rm u s c l e
H y o g l o s s u sm u s c l e
reater horn of hyoid bone
Digastricmuscle (anteriorbelly
r i o r h o r n o f t h y r o i dc a r t i l a g e
M y l o h y o i dm u s c l e T h v r o h v o i dm e m b r a n e
Hyoid bone Inferiorpharyngeal
constrictormuscle
Stylohyoidmuscle (cut) T e n d i n o uasr c h
Thyroid cartilage
Zone of sparsemusclefibers
C r i c o p h a r y n g em
u su s c l e
M e d i a n c r i c o t h y r o i dl i (partof inferiorpharyngeal constrictor)
C r i c o t h y r o im
duscle
C r i c o i dc a r t i l a g e sopnaSus
Trachea
4{r
Plate 68 Pharynx
Arteries of Oral and Pharyngeal Regions
5i"'{i',..',",. Supraorbitala
{ S u p r a t r o c h l eaarr
M i d d l e m e n i n g e a al r t e r y
Deep temporal arteries
Dorsal nasala
Massetericartery
A n g u l a ra r t e r y
Infraorbitalartery
S p h e n o p a l a t i naer t e r y
D e s c e n d i n gp a l a t i n e Transverse
P o s t e r i o sr u p e r i o r
facial
alveolarartery
artery(cut)
Superficial
S u p e r i o rl a b i a la r t temporal artery
Buccalartery Maxillaryartery
B u c c i n a t o rm u s c l e Posteriorauricularartery
and parotid duct (cut)
Ascendingpharyngealartery
I n f e r i o rl a b i a la r t Occipital artery and
S u p e r i o rp h a r y n g e a l s t e r n o c l e i d o m a s t o ibdr a n c h
c o n s t r i c t o rm u s c l e C l o s s o p h a r y n g e anle r v e ( l X )
Mental branch of Ascendingpalatineartely
i n f e r i o ra l v e o l a ra r t
Tonsillar
artery
Inferior alveolarartery Facialartery
a n d l i n g u a lb r a n c h
Linguaa
l rtery
Facialartery
A s c e n d i n gp h a r y n g e aal r t e r y
S u b m e n t a al r t e r y
M y l o h y o i db r a n c ho f Vagus nerve (X)
i n f e r i o ra l v e o l a ra r t e r y
Superiorcervical
S u b m a n d i b u l agr l a n d cardiac nerve
H y p o g l o s s anl e r v e ( X l l ) trunk
Sympathetic
Suprahyoidarter A n t e r i o rs c a l e n em u s c l e
External
carotidartery
M i d d l e s c a l e n em u s c l e
S u p e r i o rl a r y n g e aal r t
Ascending cervicalartery
S u p e r i otrh y r o i da
Inferiorthyroidartery
C r i c o t h y r o i da r
cervical artery
Common carotid Suprascapularartery
Vertebralartery Costocervicaltrunk
Subclavianartery Thyrocervicaltrunk
4{tr
Pharynx Plate 69
Veins of Oral and Pharyngeal Regions
SeealsoPlates 23,31,'lO4
S u p r a t r o c h l e avre i n
S u p r a o r b i t avl e i n
Nasofrontalvein
S u p e r i o ro p h t h a l m i cv e i n
A n g u l a rv e i n
Externalnasalvein
Emissaryvein (of Vesalius)
c o m m u n i c a t i n gw i t h
c a v e r n o u ss t n u s
lnfraorbitalvein
O c c i p i t a lv e i n
Posterior
superior 5;
and artery
alveolarveins
Superficialtemporal
Palatinevein
vein and artery
Pterygoidplexus Transversefacial vein (cut)
S u p e r i ol ra b i avl e i Posteriorauricularvein
Deep facial vein R e t r o m a n d i b u l avre i n
(anteriorand
M a x i l l a r yv e i n s posteriorbranches)
I n f e r i o rl a b i a lv e i n jugularvein(cut)
External
Mental vein Inferior alveolarvein and artery
Facialvein and a ipital vein and artery
Externalpalatinevei H y p o g l o s s anl e r v e ( X l l )
S u b m e n t a vl e i n Common trunkreceiving
facial,anterior branch of
S u b m a n d i b u l agr l a n d retromandibular,and
l i n g u a lv e i n s( c o m m o n f a c i a lv e i n )
Vena comitans of
hypoglossalnerve Externalcarotid artery
D o r s a ll i n g u a lv e i n c o u r s i n g I n t e r n ajlu g u l a rv e i n
medial to hyoglossusmuscle
L i n g u a vl e i n Vagus nerve (X) and
C o m m u n i c a t i o nt o a n t e r i o rj u g u l a rv e i n sympathetictrunk
S u p e r i o rl a r y n g e avl e i n iddle scalenemuscle
S u p e r i o rt h y r o i dv e i n
A n t e r i osr c a l e n m
e uscle
j ul g u l avr e i n( c u t )
Externa
Thyroid gland
Transversecervical
M i d d l e t h y r o i dv e i n vein (cut)
Inferiorthyroid vei Suprascapularvein (cut)
o f a n t e r i o rj u g u l a rv e i n ( c u t )
Termination Subclavianartery
Left brachiocephalicvein S u b c l a v i a nv e i n
4{v
Plate 70 Pharynx
Nerves of Oral and Pharyngeal Regions
Zygomaticotemporalnerve (V2)
Deep temporal nerves(V3
Massetericnerve (V3)
M a n d i b u l a rn e r v e ( V 3 )
Nerve to medial pterygoid and
tensor veli palatinimuscles(V:) (cut)
Zygomaticofacialnerve (V2
M a x i l l a rny e r v e( V z )
I n f r a o r b i tn
ael r v e( V z )
Pterygopalatineganglion
Creater and lesser
p a l a t i n en e r v e s( V 2 )
AuriculotemporaI
A n t e r i o r ,m i d d l e ,a n d p o s t e r i o r nerve(V:)
s u p e r i o ra l v e o l a rn e r v e s( V 2 )
meningealartery
Nerve to lateralpterygoid Superficialtemporal
m u s c l e( V 3 )( c u t ) artery(cut)
B u c c a ln e r v e ( V : ) - Facialnerve(Vll)(cut)
C h o r d at y m p a n i n e r v e ( V l l ) Maxillaryartery
l e r v e( V 3 )
Linguan Accessorynerve (Xl) (cut)
Medialpterygoidmuscle(cut) C 1 s p i n anl e r v e
(lateralpterygoid removed) (ventralramus)(cut)
l n f e r i o ra l v e o l a r 2 spinalnerve
nerve (V:) (ventralramus)(cut)
Mental nerve (Vr) Pharyngeal plexuscomposedof

branches from glossopharyn geal
Nerve to mylohyoid (V3) (lX),vagus(X),and sympathetic
S u b m a n d i b u l agr a n g l i o n nerves
Clossopharyngealnerve (lX) Internalcarotidartery
a n d t o n s i l l a rb r a n c h External carotidartery
H y p o g l o s s anl e r v e ( X I l ) Vagusnerve(X)and superior
cervicalcardiacbranch
C a r o t i dn e r v e ( l X )a n d c a r o t i d
N e r v e t o t h y r o h y o i dm u s c l e( C 1 , 2 v i a X l l ) (ventralramus)(cut)
Internaland externalbranches Phrenin c e r v e( C 3 ,4 , 5 )
o f s u p e r i o rl a r y n g e a nl e r v e( X
cervicalartery
slPerior oot
A n s ac e r v i c a l i(sC l , 2 , r , I( M i d d l e s c a l e n em u s c l e
lnferiorroot, r scalenemuscle
Nerves to superior and inferior belliesof omohyoid,
sternohyoid,and sternothyroidmuscles(ansacervicalis)
Brachialplexus(cut)
Recurrentlaryngealnerve (X)
Sympathetictrunk and middle cervical
Common carotid artery Thyrocervicaltrunk
Vertebralartery
artery
Subclavian
*{r
Pharynx Plate 7l
Lymph Vessels and Nodes of Head and Neck
Superficial parotidnodes
(deepparotidnodes
d e e pt o a n dw i t h i n
parotid gland)
Subparotid
node
Facialnodes
Nasolabial
Buccinator nodes
Mastoid nodes
Mandibular Sternocleidomastoid
nodes nodes
Superiorlateral
Submandibular superficialcervical
nodes jugular)
(external
node
Jugulodigastricnode
Submental
nodes
superficial
cervical
(spinalaccessory)
Suprahyoid
node nodes
Superiordeeplateralcervical
(internal
jugular)nodes- Intercalatednode
Superiorthyroidnodes Inferiordeep
lateralcervical
(scalene)node
node
Juguloomohyoid
Thoracicduct
Anteriordeepcervical
(pretrachealand thyroid)nodes
(deepto infrahyoidmuscles) Transverse
cervical
chain of
Anteriorsuperficial
cervical nodes
nodes(anteriorjugularnodes
J u g u l atr u n k
Supraclavicular
nodes*
Subclaviantrunk and nooe
*Thesupraclavicular groupof nodes(also

knownasthe lowerdeepcervicalgroup),
especiallyon the left,arealsosometimes
referredto asthe signalor sentinellymph
4{tr
nodesof Virchowor Troisier, especially when
sufficiently
enlargedand palpable. These
nodes(or a singlenode)areso termedbecause
theymaybe the firstrecognizedpresumptive
evidenceof malignant diseasein the viscera.
Plale 72 Pharynx
Lymph Vessels and Nodes of Pharynx and Tongue
gobasilar
Pharyn fascia
nodes
Retropharyngeal
Digastricmuscle(posterior
belly)
muscle
Sternocleidomastoid
node
lntercalated
node
f ugulodigastric
Deep lateral cervical

(internaljugular) nodes
J u g u l o o m o h y oni o
dde
entralcollectingvessels
Marginalcollectingvessels
g vessels
Basalcollectin
to
Communication
Lymphaticdrainageof pharynx:
posteriorview
Lymphaticdrainageof tongue
node
Submental
S u b m a n d i b u lnaor d e
node
Jugulodigastric
Deeo lateralcervical
(internaljugular) nodes
node
fuguloomohyoid
Pharynx Plate 73
Thyroid Gland: Anterior View
Externalcarotid Hyoid bone
Internalcarotidarterv Superiorlaryngeal
nerve
Internalbranch
Superiorthyroidarteryand Externalbranch
Superiorlaryngeal
artery Thyroidcartilage(lamina)
Thyrohyoidmembrane Mediancricothyroid
ligament
Ansa t Superiorroot
cervicalis{ Inferior
root- muscles
Cricothyroid
Commoncarotid Cricoidcartilage
Internaljugularvein
Middlethyroidvein
Inferiorthyroidveins
Ascendingcervicalartery
Pretracheal
lymphnodes
lnferiorthyroidartery
'Phrenicnerve
Superficial
cervicalartery
Anteriorscalenemuscle
Suprascapular
artery
Vagusnerve(X)
Thyrocervical
trunk
jugularvein
External
Subclavian
arteryand Anteriorjugularvein
Vagus nerve (X) 1strib (cut)
Rightrecurrent Leftrecurrentlaryngeal
nerve
laryngeal
nerve
Brachiocephalic
trunk
Brachiocephalicveins
Supenor vena cava
Aortic arch
Thyroid cartilage
Cricothyroid
ligament
Commoncarotidartery
Medialmarginof
sternocleidomastoidmuscle
Cricothyroid
muscle
Cricoid cartilage
*{ry Thyroidgland
Cupula(dome)of pleura
Plate 74 Thyroid Gland and La;ynx

Thyroid Gland and Pharynx: Posterior View
Superiorpharyngeal ExternalcarotidarterY
constrictormuscle
lnternalcarotidarterY
Middlepharyngeal
muscle
constrictor
Facialartery
Tip of greaterhorn
Lingualartery
of hyoid[ens-
Superiorlaryngealnerve
Inferiorpharyngeal -lnternal branch
muscle'
constrictor
Externalbranch
raphe
Pharyngeal SuperiorthyroidarterY
Zoneof sparse
musclefibers SuperiorlaryngealarterY
CommoncarotidarterY
Cricopharyngeus
muscle(partof inferior
pharyngealconstrictor) Vagusnerve(X)
Circularesophageal Internaljugularvein
musclein V-shaped
areaof sparse Thyroidgland
muscle
longitudinal (rightlobe)
fibers (areaof Laimer)
Superiorparathyroidgland
Longitudinal
esophagealmuscle
cervicalartery
lnferiorthvroidvein
gland
Inferiorparathyroid
Trachea
lnferiorbulbof
i n t e r n aj ul g u l avr e i n nerve
Rightrecurrentlaryngeal
Vertebralarterv cervicalartery
Leftsubclavian artery
artervandvein
Thyrocervicaltrunk
Internalthoracic Rightsubclavian
arteryandvein arteryandvein
vein
Rightbrachiocephalic
Left brachiocephalicvein
trunk
Brachiocephalic
Left recurrent laryngeal
Arch of aorta Rightvagusnerve(X)
Leftvagusnerve Superiorvenacava
Thyroid Gland and Larynx Plate 75

Parathyroid Glands
SeealsoPlate 80
h y r o h y o i dm e m b r a n e External
carotidartery
Posterior view
Hyoid bon
Internalcarotidartery
S u p e r i ol ra r y n g e a l
Internalbranch Superiorthyroidartery
External branch
Superiorlaryngeal
artery
Vagusnerve(
Inferiorpharyngeal
muscle(cut)
constrictor
Epiglottis
Superiorthyroid
Fibrouscapsuleof
thyroidgland(cut)
Cricopharyngeusmuscle(partof
F i b r o ucsa p s u l e inferiorpharyngeal
constrictor)
of
t h y r o i dg l a n d( c u t )
Superiorparathyroid
gland
Superiorparathyroid
gland
Rightlobeof thyroidglano
Leftlobeof thyroidgland
Inferiorparathyroid glano
(maybe morecaudallylocated,
Ascendingcervicalarter e v e nw i t h i nm e d i a s t i n u m )
Inferiorparathyroid
gland
recurrentlaryngealnerve
Left recurrentlaryngealnerve Superficialcervical artery
Suprascapularartery
Esophagus
Thyrocervical
trunk
Subclavianartery Vertebral
artery
Subclavianartery
Trachea
Rightlateralview
lnternalbranchof
Externalcarotio
superiorlaryngealnerve
Superiorlaryngeal
arte
External
branchof
S u p e r i otrh y r o i da r t e r y( c superiorlaryngeal
nerve
Inferior pharyngealconstrictor muscle
Superiorparathyroid
gland
C o m m o n c a r o t i da
T h y r o i dg l a n d( r i g h lto b e )
I n t e r n aj ul g u l a r (retractedanteriorly)
Inferior parathyroidgland
Rightrecurrentlaryngeal
nerve
Esophagus
*{r
Plate 76 Thyroid Gland and Larynx
Gartilages of Larynx
Hyoidbone
Thyrohyoidmembr
Superiorhorn of thyroidcartil
cartilage
Corniculate
Arytenoidcartilage
Superiorthyroidnotch
Thyroidcartilagelami
Vocalligament
ligament
Mediancricothyroid
Inferiorhornof thyroid
Cricoid cartilage
Trachea
Anteriorview Posterior view
Corniculatecartilage
Cricoid MuscularprocessI Arytenoid

cartilage Vocalprocess f cartilage
Hyoepiglottic
ligament
Hyoidbone
Thvrohvoidmembrane
Thyroidcartilagelamina
O b l i q u el i n e
arynSealpromrnence
cart
Corniculate
Arytenoid
Muscularprocess
*{r
joint
Cricothyroid
Right lateralview Medial view, median

(sagittal)section
Thyroid Gland and Larynx Plale 77

lntrinsic Muscles of Larynx
piglottis Foramen for superior

yepiglottic laryngealvesselsand
fold internalbranchof
superiorlaryngealnerve
Cuneiform
tubercle
Corniculate andtransverse
tubercle arytenoidmuscles
Aryepiglottic
muscle Posterior
cricoarytenoid
muscle
Oblique
arytenoidmuscle
Transverse
arytenoidmuscle part I
Straight
Cricothyroid
Posterior
cricoarytenoid
muscle
Oblique
part t muscte
ricoidcartilage
Posterior Rightlateralview
view
Epiglottis
Aryepiglottic
muscle Thyroepiglottic
muscte
O b l i q u ea n d
transverse
Thyroarytenoid Arytenoid
arytenoidmuscles
muscte cartilage
Posterior
cricoarytenoid Lateral Laminaof
muscle cricoarytenoid
muscte
C o n u se l a s t i c u s
Cricothyroid
muscle (cut away)
Lateraldissection
Posteriorcricoarytenoidmuscre
Lateralcricoarytenoid
Transverse
and obliquearytenoidmuscles T
Cricothyroid muscle Conus

elasticus
Thyroarytenoid
muscle
Vocalismuscle Lamina of
Nr Vocal ligament
thyroid
cartilage

Actions of Intrinsic Muscles of Larynx
Nr
Action of cricothyroid muscles
Cricothyroidjoint
(pivotpoint) Lengthening (increasing
tension)
of vocalligaments
Action of posterior cricoarytenoidmuscles Action of lateral cricoarytenoidmuscles

Abduction of vocalligaments
++
Action of transverseand oblique arytenoidmuscles Action of vocalisand thyroarytenoidmuscles

Adduction of vocal ligaments Shortening(relaxation)of vocal ligaments
Thyroid Gland and Larynx Plate 79

Nerves of Larynx
Internalbranchof
Superior superiorlaryngealnerve
laryngealnerve
Sensorybranches
to larynx
Internalbranch
Externalbranch of Calen
Aryepiglottic
muscle
Thyroepi
glotticmuscle
Transverse
and oblique
arytenoidmuscles
Thvroarvtenoid
muscle
Vocalismuscle
Cricothvroid
muscle Lateralcricoarvtenoid
muscle
Posterior
cricoarvtenoid
muscle
Cricopharyngeus muscle
(partof inferior Thyroidarticularsurface
pharyngealconstrictor)
Anteriorand posteriorbranches
of
inferiorlaryngeal
nerve
Rightrecurrent
laryngeal
nerve Rightrecurrentlaryngeal
nerve
Rightlateralview:
thyroid cartilagelamina removed
Rightlateralview
Leftvagusnerve(X)
Rightvagusnerve(
Leftcommoncarotidartery
Anomalous right inferior Leftinferiorlaryngealnerve

laryngealnerve (not recu
recurrentlaryngeal
nerve
Anomalous (retroesophageal)
right subclavianartery
Leftsubclavian
artery
Right common carotid

Anomalous(retroesophageal)
rightsubclavian arteryoriginating
from leftsideof aorticarch
Archof aorta
Leftrecurrentlaryngeal
nerve
Anteriorview:
anomalousright
inferior laryngeal
nerve,not recurrent,
associatedwith
anomalousright
subclavianarterv
Nr
Eyelids
S u p e r i o rp a l p e b r a cl o n j u n c t i v a
t a r s a (l m e i b o m i a n )g l a n d s l a p i l l aa n d p u n c t u m
S u p e r i o rl a c r i m a p
s h i n i n gt h r o u g h
P I i c as e m i l u n a r i s
L a c r i m acl a r u n c l ei n
l a c r i m a l a k e( l a c u sl a c r i m a l i s )
C o r n e o s c l e r aj ul n c t i o n
(cornealimbus)
l a p i l l aa n d p u n c t u m
I n f e r i o rl a c r i m a p
B u l b a rc o n j u n c t i v a
over sctera
In f e r i o rc o n j u n c t i v aflo r n i x
L e v a t o rp a l p e b r a es u p e r i o r i sm u s c l e
O r b i t asl e p t u m
S u p e r i o rt a r s a l( M i . i l l e r ' sm) u s c l e( s m o o t h ) Sclera
S u p e r i o rc o n j u n c t i v aflo r n r x B u l b a rc o n j u n c t i v a
O r b i c u l a r i so c u l i m u s c l e( p a l p e b r apl a r t ) Palpebralconjunctiva
S u p e r i otra r s u s Cornea
T a r s a(lm e i b o m i a n )g l a n d s -Lens
S e b a c e o u sg l a n
A n t e r i ocr h a m b e r
( csi l i a )
Eyelashe
lris
*{r
O p e n i n g so f t a r s a lg l a n d s
P o s t e r i ocrh a m b e r
l n f e r i otra r s u s
O r b i c u l a r i so c u l i m u s c l e( p a l p e b r apl a r t )
In f e r i o rc o n j u n c t i v aflo r n i x
O r b i t a ls e p t u m
F r o n t a lb o n e
l n s e r t i o no f l e v a t o rp a l p e b r a e
s u p e r i o r im
suscle
Supraorbitalartery and nerve
S u p e r i otra r s u s S u p r a t r o c h l e aarr t e r ya n d n e r v e
L a t e r ap
l alpebraligament D o r s a ln a s a la r t e r y
a n d o v e r l y i n gr a p h e a n d i n f r a t r o c h l e anr e r v e
Lacrimalsac
I n f e r i o rt a r s u s
M e d i a lp a l p e b r a l i g a m e n t
M a x i l l a( f r o n t a lp r o c e s s )
Z y g o m a t i cb o n e - - F
Infraorbitalartery and nerve
Orbit and Gontents Plate 81

Lacrimal Apparatus
6sjtif'a:+
SeealsoPlates 45, 133
O r b i t a lp a r t o f
I a c r i m a gl l a n d
L a c r i m acl a n a l i c u l i
Palpebral partof
l a c r i m agl l a n d- Lacrimalsac
Excretoryducts of
l a c r i m ag
l land N a s o l a c r i m adl u c t
P l i c as e m i l u n a r i s
O p e n i n go f
n a s o l a c r i m adl u c t
L a c r i m a cl a r u n c l e
4{tr
I n f e r i o rl a c r i m a lp a p i l l aa n d p u n c t
Frontalbone (cut away)
L a c r i m acl a n a l i c u l i
O r b i t a lp a r t o f
lacrimag l land
L a c r i m a sl a c
Palpebralpart of
l l a n d-
l a c r i m ag
a s o l a c r i m adl u c t
Excretoryducts of
l a c r i m ag
l land
Middle nasal
concna
P l i c as e m i l u n a r i s
and lacrimal
Nasalcavity
L a c r i m acl a r u n c l e
I n f e r i o rn a s a l
I n f e r i o rl a c r i m a lp a p i l l aa n d p u n c t u m c o n c h a( c u t )
O p e n i n g o f n a s o l a c r i m adl u c t I n f e r i o rn a s a lm e a t u s
Plate 82 Orbit and Contents

Fascia of Orbit and Eyeball
Horizontalsection Tarsusof eyelid
M e d i a lp a l p e b r a l i g a m e n t
Palpebralconjunctiva
B u l b acr o n j u n c t i v a
4{r
Nasalcavity
Cornea
C h e c kl i g a m e not f Lateralpalpebralligament
medialrectusmuscle
r , - C h e c k l i g a m e n to f
E t h m o i d ac le l l s lateralrectus muscle
Periorbita Periorbita
Sclera
M e d i a rl e c t u sm u s c l e
andfascialsheath sheathof eyeball
Fascial
(Tenon'scapsule)
Fascialsheathof eyeball
(Tenon'scapsule) Episcleral
space
Lateralrectusmuscle
Sclera andfascialsheath
Retrobulbar fat
(orbitalfat body)
C o m m o nt e n d i n o ursi n g
Levatorpalpebraesuperiorismuscle and fascialsheath
Frontal section -{*y* Superioroblique muscle and fascialsheath
S u o e r i o rr e c t u sm u s c l e Medial rectus muscle and fascialsheath

and fascialsheath
Periorbita
Lacrimalgland Ethmoidalcell
Lateralrectusmuscleand
fascialsheath
Periorbita ascialsheathof eyeball
(Tenon's
capsule)
Scler
lnferiorrectusmuscle
Fascialsheathof eyeball andfascialsheath
(Tenon'scapsule)
I n f e r i o ro b l i q u e m u s c l e
Episcleral
space and fascialsheath
R e t r o b u l b a fra t ( o r b i t a lf a t Infraorbitalnerve (V2)
Muscleattachmentsand nervesand vesselsenteringorbit

S u p e r i oor r b i t a l Levatorpalpebrae muscle
superioris
l e r v e( V t )
L a c r i m an S u p e r i o ro b l i q u em u s c l e
F r o n t a ln e r v e ( V t ) Suoeriorrectus muscle
Trochlearnerve (lV) Medialrectusmuscle
S u p e r i o ro p h t h a l m i cv e i n
Lateralrectus
S u p e r i o rb r a n c ho f o c u l o m o t o rn e r v e( l l l ) lnferior rectus muscle
Inferiororbitalfissure l n f e r i o rb r a n c ho f o c u l o m o t o rn e r v e ( l l l )
A b d u c e n tn e r v e ( V l ) N a s o c i l i a r yn e r v e ( V 1 )
Orbit and Contents Plate 83

Extrinsic Eye Muscles
Rightlateralview S u p e r i oor b l i q u em u s c l e
Levatorpalpebrae
superioris
muscle
,Trochlea
(pulley)
Suoeriorrectusmuscle
Medialrectusmuscle
al rectusmuscle(cut)
C o m m o n t e n d i n o u sr i n g
Lateralrectusmuscle(cut) lnferiorobliquemuscle
Inferiorrectusmuscle
periortarsus
Superiorview
Levatorpalpebrae
muscle(cut)
superioris
S u p e r i oor b l i q u em u s c l e cF
Superiorrectusmuscle(cut)
Medialrectusmuscle
Lateralrectusmuscle
Inferiorrectus
Optic nerve(ll)
Superiorrectusmuscle(cut)
Levatorpalpebrae muscle(cut)
superioris
Innervationof extrinsiceve muscles: Trochtear

anteriorview S u p e r i oor b l i q u em u s c l et nerve(lV)
(
Levatorpalpebrae
superioris
muscle
Superiorrectus
Oculomotor
n e r v e( l l l ) Medialrectusmuscle
Inferiorrectus
4{tr I n f e r i oor b l i q u e
Plate 84 Orbit and Gontents

Arteries and Veins of Orbit and Eyelids
Superiorview Medialpalpebralartery
ateralpalpebralartery
Supratrochlear
a
Dorsalnasalarterv
artery
Supraorbital
A n t e r i om
r eningeal
Zygomaticbranches
Anteriorethmoidal
ciliaryarteries
Posterior
Posterior
ethmoidal
M u s c u l abr r a n c h
Continuation of ophthalmic arter Lacrimal

artery
M u s c u l abr r a n c h Centralretinalartery
Ophthalmic
Supraorbital
artery
Supratrochlear
artery
nasalartery
Anteriorview
Superiormedial
palpebralartery
Frontalbranchof
superficial
temporal Angular artery
Superiorlateralpalpebral lnferior medial

palpebral artery
Inferiorlateralpalpebral
arter
S u p e r i oar n di n f e r i o r
palpebralarterialarches
Zygomaticofacial artery
Facialartery
Transversefacial
(X = anastomosisof vesselsfrom
Infraorbital
artery
externaland internalcarotid arteries)
Supratrochlear
vein
Lateral view
Supraorbitalvein Nasofrontalvein
S u p e r i o ro p h t h a l m i cv e i n A n g u l avr e i n
C a v e r n o ussi n u s Vorticoseveins
Facialvein
I n f e r i o ro p h t h a l m i cv e i n
Pterygoid
Maxillaryvein
R e t r o m a n d i b u l avre i Deep facialvein 4{F

Nerves of Orbit
-&lLrJ e
Superiorview
Supratrochlear
nerve Levatorpalpebrae
superioris
muscle
Medialrectusmuscle S u p e r i orre c t u sm u s c l e
Lacrimalgland
S u p e r i oor b l i q u em u s c l e
Lacrimalnerve
Infratrochlear
nerve
Lateralrectusmuscle
Nasociliarynerve
Frontalnerve
Trochlearnerve (lV)
Maxillarynerve(Vz)
Meningealbranch
of maxillarynerve
O p h t h a l m i cn e r v e ( V 1
M a n d i b u l anre r v e( V : )
Lesserpetrosalnerve
and nerve plexus Meningeal branch
of mandibularnerve
O c u l o m o t o r n e r v e( l l l )
Trochlearnerve (lV) ,
T r i g e m i n a(l s e m i l u n a rg) a n g l i o n
Abducent nerve (Vl) Tentorial(meningeal)
i:!;1
i
branch of ophthalmic nerve
Tentorium cerebelli il-
Long ciliary nerves

Superior view:
levatorpalpebraesuperioris, Short ciliary nerves
superiorrectus,and superior Lacrimalnerve
obliquemusclespartially
cut away C i l i a r yg a n g l i o n
Parasympatheticroot of ciliary
nerve(cut)
Supratrochlear ganglion(frominferiorbranch
of oculomotornerve)
Supraorbital
nervebranches(cut)
theticroot of ciliary
Infratrochlear
n ganglion (from internal
carotid olexus)
Anteriorethmoidal
Sensoryroot of ciliary ganglion
O p t i c n e r v e( l l ) (fromnasociliary
nerve)
Posteriorethmoidal nerve
to inferior
Branches
S u p e r i o rb r a n c ho f and medialrectusmuscles
o c u l o m o t o rn e r v e ( l l l ) ( c u t
A b d u c e n tn e r v e ( V l )
Nasociliarynerve Inferior branch of
oculomotor nerve (lll)
Internalcarotid plexus
Lacrimalnerve
Trochlearnerve (lV) (cut)
Frontalnerve (cut)
A b d u c e n tn e r v e ( V l )
O p h t h a l m i cn e r v e ( V 1 )
*{r
Plate 86 Orbit and Contents
Eyeball
Horizontal section Cornea
Z o r r u l afri b e r s C a p s u l eo f l e n s A n t e r i o rc h am b e r
( s u s p e n s o rl yi g a m e n ot f l e n s )
Posle r i o r c h a
S c l e r avl e n o u ss i n u s
( c a n a ol f S c h l e m m )
Iridoco I angle
S c l e r asl p ur 'ocesses
tl
C i l i a r yb o d y a n d c i l i a r yn r u s c l e
B u l b a rc o n j u n c t i v a
C i l i a r yp a r t o f r e t i n . r
I Ora serrata
T e n d o no 1
l a t e r a lr e c t u s Tendon
muscle medial
muscte
,
I
I
t
{
I\
\
\
\.
V i t r e o u sb o d y
I space/ H y a l o i dc a n a l
Sclera L a m i n ac r i b r o s ao f s c l e r a
s h e a t ho f
's
c a p s ul e O p t i c n e r v e( l l )
C e n t r a lr e t i n a l
4{tr" Subarachnoid
spac'e

Anterior and Posterior Ghambers of Eye
Schwalbe'sline Posteriorlimitinglamina
(Descemet'smembrane)
Trabecularmeshworkand spaces
of iridocornealangle(of Fontana) Endotheliumof anteriorchamber
Scleralvenoussinus(canalof Schlemm) Cornea
lridocorneal
angle
Pectinateligament
Major arterial
circleof iris
Anteriorciliaryvein
Bulbar
conjunctiva Anterior chamber
Sclera
Minor arterial
circleof iris
Ciliary Meridional Circular

part of fibers fibers
Dilatorpupillae
muscle
Ciliarymuscle
Pigment Nucleusof lens
epithelium
Ciliarybody (iridialpartof Capsuleof lens
retina)
Perichoroidal
space Sphincterpupillaemuscle
Note:For clarity,only singleplaneof zonularfibersshown;

actually,
fiberssurroundentirecircumference of lens.
4{tr
Plate 88 Olbit and Contents

Lens and Supporting Structures
Optic part of retina
Ora serrata
O r b i c u l ucsi l i a r i os f
ciliarybodycovered
by ciliarypartof retina
Ciliaryprocesses Cortex
Equator
Z o n u l a fri b e r s
Eveballsectionedin frontal plane:

airteriorsegmentviewedfrom behind
Zonularfibers
4{r Orbiculusciliarisof ciliarvbody

Horizontalsection
Ora serrata
O r b i c u l ucsi l i a r ios f
ciliarvbodvcovered Zonularfibersfanningout
Optic part
by ciliarypartof retina and blendinginto lenscapsule
of retina
of segmentoutlinedin top illustration(semischematic)

Enlargement

Intrinsic Arteries and Veins of Eye
SeealsoPlate 85
Minor arterialcircle of iris

Anterior chamber
M a j o r a r t e r i a cl i r c l eo f i r i s
( c a n a lo f S c h l e m m )
Blood vesselsof ciliary body
coniunctivaand
conjunctivalvessels
Anterior ciliaryartery and vein
I Ciliary
lridocorneal IL e n s body
angre
Ora serrata
P o s t e r i ocrh a m b e i
M u s c u l aar r t e r ya n dv e i n
Z o n u l a fri b e r s
Extrinsic
eye muscle
Vitreouschamber
Long posterior ciliary artery
Vorticosevein
Episcleralartery and vein
Retinalartery and vein
Long posteriorciliary artery
posteriorciliary arteries
S u p e r i o rm a c u l a r
Central retinalartery and vein arterioleand venule
S u p e r i onr a s a l
S u p e r i otre m p o r a l retinalarteriole
r e t i n aal r t e r i o l e a n dv e n u l e
\ ano
Macula Optic disc

Foveacentralis
*{r Inferiortemporal
retinalarteriole
and venule
Inferiornasal
retinalarteriole
a n dv e n u l e
Inferior macular
Right retinal vessels:ophthalmoscopic view arterioleand venule
Plate 90 Orbit and Gontents

Vascular Supply of Eye
within the choroid (vasculartunic) of the eyeball

Vasculararrangements
Anterior tributariesof a vorticosevein

Anterior ciliary arteries
Tendonof superiorrectus muscle

J u n c t i o nosf s u p r a c h o r o i d a l
Sclera tributaries formingvorticosevein
Posteriorconjunctival S u p e r i oor p h t h a l m ivce i n

artery and vein
Bulb of vorticose(choroid)vein
Vorticose(choroid)vein
A n t e r i o rc i l i a r yv e i n s
Longposterior
ciliaryartery
Malor arterialcircle of iris

Shortposterior
Minor arterial ciliaryarteries
c i r c l eo f i r i s
sheathof
External
opticnerve(duramater)
Conjunctiva
ano cornea
lnternalsheath
of optic nerve
(pia-arachnoidmater)
Shortposterior
ciliaryarteries
Centralretinal
Arteriesand arteryand vein
v e i n so f i r i s
( c a n a lo f S c h l e m m ) of internal
Vessels
sheathof optic nerve
Veinsdrainingscleralvenous
sinus(into anteriorciliaryveins)
Shortposterior
ciliaryarteries
A n t e r i o rc i l i a r yv e i n s
Segmentof episcleralvein*
N o n p ig m e n t e da n d p i g m e n t e d
regionsof the retina Muscular
artery lnferiorophthalmicvein
Recurrentbranch of anterior ciliarvarterv Posteriortributariesof a vorticose vein
*The episcleralveinsare shown here anastomosin1with the vorticose veins, Cryd4s/*

which they do; however they also drain into thi anterior ciliary veins.

Pathway of Sound Reception
Frontalsection Facialnerve (Vll) (cut)
Limbs of stapes Baseof stapesin oval (vestibular)window

Prominenceof lateralsemicircularcanal
Vestibule
Semicircularducts, ampullae,utricle,and saccule

Tegmen tympani
Facialnerve (Vll) (cut)
M a l l e u s( h e a d )
Epitympanic Vestibular
nerve
Cochlear nerve
Internalacoustic
meatus
Vestibulocochlear
n e r v e( V l l l )
External
acousticmeatus Nasopharynx
Tympanicmembrane'
Tympaniccavity
Cochlea
Promontory
Round (cochlear)window
Scalatvmpi
, Auditory(pharyngotympanic,Eustachian)tube
4Ntr Note: Arrows indicatecourse of sound waves.
Plate 92
External Ear and fVmpanic GavitY
Rightauricle(pinna) Otoscopicview of right tympanicmembrane

Triangular
fossa C r u xo f h e l i x
meatus
acoustic
External
t Y a r Sf l a c C l O a
Lateralprocessof malleus
Scaphoidfossa Posteriormallearfold
Cruraof antihelix Anteriormallear

fold
Auriculartubercle(of Darwin) L o n gl i m bo f i n c u s
Antihelix Tragus H a n d l eo f m a l l e u s
Concha of auricle Intertragicnotch Umbo

tttragus
Lobuleof auricle Coneof light
fympanic
Parstensa
Coronaloblique sectionof externalacousticmeatusand middle ear (tympaniccavity)
S u p e r i o rl i g a m e n to f m a l l e u s of malleus
Long limb of incus
S h o r lt i m bo f i n c u s Tendonof stapediusmuscle
Footplateof stapes
}, Handleof malleus
Chorda tympani nerve (cut) with tympanicplexus
Promontory
Anterior ligment of malleus(cut)
Tensortympanimuscle
Tympanicmembrane
Tensorveli palatinimuscle
Tympaniccavity
Auditory(pharyngotympanic,
Eustachian)
tube
Righttympaniccavity after removalof tympanicmembrane (lateralview)
Chorda tympani nerve process
Lateral of malleus
Tendon of tensor tympani muscle
L o n gl i m b o f i n c u s
Ossiclesarticulated:medial view
Prominenceof facial canar
Pyramidaleminence and tendon

of stapediusmuscle Handle of malleus process
Lenticular
of incus
Stapes Tympanic
C/Fd4g/*
Fossaof round window
Tympanic nerve
Lesserpetrosalnerve
plexuson promontory
Tympanic 4{tr
Ear Plate 93
lVmpanic Gavity
tateral wall of tympaniccavity:medial(internal)view
Superiorligament of malleus
Head of malleus
S u p e r i ol ri g a m e not f i n c u s
Epitympanic
recess
S h o r tl i m bo f i n c u s
Anteriororocessof m
Posterior
mallearfold
Chordatympaninerve
Posteriorligament of incus
Anteriormallearfold
Long limb of incus
Tensortympanimuscle
tympani nerve
H a n d l eo f m a l l e u s
Lenticular
processof incus
Tympanic membrane
(parsten
Facialnerve(Vll)
Auditory
(pharyngotympanic,
Eustachian)
tube/
lnternalcarotid artery
Medial wall of tympaniccavity:lateralview

Prominenceof lateralsemicircularcanal
Prominenceof facial canal

Mastoid antrum
G e n i c u l u m( g e n i c u l a t eg a n g l i o n )o f f a c i a ln e r v e
Baseof stapesin
fossaof oval (vestibular) Creater petrosalnerve
Tensortympanimuscle
Limbsof s (tendoncut)
-/
Pyramidaleminence Auditory
(pharyngotympanic,
Eustachian)
tube
Chorda tympani nerve (cut)
Levatorveli palatini
muscle
Mastoid cel
Tendonof stapedius
muscle
Promontory with tympanic
n e r v e ( o f J a c o b s o n a) n d p l e x u s
Fossa
of round unoer mucosa
(cochlear)
window fossi
Jugular
Facialnerve (Vll) Tympaniccells
in stylomastoid
foramei
4{F
Plate 94
Bony and ltlembranous Labyrinths
Rightbony labyrinth(oticcapsule),anterolateralview: Dissectedrieht bonv labvrinth(otic capsule):

suiroundihgcincellousbone removed membranoui labyriirth rbmoved
Ellipticalrecess
Cochlearrecess Vestibule
(note
perforations
for nerve
fibers)
Helicotrema
Internalopeningof Scalavestibuli
aqueduct
vestibular
Osseousspiral
lamina
Scalatympani
Rightmembranouslabyrinthwith nerves:posteromedialview
duct
Anteriorsemicircular
Superiorpartof vestibular
ner
(fromutricleandanteriorand
ampulla
Anteriormembranous
lateralmembranous ampullae)
ampulla
Lateralmembranous
Cochlearduct (basalturn)
Common
membranous
limb
Cochlearnerve
Lateral
semicircular
duct
Posterior
Vestibulocochlear
nerve semicircular
duct
Vestibular
membranous
Posterior
ampulla
ganglion
Vestibular
4{F nerve(from
lnferiorpartof vestibular
duct
Endolymphatic
sacculeand posteriormembranous ampulla)
Ear Plate 95
Bony and Memblanous Labyrinths (continuedl
Bonyand membranouslabyrinths:schema
A n t e r i o rs e m i c i r c u l acr a n a la n d d u c t
Posteriorsemicircular Dura mater

c a n a la n d d u c t
Endolymphaticsac
Common bony and
m e m b r a n o ul is Endolymphaticduct
i n v e s t i b u l aa
r queduct
Lateralsemicircular f,\,
canal and duct Utricle
Otic capsule Saccule
Stapesin oval Helicotrema of cochlea

(vestibular)window
D u c t u sr e u n i e n s
In c u s
Scalavestibuli
Malleus
C o c h l e a rd u c t
Tympanic cavity
Externalacoustic meatus Scalatympani
Umbo
Tympa n rc memor ane------7
ochlear aoueduct
R o u n d ( c o c h l e a rw
) indow
(closedby secondary Otic capsule
Vestibule
t y m p a n i cm e m b r a n e )
Pharyngotympanic(auditory) tube
Sectionthroughturn of cochlea
Scalavestibuli
Osseous
s p i r alla m i n a (Reissner's)
Vestibular
memDrane
Nervefibers Cochlearduct
Spiral igament
M o d i o l u so f Tectorialmembrane
Spiralorgan(of Corti)
S p i r a lg a n g l i o n
Basilam
r embrane
Scalatympani Osseouscochlea
Outerhaircells
Cochlear nerve P i l l a(rr o d )c e l l s
4{tr I n n e rh a i r c e l l
Plate 96
Orientation of Labyfinth in Skull
Superiorprojectionof
Croovefor greaterpetrosalnerve
right bony labyrinth
on floor of skull
Geniculum(geniculate
ganglion)of facialnerve
Cochlea
zPlaneof anterior
,/ semicircularcanal
Cochlear nerve
Facialnerve(Vl
lnternalacoustic
openrnS
nerve(Vlll
Vestibulocochlear Lateralsemicircular
canal
Vestibular
nerve
Petrouspart
of temporalbone
External
openingof \. Planeof posterior
vestibular
aqueduct canal
(forendolymphatic semicircular
duct)
lateral projection of right membranouslabyrinth

Ceniculum(geniculate Cochlearduct
of facialnerve
Cochlearnerve
Trigeminal nerve (V) part of

vestibular
nerve
Vestibulocochlear
n e r v e( V l l l ) lnternaljugularvein
Inferiorpart of
vestibularnerve
duct
al semicircular
Posterior duct
semicircular
Superior
petrosalsinus
Sigmoid
sinus
Confluence
of sinuses
Transverse
sinus 4{tr
Ear Plate 97
Auditory (Pharyngotympanic, Eustachian| Ti,rbe
SeealsoPlates 52, 55, 65
C a r t i l a g i n o u sp a r t o f a u d i t o r y
( p h a r y n g o t y m p a n i c ,E u s t a c h i a n )
t u b e a t b a s eo f s k u l l : i n f e r i o r v i e w
Palatineprocessof maxilla
P t e r y g o i dh a m u l u sa n d
medial pterygoid plate. Horizontal plate of palatinebone
Lateralpterygoid plate
Choana
Scaphoidfossa . ) of cartilaginouspart of
f?l"l,il11ti"1t auditorylpharynsotympanic,
M e d t a ll a m t n a )
E u s t a c f r i a nt u) b e "
Foramenovale
Foramenlacerum
F O r a m e nS p r n o s u m
S p i n eo f s p h e n o i db o n e Petrouspart of temporal bone
Internalcarotid artery Occipital condyle

entering carotid
Mastoidprocess
Foramenmagnum
Sectionthrough cartilaginouspart of auditory Sectionthrough cartilaginouspart of auditory

(pharyngotympanic, Eustachian)tube, (pharyngotympanic, Eustachian)tube,
with tube closed with tube open
Trigeminalganglion
T r i g e m i n agl a n g l i o n
Internalcarotid artery Internalcarotid artery in carotid cana
in carotid canal Duramater
Duramater
Laterallamina
Laterallamina of cartilage
of cartilage
M e d i a ll a m i n a
M e d i a ll a m i n a of cartil
of cartilage
Auditorytubelumen
A u d i t o r yt u b el u m e n
Tensorvelipalatini
Tensorveli palatini muscte
muscte
muscle
muscle
Salpingopharyngeu
s S a l pni g o p h a r y n g e u s
muscte muScre
Nasopharynx Nasopharynx
Auditory(pharyngotympanic, Eustachian) tubeclosedby Lumen opened chiefly when attachment
4{tr elasticrecoilof cartilage,

salpingopharyngeus
tissueturgidity,
muscles
and tensionof of tensor veli palatinimuscle pulls wall
of tube laterallyduring swallowing
Plate 98 Eat
Meninges and Diploic Veins
. : j ' , '
SeealsoPlate
D i p l o i cv e i n A r a c h n o i dg r a n u l a t i o n
Coronal
dissection C e r e b r a vl e i n ( b r i d g i n gv e i n ) p e n e t r a t e s u b d u r a sl p a c et o e n t e r s i n u s
S u p e r i o rs a g i t t aSl I NU
D u r a m a t e r( p e r i o s t e aal n d m e n i n g e a l a y e r s )
E m i s s a r vy e i n D u r a - s k u l li n t e r f a c e( s i t eo f e p i d u r a lh e m a t o m a )
Frontaa l n d p a r i e t a lt r i b u t a r i e s Arachnoid
o f s u p e r f i c i atle m p o r a lv e i n space
Subarachnoid
Frontaa l nd parietab l ranches P i am a t e r
o f s u p e r f i c i atle m p o r a la r t e r y
Middlemeningeal
C r a n u l a rf o v e o l a
( i n d e n t a t i o no f s k u l lb y Deep,
a r a c h n o i dg r a n u l a t i o n ) m i d d l e ,a n d
superficial
L a t e r a (l v e n o u s )I a c u n a temporal
B r i d g i n gv e i n artefles
Inferior and veins
sagittal
SINUS
/t
l{1,
'l
ir,
S u p e r i o rt h a l a m o s t r i a t ae n d
c h o r o i d a lv e i n s ,i n t e r n a lc e r e b r a l
v e i n s ,a n d c h o r o i d p l e x u so f
D e e p a n d s u p e r f i c i am
l iddle
l a t e r a vl e n t r i c l e
c e r e b r a vl e i n s
Diploicand emissary
v e i n so f s k u l l P a r i e t ael m i s s a r yv e i n
P o s t e r i o tre m p o r a l
l i p l o i cv e i n
Frontad d i p l o i cv e i n
O c c i p i t a le m i s s a r yv e i n
A n t e r i o rt e n r p o r a l
d i p l o i cv e i n
d i p l o i cv e i n
M a s t o i de m i s s a r yv e i n
Nr
Meninges and Brain Plate 99
Meningeal Arteries
Frontal(anterior)and parietal Arachnoid sranulations

(posterior)branchesof
m i d d l e m e n i n g e a al r t e r y
O p e n i n go f s u p e r i ocr e r e b r avle i n
Middle
Lateral(venous)lacuna
meningealartery
Superiorsagittalsinus
Anterior
meningeal
branch of
Dura mater
anterior
ethmoidal
artery
Mastoid branch of
occipital artery
M e n i n e e a lb r a n c h e so f
ascendingpharyngealartery
Mastoid branch of
occipital artery
Middle meningealartery
Recurrentmeningealbranch of
l a c r i m a( lo p h t h a l m i a
c )r t e r y
Accessory meningealartery
Anterior meningealbranch of
anteriorethmoidalartery
Posteriorethmoidal artery
Internalcarotid artery and its
meningohypophysealtrunk* (phantom
M i d d l e m e n i n g e a al r t e r y
4{tr
Accessorymeningeal
Superficial
temporalartery
Maxillaryartery
Anterior and posterior
Posterior
auricularartery meningealbranchesof
Occipitalartery vertebralartery
Externalcarotidarter
Tentorial,cavernoussinus,and meningeal
branchesof meningohypophysealtrunk*
*Variant;most commonly,
these branchesarisedirectly from internalcarotid artery.
Plate l OO Meninges and Brain

Epidural Hematoma
Temporalfossahematoma
Medial displacementof Shiftof normal
middle cerebralvessels midlinestructures
Skullfracture Compressionof
crossingmiddle posteriorcerebrala.
meningeal a.
Shiftof brainstemto
opposite side may
Herniationof reverselateralization
temporallobe of signsby tentorial
undertentorium pressureon contra-
cerebelli
6ii lateralpathways.
Herniationof
cerebellartonsil
Compressionof oculomotor(lll) n.
hemiparesis,deeptendonhyper-
pupil dilatation
reflexia, sign
and Babinski's
leadingto ipsilateral
and 3rd cranialn. musclepalsv
"Questionmark" skin incision(black);

outlineof free bone flap and burr holes(red)
Skinflap reflected(Raneyclipscontrolbleeding).Freebone
flap removed and dura opened. Clot evacuatedby irrigation,
suction,andforceos.
Sectionshowingacutesubduralhematomaon rightsideand
'subduralhematoma associatedwith temooral lobe intracerebral
hematoma ("burst" temporal lobe) on left
Nr
Meninges and Brain Plate I Ol
Meninges and Superficial Gerebral Veins
Calvaria
Pericranium Cranularfoveola
Superiorsagittalsinus
Galeaaponeurotica
Arachnoidgranulation Emissarv
vein
Tributary
of superficial
temporalvein
(siteof epiduralhematoma)
Duramater
Arachnoid-durainterface
Bridgingvein (siteof subduralhematoma)
Arachnoid
Subarachnoid
space
Piamater
erebralartery
Superiorcerebralvein
Falxcerebri
al hemisphere
Branches
of middlemeningeal
artery
Superiorcerebralveins
Superiorsagittal (bridgingveins)(penetrating
arachnoidand dura materto
entersuperiorsagittalsinus)
Duramater
Superiorcerebralveins
(beneatharachnoid)
ior anastomotic
vein (of Trolard)
Inferioranastomotic
vein (of Labb6)
middle
Superficial
cerebralvein
Middlemeningeal
4{r
arterVandveins/
Inferiorcerebralveins
(beneatharachnoid)
Plate I 02 Meninges and Brain

Dural Venous Sinuses
S u p e r i osra g i t t asli n u s
si
Straight
Sagittalsection
Creatcerebralvein(of Calen)
cerebelli
Tentorium
S u p e r i osra g i t t asli n u s
Inferiorsagittalsi
S p h e n o p a r i e t asli n u s
Anterior and oosterior

intercavernoussinuses
Superior
petrosalsinus
Basilar
v e n o u sp l e
Inferior
petrosalsin
Tojugular
foramen
Sigmoid
sinus
Transversesinus
O c c i p i t asl i n u i
Falxcerebelli
*{r of sinuses
Confluence
Meninges and Brain Plate 1O3

Dural Venous Sinuses (continuedl
Skullsectionedhorizontally:
superiorview H y p o p h y s (i p
s i t u i t a rg
yland)
S u p e r i o rs a g i t t asl i n u s( c u t ) , T O p t i c n e r v e( l l )
Falxcerebri (cut) Internalcarotid artery
S u p e r i o ro p h t h a l m i cv e i n O c u l o m o t o r n e r v e( l l l )
A n t e r i o ra n d p o s t e r i o r S p h e n o p a r i est ai nl u s
i ntercavernous
s tn u s e s Trochlearnerve (lV)
S u p e r f i c i am
l iddle O p h t h a l m i cn e r v e ( V 1 )
cerebralvein (cut)
Maxillary nerve (V2)
C a v e r n o u ss i n u s
Basilar T r i g e m i n agl a n g l i o n
v e n o u sp t e M a n d i b u l a rn e r v e ( V : )
Superior
p e t r o s a sl i n u s M i d d l e m e n i n g e a al r t e r y
Inferior Abducent nerve (Vl)

p e t r o s a sl i n u s Petrosalvein
Tentorial
artery F a c i a nl e r v e ( V l l ) ,
i n t e r m e d i a t en e r v e ,a n d
Tentorium v e s t i b u l o c o c h l e anre r v e ( V ll l )
cerebelli
C l o s s o p h a r y n B(el X
a l)
Inferior andvagus(X)nerves
cerebralvein
(cut J u g u l a fro r a m e n
Transverse
sinus
I n f e r i osr a g i t t a l
s i n u s( c u t ) Transverse
sinus
S t r a i g h st i n u s
Accessory nerve (Xl)
Falxcerebri (cut)
H y p o g l o s s anl e r v e ( X l l )
C o n f l u e n c eo f s i n u s e s '#r" r e a t c e r e b r a vl e i n ( o f C a l e n )
S u p e r i o rs a g i t t asl i n u s( c u t )
*{r C a v e r n o u ss i n u s ic chiasm
Posterior
c o m m u n i c a t i n ga r t e r y
Trochlearnerve (lV)
lnternalcarotid
A b d u c e n tn e r v e ( v l ) arrery
O p h t h a l m i cn e r v e Hypophysis
( p i t u i t a r yg l a n d )
M a x i l l a r yn e r v e
S p h e n o i d asl i n u s
Coronal section Nasopharynx

t h r o u g h c a v e r n o u ss i n u s
Plate 1O4 Meninges and Brain

Gerebrum: Lateral Views
Centralsulcus(of Rolando) gyrus

Postcentral
gyrus
Precentral sulcus
Postcentral
Precentral
sulcus
Superiorparietallobule
Superiorfrontalgyrus
Intraparietal
sulcus
Suoeriorfrontalsulcus
Inferiorparietallobule
Middlefrontalgyrus
pramarginal gyrus
Inferiorfrontalsulcus gurargyrus
Inferiorfrontalgyrus to-
Opercularpart occipital
Triangular part sulcus
Orbitalpart
Frontal
pole pole
Calcarine
sulcus
Lunatesulcus
t
Lateralsulcus Anteriorramus
(of Sylvius) Ascending ramus
(inconstant)
t
Posteriorramus
Transverse
occipitalsulcus
Superiortemporalgyrui notch
Preoccioital
Temporalpole
Superiortemporalsulcui Inferiortemporalgyrus
Middletemporalgyru
Inferiortemporalsulcui
Frontallobe
Parietallobe
Temoorallobe
Occipital Parietal ooerculum

F r o n t aol p e r c u l u m
Orbitalooerculum
Shortgyri
lnsula Centralsulcus
(island
4{r
Limen
of Reil) Longgyrus
C i r c u l asr u l c u s
Temporaloperculum
Meninges and Brain Plate I 05

Gerebrum: Medial Views
Forhypophysis
seePlate 147
S a g i t t a ls e c t i o n o f C i n g u l a t eg y r u s P a r a c e n t r aslu l c u s
brain in situ C e n t r a ls u l c u s( o f R o l a n d o )
Cingulate
sulcus
M e d i a l f r o n t a lg y r P a r a c e n t r al ol b u l e
M a r g i n a ls u l c u s
S u l c u so f c o r p u sc a l l o s u
C o r p u sc a l l o s u m
Fornix
;. -,-Precuneus
S e p t u n 'pr e l l u c i d u m
S u p e r i o rs a g i t t asl i n u s
I n t e r v e nt r i c u l a r
C h o r o i dp l e x u s
f o r a m e n( o f M o n r o
of 3rd ventricle
lnterthalamic '/
S t r i am e d u l l a r i s
adhesion 1 of thalamus
T h a l a m ua
snd Parietooccipital
3rd ventricle S UI C U S
S ub c a l l o s a l C un e u s
(parolfactory) Habenular
commrssure
Anterior P i n e a lb o d y
commtssure Posterior
S ub c a l l o s a l commtssure
gyrus Calcarine
Hypothalamic s ur c u s
S UI C US S t r a i g h st i n u s
in tentorium
L.rmina
cerebelli
te
S up r a - r e a t c e r e b r a vl e i n
optrc
recess S u p e r i o cr o l l i c u l u s
Optic chi I n f e r i o rc o l l i c u l u s
Tubercinereun'r T e c t a l( q u a d r i g e m i n a p l )l a t e
erebellum
H y p o p h y s i s( p i t u i t a r yg l a n o l
S u p e r i o rm e d u l l a r yv e l u m
M a m m i l l . r r yb o d y
4 t h v e n t r i c l ea n d c h o r o i d p l e x u s
C e r e b r a lp e d u n c l e I n f e r i o rm e d u l l a r yv e l u m
Cerebraa l queduct
M e d u l l ao b l o n g a t a
(ot Sylvius)
M e d i a l s u r f a c eo f c e r e b r a l
h e m i s p h e r e :b r a i n s t e m e x c i s e d
C i n g u l a t eg y r u s
M am m i l l o t h . r l a m i c l s t h m u so f c i n g u l a l eg y r u s
fasciculus
P a r i e t o o c c i p i t as lu l c u s
M a m m i l l a r yb o d y
C un e u s
uncu5
C a l c a r i n es u l c u s
O p t i c n e r v e( l l
Linguag
l yrus
( ) l i a c t o r yt r a c t
C o l l a t e r asl u l c u s
Eifl,""orro,ni*
R h i n asl u l c u s
I
M e d i a l o c c i p i t o t e m p o r agl y r u s F i m b r i ao f h i p p o c a m p u s
O c c i p i t o t e m p o r asl u l c u s
D e n t a t eg y r u s
L a t e r a ol c c i p i t o t e m p o r agl , y r u s
P a r a h i p p o c a m p agly r u s
*{r
Gerebrum: Inferior View
Sectionedbrainstem Frontalpole of cerebrum cerebralfissure

Longitudinal
Straightgyrus Cenu of corpuscallosum
Olfactorvsulcus L a m i n at e r m i n a l i s
Orbitalsulci Olfactorybulb
Orbitalgyri factory tract
Temporalpole of cerebrum O p t i cc h i a s m
Optic nerve(ll) (cut)

Lateralsulcus(of Sylvius)
Hypophysis
Inferiortemporalsulcus (pituitarygland)
Inferiortemporal Anterior
perforated
substance
Optic tract
u b e rc i n e r e u m
Inferior(infero- Mammillarybody
l a t e r a lm
) argin
of cerebrum Posteriorperforated
substance (in
interpeduncular
R h i n asl u l c u s fossa)
ebralcrus
Uncus
Lateralgeniculate
body
Inferior
temporal gyru nigra
Substantia
Medialgeniculate
Occipitotemporal body
surcus
ed nucleus
Lateraloccipito-
temporal gyrus i n a ro f t h a l a m u s
Superiorcolliculus(of
Collateral corporaquadrigemina)
ebralaqueduct
Parahippocampal
gyrus
o f c o r p u sc a l l o s u m
Splenium
Medial occipitotemporalgyrus Apexof cuneus
Calcarine
sulcu Occipitalpole of cerebrum
cerebralfissure
Longitudinal
lsthmusof cingulate
4{r
Ventricles of Brain
Left lateralphantomview Frontal(anterior)

horn
Centralpart Left
Rightlateralventricle lateral
Temporal(inferior)horn ventricle
Occipital (posterior)horn
Cerebralaqueduct(of Sylvius)
4th ventricle
Leftlateralaperture
(foramenof Luschka)
Leftinterventricular Leftlateralrecess
foramen(of Monro)
3rd ventricle Medianaperture
(foramenof Magendie)
Supraoptic
recess
Interthalamicadhesio6
I n f u n d i b u l ar er c e s 6 Centralcanalof soinalcord
Pinealrecess
Suprapineal
Corpus callosum
S e p t u mp e l l u c i d u m
Lateralventricle
Body of caudate nucleus
Choroid plexusof lateralventricle
Striaterminalis
Superiorthalamostriatevein
Body of fornix
Internalcerebralvein
Tela choroidea of 3rd ventricle
id plexusof 3rd ventricle
Thalamus
Putamen ) ,
) Lenurormnucreus
C l o b u s p a l l i d u s)
I n t e r n a cl a p s u l e
3rd ventricleand interthalamicadhesion
=
Hypothalamus
Tail of caudate nucleus
Optic tract
White arrow in left Temporal (inferior)horn of lateralventricle
interventricular
F i m b r i ao f h i p p o c a m p u s
foramen (of Monro)
-
Hippocampus
Ependyma
- Dentategyrus
Pia mater
Coronal section of brain: posterior view

gyrus
Parahippocampal
4{F

Girculation of Gerebrospinal Fluid
Choroid plexusof lateralventricle(phantom) Superiorsagittalsinus
C i s t e r no f c o r p u sc a l l o s u m achnoid space
Duramater f, rachnoid granulations
Arachnoid
lnterventricular
foramen (of Monro)
Chiasmaticcistern
Choroidplexusof 3rd vent
lnteroeduncularcistern
Cerebralaqueduct(of Sylvius)
Quadrigeminalcistern
(of great cerebral vein)
Prepontinecistern
Lateralaperture(foramenof Luschka) cistern

cerebellomedullary
Choroidolexusof 4th ven Medianaperture

(foramenof Magendie)
Duramater
Arachnoid
Subarachnoid
space
Centralcanalof soinalcoro
Nr

Basal Nuclei (Gangliaf
Horizontalsections
throughcerebrum
C e n u o f c o r p u sc a l l o s u m
H e a d o f c a u d a t en u c l e u s
L a t e r avl e n t r i c l e
C o l u m no f f o r n i x - &
I n s ul a
( i s l a n do f R e i l )
t4".
3rd ventricle
Interthalamic
adhesion
E x t e r n acl a p s u l e
Thalamus
Claustrum
C r u so f f o r n i x R e t r o l e n t i c u l apra r t
o f i n t e r n a lc a p s u l e
C h o r o i dp l e x u s
o f l a t e r a vl e n t r i c l e T a i lo f c a u d a t en u c l e u s
S p l e n i u mo f H i p p o c a m p u sa n d f i m b r i a
c o r p u sc a i l o s u m
O c c i p i t a l( p o s t e r i o r h) o r n
o f l a t e r a vl e n t r i c l e
Habenula
O r g a n i z a t i o no f
b a s a ln u c l e i ( g a n g l i a ) P i n e a lb o d y
C a u d a t eP u t a m e nC l o b u s
nucleus pallidus
Cleft for internalcapsule
Lentifornt
Striatum r-rucleus
Caudate t Body
n u c l e u Is H e a d Thalamus
Corpus
striatum Levelsot
lA- A
- sectrons
above {B- B
B a s anl u c l e i
(ganglia)
Pulvinar
L e n t i f o r mn u c l e u s M e d i a l g e n i c u l a t eb o d y
( g l o b u sp a l l i d u sm e d i a l
to putamen)
*{r Amygdaloid body -
Interrelationship
of thalamus,lentiformnucleus,caudate
nucleus/and amygdaloidbody (schema):
\Tail of caudate nur
left lateralview
Plate I I O Meninges and Brain

Thalamus
orpuscallosum(cut)
foramen(of Monro)
Interventricular
Tela choroidea (cut edge) Headof caudatenucleus
of 3rd ventricle-.
3rd ventricle
Columnsof fornix
Choroid
Anteriortubercle
Superiorthalamostriate
Striaterminalis
Peshippoca
(inferior)horn
Temporal Interthalamicadhesion
of lateral ventricle
Laminaaffixa
Internalcerebralvei
Striamedullaris
Dentategyrus
lartrigone
Collateralemi
Pulvinarketractedl
Hippocampus
Lateralgeniculatebody
F i m b r i ao f h i
Posterior
commissure I geniculatebody
Habenular
commissure Brachiumof superiorcolliculus
Pinealbody Brachiumof inferiorcolliculus
Collateral trigone Superiorcolliculus
Calcaravi lnferiorcolliculus
Occipital(posterior)horn Cerebellum
of lateralventricle
Calcarine
lnternal 3rd ventricle

medullary lnterthalamic
lamina adhesion
Intralaminar
nuclei
Reticular
nucleus
4{tr
T h a l a m i cn u c l e i Pulvinar
External Lateralgeniculatebody
medullary CM Centromedian
lamina
I geniculatebody
[D Lateraldorsal
l-P Lateralposterior
Mediannuclei Schematic representation of thalamus
M Medial
MD Medialdorsal (externalmedullarylaminaand
Schematicsection VA Ventralanterior reticularnucleiremoved)
through thalamus Vl Ventralintermedia.
(at level of broken
line shown in figure V[ Ventrallateral I Lateralnuclei
at right) VP Ventralposterior I Medialnuclei
VPt Ventralposterolateral 'r ,' ', ; ' Anteriornuclei
VPM Ventralposterornedial
Meninges and Brain Plate | | 1

Hippocampus and Fornix
Superiordissection Cenu of corpuscallosum(cut)
Septumpellucidum
Headof caudatenucleus
Columnsof fornix
Striaterminalis
Bodyof fornix
Peshippocampus
Thalami
of fornix
Dentategyrus
Fimbriaof hippocampus
Commissureof fornix
Spleniumof corpuscallosum(cut)
ventricle
Occipital(posterior)horn
of lateralventricle
4{F Tailof caudate
Temporal(inferior)horri
Fornix:schema Coronal section:posteriorview
Plate I l2 lleninges and Brain

Gerebellum
Superiorsurface
Anterior cerebellarnotc
Quadrangularlobule(H lV-V)
C e n t r a ll o b u l e ( l l & l l l Primaryfissure
Horizontalfissure
C u l m e n( l V & i m p l e l o b u l e( H V l )
Posteriorlobe
P o s t l u n a ft ies s u r e
F o l i u m( V l l A ) i o rs e m i l u n a r
(anseriform l o)b u l e( H V l l A )
Horizontalfissure
l n f e r i osr e m i l u n a r
Posteriorcerebellarnotch ( c a u d a l )o b u l e( H V l l B )
centrallobule lnferior surface

Superiorvermist of centrallobule
( L i n s u l(al ) - S u p e r i o)r
S u p e r i om
r e d u l l a rvve l u m Middle ) Cerebellar peduncles
Inferior
(HX) )
Flocculonodularlobe
ventricle
(dorsolateral)
Posterolateral
Inferior velum fissure
fissure
Retrotonsillar
N o d u l e( )
U v u l a( l X Posteriorlobe
Inferior
l onsil
vermis
Pyramid( B i v e n t e rl o b u l e ( H V l l l )
Tuber(Vl Secondary (postpyramidal)
fissure
Posteriorcerebellarnotch
Horizontalfissure
l n f e r i osr e m i l u n a r
( c a u d a l )o b u l e( H V l l B )
Cerebralcrus
Decussationof
superiorcerebellar
M e d i a l l o n g i t u d i n afla s c i c u l u s
4th ventricle
Nuclear layer of
S u p e r i om
r e du l l a r y medulla oblongata
Fastigial S u p e r i ocre r e b e l l a r
peduncle
Clobose
L i n g u l a( l )
Dentate
LmDOtl
Vermis
4{tr
Sectionin planeof superiorcerebellarpeduncle
Meninges and Brain Plate I | 3

Brainstem
Posterolateral
view Thalamus(cut surtace)
Lateralgeniculate
body
Pulvinars
of thalami Optic tract
P i n e a lb o d y Medial geniculatebody
S u p e r i ocro l l i c u l i Brachiaof superiorand inferior colliculi
Inferiorcolliculi erebralcrus
Trochlearnerve (lV)
Pons
Superiormedullaryvel
rigeminalnerve (V)
Superiorcerebellar
peduncle
cerebellar
Rhomboid fossaof
4th ventric nerve(Vlll)
Vestibulocochlear
Clossopharyngeal(lX) and F a c i a nl e r v e ( V l l )
vagus(X)
ferior cerebellarpeduncle
Cuneatetubercle
C r a c i l et u b e r c l e
Accessorynerve (Xl)
Dorsalrootsof
l s t s p i n a ln e r v e ( C 1)
Cuneatefasciculus
Cracile fascicu
Nr
factorytract
Anteriorview Anteriorperforated
substance
I n f u n d i b u l u(mp i t u i t a rsyt a l k )
Optic chiasm
M a m m i l l a rbyo d i e s
Optic tract Temporallobe (cut surtace)

n e r v e( l l l )
Tubercinereum
nerve(lV)
Trochlear
Cerebralcrus Trigeminalnerve (V)
Lateralgeniculatebody ucentnerve(Vl)
acial nerve (Vll) and
Posteriorperforatedsubstance intermediatenerve
Vestibulocochlearnerve (Vlll)
Flocculusof cerebellum
Middle cerebellarpeduncle
oid plexusof 4th
ventricle
Olive
nerve(lX)
lossopharyngeal
Pyramid
nerve(X)
V e n t r arlo o t so f 1 s ts p i n a l H y p o g l o s snael r v e( X l l )
n e r v e( X l )
Decussationof pyramids

Fourth Ventricle and Gerebellum
Posteriorview
3rd ventricle
Pulvinao
r f thalam Dorsalmediansulcus
Pinealbody peduncle
Superiorcerebellar
Locusceruleus
S u p e r i ocro l l i c u l u s
emrnence
lnferior
Facialcolliculus
Trochlearnerve (lV)
area
Vestibular
Superiormedullary
Dentate nucleus
( Superior of cerebellum
C e r e b e l l apre d u n c l e {s M i d d l e-
( Inferior- riaemedullares
Lateralrecess Taenia of 4th ventricle
Superiorfovea Cuneatetubercle
S u l c u sl i m i t a n s aciletubercle
lnferior fovea Dorsalmediansulcus
T r i g e m i n taul b e r c l e Lateralfuniculus
Hypoglossaltrigone lus
fascicu
Vagal t e fasciculus
Median sagittalsection
terthalamicadhesion
Posteriorcommissure
*{r
Bodyof forn H a b e n u l acro m m i s s u r e
T h a l a m u(si n
Pinealbody
3rd ventricle
Interventricular of corpuscallosum
foramen (of Monro
Great cerebralvein (of Calen)
Anterior commissure
Laminatermi
H y p o t h a l a m i cs u l c
C e r e b r aple d u n c l e
Cerebralaqueduct(of Sylvius
Superiorco
Tectal(quadrigeminal)plate
Superiormedullaryvelum
l n f e r i ocr o l l i c u l u s
Pons eriormedullaryvelum
M e d i a l l o n g i t u d i n afla s c i
Choroidplexusof 4th ventric

Medulla oblongata
Median aperture (foramen of Magendie)
of pyrami
Decussation
Central canal of spinalcor
Meninges and Brain Plate t t 5

Granial Nerve Nuclei in Brainstem: Schema
Posteriorphantomview O c u l o m o t o rn e r v e( l l l )
ed nucleus
nucreus
Accessorvoculomotor
Lateralgeniculate ( Edi n ger-Westphal) nucleus
Mesencephalin c ucleus Trochlearnucleus

of trigeminal
nerve(lV)
Trochlear
Principal
sensorynucleusof
trigeminal Motor nucleusof
trigeminal
nerve
Trigeminalnerve
(V) and ganglion
Trigeminal
nerve(V)
and ganglion
Facialnerve (Vll)
and geniculate
ganglion-
nucreus
Vestibulocochlear Facialnucleus
n e r v e( V l l l )
Ceniculum
(geniculateganglion)
of facial nerve
Superior
Anterior. and inferior
C o c h l e a rJ salivatory
nuclei Posterior
I nuclei
Vestibular
nuclei
pharyngeal
Glossopharyngeal nerve(lX)
n e r v e( l X )
Vagusnerve(X)
Vagus nerve (X)
A c c e s s o r yn e r v e ( X l ) *
Spinaltract and spinal Nucleua

s mbiguus
nucleusof trigeminalnerve
(dorsal)nucleus
Solitarytract o f v a g u s n e r v e( X )
Dorsalvagalnucleu H y p o g l o s snaul c l e u s
S p i n anl u c l e u s
Efferentfibers of accessory nerve
I
-
Afferentfibers
Mixed fibers
4{tr
*Recent evidence
s_uggests that the accessorynerve lacksa cranialroot and has no connection to the vagus nerve.
Verificationof this finding awaits further investigation.
Plate I 16 Granial and Gervical Nerves

Granial Nerve Nuclei in Brainstem: Schema (continuedl
Medialdissection
A c c e s s o r yo c u l o m o t o r
(Edinger-Westphal) nucleus
R e dn u c l e u s O c u l o m o t onr u c l e u s
O c u l o m o t o r n e r v e( l l l Trochlear
nucleus
Mesencephalin c ucleus Trochlearnerve (lV)

of trigeminalnerve
A b d u c e nnt u c l e u s
Trigeminal
nerve (V)
and ganglion lnternalgenu
of facial nerve
Principal
sensorynucleusof F a c i a nl u c l e u s
t r i g e m i n anle r v e -
V e s t i b u l a nr u c l e i
Motor nucleusof
t r i g e m i n a nl e r v e
Anteriorand posterior
c o c h l e anr u c l e i
F a c i a nl e r v e ( V l l )
S u p e r i oar n d
inferiorsalivatory
V e s t i b u l o c o c h l e anre r v e ( V l l
nuclei
A b d u c e n tn e r v e ( V l ) Solitarytractnucleus
C l o s s o p h a r y n g e anle r v e ( l X ) Posterior (dorsal)nucleus

o f v a g u sn e r v e( X )
nucleus
Hypoglossal
Vagusnerve(X)
Nucleua
s mbiguus
Accessorynerve (Xl)*
Spinalnucleusof accessorynerve
Olivei
I Efferentfibers
S p i n a lt r a c t a n d s p i n a l
nucleusof trigeminalnerve
t -
-
.{nelenr rroers
Mixed fibers
*{Y
C(d4/^
*Recent evidence suggeststhat the accessorynerve lacksa cranialroot and has no connection to the vagus nerve.
Granial and Gervical Nerves Plate I l7

Granial Nerves (Motor and Sensory Distributionf: Schema
Spinalnervefibers
Efferent(motor) fibers
Afferent (sensory)fibers
ill
Oculomotor
I tl C i l i a r ym u s c l es,p h i n c t e r
Olfactory Optic pupillae,and all externaleye
Nasalcavity Eye musclesexceptthosebelow
IV
Trochlear
S u p e r i o ro b l i q u e V
Trigeminal
vl Sensory-face
Abduc sinuses,teeth
Lateralrectus
muscte
Intermediate nerve
vtl Motor-submandibular,
Facial sublingual,lacrimalglands
Musclesof face Taste-anterior% of
tongue, sensorysoft palate
vill
Vestibulocochlear
Cochlear Vestibular
IX
Glossopharyngeal
Taste-posterior1Aof tongue
Sensory-tonsil,pharynx, middle ear
Motor-stylopharyn geus,
parotid gland
Vagus
Motor-heart, lungs,palate,pharynx,
larynx,trachea,bronchi, Cl tract
XI
Accessory
Sternoclei
trapezius
Sensory-heart,lungs,trachea,
bronchi,larynx,pharynx,
Gl tract,externalear
4{r
muscles
Strap
muscles
(c1,2,3
fibers)
Plate I l8 Granial and Gervical Nerves

Olfactory Nerve (ll: Schema
S u b c a l l o s a( lp a r o l f a c t o r ya) r e a
S e p t a la r e aa n d n u c l e i
Olfactorybulb cells:schema
F i b e r sf r o m I C o n t r a l a t e r a l
Efferentfibers to F i b e r tso I o l f a c t o r b
yulb
o l f a c t o r yb u l b
Afferentfibersfrom bulb A n t e r i o rc o m m i s s u r e
t o c e n t r acl o n n e c t i o n s
a n dc o n t r a l a t e rbaul l b Medial
olfactory stria
a n u l ec e l l ( e x c i t e db y
a n d i n h i b i t i n gt o m i t r a l
a n d t u f t e dc e l l s )
M i t r a lc e l l
R e c u r r e n pt r o c e s s
l u ft e d c e l l
Periglomerular
cell
Clomerulus
tory
fi b e r s
.k
-T/
ta t
\:;
fftfnflt
Olfactory trac
( ) l l a c ' t o tv t l Olfactory trigone

a n d o l f a c t o r yt u b e r c l e
L a t e r aol l f a c t o r ys t r i a UNCUS
L a t e r aol l f a c t o r yt r a c t n u c l e u s Hippocampal
fimbria
A n t e r i o rp e r f o r a t e ds u b s t a n c e
Dentate gyrus
A m y g d a l o i db o d y ( p h a n t o m )
P a r a h i p p o c a m p agly r u s
4{tr
Granial and Cervical Nerves Plate 119

Optic Nerve (lll (Visual Pathwayl: Schema
C e n t r a ld a r k e r
c i r c l er e p r e s e n t s
m a c u t a rz o n e
L i g h t e rs h a d e s
represent
n ' r o n o c u l afri e l d s
E a c hc l u a d r a n t
a d i f f e r e n tc o l o r
P r o j e c t i o no r r
r i g h tr e t i n a
nerves
ur)*
\i":,':
Structure of retina: schema )Y_ P r o j e c t i o ro. rn r i g h t

A A n r a c r i n ec e l l s d o r s a ll a t e r ; r l
B [ 3 i p o l acr e l l s g e n i c u l a t en u c l e u s
C Cones I
C C a n g l i o nc e l l s
H H o r i z o n t a lc e l l s
P P i g m e n tc e l l s
R Rods
Opticradiation Optic radiation
1
)
i \
C.rlcarine {
I
1
{
I
"\
.-<
l
I A
P r o j e c t i o no n l e f t
occipital obe P r o j e c t i o no n r i g h t
occipital obe
Plate 12O Granial and Cervical Nerves

Oculomotor(llll, Tlochlear(lVl, and AbducentlVIl Nerves:Schema
L o n g c i l i a r yn e r v e C i l i a r yg a n g l i o n
Short ciliary nerves Posteriorethmoidal nerve Abducentnucleus

A n t e r i o re t h m o i d a ln e r v e
S e n s o r yr o o t o f c i l i a r yg a n g l i o n
nucleus
Trochlear
S u p e r i oor b l i q u em u s c l e
Sympatheticroot of ciliary ganglion
Levatorpalpebrae O c u l o m o t onr u c l e u s
s u p e r i o r i sm u s c l e S u p e r i o rd i v i s i o no f
oculomotor nerve
Superior Accessoryoculomotor
rectusmuscle Frontalnerve (cut) (Edinger-Westphal)
nucleus(parasympathetic)
Lacrimalnerve (cut)
tugr:l I
t
Trochlearnerve (lV)
Nasociliarynerve
l.\
l'r**
tY-l.' Oculomotornerve(lll)
O p h t h a l m i cn e r v e( V r )
Abducent
lnfraorbitalnerve nerve(Vl)
Zygomalic nerve (cut) Pterygopalatine
ganglion
M a n d i b u l anre r v e( V 3 )
I n f e r i oor b l i o u em u s c l e
C i l i a r ym u s c l e l n f e r i o rd i v i s i o no f a n dn e r v ep l e x u s
oculomotor nerve
D i l a t o rp u p i l l a m
e uscle Maxillary nerve (Vz)
Medialrectusmuscle
S p h i n c t epru p i l l a e
muscle
Lateralrectus muscle and
I n f e r i o rr e c t u sm u s c l e abducent nerve (turned back)
Efferentfibers
Parasympatheticroot plexus
Cavernous
Afferentfibers
Sympatheticfibers
Parasympatheticfibers
o f c i l i a r yg a n g l i o n
4ftr
Granial and Gervical Nerves Plate 121
Trigeminal Nerve (Vl: Schema
SeealsoPlates 24,42,43,45,46, 167, 168
T r i g e m i n a ln e r v e ( V ) g a n g l i o na n d n u c l e i
Ophthalmic nerve M o t o r n u rl e u s
' --'-*" Efferent fibers
M t ' s t ' n 1e ' p h . r l i nc u c l e u s
'^** Afferent fibers T e n t o r i a(l n r e n r n g e a bl )r a n c h P r i r - r c . i psaeln s o r yn u r . l c u s
' " . " P r o p r i o c e p t i v ef i b e r s N a s o c i l i a r yn e r v e S p i r r atlr a c t ; r r r r nl u c ' l t ' u s
Parasympatheticfibers L a c r i m a nl e r v e
- -.* Sympatheticfibers
S e n s o r yr o o t o f
c i l i a r yg a n g l i o n
Frontan l erve
C i l i a r yg a n g l i o n
P o s t e r i o er t h m o i d a ln e r v
L o n g c i l i a r yn e r v
S h o r tc i l i a r yn e r v e s
A n t e r i o re t h n r o i d a nl e r v
S u p r a o r b i t anl
S u p r a t r o c h l e anre r v e
I n f r a t r o c h l e anr e
Internan l a s a lb r a n c h e s
an0
E x t e r n anl a s a lb r a n c h e s
o f a n t e r i o re t h m o i d a ln e r v e
Maxillary nerve (\
Zygomaticotemporal
nerve
Zygomaticofacialnerve
Zygomatic r-rerve
l n f r a o r b i t anl e r v e
Pterygopalatine
ganglion
Superior SWJ
alveolar
b r a n c h e so f
i n f r a o r b i t anl e r v e
N a s a lb r a n c h e s
( p o s t e r i o rs u p e r i o r
l a t e r a l n, a s o p a l a t i n e , F a c i a nl e r v e ( V l l )
and posterior
s u p e r i om r edial) Chorda
N e r v e ( V i d i a n )o f t y m p a n in e r v e
l r t e r y g o i dc a n a l
n{r
( f r o n rf a c i a ln e r v e l V l l l
. r n dc a r o t i dp l e x r - r s )
P h a r y n g e abl r a n c h
( , r e a t e ra n d l e s s e r
p a l a t i n en e r v e s
D e e p t e m p o r a ln e r v e s Superficial
( t o t e m p o r a l i sm u s c l e ) t e n r p o r ab
l ranches
L a t e r a pl t e r y g o i d A r t i c u l a rb r a n c h
a n d m a s s e t e r i cn e r v e s and anterior
T e n s o rv e l i p a l a t i n a
i nd a u f l c u l a rn e r v e s
m e d i a lp t e r y g o i d A u r i c u l o t e m p o r ani e r v e
B u c c a ln e r v e Submandibulal lnferior
ganglion P a r o t i db r a n c h e s
M e n t a ln e r v e a l v e o l a rn e r v e
I n f e r i o rd e n t a lp l e x u s M y l o h y o i dn e r v e Otic ganglion
Lesserpetrosalnerve (fron'r
Linguan
l erve Mandibular nerve (Vr) T e n s o rt y m p a n in e r v e g , l o s s o p h a r y n g enael r v e I l X l )
Plate 122 Granial and Gervical Nerves

Facial Nerve (Vlll: Schema
Seeals0
Facial nerve (Vll) In t e r n aal c o u s t i m

c eatus
Creater petrosalnerve
C e n i c u l a t eg a n g l i o n l n t e r m e d i a t en e r v e
Deep petrosalnerve (from internalcarotid plexus)
Internalcarotid Plexus M o t o r n u c l e u so f f a c i a ln e r v e
Lesserpetrosalnerve
(on internalcarotid arterY) S u p e r i o rs a l i v a t o r yn u c l e u s
N e r v e ( V i d i a n )o f p t e r y g o i dc a n a l
Solitarytractnucleus
Otic ganglion
P t e r y g o p a l a t i ngea ng l i o n
Facialmuscles
Frontalbellv(frontalis)
of occipitofrontalis
-
Orbicularisoculi
Corrugatorsupercilii
Zygomaticusmajor
Zygomaticusminor
Procerus
Levator labii
supeflofls
Levatorlabii
supenons
alaequenasi
Levator
angulioris
Nasalis
Depressor ipital
septinasi belly
(occipitalis)of
Orbicularis occipitofrontalis
ons muscle
Depressor
angulioris
labii aurl
Depressor
nerve
inferior
anchesto auricularmuscles
Mentalis
a u r i c u l a rn e r v e
(Risorius)
(notshown) Nerve to staDediusmuscle
Buccinator Stylomastoidforamen
T y m p a n i cp l e x u s
),'i' Tvmpanic nerve (of Jacobson)

S u b l i n g ug
al a n d (from glossopharyngealnerve)
Submandibular C l o s s o p h a r y n g e anle r v e ( l X )
Efferentfibers
Afferentfibers
Parasympathetic fibers
S u b m a n d i b u l agr a
l e r v e ( f r o m t r i g e m i n a nl e r v e )
Linguan
s t r i cm u s c l e( p o s t e r i obre l l Y )
Stylohyoidmuscle
4{tr
Sympathetic fibers C h o r d at y m p a n in e r v e aroticotympanicnerve (from internalcarotid plexus)

Vestibulocochlear Nerve (Vlll|: Schema
,I i.il nit.i,:.i:r1-e;Y+:fi9:::+-rr+1*+li++9!sr:::E!j+t!:+i:B!4$G[14fi!jeh]ii",8ddt:$riij.hr
- Afferentfibers F a c i acl a n a l
Tympaniccavity
C e n i c u l u m( g e n i c u l a t e
g a n g l i o n )o f f a c i a ln e r v e C h o r d a t y m p a n in e r v e
C r e a t e rp e t r o s a n
l erve Headof malleus
C o c h l e a r( s p i r a l g
) anglion
V e s t i b u l an
r erve
C o c h l e a rn e r v e
Motor root of facial nerve

a n d i n t e r m e d i a t en e r v e
Vestibulocochlear
nerve(Vlll)
M e d u l l ao b l o n g a t a
( c r o s ss e c t i o r \
A m p u l l ao f l a t e r a l
s e m i c i r c u l adr u c t
Internal
Medial acoustic A m p u l l ao f s u p e r i o r
meatus s e m i c i r c u l adr u c t
Superior
Inferior
A m p u l l ao f p o s t e r i o r
Lateral s e m i c i r c u l adr u c t
I n f e r i o rc e r e b e l l a r
*{r p e d u n c l e( t o c e r e b e l l u m )
V e s t i b u l agr a n g l i o n
Saccule
S u p e r i o rd i v i s i o n )
) o l v e s l i b u l a rn e r v e
- I n f e r i o rd i v i s i o n
)
Plate 124 Granial and Gervical Nerves

Glossopharyngeal Nerve (lXl: Schema
SeealsoPlates167,168
Efferentfibers S p i n a lt r a c t a n d s p i n a ln u c l e u so f t r i g e m i n a nl e r v e
- Afferentfibers S o l i t a r yt r a c t n u c l e u s
Parasympatheticfibers T y m p a n i cn e r v e( o f J a c o b s o n ) N u c l e u sa m b i g u u s
T y m p a n i cc a v i t ya n d p l e x u s I n f e r i o rs a l i v a t o r yn u c l e u s
S t y l o m a s t o i fdo r a m e n
c e r v e ( f r o m i n t e r n a lc a r o t i dp l e x u s )
Caroticotympanin
Creater petrosalnerve
Deep petrosan
l erve
N e r v e ( V i d i a n )o f p t e r y g o i dc a n a l
L e s s ep
r e t r o s a ln e r v e
P t e r y g o p a l a t i ngea ng l i o n
M a n d i b u l a nr e r v e( V t )
Otic ganglion
A u r i c u l o t e m p o r anl e r v e
l ' , r r oiIrI , l l , r r rI r- * * -
I r r l r . rllr r , r r rhr ( ) t l ) n t l ) , 1 | ] i1( , 1 , . ' . , , t - - . - - - - - - - - -
A u d i t o r yrp h a r y n g o t y m p a n i c ,
E u s t a c h i a nt )u b e a n d p h a r y n g e aol p e n i n g
Clossopharyngeal
s u s c l e( a n d b r a n c h
S t y l o p h a r y n g e um
nerve(lX)
irom glossopharyngea n le r v e )
l u g u l a rf o r a m e n
C o m m u n i c a t i o nt o a u r i c u l a r
b r a n c ho f v a g u s n e r v e
Tasteand
somaltc V a g u sn e r v e ( X )
sensatlon:
posreflor S u p e r i o rc e r v i c a l
Z of tongue s y m p a t h e t i cg a n g l i o n
S y m p a t h e t i ct r u n k
,{ C a r o t i db r a n c ho f
glossopharyngen ae
l rve
,t
lt I n t e r n a cl a r o t i da r t e r y
P h a r y n g e apl l e x u s
C a r o t i ds i n u s
P h a r y n g e a tl ,o n s i l l a ra, n d l i n g u a l
b r a n c h e so f g l o s s o p h a r y n g e n ael rve Carotid body
P h a r y n g e abl r a n c ho f v a g u sn e r v e
C o m m o n c a r o t i da r t e r y
E x t e r n acl a r o t i da r t e r y
4{tr

Vagus Nerve (Xl: Schema
Posterior
nucleusof vagus
nerve(parasympathetic
Glossopharyngealnerve (lX) andvisceralafferent)
Meningeal branch of vagus nerve Solitarytractnucleus(visceral

afferentsincludingtaste)
Auricularbranchof vagusnerve
S p i n atlr a c ta n ds p i n a l
Auditory(pharyngotympanic,
Eustachian)
tube n u c l e uos f t r i g e m i n anle r v e
(somaticafferent)
Levatorveli
palatinimuscle Nucleua s mbiguus
(motorto pharyngeal
Salpingopharyngeus and laryngeal
muscles)
muscle
Cranialroot of
Palatoglossus
muscle
accessorynerve*
(seenextplate)
Palatopharyngeus Vagusnerve (X)
muscle
foramen
Jugular
Superiorpharyngeal
constrictormuscle- Superiorganglion of vagus nerve
Stylopharyngeus
muscle Inferior ganglion of vagus nerve
Middle pharyngealconstrictormuscle Pharyngealbranch of vagus nerve (motor to musclesof

palate and pharynx;sensoryto lower pharynx)
Inferiorpharyngealconstrictormuscle
C o m m u n i c a t i n gb r a n c ho f v a g u sn e r v et o
Cricothyroid
musc carotid branch of glossopharyngealnerve
Trachea Pharyngeal
plexus
Esopha Superiorlaryngealnerve:
Internalbranch(sensory
andparasympathetic)
R i g h st u b c l a v i aanr Externalbranch(motorto cricothvroidmuscle)
Right recurrentlaryngealnerve Superiorcervicalcardiac branch of vagus nerve
Heart Inferiorcervicalcardiac branch of vagus nerve
Hepatic branch of anterior Thoraciccardiac branch ofvagus nerve

vagal trunk (in lesseromentum)
Left recurrentlaryngealnerve (motor to musclesof larynx
Celiac branchesfrom anterior except cricothyroid;sensoryand parasympatheticto
and posteriorvagal trunks larynx below vocal folds; parasympathetic,efferent,and
to celiacplexus afferentto upper esophagusand trachea)
C e l i a ca n d s u p e r i o rm e s e n t e r i c P u l m o n a rpyl e x u s
gangliaand celiac plexusl -e
Hepatic plex
Callbladder
Cardiacplexus
plexus
Esophageal
Nr
and bileducts
Anterior vagal trunk
Liver
Castric branchesof anterior vaeal trunk
(branchesfrom posterior trunkbehind stomach)
Pyloricbranch
from hepaticplexus
Vagalfibers(parasympathetic motor,
secretomotor,and afferentfibers)accompany
Pancreas
superiormesentericartery and its branches
usuallyas far as left colic (splenic)flexure
Duodenum
A s c e n d i n gc o l o S m a l li n t e s t i n e
Efferentfibers
Cecum
Afferentfibers
Appendix Parasympatheticfibers
Plate 126 Granial and Cervical Nerves

Accessory Nerve (XIl: Schema
Nucleua
s mbiguus
nerve(joinsvagusnerve
Cranialroot of accessory
andvia recurrentlaryngealnervesuppliesmusclesof
Vagus nerve (X) larynx,exceptcricothyroid)*
Spinalroot of
accessorynerve Jugularforamen
Foramen
magnum Superiorganglion
of vagus nerve
Accessory nerve (Xl)*
Inferior ganglion
of vagus nerve
C.l spinalnerve
C2 spinalnerve
Accessorv nerve
(to sternocleidomastoid
and trapeziusmuscles)
muscle(cut)
Sternocleidomastoid
3 spinal nerve
C4 soinalnerve
Trapezius
muscle
*{r
Efferentfibers
Proprioceptivefibers
*Recent evidence suggeststhat the accessorynerve lacksa cranialroot and has no connection to the vagus nerve'
Granial and Cervical Nerves Plale 127

Hypoglossal Nerve (XIII: Schema
Hypoglossalnerve(Xll) Meningeal branch

(in hypoglossal
canal)
H y p o g l o s snaul c l e u s
Superior
longitudinal
Intrinsic
muscres Transverse
of tongue andvertical
Inferior
longitudinal
'." 1t:lr/. rt-::-
Occipitalcondyle
Inferiorganglionof
vagusnerve
Ventralramiof
C 1 , 2 , 3f o r m
ansacervicalis
of cervicalplexus
Superiorcervical
sympathetic
ganglion
Superiorrootof
Cenioglossus ansacervicalis
muscre
( v i aC 1 )
Hyoglossus
muscle Inferior root of ansacervicalis
Thvrohvoidmusclei Ansa cervicalis

( v i aC 1 )
Omohyoid muscle
( s u p e r i obre l l y ) I n t e r n ajlu g u l a rv e i n
Sternohyoidmuscle Common carotid artery
Sternothyroid
muscle
Omohvoidmuscle(inferiorbel Efi'erentfibers
- Afferentfibers
4{tr
Plate 128 Granial and Cervical Nerves

Gervical Plexus: Schema
SeealsoPlate32
Sternocleidomastoidmuscle (cut) Creat auricularnerve
Accessory nerve (Xl)

Lesseroccipital nerve
H y p o g l o s s anl e r v e ( X l l )
Creater occipital nerve
(from dorsal ramus of C2)
muscte
Nerves to anterior and lateral

rectus capitisand longus
c a o i t i sa n d c o l l i m u s c l e s
N e r v e st o l o n g u sc a p i t i sa n d
colliand levatorscapulae muscles
Thyrohyoidmuscle Traoezius
muscle
S u p e r i orro o t N e r v e st o l o n g u sc a p i t i sa n d
of ansa cervicalis colli, levator scapulae,and
m i d d l e s c a l e n em u s c l e s
lnferior root
of ansa cervicalis C o m m u n i c a t i o nt o
brachialplexus
Transversecervical nerve Phrenicnerve
Omohyoidmuscle
(superior
muscle
Sternothyroid
Sternohyoid
muscle Supraclavicularnerves(medial,
intermediate,and lateral)
A n s ac e r v i c a l i s
muscle(cut)
Sternocleidomastoid
Efferentfibers
Omohyoid muscle (inferior belly)
Nr
Afferentfibers
Proprioceptivefibers

Autonomic Nerves in Neck
Internal
carotidnerve
Clossopharyngeal
n e r v e( l X )
Laryngopharyngeal
sympatheticbranch
Vagusnerve(X)(cut)
Superiorcervical
sympatheticganglion
Pharyngeal
plexus
Pharyngeal branch
or vaSusnerve
Externalcarotidarteryand plexus
Superiorlaryngealnerve
Internalcarotid artery and carotid
branch of glossopharyngealnerve
Carotidbody
arotidsinus
Superiorcervical cardiac branch
of vagus nerve
Superiorcervical sympathetic
cardiac nerve
Phrenicnerve (cut)
Middle cervicalsympatheticganglion
Commoncarotidarteryand plexus
*{r Middlecervicalsympathetic
Vertebralganglion
Vertebralarteryand plexus
cardiacnerve
Recurrent laryngealnerve
Cervicothoracic(stellate)ganglion
Ansa subclavia
Vagus nerve (X) (cut)
lnferior cervical sympathetic
cardiac nerve
Thoracicsympatheticand
vagalcardiacnerves
Subclavianarterv
Plate 13O Granial and Cervical Nerves

Autonomic Nerves in Head
SeeafsoPlates 4446,86, 121,132-134r,ffi, 106
Creater oetrosalnerve Deep petrosalnerve N a s o c i l i a r yn e r v e

Nerve (Vidian)of pterygoid canal
Sensory Roots of
Trigeminalnerve (V) O c u l o m o t o r n e r v e( l l l ) Sympathetic ciliary
ganglion
M a x i l l a r yn e r v e ( V z ) Parasympathetic
O p h t h a l m inc e r v e( V r )
Internalcarotid artery and plexus
Frontaal nd C i l i a r yg a n g l i o n
lacrimal
C e n i c u l u m( g e n i c u l a t eg a n g l i o n ) nerves (cut)
of facial nerve
ciliary nerve
F a c i a nl e r v e ( V l l )
Short ciliary nerves
Vestibulocochlear
Posterior,
superior,
and inferiorlateral
Clossopharyngeal nasatnerves
n e r v e( l X )
Vagus nerve (
Mandibular
nerve (V:)
Otic
ganglion
lnternal
carotid nerve
C h o r d at y m p a n i Pterygopalatine
ganglion
S u p e r i ol ra r y n g e a l eater
nerve (cut)
and lesser
palatinenerves
S u p e r i o rc e r v i c a l
sympatheticganglion
l n t e r n a lc a r o t i d
artery and plexus' lnferior
alveolarnerve
Carotid branch of
glossopharyngeal Submandibular
Pharyngeal
ganglion
plexus
C a r o t i ds i n u s
Maxillaryartery M i d d l e m e n i n g e a al r t e r ya n d p l e x u s
and plexus
Cervical
s y m p a t h e t i ct r u n k Facialartery and plexus
External
carotid
arteryand plexus
c a r d i a cb r a n c ho f Common carotid artery and plexus
v a S u sn e r v e
S u p e r i o rc e r v i c a ls y m p a t h e t i cc a r d i a cn e r v e
*{r
Giliary Ganglion: Schema
S p h i n c t epru p i l l a m
e uscle Oculomotor Accessoryoculomotor
Short ciliary nerves (parasympathetic) (Edinger-Westphal)
D i l a t o rp u p i l l a m
e uscle root of ciliaryganglion nucleus(parasympathetic)
Ciliary
Ciliarymuscle ganglion
Lateral
geniculatebody
Optic nerve (ll)

Ophthalmic
Nasociliarynerve n e r v e( V t )
L o n g c i l i a r yn e r v e
Trigeminal t
Nasociliary(sensory) ganglion .r-Tectosoinal tract
I
root of ciliary ganglion
Internal
I
Sympatheticroot of ciliary ganglio ! -Th^,^-i-part ^-.,
carotid plexui ---fhoracic
<- of spinalcord
O p h t h a l m iacr t e r y
Internal
carotid artery
Superiorcervical sympatheticganglion
1st thoracic sympathetictrunk ganglio

Preganglionic
sympathetic
C r a y r a m u sc o m m u n i c a cellbodies
in inter-
mediolateral
nucleus
(lateral
Preganglionic| _ horn)of gray
PostganglionicfParasytpatheticfibers T 1 s p i n a ln e r v e
matter
Afferentfibers
Visualpathway
Descending
pathway
Nr
Plate | 32 Granial and Cervical Nerves
Pterygopalatine and Submandibular Ganglia: Schema
Trigeminalganglion
Ophthalmicnerve(Vr)
Deep petrosalnerve
Mandibularnerve(V:) eaterpetrosalnerve
Otic ganglion
tympaninerve
Lingualnerve
nerve(V)
Trigeminal
Maxillarynerve(Vz)
Facialnerve(Vll)
Nerve(Vidian)of pterygoidcanal nerve)
ganglion
Pterygopalatine Superiorsalivatory
nucleus
Lacrimalgland
palatinenerves
Descending Pharyngealnerve
Posteriornasalner
nerve(lX)
-
I^ .l Superiorcervicalsympatheticganglion
Palatinen"ru"r I ureater Sympathetictrunk
( Lesser-
T1 and T2 spinalnerves
ganglion Thoracic
spinal
cord
Dorsal
root
gland
Sublingual
Submandibular White Cray

\-+v-./
Ventral
Facialartery Rami communicantes root presynapticcell
bodiesin
Lingualartery intermediolateral
carotidarterv
nucleus(lateral
Externalcarotidartervand horn)of gray
matter
Commoncarotidarteri
Nr -
r
-
r r
Sympatheticpreganglionicfibers
Sympatheticpostganglionicfibers
Parasympatheticpreganglionicfibers
r r r Parasympatheticpostganglionicfibers

Otic Ganglion: Schema
Mandibularnerve(V3) ganglion
Trigeminal
Lesserpetrosalnerve
Otic ganglion
Chordatympaninerve
Ophthalmicnerve(Vr)
nerve(V)
Trigeminal
Maxillarynerve(Vz) Facialnerve(Vll)
Auriculotemporalnerve nerve(lX)
Clossopharyngeal
Inferiorsalivatorynucleus
Superficialtemporalartery
Pons
Parotidgland
Maxillary
artery
Medulla
oblongata
Tympanic
plexus
Inferior Tympanic
alveolar nerve
(of Jacobson)
Inferiorganglion(lX)
cervicalsympatheticganglion
Sympathetictrunk
T1 and T2 spinalnerves Thoracic
Externalcarotidarterv spinalcord
Internalcarotid
Commoncarotidar
White Cray Sympathetic

\*^\r-l
preganglionic
Ramicommunicantes cell bodiesin
intermediolateral
nucleus(lateral
r- Sympatheticpreganglionicfibers horn)of gray
r r r matter
Sympatheticpostganglionicfibers
- Parasympatheticpreganglionicfibers
r r r Parasympatheticpostganglionicfibers
4{r
Plate 134 Granial and Gervical J{erves
Taste Pathways: Schema
-Usual pathway
- - - - - -' Accessorypathway
Ventralposteromedial(VPM)
nucleusof thalamus
y cortex(justbelow facearea)
Lateralhypothalamic
area
Amygdaloid
body
Pontinetastearea
nerve(V)
Trigeminal
(semilunar)
Trigeminal ganglion
Mesencephalicnucleus
and
Motor nucleus h a l m i cn e r v e( V r )
of trigeminalnerve
Maxillarynerve(Vz)
Mandibularnerve(Vr)
Nr Ceniculate
Facialnerve(Vll)
Otic
ganglion
Nerve(Vidian)
of pterygoidcanal
and
Intermediatenerve
Lingualnerve
Nucleusof solitarytract
(rostralpart) Fungiform
papillae
nerve(lX)
Clossopharyngeal
Foliate
papillae
Medullaoblongata
(lowerpart)
Vallate
papillae
Inferior(petrosal)
ganglion
of glossopharyngealnerve
Inferior(nodose)ganglionof vagus
Vagusnerve(X) Superiorlaryngeal
nerve

Arteries to Brain and Meninges
Left middle meningealartery Middlecerebralartery
Posterior
cerebralartery Anteriorcerebralartery
Superiorcerebellar
artery Anterior communicatingartery
Basilar
artery Ophthalmicartery
Leftlabyrinthine
(internalacoustic)
arterv Posterior
communicating
Mastoidbranchof artery
leftoccipitalartery
Cavernous
sinus
Anteriorinferior
cerebellarartery Middle
meningeal
Posterior
meningeal artery
branchof leftascendin
pharyngeal
Posterior
inferior
cerebellar
artery
Leftand right Maxillary

vertebralarteries artery
(intracranial
Superficial
Posterior
meningeal temporal
branchof vertebral artery
arter
External
Anteriormeningeal carotid
branchof vertebralartery atrcry
Posterior
auricular
artery Facialartery
Occipital
Lingualartery
pharyngeal
Ascending artery
Carotid
Superiorlaryngeal
artery
Carotid body
Superiorthyroidartery
Vertebral artery
(cervicalpart) Common carotid arterv
Transverseprocess of C6 Ascendingcervicalartery (cut)
Deep cervicalartery
Inferior thyroid artery
Supremeintercostal
artery Thyrocervicaltrunk
Costocervical
trunk
Subclavianartery
Brachiocephalic
trunk
thoracicartery
Nr
Plate | 36 Gerebral Vasculature
Veins of the Vertebral Golumn: Vertebral Veins
Variation:right vertebralvein crossing

anterior to right subclavianartery Left vertebral artery
Leftvertebralvein
Anterior vertebralveins
Left subclavianartery
Right deep cervicalvei Left brachiocephalicvein
A c c e s s o r yv e r t e b r a l v e i n
Right vertebralartery
Vertebral veins: detail showing
Rightsubclavianarteryand vein v e n o u sc o m m u n i c a t i o n s
R i g h ti n t e r n a jl u g u l a rv e i n Anterior arch of atlas(C1) (cut)

( i n f e r i o rb u l b )
R ig h t b r a c h i o c e p h a l ivce i n D u r am a t e r
Right vertebralvein I
R i g h tc l a v i c l e Rightvertebralartery
R i g h tc o m m o n c a r o t i da r t e r y A n t e r i o ri n t e r n a l( e p i d u r a l )
vertebralvenous plexus
Dens (C2) (cut)
Venous plexusof vertebralartery
Anterior externalvertebralvenous plexus
Epiduralfat and anterior internalvertebral(epidural)venous plexus
C o m m u n i c a t i n gv e i n
Basivertebral vein
lntervertebralveins
Veinsof the vertebral
Vertebralartery with venous plexus
column:vertebralveins
S u p e r i obr u l bo f r i g h ti n t e r n aj ul g u l a rv e i n Deep cervicalvein
Vertebralarteries
Anteriorvertebral
velns
C o n d v l a re m m i s s a r vv e i n
ii.!-i,
lar-r
Dura mater
venouscommunlcauons
M a s t o i de m m i s s a r yv e i n A n t e r i o ri n t e r n a l( e p i d u r a l v) e r t e b r a vl e n o u sp l e x u s
Venousplexusof vertebralartery
Anterior externalvertebralvenous plexus
C o m m u n i c a t i n gv e i n s Anterior vertebralveins
Left deep cervicalvein

R i g h td e e p c e r v i c a vl e i n
Left vertebralvein
Formingvertebralvein Left vertebralartery
Accessoryvertebralvei Left thyrocervicaltrunk

Rightvertebralartery and vein L e f t i n t e r n a jl u g u l a rv e i n ( i n f e r i o rb u l b )
Costocervicaltrunk
Right thyrocervical ; Left subclavianvein
trunk
R i g h ts u b c l a v i a nv e i n
Left common carotid arterv C(d4s/*
R i g h ti n t e r n a jl u g u l a rv e i n
( i n f e r i o rb u l b )
R i g h tb r a c h i o c e p h a l ivce i n
Right subclavianartery R i g h tc o m m o n c a r o t i da r t e r y
Gerebral Vasculature Plate | 37

Arteries to Brain: Schema
Anteriorcerebralartery communicatingartery
Middle cerebral Ophthalmicartery
Suoraorbital
arterv
Posteriorcommunicatingart
Supratrochlear
artery
Caroticotympanic branch
of internalcarotid artery Lacrimal
artery
Posterior Dorsalnasalartery
cerebral
Middle meningealartery
Superiorcerebellar
artery
Angular artery
Anteriortympanicarter
Superficial
temporalartery
Middle meningealar
Posterior
auricular
artery
Maxillaryarter Facialartery
B a s i l aa
r Occipitalartery
artery
Anteriorinferior
cerebellarartery pharyngealartery
Ascending
Posterior
inferior Anteriorspinalartery
cerebellar
ar
Spinalsegmental
External
carotidarterf medullary branches
Vertebral artery
InternalcarotidarterV
ommon carotid artery
Superiorthyroidartery Deep cervicalartery
Common carotid artery ial cervicalartery

Suprascapularartery
Vertebralartery
Supremeintercostal
artery
Ascendingcervicalarterir
Costocervicaltrunk
Inferiorthvroid arterv
Thyrocervicaltrunk/ ii
Subclavian
artery
S u b c l a v i a na
Internalthoracic arterv
Anastomoses
Arch
1 Right-Left
Descending 2 Carotid-Vertebral
Ascending 3 Internalcarotid-External
carotid
*{r 4
5
Subclavian-Carotid
Subclavian-Vertebral
Plate | 38 Gerebral Vasculature

Arteries of Brain: lnferior Views
(orbitofrontal)
Medialfrontobasal arter
A n t e r i o rc o m m u n i c a t i n Ba r t e r y
Anterior cerebralarterv
Distal medial striateartery
(recurrentartery ot
central(lenticulostriate)
Anterolateral arteries
Middle cerebralarterv
Lateralfrontobasal(orbitofrontal)
arter
Prefrontal
Anterior choroidal arter
P o s t e r i o cr o m m u n i c a t i n ga r t e r y
Posteriorcerebrala
Superiorcerebellar
artery
Basilar
Pontinearteries
(internalacoustic)
Labyrinthine arter
Anterior inferior cerebellararterv (AlC
Vertebralar
Anteriorspinalarte
Posterior artery(PICA)
inferiorcerebellar
Posteriorspinal
Cerebralarterial
circle(of Willis)
(brokenline)
Distalmedialstriateartery
(recurrent
arteryof Heubner)
A n t e r i o rc o m m u n i c a t i n ga r t e r y
Anterior cerebralarterv
Posteriorcommunicatingartery
Anterior choroidal artery
Optic tract
Posteriorcerebralartery
Cerebralcrus
fu 1,.
Lateralgeniculatebody
Posteriormedial choroidal artery
.
Posteriorlateralchoroidal artery
M e d i ag l e n i c u l a tbeo d y
P u l v i n aorf t h a l a m u s
Lateralventricle
Nr
Gerebral Vasculature Plate | 39
Gerebral Arterial Gircle (of Willisl
Distal medial striatearterv

Vesselsdissectedout: inferiorview (recurrentartery of Heubner)
Anterior cerebralartery
Anteromedialcentral (perforating)
(A2 segment)
arteries
Hypothalamic
artery
Anterior cerebralartery
(A1 segment)
Anterolateral
central
Ophthalmicartery (lenticulostriate)
arteries
Internalcarotid
Middle cerebralartery
Superiorhypophyseal
artery
Posteriorcommunicatingartery Inferior hypophysealartery
Anteriorchoroidalarterv
Posterior
cerebralartery
(P2segment) Thalamotuberal
(P1segment) (premammillary)artery
Posteromedialcentral
S u p e r i o rc e r e b e l l a a
r (perforating) arteries
Basilar g artery
Thalamoperforatin
Pontinearteries Posteromedialcentral
(paramedian)arteries
Anterior inferior cerebellarartery (AICA) Labyrinthine(internalacoustic)artery
Vertebralartery
Vesselsin situ: inferiorvrew
Anteriorcerebralartery Anterior communicating,artery
ic chiasm
Hypothalamicarter
sinus
Cavernous
Internalcarotid arter
I n f u n d i b u l u(mp i t u i t a rsyt a l k )
Superiorhypophyseal and longhypophyseal portalveins
Adenohypophysis (anterior
Middle cerebrala lobeof pituitarygland)
Inferiorhypophyseal
artery Neurohypophysis (posterior
lobeof pituitarygland)
Posteriorcommunicatingartery ial central
(perforating) arteries
Efferent
hypophyseal
veins
Superiorcerebellarartery
Posterior
cerebral
Basilarartery
Nr
Plate 14O Gerebral Vasculature
Arteries of Brain: Frontal View and Section
Paracentralartery
C o r p u sc a l l o s u m
M e d i a l f r o n t a lb r a n c h e s
Anterolateral
central
(lenticulostriate
a )r Pericallosal
artery
Lateralfrontobasal Callosomarginalartery
(orbitofrontal)arter
Polarfrontalartery
Prefrontal
Anterior cerebral
Precentral(pre-Rolandic) arteries
a n d c e n t r a l( R o l a n d i c )
sulcalarteries Medial frontobasal
(orbitofrontal)artery
Anterior parietal
( p o s t c e n t r asl u l c a l ) medial striate
artery artery (recurrent
artery of Heubner)
Posterior
parietal lnternalcarotid
artery artery
Branchto Anterior choroidal
a n g u l agr y r u s artery
Temporal
branches Posteriorcerebral
( a n t e r i o rm
, iddle, arterv
and posterior
artery
cerebellar
and branches Basilarand pontine arteries
(deep in lateralcerebral
l S y l v i a n sl u l c u s ) Labyrinthine(internal
acoustic)artery
A n t e r i o rc o m m u n i c a t i n g
Vertebralartery
Posteriorcommunicatingartery \Posterior inferior cerebellarartery (PICA)
Anterior inferior cerebellarartery (AICA) Anterior artery
spinal
I {ffi
Posteriorspinalar 4.t'/
Falxcerebri
Callosomarginalarteries
C o r p u ss t r i a t u m ano
(caudateand lentiform nuclei Pericallosal
arteries
(branchesof anterior
Anterolateralcentral cerebralarteries)
(lenticulostriate)arteri
I n s u l a( i s l a n do f R e i l T r u n ko f c o r p u sc a l l o s u m
L i m e no f i n s u l a I n t e r n a cl a p s u l e
Precentral(pre-Rolandic),
c e n t r a l( R o l a n d i c s) u l c a l , S e p t u mp e l l u c i d u m
and parietalarter
Rostrumof corpus callosum
Lateralcerebral(Sylvian)
Anterior cerebral arteries
Temooralbranchesof
middle cerebralartery
(recurrentartery of Heubner)
Temporallobe
Optic chiasm
Internalcarotid
Gerebral Vasculature Plate 141

Arteries of Brain: Lateral and Medial Views
Anterior parietal(postcentralsulcal)artery{ parietalartery

Posterior
C e n t r a(lR o l a n d i cs )u l c aal r t e r y Branchto angulargyrus
Precentral(pre-Rolandic)sulcalartery
Terminalbranches
of posteriorcerebral
Prefrontal
sulcal artery
artery
Terminalbranchesof
anterior cerebral
artery
Lateralfrontobasal
(orbitofrontal)
left middle
cerebralartery
Left anterior
cerebralartery
Occipitotemporal
Anterior communicatingartery
branches
Rightanteriorcerebralarteri Posteriortemporal branch
M i d d l et e m p o r abl r a n c h
Left internalcarotid artery
Suoeriorand inferior terminal branches(trunks)
Polartemooralarterv Anterior temporal branch
Posterior Pericallosal
artery
Paracentralartery
Cingularbranches
4
4. {r
Intermediate
Anterior Rightposteriorcerebralartery
Precunealartery
al
Dorsal branch
to corpus callosum
Polarfrontalartery Parietoocci
oitalbranch
Calcarinebranch
Rightanterior
cerebralartery
Medialfronto-
basal(orbito-
frontal)artery
Anterior
communicatingartery (cut)
Medial occipital artery
Posteriortemporal brancn
( r e c u r r e na
t r t e r yo f H e u b n e r
Anterior temooral branch
Right internalcarotid artery
Posteriorcommunicatingartery
*Note: Anterior parietal(postcentral

sulcal)artery also occurs as separateanterior parietaland postcentralsulcalarteries.
Plate 142 Gerebral Vasculature

Arteries of Posterior Granial Fossa
T h a l a m o e e n i c u l a taer t e r i e s L a t e r a al n d m e d i a lg e n i c u l a t eb o d i e so f l e f t t h a l a m u s
A n t e r i o rc h o r o i d a la r t e r y C h o r o i d p l e x u s e so f l a t e r a vl e n t r i c l e s
C r u r ao f f o r n i x P u l v i n a rosf l e f ta n dr i g h t h a l a m i
Splenium
Anterolateralcentral
(lenticulostriate
a )r t e r i e s O c c i p i t a l( p o s t e r i o r h) o r n o f r i g h t l a t e r a vl e n t r i c l e
H e a d so f c a u d a t en u c l e i t o r s abl r a n c ht o c o r p u sc a l l o s u m
R i g hd
(posterior pericallosal artery)
l r a n c h eosf
P a r i e t o o c c i p i )t aB
C o r p u sc a l l o s u m | ) rightposterior
Calcarine) cerebralartery
Anterior
cerebralarteries
Longitudinal ,}
cerebral
fissure
Superior
colliculi
Superior
vermtan
O p t i c n e r v e( l l ) branch
Ophthalmic artery Posteriormedial
choroidal artery
Anterior
to choroid plexus
cerebralartery of 3rd ventricle
Middle
cerebralartery Posteriorlateral
choroidal artery
Posterior
c o m m u n i c a t i n ga r t e r y L a t e r a (l m a r g i n a l b) r a n c h
T h a l a m o p e r f o r a t i nagr t e r i e s iiI.: Inferiorvermian artery
L e f t i n t e r n a lc a r o t i da r t e r v (phantom)
Basilarartery Choroidal branch to 4th ventricle

(phantom)and
Pontinearteries e r e b e l l at ro n s i l l abrr a n c h
of posterior inferior cerebellarartery
L a b y r i n t h i n e( i n t e r n aal c o u s t i c )a r t e r y
Posterior
cerebralarterV Outline of 4th ventricle(broken line)
S u p e r i o rc e r e b e l l a a
r rtery Posteriormeningealbranch of vertebralartery
Anterior inferior cerebellarartery (AICA) arterv(PICA)

inferiorcerebellar
Posterior
A n t e r i o rm e n i n g e a bl r a n c ho f v e r t e b r a a
l rtery
*{r
Leftposteriorspinalartery
of posteriorcerebralarteri,
Temporalbranches
Leftvertebralartery
A n t e r i o rs p i n a la r t e r y

Veins of Posterior Granial Fossa
Leftsuperiorand inferiorco
Basalvein (of Rosenthal)
Posteriormesencephalicvein
Medial geniculatebody
Lateral
mesencephalicvein
Lateralgeniculate
body
Leftthalamus
(cut surface)
Optic tracl Confluence

of sinuses
Inferiorthalamo-
Lefttransverse
striatevei
sinus(cut)
Deepmiddle
cerebral Superior
vetn sagittal
Srnus
Anterior
cerebral
vetn
Optic
nerve(ll)
Superior
vermtan
veln
nferior
vermlanvern
Anteriorponto- Falxcerebelli(cut)
mesencephalicveiri and occipitalsinus
Trigeminalnerve (V inferiorcerebellar
h e m i s p h e rvi ce i n s
Transversepontine veiri ntraculminatevein
Petrosalvein (draining vein (inconstant)
ior cerebellar
to superiorpetrosalsinui)
vetn
Lateralpontine vein Precentral
cerebellar
vein
Anteromedian
medullarv
veiri Superiorretrotonsillar
vein
(Inferiorretrotonsillar) Partsof cerebellum
Vein of lateralrecessof 4th ventricle
veinof cerebellomedullarv
t Lingula TU Tuber
Superior,middleand I cL CentrallobuleP Pvramid
inferiorcerebellar
pedunclei Posteriorsoinalvein c Culmen U Uvula
4{tr Anterior soinalvein 4th ventricle
D Declive
F Folium
N Nodule
T Tonsil

Deep Veins of Brain
of brainseePlate 102
veins
Forsuperficial
L o n g i t u d i n acl e r e b r a fl i s s u r e
A n t e r i o rc e r e b r a vl e i n s
R o s t r u mo f c o r p u sc a l l o s u m
A n t e r i o rv e i n o f s e p t u mp e l l u c i d u m
H e a d o f c a u d a t en u c l e u s
A n t e r i o rv e i n o f c a u d a t en u c l e u s
T r a n s v e r svee i n so f c a u d a t en u c l e u s
I n t e r v e n t r i c u l af or r a m e n( o f M o n r o )
C o l u m n so f f o r n i x
S u p e r i o rt h a l a m o s t r i a tvee t n
S u p e r i o rc h o r o i dv e i n a n d
c h o r o i d p l e x u so f l a t e r a vl e n t r i c l e
lnalamus
T e l ac h o r o i d e ao f 3 r d v e n t r i c l e
L a t e r a dl i r e c tv e i n
P o s t e r i ovr e i n o f c a u d a t en u c l e u s
l n t e r n a lc e r e b r a vl e i n s
B a s a vl e i n ( o f R o s e n t h a l )
C r e a t c e r e b r a vl e i n ( o f C a l e n )
I n f e r i o rs a g i t t asl i n u s
S t r a i g h st i n u s
T e n t o r i u mc e r e b e l l i
T r a n s v e r ssei n u s
C o n f l u e n c eo f s i n u s e s
S u p e r i o rs a g i t t asl i n u s
4ttr
Dissection:
superiorview
U n c a lv e i n
A n t e r i o rc e r e b r a lv e i n
S u p e r f i c i aml i d d l ec e r e b r a lv e i n
( d r a i n i n gt o s p h e n o p a r i e t asli n u s Optic chiasm
D e e p m i d d l e c e r e b r a vl e r n
C e r e b r aclr u s
B a s a vl e i n ( o f R o s e n t h a l )
Inferior
L a t e r a gl e n i c u l a t eb cerebral
VEI NS
M e d i a l g e n i c u l a t eb o d y
P u l v i n aor f t h a l a m u s
S p l e n i u mo f c o r p u sc a l l o s u m
C r e a t c e r e b r a lv e i n ( o f C a l e n ) Inferio r
anastomotrc
vein (of Labb6)
Dissection:
inferiorview

Subependymal Veins of Brain
P o s t e r i ovre i n so f s e p t u mp e l l u c i d u m Lateraldirect vein
S u p e r i otrh a l a m i vc e i n Posteriorterminalvein of caudate nucleus

(posteriorpart of thalamostriatevein)
S u p e r i ocrh o r o i dv e i n
Internalcerebralveins(rightand left)
Transverse
veinsof caudatenucleus
Medial(atrial)veinof lateralventricle
Superiorthalamostriatevein
Lateral(atrial)vein of lateralventricle
Lateralventricle
Splenium
Anterior vein of
caudate nucleus Creatcerebralvein
Anterior vein of
s e p t u mp e l l u c i d u m sal vein of corous
callosum
C e n uo f
corpus nferior sagittal
callosum srnus
lnternal
occipital vein
Straightsinus
Occipital
(posterior)
hornof
lateral
ventricle
Interventricular
foramen (of Monro)
Anterior commissure
Interthalamica
Anterior cerebralvein
Optic chiasm
Cerebellum
3rd ventricle
Deep middle cerebralvein
Inferiorthalamostriate
Basalvein (of Rosenthal)

Temporal(inferior)hornof lateralventricl6
Posteriormesencephalicvein ) u o e f l o r v e r m t a nv e t n
H i p p o c a m p a la n d i n f e r i o rv e n t r i c u l a vr e i n 6
Cerebralaqueduct
4{tr Lateraland medianapertures

of 4th
4th
Veinson lateralwall of ventricle
Veinson medialwall and floor of ventricle
All otherveins

Hypothalamus and Hypophysis
Septumpellucidum
Thalamus
Fornix
Hypothalamic
sulcus
Anteriorcommissure
Paraventricular
Posterior
Principal Dorsomedial
nucleIof Supraoptic
hypothalamus
Ventromedial
Arcuate
(infundibular)
Mammillarybody
tract
Mammillothalamic
Optic chiasm
Dorsallongitudinal
(pituitarystalk)
Infundibulum fasciculus
andother
4{tr (pituitary
Hypophysis
descendingpathways/ I
Hypothalamic
sulcus
Paraventricular
hypothalamic
nucleus
hypothalamic
Supraoptic
Supraopticohypophyseal
tract
Tuberohypophyseal
tract
Mammillary
body
Hypothalamohypophyseal
tract
(pituitarystalk)
Infundibulum
Arcuate(infundibular)
nucleus
Parstuberalis
Medianeminence
of tubercinereum
Adenohypophysis Fibroustr
(anteriorlobe of Neurohypophysis
Parsintermedia lnfundibular
pituitarygland) stem (posteriorlobe
of pituitarygland)
Parsdistalis
Gerebral Vasculature Plale 147

Arteries and Veins of Hypothalamus and Hypophysis
portalsystem
Superior
hypophyseal
artery hypophysealportalveins
Arteryof trabecula
portalveins
hypophyseal
(fibroustissue)
Trabecula
Efferent
hypophyseal
vein Efferent
hypophyseal
vein
to cavernous
sinus to cavernous
sinus
Secondary plexus Neurohypophysis

of hypophyseal (posteriorlobeof
portalsysteml pituitarygland)
Capillaryplexusof
infundibularprocess
Efferent
hypophyseal
vein
to cavernous
sinus
Inferiorhypophyseal
artery
Efferenthypophyseal
vernsto cavernous
4{r
Head Scans: Sagittal MR lmages
Median(A) and paramedian(8, C) sagittalMR images
c Cerebellum Inferiornasal
cc Corpus concha
callosum N P Nasopharynx
Extraocular o Occipitalpole
muscles O N Opticnerve
F Frontalpole P Pons
FV Fourth PG Pituitarygland
ventricle
s sinus
Sphenoid
Lateral
ventricle SC Spinalcord
Medulla T Thalamus
oblongata TC Tentorium
M B Midbrain cerebelli
M S Maxillary
sinus TO Tongue
Regional Scans Plate 149

Head Scans: Axial GT lmages
Axial CT imagesof the head from inferior (A) to superior(C)
B Basilarartery M Medullaoblongata
c Cerebellum M A M a s t o i da i rc e l l s
CH Cerebral MB Midbrain
hemisphere
MM Masseter
muscle
cs C o n f l u e n c eo f MR Medialrectus
stnuses muscle
E Eye MS Maxillarysinus
EA Externalacoustic N Nasalconcha
meatus
NS Nasalseptum
E S E t h m o i ds i n u s
P Pons
F Fat in orbit
S S p h e n o isdi n u s
FV Fourthventricle
SC Semicircular
t Lens canats
TP Lateralpterygoid SS Superiorsagittal
muscte
srnus
t-R Lateral rectus
T Temporalis
muscle
muscle
Tt Temporallobe
Plate 15O Regional Scans

Head Scans: Goronal GT Images
CoronalCT imagesof the headfrom anterior (A) to posterior(C)
A n t e r i ocr l i n o i d Lateralrectus
process muscle
c C r i s t ag a l l i Levatorpalpebrae
and
superioris
E Eye(vitreous superiorrectus
chamber) musctes
sinus
ES E t h m o i d
M Maxillarysinus
G Createrwing of
the sphenoid M R Medialrectus
muscle
lnferiornasal
N Nasalseptum
concha
rc lncisivecanal oc Oral cavity
S S p h e n o isdi n u s
IR lnferiorrectus
muscle z Zygomaticarch

2 Back and Spinal Gord
Section
Topographic Anatomy
Plate 152
rs2 Back
Bones and Ligaments

Plates 153-159
Column
rss Vertebral
Vertebrae
r se Thoracic
Vertebrae
rss Lumbar
RadiograPhs
Vertebrae:
r se Lumbar
andCoccyx
rsz Sacrum
Lumbar
Ligaments:
rss Vertebral Region
Ligaments:
rss Vertebral Region
Lumbosacral
Spinal Gord
Plates l6(F173
160 Cord
Soinal andVentral inSitu
Rami
161 Nerve
ofSpinal
Relation toVertebrae
Roots
162 DiscHerniation:
Lumbar Manifestations
Clinical
163 andEpidural
Puncture
Lumbar Anesthesia
t64 Dermatomes
165 Nervous
Sympathetic System: Topography
General
166 pathetrc
Parasym Nervous
System Topography
: General
167 Nervous
Sympathetic Schema
System:
t68 Nervous
Parasympathetic Schema
System:
169 Membranes
Spinal Roots
andNerve
17l, Nerve
Spinal Cross
Origin: Sections
171 Cord:
ofSpinal
Arteries Schema

Back and Spinal Gord
rzz Arteries
ofSpinal
Cord:
Intrinsic
Distribution
rzs Veins
ofSpinal
CordandVertebral
Column
Muscles and Nerves

Plates 174-l80
rze Muscles
ofBack:
Superficial
Layers
rzs Muscles
ofBack:
Intermediate
Layers
tze Muscles
ofBackDeep
Layers
rzz Nerves
ofBack
rze Suboccipital
Triangle
'rzs Lumbar
Region
ofBack:Cross
Section
reo TypicalThoracic
Spinal
Nerve

Back
muscle
Trapezius occipitalprotuberance
External
L i g a m e n t u mn u c h a e
S p i n eo f s c a p u l a
Spinousprocessof
Deltoid muscle C7 vertebra
Infraspinatus
muscle
Tricepsbrachii
muscle
Long head
Lateralhead
Tendon
D e l t o i dm u s c l e
Triangleof auscultation
Medialborderof
scapula
lnferiorangleof
scapula
major muscle Spinousprocessof

T 1 2v e r t e b r a
Latissimus
L u m b a r( t r i a n g l e d o r s i m u s c l e C l u t e u sm e d i u s
of Petit) muscle
lliac crest
Erectorspinae Sacrum
muscle
C l u t e u sm a x i m u s
Posteriorsuperior muscle
iliacspine
Greatertrochanter
of femur
Intergluteal(natal)
cleft
Clutealfold
e/fd4g/^
Topographic Anatomy Plate 152

Vertebral Golumn
Anteriorview left lateralview Posteriorview
A t l a s( C l )
A x i s( C 2 )
Cervical
curvature
C7
C7
C7
t T1
T1
Thoracic
Thoracic vertebrae
curvature
Lumbar
vertebrae
Lumbar
curvature
(S1-5)
Sacrum
S a c r u m( S 1 - 5 )
*{w

Thoracic Vertebrae
articular
Superior processand facet
Vertebralforamen costalfacet
Pedicle
Body
Transverse
costalfacet
Superior
vertebral notch Superior Transverse
(forms lower costalfacet process
margin of
Pedicle
intervertebral lnferior
foramen)
articular
process
Superior
articularfacet
T6 vertebra:
lateralview
T6 vertebra:
superiorview
Superiorarticular
processand facet
Superiorarticular
processandfacet
7th rib
Costal facet
S p i n o ups r o c e sos f
T7 vertebra T12vertebra:
lateralview
Transverseprocessof
T9 vertebra
Inferiorarticularprocess(T9)
4{tr
Spinousprocess(T9)
T7,Tgand T9 vertebrae:
posteriorview

Lumbar Vertebrae
Vertebralbody A n u l u sf i b r o s u s
Nucleus
Vertebral foramen purposus
process
Transverse lntervertebraldisc
Superiorarticularprocess Accessorvorocess
M a m m i l l a r yp r o c e s s
Lamind
Spinousprocess
Mammillary process
[2 vertebra: Transverseprocess
superiorview
Spinousprocess
Vertebralcanal Vertebralbody
Inferior
articular
Superior Intervertebral
disc process
articularprocess
M a m m i l l a r yp r o c e s s Inferior
Vertebralbody vertebralnotch
Transverse
process Intervertebral
(neural)foramen
Superior
vertebral
Parsinterarticularis notch
Accessory
process
of L3 vertebra
facet
Inferior for sacrum
articularprocess
[3 and L4 vertebrae: l-umbarvertebrae,assembled:

posterior view left lateralview

Lumbar Vertebrae: RadiograPhs
Anteroposteriorradiograph Lateralradiograph
B Body of L3 vertebra D Intervertebraldisc space

IA Inferiorarticularprocessof L1 vertebra I lntervertebralforamen
t L a m i n ao f L 4 v e r t e b r a lA Inferiorarticularprocessof L3 vertebra
P Pedicleof L3 vertebra lN lnferior vertebralnotch of L2 vertebra
s S p i n o u sp r o c e s so f L 4 v e r t e b r a P Pedicleof L3 vertebra
SA Superiorarticularprocessof L1 vertebra S Spinousprocessof L3 vertebra
S F Sacralforamen SA Superiorarticularprocessof L4 vertebra
T Transverseprocessof L3 vertebra SN Superiorvertebralnotch of L3 vertebra
Note: The vertebralbodies are numbered

Sacrum and Goccyx
SeealsoPlates 153, 159, 248,352-gS4
Superior
Baseof sacrum articular
process
Lumbosacral
articularsurface
Superior
articularprocess
Ala (wing)
Promontory
r a lp a r t
o f p e l v i cb r i m
( l i n e at e r m i n a l i s )
Sacralhiatus
Transverse
ridges Mediansagittalsection
Apexof sacrum
Transverseprocess
of coccyx
Facetsof
superiorarticular
Anteriorinferior
view Pelvic surface
A u r i c u l asru r f a c e
Nr Sacraltuberosity
Lateralsacralcrest
M e d i a n s a c r a lc r e s t
Intermediatesacralcresl
Posterior
sacralforamen Posterior
sacral
foramina
Sacralcornu
(horn)
Coccygealcornu
Anterior (pelvic) (horn)
sacralforamen
Transverseprocess
Coronalsection of coccyx
through52 foramina
Posteriorsuperiorview

Vertebral Ligaments: Lumbar Region
left lateralview Inferiorarticularprocess

(partially sectioned
in median plane) joint
Capsuleof zygapophyseal
(partiallyopened)
S u p e r i oar r t i c u l aprr o c e s s
process
Transverse
Lumbarvertebral
L i g a m e n t ufm
lavum
lntervertebraldisc
I n t e r s p i n o ul i sg a m e n t
,i
Anterior i\srprarpinous ligament

l o n g i t u d i n lai g
l ament l
tl
Intervertebralforamen
Posterior
l o n g i t u d i n lai g
l ament
Posteriorvertebralsegments:
anteriorview
Anteriorvertebralsegments:
posteriorview Pedicle(cut surface)
(pedicles sectioned)
Ligamentumflavum
Pedicle (cut surface)
S u p e r i o ra r t i c u l a r
process
Intervertebraldisc
process
Transverse
l n f e r i o ra r t i c u l a r

Vertebral Ligaments: Lumbosacral Region
Anterior Superiorarticularprocess
longitudinal
ligament I ransverseprocess
Lamina
Pedicle(cut)
Bodyof Inferiorarticularprocess
L1 vertebra longitudinal
Pedicle ligament
lntervertebral
foramen
Intervertebral
discs Spinousprocess
lnterspinous
ligament
Supraspinous
ligament
Superiorarticularprocesses;
facettropism(differencein
facetaxis)on rightside
Spinousprocess
process
Transverse
Bodyof
L5 vertebra Inferiorarticularprocess
Ligamentum
flavum
L5 spinalnerve lliolumbar
lliaccrest
Auricularsurfaceof sacrum
(forarticulation
with ilium) Posterior
supeflor
i l i a cs p i n e
Posterior
inferior
i l i a cs p i n e
left lateralview
Posteriorsacroiliacligamenl
Creatersciaticforamen
S p i n eo f i s c h i u m
Lateral,
Sacrospinous
4{tr
sacro-
Lesser
sciaticforamen coccySeal
ligaments
Sacrotuberous
ligament
Posteriorview

Spinal Gord and Ventral Rami in Situ
B a s eo f s k u l l C 1 v e r t e b r a( a t l a s )
C 1 s p i n anl e r v e C e r v i c apl l e x u s
C2 vertebra (axis) C7vertebra
C B s p i n a ln e r v e
T1 vertebra
B r a c h i apll e x u s
T.l spinalnerve
.l
st rib ldura mater
F i l a m e n t so f
s p i n a ln e r v e
roots (T7 and TB)
T't2
vertebra
L1
vertebra
1 2 t hr i b
L 1 s p i n a ln e r v e llioinguinal
C o n u sm e d u l nerve
L u m b apr l e x u s
C a u d ae q u i n a
L5 vertebra
L5 spinal nerve
Femoralnerve
S 1 s p i n a ln e r v e
Sacralplexus
S a c r u m( c u t a w
S u p e r i o ra n d i n f e r i o r
F i l u mt e r m i n a l ei n t e r n u m g l u t e a ln e r v e s
Terminationof dural sac Sciaticnerve
F i l u mt e r m i n a l ee x t e r n u m Posteriorfemoral
t c o c c y g e al i g a m e n t ) cutaneousnerve
5 5 s p i n a ln e r v e
' P u d e n d a ln e r v e
Coccygealnerve f,
nrlS
Coccyx
4.12
Spinal Gord Plate 16O

Relation of Spinal Nerve Roots to Vertebrae
'-C1
-.
'' I1Cabove
' l s p i n a ln e r v e e x i t s
Uur" / C.l vertebra
of skull c2'
C3
Cervical C3 ' c 4
enlargemenl ---C4
C5
C5
C B s p i n a ln e r v e
t) exits below
C7 C7 vertebra
(there are B cervical
T1 nervesbut only
T1 7 cervicalvertebrae)
T2
T?
r2
T3
r4
TA
T5
T5
r6
r7 Lumbar disc protrusiondoes not usuallyaffect
T7 nerve exiting above disc. Lateralprotrusion
.-TB at disc level L4-5 affectsL5 spinalnerve, not
-T9 L4 soinalnerve. Protrusionat disc level L5-S1
affectsS.l spinalnerve, not L5 spinal nerve.
--T1O T10
'r
Lumbar -zT1l T11
e n la rge me n t -----_____a '
-2r'T12 T 1 2
C o n u sm e d u l l a r i s
/Lr ( t e r m i n a t i o no f
L1 s p i n a lc o r d )
,L2
L5 --
-'L3
Filum -L4
terminale
Internum
-L5
-Sacrum
S1
Filum
terminale
externum S3 Terminationof
(coccygeal d u r a ls a c
S4
Nr
ligament)
S5
Coccygealnerve
I Cervicalnerves
I Thoracicnerves Medial protrusionat disc level L4-5 rarelyaffects
I Lumbarnerves L4 spinal nerve but may affect L5 spinalnerve
I Sacraland coccygealnerves a n d s o m e t i m e sS 1 - 4 s o i n a ln e r v e s .
Plate | 61 Spinal Gord

Lumbar Disc Herniation: Glinical Manifestations
,/."
Schematiccrosssection
s h o w i n gc o m p r e s s i o no f {''"'z;""
'//;.d,
nerve rool
.,,.| \
t
Characteristic
Nucleus
purposus
4{tr
posture in left-sided Nerverool
l o w e r l u m b a rd i s c
herniation
Surgical exposureof
l o w e rl u m b a d
r isc
herniation
C l i n i c a fl e a t u r e so f h e r n i a t e dl u m b a r n u c l e u sp u l p o s u s
Level of herniation Pain Numbness Weakness Atrophy Reflexes
L3
Changes
uncommon
L4 i n k n e ea n d
Over a n k l ej e r k s ,
Dorsiflexion Minor but internal
sacro- of great toe
\Ls iliac hamstring
and foot; reflex
joint,
difficulty diminished
SL5 hip, w a l k i n go n
lateral or absent
\ heels;foot
L4-5 disc; t h i g h Lateralleg, o r o p m a y
5th lumbar and leg first 3 toes occur
nerve root
Over Plantar
sacro- f l e x i o no f
iliac foot and
joint, great toe
hip, may be
posrero- affected;
lateral difficulty A n k l ej e r k
thigh Back of w a l k i n go n
calf, lateral toes diminished
and leg or absent
[5-Sl disc; to heel heel,foot
Castrocnemi-
1st sacral to toe
usand soleus
nerve toot
Spinal Gord Plate 162

Lumbar Puncture and Epidural Anesthesia
Lumbarpuncture
Subarachnoid
space
Needleentering
subarachnoidspace
lliac
crest
Arrows show locationsof

insertionof needles.
Epiduralanesthesia
Dural sac
Epiduralspace
Spinousprocessof L4
Ligamentumflavum
Epiduralanesthesia and lumbarpunctureare performedby insertinga needleabove or below the L4 vertebralspine,

which liesat the levelof the iliaccrest.Forepiduralanesthesia,
the needlepassesinto the epiduralspace,and anesthetic
agentbathesthe nerve rootsin proximity.Lumbarpuncture,on the other hand,is performedin order to collecta sample
of cerebrospinal fluid (CSF)or to introducean anestheticagentinto the CSF(spinalanesthesia),
so thereforethe needie
penetratesthe duralsac to enter the subarachnoidspace.
Cryd4/^
Plate 163 Spinal Gord

Dermatones
Schematicdemarcationof dermatomes
(accordingto Keeganand Carrett)
shownas distinctsegments. Thereis
actuallyconsiderableoverlapbetween
any two adjacentdermatomes.An
alternativedermatomemap is that
providedby Foerster(seeReferences).
S3
S4
ss
15,
Ll,
L2
S1
4{F L5
L4
Levels of principal dermatomes

T10 Levelof umbilicus
C5 Clavicles t1 Inguinalor groin regions
C5,5,7 Lateralpartsof upperlimbs Ll,2,3,4 Anteriorand innersurfacesof lower limbs
C8,Tl Medialsidesof upperlimbs L4,5, 51 Foot
C6 Thumb L4 Medialsideof greattoe
C6,7,8 Hand sl, 2, L5 Posteriorand outer surfacesof lower limbs
C8 Ringand littlefingers s1 Lateralmarginof foot and little toe
T4 Levelof nipples s2,3,4 Perineum

Sympathetic Nervous System: General Topography
I n t e r n a cl a r o t i dp l e x u s
I n t e r n a cl a r o t i dn e r v e
S u p e r i o rc e r v i c a lg a ng l i o n
Cray ramicommunicantes Externalcarotid nerve
C e r v i c a ls y m p a t h e t i ct r u n k
M i d d l e c e r v i c a lg a n g l i o n
C e r v i c a lc a r d i a cn e r v e s
C e r v i c o t h o r a c i (cs t e l l a t eg) a n g l i o n
Thoracic visceralnerves
P u l m o n a r yp l e x u s C a r d i a cp l e x u s
W h i t e a n d g r a yr a m i c o m m u n i c a n t e s
E s o p h a g epalle x u s
C r e a t e rt h o r a c i cs p l a n c h n i cn e r v e
L e s s e rt h o r a c i cs p l a n c h n i cn e r v e Celiacplexus
Aorticorenalganglion C e l i a cg a n g l i o n
L u m b a rs p l a n c h n i cn e r v e s S u p e r i o rm e s e n t e r i cg a n g l i o n
S u p e r i o rm e s e n t e r i cp l e x u s
In f e r i o rm e s e n t e r i cg a n g l i o n
In f e r i o rm e s e n t e r i cp l e x u s
S u p e r i o rh y p o g a s t r i cp l e x u s
Hypogastricnerve
S a c r a sl p l a n c h n i cn e r v e s
Inferiorhypogastricplexus
C/Fd4ae

Parasympathetic Nervous System: General Topography
L a c r i m agl l a n d
O c u l o m o t o r n e r v e( C N l l l )
F a c i a nl e r v e ( C N V l l ) C i l i a r yg a n g l i o n
P t e r y g o p a l a t ignaen g l i o n
C l o s s o p h a r y n g e anle r v e ( C N l X )
Parotidgland
Vagus nerve (CN X)
S u b m a n d i b u lgaar n g l i o n
l ds u b m a n d i b u lgalra n d s
S u b l i n g ua n
cardiacbranch
Cervical
C a r d i a cp l e x u s
P u l m o n a r yp l e x u s
Esophagealplexus
Anterior and posteriorvagal

tru nks
C e l i a cp l e x u s
plexus
mesenteric
Superior
P e l v i cs p l a n c h n i cn e r v e s( f r o m 5 2 - 4 )
Inferior hypogastricplexus
Cavernousnerves
Cryd4s4*

Sympathetic Nervous System: Schema
Superiorcervicalganglion Internalcarotid nerve and olexus
Externalcarotid nerve and olexus
$flacrimalgland
C r a y r a m ic o m m u n i c a n t e s
Firstthoracicgan .\
lnnervationto arrectorpili muscles,..,'

vascularsmooth muscle,and sweat i'}
g l a n d so f s k i n
diac branches
Createrthoracic
s p l a n c h n i cn e r v e
Celiacganglion
tl:
1 . t . . . - - 1 . . - Lesserthoracic
\.-.-'r'
splanchnicnerve
Aorticorenal
Liver ganglion
Whiteramus
communtcans
Callbladder
Bileducts
Pancreas
Cray ramus Leastthoracic
communtcans splanchnicnerve
Kidneys mesenteflc
ganglion
Intestines Lumbar
F i r s tl u m b a r splanchnic
nerves
Descending lnferior
colon mesenteric
ganglion
Firstsacralganglion Sigmoidcolon
lnferior
Urinary hypogastric
bladder plexus
Prostate
Preganglionicfibers
Postganglionic fibers Externalgenitalia CryW

Parasympathetic Nervous System: Schema
C i l i a r yg a n g l i o n ganglion
Pterygopalatine
B r a n c ho f o c u l o m o t o rn e r v e( l l l )
Branchof facialnerve (Vll)
Medulla oblongata
Branchof glossopharyngeal
n e r v e( l X )
Otic ganglion
S u b m a n d i b u l agra n g l i o n
fr
/t,
(f
plexus
Pulmonary
i
Liver
) Callbladder
n
g
B i l ed u c t s
K' ."
\
Pancreas
lntestines
Descendingcolon
Inferiorhypogastric
prexus
Sigmoidcolon
s2 Rectum
53j
S4 Urinarb
y ladder
P e l v i cs p l a n c h n i cn e r v e s
Prostate
6ry4c/*
Preganglionic fibers Externalgenitalia
Postganglionic fibers

Spinal Membranes and Nerve Roots
Posteriorview V e n t r a lr o o t o f s p i n a ln e r v e
Dorsal root of soinalnerve
D o r s a lr o o t ( s p i n a l g
) anglion
W h i t e a n d g r a yr a m i c o m m u n i c a n t e s
to and from sympathetictrunk
V e n t r a lr a m u so f s o i n a ln e r
Dorsal ramus of soinalnerve
D u r am a t e r
M e s o t h e l i sa el o t u mi n d o r s am
l e d i a ns u l c u s
P i a m a t e ro v e r l y i n gs p i n a lc o r d
Filamentsof dorsal root
D e n t i c u l a t el i g a m e n t
Dorsalhorn
Membranes removed: anterior view
(greatly magnified)
Ventralhorn
Lateral
horn
Craymatter
White matter t sf d o r s arl o o t
F i l a m e no
Dorsal root of spinalnerve
Filamentsof ventral root
Dorsal root (spinal)ganglion
Dorsal ramus of spinal nerve
Ventral ramus of spinalnerve
Ventral root of soinal nerve
Cray and white

rami communicantes
4{tr
Spinal Nerve Origin: Gross Sections
SeealsoPfates 169, 172,173
Sectionthroughthoracicvertebra
Body of vertebra
Dura mater F a ti n e p i d u r a ls p a c e
Arachnoid mater*
Sympatheticganglion
S u b a r a c h n osi d
pace D e n t i c u l a t el i g a m e n t
Ventral root
Pia mater*
White and gray rami
Recurrent communrcantes
meningeal
b r a n c h e so f s p i n a l
nerve S p i n a ln e r v e
Ventral ramus
Pleura (intercostalnerve)
LUnS
Dorsalramus
Dorsalroot
(spinagl )a n g l i o n
Dorsal root
Lateralhorn of
g r a y m a t t e ro f s p i n a lc o r d
of dorsal lnternalvertebral
M e d i a lb r a n c h ramus (epidural)venous plexus(of Batson)
Sectionthrough lumbarvertebra of spinal
Lateralbranch
nerve
Dura mater
Arachnoid mater
Ventral root
S p i n a ln e r v e
Ventralramus(contributes
to lumbarplexus)
D o r s arl a m u s
Dorsal and ventral Dorsalroot ganglion

Nr
r o o t s o f l u m b a ra n d Dorsal root
s a c r a ls p i n a ln e r v e s *Leptomeninges
f o r m r n gc a u o ae q u r n a C o n u sm e d u l l a r i s
Spinal Gord Plate | 7O

Arteries of Spinal Gord: Schema
SeealsoPlate 138
Posterior view
Posterior
cerebralar Posteriorinferior cerebellarartery
Superiorcerebellarartery
Posteriorsoinalarteries
Basilarartery
Anterior inferior Vertebralartery

cerebellarartery (Al
Posteriorinferior
_o Posteriorsegmental
r r t e r y( P I C A )
c e r e b e l l aa
m e d u l l a r ya r t e r i e s
A n t e r i o rs p i n a l
Deep cervicalartery
ao
Vertebral
artery
A n t e r i o rs e g m e n t a l U Ascendingcervicalartery
medullary arteries
A s c e n d i n gc e r v i c a l
arrery
Deep cervicala Subclavianartery
S u b c l a v i a na r t e r
Anterior segmental
t,.l
3
(t:, Posteriorsegmental
medullary arteries
m e d u l l a ray r t e r y /;:, ,:.i\
ifi g
Posteriorintercostalartery
L i)
Liki
Pialplexus \UI
Thoracic /n
Posterior
vertebrae
ifj intercostalarteries
,t
Major anterior segmental
m e d u l l a r ya r t e r y( g r e a t
'9,
r a d i c u l a ra r t e r yo t
Adamkiewicz)
Posteriorintercostalarter
4{tr
l"-l
, T i I' Posteriorsegmental
A n t e r i o rs e g m e n t a l
m e d u l l a r ya r t e r y medullary arteries
omotic loops to
anteriorspinalartery
Lumbar artery
Lumbar Lumbar arteries

vertebrae
Anastomoticloops to
posterior spinalarteri fi, Lateral(or medial)
sacralarteries
C a u d ae q u i n aa r t e r
N o t e : A l l s p i n a ln e r v e r o o t s h a v e
associated radicular or segmental
Lateral(or medial) medullary arleries Most roots have
radicular arteries (see Plate 172) Both
sacralarteries types of arteries run along roots, but
Sacrum r a d i c u l a ra r t e r i e se n d b e f o r e r e a c h i n g
'u \ a n t e r i o ro r p o s t e r i o rs p i n a la r t e r i e s ;
(s l a r g e rs e g m e n t a lm e d u l l a r ya r t e r i e s
c o n t i n u e o n t o s u p p l y a s e g m e n to f
rb t h e s ea r t e r i e s

Arteries of Spinal Gord: Intrinsic Distribution
Posteriorspinalarteries
Anteriorspinalartery
Anterior segmental
medullary artery
Anteriorradicular
artery
radicular
artery
Branchto vertebralbody
and dura mater
nalbranch
Dorsalbranchof posterior
intercostal
artery
intercostal
Posterior artery
Paravertebral
anastomoses
Prevertebralanastomoses
Thoracic (descending)aorta
Sectionthroughthoraciclevel:
*{r
anterosuperiorview
Rightposteriorspinalartery
Sulcal(central)branchesto
rightsideof spinalcord Peripheral from pialplexus
branches
Posterior
radicular
artery Sulcal(central)branches
to leftside
of spinalcord
Anterior segmental Leftposteriorspinalartery

medullaryartery
Pial arterialolexus

radicular
arteries
A n t e r i o rs p i n a l
Posterior artery
radicular
Arterialdistribution:schema
Anterior segmental
m e d u l l a r ya r t e r y
Note: All spinal nerve roots have associated radicular or

Pialarterialplexus
segmental medullary arteries Most roots have radicular arteries.
B o t h t y p e s o f a r t e r i e sr u n a l o n g r o o t s , b u t r a d i c u l a ra r t e r i e se n d
before reaching anterior or posterior spinal arteries;larger segmental
medullary arteries continue on to supply a segment of these arteries

Veins of Spinal Gord and Vertebral Golumn
I n t e r n a vl e r t e b r a (l e p i d u r a lv) e n o u sp l e x u s
External
vertebralvenous
plexus
l n t e r v e r t e b r avle i n
I n t e r n a vl e r t e b r a l
( e p i d u r a l v) e n o u s
p l e x u s( B a t s o n ' s Externalvertebralvenous olexus
veins)
B a s i v e r t e b r av le i n t e r n a lv e r t e b r a vl e n o u sp l e x u s
Basivertebralvein
I n t e r n a vl e r t e b r a l
( e p i d u r a l v) e n o u sp l e x u s
S e g m e n t am l edullary/
r a d i c u l a rv e i n s
A n t e r i o rs p i n a lv e i n B a s i v e r t e b r av le i n Intervertebral
vetn
A n t e r i o rs u l c a l n t e r n a lv e r t e b r a l
( c e n t r a l v) e i n ( e p i d u r avl )e n o u sp l e x u s
Internalvertebral
( e p i d u r a l v) e n o u sp l e x u s
Externalvertebral
v e n o u sp r e x u s
l n t e r v e r t e b r avl e i n
l e d u l l a r y / r a d i c u l av re i n
A n t e r i o rs e g m e n t am
P o s t e r i o sr e g m e n t am
l e d u l l a r y / r a d i c u l av re i n
P i a lv e n o u sp l e x u s
P o s t e r i osr u l c a l( c e n t r a l v) e i n
P o s t e r i o sr p i n a lv e i n
I n t e r n a vl e r t e b r a (l e p i d u r a l v) e n o u sp l e x u s
*{ry
Muscles of Back Superficial Layers
S u p e r i onr u c h alli n eo f S e m i s p i n a l icsa p i t i sm u s c l e
Spinousprocessof C2 ver l e n i u sc a o i t i sm u s c l e
Sternocleidomastoidmuscl Spinousprocessof C7 vertebra
trianeleof neck
Posterior Spleniuscervicismuscle
Trapeziusmuscle L e v a t o rs c a p u l a em u s c l e
S p i n eo f R h o m b o i dm i n o r m u s c l e( c u t )
D e l t o i dm u s c Supraspinatus
muscle
natus
Infraspi
fascia tus
posterior
s u p e r i om
r uscle
major muscle
Teresmajor (cut)
muscte
Infraspinatus
fascia(over
infraspinatus
Latissimus muscle)
dorsimuscle
Teresminor
and major
musctes
Spinousprocess
of T12 vertebra
dorsimuscle(cut)
Latissimus
fascia
Thoracolumbar
Serratusanterior muscle
External
o b l i q u em u s c l e Serratusposteriorinferior
muscre
I n t e r n aol b l i q u e 1 2 t hr i b
m u s c l ei n l u m b a tr r i a n g l e
(of Petit)
rector spinaemuscle
lliac crest External
4{tr
o b l i q u em u s c l e
Cluteal aponeurosis
nternal
( o v e r g l u t e u sm e d i u sm u s c l e
Muscles and Nerves Plale 174

Muscles of Back: Intermediate Layers
S u p e r i onr u c h alli n eo f s k u l l Rectuscapitisposteriorminormuscle
tubercleof atlas(C.l
Posterior Obliquuscapitissuperiormuscle
Rectuscapitisposteriormajormuscle
L o n g i s s i m ucsa p i t i s
O b l i q u u sc a p i t i si n f e r i om
r uscle
S e m i s p i n a l icsa p i t i s
L o n g i s s i m cuas p i t i sm u s c l e
S p l e n i ucsa p i t i sa n d
s p l e n i u sc e r v i c i s
S e m i s p i n acl iasp i t i sm u s c l e( c u t )
posteriorsuperior
Serratus Spinalis
cervicismuscle
Spinousprocessof C7 vertebra
l l i o c o s t a l im
s uscle
o n q t s s t m ucse r v t c t sm u s c t e
Erector lliocostaliscervicismuscle
sprnae Longissimm
u su s c l e
muscle
lliocostalis
thoracismuscle
Hook
S p i n a l im
s uscle
Spinalisthoracismuscle
L o n g i s s i m utsh o r a c i sm u s c l e
lliocostalislumborum muscre
SpinousprocessofT12 vertebra
Tendon of origin of
transversusabdominis muscle
Transversusabdominis
muscle and tendon
of origin
Internao
l blique
muscle
Thoracolumbarfascia
(posteriorlayer)(cut)
E x t e r n aol b l i q u e
muscle (cut)
lliac crest
4ttr
Plate | 75 Muscles and Nerves
Muscles of Back: Deep Layers
S u p e r i onr u c h alli n eo f Rectuscapitisposteriorminormuscle
Mastoid Drocess Obliquuscapitissuperiormuscle
Posterior
tubercleof atlas Rectuscapitisposteriormajormuscle
(Cl vertebra)
processof atlas(C1)
Transverse
Spinousprocessof axis
(C2vertebra Obliquuscapitisinferiormuscle
S e m i s p i n a l icsa p i t i s Loneus
" )
cervicismuscles
) Rotatores
Brevis )
Spinousprocess
of C7 vertebra Interspinaliscervicismuscle
Levatorcostaemuscle
External
intercostal
muscles
Semispinalis
thoracismuscles
Multifidusmuscles
Thoracolumbarfascia lumborummuscle
(anteriorlayer)
lntersoinalis
Thoracolumbar fascia muscle

Intertransversarius
(posteriorlayer)(
atuslumborummuscle
Transversus
abdominismuscle
and tendon of origin
liaccrest
Multifidusmuscles
Multifidusmuscles(cut)
Erectorspinaemuscle(cut)
4{tr
Muscles and Nerves PIate 176
Nerves of Back
Accessorynerve (Xl) o c c i p i t a ln e r v e ( d o r s a lr a m u so f
C 2 s p i n a ln e r v e )
Trapeziusmuscle(refI ected) 3rd occipitalnerve(dorsalramusof
Levatorscapulae
muscle
Cervicalplexus
Transversecervical artery (ventralramiof
and vein C2, 3 spinalnerves)
plexus
Subtrapezial
Posterior
cutaneous branches(frommedial
branchesof dorsalramiof C4-T6soinal
t C 7 , B a r em i n i m a l )
Deltoidmuscle
S up r a s p i n a t u s
muscle Infrasoinatus
fascia
S p i n eo f Teresminorand
scapula majormuscles
Infraspinatus Superiorlateralbrachial
fascia cutaneous nerve(from
axillarynerveC5, 6)
Posterior cutaneous
branches(fromlateral
branches of dorsalrami
o I f T - 1 2 s p i n anl e r v e s )
Rhomboid
m i n o rm u s c l e
Lateralcutaneousbranchesof
Rhomboid ventralrami(intercostal
nerves)
m a l o rm u s c l e
L a t i s s i m ud so r s im u s c l e
E x t e r n aolb l i q u em u s c l e
Spinousprocessof
T12vertebra lliaccrest
lliohypogastric nerve
Thoracolumbarfascia ( v e n t r arla m u so f L l s p i n a l
nerve)
Superior clunialnerves
( d o r s ar la m io f L l , 2 , 3 s p i n a l
nerves)
Medialclunialnerves
( d o r s ar la m io f 5 1 , 2 , 3s p i n a l
C l u t e u sm a x i m u s nerves)
muscle
lnferiorclunialnervesfrom
posteriorfemoralcutaneous
4{tr n e r v e( s a c r apl l e x u sS 1 ,2 , 3 )
Plate 177 Muscles and Nerves

Suboccipital TFiangle
Rectuscapitisposteriorminormuscle
Rectuscapitis posterior major muscle
E p i c r a n iaapl o n e u r o s i s a l i sc a p i t i sm u s c l e
(galeaaponeurotica (cutand reflected\
Occipital belly (occipitalis)of

occioitofrontalis Vertebralartery
(atlanticpart)
Obliquuscapitis
Greater occioital nerve suoeriormuscle
(dorsalramus of C2
s p i n a ln e r v e )
nerve
Suboccipital
(dorsalramusof C1
Occipitalartery spinalnerve)
Posteriorarchof
atlas(C1vertebra)
Third occipital nerve
( d o r s a lr a m u so f C 3
spinal nerve) italartery
O b l i q u u sc a p i t i s
S e m i s p i n a l icsa p i t i s inferiormuscle
a n d s p l e n i u sc a p i t i s
musclesin posterior
triangleof neck Creater occioital
nerve (dorsalramus
of C2 spinalnerve)
Posterior
auricularartery Splenius capitismuscle
(cut and reflected)
occipital nerve
C r e a ta u r i c u l anre r v e (dorsalramusof C3
(cervicalplexusC2,3 spinalnerve)
capitismuscle
Longissimus
Lesseroccipital nerve
(cervicalplexusC2) cervicismuscle
Splenius
cervicismuscle
Semispinalis
Sternocleidomastoidmuscle
Traoezius
muscle liscapitismuscle(cut)
Posteriorcutaneousbranches
of dorsalramiof C4, 5 , 6
spinalnerves
capitismuscle(cut)
Splenius
4{tr
and Nerves Plate | 78

Lumbar Region of Back: Gross Section
lnferiorvena cava
Descending(2nd) part of duodenum
Kidney Pancreas
Renal(Cerota's)fascia
(anterior and posterior layers)
Anterior longitudinalligament
Perirenalfat
Cruraof diaphragm
Superior artervandvein
mesenteric
Extraperitoneal Mesentery
(subserous)fascia
(areolar
tissue)
Abdominal aorta
Transversalis
fascia
Duodenojejunal
junction
Bodyof
L2 vertebra
Psoasmajor
muscte
and fascia
Lumbar
spinalnerve
Transverse
process
External
Spinal
oblique
duramater
muscle
Internal Cauda
o b l i q u em u s c l e equina
Transversus
abdominis
muscle
Spinousprocess
Tendonof originof of L1vertebra
transversusabdominis
and
internalobliquemuscles
ligament
Supraspinous
posterior
Serratus inferiormuscle Erector
spinaemuscle
Latissimus
dorsi muscle Thoracolumbarfascia(posteriorlayer)
lumborummuscle
Quadratus Thoracolumbarfascia(middlelayer)
Thoracolumbarfascia(anteriorlayer-
quadratuslumborum fascia)
*{r
Plate 179 Muscles and Nerves
fiTpical Thoracic Spinal Nerve
Anterior cutaneousbranch
Lateralbranch
External I Transversus
thoracis
muscle External muscle
intercostal
intercostal
membrane
lnternalintercostal
muscle
lnnermostintercostal
muscle
Ventralroot
Dorsal root
Anterior branch
lntervertebral Dorsalroot (spinal) lateral cutaneousbranch
foramen ganglion Posteriorbranch
Spinalnerve
Sympatheticganglion
ray and white rami communicantes
Ventralramus(intercostalnerve Serratusanterior muscle
atissimusdorsi muscle
Subscapularis
muscle
Teresmaiormuscle
Traoezius
muscle muscle
Infrasoinatus
Dorsalramu6
M e d i a lb r a n c h
Rhomboidmaiormuscle
Lateralbranch
Posteriorcutaneousbranch
Erectorspinaemuscle
Note: In lower thoracic

region, lateralbranch of
lnternalintercostalmembrane
*{r
dorsal ramus is longer,
motor, and cutaneous;
medial branch is shorter
and motor onlv.
Muscles and Nerves Plate l8O

3 Thorax
Section
Topographic Anatomy
Plates l8t
181 Thorax
Mammary Gland
Plates 142-144
182 Mammary
Gland
Gland
ofMammary
183 Arteries
184 Lymph of Mammary
andNodes
Vessels Gland
Body Wall
Plates 185-195
ofThorax
185 BonyFramework
Joints
186 RibsandSternocostal
Joints
187 Costovertebral
Wall
Thoracic
188 Anterior
Wall(continued)
Thoracic
189 Anterior
Tube
Drainage
190 Chest Placement
191 Anterior Wall:
Thoracic InternalView
andArteries
Nerves
192 Intercostal
Nerve
193 Phrenic
Surface
Thoracic
194 Diaphragm:
Abdominal
195 Diaphragm: Surface
Lungs
Plates t9G2lO
AnteriorView
ofLungs:
196 Topography
PosteriorView
of Lungs:
197 Topography
inSitu:
198 Lungs View
Anterior

Thorax
199 Lungs:
Medial
Views 226 Nerves
of Heaft
200 Bronchopulmonary
Segments 227 lnnervation
of HeartSchema
201 Bronchopulmonary (continued)
Segments 228 lnnervation
ofBlood
Vessels:
Schema
202 Tracheaand
MajorBronchi 229 Prenatal
andPostnatal
Circulation
203 Nomenclature
ofBronchi:
Schema
204 Intrapulmonary
Airuvays:
Schema Mediastinum
205 Intrapulmonary
BloodCirculation:
Schema Pfates 23O-24l
206 Great
Vessels
ofSuperior
Mediastinum 230 Mediastinum:
Right
Lateral
View
207 BronchialArteries
andVeins 231 Mediastinum:
LeftLateralView
208 Lymph
Vessels
andNodes
ofLung 232 Esophagus
inSitu
209 Autonomic
Nerves
inThorax 233 Topography
andConstrictions
of Esophagus
210 Innervation
ofTracheobronchial
Tree:
Schema 234 Musculature
of Esophagus
235 Pharyngoesophageal
Junction
Heart 236 EsophagogastricJunction
Plates 211-2X,
237 Arteries
of Esophagus
211 Heart
inSitu 238 Veins
ofEsophagus
212 Heart:
Anterior
Exposure 239 Lymph
Vessels
andNodes
of Esophagus
213 Radiograph
ofChest 240 Nerves
of Esophagus
214 HearL
BaseandDiaphragmatic
Surfaces 241 Mediastinum:
Cross
Section
215 Pericardial
Sac
216 Coronary
Arteries
andCardiac
Veins Regional Scans
2'17 Coronary
Arteries
andCardiac
Veins:Variations Plale 242
218 Coronary
Arteries:
Arteriographic
Views 242 Chest
Scans:
AxialCTlmages
219 Coronary
Arteries:
Arteriographic
Views(continued)
220 Right
Atrium
andVentricle Gross-Sectional Anatomy
221 LeftAtrium
andVentricle Plates 243-246
222 Yalves
andFibrous
Skeleton
of Heart 243 Cross
Section
ofThorax
atT3Level
223 Valves
andFibrous
Skeleton (continued)
ofHeart 244 Cross ofThorax
Section atT3-4DiscLevel
224 Alria,
Ventricles,
andInterventricu
larSeptu
m 245 Cross
Section
ofThorax
atT't-5DiscLevel
225 Conducting
System ofHeart 246 Cross
Section atTTLevel
ofThorax

Thorax
Biceps
brachii
muscle
muscle
Sternocleidomastoid
Sternalhead Triceps
brachii
head
Clavicular muscle
Axilla
Anterior
Jugular axillaryfold
notch
Posterior
axillaryfold
Deltoid
muscle Pectoralismajor
muscle
Bodyof Clavicularhead
sternum Sternalhead
dorsi
Latissimus
muscle
Cephalic
vetn Xiphoidprocess
of sternum
Serratus
anteriormuscle
Lineaalba
Rectusabdominis
muscle
Tendinous
intersection
External
oblique
muscle
Serratus
anteriormuscle 64a4#
Topographic Anatomy Plate l8l

Mammany Gland
Anterolateral Suspensory
dissection ligaments
of
breast(Cooper's)
ar
glands
Pectoralis
m a j o rm u s c l e
(deepto
pectoral
fascia)
A x i l l a r yt a i l ( o f S p e n c e )
Serratus
anteriormuscle
External
2nd ri
Pectoralis
maJor
muscle
Pectoral
fascia
Intercostal
muscles
of breast(Cooper's)
ligaments
Suspensory
Lactiferousduct
actiferoussinus
C l a n dl o b u l e s
Fat (subcutaneous
tissuelayer)
Sagittalsection
4{tr
Plate 182 Mammary Gland
Arteries of Mammary Gland
Subclavianarter
I n t e r n a tl h o r a c i c
artery and its
perforatingbranches
M e d i a l m a m m a r yb r a n c h e s
Axillara
y rter
Brachialplexu
Brachial
Lateralthoracic art
ano
Lateralmammary
branches
A x i l l a r yt a i l ( o f S p e n c e )
Lateralmammary
branchesof
lateralcutaneous
branchesof posterior
intercostalarteries
*fr
Mammary Gland Plate 183
Lymph Vessels and Nodes of Mammary Gland
Parasternalnodes
Apical axillary
nodes ( s u b c l a v i a nn) o d e s
(Rotter's)
Interpectoral
C e n t r a la x i l l a r yn o d e s
Lateral
axillary
(humeral)
nodes
Posterior
axillary
(subscapular)
nodes
Anterior
axillary
(pectoral)
nodes
Pathwayto anterior
mediastinalnodes
Pathwaysto opposite breast
Pathwaysto inferior phrenic (subdiaphragmatic)nodes and livei

4{tr
Plate 184 Mammary Gland

Bony Framework of Thorax
Jugularnotch
Anteriorview
Manubrium
Angle
Coracoid Sternum
process Body
Glenoid
cavity Xiphoid
process
Neck
Scapular
Subscapular
fossa
Clavicle
Trueribs(l-7)
Costal cartilages
Falseribs(B-.12
loatingribs(.11-12)
Head
Posteriorview
Neck
Tubercle Acromion
Supraspinous
Angle
fossa
Body Spine
lnfraspinous
fossa
T r u er i b s( 1 - Z )
4{r F a l s rei b s( B - 1 2 )
Floatingribs
fi1-12)
Body Wall Plate t 85

Ribs and Sternocostal Joints
Subclavius
muscle Muscleattachments
1st left rib: Croovesfor Origins

superiorview subclavian Insertions
I
Anterior
scalene Middle rib:
muscle Head posterior view
Neck
Serratus
anterior Middle Tubercle
muscle scalene
l st digitation) muscle
Posterior
scalene
muscle
2nd left rib: Articular \-V^r-l

superiorview for transverse
processof Articularfacets
vertebra for vertebralbodv
Serratus
anterior
(2nddigitation) lnterclavicula
i gra m e n t
Manubrium
Costalgroove
Costoclavicular
ligament
Articularcavity
lntraarticular
sternocostal Note:The headof a typicalrib
ligament articulates with the superior
costalfacetof the thoracic
vertebraof the samenumber(by
Costalcartilages its inferiorarticularfacet),the
inferiorcostalfacetof the
vertebraabove(by its superior
articularfacet),and the
ndraljoints intervertebral disc betweenthe
two vertebrae.The costal
tuberclearticulateswith the
transverse processof the
vertebraof the samenumber.
Radiatesternocostal Costalcartilages
ligaments
joints
Interchondral
4{tr
Xiphoid
process
Costoxiphoid Sternocostalarticulations:
ligament anteriorview
Plate 186 Body Wall

Gostovertebral Joints
Anteriorlongitudinal costalfacet(fortubercleof rib of samenumberasvertebra)

Transverse
ligament
Inferior costal Lateralcostotransverseligament

facet (for head o{
rib one number
greater) Intertransverseligament
Interarticular
ligamentof
head of ri
Superiorcostal ligament
Superiorcostotransverse
facet (for head of
rib of same
number Superiorarticular
facetof rib head
Radiate
ligament of
ligament
Intraarticular
headof Radiate
ligament
of head
of rib Synovial
cavities
Left lateral view
ligament(cut)
Superiorcostotransverse
Superiorcostal
facet(for headof rib
of samenumber)
Transverseprocess
(cutoff
ligament
Costotransverse
Lateralcostotransverseligament
section:superiorview
Transverse
Radiateligamentof head of rib
ostotransverseligament
Lateralcostotransverseligament
uperior costotransverseligament
ansverseligament
Right posterolateralview
Nr
Body Wall Plate 187
Anterior Thoracic Wall
Sternocleidomastom
i du Sternothyroidmuscle
Sternohyoidmuscle I
tnu"st"d by
cervicalfascia
Posteriortriangleof Omohyoid muscleJ
Trapeziusmuscle Clavicle
Perforatingbranchesof internal muscleinvestedby

Subclavius
thoracicarteryand anteriorcutaneous fascia
clavipectoral
branches of intercostal
nerves
Thoracoacromialartery(pectoral
Pectoralismajor muscle branch)and lateralpectoralnerve
C e p h a l i cv e i n Costocoracoidligament
Acromion Coracoid process
D e l t o i dm u s c l e Medial
pectoral
nerve
Long thoracic nerve

and lateralthoracic artery
minor
Pectoralis
muscleinvestedby
Clavipectoral
fascia
Latissimu
d so r s im u s c l e
Digitations of serratus
D i g i t a t i o n so f a n t e r i om
r uscle
serratusanterior muscle
xternal intercostal
membranesanterior to
Lateralcutaneous
branches
of internalintercostal
intercostalnervesand muscles
posterior intercostalarteries
External
intercostal
muscles
E x t e r n aolb l i q u e
musc Bodyandxiphoidprocess
of sternum
Anteriorlayerof rectussheath
I n t e r n aol b l i q u em u s c l e
4{tr
Cryd4*/*
Sternalismuscle (inconstant) R e c t u sa b d o m i n i sm u s c l e
Cutaneousbranchesof thoracoabdominal
L i n e aa l b a (abdominalportions of intercostal)nerves
and superiorepigastricartery
Plate 188 Body Wall

Anterior Thoracic Wall (continuedl
Omohyoid, sternothyroidand sternohyoidmuscles I n t e r n a jl u g u l a rv e i n
Clavicle Levatorscaoulaemuscle
S u b c l a v i umsu s c l e Anterior )
/ ruiddl" ! s.rl"n" muscles
Trapezius
muscle
/ eotturio,)
Thoracoacromialartery
Phrenicnerve
Coracoid process
prexus
C e p h a l i cv e i n
Thoracicduct
Pectoralismajor
muscle (cut)
Subclavian
artery and vein
Deltoid
muscle
artery and vein
Intercostobrachialnerve Superiorthoracic artery
Long thoracic nerve lnternalthoracic

andlateral thoracic artery artery and veins
Pectoralisminor muscle xternal intercostalmuscle
intercostal
Digitationsof muscle (cut)
serratusanterior muscle
Transversusthoracis
Lateralcutaneous muscle
branchesof intercostal
nervesand posterior
Anterior intercostal
intercostalarteries
branchesof internal
thoracic artery
Externalintercostalmuscles
lntercostalnerve
External
intercostal
membranes Musculophrenicartery
anterior to internal intercostalmuscli-'s and vein
l n t e r n a lo b l i o u e m u s c l e abdominismuscre
Transversus
S u p e r i o re p i g a s t r i ca r t e r i e sa n d v e i n s
R e c t u sa b d o m i n i sm u s c l ea n d s h e a t h( c u t )
*{r
Body Wall Plate | 89
Ghest Drainage Ti,rbe Placement
Preferredsites
1.Forpneumothorax (2ndor 3rd
interspaceat midclavicular
line)
2. Forhemothorax (5thinterspace
at midaxillarv
line)
B.Trocarwithdrawn;
tubepassed into
chestthroughcannula
C.Cannulawithdrawn;
tube connected to
underwater seal(with
suctionif indicated)
D, Intercostal_+
spacers
pierced above
rib to avoid
damageto
neurovascutar
b u n d l el y i n gi n
costal groove
Thoracocentesis
and tube drainage
with underwater-
sealdrainage
Nr
usuallysuffices.
Plate | 9O Body Wall

Anterior Thoracic Wall: lnternal View
S t e r n o t h y r om
i du s c l e of sternum
Manubrium
S t e r n o h y o im
du s c l e C o m m o n c a r o t i da r t e r y
I n t e r n a jl u g u l a rv e i n lnferior thyroid artery
Anterior scalenemu Vertebralartery
S u b c l a v i a na r t e r ya n d v e i n trunk
Brachiocephalic
C l a v i c l e( c u t ) - - * Subclavianartery and vein
Brachiocephalicvein --' B r a c h i o c e p h a l ivce i n
P h r e n i cn e r v e a n d Internalthoracic
pericardiacophrenic artery and vein
artery and vei
Anterior intercostal
Internalthoracic arteriesand veins
artery and vein and intercostalnerve
Anterior intercostal intercostal

a r t e r i e sa n d v e i n s muscles
and intercostalnerve
Perforatingbranches
of internalthoracic Innermost
artery and vein and intercostal
anterior cutaneous muscles
branch of
intercostalnerve
Collateral Transversus
branchesof thoracis
intercostalartery muscte
and vein
Bodyof ster
Sternocostal
triangle
Diaphragm
4{tr
S l i p so f
c o s t a lo r i g i n
of diaphragm
Musculophrenic
arteryandvein
Transversus
abdominis
muscle
Transversus
abdominis
muscle
Sternalpart of diaphragrh
Internalthoracic artery and veins
X i p h o i dp r o c e s S S u p e r i o re p i g a s t r i ca r t e r ya n d v e i n s
Body Wall Plate | 91

Intercostal Nerves and Arteries
Ventralroot Spinal(radicular,
or segmental medullary)
Dorsalroot branchof posteriorintercostalartery
(spinal)ganglion Dorsalbranchof posteriorintercostalartery
Erectorspinae Trapeziusmuscle
Dorsalramusof thoracicner Medialbranch Rhomboidmajormuscle
Lateralbr
Costotransverse
ligamen Erectorspinaemuscle
nerve(ventral
Intercostal Posteriorintercostalarterv
ramusof thoracicspinal Internalintercostalmembrane
Internalintercostalmembrane
deep to externalintercostal
muscle muscle
Serratusanterior is muscle
Serratus
anterior
muscle
Lateral
cutaneous
branchof
intercostal
nerve
External
Anteriorbranch oblique
of lateralcutaneous muscle
branchof
intercostalnerve
External
muscle
*{r Perforating
branch
Lateralcutaneous
branchof posterior
intercostalartery
Superior
Pectoralismajormuscle epigastricartery al intercostalmembrane
Anteriorcutaneousbranchof intercostalnervb Rectusabdominis Anteriorintercostalarteries
Plate 192 Body Wall

Phrenic Nerve
Ventralrami !1 u"",'",*',
{:; |
Anterior scalenemuscle Anterior scalenemuscle
Right common carotid a plexus
Brachial
Brachial Left phrenic nerve
Rightphrenicnerve artery
Leftsubclavian
R i g h st u b c l a v i aanr t Leftvagusnerve(X)
R i g h tv a g u sn e r v e ( Left common carotid arterv
Right internal Leftinternal
thoracicartery(cut) thoracicartery(cut)
Brachioceohalic
trunk Thoracic cardiac nerves
Right pericardiaco-
Left pericardiaco-
phrenicartery(cut phrenic artery (cut)
5upeflor vena cava
Leftrecurrent
Rootof rightlung nerve
laryngeal
Pericardialbranch Rootof leftlung

of phrenic nerve
Mediastinalpartof
Mediastinalpart of parietalpleura
parietalpleura,
Costalpart of
Diaphragmatic parietalpleura
part of parietal
pleura(cut)
P h r e n i c o a b d o m ibnraal n c h e s
of ohrenicnervesto inferior
surfaceof diaphragm
Phrenic
(efferentand
afferentfibers)
Lower intercostalnerves
(afferentonlyfrom peripheral
partof diaphragm) 4ttr
Body Wall Plate 193

Diaphragm: Thoracic Surface
SeealsoPlates23O,231
T h o r a c i c( d e s c e n d i n ga) o r t a Neck of rib
TB-9 intervertebral Left sympathetictrunk

disc
Left greaterthoracic
R i g h st y m p a t h e ttircu n k s p l a n c h n i cn e r v e
Right greaterthoracic Hemiazygosvein

s p l a n c h n i cD r V 1
M e d i a s t i n apl l e u r a
Costal part of
parietalpleura
Esophagus
Azygos
VlD-
Thoracic
duct
R i g h tl e a f l e to f Diaphragmatic
central part of
parietalpleura
Diaphragmatic (cutaway)
part of parietal
pleura (cut away) Left leaflet of
central tendon
R i g h tp h r e n i cn e r v ea n d
pericardiacophrenic Mediastinalpart of
artery and vein parietalpleura and
pericardium(cut)
Mediastinalpart of parietal
p l e u r aa n d p e r i c a r d i u m( c u t ) Left phrenic nerve and
pericardiacophrenic
artery and vein
R i g h tc o s t o d i a p h r a g m a t i c
recessof pleuralcavity
Pericardium
lnferior vena cava (receivinghepatic vein!)
Left costomediastinal
Right internalthoracic artery and veins
Transversus
thoracismuscle
R i g h tc o s t o m e d i a s t i n a l
recessof pleuralcavity Left internalthoracic artery and veins
n{r A n t e r i o rm e d i a s t i n u m
Sternum
5th costal cartilage
Middle leafletof central tendon covered bv oericardium
Plate 194 Body Wall

Diaphragm: Abdominal Surface
SeealsoPlates253,263,
Sternocostaltriangle
Sternalpart of diaphragm
Anterior branch of left phrenic nerve
A n t e r i o rb r a n c ho f r i g h t p h r e n i cn e r v e Costal part of diaphragm
R i g h ti n f e r i o rp h r e n i ca r t e r y Centraltendon of diaphragm
hiatus
Esophageal
C a v a lo p e n i n g
F i b e r fsr o mr i g h tc r u sp a s s i n g
R i g h ct r u so f d i a p h r a g m to leftof esophageal hiatus
Creater thoracic solanchnicnerve Left inferior phrenic artery
Recurrentbranch to esophagus
L e s s e rt h o r a c i cs p l a n c h n i cn e r v e
Anterior branch
Lateralbranch
Leastthoracic Leftsuperior
s p l a n c h n i cn e r v e . artery
suprarenal
Left phrenic nerve
Costal part
of diaphragm
Leftcrusof
diaphragm
Transversus
abdominis
m
triangle
Lumbocostal
1 2 t hr i b
Lateralarcuateligament
Lumbarpartof diaphragm
Quadratus M e d i a la r c u a t el i g a m e n t
l u m b o r u mm u s c l e
P s o a sm a j o r m u s c l e
S y m p a t h e t i ctru nk Aortichiatus
C e l i a ct r u n k
Body Wall Plate t 95

Topography of Lungs: Anterior View
Thyroid cartilage Cricoid cartilage
Thyroid gland Trachea

Cervical(cupula,or dome, of)
parietalpleura
J ug u l a r( s u p r a s t e r nnaol )t c h
j or i n t
A p e xo f l u n g
Sternoclavicula
Arch of aorta
Clavicle
I st rib and costalcartila Cardiacnotchof leftlune
R i g h tb o r d e ro f h e a r t Left border of heart
Horizontal
fissure
of right
lung
(often
incomplete)
Right
nipple Left
nipple
Costomediastinal
recessof pleural
cavtty
fissure
O b l i q u ef i s s u r e
of leftlung
Costodiaphragmatic
recessof pleural
cavity Costodiaphragmatic
Spleen
I n f e r i o rb o r d e r o f r i g h t l u n g Inferiorborderof leftlung
Pleuralreflection Left dome of diaphragm
Pleuralreflection
Callbladdei
Stomach
R i g h td o m e o f d i a p h r a g m
Bare area of pericardium
Xiphoid process *{r

Plate 196 Lungs
Topography of Lungs: Posterior View
Spinousprocessof T1 vertebra Cervical(cupula,or dome, of) parietalpleura
A p e xo f l e f tl u n g 1 s tr i b
e f r i g h tl u n g
O b l i q u ef i s s u r o
1s t r i b
Clavicle
Obliquefissureof leftlung
H o r i z o n t af ils s u r e
S p i n eo f s c a p u l a of rightlung(often
incomplete)
Left border of costal R i g hb
t order
parietapl leura of costal
parietalpleura
Costodiaphragmatic Costodiaphragmatic
recessof pleural recessof pleural
cavity cavity
Spleen
Liver
Pleuralreflection Pleuralreflection
Inferiorborderof leftlung Inferiorborderof rightlung
Left kidney R i g h tk i d n e y
*{r Left dome of diaphragm
Left suprarenalgland
R i g h td o m e o f d i a p h r a g m
R i g h ts u p r a r e n agl l a n d
Lungs Plate | 97
Lungs in Situ: Anterior View
Thyroidgland Tracheaand inferior thyroid veins
Omohyoid, sternothyroidand sternohyoidmuscles Common carotid artery
Manubrium
of sternum I n t e r n ajlu g u l a rv e i n
Sternocleidomastoidmuscle Phrenicnerve
j ul g u l avr e i n
Externa Anteriorscalenemuscle
Costal part of parietalpleura (cut away) Thoracicduct
Clavicle a c h i apl l e x u s
Pectoralismaior muscle Subclavianartery and vein
Pectoralis Internalthoracic artery

m i n o rm u s c l e and vein
Intercostal Axillaryartery and vein

musctes
notch
of leftlung
Superiorlobe,
M i d d l el o b e , Superiorlobe,
I n f e r i olro b e Inferiorlobe
o f r i g h tl u n g of leftlung
Costomediastinal
space
O b l i q u ef i s s u r e
Horizontal fissure
o f r i g h tl u n g Oblique fissure
Costodiaphragmaticrecess
Diaphragmatic M u s c u l o p h r e nai cr t e r y
part of parietalpleura
L i n g u lo
a f s u p e r i olro b eo f l e f tl u n g
Diaphragm
Internalthoracic artery
*{r 7th costal cartilage

Xiphoid process
Pleuralreflectioni
Mediastinalpart of parietalpleura
F i b r o u sp e r i c a r d i u m
Plate | 98 Lungs
Lungs: Medial Views
Rightlung
Areafor trachea
Groovefor subclavian
a
Areafor esophagus
Croovefor brachiocephalic
vein
Croovefor azygosvein
Croovefor 1stri Obliquefissure
Croove for superiorvena cava Pleura(cutedge)
Superiorlobe Rightsuperiorlobar
(eparterial)
bronchus
Areafor.thymus and fatty.
tissueof anteriormediasti Rightpulmonaryarteries
Rightbronchialartery
Anteriorborder
Rightintermediate
bronchus
Hilum
R i g h st u p e r i opr u l m o n a rvye i n s
Horizontalfissure
(hilar)
Bronchopulmonary
C a r d i a ci m p r e s s i o n lymphnodes
Obliquefissure Rightinferiorpulmonaryveins
lnferior lobe
Middle lobe
for esophagus
Groove for inferior vena cava
ligament
Pulmonary
Diaphragmaticsurface
Inferiorborder
4{ffi
Apex
4t-/
Left lung
arterv
Croovefor subclavian
Areafor tracheaand esophagus Croovefor left
brachiocephalicvein
Oblique
roovefor l st rib
Croove for arch of aor
Anteriorborder
Pleura (cut edge)
Areafor_thymus and fatty.
Leftpulmonary tissueof anteriormediastinum
Leftbronchialarteries Superiorlobe
Hilum
Leftmainbronchus
Cardiacimpression
L e f ts u p e r i o rp u l m o n a r yv e i n s
P u l m o n a rl yi g a m e n t
B r o n c h o p u l m o n a r (yh i l a r )
lymphnodes Cardiacnotch
Inferior Obliquefissure
Leftinferiorpulmonaryvei tor esophagus
surface
Diaphragmatic
Croovefor descending
aorta
ingula
Inferiorborder
Lungs Plate 199

Bronchopulmonary Segments
Anteriorview
Rightlung
Superiorlobe Superiorlobe
Apical(S1
Anterior(S3
Posterior(S
l i n g u l a(rS a )
Middle lobe I l,lnferior
f t. ' , ^q '
l/ (5")
Lateral(Sa \ lrngutar
I
I
rl
Medial(Ss) l1
I
I
,
\
Inferiorlobe
Anterior
ii Inferior lobe
basal(SB) Anteromedial
basal(S7*8)
Medial
basal(S7 \ Posterior
basal(S1o)
Lateral
basal(Se)
, Lateral
basal(Se)
Posterior
basal(S1o) '.., ---f--
'EE
Posteriorview
Left lung
--+--' T
Superiorlobe
Apical(Sr)
-.i;--- (S2)
1:, Posterior
Anterior(S3)
-'iir'-
Middle lobe
isl Lateral(Sa)
Inferior lobe tl Inferior lobe

7'
Superior(56) Superior(56)
Lateral Lateral
basal(Se) basal(Se)
'-lZ.tr.-
Posterior rr! Posterior
b a s a1l S t o l basal(Sro)
lt
tt
t,
ll,
\t,
,I
', r/-\
iri
t--t
4{F
Plate 2OO Lungs

Bronchopulmonary Segments (continuedl
Lateralviews
Rightlung
Apical(S1)
Posterior(52)
A n t e r i o r( S 3 )
Middle lobe
Lateral(Sa)
M e d i a (l S s )
lnferiorlobe
S u p e r i o r( 5 6 )
lnferiorlobe
Antero-
Superior(56) medial
basal(S7*8)
Anterior
basal(58) Lateral
basal(Se)
Lateral
basal(Se)
Medialviews
4{tr
A p i c a l( S l )
Posterior(S2)
A n t e r i o r( 5 3 )
Middle lobe
(Ss)
tr4edial
Inferiorlobe
S u p e r i o(r5 6 )
lnferiorlobe
Medial
basal(Si Superior(56)
Anterior Anteromedial
basal(S basal(S7*8)
Lateral Lateral
basal(Se) basal(Se)
Posteriorbasal(S1o) Posteriorbasal(Slo)
Lungs Plate 2Oi

l|achea and Major Bronchi
Thyroid cartilage Connectivetissuesheath

(visceral
layerof pretracheal
fascia)
Median cricothyroid
ligament...- Trachealcartilage(ring)
Elastic
fibers
Cricoid cartilage
Cland
Smallartery
Connective tissue Lymphvessels
sheath(viscerallaver Nerve
of pretracheal fascia)
(cutaway)
A n n u l a (r i n t e r c a r t i l a g i n o u s )
ligaments
Trachealcart
Mucosaof oosteriortracheal
wallshowslongitudinalfolds
formedby densecollections
of elasticfibers
Superiorlobar
(eparterial) (smooth)
Trachealis
bronchus muscle
Gland Esophagealmuscle
Elastic
fibers Epithelium
Superiorlobar Lymphvessels
bronchus
To
supenor
lobe
Suoeriordivisionbronchus
To
Lingularbronchus superior
lobe
Middle
lobar bron Rightand left
m a i nb r o n c h i
To
middle
lobe
{r Intermediate
Inferiorlobar
bronchus
bronchus
Inferiorlobar
bronchus
g6
87+8
To
To inferior
inferior lobe
lobe
*{r
Intrapulmonary Extrapulmonary Intrapulmonary
Pfate 2O2 Lungs

Nomenclature of Bronchi: Schema
g 1 + 2 b i ci
glbic Trachea
BlbiP
B 1 + 2 bci p
B1+2bii
glbiic
B 1 + 2 a i0i
glbiiP 9 1 + 2 b iB
lbi p
91+2aii
glai
B1 b g1+2aii
B1a
92aii g 2 a iP 1+2a
92ai g2ai c 81+2ci

g 1+ 2 b i +2cii
B Superior B1
92bii
B1(apical) lobar
81+2b
g 3 a ie S u p e r i o rl o b a r
g3ai B2b (eparterial)I B1+2(apicoposterior)
Superior
g 3 a iP B2(posterior) oroncnus
division g:c7p g:a 33ai
bronch
9 3 a i ia
g 3 a i iP B3 (anterior) and left

ir3b main bronchi B3 (anterior)
g6ai
Brb $.3:bii
g3bii g3bi ---
B6aii Lingular
bronchus
Intermediate
g6a - 86 lsuperior, I
bronchus 84 (superiorlingutar)
B6bi lower lobe)---_
\ a6! B6 (superior,tower lobe)
84a
Middle lobar bronchus b6b 94ai
ga (lateral) B6c B6c B5 g4aii
g4ai ..
4a ;p Socrt (inferior
r B4bi
g4aii lingular)
g6ci
Bsb b4b gabii
gs
gabi I n f e r i o rl o b a r
(medial) I n f e r i o rl o b a r
bronchus
bronchus B7*8(anteromedialbasal)
g4bii
B Bz (medialbasal) g7+8a -97+8ai
B8 (anteriorbasal)
gSai 89 (lateralbasat) g7+8aii
87b
g o a i iv Blo (posteriorbasal) B7+8b
gab
gTbi 7+8bi
gsbi g10a
g7+8bii
89 (lateralbasal ETbii B9a
B9ai
g9ai o Bel
Blo (posteriorbasal)
geaiP gl Oaii
g 9 a i io g10b
g10c
g e a i iP
[e"ii
g9bii
g1Oci
g 9 b ic
gsbiiP
g9bii
g10aii
d
[10ai
glObi glObii
4{tr gl0cii globii
'B1Obi gebiP
Nomenclature in common usagefor bronchopulmonary Bt and 82 are combined as are 87 and 88. Subsegmental,
segments(Plates200 and 201) is that of .lacksonand or 4th order, bronchi are indicated by addition of lower-
Huber, and segmentalbronchi are named accordingly. case lettersa,b,or cwhen an additional branch is present.
lkeda proposed nomenclature(as demonstratedhere) for Fifth order bronchi are desisnatedbv Roman numeralsi
bronchialsubdivisionsas far as 6th generation.For simpli- (anterior)or ii (posterior)a;d 6th oriler bronchi by Greek
fication on this illustration.onlv some bronchial subdivisions lettersa or p. Severaltexts use alternatenumbers (as
are labeled as far as 5th or 6th generation.Segmental proposed
' bv Bovden)for segmentalbronchi.
b r o n c h i( B ) a r e n u m b e r e df r o m 1 t o 1 0 i n e a c h l u n g , Variationsof'standardbronchial pattern shown here
correspondingto pulmonary segments.ln left lung, are common, especiallyin peripheralairways.
Lungs Plate 2O3

lntrapulmon ary Airways: Schema
*{Y
9
@!
E
s
Cartilages
92
^:
Respiratory
tro
N@ bronchioles
$n (alveoli
appearat
oc thislevel)
N-
6'
J
Cartilages Alveolarducts
Decomesparser
! . =
ii
(mostlyat Alveolarsac
pointsof
m-
branching)
Alveoli
Acinus
(part
of lung
suppliebdy
No further terminal
cartilages bronchiole)
lermtnat
bronchiole
OJ
Respiratory
bronchioles
(3-B orders)
Acinus
Alveolar
s a c sa n d
alveoli
Poresof Kohn
Subdivisions
of intrapulmonaryairways
Structureof intrapulmonaryairways
Plale 2O4 Lungs

lntrapulmonaty Blood Girculation: Schema
Terminalbronchiole
Bronchialartery (from left heart
via thoracic aorta)
-.> P u l m o n a rvye i n
(to leftheart)
Pulmonary
artery (from
r i g h th e a r t
Pulmonary
vein (to
left heart)
V i s c e r a pl l e u r aa n d s u b p l e u r acl a p i l l a r i e s C a p i l l a rbye dw i t h i na l v e o l awr a l l
4{tr Pulmonaryarteriesand their branchesdistributesegmentallywith the bronchi.

Pulmonaryveinsand their tributariesdrain intersegmentally.
(cutawayin places)
Lungs Plate 2O5

Great Vessels of Superior Mediastinum
C r i c o i dc a r t i l a g e Thyroid cartilage
T h y r o i dg l a n d I racnea
R i g h tc o m m o n c a r o t i da r t e r y Left common carotid artery

R i g h tv a g u sn e r v e( X )
Leftvagus nerve (X)
Phrenicnerve (cut)
R i g h ti n t e r n a jl u g u l a rv e i n
Thoracic duct
E x t e r n aj lu g u l a rv e i n
B r a c h i a pl l e x u s
Left subclavianartery and vein
Right subclavianartery and vein
B r a c h i o c e p h a l itcr u n k Left brachioceohalicvein
R i g h tb r a c h i o c e p h a l ivce i n Internalthoracic artery
Phrenicnerve and Arch of aorta

pericardiacophrenic
artery and vein (cut Vagus nerve (X)
S u p e r i o rv e n a c a v a Left recurrent
laryngealnerve
R i g h ts u p e r i o rl o b a r
(eparterial) Ligamentum
bronchus arteriosum
R i g h tp u l m o n a r y
Left
purmonary
P u l m o n a r yt r u n k artery
Right Left
purmonary
verns g:lilo"u"
Mediastinal
part of Mediastinal
part of
parietalpleura
(cut edge) parietapl leura
(cut edge)
Costal part of
parietalpleura Costal part of
(cut edge) parietalpleura
(cut edge)
Diaphragmatic
part of P h r e n i cn e r v e
parietapl leura (cut)
Rightcosto-
diaphragmatic Diaphragmatic
recessof part of
pleuralcavity parietapl leura
and cut edge
R i e h ti n t e r m e d i a t eb r o n c n u s
P h r e n i cn e r v e( c u t ) Left main bronchus
Azygos vein Pericardium(cut edge)
T h o r a c i cd u c t
I n f e r i o rv e n a c a v a
Diaphragm
E s o p h a g uas n d e s o p h a g e apl l e x u s
*{r
Plate 2O6 Lungs
Bronchial Arteries and Veins
Esophagus
Trachea(pulledto left by hook

Nr
3 r d r i g h tp o s t e r i o r
intercostalartery-
Superiorleft
b r o n c h i aalr t e r y
R i g h tb r o n c h i a a
l rtery
Aorta(pulledaside
R i g h tm a i n b r o n c h u s by hook\
Left main bronchus

(pulled to right by hook) lnferior left
bronchialartery
Esophagealartery
Esophagealbranch
of bronchialartery
Variationsin bronchialarteries Bronchialveins
Left main
Azygos bronchus(turned
up by hook)
Right Leftbronchialvein
b r o n c h i a vl e i n
Accessory
hemiazygosvein
R i g h ta n d l e f t b r o n c h i a l O n l y s i n g l eb r o n c h i a la r t e r y
a r t e r i e so r ig i n a t i n gf r o m t o e a c h b r o n c h u s( n o r m a l l y ,
aorta by singlestem two to left bronchus)
Lungs Plate 2O7

Lymph Vessels and Nodes of Lung
SeealsoPlates 72, 184.,239
R i g h tp a r a t r a c h e anl o d e s Left paratrachealnodes
R i g h ts u p e r i o rt r a c h e o b r o n c h i anl o d e s B r o n c h o m e d i a s t i n layl m p h a t i ct r u n k
B r o n c h o r r r e d i a s t i nl vam
l p h a t i ct r u n k Brachiocephalicvein
B r a c h i o c e p h a l ivce i n I n f e r i o rd e e p c e r v i c a l
(scalene)node
l n f e r i o rd e e p c e r v i c a l V i r c h o w ' sn o d e
( s c a l e n en) o d e
Thoracicduct
I n t e r n a jl u g u l a rv e i n
a n d j u g u l a rl y m p h a t i ct r u n k Left superior
t r a c h e o b r o n c h i anl o d e s
R i g h tl y m p h a t i cd u c t
Subclavian vein
and subclavian Bronchopulmonary
l y m p h a t i ct r u n k ( h i l a r )n o d e s
P u l m o n a r y( i n t r a -
Bronchopulmonary p u l m o n a r y )n o d e s
( h i l a r )n o d e s
Subpleural
P u l m o n a r y( i n t r a - lymphatic
p u l m o n a r y )n o d e s prexus
Subpleural Interlobular
Iymphatic lymph
prexus vessets
Interlobular Drainage
lymph follows
vessel bronchi,
arteries
Drainage lnferior and veins
follows t r a c h e o b r o n c iha l
bronchi, ( c a r i n a ln
) odes
arterres
and Pulmonary
v e tn s ligaments
Routesto
mediastinum
4{tr
Drainageroutes
R i g h t l u n g : A l l l o b e sd r a i n t o p u l m o n a r ya n d b r o n c n o - L e f t l u n g : S u p e r i o rl o b e d r a i n st o p u l m o n a r ya n d b r o n c h o -
p u l m o n a r y( h i l a r )n o d e s ,t h e n t o i n f e r i o rt r a c h e o b r o n c h i a l p u l m o n a r y( h i l a r )n o d e s ,i n f e r i o rt r a c h e o b r o n c h i a( lc a r i n a l )
( c a r i n a ln) o d e s ,r i g h t s u p e r i o rt r a c h e o b r o n c h i anl o c r e s , nodes,left superiortracheobronchialnodes,left paratracheal
and right paratrachealnodes on way to brachiocephalic nodes and/or (aortic arch) node of ligamentumarteriosum,
v e i n v i a b r o n c h o m e d i a s t i n al yl m p h a t i ct r u n k a n d / o r t h e n t o b r a c h i o c e o h a l ivce i n v i a l e f t b r o n c h o m e d i a s t i n at rlu n k
i n f e r i o rd e e p c e r v i c a l( s c a l e n e n) o d e . a n d t h o r a c i cd u c t . L e f t i n f e r i o rl o b e d r a i n sa l s ot o o u l m o n a r v
a n d b r o n c h o p u l m o n a r y( h i l a r )n o d e sa n d t o i n f e r i o rt r a c h e o -
b r o n c h i a l( c a r i n a l n
) o d e s ,b u t t h e n m o s t l yt o r i g h ts u p e r i o r
t r a c h e o b r o n c h i anl o d e s ,w h e r e i t f o l l o w ss a m e r o u t e a s l y m p h
f r o m r i g h tl u n g .
Plate 2O8 Lungs

Autonomic Nerves in Thorax
SeealsoPlates 130, 131, 165, 166, 318
Cervicothoracic Left recurrentlaryngealnerve

( s t e l l a t eg) a n g l i o n
Cervicalcardiac nerves
A n s as u b c l a v i a (sympatheticand vagal)
Cervicalcardiac nerves Vagus nerve (X) (cut)

(sympathetiac nd vagal)
Thoracic(sympathetic)
T h o r a c i c( s y m p a t h e t i c ) c a r d i a cb r a n c h e s
c a r d i a cb r a n c h e s
Left recurrentlaryngealnerve
T h o r a c i cc a r d i a cb r a n c h
Vagus nerve (X) (cut) ofvagusnerve
a n d b r a n c h e st o c a r d i a c
a n d p u l m o n a r yp l e x u s e s
C a r d i a cp l e x u s
T h o r a c i c( s y m p a t h e t i c )
c a r d i a cb r a n c h e s A n t e r i opr u l m o n a rpy l e x u s
A n t e r i o rp u l m o n a r yp l e x u s P o s t e r i opru l m o n a rpyl e x u s
( p r o t r u d i nfgr o mb e h i n d
leftbronchus)
P o s t e r i opru l m o n a rpyl e x u s
( p r o t r u d i n gf r o m b e h i n d
r i g h tb r o n c h u 5 ) - Sympathetictrunk
6th intercostalnerve Thoracicaortic olexus
Cray and white E s o p h a g epal le x u s

ramicommunicantes
Bth intercostalnerve
6th thoracic
s y m p a t h e t i cg a n g l i o n
ay andwhite
ramicommunicantes
Creater thoracic
Creater thoracic
S y m p a t h e t i cb r a n c h
t o e s o p h a g e apl l e x u s
L e s s e tr h o r a c i c
A n t e r i o rv a g a lt r u n k
L e s s e tr h o r a c i c
Diaphragm
(pulled down)
Leastthoracic
Azygosvein (cut)
I n f e r i o rv e n a c a v a ( c u t ) Nr
Lungs Plate 2O9
Innervation of Tlacheobronchial Tlee: Schema
SeealsoPlates 167,168
C l o s s o p h a r y n g e anle r v e( l X )
Afferent nervesfrom
n o s e a n d s i n u s e s( v i a
t r i g e m i n a [l V ] a n d
Vagus nerve (X) glossopharyngealflXl
(cholinergic;efferent to smooth nerves)may also initiate
muscle and glands;afferent reflexesin airways
f r o m a o r t a ,t r a c h e o b r o n c h i a l
D e s c e n d i n gt r a c t s m u c o s aa n d a l v e o l i )
i n s p i n a lc o r d Larynx
S u p e r i o rc e r v i c a l Superior
s y m p a t h e t i cg a n g l i o n laryngeal
nerve
Sympathetic nerves
(adrenergic)
T3
Cough
T4 receptors
T5
n{r P u l m o n a rpyl e x u s
ough receptors
Parasympathetic
fibers
Sympathetic
fibers
Afferentfibers
lrritant receptors
Stretchreceptors(Hering-Breuerreflex)
Plate 21O Lungs

Heart in Situ
Inferiorthyroid veins Trachea
Thymus Left common carotid artery
B r a c h i o c e o h a l itcr u n k Left brachiocephalicvein
R i g h tb r a c h i o c e p h a l ivce i n I n t e r n ajlu g u l a rv e i n
P h r e n i cn e r v e Vagus nerve (X)
A n t e r i o rs c a l e n em u s c l e Arch of aorta
B r a c h i apl l e x u s T h o r a c idc u c t
E x t e r n aj lu g u l a rv e i n Left recurrentlaryngealnerve
Subclavianartery and vein Internalthoracic artery
Superiorvena cava Phrenicnerve and

pericardiacophrenic
1s t r i b artery and vein
P h r e n i cn e r v ea n d Mediastinalpart
pericardiacophrenic of parietalpleura
artery and vei
R i g h tl u n g
Leftlung
Pericardium
Diaphragm
lnternal
L i n eo f f u s i o n thoracic
of fibrous
Mediastinal
I Partsof
pericardium
to diaphragm
artery
*{r
Diaphragmatic parietal Superior
pleura epigastric Musculophrenic
Costal artery arrery
\
Heart Plate 211

Heart: Anterior Exposure
Pericardium(cut edge) at site

of reflectionfrom great vessels Brachiocephalic
Right vagus nerve

R i g h itn t e r n al u
l g u l avr e i n
Right recurrentlaryngealnerve Arch of aorta
R i g h tb r a c h i o c e p h a l ivce i n
Left common carotid artery
Phrenicnerve
S u b c l a v i a na r t e r ya n d v e i n Left internaljugular vein
Internalthoracic Left vagus nerve

artery and vein
Ligamentum
arteriosum
P h r e n i cn e r v ea n d
pericardiacophrenic
Left recurrentlaryngealnerve
artery and vei
Superiorvena cava P u l m o n a rtyr u n k
Right Leftpulmonary
p u l m o n a r ya r t e r artery
Transverse Transverse
pericardial p e r i c a r d i sailn u s
R i g h st u p e r i o r
p u l m o n a rvye i n
Left
supenor
pulmonary
Hilumof vetn
r i g h tl u n g
Mediastinal
pleura
(cut edge) Hilum
of left
Pericardium lung
(cut edge)
Mediastinal
part of
parietal
preura
(cut edge)
Pericardium
(cut edge)
Right
ventricle
4{tr Conusarteriosus
Left
auricle
(atrial
appendage) Apex
R i g h ta u r i c l e
( a t r i a la p p e n d a g e ) A n t e r i o ri n t e r v e n t r i c u l a i Inferior of heart
s u l c u sa n da n t e r i o r border Leftborder
C o r o n a r ys u l c u s i n t e r v e n t r i c u bl ar ra n c h (acute Left ( o b t u s em a r g i n )
R i g ha
t trium right coronary artery of leftcoronaryartery margin) ventricle of heart
of heart
Plate 212 Heart

Radiograph of Chest
Precordialareasof auscultation
A Apex of heart
AA Aortic arch
C Clavicle
CP C o r a c o i d p r o c e s so f s c a p u l a Aortic area P u l m o n i ca r e a
D D o m e o f d i a p h r a g m( r i g h t )
lV l n f e r i o rv e n a c a v a
PA P u l m o n a r ya r t e r y ( l e f t ) Tricuspidarea
RA R i g h ta t r i u m Valves
valve
Pulmonic
S Spineof scapula
SV S u p e r i o rv e n a c a v a Aortic valve
T T r a c h e a( a i r ) M i t r a la r e a
Mitral
V Left ventricle
Tricuspidarea
eUd4/*
Heart Plate 213

Heart: Base and Diaphragmatic Surfaces
R i g h tp u l m o n a r ya r t e Arch of aorta
Left pulmonary artery Right auricle (atrialappendage)
Left auricle
( a t r i a la p p e n d a g e ) Superiorvena cava
Left superior
p u l m o n a r yv e i n R i g h ts u p e r i o r
p u l m o n a r yv e i n
Left atrium
Rightatrium
Left inferior
p u l m o n a r yv e i n S u l c u tse r m i n a l i s
Pericardialreflection
Right inferior
O b l i q u ev e i n p u l m o n a r yv e i n
of left atrium
(of Marshail) C o r o n a r sy u l c u s
C o r o n a r ys i n u s Inferiorvena cava
Left ventricle R i g h tv e n t r i c l e
Apex
Baseof heart:posteriorview
B r a c h i o c e p h atlriucn k
L e f tc o m m o n c a r o t i da r t e r y S u p e r i o rv e n a c a v a
Arch of aorta
Leftpulmonaryartery
Right pulmonary artery
L e f ts u p e r i o rp u l m o n a r yv e i n
R i g h ts u p e r i o rp u l m o n a r yv e i n
Left auricle (atrialappendage)
R i g h ti n f e r i o rp u l m o n a r yv e i n
Left inferior pulmonary vein terminalis

O b l i q u e v e i n o f l e f ta t r i u m
R i g h at t r i u m
Left atrium Inferiorvena cava
Pericardialreflection Coronary sulcusand

right coronary artery
C o r o n a r sy i n u s Posteriorinterventricularsulcus
and posterior interventricular
Leftventricle branch of right coronary artery
(posteriordescendingartery)
R i g h tv e n t r i c l e
*{r Baseand dia.phragmatic

surfaces:
posrerornreflor
vtew
Plate 214 Heart

Pericardial Sac
Suoeriorvena cava
Archof aorta
Pericardium(cut edge)
P u l m o n a rtyr u n k
Ascendingaorta
Left auricle (atrialappendage)

pericardial
Transverse sinus
Left ventricle
eft pulmonary veins
Coronary sinus
Oblioue vein of left atrium
(Marshall's)
Posterior
i n t e r v e n t r i c usl aurl c u s
O b l i q u ep e r i c a r d i sa iln u s
Leftatrium
Diaphragmaticpart R i g h tp u l m o n a r yv e i n
of pericardium
Esophagealprominence
Sternocostaloart of
pericardium(cut edge)
R i g h at t r i u m
!,
{r.";.1"h
Heart drawn out of opened lnferior vena cava
pericardialsac:left lateralview
Arch of aorta
Ascendingaorta
R i g h tp h r e n i cn e r v ea n d
pericardiacophren ic Mediastinalpart of
parietalpleura (cut edge)
5 U p e n o rv e n a c a v a
phrenic nerve and
pericardiacophrenicvessels
pericardial
Transverse sinus
P u l m o n a rtyr u n k( b i f u r c a t i o n )
Superiorvena cava
Leftlung
R i g h tp u l m o n a r yv e i n s
eft pulmonary veins
Mediastinalpart of Pericardium(cut edge)

parietalpleura (cut edge)
Obliquepericardial
sinus
Pericardium(cut edge)
Esophagealprominence
Inferiorvena cava
Diaphragmaticpart
Line of fusion of oericardium
o f f i b r o u sp e r i c a r d i u m
to diaphragm
Pericardialsacwith
',
heart removed:anteriorview
4{tr
Heart Plate 215

Goronary Arteries and Gardiac Veins
(SA)
Sinuatrial
nodal branch
Leftauricle(cut)
Leftcoronaryartery
Atrialbranchof right
coronaryartery
Circumflexbranchof
left coronaryartery
Rightcoronaryartery
Creatcardiacvein
Anteriorcardiacveins Left (obtuse)marginalartery

Anteriorinterventricular
branch(leftanterior
descending) of left
Smallcardiacvei coronaryartery
Right(acute)marginalbranch
of rightcoronaryiltery - Diagonalbranch
of anterior
interventricu
lar
artery
Interventricular
septalbranches
Sternocostalsurface
(SA)nodalbranch
Sinuatrial
Obliqueveinof leftatrium
(of Marshall)
(SA)node
Sinuatrial
Creat cardiacvein
Circumflexbranchof
" leftcoronaryartery
Leftmarginalbranch Smallcardiacvein
Coronarysinus
Posterior
left Rightcoronaryartery
ventricular
branch
Posteriorinterventricular
Posterior veinof branch(posteriordescendin g)
left ventricle of right coronaty artery
Middle cardiac vein Right marginalbranch
Interventricular
septalbranches Diaphragmaticsurface
4{tr
Plate 216 Heart

Coronary Arteries and Gardiac Veins: Variations
(leftanteriordescending)
Anteriorinterventricular
branchof left coronaryarteryis very short.Apicalpart (posteriordescending)
of anterior(sternocostal)
surfacesuppliedby branches branchis derivedfrom circumflexbranchof
(posterior
from posteriorinterventricular descending) left coronaryarteryinsteadof from right
branchof rightcoronaryarterycurvingaroundapex. coronaryartery.
(posteriordescending)
Posteriorinterventricular Posterior (posterior
interventricular g)
descendin
branchis absent.Areasuppliedchieflyby small branchis absent.Areasuppliedchieflyby elongated
branchesfrom circumflexbranchof left (leftanteriordescending)
anteriorinterventricular
coronaryarteryand from rightcoronaryartery. branchcurvingaroundapex.
Heart Plate 217

Goronary Arteries: Arteriographic Views
Rightcoronaryartery:left anteriorobliqueview
(SA)
Sinuatrial
nodalbranch
Right
coronaryartery
Branches to back of left ven
Right(acute)marginalbranch
Posterior
interventricular
branch(posterior
descending
artery)
Rightcoronaryartery:right anteriorobtiqueview
(SA)nodalbranch
Sinuatrial
Conus(arteriosus)
brancn
coronaryartery
R i g h (t a c u t e )
marginalbranch
Atrioventricular(AV)nodalbranch
Rightposterolateralbranches(to back
of left ventricle)
(posteriordescending
branch
artery) 4{r
Plate 218 Heart

Goronary Arteries: Arteriographic Views (continued|
Left coronaryartery:left anteriorobliqueview
coronary artery
C i r c u m f l e xb r a n c h
A n t e r i o ri n t e r v e n t r i c u l abrr a n c h( l e f ta n t e r i o rd e s c e n d i n g )
Diagonal branchesof anterior interventricularbranch
Atrioventricularbranch of circumflexbranch
Le{t (obtuse)marginalbranch
rolateralbranches
(Perforating)interventricularseptal branches
Left coronaryartery:right anteriorobliqueview
coronary artery
Anterior interventricular
branch (left anterior
descending)
Circumflex
branch
Perforating)
Interven-
tricular
septalbranches Arteriogram
Left (obtuse)marginalbranch
branches
erolateral
D i a g o n a lb r a n c h
of
A n t e r i o irn t e r v e n t r i c u bl ar ra n c h
4{F
Atrioventricularbranch of circumflexbranch
Heart Plate 2l9

Right Atrium and Ventricle
A s c e n d i n ga o r t a P u l m o n a r yt r u n k
Superiorvena cava Right auricle (atrialappendage)
C o n u sa r t e r i o s u s
R i g h tp u l m o n a r ya r t
Cristaterminalis
Pericardialreflection
Atrioventricular
part
R i g h st u p e r i o r of membranous
p u l m o n a rvye i n septum
Left atri a lc u s p
of tricuspidvalve
R i g h ti n f e r i o r
p u l m o n a r yv e i n Pectinatemuscles
ingof
Interatrialseptum
c o r o n a r sy r n u s
Limbusof fossaovalis alve
(Thebesian)
Fossaovalis of coronary
s r nu 5
Valve(Eustachian)
of inferiorvena cava
Inferiorvena cav
Openedright atrium: right lateralview
Pericardialreflection Pulmonary
trunk
Aorta Transversepericardialsinus
Transverse A n t e r i osr e m i l u n acru s p

p e r i c a r d i sa il n u s
Rightsemilunar
cusp Pulmonary
Superiorvena cava VAIVC
L e f ts e m i l u n a cr u s p
R i g h ta u r i c l e( a t r i a la p p e n d a g e )
C o n u sa r t e r i o s u s
Right atrium
Supraven
tricular
P a r i e t alli m b
crest
Septal
M e m b r a n o u sp a r t o f
p a p i l l a rm
y uscle
interventricularseptum
lnterventricularseptum
(musculap r art)
Tricuspid
valve
S e p t o m a r g i n at rl a b e c u l a
(moderator band)
Chordae tendineae
P o s t e r i opra p i l l a rm
y uscle 4{tr
A n t e r i o pr a p i l l a rm
y uscle
Trabeculaecarneae Openedright ventricle:anteriorview
Plate 22O Heart

Left Atrium and Ventricle
Arch of aorta
T r a n s v e r spee r i c a r d i a
s il n u s
F o l do f l e f ts u p e r i o r Ligamentum
v e n ac a v a( l i g a m e n t arteflosum
of Marshall)
L e f tp u l m o n a r y
L e f ta u r i c l e( a t r i a a
l ppendage) artery
O b l i q u ev e i n o f
left atrium (of Marshall) R i g h tp u l m o n a r y
artery
f t p u l m o n a r yv e i n s
Leftatrium
A n t e r i o rp a p i l l a r y
R i g hp
t ulmonary
C h o r d a et e n d i n e a e
vetns
Coronary
Posteriorpapillarymuscle
srnus
lnferior
venacava
Flap opened in posterolateral

4{F
wall of left ventricle
L e f ta u r i c l e( a t r i a la p p e n d a g e ) Archof aorta
eftpulmonary
artery
L e f t s e m i l u n a cr u s p
Aortic R i g h tp u l m o n a r y
VAIVE
R i g h ts e m i l u n a cr u s p artery
P o s t e r i o sr e m i l u n a cr u s p Left superior
p u l m o n a r yv e i n
Valve of
Membranous
septum foramenovale
R i g hp
t ulmonary
vetns
M u s c u l a rp a r t o f
i n t e r v e n t r i clua r Leftatrium
seprum
C o r o n a r ys i n u s
Mltral valve
kut away lnferior vena cava
Sectionthrough left atrium and ventricle

with mitral valvecut away
Heart Plale 221

Valves of Fibrous Skeleton of Heart
A n t e r i o rs e m i l u n a rc u s p C o n u sa r t e r i o s u s
Pulmonary
R i g h ts e m i l u n a cr u s p
VAIVE
t L e f ts e m i l u n a rc u s p
Left fibrous trigone
Right coronary artery
Right (coronary)
s e m i l u n a cr u s p
Left (coronary) Atrio-
Aortic ventricular
valve semilunar
partof
Posterior membranous
(noncoronary)
s e m i l u n a rc u s p
C i r c u m f l e xb r a n c h l
Mitral Commissural
VAIVE cusps
Posterior
\Right fibrou
-Atrioventricul;
Left fibrous ring
(of mitral valve nodalbrancht
Posteriorinterventricularbrancht
Heart in diastole:
viewedfrom basewith atria removed
*{r
A n t e r i o rs e m i l u n a cr u s o Conusarteriosus
Pulmonary
R i g h ts e m i l u n a rc u s p
valve
t L e f ts e m i l u n acru s p
eft fibrous trigone
Rightcoronaryartery
Right (coronary)
semilunar l n t e r v e n t r i clua r
part
Left (coronary) Membranous
s e m i l u n a rc u s p Atrio- septum
ventricular
Posterior part
(noncoronary)
semilunar
Anterior
C i r c u m f l e xb r a n c h l cusp
Septal Tricuspid
cusp VAIVC
Rightfibrousring
Left fibrous ring (of tricuspidvalve)
(of mitral valve)
Rightfibroustrigone
Posteriorinterventricularbrancht
Heart in svstole: Atrioventricular(AV) nodal brancht
viewedfrom basewith atria removed
.Of left coronary
artery
tOf right coronary artery
Pfate 222 Heart

Valves and Fibrous Skeleton of Heart (continued|
C o m m i s s u r eo f s e m i l u n a vr a l v ec u s p s
Ascendingaorta Opening of left coronary artery
N o d u l e o f s e m i l u n a vr a l v e
Aortic sinuses(of Valsalva) (body of Arantius)
O p e n i n go f
right coronary artery
Membranous
septum
B r o k e nl i n e i n d i c a t i n gl e v e l
of origin of tricuspidvalve
o n o p p o s i t es i d eo f s e p t u m - ' A n t e r i opr a p i l l a rm
y uscle
Muscularpartof Anteriorcusp
interventricularseptum of mitralvalve
O p e n i n go f tricular
Atrioven
inferiorvena cava part Membranous
- lnterventricular septum
R i g h ta t r i u m part (behind valve)
O p e n i n go f
c o r o n a r ys r n u s
Posterior
cusp
I Tricuspid
t
Anteriorcusp
VAIVE
Septalcusp
Septal
p a p i l l a rm
y uscle Posteriorpapillary
muscle (sectioned)
Posterior
p a p i l l a r ym u s c l e A n t e r i o pr a p i l l a r y
(sectioned) muscle
Tricuspid(right atrioventricular)valve
Anteriorcusp
Left atrium
cusp
Posterior Mitral
VAIVE
Commissural
cusps
Anterior
p a p i l l a rm
y uscle
(sectioned) Anterior papillary
muscle (sectioned)
Mitral (left atrioventricular) valve

*{r
Heart Plale 223
Atria, Ventricles, and Interventricular Septum
P u l m o n a r yt r u n k Openings of coronary arteries
Anteriorcuspof
mitralvalve Ascendingaorta
R i g h ts u p e r i o rp u l m o n a r yv e i n
Left atrium
R i g h ta u r i c l e( a t r i a la p p e n d a g e )
Aortic sinus(of Valsalva) Left auricle
( a t r i a la p p e n d a g e ) Left semi-
Ascendingaorta l u n a rc u s p
Left Aortic
L e f ts e m i l u n a cr u s p pulmonary valve
R i g h ts e m i
vetns
Aortic r u n a rc u s p
t
valve Posterior
s e m i l u n a r( n o n -
coronary) cusp
Superior
venacava
Atrio-
ventric
Outflow
ut a r
to
part
\ put-
Inter- monary
ventric trunk
ular
pdrr\\
onus
arteriosus
Right
anteflor
papillary
muscle (cut)
Right
ventricle
Rightatriurir
S e p t o m a r g i n at rl a b e c u l a
Anterior (moderator band)
cusp
(retracted)
S e p t a l( m e d i a l )p a p i l l a r ym u s c l e
Septal
cusp
Left
Posterior
cusgi ventricle
Leftposterior
4{tr
p a p i l l a rm
y uscle
R i g h ta n t e r i o r
papillarymuscle(cut) Left anterior
p a p i l l a rm
y uscle
Right posterior papillarymuscle
Left ventricle
M u s c u l a rp a r t o f i n t e r v e n t r i c u l asre p t u m
Planeof section
Plale 224 Heart

Gonducting System of Heart
Ascendingaorta
A t r i o v e n t r i c u l apr a r t
S u p e r i o rv e n a c a v a septum
v"ru,.rnous
I n t e r v e n t r i c u l apra r t
I
S i n u a t r i a(lS A ) P u l m o n a r yv a l v e
nodal artery
Atrioventricular(AV) node
Sinuatrial
( S A )n o d e Atrioventricular (AV)
b u n d l e( o f H i s )
C r i s t at e r m i n a l i s R i g hb
t undle
Note: Specific Purkinjefibers
i n t e r n o d a cl o n d u c t i o n L,
pathwaysin the atria
Septomarginal
may exist based on
trabecula
s t r o n gp h y s i o l o g i c a l ( m o d e r a t o rb a n d )
and someanatomical
evidence
terior
R i g h ft i b r o u sr i n g p a p i l l a rm
y uscle
( o ft r i c u s p i vda l v e
Subendocardial
branches
Inferior vena cava ----{ ( P u r k i n jfei b e r s )
Rightside
P o s t e r i o sr e m i l u n a rc u s o
Aortic
L e f ts e m i l u n a rc u s p Arch of aorta
valve
R i g h st e m i l u n acru s p
P u l m o n a r yt r u n k
I n t e r v e n t r i c u l apra r t S u p e r i o rv e n a c a v a
Membranous
septum
Atrioventricularpart
Left auricle
Leftbundle
Anterior Right
p a p i l l a r ym u s c l e p u l m o n a r yv e i n s
Mitral valve
Subendocardial (cut awaY)
branches
( P u r k i n j ef i b e r s )
M u s c u l apr a r to f
i n t e r v e n t r i c usl aerp t u m
/\_
Left side
Plale 225
Nerves of Heart
$@So Pmts13O, 15,ltr, ffi
S u p e r i o rc e r v i c a l S u p e r i o rc e r v i c a l
sympatheticganglio sympatheticganglion
Rightvagus nerve (X) Leftvagus nerve (X)
( C o n j o i n e ds y m p a t h e t i ca n d Superiorcervical
vagal)superiorcervicalcardiac nerves (sympathetic)cardiac nerve
Middle cervical Superiorcervical

sympathetic (vagal)cardiac branch
Middle cervical Middle cervical

(sympathetic)cardiac nerve s y m p a t h e t i cg a n g l i o n
Phrenicnerve Phrenicnerve
Inferior cervical Middle cervical

(vagal)cardiac branch (sympathetic)cardiac nerve
Vertebralganglion Inferiorcervical
(vagal)cardiac branch
I n f e r i otrh y r o i da r t e r y
ertebralganglion
Vertebralartery
Cervicothoracic
Cervicothoracic
Inferiorcervical
sympathetic
Ansa subclavia cardiac nerves
Right recurrent
laryngealnerve
Inferior cervical 3rd thoracic

( s y m p a t h e t i cc)a r d i a cn e r v e s s y m p a t h e t i cg a n g l i o n
Thoracic cardiac brancn Thoracic (sympathetic)

of vagus nerve cardiac branches
4th thoracic 'Thoraciccardiac
sympatheticganglion
branch of
vaSusnerve
Thoracic (sympathetic)
c a r d i a cI p 1 n 6 h s 5 -
Left recurrent
Cardiac plexus laryngealnerve
Phrenic nerve (cut)
Plale 226 Heart

lnnervation of Heart: Schema
Posterior
nucleus
ofvagusnerve Nucleusof
Superiorcervical
s y m p a t h e t i cg a n g l i o n solitarytract
Superiorcervical
(sympathetic)cardiac nerve
Middle cervical
sympatheticga
Middle cervical (vagal)cardiac br
I
lnferior cervical
I (vagal)cardiac branches
I
Vertebralganglion (variation) t
I Ascending
I
connections
A n s as u b c l a v i a
I
Cervicothoracic I
(stellate) I
I
I
lst intercostal
nerve
lnferior cervical
Thoracic cardiac
branch ofvagus nerve
2nd thoracic
sympatheticganglion
W h i t e r a m u sc o m m u n i c a
C r a y r a m u sc o m m u n i c a n s
Thoracic (sympathetic)
cardiac branches-
gangliori
4th thoracicsympathetic
Cardiac
prexus
Sympatheticpreganglionic
Sympatheticpostganglionic
preganglionic
Parasympathetic
postganglionic
Parasympathetic
Visceralafferentaccompanying
*{r
sympatheticfibers
Visceralafferentaccompanying
parasympathetic fibers
Heart Plale 227

lnnervation of Blood Vessels: Schema
Cervicalsympathetic
trunkganglia Internalcarotidnerve
- I - ------r-r-----r
,a---
White ramuscommunicans
Cervicalcardiacnerves
Brachial
plexus
Cardiopulmo-
narysplanchnic
\ aand _ _ : _nerves
: : _ aortic
lntercostal
nerves
Spinalnerves
Upperlumbar
sympathetic
trunkgangli
Spinalnerves
Grayramuscommunicans
Lowerlumbar
*{r sympathetic
trunkganglia
Postganglionicsympathetic
fibersto lumbarand
sacralplexusesand
Sympatheticfibers to nervesof lowerlimb
Preganglionic
Postganglionic
Plate 22a Heart

Prenatal and Postnatal Girculation
Prenatalcirculation
Pulmonarv
trunk Ductusarteriosus
Superiorvena Leftpulmonaryartery
Rightpulmonary eft pulmonaryvein
Rightpulmonaryvein
Foramen ovale
Inferiorvenacava
Hepaticvein
Ductusvenosus
Celiactrunk
artery
Superiormesenteric
Ligamentur
arteriosum
Umbilicalarteries
Fossaovalis
(obliterated
*{r Ligamentum
foramenovale
venosum
(obliterated
ductusvenosus)
Ligamentum teres
(roundligament)of liver
(obliteratedumbilicalvei
Medialumbilicalligaments
(occludedpartof umbilicalarteries)
Postnatal circulation
Heart Plate 229

Mediastinum: Right Lateral View
Cervical(cupula,or dome, of) parietalpleura Anterior scalenemuscle and phrenic nerve

and suprapleuralmembrane (Sibson'sfascia)
1s t r i b
R i g h ts u b c l a v i a na r t e r ya n d v e i n
Trachea
Clavicle
Rightvagus nerve (X)

S u b c l a v i umsu s c l e
1s t r i b
Sympathetictrunk Right and left

b r a c h i o c e p h a l ivce i n s
Right superior intercostalvei
Right internalthoracic
artery
4th thoracic vertebral
Arch of azygosvein Thymus(seenthrough
m e d i a s t i npalle u r a )
R i g h tm a i n b r o n c h u s
a n d b r o n c h i a la r t e r y
S u p e r i o rv e n a c a v a
Azygos vein
P h r e n i cn e r v ea n d
pericardiacophrenic
Posteriorintercostal
artery and vein"
v e i n a n d a r t e r ya n d
intercostalnerve
R i g h tp u l m o n a r y
artery
Internalintercostal
muscte
M e d i a s t i np
aal rt
of parietalpleura
Internalintercostal (cutedge)
m e m b r a n ed e e p t o
externalintercostal
muscle F i b r o u ps e r i c a r d i u m
overrightatrium
Cray and white

r a m tc o m m u n r c a n t e s
Righp
t ulmonary
vetns
Costal part of lnferior vena cava

parietapl leura (covered by
(cut edge) m e d i a s t i n apl a r t
of parietalpleura)
Creater thoracic
s p l a n c h n i cn e r v e Diaphragm (covered by
diaphragmaticpart
of parietalpleura)
E s o p h a g uasn d
esophageal plexus
Costalpartof
parietalpleura(cutedge)
B r o n c h o pl m
u onary
(hilar)lymph
Costodiaphragmaticrecess
of pleuralcavity
P u l m o n a r yl i g a m e n t
Nr
(cut)
* N e r v e a n d v e s s e l sc o m m o n l y r u n i n d e p e n d e n t l y
Plate 23O Mediastinum

Mediastinum: Left Lateral View
A n t e r i o rs c a l e n em u s c l ea n d o h r e n i cn e r v e Cervical(cupula,or dome, of) parietalpleura and

l e m b r a n e( S i b s o n ' sf a s c i a )
s u p r a p l e u r am
1s t r i b
Left subclavianvein and artery
Esophagus
S u b c l a v i umsu s c l e
Thoracicduct
Clavicle v a g u sn e r v e( X )
Left brachiocephalicvein Leftsuperior

vein
intercostal
Left internalthoracic arterv
Archof aorta
T h y m u s( s e e nt h r o u g h
m e d i a s t i n apl l e u r a ) Leftrecurrent
nerve
laryngeal
L i g a m e n t u ma r t e r i o s u m
Bronchopulmonary
( h i l a rl)y m p hn o d e s
Left pulmonary artery
Accessory
hemiazygosvein
Left phrenic nerve and
pericardiacophrenic
Posteriorintercostal
artery and veinl vein and artery and
intercostalnerve
Mediastinalpart o{
parietalpleura Internalintercostal
(cut edge) muscle
F i b r o u sp e r i c a r d i u m Internalintercostal
m e m b r a n ed e e p t o
externalintercostal
L e f tp u l m o n a r y muscre
vetns
Crayand white
P u l m o n a r yl i g a m e n t ramicommunicantes
(cut)
Costalpleura
(cut edge;
E s o p h a g uasn d
esophageal plexus thetic trunk
(coveredby mediastinal
part of parietalpleura) reater thoracic
splanchnicnerve
Diaphragm (covered
b y d i a p h r a g m a t i cp a r t Thoracic
of parietalpleura) (descending)aorta
C o s t o di a p h r a g m a t i c Leftmainbronchus
recessof pleuralcavity andbronchialartery
Costalpartof
parietalpleura(cutedge)
*Nerve and vesselscommonly run independently

4{F
Mediastinum Plate 231
Esophagus in Situ
C o m m o n c a r o t i da r t e r y L o n g u sc o l l i m u s c l e
A n t e r i o rs c a l e n em u s c l e I p a r to f e s o p h a g u s
P h r e n i cn e r v e Recurrentlaryngealnerves
P o s t e r i o sr c a l e n em u s c l e Thoracicduct
I n t e r n ajlu g u l a rv e i n ( c u t )
B r a c h i apl l e x u s
S u b c l a v i a nv e i n ( c u t )
S u b c l a v i a na r t e r y
L e f tb r a c h i o c e p h a l ivce i n ( c u t )
T h y r o c e r v i c at lr u n k
Internalthoracic artery (cut)
V a g u sn e r v e( X
Phrenicnerve (cut)
1 s tr i b( c u t )
t Common carotid artery
Brachio-
cephalic S u b c l a v i a na r t e r y
trunk-' i Vagus nerve (X)
Trachea Left recurrent
Arch of l a r y n g e anl e r v e
aorta
Bifurcation
Arch of of trachea
a z y S o sv e t n
R i g h tm a i n pleura
bronchus (cut edge)
S u p e r i ol ro b a r eft main
(eparterial)
bronchus
bronchus
Thoracic
Thoracicpart (descending)
of esophagus aorta
Esophageal M e d i a s t i n apl a r t o f
plexus parietalpleura
(cut edge)
Mediastinal
part ot Pericardium
parietapl leura (cut edge)
Gut eagel-
Diaphragm
Diaphragmatic
part of
Inferior parietapl leura
vena cava
(cur) Anterior
v a g a lt r u n k
Hepatic
v e i n s( c u t )
Inferior
v e n ac a v a
R i g h ta n d
l e f t c r u r ao f
diaphragm
In f e r i o rp h r e n i ca r t e r i e s
Stomach
4{tr A b d o m i n a la o r t a
Abdominal
part of
esopnagus
Plale 232 Mediastinum

Topography and Gonstrictions of Esophagus
lnferiorpharyngeal
muscle
constrictor
Thyroidcartilage
Cricoidcartila
Piriformfossa(recess)
Pharyngo- Thyroidcartilage (muscle)

Cricopharyngeus
esophageal partof inferiorpharyngeal
constriction constrictor
Cricoidcartilage
16 Cricopharyngeus
(muscle)partof
inferior
q
pharyngeal Archof aorta
O
o Thoracic constrictor
E (aortobronchial) Sternum
constriction
o Trachea
.E
oo
Arch of aorta
s
DO
GI Leftmain
q, bronchus
Lateralview
Diaphragmatic
constriction
(inferior
esophageal
"sphincter";+
38
Abdominalpart
40 of Fundusof stomach
Cardiacparl
of
4{tr
Musculature of Esophagus
nferior pharyngealconstrictor muscle
Zone of sparsemusclefibers
Cricopharyngeus (muscle)
partof inferiorpharyngeal
constrictor
Mainlongitudinal musclebundle
passingupwardandventrallyto
attachto middleof posterior
Cricoid surfaceof cricoidcartilage
cartilage
Accessory musclebundlefrom postero-
lateralsurfaceof cricoidcartilage-
Additionalfibersfrom contralateral
sideof cricopharyngeus (muscle)
partof inferiorpharyngeal
constrictor
Trachea Circularmusclelaverwith
sparselongitudinal
fibers
area(of Laimer)
in V-shaped
Bareareaon ventralsurfaceof
Lateralmassof longitudinal
muscle
Fibroelastic
membranes
with sparsemusclefibers
Windowcut in longitudinal
musclelayer
Circularmusclelayer
Leftmain
bronchus
4{r
Plate 234 Mediastinum
Pharyngoesophageal Junction
Superiorpharyngeal muscle
constrictor
Rootof tongue
Epiglottis
I Longitudinal
Palatopharyngeusmuscle
t lil"r'J:g*'
fold
inlet(aditus)
Laryngeal
Thyroidcartilage(superiorhorn)
Thyrohyoidmembrane
branchof superiorlaryngeal
nerveandsuperiorlaryngealartery
andvein
arvtenoidmuscle
arvtenoidmuscle
Transverse
Thyroidcartilage
Posteriorcricoarytenoidmuscle
Inferiorpharyngeal muscle
constrictor
aponeurosis(cut away\
Pharyngeal
Zoneof sparsemusclefibers
(muscle)partof inferior
Cricopharyngeus
pharyngeal
constrictor
Cricoidcartilage(lamina)
Cricoesophagealtendon
(attachmentof longitudinalesophagealmuscle)
Posteriorview with muscle
Circularesophageal
pharynxopenedand
mucosaremoveo mucosaand submucosa
Esophageal
area(of Laimer)
Circularmusclein V-shaped
Rightrecurrentlaryngealnerve
muscle
esophageal
Longitudinal
muscle
Windowcut in longitudinal
exposescircularmusclelayer
4{F

Esophagogastric Junction
Esophagus
gitudinalesophagealmuscle
Esophageal
m Circularesophagealmuscle
Submucosa
Cradualslightmuscularthickening
Phrenoesophageal ligament
(ascendingor upper limb)
Supradiaphragmatic fascia
Diaphragm
nfradiaphragmatic
(transversalis)
fascia
Phrenoesophageal
Iigament
Subhiatal (descendinglimb)
fat ring Peritoneum
Zigzag (Z) line: Cardiacnotch

junctureof
esophagealand
gastnc
Cardiacpart
(cardia)
of stomach
Longitudinalesophagealmuscle(cut)
Circularesophagealmuscle
Castricfolds (shown hereas spiral)
(rugae)
Cardiacnotch
Fundus
of
stomach
Collarof Helvetius
Window cut in middlecircularmusclelayerof stomach
Innermostobliquemusclelayerof stomach
(formssling)
Outer longitudinalmusclelayerof stomach(cut)
4{F
Arteries of Esophagus
Esophageal branchof
Inferiorthyroidartery Esophageal branchof
Common Cervicalpartof esophagus
carotidartery
Thvrocervicaltrunk
Subclavian artery
Subclavian
Vertebralartery
lnternalthoracicartery
Commoncarotidartery
trunk
Trachea
Arch of aorta
3rd rightposteriorintercostal
artery
t bronchialarterv
Superiorleftbronchialartery
Esophageal branchof rightbronchialartery
branch
Inferiorleftbronchialarteryand esophageal
Thoracic(descending) aorta
of thoracicaorta
branches
Esophageal
Thoracicpart
of esophagus
inalpart
of esophagus
Diaphragm
Stomach
Commonvariations: EsoPhageal
Esophageal branchesmayoriginatefrom left
branchof left inferiorphrenicarteryand/or
gastricartery directlvfrom celiactrunk.
Branches to abdominalesophagus
Leftgastricartery mayalsocomefrom splenicor
Inferior phrenic Celiactrunk shortgastricarteries.
Common hepatic artery artery(cut)
Mediastinum Plale 237

Veins of Esophagus
SeealsoPlate 312
I n f e r i o rt h y r o i dv e i n I n f e r i o rt h y r o i dv e i n
I n t e r n ajlu g u l a rv e i n I n t e r n aj ul g u l a r
vetn
E x t e r n aj lu g u l a rv e i n
S u b c l a v i a nv e i n
\ Subclavian
Vertebralvein
vetn
Thoracic
duct
Right
b r a c h i o c e p h a l ivce i n Left brachio-
c e p h a l i cv e i n
S u p e r i o rv e n a c a v a
Left superior
i n t e r c o s t avl e i n
R i g h ts u p e r i o r
i n t e r c o s t avl e i n E s o p h a g e avle i n s
(plexus)
Esophagus Accessory
h e m i a z y g ovse i n
6 t h r i g h tp o s t e r i o r
i n t e r c o s t avl e i n
Azygos vein
Junctionof accessory
nemrazygos
a n d a z y g o sv e i n s
Hemiazygos
Inferiorvena cava ( vetn Submucous venousplexus
inferior phrenic vein
TLeft
Diaphragml ,il S h o r tg a s t r i cv e i n s
Liver
H e p at i c
verns
Hepatic
portal
vetn
Omental
(epiploic)
R i g h tr e n a lv e i n verns
Left gastricvein Left gastro-omental

( g a s t r o e p i p l o i cv)e i n
Right gastricvei
S u p e r i o rm e s e n t e r i cv e i n I n f e r i o rm e s e n t e r i cv e i n
Nr
Esophagealbranchesof left gastricveiri R ig h t g a s t r o - o m e n t a( g
l a s t r o e p i p l o i cv)e i n

Lymph Vessels and Nodes of Esophagus
SeealsoPlates 2O8,266
Inferior deep cervical

( i n t e r n ajlu g u l a r )n o d e s
V i r c h o w ' sn o d e
Paratracheal
nooes
Posterior
mediastinal
nodes Posterior
parietalnodes
S u p e r i o ra n d i n f e r i o r Intercostal
t r a c h e o b r o n c iha l nooes
nooes
S u p e r i o rp h r e n i cn o d e s
Left eastricnodes
(cardiacnodes of stomach)
Juxtaesophageal
and superior
phrenic
C e l i a cn o d e s
*{r
Nerves of Esophagus
Anterior Superiorganglionof vagusnerve

view ganglion
Superiorcervicalsympathetic
nferior ganglionof vagus nerve
Pharyngealbranch of vagus nerve
*{r
Esophagus
Vagusnerve(X)
Recurrent
laryngeal Superiorlaryngeal
nerve
nerves
Cervicalsympathetic
trunk
ganglion
Middlecervicalsympathetic
Rightrecurrent
laryngeal
nerve Cervical(sympathetic
andvagal)cardiacnerves
ganglionof cervicalsympathetic
Vertebral trunk
Ansasubclavia Ansasubclavia
Branchto esophagus and recurrent
nervefrom stellateganglion
(stellate)
Cervicothoracic
3rd ganglion
intercostal
Leftrecurrentlaryngeal
nerve Posterior
Thoracic(vagal view
Crayand and sympathetic)
white rami cardiacbranches
communicantes
Cardiacolexus
3rd thoracic
plexuses
Pulmonary
sympathetic
ganglion Esophageal plexus
(anteriorportion)
Thoracic
sympathetic Branchesto esophageal
trunk_ plexusfrom sympathetic
trunk,greaterthoracic
Rightgreater splanchnicnerve,and
thoracic thoracicaorticplexus
splanchnic
nerve Leftgreaterthoracic
solanchnicnerve Esophageal
Sympathetic prexus
Anteriorvagaltrunk
fibers along (posterior
left inferior Vagalbranchto hepaticplexus portion)
phrenic artery via lesseromentum
Branchof Principalanteriorvagalbranch
posteriorvagal to lessercurvatureof stomach
trunkto celiac Vagalbranchto fundus
plexus and bodyof stomach Posterior
vagaltrunk
Greater
thoracic
splanchnic
nerves
Vagalbranch
Sympathetic to celiacplexus
fibers along
esophageal
branch of left Posterior
vagal
gastricartery branchto
Vagal branch lesser
Celiacplexus to fundus and curvature
and ganglia cardiac part
of stomach
Plate 24O Mediastinum

Mediastinum: Gross Section
5th left costal cartilage
Rightventricle Internalthoracicarteryand vein
thoracismuscle
Transversus
ma.jormuscle
Pectoralis
Pleuralcavity
part,
Interventricular Muscularpartof
part
Atrioventricular interventricular
of membranous septum
septum
Leftventricle
Suoeriorvena cava
Papillarymuscle
Rightatrium
Phrenicnerveand
Pericardialcavity pericardiacophrenic
artery and vein
Mediastinalpartof
parietalpleura
R i g hltu n g
(middlelobe)
Leftatrium
Phrenicnerveand
pericardiacophrenic
arteryand vein Coronarysinus
Branchesof right Leftlung

mainbronchus (superiorlobe)
Rightinferior Branchesof
pulmonaryvein leftmainbronchus
Leftinferior
Oblique pulmonary vein
pericardialsinus
Thoracic
Esophagusand (descending)aorta
esophagealplexus
8th rib
Azygosvein
Hemiazygos vein
Thoracicduct
TBvertebra
trunk
Leftsympathetic
Leftgreaterthoracicsplanchnicnerve
*{r
Mediastinum Plale 241
Ghest Scans: Axial GT lmages
Seriesof chestaxialCT imagesfrom superior(A) to inferior(C)
A
B
C
ery#
A, Ascendingaorta R Rib
A, D e s c e n d i n ga o r t a R B R i g h (t m a i ns t e m )b r o n c h u s
AZ Azygos vein RSI- Rightsuperiorlobeof lung
B Body of vertebra RV Rightventricle
IV Inferiorvena cava S Sternum
t Liver SC Spinalcord
TB Left (main stem) bronchus SP Spinousprocessof vertebra
tst_ L e f t s u p e r i o rl o b e o f l u n g SV Superiorvenacava
LV Left ventricle T Trachea(bifurcation)
PA Pulmonaryartery
Plate 242 Regional Scans

o
t f oint
TransverseSection:LowerLevelof T3, Sternoclavicular
o Plate243
o M e d i a s t i n allv m p h n o d e Manubrium
oT
o Sternoclavicularioint (articulardisc) Brachiocephalictrunk
o
o
t Clavicle Trachea
II
o R i g h tb r a c h i o c e p h a l ivce i n
5 Left brachiocephalicvein
g C o s t a lc a r t i l a s eo f 1 s t r i b
Left common carotid arterY
D Pectoralismajor muscle
3 Left vagus nerve (X)
!f
t R i g h tl u n g
o Pectoralisminor muscle
3 Axillaryfossa
Left subclavian
Tendon of long
head of biceps
artery
o
-
brachii muscle
Shaft of left o
S u r g i c anl e c k
humerus o
of right
Long
o
humerus
headof o
Delroid triceps o
muscte brachii
muscle
o
t
II
Teres
mtnor
Teres
mrnor
o
muscle muscle
5
lntercostal Scapula
o
t
muscles
{
Leftlung
muscle
Subscapularis 5
Phrenicnerve I n f r a s p i n a tm
u su s c l e
o
rl
ll
Right vagus nerve (X Serratusanterior muscle x
Esophagus ql
Left recurrent laryngealnerve t
R h o m b o i dm a i o r m u s c l e
Thoracic duct {
q)
Costotransverseioint
!
qt Erectorspinae muscle F
t
o
muscle
Trapezius
o
Rhomboid maior muscle C./Td4s/*
N
5
Body ofT3 vertebra
o
S p i n acl o r d muscle
Transversospinalis
G)
!
ql
t
o
Transverse
Section:T3-4 Intervertebral
Disc,Manubrium
o
-
N
Plate 244
o
D
S u p e r i o rt r a c h e o b r o n c h i al yl m p h n o d e Trachea
o
D Superiorvena cava
o
o
Right phrenic nerve
o
Arch of azygosvein o
t
IT
R i g h tl u n g Internalthoracic artery and vein o
Intercostalmuscl
5
Left lung Pectoralismaior muscle
Serratusanterior muscle Ribs P e c t o r a l i sm i n o r m u s c l e

o
rh
Tendon of long head of Axillaryfossa {

b i c e p sb r a c h i im u s c l e 5
L a t i s s i m udso r s i
C o m b i n e ds h o r t h e a d o
r|
o f b i c e p sb r a c h i ia n d
tendon coracobrachialismuscles !l
Shaft o{
x
T e n d o no f l o n g
numerus head of biceps !,
t
brachii muscle
Deltoid
muscte {
Shaft of g)
LOnS numerus I
head of
Lateral
D
tnceps
brachii
muscte
head of
tnceps
brachii
I
o
o
rl
Teres muscle o
maJor
o Long head of F
o
o
muscte triceps brachii
muscle
o
Teresminor muscle
g
I
o
o Scapula
Left latissimusdorsi tendon
o ( i n s e r t i n go n t o h u m e r u s )
=, Esophagus
o Teresmajor muscle
5 S p i n a lc o r d
g Thoracic duct S u b s c a p u l am
r i su s c l e
T3-4 intervertebraldisc Left recurrent
D laryngealnerve
T e r e sm i n o rm u s c l e
5
ql R h o m b o i dm u s c l e Scapula
t Left vagus nerve (X)
o Trapeziusmuscle I n f r a s p i n a t um
s uscle
l Obliquefissure(of leftlung)
CUd4*/*
o
rt TransverseSection: T4-5 Intervertebral Disc, Sternal Angle
o
o I n f e r i o rt r a c h e o b r o n c h i al yl m p h n o d e s
oI
M a n u b r i o s t e r n aj ul n c t i o n
o A s c e n d i n ga o r t a
o
o
Internalthoracic arterYand vein
R i g h tp u l m o n a r ya r t e r y
=. 2nd costal cartilage
o Superiorvena cava
3
g Pectoralismajor muscle
P u l m o n a rtyr u n k
D Left pulmonary artery

=
ql
R i g h tl u n g
Left lung
o
rt
i
o
lntercostalmuscles
o
3 Axillaryfossa s inor muscle
P e c t o r a l im o
o
Tendon of long
head of biceps
Ribs
o
b r a c h i im u s c l e o
o
Coracobrachialis L o n gh e a d =.
muscre of biceps o
Deltoid
b r a c h i im u s c l e a
muscle
Shaftof o
t
Lateral numerus
head of {
triceps Latissimus ,
brachii
muscle
dorsi
tendon
o
rt
ll
Latissimus
dorsi
x
tendon
Teres major ll
muScle t
Long head of triceps anterior
Serratus {
b r a c h i im u s c l e muscle $
I
Teresmajor muscle S u b s c a p u l am
r i su s c l e (tl
Scapula
I n f r a s p i n a t um
s uscl
Left main bronchus
D e s c e n d i n ga o r t a
9.
o
!- Rhomboid maior muscle! Accessoryhemiazygosvein
o
!l F
t
o
R i g h tm a i n b r o n c h u s Trapeziusmuscle
o
N
D
Azygos vein Thoracic duct Cfd4*/* q
Esophagus T4-5 intervertebraldisc
|,|
!
!f
t
o Transverse
Section:Levelof T7,3rd InterchondratSpace o
rt
N o
D
o o
Orifice of tricuspidvalve o
Coronarysulcus S t e r n u m( b o d y ) o
o
Internalthoracic artery and vein R i g h tv e n t r i c l e o
t
IT
Anterior interventricularsulcus o
R i g h ta t r i u m
5
Pectoralismajor muscle
o
rt
Interatrialseptum
Apex of heart
{
Superiorvena cava 5
R i g h ti n f e r i o r
l n t e r v e n t r i c u l asre p t u m o
rl
p u l m o n a r yv e i n !t
ry muscte
x
Left ventricle qf
Azygos vein
t
Leafletof mitralvalve {
Serratus {
a n t e r i o rm u s c l e Coronarysulcus
F
L a t i s smi u s
dorsi muscle Coronarysinus
o
o
o
rt
Inferior
a n g l eo f s c a p u l a
Oblique
pericardialsinus
o
o Descendingaorta
o I
o Thoracic duct
o
o
-t
-a L a t i s s i m uds o r s i m u s c l e
o Triangleof auscultation
f
g Triangleof auscultation
Neckof 7th rib

D Head of 7th rib
=
ql Zygapophyseal(facet)joint
t Body offT vertebra
o
3 Trapezius muscle
CUd4/^
4 Abdomen
Section
Topographic Anatomy
Plale 217
z+z Abdomen
Body Wall
Plates 24&167
zca Bony ofAbdomen

Framework
zlg Anterior Wall:
Abdominal Dissection
Superficial
Abdominal
zso Anterior Dissection
Wdl:Intermediate
Abdominal
zsr Anterior Deep
Wall: Dissection
zsz Rectus Cross
Sheath: Sections
zsg Anterior Internal
AbdominalWall: View
Wall
Abdominal
zsl Posterolateral
zss Arteries Abdominal
ofAnterior Wall
zse Veins Abdominal
ofAnterior Wall
ofAnterior
z5z Nerves Wall
Abdominal
Nerves
zss Thoracoabdominal
zss Inguinal Dissections
Region:
zeo Inguinal Spermatic
Canaland Cord
zer Indrrect
Inguinal
Hernta
zez Femoral andInguinal
Sheath Canal
Wdl:Internal
Abdominal
zee Posterior View
ofPosterior
zec Arteries Abdominal
Wall
zes Veins
ofPosterior Wall
Abdominal
zee Lymph andNodes
Vessels Abdominal
of Posterior Wall
zsz Nerves Abdominal
ofPosterror Wall

Abdomen
Peritoneal Gavity Visceral Vasculature

Plates 26,&174 Plates 3OO-317
zea Regions
andPlanes
ofAbdomen 300 Arteries
ofStomach,
Liver,
andSpleen
zeg Greater
Omentum
andAbdominalVrscera 301 Arteries
ofLiver,
Pancreas,
Duodenum,
andSpleen
zzo Mesenteric
Relations
ofIntestines 3o2 Variations
inCeliac
Trunk
zzr Mesenteric
Relations (continued)
ofIntestines 303 Arteriogram
Celiac
zzz Omental
Bursa:Stomach
Reflected 304 Arteries
of Duodenum
andHeadofPancreas
zzg 0mental
Bursa:
Cross
Section 305 ArterialVariations
andCollateral
Supply
ofLiver
zzc Peritoneum
ofPosterior
Abdominal
Wall andGallbladder
306 Arteries
ofSmall
Intestine
Viscera (Gutl 307 Arteries
ofLarge
Intestine
Pfates 275-285 308 Variations
inColic
Arteries
zzs Stomach
inSitu 309 Veins
ofStomach,
Duodenum,
Pancreas,
andSpleen
zzs Mucosa
ofStomach 3 t o Veins
ofSmall
Intestine
zzz Musculature
ofStomach 3tt Veins
ofLarge
lntestine
zza Duodenum
inSitu 312 Hepatic
Portal
VeinTributaries:
Portacaval
Anastomoses
zzs MucosaandMusculature
of Duodenum 313 Variations
ofHepatic
Portal
Vein
zso MucosaandMusculature
ofSmall
Intestine 314 LymphVessels
andNodes
ofStomach
zar lleocecal
Region 315 Lymph
Vessels
andNodes
ofPancreas
zsz lleocecal (continued)
Region 3t6 Lymph
Vessels
andNodes Intestine
ofSmall
zss Vermiform
Appendix 317 Lymph
Vessels
andNodes
ofLarge
Intestine
zac Mucosa
andMusculature
ofLarge
Intestine
zas Sigmoid position
Colon:Variations
in Innervation
Plates 318-328
Viscera (Accessory Organsf 318 Autonomic

Nerves
andGanglia
ofAbdomen
Plates 286-299 3 t 9 Nerves
ofStomach
andDuodenum
zae Topography
ofLiver 3.20Nerves
ofStomach (continued)
andDuodenum
zez SurfacesandBedofLiver 321 Innervation
ofStomach
andDuodenum:
Schema
zaa LiverinSituandVariations
inForm 322 Nerves
ofSmall
Intestine
zag Liver
Segments
andLobes:Vessel
andDuctDistribution 323 Nerves
ofLarge
Intestine
zso Intrahepatic
VascularandDuctSystems 324 Innervation
ofSmall
andLarge
Intestines:
Schema
zsr Liver
Structure:
Schema 325 Autonomic
Reflex
Pathways:
Schema
zsz Intrahepatic
Biliary
Systems:
Schema 326 Intrinsic
AutonomicPlexuses
ofIntestine:
Schema
zse Schematic
CrossSection
ofAbdomenatT10 327 Innervation
ofLiver
andBiliary
Tract:
Schema
zse Gallbladder
andExtrahepatic
BileDucts 328 lnnervation
ofPancreas:
Schema
zss Junction
of(Common)BileDuct
andDuodenum
zge Variations
inCystic
andHepatic
Ducts Kidneys and Suprarenal Glands
Plates SZC}-347
zsz Schematic
CrossSection
ofAbdomen
atT'12
zgs Pancreas
inSitu szs Kidneys
inSitu:
Anterior
Views
zss Spleen inSitu:Posterior
seo Kidneys Views

Abdomen
Cross
33r Schematic Section atT12
ofAbdomen Ureters,
ofKidneys,
sce Nerves Bladder
andUrinary
andVeininSitu
sez RenalArtery ges Innervation andUpper
ofKidneys Schema
Ureters:
andVein
inRenalArtery
eos Variations oee Nerves Glands:
ofSuprarenal andSchema
Dissection
ggr Gross ofKidney
Structure gcz Arteries
andVeins
ofSuprarenal inSitu
Glands
andRenal
sos IntrarenalArteries Segments
sse Nephron Tubule:
andCollecting Schema Abdominal Sections
gsz Blood Plates 348-349
inParenchyma
Vessels ofKidney:
Schema
Section
Cross
esa Schematic atT12-11
ofAbdomen gcg AbdominalWall (Sagittal)
Paramedian
andViscera: Section
Cross
esg Schematic ofAbdomen
Section atLl-2 CrossSection
srs Schematic at 13,4
ofAbdomen
geo Ureters
ofUreters
ser Arteries Bladder
andUrinary Regional Scans
Plate 35O
sez Renal
Fascia
Vessels
a+s Lymph of Kidneys
andNodes Bladder
andUrinary eso Abdominal CTlmages
Scans:Axial
Atlas of Human AnatomY

Abdomen
muscle
Sternocleidomastoid
Sternalhead
Deltopectoral Clavicularhead
triangle
muscle
Trapezius
Sternum Deltoidmuscle
Body
Xiphoid Pectoralis
process major muscle
Serratus
anterior
muscle
Tendinous
intersection
External
oblique
muscle
Lineaalba
S e m i l u n al irn e
Anteriorsuperior Umbilicus
i l i a cs p i n e
lliaccrest
Superficial
circumflexiliac vein
Superficial
epigastricveins
lnguinal
ligament
Pubicsymphysis
Pubictubercle
c(d4#
Topographic Anatomy Plale 247

Bony Framework of Abdomen
4{tr
Transverseorocessesof lumbar vertebrae
I n n e rl i p
lliactuberosity
Intermediate
zone
lliaccrest
Outerlip
Wing (ala)of ilium
Tuberculum
Creater
sciatic
notch
Arcuateline
Anteriorsuperior
lschialspine
iliacspine
Anteriorinferior Lesser
iliacspine sciaticnotch
Iliopubic ter trochanter

emtnence of femur
Superior Pectenpubis
pubicramus (pectinealline)
Obturator
Pubicsymphysis
foramen
Pubictubercle lschial
tuberosity
Inferior Lessertrochanter
pubicramus of femur
Pubicarch
Inferiorpubic ligament
Plate 248 Body Wall

Anterior Abdominal Wall: Superficial Dissection
*{r
major
Pectoralis
muscle
Xiphoidprocess
Rectussheath
L i n e aa l b a
Serratus Subcutaneous tissue

anterior (superficialfascia)
of abdomen
Thoracoepigastric
vein
Muscular
External part
oblique
muscle Aponeurotic Camper's(fatty)layer,
pan Scarpa's (membranous)
layerof subcutaneous
Anteriorsuperior tissueof abdomen
i l i a cs p i n e (turned back)
of
I n g u i n al il g a m e n t Scarpa's layerto
(Poupart's) fascialata
lntercrural
fibers Superficial
circumflex
iliacvessels
Superficial
i n g u i n arli n g
Superficial
vessels
epigastric
Externalspermatic
fasciaon
spermaticcord external
pudendalvessels
Cribriformfascia
in saphenous ligament
Fundiform
openrnS
fasciaof
Superficial
Fascialata penisand scrotum
(dartosfascia)(cut)
Creat
s a p h e n o uvse i n
Deep(Buck's)
fasciaof peniswith
Superficial deepdorsalveinof
dorsalveinof penis penisshowingthrough
Body Wall Plate 249

Anterior Abdominal wall: Intermediate Dissection
Nr
Pectoralismajor
muscles
'Anteriorlayerof
rectussheath
(cutedges)
Latissimus
d o r s im u s c l e L i n e aa l b a
Serratus Rectusabdominis
anteriormuscle muscle
External
External o b l i q u em u s c l e
o b l i q u em u s c l e lcut away)
\cut away)
Tendinous
intersection
External
intercostal
muscles Internaloblique
muscle
External
oblique
aponeurosts Pyramidalis
muscle
(cut edge
Inguinalfalx
(conjointtendon)
Rectussheath
l n g u i n al il g a m e n t
Internal (Poupart's)
Anteriorsuperior
Anteriorsuperior i l i a cs p i n e
i l i a cs p i n e - -
External
oblique
aponeurosis(cutand
I n g u i n al i g a m e n t
(Poupart's) turneddown)
Pectineal
ligament
Cremaster muscle (Cooper's)
(lateralorigin
Lacunarligament
Inguinalfalx (Cimbernat's)
(conjointtendon
Reflected
inguinal
Reflected ligament
i n g u i n al il g a m e n t
Pubictubercle
Femoralvein ligament
Suspensory
(in femoral sheath) of penis
Saphenous Cremastermuscles
openrnS and cremasteric
fascia
Cremaster
muscle Deep(Buck's)
( m e d i a lo r i fasciaof penis
Externalspermatic
Fascialata fascia(cut)
Great saphenousvein Superficial
fascia
of penisand
scrotum(cut)
Plate 25O Body Wall

Anterior Abdominal Wall: Deep Dissection
Superior
vessels
epigastric
4{tr
External Anteriorlayerof
o b l i q u em u s c l e rectussheath(cut)
\cut away)
L i n e aa l b a
R e c t u sa b d o m i n i s
muscte Anteriorlayerof
rectussheath
E x t e r n aol b l i q u e
aponeurosis(cut)
abdominis
Transversus
muscle(cut)
I n t e r n ao
l blique fascia
Transversalis
a p o n e u r o s i s( c u t ) (opened on left)
Transversus Extraperitoneal
a b d o m i n i sm u s c l e fascia(areolartissue)
Internal
o b l i q u em u s c l e( c u t )
M e d i a lu m b i l i c a l
Posteriorlayer l i g a m e n t( o c c l u d e dp a r t
of rectus sheath o f u m b i l i c a la r t e r y )
A r c u a t el i n e
Inferior
epigastricvessels
I n f e r i o re p i g a s t r i c
A n t e r i osr u p e r i o r artery and vein (cut)
i l i a cs p i n e
S i t eo f d e e p i n g u i n a l
lnguinal ligament r i n g ( o r i g i no f i n t e r n a l
(Poupart's) spermaticfascia)
C r e m a s t e r i ca n d p u b i c
Superficial branchesof inferior
circumflexiliac, epigastricartery
S u p e r f i c i ael p i g a s t r i
Superficial Femoralsheath
externalpudendal (containsfemoral
arteries(cut) a r t e r ya n d v e i n )
I n g u i n a fl a l x I n g u i n al i g a m e n t
(conioint tendon) (Poupart's)
P e c t i n e alli g a m e n t L a c u n a rl i g a m e n t
(Cooper's) (Cimbernat's)
P e c t i n e alli g a m e n t
L a c u n a rl i g a m e n l (Cooper's)
(Cimbernat's)
Fat in retropubic space
Reflected (of Retzius)
inguinaligament
Pectinealfascia
P u b i ct u b e r nternal spermaticfascia
C r e m a s t e rm u s c l ea n d f a s c i a Superficialfascia muscleandfascia(cut)
Cremaster
Deep(Buck's) o f p e n i sa n d
E x t e r n asl p e r m a t i cf a s c i a fasciaof penis scrotum (cut) xternal spermaticfascia(cut)
Body Wall Plate 251

Rectus Sheath: Gross Sections
Sectionabovearcuateline
Aponeurosis of External
externalobliquemuscle Anteriorlayerof rectussheath oblique
Skin
Rectusabdominis muscle lnternal
Aponeurosis
of
i n t e r n a lo b l i q u e m u s c l e o b l i q u em u s c l e
L i n e aa l b a
Transversus
Aponeurosis of transversus a b d o m i n im
s uscle
a b d o m i n im
s uscle
Posteriorlayer Falciform
of rectussheath ligament
Peritoneum Subcutaneous
tissue(fattylayer)
Extraperitoneal fascia Transversalis
fascia
Aponeurosisof internalobliquemusclesplitsto formanteriorandposterior layersof rectussheath.

Aponeurosisof externalobliquemusclejoinsanteriorlayerof sheath; aponeuiosisof transversus
abdominis
musclejoinsposteriorlayer.Anteriorandposterior layeisof rectussheathunitemediallyto formlineaalba.
Sectionbelow arcuateline
Aponeurosis of External
e x t e r n aol b l i q u em u s c l e Anteriorlayerof rectussheath
A p o n e u r o s i so f R e c t u sa b d o m i n i sm u s c l e Internal
internaloblique muscle oblique muscle
Aponeurosis of transversus Transversus
a b d o m i n im
s uscle a b d o m i n im
s uscle
Transversalis
fascia M e d i a lu m b i l i c a l
ligamentand fold
Median umbilical
Peritoneum ligament(obliterated aneouS
u r a c h u s i)n m e d i a n tissue(fattyand
Extraperitonealfascia u m b i l i c aflo l d membranous layers)
A p o n e u r o soi sf i n t e r n aol b l i q u em u s c l ed o e sn o t s p l i ta t t h i sl e v e b
l u t p a s s ecso m p l e t e layn t e r i otro
rectusabdominismuscleand is fusedtherewith both aponeurosis of externalobliquemuscleund thut
of transversus
*{r
abdominismuscle.Thus,posteriorwalloi rectussheathis absentbelbwarcuateiine,
and rectusabdominismusclelieson transversalis fascia.
Plale 252 Body Wall

Anterior Abdominal Wall: Internal View
seePlate229
Forumbilicalvessels
Parietal
Diaphragm
pleura
Diaphragmatic Round
fascia ligament
(ligamentum
Falciform
ligament teres)of liver
ano
Peritoneum paraumbilical
(cut edges) vetns
Transversalis tcus
fasciaand Peritoneum
its cut edge
ransversalis
A r c u a t el i n e fascia
Rectus Externaland
abdominis lnternal
muscle oblique
musctes
Inferior
epigastric Transversus
VCSSCIS
abdominis
muscle
Inguinal
Left medial
triangle
(Hesselbach's) umbilical
ligament
Transversalis (obliterated
fascia(cut) leftumbilical
artery)
lnterfoveolar
R i g h tm e d i a l
ligament
u m b i l i c a fl o l d
Deep Median
circumflex umbilical
i l i a cv e s s e l s ligament
(obliterated
Deep
i n g u i n arl i n g urachusa ) nd
paraumbilical
Cremasteric v e i n si n m e d i a n
and pubic u m b i l i c a fl o l d
branchesof
inferior
U m b i l i c a lp r e v e s i c a l
epigastricartery
fascia
Testicularvessels
L a t e r a ul m b i l i c a fl o l d
E x t e r n aill i a cv e s s e l s (containsinferior
Spermaticcord epigastricvessels)
oral nerve
Femoralsheath
Lacunarligament (Cimbernat's) muscle

lliopsoas
Pectinealligament (Cooper's) xternal iliac vessels
I n g u i n afl a l x ( c o n j o i n t e n d o n ) Supravesicalfossa
Transversevesicalfold
U m b i l i c a la r t e r y
(occluded part distalto this point) Obturator internusmuscle
Obturator nerve and vessel6
L e v a t o ra n i m u s c l e
"**r --Brlbourethral (Cowper,s)
gland embedded
Ureter(cut) perinealmuscle
inalvesicle in deeptransverse
Anterior recessof ischioanalfossa Prostateand sphincterurethraemuscle
Superiorvesicalartery U r i n a r yb l a d d e r
Ductus (vas)deferens P e r i n e am
l embrane
Body Wall Plate 253

Posterolateral Abdominal Wall
Serratus
anteriormuscle
lnfraspinousfascia
Rhomboim
d a j o rm u s c l e
Auscultatory
triangle
Lateralcutaneous
branchof dorsalramusof TZ soinal
Medialcutaneous
branchof dorsalramusof TZ spinal
Trapezius
muscle
Latissimu
d so r s im u s c l e
E x t e r n aolb l i q u em u s c l e
fascia(posterior
Thoracolumbar layer)
Lateralcutaneousbranchof
subcostalnerve(ventralramusof T12)
Lumbartriangle(of Petit)
lliaccrest
Lateralcutaneous nerve(11)
branchof iliohypogastric
Superiorclunialnerves(lateralcutaneous
branchesof dorsalramiof L1-13spinalnerves)
overqluteusmediusmuscle
Glutealaponeurosis
Cluteusmaximusmuscle
Latissimus
dorsimuscle
dorsimuscle(cutand turnedback)
Latissimus
Serratus
oosteriorinferiormuscle
Digitations dorsimuscle
of costaloriginof latissimus
Digitations
of costaloriginof externalobliquemuscle
Externalobfique muscle(cutand turnedback)
Tendon of origin of transversusabdominis muscle
Internaloblioue muscle
Lateralcutaneous nerve(ventralramusofTl 2)
branchof subcostal
Lateralcutaneous nerve(Ll )
branchof iliohypogastric
l l i a cc r e s t
Superiorclunialnerves(lateralcutaneous
branches
of dorsalramiof L1-13soinalnerves)
Cluteusmaximusmuscle
4{tr
Plate 254 Body Wall

Arteries of Anterior Abdominal Wall
arterv
Subclavian
Lateralthoracic Internalthoracicarteries
Pericardiaco-
artery
Subscapular phrenic
arterywith
phrenicnerve
*{r
ransversus
thoracis
arterv
Thoracodorsal muscle
anch to falciform
ligamentof liver
Anterior Musculophrenic
intercostal
arteries arteries
Superiorepigastric
arteries
Diaphragm
Transversus
abdominis
muscleand aponeurosis
Anastomoses with lower
intercostal, subcostal, Rectusabdominis
a n dl u m b a r muscles
Internal
Ex o b l i q u em u s c l e
Internal
oblique External
muscres o b l i q u em u s c l e
Transversus
abdominismuscre Posteriorlaverof
rectussheath
Ascendingbranch of
ate line
deep circumflexiliac artery
Inferiorepigastric
Superficial artery
circumflexiliac
Superficialepigastric
Superficial arterv
epigastric
artery
Femoralartery
Femoralartery Superficial
external
pudendalartery
Deepexternal
pudendalartery
Cremasteric andtesticular arteriesof

arteriesand artervto ductus penis (deep to
deferensin spermatic Buck's fascia)
Body Wall Plate 255

Veins of Anterior Abdominal Wall
Subclavian
vein External
Internal
Axillaryvein Anterior
Cephalicvein
Intercostal
tributaries
to axillary
vern
Lateralthoracicvein
Anterior
intercostalveins Axillaryvein
Internalthoracic vein al thoracicvein
Musculophrenic
vei
venousplexus
Superiorepigastric
veins
Perforatin
g tributaries
Thoracoepigastric to internalthoracic
vein
vetn
Paraumbilical
veinsin
roundligamentof liver gastricvein
Thoracoepi
Inferiorepigastric
veins tariesof
paraumbilicalveins
Tributaries
to deep
circumflexiliacveins
Thoracoepigastric
vein
Thoracoepi
gastricvein
Superficial
epigastric
vein
Superficial
circumflexiliacvein al circumflex
iliacvein
Superficialepigastricvein
External
pudendalvein Externalpudendalvein
S a p h e n o u so p e n i n g fascia over
s a p h e n o uosp e n i n g
Femoralvein
saphenousvein
Creatsaphenous
vein
(venous)plexus
Pampiniform Anteriorscrotalveins
Deep dorsal vein of penis

(deep to Buck'sfascia)-
Superficialdorsalvein of penis
Nr
Plate 256 Body Wall
Nerves of Anterior Abdominal Wall
Medial brachial
cutaneous nerve
Intercostobrachial anteriormuscle
Serratus
n e r v e( T 1 , 2 )
External
obliquemuscle(cut)
Long thoracic nerve
Posteriorlayerof
Latissimus
dorsimuscle rectussheath
Anteriorlayerof
rectussheath(cut)
Lateralcutaneous branches Rectusabdominismuscle

of intercostalnerve(T2-11
Transversus
abdominis
muscle
Anteriorcutaneousbranches
nerve(T1-11
of intercostal Internalobliquemuscle
and aponeurosis(cut)
Lateralcutaneous
branch
nerve(T12)
of subcostal Anteriorand lateral
cutaneous branches
nerve(T12)
of subcostal
Lateralcutaneousbranch
nerve(11)
of iliohypogastric Anteriorbranchof
nerve(11)
iliohypogastric
Anteriorcutaneousbranch
nerve(T12
of subcostal i o i n g u i n anle r v e( 1 1 )
External
oblique
Lateralfemoralcutaneous aponeurosis(cut)
nerve(12,3)
Anteriorcutaneous branch
Anterior cutaneousbranch nerve(11)
of iliohypogastric
of iliohypogastricnerve (11
llioinguinn
ael r v e( 1 1)
Femoralbranchesof Cremastericmuscle
genitofemoralnerve (11,2) cord
of soermatic
Anteriorscrotalbranch External
spermaticfascia
o f i l i o i n g u i nn
ael r v e( 1 1 ) of spermatic
cord
Cenitalbranchof
genitofemoralnerve (11, 2)
4{tr
Body Wall Plate 257

Thoracoabdominal Nerves
Spinalnervetrunk
Meningealbranch Erectorspinaemuscle Ventral(anterior)
ramusof spinalnerve(intercostal
nerve)
Spinalsensory Medialbranch, Collateralbranch
(dorsalroot)ganglion
Lateralbranchof Externalintercostal
muscle
Dorsalroot Dorsal(posterior) Internalintercostal
muscle
Ventral rool r
Innermostintercostal
muscle
Latissimus
dorsi
muscle
Subcostal
muscles
Serratus
anterior
muscle
Windowcut
in innermosl Lateral
intercostal
muscl6 cutaneous
branch
Communicating
branch Internal
Internalintercostal intercostal
membranes muscle
anteriorto
Creater and lesser externalintercostal lnnermost
thoracic s p l a n c h n i c muscles intercostal
nerves Collateralbranch muScle
rejoiningintercostal
Sympathetictru
Internal
Cray and white rami communicante! Transversus
abdominismuscle intercostal
muscle
R e c t ua
s b d o m i n im
s uscle External
intercostal
muscte
Lineaalba
External
intercostal
membrane
External
Anteriorcutaneous
branch
*{r
Plate 258 Body Wall
lnguinal Region: Dissections
E x t e r n aol b l i q u e L i n e aa l b a
m u s c l ea n d
aponeurosrs Rectussheath
(anteriorlayer)
A n t e r i o rs u p e r i o ri l i a cs p i n e
Transversalis
Internao
l b l i q u em u s c l e fasciawithin
kut and reflected\ inguinaltriangle
(site of direct
Transversus
abdominismuscle i n g u i n a lh e r n i a )
D e e pi n g u i n arli n g l n g u i n a fl a l x
(in transversalis
fascia) (conjoint
tendon)
Cremastermuscle
(lateralorigin) Reflected
inguinal
InferiorepiBastricvessels ligament
(deep to transversalis
fascia)
I ng u i n a ll i g a m e n t( P o u p a r t ' s ) fibers
L a c u n a rl i g a m e n t( C i m b e r n a t ' s ) External
spermaticfascia
Cremaster
muscle
( m e d i a lo r i g i n ) on spermatic
cord exiting
S u p e r f i c i ai ln g u i n a lr i n g Superficial
L a t e r a cl r u s - i n g u i n a lr i n g
M e d i a cl r u s Fundiform
Pubiccrest l i g a m e n to f p e n i s
Posterior(internal)view
4{tr
Rectussheath(posteriorlayer)
Arcuateline
M e d i au l m b i l i c al il g a m e n t
Anteriorsuperioriliacspine
Transversalis fascia(cutaway)
Rectusabdominismuscle
l l i o p u b i tcr a c t
Inferiorepigastric vessels
i n a l ( H e s s e l b a c h ' st r)i a n g l e
Femoralnerve
enital branch of genitofemoralnerve
and testicularvessels
D e e p i n g u i n a lr i n g
lliopsoasmuscle
Externaliliac vessels
al ring (dilated)(broken line)
L a c u n a rl i g a m e n t( C i m b e r n a t ' s )
Rectinealligament (Cooper's)
Ductus (vas)deferens
anastomosis
Obturator-pubic
Obturatorvessels
Pubicbranches vessels
of inferiorepigastric
M e d i a nu m b i l i c al il g a m e n t
Hesselbach'striangle by Carlos Machado after Frank Netter

Pubicsymphysis
Cryd4/*
Body Wall Plate 259

lnguinal Ganal and Spermatic Gord
Testicularvesselscovered by peritoneum External

obliquemuscle
Testicularvesselsand genital branch of genitofemorai Internao
l b l i q u em u s c l e
Ductus (vas)deferens Transversus

abdominis muscle
Cremastericvessels Transversalis
fasc
Externaliliac vesselscovered by peritoneum Extraperitoneal
fascia(loose
Ductus (vas)deferenscovered by peritoneum connectivetissue)
I n f e r i o re p i g a s t r i cv e s s e l s
Peritoneum
Medialumbilicaligament
( o c c l u d e dp a r t o f u m b i l i c a la r t e r y )
U m b i l i c a lp r e v e s i c afla s c i a
Urinarybladder
R e c t u sa b d o m i n i sm u s c l e
P y r a m i d a l im
s uscle
Medianumbilical
ligament (urachus)
Superficial
i n g u i n a lr i n g s Anterior
supeflor
i l i a cs p i n e
gin of internal
spermaticfascia
from transversalis
fasciaat deep
i n g u i n a lr i n g
llioinguinalnerve
Pubic
symphysis S p e r m au c
(covered by cord
intermingling
fibers of
external Femoral
oblique vessets
aponeurosts)
P u b i ct u b e r c l e Cremastermuscle
and cremasteric
fasciaon
Externalspermaticfascia spermaticcord
e n v e l o p i n gs p e r m a t i c
In g u i n a l i g a m e n t(P o u p a r t ' s )
Inguinalfalx (conjoint tendon)
Intercruralfibers
Plate 260 Body Wall

Indirect Inguinal Hernia
Loop of bowel Ductus(vas)deferens, vessels,

testicular
e n t e r i n gh e r n i a ls a c and genitalbranchof genitofemoralnerve
forming spermaticcord
Neck of hernialsac
Inferiorepigastric
vessels
Origin of
internalspermatic
fasciafrom
fasciaat
transversalis
d e e p i n g u i n a lr i n g
Peritoneum
Extraperitoneal
fascia
fascia
Transversalis
*;';,
D e e p i n g u i n a lr i n g
"?,:',
,
External
spermatic
fascia
Cremaster
muscleand
Superficial fascia
Internalspermatic
fascia
H e r n i a ls a c
Ductus(vas)deferensand
vessels cord
of spermatic
*{r
Body Wall Plate 261
Femoral Sheath and Inguinal Ganal
fascia(cutedge)
Transversalis
Extraperitonealfascia
Parietalperitoneum
Medianumbilicalligament(urachus)
Medialumbilicalligament(occludedpart
of umbilicalarterv)
Inferiorepigastricvessels
Deepcircumflexiliacvessels
Testicularvessels
teric artery
Ductus(vas)deferens
Externaliliacvessels
Pubic(obturatoranastomotic) vessels
Externalobliqueaponeurosis (cut)
Internalspermatic fasciaon spermatic
cord
Femoralnerve(deepto iliopsoas fascia)
Femoralvessels in femoralsheath
Falciformmarginof saphenous
opening
(cutand reflected)
Ureter
Cenitofemoral nerve
Urinary
bladder
Pectineal
ligament
(Cooper's) Transversalis
fasciaforms
Lacunar anteriorwall of
ligament femoralsheath
(Gimbernat's) (posteriorwall
formedby
Inguinal iliopsoasfascia)
ligament
(Poupart's
Lateralfemoralcutaneous
lliac fascia
Cenital branch of genitofemoralnerve
Femoralbranch of genitofemoral
Testicular
vessels
Externaliliac
Inferior epigastric
Ductus(vas)deferensandcremasteric
a
Pectinealligament (Cooper's
Femoralring
Transversalis fasciaforms
*{r anterior wall of femoral sheath

L a c u n a rl i g a m e n t( C i m b e r n a t '
I n g u i n al il g a m e n(tP o u p a r t ' s
Lymphnode(Cloquet's) in femoral
Femoralsheath(cutopen)
Pectineal fascia
Plate 26.2 Body Wall

Posterior Abdominal Wall: Internal View
Cavalopening
Diaphragm
tendonof diaphragm
andvagaltrunks
crusof diaphragm
Leftcrusof diaphragm
Medianarcuateligament
Aortaandthoracicduct
and least
; lesser,
nerves
thoracicsplanchnic
Medialarcuateligament
Lateralarcuateligament
trunk
Sympathetic
Quadratuslumborum
muscle
minormuscle
majormuscle
abdominis
Transversus
muscle
obliquemuscle
Internal
obliquemuscle
External
lliacusmuscle
iliacspine
superior
muscle
Piriformis
(ischiococcygeus)
muscle
ligament(Poupart's)
internusmuscle
muscle
Rectococcygeus
Tendinous archof
levatorani muscle
Openingfor femoralvessels
ligament(Cooper's)
Pectineal
Lacunarligament(Cimbernat's)
Pubicsymphysis
trochanterof femur
Lesser
membrane
Pubictubercle
Urethra
*{r
Body Wall Plate 263
Arteries of Posterior Abdominal Wall
Inferior phrenic Recurrent

branch Superiorsuprarenal
arteries
esophagus
Celiactrunkwith commonhepatic, $iddle suprarenal
artery
leftgastric,
and splenicarteriel
Superiormesenteric
Superiorsuprarenal
arteries artery
Middlesuprarenal
artery Inferiorsuprarenal
artery
lnferior
suprarenal
artery Leftrenalartery
Right (ovarian)
Testicular
renalartery arteries
Psoasmajor Abdominalaorta
muscle(cut) mesenteric
artery
Quadratus
lumborum Leftcolic artery
muscle
arteries
Subcostal
artery
Superiorrectal
1stto 4th right artery
lumbararteries
Common
iliacarteries
Mediansacral
lliolumbar artery
artery Internaliliac
artery
Superiorgluteal
artery
Lateral
sacralarteries
External
iliac artery
Umbilical(patent
Testicular part)arterygiving
(ovarian)
artery riseto superior
vesicalarteries
Ascending
branch of-
qeep Obturatorarterv
circumflex Inferiorvesical
iliacartery arteryand arteryto
Superficial ductusdeferens
circumflex Middlerectal
iliacartery
artery
lnferior Internalpudendal
epigastric artery
artery
Inferiorgluteal
Pubic, artery
Cremasteric
branchesof inferior
epigastric
artery
Transversalis
Superficial artery(cua)
epigastric fascia(cut)
Femoralartery
Ductusdeferensand testicular
artery(cut)
externalpudendalarteri
Superficial Medialumbilicalligament
(occludedpartof umbilical
4{F
abdominalwall
Deepexternalpudendalartery (turned down) artery)
Plate 264 Body Wall

Veins of Posterior Abdominal Wall
lnferiorphrenic Diaphragm Hepatic veins
lnferior vena cava Esophagus
Right inferior
veinsand
Leftsuprarenal
s u p r a r e n avl e i n anastomosiswith inferior
phrenicvein
Right renal vein
Leftrenalvein
Psoasmajor
Ovarian(testicular)
muscle (cut)
verns
Quadratus Ascending
l u m b o r u mm u s c l e l u m b a rv e i n s
vein
Subcostal iliac
vetn
l st to 4th right
lumbar vei Internaliliac
vetn
l l i o l u m b a rv e i n
Superiorgluteal
Common vetn
i l i a cv e i n
nferiorgluteal
Ovarian veln
(testicular)
v e i n sa n d lnternal
ureter(cut) pudendal vein
Internal iliac
External
i l i a cv e i n vetn
Median
Middlerectal
sacralvein
veln
Uterinevein
Lateral
sacralvei
Superiorvesical
vern
Deepcircumflex
i l i a cv e i n
Deep circumflex
iliacvein
Superficial
circumflex Obturatorvein
i l i a cv e i n
lnferior of uterus
epigastricvein
(cut)
Inferiorepigastric
vetn
Superficialepigastricvein (cut)
tal venous
plexus
Pubic (obturator anastomotic)vein
Uterovaginalvenous
Femoralvein plexus
4{tr vein
Creatsaohenous
pudendalvein
External
Anteriorabdominal
wall fturned down)
Vesicalvenousplexus
Body Wall Plate 265

Lymph vessels and Nodes of posterior Abdominal wall
Thoracicduct
R i g h st u b c l a v i at n
runk
Tracheobronchialnodes
Inferiorphrenicnodes
Thoracicduct
Celiac
nooes
Cisternachyli
Superior Visceral
mesenteric (preaortic)
R i g h ltu m b a trr u n k nodes lymph
nodes
lnferior
Intestinal
trunk mesenteric
node
Leftlumbartrunk Lumbarnodes
(lateralaorticnodes)
Common iliac nodes Common iliac nodes
Internaliliacnodes
Middle sacralnodes
External
iliacnodes
Lateralsacralnodes
Superficial
inguinal
Inferior nooes
epigastric (superior,
OOO- horizontal,
and
inferior
Node of Cloquet, lverticall
- groups)
or Rosenmi.iller
(highestdeep
i n g u i n anl o d e )
Deep
inguinal
nooes
n{r
Plate 266 Body Wall
Nerves of Posterior Abdominal Wall
Creater,lesser,
and least
Celiac,superiormesenteric,
nerves
thoracicsplanchnic and aorticorenalganglia
trunks
Sympathetic nerve(11)
lliohypogastric
llioinguinalnerve (Ll)
nerve(T12)
Subcostal
Muscularbranches
from lumbarplexus
lliohypogastricnerve
(L 1 ) nerve(T12)
Subcostal
llioinguinal Psoasmajor
n e r v e( L l muscle(cut)
Cenitofemoral
Quadratus
lumborum
n e r v e( L 1 , 2 ) muscle
Transversus lliohypogastric
abdominis nerve(11)
muscle(cut)
llioinguinal
Subcostal n e r v e( 1 1 )
nerve (T1
and its Cenitofemoral
lateral n e r v e( L 1 , 2 )
cutaneous
branch Lateralfemoral
cutaneous
Intermesenteric
nerve(L2,3)
(paraaortic) Femoralbranch,
plexus Cenitalbranch
of genitofemoral
Crayand n e r v e( L 1 , 2 )
white rami
communicantes Lumbosacral
trunks(14,5)
Obturatornerves
Accessorvobturator
nerve(13,4) (occasional)
Lateral Femoralnerve
femoral
cutaneous plexus(14-54)
nerve
(L2,3\
Femoral nerve(S2,3, 4)
Pudendal
nerve
(L2-L4)
Obturatornerve(12,3, 4)
Anteriorcutaneous branchof iliohypogastric nerve(11)

'Anterior
*{r
scrotal(labial)branches nerve(L.l)
of ilioinguinal
Body Wall Plate 267

Regions and Planes of Abdomen
Right Left
lateralrectusplane lateralrectusplane
( s e m i l u n al irn e ) ( s e m i l u n al irn e )
Righthypochondrium Left
(hypochondriac
region hypochondr
Umbilical region
Leftflank(lumbar
region)
Rightflank(lumbarregion)
.Et9$g!9tc!elplaE
nous Dlane
Rightgroin(inguinalregion eft groin(inguinal

region)
Pubic(hypogastric
region)
Plate 268 Peritoneal Gavity

Greater Omentum and Abdominal Viscera
Falciformligament
Left lobe of liver
Right lobe of liver
Stomach
Callbladder
Creater omentum overlYing

transverse colon and small
i n t e s t i n e( j e j u n u ma n d i l e u m )
Createromentum(turnedup)
colon(turnedup)
Transverse
Transverse
mesocolon
Left colic (splenic)fle
R i g h tc o l i c ( h e p a t i c )f l e x u r
S m a l li n t e s t i n e( l e j u n u ma n d i l e u m )
A s c e n d i n gc o l o n
Cecum
S m a liln t e s t i n(ec o v e r i ndge s c e n d i ncgo l o n )
S i g m o i dc
U r i n a r yb l a d d e r 4{v
Peritoneal Gavity Plate 269
Mesenteric Relations of Intestines
Transverse
colon (e/evated)
Transversemesocolon
S u p e r i odr u o d e n af lo l d
Superiorduodenal fossa
Left colic (splenic)flexure
Paraduodenalfossa
Inferior duodenal fossa
I n f e r i o rd u o d e n a lf o l d
Mesentericoparietalrecess(fossa)
Superiormesenteric artery
in root of mesentery
ferior mesentericartery and vein
A b d o m i n a la o r t a
Esophagus
R i g h tc r u s o f d i a p h r a g m
( p a r tp a s s i n gt o r i g h t
of esophagealhiatus)
(part passingto left
of esophagealhiatus)
Left crus of diaphragm
Exposureof suspensory Celiac trunk

muscleof duodenum Suspensorymuscle of
(ligamentof Treitz) d u o d e n u m( l i g a m e n o
tf
Treitz)
Superiormesentericartery
Duodenojejunalflexure
e n d i n g( 4 t h ) p a r t
of duodenum
Jejunum
Inferior (horizontal,or
4{tr 3rd) partof duodenum

D e s c e n d i n g( 2 n d ) p a r t
of duodenum
Pfate 27O Peritoneal Gavity

Mesenteric Relations of Intestines (continuedl
colon
ransverse
(e/evated)
mesocolon
Creater (e/evatedover pancreas\
omentum
(e/evated)
fejunum(cut)
Freetaenia
(taenialibera) Mesentery(cutand
smallintestineremoved)
Omental
(epiploic)
append eft colic(splenic)
flexure
Rightcolic
(hepatic)
flexure
Rightparacolic Leftparacolicgutter
gutter
Ascending Sigmoidmesocolon
Terminalpartof
i l e u m( gmoidcolon
Cecum
Retrocecal
recess
Vermiform
appendix
*{r Sigmoid colon (reflected)
Sigmoid mesocolon
Intersigmoid
Parietal
peritoneum
Commoniliacvessels
Peritoneal Gavity Plale 271

Omental Bursa: Stomach Reflected
Inferior vena cava (retroperitoneal) Castro-omental(gastroepiploic)arterialanastomosis(enclosed

in gastrocolicligament)
Common hepatic artery
(in peritonealfold) Stomach(posteriorsurface)
Hepatoduodenalligament Caudatelobeof liver

(right margin of lesseromentum)
in superiorrecessof omentalbursa
Probe in omental Left gastricartery (in gastropancreaticfold)
(epiploic)foramen
Leftinferiorphrenicartery
Callbladder (retroperitoneal)
Castrophrenicligament
Diaphragm
Leftsuprarenalglandand superior
Liver poleof kidney(retroperitoneal)
stro-
splenic
(gastro-
lienal)
ligament
Spleen
R i g h tc o l i c
(hepatic)flexure Left colic (splenic)flexure
Kidney(retroperitoneal) ligament
(2nd)partofduodenurh S p l e n o r e n a(ll i e n o r e n a ll)i g a m e n t

Descending
Tailof pancreas(intraperitoneal)
Rightgastro-omental(gastroepiploic)
artery(coveredby peritoneum)
I Posteriorlayers | ^,
Anteriortry"r, iiril I of Sastrocolic
ligament
A n t e r i osr u p e r i opr a n c r e a t i c o -
duodenal artery (retroperitoneal) Transverse
mesocolon
Head of pancreas(retroperitoneal) Body of pancreas(retroperitoneal)
Nr
Plate 272 Peritoneal Gavity
Omental Bursa: Cross Section
Vertebralbodyof L1
R i g h tk i d n e y Left kidney
Parietal
perttoneum
C r e a t e ro m e n t u m
Visceralperitoneum (cut edges)
O m e n t a l( e p i p l o i c ) / Stomach
foramen (of Winslow)
Pancreas
( C o m m o n )b i l e d u c t
Portal O m e n t a l b u r s a( l e s s e sr a c )
Nr
Hepatic portal vein
triad
r m e n t u m( h e p a t o d u o d e n a l
L e s s eo
Proper hepatic artery and hepatogastricligaments)
Peritoneal Gavity Plate 273

Peritoneum of Posterior Abdominal wall
Inferiorvena cava Abdominal aorta and celiac trunk

( C o m m o n )b i l e d u c t a n d
F a l c i f o r ml i g a m e n t
proper hepatic artery
Hepatic
C o r o n a r yl i g a m e n to f l i v e r VCINS Superiorrecessof omental bursa (lessersac)
R i g h st u p r a r e ngal a n d Attachment of lesseromentum and
O m e n t u m ( e p i p l o i c )f o r a m e n left gastricartery
behind right free margin \
Esophagus
o f l e s s e ro m e n t u m Left triangular
ligament
R i g h tt r i a n g u l a r of liver
ligament---1
Castrophrenic
Attachment
l i g a m e n ta n d
of transverse
left inferior
mesocolon
phrenic artery
and right
gastro-omental t gastflc
(gastro- vessels
epiploic)
vessels Splenorenal
(lienorenal)
Duodenum l i g a m e n ta n d
R i g h tk i d n e y splenicvessels
Parietal Phrenicocolic
peritoneum ligament
Pancreasand
splenicartery
(retroperitoneal)
Root of
mesentery Attachment of
transverse
Site of
meS0colon
ascending
colon Superior
Common iliac mesenteric
artery (retro- vessels
peritoneal)
Siteof
Externaliliac descending
artery (retro- colon
peritonea
Attachment of
Testicular sigmoid
v e s s e l(sr e t r o - mesocoton
peritoneal) and sigmoid
vessets
Ureters(retro-
peritoneal
Superior
Siteof deep rectal vessels
i n g u i n a lr i n g
Sacrogenital
Median fold (ligament)
umbilical
fold Lateral
(contains u m b i l i c a fl o l d
uracnus) (contains
inferior epi-
gastricvessels)
Medial
u m b i l i c a fl o l d
Nr (contarns
occluded part
of umbilical
artery)
Plale 274 Peritoneal Cavity

Stomach in Situ
Leftlobeof liver ligament )

Hepatoduodenal
omentum
I Lesser
ligament,
Hepatogastric
Falciform
ligament Abdominalpart notch(incisure)
Cardiac
of esophagus
Fundusof stomach
Round
ligament Diaphragm
ofl
(obliterated
umbilical
vein)
lnferior
border
of
Quadrate
lobeof
liver
Riehtlobe
ofliver.-
Gallbladder
Omental
(epiploic)
fora
(of Winslow)
Pylorus
Duodenum
Rightkidney
(retro-
peritoneal)
*{r
Rightcolic
(hepatic)
flexure
createromentum Leftcolic(splenic)
flexure
Variationsin
positionand
contour of
stomachin
relationto
bodv habitus
Hypertonic stomach Orthotonic stomach Hypotonic stomach Atonic stomach
Viscera (Gutl Plate 275

Mucosa of Stomach
SeeatsoPhe 236
Z i g z a g( Z ) l i n e
(junction of gastric
and esophagealmucosa)
Cardiacorifice
Gastricfolds(rugae)
Pyloricorifice Gastriccanal
(magenstrasse)
S u p e r i o(r1 s t )p a r t
of duodenum Pylorus
( a m p u l l ao,r
d u o d e n a lc a p )
Castric and
fundic zones
Pyloriczone
4{F
Surfaceepith e l i a l
e1
M u c o u sc e l l
Parietal cell
(betweenmucouscell
a n dc h i e fc e l l )
S o l i t a r yl y m p h f o l l i c l e( n o d u l e )
N e u r o e n d o c r i n eC c e l l
Muscularis
Submucosa Castric (fundic)glands
Plate 276 Viscera (Gutl

Musculature of Stomach
muscleof esopha
Longitudinal
Outerlongitudinalmusclelayerof stomach
(concentratedchieflyat lesserand Sreater
curvaturesand at pyloric part)
Middlecircularmusclelaverof stomach
4{tr
Collarof Helvetius
(middlecircularand
i n n e r m o sotb l i q u e
fibersblendhere)
Outer longitudinalmuscle
layer(cutaway)
Section Middlecircular
through musclelayer
pylorus
(composeo lnnermost
chieflyof obliquemuscle
thickened layer
circular
muscle)
Circularmuscle
of duodenum
Longitudinal Windowscut in
m u s c l eo f d u o d e n u m m i d d l ec i r c u l a r
musclelayer
Viscera lGutl Plale 277

Duodenum in Situ
Head of pancreas Suprarenal

gland
Superiormesentericvessets Kidney
Celiactrunk Transverse mesocolon

and itscut edges
Splenicartery
Rightfreemarginof lesser colon (cut)
Transverse
omentum(hepatoduodenal ligament) Leftcolic
(splenic)
flexure
Suprarenal
gland
Pylorus
Ki
Transverse
mesocolon
and its
cut edges
Right
colic
(hepatic)
flexure
Transverse
colon(cut)
Ascending
colon
Psoas
maJor
muscle
S u p e r i o(r1 s t )p a r t
Descending
colon
Descending(2nd) part
Duodenum Inferiorduodenalfold andfossa
Inferior (horizontal,
or 3rd)part Duodenojejunal
flexureandjejunum(cut)
Ascending
(4th)par Inferiormesenteric
artery
Rootof mesentery(cut edgei)
Abdominalaorta
Inferiorvena cava
4{r
Mucosa and Musculature of Duodenum
Hepatic portal vein Properhepaticartery
( C o m m o nb) i l ed u c t artery
troduodenal
Rightgastricartery
Rightfreemarginof lesser
omentum(hepatoduodenal ligament) Commonhepaticartery
Pyloricorifice
Superiorduodenal (Common)bileduct
S u p e r i o(r1 s t )p a r t Accessorypancreatic
( a m p u l l ao,r duct (of Santorini)
duodenalcap)
(no circularfolds)
(Principal)pancreatic
duct (of Wirsung)
Descending
(2nd)part
Minor duodenal
papilla (inconstant flexure
Duodenojejunal
Circularfolds
(valves
of Jejunum
Major duodenal
papilla(of Vater)
(4th)part
Ascending
Head of pancreas
mesentericartery and vein
Inferiorduodenalflexure
Inferior(horizontal,
or 3rd)part
Outer
longitudinal
musclelayer
(with window
cut)
lnner
circular
muscle
layer
(with Laversof
window dubdenalwall Barium radiograph of stomach,
-proximal
cut) duodenum, and jejunum
B Bodyof stomach
Submucosa
D Duodenalcap (1st part)
with duodenal
(Brunner's) D 2 D e s c e n d i n(g2 n d )p a r t
glands of duodenum
F Fundusof stomach
I Proximal jejunum
*{r P Pylorus
PA Pyloricantrum
Viscera lGutl Plate 279

Mucosa and Musculature of small Intestine
fejunum
Mesentery
A n a s t o m o t i cl o o p
( a r c a d e )o f
jejunal arteri
Straightarteries
(arteriaerectae)
Serosa(visceral
pefltoneum)
Longitudinal
m u s c l el a y e r
Circular
m u s c l el a y e r
Barium radiographof jejunum
Submucosa
Mucosa
C i r c u l afro l d s
(valves of
Kerckring)
Solitary
l y m p h o i dn o d u l e
lleum
Mesentery
Anastomotic loops
(arcades)of
ileal arteries
Straightarteries
(arteriaerectae
Serosa(visceral
pefltoneum)
Longitudinal
musclelayer
Circular
musclelayer Barium radiographof ileum
Submucosa
Mucosa
Circularfol
S o l i t a r yl y m p h o i dn o d u l e s
Aggregatelymphoid
n o d u l e s( P e y e r ' sp a t c h e s
4{tr
Plate 28O Viscera (Gutl

lleocecal Region
lleocolicartery
-Colic branch
llealbranch
Superiormesentericartery
Posteriorcecalarterv
artery
Appendicular
Anteriorcecalartery
Vascularfold of cecum
uoeriorileocecalrecess
lleocecalfold (bloodlessfold of Treves)
Terminalpartof ileum
Inferiorileocecalrecess
Appendicular
artery
Vermiformappendix
Freetaenia
(taenialibera)
External
iliacvessels
(retroperitoneal)
Retrocecalrecess
Cecalfolds
Rightparacolicgutter
Omental taenia
*{r Posteriorcecal
Cecalfolds
Somevariationsin posteriorperitonealattachmentof cecum
nesof
Viscera (Gutl Plate 281

lleocecal Region (continuedl
Free taenia (taenia libera)
Ileocecallips:labialform of ilealorifice
(asseencommonlypostmortem
and occasionally in vivo)
Terminalpartof ileum
Orifice of vermiform appendix
Freetaenia
(taenialibera)
Vermiform appendix
Circularmuscleof colon
Mesocolic taenia
Fibersto papilla
Fibersto ileum
Fibersaround ileocecaljunction
C i r c u l am
r u s c l eo f i l e u m
llealpapilla:papillary
formof ilealorifice
(found.mostcommonly
In vtvol
Schemaof musclefibersat ileal orifice

4{F
Vermiform Appendix
of unusually
Bariumradiograph long
appendix(A Appendix;C Cecum)
Variationsin position of appendix
Mesoappendix
(visceral
peritoneum)
o n g i t u d i n aml u s c l e
Circularmuscle
4{tr

Mucosa and Musculature of Large Intestine
Forrectum seeplates391-396
andanalcanal
Creater omentum (cut away)
R i g h tc o l i c Transversemesocolon
(hepatic)flexure
Transversecolon
Omental taenia
Omental
(epiploic)
appendices
Haustra
Peritoneum Peritoneum
(cut away) (cutaway)
Omental
taenia Descending
(exposed colon
by hook
Freetaenia
(taenialibera)
Ascending Mesocolic
coton taenta
(exposed
S e m i l u n af or l d s by hook)
R e c t o s i g m o i jdu n c t i o n
(taeniaespreadout and Freetaenia
(taenialibera)
unite to form longitudinal
musclelayer)
lleal
orifice
Vermiform appendix
Levatorani muscl
Nr
Externalanal sphinctermuscle

Sigmoid Golon: Variations in Position
obliquelyinto pelvis
Short,straight,
*{r
Looping to right side Ascendinghigh into abdomen

Topography of Liver
Lateralrectus Transpyloric
( s e m i l u n a rp) l a n e plane
Diaphragm
Liver
covered by
diaphragm,
p l e u r aa n d
rung
(percussion
duliness)
Diaphragm
Liver
covered by
diaphragm
and pleura
(percussion
flatness)
Liver
Liver coveredby
covered by diaphragm,
diaphragm p l e u r aa, n d
(percussion rung
flatnessor (percussion
intestinal dullness)
resonance)
Liver
covered by
diaphragm
and pleura
(percussion
flatness)
Nr Livercovered Livercovered
bydiaphragm, by diaphragm
preura, and pleura
a n dl u n g (percussron allbladder
(percussion flatness)
Diaphragm lnferior border of liver
d ul l n e s s )
Plate 286 Viscera (Accessory Organsl

Surfaces and Bed of Liver
Diaphragm(pulled Coronaryligament
ligament
Lefttriangular
Right
Fibrousappendixof liver
triangular
ligament
Leftlobe of liver
Rightlobe
of liver- ligament
Falciform
Roundlieament(ligamentum teres)of liver

(obliteraiedumbiliial vein)formingfree
Costal borderof falciformligament
Anteriorview
*{r
Portahepatis
teres
for ligamentum
Fissure
C o l i ci m p r e s s i o n Hepaticportalvein
Roundligamentof liver hepaticartery
process
Callbladder process
Papillary
Caudatelobe
Quadratelobe
Fissurefor
Duodenal venosum
ligamentum
R e n ailm p r e s s i sophageal
Cysticduct rmpresslon
Common hepatic duct Castricimpression
ligament
Righttriangular
Hepatorenal portionof
coronary ligament
impr
Suprarenal
Bare area
lnferior vena
Coronary
Hepatic veins ligament Lefttriangular
ligament
Visceralsurface
ligament
Coronary
Barearea
lnferior vena cava
Suprarenalgland
Rightkidney
Left
triangular R i g ht r i a n g u l a r
ligament ligament
for
Fissure Superiorrecess
ligamentum of omentalbur
venosum
Duodenum Stomach
Croove for (inferior)vena
Posteriorview Bedof liver
Viscera (Accessory Olgansl Plale 287

Liver in Situ and Variations in Form
Roundligament(ligamentum teres)of liver Leftlobe of liver

(obliterated
umbilicalvein)
Quadrate Caudatelobeseenthroughlesser
Callbladder omentum(hepatogastric
ligament)
Rightlobeof liver
cut in lesseromentum
(hepatoduodenal ligament)
Omental Properhepaticartery
(epiploic)
foramen (Common)bileduct
(of Winslow)
portalvein
Kidney Lesser
(retro-
omentum
peritoneal) (hepatogastric
ligament)
Duodenum Spleen
Leftcolic
(splenic)
flexure
Rightcolic
(hepatic)
flexure
*{r
Variationsin form of liver
Completeatrophy
Verysmallleft of leftlobe Transverse, "saddlelikd'liver,
lobe,deepcostal (leftportalvein relativelylargeleft lobe
impressions compression)
Verydeep renal
impressionand
'torsetconstriction"
Plate 288 Viscera lAccessory Olgansl

Liver Segments and Lobes: Vessel and Duct Distribution
Anatomicf- Rightlobe Leftlobe

6b;; l Divisioninto segments is
Right(partof) liver Left(partof) liver basedupon ramificationsof
bile ductsand hepaticvessels.
Functional It doesnot entirelycorresPond
surgical Lateral Medial division
Medial Lateraldivision with divisioninto anatomiclobes.
segments division division
Posterior
lateral
seBment
(vil)
(Posterior Parietal
supenor surface
area)
Right Rightlobe
anterior
lateral
segment
(vt)
(Posterior
inferior
area
Visceral
surface
4{F
Distributionof vessels
and ducts
I Rightbranch
2 Left branch
3 Anteriorsegment
4 Medialsegment
D Posteriorsegment
6 Lateralsegment
7 Anteriorinferiorarea
8 Medialinferiorarea
9 Anteriorsuperiorarea
10 Medialsuperiorarea
11 Posteriorinferiorarea
12 Lateralinferiorarea
13 Posteriorsuperiorarea
t4 Lateralsuperiorarea
Phantomdivision Commonhepaticduct,hepaticportal l5 Caudatelobe
betweenanteriorand Inferiorvenacavd vein,and properhepaticarterY (rightand left)
posteriorsuperiorareas 16 Caudateprocess
Viscera lAccesso;y Organsl Plate 289

lntrahepatic vascutar and Duct systems
H e p a t i cv e i n
S u b l o b u l avre i n
o b u l a rv e i n s
Portal
triad
Portal triads
Properhepaticartery
Perivascular
fibrous(Clisson,s) Hepatic portal vein
capsuleextendinginto porta
hepatisalongvesielsa'jd bileduct C o m m o n h e p a t i cd u c t
Portaltriad
to hepatic vein
Normallobularpatternof liver 4{tr

Plate 29O Viscera (Accessory Olgansl
Liver Structure: Schema
Connective
tissue Lymphvessel
Limiting
plate Centralvein
of portal space
vein (tributary
Sublobular to hepaticvein)
Periportal
space(of Mall)
spaces(of Disse)
Perisinusoidal
Centralvein
Sinusoids
Centralvein
Periportal
bileductule
(canalof
Branchof
portal vein
Bileduct
Branchof
hepaticartery
Portalarteriole
Periportal
arteriole bileductule(cholangiole)
Intralobular
Central vein
Intralobular
arteriole bileductule(canalof Hering)
Periportal
Inletvenule
Distributing
vein
4{tr
Viscera (Accessory Organsl Plate 291

Intrahepatic Biliary Systems: Schema
l l i l , ' , . rn . r l i tu l i
Si r ru s o i c i
&.1'
$
#
I n l t , r l , r, tl r l , rIrr r l l r l r r rl L r l r , r ,J r , , l ,rr, r; j , , 1 , . ( ,
N o l r . ; l r r t l t e . t l r o v r ,i l l u s l r . r t i o r r ,
l r i c r . l r . r l r cu l i , r 1 t p r ' , rars
: l t . t rlrr r r l sr r i l l rr r , r l l , , r lt l r r . i r
o , , rn l l o t t e \ ( , r ,i t \ r l t o t t n l r l r t l
, t c lr r , r i l t , ,st l t e ' ri . t l i z , r l r o O
r tl
- t r ' l ' { t s r , r l ' r . , . , - , , t r { 1 , , ri i | r
l i v t ' r p . r r r , n lr t l r n a l r r ' l l s .
(, ic?
4{tr .::' '' i'\

d)
L o w - p o w e rs e c t i o n o f l i v e r

s
o TransverseSection: Level of T1 0, Esophagogastricfunction
o
o
rt
ql
,-'
D
o Diaphragm Xiphoidprocess
o
o
o
o R e c t u sa b d o m i n i sm u s c l e Costal cartilages
o
! o
o
o ju nction
Esophagogastric 5
rt
|o
o
3
ql
R i g h tc r u s o f d i a p h r a g m Castric folds (rugae)
3
ql
-o
(forming right boundary t
II
of esophagealhiatus)1
o
lnferior vena cava
F u n d u so f s t o m a c h
o
rt
o
Right crus of diaphragm o
Serratus
(forming left boundary of
esophagealhiatus)
o
a n t e r i o rm u s c l e to
o
Azygos vein
Thoracic aorta o
t
IT
o
Left crus of =
Diaphragm diaphragm
o
rh
Latissimusdorsi muscle Spleen

r
c
I n f e r i o rl o b e o f r i g h t l u n g i n lnferior lobe of left lung in o
costodiaphragmaticrecess costodiaphragmaticrecess 3
o
f
! Bodyof T10 vertebrS Erectorspinae muscle
!t
!r
rf rl
o Thoracic duct
.{
N d
o
gf
cryd4# 0
Gallbladder and Extrahepatic Bile Ducts
Right and left Rightand left hepaticarteries

h e p a t i cd u c t s
Properhepaticartery
Common
hepatic ducl
Anteriorlayerof
Cystic lesseromentum(cutedge)
artery
Rightgastricartery
Cystic duct
ommon hepatic artery
Hepatic
p o r t a lv e i n
Gastroduodenal
artery
Liver
Stomach
(Common)
bileduct
Callbladder
S u p e r i o(r1 s t ) Hepaticducts
partof
duodenum t Left
Transverse Cysticduct
colon (cut)
Spiral Smooth
Head of fold par!
pancreas
Common
hepatic
4{tr (Hartmann's
pouch)
duct
Cland
orifices
Callbladder
(Common)
bileduct
Descending
( 2 n d )p a r t o f
duoden
Hepatopancreatic
ampulla (of Vater)
M a j o r d u o d e n a lp a p i l l a( o f V a t e r

Junction of (Gommonl Bile Duct and Duodenum
(Common) bile duct

( d u c t u sc h o l e d o c h u s )
Minor Longitudinalmuscle
duodenal of duodenum
papilla Longitudinal
ircularmuscle
duodenal
of duodenum
muscteseen
Circular
through Pancreaticduct
folds
openrng
in circular Sphincterof (common)
Major muscle bile duct (choledochus)
duodenal o n g i t u d i n ablu n d l e
papilla Reinforcing
fibers Sphincterof pancreatic
Longitudinal duct (inconstant)
fold Fibersto Reinforcing
fibers
longitudinal
bundle Duodenalmusclefibersto
longitudinal
bundle
Interior of descending Sphincterof hepatopancreatic
(2nd)part of duodenirm ampulla
( C o m m o n )b i l e d u c t D u o d e n am
l ucosa
Pancreas Sphincterof
( c o m m o n )b i l e
L o n g i t u d i n aIl D u o d e n a l
Circular I muscle L o n e i t u d i nbaul n d l e
Pancreatic
D u o d e n am
l uscle
L o n g i t u d i n abl u n d l e Pancreas
S p h i n c t e ro f ( c o m m o n )
bileduct (choledochus)
( C o m m o nb) i l ed u c t
Pancreaticduct
of
Sphincter
Fibersto hepatopancreatic
longitudinb
aul ndle ampulla
Sphincterof pancreatic L o n g i t u d i nbaul n d l e
duct (inconstant)
Pancreaticduct
S p h i n c t eorf
hepatopancreatic ion, level B
ampulla
Sphincterof
hepatopancreatic
Major
d u o d e n a lp a p i l l a
ampulla
Reconstruction
Hepatopancreatic
ampulla
Variationsin union of bile and pancreaticducts (common
channel)
(Common) f (Common;
b i l ed u c t I bileduct
Pancreatic Pancreatic
duct duct ncter of
ampulla
tncter Duodenal
of ampulla
Short common
watl
No common L o n gc o m m o n
4{tr
channel channel channel
Viscera (Accessory Olgansl Plate 295

Variations in Gystic and Hepatic Ducts
Variationsin cysticduct
Adherentto Highunion
common with common
hepaticduct hepaticduct
Anteriorspiral
, o r n r n cgo m m o n
hepaticducton
left side
Accessory(aberrant)hepatic ducts

s
o TransverseSection: level of T12, Inferior to Xiphoid
o
o
rt
!f
A
D Pyloric canal
o
o
o
o
o
o
- Right colic (hepatic)flexure of colon o
Transversecolon
(ascendingto left colic flexure)
o
o 5
rt
to
Gallbladder o
!l 3
= Superior(.1st)part ll
o
Y
of duodenum t
IT
o
Hepatoduodenal
ligament
o
rt
D e s c e n d i n gc o l o n o
(descendingfrom left o
colic flexure) o
o
Spleen
o
(Common)
o
b i l ed u c t Splenicartery and vein !i.
Proper
o
hepatic Left suprarenalgland
5
Portaltriad
anery o
+
Superiorpoleof
Portal leftkidney D
r
Inferiorvena cav c
o
Right suprarenalgland Thoracic aorta 3
o
Pancreas
Rightcrusof diaphragm
5
!ql ll
t t
o {
N -
o cr7# N
{
\
Pancreas in Situ
C e l i a ct r u n k Splenicartery
Stomach (cut)
Portal
triad( Proper
heparrc
I
( ( C o m m o n )b i l e
Right free margin of lesseromen
Suprarenalgla
Duodenum
R i g h tk i d n e y
(retroperitoneal)
Attachment
of transverse
mesocolon
R i g h tc o l i c
(hepatic)
flexure
Transverse
colon (cut)
Transverse
colon (cut Left kidney (retroperitoneal)
Attachment of
transversemesocolon
Inferior mesentericvein
(retroperitoneal)
Middlecolicarteryandveifi
Superiormesentericartery and veir{
Uncinate processof panc

Duodenofejunal
Root of mesentery(cut)
flexure
4ttr
Low-power
section
of pancreas
Pancreaticnotch
(of Langerhans)
Pancreaticduct
n t e r l o b u l adru c t (ofWirsung)
Interlobula
ser ptum
y pancreaticduct (of Santorini)

Spleen
Posterior ligament
Castrosplenic Posterior
extremity extremity
Superior
Short
gastric
vessels Castric
impression
Renal
impression Hilum
lnferior
border
Splenorenal
(lienorenal)
ligament
Splenicartery
Leftgastro-omental
(gastroepiploic)
vessels
Splenic
Colic
Anteriorextremi
Diaphragmatic
Visceralsurface surface Anteriorextremitv
Shortgastricvessels
Stomach(cut)
Serosa(visceral
S p l e n ip
culp
Splenic
trabeculae
Splenicvein
Crosssection gland
Suprarenal
Splenicarteryand
Splenorenal(lienorenal)
ligament
*{r Attachmentof transversemesocolon(cut)
Spleenin situ
Viscera (Accessory Organsl Plate 299

Arteries of Stomach, Liver, and Spleen
Right and left inferior phrenic arteries Left gastricartery

A b d o m i n a la o r t Splenicartery
Celiac trunk
Esophagealbranch of left gastricartery
Lefthepaticartery
Recurrentbranch of left inferior
Right hepatic artery phrenic artery to esophagus
Short
gastric
arteries
Cystic
artery
Cystic
duct
Proper
hepatic
artery
(Common;
bileduct
Hepatic
portal vein
Right
gastric
artery
Supra-
duodenal
artery
*{ry
S p l e n i cb r a n c h e so f
C o m m o n h e p a t i ca r t e r v splenicartery
Posterior superior,
A n t e r i osr u p e r i o r Right gastro-omental Left gastro-omental
pancreaticoduodenalarteries ( g a s t r o e p i p l o i ca)r t e r y (gastroepiploic)artery
Castroduodenalartery Dorsal pancreaticartery
Plate 3OO Visceral Vasculature

Arteries of Liver, Pancreas, Duodenum, and Spleen
Intermediate
hepaticartery Lefthepaticartery Rightand leftinferiorphrenic
arteries(shownherefrom
Properhepaticartery Hepatic portal vein
commonstem)
Righthepaticartery e l i a ct r u n k
Common hepatic
artery
Abdominalaorta
Cysticartery
Left
gastric Short
Callbladder gastric
artery
arteries
Cystohepatic
triangle
(of Calot)
Cystic
Commonhepaticduc
( C o m m o n )b i l e
Rightgastricartery
Supraduodenal Leftgastro-omental
a (gastroepiploic)
artery
Gastroduodenal Arteryto tail of pancreas

artery
eaterpancreaticartery
Splenicartery
I pancreaticartery
pancreatic
artery
Anastomotic
branch
Middlecolicartery(cut)
Posterior
superior
pancreaticoduodenal Superiormesenteric
artery
attery (phantom
Inferiorpancreaticoduodenal
artery
Anteriorsuperior
pancreaticoduodenalartery
Posterior
inferior
pancreaticoduodenal
artery
Right gastro-omental
(gastroepiploic)
arteri
Anteriorinferior
pancreaticoduodenal
artery *{r
Visceral Vasculature Plate 3Ol
Variations in Geliac llunk
C o m m o no r i g i no f Splenicartery ,/
c e l i a ct r u n ka n d t a k e so r i g i n f
superiormesenteric f r o ms u p e r i o r
arrery m e s e n t e n(cn o t e
replacedleft
hepaticartery
from leftgastric)
Splenicand hepatic Lienogastric

Replacedhepatic
arteriestakeorigin Hepatolieno- artery takes origin
trunk
rromsupenor mesenteric
trunk Tromsupenor
mesenteric Hepato-
mesenteric(note
mesenteric
inferior pancreat-
trunk
icoduodenalartery
from 1st jejunal)
Replacedright hepatic te
artery takes origin from c e l i a ct r u n k Accessory Complete
superior mesenteric; teflc right hepatic celiac trunk
inferior pancreatico- artery takes
d u o d e n a la n d 1s t origin from Hepato-
jejunal arteriesfrom supeflor mesenteric
replaced right hepatic mesenteric trunk
Rightgastroepiploic
Accessory righthepatic (gastro-omental)
:r
arterytakesoriginfrom celiac trunk artery takes
superiormesenteric; origin from
inferioroancreatico- Hepatomesenteric
supenor
duodenalarteriesfrom mesenteric
accessory righthepatic; (Noteaccessorv (note accessory
I stjejunalartery left gastricartery left hepatic
from anteriorinferior from left hepatic) artery from
pancreaticoduodenal left gastric)
Plate 3O2 Visceral Vasculature

Geliac Arteriogram
1i
CH C o m m o n h e p a t i ca r t e r y
CT C e l i a ct r u n k
G Left gastricartery
CD C a s t r o d u o d e n aal r t e r y
H P r o p e rh e p a t i ca r t e r y
RC R i g h tg a s t r i ca r t e r y
s S p l e n i ca r t e r y
Visceral Vasculature Plate 3O3

Arteries of Duodenum and Head of Pancreas
Duodenum and head of pancreasreflectedto left
Castroduodenal
artery
Posterior
superiorpancreaticoduodenal
Anteriorsuperiorpancreaticoduodenal
artery
(phantom\
Superiormesenteric
artery
Inferior pancreaticoduodenalarterv
Posterior
inferior
Anteriorinferior
(partially in phantom)
Inferiorvena cava
Celiactrunk oper hepatic artery
Splenicartery Common hepatic artery
Supraduodenalartery
Castroduodenal artery
(partiallyin phantom\
Posterior
superior
pancreaticoduodenal
artery
Rightgastro-omental
(gastroepiploic)
artery
(phantom,cut)
Createrpancreaticartery
Anteriorsuperior
pancreaticoduodenal
artery
Inferior (phantom)
pancreaticartery
ic branch
Dorsal
pancreaticartery Posteriorinferior
Superior
mesentericartery
Anterior inferior pancreatico-
duodenaf artery (ph antom)
Inferior
Posteriorview

ArterialVariationsandGollateralSupplyof Liverand Gallbladder
Umbilicus(turnedup\ Internalthoracicarteries
with arteries
alciformand roundligaments
Right,middle(variable),
and lefthepaticarteries
Shortgastricarteries
Cystic
artery lntercostal
arteries
Inferior Left
phrenic gastro-omental
(gastroepiploic)
artery
artery
Castroduodenal
artery Leftgastric
artery
Common hepatic
Celiactrunk
Posteriorsuperior
pancreaticoduodenal
artery Splenicartery
Dorsal
Anteriorsuperior pancreatic
pancreaticoduodenal
arter artery
Rightgastricartery Superior
mesenteric
Rightgastro-omental artery
(gastroepiploic)
Inferiorpancreatic
Inferior pancreaticoduodenalartery artery
Omental(epiploic)arteri
Omental(epiploic)arterialarc
Accessoryor replacedarteries
*{r Cystic
Right
gastric
Capsular
1. Rightor commonhepatic
2. Lefthepatic Gastroduodenal
3. Righthepatic
4. Cvstic
relativesafety
Anastomoses of correspondingarteries Effectsof hepatic I l" Zonr.of
5. Inferiorphrenic/leftgastricH
6. Right<-+ left hepatic
left hepatic ;[il;;'i''ffiil"I Bi:ffi:1iJ""Ji':;E?i?"",'5:

Arteries of Small Intestine
S u p r a d u o d e n aal r t e r v
S p l e n i ca r t e r va n d v e i n
C a s t r o d u o d e n aal r t e r y
Posterior
superior
pancreaticoduodenalartery Dorsal
pancreatrcartery
Right gastro-omental nor
( g a s t r o e p i p l o i ca)r pancreatrc
artery
A n t e r i o rs u p e r i o r Superiormesenteric
pancreaticoduodenalartery arteryandvein
Anastomosis
(inferior
pancreattco-
duodenal to
1s t j e j u n a l
artery
R i g h tc o l i c
artery
lleocolic
anery
Superior
mesenteflc
artery
Anterior
cecal artery
Posterior
cecal artery
Appendicular
artery
J e j u n aal n d i l e a l( i n t e s t i n a la) r t e r i e b
A n a s t o m o t i cl o o p s ( a r c a d e s )
Straightarteries(arteriaerectae)
4{tr
Arteries of Large Intestine
Forafteries
Middle colic artery Superiormesentericartery

Transverse Marginal
mesocoron dr rEr y
Straightarteries i u n a la n d i l e a l
(arteriaerectae (intestinal)arteries
\
(Common Marginal artery
portion)
lnferior
Posterior mesenteric
aruery
Anterior
eft colic
Marginal artery artery
Ascending
branch
Descending
branch
Marginal
lleocolic arrery
a
Colic Sigmoid
branch arteries
lleal
branch igmoid
mesocolon
Anterior
cecal arter
Posterior
cecalartery
Appendicular
arrery
I n t e r n a li l i a c
aight
artenes
(arteriae
rectae)
Median sacralartery
(from abdominal aorta)
rior rectalartery
Middlerectalartery
,d,
Branchof superior rectalartery nferiorrectalartery
4{r
Variations in Golic Arteries
Middle Middlecolic
colic artery artery
Right
colic
arrery R i g h tc o l i c
arrery
lleocolic
artery
Commontrunk for
right colic and middle
colic arteries
Largebranch
Middlecolic from left
artery absent colic artery
R i g h tc o l i c
Right
artery absent
colic
artery -
lleocolic
artery -
lleocolic
artery
Absenceof middlecolic
artery replacedby large
branchfrom left colic
artery
of Riolan
Middlecolic
artery Superior
mesenteric
artery
R i g h tc o l i c Inferiormesenteric
arrery artery
Leftcolic
lleocolic
artery
artery
Arc of Riolanbetween
middlecolic and
left colicarteries $r
Veins of Stomach, Duodenum, Pancreasr and Spleen
H e p a t i cv e lnferior vena cava

Hepatic portal
Left gastricvein and esophagealtributary
Posterior Short
supenor gastnc
pancreatico- vetns
duodenal
vetn
Right
gastricvei
Prepyloric
vetn
Anterior
supenor
pancreatrco-
duodenal
vern
Right
gastro-omental
(gastroepiploic)
Leftgastro-
vel
omental
(gastro-
Posterior epiploic)
inferior vetn
pancreatrco-
duodenal
vet
Anterior
inferior
pancreatico-
d u o d e n a lv e i n
vern
n t cv e t n
S u p e r i o rm e s e n t e r i c
gastric
verns
Hepatic portal vein
R i g h tg a s t r i cv e i n
P o s t e r i o sr u p e r i o r
pancreaticoduodenalvein
S u p e r i o rm e s e n t e r i cv e i n
Right gastro-omenta
( g a s t r o e p i p l o i cv)e i
Anterior superior pancreaticoduodenalvei

Left gastro-omental
(gastroepiploic)vein
(Creat) pancreaticvein
Anterior inferior oancreaticoduodenaJ
vein
Inferior mesentericvein
*{r
Posteriorinferior oancreaticoduodenalvei

Veins of Small Intestine
Hepatic portal vein
Left gastricvein
S p l e n i cv e i n
Right
gastric
vern S u p e r i o rm e s e n t e r i cv e i n
Middle
colic J e i u n a al n d i l e a l( i n t e s t i n a lv)e i n s
vetn
(cut)
A n a s t o m o t i cl o o p s
Right
colic Straightveins (venae rectae)
vetn
Transversecolon
(e/evated)
Transverse
mesocoton
*{r
S u p e r i o rm e s e n t e r i ca r t e r ya n d v e i n
l e j u n a la n d i l e a l( i n t e s t i n a lv)e s s e l
Relations of superior
mesentericvein and artery
in root of mesenterv
Plate 31O Visceral Vasculature

Veins of Large lntestine
Hepatic Left gastric vein

portal vein
S p l e n i cv e i n
Prepyloric
vetn
Superior
mesenteric
(Dorsalor superior)
Rightgastro- pancreaticvein
omental(gastro-
epiploic) vei lnferior
vein
mesenteric
Anteriorsuperior
pancreaticoduodenalvein Jeiunaland ileal
(intestinal)
veins
from colon(cut)
Tributary
eft colic vein
Posterior
inferior
pancreaticoduodenalvein
Lefttesticular
Anterior inferior (ovarian)vessels
pancreaticoduodenalvei
Middle colic vein (cut) mesentertcveln
Right colic
Sigmoidveins
lleocolic
Median
Anterior cecal vein sacralvein
Posteriorcecal vein Superior

rectalvein
Appendicular
Righttesticular
(ovarian)
vessels
iliacvessels
External of left
Tributaries
and rightsuperior
lnternaliliac ve rectalveins
Superiorglutealvein rectalvenousplexus
Perimuscular
Obturator
Leftmiddlerectalvein
Leftinternalpudendalvein
in pudendalcanal(Alcock's)
Externalrectalvenousplexus
Right middle rectalvein
Right inferior rectalvein

(to internalpudendalvein)
Nr
Visceral Vasculature Plate 3l I
Hepatic Portal Vein Tlibutaries: Portacaval Anastomoses
Falciform
ligamentand Esophageal
veins
roundligamentof liver
Paraumbilical
veins I Bloodfrom superior
mesentericvein
I Bloodfrom splenic,gastric,
and inferior mesentericveins
Right
gastric
I Mixture of above two
vetn Cavaltributaries
Hepatic Leftgastricvein
portal
Short
gastric
veins
Posterior,
Anterior
superior Left
pancreatico-
gastro-
duodenal
omental
vernS (gastro-
epiploic)
vein
Superiormesenteric
vein
Splenicvein
Posterior, Rightgastro-
Anterior omental(gastro-
inferior epiploic)vein
pancreati
duodenal
verns Inferior
mesenteric
vein
Middle
colicvein Leftcolic
vein
Right Sigmoidveins
colicvein
Leftand right
Anterior, superior
Posterior rectalveins
cecal i
vetns
Appendicular
vetn
Middlerectalveins
Levatorani muscle
Portacavalanastomoses lnferiorrectalveins
1 Esophageal 3 Rectal
2 Paraumbilical 4 Retroperitoneal
4{tr
Pfate 312 Visceral Vasculature
Variations of Hepatic Portal Vein
Typicalarrangement
Short
Esophagealvein gastric
vetn
Cysticvein Leftgastric
veln
Hepatic
portal vein
--t---,
1 . 0 9c m
__t___
Posterior
superior
pancreaticoduodenalvein Pancreaticveins
Suoeriormesentericvei Leftgastro-omental
Rightgastro-omental (gastroepiploic)
vein
(gastroepiploic)
vein lnferior mesentericvein
Inferiorpancreatico- Left colic vein
duodenal veins
Middlecolicvein Jejunaland ileal
(intestinal)
veins
Right colic
l l e o c o l i cv e i n
lnferior mesenteric lnferior mesentericvern

vein mav enter mayentersuperior
junctionof splenic mesentericvein
and superior
mesentericveins Hepatic High intestinalveins
portal Splenicvein
Hepatic
S p l e n i cv e i n vetn
portal vein
Superior
mesenteric lnferior
Superior vein
mesenteric
mesenteric vetn
vetn
Left gastricvein may Leftgastricvein

entersplenicvein oftenentersjunction
(24% of cases) of splenicandsuperior
Right gastricvein mesentericveins
Hepatic Leftgastric
Hepatic Left gastric vein portal
portal vetn
vetn
Superior
mesenteric
vetn
4{tr
Visceral Vasculature Plate 313
Lymph Vessels and Nodes of Stomach
Celiac nodes
Nodes around cardia
Left gastricnodes
Right
supeflor
pancreatlc
Supra-
pyloric
nodes.
Splenic
nodes
Sub-
pyloric
nooes. Leftgastro-
omental
(gastroepiploic)
nooe
Right gastro-omental
(gastroepiploic) Left gastric nodes
Nodesaround
cardia
Leftgastro-
omental
Z o n e sa n d z'
pathwaysof
gastriclymph
d r a i n a g e( z o n e s
not sharply
demarcated)
Right gastro-omental(gastroepiploic)n
Suprapyloric, retropyloric,
and Left superior pancreatic
s u b p y l o r inco d e s nodes
4{tr Right superior pancreaticnode

Celiac nodes
Superiormesentericnodes
Plate 314 Visceral Vasculature

Lymph Vessels and Nodes of Pancreas
Anterior view
gastricnodes
Hepatic nodes
Splenicnodes
Superiorpancreatic
nodes
Celiacnodes
Superiormesenteric nodes
(centralsuperiorgrouP)
node
Pancreaticoduodenalnodes
(of Calot)
Hepatic
portalvein
Celiacnodes
Posteriorview
Hepaticnodes
aroundbileducts
Superiorpancreatic
nodes andproperhepatic
artery
S p l e n i vc e i n
lnferior mesentericvein
Superiormesenteric
arteryand vein Pancreaticoduodenal
nodes
Superiormesenteric nodes
(centralsuperiorgroup)
4{tr

Lymph Vessels and Nodes of Small Intestine
R i g h tl y m p h a t i ct r u n k Thoracic duct
Celiac nodes
Superiormesenteric
nodes (central
s u p e n o rg r o u p )
Thoracic duct
Cisternachyli
Intestinal
lymphatic
Superior
tru nk - mesenteric
nodes
(juxtaintestinal
R i g ha
t nd group)
leftlumbar
lymphatic
trun
Plate 316 Visceral Vasculature

Lymph Vessels and Nodes of Large Intestine
E p i c o l i cn o d e s
Middle
c o l i cn o d e s
Superior
mesenleflc lnferior mesentericnodes
nooes
(central
supenor
group) Left colic nodes
Right
colicnodes Preaorticnodes
S i g m o i dn o d e s
P a r a c o l i cn o d e s
Superiorrectal nodes
Left colic
nooeS
Preaortic
nooes
Superior
rectal
Common iliac nodes
I n t e r n a li l i a cn o d e s
Middle
rectal
nooes
E x t e r n aill i a cn o d
M i d d l e r e c t a ln o d e s
S u p e r f i c i ai ln g u i n a l
Nr Perineallymph vessels
( d r a i nl a r g e l yt o i n g u i n a l

Autonomic Nerves and Ganglia of Abdomen
$eealsoPlates lGi, 166
R i g h ts y m p a t h e t i ct r u n k Anterior,
Posterior
Thoracic duct vagal trunks
Right greater Left gastricartery

a n d l e s s e rt h o r a c i c and plexus
s p l a n c hn i c
nerves Celiac ganglia
R i g h tp h r e n i cn e r v e Left greaterthoracic
I n f e r i o rp h r e n i c
Left lesserthoracic
a r t e r i e sa n d p l e x u s e s
Right greater S p l e n i ca r t e r y
a n d l e s s e rt h o r a c i c and plexus
s p l a n c hn i c
nerves Common hepatic
artery and plexus
R i g h ts u p r a r e n a l
prexus Superiormesenteric
g a n g l i o na n d p l e x u s
Right aortico-
r e n a lg a n g l i o n Left aorticorenal
ganglion
R i g h tl e a s tt h o r a c i c Left sympathetic
s p l a n c h n i cn e r v e/ t r un k
R i g h tr e n a l Intermesenteric
artery and plexus (aortic)plexus
Right Inferior mesenteric

s y m p a t h e t i ct r u n k ganglion
W h i t ea n dg r a y Left colic artery

r a m ic o m m u n i c a n t e s and plexus
Inferior mesenteric
C i s t e r n ac h y l i
artery and plexus
C r a y r a m u sc Left common iliac
artery and plexus
3 r d l u m b a rg a n g l i o n
of sympathetictrunk Superiorrectal
artery and plexus
2nd and 3rd lumbar
s p l a n c h n i cn e r v e s Superior hypogastric
prexus
R i g h tu r e t e ra n d p l e x u s
Internaland external
R i g h tt e s t i c u l a (r o v a r i a n ) i l i a ca r t e r i e sa n d
plexuses
artery a n d p l e x u s
4 t h l u m b a rs p l a n c h n i cn e r v e Right and left

hypogastricnerves
l st sacralganglion to inferior hypo-
gastric(pelvic)plexus
o f s y m p a t h e t i ct r u n k
Cray ramicommunicantes
4{tr
Plate 318 Innervation

Nerves of Stomach and Duodenum
Right and left inferior phrenic arteriesand plexu H e p a t i cb r a n c ho f a n t e r i o rv a g a lt r u n k
A n t e r i o ra n d p o s t e r i o rl a v e r so f l e s s e ro m e n t u m A n t e r i o rv a g a lt r u n k
Celiac branch of posteriorvagal trunk
C e l i a cb r a n c ho f a n t e r i ovr a g a tl r u n k
Right greaterthoracic
s p l a n c h n i cn e r v e Left gastricartery and plexus
Vagal
branch
from
hepatic
plexus
to
pyloric
part of
stomach
H e p a t i cp l e x u s
R i g h tg a s t r i c
Anterior gastric
branch of anterior
vagal trunk
$.'
i?,
Left lesserthoracic
Splenicarteryand plexus
C e l i a cg a n g l i aa n d p l e x u s
Plexuson gastro-omenta
(gastroepiploic)arteries
Superiormesentericartery and plexus
P l e x u so n a n t e r i o rs u p e r i o ra n d a n t e r i o r
*{Y inferior pancreaticoduodenalarteries

(posteriorpancreaticoduodenalarteries
a n d p l e x u s e sn o t v i s i b l ei n t h i s v i e w )
lnnervation Plate 319

Nerves of Stomach and Duodenum (continuedl
SeealsoPlates 16ti, 166
Plexuson gastro-omental Posteriorgastricbranch of posteriorvagal trunk

(gastroepiploic)arteries
Hepatic branch of anteriorvagal trunk via lesseromentum
H e p a t i cp l e x u s
Rightgastric Branchfrom hepatic plexusto cardia via lesseromentum
arteryand
prexus Rightinferiorphrenicarteryand plexus
teriorvagaltrunk
Celiacbranchof posteriorvagaltrunk
Celiac branch of anterior vagal trunk
eft gastricartery and plexus
eft inferiorphrenicarteryand plexus
Celiac gangliaand plexus
Creater, lesser,and least

thoracic splanchnicnerves
Aorticorenalganglia
Splenicartery and plexus
4{tr
Greater, ganglion
Lesser,
anch from right inferior phrenic
Least plexusto cardiaof stomach
thoracic
splanchnic Rightand leftinferiorphrenic
nerveS arteriesand plexuses
Anteriorvagaltrunk
View
with
stomach
reflected
cephalad
Plexus
on
anteriorsuperior
and anteriorinferior
pancreatico-
Celiac branches
duodenal arteries
Right greater, of anterior
Plexuson gastroduodenalartery lesser,and and posterior
leastthoracic vagal trunks
Plexuson posteriorsuperior s p l a n c h n i cn e r v e s
and posteriorinferior Left gastric
pancreaticoduodenal arterie6 C e l i a cg a n g l i a arteryand plexus
Leftgreater,lesser,
S u p e r i o rm e s e n t e r i cg a n g l i o na n d p l e x u ' s R i g h ta o r t i c o - and leastthoracic
r e n a lg a n g l i o n splanchnn i ce r v e s
S u p e r i o rm e s e n t e r i cg a n g l i o na n d p l e x u s Left aorticorenalganglion
Plate 32O Innervation

lnnervation of Stomach and Duodenum: Schema
R i g h t6 t h t h o r a c i c
g a n g l i o no f
s y n rp a t he t i c -y \
trunk
pl exus
Esophagea
-"-o=
Cray,
2 e t t g r e a t e rt h o r a c i c
s p l a nc hn i < nerve
White
r a t n lc o m m u n r c a n t e s s/ ticplexus
S p i n a sl e n s o r v
( c l o r s ar lo o t ) L e f t9 t h t h o r a c i c
ganglion g a n g l i o no f
s y m p a t h e t i ct r u n k
Anterior
( v o n t r a l r) o o t
of spinan l erve P o s t e r i ovr a g a lt r u n k
a n d c e l i a cb r a n c h
R i g h tg r e a t e rt h o r a r . i <
s p l a n c h n i ct ' t e f v - - A n t e r i o rv a g a lt r u n k
\, a n d c . e l i a cb r a n c ho f
R ig , h tl e s s e rt l r o r . r c - i < v a g u sn e r r v e( X )
s p l a n c h n i nc e r v e \
\
C e l i a cg a n g l i . r Left gastricartery
t*
L e r a st th o r a c i c t
e l i a ct r u n k
I
s p l a n c h n i nc e r v e /\s-
.rrtery
Cornn'ror.r t\
h e p a t i ca r t e r l - I
Short
gastflc
Proper
arIefles
h e p a t i ca r t e r y
Superior
nresenterc
gangJion
Aortir.orenal
g,.r
n glia
R i g h tg a s t r i ca r t e r y ,
R i g , hrte n a la r t e r v
( l a s t r o d u o d e n aal r t u r y
P o s t e r i oar n d a n t e r i o r
s u p e r i o pr a n c r e a t i r . o - Left,
c l u o c l e n aalr t e r i e s R i g h tg a s t r o -
o n r e nt a I
Superior (gastroepiploic)
r ) r e s et e
n rc artenes
ar r e r y
Posterior Sympatheticfibers
. r n da n t e r i o r
Preganglionic
ilttenor
p.rnc.reatico P o s t g a n g l i o n i .- - * * *
cluocler-ral
.lrteI es Parasympatheticfibers
Preganglionic
4{tr Postganglionic
Afferent fibers

Nerves of Small Intestine
SeealsoPlates 165,166
A n t e r i o rv a g a lt r u n
Posteriorvagal trunk
C e l i a cb r a n c h e so f a n t e r i o r
and posteriorvagal t
Hepatic plexus
Creater thoracic
s p l a n c h n i cn e r v e s
Castroduodenalartery and plexus

Lesserthoracic
Leastthoracic
Aorticorenalganglia
S u p e r i o rm e s e n t e r i cg a n g l i o n
I n t e r m e s e n t e r i(ca o r t i c )p l e x u s
Inferior pancreaticoduodenal
arteriesand plexuses
arteryand plexus
Middle colic artery and plexus (cut)
R i g h tc o l i c a r t e r ya n d p l e x u s
l l e o c o l i ca r t e r ya n d p l e
artery and plexus
Peritoneum(cut edge)
M e s e n t e r ibcr a n c h e s
M e s o a p p e n d i x( c o n t a i n s
a p p e n d i c u l a ar r t e r ya n d
nerve ptexus
4{tr

Nerves of Large Intestine
Fornerves
of
A n t e r i o rv a g a lt r u n k a n d hepatic branc M a r g i n aal r t e r ya n dp l e x u s
Posteriorv a g a lt Esophagus
Right greaterthoracic
s p l a n c h n i cn e r v e Left greaterthoracic
Leftsuprarenal
plexus
Left lesserand
leastthoracic
R i g ha
t ortico-
r e n ag
l anglion
Left aorticorenal
Superior ganglion
mesenteric
ganglion Leftrenalartery
a n dp l e x u s
Middlecolic
artery l s t l e f tl u m b a r
and plexus splanchnic nerve
Leftlumbar
sympathetictrunk
lntermesenteric
(aortic)plexus
R i g h tc o l i c Left colic artery

arrery and plexus
and plexus
lnferior
lleocolic mesenteric
artery ganglion,artery,
and plexus and plexus
C e c a la n d Sigmoid
appendicular arteries
arteries and plexuses
and plex
Superior
hypogastric
plexus
tor
rectal
Sacralsympathetictru
arrery
Rightsacralplexu and plexus
P e l v i cs o l a n c h n i cn e r v e s
ightand left
hypogastric
nerves
Middle rectal arterv and plexus
R i g h ti n f e r i o rh y p o g a s t r i c
( p e l v i cp) l e x u s
Vesicalplexus
Nerves from inferior hypogastric(pelvic)
Nr Rectalplexus p l e x u s e st o s i g m o i dc o l o n , d e s c e n d i n g
c o l o n , a n d l e f t c o l i c ( s p l e n i c f)l e x u r e
U r i n a r yb l a d d e r

Innervation of Small and Large Intestines: Schema
Thalanrus
l{
t
.J
Hypothalamus
P o s t e r i o (r d o r s a l ) ( r e d : s y m p a t h e r i cp a r t ,
n u c l e u so f v a g u s b l u e = p a r a s y n r p a t h e t pi ca r t )
V a g u sn e r v e ( X )
M y e l e n c e pl . r al o n
(medulla
oblongata)
S y n r p a t h e t itcr u n k
S p i n a ls e n s o r y
I wr'it" I
( d o r s a lr o o t ) g a n g l i r > n I cray/ |
Creater
Thoracic { Lesser
splanchnic ( L e a st
nerves*
T10
Aorticorenal
T11 ganglion
I n t e r m e s e tne r i c
T12 ( a o r t i c )p l e x u s
l n f er i or
T h o r a c o lu n r b a r mesenteilc
s p i n a lc o r d
L.l
ganglion
L2
=1t--'
[3 Lunrbar
splanchnic
ne r v e s *
L4
t5
Hypogastric
ne r v e s
Sacral
rJ s p l a n c h ni c
n e r v e s-
I n f e r io r
hypogastric
Sacral
s p i n a lc o r d S ( p e l v i c )p l e x u s
rY
P e l v i cs p l . r n c h n i nc e r v e s
P u d e n d a ln e r v e
* A b d o m i n o p e l v i cs p l a n c h n i cn e r v c s
Plate 324 lnnervation

Innervation of Small and Large Intestines: Schema
Sympatheticefferents
Parasympatheticefferents
Somaticefferents
Afferentsand CNSconnections
Indefinitepaths -----
4{tr
C h i e f s e g m e n t a ls o u r c e s
of sympathetic fibers
i n n e r v a t i n gd i f f e r e n t
S u p e r i o rr e c t a l a r t e r v a n d n e r v e s r e g i o n so f i n t e s t i n a l
tract are indicated.
Rectalplexus N u m e r o u s a f f e r e n tf i b e r s
Levator
are carriedcentripetally
ani muscle
through approximately
the same sympathetic
I n f e r i o r a n a l ( r e c t a l )n e r v e E x t e r n a la n a l s p l a n c h n i cn e r v e s
s p h i n c t e rm u s c l e that transmit
preganglionic fibers.
Innervation Plate 324

Autonomic Reflex Pathways: Schema
Sympathetic Spinal Dorsal(posterior)

root Thoracicpart
sensory of spinalcord
(dorsal
lntermediolateral
root) c e l lc o l u m n
ganglion
C a n g l i o no f
s y m p a t h e t i ct r u n k
Spinalnerve
to vesselsand
g l a n d so f s k i n
V e n t r a(la n t eior)
r ror
Meningeal branch to spinal

m e n i n g e sa n d s p i n a lp e r i v a s c u l a r Stretch
plexuses(usuallyarisesfrom (distention)
W h i t er a m u sc o m m u n i c a n s
spinalnerve)
C r a yr a m u sc o m m u n i c a n d Abdominopelvic
(greater,
lesser,
C a n g l i o no f and least)thoracic
s y m p a t h e tti rcu n k splanchnn i ce r v e s
Vagus
nerve(X)
Enteric
C a n g l i o no f prexuses
sympathetictrunk
of gut
Superior
mesenteric
ganglion
4{tr
-
Sympatheticf Preganglionic Parasympathetic Preganglionic Afferentfibers -
fibers fibers
I eostganglionic----- P o s t g a n g l i o n -i c- - - -

Intrinsic Autonomic Plexuses of Intestine: Schema
Peritoneal
layersof
mesentery
Branchof
straight
artery
(arteriaerectae)
to intestineand
accompanying
nerves
Longitudinalintramuscular
plexus
(Auerbach's)plexus
plexus
r intramuscular
(Meissner's)plexus
plexus
Periglandular
Visceralperitoneum(serosa)
Subserous
connectivetissue
muscle
Longitudinal
Intermuscular
stroma
Circularmuscle
Submucosa
S u b m u c o sgal a n d s
Nr Muscularismucosae
glands
Mucosaand intestinal
Note:Intestinal
wall is shown
muchthickerthanin actualitv.

Innervation of Liver and Biliary Tlact: Schema
SeeahoPlateo 167,168
S y m p a t h e ttircu n k
Dorsalroot
(spinagl )a n g l i o n
Thoracicpartof spinal
cord
R i g h tg r e a t e rt h o r a c i cs p l a n c h n i c
Leftgreaterthoracic
Posteriorvagal trunk nerve
splanchnic
Right phrenic nerve to diaphragmatic
part of parietal(and visceral?)periton
Anteriorvagaltrunk
*{r
ic branchof
anterior vagal trunk
Diaphragm
P h r e n i cg a n g l i o n
C e l i a cg a n g l i a
Splenicartery
Anterior hepatic plexus

Posteriorhepatic plexus
\Castroduodenal
arteryand plexus
Sympatheticfibers
Preganglionic S o h i n c t e ro f
P o s t g a n g l i o n i-c- - - - - - h e p a t o p a n c r e a t iacm p u l l a
Parasympathetic fibers
Preganglionic
Ramificationof
P o s t g a n g l i o n i-c- - - - - - fibersaroundfine
Afferentfibers of hepaticartery

Innervation of Pancreas: Schema
Dorsalroot
Right (spinagl )a n g l i o n
sympathetic
t r u n k_ eft sympathetic
trunk
Thoracic part of
Rightgreater spinalcord
thoracic
splanchnic Leftgreaterthoracic
nerve splanchnicnerve
t Anteriorvagaltrunk
Posterior
vagaltrunk
Common areasof
p a n c r e a t i cp a i n
Celiac ganglia
n{r mesenteric
ganglion
arteryand plexus
Superiormesenteric
Sympatheticfibers S c h e m ao f
Preganglionic intrinsic
Postganglioni nerve
supply
Parasympathetic
fibers
Preganglionic
Postganglioni
Afferentfibers

Kidneys in Situ: Anterior Views
Esophagus
Diaphragm
Left suprarenalgland
R i g h ts u p r a r e n a l
gland C e l i a ct r u n k
R i g h tk i d n e y Left kidney
R i g h tr e n a l Left renal artery

artery and vein and vein
Right subcostalnerve mesenteric

artery (cut)
Transversus
a b d o m i n i sm u s c l e tal nerve
Abdominal aorta
Quadratus
Iumborum
muscle
liohypogastricnerve
l l i a cc r e s t
l i o i n g u i n anl e r v e
P s o a sm a j o r m u s c l e
Lateral femoral
l l i a c u sm u s c l e cutaneousnerve
Right ureter Cenitofemoral nerve
Left testicular
R i g h tc o m m o n
(ovarian)artery and vein
iliac artery
Inferior mesenteric
Right external
artery (cut)
i l i a ca r t e r
Peritoneum(cut)
R i g h ti n t e r n a l
iliac artery
Sigmoid mesocolon (cut)
U r i n a r yb l a d d e r Rectum
*{r
Esophagus
Inferiorvena cava
eft suprarenalgland
Area for bare
a r e ao f l i v e r S p l e n o r e n al li g a m e n t
Right
Area for stomach
s u p r a r e n agl l a n d
Peritoneum Area for spleen

(cut)
Tailof pancreas
Area for liver
Duodenum Transversemesocolon
Peritoneum Area for small intestine

(cut)
A r e a f o r d e s c e n d i n gc o l o n
Area for colon
Area for
s m a l li n t e s t i n e Anterior relations
of kidneys
Plate 329 Kidneys and Suprarenal Glands

Kidneys in Situ: Posterior Views
Latissimus Pleura(costo-
dorsi diaphragmaticrecess)
mbocostalligament
Serratusposterior
inferiormuscle-
Quadratuslumborum
muscle(cut)
External
obliquemuscle
Diaphragm
Aponeurosisof Subcostalnerve
transversus
abdominismuscle
ightkidney
lnternal Ascending
colon
obliquemuscle
Transversus
Thoracolumbar fascia abdominismuscle
(posterior
layer)
nerve
lliohypogastric
lliaccrest
Erectorspinae
dratuslumborum
muscle(cut)
Clutealaponeurosis
(overgluteusmedius Psoasmajor muscle
muscle)
r ligament
Gluteusmaximus
muscle
*{r
Posteriorrelations
Projection
of 11th rib of kidneys
Areafor Areafor diaphragm
Projectionof 12th o f 1 2 t hr i b
Areafor aponeurosis Areafor aponeurosis

ot transversus of transversus
abdominismuscle abdominismuscle
Areafor quadratus Areafor quadratus

lumborummuscle lumborummuscle
Areafor Areafor psoas

psoasmajormuscle majormuscle
Kidneyls and Supralenal Glands Plate 33O

Schematic Cross Section of Abdomen at T12
Lineaalba
Falciformligamenl
Superiorepigastricvessels Rectusabdominismuscle
Lesseromentum
Transversalis
fascia Leftgastricarteryand vein
Parietalperitoneum
Visceralperitoneumof liver
Properhepatic
(bifurcation) 7th costalcartilage
Commonhepaticduct External
obliquemuscle
Cysticduct Diaphragm
Hepatic Stomach
portalvein
Costo- Castrosplenic
diaphrag- ligamentand
matic short gastric
recessof vessets
pleural
cavity Spleen
lnter-
costal
vessets
and
nerve
Omental
(epiploic)
foramen
(of Winslow)
Common
hepaticartery
(retroperitoneal)
Intercostal
Hepatorenalrecess muscles
(Morison'spouch)
Splenorenal ligament
Inferiorvena cava with splenicvessels
Omentalbursa(lessersac) Parietalperitoneum
on posteriorwall
Rightsympathetic
trunk
of omentalbursa
Rightcrusof diaphragm
Azygosvein Left kidney
Thoracicduct Leftsuprarenalgland
Anteriorlongitudinal
ligament
Celiacganglia musc'e
Abdominalaorta
Body of T12 vertebra iH*F;"Trs 4{tr
[fft;f*r,
Plate 331 Kidneys and Supranenal Glands

Renal Artery and Vein in Situ
Inferiorvena cava Esophagus
Right and left inferior phrenic arteries Left inferior phrenic vein
Leftsuperiorsuprarenalarteries
Celiac trunk
Leftmiddle
Rightsuperior suprarenal
artery
suprarenala
vein
Leftsuprarenal
R i g h tm i d d l e
suprarenalartery
Leftinferior
suprarenalartery
vein
Rightsuprarenal
Rightinferior
suprarenalarter
Uretericbranchof
left renalartery
Leftrenal
arteryandvein
Uretericbranch
of right renal artery Left testicular (ovarian)
arterv and vein
Right renal artery and vein
Left2nd lumbarveinand communication
Right testicular (ovarian) artery and vein lumbarvein
to ascending
Inferiorvenacavi
Abdominalaortd
arterv
Inferiormesenteric
artery(cut)
Superiormesenteric
*{r
Kidneys and Suprarenal Glands Plate 332
Variations in Renal Artery and Vein
Proximal
subdivision
of renal
artery
A Low accessoryrightrenal
arterymay passanteriorto inferior
venacavainsteadof posteriorto it
B Inferiorphrenicarterywith
superiorsuprarenalarteriesmayarise
from renalartery(middlesuprarenal
arteryabsent)
Doubleleftrenal
vein mayform
ringaround
abdominalaorta
Multiplerenalveins
Persistentleft
inferiorvenacava
mayjoin leftrenalvein
*{r

Gross Structure of Kidney
Anteriorsurface
of right kidney
Fibrouscapsule
(cutand peeledback)
Medialborder
Hilum
Renalartery
R e n avl e i n
Renalpelvis
Stellateveins visible
Medialborder
throughcapsule
Ureter
Suprarenalgland
and lobulated
kidney of infant
Fibrouscapsule
Minorcalices
Cortex
Bloodvessels
Medulla(pyramids) enteringrenal
parenchyma
Renalpapilla I sinus
Majorcalices
Renalcolumn
(of Bertin)
Renalpelvis
Fatin renalsinus
Minor calices
Baseof pyramid
Ureter
Rightkidneysectionedin
severalplanes,exposing
parenchymaand renal pelvis

Intrarenal Arteries and Renal Segments
Superior(apical)segmental Frontalsectionof left kidnev:

anteriorview
Anteriorsuperior
segmentalartery
Capsularand
perirenalbranches
Inferior
suprarenalartery
Anteriorbranch
of renalartery
Renal
Posteriorbranch
of renalartery
(posteriorsegmental
artery)
Pelvicand uretericbranches
Anteriorinferior
segmental artery
Posterior
segmental
arteries
Inferiorsegmentalartery
Vascularrenalsegments
Nr
Anteriorsurfaceof left kidnev Posteriorsurfaceof left kidney
Plate 335 Kidneys and Supralenal Glands

Nephron and Gollecting Ti,rbule:Schema
Fibroustuot''".--.-----.=
'
" convolutedtubule
Proximal
--ciitl-.il--
renalcorpuscle
luxtamedullary L
renalcorpuscle
Distal I convolutedtubule
Proximal convoluted
convoluted tubule
tubule
H e n l e ' sl o o p
D e s c e n d i n gl i m b
A s c e n d i n gl i m b
C o l l e c t i n gt u b u l e
5 Henle's
- LCJ
loop
t
Descending
R e n a l( m a l p gi h i a n )c o r p u s c l e ;
Renal g l o m e r u l a r( B o w m a n ' s )c a p s u l e
medulla with glomerulus
(pyramid) Ascending
li Afferent and efferent
glomerulaa r rterioles
c
c
Openings
of papillary
ducts
tubutes
Cottecting
Nr C r i b r i f o r ma r e a o f r e n a lp a p i l l a
ffi

Blood Vessels in Parenchyma of Kidney: Schema
A f f e r e n tg l o m e r u l a ra r t e r i o l e Corticomedullarg
y lomerulus
C o r t i c a lg l o m e r u l u s
Cortical f f e r e n tg l o m e r u l a ra r t e r i o l e
E f f e r e ngt l o m e r u l a ra r t e r i o l e capillary ( j o i n sc o r t i c a lc a p i l l a r yp l e x u s
E f f e r e n gt l o m e r u l a r US
a r t e r i o l e( j o i n sc o r t i c a l a n d a l s od e s c e n d si n t o r e n a lp y r a m i d )
J u x t a m e d u l l agrlyo m e r u l u s
( e f f e r e ngtl o m e r u l aarr t e r i o l e c a p i l l a r yp l e x u s
Stellate
d e s c e n disn t or e n a p l yramid) vetn
F i b r o u sc a p s
C a p s u l a ra n d p e r f o r a t i n gv e i n s
Cortical
radiate
(interlobular)
artefles
a n dv e i n s
Subcapsular
X
,> zone
uate
artery
andvein
Vasa rectae
s p u r i a( f r o m
juxtamedullary
efferent
glomerular
arterioles)
Vasa rectae
vera (from
a r c u a t ea n d
\1 i 1 cortical radiate
artefles)
Venulae
rectae
Medullary
capillary
plexus
Interlobar
arrery
andvein
e, Renal
cotumn
(of Bertin)
H e n l e ' sl o o p
of nephron
Collecting
tubule
lnterlobar
4{tr a r t e r ya n d
v e t nI n
perirenal
fat of
r e n a ls i n u s

5
c TransverseSection: Level of T12-L1 lntervertebral Disc
f
o
o
o
3
c
o S u p e r i o rm e s e n t e r i cv e i n ( b e c o m i n gp o r t a lv e i n ) o
tr o
E! 5
qt o
ll
o
5
3
ql
g Transversecolon t
II
o o
I
!r
J A s c e n d i n gc o l o n
o
rt
c
o
( r i g h tc o l i c f l e x u r e ) o
o
E x t e r n aol b l i o u e m u s c l e o
o
D e s c e n d i n gc o l o n o
o
D e s c e n d i n g( 2 n d ) =i.
partof duodenum
Left suprarenalgland o
J
I n f e r i o rv e n a c a v a o
rh
Spleen
D
R i g h ts u p r a r e n agl l a n d r
c
Liver o
S u p e r i o rp o l e o f r i g h t k i d n e y 3
o
f
L e f tc r u s o f d i a p h r a g m
qt
i
!
qf f 12-t'l intervertebraldisc
{
I
t A b d o m i n a la o r t a
o N
I
G) F
g) c44e/* I
o
!
!l
i
o
TransverseSection:Levelof L1-2 IntervertebralDisc o
o
G) :'
g)
o
o
Superiormesentericvein 3
qt
t
II
Creater omentum Superiormesentericartery o
Pancreaswith uncinate process Transversecolon
o
rt
o
Transversecolon lleum o
o
J u n c t i o no f 2 n d a n d 3 r d lejunum o
p a r t so f d u o d e n u m o
Perirenalfat o
rt
IT
A s c e n d i n gc o l o n
o
3
o
rh
R i g h tr e n a lv e i n D e s c e n d i n gc o l o n D
(enteringinferior
r
4
vena cava)
Renalfascia c
c o
5
o
Right kidney
Left kidney 3
o
o Major calyx and renal pelvis
=
ql !t
f t
c Inferior vena cav Pararenalfat
o F
I
tr Right crus of diaphragm Left renal artery I
lt
ql N
! Psoasmajor muscl Left renal vein (entering
o inferior vena cava)
3
t L1-2 intervertebraldist
o
I C o n u sm e d u l l a r i sa n d c a u d a e q u i n
o
3
o Cfd4/*
o
Ureters
Uretersin male:
anterior view
Leftkidney
Rightkidney
Leftureter
Duodenum
lnferior
Superior mesenteric
artery
mesenteric
Leftcolic artery
Rightcolicartery
Sigmoidarteries
R i g hu
t re
Superiorrectal
lleocolic artery artery(cut)
Testicular
vessel nerve
Cenitofemoral
C o m m o n i l i a ca r t e r
lnternal iliac arter
Externaliliac arter
Inferiorvesicalarterv
Middle rectal a
Ductusdeferens
Diagonalcourse
of ureter
narybladder
throughbladder
wall
Bladdermucosa
Ureter
4{tr Urinarybladder
Medialumbilical
ligament(occluded
partof umbilicalartery)
Roundligament
of uterus
Superiorvesicalartery
Uterineartery
Umbilicalartery
Obturatorartery
and nerve
Broadligament Ureter
Uterosacral
(sacrogenital) Vaginalarteryand
fold inferiorvesicalbranch
Ureter External
iliacartery
(re
ian vessels
Intersigmoid
Internaliliacartery
Sigmoid mesocolon
iliacartery
Uretersin female:
superiorview Root of mesenterv
Kidneys and Suprarenal Glands Plate 34O

Arteries of Ureters and Urinary Bladder
a
A b d o n r i n aal o r t a
S u p e r i o nr r e s e n t e r i c
arterv
R e n aa
l r t e r ya n d v e i n
Uretericbrar-rch
from renalartery
Ovarianartery
Ureter
Inferior
mesentencartery(cut)
Uretericbranchfronr aorta
Uretericbranchesfron'r
ovarianand conrmon
r l i a ca r t e r i e s
C o m n r o ni l i a ca r t e r y
M e d i a ns a c r aal r t e r y
I n t e r n aill i a ca r t e r y
l l i o l u n r b aar r t e r y
S u p e r i o gr l u t e aal r t e r y
Lateralsacral:rrtery
Inferiorglute.rland
i n t e r n apl u d e n d aal r t e r i e s
U m b i l i c aal r t e r y
(patentpart)
U t e r i n ea r t e r y
Inferiorvcsicalartery
a n d u r e t e r i cb r a n c - h
S u p e r i ovr e s i c aal r t e r i e s
I n f e r i o cr p i g a s t r iac r t e r y
Uretericbranc-hfronr
s u p e r i o vr e s i c aal r t e r y
M e d i a lu n r b i l i c al il g a n r e n t

Renal Fascia
Duodenum flexure
Duodenojejunal Left renal vein and artery
Right Superiormesenteric Left kidney
vein and artery Abdominal
Rightcolic (hepatic)flexure
Liver lnferior
vena cava
Transversalis
fascia
fat
Pararenal
(retroperitoneal)
Quadratuslumborum muscre Perirenal

fat
Cruraof diaphragm
Transversesectionthrough 2nd Fibrouscapsuleof kidney
Psoasmaior muscleand fascia
lumbarvertebrademonstrates
horizontaldispositionof fascia layersof renal (Cerota's) fascia
Diaphragm
Diaphragmaticfascia
( c o n t i n u a t i o no f Lung
transversalis fascia)
Liver
Costodiaphragmatic
recess Bare area of liver
S u p r a r e n agl l a n d F i b r o u sc a p s u l eo f k i d n e y
Perirenalfat
Peritoneum
1 2 t hr i b
layersof renal (Cerota's)fascia
Pararenalfat
(retroperitoneal)
R i g h tk i d n e y
Transversalis
fa
Right colic (hepatic)flexure
Q u a d r a t ulsu m b o r u mm u s c l
l l i a cc r e s t
*{r Sagittalsectionthrough right kidney

and lumbarregiondemonstrates
verticaldispositionof renalfascia

Lymph Vessels and Nodes of Kidneys and Urinary Bladder
SeealsoPlates406,408
Cortical lymph vesselsalong cortical

Subcapsular r a d i a t e( i n t e r l o b u l a rat r t e r i e s
l y m p h a t ipc l e x u s
Lymph vesselsalong arcuatearteries
Lymph vesselsalong interlobararteries
Medullary
lymphvessels
*{r
Note:Arrows
indicatedirection
of flow.
L u m b alry m p ht r u n k st o
cisternachyliandthoracicduct
Lateralaortic (lumbar),precaval,
and postcavalnodes
C o m m o n i l i a cn o d e s
P r o m o n t o r i a(l m i d d l es a c r a l )n o d e
I n t e r n a li l i a cn o d e s
E x t e r n aill i a cn o d e s
Lymph vesselsfrom dorsal

part and trigone of bladder
Lymphvesselsfromsuperior
andanteriorpartsof bladder
Lateralvesicaland
prevesicalnodes
Plate 343 Kidneys and Supralenal Glands

Nerves of Kidneysr Ureters, and Urinary Bladder
Anteriorvagaltrunk
Posteriorvagaltrunk
nerve
Createrthoracicsplanchnic
Lesser
thoracicsplanchnic
nerve
ganglion
Superiormesenteric
Leastthoracic splanchnicnerve
Aorticorenal ganglion
Renalplexusand ganglion
2nd lumbarsplanchnic
Renaland upperuretericbranches
fromintermesenteric
(aortic)plexus
Intermesenteric
ganglion
Inferiormesenteric
trunkand ganglion
Sympathetic
Middleuretericbranch
Superiorhypogastric
nerves
Sacralsplanchnic
(branchesfrom uppersacral
sympatheticgangliato
hypogastricplexus)-
Cravramuscommunicans
Hypogastricnerves
Sacralplexus
Pelvicsplanchnic
(pelvic)plexus
Inferiorhypogastric
with periureteric
loopsand
branches to lowerureter
Rectalplexus
Vesicalplexus
Prostaticplexu
4{tr

Innervation of Kidneys and Upper Ureters: Schema
ucleusof solitarvtract
(dorsal)nucleus
Posterior
of vagusnerve
Medullaoblongata
Crayramuscommunicans
Vagusnerve(X)
Ventralramusof T10 ng fibers

(intercostal
nerve)
Ascending
fibers
nalcord segments
T10-11
Cangliaof sympathetic
trunk Lesser
thoracic
splanchnic
nerve
thoracic
1 s tl u m b a sr p l a n c h n n
i ce r v e splanchnic
nerve
Celiacgangliaand plexus
Superiormesenteric
ganglion
ganglion
Aorticorenal
plexus
Intermesenteric
4{tr Superiorhypogastric
plexus
Sympatheticfibers Hypogastric
nerve
Preganglionic
P o s t g a n g l i o n i-c- - - - - - - .
Sacralplex
Parasympathetic
f ibers
Preganglionic Pelvic
Postganglioni splanchnic
nerves
Afferentfibers

Nerves of Suprarenal Glands: Dissection and Schema
Right phrenic nerve Left phrenic nerve

vagaltrunk
Posterior
Left inferior phrenic
artery and plexus
R i g h st u p r a r e n g
al a n d Left suprarenalgland
Right greaterthoracic s p l a n c h n i cn e r v e
splanchnichrv:-
C e l i a cp l e x u s
a n dg a n g l i a
Leftlesserthoracic
splanchnn i ce r v e
Aorticorenal
R i g h tr e n a l ganglia
g a n g l i o na n d p l e
Left least
thoracic
splanchnic
nerve
Left
renal
ganglion
and
prexus
trunk
Leftsympathetic
R i g h ts y m p a t h e t i c
L e f t 1 s t l u m b a rs p l a n c h n i cn e r v e
t s tl u m b a sr p l a n c h n n
Righ1 i ce r v e
In t e r m e d i o l a t e r acle l l c o l u m n
(lateralhorn of gray matter)
T5 Medulla
Thoracic
splanchnic
T6 nerves Postganglionic
(preganglionic Celiac f i b e r ss u p p l y
flbers) ganglion bloodvessels
T7
T8
t
I
I
I
4{tr Preganglionic
fibers ramify
a r o u n dc e l l s
of medulla
Suprarenalgland

Artefes and Veins of Suprarenal Glands in Situ
Liver(retractedsuperiorly) Superiorsuprarenalarteries
(frominferiorphrenicartery)
lnferior vena cava (retracted mediallvl
Suprarenal
vein
Branches of middlesuprarenal
arteries(fromabdominalaorta)
(cutedge)
Peritoneum
Pancreasand spleen
(re tr acted sup eri o r Iy)
Leftinferiorphrenicartery
ior suprarenal
arteries
gland
Suprarenal
Renal(Cerota's)
fascia
Left
kidney
Renal
(Cerota's)
fascia
Right kidney
(pulleddown)
gland
Suprarenal
Inferiorsuprarenalartery
(from renalartery)
Abdominal exposure of right suprarenal gland
Crosssection psule
through Cortex Duodeno-
suprarenal Medulla jejunalflexure
gland
Leftcolic(splenic)
flexure(pulled
Middlesuprarenal
artery
Suprarenalvein Leftrenalartery
*{r andvein Peritoneum

Inferiorsuprarenal
arterir (cut edges)
Abdominalexposureof left suprarenalgland
Plate 347 Kidneys and Supranenal Glands

AbdominalWall and Viscera: Paramedian(Sagittall Section
C o r o n a r yl i g a m e n t
-,":ij e n c l o s i n gb a r e a r e a
D i a p h r a g m( c e n t r a tl e n d o n )
of liver
Esophagus
P a r i e t apl e r i t o n e u m
Superiorrecessof omental
Liver bursa (lessersac)
L e s s e ro m e n t u m
H e p a t i cp o r t avl e i na n d
properhepaticartery
i n r i g h tm a r g i no f O m e n t a l( e p i p l o i c )
l e s s e ro m e n t u m foramen (of Winslow)
O m e n t a lb u r s a
(lessersac) e l i a ct r u n k
Stomach S p l e n i cv e s s e l s
Middle colic artery Renalvessels

Transversemesocolon Pancreas
Parietalperitoneum (of
a n t e r i o ra b d o m i n a lw a l l ) Superiormesentericartery
Transversecolon Inferior (horizontal,or 3rd) part

of duodenum
Creater omentum
S m a l li n t e s t i n e
Rectusabdominis Abdominal aorta
muscle
Parietaloeritoneum (of
posterior abdominal wall)
Mesenteryof small intestine

Transversalis
fascia
Medianumbilical
l i g a m e n t( u r a c h u s )
Fatty layer of
subcutaneou
t is s u e Rectovesicaloouch
(Camper'sfascia)
Rectum
M e m b r a n o u sl a y e r
o f s u b c u t a n e o u tsi s s u e Rectoprostatic
(Scarpa'sfascia) ( D e n o n v i l l i e r sf' a
) scia
U r i n a r yb l a d d e r Levatorani muscle
Prostate
P u b i cb o n e
Deep
Superficial
R e t r o p u b i c( p r e v e s i c a l )
Subcutaneous
space (cave of Retzius) Deep and superficial
D e e p ( B u c k ' s f) a s c i a p e r i n e a lm u s c l e s
of penis
B u l b o s p ogni o s u sm u s c l e
l e m b r a n ea n d b u l b o u r e t h r a(lC o w p e r ' s )g l a n d
P e r i n e am
Tunica vaginalistestis
s u s c l e( t h i c k e n e dm e d i a l
P u b o r e c t a l im
edge of left levator ani muscle)
Abdominal Sections Plate 348

Schematic Gross Section of Abdomen at L3, 4
Round ligament(ligamentumteres)of liver L i n e aa l b a

Transverse
colon Rectusabdominismuscle
Branchesof inferiorepigaslricvessels
Omental appendices
Rectussheath
Createromentum
Transversus
abdominis
aooneurosis
Parietalperitoneum
Externaloblique aponeurosis
Transversalis
fascia
Internaloblique aponeurosis
Mesenteryof smallintestine Transversus
abdominismuscre
Superiormesentericvessels I n t e r n aol b l i q u e
muscte
S m a liln t e s t i n(ei l e u m )
External
oblique
L y m p hn o d e muscle
Ascending
coton Smallintestine
(jejunum)
R i g h t1 X,
paracolic Descending
gutter coron
Left
paracolic
gutter
Tendon Left
of origin of ureter
transversus
abdominis Quadratus
lumborum
muscle
muscle
Latissimus
l l i o i n g u i n anl e r v e dorsimuscle
Laversof ( Combined Testicular(ovarian)vessels
; -
thoracolumba' ""'' -
I| ftiddl. Psoasminor muscle
Tascra ( posterior
Parietalperitoneum
Psoasmajormuscle
Right genitofemoral nerve
Inferiorvena cava Leftsympathetictrunk
Anterior longitudinalligament
Ligamentumflavum
Erectorspinaemuscle
Abdominal aorta
Spinousprocessof L3 vertebra
Intermesenteric(aortic)plexus
Plate 349 Abdominal Sections

Abdominal Scans: Axial GT lmages
Seriesof abdominalaxial CT imagesfrom superior(A) to inferior (D)
A Aorta M Deepbackmuscles
AC Ascending colon P Psoasmuscle
B Bodyofvertebra R Rib
DC Descending colon RA Rectusabdominismuscle
It lleum RI Rightcommoniliacartery
lV Inferiorvenacava Rt Rightlobeof liver
tA Lineaalba s Spleen
tl Leftcommoniliacartery ST Stomach
tK Leftkidney TC Transverse
colon
tt Leftlobeof liver
Abdominal Sections Plate 35O

5 Pelvis and Perineum
Section
Topographic AnatomY
Plate 351
andPerineum
ssr Pelvis
Bones and Ligaments

Plates 352-355
of Pelvis
andLigaments
ssz Bones
andLigaments
3s3 Bones (continued)
of Pelvis
Measurements
of Pelvis:
sse SexDifferences
oftheMaleandFemale
sss Radiographs Pelvis
Pelvic Floor and Gontents

Plates 35F364
gse Pelvic Female

Diaphragm:
Diaphragm:
ssz Pelvic (continued)
Female
Male
Diaphragm:
ssa Pelvic
Male(continued)
Diaphragm:
oss Pelvic
geo Pelvic Female
andPerineum:
Viscera
Viscera
ser Pelvic Male
andPerineum:
Female
Contents:
aez Pelvic
ses Pelvic Male
Contents:
Fascia
oel Endopelvic Spaces
andPotential
Urinary Bladder
Plates 36$68
Bladder:
oes Urinary andSupports
0rientation
Female
Bladder:
eee Urinary andMale
oez Sphincters
368 MaleandFemale
Cystourethrograms

Pelvis and Perineum
ina, andSupporti
ns Rectum
t.r".i3ft,vas Plates 391-396
Plates 36975
ssr Rectum
inSitu:Female
andMale
oes Pelvic
Viscera:
Female ogz lschioanal
Fossae
ozo Uterus,
Vagina,
andSupporting
Structures gss RectumandAnalCanal
szr Uterus
andAdnexa sgl Anorectal
Musculature
szz Pelvic
Ligaments sss External
AnalSphincter
Muscle:
Perineal
Views
3zs Uterus:
AgeChanges
andMuscle
Pattern 396 Actual
andPotential
Perineopelvic
Spaces
szl Uterus:
Position
andProlapse
ozs Ectopic
Pregnancy Regional Scans
Plate 397
Regional Tlansverse Section ssz Pelvic

Scans:
Sagittal
MRlmages
Plate 376
sze MalePelvis:
Bladder-Prostate
Junction Vasculature
Plates 398409
Perineum and External ese Arteries

ofRectum
andAnalCanal(Male)
Genitalia: Female ess Veins
of Rectum (Female)
andAnalCanal
Plates 377-379
loo Arteries
andVeins
ofPelvic Female
0rgans:
ezz Female
Perineum
andExternal (Pudendum
Genitalia orVulva)
cor Arteries
andVeins
ofTestis
szs Female (Superficial
Perineum Dissection)
andVeins
coz Arteries of Pelvis:
Female
gzs Female
Perineum
andDeepPerineum
eos Arteries
andVeins
of Pelvis:
Male
Perineum and External eoe Arteries
andVeins
of Perineum
andUterus
Genitalia: Male eos Arteries
andVeins
of Perineum:
Male
Plates 38G87
me Lymph
Vessels
andNodes
ofPelvis
andGenitalia:
Female
oso Perineum
andExternal (Superficial
Genitalia Dissection) mz Lymph
Vessels
andNodes Female
ofPerineum:
set Perineum
andExternal (Deeper
Genitalia Dissection) eoe Lymph
Vessels
andNodes
ofPelvis Male
andGenitalia:
gaz Penis
ges Perineal
Spaces lnnervation
Plates 4O9-4l7
sal Prostate
andSeminalVesicles
ses Urethra 409 Nerves
of External Male
Genitalia:
sse Descent
ofTestis 4lo Nerves
ofPelvic
Viscera:
Male
sgz Scrotum
andContents 4ll Nerves
ofPerineum:
Male
412 Nerves
ofPelvic
Viscera:
Female
Homologues of Genitalia 413 ofPerineum
Nerves andExternal Female
Genitalia:
Plates 38&389
414 Neuropathways
in Parturition
see Homologues
of External
Genitalia 415 Innervation
of Female
Reproductive
Organs:
Schema
ees Homologues
ofInternal
Genitalia 4t6 ofMaleReproductive
Innervation 0rgans:
Schema
417 Innervation Bladder
of Urinary andLowerUreter:
Schema
Testis, Epididymis, and Ductus
Deferens
Plate 39O
Epididymis,
ogo Testis, andDuctus
Deferens

Pelvis and Perineum
Sternocleidomastoid
muscle
muscle
Trapezius
Deltoidmuscle
Pectoralis
majormuscle
Serratus
anterior
Semilunar muscle
line
Tendinous
intersection
External
oblique
muscle
Rectus Lineaalba
abdominis
muscle
Anteriorsuperior Umbilicus
i l i a cs p i n e
lliaccrest
Superficial
circumflexiliacvein
Superficial
epigastricveins
Inguinal
ligament
Pubicsymphysis
Pubictubercle
dorsal
Superficial
veinof penis
Body(shaft)of
C l a n so f p e n i s penis
Externalurethral Scrotum
orifice(meatus)
+*
f"{,
6(d4/*
Topographic Anatomy PIate 351

Bones and Ligaments of Pelvis
Bodyof L5 vertebra
lliac J Intermediate zone
c r e s t I n n e rl i p - Falsepelvis
I
(15-S1) intervertebral
Lumbosacral disc
llia.cfossa(wing
OI lllum)--
Sacralpromontory
Anteriorsuperior Creatersciaticforamen
iliac
'Truepelvis
Arcuateline
ial spine
Anteriorinferior
iliac spine Sacrospinous
ligament
lliopubiceminence Lessersciaticforamen
Obturatorcanal Sacrotuberous
ligament
Superiorpubicramus Coccyx
Pectenpubis lschialtuberosity
(pectineal
line)
Pubictu
Symphyseal
surface
Obturatormembrane
Bodyof L4 vertebra
rmediateron" )
lateral view Supraspinous
ligament Outerlip ) lliaccrest
lliactubercle )
Posterior,anterior,and
inferiorgluteallines Wing (ala)of ilium
(glutealsurface)
Posterior
superioriliacspine Bodyof ilium
Mediansacralcrest Anteriorsuperior
iliacspine
Posterior
inferioriliacspine Anteriorinferior
iliacspine
Posteriorsacroiliacligament
Greatersciaticforamen labrum
Sacrospinous
ligament Acetabularmargin
Posterior (articular)
surface
and lateral
sacrococcygealligaments notch
ligament
Sacrotuberous Transverse
acetabular
ligament
lschialspine Superiorpubicramus
Lessersciaticforamen Pubictubercle
*{r lschialtuberosity
Obturatormembrane
Obturatorcrest
canal
Inferiorpubicramus

Bones and Ligaments of Pelvis (continuedl
lliolumbarligament
ligament
Supraspinous
superioriliacspine
Posterior
Posteriorsacroiliacligaments
Posteriorsacralforamina
reatersciaticforamen
ligament
acrospinous
ligament
Sacrotuberous
Lessersciaticforamen
margin
Acetabular
tuberosity
Tendonof longheadof
bicepsfemorismuscle
lliolumbar
ligament
Anterior sacroiliacligament
Sacralpromontory
Anteriorsuperioriliacspi
ligament
Sacrotuberous
ligament
Sacrospinous
Anterior inferior iliac spine
lschialspine
/ z-----Arcuateline.-
Lesser .-
sciaticforamen
/ ,t
--{
lliopectineal lliopubiceminence Anterior
sacrococcygeal
Nr
(pectinealline)
Obturatorforamen
Inferiorpubicr
Anteriorview Pubictubercle

Sex Differences of Pelvis: Measurements
SFSo'Blrb,2l8
Femalepelvis/femalepelvic
inlet: anteriorview
S a c r o i l i a jco i n t
al promontory
Diagonal conjugate (-12 cm)
(-13cm)
Transverse Diameters of
the pelvis
O b l i q u e( - 1 2 . 5c m )
l l i o p u b i ce m i n e n c e
Nr
Pubicsymphysis
lschialtuberosity
Male pelvis/malepelvic
inlet: anteriorview
Allmeasurements
slightly
shorter
in
relationto body sizethanin female
Pelvicinletorientedmoreantero-
posteriorlythanin female,where
it tendsto be transverselyoval
Pubicsymphysis deeper(taller)
Pubicarch(subpubicangle)narrower
lschialtuberositieslessfar apart
lliacwingslessflared
Pubic
Transverse
symphysis
diameter of pelvic
o u t l e t( - 1 1c m )
Sacral
oromontorv-
onjugate
diameter
of pelvic inlet
schial ("11cm)
tuberosity
Anteroposterior l s c h i a sl p i n e
diameter of
pelvic outlet
( v a r i e s9 . 5 - l 1 . 5c m Anteroposterior
diameter of
becauseof mobility Tip of coccyx Pubic pelvic outlet
of coccyx) symphysis ( 9 . 5 - 1 1 . 5c m )
Fema.lepelvis/femalepelvicoutlet:
tntenor vtew Female:sagittalsection

Female and Male Pelvis Radiographs
FemalePelvis
A Sacrum
B llium
C Pubis
D lschium
E P u b i ss y m p h y s i s
F Obturatorforamen
G Headof femur
H Creatertrochanter
I Lesser trochanter
I Femur
K P e l v i cf o r a m i n a
L Airincolon
M S a c r o i l i aj oci n t
Acetabulum
Pelvicinlet
Male Pelvis
AL5
B Sacrum
C Ala of sacrum
D llium
E Pubis
F lschium
C P u b i cs y m p h y s i s
H Obturatorforamen
I lschialtuberosity
I l s c h i asl p i n e
K Headof femur
L Creatertrochanter
M Lesser trochanter
N Femur
O Airincolon
P S a c r o i l i aj oci n t
Acetabulum
S u b p u b iac n g l e

Pelvic Diaphragm: Female
SeealsoPlates 263,366,370,392
Superiorview l n f e r i o r( a r c u a t e p
) ubic ligament
P u b i cs y m p h y s i s Deeo dorsal vein of clitoris

perinealligament
Transverse
Inguinaligament Fasciaof deep perinealmuscles
(Poupart's)
Urethra
Vagina
Obturator canal
Obturatorfascia
( o v e ro b t u r a t o r
i n t e r n um
s uscle)
Pubococcygeus muscle
(partof levatorani
muscle)
Tendinous archof
levatorani muscle
Rectum
lliococcygeusmuscle
( p a r to f l e v a t o ra n i m u s c l e )
l s c h i a sl p i n e
Levatorplate (median raphe)
of levatorani muscle
Coccygeus(ischiococcygeus)
muscte
mismuscle
Coccyx
A n t e r i o rs a c r o -
coccygealligament
Sacralpromontory
Piriformis
muscte
l s c hi a l
Medialview sprne
A r c u a t el i n e o f i l i u m
o b t u r a t o r i n t e r n u sm u s c l e
and obturator fascia(cut)
T e n d i n o u sa r c h o f l e v a t o ra n i m u s c l e
O b t u r a t o rc a n a l ,
l l i o c o c c y g e u sm u s c l e
( p a r to f l e v a t o ra n i m u s c l e )
Rectum Coccygeus
Urethra ( i s c hi o c o c c y g e u s )
Pubococcygeusmuscle muscre
( p a r to f l e v a t o ra n i m u s c l e ) Left levatorani
muscle (cut)
Vagina
S p h i n c t e ru r e t h r a em u s c l e Externalanal
Left puborectalismuscle and s p h i n c t e rm u s c l e
4{ffi*
p e r i n e a lm e m b r a n e
C o m p r e s s o ru r e t h r a ea n d u r e t h r o v a g i n a l Superficialand deep
s p h i n c t e r( p o r t i o n so f s p h i n c t e ru r e t h r a em u s c l e transverseperinealmuscles
Plate 356 Pelvis Floor and Contents

Pelvic Diaphragm: Female (continuedl
lnferior view
Musculofascial to urethra
extensions
Pubicsymphysi Musculofascial to vagina
extensions
Inferior(arcuate) fibersof perineum
Interdigitating
pubicligament
muscle
Deepdorsal (partof levatorani muscle)
vein of c
Pubococcygeus muscle
Inferiorpubicra (partof levatorani muscle)
Urethra archof levatorani muscle

Tendinous
Vagina Obturatori nternusmuscle

lliococcygeusmuscle
Rectum (partof levatorani muscle)
lschialtuberositv
l s c h i asl p i n e
Obturatorinternus
tendon
ligament
Sacrospinous
ligament
Sacrotuberous
muscle
Piriformis
lschialspine Median raphe

of levator ani muscle
Coccygeus
(ischiococcygeus)
Anococcygeal body (ligament)
muscle (attachmentof externalanal sphinctermuscle)
muscle(
Piriformis
Sacrospinous
ligament Tip of coccyx
Sacrotuberous
ligament
Piriformis
muscle
sciaticforamen
Lateralview l s c h i asl p i n e
lliococcygeusmuscle
(part of levator ani muscle)
Mediansacralcrest
Tendinous archof levatorani muscle
ligament(cut)
Sacrotuberous Pubococcygeus muscle
(partof levatorani muscle)
4th posterior(dorsal)sacralfor Puborectalismuscle
(partof levatorani muscle)
Coccygeus (ischiococcygeus) muscle
liBament(cut)
Sacrospinous
Pubicbone
Coccyx (cut surface)
Deepdorsalvein
of clitoris
Urethra
4{tr
Pelvic Floor and Contents Plate 357
Pelvic Diaphragm: Male
SeealsoPlates 263, 266, 392
I n f e r i o r( a r c u a t e p
) ubicligament
Superiorview P u b i cs y m p h y s i s
(viscera removedl H i a t u sf o r d e e p d o r s a lv e i n o f p e n i s
Pubic crest
Transverseperinealligament
P u b i ct u b e r c l e ( a n t e r i o rt h i c k e n i n go f
r i n e a lm e m b r a n e )
P e c t e np u b i s( p u b i cp a r t
o f i l i o p e c t i n elai nl e ) Hiatus for urethra
S u p e r i orra m u so f p u b i s Muscle fibers from levator anr ro
c o n l o i n e dl o n g i t u d i n am
l u s c l eo f a n a lc a n a l
O b t u r a t ocr a n a l
Obturator fascia Levatorani

muscle
A c e t a b u l a rm a r g i n Tendinousarch of
l e v a t o ra n i m u s c l e
A n t e r i o ri n f e r i o r
i l i a cs p i n e Obturator
i n t e r n um
s uscle
Wing (ala)
of ilium
A r c u a t el i n e
( i l i a cp a r t o f l s c h i a sl p i n e
i l i o p e c t i n e al li n e )
l s c h i a sl p i n e muscle
P i r i f o r mm
i su s c l e
S a c r o i l i a jco i n t
A n t e r i o rs a c r a l( p e l v i c )f o r a m r n a
Sacrum Anterior sacrococcygealligament
Sacralcanal A n o r e c t a lh i a t u s
4{tr
Plate 358 Pelvic Floor and Gontents
Pelvic Diaphragm: Male (continuedl
Forurogenital seePlate 383
diaphragm
Inferiorview
D e e p d o r s a lv e i n so f p e n i s P u b i cs y m p h y s i s
Fat in retropubic (prevesical)space I n f e r i o rp u b i c ( a r c u a t e l)i g a m e n t

P e r i n e abl o d y
S p h i n c t e ru r e t h r a em u s c l ea s c e n d i n g F i b r o m u s c u l aerx t e n s i o n so f l e v a t o r
a n t e r i o ra s p e c to f p r o s t a t e ani muscle to orostate
Urethra P u b i ct u b e r c l e
R e c t o u r e t h r a l si su p e r i o rm u s c l e
R e c t o p r o s t a t i(cD e n o n v i l l i e r sf' a
) scia
Prerectal musclefibers(of Luschka)
M e d i a l b o r d e r( p i l l a r ) f r o ml e v a t oar n im u s c l e
o f l e v a t o ra n i m u s c l e Musclefibersfrom levator
l e m b r a n e( c u t a w a y
P e r i n e am
longitudinal
a n it o c o n j o i n e d
m u s c l eo f a n a lc a n a l
lschiopubic
ramus\
-"t*
i'PF"
ti
Obturator
i n t e r nu s
tendon
l s c h i a tl u b e r o s i t y muscle
S a c r o t u b e r o ulsig a m e n t( c u t ) Obturator internusmuscle

S a c r o s p i n o ulsi g a m e n t( c u t )
O b t u r a t o ri n t e r n u sm u s c l e
( i s c h i o c o c c y g e u sm)u s c l e
S a c r o s p i n o ulsi g a m e n t( c u t )
Sacrotuberousligament (cut)
Tip of coccyi
Pelvic Floor and Gontents Plate 359

Pelvic Viscera and Perineum: Female
Paramedian(sagittal)dissection
Ureter
Uterine
(fallopian) pouch
Rectouterine
tube (of Douglas)
Ovary Peritoneum(cutedge)
Ligament pouch
Vesicouterine
of ovary -
Rectum
Round
ligament reter
of uterus Urinarybladder
Broad
ligament(cut) Vagina
S u p e r i opr u b i c Pelvicdiaphragm
ramus(cut) (levatorani muscle)
Inferiorpubic Deeptransverse
ramus(cut) perinealmuscle(cut)
Ischiocavernosus External
anal
muscle sphinctermuscle
Bodvof clitoris
Labia
minora
Labium
marus
Median (sagittal)section
Sacralpromontory
Ureter terosacral
ligament
Suspensory ligamentof ovary Vesicouterinepouch
Uterine(fallopian) tube Rectouterinepouch
Ovary (of DouBlas)
External iliacvessels Cervixof uterus
Ligament of ovary part
Posterior
Bodyof uterus of vaginalfornix
R o u n dl i g a m e not f u t e r u s Anteriorpart
(ligamentumteres of vaginalfornix
F u n d u os f u t e r u s -Rectum
Vagina
Urinarybladder .Peiineal
Pubicsymphysis memDrane
Levatorani
Urethra
Sphincterurethrae muscle
Analcanal
Deep transverse
perinealmuscle
Deepdorsalveinof clitoris
Crusof clitoris
External
urethralorifice
Superficial perinealmuscle
transverse
L a b i u mm i n u s
Labiummajus
Vaginalorifice
Plate 360 Pelvic Floor and Contents

Pelvic Viscera and Perineum: Male
(sagittal)dissection
Paramedian Ductus(vas)deferens
Urinarvbladderandfascia
iliacvessels
External
Peritoneum Ureter(cut)
Rectusabdominis Seminalvesicle
muscte Rectovesicalpouch
Anterior layer
of rectus sheath
Transversalis
fascia Rectoprostatic
(Denonvilliers')
fascia
Umbilical
prevesicalfascia te (covered by fascia)
Sub- ( fatty{Camper' ramus(cut)
lschiopubic
c u t a n e o u{sm e m b r a n o u s
tissue ( ts.urpu'rt- Pelvicdiaphragm
(levatorani muscle)
Superiorpubicramus(cut
Fundiform Deeptransverse
l i g a m e not f p e n i s perinealmuscle
Suspensory Perineal
body
ligamentof penis
Deep ) External
anal
Areolartissueandvesical Superficial ) sPhincter
venousplexusin retro- Subcutaneous) muscle
pubic(prevesical) space
Deep perineal(investingor
Deepdorsalveinof pen Callaudet's)fascia
Corpuscavernosum
Superficialperineal(Colles')fascia
Deep(Buck's) (inferiorfasciaof superficial
fasciaof peni perinealspace)
Corpusspongiosum Superficial(dartos)fasciaof scrotum
(dartos)
Superficial fascia
of penisand scrotum Externalspermatic fascia
Septumof scrotum
Vesical fascia
Rectovesicalpouch
Rectum
Median (sagittal)section Seminal
vesicle
Prostate
Rectoprostatic
(Denonvilliers')
fascia
Fundiformligamentof Sphincter
Suspensoryligamentof peni
urethrae
muscte
lnferior (arcuate)pubic ligamen
Bulbourethral
Transverseperinealligament (anterior (Cowper's)
gland
t h i c k e n i n go f p e r i n e a lm e m b r a n s ) -
Perinealbody
Perinealmembrane
perinealspace
Superficial muscle
Bulbospongiosus
Corpuscavernosum Deep perineal(investingor
Callaudet's)fascia
Corpusspongiosum
Superficial(dartos)fasciaof penis and scrotum
Buck'sfascia
Deep (Buck's)fasciaof penis
Septumof scrotum
Prepuce
fossa
Navicular
Clanspenisandexternalurethralmeatus
Pelvic Floor and Gontents Plate 361

Pelvic Gontents: Female
Uterus(fundus) Lineaalba Urinarybladderand transversevesicalfold

Superiorview Rectusabdominismuscle
Ligamentof ovary Median
umbilical Medialumbilicalfold and ligament
Ova (occludedpartof umbilicalartery)
fold and
U t e r i n e( f a l l o p i a nt)u b e ligament
R o u n dl i g a m e not f u l (urachus) pouch(of Douglas)
Rectouterine
Broad(lateraluterine)ligament
Inferiorepigastricvessels
and
lateralumbilicalfold
Femoralring Uterosacralfold
Deepinguinalring Uretericfold
lliopubictract Suspensoryligament
(coveredby peritoneum) of ovary (contains
External ovarian vessels)
iliacvessels
lliac fossa
(false pelvis) Cecum
Cecalfolds
Left
Right
paracolic
paracolic
Butter gut
4{F
Sigmoidcolori aflan
Quadratus vessels Transversalis
lumborum Psoasmajor fascia
muscle a n dm i n o r Pararectal
fossa
muscles peritoneum
Parietal
Descendingcolon Inferiorvena cava
Ascending colon
Sympathetic trunk Sacralpromontory ileum
Terminal
Abdominal Anterior
Abdominalaorta Ureter
muscles longitudinalligament
Bodyof L3 vertebrd plexus
Superiorhypogastric Root of mesenterv

Pelvic Gontents! Male
Superiorview
Rectum L i n e aa l b a vesicalfold
Urinarybladderandtransverse
Median M e d i a l u m b i l i c a fl o l d a n d l i g a m e n t
S e m i n a vl e s i c l e( s u b p e r i t o n e a l ) (occluded part of umbilical artery)
umbilical
Ductusdeferens(in peritoneal
fold) fold and s b d o m i n im
R e c t ua s uscle
Lineaterminalisof pelvis ligament
(urachus) Rectovesicalpouch
Femoralring Inferior epigastricvesselsand
lateralumbilicalfold
Pubicbranchof in{eriorepigastric
arterv (obturator anastomotic) Vesicosacral
(sacrogenital)fold
D e e p i n g u i n a lr i n g fossa
Pararectal
iliacvessels
External Uretericfold
Testicular vessels
( i n p e r i t o n e af ol l d ) l l i o p u b i ct r a c t,
l l i a cf o s s a( f a l s ep e l v i s ) (extraperitoneal)
fascia
Transversalis
Cecum
Cecal
Parietal folds
perl
Left
paracolic
guttef
Testicular
Quadratui S i g m o i dc o l o n vessels Right paracolic
lumborum Psoasminor gutter
muscle and major Inferior
vena cava A s c e n d i ncgo l o n
D e s c e n d i n gc o l o n muscles
Svmpathetictrunk Sacralpromontory ileum
Terminal
Transversus
abdominis Abdominal Anterior Ureter
Abdominal aorta
I n t e r n aol b l i q u e m u s c l e s l o n g i t u d i n alli g a m e n t
E x t e r n aol b l i q u e Body of L3 vertebra plexus
Superiorhypogastric ormesentery
fi{tr
Pelvic Floor and Contents Plate 363

Endopelvic Fascia and Potential Spaces
Female:superiorview (peritoneumand looseareolartissueremoved)

Umbilicalprevesical fascia Medianumbilicalligament(urachus)
Medialumbilicalligament(occludedpartof umbilicalartery) Pubicsymphysis
Urinary bladder and vesicalfascia Inferior(arcuate) pubicligament
dorsalveinof clitoris
Rectusabdominismuscle
pubic(prevesical) space
Superiorvesicalarteryin lateralligamentof bladder
Transverse perinealligament(anterior
Lineaterminalisof pelvis t h i c k e n i nogf p e r i n e aml e m b r a n e )
Femoral ring Medial pubovesicalligament
Lateralpubovesical
ligament
Inferiorepigastric
artery
and Vesicocervicalfascialfibers
Pubic branch Superiorfasciaof pelvic
D e e pi n g u i n arli n g 4iaphragm(superior
levatoranifascia)
lliopubic trac Obturatorcanaland
Transversalis obturatorarterv
fascia
External
iliac
vessels
Femoral
nerve
(under
fascia)
Deep
circumflex
iliac
vessels
Tendinous arch
of pelvicfascia
(reflected
laterally)
lliac
fascia
Ovarian
vesselsin
suspensory
ligament
of ovary
lliacusmuscle
urator
internus
Psoasmaiormuscle fascia
Internaliliacvessels Tendinous archof
Inferiorvesical Jevatorani muscle
and vaginalarterie
Tendinous archof
(neurovascular)
Hypogastric sheath pelvicfascia
Middlerectalarterv Uterosacralligament
Cervixof uterusand uterinefascia Cardinal(transverse cervicalor
Superiorrectalartery(leftbranc6) Mackenrodt's) ligamentwith uterineartery
Rectum and rectal fascia Vaginorectal fascialfibers
Rectovaginal(potential)spa Presacraltascia(pulled away)
(potential)space(spreadoperi)
Presacral Anterior sacrococcygealligament
4{tr Median sacralarteri Vesicocervicaland vesicovaginal(potential)spaces

Urinary Bladder: Orientation and Supports
Female:midsagittalsection
Peritoneum
fascia
Transversalis
M e d i a n u m b i l i c a l i g a m e n t( u r a c h u s )
Umbilical prevesicalfascia
U t e r u s( f u n d u s )
Vesicouterinepouch
Fundus
Uretericorifice
Trigone
P u b i cs y m p h y s i s
Retropubic(prevesical)space and
venous plexus
Inferior (arcuate)pubic ligament
Deep dorsal vein of clitoris
Transverseperinealligament
Sphincterurethraeand
S p h i n c t e ru r e t h r o v a B i n a l t s
musctes
Perinealmembrane
Urethra
Vagina
Perinealbody Labium ma.jus
'Ampulla
External anal of rectum
s o h i n c t emr u s c l e Superiorview with
peritoneum
P u b i cs y m p h y s i s and vesical
I n f e r i o r( a r c u a t e p
) ubicligament fascia
removed
Deep dorsal vein of cli
M e d i a l p u b o v e s i c alli g a m e n t
( m e d i a lp u b o p r o s t a t i cl i g a m e n ti n m a l e )
Transverseperinealligament (anterior
t h i c k e n i n go f p e r i n e a lm e m b r a n e ) - -
Tendinousarch of levatorani muscle
Obturator canal
Lateralpubovesicalligament
(lateralpuboprostaticligament in male)
Tendinousarch of pelvic fascia
S u p e r i o rf a s c i ao f p e l v i cd i a p h r a g m
( c o v e r i n gl e v a t o ra n i m u s c l e )
Obturator fasciaover
obturator internusmusc
Urinary bladder pulled up and back
(vesica/fasciaremoved)
4{tr
e/Fd4/*
M e d i a n u m b i l i c a l i g a m e n t( u r a c h u s () c u t )
l n d v a g i n a la r t e r i e s
I n f e r i o rv e s i c a a
Ureter
Urinary Bladder Plate 365

Urinary Bladder: Female and Male
StraboPfatsg{q ffi1, St,oGq {S, M,4oo.417
Female:frontal section
Peritoneum
Body of bladder
F u n d u so f b l a d d e r
Interuretericcrest
Left uretericorifice
Trigoneof bladder
Neck of bladder
Paravesicalendopelvicfascia
and vesicalvenous plexus
Vesicalfascia
Tendinousarch of levatorani muscle
O b t u r a t oirn t e r n u m
s uscle
Levatorani muscle
Tendinousarch of pelvic fascia
Urethra
Sphincter
urethraemuscle
Perinealmembrane
Round I n f e r i opr u b i cr a m u s
ligament C r u so f c l i t o r i sa n d i s c h i o c a v e r n o s umsu s c l e
of uterus B u l bo f v e s t i b u laen db u l b o s p o n g i o sm
u su s c l e
Deep perineal(investingor Gallaudet's)fascia
Peritoneum
Body of bladder
F u n d u so f b l a d d e r
Ductus (vas)deferens
Interuretericcrest
Right uretericorifice Internal
Trigone of bladder urethral
sphincter
Neckof bladder
Tendinous
Paravesicalendopelvic fascia arch of
a n d v e s i c a vl e n o u so l e x u s pelvic
T e n d i n o u sa r c h o f l e v a t o ra n i m u s c l e fascia
Uvula of bladder Anterior
O b t u r a t o ri n t e r n u sm u s c l e recessof
ischio-
L e v a t o ra n i m u s c l e anal
fossa
Capsuleof prostate
Inferior
Prostateand prostaticurethra pubic
ramus
Seminal
C r u so f
p e n i sa n d
B u l b o u r e t h r(aCl o w p e r ' sg)l a n d ischiocaver-
P e r i n e am
l e m b r a n ea n d s p h i n c t e ru r e t h r a em u s c l n o s u sm u s c t e
tg Bulbousportionof spongyurethra-
C o r p u ss p o n g i o s u a
mn db u l b o s p o n g i o sm
u su s c l e -
4Nffi
"Cryr4gl*
Deepperineal(investing or callaudet's) fascia
Plate 366 Urinary Bladder

Sphincters
Vagina
Urethra
Levatorani muscle
Urogenitah
l iatus
Sphincter
u r e t h r a em u s c l e
Perineal External
U rethrovaginal
body sphincter
muscle
(voluntary)
Compressor
urethraemuscle
Urinary Bladder Plate 367

Male and Female Gystourethrograms
Femaleurethra,
8-year-oldchild
Voiding
cystourethrogram,
2-year-oldmale
Plate 368 Urinary Bladder

Pelvic Viscera: Female
Superiorview with peritoneumintact

Medianumbilicalfold (urachus)
Vesicouterine bladder
pouch
of uterus
Paravesical Deepinguinalring
fossa Roundligamentof uterus
Bodyof uterus
Broad ligament
Ligamentof ovary
lpinx(of broadligament)
Cervixof uterus
pouch(of Douglas)
Rectouterine
Rectouterine fold
Uterine(fallopian)tube
iliacvessels
External
fossa
Suspensory ligamentof ovary
(containsovarianvessels)
Uretericfold
bladder
fascia (cut edge)
Obturator fascia
Sigmoidcolon
Sacral
Median sacral
Abdominalaorta
Obturatorcanal
Obturatorartery
Superiorfasciaof pelvicdiaphragm
fascia
Cervixof uterusand uterovaginal
Uterinevessels
Cardinal(transversecervical
or Mackenrodt's)
Rectocervicaland rectovaginal(potential)
Rectal fascia (cut edge)
(sacrouterine)
Rectouterine
4{tr ligament
Ureter
Sacralpromon
Superiorview with peritoneum and uterusremoved
Uterus, Vagina, and Supporting Structures Plate 369

Uterus, Vagina, and Supporting Structures
Mesovarium
Ovary Broad ligament
Uterine Cut edge of peritoneum
Planeof section
forming floor of
A n g l eo f v i e w +\ ( f a l l o p i a nt)u b e
R o u n dl i g a m e n t
paravesicalpouch
Suspensory
il of uterus ligamentof ovary
Uterus Ligament
(pulled of ovary.
I n t e r n a li l i a c
artery and vein
\q d !
Lineaterminalis
(pelvic brim)
' ',t,
Uterinevessels
Obturator Cardinal(transverse
membrane cervicalor
Mackenrodt's)
Obturator ligament
fascia
Tendinousarch
of levator ani
Obturator
muscle
i n t e r n um
s uscle
Vaginalartery
Levatorani muscle
(iliococcygeusand Ureter
puDococcygeus
muscles) Uterovaginalfascia
l s c h i o p u b i cr a m u s Anteriorrecess
of ischioanal
fossa
Compressor of clitoris
urethralis
musc
lschi ocavernosus
Perineal muscle
memorane
Fascialata of thigh
Artery of bulb of ves
Superficialperineal
space
S p h i n c t eurr e t h r o v a g i n aml ius s c l
Perinealartery
Terminalpart of round
ligamentof uterus perineal
Superficial
(Colles')
fascia
L a b i u mm a B u l b o s p o n g i o s um
s u s c l ea n d d e e p
perineal(investingor Callaudet's)fascia
L a b i u mm i n u d
Bulbof vestibule
Vestibule Vaginalwall
H y m e n a lc a r u n c l e
Plate 37O Uterus, Vagina, and Supporting Structures

Uterus and Adnexa
Suspensoryligamentof ovary Posteriorview Uterine(fallopian)

tube
Ampulla Infundibulum
Mesosalpinx(of broad ligament)
Ligamentof ovary
Vesicular
appendix Fundus of
(hydatidof uterus
Mor8agni)
Abdominal
Corpusluteum ostium
Ovary
ligament
Suspensory
Body of ovary
of uterus Ovary
Mesovarium(of
Mesometrium(of
broad ligament)
broad ligament)
Ligamentof ovary
Ureter
Uterosacralligament Uterine(fallopian)tube
Rectouterineoouch
(of Douglas)
Fundus
of uterus
Body
of uterus
lnfun-
dibulum
Foldsof
utenne
tube
lsthmus Fimbriae
of Ligament
uterus of ovary Suspensory ligament
of ovary(contains
Internal Endometrium ovarianvessels)
os
Myometrium Vesicularappendix
(hydatid of Morgagni)
Mesometrium(of
broad ligament) Epoophoron
Cervix Uterine vessels
of
uterus Cardinal(transverse
cervicalor
Mackenrodt's)
ligament
Cervicalcanal
*{r
with palmatefolds
Vaginalfornix Frontalsection
Vagina

Pelvic Ligaments
Anterior Posterior
Suspensoryligament
of theovary
(containing
theovarianvessels)
Subdivisionsand
contentsof the
broad ligament
External
iliacvessels
A m p u l l ao f u t e r i n et u b e
Rightovary
Rightureter
Laminaeof the mesosalpinx

Obliteratedumbilicalartery- Laminaeof the mesovarium
Ovarian branches Posteriorlaminaof broadligament
of uterine vessels
Anteriorlaminaof broadligament
Transversevesicalfold
Vesicouterine
(uterovesical)pouch Uterinearteryandvenousplexus
Vaginalartery
Horizontal portion of
ligament
Uterosacral
Cardinalligament
Pelvicfascia
and ligaments
Horizontal
portionof vagina
Arcustendineous fasciaepelvis
Vertical
portion of Distal(vertical)
portionof
vagrna pubocervical fasciasupports
urethraand U-Vjunctionand
providesbackstopagainst
Urethra
,ol'INAC{-ro which urethrais compressed
e4a4/* duringstraining
Plate 372 Uterus, Vagina, and Supporting Structures

Uterus: Age Ghanges and Muscle Pattern
Adult Adult Adult

(nulliparous) (parous) (postmenopausal)
C Contrastmediumin abdominalcavity
uterus
H Hysterosalpingogram
R Rightfallopiantube infection
Ligament
of ovary
Round
ligament
of uterus Uterine
musculature
Uterosacral (schema)
ligament
Cardinal fiberspass
Spiral
(transverse deeplyintowall
cervicalor and interlace
Nr
Mackenrodt's) (schema)
ligament
Vaginalwall

Uterus: Position and Prolapse
Degrees of retroversion
3rd degree 2nd degree l st degree
Variations
in position
Anteflexion
Retroflexion (normal and severe)
Slightdescent(1st degree)
*{r
Cervixat introitus (2nd degree)
Plate 374 Uterus, Vagina, and Supporting Structures

Ectopic Pregnaney
Sitesof ectopic implantation Abdominal

Tubal Iuoal
Interstitial (isthmic) (ampullar) o
lnfundibular
(ostial)
*{r
Unruptured
tubalpregnancy
Villi invading Chorion
tubularwall Amnion
Sectionthrough
tubal pregnancy

!
ql fransverse Section: Pubic Crest, Femoral Heads, Coccyx
i =
o !l
I
GI
{ Superiorportionof pubicsymphysis Interior of urinary bladder o
o !
Spermaticcord A d d u c t o lro n s u sm u s c l e
g
s.
Plate 376
B e g i n n i n go f u r e t h r a of pubis
Prostategland with
prostatic urethra
s muscte 2
P s o a sm u s c l ea n d
Femoralvein tr
I
Femoralartery qt
l l i a c u sm u s c l e c
Femoralnerve c
Headof femur
S a r t o r i um
s uscle
o
rt
Neckof femur I
l l i o p s o a sm u s c l e !rl
Cluteus
medius Rectusfemoris o
muscle muscle o
t
Cluteus Tensor It
t
mtntmus fasciaelatae
tendon muscle o
Creater Cluteus c
trochanter medius C
muscre 5
1
o lnferior
Obturator
o
9.
gemellus !L
o
muscl artery,vein,
and nerve o
f 5
g Acetabular
fossa
+
ql
Cluteus
L u n a t e( a r t i c u l a r )
surfaceof
f O b t u r a t o ri n t e r n u sm u s c l e
acetabulum
o
Sacrotuberousligament
o
rt
Left sciaticnerve
o Ejaculatory
ducts Internalpudendal artery and vein
o
o Perinealflexure (terminationof Pudendalnerve
o rectum, beginningof anal canal)
o
t Tip of coccyi
Fat bodv of ischioanalfossa
II
o Levatorani muscle (puborectalis) Cfd4/*

5
FemalePerineumand ExternalGenitalia(Pudendumor Vulva|
M o n sp u b i s
Anteriorcommissure
of
labiamajora
Prepuceof clitoris
Pudendalcleft(grooveor
spacebetweenthe
labiamajora)
Clansof clitoris
Frenulumof clitoris
urethralorifice
Labiummajus
Openingsof paraurethral
(Skene's)
ducts
of vagina
(cleftor spacesurrounded
by labiaminora)
Openingof greater
(Bartholin's)
vestibular gland
Hymenalcaruncle
Vestibularfossa
of labiaminora
Frenulum
ol
commrssure
labiamajora
raphe
Perineal
(overperinealbody)
Anus
*{r
A n n u l ahr v m e n Septatehymen Parousintroitus
Perineum and External Genitalia: Female Plate 377

Female Perineum (Superficial Dissection)
S u p e r f i r . i af al t t y ( C a n r p e r ' sl)a y c r
) Su b c u t an e o u s
trssue
R e i t u s s h e a t h( a n t e r i o rl a y e r )
A p o n e u r o s i so f e x t e r n a o
i b l i q u en r u s c l e
S u p e r f i ir. r li n g u i n . rrl i n g
A t t l e r i o r s t t l t e r i o ri l i , t t : p i n e
I l o u n c l i g a m e n to f u t e r u sa n d c o v e r i n g s( c u t )
l n g , u i n aI li g a n r e n(t P o u p a r t ' s )
P u b i ct u b e r c l e
P u b i cs y n r p h y s i s
S a p h e n o uosp e n i n g
S u s p e n s o r lyi g a n r e not f c l i t o r i s
F a s c . il.ar t ao f t h i g h
l s c ' h i o p u b ri ca n r u s
S L r p e r i i c ipael r i n e a(l C o l l e s 'f)a s c i a
( c r / ta \ v . r v t)o o p e n s u p e r i i c i a l
p e r i n e asl p a c e
Is r - hio c a v e r no su s n rr - r s c l e
B u l b o s p o n g , i o s runsu s c l e( c o v e r s
br,rllrot vestiltr-rle )
l ) e r i n e . rnl r e n r b r a n e
D e e l rp e r i n e a{l i n v e s t i nogr C a l l a u c l e t ' s )
iascia(lrartia//),cut a\1,.ry)
S r r rl t ' r t i ri . r ll r . t t r ' re r r e l l e r i t r e a n
l ru\cle
I s c h i a tl r - r b e r o s i t y
S u p e rl i c i a lp e ' r i n e a(lC o l l e s ' i)a s c i a
(c'utc'c/gc, trrlrcc/c/orvn)
F a tb o c l yo f i s c h i o a n aflo s s a
- Tt'atrsve,rs,tIis i.rsc.i.t
-:-Rt't ltts
\ f ..xy-------l
Sulrcutanr:ous
Superficial
perir.rea
(Cl olles') i ii:lt.;;,,,,./
I rvl.l tr,t r l t{ ,U\_
-.,-
iascia R e t l u . r l t e . t t l tt . r r t l e r i o lr , r t t t t /
I P u b i cs y n t p h y s i-s. -
(arcuafe)
tnferior tiganrcr,r---__
uubir'
|f';ilX,l'.-:ili"'
c()vennBS T r a n s v e r s e1 l t ' r i t ' t t ' al il g . t r l r t ' l l t
S u s l ; e n s o r yl i g a n t e n to l t l i l o r i s ___=-.=N
Sphi nc:teru rethrae ar-rcl
slth i nc'teru rethrovaginalis ntust lt,s---l-\
l l . r i n t , arl r t ' n r l t r . r r r t ,
-
Sr-r1re rf ir:ia | 1rc ri nt' a| (( rrIIt's' ) l,\ s( id -------/
Anococcygeal
S u l t t ' r i o r[ . r s ri a < >p[ r ' l v i r r l i a l t h r a g n r body
E x t e r n aal n a l
I r ' v . r l o r. r r r n
i ruscle s p h i n c t enr r u s c l e
Plate 378 Perineum and External Genitalia: Female

Female Perineum and DeeP Perineum
B u l b o s p o n g i o smu us s c l e Clitoris S u s p e n s o r yl i g a m e n to f c l i t o r i s
with deepperineal(investing
o r C a l l a u d e t ' sf;a s c i a
partiallyremoved lschiocavernosusmuscle
B u l bo f v e s t i b u l e
S u p e r f i c i apl e r i n e a sl p a c e
( p o u c ho r c o m p a r
membrane
Perineal
l s c h i o p u b irca m u s
w i t h c u t e d g eo f Creatervestibular
( B a r t h o l i n 'Bs l)a n d
superficial
p e r i n e a(lC o l l e s ' )
fascia- Bulbospongiosus
muscte
lcut away)
Perineal
membrane
Superficial
transverse
lschial perineal
tuberosity muscle
Sacro-
tuberous Perineal
ligament, body
Cluteus
maxrmus
muscte
lschioanalfossa
Coccyx Obturator
fascia
Urethra
Tendinousarch of
Crusof levator ani muscle
clitoris- S p h i n c t e ru r e t h r a e
muscle lnferior fasciaof
lschio- pelvic diaphragm (cut)
pubic
ram P e r i n e aml e m b r a n e Levatorani muscle
(cutand reflected)
Externalanal sphinctermuscle
urethrae
Compressor
muscte
Anococcygeal(ligament)body
S p h i n c t e ru r e t h r o v a g i n a l i s
muscle
Creater vestibular
( B a r t h o l i n ' sg)l a n d
Vagina
Deeptransverse
4{tr
p e r i n e aml u s c l e
P e r i n e am
l embrane
Perineum and External Genitalia: Female Plate 379

Perineum and External Genitalia (Superficial Dissectionf
SLrpcrlia cl
l.rtt\'{(-.rnl)er's)
in(| (|('('l)('l
n r t ' n rIr T , n
t c lL rs
{ S <a r p a ' sltr v t ' r
( ) l s u l ) cu t . l t e o L t s
trstu('
Anterior
sul)e11 ol
i l i a cs p i n t '
Ingr,rin.rl
S L r l ; t ' ri lr . i l l ( c l a r t o s )
lrSainrent
l a s ci a o 1 p c n i s a n c l
s( rotu|ll b (Poupart's)
S .p
r h c r ro L r s
ol)('nilr{l .lnd
1r'nror.rl
.trt('rv
a r r r lv t , i n
l l r o l < t ' nl i n e
in(li(.lt('s l s ch i o -
lint'o1 pulrit
n t f . r h( n r ( ' n t rJnrLrs
ol (.olles'
a n r lS ca r p a ' s
l . r s r . i . rwt ,i t l r
cleep l-.rsc'iir
I : , r l r o c l yi n i s c h i o a n . r{ lo s s a P u b i cs y m p h y s i s
U r o g e n i t at lr i a n g l e
l s c hi o p r . r l r irca-n r u s
R e g i o n s( t r i a n g l e s )
ot penneum:
s u r l a c et o p o g r a p h y
\ n ( l lt r i a n g l e
Nr %tc#
Tip of cocc.vr
Plate 38O Perineum and External Genitalia: Male

Perineum and External Genitalia (Deeper Dissectionf
Skinof penis
Superficial(dartos)
fasciaof penis
Aponeurosis of
externaloblique
muscre
Deepmembranous (Scarpa's)
layerof subcutaneous
tissue(cutaway)
I n g u i n al il g a m e n t
(Poupart's)
Deep(Buck's)
fasciaof penis
Superficial
Externalspermaticfascia
investingspermaticcord
*J,
Fascialata (deep fascia)of thigh
B u l b o s p o n g i o smuus s c l e
muscle
lschiocavernosus
coverscrusof penis
perineal(Colles')fascia(cut
Superficial
perinealspacel
awayto open superficial
Perinealmembrane
Deepperineal(investing or Callaudet's)
fascia(partiallycut away)covers
musclesof superficial perinealspace
perinealmuscle
transverse
Superficial
lschialtuberosity
fascia(cutedge)
perineal(Colles')
Superficial
fossa
Levatoranimuscleroofingischioanal
xternalanalsphinctermuscle
C l u t e u sm a x i m um
s uscle
Superficialdorsalvein
Dorsalarteryand nerve
Deep dorsal vein
vein
Lateralsuperficial
Superficial(dartos)fasciaof pe
Corpus cavernosumand its
Deep (Buck's)fasciaof penis tunica albuginea
Deep artery
Intercavernousseptum of deep fascia
Urethra
Corpusspongiosum
t u n i c aa l b u g i n e a
and its
4{tr
Sectionthrough body of penis
Perineum and External Genitalia: Male Plate 381

Penis
l r i f i c e( m e a t u s )
E x t e r n aul r e t h r a o
C l a n sp e n i s
oronaof glans
Frenulum Neckof glans
Skin O p e n i n g o f p r e p u t i a l( T y s o n ' sg) l a n d
Superficial(dartos)fasciaof penis
D e e p( B u c k ' sf )a s c i ao f p e n i s
Externalspermaticfasciainvestingspermaticcord (cut)
Superficialperineal(Colles')fascia(cut away to open

supe rfi cial per i neal space\
Deep perineal(investingor Gallaudet's)fascia

(cut away) over musclesof superficialperinealspace
lschiocavernosusmuscle (cut away)
Superficialtransverseperinealmuscle
C l a n sp e n i s
oroora cavernosa
of penis
lntercavernous
septumof deep
(Buck's)fascia
C o r p u ss p o n g i o s u m
Pubictubercle
Superior
p u b i cr a m u s
lschial
tuberosity Perineal
membrane
C l u t e u sm a x i m u m
s uscle
Perineal
L e v a t o ra n i m u s c l e
body
and inferior fascia
of pelvic dia.phragm I B u l bo f p e n i s
rooilng rscnroanatlossa Tip of coccyx
Externalanal C r u so f p e n i s
s p h i n c t e rm u s c l e
Perineal
memorane
4{F lschial
tuberosity
External anal
s p h i n c t emr u s c l e
Plate 38.2 Perineum and External Genitalia: Male

Perineal Spaces
Pubic
P u b i cb o n e
Superior
pubic Transverse perinealligament(anterior
ramus\\ t h i c k e n i nogf p e r i n e aml e m b r a n e )
\
Inferior Dorsalarteryand nerveof penis
(arcuate)
pubic Deeparteryof penis
ligament
Urethralartery
D e e pd o r s a l (Cowper's)
gland
veinof penis Ductof bulbourethral
Arteryof bulbof penis
Urethra Deepperineal(investing fasciaover

or Callaudet's)
bulbospongiosus,
ischiocavernosus, and
Perineal perinealmuscles(cutaway)
transverse
superficial
m e m b r. at l lnt re-
ficial perineal(Colles')fascia(cutaway)
perinealmuscle
transverse
Superficial
kut and reflected)
tuberosity
Perineal
External
body
a n a ls p h i n c t e r
muscte
Inferior views Dorsal artery and nerve of

Deep artery of penis
Urethral
(Cowper's)
Bulbourethral gland Sphincter
urethrae
Arteryof bulbof penis muscle
membrane(cutedge)
Perineal
Internalpudendalartery
and dorsalnerveof penis
I n t e r n apl u d e n d aal r t e r ya n dp e r i n e abl r a n c h
Urethra
Deeptransverse
perinealmuscle
Levatorani muscle
P e r i n e am
l embrane
Deep transverseperinealmuscle Prostate
uratorinternusmuscle
Deep perineal(investing
fascia
or Callaudet's) l s c h i o p u b ri ca m u s
Sohincter urethraemuscle
Corpus cavernosum(crus of penis)
and deep (Buck's)fasciaof peni Bulbourethral (Cowper's)
gland
lschiocavernosus muscle
lschiocavernosusmuscle
B u l bo f p e n i s( c o r p u s p o n g i o s u m
a )n d
S u p e r f i c i apl e r i n e a l( C o l l e s ' f) a s c i a d e e p( B u c k ' sf )a s c i ao f p e n i s
( c l o s e ss u p e r f i c i apl e r i n e a sl p a c e ) B u l b o s p o n g i o smuus s c l e q
1frffi
Frontalsection,anteriorview of perineum:schema "'"erfu#
A aa

Prostate and Seminal Vesicles
SeealsoPlates361,363,366,403,
410
Ureteric
orifice
Trigone
of urinary
bladder
In t e r n a l
urethral
sphincter
Uvula Prostate
of bladder
Urethral S e m i n aclo l l i c u l u s
crest
Openings
Prostatic
utricle
of prostatic
d u c t si n O p e n i n go f
prostatrc ejaculatoryduct
S I NU S
Sphincter
urethrae
muscle
Bulbourethral
(Cowper's)
gland
i+...j ; Rectum
O p e n i n go f b u l b o u r e t h rdaul c t and
Perinealbody rectal
fascia
Frontalsection,anteriorview Rectovesicalor rectoprostatic
of bulbousportion of sponsy (Denonvilliers')fascia Seminal
urethraschematicallvextendtid vesicle
Sagittalsection
Ductusdeferens
Anteriormuscularbandof skeletalmuscle
(continuationof sphincterurethrae)
I s t h m u sa n d f i b r o m u s c u l a r
Ampulla Prostatic ma (smooth muscle)
of ductus urethra atic utricle
deferens
Seminal ian lobe
col
Inferolateral
Beginning Inferolateral lobe
of ejaculatory lobe
duct
Prostate
l s c h i o p u b i cr a m
Deep t
perineaml uscle
and fascia
Capsuleof
prostate
(Cowper's)
Bulbourethral glands lnferooosteriorlobe
Posteriorview Crosssectionthrough prostate
Plate Perineum and External Genitalia: Male

Urethra
Trigoneof
i urinary bladder
of bladder
Prostate
Urethralcrest
Prostatic
sinuses
Prostatic
u rethra O p e n i n g os f
Prostaticutricle prostaticducts
lntermediate
part of
(membranous) urethrae
urethra
Bulbof oeni
C r u so f p e n i s
Bulbourethral
Bulbous (Cowper's)
gland
portion
:el
,:,_$s/
Corpus cavern
T u n i c aa l b u g i n e a
Corpusspongiosum
T T u n i c aa l b u g i n e a
f
- Deeparteryof peni
lntercavernousseptum
of deep (Buck's)fascia
oo Pendu-
touS
(penile) Urethrallacunae(Morgagni)
portion and urethralglands(Littr6)
LacunamaBna(inconstant)
fossa
Navicular
C l a n sp e n i s
urethralorifice(meatus)
External
Roof of Floor of
urethra urethra

Descent of Testis
gland
Suprarenal gland
Suprarenal
Suspensory Kidney
(diaphragmatic)
ligament Suspensory
(diaphragmatic)
ligament
(atrophic)
Mesonephric
(wolffian)duct Testes
Cubernacul Epididymis
Urinarybla Cubernaculum
Deepinguinalring
Urinarybladder
I weeks
(22.5-mmcrown-rump)
(43-mm crown-rump)
Cubernaculum
f
4 lunar months
(107-mmcrown-rump)
S u p e r f i c iianlg u i n arli n g
Ductusdeferens
Scrotum(cutopen)
*{r Processus
vaginalis Cavityof
Cubernaculum tunica
8 lunarmonths vaginalis
(26-cm crown-rump) (cutopen)
Plate 386 Perineum and External Genitalia: Male

Scrotum and Gontents
Skinof penis
Superficialfascia
of penis(Colles'fascia)
Deep(Buck's)
Superficial fasciaof penis
Testicular
artery
External Ductusdeferens
spermaticfascia
to ductusdeferens
muscle
Cremaster
and fascia italbranchof
genitofemoralnerve
(venous)
Pampiniform plexus
Septumof scrotum
(formedby
dartosfascia)
Appendixof epididymis
Superficial
(dartos)fascia Appendixof testis
of scrotum
Testis(coveredby visceral
layerof tunicavaginalis)
Skinof scrotum
layerof tunicavaginalis
Parietal
(dartos)
Superficial fasciaof scrotum
External fascia
spermatic
Cremastermuscleand fascia
Internalspermatic
fascia
Parietal
layerof tunicavagi
Epididymis
Testis(coveredby viscerallayerof tunicavaginalis)
Skinof
*{r
Homologues of External Genitalia
Undifferentiated
Epithelialtag
fold
Urogenital
Cenitaltubercle
Urogenitalgroove
Lateralpart
of tubercle
Analtubercle
Anal pit
Male Female
Epithelial
tag
45-50 mm 45-50 mm
(-10 weeks) Coronalsulcus (-10 weeks)
Siteof futureoriginof prepuce
Urethralfold
Urogenital groove
Lateraltubercle
(shaftor corpus)
Labioscrotal
swelling
Urethralfoldspartly -
fused(urethralraphe)
Analtubercle
Anus
External
urethralorifice
Body of
clitoris
Prepuce
Fully developed Clansof
clitoris
External
Raphe urethral
of penis orifice
Labium
mrnus
Labium
maJus
Posterior
commrssure
Perinealraphe
Perianal
tissues
(includingexternal
analsphincter
muscle)
Plate 388 Homologues of Genitalia

Homologues of lnternal Genitalia
-- Diaphragmaticligament
(suspensory
ligamentof ovarY)
(mi.illerian)
Paramesonephric duct
Mesonephric
tubules
(wolffian)duct
Mesonephric
Cenitalcord
fold1
Inguinal sinus
Urogenital
\
i
Primordium of prostate
(d ) Primordium (Cowper's)
of bulbourethral (d)
(Skene's)
or of paraurethral or of greatervestibular (9 ) glands
(Bartholin's)
(9) glands
Undifferentiated 4{tr
1*
M^r" 2,/ Femare
Seminalvesicle
deferens
Prostatic
utricle
Prostate
Openingof
ejaculatory
Bulbourethral
(Cowpe/s)
of epididymis
Epididymis
Efferent
ductules
Appendixof testis
Testis
Paradidvmis
Scrotalligamen
(gubernaculum)
Homologues of Genitalia Plate 389

Testis, Epididymis, and Ductus Deferens
Efferentductules
Aberrantductule(vestigial
mesonephric
tubule)
Ductusdeferens
Areaof rete testis(in mediastinumtestis)
Epididymis
Frontal section
Ductusdeferens
Efferentductules
Epididymalduct
Retetestis(in mediastinum
testis)
Aberrantductule
Seminiferous
tubules
Schema
Skinof scrotum
(dartos)fascia
Superficial
Lobulesof testis External
spermatic
fascia
Scrotalseptum(dartos) muscleandfascia
Internalspermatic
fascia
Septa
Parietallayerof tunicavaginalis
Retetestis(in Viscerallayerof tunicavaginalis
mediastinum testis)
Tunicaalbuginea
of testis
Ductusdeferens Sinusof epididymis
Epididymis
Crosssectionthroughscrotumand testis Nr
Plate 39O Testis, Epididymis, and Ductus Defenens
Rectum in Situ: Female and Male
Sigmoidcolon
Free taenia
Sigmoidmesocolon (taenialibera)
Rectosigmoid Ductus(vas)
deferens(cut)
Peritoneal
reflection
Ureter(cut)
pouch
Rectovesical
Urinary
Rectumand bladder
rectalfascia Seminal
vesicle
Levatorani muscle
(pelvicdiaphr
(Denonvilliers')
Coccyx fascia
Puborectalispart of Prostate
levatorani muscle
lschiocavernosus
muscleanddeep
External
anal Deep perineal(investing
sphinctermuscle* Superficial or Callaudet's)
Subcutaneous fascia(partially
cut away)
Deep transverse
perinealmuscle
Female Perineal
body
Sigmoid transverse
mesocolon perinealmuscle
and deep perineal
Rectosigmoid (investing)
fascia
lunction perineal(Colles')
fascia
Peritoneal
reflection Sigmoidcolon
Rectalfascia Freetaenia(taenialibera)
and rectum
Rectouterine pouch
pouch 4{y
(of Douglas) Ureter(cut)
Vaginaand vaginalfascia
Coccyx
Urinarybladderandvesicalfascia
Levatorani
muscle muscleand
lschiocavernosus
(pelvic deepperineal(investing
or
diaphragm) fascia
Callaudet's)
Puborectalis Deeptransverseperinealmuscle
part of levator and perinealmembrane
ani muscle
perineal(Colles')
Superficial fascia
Superficialtransverseperinealmuscleand deep
perineal(investing fascia
or Callaudet's)
bodv
Perineal
*Partsvariableand often indistinct
Rectum Plate 391

lschioanal Fossae
SaeahoPt$asO' ?, 41o-{t8
lliacus
muscle
andfascia
External
iliac
vessels
Obturator
internus
m u s c l ea n d
fascia
canal
(Alcock's)contains
internalpudendal
pudendal
vessels,
nerve,and
perinealnerve
lschial
tuberosity
Ureter Tendinousarch of levator ani muscle
Extraoeritoneal Sacrogenitalfold (uterosacral

(supralevator)space in female)
(fibrofatty
tissue)
Levatorani muscle and superiorand
Fatbody of ( DeePerPart 1 inferior fasciaof pelvic diaphragm
ischioanal J Superficial I
tossa ( (perianal)
part (cutedge)formingfloorof pararectal
fossa
Peritoneum
Transversefibrousseptum
of ischioanal
fossa Rectalfascia
S u b m u c o ussp a c e( i n t e r n avle n o u sp l e x u i ) analsphinctermuscle

External
space(external
Perianal venousplexui) C o n j o i n e dl o n g i t u d i n am
l uscle 4{tr
Intersphinctericgroove (anocutaneouslinb) Internalanal sphinctermuscle
Pfate 392 Rectum

Rectum and Anal Ganal
Sigmoidcolon
15-17
junction
Rectosigmoid
11-13
Transversefolds
of rectum(valves
of Houston)
reflection
Peritoneal
8-9
fascia
musclelayer
Longitudinal
musclelayer
mucosae
Muscularis
evator ani muscle
5-6
Anorectalline
A n a lc o l u m n s( M o r g a g n i ' s )
Analsinus
(dentate)line
InternalrectalvenousPlexus
4-5 in submucous space
Deep part* of external
sphinctermuscle
Conjoinedlongitudinal muscle
2.5-3 Internalsphinctermuscle
Analvalve
Analcrypt
Superficialpart* of external
sphinctermuscle
0.s-1 Analglands
Transverse fibrousseptum
Muscularis mucosaeof analcanal
space
Anal verge utaneouspart*of externalsphinctermuscle
Pecten Corrugatorcutisani muscle
Anoderrh Externalrectalvenousplexusin perianalspace
groove(anocutaneous
Intersphincteric line)
*Partsvariableand oftenindistinct
4{F
Rectum Plate 393

Anorectal Musculature
Rectosigmoid Anteriorview
junction
S i g m o i dc o l o n
Freetaenia (taenialibera)
of taeniaspreadout to form longitudinal

musclelayerof rectum
ibersfrom longitudinalmusclejoin circular muscle layer
Window cut in longitudinalmuscle layerto expose underlying

rculam
r u s c l el a y e r
Levatorani muscle
Frontalsection
Deep Parts"of
Superficial externalanal
S u b c u t a n e o u s s p h i n c t emr u s c l e
Fibrousseptum
Corrugator cutis
a n im u s c l e
4{tr Perianal
skin
Superiorfasciaof pelvic diaphr

Inferiorfasciaof pelvic diaphr
Levatorani muscle
Rectalfascia
L o n g i t u d i nm
a lu s c l eo f r e c t u m
Circularmuscleof rectum
Muscularis
mucosaeof rectum
Deep part* of externalanal sphincterm
Internalrectalvenousplexus
Conjoinedlongitudinal
muscle
part*of externalanalsphincter
Superficial
I n t e r n aa
l n a l s o h i n c t e rm
Muscularismucosaeof anal canal
Transversefibrous septum of ischioanalfossa
part*of externalanalsphincter
Subcutaneous
Corrugatorcutis ani muscle Intersphincteric
groove
Externalrectalvenous plexus (anocutaneous
line)
*Partsvariableand
often indistinct
Plate 394 Rectum

External Anal Sphincter Muscle: Perineal Views
Superficial scrotal(dartos)fascia
tum of scrotum
(Buck's)fasciaof penis
u su s c l ew i t h d e e pp e r i n e a l
B u l b o s p o n g i o sm
(investingor Callaudet's)fasciaremoved
schiocavernosus musclewith deep perineal
(investingor Gallaudet's) fasciaremoved
Perinealmembrane
I s c h i o p u b irca m u s
Perinealbody
Superficial transverse perinealmusclewith deep
peiineal(investingor Callaudet's)fasciaremoved
subculaneous
) ,uur- of externalanal
5uPerllclal
I sohinctermuscle
ueep ,
Superficialperineal(Colles')fascia(cut edges)
Transversefibrousseptumof ischioanalfossa(cut)
lschialtuberosity
t u b e r o u sl i g a m e n t
Pubococcygeus)
Puborectalis I Levatorani muscle
lliococcygeus )
Anococcygealbody (ligament)(posteriorextensions
of superficialexternalanalsphinctermuscle)
C l u t e u sm a x i m u sm u s c l e
Tip of coccyx
Female
Clitoris
Externalurethral
orifice
Superficialperineal(Colles')fascia(cut edge) iopubic

lschiocavernosus musclewith deep perineal ramuS
(investingor Callaudet's)fasciaremoved Anus
Bulbospongiosus musclewith deep perineal
(investingor Callaudet's)fasciaremoved
Fibersfrom superficialexternalanal
sphinctermuscleto ischiopubicramus
P e r i n e aml e m b r a n e
Superficialtransverseperinealmusclewith
deep perineal(investingor Callaudet's)
fasciaremoved
Superficialperineal(Colles')fascia(cut edge)
Perinealbody
Crossedfibersfrom superficialand deep external
sphinctersto superficialtransverseperinealmuscle
P a r r so* f e x t e r n a l a n- a Il P e e P r /
s'o h i n c t e r ' m u s ; i ; - J S u p e r f i c i a l
( Subcutaneous
. ( Puoococcygers
L e v a t o r a nm i u s c l e{ P u b o r e c t a l i s /
( lliococcygeus-
Anococcygealbody (ligament)(posteriorextensions
of superficialexternalanalsphinctermuscle)
"Partsvariableand often indistinct
Rectum Plate 395

Actual and Potential Perineopelvic Spaces
Sagittalsection
Peritoneum
fascia
Rectal
fascia
Rectal
fascia
Presacral
fascia
Retropubic
(prevesical) Presacral
space(of Retzius) space
Recto-( Retrovesicall Rectovesical
vesicalI P1g1ss16l- or rectoprostatic
space ( Retroprostatic (Denonvilliers')
Sphincter fascia(septum)
urethrae
DeePand superficial- Levatorani muscle
perinealmuscles
transverse and fasciaof
pelvicdiaphragm
Deep postanalspace
body (ligament)
Anococcygeal
Deep(Buck's)fasciaof penis postanalspace(part
Superficial
perineal(Colles')
Superficial fascia of perianalspace)
*Partsvariableand Submucous
space
oftenindistinct
Perianalspace
muscleanddeepperineal(Gallaudet's)
Bulbospongiosus fascia
perinealcompartment
Superficial (spaceor pouch)
Perineal
membrane,
Deeptransverse perinealmuscleand
Superficial
transverseperinealmuscle
(cutaway)to expose
Anteriorrecessof ischioanal
fossa
-Preanalcommunication (inconstant)
between
rightand leftischioanal
fossae
Pusin ischioanal
fossa
Posterior
communication betweenrightand left
ischioanalfossaevia deeppostanalspace
deepto anococcygeal body(ligament)
Gluteusmaximusmuscleand
(cut)
Posteriorrecessof ischioanalfossa
Spreadof perinealabscessin perinealspaces

Perinealview
4{ft*
Plate 396 Rectum
Pelvic Scans: Sagittal MR lmages
Median (A) and paramedian(B) sagittalMR imagesof femalepelvis

AB
A Analcanal RA Rectusabdominis muscle

c os of cervix
External s Sacrum
D Dural(thecal)sac U Uterus
P Pubicsymphysis U B Urinarybladder
R Rectum v Vagina
Median (C) and paramedian(D) sagittalMR imagesof male pelvis

c
c Corpusspongiosum R Rectum
cc Corpuscavernosum s Sacrum
G Glanspenis T Testis
P Pubicsymphysis U Urinarybladder
PS Prostate

Arteries of Rectum and Anal Ganal (Male|
Posteriorview Left colic artery Inferiormesenteric

artery
Ascendingbranch Abdominal aorta
D e s c e n d i n gb r a n c h Inferiorvena cava
Sigmoid arteries Median sacralartery
Marginal artery Common iliac artery
Rectosigmoidarteries Externaliliac artery
Superior Internaliliac artery
rectal Lateral sacral artery
arrery
(bifurcation) Superiorgluteal
artery
Middle Inferior
rectal gluteal
artery artery
Obturatorartery
Obturator I n t e r n apl u d e n d a l
i n t e r n um
s uscle artery
lnternal ical artery
pudendalartery
nferior vesicalartery
Pudendalcanal (Alcock's)
to ductus deferens
Anus
lschialtuberosity
Coccygeus(ischiococcygeus)muscle External anal
s p h i n c t emr u s c l e Middle rectal artery
Inferior rectal artery
Levatorani muscle
P u b o r e c t a lm
(severed)
i su s c l e
Inferior rectal artery
Nr
Plate 398 Vasculature
Veins of Rectum and Anal Ganal (Femalel
Anterior view
Inferiormesentericvein (to portalvein
via splenicvein)
lnferior vena cava
S i g m o i dv e i n s
Common iliac veins
Median sacralvein
Superiorrectalvein(bifurcation)
iliacvein
External
Internaliliacvein
Obturatorvein
Superiorvesicaland
uterineveins(from
uterinevenousplexus)
Middle rectalvein
nternalpudendalvein
Communicationbetweeninternal
rectalplexuses
and perimuscular
aginalvein (fromvaginal
venousplexus)
vein
lnferiorvesicular
Internalpudendalveinin
pudendalcanal(Alcock's)
lnferiorrectalvein
betweeninternal
and externalvenousplexuses
Internalrectalplexus
Perimuscular
rectalvenousplexus
External
rectalolexus 4{tr
Vasculature Plate 399
Arteries and Veins of Pelvic Organs: Female
Anteriorview
Renalarteryandvein
Renal Ovarianarteryand vein

artery
andvein
Abdominalaorta
Kidney
Ureter
Ovarian Inferiormesenteric
artery
artery
andvein
Psoasmajormuscle
Ureter
Commoniliacartery
Inferior
venacava Mediansacralvessels
Psoasmajor Superiorrectalartery(cut)
muscle
ligamentof uterus(cut)
Peritoneum
(cut edge) artery
Suspensory nternal iliac artery

ligament Anteriordivision
of ovary
contains Externaliliacarterv
ovanan
vessels
Obturatorarteryand nerve
Rectum
Umbilicalartery
(patentpart)
Ovary
Middle rectalartery
Uterine
(fallopian)
Uterinearterv
'aginal
artery
Uterus
Inferiorvesicalartery
Round
ligament
of uterus Roundligament
of uterus(cut)
Vagina
Superiorvesicalarteries
Urinary ior epigastric
bladder arteryandvein
Medial Umbilicalartery
umbilicalfold (occludedpart)
Superiorvesicalarteries
*{r Medialumbilicalligament
Medianumbilicalligament(urachus)
Vasculature
Arteries and Veins of Testis
Anteriorview
Renalvessels
*
q lnferior vena cava
Abdominal aorta
Testicularvessels
(part of spermaticcord)
Ureter
Inferior
mesenteflcarterY
o m m o n i l i a cv e s s e l s
l n t e r n a li l i a cv e s s e l s
Inferiorvesical
artery
Inferior epigastric
vessels
Artery to ductus
deferens
Cremasteric
vessers
Testicularvessels
in spermaticcord
Femoral
vessels
Superficial
external
pudendal
vessels(cut-Pass
superficialto
s p e r m a t i cc o r d )
Deep external
pudendal
vessels
Pampiniform
v e n o u sp l e x u s
Deep dorsal vein

and dorsal
arteriesof
p e n i su n d e r
deep (Buck's)
fasciaof penis
4{r
Vasculature Plate 4Ol
Arteries and Veins of Pelvis: Female
M e d i a ns a c r a l
arrery A b d o m i n a la o r t a
n i g h t I C o m m o ni l i a c
lliolumbar
artery
Left I arteries I n t e r n a il l i a ca r t e r y
P o s t e r i odr i v i s i o n
Anterior division
Lateral
sacral Externaliliac artery
arteries
Umbilicalartery (patent part)
Superior Obturator artery
gluteal
arter M i d d l e r e c t a la r t e r y
Piriformis U t e r i n ea r t e r y
muscle Vaginalartery
Inferior Inferiorvesicalartery
gluteal
artery Superiorvesicalarteries
M e d i a lu m b i l i c a l i g a m e n t
Internal (occluded part of umbilicalartery)
pudendal
artery P u b i cs y m p h y s i s
Coccygeus
(ischiococcygeus
muscle
Sacrotuberous Right paramedian section:
ligament---- lateral view
Obturator fascia
( o f o b t u r a t o ri n t e r n u sm u s c l e A b d o m i n a la o r t a
Internap l u d e n d a la r t e r y Inferiorvena cava
i n p u d e n d a lc a n a l( A l c o c ks t
R i g h tc o m m o n i l i a ca r t e r y
L e v a t o ra n i m u s c l e{ c u t e d g e Left common iliac artery
Ureters
Externaliliac artery (cut)
S u p e r i o rg l u t e a la r t e r I n t e r n a il l i a ca r t e r y
U m b i l i c a la r t e r y( p a t e n tp a r t ) P o s t e r i odr i v i s i o n
A n t e r i o rd i v i s i o n
Obturatorartery
Piriformm
isuscle
Internap
l u d e n d a la r
Inferior glutealartery
C o c c y g e u s( i s c h i o c o c c y g e u sm) u s c l e
Middle rectal artery-----j
U t e r i n ea r t e r y
Vaginalartery
I n f e r i o rv e s i c a a
l rt
Internap
l u d e n d a la r t e r turator
canal
4{tr Inferior rectal arte

S u p e r i o rv e s i c a a
l rteries
Obturator
tnlernus
muscle
M e d i a lu m b i l i c a l i s a m e n r Levatorani
( o c c l u d e dd i s t a lp a r t o f u m b i l i c a a
l rtery) muscle
Plate 4O2 Vasculature

Arteries and Veins of Pelvis: Male
left paramediansection:
lateralview
lnferior vena cava Abdominalaorta
Rightobturator Commoniliacvessels
Righut m b i l i c aalr t e r Mediansacralvessels
(patentpart)
External (cut)
iliacvessels
Internaliliacvessels
Umbilicalartery
(occludedpart) lliolumbararterv
Deep teralsacralartery
circumflex
iliac Superiorglutealartery
Obturatorartery
Inferior
epigastric Umbilicalartery
vessels
Ureter(cut)
Ductus
deferens
and its artery
Inferiorglutealartery
M e d i a lu m b i l i c a l Inferiorvesicalartery
ligament
Middle rectalartery
M e d i a nu m b i l i c a l
ligament(urachus) Internalpudendal
artery
Ductusdeferensand
its arterv
Superior
vesicalartery Prostaticbranches of
inferiorvesicalartery
Superficial Inferiorrectalarterv
dorsalvein
of venousplexus
Deepdorsalvein urethraemuscle
Sphincter
a n dd o r s a l
arteryof Perineal
artery
Deep(Buck's) lnternalpudendalartery
fascia of pen Posterior on superioraspectof perinealmembrane
scrotal
Testicular
a arteries
Pampiniform
(venous)
Arteryto ductusdeferens
Inferior
Vesical(retropubic)
venousplexu6 vesical
Branchto prostate
Urethralbranches
Capsular
branches
Hyperplastic
middlelobe
Hyperplasticlaterallobe
urethraemucle
Sohincter
Arterialsupplyof prostate
(Frontal
section,
anterior
viewof
specimenwith benign hyperplasia)
Vasculature Plate 4O3

Arteries and Veins of Perineum and Uterus
Posterior Dorsalarteryof clitoris

labialartery
Deeparteryof clitoris
Ischiocavernosu
s
muscte B u l bo f v e s t i b u l e
urethraemuscle
Compressor
Bulbospongiosus
muscle Arteryto bulbof vestibule
Superficial (Bartholin's)
Creatervestibular gland
perinealspace
perinealmuscle
Deeptransverse
Perineal
membrane Internalpudendal(clitoral)artery
Perinealmembrane(cut away)
Perineal
artery Perinealartery(cut)
Superficial perineal(Colles')
Superficial
transverse fascia(cutand reflected)
perineal to opensuperficialperinealspace
muscle
Perineal
art Inferiorrectalartery
Internal
pudendal
arteryin
pudendal
canal Roundligament Branches
(Alcock's) of
Tubal
uterine
Inferior artery
rectalartery
External
analsphinctermuscle
Note:Deepperineal(investingor
fasciaremovedfrom
Callaudet's)
perinealspace.
musclesof superficial
Ovarianvessels
Tubal branchesof ovarianvessels
Vaginalbranches
of uterine
Vaginalarter
Levatorani
Perineal
membrane
Perineala
perinealspace
Superficial
perineal(Colles')
Superficial f,

Arteries and Veins of Perineum: Male
External (dartos)fasciaof scrotum

Superficial
spermatic
fasciaover Septumof scrotum
testis
ano
spermaticcord Posteriorscrotalarteries
Deep(Buck's)
fasciaof penis
Bulbospongiosus
muscle perineal(Colles')fascia(cutedge)
Ischiocavernosu
s perinealspace(opened)
Superficial
muscle
Perinealartery and vein
Perineal
membrane Internalpudendalarterypasses
superior
to perinealmembrane
Perineal
body
rficialtransverseperineal
muscleand transverse perineal
Superficial arterv(cut and reflected)
transverse
perineal
muscle Internalpudendalvessels
and
pudendalnerve(cut)in pudendal
canal(Alcock's)
(openedup)
Transverse
perineal
arter lnferiorrectalarterv
Inferiorfasciaof pelvicdiaphragm
Superficial (roof of ischioanalfossa)
perineal
(Colles')fascia
(cut edge
Pudendal
canal(Alcock'
Note:Deepperineal
(investing
or
Gallaudet's)fascia
removedfrom muscles
of superficialperinealspace
Deep arteryof penis

Deepdorsalveinof peni
Dorsalartervand nerveof
Transverseperinealligament (anterior
thickeningof perinealmembrane;-
4{tr Deep arteryof penis

Dorsalarteryof penis
Urethralartery
membrane(cutedge)
Perineal
Arteryof bulbof penis
artery(cut)
Perineal
Internalpudendalvessels
perineal(Colles')
Superficial fascia(cutedge)
Vasculature Plate 4O5

Lymph Vessels and Nodes of Pelvis and Genitalia: Female
L a t e r . ral o r t i c( l u n r b a r )
nodes
P r e a o r t i cl y n r p hn o d e s
P r o n r o n t o r i a(lm i c l d l es a c r a l )n o d e s
iliac r-rodes
Conrnror-r
( L a t e r a ls)a c r anl o d e
l n t e r n aill i a cn o d e
L a t e r a(l s u p e r i o r )
e x t e r n aill i a cn o d e
O b t u r a t o rr r o d e
Su p e r i i c i aI
inguinal
nodes
Hig,hest
deep
i n pl,ui r-ral
no(le
(of Cloquet)
f)een
inguinaI
nodes
t,/
Nr
Plate 406 Vasculature

Lymph Vessels and Nodes of Perineum: Female
Highestdeep
inguinal
node
(of Cloquet)
'ascialata(cutaway\
lnferior nodes
(verticalgroup) and nerve
vessels
Superolateralnodes
(horizontal
group Deepinguinalnodes
Suoeromedialnodes
(horizontal
group)
4{tr
Vasculature Plate 4OZ

Lymph Vessels and Nodes of Pelvis and Genitalia: Male
Preaorticnodes
Pathwaysfrom testesalong
testicularvessels
C o m m o n i l i a cn o d e s
Promontorial sacral)nodes
Lateral)sacralnode
I n t e r n a il l i a cn o d e s
E x t e r n aill i a cn o d e s
H i g h e s td e e p i n g u i n a l
node (of Cloquet)
D e e p i n g u i n a ln o d e s
S u p e r f i c i ai ln g u i n a ln o d e s
y
: t.
Preaorticnode
is
Promontorialnode
Internal
Presymphysealnode Common iliac i l i a cn o d e s
(Middle
E x t e r n aill i a cn o d e s and lateral)
sacralnodes
Pathwayalong inferior vesicalvessels

t o i n t e r n a li l i a cn o d e s( p r i n c i p apl a t h w a y )
Pathway
alongside
rectum to
P a l h w a yo v e r b l a d d e rt o e x t e r n a il l i a cn o d e s ( m i d d l ea n d
lateral)sacral
nodes
Prevesicalplexusand pathway (broken line\
to externaliliac nodes
Pathway(broken /ine)from lower

p r o s t a t ea n d m e m b r a n o u su r e t h r a
a l o n g i n t e r n a lp u d e n d a lv e s s e l s( b e n e a t h
p e l v i cd i a p h r a g m )t o i n t e r n a li l i a cn o d e s

Nerves of External Genitalia: Male
SeealsoPlates165,166,318
Splanchnic 5 Creater
Lesser
C e l i a cg a n g l i a
nerves
I Least
S u b c o s t anl e r v e ( T 1 2 ) ganglia
lliohypogastricnerve L u m b a rs p l a n c h n i cn e r v e s
llioinguinalnerve nferior
mesenteflc
ganglion
5 y m p a t h e t ti cr u n k
and ganglia
Cenitofemoral
nerve
Testicular artery
Lateralfemoral a n dp l e x u s
cutaneousnerve
Superior
hypogastric
Femoralbranch
plexus
ano
C e n i t a lb r a n c h
of genitofemoral
nerve
Femoralnerve lnferior
hypogastric
(pelvic)
prexus
Lateralfemoral
c u t a n e o us
nerve Ductus
deferens
Femoral a n dp l e x u s
b r a n c h e so f
genitofemoral
nerve
Anterior
cutaneous
b r a n c h e so f
Testicular
femoral nerve
artery
and plexus
A n t e r i o rc u t a n e o u s
branch of iliohypogastric
D o r s a ln e r v e so f p e n i s
Cenital branch of senitofemoralnerve

4{ry
Anterior scrotalnerve (from ilioinguinalnerve)
lnnervation Plate 4O9

Nerves of Pelvic Viscera: Male
Anteriorvagaltrunk T10spinalnerve(ventralramus)
Posterior
vagaltrunk te and grayramicommunicantes
and
Celiac branch
lnferiorphrenicarteriesand
Leftgastricarteryand gastric
Diaphragm
Celiacganglia,
plexus,andtrunk
Leftrenalartery
Left aorticorenalganglion and plexus
Superiormesentericganglion L 1s p i n anl e r v e
(ventralramus)
Superiormesenteric
arteryand
(aortic)plexus
Intermesenteric
Inferiormesenteric
ganglion, 1 s t2
, n d ,3 r dl u m b a sr p l a n c h n n
i ce r v e s
arteryand plexus
Cravramicommunicantes
Ureterand uretericplexus
trunkand ganglia
Sympathetic
Superiorhypogastric
plexus
5th lumbarsplanchnic
nerve
Superiorrectalarteryand plex
L5 spinalnerve(ventralramus)
Hypogastricner
Lumbosacral
trunk
Nerve from inferior
hypogastricplexus Crayramicommunicantes
to sigmoid and descending
colon(parasympathetic) S 1 s p i n a ln e r v e
(ventralramus)
Sacralsplanchnic
nerves
(sympathetic)
1_ ic splanchnic
nerves
Inferiorhypogastric (parasympathetic)
(pelvic)plexus-
Obturatornerve al plexus
and artery
Piriformis
muscle
Ductusdeferens
and plexus C l u t e u sm a x i m u s
muscleandsacro-
Vesicalplexus tuberousligament
Rectalplexus Coccygeus(ischiococcygeus)
muscleand sacrospinous
Prostatic
plexus ligament
Cavernousnerves Pudendalnerve
of penis
atorani muscle
nferior anal (rectal)nerve
Perinealnerve
Dorsal nerve of penis
scrotalnerves
Posterior
Plate 41O Innervation

Nerves of Perineum: Male
Posteriorscrotal nerves Dorsal nerve of penis
Perineal t Superficial
P e r i n e aml e m b r a n (ec u t t os h o w
neurovascular structures on superior
nerves
t Deep aspectof perinealmembrane)
Dorsalnerveof oenis
# ( c o n t i n u a t i oonf
p u d e n d anl e r v es u p p l y i n g
f muscleson superioraspect
of oerinealmembrane)
Superficialperineal
(Colles')fascia(cut
to open superficial
perineal space)
Superficialand deep
branchesof
perinealnerve
ffi (passes
nerve of penis
superiorto
p e r i n e aml e m b r a n e )
Perinealnerve
Obturatorfascia
(of obturator
internusmuscle)
Posteriorfemoral
cutaneousnerve
Pudendalcanal
(Alcock's)
(openedup)
Pudendalnerve
Inferior
c l u n i a ln e r v e s
Piriformm
isuscle
Inferior anal (rectal) Coccygeus(ischiococcygeus)
muscle -------_--.\
Perforating
curaneousnerve Pudendalnerve
Levatorani muscle
Anococcygealnerve
Obturatorinternusmuscle
Sacrotuberousligament (cut)
4{r s u s c l e( c u t )
l n f e r i o ra n a l( r e c t a l )n e r v e
Perinealnerve

Nerves of Pelvic Viscera: Female
SeealsoPlates165,166,318
S y m p a t h e ttircu n k A b d o m i n a la o r t a Peritoneum
and L2 ganglio
Inferiorvena cava
Extraperitoneal
W h i t ea n d ( s ub s e r o u s )
grayraml fascia
communicantes
Common
i l i a cv e s s e l s \.
a n dp l e x u s
Lumbar
splanchnic Ureter
nerves Intermesenteric
( a o r t i c )p l e x u s
Ovarian artery
Crayrami and plexus
communicantes
Superior
hypogastric
prexus
Sacral
promontory
Superior
Right
hypogastric
hypogastric
prexus
nerve(cut)
Common
i l i a ca r t e r y
R i g h ta n d and plexus
left sacral
Ureter
sympathetic
t r u n k sa n d Internal
ganglia iliac artery
ano prexus
External
Piriformis Right and left
iliac artery
muscle hypogastricnerves
and plexus
Uterus
Sacral R ig h t s y m p a t h e t i ct r u n k
s p l a n cnhi c
nerves eft hypogastricnerve
(sympathetic)
Inferior hypogastric(pelvic)plexus
U t e r i n e( f a l l o p i a nt u) b e
Ovary
Pelvic surfaceof pubis

Symphyseal
splanchnic
nerves
(parasympathetic) U r i n a r yb l a d d e r
Vesicalplexus
muscle
plexus
Uterovaginal
R e c t apl l e x u s
(retracted)
Nr
Rectum (retracted)

Nerves of Perineum and External Genitalia: Female
Anteriorlabialnerve
(fromilioinguinal
nerve)
Dorsalnerveof clitoris
labialnerves
Posterior
- ) B'unth"'
'suoer[;.;u;
,/---- ) otperineal
,/ ,zDeep nerve
)
branchof
posteriorfemoral
cutaneousnerve
Dorsalnerveof
clitorispassing
superiorto
perinealmembrane
nerve
nervern
pudendalcanal
(Alcock's)(dissected)
nferiorclunial
nerves
maxtmus
muscle(cut away)
ligament
Sacrotuberous
g cutaneous
Perforatin nerve
Inferioranal(rectal)nerves
Anococcygeal nerves
lschialtuberosity
sprne
*fr
Innervation Plate 413
Neuropathways in Parturition
Greater
Splanchnic
nerves Lesser T7 spinal
Least nerve(anterior
ramus)
Celiac ganglion
Sympathetic trunk
and ganglia
Aorticorenalganglion
T 11 s p i n a l
nerve(anterior
Superiormesenteric ramus)
ganglion
R a m ic o m m u n i c a n t e s
Intermesenteric
(aortic)plexus
I n e r v e( T 1 2 )
Lumbar nferior
splanchnic mesentericganglion
nerves
Intermesenteric
(aortic) plexus
Superiorhypogastric
plexus
Sl spinalnerve
(anteriorramus)
lliohypogastric
nerve (Ll ) Hypogastricnerves
l l i o i n g u i n anl e r v e( 1 1) Pelvicsplanchnic
nerves
Vesicalplexus Inferiorhypogastric
(pelvic)plexus
Dorsalnerveof clitoris
plexus
Uterovaginal
Posterior
labial
Pudendalnerve(S2,3, 4)
Inferioranal(rectal)nerve
Sensorv fibersfrom uterine Sensoryfibersfrom cervixand upper Sensoryfibersfrom lower vagina

bodyandfundusaccompanysympathetic vaginaaccompanypelvicsplanchnic nerves and perineumaccompanysomaticfibers
fibersvia hypogastricplexusesto T11, 12 (11?) (parasympathetic)to 52,3, 4 via pudendalnerveto 52,3,4
Motor fibersto uterinebody Motor fibersto loweruterinesegment, Motor fibersto lowervaginaand
dus(sympathetic) cervix,and uppervagina(parasympathetic) perineumvia pudendalnerve(somatic)

lnnervation of Female Reproductive Organs: Schema
S y m p a t h e ttircu n k
and ganglion rT5
W h i t e r a m u sc o m m u n i c a n s
'+- ganglia
Aorticorenal
Creater
splanchnn
i ce r v e
Superiormesenteric
Lesser ganglion
s p l a n c h n i cn e r
Least T11 '-'

r12
trunk
Sympathetic
L u m b a rs o l a n c h n i c
L 3 s p i n a ln e r v e
Ovarian artery and plexus Superiorhypogastric

plexus
U t e r i n e( f a l l o p i a nt)u b e
nerves
Hypogastric
Note: Painfrom
intraperitonealpelvic
viscera(e.g.,uterine - - - - - l n f e r i o re x t e n t
contractions)goesvia of peritoneum
uterovaginaland pelvic
plexuses,hypogastric and inferior
Uterovaginal
nerves/supenor Ovary (pelvic)plexuses
hypogastric
hypogastricplexus,lower
aortic plexus,lower nerves
Pelvicsplanchnic
lumbarsplanchnic nerves,
sympathetictrunkfrom
L4to L5to soinalnerves
T11, 12. Painfrom Sacralplexus
subperitonealpelvic
viscera(e.g.,cervical
dilationand upper
vagina)goesvia pelvic
splanchnicnervesto 52,
3, 4. Afferentfibersfrom
*{r
lowervaginaandperineum Pudendalnerve
go viapudendalnerves
to 52,3,4.
Sympatheticf Preganglioni6- Parasympathetic{ Preganglionic Afferentfi[s15 -
fibers postganglionic
----- fibers
I lpostganglionic-----

Innervation of Male Reproductive Organs: Schema
SeealsoPlatos 167, 168
Sympathetictrunk and ganglia C e l i a cg a n g l i a
Creater splanchnicnerve (T5-9)

T1
Superiormesentericganglion
G r a y r a m u sc o m m u n i c a n s
T11;1
Left aorticorenalganglion
Lessersplanchnicnerve T12
Leastsplanchnicnerve
R e n a lg a n g l i o n
L1.7
U p p e rl u m b a sr p l a n c h n i c
Intermesenteric
L2:'; (aortic)plexus
L3 nferior mesentericganglion
arteryand plexus
Testicular
Testicular
artervand olexus plexus
Superiorhypogastric
Hypogastric
nerves
Ductusdeferensand plexus
Inferiorextentof peritoneum Ductusdeferens

and plexus
P e l v i cs p l a n c h n i cn e r v e s
ic splanchnic
nerves
Sacralplexus
$2sp3lplgxu5-
Pudendalnerve
Pudendan
l erve
Inferior hypogastric(pelvic)plexus Dorsalnervesof penis
Vesical
plexus
Epididymis
(Createrand lesser) nervesof penis

cavernous
plexus
Prostatic
Testis 4{F
Sympathetic{ Preganglionic- Parasympathetic Preganglionic Afferentfibers -
fibers
f postganglionic__-__ fibers Postganglionic-----

lnnervation of Urinalv Bladder and Lower Ureter: Schema
S p i n asl e n s o r y sal(posterior)
root Celiac ganglia
(dorsalroot) Ventral(anterior)
root
ganglion
Superiormesentericganglion
white I Rami
lCraY I communicantes
Aorticorenalganglion
arteryand plexus
lntermesenteric
(aortic)plexus
ganglion
Inferiormesenteric
l s t a n d2 n d l u m b a r
Lumbarpart splanchnic nerves
of spinalcord plexus
L 2s p i n a l Superiorhypogastric
nerve(ventral
ramus)
nerves
Hypogastric
Sacralpart
of spinalcord Sympathetic
trunk
Inferiorhypogastric
nervesfrom (pelvic)plexus
Ascending Descending sacral
fibers fibers sympathetic
trunkto
inferior
Crayrami hypogastric Urinarybladder
communicantes (pelvic)
plexus
\
f,"--
nerve
Pudendal
plexus
Vesical
Sacralplexus
Prostatic
Pelvicsplanchnicnerves
urethraemuscle
Sphincter
superior to perinealmembrane
Bulbospongiosus
Sympathetic f Preganglionic Parasympathetic( Preganglionic Somaticefferentfibers -

fibers fibers Afferent fibers -
I P o s t g a n g l i o n- i-c- - - ipostganglionic-----

6 Upper Limb
$ection
Topographic AnatomY
Plate 418
Limb
ere Upper
Shoulder and Axilla

Plates 419430
Joint
andSternoclavicular
ers Clavicle
lzo Humerus Views
andScapula:Anterior
andScapula:
lzt Humerus View
Posterior
Radiograph
Anteroposterior
ezz Shoulder:
(Glenohumeral
cze Shoulder Joint)
ofShoulder
lzl Muscles
Cuff
ofRotator
ezs Muscles
Dissection
eze Scapulohumeral
andAnastomoses
Artery
ezz Axillary Scapula
around
Clavipectoral,
eze Pectoral, Fasciae
andAxillary
(Dissection):
lzs Axilla View
Anterior
Schema
Plexus:
mo Brachial
Arm
Plates 43t4il5
Views
ofArm:Anterior
csr Muscles
Views
ofArm:Posterior
esz Muscles
inSitu
ess BrachialArterY
andAnastomoses
Artery
ege Brachial Elbow
around
Sections
Cross
lss Arm:Serial
Atlas of Human AnatomY

Upper Limb
Elbow and Forearm Lumbrical

Muscles
andBursae,
Spaces,
andSheaths:
Plates 436-451 Schema
r3e Bones
of Elbow 464 Flexor
andExtensor
Tendons
inFingers
eez Elbow:
Radiographs 465 Intrinsic
Muscles
ofHand
ese Ligaments
of Elbow 466 Arteries
andNerves
of Hand:
Palmar
Views
lgg Bones
of Forearm 467 Wrist
andHand:Superficial
Radial
Dissection
clo Individual
Muscles
ofForearm:
Rotators
ofRadius 468 Wrist
andHand:
Superficial
Dorsal
Dissection
eer Individual
Muscles
of Forearm:
Extensors
ofWristandDigits 469 Wrist
andHand:
Deep
DorsalDissection
llz Individual
Muscles
of Forearm:
Flexors
ofWrist 47|, Extensor
Tendons
atWrist
elg Individual
MusclesofForearm:
Flexors
of Digits 471 Fingers
lec Muscles (Superficial
of Forearm Layer):
Posterior
View
ss Muscles (Deep
of Forearm Layer):
Posterior
View Neurovasculatune
Plates 472483
ele Muscles (Superficial
of Forearm Layer):Anterior
View
lez Muscles
ofForearm(lntermediate
Layer):Anterior
View ezz Cutaneous
Innervation
ofWristandHand
lle Muscles (Deep
ofForearm Layer):Anterior
View lzs Arteries
andNerves
ofUpper
Limb
lcg Forearm:
SerialCross
Sections lzl Musculocutaneous
Nerve
eso Attachments
of Muscles
of Forearm:
Anterior
View czs Median
Nerve
lsr Attachments
of Muscles
of Forearm:
Posterior
View eze Ulnar
Nerve
lzz Radial
NerveinArmandNerves
of Posterior
Shoulder
Wrist and Hand rzs RadialNerve
inForearm
Pfates 45471 lzg Cutaneous
Nerves
andSuperficial
VeinsofShoulder
rsz Carpal
Bones andArm
lss Movements eso Cutaneous
Nerves
andSuperficial
Veins
ofForearm
ofWrist
csl Ligaments lat Cutaneous
lnnervation
ofUpper
Limb
ofWrist
ess Ligaments lsz Dermatomes
ofUpper
Limb
ofWrist(continued)
es6 Bones ces Lymph
Vessels
andNodes
of Upper
Limb
ofWristandHand
lsz Wrist
andHand:Anteroposterior
Radiograph
ese Metacarpophalangeal
andInterphalangeal
Ligaments
Regional Scans
Plate 484
css WristandHand:
Superficial
PalmarDissections
eal CTAngiograms
ofArteries
of theUpper
Limb
eeo WristandHand:
Deeper
Palmar Dissections
eer Flexor
Tendons,
Arteries,
andNerves
atWrist
lez Bursae,
Spaces,
andTendonSheaths
of Hand

Trapeziusmuscle Anterior view
Clavicle
Acromion
Deltoidmuscle
Cephalicvein
Bicepsbrachiimuscle
Pectoralismajor
muscle
Cubitalfossa
Posteriorview
Deltoid
Cephalicvein muscle
Mediancubitalvein muscle
Tricepsbrachii
Brachioradialis
muscle muscle(longhead)
silicvein
Flexorcarpi
radialis
tendon (median)
Intermediate
vein
antebrachial
Thenar Triceps
Palmaris longus brachiimuscle
tendon
Longhead
Flexordigitorum Lateralhead
superficialis
tendons
Tendon
Flexorcarpiulnaristendon
\ Hypothenar eminence
Brachioradialis
Proximal palmar crease and extensor
carpiradialis
Proximaldigitalcrease longusmuscles
Middle digital crease
Distaldigitalcrease Extensor carpi
Radial
radialisbrevis
longitudinal muscte
crease Olecranonof ulna
Commonname
of digits Extensorpollicis Flexorcarpiulnarismuscle
longustendon
1 Thumb Extensorcarpiulnarismuscle
2 Index
3 Middle Extensor
indicis Cephalicvein
4 Ring tendon
5 Little
digitorumtendons
Extensor
Siteof proximal
(PlP)joint
interphalangeal
Siteof distal
e/fZN*
(DlP)joint
interphalangeal
Topographic Anatomy Plate 4t I

Glavicle and Sternoclavicular Joint
Right clavicle
Superiorsurface
A c r o m i a le n d Posbrior
S t e r n a el n d
4a
Inferior surface
Anterior -
T r a p e z o i dl i n e
Postertor
Conoid tubercle
S u b c l a v i a ng r o o v e
( f o r s u b c l a v i u sm u s c l e )
T r a p e z i u sm u s c l e I Muscleorigins
Superiorsurface I Muscleinsertions
I Iigament attachments
'Dosterior
S t e r n o c l e i d o m a s tm
oui ds c l e
Deltoid
P e c t o r a l im
s ajormuscle
t o r a l i sm a j o r m u s c l e
C o s t o c l a v i c u l al irg a m e n t
C o r a c o c l a v i c u rl a I Trapezoid
ligament
Postertor
ligament
I Conoidligamen
S u b c l a v i u sm u s c l e
S t e r n o h y o i dm u s c l e
A n t e r i o rs t e r n o c l a v i c u l al irq a m e n
Sternoclavicular
foint
A r t l c u l a rd i s c o f
s t e r n o c l a v i c u l aj or i n t
Clavicle
S u b c l a v i umsu s c l
C o s t o c l a v i c u l al irg a m e n t ''"it'. C o s t o c l a v l c u l al irg a m e n t

\fEr.
S y n c h o n d r o s iosf 1 s t r i b
Manubrium
Costal cartilages
Sternocostal
*{ry R a d i a t es t e r n o c o s t al li s a m e n
( s y n o v i a lj)o i n t
t e r n a ls y n c h o n d r o s i s
Plate 419 Shoulder and Axilla

Humerus and Scapula: Antelior Views
Acromion Coracoid process Clavicle(cut)

Acromial angle
Superiorangle
Supraglenoid
tubercle.- Superiorborder
Anatomical neck scapularnotch
Creater tubercle Neck
Lesser
tubercle Medialborder
neck
Surgical fossa
Subscapular
lntertubercular Clenoid lnfraglenoid

tubercle
sulcus cavity of
scapura Lateralborder
Crestof
Head of
SreaIer Inferiorangle
numerus
Trapezius
muscle
Crest of
lessertubercle minormuscle
Pectoralis
Humerus
Deltoidtuberosity muscle
Medial
ridge.
supracondylar B i c e p sb r a c h i im u s c l e
( l o n gh e a d )
Lateral
Supraspinatus
muscle
muscle
Subscapularis
Coracobrachialismuscle
and
Bicepsbrachii musc
Radial (short head)
fossa Triceps
majormuscle
Pectoralis brachii
Lateral muscle
epicondyle Latissimus
dorsimuscle ( l o n gh e a d )
atus
anterior
Capitulum Teresmajor muscle muscle
Subscapularid
Deltoidm muscle
Coronoid fossa
Trochlei muscle
Coracobrachialis
Muscleattachments
M e d i a le o i c o n d v l e B r a c h i a lm
i su s c l e I Origins
Brachioradialis
muscle I Insertions
carpiradialis
Extensor longusmuscle
Pronatorteresmuscle(humeralhead)
Common flexor tendon

Common extensortendon (flexorcarpiradialis,
palmarislongus,
(extensorcarpi radialisbrevis,extensor flexorcarpiulnarisandflexordigitorum
digitorum with extensordigiti minimi, superficialis
[humeroulnar head]muscles)
and extensorcarpi ulnarismuscles)
muscle
Flexordigitorumsuperficialis
B r a c h i a l im
s uscle ( h u m e r o u l nh
aer ad)
4{tr Supinatormuscle
Bicepsbrachii muscle
Pronatorteresmuscle(ulnarhead)
Flexorpollicislongusmuscle(ulnarhead)
Shoulder and Arilla Plate 42O

Humerus and Scapula: Posterior View
Suprascapular
notch
Superiorborder
S u p e r i o ra n g l e
angle
Supraspinous
fossa
Notchconnecting
Spine
supraspinous
and
Inlrasprnous
tossae
Neck
Greatertubercle
Infraspinousfossa Headof humerus
Medial border Anatomical neck

Surgicalneck
Lateralborder
Croovefor Infraglenoid
tubercle
Inferiorangle circumflex
scapular
vessels Deltoidtuberosity
Supraspinatus
muscle Trapezius
muscle Radialgroove
Scapula Humerus
Medial
Deltoid muscle supracondylarridge
aspinatusmuscle
Rhomboid Lateral
mtnor Infraspinatus
muscle supracondylarridge
muscle
Teresminormuscle
Olecranon fossa
Rhomboid Triceosbrachii muscle

(lateralhead) Lateraleoicondvle
maJor
muscle Triceps
brachii
muscte Trochlea
( l o n gh e a d )
Infraspinatus Croove for ulnarnerve
muscle Teresminor
muscle
Medial epicondyle
Teresmajor Brachialismuscle
Latissimusdorsi muscle
m u s c l e( s m a l l
slip of origi iceps brachii muscle
( m e d i a lh e a d )
Muscleattachments
I Origins
I Insertions
Tricepsbrachii
Commonextensortendon
Commonflexortendo
Anconeus muscle
*{r
Plale 421 Shoulder and Axilla
Shoulder: Anteroposterior Radiograph
SeealsoPlate 420
A r\rronr()n
AN , \ n . t t o n r i r , r rl l r I ' o l h L t t l t ' t t t s
C ( l , r ri <l r ,
CP ( o r a co i t l l ) r () ( ( ' \ \
G ( , l t ' r t o i r l( , r \ l \ ( ) l \ ( J l ) l . ,t t
GT ( , t t ' , t 1 t 'l tL t l r t ' tl ir '
H I lrllc'rrrs
HH [ ] t , . r rol L l r r r r r r l l t t
LT Lt ' : r t , rl u l r c t r l
S S c. t l t t t l , rl , r l c r , tl lr o t c l t ' r
SN S L r r g , i r .nrcl t l . o l i r t r l r t t ' t u s
SS S p i n t .o l s r , r 1 r r t [ , r
Shoulder and Axilla Plate 422

Shoulder (Glenohumeral Joint|
Anteriorview
A c r o m i o c l a v i c u l aj or i n t c a p s u l e
( i n c o r p o r a t i nagc r o m i o c l a v i c ulliagra m e n t ) Clavicle
Acromion
Coracoacromialligament
Supraspinatustendon (cut)
Coracohumeralligament
Superiortransverse
Creater tubercle and scapularligamentand
Lesser
tubercle suprascapularnotch
of humerus
process
Transverse
humeralligament
Communication oI
Intertubercular
tendonsheath subrtendinous
(communicateswith synovialcavity) bursaof subscapularis
tendon(cut)
Subscapularis Brokenlineindicates
positionof subtendinous
Bicepsbrachii tendon (long head) bursaof subscapularis
Capsular
ligaments
Anterior
view aspinatus
muscle 4{r
Subdeltoid
bursafusedwith
Deltoid subacromialbursa
muscle
(reflected) Subscapularis
muscle
Subdeltoid
bursa
Supraspinatus
tendon
Capsularligament
Capsular Svnovialmembrane
ligament
Deltoid
muscte
acoacromialligament
Acromion
Coracoid process
Supraspinatus
(fusedto capsule) o r a c o h u m e r alli g a m e n t
Subdeltoid
bursa Bicepsbrachiitendon
( l o n gh e a d )
Infraspinatustendon
(fusedto capsule) S u p e r i ogr l e n o h u m e r a l
ligament
Clenoid cavity (cartilage)
S u b s c a o u l atrei sn d o n
Teresminor tendon (fusedto capsule)
(fusedto capsule)
M i d d l eg l e n o h u m e r a l
Synovialmembrane (cut edge) ligament Clenoid
cavity of
O p e n i n go f s u b t e n d i n o u s I n f e r i o rg l e n o h u m e r a l Clenoid scapula
b u r s ao f s u b s c a o u l a r i s ligament labrum
Axillaryrecess
loint opened:lateralview Coronalsectionthroughjoint

Muscles of Shoulder
Posteriorview capitismuscleI Not .onn".t"d

Semispinalis
to upperlimb
spleniuscapitismuscle I
Spinousprocessof C7 vertebra
muscle
Levatorscapulae
Trapezius
muscle
d i n o rm u s c l e
Rhomboim
id majormuscle
Deltoid
muscle
muscle
Supraspinatus
muscle
lnfraspinatus
Teresminormuscle
Teresmajormuscle
dorsimuscle
issimus
Longhead of tricePs
)
> Dracnll
Lateralhead ! muscle
Spinousprocessof
T12vertebra
Triangle
of auscultation
muscle
Trapezius
Omohyoidmuscleand
investing
layerof
deep cervicalfascia
Anteriorview
Acromion Sternocleidomastoid
muscle
Deltopectoraltriangle
Deltoid muscle
Deltoidbranchof
thoracoacromial
artery Pectoralis
maJor
Cephalicvein muscte
Biceps Longhead,
f
Dracnil1
muscle ( Shorthead
-Sternum
Tricepsbrachiimuscle
(lateralhead) 6th costalcartilage
Latissimus
dorsimuscle 'Anterior laver of
rectus sheath
anteriormuscle
Serratus
External
obliquemuscle
Shoulder and Axilla Plate 424

Muscles of Rotator Guff
Superiorview
Trapezoidligament Coracoid orocess
"t
C o r a c o c l a v i c u l a r l i g a m e n{t
Conoidligamenl
ubscapularis
tendon
oracoacromialligament
u l a rj o i n t
Supraspinatus
tendon
Infraspinatus
tendon
Teresminor
tendon
4{r
nfraspinatus
muscle
Spineof scapula
Superiorborderof sca
Subscapularis Supraspinatus
muscle
muscle
Coracoacromialligament
Coracoid process
Superiortransverse
s c a p u l al irg a m e nat n d
suprascapular notch
Acromion
Supraspinatus
tendon
Biceps
brachii Infra-
tendon spinatus
(long muscle
head)
Teres
mtnor
muscle
Subscapulari6
e&4/* Axillarynerve
Anteriorview Posteriorview

Scapulohumeral Dissection
Lateral view L e v a t o rs c a p u l a em u s c l e
A c c e s s o r yn e r v e ( X l )
( Anterior'
S c a l e n em u s c l e s { t r , t i d a t e-
( Posterior
B r a c h i a lp l e x u s
S u b c l a v i a na r t e r y a n d v e i n
S u p e r i o rt h o r a c i c a r t e r y
E x t e r n a il n t e r c o s t a m
l embrane Scapula (rettacted\
a n t e r i o rt o i n t e r n a li n t e r c o s t a m
l usc
P e r f o r a t i n gb r a n c h o f i n t e r n a Subscapularis
t h o r a c i ca r t e r y a n d a n t e r i o r muscle
c u t a n e o u sb r a n c h o f i n t e r c o s t a ln e r v e
major muscle
l n t e r c o s t o b r a c h i anl e r v e
L o n g t h o r a c i cn e r v e
E x t e r n a il n t e r c o s t a l
L a t e r a lt h o r a c i c a r t e r y
L a t e r a lc u t a n e o u sb r a n c h e s
of intercostan l e r v e sa n d
p o s t e r i o ri n t e r c o s t a l
S e r r a t u sa n t e r i o r
Anterior view C o r a c o a c r o m i al i g a m e n t
coid process
Acromion
S u p r a s c a p u l aar r t e r Ya n d n e r v e
S u p r a s p i n a t utse n d o n
S u p e r i o rt r a n s v e r s es c a P u l a r
C r e a t e r t u b e r c l eo f h u m e r l i g a m e n ta n d s u P r a s c a P u l a r
S u b s c a p u l a r itse n d o n notch
P e c t o r a l i sm i n o r t e n d o n ( c u t )
l n t e r t u b e r c u l a tre n d o n s h e a t h
B i c e p sb r a c h i i t e n d o n
A n t e r i o r c i r c u m f l e xh u m e r a la r t e r y (short head) (cut) and
B i c e p sb r a c h i it e n d o n c o r a c o b r a c h i a l i tse n d o n
( l o n g h e a d )( c u
b s c a p u l a r i sm u s c l e
A x i l l a r yn e r v e a n d
p o s t e r i o rc i r c u m f l e x Subscapularartery
h u m e r a la r t e r y Lowersubscapularnerve
(to teresmaiormuscle)
Q u a d r a n g u l a rs p a c e
Radial nerve -/-)
Circumflexscapularartery
Thoracodorsal artery and
n e r v e ( t o l a t i s s i m u sd o r s i
muscle)
S u b s c a p u l a r im s uscle
C o r a c o b r a c h i a l i sm u s c l e Teres maior muscle
Triangular
L a t i s s i m u sd o r s i m u s c l e
S u p r a s c a p u l aar r t e r ya n d n e r v e
Acromion
Posteriorview nfraspinatustendon (reflected)
S u p e r i o rt r a n s v e r s es c a p u l a r c a p s u l eo f s h o u l d e r
l i g a m e n ta n d s u p r a s c a p u l a r
Deltoid muscle (reflected)
notch
T e r e sm i n o r m u s c l e
S u p r a s p i n a t um
s u s c l et c u t )
Q u a d r a n g u l a rs p a c e
t r a n s m i t t i n ga x i l l a r Y
nerve and posterior
I n f r a s p i n a t u sm u s c l e( c u t ) c i r c u m f l e xh u m e r a la r t e r Y
S u p e r i o rl a t e r a lb r a c h i a l
T r i a n g u l a rs p a c ew i t h cutaneouSnerve
c i r c u m f l e xs c a p u l a ra r t e r y
deep to space P r o f u n d ab r a c h i i ( d e e P
b r a c h i a l )a r t e r ya n d
T e r e sm a j o r m u s c l e R a d i a ln e r v e
shown between
4{tr eral head and

Lone head of
trice-psbrachii muscle
Shoulder and Axilla Pfate 426

Axillary Artery and Anastomoses around scapula
scendingcervicalartery
Anteriorview Transversecervicalartery Inferiorthyroidartery
Suprascapular
artery Thvrocervical
trunk
Subclavian
artery
A c r o m i o na n d
acromial anastomosis Anterior scalenemuscle
Dorsalscapular Clavicle(cut)
Superiorthoracic
Coracoidprocess artery
Anteriorcircumflex Thoracoacromialartery
humeralartery
cularbranch
Posterior
circumflex Acromialbranch
humeralartery
Deltoidbranch
Subscapular
art
Pectoral
branch
Circumflex
scapulararl 1,2, 3 indicate1st,
2nd, and 3rd partsof
Brachial
artery axillaryartery
Thoracodorsala
Lateralthoracic
Nr Omohyoid muscle (inferiorbelly)
Suprascapular
artery
Acromial branch of
thoracoacromialartery
Levatorscapulaemu
A c r o m i o na n d
acromial plexus
Dorsal scapularart
Infraspinous
branchof
suprascapurar
Supraspinatus
muscle(cut) artery
Superiortransverse Posterior
s c a p u l al irg a m e n t circumflex
and suprascapular humeral
notch
a r t e r y( i n
quadrangular
space)and
S p i n eo f s c a p u l a ascending and
descending
branches
Infraspinatus
muscle(cut)
Circumflex
scapular
artery
Teresminor muscle (cut)
Teresmajormuscle Lateralhead
L o n gh e a d
c4d4/*
Posteriorview

Pectoral, Glavipectoral, and Axillary Fasciae
Thoracoacromial
arter Trapeziusmuscle
muscleinvestedby
fasciaof infrahyoidmuscles
Coracoidprocess
Clavicle
Cephalicvein Fascia
investing
subclavius
muscle*
Costocoracoidligament*
Deltoid
muscle ligament
Costoclavicular
membrane*
Costocoracoid
Pectoralis Fasciainvesting pectoralis
maJor minormuscle*
muscle(cut)
ligamentof axilla*
Suspensory
Pectoralismajormuscleand
Biceps pectoralfascia(superficial
brachii anddeeplayers)
muscle
Shorthead dorsifascia
Latissimus
Long head
anteriorfascia
Serratus
Axillaryfascia(anteriorpart)
Brachial fascia
(cut edge) over
coracobrachialis
and biceps brachii
muscles
Nr
Omohyoidmuscle
Oblique parasagittalsectionof axilla
lavicle
Trapezius
muscle muscleandfascia*
Subclavius
( Lateralcord- ligament*
ostocoracoid
plexus
Brachial
J Posteriorcord
( Medialcord- Thoracoacromial artery and cephalic vein
muscle
Supraspinatus membrane*
ostocoracoid
scapura;U; Lateralpectoralnerve
{
Axillaryarteryandvein
Infraspinatus
muscle
majormuscleand fascia
Pectoralis
Subscapularis
muscle
Pectoralisminor muscle and fascia*
Teresminormuscle
Teresmaiormuscle Medial pectoral nerve
Latissimus
dorsimuscle ligamentof axilla
Suspensory
Axillaryfascia(fenestrated)
*Components fascia
of clavipectoral
Shoulder and Axilla Plate 428.

Axilla (Dissection|: Anterior View
Thoracoacromial
artery Trapezius Suprascapularartery and nerve
muscte
Pectoralisminor tendon (cut) A c r o m i a lb r a n c h Dorsalscapular
arteryandnerve
Coracoid process Deltoidbranch Transversecervical artery
Acromion Clavicularbranch
C e p h a l i cv e i n Pectoralbranch
Musculocutaneous
nerve Axillaryartery Anterior scalene
Anteriorcircumflexhumeralartery muscle
Clavicleand
Axillarynerve and posterior
subclavius
circumflexhumeralartey Sternocleidomastoid
muscle muscte
Pectoralismajor muscle (cut) (cut)
Coracobrachialis
muscle
Phrenic
Deltoidmuscle nerve
B i c e p sb r a c h i im u s c l e Omo-
hyoid
muscte
Musculocuta-
neousnerve
Brachi
muscle
U l n a rn e r v e
M e d i a lb r a c h i a l
Profunda cutaneousnerve
brachii Intercostobrachial
(deep nerve
brachial) Circumflex
artery scapularartery
Radialnerve
Lower sub-
Triceps scapular
brachii
muscle Teresmajor muscle
B r a c h i avle i n i Subclavian
Subscapular
artery artery and vein
Ulnarnervi:
Median nerve Latissimus
dorsimuscle 1st rib
Brachial
arterf Thoracodorsalartery and nerve
Uppersubscapular
nerve
M e d i a la n t e b r a c h i a l
c u t a n e o u sn e r v e S e r r a t uasn t e r i om
r uscle Suoeriorthoracic arterv
*{r
B a s i l i cv e i n
Lateralpectoral nerve
Lateralthoracic artery and long thoracic nerve
Ansapectoralis Medial pectoral nerve
Pectoralisminor (cut)

Brachial Plexus: Schema
Note:Usualcomposition shown.
PrefixedplexushaslargeC4 Contribution
contributionbut lacksT1. from C4
PostfixedplexuslacksC5 but
hasT2 contribution.
Dorsalscapular Dorsal
jt(\$\Ss nerve(C5) ramus
Tophrenic
Suprascapular nerve
n e r v e( C 5 , 6 )
Tosubclavius
n e r v e( C 5 , 6 )
..ts"
a-
Lateralpectoral
n e r v e( C 5 , 6 ,7 )
^"$'"
Musculocutaneou s
n e r v e( C 5 , 6 ,7
Contribution
from T2
fo longuscolli
Axillary and scalene
nerve(C5,6) muscles
(c5,6,7,9)
Radialnerve
( c 5 , 6 , 7 ,8 , T 1 ) 1st intercostalnerve
Longthoracic
Mediannerve nerve(C5,6, 7)
( c 5 , 6 , 7 ,8 , T 1
Medialpectoralnerve(C8,T1)
Ulnarnerve
(c7,8,T"1 Medialbrachialcutaneousnerve(T1)
nerve (C8,Tl)
cutaneous
antebrachial
nerve(C5,6)
Uppersubscapular
Inconstant
contribution
nerve(C6,Z 8)
(middlesubscapular)
acodorsal
nerve(C5,6)
4{r
subscapular
Shoulder and Axilla Plate 43O

Muscles of Arm: Anterior Views
SeealsoPlate 474
C o r a c o a c r o m i al li g a m e n t Acromion
S u b d e l t o ibdu r s a Coracoidprocess
minortendon(cut)
Pectoralis
Creatertubercle,
Lessertubercle Subscapularis
muscle
of humerus nerve(cut)
Musculocutaneous
Intertubercular C o r a c o b r a c h i aml ius s c l e
tendonsheath
scapularartery(cut)
Circumflex
D e l t o i dm u s c l e Teresmajormuscle
(reflected)
Latissimus
dorsimuscle
Pectoralismajor
muscle (reflected)
Anterior circumflex
h u m e r a la r t e r y
B i c e p s L o n gh e i
f
oracnil \
m u s c l e( S h o r n
te
artery(cut)
Brachial B i c e p sb r a c h i i
tendons (cut)
Median nerve (cut) S h o r th e a d
Long head
B r a c h i a l im
s uscle
C o r a c o b r a c h i a l im
suscle
Lateralantebrachial
cutaneousnerve
M u s c u l o c u t a n e o uns e r
B i c i p i t aal p o n e u r o s i s Branchto biceps brachii (cut)
D e l t o i d m u s c l e( c u t )
Bicepsbrachiitendon
B r a c h i o r a d i a lm
i su s c l e
Pronatorteres muscle
Flexorcarpi
r a d i a l i sm u s c l e
B r a c h i a l im
s uscle
Superficiallayer
Medial
intermuscular
Lateralintermuscularseptum septum
Lateralepicondyleof humerus
Medial
Lateralantebrachialcutaneousnerve epicondyle
of humerus
Head of radius
Nry B i c e o sb r a c h i it e n d o n
R a d i a tl u b e r o s i t y
Deep layer
Tuberosity
of ulna
Plate 431 Arm

Muscles of Arm: Posterior Views
Acromion Superficiallayer
S u p r a s p i n a tm
u su s c l e
atertubercleof humerus
muscle
Infraspinatus
Teresminor muscle
Axillary nerve and posterior

circumflexhumeral artery
Deltoid muscle (cut and reflected)
Superiorlateralbrachialcutaneousnerve
.ateralhead I of Tricepsbrachii muscle

-endon
)
i su s c l e
e f s h o u l d ej o
C a p s u lo r int
tendon
Supraspinatus
Teresmaiormuscle and
Infraspinatus
Posteriorbrachial Teresminortendons(cut)
c u t a n e o u sn e r v e
(from radial nerve Axillarynerve
Medial inter- Posterior

circumflex
m u s c u l a rs e p t u m humeralartery
Teres
Ulnar nerve malor
muscle Superiorlateralbrachial
M e d i a le p i c o n d y l e cutaneous nerve
of humerus
Profundabrachii(deep
O l e c r a n o no f u l n a
artery
brachial)
Flexorcarpi Radialnerve
u l n a r i sm u s c l e
Middlecollateral
artery
A n c o n e um
s uscle
Extensor
carpi Radialcollateral
artery
r a d i a l i sl o n g u sm u s c l e
Extensorcaroi ulnarismuscle Inferiorlateralbrachial

cutaneous nerve
Posteriorantebrachial
Long head of
cutaneousnerve (f Lateralintermuscular
tricepsbrachii muscle
radial nerve) septum
Lateralhead of triceps
E x t e n s odri g i t o r u m
muscle i u s c l e( c u t )
b r a c h im Nerve to anconeusand
Extensorcarpi radialisbrevis muscle medial head of
Medialheadof
tricepsbrachii muscle
tricepsbrachiimuscle
Medialepicondyle Posteriorantebrachial
of humerus cutaneousnerve
*{r Deep layer

U l n a rn e r v e
Olecranon of ulna
Lateralepicondyle
of humerus
A n c o n e u sm u s c l e
Arm Plate 432

Brachial Artery in Situ
C o r a c o i dp r o c
Axillaryartery
Pectoralisminor muscle (cut)
Anterior circumflex
humeral artery Lateralcord,
Medialcord
of brachialplexus
Humerus
Musculocutaneous
nerve
Pectoralismajor
m u s c l ea n d t e n d o n (
S u b s c a p u l am
r i su s c l e
B i c e p s ( L o n gh e a d
b r a c h i i{ Anterior and oosterior
m u s c l e ( S h o r th e circumflexhumeral arteries
Teresmajor muscle
atissimusdorsi muscle
Brachial
Profundabrachii (deeo
brachial)arterv
M u s c u l a rb r a n c h
Medial brachialcutaneousnerve
Median nerve Ulnar nerve
M u s c u l a rb r a n c h Medial antebrachialcutaneousnerve
B i c e p sb r a c h i im u s c l e
Superiorulnar collateralartery
B r a c h i a l im
s uscle
i n t e r m u s c u lsaer p t u m
Radialrecurrentartery
Inferior ulnar collateralartery
B i c e p sb r a c h i it e n d o n M e d i a le p i c o n d y l eo f h u m e r u s
B i c i p i t aal p o n e u r o s i s
Radialartery
Pronator muscre
nar artery
F l e x o rc a r o i r a d i a l i sm u s c l e
r a c h i o r a d i a l im
s uscle 4{tr
Plate 433 Arm

Brachial Artery and Anastomoses around Elbow
branch
Clavicular
Pectoralbranch
Acromialbranch
Deltoidbranch
Thoracoacromial
arterv
thoracicarterv
Axillary artery
Anteriorcircumflexhumeralarter al thoracicartery
Posterior
circumflexhumeral artery
Subscapular
ircumflexscapular
artery
Brachialartery
artery
Thoracodorsal
Profundabrachii(deepbrachial)
artery
of lowermargin
of teresmajormuscle
is landmarkfor name
changefrom axillary
to brachialartery
Radialcollateral
Middlecollateral
artery
Superiorulnarcollateralartery
artery
Inferiorulnarcollateral
Radialrecurrent artery
Recurrent
interosseous
arterv
Anteriorulnarrecurrentartery
ulnarrecurrentarterv
Posterior
Radialartery
common interosseous
artery
Anteriorinterosseous
artery
4{tr
Ulnarartery
Arm Plate 434

Arm: Serial Gross Sections
Pectoralis
majormuscleandtendon neousnerve
Cephalicvein Mediannerve
( Medialantebrachial
Biceps shorthea cutaneousnerve
brachii
muscleI
( Long hea,
Brachial
artervandveins
Coracobrachialis
muscle
vern
Profundabrachii(deep
brachial)
artery
Deltoidmuscle
Ulnarnerve
Radialnerve
Medialbrachial
cutaneousnerve
Bicepsbrachiimuscle
Latissimus
dorsitendon
Musculocutaneous
nerve
Teresmajor muscle
Brachialis
muscle
Brachial
fascia
Cephalicvein Mediannerve
Radial Brachial
artervandveins
Posterior
an
cutaneous nerve Medial antebrachial
(fromradialnerve) cutaneousnerve
Radialcollateral silicvein
artery
Medialbrachialcutaneous
nerve
Middlecollateral
arterv
Neurovascular
compartment
Lateralintermuscular
septum
Ulnarnerve
of Triceps( u"ai"tr'""a Superiorulnarcollateral
artery
brachii { Lateralhead
muscle Medialintermuscular
septum
( Longhead-
Bicepsbrachii Brachialfascia
ateralantebrachial
cutaneous
nerve
Cephalicvein (frommusculocutaneousnerve)
Brachialis
muscle Medialantebrachial nerve
cutaneous
Brachioradialis
muscle Basilicvein
Median nerve
Radialnerve
Ulnarnerve
Extensor carpi
radialislongus Brachial
artervandveins
muscte
Medialintermuscular
septum
Posterior
antebrachial
cutaneous
nerve(from
Humerus
Tricepsbrachiimuscleand tendon
*{r
radialnerve)
septum
Plate 435
Bones of Elbow
Rightelbow
Humerus Humerus
edial
supracondylarridge
*{r
Olecranon
Coronoid fossa
Radialfossa fossa
Lateralepicondyle
Lateralepicondyle Medial epicondyle
Olecranon
Capitulum Trochlea
Head
Head Coronoid
process K
Neck Tuberosity
Radialnotchof ulna
Tuberosity
Tuberosity
Ulna
In extension: anterior view In extension:posteriorview
ln extension:medialview
Humerus
Medialepicondyle
Lateralepicondyle
Capitulum
Capitulum
Head
Tuberosity
Radialnotch
Tuberosity
Coronoid process Coronoid process
of ulna Trochlearnotch
Trochlearnotch
Olecranon Olecr
Olecranon
In 90" flexion: lateral view In 90'flexion: medialview
Elbow and Forearm Plate 436

Elbow: Radiographs
Lateralradiograph
c Capitulum
CP Coronoidprocessof ulna
H Humerus
HR Headof radius
t Lateralepicondyle
o Olecranon
R Radius
T Trochlearnotch
U Ulna
Anteroposteriorradiograph
c Capitulum
CP Coronoidprocessof ulna
H Humerus
HR Headof radius
t Lateralepicondyle
M Medialof epicondyle
NR Neckof radius
o Olecranon
OF Olecranonfossa
R Radius
T Trochleaof humerus
RT Radialtuberosity
U Ulna
Plate 437 Elbow and Folearm

Ligaments of Elbow
Rightelbow
Anteriorview Humerus
Jointcapsule
Medial epicondyle
Lateralepicondyle
Radialcollateralligament Ulnarcollateral
ligament
A n n u l alri g a m e not f r
Insertionof brachialismuscle
Bicepsbrachiitendon
Obliquecord
4{r
Humerus Joint Humerus
ioint capsule
ligament
Ulnarcollateral
Radialcollateralligament
A n n u l alri g a m e not f r a d i u s A n n u l a lri g a m e not f r a d i u s Triceps
Biceosbrachiitendon Bicepsbrachiitendon brachii
tendon
Obliquecord
Sub-
-$=::---:.Ff
cutaneous
olecranon
DUTSA Subcutaneous
olecranon
In 90o flexion:lateralview ln 90o flexion:medialview bursa
Jointcapsule(cutedge) Humerus
Fatpads
Openrd joint: Openedjoint:
antenor vrew Synovialmembrane postenorvrew
Articularcartilage

Bones of Forearm
Rightradiusand ulna Olecranon Rightradiusand

in supination:anteriorview Trochlearnotch ulna in pronation:
anteriorview
Coronoid process
R a d i a ln o t c h o f u l n a
U l n a rt u b e r o s i t y Obliquecord
O b l i q u ec o r d Ulnartuberosity
R a d i atlu b e r o s i t y
Anteriorsurface Anterior surface

Lateralsurface
Posterior
border
Anterior border
Anteriorborder Posterior
surface
lnterosseous
membrane
Interosseous
border
Interosseous
border
Interosseous
membrane
Dorsaltubercle
Croove for extensor
p o l l i c i sl o n g u sm u
Croove for extensor
carpi radialislongus
Croove for extensor and brevis muscles
digitorum and extensor
i n d i c i sm u s c l e s
Areafor extensor
pollicib
s r e v i sa n d
Styloidprocess
of ulna abductorpollicis
longusmuscles
Styloidprocess
Styloidprocess
U l n a rn o t c h
of radius
Styloid Coronal sectionof
process radiusdemonstrates
Styloidprocess how thicknessof
cortical bone of
shaftdiminishes
to thin layerover
Areafor s phoid bone Area for lunate bone cancellousbone
Carpalarticularsuface 4{F at distalend
Plate 439 Elbow and Forearm

lndividual Muscles of Forearm: Rotators of Radius
Rightforearm:anteriorview
Supinatedposition Pronatedposition
Lateralepicondyle Medial eoicondvle
Pronatorteres
*{r
Elbow and Forearm Plate 44O

Individual Muscles of Forearm:Extensorsof Wrist and Digits
N o t e : A n c o n e u sm u s c l en o t s h o w n al epicondyle
becauseit is extensorof elbow
Olecranon
Lateralepicondyle
Extensorsof wrist Common

extensor
Olecranon Extensor carpi tendon
radialislongus
Extensor carpi
Lateral
radialisbrevis
epicondyle
Extensor carpiulnaris Extensor
digitorum
Common and extensor
extensor d i g i t im i n i m i
tendon (cutaway\
Interosseous
memDrane
Extensorsof digits
(exceptthumb)
Extensor
digitorum
Extensor
digiti minimi
Extensorindicis
Extensors
of thumb
Abductorpollicis
pollicisbrevis
Extensor
Extensorpollicislongus
E x t e n s odr i g i t o r u m
and extensordigiti
m i n i m i t e n d o n s( c u t
t!
I Rightforearm:
posterior
(dorsal)views
4{tr
Plale 441 Elbow and Forearm

Individual Muscles of Forearm: Flexors of Wrist
Note:Brachioradialis musclenot shown

becauseit is flexorof elbow
Medial epicondyle
Lateralepicondyle
flexortendon
Flexorcarpiradialis
Palmarislongus
Flexorcarpiulnaris
(cut)
almaraponeurosis
Rightforearm:
anterior(palmar)view

lndividual Muscles of Forearm: Flexors of Digits
Medial epicondyle
Lateralepicondyle Lateralepicondyle
Common flexor tendon
Coronoid process
Interosseousmembrane
Flexorpollicislongus
tendons (cut away)
4{tr Rightforearm:
anterior(palmar)views

Muscles of Forearm (Superficial Layerf: Posterior View
S u p e r i our l n a rc o l l a t e r aalr Tricepsbrachiimuscle

( a n a s t o m o sdeiss t a l lw y itn
posteriorulnarrecurrentartery)
B r a c h i o r a d i aml ius s c l e
U l n a rn e r v e
Extensor carpi radialislongus muscle

M e d i ael p i c o n d y loef h u m e r u s
Common extensortendon
O l e c r a n o no f u l n a
Extensorcarpi radialisbrevis muscle

Anconeus muscle
Extensordigitorum muscle
Flexorcarpi ulnarismuscle
Extensorcaroi ulnaris Extensordigiti minimi muscle
Abductorpollicislongusmuscle
oollicisbrevismuscle
Extensor
xtensorpollicislongustendon
Extensorcarpi radialisbrevistendon
Extensor
retinaculum Extensorcarpi radialislongustendon
(compartmentsnumbered)
Suoerficialbranch of radial nerve

Dorsal branch of ulnar nerve
A b d u c t op
r o l l i c i lso n g u st e n d o n
E x t e n s ocr a r p i u l n a r i st e n d o n Extensor oollicisbrevistendon
E x t e n s o dr i g i t im i n i m i t e n d o n E x t e n s opro l l i c i sl o n g u st e n d o n
Extensordigitorum
E x t e n s o irn d i c i st e n d o n
Anatomical snuffbox
Nr
5th metacarpalbone

Muscles of Forearm (Deep Layerf: Posterior View
SeeafsoPlates 47O,479
Superiorulnarcollateral Middlecollateral
branchof
Branches of { deepbrachialartery
tnreflorutnar
" ! ' / I ( p o s t e r i o r coilareral
brachial'arterv
( branch)1
Medialintermuscular
septum Lateralintermuscular
septum
U l n a rn e r v e Brachioradialis
muscle
Posterior
ulnarrecurrenta Extensor longusmuscle
carpiradialis
M e d i a el p i c o n d y loef h u m e r u s Lateralepicondyleof humerus
Tricepsbrachiitendon(cut) Commonextensortendon(partiallycut)
O l e c r a n o no f u l n a carpiradialis
Extensor brevismuscle
Anconeus S u p i n a t omr u s c l e
F l e x ocr a r p iu l n a r i m
s nerve
interosseous
Posterior
Recurrent
interosseous
artery onatorteresmuscle(slipof insertion)
Posterior
interosseous
artery Radius
Ulna nerve
rnterosseous
pollicislongusm
Extensor t o r p o l l i c i lso n g u sm u s c l e
Extensor
indicismuscle pollicisbrevismuscle
Anterior interosseousartery (termination)

xtensorcarpiradialis
brevistendon
xtensorcarpiradialis
longustendon
carpiulnaristendon(cut)
Extensor
adialartery
Extensordigiti minimi tendon (cut)
2'"
digitorumtendons(cut)
Extensor
4 ir,
C '&, 1st metacarpalbone
Extensor
retinaculum bone
2nd metacarpal
(compartmentsnumbered)
Nr 5th metacarpal
bone
I st dorsal
interosseousmuscle
Plate 445 Elbow and Folearm

Muscles of Forearm (superficial Layerl: Anterior View
SeeahoPtaH 475,476
Bicepsbrachii muscle Medialantebrachial

cutaneous
nerve
Ulnarnerve
Brachialartery and median nerve
Tricepsbrachiimuscle
Lateralantebrachialcutaneousnerve
(terminaml u s c u l o c u t a n e o unse r v e )
Medialintermuscular
septum
B r a c h i a lm
i su s c l e Ulnarartery
B i c e p sb r a c h i it e n d o n M e d i ael p i c o n d y loef h u m e r u s
ommon flexor tendon

Radialartery
B i c i p i t aal p o n e u r o s i s
Flexorcarpi
radialismuscle
Brachioradialm
isuscle
longus
Palmaris Superficial
f
Extensor carpi muscle ) flexor
r a d i a l ilso n g u sm u s c l e f muscles
Extensorcaroi
radialisbrevis muscle
F l e x opr o l l i c i lso n g u s
muscle and tendon
P a l m a r li o
s n g u st e n d o n
Radialartery
branch of ulnar nerve
Median nerve artery and nerve
Palmarcarpal ligament
( c o n t i n u o u sw i t h
e x t e n s orre t i n a c u l u m )
Pisiform
T h e n am
r u Palmarbranch of median nerve
P a l m a ra p o n e u r o s i s
Hypothenar muscles
4{tr
Elbow and Forearm Pfate 446

Muscles of Forearm (lntermediate Layer|: Anterior View
Sceal$oPbba{ft4 {ru
Bicepsbrachiimuscle U l n a rn e r v e
Median nerve
Brachialis
muscle
Brachial
artery
Lateralantebrachialcutaneousnerve (cut)
(frommusculocutaneous
nerve)
intermuscular
septum
Pronatorteresmuscle (humeralhead)
Radialnerve (cut and reflected)
Deepbranch
Superficial
branch Medial epicondyle
Flexorcarpi radialisand palmaris

Biceosbrachiitendon longus tendons (cut)
Anteriorulnarrecurrentartery
Radialrecurrentarterv
m u s c l e( h u m e r o u l n h
aer ad)
Radialartery
U l n a ra r t e r y
S u p i n a t omr u s c l e Common interosseousarterv
Pronatorteresmuscle(ulnarhead)(cut)
Anteriorinterosseous
artery
Pronatorteresmuscle(cut
lexorcarpiulnarismuscle
Flexordigitorumsuperficialis or digitorumsuperficialis
muscle
muscle(radialhead)
U l n a ra r t e r y
F l e x o rp o l l i c i sl o n g u sm u s c l e Ulnarnerveanddorsalbranch
Median nerve
Palmar of medianand ulnarnerves(cut)

branches
siform
Flexorcarpi radialis Deeppalmarbranchof ulnarartery

tendon (cut) anddeepbranchof ulnarnerve
branchof ulnarnerve
Superficial
palmarbranch
Superficial
of radialartery Flexorretinaculum
(transverse
carpalligament)
Nr

Muscles of Forearm (Deep Layerf: Anterior View
B r a c h i a lm
i su s c l e U l n a rn e r v e
M u s c u l o c u t a n e o unSe r v e
M e d i a nn e r v e
(becomes)
Brachialartery
septum
Medialintermuscular
septum
Radialnerve
Pronatorteresmuscle
(humeralheadcut and reflected)
Lateralepi
ulnarrecurrentartery
Bicepsbrachiitendon (cut)
'Medial
epicondyle of humerus
Radialrecurrentartery
Radialartery Flexorcarpi radialis,

palmarislongus,
S u p i n a t o rm u s c l flexor digitorum superficialis
( h u m e r o u l n ahr e a d ) ,a n d
flexor carpi ulnaris
Posteriorand anterior muscles(cut)
i nterosseousarteries-
Flexordigitorumsuperficialis Posterior
ulnarrecurrentartery
muscle (radialhead) (cut)
Ulnarartery
(cut and reflected) ommon Interosseousarterv
Radialartery r e a d )( c u t )
t o r t e r e sm u s c l e( u l n a h
Flexorpollicislongus Median nerve (cut)

muscleandtendon(cu
Flexordigitorumprofundusmuscle
Anterior interosseousartery and nerve

Pronatorquadratusmuscle
s n d o n( c u t )
B r a c h i o r a d i a l ti e U l n a r n e r v e a n d d o r s a lb r a n c h
Radialartery and Palmarcarpal branchesof radialand ulnar arteries

palmarbranch
superficial
Flexorcarpi ulnaristendon (cut)
F l e x o rp o l l i c i sl o n g u st e n d o n
Pisiform
Flexorcarpi radialistendon (cut)
palmar branch of ulnar artery
A b d u c t o pr o l l i c i lso n g u s and deeo branch of ulnar nerve
Extensorpollicis brevistendon
l s t m e t a c a r o abl o n e
of hamate
5th metacarpalbone
Nr
Elbow and Forearm Plate 44A

Forearm: Serial Gross Sections
M e d i a n a n t e b r a c h i avl e i n l e x o rd i g i t o r u m
superficialis
m u s c l e( r a d i a lh e a d )
Anterior branch of media
Radialarterv and superficialbranch of radial nerve antebrachialcutaneousnerve
F l e x o rp o l l i c i sl o n g u sm u s c l e
Radius
Interosseousmembrane
i su
Flexorcarpi radialismuscle
Cephalicvein and lateralantebrachial
cutaneousnerve (from musculocutaneous
Ulnararteryand mediannerve
nerve) P a l m a r il so n g u sm u s c l e
S u p i n a t o rm u s c l e
Deep branch of radial nerve m u s c l e( h u m e r o u l n h
aer ad)
E x t e n s o cr a r p i r a d i a l i sl o n g u sm u s c l e Commoninterosseous
artery
U l n a rn e r v e
Extensorcaroi radialisbrevismuscle
F l e x ocr a r o iu l n a r i m
s uscle
Extensordigitorum muscle
E x t e n s odr i e i t i m i n i m i m u s c l e p r o f u n d um
F l e x odr i g i t o r u m s uscle
E x t e n s ocra r p iu l n a r i m
s uscle and antebrachialfascia
F l e x ocr a r p ir a d i a l im
s uscle A n c o n e u sm u s c l e
Posterior
antebrachial
cutaneous
i su s c l e nerve (from radial nerve)
Radialartery and superficial P a l m a r i sl o n g u sm u s c l e
branch of radial nerve
muscle
F l e x o rp o l l i c i sl o n g u sm u s c l e Median nerve
Extensorcaroi radialis Ulnar artery and nerve
l o n g u sm u s c l ea n d t e n d o n 'lexorcarpi ulnarismuscle
Radiu Anterior interosseousartery and nerve
(from median nerve)
E x t e n s ocr a r o i r a d i a l i s
b r e v i sm u s c l ea n d t e n d o n F l e x o rd i g i t o r u mp r o f u n d u sm u s c l e
A b d u c t o pr o l l i c i lso n g u sm u s c l U l n a a n d a n t e b r a c h i af la s c i a
In t e r o s s e o u m s e m b r a n ea n d
E x t e n s odri e i t o r u m
muscle e x t e n s o rp o l l i c i sl o n g u sm u s c l e
E x t e n s o dr i g i t im i n i m i m u s c l e Posteriorinterosseousartery and nerve
(continuationof deep branch of radialnerve)
E x t e n s o cr a r p i u l n a r i sm u s c l e
P a l m a r i sl o n g u st e n d o n
F l e x o rc a r p i r a d i a l i st
Median nerve
Radialartery digitorum superficialismuscle and tendons
B r a c h i o r a d i a lti e
sndon Flexorcaroi ulnarismuscle and tendon
A b d u c t o pr o l l i c i sl o n g u s Ulnar artery and nerve

Dorsalbranchof ulnarnerve
S u p e r f i c i abl r a n c ho f r a d i a l
lexor digitorum profundus muscle and tendons
E x t e n s opro l l i c i sb r e v i st e n d o n
Antebrachialfascia
E x t e n s ocra r p ir a d i a l i s Ulna
l o n g u st e n d o n
t e n s o rc a r p i u l n a r i st e n d o n
Extensorcaroi radialisbrevis tendon
P r o n a t o ro u a d r a t u sm u s c l ea n d i n t e r o s s e o um
s embrane
F l e x opr o l l i c i lso n g u sm u s c l e E x t e n s o irn d i c i sm u s c l ea n d t e n d o n
E x t e n s o pr o l l i c i sl o n g u st e n d o n E x t e n s o dr i g i t im i n i m i t e n d o n
E x t e n s odr i g i t o r u mt e n d o n s( c o m m o n t e n d o n
*{ry t o d i g i t s4 a n d 5 a t t h i s l e v e l )

Attachments of Muscles of Forearm: Anterior View
B r a c h i o r a d i am
l iu
sscle a c h i a l i sm u s c l e
Extensor
carpiradialis
longusmuscle Pronatorteresmuscle(humeralhead)
Supinator
Extensor carpiradialisbrevis,
extensordigitorum,extensor
d i g i t im i n i m ie, x t e n s ocra r p i
ulnarim s uscles
Brachialis
muscle
muscle
( h u m e r o u l nh
aer ad)
B i c e p sb r a c h i im u s c
t e r e sm u s c l e( u l n a h
r ead)
m u s c l e( r a d i ahl e a d ) - Flexordigitorumprofundusmuscle
Pronatorteresmuscl
F l e x o rp o l l i c i sl o n g u sm
Note:Attachmentsof intrinsic
musclesof handnot shown
A b d u c t o pr o l l i c i sl o n g u sm u s c l e
F l e x o rc a r o i u l n a r i sm u s c l e
Extensor
caroiulnarismuscle
Flexorcarpi radialis
Flexorpollicis Flexordigitorumsuperficialis
muscle
l o n g u sm u s c l e
Flexordigitorum profundus muscle
I origins I Insertions
Elbow and Forearm Plate 45O

Attachments of Muscles of Forearm: Posterior View
Note: Attachmentsof intrinsic Tricepsbrachii muscle (medial head)

musclesof hand not shown
Tricepsbrachii tendon
Supinator
s u s c l e( h u m e r a l
F l e x ocr a r p iu l n a r i m
origin via common flexor tendon A n c o n e um
s uscle
s brachiimuscle
Flexorcarpi ulnarismuscle
p r o f u n d um
F l e x odr i g i t o r u m s uscle
s u s c l e( u l n a o
E x t e n s ocra r p iu l n a r i m r rigin)
Extensor
pollicislongusmuscle
pollicisbrevismuscle
Extensor
Extensorindicis
Extensorcarpi radialislongus muscle

i su s c l e
Extensorcarpi radialisbrevismuscl
A b d u c t o pr o l l i c i sl o n g u sm u s c l e
Extensor
caroiulnarismuscle
Extensoroollicis brevis muscle

Extensordigitorum muscle (centralbands)
E x t e n s o dr i g i t im i n i m i m u s c l e pollicislongusmuscle
Extensor
Extensor
indicismuscle
Extensordigitorum muscle (lateralbands)
I origins I Insertions
4{ry
Garpal Bones
Anterior(palmar)view
Ulna
Radialstyloidproc Ulnarstyloidprocess
Lunate
Tubercleof scaphoid Triquetrum
Pisiform
Tubercleof trapeziu Hamate
of hamate
pitate
Metacarpalbones
Posterior(dorsal)view
Dorsaltubercleof radius(Lister's)
Ulnarstyloid
Radialstyloidprocess
Trapezium
Trapezoid
Metacarpalbones
4{tr
Wrist and Hand Plate 452
Movements of Wrist
-Ulna -Ulna
Radius
: ,zLunare
Scaphoid
Triquetrum
Capitate
Scaphoid.
Trapezoid Pisiform
Lunate
Capitate
Trapezium
Triquetrum Trapezoid
Trapezium
Pisiform
Hamate
Metacarpal
Metacarpal 00nes
bones
Sesamoid
DOnes
P o s i t i o no f c a r p a l b o n e s w i t h h a n d i n a b d u c t i o n : P o s i t i o no f c a r p a l b o n e s w i t h h a n d i n a d d u c t i o n :
anterior (palmar)view anterior (palmar)view
W r i s t ( r a d i o c a r p a jl o
) int
Radius M i d c a r p a lj o i n t
Wrisl C a r p o m e t a c a r p aj ol i n l
(radiocarpal)
lornr
A r t i c u l a rd i s c
o f w r i s tj o i n t
L un a t e
Midcarpal
joint
aprtate
Carpometacarpal W r i s t ( r a d i o c a r p a jl o
) int
JOrnt
3 r d m e t a c a r p abl o n e M i d c a r p a jl o i n t
C a r p o m e t a c a r p aj ol i n t
Dorsum-) f-Palm
Hand in
anatomical
position Hand in
extension
Sagittal
- sectionsthroughwrist and
middlefinger 4{v
Plate 453 Wrist and Hand
Ligaments of Wrist
Carpaltunnel:palmarview
Radius Ulna
P a l m a r i sl o n g u st e n d o n l n t e r o s s e o um
s embrane
P a l m a rc a r p a ll i g a m e n t Ulnar artery and nerve

(thickeningof deep antebrachial
fascia)(cut and reflected)
Flexorcarpi ulnaristendon
Radialartery and
F l e x o rd i g i t o r u m
s u p e r f i c i apl a l m a rb r a n c h profundustendons
Flexorcarpi radialistendon Flexordigitorum
superficialistendons
F l e x o rp o l l i c i sl o n g u st e n d o n
Pisiform
M e d i a nn e r v e
Deep palmar branch of ulnar artery
P a l m a ra p o n e u r o s i s a n d d e e p b r a n c ho f u l n a rn e r v e
Tubercleof scaphoid
Hook of hamate
Tubercleof trapezium
Flexorretinaculum
(transversecarpal ligament)
Flexorretinaculumremoved:
palmarview
S h o r tr a d i o l u n a t el i g a m e n t
P a l m a rr a d i o l u n a t el i g a m e n t
L o n g r a d i o l u n a t el ig a m e n t
U l n o l u n a t el i g a m e n t
R a d i o s c a p h o c a p i t altieg a m e n t
U l n o c a p i t a t el i g a m e n t
Scaphotrapeziotrapezoidligament
Ulnotriquetralligament
Scaphocapitateligment Lunotriquetralligament
Trapeziotrapezoidligament
Triquetrohamateligament
Triquetrocapitateligament
Capitohamateligament
ligament
Trapeziocapitate
Metacarpalbones

Ligaments of Wrist (continuedl
Dorsal radial metaphysealarcuateligament
Dorsal radiocarpalligament
D o r s a lr a d i o u l n a lri g a m e n t
U l n o t r i q u e t r alli g a m e n t( d o r s a vl i e w ) S c a p h o l u n a t lei g a m e n t
Triquetrohamateligament
Trapeziotrapezoidligament
D o r s a li n t e r c a r p alli g a m e n t
Trapeziocapitateligament
C a p i t o h a m a t el i g a m e n t
Metacarpalbones
Coronal section: dorsal view
Ulna Radius
D i s t arl a d i o u l n aj or i n t Lunate
A r t i c u l adr i s co f w r i s tl o i n t joint
Wrist(radiocarpal)
Meniscus Scaphoid
M i d c a r p a lj o i n t
I n t e r o s s e o uisn t e r c a r p alli g a m e n Trapezoid
Trapezium
Triquetrum
Carpometacarpaljoint
Hamate
ntermetacarpaljoints
Capitate
4{tr
6(a4*/*
Metacarpalbones

Bones of Wrist and Hand
saseI
Shafts) Metacarpalbones
Head J Righthand:
anterior(palmar)view
gase I
Proximal
Phalanges
nXf f
oaseI
Middlephalanges
n'jf I
Lunate \ Carpal
bones
-.-scaphoid \
Capitate
Trapezoid
Carpalbones {
r Triquetrum
Trapezium
l. Hamate
1' a"r"
Metacarpalbones ( Shafts
I Head
f Base
phalanges{
Proximal Shafts
Riehthand: I Head
(dorsal)view
po-sterior
f ert"
Middle phalanges{ Shafts
I Head

Wrist and Hand: Anteroposterior Radiograph
Seealso
BM Baseof 5th metacaroal P Pisiform

BP Baseof 4th proximal phalanx PP Proximalphalanxof thumb
C Capitate PPI Proximalphalanxof indexfinger
DP Distal phalanxof thumo R Radius
DPR Distal phalanx of ring finger S Scaphoid
H Hamate SH Shaftof 5th metacarpal
HH Hook of hamate SP Styloidprocessof ulna
HM Head of 5th metacaroal SPR Styloidprocessof radius
HP H e a d o f p r o x i m a lp h a l a n x T Triquetrum
L Lunate TP Trapezoid
M Metacarpalof index finger TZ Trapezium
MP Middle phalanxof middle finger U Ulna

Metacarpophalangeal and lnterphalangeal Ligaments
Anterior (palmar)view form
of hamate
Trapezium
mar carpometacarpalligaments
Palmarmetacarpalligaments
J o i n tc a p s u l e
Deeptransverse
CollateralIigam
ligaments
metacarpal
Palmarligaments
(plates)
Cut marginsof
digitalfibrousshea
Flexordigitorum
suoerficialistendons (cut)
Flexordigitorum profundustendons
M e t a c a r p o p h a l a n g(eMaPl )i o i n t
collateral proximal interphalangeal(plp) joint
Accesso.ry
7
ligament
Metacarpalbone Truecollateral Distal interphalangeal
ligament ( D l P )j o i n t
ln extension:
medialview
Palmarsurface
Proximal Middle
Palmarligament (volarplate
Accessory Phalanges
collateral
ligament
In flexion:
medialview
Palmarligament(volarplate)
True collateralligament
4{tr
Note: Ligamentsof metacarpophalangeal
and inteiphalangealjoints are similar

Wrist and Hand: Superficial Palmar Dissections
Palmarislongustendon Palmarbranch of ulnar nerve
Branchof superficial Pisiform

radial nerve to skin of
lateralthenar area Deep palmar branch of ulnar artery and deep
P a l m a rc a r p a ll i g a m e n t
( t h i c k e n i n go f d e e p Superficial
branchof ulnarnerve
antebrachialfascia
c o n t i n u o u sw i t h U l n a ra r t e r y
extensorretinaculum)
Palmaris
brevismuscle
Palmarbranch of
m e d i a nn e r v e Hypothenar
muscles
T h e n a rm u s c l e s Palmar
aponeurosis
Recurrent
(motor)
branch of
median
nerve to
thenar
muscres
Minute fasciculi Palmarisbrevis

attach palmar muscle (reflected)
a p o n e u r o s i st o d e r m i s
Palmardigital
nervesfrom
superficial
branch of ulnar
nerve to 5th and
Anterior (palmar)views medial half of
4th fingers
Palmaraponeurosis
Transversefasciculi
Palmardigital arteriesand nerves
Superficialtransversemetacarpalli
*{ry

Wrist and Hand: Deeper Palmar Dissections
Radialartery and venae comitantes Ulnar artery with venae comitantesand ulnar nerve
Flexorcarpi radialistendon Flexorcarpi ulnaristendon

T e n d i n o u ss h e a t ho f C o m m o n f l e x o rs h e a t h( u l n a rb u r s a )c o n t a i n i n g
flexor pollicislongus superficialisand profundusflexor tendons
( r a d i abl u r s a )
Pisiform
Median nerve
Deep palmar branch of ulnar artery and deep
P a l m a r i sl o n g u st e n d o n a n d branch of ulnar nerve
p a l m a rc a r p a ll i g a m e n l
Superficialbranch of ulnar nerve
Transversecarpal
ligament(flexor Palmardigital nervesto 5th finger and
retinaculum) medial half of 4th finger
T h e n am
r uscles n nerve
Properpalmar Commonflexorsheath(ulnarbursa)
digital nerves
of thumb- palmararterialandvenousarches
Superficial
(Synovial) 2nd.3rd.and4th lumbricalmuscles(in fascialsheaths)
tendinous
sheathof flex (Synovial) of fingers
flexortendonsheaths
p o l l i c i sl o n g u s
(radialbursa)
P r o b ei n I s t
lumbrical
fascial Superficial
palmarbranch
Common palmar of radialartery
digital and recurrent
branchof
Properpalmar mediannerve
digitalarteries to thenar
Septafrom.palmar muscles
a p o n e u r o srrosr m r n g Ulnarartery
ano nerve
Palmaraponeurosis
(reflected) Common palmar
digital branches
of median nerve (cut)
Anterior(palmar)views
muscles
Proper palmar digital nervesof
s h e a t h( u l n a r
Fasciaover adductor oollicismuscl bursa)
5th finger
l s t d o r s ailn t e r o s s e o m
u su s c l e (synovial)
t e n d i n o ussh e a t h
Probein dorsalextension
of thenar
space deep to adductor pollicis Probein
midpalmarspace
Thenarspace (deep to flexor tendons
'l
and st lumbricalmuscle M i d p a l m asrp a c e
(deepto flexor
Septum separatingthenar from midpalmarspace tendonsand
l u m b r i c aml u s c l e s )
C o m m o n p a l m a rd i g i t a l
Insertionof
flexor digitorum
Proper palmar digital arteriesand superficialistendon
Annular and cruciform oartsof fibrous sheath lnsertionof flexor digitorum

over (synovial)flexor tendon sheaths profundustendon

Flexor Tendons, Arteries, and Nerves at Wrist
Palmar view
P a l m a r i sl o n g u st e n d o n t e n d o n sa n d
flexordigitorumprofundus
Median nerve tendons
Commonflexorsheath
Radialartery ( u l n ab
r ursa)
tendon
F l e x opr o l l i c i lso n g u s Ulnarartery
t e n d o ni n t e n d o n U l n a rn e r v e
sheath(radialbursa)
F l e x ocr a r p iu l n a r i s
Palmarcarpal ligament (reflec tendon
(Synovial)tendon sheath
Flexorretinaculum(transverse Pisiform
carpalligament)
Trapezium A b d u c t o rd i g i t im i n i m i m u s c l e
1st metacarpalbone
Opponenp
s ollicim
s uscle Flexordigiti minimi brevis muscle
Abductorpollicis
b r e v i sm u s c l e O p p o n e n sd i g i t i m i n i m i m u s c l e
(reflec
Superficialpalmar (arterial)arch
u m b r i c am
l uscles
Flexorpollicis
b r e v i sm u s c l e
(reflected)
A d d u c t o r o o l l i c i sm u s c r e
4{tr
Transverse
crosssectionof wrist demonstratingcarpaltunnel
Palmarislongus
Flexorretinaculum(transverse
tendon
carpalligament)
Median nerve*
Ulnar artery
and nerve
Flexorcarpi
u l n a r i tse n d o n
Flexor
digitorum
superficialis
tendons'
Flexorcarpi
Flexor radialistendon
digitorum
profundus Flexorpollicis
tendons* longustendon
in tendonsheath*
Radialartery
Trapezium
S i m p l em e t h o d o f d e m o n s t r a t i n g
arrangementof flexor Capitate Trapezoid
di gitorum superficialis
tendonswithin carpaltunnel *Contentsof carpal tunnel

Bursae, Spaces, and Tendon Sheaths of Hand
Pronatorquadratus
muscle
Flexorcarpiradialis
tendon
sheathof flexorpollicislongus(radialbursa
Tendinous Common
flexorsheath
(ulnarbursa)
carpalligament)(reflectedl
Flexorretinaculum(transverse
Flexordigitorumprofundus
Tendinoussheathof flexorpollicis
longus(radialbursa)
of adductorpollicismuscle
Fascia Flexordigitorum
tendons
superficialis
Thenarspace Commonflexorsheath
(deepto flexortendon (ulnarbursa)(opened)
and1stlumbrical muscle
Lumbricalmusclesin
fascialsheaths
(Synovial)tendon
sheathof finger
Midpalmar space
Lumbricalmusclesin fascialsheaths (deepto flexortendons
(cutand and lumbricalmuscles)
Fibrousand synovial(tendon)
Annularand cruciformparts sheathsof finger(opened)
(pulleys)
of fibroussheathover
synovialsheath)of finger
tendon
Flexordigitorumprofundus
4{ffi*
tendon
Septaformingcanals
Midpalmarspace
flexortendonsto 3rd diSit
and superficialis
Profundus
and thenarspaces
Septumbetweenmidpalmar
Palmaraponeurosis
Thenarspace
Commonpalmardigital
arteryand nerve\ Flexorpollicislongus
tendonin tendon
Lumbricalmuscle sheath(radialbursa)
in its fascialsheath
Extensorpollicis
Flexortendonsto 5th longustendon
digitin commonflexor
sheath(ulnarbur
Adductorpollicismuscle
Hypothenarmuscles
fascia
Palmarinterosseous
Dorsalinterosseous
fascia
muscles
Palmarinterosseous
Dorsalsubaponeurotic
space
Dorsalfasciaof hand muscles

Dorsalinterosseous
Dorsalsubcutaneous
space Extensortendons

Lumbrical Muscles and Bursae,Spaces,and Sheaths:Schema
Usualarrangement Commonvariation
Tendinoussheathof flexor
p o l l i c i sl o n g u s( r a d i a lb u r s a )
Intermediatebursa
Common flexor sheath (communication
( u l n ab
r ursa) between common
flexor sheath Iulnar
Thenar b u r s a la n d t e n d i n o u s
sheathof flexor pollicis
l o n g u sI r a d i a lb u r s a ] )
L u m b r i c aml u s c l e s
(in fascialsheaths)
J
( S y n o v i a lt)e n d o n
s h e a t h so f f i n g e r s
[umbricalmuscles:
schema
Flexordigitorum
profundustendons
1 s t a n d 2 n d l u m b r i c a lm u s c r e s 3rd and 4th lumbricalmuscles

(unipennate) (bipennate)
C a m p e rc h i a s m
Flexordigitorum
s u p e r f i c i a l itse n d o n s( c u t )
N o t e : F l e x o rd i g i t o r u ms u p e r f i c i a l iasn d
p r o f u n d u st e n d o n se n c a s e di n s y n o v i a l
s h e a t h sa r e b o u n d t o p h a l a n g e sb y f i b r o u s
digital sheathsmade up of alternating
s t r o n ga n n u l a r( A ) a n d w e a k e rc r u c i f o r m( C )
p a r t s( p u l l e y s ) .
41 Cl C2 A3 C3 C4 n)
Tendonsof
flexor digitorum
superficiali
a n dp r o f u n d u s /i
muscres ,i
tendon sheath a l m a rl i g a m e n t s( p l a t e s
4{tr
Flexor and Extensor Tendons in Fingers
lnsertionof central band of extensor Extensor Long extensor lnterosseous

muscles
tendon to base of middle phalanx expansron tendon
S l i p so f l o n g (hood)
extensortendon
T r i a n g u l aarp o n e u r o s i s to lateral
Posterior Metacarpal
bone
(dorsal)
vtew
Insertionon extensortendon lnterosseous

to baseof distalphalanx t e n d o ns l i p
Lateralbands to lateralband
Partof interosseoustendon
passes to baseof proximal
Lumbricalmuscle phalanxandjoint capsule
Lateralband Extensor (hood)

expansion
Insertionof extensortendon
to baseof middlephalan Long extensortendon
Centralband
Insertionof extensor
tendon to base
-1S
o f d i s t apl h a l a n x Metacarpalbone
Fingerin
extension:
lateralview
Collateral Flexordigitorum
Vinculum Vincula orofundustendon
muscles
lnterosseous
ligament oreve longa
Flexordigitorum Lumbricalmuscle
superficialistendon
Insertionof smalldeepslipof extensor .-,

x n dj o i n tc a p s u l e
t e n d o nt o p r o x i m apl h a l a n a
Attachment of interosseousmuscle to
base of proximal phalanxand joint capsule #)>
,4
aa
Palmarligament(plate) muscles
lnterosseous
/,
Insertionof lumbrical
muscleto extensor Flexordigitorum Lumbrical
muscle
tendon(cut)
superficialis
ligaments
Collateral
Flexordigitorum
profundustendon(cut)
Note: Blackarrows indicate
Palmarligament(plate) pull of long extensortendon;
red arrows indicatepull
of interosseousand
lumbrical muscles;dots
c44e/^ indicate axis of
rotation of ioints
Wrist and Hand Pfate 464

lntrinsic Muscles of Hand
Radialartery and palmar carpal br Pronatorouadratusmuscle
Radius U l n a rn e r v e
Superficialpalmar branch of radial ar artery and palmar carpal branch
Flexorretinaculum(transverse c a r o iu l n a r i st e n d o n
carpal ligament)(reflected) Palmarcaroalarterialarch
Opponenp
s o l l i c i sm u s c l e l'rsrlorm
Branchesof median nerve Median nerve

t o t h e n a rm u s c l e sa n d t o 1 s t
A b d u c t o r d i g i t im i n i m i m u s c l e( c u t )
a n d 2 n d l u m b r i c a lm u s c l e s
D e e pp a l m a br r a n c ho f u l n a ra r t e r y
A b d u c t o rp o l l i c i s and deeobranchof ulnarnerve
brevismuscle(cut
F l e x o rd i g i t im i n i m i b r e v i sm u s c l e( c u t )
F l e x opr o l l i c i s
brevis muscle O p p o n e n sd i g i t i m i n i m i m u s c l e
Deep palmar (arterial)arch

A d d u c t o rp o l l i c i s
muscle Palmarmetacarpalarteries
lst dorsal Common palmar digital arteries

interosseous
muscle
Deep transversemetacarpalligaments
Branches
from deep
to 3rd and 4th lumbrical
musclesand to all
interosseousmuscles
Anterior(palmar)view
muscles(reflec
Lumbrical
Palmarinterosseous
m u s c l e(su n i o e n n a t e
Deep transverse
metacarpalligaments
Radialartery
A b d u c t o rd i g i t i A b d u c t o pr o l l i c i s
m i n i m im u s c l e brevismuscle
Dorsalinterosseous
m u s c l e(sb i p e n n a t e ) T e n d i n o ussl i p s
to extensor
expansrons
(hoods)
Cryd4*/*
Posterior
(dorsal)view
Note: Arrows indicateaction of muscles.

Arteries and Nerves of Hand: Palmar Views
Radialartery Ulnar artery and nerve
P a l m a rc a r p a ll i g a m e n t( c o n t i n u o u s
M e d i a n n e r v ea n d o a l m a rb r a
w i t h e x t e n s o rr e t i n a c u l u m )
S u p e r f i c i apl a l m a rb r a n c ho f r a d i a la r t e r Flexorretinaculum(transverse
c a r p a ll i g a m e n t )
A b d u c t o r p o l l i c i sb r e v i sm u s c l e( c u t )
D e e p p a l m a rb r a n c ho f u l n a ra r t e r y
and deep branch of ulnar nerve
O p p o n e n sp o l l i c i sm u s c l e
Suoerficialbranch of ulnar nerve
F l e x o ro o l l i c i sb r e v i sm u s c r e
Common flexor sheath
Recurrent(motor) branch of ( u l n a rb u r s a )
median nerve to thenar mu
palmar (arterial)arch
Proper digital nerves

o m m o n p a l m a rd i g i t a ln e r v e s
a n d a r t e r i e st o t h u m b
and arteries
A d d u c t o r p o l l i c i sm u s c l e Communicatingbranch of
median nerve with ulnar nerve
Branchesof median nerve to Proper palmar digital nerves

l s t a n d 2 n d l u m b r i c a lm u s c l e s and arteries
Flexortendons, ovial
and fibrous
Branchesof proper palmar
digital nervesand
arteriesto dorsum of
middle and distal
phalanges
Ulnar artery and nerve
Radial Palmarcarpal branchesof

radialand ulnar arteries
M e d i a nn e r Pisiform
Superficialpalmar branch of radialarter Deep palmar branch of

u l n a ra r t e r ya n d d e e p
D e e p p a l m a r( a r t e r i a la) r c h a n d branch of ulnar nerve
d e e o b r a n c ho f u l n a rn e r v e
Branchesto hypothenar
P r i n c e p sp o l l i c i sa r t e r y muSctes
Superficialbranch of
u l n a rn e r v e
Hook of hamate
D i s t a ll i m i t o f
Deep palmar branch of
s u p e r f i c i apl a l m a ra r c h
u l n a rn e r v et o 3 r d a n d
4 t h l u m b r i c a l a, l l
R a d i a l i si n d i c i s interosseous,adductor
p o l l i c i s a, n d d e e p h e a d
Palmarmetacaroalarteries of flexor pollicis brevis
muscles
Common palnrardigital arteri
ing branch
Proper palmar digital arter of median nerve with
u l n a rn e r v e
Proper palmar digital nervesfrom median nerve Proper palmar digital
nervesfrom ulnar nerve

Wrist and Hand: Superficial Radial Dissection
lateral (radial)view
branch of radial nerve
Extensor M e d i ab
l ranch
retinaculum
Lateralbranch
Dorsal digital branchesof radial nerve
Dorsal carpal branch Scaphoid

of radialartery
Radialartery in anatomicalsnuffbox
Extensorcarpi
r a d i a l i sb r e v i s Trapezium
tendon
lnsertionof abductor
Extensor carpi p o l l i c i sl o n g u st e n d o n
r a d i a l ilso n g u s
tendon
l s t m e t a c a r p abl o n e
Radialartery
Insertionof extensor
1 s td o r s ailn t e r o s s e o u
msu s c l pollicisbrevis tendon
nsertionof extensor
p o l l i c i sl o n g u st e n d o n
Deep fascia(cut
Fractureof middle
third (waist)of
scaphoid(most
common)
4{F

Wrist and Hand: Superficial Dorsal Dissection
Posterior
antebrachialcutaneous
nerve(from radialnerve)
branchof radialnerve
Superficial
Extensorretinaculum(thickening
of posteriorantebrachial
fascia)
Communicating of
branches
radialand ulnarnerves
Dorsalbranchof ulnar
Dorsalvenous
network of
Dorsalmetacarpalveins
Probein dorsal
subaponeurotic space
(betweenopened
dorsalfasciaof handand
dorsalinterosseous
fascia)
Intercapitular
veins
Dorsaldigitalnervesand
Dorsalbranchesof
properpalmardigitaln
Note:Lymphatic pathwaysshownin black;

4{tr
arrowsindicatedirectionof drainage

Wrist and Hand: Deep Dorsal Dissection
M e d i a la n t e b r a c h i a l Lateralantebrachlalcutaneousnerve
cutaneousnerve (terminalpart of musculocutaneousnerve)
Posteriorantebrachial Suoerficialbranch of radial nerve

culaneous nerve
(branch of radial nerve
Extensordigitorum, extensordigiti minimi,
and extensorindicistendons (cut)
Extensor
retinaculum
Radialartery in anatomicalsnuffbox
Dorsalbranchof ulnar
Abductorpollicislongustendon
Dorsal carpal branch pollicisbrevistendon
Extensor
of ulnar artery e n s o rp o l l i c i sl o n g u st e n d o n
Extensorcarpi radialislongus
Extensorcarpi ulnaris tendon
Extensorcarpi radialisbrevis
tendon
Dorsal carpal (arterial)
Dorsal metacarpalarteries Dorsaldigitalarteries
Dorsal digital branches

of dorsal branch
o f u l n a rn e r v e
Dorsal digital branchesof superficial

'lst,2nd,
branch of radial nerve to
3rd, and radial half of 4th fingers
Dorsal branchesof proper

p a l m a rd i g i t a lb r a n c h e s
of ulnar nerve and of
p r o p e r p a l m a rd i g i t a l
arteriesto dorsum
o f m i d d l ea n d
distal phalangesof
5 t h a n d u l n a rh a l f Posterior(dorsal)view
of 4th fingers
Dorsalbranches of properpalmardigital
branches of mediannerveand of
4ttr
properpalmardigitalarteriesto
d o r s u mo f m i d d l ea n dd i s t apl h a l a n g e s
o f 2 n d , 3 r d a, n dr a d i ahl a l fo f 5 t h
fingers

Extensor Tendons at Wrist
carpiulnaris- Compartment6
Extensor
digitiminimi- Compartment5
Extensor
Extensor
9'qlt:"t I co.partment+
indicis I
Extensor
xtensorpollicislongus- Compartment3
---: --;:-:.-,- -
Compartment2
longus |)
r carprraoralrs
Planeof crosssection Abductorpollicislongus)

comPartment1
shownbelow pollicisbrevis i
Extensor
Extensor
retinaculum
snuffbox
Radialarteryin anatomical
A b d u c t odr i g i t i
m i n i m im u s c l e
l n t e r t e n d i n o u cs o n n e c t i o n s
Transverse
fibersof
extensorexpansions(hoods)
Crosssectionof most distalportion of forearm

Extensor
retinaculum
pollicislongus- Compartment3
Extensor
and
ComRartment
+
{ extensorindicis Extensor carpi
radialisbrevis
I Compartment2
Extensor carpi
c o m 'p a r t m e n t s I E l t g l s o . r . r a d i a l ilso n g u s
( olSltl mlnlml
{ Extensor
Compartment5 J carpi
( ulnaris
Wrist and l{and Plate 47O

Fingers
Svnovialmembrane
Articularcartilage
Eponychium
Sagittalsection (cuticle)
Lunule
Flexor
Bodyof nail digitorum
superficialis
tendon
Distalphalanx
tendon
sheathof finger
Synovial(flexortendon)
sheathof finger
Nerves Arteries Septa Flexordigitorumprofundustendon
\-------- --___--t Palmarligament(plate)
v
Distalanteriorclosedspace(pulp) Articularcavity
Bodyof nail
Subungual
space Nailbed
Crosssection
throush distal
phalaix Minutearteries Distalphalanx
Fine nerves Fibrousseptaand areolar

tissuein anterior
closedspace(pulp)
Dorsaldigitalarteryand nerve
Dorsalbranches of properpalmar
digitalarteriesand nervesto dorsum
of middleandterminalphalanges
Arteriesand nerves
4{tr
Nutrientbranchto epiphysis Properpalmardigitalartery
t o n e i g h b o r i ndgi g i t
Nutrientbranches
to metaphysis Properpalmardigitalarteryand nervti

Gutaneous lnnervation of Wrist and Hand
A n t e r i o r ( p a l m a r )v i e w
nadial S u p e r f i c i a l
nerve J branch
t
Ulnar nerve
Palmar
digital
branches
Palmar
branch
Median
nerve Palmar Posterior(dorsal)view
digital
branches
M usculocutaneous
nerye
Medial an
cutaneousnerve
D i v i s i o nb e t w e e n u l n a ra n d r a d i a l
n e r v ei n n e r v a t i o no n d o r s u mo f
handisvariable.
Superficial
Dorsal branch
branch ano
ano dorsal
dorsal digital
digital branches
Dranc
Proper
Proper palmar Median
palmar digital nerve
digital branches
Nr branches
Neurovasculature Plate 472

Arteries and Nerves of Upper Limb
Anteriorview
C o r a c o b r a c h i a l im
s uscle
Intercostobrachial nerve
M e d i a lb r a c h i a l
M u s c u l o c u t a n e o uns cutaneousnerve
B r a c h i a l im
s uscle Radialnerve
B i c e p sb r a c h i im u s c l e( c u t )a n d t e n d o n
U l n a rn e r v e
(from musculocutaneousner Medial antebrachial
cutaneousnerve
oeeobranch-1
Radialnerve J Median nerve
I Superficial
branch
Brachialartery
i su s c l Bicipitalaponeurosis
Radialartery
Pronator teres muscle (partially cut
Median nerve Flexorcarpi radialismuscle (cut)
F l e x o rp o l l i c i sl o n g u s
tendon (cut)
Flexordigitorum profundus muscle
F l e x o rr e t i n a c u l u m
(transversecarpal F l e x o rc a r p i u l n a r i sm u s c l e
ligament)
S u p e r f i c i abl r a n c h U l n a r a r t e r ya n d n e r v e
of radial nerve
D o r s a lb r a n c ho f u l n a rn e r v e
R e c u r r e n (t m o t o r )
branch of
median nerve to F l e x o rd i g i t o r u ms u p e r f i c i a l itse n d o n s( c u t )
t h e n am
r uscles
D e e p p a l m a rb r a n c ho f u l n a ra r t e r ya n d d e e p b r a n c ho f u l n a rn e r v e
S u p e r f i c i abl r a n c ho f u l n a rn e r v e
S u p e r f i c i apl a l m a ra r c h ( c u t )
Common palmar C o m m o n p a l m a rd i g i t a lb r a n c ho f u l n a rn e r v e
digital branches
of median nerve
C o m m u n i c a t i n gb r a n c ho f m e d i a nn e r v ew i t h u l n a rn e r v e
P r o p e rp a l m a r P r o p e rp a l m a rd i g i t a lb r a n c h e so f u l n a rn e r v e
digitialbranches
of median nerve 4{tr
Plate 473 Neurovasculature
Musculocutaneous Nerve
Anteriorview
Note: Only musclesinnervated

by musculocutaneous
nerve snown
nerve(C5,6,7)
Musculocutaneous
1 i e d i a l ) Cordsof
. Posterior) brachial
Lateral ) p r e x u s
Medialbrachial
cutaneousnerve
Medial antebrachial
Bicepsbrachiimuscle cutaneousnerve
(retracted\
Ulnarnerve
Median nerve
Radialnerve
Nr
Brachialis
muscle Axillarynerve
Articularbr
Anterior branch
Posterior
bra
Cutaneous
innervation
(via lateral
antebrachial
cutaneous
nerve)
Anterior (palmar)view Posterior(dorsal)view
Neurovasculatune Plate 474

Median Nerve
Anterior view by mediannerveshown

Note:Onlv musclesinnervated
Musculocutaneous
nerve
Mediannerve(C5,6,7, 8,T1
Medial
lnconstantcontribution Cordsof
Posterior brachial
Lateral prexus
Pronatorteresmuscle(humeral
Medialbrachial
cutaneousnerve
Articularbranch
Medialantebrachial
cutaneousnerve
Nr
Flexorcaroi radialismuscre
Axillarynerve
Palmaris
longusmuscle
Radial nerve
Pronatorteresmuscle(ulnarhead)
Ulnarnerve
muscle
(turnedupl
Flexordigitorumprofundusmuscle
(lateralpartsuppliedby median
[anteriorinterosseous]nerve;
medialpartsuppliedby ulnarnerve)
Anterior interosseousnerve
Flexorpollicislongusmuscle
Pronatorquadratus
muscle
Palmarbranchof mediannerve
Abductoroollicisbrevis
Opponenp s ollicis
Thenar Superficial headof
muscles flexorpollicisbrevis
(deephead
suppliedby
u l n a rn e r v e ) Palmar view
C o m m u n i c a t i nbgr a n c h
of mediannervewith
1st and 2nd ulnarnerve
lumbricalmuscles
Commonoalmar
digitalnerves
Properpalmar
digitalnerves
Dorsalbranchesto
dorsumof middleand
distalphalanges

Ulnar Nerve
Anterior view Note:Only musclesinnervated

bv ulnarnerveshown
Ulnar nerve(C7,8,T11
(no branchesaboveelbow)
tnconstantcontribution
Medialepicondyle
branch
(behindcondyle)
digitorumprofundus
muscle(medialpart only;
lateralpart suppliedby
anteriorinterosseous
branchof mediannerve)
Palmarview
Flexorcarpiulnarismuscle
(drawn aside)
I branchof ulnarnerve
Palmarbranch
Flexorpollicisbrevismusclel
(deepheadonly;superficial\
headand otherthenarmuscles
suppliedby mediannerve)
Adductorpollicis
Abductordigitiminimi
Hypothenar
muscles
Flexordigitiminimibrevis
Opponensdigitiminimi
Commonpalmardigitalnerve
branchof mediannervewith
Communicating
ulnarnerve
muscles
Palmarand dorsalinterosseous
3rd and 4th lumbricalmuscles(turneddownl
Properpalmardigitalnerves
4{r (doisaldigitalnervesarefrom dorsalbranch)
to dorsumof middleanddistalphalanges
branches
Neurovasculatule Plate 476l

Radial Nerve in Arm and Nerves of Posterior Shoulder
scapularnerve(C5)
S u p r a s p i n a tm
u su s c l e
pular nerve(C5,6)
Levatorscapulae
muscle(supplied Deltoidmuscle
alsobv branches
from C3 and C4
Teresminormuscle
Axillary nerve(C5, 6)
Rhomboid Superiorlateralbrachial
m i n o rm u s c l e cutaneous nerve
Radialnerve
( c 5 ,6 , 7 , 8 , T 1 )
lnconstantcontribution
Rhomboid
majormuscle
lnferiorlateralbrachial
cutaneous nerve
cutaneous nerve
Infraspinatus
muscld
Teresmajormuscld
septum
Lowersubscapularnerve(C5, 6)
Posteriorbrachialcutaneousnerve
(branchof radial nerve in axilla) muscle(lateral
Brachialis
part;remainder
of muscle
suppliedby musculo-
Long head cutaneousnerve)
Tricepsbrachiimuscle Lateral
Medial
Brachioradialis
muscle
Tricepsbrachii
Medial epicondyle Extensor

carpiradialis
longusmuscle
Olecr
Anconeus
Extensor
digitorum
Extensor
carpiulnaris
Pfate 477 Neurovasculature

Radial Nerve in Foreatm
Radialnerve(C5,6, Z8,T1l I nconstantcontribution
(terminal)
Superficial branch
Deep (terminal)branch Posteriorview
Lateralepicondyle
A n c o n e um
s uscle
Extensorcarpi radialislongus muscle
xtensorcarpiradialisbrevismuscle
Extensor
caroiulnarismuscle Extensor-supinator
groupof muscles
Extensor
digitorummuscleand
extensordigitiminimimuscle
Extensor
indicismuscle
pollicislongusmuscle
Extensor
Extensorpollicis brevis muscle 4{tr

Posterior
i nterosseousnerve
(continuationof deepbranchof
radialnervedistalto supinatormuscle)
branchof radialnerve
Suoerficial
Superiorlateral
Fromaxillarynerve brachialcutaneous
nerve
lnferiorlateral
brachialcutaneous
nerve
Posterior
brachial
cutaneousnel
From radial nerve
Posterior
antebrachial
I
cutaneousnerve
radialnerve and dorsal
digital branches
Dorsaldigitalnerves
Cutaneousinnervationfrom
radialand axillarynerves

GutaneousNervesand SuperficialVeinsof Shoulderand Arm
Anterior view Posteriorview
Medial Lateralsupraclavicular
nerve
Supraclavicular
nerves lntermediate
(fromcervicalplexus)
Lateral
branchof
Acromialbranchesof
thoracoacromial
vein Superficial
branchesof
posterior
circumflex
humeralvein
-
Intercosto
brachialnerve
Medialbrachial
cutaneousnerve
Superiorlateral
brachialcutaneous
nerve(from Superiorlateral
axillarynerve) brachial
cutaneous nerve
(fromaxillary
Cephalic nerve)
Posteriorbrachial
Inferiorlateral cutaneous nerve
brachialcutaneous (from radialnerve)
nerve(from
radialnerve)
Inferiorlateral
brachialcutaneous
Posterior nerve(from
antebrachial radialnerve)
cutaneous
nerve(from
Posterior
radialnerve)
antebrachial
Branches
of medial cutaneous
Accessory antebrachial nerve
cutaneousnerve (fromradial
nerve)
Basilicvein
Branches
Lateralantebrachial of medial
cutaneousnerve antebrachial
(terminaloart of cutaneous
m u s c u l o c u t a n e o unse r v e ) nerve
Median cubital vein
Intermediate(median)
antebrachialvein
tcvetn Branches of
lateralantebrachial
Perforatingveins cutaneous nerve
(terminalpartof
Cephalicvein musculocutaneous nerve
4{tr
Plate 479 Neurovasculatule
Gutaneous Nerves and Superficial Veins of Forearm
Anterior(palmar)view Posterior(dorsal)view
cutaneousnerve terior branch
(from radial nerve) and
Posteriorbranch
of medial
Lateralantebrachial Posterior
antebrachial
cutaneousnerve antebrachial
(frommusculocutaneous
cutaneous
nerve Posterior
c u t a n e o unse r v e ) nerve (from
branch radial nerve)
Accessory Median of medial
cephalicvein b a s i l i cv e i n antebrachial
cutaneous Accessory
nerve cephalic
Median Bicipital vetn
c e p h a l i cv e i aponeurosrs
B a s i l i cv e i n Posterior
C e p h a l i cv e i
branchof
lateral
Perforating antebrachial
Median vetns cutaneous
antebrachialvein nerve(from
Note: ln 7O"/"o( cases, musculocu-
a median cubital taneousnerve)
vein (tributaryto
basilicvein) replaces
m e d i a nc e p h a l i c Cephalicvein
a n d m e d i a nb a s i l i c B a s i l i cv e i n
veins (see PlaLe479\.
Extensor
Superficialbranch retinaculum
of radial nerve
r branch
o f u l n a rn e r v e
Palmarbranch Dorsalbranch Suoerficialbranch
of median of ulnarnerve of radial nerve
Dorsal branch
of ulnar nerve
lntercaoitularveins
Palmarcarpal Dorsal Dorsal
ligament metacarpal venous
(continuous v e tn s network
with extensor
retinaculum)
lntercapitular
Palmar vetns
aponeuroSrs
transverse
metacarpal
ligament
Proper palmar digital nerves Dorsal digital nervesand veins

a n d p a l m a rd i g i t a lv e i n s
Neurovasculature Plate 48O

Gutaneous Innervation of Upper Limb
Anterior (palmar)view Posterior(dorsal)view
aclavicularnerves
Supraclavicularnerves (from cervical
(from cervical plexus-C3,4)
plexus-C3,4)
Axillarynerve Axillarynerve
Superiorlateral lateralbrachial
brachialcutaneous cutaneousnerve
nerve (C5,6) (c5,6)
Radialnerve
Inferiorlateral Radialnerve
brachialcutaneous Posteriorbrachialcutaneous
n e r v e( C 5 , 6 ) nerve(C5-8)
Inferiorlateralcutaneous
Intercosto' nerye
brachial Posteriorantebrachial
nerve (T2) cutaneousnerve
and medial (clsl,6-8)
brachial
Lateralantebrachial cutaneous
cutaneousnerve nerye
(cs,5171) (c8,T1,2)
(terminalpart of
musculocutaneous
Medial Lateralantebrachialcutaneous
nerve)
antebrachial nerve
cutaneous (c5,6 [7])
nerve (terminalpart of
( c 8 ,T 1 )
musculocutaneous
nerve)
Ulnarnerve(C8,T1)
Radialnerve
Superficialbranch Radialnerve
(c6-8) \ Superficialbranch
Dorsalbranch and dorsaldigital
and dorsal branches(C6-8)
digital
Properpalmar
digital digital
branches branches
Mediannerve Mediannerve
Palmarbranch Properpalmar
and digitalbranches
Nr
Palmar
digitalbranches
(c6-8)
Note: Divisionvariablebetweenulnarand radial
innervationon dorsumof handand often alignswith
middleof 3rd digit insteadof 4th digit as shown
Plate 481 teurovasGulatur

Dermatomes of Upper Limb
Note: Schematicdemarcationof dermatomes

(accordingto Keeganand Carrett) shown as
distinct segments.There is actuallyconsiderable
overlap between adjacent dermatomes.An
alternativedermatome map is provided by
Foerster(seereferences).
Anteriorview
s
*:.
ki
$'r
s
$
ii
*{r
Lymph Vessels and Nodes of Upper Limb
D e l t o p e c t o r anl o d e
Lateralaxillarynodes
( a l o n ga x i l l a r yv e i n )
C u b i t anl o d e s
M e d i a n c u b i t a lv e i n
Vessels passing to
d o r s u mo f h a n d
Vesselspassingto
d o r s u mo f h a n d
V e s s e l sp a s s i n ga r o u n d
web to dorsum of hand
Vesselspassingto
dorsum of fingers
Note: Arrows indicate

d i r e c t i o no f d r a i n a g e

GT Angiograms of Arteries of the Upper Limb
Regional Scans PIate 484

7 Lower Limb
Section
Topographic Anatomy
Plate 485
las Lower
Limb
Hip and Thigh

Plates 486-505
486 Hip(Coxal)
Bone
487 HipJoint
488 Anteroposterior
HipJoint: Radiograph
489 Femur
490 of Muscles
BonyAttachments View
of HipandThigh:Anterior
49t Bony of HipandThigh:
of Muscles
Attachments Posterior
View
View
492 MusclesofThigh: Views
Anterior
493 MusclesofThigh:Anterior
Views (continued)
494 ofHipandThigh:
Muscles Lateral
View
ofHipandThigh:
495 Muscles Views
Posterior
Muscles
andlliacus
496 Psoas
497 Lumbosacral Plexuses
andCoccygeal
498 Lumbar
Plexus
499 Sacral Plexuses
andCoccygeal
ofThigh:Anterior
andNerves
500 Arteries Views
andNerves
501 Arteries Views
ofThigh:Anterior (continued)
502 andNerves
Arteries ofThigh: View
Posterior
503 Nervesof HipandButtock
Head
of Femoral
504 Arteries andNeck
505 Thigh:
SerialCross
Sections
Atlas of ]luman Anatomy

Lower Limb
Knee szz Ligaments

andTendons
ofAnkle
Platec 506-512
sza Ligaments
andTendons Plantar
ofFoot: View
soe Knee: andMedialViews
Lateral szg Tendon
Sheaths
ofAnkle
soz Knee:
AnteriorViews sso Muscles
of Dorsum
ofFoot:Superficial
Dissection
sos Knee:
lnterior ssr Dorsum
ofFoot:
Deep
Dissection
sog Knee:
Cruciate Ligaments
andCollateral ssz SoleofFoot:
Superficial
Dissection
sro Knee: Radiograph
Anteroposterior ses Muscles
ofSoleofFoot:
FirstLayer
st r Knee:
Posterior
andSagittal
Views sse Muscles
ofSoleof FootSecond
Layer
sr z Arteries andKnee:
ofThigh Schema sss Muscles
ofSoleofFoot:Third
Layer
sse Interosseous
Muscles Arteries
andDeep of Foot
Leg ssz Interosseous
Muscles
of Foot
Pfates 513-622
srs TibiaandFibula Neurovasculature

(continued)
srr TibiaandFibula Plates 538-546
srs Attachments
ofMuscles
ofLeg sse Femoral
Nerve
andLateral
Femoral
Cutaneous
Nerve
of Leg(Superficial
sre Muscles Dissection): View
Posterior Nerve
sos 0bturator
ofLeg(lntermediate
sr z Muscles Dissection): View
Posterior Nerve
slo Sciatic andPosterior
Femoral
Cutaneous
Nerve
ofLeg(Deep
sre Muscles Dissection):
Posterior
View Nerve
ser Tibial
ofLeg(Superficial
srg Muscles View
Dissection):Anterior sez Common (Peroneal)
Fibular Nerve
ofLeg(Deep
szo Muscles Dissection):Anterior
View ses Dermatomes
ofLower
Limb
szr Muscles
ofLeg:LateralView Nerves
ss Superficial andVeins
ofLower
Limb:Anterior
View
szz Leg:Cross andFascial
Sections Compartments ses Superficial
Nerves of Lower
andVeins Limb:
Posterior
View
*e Vessels
Lymph andNodes
of Lower
Limb
Ankle and Foot
Plates 523-537
Regional Scans
szs Bones
of Foot Plate 547
of Foot(continued)
szl Bones scz CTAngiograms
ofArteries
of theLowerLimb
szs Calcaneus
szs Ankle:
Radiographs

Lower Limb

l l i a cc r e s t
l l i a cc r e s t Cluteus Cluteus
medius maxrmus
Anterior MUSCIE muscle
s u p e r i o ri l i a Inguinal
spn
re ligament
Creater
trochanter
T e n s o rf a s c i a e of femur
l a t a em u s c l e S a r t o r i u sm u s c l e
Cluteal
Vastus fold
l a t e r a l i sm u s c l e
Semitendi-
R e c t u sf e m o r i s Creat nosus
muscle s a p h e n o us muscle
vetn
Adductor
maSnus
muscre
Vastus
medialis
MUSCIE
C racilis B i c e p sf e m o r i s
tenoon muscle
L o n gh e a d
R e c t u sf e m o r i s
Short head
l l i o t i b i a tl r a c t t e n d o n( b e c o m i n g
p a r to f q u a d r i c e p s
f e m o r i st e n d o n ) Creat
saphenous Popliteal
Patella vern fossa
P a t e l l a lri g a m e n t
F i b ul ar i s
(peroneus) T i b i a lt u b e r o s i t y
Castrocnemius
l o n g u sm u s c l e muscte
M e d i a lh e a d
Creatsaphenous
vetn Lateralhead
Tibialis
a n t e r i om
r uscle
A n t e r i o rb o r d e r
of tibia Small
sapnenous
vetn
Calcaneal
tendon
Fibularis
Medial ( p e r o n e u s l)o n g u s
L a t e r aml a l l e o l u s malleolus a n d b r e v i st e n d o n s
M e d i a lm a l l e o l u s L a t e r am
l alleolus
E x t e n s o dr i g i t o r u m Calcaneal
l o n g u st e n d o n s P l a n t a rs u r f a c e
tuberosity
of foot
6ryd4/*
Topographic Anatomy Plate 485

Hip lGoxalf Bone
Lateralview Intermediate
ron" )
-Tuberculum ) lliaccrest
--Outerlip )
Posterior (ala)of ilium
(glutealsurface)
Posterior superioriliacspine
superior
iliacspine
Anteriorinferioriliacspine
Posterior
inferior
iliac
lum
Lunatesurface
Margin(limbus)of acetabulum
Acetabularnotch
Creatersciaticnotch
Bodyof ilium
lschialspine
pubicramus
tubercle
*{r
Lesser
sciatic
Bodyof ischium Obturatorcrest
ior pubicramus
lschialtuberosity
Ramusof ischium
Wing (ala)of ilium

(iliacfossa)
Anteriorinferioriliacspine surface
(for sacrum)
Arcuateline
l l i o p u b i ce m i n e n c e inferior
iliacspine
Superiorpubicramus
Creatersciaticnotch
Pectenpubis
(pectinealline) sprne
of ilium
Pubictubercle
Lessersciaticnotch
Symphyseal
surface
f llium of ischium
Obturatorgroove
I lschium lschialtuberosity
f eutis Inferiorpubicr Ramusof ischium
Plate 486 Hip and Thigh

Hip Joint
Anteriorview
l l i o f e m o r a l i g a m e n t( Y l i g a m e n to f B i S e l o w )
Anterior lliopectinealbursa (over gap in ligaments)

supenor \\
i l i a cs p i n s - P u b o f e m o r alli g a m e n t
Obturatorcrest
A n t e r i o ri n f e r i o r
i l i a cs p i n e
S u p e r i opr u b i cr a m u s
Creater
trochanter
Posteriorview
l l i o f e m o r al i a g m e n t
l s c h i o f e m o r al li g a m e n t
Zonaorbicularis
Creater
trochanter
Lessertrochanter
lschial
tuberosity
Protrusion
l n t e r t r o c h a n t e r ilci n e of synovial
memDrane
\
n te rtrochan teric
crest
HlJ"iliJ;o'
b Lessertrochanter
A n t e r i o rs u p e r i o ri l i a cs p i n e
L u n a t e( a r t i c u l a r )
surfaceof A n t e r i o ri n f e r i o ri l i a cs p i n e
acetabulum
A r t i c u l a rc a r t i l a g e A c e t a b u l a rl a b r u m( f i b r o c a r t i l a g i n o u s )
Fatin acetabularfossa (covered by

Creater s y n o v i am
l embrane)
trochanter
Obturatorartery
A n t e r i o rb r a n c h
Headof
Posteriorbranch
Acetabularbranch
Neckof femur
O b t u r a t o rm e m b r a n e
lntertrochanteric
line Transverseacetabularligament
L i g a m e n to f
h e a do f f e m u r
(cut) Lessertrochanter
l s c h i a tl u b e r o s i t y 4{ry
Hip and Thigh Plate 487

Hip Joint: Anteroposterior Radiograph
A Acetabulum
F Femur
G Greatertrochanter
H Headof femur
I lschium
lC Intertrochanteric crest
It llium
lT lschialtuberosity
L Lessertrochanter
N Neck
O Obturatorforamen
P P u b i s( s u p e r i orra m u s )

Femur
Anteriorview
Creater
trochanter
Neck
Intertrochanteric
crest
trochanter
Lesser
Pectinealline
Cluteal tuberosity
Shaft(body)
Lineof attachment
of borderof
synovialmembrane
Lineof reflection
of synovialmembrane
of fibrouscapsule
Lineof attachment
Lineof reflectionof fibrous

capsule(unattached)
Poplitealsurface
4{F
Adductortubercle
Lateralepicondyle Lateralepicondyle
Lateralcondyle Patellar
surface fossa
Intercondvlar

Bony Attachments of Muscles of Hip and Thigh: Anterior View
Origin of psoasmajor muscle

from sidesof vertebralbodies,
lliacum
s uscle #: ",, intervertebraldiscs,and
transverseprocesses (J'l 2-L4)
Sartorius
Piriformm
isuscle
Rectusfemorismuscl
Obturatori Pectineus
muscle
and superiorand inferior
g e m e l l u sm u s c l e s Adductorlongusmuscle
Piriformis
muscle
Adductorbrevismuscle
C l u t e u sm i n i m u s
racilismuscle
Vastuslateralis
mu
Obturatorexternusmuscle
l l i o p s o a sm u s c l e
A d d u c t om
r a g n u sm u s c l e
Vastusmedialismu
femorismuscle
Quadratus
Vastusintermedius
muscle
I Origins
I Insertions
Articularis
genusmuscle
u c t o r m a g n u sm u s c l e
lliotibialtract
Bicepsfemorismuscle
Quadricepsfemoris muscle Pesanserinus

(rectus femoris,
4{tr
vastuslateralis,
vastusintermedius/
and vastusmedialis
via patellarligament)
Plate 49O Hip and Thigh

Bony Attachments of Muscles of Hip and Thigh: Posterior View
C l u t e u sm e d i u sm u s c l e
C l u t e u sm i n i m u sm u s c l e
Tensor fasciaelatae muscte

S a r t o r i u sm u s c l e
R e c t u sf e m o r i sm u s c l e
S u p e r i ogr e m e l l um
s uscle Obturatorexternusmuscle
I n f e r i ogr e m e l l um
s uscle C l u t e u sm e d i u sm u s c l e
Q u a d r a t ufse m o r i sm u s c l e ' Q u a d r a t ufse m o r i sm u s c l e
O b t u r a t o ri n t e r n u sm u s c l e l l i o p s o am
s uscle
A d d u c t o r m a g n u sm u s c l e C l u t e u sm a x i m u m
s uscle
B i c e p sf e m o r i s( l o n g h e a d ) a s t u sl a t e r a l i sm u s c l e
a n d s e m i t e n d i n o s um s uscles
A d d u c t o r m a g n u sm u s c l e
S e m i m e m b r a n o s um
s uscle
uctor brevis muscle
V a s t u si n t e r m e d i u sm u s c l e
Pectineusmuscle
B i c e o sf e m o r i sm u s c l e( s h o r th e a d )
V a s t u sm e d i a l i sm u s c l e
I Origins
d u c t o r m a g n u sm u s c l e
I lnserlions A d d u c t o r l o n g u sm u s c l e
V a s t u sl a t e r a l i sm u s c l e
Plantarim
s uscle
C a s t r o c n e m i u sm u s c l e( l a t e r a hl e a d )
C a s t r o c n e m i u sm u s c l e( m e d i a lh e a d )
muscte
s uscle
P o p l i t e u sm u s c l e
Note: Width of zone of attachmentsto posterioraspect

4{tr
o f f e m u r ( l i n e aa s p e r a )i s g r e a t l ye x a g g e r a t e d .

Muscles of Thigh: Anterior Views
A n t e r i osr u p e r i oirl i a cs p i n e
l i a c u sm u s c l e A n t e r i o rs u p e r i o ri l i a cs p i n e
majormuscle s u s c l e( o r i g i n )
S a r t o r i um
C l u t e u sm e d i u sm u s c l e Anteriorinferior
i l i a cs p i n e
I n g u i n al i g a m e n t
ments
Pubictubercle of hip joint
Pectineus
Tensorfasciaelatae muscle muscte
Pectineusmuscle
Tensorfasciaelatae muscle (origin
R e c t u sf e m o r i sm u s c l e( o r i g i n )
Creater trochanter
l l i o p s o a sm u s c l e( c u t )
A d d u c t o lro n g u sm u s c l e
racilim
s uscle
Sartorius
muscle
Rectusfemorismuscle*
Vastuslateralis
muscle*
Vastusintermedius
muscle*
'astus
medialismuscle"
lliotibialtract
Rectusfemoris tendon (becoming part

of quadricepsfemoris tendon)
Lateralpatellarretinaculum
Patella Anteromedial
intermuscular
M e d i a l p a t e l l a rr e t i n a c u l u m
septum
Patellarligament
Sartoriustendon
C r a c i l i st e n d o n P e sa n s e r i n u s
S e m i t e n d i n o s utse n d o n
l l i o t i b i a tl r a c t ( c
Tibial tuberosity
Rectusfemoris tendon
Quadricepsfemoris I
Medial patellarretinaculum
Head of fibula
4{tr P a t e l l a lri g a m e n t
Tibial tuberosity
Sartorius
tendon
* M u s c l e so f q u a d r i c e p sf e m o r i s

Muscles of Thigh: Anterior Views (continuedl
Deepdissection
Pectineusmuscle (cut and reflected\
A n t e r i o rs u p e r i o ri l i a c
S u p e r i orra m u so f p u b i s
A n t e r i o ri n f e r i o ri l i a cs o i
tor longusmuscle(cutand reflected)
L i g a m e n t so f h i p j o i n t
ctor brevismuscle(cut)
Creater trochanterof femur
s u s c l e( c u t )
l l i o p s o am P u b i ct u b e r c l e
P e c t i n e ums u s c l e
(cut and reflected) s u s c l e( c u t )
C r a c i l im
(cut and reflected) Obturatorexternusmuscle
V a s t u si n t e r m e d i u sm u s c l e
Q u a d r a t ufse m o r i sm u s c l e
A d d u c t o lro n g u sm u s c l e
(cut and reflected) r i n i m u sp a r to t
A d d u c t om
r a g n u sm u s c l e
A d d u c t om
Femoralarteryandvein
p a s s i ntgh r o u g hh i a t u s
of adductormagnusmuscle ingsfor perforating
branchesof profunda femoris
(deep femoral) artery
V a s t u sm e d i a l i sm u s c l e( c u t )
Tendon of adductor magnus muscle
Rectusfemoris tendon (cut as it insertineon adductor tubercle
becomes part of quadriceps tendon) on medial eoicondvle of femur
muscle(
Vastuslateralis
Cracilismuscle(cut)
Lateraleoicondvle of femur
Tibialcollateralligament
Lateralpatellar
F i b u l a rc o l l a t e r alli g a m e n t
Head of fibula
P e sa n s e r i n u s
Patellarligament
Tibial tuberosity
4{r
Muscles of Hip and Thigh: Lateral View
External
oblique
l l i a cc r e s t muscle
Clutealaponeurosis Anteriorsuperior
o v e rg l u t e u m
s e d i u sm u s c l e i l i a cs p i n e
Sartorius
muscle
G l u t e u sm a x i m u m
s uscle
Tensorfasciaelatae muscle
Rectusfemoris muscle
Vastuslateralis
muscle
l l i o t i b i at rl a c t
Lateralcondvle of tibia
and Cerdv's tubercle
s uscle
Fibularcollateralligament
Plantaris
muscle
tensordigitorumlongusmuscle
muscle(lateralhead)
Gastrocnemius
Patellar
ligament
Head of fibula
F i b u l a r i s( p e r o n e u s l)o n g u sm u s c l e T i b i a l ias n t e r i om
r uscle
*{r
Muscles of Hip and Thigh: Posterior Views
Forpiriformis
andobturator seealsoPlates356,357;For
internus seePlate
Superficialdissection
C l u t e a la p o n e u r o s i so v e r
C l u t e u sm e d i u sm u s c l e
s uscle
Piriformis
muscle
Sciaticnerve
S a c r o s p i n o ulsi g a m e n t
S u p e r i o rg e m e l l u sm u s c l e
O b t u r a t o ri n t e r n u sm u s c l e
l n f e r i o rg e m e l l u sm u s c l e
femorismuscle
Quadratus
lschialtuberosity
Semitendinosusmuscle
Creater trochanter
B i c e p sf e m o r i sm u s c l e{ l o n g h e a d )
Adductor minimus part of
Adductor magnus muscle
S e m i m e m b r a n o smuuss c l e
l l i o t i b i a tl r a c t
C r a c i l i sm u s c l e
B i c e p fse m o r i sm u s c l e
S h o r th e a d
Long head
s uscle
S e m i t e n d i n o s um
s uscle
Poplitealvesselsand tibial nerve
C o m m o n f i b u l a r( p e r o n e a l n
) erve
tarismuscle
C a s t r o c n e m i u sm u s c l e
M e d i a lh e a d
Lateralhead
Sartoriusmuscle
Popliteusmuscle
T e n d i n o u sa r c h o
Soleum
s uscle
tendon(cut
Plantaris

Psoas and lliacus Muscles
SeealsoPlate 263
1 2 t hr i b
Q u a d r a t ulsu m b o r u m
muscle 'l
T 1 2\ Origin of psoas major
musclefrom vertebral
Transversusabdominis bodies,transverse
muscle (cut) procesSes/ ano
[1 intervertebraldiscs
lliohypogastricnerve $12-L4) and origin
of psoas minor muscle
from vertebralbodies
l l i o i n g u i n anl e r v e ( T 1 2 ,L 1 )
P s o a sm i n o r
muscte L u m b a rp l e x u s
Psoasmajor
muscte
umbosacral
trunk
Cenitofemoral nerve
Lateralfemoral lliac crest

cutaneousnerve
l l i a c u sm u s c l e Anteriorsuperior
i l i a cs p i n e
Femoralnerve
S u p e r i opr u b i cr a m u s lliopectinealbursa
Creatertrochanter
of femur lliofemoral
l i g a m e n to f
hipjoint
(Y ligament
of Bigelow)
lliopsoasmuscle
passesbackward
to insertionon
lessertrochanter
Shaft(bodv)of femur
Abductors Note: Arrows indicate

( g l u t e um
s edius
direction of action
and of ilioosoasmuscle.
m r n t m ums u s c l e s )
Adductors
4{r
Lumbosaeral and Goccygeal Plexuses
.l
Intercostalnerve (T1 ) f Anteriordivision
-1:::
nerve(T12
Subcostal Posteriordivision
( T 1 2 ,L 1 ) Sympathetictrunk
l l i o i n g u i n anl e r v e ( L l )
To psoasmajorand
osoasminormuscles
C e n i t o f e m o r a nl e r v e( 1 1 2
,)
Lateralfemoral cutaneous
n e r v e( 1 2 ,3 )
G e n i t a lb r a n c ha n d Lumbarplexus
Femorab l ranch
of genitofemoralnerve
ro psoasmalor
To major and
i l i a c u sm u s c l e s
Anterior branches. ;
and\l
Lateralbranches
and
of subcostal
iliohypogastricnerves
L u m b o s a c rtar u
l nk
Nerve to quadratus
femoris (and inferior
g e m e l l u s () 1 4 ,5 , S 1 )
*{r
Nerve to obturator
i n t e r n u(sa n ds u p e r i o r Sacralplexus
g e m e l l u s( 1
) 5 ,S 1 ,2
S u p e r i ogr l u t e a l
n e r v e( 1 4 ,5 , S 1)
N e r v e t o p i r i f o r m i s( S 1 ,2
O b t u r a t o r n e r v e( L 2 , 3 , 4 l
Accessoryobturator nerve
( 1 3 ,4 ) ( i n c o n s t a ao""r*"at plexus
)
I n f e r i ogr l u t e anl e r v e( L 5 ,5 1, 2
P e l v i cs p l a n c h n i c
Femoralnerve (12, 3, 4 nerves
Perforatingcutaneous
Sciaticnerve nerve (S2,3)
Posteriorfemoral Nerve to levator ani
c u t a n e o u sn e r v e( S 1 , 2 , and coccygeus(53, 4)
Perinealbranch of
Pudendalnerve (S2,3, 4) 4th sacralnerve
Anococcygealnerves
Obturator nerve
lnferior anal
(rectal)nerve
Dorsal nerve of penis/clitoris
nerveand Posterior
Perineal branches
scrotal/labial

Lumbar Plexus
Schema Subcostal
nerve T12
White and gray rami communicantes
lliohypogastric
nerve
l l i o i n g u i n anl e r v e
Ventral
Genitofemoralnerve ramiof
spinal
nerves
Lateralfemoral
cutaneous nerve
Cray rami
M u s c u l abr r a n c h e s
to psoasand iliacusmusctes
Femoralnerve t5
Accessoryobturator nerve (often a I Anteriordivision
Obluratornerve ffi Posteriordivision
Lumbosacraltrunk
White and gray

(cut)
Diaphragm ramicommunicantes
nerve(T12)
Subcostal Subcostalnerve (T12)
Sympathetic
trunk
l l i o i n g u i n anl e r v e
l l i o h y p o g a s t rniec r v e
Transversus
abdominis
muscre
llioinguina
n le r v e
Quadratuslumborummuscle
Genitofemoralnerve (cut)
Psoasmajormuscle
Lateralfemoral Cray ramicommunicantes
cutaneous
Cenitofemoral nerve
Femoralnerve
l l i a c u sm u s c l e
obturator nerve Lateralfemoral
cutaneousnerve
Psoasmajormuscle(
Femoralnerve
Lumbosacraltrunks Cenital branch and
Femoralbranch of
I n g u i n a l i g a m e n t( P o u p a r t ' s ) genitofemoralnerve
Obturatornerve
Nr
Sacral and Goccygeal Plexuses
Schema trunk
Lumbosacral
I Anterior division
f Posteriordivision Gray rami communicantes
sl
Pelvicsplanchnicnerves
Superiorglutealner S2 (parasympatheticto
inferiorhypogastric
lnferiorgluteal
lpelviclplexus)
Nerveto oiriformis
Tibial nerve
Coccygeal nerve
Commonfibular
(peroneal) Anococcygealnerve
branchof 4th sacralnerve
Perineal
to levator ani and
coccygeus (ischiococcygeus)
muscles
Pudendal nerve
g cutaneousnerve
Perforatin
Nerveto obturatorinternus(andsuperiorgemellu's)
nerve
femoralcutaneous
Posterior 4{F
trunk
Sympathetic
trunk
Lumbosacral
Gravramicommunicantes
Psoasmaiormuscle
splanchnic
Superiorglutealarteryand nerve nerves(cut)
(parasympathetic
Obturatornerve to inferior
hypogastric
lliacusmuscle
lpelviclplexus)
Inferiorglutealartery
Nerveto ouadratus
Nerveto obturatorinternus
Pudendalnerve
Obturatorinternusmuscle,
Superiorpubicramus
Piriformis
muscle
(ischiococcygeus)
Coccygeus muscle
I
Nerve to levatorani muscle splanchnic
nerves(cut)
Levatorani (sympathetic
to inferior
hypogastric
Topography:medialand slightlyanteriorview lpelviclplexus)
of hemisectedpelvis

Arteries and Nerves of Thigh: Anterior Views
SeealsoPlate 538
A n t e r i o rs u p e r i o ri l i a cs p i n e Superficial
dissections
Lateralfemoral cutaneousnerve
I n g u i n al i g a m e n t Lateralfemoral cutaneousnerve (cut)
Tensorfasciaelatae
muscle (retracted) muscle(cut)
Sartorius
l l i o p s o a sm u s c l e
Superficialcircumflex Cluteus
i l i a cv e s s e l s mtntmus lliopsoasmuscle
and medius
Superficial muscres Femoralnerve,
epigastric
vessels artery,and
vetn
Superficialand
Deep external
p u d e n d a lv e s s e l s
Pectineus
muscre
Lateral
circumflex u n d af e m o r i s
(deep femoral)
femoral
artery artery
Rectus
femoris Adductor
Vastus
lateralis Adductor canal
muscle ( o p e n e db y
Vastus removal of
medialis sartorius
muscle muscle)
Femoral
sheath Saphenous
nerve
Femoralnerve,
artery,and vein Nerve to
vastusmedialis
Pectineus muscte
muscle
ofunda femoris Adductor
(deep femoral) magnus muscle
artery
Cracilis Anteromedial
muscle Saphenous intermuscular
n e r v ea n o septum
sapnenous covers
Adductor entranceof
longus branch of
descending femoralvessels
muscle to poplitealfossa
genicula
(adductorhiatus)
artery
Sartorius
muscle Sartorius
Articularbra
of descending muscle (cut)
genicularartery
Vastusmedialis (emergesfrom
muscle v a s t u sm e d i a l i s S u p e r i o rm e d i a l
muscle) genicular
Fascialata (cut) artery (from
Patellar popliteal artery)
*{r
Rectusfemoris muscle anastomos
I n f e r i o rm e d i a l
Vastuslateralismuscle Infrapatellar genicular
branch of artery (from
Tensorfasciaelatae muscle S a p h e n o u sn e r v e popliteal artery)
Plate 5OO Hip and Thigh

Arteries and Nerves of Thigh: Anterior Views (continuedf
Deepdissection
Deep circumflex iliac artery Externaliliac artery and vein
Lateralfemoral Inguinalligament (Poupart's)

Femoralartery and vein (cut)
muscle(cut)
Sartorius
muscle(cut)
Pectineus
l l i o p s o a sm u s c
Obturatorcanal
Tensorfasciaelatae
muscle (retracted) Obturatorexternusmuscle
C l u t e u sm e d i u sa n d Adductorlongusmuscle(cut)
m i n i m u sm u s c l
Anterior branch and

Femoral ior branch of
obturatornerve
femorismuscle
Quadratus
Ascending,transverseand
d e s c e n d i n gb r a n c h e so f
Lateralcircumflex
femoralar Adductorbrevismuscle
Medial circumflexfemoral artery Branches of posteriorbranch

of obturatornerve
Pectineusmuscle (cut
r magnusmuscle
Profundafemoris(deepfemoral)artery
C r a c i l im
s uscle
Perforatingbranches
utaneousbranch of obturator nerve
A d d u c t o lro n g u sm u s c l e( c u t )
Femoralartery and vein (cut)
V a s t u sl a t e r a l im
s uscle
Descendinggenicularartery
Vastusintermediusmuscle
Articularbranch
S a p h e n o ubsr a n c h
Rectusfemorismuscle(cut)
A d d u c t o hr i a t u s
S a p h e n o u sn e r v
muscle(cut)
Sartorius
Anteromedialintermuscular
septum (opened) magnustendon
Vastusmedialismuscle Adductor tubercle on

medial eoicondvle of femur
Quadricepsfemoris tendon
Superiormedial genicularartery
(from poplitealartery)
Patellaand patellar
anastomosis
Infrapatellarbranch of
Nr Medialpatellarretinaculu
l------
Saphenousnerve
Inferior medial genicularartery

(from popliteal artery)
Hip and Thigh Plate 5Ol

Arteries and Nerves of Thigh: Posterior Views
Seealm Pfatc 310
l l i a cc r e s t
S u p e r i o rc l u n i a ln e r v e s
C l u t e a la o o n e u r o s i sa n d
Gluteus maximus muscle (cut) gluteusmedius muscle (cut)
Superiorglutealartery and nerve

M e d i a l c l u n i a ln e r v e s
t e u sm i n i m u sm u s c l e
Inferior glutealartery and nerve
Tensorfasciaelatae muscre
Pudendan
l erve
Piriformm
isuscle
Nerve to obturator internus
( a n ds u p e r i ogr e m e l l u s ) C l u t e u sm e d i u sm u s c l e( c u t )
Posteriorfemoral S u p e r i ogr e m e l l um
s uscle
culaneous nerve
Greatertrochanter
of femur
Sacrotuberouslieament
Obturatorinternusmuscle
lschialtuberosity lnferiorgemellusmuscle
Inferiorclunialnerves(cut) uteus maximus muscle (cut)
A d d u c t o r m a q n u sm u s c l e Quadratusfemoris muscle
C r a c i l i sm u s c Medial circumflexfemorar
artery
Sciaticnerve
Vastuslateralismuscle
and iliotibialtract
Muscular branchesof sciaticnerve
A d d u c t o r m i n i m u sp a r t o f
Semitendinosusmuscle (retracted) adductor magnus muscle
.l
s st perforating artery (from
profunda femoris artery)
Sciaticnerve
A r t i c u l abr r a n c h 2nd and 3rd perforatingarteries

(from profunda femoris artery)
Adductorhiatus
4th perforatingartery (from
P o p l i t e avl e i n a n d a r profunda femoris artery)
Long head (retractecl)| ,,."0, femoris

S u p e r i o rm e d i a lg e n i c u l a ra r t e r y
Short head muscle
J
Medial epicondyle of femur
S u p e r i o rl a t e r a lg e n i c u l a ra r t e r y
T i b i a ln e r v e Common fibular (peroneal)nerve
Castrocnemiusmuscle (medial head) Plantarim

s uscle
Medial suralcutaneousnerve Castrocnemiusmuscle (lateralhead)
Lateralsuralcutaneousnerve
*{ry
S m a l ls a o h e n o u sv e i n
Plate 5O2 Hip and Thigh

Nerves of Hip and Buttock
lliac crest
Cluteusmaximusmuscle(cut)
C l u t e u sm e d i u sm u s c l e( c u t )
Superiorglutealnerve
Sciaticnerve
formismuscle
Inferior gluteal nerve
S u p e r i ogr e m e l l um
s uscle
Posteriorfemoral
culaneous nerve
Tensorfasciaelatae
muscle
Nerve to obturator internus
( a n d s u p e r i o rg e m e l l u s )
C l u t e u sm e d i u s
muscle(cut)
Pudendalnerve
Sacrospinous e to quadratus
ligament femoris (and
inferior
gemellus)
Perforating
supplying
cutaneousnerve
articularbranch to
hipjoint
Sacrotuberous
ligament-
Greater trochanter
I n f e r i o ra n a l of femur
(rectal)nerve
Intertrochanteric
Dorsal nerve crest
of penis
Inferiorgemellus
Perineal muscle
nerve
femoris
Quadratus
Posterior muscle
scrotal
muscle(cut)
P e r i n e abl r a n c h e s
of posteriorfemoral
cutaneous Sciaticnerve
l s c h i a tl u b e r o s i t y Posteriorfemoral cutaneousnerve
S e m i t e n d i n o sm
uus scle I n f e r i ocr l u n i anl e r v e s
B i c e p fse m o r i sm u s c l e( l o n gh e a d )
(coverssemimembranosus muscle)
4{tr
Hip and Thigh Plate 5O3
Arteries of Femoral Head and Neck
SeealsoPlate 512
Anteriorview Posteriorview
AcetabuJar
Retinacular Superior
artefles
I
I Anterior
branchof
obturator artery
Superior
Posterior I Retinacular
arteries
(subsynoviall
( lnferior (often minute) lnferior (subsynovial)
Anastomosis nastomosrs
betweenmedial
and lateral
circumflex
femoral lschiofemoral
arteries ligamentand
joint capsule
lliofemoral(Y) Medial
ligamentand tendon circumflex
joint capsule femoral artery
Medial circumflex
femoral artery Lateral
Ascending, circumflex
Transverse, femoral artery'
Profunda
femoris
Descending (deepfemoral)
branchesof artery Nutrientartery
Lateralcircumflex of femur
femoralartery
Nutrientartery
of femur
Coronal section
Medial circumflex
femoral artery muscre
Acetabular
labrum
Anastomosis Femoral
Ligamentsand artery
joint capsule1 Lateralcircumflex
femoral artery Pectineus
Ascending, muscte
Transverse,
Descending
Retinacular branches
Acetabular
branch
Obturator
artery
Medial
circumflex
femoral
artery
Profundafemoris
(deepfemoral)
artery
Medial circumflexfemoralartery
lliopsoastendon
Lateralcircumflexfemoral artery
4{N
Femur of child: anterior view
Plate 5O4 Hip and Thigh

Thigh: Serial Gross Sections
S a r t o r i um
suscle Fascialata
Profundafemoris (deep femoral) artery and vein Branchesof femoral nerve
Pectineus Femoralartery and vein
lliopsoas Adductorlongusmuscle
Rectusfemorismuscle Creat saphenousvein
V a s t u sm e d i a l i s Obturatornerve(anteriorbranch)
Lateralfemoralcutaneous Adductorbrevismuscle
V a s t u si n t e r m e d i u s Obturatornerve
(posteriorbranch)
C r a c i l im
s uscle
Vastuslateralis r a g n u sm u s c l e
A d d u c t om
Tensorfasciaelatae muscre
Sciaticnerve
l l i o t i b i a tl r a c t femoral
Posterior
C l u t e u sm a x i m u sm u s c l e cutaneous nerve
S e m i m e m b r a n o smuuss c l e
S e m i t e n d i n o sm
u su s c l e
Bicepsfemoris muscle (long head)
Vastusmedialism
i n t e r m u s c u lsaer p t u mo f t h i g h
V a s t u si n t e r m e d i u sm u s c l e muscle
Sartorius
Vastuslateralis
muscle
lliotibialtract in adductor
canal
septumof thigh
Biceps Creat saphenousvein
{ S h o r th e a d
temons I Adductorlongusmuscle
muscle ( Long head
Cracilismuscle
s uscle
s uscle
femoris (deep femoral) artery
A d d u c t om
r a q n u sm u s c l e
Rectusfemoris tendon Posterior septumof thigh

intermuscular
V a s t u si n t e r m e d i u sm u s c l e Sciaticnerve
l l i o t i b i a tl r a c
V a s t u sm e d i a l i sm u s c l e
Vastuslateralis muscle
Sartorius
A r t i c u l a rg
i se n u sm u s c l e genicular
artery
aphenousnerveand descending
Creat saphenousvein
septumof thigh
Fem C r a c i l im
s uscle
Bicepsfemoris muscle
Common fibular
(peronealn
) erve
AdductormaBnustendon
Poplitealvein and artery
s uscre
Nr
Tibial nerve Semitendinosusmuscle
Hip and Thigh Plate 5O5

Knee: Lateral and Medial Views
Lateral view Vastuslateralis

muscle
lliotibialtract
Bicepsfemoris { Lone head femoristendon

Quadriceps
muscle
I Snoitneao
Bursadeep to iliotibialtr
Patella
and bursa deep to it---
Plantaris
muscle
Bicepsfemoris tendon and its

inferiorsubtendinous
bursa Jointcapsuleof knee
C o m m o nf i b u l a r
(peroneal) nerve
Head of fibula
Castrocnemius
muscle
Tibialtuberosity
Soleum
s uscle
F i b u l a r (i sp e r o n e u s ) Tibialisanterior muscle
Medialview
Sartorius
muscle
Vastus
medialis
muscle
Cracilim
s uscle
Tendon of semitendinosusmuscle
Quadricepsfemoris tendon
anosusmuscle and tendon

Medialepicondyle
of femur A d d u c t om
r a g n u tse n d o n
Parallel
- . . - fibers
--- ) Tibial
) collateral
Obliquefibers ligament
)
Semimembranosus
Medialpatellarretinaculum DUrSa
Anserinebursa
deep to
Semitendinosus, l
Pes
Nr
C r a c i l i s a, n d ) anseflnus
Patellarli Sartoriustendons )
Castrocnemim
u su s c l e
T i b i atlu b e r o s i
Soleusmuscle
Plate 506 Knee

Knee: Anterior Views
Rightknee in extension
Femur
muscle
Vastusintermedius
genusmuscle
Articularis
Vastuslateralis
muscle
Vastusmedialismuscle
lliotibialtract
Rectusfemoristendon(becoming
Lateralpatellarretinacul femoristendon)
quadriceps
Lateralepicondyleof femur Patella
Fibularcollateralligament and
Medialepicondyleof femur
Bicepsfemoris tendon and its
inferiorsubtendinous Medialpatellarretinaculum
Broken line indicates ligament

Tibialcollateral
bursa deep to iliotibialtract
Pes
Insertionof iliotibialtract to Cerdy's
ansennus
t u b e r c l ea n d o b l i o u el i n e o f t i b i a
) erve- A n s e r i n be u r s a
Head of finut.-=} Medialcondyleof tibia
(peroneus)
Fibularis longusmuscle ligament
Patellar
digitorumlongus
Extensor
Tibialtuberosity
T i b i a l ias n t e r i om
r uscle
muscle
Castrocnemius
foint opened,
kneeslightlyin flexion
(synovial)
Suprapatellar bursa
genusmuscle Cruciate ligaments(covered by synovialmembrane)

Articularis
Synovialmembrane (cut edge Medial condyle of femur
Lateralcondyle of
Infrapatellarsynovialfold
Origin of popliteustendon
(covered by synovialmembrane
M e d i a lm e n i s c u s
recess
Subpopliteal
Alar folds (cut)
Lateralmeniscus
Fibularcollateralligament Infrapatellarfat pads (lined by synovialmembrane)
Head of fibula
Suprapatellar(synovial)bu rsa (roof re flected)
(articular
Patella surface
on posterioraspect) Vastus medialis muscle (reflected inferiorly)
Vastuslateralis
muscle
(reflected i nferiorly\
4{r
Knee Plate 5O7
Knee: Interior
lnferior view
l l i o t i b i a tl r a c t b l e n d e di n t o l a t e r a l P a t e l l a lri g a m e n t
p a t e l l a rr e t i n a c u l u ma n d c a p s u l e
, -------- patellarrelinaculum
Yedial
b l e n d e di n t o j o i n t c a p s u l e
Bursa
S u p r a p a t e l l asry n o v i a b
l ursa
Subpopliteal
l e m b r a n e( c u t e d g e )
S y n o v i am
P o p l i t e u st e n d o
I n f r a p a t e l l asry n o v i a fl o l d
'---
Posterior cruciaIe ligamenl
ri
p-Iibi al col la.tera| |igament
l' (superlicia d ln d d e e p p a r l s )
L . r t e r acl o n d y l eo f f e m u r
M e d i a l c o n d y l eo f f e m u r
A n t e r i o rc r u c i a t el i g a m e n t Obliquepopliteal igament
A r c u a t ep o p l i t e a l i g a m e n t S e m i m e m b r a n o s ut se n d o n
Posterior aspect
Superior view
--- .- semimembranosustendon
P o s t e r i om
r e n i s c o f e m o r al lig a m e n t
A r c u a t ep o p l i t e a l i g a m e n t Obliquepopliteal igament
Posteriorcruciate ligament
T i b i a lc o l l a t e r alli g a m e n t
( d e e pp a r t b o u n d t o
P o p l i t e u st e n d o n m e d i a lm e n i s c u s )
S u b p o p l i t e arle c e s s M e d i a lm e n i s c u s
L a t e r am
l eniscus S y n o v i am
l embrane
S u p e r i o ra r t i c u l a sr u r f a c e S u p e r i o ra r t i c u l a rs u r f a c e
o f t i b i a ( l a t e r afl a c e t )
l l i o t i b i a tl r a c t
\.:l'l:;Jffdia'|fa'ce,
b l e n d e di n t o c a p s u l e
A n t e r i o rc r u c i a l el i g a m e n t
I n f r a p a t e l l af ra t p a d P a t e l l a lri g a m e n t
ani".io, aspectI
S u p e r i o r v i e w : l i g a m e n t sa n d c a r t i l a g er e m o v e d
A t t a c h m e n to f p o s t e r i o rc r u c i a t el i g a m e n t In t e r c o n d y l aer m i n e n c e
A l t a rh m e n t o f s y n o v i a m
l embrane---r-_ A t l a c h m e nol I s y n o v i am
l embrane
S u p e r i o ra r t i c u l a rs u r f a c e S u p e r i o ra r t i c u l a sr u r f a c e
o f t i b i a ( m e d i a lf a c e t )
o f t i b i a( l a t e r afl a c e t )
A t t a c h m e n to f a n t e r i o r
A t t a c h m e n t so f h o r n s c r u c i a t el i g a m e n t
o f l a t e r a lm e n i s c u s
A t t a c h m e n t so f h o r n so f m e d i a lm e n i s
T i b i atl u b e r o s i t y
Nr
Plate 5O8 Knee
Knee: Gruciate and Gollateral Ligaments
Right knee in flexion: anterior view
Anteriorcruciate cruciateligament
Posterior
Lateralcondvleof
femur(articular Medialcondyleof femur(articular
surface)
surf
Medialmeniscus
Popliteus
tendon
Fibularcollateral ligament
collateral
ligament
Lateralmeni Medialcondyleof tibia
Transverse
ligamentof 'Tibialtuberosity
Headof fibu
Right knee.inextension:
posteflor vlew
Cerdv'stubercle
Posteriorcruciateligament
Anteriorcruciateligament
Posteriormeniscofemoral
ligament
Adductortubercleon
medialepicondyleof
Lateralcondyleof
femur (articular
surface)
Medialcondyleof femur(articular
surface)
Popliteustendon
Medialmeniscus
Fibularcollateral
ligament
ligament
Tibialcollateral
Lateralmeniscus
Medialcondyleof ti of fibula
4{tr
Knee Plate 5O9

Knee: Anteroposterior Radiograph
F Fibula
FE Femur
HF Head of fibula
ICE Intercondylareminence
L L a t e r ael p i c o n d y l e
l-CF Lateralcondyle of femur
tCT Lateralcondyle of tibia
M M e d i a le p i c o n d y l e
M C F M e d i a lc o n d y l eo f f e m u r
M C T M e d i a l c o n d y l eo f t i b i a
P Patella
T Tibia
Plate 5l O Knee
Knee: Posterior and Sagittal Views
Rightknee:
Femur(poplitealsurface)
A d d u c t o r m a g n u st e n d o n Attachment of joint capsule
Medial head of gastrocnemrus Plantarismuscle

m u s c l ea n d s u b t e n d i n o u sb u r s a
Lateralhead of gastrocnemiusmuscle
T i b i a lc o l l a t e r alli g a m e n t
a n d s u b t e n d i n o u sb u r s a
S e m i m e m b r a n o s ut se n d o n
and its inferior
Obliquepopliteal igament
S u b t e n d i n o u sb u r s a
( t e n d i n o u se x p a n s i o no f
s e m i m e m b r a n o s um s uscle)
Biceosfemoris tendon
S e m i m e m b r a n o s ubsu r s a and bursa beneath it
deep to tendon (broken line
Arcuate popliteal ligament
Popliteusmuscle (edge of capsulethat arches
o v e r p o p l i t e u sm u s c l e )
Headof fibula
Posteriorligament of
f i b u l a rh e a d
Femur Attachment of joint capsule
Articularis Interosseousmembrane
S e n u sm u s c l e
Tibia
Quadriceps
femoristendon
Lateral
subtendinous S u p r a p a t e l l(asry n o v i abl )u r s a
bursaof
gastrocnemius Patella
muscte
S u b c u t a n e o up
s r e p a t e l l abr u r s a
Articularcavity
S y n o v i am
l embrane
Synovial
Infrapatellarfat pad
memDrane
infrapatellar
Subcutaneous bursa
D e e p( s u b t e n d i n o ui ns f) r a p a t e l lbaur r s a
Lateralmeniscus
A r t i c u l acra r t i l a g e s
Tibia
Tibialtuberosity
*{r
Sagittalsection
(lateralto midlineof knee)
Knee Plate 511

Arteries of Thigh and Knee: Schema
Superficial Superficialepigastricartery
circumflex iliac artery
Superficialexternalpudendal artery
Femoralartery Obturator artery
Deep externalpudendal artery
Medial circumflexfemoral artery

A s c e n d i n gb r a n c h ,
Transversebranch,
Descendingbranch of
Lateralcircumflex Femoralartery
femoral artery
Muscularbranches
Profundafemoris
(deep femoral)
artery
Perforatingbranches
Femoralartery passing
through adductor hiatus
Descendinggenicularartery
.zArticular branch
S a p h e n o ubsr a n c h
r e d i agl e n i c u l aarr t e r y
S u p e r i om
S u p e r i o rl a t e r a lg e n i c u l a ra r t e r y
artery(phantom)
Popliteal
Patellaranastomosis
Inferior lateralseniculararter Middlegeniculararrery(phantom)

(partiallyin phintom)
lnferiormedialgenicularartery
Posteriortibial recurrentartery (partiallyin phantom)
(phantom\
Anteriortibialrecurrentartery
C i r c u m f l efxi b u l a b
rr
Anterior tibial a tibialartery(phantom)

Posterior
Nr I n t e r o s s e om
u se m b r a n e Fibular(peroneal)
artery(phantom)
Plate 512 Knee

Tibia and Fibula
B o n e so f
right leg Anterior view view
Posterior
/-lntercondylar eminencel -lntercondylar eminencel

Lateral Medial Medial Lateral
intercondylar intercondylar intercondylar intercondylar
Anterior tubercle tubercle tubercle tubercle
Posterior Superior
i n t e r c o n d y l aar r e a
intercondylar articularsurfaces
area \ /___- ( m e d i a la n d
L a t e r a cl o n d y ' " \ , lateralfacets)
Medial
condyle
Lateralcondyle
C e r d y ' st u b e r c l e
Neck ( i n s e r t i oonf Apex,
of iliotibialtract) Head,
fibula Neck
of
fibula
Croove for
insertionof
Tibial
semimembranosus
Solealine tendon
Lateral
Lateralsurface
Nutrient
foramen
A n t e r i o rb o r d e r
Anterior
border..............._
Interosseous
Interosseous border Posterior
border surface
It
I
Posterior
Medial surface surface
Medial crest
Medial surface
M e d i a lb o r d e r
M e d i a lb o r d e r - .
Lateralsurface
Tibia
Posterior
border
4ftr Croove for

t i b i a l i sp o s t e r i o r
a n d f l e x o rd i g i t o r u m
l o n g u st e n d o n s
F i b u l a rn o t c h
Lateral Medial
malleolus malleolus Lateral
malleolus-
\ malleolus
\ i
{
Y
M a l l e o l a rf o s s a
Articularfacet lnferior lnferior of lateral
Articularfacet
of lateral articular r t i c u l a rf a c e to f articular malleolus
of medial
malleolus surface m e d i a lm a l l e o l u s surface
malleolus
Leg Plate 513

Tibia and Fibula (continuedl
Anteriorview with ligamentattachments Superiorview

lliotibialtract osterior I Cruciate Posteriorligament
Anterior J ligaments of fibular head intercondylararea
Fibular (origin of posterior
collateral Tibial cruciate ligament)
ligament collateral
ligament Intercondylar
Biceps Posterior emtnence
Fibula
femoris
te Tibia
Anterior ligament
of fibular head
Head of
Medial condvle
fibula Lateral
condyle
Superior
Anterior
articularsurface
ligament Superior (medialfacet)
of fibular articularsurface
head (lateralfacet)
\tuuai"t
I Intercondylar
Tibial Anterior
Cerdy's tuberosity Anterior Lateralt tubercles
tubercle intercondylararea
(originof anterior
cruciate ligament
Anterior
border Anterior
border
Crosssection
Interosseous Interosseous
border border Interosseousborder Lateralsurface
nterosseous
Lateral
membrane
surface
Lateral
surface
Tibia
4{ry Posteriorsurface
Inferior view
Anterior
Anterior Articular
tibiofibular Anterior facet of
ligament Articularfacet medial
of lateral malleolus
Lateral Fibula Medial

malleolus Medial malleolus
malleolus Malleolar
fossaof
lateralmalleol Tibia
Anterior Medial Posterior
talo- (deltoid)
Calcaneofibular fibular ligament Posterior Inferiorarticular
ligament ligament of ankle tibiofibularligament surfaceof tibia
Pfate 514 Leg

Attachments of Muscles of Leg
Anteriorview Posteriorview Plantaris

muscle
muscle
Castrocnemius
( m e d i a lh e a d ) (lateralhead)
l l i o t i b i a tl r a c t muscle
Popliteus
Bicepsfemoris muscle
Fibularis
(peroneus)
Tibialisposterior
Extensor Quadricepsfemoris Soleus muscle
digitorum m u s c l ev i a musc
l o n g u sm u s c l e p a t e l l a rl i g a m e n t
T i b i a l i sa n t e r i o r
muscle
Extensor hallucis Flexor Flexorhallucis
l o n g u sm u s c l e digitorum l o n g u sm u s c l e
Fibularis
(peroneus) Origins
! F i b u l a r i(sp e r o n e u s )
brevismuscle
f Insertions brevismuscle
Fibularis Note:Attachments Plantaris

muscle
(peroneus) of intrinsicmuscles
t e r t i u sm u s c l e of foot not shown
S o l e ua
snd
gastrocnemius
muscles via
calcaneal (Achilles)
Tibialis
posteriormuscle tendon
Fibularis
(peroneus)
Fibularis
(peroneus)
tertiusmuscle
Fibularis
(peroneus)
Extensor rongus
digitorum muscre
Flexor
4fF Extensor
Flexorhallucis
longusmuscle
digitorum
longus
muscle
hallucis
Leg Plate 515

Muscles of Leg (superficial Dissection|: Posterior view
Seealm Plate 540
s uscre l l i o t i b i at rl a c t
s uscre B i c e p fse m o r i sm u s c l e
Cracilim
s uscle Tibialnerve
P o p l i t e aal r t e r ya n d v e i C o m m o n f i b u l a r( p e r o n e a l n
) erve
S a r t o r i u sm u s c l e S u p e r i o rl a t e r a lg e n i c u l a ra r t e r y
S u p e r i o rm e d i a lg e n i c u l a ra r t e r y t a r i sm u s c l e
C a s t r o c n e m i u sm u s c l e( m e d i a lh e a d u su s c l e( l a t e r ahl e a d )
Castrocnemim
N e r v et o s o l e u sm u s c l e nerve(cut)
Lateralsuralcutaneous
nerve(cut)
Medialsuralcutaneous
S m a l ls a p h e n o u sv e i n
S o l e u sm u s c l e S o l e u sm u s c l e
P l a n t a r ti e
s ndon
Flexordigitorum longus tendon --__*
Tibialis posterior t"naon __________ F i b u l a r i s( p e r o n e u s l)o n g u st e n d o n

i
Posteriortibial artery and vei Fibularis(peroneus)brevis tendon
T i b i a ln e r v e a l c a n e a (l A c h i l l e st)e n d o n
-"---j
Medialmalleolus L a t e r am
l alleolus
Flexorhallucislongus tendon S u p e r i o rf i b u l a r( p e r o n e a l r) e t i n a c u l u m
F l e x o rr e t i n a c u l u i b u l a r( p e r o n e aal )r t e r y
Calcanealbranch of Calcanealbranchesof fibular (peroneal)artery
*{r posterior tibial artery

alcanealtuberosity
Plate 516 Leg

Muscles of Leg (lntermediate Dissection): Posterior View
SeealsoPlate 541
Tibial nerve
Adductor magnustendon
Common fibular (peroneal)nerve (cut)
P o p l i t e aal r t e r ya n d v e i n
Superiorlateralgenicularartery
S u p e r i o rm e d i a lg e n i c u l a ra r t e r y {
Lateraland medial suralcutaneousnerves(cut)
C a s t r o c n e m i u sm u s c l e C a s t r o c n e m i u sm u s c l e( l a t e r ahl e a d )( c u t )
( m e d i a lh e a d )( c u t )
T i b i a fc o l l a t ear l | g a m e n t /
Bicepsfemoris tendon (cut)
S e m i m e m b r a n o s ut se n d o n (
taris muscle
I n f e r i o rm e d i a lg e n i c u l a ra r t e r y
lnferior lateralgenicularartery
Popliteus
muscle
Head of fibula
T e n d i n o uasr c ho f ) e r v e( c u t )
m m o n f i b u l a r( p e r o n e a l n
Soleum s uscle
N e r v e t o s o l e u sm u s c l e
P l a n t a r i tse n d o n
F i b u l a r i (sp e r o n e u s l)o n g u sm u s c l e
C a s t r o c n e m i u sm u s c l e( c u t )
muscle
S o l e u sm u s c l ei n s e r t i n gi n t o
c a l c a n e a(l A c h i l l e st)e n d o n
F l e x o rd i g i t o r u ml o n g u st e n d o n
T i b i a l i sp o s t e r i o rt e n d o n
Posteriortibial artery and vein F i b u l a r i s( p e r o n e u s l)o n g u st e n d o n
Tibial F i b u l a r i s( p e r o n e u s b) r e v i st e n d o n
Medial L a t e r am
l alleolus
F l e x o rh a l l u c i sl o n g u st e n d o n S u p e r i o rf i b u l a r( p e r o n e a l r) e t i n a c u l u m
Fibular(peroneal)artery
Flexorretinaculum
Calcanealbranches
Calcaneal(Achilles)tenoon
of fibular (peroneal)artery
Calcanealbranch of
posteriort i b i a la r
Calcanealtuberosity
4{tr
Leg Plate 517
Muscles of Leg (Deep Dissectionf: Posterior View
Superiormedialgenicular
artery Superiorlateralgenicular
artery
muscle(medialhead)(cut)
Castrocnemius muscle(cut)
Plantaris
S u r a(l m u s c u l abr )r a n c h e s muscle(lateralhead)(cut)

Castrocnemius
Popliteal
arteryand tibialnerve Fibularcollateral
ligament
Bicepsfemoristendon(cut)
Tibial collateralligament
Inferiorlateralgenicular
artery
tendon(cut
Semimembranosus
of fibula
Inferiormedialgenicular
artery
Commonfibular(peroneal)
nerve
Popliteus
muscle
Posterior
tibialrecurrentartery
muscle(cutand reflected)
Tendinous
archof soleusmuscre
Anteriortibialartery
Posterior
tibialartery
Fibular(peroneal)
artery
Flexordigitorumlongusmuscle
Tibial nerve
Flexorhallucislongusmuscle(retracted)
Tibialisposterior muscle
Fibular(peroneal)
artery
(Achilles)
Calcaneal tendon Interosseous
membrane
Flexordigitorumlonguste
Tibialisposteriortendon (peroneus)
Fibularis longustendon
Medial malleolusand posterior medial (peroneus)
Fibularis brevistendon
malleolarbranch of posteriortibial art<
Lateralmalleolus
and posteriorlateral
branchof fibular(peroneal)
malleolar artery
Flexorretinaculum
Superiorfibular(peroneal)
retinaculum
Medial calcanealbranchesof
posteriortibial artery and tibial Lateralcalcanealbranch
of fibular(peroneal)
artery
Tibialisposteriortendon Lateralcalcaneal
branchof suralnerve
Medialplantararteryand nerve Inferiorfibular(peroneal)
retinaculum
(peroneus)
Lateralplantararteryand nerve
(peroneus)
Fibularis longustendon
Flexorhallucislongustendon
Flexordigitorumlongustendon
*{r l st metatarsalbone 5th metatarsal

bone
Plate 518 Leg

Muscles of Leg (superficial Dissection|: Anterior View
Vastuslateralis
muscle Vastusmedialismuscle
Rectusfemoris tendon Patella

q u a d r i c e p sf e m o r i st e n d o n )
Superiormedialgenicularartery
lliotibialt
ligament
Tibialcollateral
Superiorlateralgenicular
artery
M e d i a pl a t e l l arre t i n a c u l u m
nferiormedialgenicular
artery
Bicepsfemoristendon
branch(cut)of
lnfrapatellar
Inferiorlateralgenicular Saphenous nerve(cut)
) erve J o i n tc a p s u l e
Headof fibula ligament

Patellar
Insertion muscle
of sartorius
Tibialtuberosity
(peroneus)
Fibularis longusmuscle
Tibia
r uscle
muscle
Gastrocnemius
Superficial
fibular
(peroneal)nerve
Soleum
s uscle
hallucislongusmuscle
Extensor
digitorumlongusmuscle
Extensor
Fibula
Superiorextensorretinaculum Medialmalleolus
Lateralmalleolus
lis anterior tendon
Inferiorextensorretinaculum
Extensor
digitorumlongustendons Medial branch of deep fibular (peroneal)nerve
F i b u l a r (i sp e r o n e u st e) r t i u st e n d o n E x t e n s o hr a l l u c i sl o n g u st e n d o n
Extensor
digitorumbrevistendons
Extensorhallucisbrevistenoon
Dorsaldigital branches
of deep fibular (peroneal)nerve
Dorsaldigitalnerves
4{tr
Leg Plate 519
Muscles of Leg (Deep Dissection): Anterior view
SeeafsoPlate &2
S u p e r i o rl a t e r a lg e n i c u l a ra r t e r y S u p e r i o rm e d i a lg e n i c u l a ra r t e r y
Fibular collateralliBament---_____-_ Q u a d r i c e p sf e m o r i st e n d o n
L a t e r a pl a t e l l a r e t i n a c u l u m T i b i a lc o l l a t e r alli g a m e n t
l l i o t i b i a tl r a c t ( c u r M e d i a l p a t e l l a rr e t i n a c u l u m
Bicepsfemoris tendon (cut) nfrapatellarbranch of saphenousnerve (cuf)
I n f e r i o rl a t e r a lg e n i c u l a ra r t e r y I n f e r i o rm e d i a lg e n i c u l a ra r t e r y
C o m m o n f i b u l a r( p e r o n e a rnJ e r v e
Saphenousnerve (cut)
Headof fibula
F i b u l a r i s( p e r o n e u s l)o n g u sm u s c l e( c u t
Insertionof sartoriustenoon
A n t e r i o rt i b i a la r t e r y
A n t e r i o rt i b i a lr e c u r r e n ta r t e r ya n d
l o n g u sm u s c l e( c u t r e c u r r e n tb r a n c ho f d e e p p e r o n e a ln e r v e
S u p e r f i c i af li b u l a r( p e r o n e a t n
) erve I n t e r o s s e o um
s embrane
D e e p f i b u l a r( p e r o n e a rnl e r v e T i b i a l i sa n t e r i o rm u s c l e( c u t )
F i b u l a r i s( p e r o n e u s l)o n g u sm u s c l e C a s t r o c n e m i u sm u s c l e
E x t e n s o dr i g i t o r u ml o n g u sm u s c l e
F i b u l a r i s( p e r o n e u s ) Soleum
s uscle
b r e v i sm u s c l ea n d t e n d o n
Tibia
S u p e r f i c i af li b u l a r( p e r o n e a l n
) e r v e( c u t )
E x t e n s oh
r a l l u c i sl o n g u sm u s c l ea n d t e n d o n ( c u t )
F i b u l a r i s( p e r o n e u s l)o n g u st e n d o n
l n t e r o s s e o um
s embrane
Perforatingbranch of
f i b u l a r( p e r o n e a l a
) rtery A n t e r i o rm e d i a lm a l l e o l a ra r t e r y
Anterior lateralmalleolarar
ial malleolusand arterialnetwork
L a t e r am
l a l l e o l u sa n d a r t e r i a n
l etwork
D o r s a l i sp e d i sa r t e r y
Lateraltarsalartery and lateral
b r a n c ho f d e e p f i b u l a r( p e r o n e a rn. ,e r v T i b i a l i sa n t e r i o rt e n d o n
E x t e n s o dr i g i t o r u mb r e v i sa n d M e d i a lt a r s a la r t e r y
e x t e n s o rh a l l u c i sb r e v i sm u s c l e s( c u t
M e d i a l b r a n c ho f d e e p f i b u l a r( p e r o n e a l n
) erve
F i b u l a r i s( p e r o n e u s b
) r e v i st e n d o n
Arcuate artery
Posteriop
r e r f o r a t i n gb r a n c h e s
from deep plantar aich Deep plantar artery
E x t e n s odr i g i t o r u ml o n g u st e n d o n s( c u t ) Dorsal metatarsalarteries

Extensordigitorum brevis tendons (cut Extensorhallucislongus tendon (cut)
D o r s a ld i g i t a la r t e r i e s E x t e n s o hr a l l u c i sb r e v i st e n d o n ( c u t )
digital branchesof
4{tr
Branc.hes of proper plantar
d i g i t a la r t e r i e sa n d d e e p f i b u l a r( p e r o n e a l )n e r v e
Pfate 52O Leg

Muscles of Leg: Lateral View
muscle
Vastuslateralis
lliotibialtract
Biceps
femoris
I Long
Short head femoristendon
Quadriceps
muscle
I Tendon Superiorlateralgenicular
artery
Patella
F i b u l a rc o l l a t e r a l i g a m e n t
( p e r o n e anl )e r v e
Lateralcondyle of tibia
Patellarligament
lnferior lateral
genicularartery
Tibialtuberosity
Headof fibula
Tibialisanteriormuscle
digitorumlongusmuscle
Extensor
F i b u l a r (i sp e r o n e u sl o) n g u s fibular
Superficial
muscle and tendon
nerve(cut)
(peroneal)
Extensordigitorum longus tendon
Extensorhallucislongus muscle and tendon

F i b u l a r (i sp e r o n e u sb)r e v i s
m u s c l ea n d t e n d o n S u p e r i oer x t e n s orre t i n a c u l u m
Inferiorextensorretinaculum
Fibula
nsor digitorum brevis muscle
Lateralmalleolus
xtensor hallucislongus tendon
Calcaneal(Achilles)
tendon
\\ l o n g u st e n d o n s
(Subtendinous) bursa \ -l'
of tendocalcaneus\ (peroneus)
brevistendon
Superiorfibular (peroneus)
Fibularis tertiustendon
( p e r o n e arl e
) tinaculum
5th metatarsal
l n f e r i ofri b u l a r oone
( p e r o n e arl e ) tinaculum
(peroneus)
Fibularis longus
tendonpassingto soleof foot
*{r
Leg Plate 521
Leg: Gross Sections and Fascial Gompartments
Deepfasciaof Interosseous
membrane
(cruralfascia)
Anteriorcompartmenl ilDra
Extensor muscles
T i b i a l ias n t e r i o r
E x t e n s odri g i t o r u m longus Deepposteriorcompartment
E x t e n s ohra l l u c ilso n g u s Deepflexormuscles
F i b u l a r i(sp e r o n e u st e) r t i u s F l e x odr i g i t o r u m longus
A n l e r i o tri b i a a
l r t e r ya n dv e i n s T i b i a l ios o s t e r i o r
D e e pf i b u l a (r p e r o n e anl )e r v e F l e x ohr a l l u c ilso n g u s
Popliteus
Posteriortibial artery and veins
Anteriorintermuscular
septum T i b i a ln e r v e
F i b u l a r( p e r o n e a l a
) r t e r ya n d v e i n s
Lateral compartment
F i b u l a r i s( p e r o n e u s l)o n g u sm u s c l e
Transverseintermuscular septum
F i b u l a r i s( p e r o n e u s b) r e v i sm u s c l e
Superficialfibular (peroneal)nerve
Superficialposteriorcompartmenl
Posteriorintermuscular
septum Superficial flexormuscles
Soleus
Gastrocnemius
FIDUIA P l a n t a r (i st e n d o n )
Deep fascia of leg (crural fascia)
Crosssectionjust abovemiddle of leg
T i b i a l i sa n t e r i o rm u s c l e A n t e r i o rt i b i a la r t e r ya n d v e i n sa n d
d e e p f i b u l a r( p e r o n e a l )n e r v e
E x t e n s ohr a l l u c i sl o n q u sm u s c r e
ilDta
E x t e n s odr i g i t o r u ml o n g u sm u s c l e
l n t e r o s s e o um
s embrane
S u p e r f i c i af li b u l a r( p e r o n e a l )
Creat saphenousvein
A n t e r i o ri n t e r m u s c u l asr e p l a n d s a p h e n o u sn e r v e
Deep fasciaof leg T i b i a l ipso s t e r i om

r uscle
(cruralfascia)
F i b u l a r i(sp e r o n e u s ) Flexordigitorum longus
l o n g u sm u s c l e muscre
F i b u l a r i s( p e r o n e u s ) F i b u l a r( p e r o n e a l a
) rtery
b r e v i sm u s c l e and veins
P o s t e r i o irn t e r m u s c u l asre D r u m Posteriortibial artery

a n d v e i n sa n d t i b i a ln e r v e
F
Flexorhallucislongus
muscte
Lateralsuralcutaneousnerve
Deep fasciaof leg (cruralfascia)
TransverseintermuscularseDtum
P l a n t a r i tse n d o n
Soleum
s uscle
C a s t r o c n e m i u sm u s c l e( m e d i a lh e a d )
C a s t r o c n e m i u sm u s c l e( l a t e r ahl e a d )
M e d i a l s u r a lc u t a n e o u sn e r v e
S u r a lc o m m u n i c a t i n gb r a n c h
4{tr o f l a t e r a sl u r a lc u t a n e o u sn e r v e
S m a l ls a p h e n o u sv e t n
Pfate 522 Leg

Bones of Foot
Dorsalview
Lateral tubercle
Calcaneus tubercle
Posterior
Body- Croove for process
Fibular tendon of
(peroneal)
flexor hallucis
trochlea longus
Trochlea
Neck
ao
Navicular
Tuberosity
Tuberosity
of 5th
metatarsal
DOne
.q
r"rroretatarsaljoint
Base Plantarview Calcaneus
Tuberosity
Shaft(body) Medial process
Lateral ateralprocess
tubercle
Sustentaculumtali
Medial Croove for
tubercle tendono{ flexor
Posterior h a l l u c ilso n g u s
process Fibular(peroneal)
trochlea
Head
Transverse Cuboid
tarsaliointl, Tuberosity
roove for
Navicular fibularis
Tuberosity (peroneus,
Tuberosity longustendon
Tuberosity
of 5th
metatarsal
bone
al iointj
Tarsometatars Base
Shaft(body)
Metatarsalbones Head
r ''-dirl Base
Sesamoid
Uones{ i"lYj Shaft(body)
Lareral
t Head
Base
Head
Tuberosity
*{r
Phalanges
Ankle and Foot Plate 523

Bones of Foot (continued|
lateral view
ransversetarsaljoint
Navicular
l"T;1J;: cun"iro,.
tron",
I
joint
Tarsometatarsal
Metatarsalbones
Body
Fibular t.
(peroneal)
trochlea
Tuberosity
Croovefor Cuboid Tuberosity
of
f i b ul a r i s 5th metatarsal
bone
(peroneus) Tuberosity
l o n g u st e n d o n
Croove for fibularis
( p e r o n e u sl o) n g u st e n d o n
M e d i a l vew
i
Transversetarsaljo i n t
Navicular
Tuberosity
cuneiform"uon", Intermediate
" -" { \
I Mediat-f
Tarsometatarsal
ioint--a
Metatarsalbones
Tuberosity
Tuberosityof
l st metatarsal
bone
Croove for tendon of Calcaneus
Sesamoidbone flexor hallucisloneus
Sustentaculum
tali
Plate 524 Ankle and Foot

Galcaneus
Rightfoot
Posteriortalar Middletalar Anteriortalar Articularsurface
articularsurface articularsurface a r t i c u l asru r f for cuboidbone
Anteriortalar
articularsurface
Middletalar
articularsurface
Posterior
Articularsurface talar
f o r c u b o i db o n e articular
surface
Fibular ibular
(peroneal) (peroneal)
Tuberosity Sustentaculumtali
trochlea trochlea
Lateralprocess Croovefor fibularis
of tuberosity ( p e r o n e u s l)o n g u st e n d o n Body
Lateralview C a l c a n e asl u l c u s
Middle talar articularsurface Tuberosity
Anterior talar
articularsurface Posterior talar
articularsurface Superiorview
Articular Middletalararticularsurtace
surface
Tuberosity rior talar
for cuboid
bone
articularsurface
tali
Sustentaculum
Medial Croove for

Sustentaculumtali
Groovefor tendon processof tendon of flexor Fibular
o f f l e x o rh a l l u c ilso n g u s tuberosity h a l l u c ilso n g u s (peroneal)
trochlea
Medialview Medial
processof teral
tuberosity processof
Fibula
tuberosity
Tuberosity
I n t e r o s s e om
u se m b r a n e
Posterior Posteriorview
tibiofibular
Talus ligament
Posterior
talofibular
Medial ligament
(deltoid)
ligament
Calcaneofibular
of ankle
ligament
F i b u l a r( p e r o n e a l )
Posterior t e n d o n si n i n f e r i o r
talocalcaneal f i b u l a r( p e r o n e a l )
ligament retinaculum
Posteriorview
*{r with ligaments Functionalrelationsof calcaneus

Ankle: Radiographs
Lateralview
C Calcaneus
CB Cuboid
F Fibula
HT Headof talus
tC Lateralcuneiform
N Navicular
PT Posteriorprocessof talus
ST Sustentaculum taliof calcaneus
T Tibia
TC Tuberosityof calcaneus
TM Tuberosityof 5th metatarsal
TT Trochleaof talus
Anterior view
F Fibula
t-M Lateralmalleolus
MM M e d i am
l alleolus
T Tibia
TA Talus

Ligaments and Tendons of Ankle
Tibia Rightfoot: lateralview

Components of lateral
(collateral)
ligament
Fibula--------
of ankle
A n t e r i o ra n d lnterosseoustalocalcanealligament
Posterior Dorsal talonavicularligament
tibiofibular
ligaments C a l c a n e o n a v i c u l a r l i g a m e| n t^ . . a,:-----.-a
BlturcatellEament
/ c.l.rn"o.uboid lig--amentI
cu boideonavicularligament
Superiorfibular(peroneal) ligaments
Dorsalcuneonavicular
retinaculum-
Dorsalintercuneiformligaments
ligaments
Dorsaltarsometatarsal
Calcaneal(Achilles)
tendon (cut
lnferior
fibular
(peroneal)
retinaculum
Dorsal metatarsalligaments
Lateraltalocalcanealligament
Dorsalcuneocuboidligament
Long plantar ligament
F i b u l a r (i sp e r o n e u sl o) n g u st e n d o n Cuboidbone
(peroneus) Dorsal calcaneocuboidliqament

Rightfoot: medialview
ligament
Medialtalocalcaneal
Medial(deltoid)
l i g a m e n to f a n k l e
processof talus
Posterior
Dorsal talonavicularligament
Posterior
talocalcaneal
Navicularbone
ligament
Dorsal cuneonavicularli
Medial cuneiform bone Calcaneal
(Achilles)
Dorsal intercuneiformligament
tendon
ligaments
Dorsaltarsometatarsal (cut)
I st metatarsal
Tuberosity
Shortplantar
Nr
T i b i a l i sa n t e r i o r ligament
Tibialisoosteriortendon Plantarcalcaneo- ong plantarligament
n a v i c u l a r( s p r i n g )l i g a m e n t
Ankle and Foot Plale 527

Ligaments and Tendons of Foot: Plantar View
F l e x o rd i g i t o r u ml o n g u st e n d o n t o 2 n d t o e ( c u t Distalphalanxof greattoe
Flexordigitorum brevis tendon to 2nd toe (cut
I n t e r p h a l a n g e( laPl )j o i n t
4 t h d i s t apl h a l a n x
F l e x ohr a l l u c ilso n g u st e n d o n( c u t )
4 t h m i d d l ep h a l a n x
Proximalphalanxof great toe
Deep transversemetatarsalIigaments
Metatarsophalangeal(MP) joint
5 t h p r o x i m a lp h a l a n
S e s a m o i db o n e s
4 t h l u m b r i c a lt e n d o n ( c u t )
A b d u c t o rd i g i t i m i n i m i A b d u c t oh
r a l l u c iasn dm e d i ahl e a d
a n d f l e x o rd i g i t im i n i m i of flexorhallucisbrevistendons(cut)
brevistendons (cut)
Adductor hallucisand lateralhead
Plantarligaments(plates) of flexor hallucisbrevis tendons (cut)
muscles(cut)
Interosseous l st metatarsal
bone
5th metatarsalbone
Plantartarsometatarsalligaments
Plantarmetatarsalligaments
M e d i a lc u n e i f o r mb o n e
Tuberosity
of 5th metatarsal
bone
Tibialisanterior tendon (cut)
F i b u l a r (i sp e r o n e u s )
brevistendon P l a n t a rc u n e o n a v i c u l alri g a m e n t
Cuboidbone
P l a n t a rc u b o i d e o n a v i c u l al ri g a m e n t
F i b u l a r i s( p e r o n e u s )
longus tendon T u b e r o s i toyf n a v i c u l abro n e
T u b e r o s i t yo f c u b o i d b o n e P l a n t a rc a l c a n e o n a v i c u l a( sr p r i n g )l i g a m e n t
L o n g p l a n t a rl i g a m e n t Tibialisoosteriortendon
Plantarcalcaneocuboid
Flexordigitorum longustendon (cut)
(short plantar)ligament,
Calcaneus S u s t e n t a c u l ut aml i
Medial process F l e x o rh a l l u c i sl o n g u st e n d o n ( c u t )
and
Lateralprocess Posteriororocessof talus
of ( m e d i a la n d l a t e r a tl u b e r c l e s )
Tuberosity
of calcaneus
*{r
P h a l a ng e s
J o i n ct a p s u l e
Metatarsalbone
Proximal
Capsulesand ligaments of
metatarsophalangealand
i n t e r p h a l a n g e a jl o i n t s :
lateral view
Collateralligaments P l a n t a rl i g a m e n t

Tendon Sheaths of Ankle
Lateralview
S o l e u sm u s c l e
Extensordigitorum longus muscle
F i b u l a r (i sp e r o n e u s )
l o n g u sm u s c l e Suoeriorextensorretinaculum
F i b u l a r (i sp e r o n e u s ) T e n d i n o ussh e a t ho f t i b i a l i a
snterior
b su r s a
L a t e r aml a l l e o l uasn ds u b c u t a n e o u
C a l c a n e a(l A c h i l l e st)e n d o n Inferiorextensorretinaculum
C o m m o n t e n d i n o u ss h e a t h Tendinoussheathof extensordigitorum
o f f i b u l a r i(sp e r o n e u s ) longusandfibularis(peroneal)
tertius
l o n g u sa n d b r e v i
Tendinoussheathof
Subcutaneouscalcanealoursa extensorhallucislongus
( S u b t e n d i n o ubsu)r s a
of calcanealtendon
S u p e r i o ra n d
l n f e r i o r-
f i b u l a (r p e r o n e a l )
r e t i n a clua
Calcaneus
Extensordigitorum brevis
Fibularis Fibularis (peroneus)
Fibularis tertiustendon
(peroneus) (peroneus)
Abductordigiti
ronSus brevis of 5th metatarsal
Tuberositv bone
tendon tendon
Medialview
Calcaneal(Achilles)
tendon
T i b i a l i sa n t e r i o rt e n d o n a n d s h e a t h
4{tr Tibia
S h e a t ho f t i b i a l i so o s t e r i o rt endo
T e n d i n o u ss h e a t ho f
flexor digitorum longus
Superiorextensor Posteriortibialartery
and tibialnerve
Medialmalleolus
and subcutaneous
bursa
lnferior extensorretinaculum Tendinous sheathof
f l e x o rh a l l u c ilso n g u s
Tibialisoosteriortendon and sheat
Tibialisanterior tendon and sheath Subcutaneous

bursa
calcaneal
T e n d i n o u ss h e a t h
o f e x t e n s o rh a l l u c i sl o n e u
( S u b t e n d i n o ubsu)r s a
of calcaneal tendon
F l e x or e t i n a c u l u m
Calcaneus
Lateralplantarnerve
Abductorhallucismuscle(cut)
M e d i a lp l a n t a r
1st metatarsal Plantaraponeurosis(cut)
Tendinoussheathof
Tendinoussheathof flexor hallucislongui flexor digitorum Flexordigitorumbrevismuscle(cut)
Ankle and Foot Pfate 529

Muscles of Dorsum of Foot: Superficial Dissection
Superficialfibular (peroneal)nerve (cut) Tibialisanterior tendon
F i b u l a r i s( p e r o n e u s b) r e v i sm u s c l e A n t e r l o rt i b i a la r t e r ya n d
d e e p f i b u l a r( p e r o n e a l n ) erve
Fibularis(peroneus)longus tendon---]
Tibia
Extensordigitorum
l o n g u sm u s c l ea n d t e n d o n E x t e n s o hr a l l u c i sl o n g u st e n d o n
S u p e r i o re x t e n s o r e t i n a c u r u m T e n d i n o u ss h e a t ho f
extensordigitorum longus
F i b ul a
M e d i a lm a l l e o l u s
Perforatingbranch of
T e n d i n o u ss h e a t ho f
fibular (peroneal)artery
t i b i a l i sa n t e r i o r
L a t e r am
l a l l e o l u sa n d a n t e n o r T e n d i n o u ss h e a t ho f
lateralmalleolarartery e x t e n s o rh a l l u c i sl o n g u s
I n f e r i o re x t e n s o rr e t i n a c u r u m ior medial malleolarartery
Lateraltarsalartery and lateral Dorsalispedis arterv and medial branch

b r a n c ho f d e e p p e r o n e a ln e r v e o f d e e p f i b u l a r( p e r o n e a l )n e r v e
(to musclesof dorsum of foot)
Medial tarsalartery
F i b u l a r i s( p e r o n e u s b
) r e v i st e n d o n
Arcuate artery
Tuberosity
of 5th metatarsal
bone
Deepplantar .l arterypassingbetween
headsof st dorsalinterosseous
F i b u l a r i s( p e r o n e u s t)e r t i u st e n d o n m u s c l et o j o i n d e e pp l a n t aar r c h
E x t e n s odr i g i t o r u mb r e v i sa n d E x t e n s oh
r a l l u c i sl o n e u st e n d o n
e x t e n s o rh a l l u c i sb r e v i sm u s c l e s
Extensorexpansions
E x t e n s odri s i t o r u m
rongus
Lateraldorsal cutaneous Dorsaldieitalbranches

of
n e r v e( c o n t i n u a t i o no f deepfibular(peroneal)
nerve
sural nerve) (cut)
Dorsal metatarsalarteries Dorsal digital branches

o f s u p e r f i c i af li b u l a r
( p e r o n e a l )n e r v e
Dorsaldigitalarteries
D o r s abl r a n c h eosf
properplantardigital
arteriesand nerves
4ffffi
4.t'/
Plate 53O Ankle and Foot

Dorsum of Foot: Deep Dissection
Superficialfibular (peroneal)nerve (cut) Soleum

s uscle
F i b u l a r i s( p e r o n e u s l)o n g u st e n d e n - r u s c l ea n dt e n d o n
F i b u l a r i s( p e r o n e u s b) r e v i s Tibia
m u s c l ea n d t e n d o n
Anterior tibial artery and
E x t e n s o dr i g i t o r u ml o n g u s d e e pf i b u l a (r p e r o n e anl )e r v e
m u s c l ea n d t e n d o n-
E x t e n s ohra l l u c ilso n g u s
hrbula m u s c l ea n dt e n d o n
Perforatingbranch of A n t e r i o rm e d i a lm a l l e o l a a
r rtery
fibular (peroneal)artery
M e d i a lm a l l e o l u s
Anterior lateralmalleolarartery
Dorsalispedis artery
Lateral
M e d i a l b r a n c ho f d e e p f i b u l a r
Lateralbranch of deep peroneal (peronealn ) erve
n e r v e( t o m u s c l e so f d o r s u m
of foot) and lateraltarsalartery
Medial tarsalarteries
Fibularis(peroneus)longustendon (cut)---_.-
Tuberosityof navicularbone
Extensordigitorum brevis and extensor l'
hallucis breiris muscles (cut)-----------< Arcuate artery
F i b u l a r i(sp e r o n e u sb)r e v i st e n d o n( c u 0 - 1 Posteriorperforatingbranches

from deep plantar arch
F i b u l a r (i sp e r o n e u s ) f ,.
tertiustendon (cut) Deep plantar artery
to deep plantar arch
A b d u c t o dr i g i t i m i n i m i m u s c l e
A b d u c t o hr a l l u c im
s uscle
Dorsalmetatarsalarteries
E x t e n s o hr a l l u c i sl o n q u st e n d o n
Metatarsalbones
E x t e n s o hr a l l u c i sb r e v i st e n d o n
D o r s a li n t e r o s s e o um
s uscles (cut)
Lateraldorsal cutaneous Extensordigitorum brevis

n e r v e( c o n t i n u a t i o no f t e n d o n s( c u t )
sural nerve) (cut)
E x t e n s o dr i g i t o r u m
Anterior perforating branches l o n g u st e n d o n s( c u t )
from plantar metatarsalarteries
E x t e n s oer x p a n s i o n s
Dorsal digital arteries
Dorsal digital branchesof
D o r s a lb r a n c h e so f d e e p f i b u l a r( p e r o n e a l n
) erve
p r o p e r p l a n t a rd i g i t a l
arteriesand nerves
Dorsal digital branches
of superficialfibular
( p e r o n e a l )n e r v e
Nr
Sole of Foot: Superficial Dissection
Superficial
transverse
metatarsal
ligaments
Properplantardigital
arteriesand nerves
Superficial
branchof
medialplantarartery
Transversefasciculi
Digitalslipsof
plantaraponeurosis
Medial olantarfascia
Lateralolantarfascia
Cutaneous branches
of lateralplantar
artery and nerve
Cutaneous branchesof medial

plantararteryand nerve
Plantaraponeurosis
Lateralbandof plantaraponeurosis
(calcaneometatarsal
ligament)
Medial calcanealbranchesof tibial

nerve and posteriortibial artery
Tuberosityof calcaneus
with overlyingfat
pad (partially cut awa
4{F

Muscles of Sole of Foot: First Layer
Proper plantar digital branches

o f m e d i a lo l a n t a rn e r v e
Properplantardigitalbranches
of lateralolantarnerve
plantar digital arteries
plantar digital arteries

from plantar metatarsalarteries
L u m b r i c am
l uscles
F i b r o ussh e a t h s
Superficialbranch o{
of flexortendons
medial plantarartery
Lateralhead
Flexordigitorum brevis and
overlying Medial head
F l e x o rd i g i t o r u ml o n g u st e n d o n s of flexor hallucis
brevis muscle
F l e x o rh a l l u c i sl o n g u st e n d o n
Plantarmetatarsal branchof
lateralplantarartery
Abductorhallucismuscle
andtendon
F l e x o rd i e i t im i n i m i b r e v i sm u s c l e
Flexordigitorumbrevismuscle
Abductordigiti minimi muscle

(deepto lateralplantarfascia)
Plantaraponeurosis(cut)
Medial process
ano
Lateralprocess Medial calcanealbranchesof tibial
of nerve and posteriortibial artery
Tuberosity
of calcaneus
4{tr

Muscles of Sole of Foot: Second Layer
Proper plantar digital branches

of medial plantar ner
Flexordigitorumlongustendons
of lateralplantarnerve Flexordigitorum brevis tendons
Fibroussheaths(opened)
C o m m o n p l a n t a rd i g i t a l
nervesand arteries
Lumbrical muscles
Lateralhead
ano
Medial head of
F l e x o rd i g i t i m i n i m i flexorhallucisbrevismuscre
brevis muscle
Flexorhallucislongustendon
Superficialbranch Abductorhallucistendon
and and muscle(cut)
Deepbranch
of lateral Flexordigitorumlongustendon
plantarnerve
and deep branches

Lateralplantar nerve and a of medial plantar artery
Medial plantarartery and nerve

Quadratusplantaemuscle
T i b i a l i so o s t e r i o rt e n d o n
i u s c l e( c u r )
A b d u c t o dr i g i t im i n i m m
F l e x ohr a l l u c ilso n g u st e n d o n
N e r v e t o a b d u c t o rd i g i t i m i n i m i m u s c l e Posteriortibialarteryand
(from lateralplantar nerve) tibialnerve(dividing)
Flexorretinaculum
Flexordigitorum brevis muscle
and plantar aponeurosis(cut)
Abductorhallucismuscle(cut)
Lateralcalcanealnerve and arterv (from Medial calcanealartery and nerve

sural nerve and fibular [peroneal]artery
Tuberosityof calcaneus
Nr
Muscles of Sole of Foot: Third Layer
of medialplantarnerve
P r o p e rp l a n t a rd i g i t a lb r a n c h e s
of lateralplantar nerve
Proper plantar digital branch

of superficialbranch
of medial plantar artery
Anterior perforating arteries

to dorsal metatarsalarteries
Tendonsof lumbricalmuscles(cut)
Flexordigitorum Transversehead
l o n g u st e n d o n s and
Obliqueheadof
Flexordigitorum adductorhallucismuscle
brevistendons (cut
head
and
Flexordigiti minimi
Lateral head of
brevismuscle
flexor hallucis brevis muscle
Plantarmetatarsal
arteries Superficialbranchesof medial
plantar artery and nerve
Plantarinterosseous
muscles
Flexorhallucislongustendon (cut)
lateralplantar nerv Abductor hallucismuscle (cut)
Deep plantar arterialarch and Deep branchesof media

deep branchesof lateralplantar nerve plantarartery and nerve
Tuberosityof 5th metatarsalbone Flexordigitorum longus tendon (cut)
Peroneusbrevistendon Tibialisposteriortendon
Peroneuslongustendon Medial plantar artery and nerve

andfibroussheath
F l e x o rh a l l u c i sl o n g u st e n d o n
Q u a d r a t u sp l a n t a em u s c l e
(cut and slightly retracted) Flexorretinaculum
L a t e r a pl l a n t a ra r t e r ya n d n e r v e Abductorhallucismuscle(cut)
A b d u c t o r d i g i t i m i n i m i m u s c l e( c u t Flexordigitorum brevis muscle

a n d p l a n t a ra p o n e u r o s i s( c u t )
Lateralcalcanealartery and
edial calcanealartery and nerve
Tuberosity
of calcaneus

lnterosseous Muscles and Deep Arteries of Foot
Dorsalview
N a v i c u l a rb o n e
Dorsalispedisartery
Fibularis (peroneusl-./ Medial tarsalartery
l o n g u st e n d o n\ c u t ) / , /
Lateral l
['3ii:1:lt:'f
i::,i/) bones
I n t e r m e d i a tIe C u n e i f o r m
Medial )
Cuboidbone
Dorsaltarsometatarsalligaments
Lateraltarsalartery
Tuberosityof 5th metatarsalbone Dorsal metatarsalligaments
F i b u l a r i s( p e r o n e u s ) Arcuateartery
tertiustendon (cut)
D e e p p l a n t a ra r l e r yp a s s e st o
Posteriorperforating branches contribute to deep plantar arch
(from deep plantar arterialarch
Dorsal metatarsalarteries muscles

interosseous
E x t e n s o dr i g i t o r u m Metatarsalbones
longus tendons (cut)
E x t e n s o hr a l l u c i sl o n g u st e n d o n
E x t e n s o er x p a n s i o n s
A n t e r i o rp e r f o r a t i n gb r a n c h e s
(from plantar metatarsalarteries)
D o r s a ld i g i t a la r t e r i e s
F l e x o rh a l l u c i sl o n g u st e n d o n ( c u t )
Plantarview
A n t e r i o rp e r f o r a t i n gb r a n c h e s
Proper plantar digital arteries (to dorsal metatarsalarteries)
C o m m o n p l a n t a rd i g i t a la r t e r i e s
l n s e r t i o no f a d d u c t o rh a l l u c i s
L u m b r i c aml u s c l e(sc u t ) and laterah l e a d o f f l e x o rh a l l u c i s
brevis muscles(cut)
Deep transversemetatarsalligament
a n d p l a n t a rl i g a m e n t s( p l a t e s ) l n s e r t i o no f a b d u c t o rh a l l u c i s
a n d m e d i a lh e a d o f f l e x o rh a l l u c i s
musclesI Plantar
Interosseous b r e v i sm u s c l e s( c u t )
I Dorsal. M e d i a l o r i g i no f f l e x o rh a l l u c i s
A b d u c t o r d i g i t i m i n i m i m u s c l e s( c u t ) brevis muscle (cut)
Deep plantarartery (from dorsalis
Plantarmetatarsalarteries pedis artery)
F l e x o rd i g i t i m i n l m i b r e v i sm u s c l e Posteriorperforatingbranches
(to dorsal metatarsalarteries)
Deep plantar arch
Plantarmetatarsalligaments(between
Lateralplantarartery (cut) basesof metatarsalbones)
T u b e r o s i t yo f 5 t h m e t a l a r s abl o n e M e d i a lc u n e i f o r mb o n e
Tibialisanteriortendon (cut)
F i b u l a r i s( p e r o n e u s l)o n g u st e n d o n
L a t e r a ol r i g i no f f l e x o rh a l l u c i s
F i b u l a r i s( p e r o n e u s b) r e v i st e n d o n ( c u t ) brevis tendon (cut)
T u b e r o s i t yo f c u b o i d b o n e Tuberosityof navicularbone
T i b i a l i sp o s t e r i o rt e n d o n ( c u t )
L o n g p l a n t a rl i g a m e n
P l a n t a rc a l c a n e o n a v i c u l a r
C a l c a n e o c u b o i d( s h o r tp l a n t a r )l i g a m e n l ( s p r i n g )l i g a m e n t

Interosseous Muscles of Foot
Dorsalview
Navicular
Tuberosity
of 5th metatarsal
bone
ateral
Dorsalinterosseousmuscles
(bipennate)
5th metatarsalbone
1stmetatarsal
bone
Proximalphalanx
Little
(srh) Middlephalanx
toe
Distalphalanx
Proximalphalanxof greattoe
Distalphalanxof greattoe
Distalphalanxof greattoe
Plantarview
Proximalphalanxof greattoe
Distal phalanx
Little Sesamoid
bones
(sth) Middlephalanx
toe
Proximalphalanx
1stmetatarsal
bone
Plantarinterosseous
muscles
(unipennate)
5th metatarsal
Tuberosity
of 5th metatarsal
bone
Navicular
4{tr
Ankle and Foot Pfate 537
Femoral Nerve and Lateral Femoral Gutaneous Nerve
T12
lateral femoral cutaneousnerve (12, 3)
Femoralnerve (12, 3, 4)
Obturatornerve
'Lumbosacral
trunk
l l i a c u sm u s c l e
Psoasmajormuscle(lowerpart
Articularbranch
Sartoriusmuscle
(cutand reflected)
Lateralfemoral
Pectineus
muscle cutaneouS nerve
Rectusfemoris Anteriorcutaneous
muscle (cut branches of
and reflected) femoralnerve
Quadriceps Vastus Sartoriusmuscle

femoris intermedius
muscle kut and reflected)
Vastus
medialismuscle
Vastus nerve
Saphenous
lateralismuscle
genusmuscle
Articularis
branch
nfrapatellar
nerve
of saphenous
Medialcruralcutaneous
nerves(branchesof
Note:Only muscles saphenousnerve)
innervated
by femoral
nervesnown
Cutaneous
innervation
4{tr
Plate 538 Neurovaseulature
Obturator Nerve
l l i o h y p o g a s t r inc e r v e
l l i o i n g u i n anl" r r . - F
C e n i t o f e m o r a nl e r v e z Lumbosacra
L a t e r afl e m o r a l
Femoran
l erve " r*
r|F
O b t u r a t oer x t e r n um
s uscre
Obturatornerve
( L 2 , 3 ,4 ) $,i1";r
P o s t e r i ob
r ranch
A r t i c u l a rb r a n c
A d d u c t o rb r e v i sm u s c l e
A n t e r i o rb r a n c h A d d u c t o r l o n g u sm u s c l e( c u t )

( i s c h i o c o n d y l aor ,r 3
P o s t e r i ob
rr =
" h a m s t r i n g s ,p" a r t s u p p l i e d
b y s c i a t i cI t i b i a l ]n e r v e ) ,.
:::i
C u t a n e o u sb r a n c h C r a <i l i sm u s c l e
A r t i c u l a rb r a n c h
t o k n e ej o i n t
A d d u c t o rh i a t u s
N o t e :O n l y m u s c l e s
i n n e r v a t e db y o b t u r a t o r
nerve snown
r, ij Cutaneous
innervation
4{tr
Sciatic Nerve and Posterior Femoral Gutaneous Nerve
Posteriorfemoral
cutaneousnerve
(s1,2, 3)
Inferiorclunialnerves
S c i a t i cn e r v e( 1 4 ,5 , 5 1 , 2 , 3 )
Perineal
branches
' C o m m o nf i b u l a (r p e r o n e a l )
*tY
ilDtatotvtston
of sciaticnerve divisionof sciaticnerve
Long head (cut) of

Shortheadof
biceps femoris muscle
biceosfemorismuscle
Cutaneousi n n e r v a t i o n
Adductor magnus muscle

(also partiallysupplied Long head (cut)
by obturator nerve) of biceps femoris
muscle
Semitendinosusmuscle
Commonfibular
s uscle (peroneal)nerve
Tibial nerve
Articular
branch
Articular branch
Plantarismuscle
M e d i a ls u r a l
cutaneous nerve Sural
communicating
branch
Castrocnemiusmuscle (peroneal) nerve
via lateralsural
cutaneous nerve
S u r anl e r v e
Medialsural
cutaneousnerve
Soleum
s uscle From sciatic
nerve Superficial
fibular
(peroneal)nerve
Tibialnerve
Suralnerve
Lateralcalcaneal Tibial nerve

Medial branches via medial
calcanealbranches calcaneal
branches
Lateraldorsal
Medial and lateral cutaneousnerve
plantarnerves
Plate 54O Neurovasculature

Tibial Nerve
) erve
Tibialnerve
(L4,5,51,2,31 Articular branch
nerve(cut)
Lateralsuralcutaneous
4{F
M e d i a sl u r a l
cutaneousnerve Medial calcaneal
branches
(s1,2)
Articularbranch Medial
From
plantar nerve
tibial nerve
(14, 5)
Plantaris
muscle Lateral
plantar nerve
(s1,2)
Gastrocnemius
muscle(cut) Saphenousnerve
(L3,4)
Suralnerve
Nerveto popliteusmuscle (S1,2)via
lateralcalcaneal
and lateraldorsal
P o p l i t e um
s uscle cutaneous
branches
Interosseousnerve ot Cutaneousinnervationof sole
Flexor Lateralcalcaneal
Soleusmuscle(cut retinaculum
branch of sural nerve
partly retracted)
Lateralplantar
Tibial nerve
nerve
Flexordigi Nerveto abductor
Medial
longusmuscle digitiminimimuscle
calcaneal
Dranc Quadratusplantae
Medialplantar muscleand nerve
Tibialisposterior nerve Abductor digiti
Flexordigitorum minimimuscle
brevis muscle Deepbranch
Flexorhallucis and nerve
l o n g u sm u s c l e to interosseous
A b d u c t o hr a l l u c i s muscles,
m u s c l ea n dn e r v e 2 n d , 3 r da, n d4 t h
lumbricalmuscles
Suralnerve ( Flexorhallucis and
brevismuscle Adductorhallucis
ano nerve muscle
Lateralcalcanealbranch 1 s tl u m b r i c a l
m u s c l ea n d
l]IV-
branch to
,l
4th interosseous
Medial Common { muscle
plantar ano
calcaneal
branch
digital F l e x odr i g i t im i n i m i
ner brevismuscle
Proper Common and
Flexorretinaculum(cut) plantar plantar
digital
nerves
Note: Articular branchesnot shown

Gommon Fibular (Peroneall Nerve
Lateralsuralcutaneousnerve (phantom)
Commonfibular
(peroneal)
nerve
*{r
(phantom)
Articularbranches
Bicepsfemoris tendon
Recurrent
articularnerve
Commonfibular(peroneal)
nerve(L4,5,51,2')
digitorumlongusmuscle(cut)
Extensor
Headof fibula
Deep fibular (peroneal)nerve
(peroneus)
Fibularis
longusmuscle(cut) Tibialisanteriormuscle
Superficialfibular Cutaneousinnervation
(peroneal)nerve
Branches of lateral Extensor

digitorum
suralcutaneous longusmuscle
Fibularis (peroneus)
l o n g u sm u s c l e xtensorhallucis
F i b u l a r i(sp e r o n e u s )
brevismuscle
Medial dorsal cutaneousnerve Superficial

fibular
(peroneal)nerve
Lateralbranchof
deepfibular
(peroneal)nerveto
Extensorhallucisbrevis
and
Inferiorextensor tensordisitorumbrevis
muscles Deep
retinaculum (partiallycut\ fibular
(peroneal)
Medialbranchof Dl'V r
deepfibular
Lateraldorsal cutaneous nerve (peroneal)
nerve
(branch of sural nerve)
Suralnerve
via lateraldorsal
Dorsal digital nerves cutaneousbranch

Dermatomes of Lower Limb
Schematic
demarcationof
dermatomes
(accordingto
Keeganand
Carrett)shownas
distinctsegments.
Thereis actually
considerable Autonomous
overlap between sensoryzones
any two adjacent
dermatomes.An
alternative
dermatomemap
is that provided
by Foerster(see
References).
Segmentalinnervation
of lower limb movements
I
*,,
Dorsiflexion
r
5 1' 2 $r
Plantarflexion
J{eurovasculaturc PHo 543

Superficial Nerves and Veins of Lower Limb: Anterior View
Lateralcutaneous
b r a n c ho f s u b c o s t anl e r v e
Superficialepigastricvein
I n g u i n a l i g a m e n t( P o u p a r t ' s
l l i o i n g u i n anl e r v e ( s c r o t a b
l r a n c h )( u s u a l l y
p a s s e st h r o u g hs u p e r f i c i ai ln g u i n a lr i n g )
S u p e r f i c i acl i r c u m f l e xi l i a cv e i n
Cenital branch of genitofemoralnerve
Femoralbranches
of genitofemoral
Femoralvein
Lateralfemoral cutaneous
uperficialexternalpudendal vein
S a p h e n o u so p e n i n g( f o s s ao v a l i s )
Accessorvsaphenousvein
Fascialata
C r e a t s a o h e n o u sv e i n
A n t e r i o rc u t a n e o u s
branchesof femoral nerve
C u t a n e o u sb r a n c h e so f o b t u r a t o rn e r v e
Patellarnerve plexus Infrapatellarbranch of saphenousnerve
S a o h e n o u sn e r v e ( t e r m i n a b
l ranch
of femoral nerve)
B r a n c h e so f l a t e r a sl u r a lc u t a n e o u sn e r v e
( f r o m c o m m o n f i b u l a r[ p e r o n e a l ]n e r v e )
C r e a t s a p h e n o u sv e i n
Deep fasciaof leg
(cruralfascia)
S u p e r f i c i af li b u l a r( p e r o n e a l )n e r v e
M e d i a ld o r s a l
c u t a n e o u sb r a n c h
I n t e r m e d i a t ed o r s a l
c u t a n e o u sb r a n c h
S m a l ls a p h e n o u sv e i n a n d l a t e r a l
d o r s a lc u t a n e o u sn e r v e ( f r o m s u r a ln e r v e )
D o r s a ld i g i t a ln e r v e s Nry
Dorsal venous arch
Lateraldorsal digital nerve
and veinof 5th t
D o r s a ld i g i t a ln e r v ea n d v e i n o f m e d i a ls i d eo f g r e a tt o e
Dorsal metatarsalveins
Dorsal digital branch of deep fibular (peroneal)nerve

Dorsal dieital nervesand verns

Superficial Nerves and Veins of Lower Limb: Posterior View
Lateralcutaneousbranch
nerve
of iliohypogastric
lliaccrest
Medial clunial nerves(from
d o r s arl a m io f 5 1 , 2 , 3 ) Superiorclunialnerves(from
d o r s arl a m io f L l , 2 , 3 )
Inferiorclunialnerves(from
posteriorfemoralcutaneous nerve)
Perforatingcutaneousnerve
(from dorsal rami of S1,2, 3)
Branchesof posterior
femoral cutaneousnerve
A c c e s s o r ys a p h e n o u sv e i n
Branch of cutaneous Terminalbranchesof posterior

branch of femoral nerve femoral cutaneousnerve
Great saohenousvein Lateralsuralcutaneous nerve (from

c o m m o n f i b u l a rI p e r o n e a l ]n e r v e )
S m a lsl a p h e n o uvse t n
Suralcommunicating nerve
Branchesof saphenousner
Medial suralcutaneousnerve (from tibial nerve)
S u r a ln e r v e
Lateralcalcanealbranchesof suralnerve
Lateraldorsal cutaneousnerve
Medial calcanealbranchesof tibial nerve (continuationof sural nerve)
P l a n t a rc u t a n e o u sb r a n c h e s
of
4{F of medial olantar nerve
Plantarcutaneous branches
lateralolantarnerve

Lymph Vessels and Nodes of Lower Limb
Cribriform
fascia
within
saphenous
openrnS
Small
s a p h e n o uvs
Deep Externaliliac
fascia lymph nodes
of leg
(crural
fascia)
Femoralnerve
Femoralring
Creat
s a p h e n o u sv e i n lnguinal ligament
(Poupart's) Lacunar
ligament
(Cimbernat's)
Ductus(vas)deferens
Femoral
sheath
Femoralcan
(opened)
Femoralartery
and vein
Creat saphenousvein Deep inguinal

lymph nodes
Plate 546 Neurovasculatune

GT Angiograms of Arteries of the Lower Limb

I Gross-Sectional Anatomy
Section
Plate 548
s+e KeyFigure Sections

forCross

Key Figure for Gross Sections
Gross-Sectional Anatomy Plate 548
References
Plate 58 Plates 2911 292

Braus H. Anatomiedes Menschen.Berlin,Verlagvon Julius EliasH. Livermorphology.Biol Rev 1955;30:263.
Springer,1924.
_. Origin and early developmentof the liver in variousver-
Plate 89 tebrates.Act Hepat 1955;3:1.
NishidaS. The Structureof the Eye. New York, ElsevierNorth-
Holland,'1982. _. Morphology of the liver. In Liver Injury Trans 11th
Conference.New York, Macy Foundation,1953.
Pfates I16, 1 17, 127
LachmanN, Acland RD, Rosse C. Anatomicalevidencefor the _. A re-examinationof the structureof the mammalianliver:
absence of morphologicallydistinct cranial root of the acces- the hepatic lobuleand its relationto the vascularand biliarysys-
sory nervein man.ClinAnat 2O02:15:4. tem. Am J Anat 1949;85:379.
Plates 164, 482, 525, 543 _. A re-examinationof the structureof the mammalianliver:
parenchymalarchitecture.Am J Anat '1949;84:311.
FoersterO. The dermatomesin man. Brain 1933;56:'l.
Garrett FD. The segmentaldistributionof the cutaneousnerves Plates 3O5, 3O8

in the limbsof man.Anat Rec 1948;1O2:4O9. Michels NA. Blood Supply and Anatomy of the Upper
Abdominal Organs, With a DescriptiveAtlas. Philadelphia,JB
Keegan JJ. Dermatomehypalgesiawith posterolateralhernia- Lippincott,1955.
tion of lower cervical intervertebraldisc. J Neurosurg 1947;
4 : 11 5 . Plate 326
Thomas MD. In The Ciba Collectionof Medical lllustrations,Vol
Plale 172 3, Part ll. Summit,NJ, CIBA,p 78.
Turnball lM. Bloody supply of the spinal cord. In Vinken pJ,
Bruyn GW (eds): Handbook of Clinical Neurology, Xll. P l a t e s 3 4 8 , 3 6 1 , 3 8 4 , 3 9 6 , 4 1 4
Amsterdam,North-Holland StormontTJ, Cahill DR, King BF,Myers RP.Fasciasof the male
, 1912,pp 47849i.
externalgenitaliaand perineum.ClinAnat 1994;7:115.
Plates 2OO,2O1
Jackson CL, Huber JF. Correlated applied anatomy of the Plates 356, 360,365, 37O,378, 379
bronchialtree and lungs with a system of nomenclature.Dis OelrichTM. The striated urogenitalsphinctermuscle in the fe-
C h e s t1 9 4 3 ; 9 : 3 1 9 . male.Anat Rec 1983;205:223.
Plate 2O3 Plates 359, 361

lkeda S, Ono Y MiyazawaS, et al. Flexiblebroncho-fiberscope. Myers RP,GoellnerJR, Cahill DR. Prostateshape, externalstri-
Otolaryngofogy(-fokyo)197O; 42:855. ated urethralsphincter and radical prostatectomy:the apical
dissection.J Urol 1987:138:543.
Plale 225
James TN. The internodalpathwaysof the human heart. prog Plates 359, 361, 383, 384
CardiovasDis 2001;43:495. Oelrich TM. The urethralsphincter muscle in the male. Am J
Anat 1980;158:229.
Plates 253, 366, 37O, 383
MyersRP,King BF,CahillDR. Deepperineal"space,'asdefined Plate 4O3
by mag,neticresonance imaging. Presented at 14th Annual Flocks RH, Kerr HD, ElkinsHB, et al. Treatmentof carcinomaof
prostate by interstitialradiationwith radio-activegold (Au
Scientific Session of the American Associationof Clinical the
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Plate 282 Plate 482

DiDio LJA. Anatomo-Fisiologiado Piloro ileo-ceco-colicano Keegan JJ, Garrett FD. The segmentaldistributionof the cuta-
homen. Actas das Primeiras Jornadas Interuniversitarias neous nerves in the limbsof man.Anat Rec 1948:102:409.
Argentinasde Gastroenterologia, Rosario,1954. Plate 543
-. Dados anatomicos sobre o "piloro" ileo-ceco-colico. KeeganJJ. Neurologicalinterpretationof dermatome hypalge-
(Com observacao direta in vivo de "papila" ileo-ceco-colico.) sia with herniationof the lumbarintervertebraldisc. J Bone Joint
summary]. paulo, Surg 1944; 26:238.
[English Thesis,Fac Med, Univde Sdo 1952.
Plate 29O Last RJ. Innervationof the limbs. J Bone Joint Surg 1949;
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Index
Referencesare to olate numbers.In most Abdominis muscle (Continued) Acromioclavicular ioint' 423, 425
cases,structuresare listed under singular sheathof, 189 caosuleof, 423
nouns. transversus, 25, 94, 96, 179,189,255, Acromioclavicular ligament' 423
257, 258, 263, 267, 329, 498 Acromion, 27, 185, 188, 418, 42O,423,
A aponeurosiso'f, 252, 330, 349 424, 425, 427, 429, 432
tendonof originof, 175,176,179 anteroposteriorradiographof , 422
Abdomen,268 Abducent nervc (Vll' 83, 84, 86, 114, Adamkiewicz' arteiy ol, 171
autonomicnervesand gangliaof, 318 1 1 7 .1 1 8 .1 2 1 Adductor brovis muscle' 489, 493,
axial CT imagesof, 350 distribution of, 118 539
bony frameworko1,248 schemaof, 118 attachmentsof, 489, 491
cross sections of Abducent nucleus, 116, 1 17, 121 Adductor Ganal' 500
at L3, 349 Abductor digiti minimi muscle' 465, Adductor hallucis muscle' 541
at L3, 4, 349 470,476,533,534,536,541 deep tibial nerve branch to, 541
at L1-L2, 339 nerveto, 534 insertionof, 536
at T10,293 tendon of, 533 obliquehead of, 535
atr12,297,331,338 Abductor hallucis muscle, 533, 534, transversehead of, 535
innervationof, 318 535, 541 Adductor hiatus' 539
left lower quadrant of, 268 insertionot, 534, 536 femoral artery passing through, 512
left upper quadrantof, 268 Abductor hallucis newe' 541 Adductor longue muscler 376,489,
regionsand planesof, 268 Abductot pollicis brevis muscle' 492,493,500, 505, 539
right lower quadrantof, 268 4 6 1 ,4 6 5 attachmentsof, 489, 491
right upper quadrantof, 268 Abductor pollicis longus muscle, innervationof, 540
subcutaneoustissue of, 249 441,444,449,451 transversesection of, 521
surface anatomy ot,247 area for, 439 Adductot magnus muscle' 485,489'
visceraof, 269 Abductor pollicis longus tendon' 495, 500, 502, 505, 540
Abdominal aortic plexus. See 444.469.470 adductor minimuspart of, 493
lntermesentericolexus Aberrant ductule' 390 attachmentsof, 489, 491
Abdominalis muscle, ttansyetsust Accessory muscle bundle, 67 hiatusof, 493
362 Accessory nerve (Xll' 34,114,116, innervationof, 540
Abdominal muscles, transversus, 1 1 7 ,1 2 9 , 1 7 7 tendon of, 493
363 cranialroot ot, 126, 127 Adductor magnus tendonr 501,506,
aooneurosisof, 252 s c h e m ao l , 1 1 8 , 1 2 7 510,511
Abdominal wall soinalnucleusof, 116, 117 Adductot muscles' thigh' 496
anterior,249,265 spinalroots ot, 10, 118,127 Adductor pollicis muscle' 462, 465'
arteries of, 255 Accessory oculomotor nucleust 476, 535
deeo dissectionof, 251 116,117,121,132 fasciaover, 460,462
intermediatedissectionof, 250 Acetabular fossa' 376, 487 Adductot tubercle' 489
internalview of, 253 lal in, 487 Adenohypophysis, 140, 147, 148
nerves of, 257 transversesection of, 376 cletl ot, 147
superficialdissectionof, 249 Acetabular labrum' 352, 487 Adnexa,371
veins of, 255 Acetabular ligamentr transvetset Afferent fibers, ollaclory bulb' 119
arteries of, 263 352,487 Affetent nerves
internalview of, 263 Acetabular notch, 352, 486 of mouth and pharynx,62
lymph vesselsand nodes of, 266 Acetabulumt 352,486 of nose and sinuses,210
nervesof, 267 anteroposteriorradiograph of , 488 of stomachand duodenum,321
peritoneumof, 274 articularsurfaceof, 376 Agger nasir 37, 38
veins of, 265 lunatesurfaceof, 486 Aglomerular a?teriol' 337
median(sagittal)sectionof, 348 marginof, 352, 353, 486 Air, in colon' radiograPh of' 355
posterior radiograph of, 355 Air cells, mastoidr axial llR image
arteriesof, 264 Achilles tendon. See Calcaneal of' 150
internalview of, 263 (Achilles)tendon Airway
lymph vesselsand nodes of, 266 Acinus,204 intrapulmonary, 204
nervesof, 267 Acoustic attety' internal. See to nasopharynx,37
peritoneum of, 274 Labyrinthineartery Airway reflexes, newes initiating'
veins of, 265 Acoustic meatus 210
posterolateral,254 external,8, 13, 92, 93 Ala,8
Abdominis aponeurosis, transver. auricularbranchof vagus nerveto, 24 lateralpart of, 157
sus, 252, 330, 349 axialCT imagesof, 150 wing of, 157
Abdominis muscle axial MR imageof, 150 Alar fibrolatty tissuer 36,38
aponeurosisof, 255, 330 cartilaginousand osseous,93 Alar fold, 507
rectus,181,188, 189, 192,247, 250, coronalobliquesectionof, 93 Alar ligament, 22
251, 258, 259, 293, 349, 351, 378 internal,92,97, 123 Albini's nodules. See Fibrous(Albini's)
axial CT imageof, 350 Acoustic openingr internal' 97 nodule
capsularbranchof, 335 Acromial anastomosis' 427 Alcock's canal. See Pudendalcanal
cross sectionof, 252 Acromial angle' 420, 421 (Alcock's)
oelvic branchof, 335 Acromiaf glexusr 427

Alveolat artery Anastomosis (Continued) Aorta, 207, 263, 324, 330, 342
anteriorsuperior,40 between septal sphenopalatineartery abdominal,27, 179, 195, 207, 225, 232,
inferior,40, 53, 60 and greater palatine arlery, 41, 270, 273,274,278, 298, 300,301,
lingualbranchof, 69 138 324,327,329,330, 331,332, 339,
mentalbranch of, 40, 69 subclavian-carotid, 138 341, 342, 363, 369, 398, 400, 401,
middlesuperior,40 subclavian-vertebral, 138 403.412
posteriorsuperior,40, 69 Anastomotic branch, 3Ol cross sectionof, 338
Alveolar duct, 204 Anastomotic loop abdominal,412
openingof, 204 of ilealarteries,280 a r c ho f , 2 3 7 , 2 4 4
Afveolar nerve, 53, 55,122,131,134 of jejunalarteries,280 ascending,138, 215, 22O,223,224,225,
anteriorsuperior,45 of posteriorspinalarteries,171 242,245
nasalbranchof, 42 of small intestinalveins,310 axjal CT imagesof, 242,350
inferior,16, 40, 53, 55, 60, 131, 134 of small intestine,306 descending,237, 242, 245, 246
branchof, 40 Anastomotic vein thoracic,194,242
enteringmandibularforamen,46 inferior,102, 145 prenatal,229
middlesuperior,45 superior,102 thoracic,172,297
posteriorsuperior,44, 45 Anatomical snuffbox, 444 cross section of. 297
superior,62, 71 radial artery to, 469, 470 descending,172, 231, 241
Afveolar sac,2O4 Anconeus muscle, 432, 444, 445, 477 esophagealbranchesof, 237
Alveolar vein nerveto. 432 ureteric branch from, 341
inferior.60. 70 originof, 421 Aortic arch. See Arch of aorta
posteriorsuperior,60, 70 Angular artery, 23, 36, 68, 85, 138 Aortic hiatus, 195
Alveolus, 204 Angular gyrus, 105 Aortic lymph node, lateral, 266,343,
capillarybed in, 205 cerebralarteryto, 141 406
Amacrine cells, 120 cerebralbranchesto, 141, 142 Aortic lymph nodes,266
Ampulla Angulal vein,23,70,85 Aortic nerve,228
ear,95, 96 Ankle Aorticorenal ganglion, 165, 167, 267,
semicircular,92 dorsiflexionand plantarflexionof, 543 318, 320, 321,322,324,344,345,
of uterinetube, 372 lateralligamentof, 514 346. 409
Amygdaloid body, 110,112, 119 ligamentsand tendonsof,514 celiac.267
thalamusand, 110 ligamentsof, 527 left, 318, 320, 323, 41O,415
Anal canal,393 medialligamentof, 514 right,318, 320,323
anatomical,393 radiographof, 526 superiormesenteric,267
arteries of, 398 tendonsof, 527 Aortic pfexus, 321, 322, 412
beginningof, 376 Annular ligament Aortic sinus,223,224
beginningof, transversesectionof, 357, of radius,438 Aortic valve
521 of trachea,202 anatomy ot,223
longitudinalmuscleof, 356, 357 Anococcygeal body, 380, 381, 395, semilunarcusps of, 221, 222, 223, 224,
muscularismucosaeof, 393, 394 396 225
sagittalMR imagesof, 397 Anococcygeal neiYe, 411, 412,499 left,224
surgical,393 Anocutaneous line, 392, 393, 394 Apical foramen, 53
veins of, 399 Anoderm,393 Apical ligament, of dens, 63,65
Anal columns,393 Anorcctal hiatus, 358 Appendicular artery, 281, 306, 307,
Anal glands,393 Anorectal junction, circular muscle 322,323
Anal nerve, inferior, 41O,411, 414, layer of, 359 Appendicular nodes, 317
496, 503 Anorectal line, 393 Appendicular plexus, 322, 323
Anal pit, 388 Anorectal musculature, 394 Appendicular Yein, 311, 312
Anal sinus, 393 Ansa cervicalis, 31, 32,128, 129 Appendir, 126
Anal sphincter muscle inferiorroot ot, 32, 34, 71, 74, 128, 129 fibrous,287
external,356, 358, 360, 365 superiorroot of, 32, 34, 71, 74, 128, 129 vermiform,271, 281, 283, 284, 362, 363
deep part of, 394, 395, 396 ventralrami of, 128 aggregatelymphoidnodulesot, 283
peripheralview of, 395 Ansa of Galen, 80 barium radiographof, 283
subcutaneousof, 391, 393, 395, 396 Ansa subcfavia, 130, 2O9,226, 24O circularmuscleof, 283
superficialpart of, 391, 393, 394, 395 Anserine bursa, 506, 507 fixed retrocecal,283
internal,393, 394 Antebrachial vein oritice o1,282
Anal triangle, 380 intermediate.418.479 serosa of, 283
Anal tubercle, 388 median,449 submucosaof. 283
Anal valve, 393 Anterior chamber, 81, 87, 88, 89, 90 variationsin positionof, 283
Anal verge, 393 endotheliumof, 88 Arachnoid, 102,109
Anastomosis Anterolateral central arteries, 140, cerebralveins penetrating,102
aroundelbow,434 141 Arachnoid-dura interface, 102
aroundscapula,427 Anteromedial central arteries, 140 Arachnoid granulation, 100, 102, 109
carotid-vedebral,138 Antidromic conduction, 167 granular foveola for, 99
gastro-omental arlerial,272 Antihelix, 1, 93 skull indentationfor, 99
in incisivecanal,40 cruraof, 1, 93 Arachnoid mater, 169
obturator-pubicarterial,259 Antitragus, 1, 93 lumbar,170
paravertebral,172 Anulus fibrosus, 19, 155 thoracic,170
patellar,500, 512 Anum, fibrcus septum of,394 Arantius, body olr223
portacaval,312 Anus, 360, 377, 38O,382, 388, 395
right-|eft,138 fetal, 388
transversefibrousseptum of, 393
l-2 Atlas of l{uman Anatomy

Arch of aorla,74, 75, 80, 138, 206, 210, Arteryfiesf (Continued) Atlas lGl) (Continued)
2 1 1 ,2 1 2 ,2 1 3 ,2 14 , 2 1 5 ,2 2 1 ,2 3 2 , of femoralhead and neck, 504 lateralmass of, 17
233 of fingers,471 occipitalcondyleof, 17
groove for, 'l99 of foot, 536 posterior,21
radiographof, 213 of foot, deep, 536 posteriorarch of, 17,18,178
Arcuate artery, 335, 337, 530, 531, 536 of hand, palmarview of, 466 posteriortubercle ot, 17, 175, 176
afferentglomerulararteriolefrom, 337 of head,23 spinousprocessof, 18
lymph vesselsalong,343 of hip and thigh, 500-502 superiorarticularfacet for, 17
Arcuate eminence, 9 of hypothalamusand hypophysis,148 superiorview of, 17
Arcuate ligament intrarenal,335 transverseforamenof, 17
dorsal radialmetaphyseal,455 intrinsicdistributionof, in spinalcord,172 transverseprocessot, 17, 21,30, 39, 176
lateral,195, 263 of largeintestine,307 Atrioventricular bundle' 225
medial,195,263 of liver,301 Atrioventricular node' 22, 218, 225
median,195,263 of liver,pancreas,duodenum,and Atrioventricular valve
Arcuate line, 248, 251, 255,259,279, spleen,301,305 left. See Mitralvalve
348, 352, 353, 356, 486 of liverand gallbladder,variationsin, 305 right.See Tricuspidvalve
sectionabove,252 of male pelvis,403 A|lium,224
sectionbelow,252 of male oerineum,405 internodalconductionpathwaysof, 225
Arcuate nucleusr 147 of mammarygland, 183 left, 214, 215, 220, 221, 224, 246
Arcuate popliteal ligament, 508, 511 to meninges,136 auricleot,212
Arcuate vein,337 of nasal cavity, 41 obliqueveinof, 214, 215, 216
Arcus tendineous fasciae pelvis, of neck, 504 sectionthrough,221
372 of oral and pharyngealregions, 69 right,212, 2'l'3,214, 215, 22O,223, 224,
Areola, 182 of oral region,69 241,246
Areolar gland, 182 of pancreas,301 opened,220
Areolar tissue, 179, 251, 361, 471 of posteriorabdominalwall,264 radiographof, 213
in anteriorclosed space ol tinger,471 of posteriorcranialfossa,142,143 Auditory ossicles, 93
Areolar venous plexus, 256 of rectum and anal canal.398 Auditory {pharyngotymPanic'
Arm. See a/so Forearm renal,335 Eustachianl tube' 92, 93, 96,
arteriesof, 484 of scalp,23 125,126
cutaneousnervesof, 479,481 of spinalcord, 171 cartilageof, 47
inferiorlateral,432,477, 479, 481 of spleen,301 cartilaginouspart of, 52, 55, 64, 65, 67
medial,257, 429, 432, 435,473, 474, of stomach,liver,and spleen,300 groove for, 8
479 of testis,401 openingof, 37
posterior,432, 477, 479, 481 of thigh pharyngealopeningof, 63, 64, 66, 125
superiorlaleral, 432, 477, 478, 479, 481 anteriorview of, 501 Auerbach's plexus. See MYenteric
deep artery of , 429, 432, 433, 434, 435 posterior view of, 502 (Auerbach's)plexus
middlecollateralbranchof, 445 of upper limb, 473 Auricle, 92, 97
musclesof, 432 computedtomographyof, 484 concha of, 93
anteriorviews of, 430 at wrist, 461 teft, 212, 213, 215, 216, 224, 225
deep layer oI,43O,432 Articufar cavatyr 4Tl lobuleof, 93
posterior,432 of finger,471 oosteromedialsurfaceof, 24
posteriorview ot,432 Articular disc, 16, 243 right,93, 212, 214, 219,220, 224
superficiallayerof, 430,432 Articularis genus muscle, 505, 507, Auricular attery
superiorlateral,432 511,538 anterior,23
neurovascularcompartmentof, 435 attachmentof, 489 deep, 40
radial nerve in, 477 Articular newe posterior, 23,34,40,100, 136, 138,178
serialcross sectionof, 435 great, 32 Auricularis antedor muscle' 26
superficialveins of, 480 recurrent,542 Auriculads posterior muscle' 26
Arrctor muscle, hair follicle, 167 Articular pnocess Audcularis supetior muscle' 26
Arteriae rectae, 307 inferior,lumbar,155 Auricular muscler facial nerve
Arteriogram, celiac, 303 superior,lumbar,155 branches to' 123
Arteriole Articular tubercle, 55 Auricular nervet 122
intralobular, 291 Aryepiglottic fold, 66, 67, 78 anterior,122
periportal,291 Aryepiglottic muscle, 78, 80 articular branch ol, 122
portal,291 Aryltenoid muscle great,21, 22,24,32, 129,177,178
Artery(iesl. See a/so specific arteries oblique,67, 78, 79, 80, 235 greater,31
of anteriorabdominalwall, 255 transverse,63, 78, 79, 80, 235 posterior,25, 123
ol atm,484 action of, 79 occipitalbranchof, 123
to brain,136-137,138,1 41, 142 Atlantoaxial ioint, 19 Auricular tubercle (of Darwinl' 93
frontalview of, 141 lateral,19 Auricufar vein, poster-or, 23, 70
lateraland medialviews of, 142 capsuleof, 21 Auriculotemporal nerve, 16, 24, 40,
colic, 308 median,superiorview ot,22 5 5 , 7 1 ,1 2 2 ,1 2 5 ,1 3 4
of duodenumand head of pancreas, radiographof, 17 Auscultation' triangle ol, 152, 246,
301,304 Atlantooccipital joint caps,uae, 21, 22 424
of esophagus,237 Atfas (Gf f, 13, 17, 19,22, 153,160 precordialarea of, 213
of face, 23 anterior,21 Autonomic Aanglion, abdominal'
of femalepelvicorgans,400 anteriorarch of, 5, 17, 19,37,62, 137 318
of femalepelvis,403 anteriortubercleof, 19 Autonomic netves
of femaleperineumand uterus,405 dens of, articularfacet for, 17 of abdomen,318
of femoralhead, 504 inferiorview of, 17 in head,131

Autonomic nerves (Continued) B Bladder-prostate junction, 376
of nasal cavily,44 Blood circulation
to neck, 24 Babinski's sign, 101 intrapulmonary205
in thorax,209 Back postnatal,229
Autonomic neryous system bones and ligamentsof, 153-157 prenatal,229
schemaof, 167 lumbarregion,cross sectionof, 179 Bfood vessels, innervation o1,228
topographyof, 167 musclesof Bonefsf See a/so specific bones
Autonomic plexus, intrinsic, 326 deep layerof, 176 of abdomen,248
Autonomic reflex pathways, 325 axial CT images of, 350 of cranialbase,9
Axilla intermediatelayerof, 175 of elbow,436
dissectionof, 181 superficiallayersof, 174 ol toot,523,524
anteriorview of, 429 nervesof, 177,179 of forearm,439
dissectionof, anteriorview,429 surfaceanatomyof, 152 ot hand,474
musclesof, 424 Bartholin's gland. See Vestibulargland, of head,2-16
obliqueparasagittalsectionof, 428 greater of lowerlimb,513,524
obliqueparasagittalsectionof, 428 Basal nucleus, organization of, 110 of nasal cavity and paranasalcavity, at
suspensoryligamentof, 428 Basaf vein, 144, 145, 146 birth,50
Axillary artery, 183, 189,198,200,2S5, Basifar artery, 140, 1 41, 143, 171 pelvic,352-353
427, 428, 429, 433, 434 axial MR image of, 150 of rightleg,513
acromialbranch of, 434 Basilar membtane, 96 ofthorax,185
anteriorview of, 434 Basilar venous plexus, 103 of wrist. 453. 456
clavicular branch of, 434 Basific vein, 418, 429,449,468,480, Bowel loop, entering hernial sac,
computedtomographyof, 484 483,484 261
deltoid branch of, 434 intermediate,480 Bowman's capsule, 336
pectoralbranchof, 434 Basivertebral vein, 137, 173 Brachial anastomosis, alound
posteriorview of, 434 Biceps brachii muscle, 181, 418, 420, elboq 433
Axillary fold, 181 429, 433, 435, 446, 447,451 Brachiaf artery, 27, 30, 31, 183, 193,
anterior,181 fasciaover,428 198, 206, 211, 230, 427, 429, 447
posterior.181 branchesol,433,434
insertionof, 420
Axif fary fossa, 243,244,245 long head o1,424, 426, 428,433, 435, muscularbranch,433, 434
Axillary lymph nodes, 428 474 cords of , lateral, 428, 433
along axillaryvein, 484 originof, 420 deep,429
apical,184 tendonof, 243,244,245 computedtomographyof, 484
brachial.184 short head ol, 424, 428, 430, 433, 434, in situ, 433, 434
central.184.428 435,474 medial,428, 433
lateral,483 combined,244 posterior,428
along axillaryvein,483 originof, 420 Brachial cutaneous nerye, superiol
parasagittalsection of, 428 tendon of, 425,432,433, 438, 446,447 laletal, 177
pectoral,184,428 long head ot, 423, 425, 430 Brachialis muscle, 420, 429, 430, 433,
subscapular,lS4 short head of, 430 435,446,447,448
Arif fary nerve, 177, 425,427, 429, 432, Biceps femoris muscle, 485, 489, insertionoI,420,438
476, 477. 481 495, 503, 515 originof, 420,421
superiorlateralcutaneousnerveof arm attachmentsof, 489, 515 Brachiaf plexus, 27,30, 31, 32, 129,
trom,479 long headof, 485, 494,495,540 1 6 0 ,1 8 3 ,1 8 9 ,1 9 3 ,1 9 8 , 2 0 6 , 2 1 1 ,
Axillary tecess,423 attachmentsof, 491 228, 230, 231, 232, 428, 429
Axillary tail lof Spence), 182, 183 short head of, 488, 494,495,540 anteriorand posteriordivisionsof, 430
Axillary vein, 189, 198,256,428 attachmentsof, 491 communication to, 129
intercostaltributariesto, 256 tendon of, 506, 511, 514, 517, 520, 542 cords of
lymph nodes along,483 bursa of, 511 lateral,428, 433
Axis (G2f, 13, 17, 19,22, 153 inferiorsubtendinous,506, 507 medial,428
anteriorview of, 153 long head of, 353 posterior,428
b o d y o f ,1 7 , 2 1 Bicipital aponeurosis, 430, 433, 446, medial.428. 433
dens of, 5, 17, 37, 63 480 posterior,428
inferiorarticularprocessof, 17 Bifurcate ligament, 527 roots of, 430
interarticularpaft ol, 17 Bigeloq Y ligament ot, 487,496 schemaof, 430
left lateralview of, 153 Bile canaliculus,292 terminalbranchesof, 430
pedicleof, 17 Bile duct, 126, 29O,291, 292 trunks of, 430
posterosuperiorview of , 17 common, 167, 273, 274, 278, 279, 288, Brachial vein, 429, 435
posteriorarticularfacet of, 17 294, 295, 297, 298, 300, 301, 304 Brachiocephalic trunk, 33, 74, 75, 76,
posteriorlateralview of, 153 cross sectionof, 338 136,193,206, 211,212, 214,232,
posterior tubercle of transverse process hepaticducts joining,290 237,243, 420
of, 30 junctionwith duodenum,295 Brachiocephalic Yein, 74, 208
spinousprocessol, 17, 174, 176 extrahepatic,294 groovefor, 199
transverse process of, 30 union of pancreaticducts and, 295 left,70, 75, 137,206, 211,212, 230,
Azygos vein, 17,21, 153, 194,206,207, Bile ductule, 290 231,243
209, 230, 241, 245, 246, 293, 331, intralobular, 290 right,75, 137,206,21O,211,212, 230,
349 periportal,29O,291, 292 243
arch of, 230,232,244 Biliary tract Brachioradialis muscle, 418, 433,
axial CT imagesof, 242 innervationof, 327 444,446,447
groovefor, 199 intrahepatic,292 originof, 420
Bipolar cells, 120 Brachioradialis tendon, 448, 449
l-4 Atlas of Human Anatomy

Brain, 48 Bronchus (Continued) G3 vertebra (Continued)
arteriesto, 136, 141, 142 major,202 tubercles of transverse process of
frontalviews of, 141 medialbasal,203 anterior,26
inferiorviews of, 139 middle lobar,202,203 posterior,26
lateraland medialviews of, 142 nomenclatureof, 203 C4 vertebra
schemaof, 138 oosteriorbasal.203 anteriortubercleof, 18
coronalsectionof, 108 right body of, 18
deep veinsof, 145 axial CT imagesof, 242 laminaof, 18
sagittalsectionof, in situ, 106 intermediate,206 posteriortubercleof, 18
subependymalveins of, 146 rightmainbranchesof,207,230,245 posterosuperiorview of, 17
ventriclesof, 108 smooth muscleof, 204 G7 vertebra, 13, 153,160
Brainstem superiorlobar,202, 2O3,2OG posterior tubercle of transverse process
anteriorview of, 114 Brunnerts gland. See Duodenalglands of, 30
cranialnervenucleiin, 116, 117 Buccal artery, 40, 69 spinousprocessol, 18, 152, 174,175,
medialdissectionof, 117 Buccal nerve, 24, 40, 46, 62, 71, 122 176,424
posteriorphantomview of, 116 branchesof, 25 superiorview of, 18
schemaof, 117 Buccinator crest, 68 Calcaneal artery
sectioned,107 Buccinator lymph node, 72 lateral.534. 535
Bregma,7 Buccinator muscle, 15, 26, 48, 52, 54, medial,534, 535
Broad ligament, 389 55, 60, 65, 68, 123 Calcaneal nerve
anteriorlaminaot,372 Buccopharyngeal fascia, 60, 63, 65 lateral.534. 535
of femaleureter,340 Buck's fascia. See Deep (Buck's)fascia medial.534.535
mesometriumof, 371 Bulbar conjunctiva, 81, 87 Galcaneal lAchillesl tendon' 485,
mesosalpinxof, 369 Bulbospongiosus muscle' 358, 366, 5 1 5 ,5 1 6 ,5 1 7 ,5 1 8 ,5 2 ' 1 , 5 2 7
posteriorlaminaof,372 370, 380,381, 383, 404,405,417 soleusmuscleinsertionin, 515, 517
subdivisionsand contentsof, 372 bulb of vestibule of, 366 Galcaneocuboid ligament' 527, 536
uterine.360. 362 Bulbourethral (Gowper'sl gland' dorsal,527
Bronchiaf artery, 204, 205, 207 253, 361,366, 383, 384,389,417 plantat 528
esophagealbranch of, 207 duct of, 383 Gaf caneofibular ligament, 514, 525,
inferiorleft, 207 openingof, 384, 385 527
left,199,231 oerinealmembraneand. 348 Galcaneometatarsal ligamentr 532
esophagealbranch of, 237 orimordiumof, 389 Galcaneonavicular ligament' 527
inferior,237 Bulging septum,37 plantar,527, 528, 536
superior,237 Bursa Gafcaneus, 524, 527, 528
right,199, 2O7,230,237 anserine.506. 507 anteriortalar articularsurfaceof, 525
suoeriorleft,2O7 fibularcollateral,507 body of, 523,524,525
variationsin, 207 of hand,462 dorsal view of, 523
Bronchial vein iliopectineal,496 fibulal524
left,2O7 infrapatellar,511 fibulartrochleaof, 523
right,207 patellar,508 functionalrelationsof, 525
Bronchiole radial,460 groovefor tendon of flexor hallucis
respiratory,2O4,205 subdeltoid,423 longus,523
terminal,204,2O5 ulnar,460 lateralprocess,523, 533
Bronchomediastinal lymphatic Buttock, nerves of, 503 lateralview of, 525
trunkr 208 medialprocess,523
left, 266 c medialview of, 525
right,266 middletalar articularsurfaceof, 525
Bronchopulmonary lymph nodes, Gf spinal nerve, 127 olantarview of, 523
199,208,230,231 dorsal ramusof, 178 oosteriortalar articularsurfaceof, 525
Bronchopulmonary segments, 200, dorsal roots of, 114 posteriorview of, 525
201 exit of, 161 radiographof, 54
anteriorview of, 200 ventralramusof, 71 superiorview of, 525
lateralview of, 201 ventralroots of, 114 sustentaculumtali of, 523
medialview of, 201 G2 spinal nerve,127 trochleaof, 524
nomenclaturefor, 203 dorsalramusof, 177, 178 tuberosityof, 485,488, 516, 517,523,
posteriorview of, 200 v e n t r arl a m u so f, 3 2 , 7 1 , 1 7 7 533. 534. 535
Bronchus' 167,2O2,2o4, 234 G3 spinal nerve, 19 radiographof, 54
anteriorbasal,203 dorsal ramusof, 177 Calcar, 489
anteromedialbasal,203 v e n t r arl a m u so l , 3 2 , 7 1 ,1 7 7 C a l c a r a v i s , 1 1 1 ,1 1 2
apicoposterior,203 G4 spinal nerrre, 127 Gafcarine artery, 142, 143
elasticfibers of, 204 G5 spinal nerve, Yenttal ramus of, G a f c a r i n e s u l c u s , 1 0 5 ,1 0 6 ,1 O 7 , 1 1 1 ,
extrapulmonary, 202 32 120
inferiorlobar,202 G8 spinal nerYe, 160 Gaf fosomarginal artery' 141, 142
intermediate,202 exit of, 161 Galot, cystic node of' 315
intrapulmonary, 2O2,2O4 G6 transverse process, 136 Galot, triangle of' 301
lateralbasal,203 Gl vertebra. See Atlas (C1) Galvaria, 102
left, 203 G2 vertebra. See Axis (C2) inferiorview of, 7
axialCT imagesof, 242 G3 vertebra, 13 superiorview of, 7
left mainbranchesof, 199,206,232, inferiorarticularfacet for, 19 Galyx, maior,339
233,241 Gamper chiasm, 461
lingular,202 Camper's fascia, 348
Atlas of Human Anatomy I.5

Gamper's (fattyf layer of subcuta. Garctid nerve llXf, 71 Gailifage (Continued)
neous tissue, 249, 361, 348, external,165,167 thyroid,28, 29, 31, 74, 196, 2O2,206,
378, 380 internal,130, 131, 133, 165, 167 233,234,235
Ganal of Schlemm. See Scleral venous Garctid plexus,86, 121, 131,209,226 laminao1,77,78
sinus (canalof Schlemm) common,130, 131 obliqueline of, 29
Ganine teeth, 57 e x t e r n a l , 1 3 01,3 3 , 1 6 7 superiorhorn o1,77
Gapiffary plexus, 148, 2O5 internal,86, 123,132, 165, 167 tracheal,28,2O2
cortical.337 Garotid sheathr 28,32 Gartifage lamina, lthyrold, 77
medullary,337 cranialnervesin, 60 posterior border of, 67
Gapitate, 452, 453, 455, 456, 461 G a r o t i d s i n u s , 1 2 5 ,1 3 0 , 1 3 1 , 2 1 0 Gauda equina, 160,161, 170,179,339
anterior (palmar)view of, 452 Garotid vein, common, 70 in lumbar puncture,162
coronal section of, 455 Garpal atterial arch, dorsal, 469 Gauda equina arlery, 171
posterior (dorsal)view of, 452 Garpal articular surtace, 439 Gaudal mesonephric duct, residua
radiograph of, 457 Garpal bones,452 of, 389
Gapitis muscle, rectus in abduction.453 Gaudate nucleus, 141
anterior,32, 47,73 in adduction,453 anteriorvein of, 145, 146
anteriorand lateral,nervesto, 129 anterior(palmar)view of, 452 bodyof,108,110
lateral,nervesto, 129 posterior (dorsal)view of, 452 h e a do f , 1 1 0 ,1 1 1 ,1 1 2 ,1 4 5
lateralis,30, 32 Garpal ligament posteriorvein of, 145
posteriormajor,175, 176,178 palmar,454, 460 terminal,146
posteriorminor,175, 176, 178 transverse.See Flexorretinaculum t a i lo f , 1 0 8 ,1 1 0 , 1 1 2
Gapitohamate ligament, 454, 455 Garpal tunnel, 461 thalamusand, 110
Gapitufum, 420, 436, 437 palmarview of, 454 transverseveins of, 145,146
Gapsular artery, 335 transversecross sectionof, 461 Gavernous nerve, 166,41O,412
Capsular ligament, 423 Garpometacarpal ioint, 455 Gavernous plexus, 121
of shoulder.423 articularcapsuleof, 454 Gavernous sinus, 85, 100, 104, 136,
Gapsular vein, 337 capsuleof first, 455 140
Gapsule, internal, 141 Garpometacarpal ligament coronalsectionthrough,104
Gardia, nodes around, 314 dorsal,455 efferent hypophysealvein to, 148
Cardiac nerve, cervical, 165 palmat 454 emissaryvein communicatingwith, 70
Gardiac notch, 236,275 Garpotriquetral ligament, 454 superiorview of, 104
Cardiac otificer 276 Gartilage Gecal artery, 323
Gardiac plexus, 126, 165,2O9,226, accessory nasal, 36 anterior,281, 306, 307
227,240 alar posterior,281,307
Gardiac vein lateral and medial crus of, 36 Gecal fold, 281, 362, 363
anterior,216 major, 36, 38, 39 Gecal plexus, 323
of diaphragmaticsurface,216 minor,36 Gecal vein
great,216 articular a n t e r i o r , 311, 3 1 2
middle,216 of elbow.438 posterior,311,312
small,216 of finger,471 Gecum, 126, 269, 272, 281, 284, 362,
of sternocostalsurface,216 of hip joint, 487 363
Gardinal ligament, 360, 364, 37O,371, of knee,511 variationsin posteriorperitonealattach-
372,373 arylenoid,77,78 ment of, 281
Garoticotympanic newe, 123, 125 muscularprocessof, 78 vascularfold of, 281
Garctid arteria! arch, dorsalr 469 vocal process of, 78 Geliac ganglion, 44, 126, 165, 167,
Garotid artery auricular,47 168, 219, 267, 318, 320, 321, 323,
common, 23, 29, 31, 32, 33, 34, 71, 74, bronchial,204 324, 325, 327, 328, 331, 345, 346,
75, 76, 100, 125, 128, 130, 133, corniculate,77 409
1 3 4 ,1 3 6 ,1 3 7 ,1 9 8 ,2 1 0 , 2 3 2 , 2 3 7 costal, 186, 248,293, 419 Geliac lymph node, 266,314,315
external,28, 32, 34,40, 59, 75, 76, 85, cross sectionof, 196 Geliac plexus, 126,165, 166,240,319,
86, 121, 123, 128, 130, 131 eighth,415 320,322,323,344,345,346, 410,
schemaof, 34 fifth, 194 415
internal,10, 23,28,33,34, 44, 47,69, fifth left,241 posteriorvagaltrunk to, 240
71, 75, 76, 85, 86, 100, 123, 125, of first rib, 243 vagal branch to, 240
1 3 0 ,1 3 1 ,1 3 2 ,1 3 4 ,1 3 8 ,1 3 9 ,1 4 0 , second,245 Geliac trunk, 165, 195, 206, 278, 298,
1 4 1 ,1 4 2 seventh,198,331 300, 305, 321, 324, 328, 329, 333
caroticotympanicbranch of, 138 sixth, 424 arteriogramof, 303
groove for, 9 cricoid, 20, 28, 29, 74, 77, 78, 196, 233, bifurcationof, 297
left common, 74, 80, 137, 193, 211, 214, 234 common originof, 302
243 arch of.77 cross section of, 338
left internal,142, 143 laminaot.77.78 prenatal,229
rightcommon,30, 80, 137,193 longitudinalmusclebundleattached variations in, 302
right internal,142 to,234 Ceneus, apex of, 107
right lateral dissection of, 34 posterolateralsurface of, 234 Gentral artery
Carotid autonomic plexus, 10 prominenceover laminaof, 66 anterolateral,141
Garotid body, 34, 125, 130, 210 ol larynx,77 anteromedial,140
Garctid canal, 10 septal, 39 central, anterolateral,143
externalopeningof, 8 septal nasal,36 posteromedial,140
for internal carotid artery 11 lateral process of, 38, 39 precentral,141
for internalcarotidnerveolexus,I Gentral sulcus, 106
Garotid groover 9
1.6 Atlas of Human Anatomy

Gentral vein, 290, 291 Gerebral artery Gerebrum (Continued)
of liver.290. 291 anterior,136,138, 1 40, 141, 143 oosterolateralfissure of, 113
Gephalic vein, 181, 188,189,256, 418, branchesof, 141 sulciof, 107
424, 428, 429, 449, 468, 479, 480, left. 142 superior surface of, 113
483,484 right,142 superiorvermisof, 113
accessory 479,48O terminalbranchesof, 142 temporalpole of, 107
intermediate,480 communicating, 140 t o n s iol f , 1 1 3
Gerebellar artery left anterior,142 Gervical artery
anterior,140 left middle,142 ascending,33, 69, 71, 74,75,76, 136,
anteriorinferior,136, 138,139, 14O,141, middle,136, 138, 140, 14'l, 143 138.171.427
143,171 branchesof, 141 d e e p , 3 3 1, 3 6 ,1 3 8 , 1 7 1
posterior,141, 143 left. 142 superficial,74, 75
inferior,143 temporalbranchesof, 141 transverse,32, 69, 74, 75, 76, 138, 177,
posteriorinferior,141, 171 posterior,136, 138, 140, 141, 143, 171 427, 429
superior,136, 138, 139, 140, 141, 143, branchesto, 136,138 Gervical canal, 371
171 right,142, 143 Gervical cardiac newe' 166,209
Gerebellar hemispheric vein, infe. temporalbranchesof, 143 inferior.165. 226
riot, 144 terminalbranchesof, 142 middle.165.226
Gerebellar notch right anterior,142 superior,69, 71, 165, 226
anterior,97 temporalbranchesof, 143 sympatheticand vagal,226
posterior,97,113 posteriorand anterior,142 Gervical curvatute, 18, 153
Cerebellar nucleus, 113 terminalbranchesof, 142 Gervical enlargementr 161
dentate,113 Cerebral crus, 107, 113,114,139,145 Gervical ganglion
emboliform,113 Cercbral lalx,48 middle,165
fastigial,113 Gerebral fissure superior,165,167
globose,113 anterior,143 Gervical nerve, 130-133,134-135,161
Gercbellar peduncle longitudinal, 107, 143,145 branchesof, 25
inferior,113, 144 Gerebral hemisphere superficial,177
inferior,superior,middle,144 axialCT imagesof, 150 transverse,24, 31, 71, 129
middle,113,114, 144 axial MR imageof, 150 vertebraeand,127,161
superior,113, 114, 115, 144 medialsurfaceof, 106 Gervical plexus, 160, 177, 178, 481
decussation of,113 Gerebral peduncle, 106, 115 ansa cervicalisol,32, 128
superiorplaneof, 113 Gercbral sulcus, lateral, 141 brancheslrom,24
Gerebellar tonsil, herniation of, 101 Gerebral vasculature, 136-1 38, in situ, 32
Gercbellar tonsillar artery, 143 139-141, 143-144,145-146 schemaot,32,129
Gerebellar vein Gerebral veine supraclavicularnerves from, 479
hemisphericinferior,151 anterior,144, 145, 146 Gervical spinal nerves, 160
precentral,l44 deep, 99 c1.160
superior,144 middle,144,145 exit of, 161
Gerebellomedullary cistern great,103, 104, 106, 115, 144, 145, 146 C2, dorsal ramusof, 177
posterior,109 quadrigeminalcisternof, 109 C3, dorsal ramusof, 177
veinof, 144 inferior,102, 1O4,145 C4, dorsal ramusof, 177
G e r c b e l l u m , 1 0 6 ,1 1 1 , 1 1 5 ,1 4 6 internal,99, 108, 111,144,145,146 c8. 160
anteriorlobe of, 113 lateraldirect, 146 exit of, 160
axial MR imageof, 150 middle dorsaframi o1,24, 32, 177
biventerlobe of, 113 d e e p , 1 4 41, 4 5 , 1 4 6 medialbranchesof,24
dentatenucleusof, 115 superficial,145 posteriorcutaneousbranchesof, 178
flocculonodularlobe of , 113 penetratingsubduralspace,99 Gervical sympathetic catdiac
flocculusof, 114 superficial,99, 102 nelYe
horizontalfissureof, 113 middle,99, 102, 1O4 inferior,130, 226,227
inferiorfovea of , 115 superiot102 middle,33, 130, 165,226,227
inferiorsurfaceof, 113 openingof, 101 superior,32, 60, 128,130, 132,133, 134,
lateralrecessof, 115 Gerebrospinal fluid, circulation of, 165,226,227,240
lateralviews of, 105 109 Gervical sympathetic ganglion'
medialeminenceof, 115 Celbrum, 113 middle, 32, 60, 130, 131, 132,
mediansagittalsectionof, 115 anteriorlobe of , 113 133,134,167
parts of, 144 biventerlobuleof , 113 Gervical sympathetic trunk, 131,
posteriorlobeof, 113 externalcapsuleof, 110 240
oosteriorview of. 115 flocculonodular lobe,113 vertebralganglionof, 240
posterolateral fissureof, 107 frontalpole of, 107 Gervical vagal cardiac netve
sagittalMR image of, 149 gyri of, 107 interior,227
secondaryfissureof, 107 horizontalfissureof, 113 superior,227
superior fovea of, 115 horizontalsectionsthrouoh.110 Gervical vein
superiorsurfaceof, 113 inferiorsurfaceof , 113 deep,137
tonsio l f , 1 0 7 ,1 1 5 inferiorview of, 107 left,137
Cerebral aqueduct, 106, 107, 108, internalcapsuleof, 110 right,137
109,146 lateralviews of, 105 right,deep, 137
Cercbral arterial circle (of Willisf, medialview of, 106 suoefficial, 177
139,140 medialviews of, 106 transverse, 70,177
occipitalpole of, 107
posteriorlobe of , 113
Atlas of Human Anatomy l-7

Gervical yertebrae. See a/so Atlas Gif iary ganglion (Continued) Goccygeal nerYe, 160, 161,499
(C1);Axis (C2); specific vertebrae roots of, 131 vertebraeand, 161
anteriorview of, 17, 171 schemaof, 132 Goccygeal plexus,499
arteriesof, 171 sensoryroot of, 86, 121,122,131 schemaof, 499
articularpillaro1,21 sympathetic root of, 86, 121, 132 Goccygeus (ischiococcygeusf
costal facets of, 21 Giliary muscle,87, 118, 121,132 muscle, 263, 358, 359, 398,
externalcraniocervicalligamentsof, 21 circularfibers of, 88 4 0 2 , 4 1 0 ,4 1 1 , 4 1 2
inferioraspect of, 18 meridionalfibers of, 88 Goccyx, 153, 157, 160,161, 248,352,
lateralradiographof, 21 Giliary nerve 353, 357, 376, 379, 391
numberof, 161 long, 86, 121, 122, 131, 132 anteriorinferiorview of, 157
right lateralview of, 21 short,86, 121,122,131,132 posteriorsuperiorview of, 157
superioraspect of, 18 Giliary process, 87, 88, 89 spinalnervesand, 161
superiorview of, 18 Giliary vein, anterior, 88, 90, 91 tip of, 354, 357, 359, 376, 380, 382, 395
upper,17 Gingular ant.cty, 142 transverseprocess of, 157
Geryicis muscle, interspinalis, 176 Gingulate gyrus, 106 Gochfea, 92,95,97
Gervicofacial nerve, 25 isthmusof, 106, 107 helicotremaof, 92, 96
Gervicothoracic (stellatef ganglion, Gingulate sulcus, 106 osseous,92, 96
13, 130,165,209, 226,227, 240 Gircle of Willis. See Cerebral arterial sectionthrough,92, 96
esophagealand recurrent nerve circle (of Willis) Gochlear aqueduct, 96
branchesfrom,24O Gircular muscle,326 Gochlear cupula,95
Gervix, 360, 364, 369, 370, 371, 372 Gisterna chyli, 266, 314, 318 Gochlear ganglaon, 124
externalos of, 371 lumbar lymph trunk to, 343 Gochlear nerYe, 92, 95, 96, 97
sagittalMR imagesof, 397 Glaustrum, 110 distributionof. 118
C5 spinal nerue, ventral ramus of, 32 Glavicle, 1, 26, 27, 28, 29, 31, 181,182, posteromedialview of, 95
G4 spinal nerve,127 184, 186, 188, 189, 196, 197, 198, Gochlear nucleus, anterior and
Gheek ligament, 83 213,230,231,243,418, 420, 421, posterior, 116, 117, 124
Ghest 422, 423, 424, 425, 427, 428, 425 Gochlear necess, 95
axial CT images of, 242 acromialend of, 419 Gochlear window. See Roundwindow
radiographof, 213 acromialfacet of, 419 (cochlear)
Ghest drainage tubes, placement anteroposteriorradiograph ot, 422 Gochleus, modiolus of, 96
of, 190 conoid tubercleof, 419 Golic artery
Ghiasmatic cistern, 109 costoclavicularligamentimpressionon, arc of Riolan between middle and left,
Ghief cell, 276 419 308
Ghoana, 8, 13, 14, 37, 38, 39, 52, 55, 66, inferiorsurfaceof, 419 ascendingbranchof, 307, 398
67 radiograph of, 422 descendingbranchof, 307, 398
Gholangiole,292 right,419 lett,264,307, 318, 323,324,340, 398
Ghordae tendineae, 220, 221, 223 shaftbody of,419 middle,29O,298,301 , 306,307, 318,
Ghorda tympani nerve, 62, 7 1, 93, 94, sternalend of,419 322,323,340,348
122, 123, 124, 131,133, 134, 135, sternalfacet of, 419 absence of, 308
165 subclaviangrooveof, 419 right,306, 307, 308, 322, 323, 34O
Ghorcid,87,89,90 superiorsurfaceof, 419 absence of, 308
vasculararrangementswithin,91 trapezoidline of, 419 variations of, 308
Ghoroidal artery Glavipectoral fascia, 428 Golic flexurc
anterior,139, 140, 141, 143 pectoralisminor muscleinvestedby, 188 left, 126, 269, 270, 271, 272, 275, 278,
posteriorlateral,139, 143 subclaviusmuscleinvestedby, 188 284,288,298,347
posteriormedial,139, 143 Glavipectoral lossa, 428 right,269, 288,297
Ghoroid pfexus, 111,112,145 Glinoid pnocess Golic impression,287
of fourthventricle,106,108, 109, 114, anterior,9 Golic lymph nodes
115 coronalCT imagesof, 151 left.317
of lateralventricle,108, 109, 110, 143, posterior,I middle,317
145 Glitoris right,317
of third ventricle,106, 108, 109 body of, 388 Golic plexus
Ghoroid Yein, 91 crus of, 360, 366, 370 lett,278,284,318,323
bulb of, 91 deep artery of, 404 middle,322, 323
Ghoroid vein, superior, 99, 145, 146 deep dorsal vein of, 356, 357, 360, 364, right,275, 322,323
Giliary artery 365 Golic vein
anterior,90, 91 dorsal artery of, 404 left,311, 312, 313
recurrentbranch of, 91 dorsal nerve ot,267, 413, 414 middle,298,303, 311,312
long posterior,90, 91 frenulumof, 377 right,311, 312,313
posterior,85 glansof, 377,388 Gollateral artery
short, 91 prepuceof, 377 middle,432, 434,435
short posterio( 90, 91 suspensoryligamento1,378, 379, 380 radial,434, 435
Giliary bodn 87,90 Glivus,9 Gollateral eminence, 111
blood vesselsof, 90 surface of, 22 Gollateral ligament, 509
fibers of. 88 Gloquet, node of, 266, 408 fibular,493, 499
orbicularisciliarisof. 89 Glunial nerve radial.438
Giliary ganglion, 45,86, 121, 122, 131, interior,177, 411, 413,503, 540, 545 tibial,493, 514
132,165,166,168 m e d i a l1, 7 7 , 5 0 2 , 5 4 5 ulnar.438
nasociliary root of,86, 131, 132 superior,177, 254, 502, 545 Gollateral sulcus, 106
oculomotorroot of, 132 Goccygeal co?nu, 157 Gollateral trigone, 111
parasympatheticroot of,86, 121 Goccygeal lagament, 160, 161

Gollecting lubule, 336, 337 Gondylar canal, 11 Goronary attery/ (Continued)
schemaof, 337 Gondylar emlssary vein' 137 l e f t ,2 1 6 ,2 1 7 , 2 1 9
Golles' fascia. See Superficialperineal Gondyle anteriorinterventricular branchof, 216,
(Colles')fascia lateral,489 217,219
Golliculus medial,489 circumflexbranch of, 2'16,217, 219
brachiaof, 114 Goneus, 106 marginalbranchof, 216,217,218
inferior,106, 111 Gl spinal nerve, 133 openingof, 224
brachium of,111 dorsal ramusof, 178 posterior interventricularbranch ot, 218
left, 144 dorsal roots of, 114 oosteriorleft ventricularbranchof, 217
s u p e r i o r1,0 6 ,1 0 7 ,1 1 1 ,1 1 4 ,1 1 5 ,1 1 6 , exit of, 161 posterolateralbranches of, 218, 219
132.143.144 ventralramus of, 71 right,217,218
brachiumof, 111 ventral roots of, 114 atrialbranch ol. 216, 217
left, 144 Gl vertebra. See Atlas (C1) marginalbranchof, 216,217
Goffi muscle, netves lo, 129 Coniunctiva, 91 openingof, 223
Golon bulbar,81, 83, 88, 90 oosterior interventricularbranch of,
air in, radiographof, 355 inferiorpalpebral,81 216,217
area for, 329 palpebral,83 posterolateralbranchesof, 216
ascending,126, 269, 272, 278, 284, 339, superiorpalpebral,81 sinuatrialnodal branch ol, 216, 218
349 Goniunctival artery, posterior' 91 of sternocostal surface, 217
axial CT images of, 350 Gonjunctival fornir variationsin, 217
cross sectionof, 338 inferiot 81 Goronary ligament
site of.274 superior,81 enclosing bare area of liver,348
circularmuscleof, 282 Gonjunctival vein, posterior, 91 hepatorenalportion of, 287
descending,167, 271, 278, 339, 342 Gonjunctival vessels, 90, 91 of liver.287
areafor,329 Gonnective tissue Goronary sinusr 214, 215, 216,221,
cross sectionof. 338. 349 of liver,291 233,241
descendingfrom left colic flexure,297 subserous,326 openingot,220,223
from left colic flexure, 297 Connective tissue sheath' 202 valve ol,22O
site ol,274 Gonoid ligament, 425,423 Goronary sulcusr 214
mucosaand musculatureoI,284 attachmentof,419 Gorcnary vein, variations inr 217
nerveto, 410 Gonus arteriosus, 212, 218, 220, 222, Goronoid fossa, 420
right colic flexureof, 297 224 Goronoid pnocess' 15, 436, 443
cross sectionof, 297 Gonus elasticus, 78 radiograph of,422
sigmoid,167, 168,269,271, 284,391, Gonus medullaris, 160,161, 170,339 Gorpora cavernosar 382
392, 393, 394,412 Gonvoluted tubule Gorpora quadrigemia' 107
loopingto right side, 284 distal,336 Gorpus albicansr 371
nerveto, 410 oroximal,336 Gorpus callosum, 106, 107, 108,111,
reflected,271 Gooper's ligament. See Pectinealliga- 1 4 1 ,1 4 3
variationsin positionof, 285 ment (Cooper's) anterior,145
transverse,269, 270, 273, 278, 284, 291, Goracoacromial ligament' 423, 425, cisternof, 109
294,298,299,339 426,430 dorsalvein of,144,146
ascendingto left colic flexure,297 Goracobrachialis muscle' 244, 245, g e n uo f , 1 0 6 ,1 0 7 ,1 1 0 ,1 1 2 ,1 4 6
axialCT imagesof, 350 429, 430, 433, 435, 474 right dorsal branchto, 143
cross section of, 338 fascia over, 428 rostrumof, 106, 141
tributary from, 309 insertionof, 420 sagittalMR imageof, 149
tributaryfrom, 311 originof, 420 spleniumof, 106, 107, 110,112, 143,
Gommissure Goracoclavicular ligamenl, 423 144,145,'t46
anterior,106, 115, 146, 147 Goracohumeral ligamentr 423 sulcusof, 106
of fornix, 112 Goracoid pnDcess, 185, 189, 420, 421, trunkof, 106, 141
habenular. 106. 111 423, 425, 427, 428, 429, 433 Gorpus cavernosum, 361, 382,383,
posterior,106, 111, 388 anteroposteriorradiograph ot, 422 385
Gommunicating artery Gornea, 81,83,87,88, 90, 91 sagittalMR imagesof, 371,397
anterior,136, 138, 139,140, 141,142 Corneal limbus,81 Gorpus luteumr 3Tl
posterio( 104, 136, 139, 140, '141, 142, Gorneoscleral iunction, 81 Gorpus spongiosum' 361, 366, 381,
143 Gorniculate tubercle, 77 382, 383
Gommunicating vein, 31, 137 Goronal sulcus, 246, 385, 388 sagittalMR imagesof, 397
Gompressor uTethra, female, 356 Goronal suture,2,5 Gorpus striatumr 110, 141
Compressor urethrae muscle, 367, Goronary artery Gorrugator cutis ani muscle' 393
404 anteriorinterventricular branchof, 219 Gorrugator supercilii muscle' 25, 36,
Gompressor urethrali$ muscle, 370 diagonalbranchesof, 219 123
Gomputed tomography lCTl arteriographicviews of, 218,219 Gorti, organ of. See Spiral organ (of
abdominal,350 arterioventricular nodal branchof, 218 Corti)
of arteries of the arm, 484 circumflexbranchof, 219 Gortical radiate artery' 335, 337
of chest, 242 atrioventricular branchof, 219 lymph vesselsalong,343
of head, 150 conus branchof, 218 Cortical radiate vein' 337
coronalimagesof, 151 of diaphragmaticsurface,216 Gostal facet
of upper limb arteries,484 interventricularseptal branchesof, 216, inferior,187
Goncha 217 superior,187
inferior,14 Gostal groove, 186
nasal.See Nasalconcha Gostal impression' 287
Gonducting syslem,225
Atlas of Human Anatomy 1.9

Costal pleural, 231, 232 Gricoaryrtenoid muscle (Continued) Guneiform bone (Continued)
Gostocervical trunk, 33, 69, 136, 197, posterior,78, 80, 235 medial,523, 524,527, 536
138 action of, 79 plantarview of, 523
Gostochondral joint, 186 Gricopharyngeus muscle | 75, 76, 80, Guneiform tuberrle, 66, 67, 78
Gostoclavicular ligament, 186, 419 233,234,235 Guneocuboid ligament, dorsal, 527
attachmentof,419 Gricothyrcid altery, 69 Guneonavicular ligament
Gostocoracoid ligament, 1BB,4Zg Gricothyroid ioanl,77 dorsal,527
Gostocoracoid membrane, 428 pivot point of, 79 plantar,528
Gostodiaphragmatic recess, 198, Gricothyroid ligament Cuneus, 106
230, 231, 293, 330, 332, 342. 349 lateral, TT apex of, 107
right,206 m e d i a n7, 4 , 7 7 , 2 0 2 Guspid teeth. See Teeth,canine
Gostomediastinal space, 331 Cricothyroid muscle, 126 Gutaneous nerve(sl
lateral,198 action of, 79 antebrachiallateral,469
superior,198 obliquepart of, 79 dorsal,lower limb
Costovertebral joint, 243 straightpart of, 79 intermediate,540, 541, 542
left lateralview of, 187 Grista galli, 3,6,9,39 laleral,542,545
right posterolateral view of, 187 coronalCT imagesof, 151 medial,541, 542
transversesection of, 187 Grista terrninalis, 220, 225 femoral
Cough receptor,210 Gross section lateral,409
Gowper's gland. See Bulbourethral of abdomen posterior,411
(Cowper's)gland atLl-2,339,349 of forearm, medial, 469
Coral bone. See Hip bone at L3. 349 of head,24
Granial base at L3, 4, 349 lateral antebrachial,447
bones of, 9 at T10, 293 lateral dorsal, 544
foraminaof, 10, 11 atT12,297,331,338 lateralfemoral,329, 499,538, 539
inferiorview of, 10 of descendingduodenum,179 medial antebrachial, 429, 432, 469
inferiorview of, 8 forearm,serial,449 of neck, 24, 31
Granial fossa of gallbladder,297 perforating,411, 499
anterior,9 of scrotum.390 posterior antebrachial,469
middle,9 of testis,390 superiorlateralbrachial,177
posterior,I Cruciate ligament, 22, 507, 5Og Guticle,471
arteriesot, 142, 143 anterior,508, 509, 514 Cl vertebra. See Atlas (C1)
veins of, 144 attachment of, 508 G2 vertebra. See Axis (C2)
posterior veins of, 144 origin of, 514 C3 Yertebra, 13
Granial mesonephric lGartner'sf inferiorlongitudinalband of, 22 inferior articular facet for, 19
duct, 389 posterior,514 tubercles of transverseprocess of
Granial mesonephric tubule, 389 attachmentof. 514 anterior,30
Granial nerye, 116, 130-133,134-135 superiorlongitudinalband ol,22 posterior,30
in carotidsheath,60 transverse.22 G4 vertebra
communicatingbranchof, 45 G3 spinal nerYe, 19,127 anteriortubercleof, 18
motor and sensorydistributionof, 118 dorsal ramusof, 178 body of, 18
nucleiof ventraframus ot, 32, 71, 178 laminaof, 18
medialdissectionof, 117 G2 spinal nerve, 133 posteriortubercleof , 18
posteriorphantomview of, 116 dorsalramusot.177. 178 posterosuperiorview of, 18
schemaof, 116 ventralramus ot, 32, 7 1, 177 superiorarticularprocessof, 19
palsy of, 101 Gubital fossa, 418 G7 vertebra, 13, 153,160
Granial nuclei, in brainstem, Gubitaf lymph nodes, 483, 484 posterior tubercle of transverse process
schema ol, 117 Gubital node,483 of, 30
Graniocervical ligaments Gubital vein spinousprocessof, 18, 152, 174,175,
external intermediate,480 176,424
anteriorview of, 21 median,418, 479, 483, 484 superiorview of, 18
posteriorview of, 21 Guboid bone, 523,524,527,536,537 Gymba,93
right lateralview of, 21 articularsurfacefor, 525 Gystic attery, 294, 300, 301, 305
internal,22 base of, 523 Gystic duct, 331
Cremaster fascia, 250 dorsalview of, 523 smooth part of, 294
Gremasteric artery, 255 groovefor fibularislongustendon inser- spiralfold of, 294
Gremasteric muscle, 25O,251, 2Sg, tion, 523 variationsin, 296
261 plantarview of, 523 Gystic node (of Galotf, 315
lateraloriginof, 259 radiograph of, 54 Gystic vein, typical arrangement
medialoriginof, 259 shaft of, 523 of, 313
Gremasteric yessels, 260, 4O1 tuberosityof, 523, 524, 528, 536 Cystohepatic triangle, 301
Gremaster muscle, 390 Guboideonavicular ligament, Gystourethrograms, male and
lateraloriginof, 259 plantaT, 528 female,368
medialorigin of, 259 Gufmen, 113, 115,144
Cribriform fascia, 546 Cuneate fasciculus, 114 D
Gribriform plate, 6, 9, 37, 39, 119 Cuneate tubercle, 114
foraminaof. 11 Guneiform bone Declive, 113
Gricoaryrtenoid muscle intermediate,523, 536 Deep (Buck'sf fascia, 249, 25O,348,
lateral,78, 80 lateral,523, 536 361, 380, 381, 382, 383, 396, 401,
action of. 78. 79 radiographof, 54 403, 405
intercavernousseptum of, 382, 385

Deep palmar arch, 465 Diaphragmatic ligament, 389 Ductus (vasf deferensr 259, 261, 34O,
Deftoid muscle, 152, 174, 177, 188, Digastric fossa, 15 389, 390, 409, 546
189,243,244,245, 423, 428, 429 Digastric muscle, 29, 123 ampullaof, 384
attachments of, 420 anteriorbellyof, 27,28,29,31,32,34, arteryto, 255,264,340, 398, 4O1,4O3
insertionot,42O,421 46,53,61,68 Ductus deferens plexus' 409, 415
origin of, 419,420 intermediatetendon of, 59 Ductus plexusr 409
Deltoid tuberosity, 420 fibrous loop for, 59 Ductus reuniensr 96
Deltopectoral lymph node, 483, 484 phantom,34 Ductus Yenosus
Deltopectoral node, 483 posteriorbellyof, 27,28,29,32,34, 40, obliterated,229
Deltopectoral triangler 247, 424 59, 73 prenatal,229
Denonvilliers' fascia, See nerveto, 25 Duodenal capr279
Rectoprostatic(Denonvilliers') Digastric tendon, intermediater 60 Duodenal flexure
fascia fibrousloop 1or,28, 29, 53 inferior,279
Dens,137 Digital artery superior,279
apical ligamentof, 63, 65 common,computedtomographyof, 484 Duodenal fold
of axis,19, 37 common palmar,465 inferior,278
posteriorauricularfacet of ,22 common plantar,536 superior,270
Dental plexus dorsal,469, 471, 530, 536 Duodenal fossa
inferior,122 nutrientbranchesof, 471 inferior,2TO
superior,122 oalmar superior,270
Dental pulp, 57 common,460 Duodenal glandsr 2T9
D e n t a t e g y r u s , 1 0 6 ,1 0 8 ,1 1 1 ,1 1 2 ,1 1 9 proper,460 Duodenal impression' 287
Dentate nucleus, 108, 112,119 properpalmar,460,471 Duodenal papilla
Denticulate ligament, 169, 170 dorsalbranchesol,471 ma:1or,279,294,295
Dentinal tubules, 57 proper plantar,533, 535, 536 minor,279
Dentine,57 dorsal branches of, 530 Duodenal wall
Depressor anguli oris muscle, 54 Digital creases,418 circularmuscle layerof, 279
Depressor labii inferioris muscle, Digital nerves longitudinalmusclelayerof, 279
26,54,123 common oalma', 476 submucosaof, 279
Depressor septi nasi musclo, 36, 123 common plantar,476, 541 Duodenojejunal flexure, 270, 279, 342
Dermatomes dorsal,468,471, 475,542,544 Duodenojejunal iunction' 179
anterior,482 lateraldorsal.544 Duodenum, 126, 248, 273, 275, 278,
levelsof, 164 parmar 288,329,340,342
of lower limb, 543 to fourth and fifth fingers, 460 arteries of, 301, 304
posterior,482 proper, 476 ascending,27O,278, 279
schematicdemarcationof, 164 proper palmar,460, 471, 476 bariumradiographol, 279
of upper limb dorsal branchesof, 468 circularmuscleof, 277,295
anteriorand posteriorviews of, 482 to thumb. 460 descending,272, 279, 294
Descemetts membrane. See Posterior properplantar,535, 541 cross sectionof, 179
limitinglamina(Descemet's Digital vein descendingpart of, 270
membrane) dorsal,468, 480,544 inferior pad of, 270
Diaphragn, 198,206, 211,215,23O, Dilator pupillae muscle, 88, 121 in situ.278
233, 236, 237, 272, 273, 275, 286, Diplo6, 7 innervationof. 321
3 2 7 , 3 2 9 , 3 3 13, 4 2 ,4 9 8 Diploic vein, 102 lunctionwith common bile duct, 295
abdominalsurfaceof, 195 anteriortemporal,99 longitudinalfold of, 279
area for, 330 coronaldissectionof, 99 longitudinalmuscleof, 277
caval openingfor, 195, 263,267 frontal, 99 mesentery root ot, 278
central tendon of, 263 occipital,99 mucosaof. 279
right leafletof, 194 posteriortemporal,99 musculatureof, 279
costal part of, 195, 258 Dircct vein, lateral, 145, 146 nervesof, 319,320,321
cross sectionof, 338 Distal interphalangeal (DlPl joint' second-third parts of, 338
crura of, 179, 293,338, 342 site of' 418 junctionof, 339
left,263,27O,297,339 Distal medial striate artery (recur- submucosaof, 279
right,263,27O,293,297,331, 339 rent artery of Heubner)' 140, superior,276,274
domesof, 213 141, 142 cross section of, 297
.196, superiorpart of, 294
left, 197 Dorsalis pedis artery, 520,530,536
right,196,197 Dorsaf ramus, spinal, 17O,258,430 superior(1st)part of, 297
lateral view of, 233 medialclunialnervesfrom, 545 suspensoryligamentof, 270
lumbar part of, 195 perforatingcutaneousnervesfrom, 545 suspensorymuscleof, 270
pelvic,361 Dorsal tubercle of radius (Listet'sl' veins of, 309
fascia of, 364 452 Dural sac
female,356, 357 Dorsal venous arch, foot, 544 in lumbarpuncture,162
inferiorand superiorfasciaof, 392 Dorsomedial nucleus, 147 sagittalMR imagesof, 397
male,358-359 Dorsum sellae,9 terminationof, 160, 161
superiorfasciaof, 360, 364, 365, 369, Douglas, cul.de-sac of. See Dural venous sanusesr 104
394 Rectouterinepouch (of Douglas) coronalsectionthrough,104
phrenicnervesto, 193 Ductus arteriosus sagittalsectionof, 103
slip of originot, 349 obliterated, 229 superiorview of, 104
sternalpart of, 195 prenatal,229
thoracicsurfaceof, 193 Ductus choledochus. See Bile duct,
Diaphragmatic constriction, 233 common
Atlas of l{uman Anatomy l.t I

Dura mater, 39, 91, 93, 96, 99, 100,102, Epididymis (Continued) Esophagus (Continued)
109,119,137,169 sinus of, 390 arteries of, 237
around bony and membranous tail of, 390 common variationsin, 237
labyrinths,96 Epidural anesthesia, for lumbar bare area on ventral surface. 234
cerebralveins penetrating,102 puncture,162 cervicalpartot,237
lumbar,170 Epidural hematoma, 101 circularmuscle layerof ,234,277
periostealand meningeallayersof, 99 Epidural space gradualslight muscularthickeningof,
s p i n a l , 1 6 01, 7 9 fat in, 170 232
spinaladeriesto, 172 in lumbarpuncture,162 greater curvature ol, 277
of thoracicspine, 170 Epigastric artery groove for, 199
Dura-skull intedace, 102 superficial, 211, 511 in situ,232
s u p e r i o r , 1 8 81,8 9 , 1 9 2 lateralview of, 233
E Epigastric lymph nodes, inferior, longitudinalmusclelayer ot, 234, 277
266 lateral mass of, 234
Ear, 93 Epigastric lcgionr 268 mucosa o1,235,236
bony and membranouslabyrinthsof, 95 Epigastric vein lunctionwith gastricmucosa,276
external inferior,251, 256,265, 4OO musculatureof, 239
coronalobliquesectionof, 93 superficial,247, 256, 265, 544 nerves of, 240
superolateralview of, 93 superior,189,256 opened posterior view of, 66
lobuleof, 1 Epigastric vessels posteriorview of, 240
middle coronalobliquesectionof, 93 inferior,251, 259, 261, 349, 362, 363, pyloric part of, 277
surface anatomy of, 1 401,403 recurrentarterialbranchto. 195. 264
Edinger.Westphal nucleus, 116, 117, superficial,249, 500 submucosaof, 235, 236
132 superior,331, 500 thoracic parl ol, 232, 237
Efferent ductule, 389, 390 Epiglottis, 13, 58, 63, 66, 67, 76, 77, 78, topographyand constrictionsof, 233
Effercnt fiber, to olfactory bulb, 119 135.233. 235 zone of sparsemusclesol,234,235
Ejaculatory duct, 376 Epiphyseal plate, 504 Ethmoidal artery
beginningof, 384 Epiphysis, 471 anterior,11, 85
openingsof, 316, 384,385 nutrientarterialbranchto, 471 meningealbranchof, 100
Elbow Epiploic appendices. See Omental septal and meningealbranchesof, 41
anastomosesaround,434 appendices posterior, 11, 85, 100
bones of, 436 Epiploic foramen, 331 septal and meningealbranchesof, 41
ligamentsof, 438 Epiploic loramen. See Omental Ethmoidal bulla, 37,38
musclesot,447448 foramen Ethmoidal cells, 48, 49, 83
attachmentsof, 450, 451 Episcleral artery, 90 anterior,50
radiographsof Episcleral space, 83, 87 openingof, 37, 38
anteroposterior, 437 Episcleral vein, 90,91 semilunarhiatusof, 37
lateral,437 segmentof, 91 middle,50
Emissary vein, 99, 102 Epithelia! cell, stomach surface, 276 openingof, 37, 38
communicatingwith cavernoussinus,70 Epithelial tag, 388 posterior,37, 38
condylar,137 Epitympanic recess, 92, 93 openingof, 38
coronaldissectionof,99, 102 Eponychium,471 Ethmoidal foramen
mastoid,23,99, 137 Epoiiphoron, 343 anterior,2, 11, 12
occipital,99 Epoiiphorcn canal,389 Posterior,2, 11
parietal,23, 94, 99 Erector spinae muscle, 152, 174, 175, Ethrnoidal nerve
parietal foramen for, 7 179, 180, 192, 243, 258, 293, 330, anterior,11, 43, 86, 121, 122
of skull,99 331 externalnasalbranchesto,24,122
to superiorsagittalsinus,7 Esophageal arleryr2OT lateralinternalnasal branchesto. 42.
Endolymphatic duct, 11, 95 Esophageal hiatus, 195 43
openingfor, 97 Esophageal impression, 287 medial internal nasal branches to, 42
in vestibularaqueduct,96 Esophageal iunction, 236 posterior, 11, 45, 86, 121,122
Endolymphatac sac,96 Esophageal muscle,202 Ethmoidal vein
Endometrium,371 circular,75,235,236 anlerior,122
Endopelvic fascia, 364 longitudinal,75, 235, 236 posterior,122
Ependyma, 108 cricoesophageal tendon of, 235 Ethmoid bone, 4,6,9,38
Epicolic nodes,317 Esophageal plexus, 126, 165,166, anteriorethmoidalforamenof, 12
Epicondyles 206, 209, 230, 231, 232, 241, 321 cribriformplate of, 37, 38, 39, 119
lateral,438, 440, 441, 442, 443, 489 anterior,240 crista galli of, 39
radiographof, 510 posterior portion of, 240 middle nasalconcha of, 2
medial,437, 440, 441, 442, 443,447, sympatheticbranchesto, 2O9,24O nasalconcha of, 38
476,489 Esophageal prominence, orbitalplateoI,2,4, 12
Epicranial aponeurosis, 26, 178 pericardial,215 perpendicularplate of, 2, 6, 39
Epicranius muscle Esophageal vein, 312, 313 uncinateprocessof, 38
frontalbelly of, 26 Esophagogastric junction, 236 Ethmoid sinus
occipitalbelly of, 26 transversesection of, 293 axial MR imageof, 150
Epididymal duct,390 Esophagus, 63, 68, 76, 126,194,2O4, coronalCT imagesof, 151
Epididymis,390 206, 207, 230, 231, 233, 240, 241, Eustachian tube. See Auditory(pharyn-
appendixof, 389 243, 244, 245, 246, 263, 264, 270, gotympanic,Eustachian)tube
body of, 390 274,323,329,332,348
head of, 390 abdominalpart of,233, 237,275
anteriorview of, 240
t-12 Atlas of Human Anatomy

Extensor carpi radialis brevis Extensor tendons' 420, 441, 444 Facial nerve (Vlll (Continued)
muscle, 418, 420, 444, 446,477 common,of forearm,42O,441, 444 temooralbranchesof, 123
groovefor, 439 in fingers,464 zygomaticbranchesof, 123
tendon of, 444, 445, 449, 469, 470 of hand, 445 F a c i a l n u c l e u s ' 1 1 6 ,1 1 7
attachmentof, 420 at wrist, 470 Facial plexus' 131
Extensor carpi radialis longus Extraocular muscles, sagittal MR Facial vein, 23, 30, 32, 59, 60, 85
muscle, 432, 435, 441, 444, image of, 149 common trunk for, 23
445, 446, 449, 451,477 Extraperitoneal fascia, 412 deep,23, 85
groove for, 439 Extraperitoneal space' fibrofatty transverse,23, 70
originof, 439 tissue otr392 Falcilorm ligament' 252, 269, 274,
tendonof, 444,469,47O Eye, 168 2 7 5 , 3 0 5 , 3 1 23, 3 1 ,3 4 9
Extensor carpi ulnaris muscle, 418, anteriorand posteriorchambersof, 88 branchto, 255
420, 432, 441, 444, 449, 451,477 axial CT imagesof, 150 of liver,305
tendonof, 444,469,470 axialMR imageof, 150 Fallopian tube. See Uterine(fallopian)
ulnarorigin ot, 451, 470 coronalCT imagesof, 151 tube
Extensor digiti minima muscle, 420, externalmusclesof, 90 Falx cerebeali' 144
441, 444, 450, 451 extrinsicmusclesof. 84, 90 Fafr cerebri, 39, 102, 103,141, 144
tendon of, 420, 441, 444, 449, 470 intrinsicarteriesand veinsof, 90 Fascia
Extensor digitorum brevis muscle, musculararteryand vein of, 90 axillary,428
520, 521, 530, 531, 542 vascularsupply of, 91 anterior c,att ot, 428
innervationof, 542 Eyeball,81 fenestrated, 428
tendonof, 519,520, 531, 536 arteriesand veins of, 85 brachial,428
Extensor digitorum longus nuscle, choroidof buccopharyngeal, 60, 63, 65
494, 519, 520,522, 530,531, 542 vasculararrangementswithin,91 Camper's,348, 361, 378
attachmentsof, 515 tarsusof, 83 cervical
tendonof, 519, 520,521, 530,531, 536, vascularsupply of, 91 investinglayer ot, 26, 28
Ra.7 Eyelashes,81 musclesinvestedby, 188
sheathof, 530 Eyelid, 81 pretracheallaYerof, 28
Extensor digitorum minimi tendon, arteriesand veins of, 85 clavicopectoral,188
469 tarsusof, 83 clavipectoral,428
Extensor digitorum muscle, 432, cremaster,390
441, 449, 450, 477 F cremasteric,25O,261
centralbands of, 451 cribriform,in saphenousopening,249
groove for, 439 Face dartos,390
lateralbands of, 451 arterialsupply sourcesof, 19 deep (Buck's),249, 25O,253,348, 380,
tendon of, 418, 441, 444, 445,449, 469, musclesof, 123 381, 382, 383, 396, 401, 403, 405
470,471 sensorynervesof, 123 deltoid,26
Extensor expansions, 536 superficialarteriesand veins of, 23 diaphragmatic,342
tendinousslips to, 465 Facets,246 inferior.348, 349
transversefibers of, 470 Faciaf artely' 31, 32, 34, 36, 40, 60, 75, endopelvic,364
Extensor hallucis brevis muscle, 85, 131, 133, 136, 138 extraperitoneal, 252, 261, 412
520, 530, 542 lateralnasalalar branch of, 41 infradiaphragmatic, 236
innervationof, 542 nasalseotal branch of, 41 infrahyoid,28
t e n d o no f , 5 1 9 , 5 3 1 , 5 3 6 superiorlabialbranchof, 41 of infrahyoidmuscle,428
Extensor hallucis longus muscle, tonsillarbranch of, 64 infraspinatus, 174, 177
519, 520, 521, 522, 531 transverse,23, 34, 36, 69, 85 interosseous
attachmentsof, 515 Facial cana,' 124 dorsal,462
innervationof, 542 orominenceof, 93 palman462
tendon of, 519, 520, 521, 530, 531, 536 Facial expression muscles, 26,60 intraspinous,424
sheathof, 530 lateral view of, 26 investingpectoralisminor muscle,428
Extensor indicis muscle, 441, 445, Facial lymph node, 72 investingsubclaviusmuscle,428
449 Facial muscles, 123 latissimusdorsi, 428
groove for, 439 F a c i a f n e r v e ( V l l l , 1 1 , 3 4 ,4 0 , 6 2 , 7 1 , ol 1e9,522,546
.1 obturator, 356,369, 379,4O2,411
tendon of, 418, 441, 444, 469, 47O 92, 104,114, 16, 117, 122, 131,
Extensor pollicis brevis muscle, 133, 134, 135, 165, 166 over obturatorinternusmuscle,365
441, 443,444,445,451 branchesof.25. 168 obturatorinternus,364,392, 4O2,411
area for, 439 buccal branchesof, 123 of orbit and eyeball,83
tendon of. 444.469 cervicalbranchesof, 123 over adductor Pollicismuscle,460
Extensor pollicis longus muscle, communications to, 123,125 paravesicalendopelvic,366
418, 441, 444, 449 distribution of, 118 parotid,26
groovefor, 439 geniculum(geniculate ganglion)of, 97, pectoral,182,428
tendon of, 418, 444, 462, 468, 469 123.124.125 superficialand deep layersof, 428
Extensor pollicis longus tendon, intermediate,133 of oectoralisminor muscle,428
444,469,470 internalgenu of, 117 pelvic,372
Extensor retinaculum, 444, 446, 468, main trunk of, 25 penile,249
469,470,530,542 marginalmandibularbranchof, 30 oerineal.356
inferior,530, 542 motor nucleusof, 123 deep,355, 361, 370, 378, 381, 382,
superior,519, 521, 530 motor root of, 124 383, 391, 396, 404, 405
schemaof, 118, 123,134 deep transverse,384
in stylomastoidforamen,94 superficial,348, 366, 370, 378, 380,
381, 395, 396,404, 405, 411
Atlas of Human Anatomy 1 . 13

Fascia (Continued) Fat (Continued) Femur (Continued)
pharyngobasilat52,73 perirenal,179, 339, 342 neck of. 376
olantar retrobulbar,83 nutrient artery of, 504
lateral,532 of sole of foot, 532 nutrient foramen of, 489
medial,532 suprapatellar, 511 patellar surface of, 489
posteriorantebrachial,thickeningof, 468 Fat body, of ischioanal fossa, 376 pectinalline of, 489
presacral,348, 364, 396 Fat pad poplitealsurfaceof, 489, 511
pretracheal,63 infraoatellar. 511 posteriorview of, 489
viscerallayer ot,2O2 suprapatellar, 511 radiographof, 355, 510
prevertebral,60, 63, 65 Fauces, 64 shaft of, 489, 496
oubocervical Female ]eploductive organs, inner. Fibroelastie rnembranes, 234
distal portionof, 372 vation ol,415 Fibrous lAlbini'sl nodule, 223
horizontalportionof, 372 Femoral artery, 250, 493, 500, 512, 546 Fibrous sheath, of sole of toot, 534
quadratuslumborum,179 circumflex Fibrous trabecula, 147
rectal,348, 364, 378, 384, 391, 392, 393, ascending,501, 512 Fibula, 513, 517,530
394, 396 descending, 501, 512 at ankle,525,527,531
rectoprostatic(Denonvilliers'), 348, 359, lateral,500,512 anteriorborderof, 513
361,386,391,396 medial,501, 502,5O4,512 anteriorintercondylar, 514
rectovesical,384, 391, 396 transverse,501, 512 anteriorview of, 513,514
renal,339, 342,347 deep,493, 500, 512 with ligamentattachments,514
anteriorlayerof, 179 muscularbranchesof, 512 apex of,513,514
Gerota's,342 Femoral canal,546 cross sectionof, 514
posteriorlayerof, 179,342 lymph nodes in, 546 headof, 492,493,494,511, 513,514,
sagittal section of, 342 Femoral nerve, 160, 259, 267, 376, 515, 518, 520, 521, 542
transversesection of, 342 409, 496, 498, 500, 538, 546 anteriorligamentof, 514
Scarpa's,348, 361, 378 anteriorcutaneousbranchesof, 409 anteroposteriorradiographof, 510
attachmentof, 380 branchesof, 545 posteriorligamentof, 514
scrotal,249 cutaneous,545 radiographof, 510
superficial,395 anterior.538. 544 interosseousborderof, 513, 514
serratusanterior,428 lateral, 267, 329, 496,498, 500, 544, lateralcondyleof, 514
Sibson's,230 565 lateralsurfaceof. 513. 514
spermatic, 249, 250, 259, 261 posterior,160,177,503,540, 545,546 medialcrest of, 514
external,249, 25O,251, 257, 259, 260, terminalbranch of, 544 medialsurfaceof, 513
261, 361, 380, 390, 405 Femoral ring, 259,262,363,364,546 n e c ko f , 5 1 3
internal,251, 261, 390 Femoral sheath, 250, 251, 262, 5OO, posteriorview of, 513
originof, 260,261 546 radiographof, 54, 510
subclavius,428 Femoral vein, 250, 256,376,380, 493, superiorarticularsurfaceof, 513
subserous,412 500, 505, 544,546 superiorview of, 513
superficial,390 Femoral vessels, 260, 401,4O7 trochleaof, 522
supradiaphragmatic, 236 openingsfor, 263, 500 Fibular artery, 512, 516, 517, 518, 522,
temporal,26, 54 Femoris muscle, rectus, 376,485, 534
deep layerof, 54 489,491, 492,494,500,538 calcanealbranchesof, 516, 517
supediciallayerof, 54 attachmentsof, 490, 491 circumflex,5l2
thoracolumbar, 174, 175,176,177,33O originof, 492 communicatingbranchof, 518
anteriorlayerof, 176, 179 Femoris tendon, nectus, 485, 493, perforatingbranchof, 518, 520, 530, 531
layersof, 179 505, 507,519 posteriorlateralmalleolarbranchof, 518
middle layerof, 179 Femur, 489, 511 Fibular collateral bursa, 507
posterior layer of, 176, 179, 330 adductortubercleof, 489 Fibular collateral ligament, 506, 507,
transversalis,179, 252, 259, 261, 331 anteroposteriorradiograph of , 488 508, 511, 514, 517, 520, 521
umbifical prevesical,251, 252,260, 348, anteriorview of, 489 inferiorsubtendinousbursa of, 511
364, 365 calcarof, 489 Fibularis brcvis muscle, 530, 531,
uterine,364 of child, 504 542
uterovaginal, 369, 370, 378 fibrouscapsuleof, 489 attachmentsof, 515
vaginal,391 glutealtuberosityof, 489 innervationof, 542
vesicle,348, 361, 366, 369, 391, 396 greatertrochanterof, 152, 489, 493 tendonof, 485, 516, 517, 518, 520, 521,
Fascia lata, 250, 500, 544 headof, 376,487,489 527, 528,530, 536
attachment to Scarpa's layer,249 anteroposteriorradiographof, 488 Fibularis brevis tendon, 530, 535
of leg, 546 arteries of, 504 Fibularis longus muscle, 485,494,
Fascial compartments, leg, 522 fovea of ligamentof, 489 515, 517, 519, 521, 522, 542
Fascial sheath of eyeball lTenon's radiographof, 355 attachmentsof,515
capsulel, 83,87 intercondylarfossa of, 489 innervationof, 542
Fasciculus intertrochantercrest of, 489 tendon of, 485, 516, 517, 52O,521, 527
dorsal longitudinal,147 lateralcondyleof, 489, 493, 510 528,530,531,536
mediallongitudinal, 113 lateralepicondyleof, 489 groove for, 524
Fat lessertrochanterof, 263, 489 to sole of foot, 521
of elbow,438 ligamentof head ot,487, 489 Fibularis longus tendon, 536
epidural,137, 17O lineaasperaof, 489 Fibularis tertius muscle, 530
infrapatellar,507, 508, 511 medialcondyleof, 489 attachmentsof,515
of mammarygland, 182 adductor magnusmuscle insertionon, tendonof, 519, 521, 530,531, 536
in orbit, axial MR image of, .|50 493
pararenal, 179,339 adductortubercleon, 493

Fibular nerve Fingers (Continued) Flexor muscles
articularbranchof. 540. 541 sePtaof, 471 of fingers,444
common,495,499, 505, 506, 507,508, synovialflexortendon sheathsof, 460 of forearm,superficial,446
518, 519, 520, 521, 540, 541, 542, tendon sheathsof, 462 of leg
544,545 fibrous,471 deep,522
musclesinnervatedby, 542 Flank superficial,522
deep,520, 522,542 left, 268 of wrist, 442
dorsal digitalbranchesof, 520, 530, right,268 Flexor pollicis brevis muscle' 465,
531,544 Flexor carpi radaalis muscle' 420, 4IO
dorsal digitalbranch of, 544 433,442,446 deep head of, 476

lateral branch ot, 520, 542 tendon of, 418,42O,447, 448, 454, 460, superficialhead of, 476
medialbranchof, 519,520, 530,531, 461 Flexor pollicis longus muscle' 444,
542 Flexor carpi radialis tendon' 447, 454 446,447, 448, 449, 450, 474
superficial,519, 520, 521, 530, 542, 544 Flexor carpi ulnaris muscle' 418, superficialhead of, 443,446
dorsal digitalbranchesof, 530 420,444,446,447,476 synovialtendinoussheathof, 460
intermediatedorsal cutaneousbranch humeralorigin of, 451 tendinoussheathof, 460,462
ot,544 tendon of, 418, 420, 448, 449, 454, 461, tendon of, 446, 448, 449, 454
medialdorsalcutaneousbranchof, 465 in tendon sheath,461, 462
544 ulnaroriginof, 451 ulnar head ot, origin ot,42Q
Fibular notch,513 Flexor carpi ulnaris tendon' 418, Flexor pollicis longus tendon' 454
Fibular retinaculum 454,460,465 Flexor r.etinaculum, 447, 460, 461,
inferior,518, 521, 525, 527 Flexor digiti minimi brcvis musclet 462, 465,474, 516, 517, 534, 535,
superior,516, 517, 521, 527 465,476,533,534, 536,541 541
Fibular tendon, 525 superficialtibial nervebranchto, 541 removed,454
Fibufar vein,522 tendon of, 528 transverse,465
Filiform papillae, 58 Flexor digitorum brevis muscle' Flexor sheath, commonr 460
Filum terminale externum, 160, 161 533, 534, 535 Flexor tendons
Filum terminale internum, 160, 161 tendon of, 533, 534, 535 common,of forearm,443,446
Fimbriated fold, 51 Flexor digitorum brevis nerve, 541 in fingers,464
Fingernail Flexor digitotum longus muscle' profundusand superficialis,462
body of, 471 515, 535,541 at wrist, 461
lunuleof, 471 innervationof, 541 Fleror tendon sheath
nailbedof, 471 tendonof, 513,516, 517,528,533,534, common,460
Fingernail, body ol, 471 535 common ulnar,462
Fingers, 418 Flexor digitotum profundus muscle fibrous. of sole of foot, 533
arteriesand nervesof, 471 medial part of, 476 fibroussheathover,annularand cruci-
arteriesof, 471 tendon of, 460 form parts of, 460
bones of, 452 Flexor digitorum superfi cialis ol finger,471
common namesof, 418 muscle, 420, 443, 444, 446,447, Flocculonodular lobe' 113
cross section of, 471 448,449,450,451,474,475,476 Flocculus, 113
cross sectionthrough,471 humeroulnarhead of. 420 Foliate papillae, 58, 135
distal anterior closed space of, 471 originof, 420 F o l i u m , 1 1 3 ,1 1 5 ,1 4 4
dorsum of radialhead ot,447, 448,449, 450,474 Follicle,371
lymph vesselspassingto, 483 tendon of, 418, 420, 446, 449, 454, 461, Fontalis muscle,36
in extension,464 462,474 Fontanelle
extensormechanismof, 471 Flexor digitorum superficialis ten- anterior,12
extensormusclesof, 441 don, 418, 454,471 mastoid,12
extensortendonsof, 464 insertionof, 460 posterior,12
fibroussepta of, 471 Flexor digitorum profundus muscle' Foot
fibroussheath,annularand cruciform 476 arteries of, 536
Parts of, 462 Fleror hallucis brcvis muscle' 541 bones of, 523,524,525
fibroussheathof, 471 insertionof, 536 deep arteries of, 536
fifth lateral head of. 533. 535 dorsal view of, 536
palmardigitalnervesto, 460 insertion of, 536 dorsum of
synovialtendinoussheathof, 460 medialhead of, 533, 534, 535 deep dissectionof, 530, 531
in flexion,464 insertionof, 536 musclesof, 530
flexor and extensortendons in, 471 medialoriginof, 536 fibrouslongustendon passingto, 521
flexors of, 443 tendon of interosseousmusclesof, 530, 536
flexortendonsof, 464 adductor hallucisand lateralhead of, inversionand eversionof, 543
fourth, palmardigitalnervesto, 460 528 lateral dorsal cutaneous nerve of, 530
index,metacarpalof, radiographof, 457 lateraloriginof, 536 ligamentsand tendonsof, 527
innervationof, 469 medialhead of, 528 plantarview of, 528
lateral view of, 464 Flexor hallucis longus muscle' 541 olantarsurfaceof, 485
lymph vesselspassingthrough,483 attachmentof,515 plantarview of, 536
middle,middlephalanxof, 457 innervationof, 541 right
middle,sagittalsectionof, 453 tendonof, 516,517, 518,528, 533,534, lateralview of, 527
muscleattachmentsof, 450 c3c, cJo medialview of, 527
nervesof, 471 groove for, 523, 524, 525 sole of
posterior(dorsal)view of, 464 on talus,523 musclesof, 533, 534, 535
ring, distal phalanxof, 457 superficialdissectionof, 532
sagittalsectionthrough,453,471 tendonsof, plantarview of, 528
Atlas of Human Anatomy l.l 5

Foramen lacerum,8, 10 Frontal bone, 9, 36, 38, 81, 82 Gastric artery (Continued)
petrosalnervesof, 10 glabellaof, 4 right,279, 294, 300, 305, 320, 321, 331
Foramen magnum, 8,9, 11, 14, 58, nasalspine of, 38, 39 arteriogramot,303
123,127 orbital part of, 2, 9 short,300, 301,305, 321
Foramen of Luschka. See Lateral sinus of, 38, 39 sympatheticf ibers along esophageal
aperture (foramenof Luschka) squamouspart of, 38, 39 branchof, 240
Foramen of tagendie. See Median supraorbital notchof,4, 12 Gastric c,anaar276
aperture(foramenof Magendie), Frcntal cnest, 9 Gastric.esophageal mucosa
109 Frontal gyrus junction,276
Foramen of Monro. See Interventricular inferior,105 Gastric iolds,236,276
foramen(of Monro) medial,106 Gastric glands, 276
Foramen of Winslow. See Omental middle,105 Gastric impression, 286
foramen(of Winslow) suoerior.105 Gastric lymph drainage pathways,
Foramen ovale, 4, 8, 11, 14, 45,46 Frontalis muscle, 36 314
obliterated,229 Frontal lobe, 105 Gastric lymph nodes, 314, 315
prenatal,229 Ftontal nerve, 83, 86, 121, 122 131 Gastric plexus,410
valveo1,221 Frontal operculum, 105 left,318,319, 320, 322,323
Foramen rotundum, 11, 45 Frontal pole, 105 right,319, 320,322
Foramen spinosum, 11, 14, 46 sagittalMR image of, 149 Gastric vein
Foramentransversarium,19 Frontal sinus, 3, 5, 37, 38, 39, 48, 63 |eft,309,310, 311, 312, 313
Forearm with frontal bone, 50 esophagealtributaryof, 309
bones of, 439 growth of, 50 right,309,310, 311, 312, 313
cutaneousnervesof, 480 Frontal sulcus short,309, 311, 312, 313
lateral,435, 446, 447, 448, 449, 469, inferior,105 Gastric vesselg, short, 331
473,481 superior,105 Gastrocnemius muscle, 506, 507,
branchesof, 479 Frcntobasal artery 516, 519, 520, 521, 522, 540, 541
posterior branch of, 480 lateral,141. 142 innervationof, 541
deep muscle layerof medial.141.142 lateralheadof, 485, 494,495,511,515,
anteriorview o1,447 Frpntonasal canal 516,517,518
posteriorview of. 445 infundibulum leadingto, 38 attachmentsof. 491. 515
distal,cross sectionof. 470 openingof, 38 subcutaneousbursaof, 511
intermediatemusclelayerof, anterior Frontonasal duct, 37 lateralsubtendinousbursaof, 511
view o1,447 openingof, 49 medialheadof, 485, 491,495, 502, 511,
ligamentsof, 438 Fundiform ligament, 249 517,518,522
medial,429, 430, 433, 446,469,473, of penis,361 attachmentsof, 491, 515
479, 481, 474, 475 Fundus, of stomach,293 Gastrocolic ligament, 272
anteriorbranch of, 449,480 Fungiform papilla, 58, 135 Gastrcduodenal artery, 279, 294, 301,
posteriorbranch of, 480 304, 305,306, 321, 322,327
musclesof, 44O,441,442, 444, 446,447 G arteriogramof, 303
deep layerof, anteriorview of, 448 plexuson, 320
muscularattachmentsof Gafea aponeurotica, 26, 1O2,178 Gastroduodenal plexus, 320, 322, 327
anteriorview of, 450 Galen, ansa of, 80 Gastroepiploac artery, left, 301
posteriorview of, 451 Galen, vein of. See Greatcerebralvein Gastroilenal ligament. See
posterior, 432, 435, 449, 468, 469, 477, (of Galen) Gastrosplenicligament
479, 480, 481 Gaf fbfadder, 126, 167, 196, 269, 272, Gastro-omental arterial
pronated position of, 440 275,294,301,331 anastomosis,272
serial cross sections of, 449 arterialvariationsand collateralsupply Gastro-omental artery
superficialmusclesof of, 305 left, 300, 301, 305, 306, 321
anteriorview of, 446 body of, 294 plexuson, 319, 320
posterior view ol. 444 cross sectionof, 297 ri1ht,272, 300, 305, 306, 321
superficialveins of, 480 fundusof,294 originof,3O2
supinatedpositionof, 440 gland orificesof, 294 Gastro.omental lymph nodes
Fornix, 106,112,147 infundibulumof, 294 left,314
bodyof,106,108,112 innervationof, 168 right,314
c o l u m n s o f1, 0 6 ,1 1 0 ,1 1 1 , 1 1 21, 4 5 joining hepaticduct, 294, 296 Gastro.omental Yein, 312
conlunctival,81 neck of, 294 left, 309, 311, 312,313, 314
c r u r ao f , 1 0 6 ,11 0 , 1 1 2 , 1 4 3 Ganglion, basal nuclei of, 110 right,309, 311, 312,313
schemaof, 112 Ganglion cells, 120 Gastro.omental vessels
Fossa ovalisr 22O,544 Gartner's duct. See Cranial attachment to greater omentum,274
limbusof, 220 mesonephric(Gartner's)duct, 389 left, 299
Fovea centralis, 87,90 Gastric artery, 272, 3OO,305, 318, 319, Gastropancreat c Iold, 272
Frenulum,282 320,321 Gastrcphrenic ligament, 272, 329
artery to, 59 arteriogramof, 303 Gastrcsplenic ligament, 272, 273,
of lower lip, 51 attachedto lesseromentum,274 299, 331
of tongue,51, 61 esophagealbranchof, 300 short gastricvesselsin, 299
of upperlip, 51 sympatheticfibers along,240 Gemellus muscle
Frontal artery, 23 left, 206, 237, 264, 300, 301, 306, 318, inferior,376, 495, 503
medial,142 319, 320, 321, 323,331, 348,349, attachmentsof. 489. 491
polar,141,142 410 nerveto, 503
Frontal anlely, polaJ, 1 41, 142 esophagealbranchof, 237 superior,495, 499, 503
attachmentsof, 489, 491

Genicular artery Glisson's capsule. See Perivascularfi- Great cercbral vein lof Galenl, 103,
descending,512 brous (Glisson's)capsute 104, 106, 144, 145, 146
articularbranch of, 500, 512 Globus pallidus, 108, 110, 539 Groin
saphenousbranch of, 500, 512 Glornerular arteriole left, 268
inferiorlateral,512, 517, 518, 519, 520 afferent,336 right,268
inferiormedial,500, 512 efferent,336 Gubernaculum, 389, 415
middle,S12 G l o m e r u l u s , 1 1 9 ,1 3 6 Gum,57
superiorlateral,502, 512, 516, 517, 519, Glossoepiglottic fold Gut. See a/so Viscera
520,521 lateral,58 entericplexusof, 325
superiormedial,51, 500, 501, 5O2,512, median,58 prenalal,229
516,518,519,520 Glossopharyngeal nerve,34,114,
Geniculate body 116,117,118,129,125,126,130, H
l a t e r a 1l ,0 7 ,1 1 0 ,1 1 1, 1 1 4 , 1 1 6 , 1 2 0 , 1 3 1 ,1 3 3 ,1 3 5 ,1 6 6
132,143,144,145 branchof, 168 llabenula, 110
o f l e f t t h a l a m u s1,4 3 c a r o t i d b r a n c h o t , 3 4 , 1 2 5 , 1 2163, 0 ,1 3 1 H a b e n u l a r c o m m a s s u n e , 1 0 6 ,1 1 1 , 1 1 5
m e d i a l1, 0 7 ,1 0 8 ,1 1 0 ,1 1 1 , 1 1 4 ,1 1 5 , i n f e r i o r g a n g l i o n o1f2, 5 ,1 3 5 l{abenulartrigone, 111,115
139, 143, 144, 145 pharyngeal,tonsillarand lingual Hair cells (cochlearl
Geniculate nucleus branches,125 inner,96
left dorsal lateral,120 schemaof, 118, 125, 134 outer,96
right dorsal lateral,120 tympanicbranchof, 10 Hamate, 452,455,456,474
Geniculum (geniculate ganglionf, Gluteal aponeurosis, 330, 494, 495 anterior(palmar)view of, 452
116, 131, 135 over gluteusmediusmuscle,174 coronalsectionof , 455
of facialnerve,97, 116, 125 Gluteal artery hook of, 442,452,454,456
site of, 124 inferior,341,499 radiographof,457
Genioglossus muscle, 29, 32, 59, 60, superior,499 posterior(dorsal)view of, 452
128, 129 Gluteal fold, 152 radiographof, 457
superiormentalspine for originof, 52 Gluteal line l{amulus, 8, 14, 38, 52
Geniohyoid muscle, 29, 53, 59, 128, anterior,352,486 of spirallamina,95
129 right inferior,352,486 Hand
Genital cold, 389 superior,265, 311 in abduction,453
Genitalia, 388 Gluteal nerve in adduction,453
external,167 inferior,160, 499, 503 in anatomicalposition,453
female,377, 388 superior,160, 499, 503 anterior(palmar)view of, 459,465,472
homologuesof, 388 Gluteal tuberosity, 489 anteriorview of, 460
innervationof, 168 Gluteal vein arteriesand nervesof, palmarview of,
male,388 inferior,311 466, 484
internal superior,311 bones of, 456
female,389 Gluteus maximus muscle, 152, 174, bursaeof, 462
homologuesof, 389 177,254,330,376,381, 382,395, cutaneousinnervation o'f,472,476
male,389 396, 410, 411, 413, 485, 494, 495, deep digitalcreaseof, 418
lymph nodes and vesselsot,406,4O7, 502, 503, 504 deep dorsal dissectionof, 469
408 attachmentsof, 491 deeper palmardissectionof, 460
undifferentiated, 388 Gluteus medius muscle, 152,376, dorsalfasciaof, 462
Genitaf tubercle 492,496,500, 501, 502, 503 dorsalvenous networkof, 468, 483
epithelialtag of, 388 attachmentsof, 491 dorsum of, 483
glans area of, 388 glutealaponeurosisover,330, 494, 495 lymph vesselspassingto, 483
lateralpart of, 388 Gluteus minimus muscle, 489, 495, in extension,453
Genitofemoral nerve, 329, 340, 496, 496, 500, 501, 502, 503 in flexion,453
498, 539, 409 attachmentsof, 489, 491 lymphaticpathwayof, 468
femoralbranch of, 267,409, 498,544 tendon of, 376 lymph vesselspassingto
genitalbranch of, 259, 261,267,409, Gonads, 389 aroundweb in, 483
544 male,descentof, 386 dorsum of, 483
testicularvesselsand genitalbranchof, Gracile fasciculus, 114, 115 middledigitalcreaseof, 418
259,261 Gracile tubercle, 114, 115 musclesof, 465
Genu, of corpus callosurn, 146 Gracilis muscle, 489,492,493, 495, intrinsic,465
Gerdy's tubercle, 494,513 500, 501, 502, 505, 506, 516 nervesof, palmarview of, 466
Gerota's fascia. See Renalfascia, attachmentsof, 489, 515 palmardissectionof
Gerota's innervationof, 540 deeper,460
Gimbernat's ligament. See Lacunar Gracilis tendon, 485,492,493,506, superficial,459-460
ligament(Gimbernat's) 5O7 palm of, 453
Gingiva Granular foveola, 99, 102 posterior(dorsal)view of, 465,472
epitheliumof, 57 Granule cells, 119 proximaldigitalcreaseof, 418
laminapropriaof, 57 Gray matter, 169 proximalpalmarcreaseof, 418
Gingivaf groove' 57 interomediolateral nucleuso1,44, 132, radialdissectionof, superficial,467
Gfenohumeral joint' 423 134 radiallongitudinalcreaseof, 418
Gfenohumeral ligament lateralhorn ot,170,325,346 radiographof, anteroposterior,4ST
inlerior,423 spinal, 169 septa between spaces of, 462
superior,423 sympatheticpreganglioniccell bodies in, spacesand sheathsof, 462
Glenoid cavity, 185,423 132 spacesof, 462
Glenoid labtumr 423 Great cerebral artery, quadrigemi. superficialdorsal dissectionof, 468
nal cistern of, 109
Atlas of Human Anatomy l.l7

Hand (Continued) Hepatic artery (Continued) Hip
surface anatomy o1,418 intermediate,301 anteroposteriorradiograph of, 488
tendon sheathsof, 462 left,294,300,301,305 arteries of, 500-502
Hartmann's pouch. See Infundibulum middle,305 bony attachments of
(Hartmann'spouch) originof, 302 anterior view of, 490
l{austra, 284 proper,273, 278, 279, 288, 290, 294, posterior view of, 491
Head. See a/so Brain; Skull; speclflc parfs 298,301,321,330 flexion and extension of. 543
of head arteriogramof, 303 musclesof, 496
arteriesot,4041 bifurcationof, 331 lateral view of, 494
autonomicnervesin, 13' to lesseromentum,348 posteriorview of, 495
axial CT imageof, 150 right,294, 300, 301, 305 nerves of, 503
axial MR imageof, 150 accessory 302 Hip bone
bonesand ligamentsof,4-16 origin of, 302 auricularcartilageof, 487
coronalCT imagesof, 151 Hepatic duct,290 lateral view of, 486
cutaneousnervesof, 24 aberrant.294.296 medialview of, 486
faucesof, 64 accessory,296 Hip joint
lymph vesselsand nodes of,72-73 common,287,289,290,294,301,331 anteroposteriorradiographof, 488
masticationmusclesof, 54-55 lett,294 anteriorview of, 487
musclesof, 26 right,294 capsuleof, 504
nasalregionof, 36-37, 4M7, 48-49 variationsin,294,296 iliofemoralligamentof, 496
nervesof, 24 Hepatic llerure. See Colic flexure,right lateral view of, 487
oral regionof, 50-61 Hepatic lymph nodes, 314,315 ligamentsof, 492
sagittalMR imageof, 149 Hepatic nerve plexus, 349 posteriorview of, 487
surfaceanatomyof, 1 l{epatic plexus, 126, 319, 320, 322 Hippocampal fimbria, 119
Heart,126,233 anterior,327 Hippocampal sulcus' 112
anteriorexposureof, 212 branchesfrom, 319 Hippocampus, 110, 111, 112
apex of, 212, 213, 214, 246 to cardia,320 alveusof, 112
atria,ventricles,and interventricular sep- pyloric,126 fimbriaof, 106, 108, 111, 112
tum ot,224 vagal,319 superiordissectionof , 112
base of common,318 His, bundle olr 225
posteriorview of, 214 posterior,327 Horizontal cells, 120
surfaceof,2.l4 pyloricbranchfrom, 126 Houston, valves of, 393
conductingsystem of, 225 vagal branchto, 319 Humeral artery, circumflex
diaphragmaticsurfaceof, 214 Hepatic portal Yein, 273, 278, 279, anterior,427, 429, 433, 434
in diastole,222 288,294,298, 300, 301, 311, 312, posterior,427, 429, 432, 433, 434
f ibrousskeletonof, 222 315,331,349 Humeral ligament, transverser 423
inferiorborderof, 212 to lesseromentum,348 Humeral vein, circum|lext 479
i n s i t u ,2 1 1 orenatal,229 Humeroulnar headt 447
innervationof, 227 tributariesof, 312 Humetus, 433, 436, 438
innervationof, schemaof, 227 typical arrangementof, 313 anatomicalneck of, 42O,421
left borderof, 196 variations of,313 anteroposteriorradiograph of, 422
left side of, 225 Hepatic vein, 194, 232, 265, 274, 287, anteriorview of, 420
membranousseptum ol, 221, 222 290, 309 anteroposteriorradiograph of, 422
nerves of, 226 prenatal,229 capitulumot,42O,436
pericardiafsac and, 282 Hepatoduodenal ligamenl, 272, 275, common extensiontendon of, 421
right borderof, 196 278,297 common flexortendon of, 421
right side of, 225 Hepatogastric ligament, 275, 288 condylesof,42O,436
in systole,222 Hepatogastric trunk, 302 coronoidfossa of, 420
valvesot,222 l{epatomesenteric trunk, 302 greatertubercle ol, 42O,421, 423, 432
Heiss, loops of, 367 Hepatopancreatic ampulla' 294 crest of, 420
Helicotrema, 92, 95, 96 sphincterot,295,327 head of, 420
Helix,93 Hepatorenal neoesa (Morison's anteroposteriorradiographof , 422
crus of, 93 pouchl, 331 infraglenoidtubercleof, 421
l{elvetius, collar of, 236,277 Hering, canal of, 291,292 intertubercular sulcusof, 420
Hemiazygos vein, 236, 245 Hering.Breuer reflex, receptors fort intertubercular tubercleof, 420
accessory,194, 2O7 210 lateralepicondyleof, 42O,421, 436, 437,
Hemothorax, chest drainage tube Hernia 438, 441,442, 444, 448
placement in, 190 inguinal lateralsupracondylarridge on, 42O
Henle's loop,337 indirect,261 lessertubercleot, 420, 423
ascendinglimb of, 336 site of, 261 medialepicondyleot, 42O,421, 432,
descendinglimb of, 336 sliding,236 433, 437,440, 442,444, 445, 446,
proximalsegmentof, 336 Hernial sac,261 447, 476,477
thin segmentof, 336 neck of, 261 medialsupracondylarridge on,42Q
Hepatic artery, 297, 337 Herniated disc. See Lumbardisc olecranon fossa of, 421, 436, 437
branchesof, 290, 291, 292 herniation olecranon of, 437
common,237, 264, 272, 279, 294, 300, Hesselbach, triangle of. See lnguinal posterior view of, 421
301, 305, 306,318, 321,327,331, (Hesselbach's) triangle radial fossa of, 420
349 Heubner, recurlnt ailety of. See radial groove of, 421
arteriogramof, 303 Distal medial striate artery (recur- radiographsof, 437
cross section of, 297 rent artery of Heubner) right
effects of obstruction on. 305 High intestinal vein, 313 surgicalneck ot,243

Humerus (Continued) Hypothalamic artery, 140 lliac artery (Continued)
shaftof. 244.245 Hypothalamic sulcus, 106, 147 internal,264, 307, 318, 329, 340, 341,
surgicalneck of, 420 Hypothalamic vessels,'148 370, 398, 412
anteroposteriorr adiograph ot, 422 Hypothalamohypophyseal ttact, 147 anteriordivisionof, 400
trochleaot.42O.437 Hypothalamus, 108, 147, 324 posteriorand anteriordivisionsof, 402
ulnarnervegrooveof, 421 arteriesof, 148 right,323, 329
Hyaloid canal, 87 nucleiof lliac crest, 152,174, 175, 176,177,247,
Hydatid of Morgagni. See Vesicular arcuate,147 248,254,329, 330, 342, 351, 485,
.147 486,494,495, 496, 502, 503, 545
appendix(hydatidof Morgagni) dorsomedial,
Hymen paraventricular,147 innerlip ot,248,352,353
annular,377 posterior,147 intermediatezone of, 248,352,353, 486
cribriform,3TT supraoptic,l4T in lumbarpuncture,162
septate,377 ventromedial,147 outer lip ot, 248, 352, 353, 486
f{ymenal catuncle, 37O,377 parasympathetic, 324 tuberculumo1,248, 352, 353, 486
Hyoepiglottic ligament, 63, 77 sympathetic,324 upper lip of, 486
Hyoglossus muscle, 34, 60 l{ypothenar eminence, 418 lliac fossa, 352, 353, 363, 486
Hyoid bone, 27, 28, 29, 34, 59, 60, 61, l{ypothenar muscle, 446, 462, 476 lliac lymph nodes
63, 65, 68, 74, 76, 77 Hysterosalpingogram, uterus, 373 common, 266, 317, 343, 408
b o d yo f , 1 3 , 5 3 external,266, 317, 343, 408, 546
greaterhorn of, 13, 53, 75 I lymphaticpathwaysto, 408
lesserhorn of. 13. 53 internal,266, 317,343, 408
tip of greaterhorn of, 67, 75 lleal artery, 306, 307 lateral,406
Hyothenar muscle, 444, 476 anastomoticloops of, 280 medialexternal,406
Hypochondrium lleal fold, 311, 313 lliac plexus
left, 268 lleal orifice, 284 common,412
right,268 musclesfibers of, 282 external,318,412
l{ypogastric nerve, 165, 218, 324, 344, papillary,282 internal,318,412
345, 409, 410,414,415, 416 lleal papilla, 282 left common, 317
inferior,324 lleocecal fold, 281 right internal,323
left, 318, 323, 412 lleocecal junction, muscle fibers lliac spine
oelvic.414 around, 282 anterior,247, 248, 250, 486, 487, 492
right,318, 323, 412 lfeocecal llpsr 282 anteriorsuperior,248, 249, 259, 263,
superior,345,415 lleocecal necess 486, 487, 492, 493,496, 500
Hypogastric plexus inferior,281 posteriorinlerior,486
inferior,165,166, 168,323,324,344, superior,281 posteriorsuperior,152, 352, 353, 486
345,409, 412,499 lfeocecal negaon, 281, 282 lliac tubercle, 353
parasympatheticbranchfrom, 165 f leocolic artery, 281, 307, 322, 323, lliac tuberosily,24S
with periuretericloops,344 340 f fiacus muscle, 263,329,376, 490,
right,323 colic branchof, 281, 306, 307 496, 498, 499, 538
superior,165, 318, 323, 324, 345, 409, ilealbranchof, 281, 306, 307 attachmentof, 490
412 lleocolic lymph nodes, 317 muscularbranchof, 498
Hypogastric sheath, 364 lleocolic plexus, 322, 323 lliacus wing, male, 354
Hypoglossal canal, 8, 10, 11 l l e o c o l i c v e i n , 3 1 1 ,3 1 2 ,3 1 3 lliac vein, superficialcircumflex,544
f{ypogfossaf nerve, 10, 32, 34, 114, lleum, 269,282,284, 339, 349 lliac vessels
117,129,344 bariumradiographof, 280 circumflex
distribution of, 118 circularmusclelayer ot,280,282 deep, 364, 403
meningealbranchof, 128 longitudinalmuscle layer ol, 28O,282 superficial,249,5OO
schemaof. 118. 128 lymphoidnodulesof, 280 common,271, 401,412
vena comitansof, 59, 60, 70 mucosaof, 280 external,259, 260,281, 311, 360, 361,
Hypoglossal nucleus, 116, 128 musclefibersto, 282 362, 364, 372, 392, 401, 403
Hypoglossaltrigone,115 musculatureof, 280 internal,311
Hypogfossus muscle, 27, 53, 74, 77, serosa of, 280 superficialcircumflex,249
128 submucosaof, 280 lliococcygeus muscle, 356, 357, 358,
dorsal lingualvein medialto, 70 terminal,271, 281, 282, 362, 363 359, 395
Hypophyseal artery lliac artery lliocostalis cervicis muscle, 175
inferior,140, 148 circumflex lliocostalis lumborum muscle, 175
superior,14O,148 ascendingbranchof, 255,264 lliocostalis muscle, 175, 331
Hypophyseal fossa, 5, 9 deep,501,512 lliocostalis thoracis muscle, 175
at birth, 50 superficial,247, 512 fliofemoral ligament, 487, 496
Hypophyseal portal system common,264,274,340,341, 398,400, lf iohypogastric nerve, 160, 177, 267,
primaryplexusof, 148 412 329,409,496,498, 539
secondaryplexusof, 148 left,318 anteriorbranch of. 257
Hypophyseal portal vein axial CT imagesof, 350 anteriorcutaneousbranchof, 257,267,
l o n g ,1 4 0 , 1 4 8 right,329 410
short,148 axial CT imagesof, 350 genitalbranch of, 409
Hypophyseal vein, eftercnt, 140 uretericbranchfrom, 341 lateralcutaneousbranchof, 545
to cavernoussinus, 148 external,264, 274, 318, 329, 340, 398, schemaof, 498
Hypophyeis, 106, 107, 147. See also 4 0 0 , 4 0 24
, 12,501,512
Pituitarygland right,329
arteriesand veins of, 148
Hypothalamic area, lateral, 135
Atlas of Human Anatomy l,l9

f lioinguinal nerve, 160, 257, 260, 267, lnfrapatellar bursa Intercavernous septum, 382, 385
329, 330,340, 409, 414,496,498, deep,511 of deep fascia,381
539. 540. 544 subcutaneous,511 lnterchondral joints, 186
anteriorlabialbranch of, 413 Infrapatellar synovial fold, 507, 508 Interclavicular ligament, 186, 419
anteriorscrotalbranchesof. 267. 409 lnfraspinatus fascaa, 174, 177 Intercondylat alea
schemaof, 498 Infraspinatus rnuscle, 152, 18O,244, anterior,513
scrotalbranchesof, 267, 409,544 245, 424, 425,427, 428,432 posterior,513
ffiofumbar attery, 264, 341, 4O2 fasciaover,174 lntercondylar condyle, radiograph
lliolumbar ligament, 330, 353 insertionof, 421 of,510
lliolumbar vein, 330, 353 originof, 421 lntercondylat eminence, 514
lliopectineal bursa, 496 fnfraspinatus tendon, 423, 425 anteroposteriorradiographof, 510
lliopectineal line, 353, 392 Infratemporal fossa, 4, 13 Intercostal artery, 183, 192,305
iliac part of, 358 lnfratrochlear nerve, 24, 36, 56, 81, anterior,192
pubic part of, 358 86,122 first posterior,33
f liopsoas muscle, 259, 376, 489, 492, from nasociliarynerve,45 lower,anastomosiswith, 255
493, 500 Infundibular nucleus, 147 posterior,171, 172, 188, 189, 23O,231
attachmentsof, 489, 491, 496 Inlundibular process, 147 dorsal branchof, 172
lliopsoas tendon, 504 capillaryplexusof, 148 lateral mammary and cutaneous
lf iopubic eminence, 248,352, 486, lnfundibular necess, 108 branchesof, 183, 192
487 lnfundibular stem, 147 second,33
female,354 Infundibulum (Hartrnann's pouchl, third right,207,237
lliopubic tract, 259, 362, 363, 364 1 1 4 , 1 4 0 ,1 4 7 , 2 9 4 s u p r e m e , 3 31, 3 6 , 1 3 8
lliotibial tract, 485, 492, 494, 495, 502, body of, 114 lntercostal lymph nodes, 266
5 0 6 ,5 0 7 ,5 1 4 ,5 1 5 ,5 1 9 ,5 2 0 fundusof, 114 Intercostal membrane
bursa deep to, 506, 507 neckof, 114 external,180, 189, 192, 258
insertions of, 515 of uterinetube, 372 internal,180, 192, 23O,258
lateralpatellarretinaculumand capsule lnguinal canal, 260, 262 lntercostal muscle, 198, 243, 244,
and, 508 Inguinal falx, 250 245,331
llium conjoint tendon of, 250, 253, 259, 263 anteriorcutaneousbranch of, 180
arcuateline of, 356 Inguinal fold, 389 external,176, 188, 189, 192, 250, 258
adicularsurfaceof, 486 Inguinal hernia external intercostal membranes anterior
axial CT imagesof, 350 indirect,261 to, 189
body of, 352, 486 site of, 261 innermost,180,192,258
glutealsurfaceof, 352 Inguinal ligament (Poupart'sl, 247, internal,189, 192, 23O,231,255,258
radiographof, 355 249, 250, 259, 263, 351, 356, 378, lateralbranchof, 188
anteroposteriorradiographof, 488 380, 381, 407,485,492,498, 500, medialbranchof, 188
wing of, 248, 352, 358, 486 501,544,546 lntercostal nerve, 160,170, 180, 189,
Incisive canal, 37, 38, 39, 43, 63 reflected,25O,251, 259 192,331
anastomosisin, 40 lnguinal lymph nodes abdominalportionsof. 188
posteriorseptal branchof sphenopala- deep,266, 406,407,408,546 anterior,258
tine and greaterpalatinearteries highestdeep, 266, 408 anteriorcutaneousbranchesof, 177,
in,41 horizontal,266 188,192,257
I n c i s i v e f o s s a , 1 0 ,1 4 , 5 2 , 5 6 inferior,266 collateralbranch reioining,258
lncisive papilla, 52 superficial,266, 317, 406, 4O7,408, 546 eighth,209
Incisor teeth, 56, 233 superficialinferior,407 tirsr. 227. 430
Incus, 89, 93, 96, 124 superolateral, 407 lateralcutaneousbranchesot, 177,188,
articularsurfacefor, 93 superomedial,407 189,192
body of, 93 Inguinal region,259 lateralcutaneousbranchesto, 177, 188,
lateral view of, 93 anteriorview of, 259 189,257
long limb of, 93 posteriorview of, 259 posterior,192,23O
posteriorligamentof, 94 Inguinal ring seventhright,321
short limb of, 93 deep, 251, 259, 261, 362, 363, 369, 386 s i x t h ,1 6 5 , 2 0 9
superiorligamentof, 94 site oI,274 third, 240
lnfant, mandible of, 15 superficial,249, 259, 261, 386, 544 ventralramus of, 180
Inferior anastomotic vein lof lateraland medialcrus of, 259 lntercostal vein
Labb6f, 102,145 Inguinal (Hesselbach'sf triangle, anterior,256
Infragfenoid tubercle, 420, 421 259 left superior,231
lnfrahyoid muscler 29 I n $ u l a , 1 0 5 ,1 1 0 ,1 4 1 posterior, 230,231
action of, 29 centraland circularsulci of, 105 right superior,230
fasciaof. 28.428 limenof. 105. 141 lntercostal vessels, 331
Infraorbital ailery, 23, 36, 40, 81, 85 short and long gyri of, 105 lntercostobrachial muscle, 189
Inlraorbital canal, 45 lnteralveolar septa, 15 Intercostobrachial nerve, 189, 257,
lnfraorbital foramen, 12, 36 Interarticular ligament, 187 429,474,479,481
Infraorbital groovo,2 lnterarytenoid notch, 66 lntercrural flbers, 249, 259
Infraotbital margin, 1 fnteratrial septum, 22O,246 Intercuneiform ligament, dorsal,
lnfraorbitaf nerve lVrf, 24, 36, 44, 81, lntercalated lymph node, 73 527
83, 121, 122 lntercapitular Yean, 468, 480 Interglobular space, 57
enteringinfraorbitalcanal,45 Intercarpal ligament, 455 Intergluteal cleft, 152
internalnasal branchesof, 122 Intercavenous sinus lnterlobar artery, 335, 337
superioralveolarbranchesof, 122 anterior,103 lymph vesselsalong,343
Infraorbital vein, 23, 70 suoerior.103 Interlobar lymph vessels, 208
a-2o, Atlas of Human Anatomy

lnterlumborum cervicis muscle, 176 Interspinous ligament Intestine (Continued)
Intermarillary suture, 36 lumbar,176 small (Continued)
Intermediate nerve, 104,114, 118, lumbosacral, 177 v e i n so f , 3 1 0
1 2 3 , 1 2 4 , 1 3 31,3 5 lnterspinous plane, 268 submucosaof, 326
Intermediolateral cell column, 346 Intertendinous connection, hand, lntraarticular ligament, 187
Intermediolateral nucleus, 133, 134 470 Intraculminate vein, 144
Intermediolateral nucleus, plegan. Interthalamic adhesion, 106,108, lntrahepatic biliary system'
glionic sympathetic cell 110,111,146 scherna otr 292
bodies in, 132 lntertragic notch, 93 lntralaminar nuclei, 111
lntermesenteric plexus, 267, 318, lntefiransversarius muscle, lateralt lntraparietal sulcus, 105
322, 323, 324, 344, 345, 412 176 lntrapulmonary airway
renal and upper ureteric branches lntertransverse ligament, 187 schemaof, 204
frofi,344 fntertrochanteric crest, 487, 503 lntrapulmonary blood circulation,
Intermetacarpal ioint, 455 anteroposteriorradiographof, 488 205
Intermuscular septum fntertrochantelic line, 487, 489 Intiaspanatus tendon, 423
anlerior,522 lntertubercular plane, 268 Intrinsic arterg of eye, 90
anteromedial, 492, 500, 501 lntertubercular tendon sheath, 423 Intrinsic muscle
lateral,430, 432, 435, 445, 448 Interureteric crest, 366 action of, 79
oI arm,477 Interventricular foramen (of Monrol, of larynx,78
medial,430, 432, 433, 445, 446,447, 1 0 6 ,1 0 9 ,1 ' r 1 , 1 1 51, 4 5 ,1 4 6 of tongue,128
448 left,108 Intrinsic nerve, pancreatic, 328
posterior, 522 Interventricular septum, 216, 22O Intrinsic vein, of eyer 90
transverse,522 muscularparl ot, 220, 223, 224, 225 lridocorneal angle, 87, 88, 90
lntermuscular stroma, 326 Interventricular sulcus trabecularmeshworkand spaces of, 88
lnternal capsule, 108, 141 anterior,246 lris, 81, 87, 89, 90
cleft for, 110 posterior,214,215 arteriesof, 9'1
g e n uo f , 1 1 0 Interveitebral disc, 19, 155. folds of, 88
retrolenticular part of, 110 Intervertebral disc, 19, 155. See a/so major arterialcircleof, 88, 90, 91
Interosseous artery specific veftebrae minor arterialcircle of, 88, 90, 91
anterior,434,447 anulusfibrosisof, 155 veins of, 91
computedtomographyof, 484 lumbar,157,339 lrritant rcceptots, 210
common, 434, 447, 448, 449 lumbosacral,352 lschial spine, 248,263, 411, 486, 487,
posterior, 434, 445, 448, 449 nucleuspulposusof, 155 503
recurrent.434.445 sternalangle of, 245 female,354
terminationof, 445 lntervertebral disc space, 156 radiographof, 355
Interosseous intercarpal ligament, lntervertebral foramen, 19, 180 lschiaf tuberpsity, 248, 352,353, 359,
455 lower marginof, 154 378, 379, 381, 390, 395, 398, 486,
Interosseous ligament, intercarpal, lumbar,155 487. 502. 503
455 radiographof, 156 anteroposteriorradiographof, 488
Interosseous membrane, 439, 441, Intervertebral joint, 18 female,354
443,444, 454, 455,511,512,517, fnterveftebral vein, 137, 173 male,354
5 1 8 ,5 2 0 ,5 2 2 , 5 2 5 Intestinal glands, 326 radiographof, 355
Interosseous muscle, 528 Intestinal lymphatic trunk, 316 lschioanal fossa, 366, 392
deeo tibial nerveto. 541 Intestinal trunk, 266 anteriorrecessof, 366, 370, 396
dorsal,462, 465,470,476,531,536, Intestine, 167.Seea/soColon; fat body ot, 376, 380, 392
537 Duodenum;Jejunum;Mesocolon posteriorcommunicationbetweenright
first, 445, 460, 465, 530 circularmuscleof, 326 and left, 396
of foot, 536, 537 intrinsicautonomicplexusesof, 326 posterior recess of, 396
dorsal,536 rarge preanalcommunicationbetweenright
palmar,465,476 arteriesof, 307 and left, 396
plantar,535 innervation of,324 pus in, 396
plantardorsal,536 lymph nodes vesselsand nodes of, roof of, 405
super{icialtibial nervebranchto, 541 317 transversefibrousseptum of, 392, 394,
lnterosseous nerve mucosaand musculatureo1,284 395
anterior,448, 449,475 nervesof,323,324 lschiocavernous muscle, 360, 361,
of leg,541 schemaof, 324 370, 378,379,381, 382, 383,391,
plantar,537 veins of, 311 395. 404. 405
posterior,445,449 longitudinal muscleof, 326 crus of, 366
Interosseous talocalcaneal lumenof, 326 lschiococcygeus muscle, 263, 356,
ligament,527 mesentericrelationsot, 270, 271 357, 398, 402, 411, 412, 499
Interpectotal (Rotter's) lymph mucosaof, 326 nerveto, 499
nodes,184 s m a l l ,1 2 6 , 2 6 9 , 3 2 2 lschiocondylar muscle, 540
lnterpeduncular cistern, 109 area for, 329 lschiofemoral ligament, 487
Interphalangeal ioint, 41I arteriesof,306 fschiopubic ramus, 359, 361, 378,379,
capsulesand ligamentsof, 528 innervationof, 324 380, 382, 383, 384, 395
Interphalangeal ligaments, 458 lymphnodesof, 316 lschium
Intersigmoid recess, 271, 340 lymphvesselsof, 316 anteroposteriorradiographof, 488
Intersphincteric groove, 392, 393, mesenteryof, 348 body of, 486
394 mucosa and musculatureof, 280 radiographof, 355
lnterspinalis cervicis muscle, 176 nervesof, 322 ramusof, 486
schemaof, 324

J Kidneys (Continued) L4 vertebra
lymph vesselsand nodes of, 343 body of, 352
Jaw. See a/so Mandible;Maxilla majorcalicesof, 334 inferiorvertebralnotch of, 156
angleof, 1 medialborderof, 334 laminaof, 156
closed,16 medullaof, 334 posteriorview of , 155
slightlyopened,16 minor calicesof, 334 spinous processof, 156
widely opened, 16 nervesof, 334 L5 Yenebra, 153, 160
Jejunal artery, 306, 307 outer zone of. 336. 345 body of, 352
anastomoticlooo of. 280 perforating radiate artery of, 335 superiorvertebralnotch of, 156
first, 302 posteriorsurfaceof, 335 Labb5 vein. See Inferioranastomotic
plexuson, 3190 prenatal,229 vein (of Labb6)
Jeiunal vean,311,313 renalcolumn of, 334 Labial artery
Jejunum, 269,270,271, 278, 279,297, renal cortex of. 338 inferior,69
298 renalpapillaof, 334 posterior,404
bariumradiographot, 279, 280 retroperitoneal, 288 superior,69
circularmusclelayerof, 280 right,197, 275,298,329,330, 34O,342, Labiaf nerve, posterior, 413,414
cross sectionof, 297, 338 347 Labial vein
longitudinalmuscle layerof, 280 subscapularzone of, 336, 337 inferior,70
lymphoidnoduleof, 280 superiorpole of, 272,334 superior,70
mucosaof, 280 cross section of, 338 Labioscrotal swelling, 388
musculatureof, 280 Knee Labium majus, 360, 365, 388
submucosaof, 280 anteriorviews of, 507, 508 Labium minus, 360, 365, 388
Jugular foramen, 103, 125, 126,127 anteroposteriorradiographof, 510 Labyrinth
Jugular fossa, 8, 11 arteriesof, 507 bony,95, 96
Jugular lymphatic trunk, 208 articularcavity of, 511 common limbs of, 95
Jugular nerve, internal, 1, 10 attachmentof, 511 right,95
Jugular notch, 28, 181,196 collateralligamentsof, 509 schemaof, 96
Jugular |runkr T2 cruciateligamentsof, 509 superiorproiectionof, right,97
left, 266 in extensionof, 507 common membranouslimb of, 95
right,266 in flexion,509, 543 membranous,95, 96
Jugular vein interiorof, 508 right,95
anterior,30,74,256 joint capsuleof, 506, 508, 519 schemaof, 96
communicationto, 70 lateral view of, 506 orientationof in skull, 97
terminationof, 70 ligamentsof, 508, 509 Labyrinthine artely, 1 40, 141, 143
external,23, 31, 74, 198, 206, 211, 256 medialview of, 506 internal,143
interna|,23,28,29,30, 31, 32, 34, 59, posteriorview of, 511 left, 136
74, 75, 76, 97, 128,189, 198,206, right Lacdmal apparatus,82
211,232,256 in extension.507. 509 Lacrimal artery, 85
inferiorbulb of, 75 in flexion,509 recurrentmeningealbranchof, 100
left, 137 sagittalview of, 511 Lacrimal bone, 2, 4,6, 12,38
right,137 slightlyin flexion,507 at birth,46
Jugulodigastric muscle, 73 Kohn, pores otr 204 Lacrimal canaliculi, 82
Juguloomohyoid node, 73 Lacrimal carunele, 81, 82
Jugum,9 L Lacrimal gland, 83, 85, 86, 133,166,
167,168
K Ltl-5 disc herniation, 162 excretory ducts of, 82
L5-Sl disc herniation, 162 orbital part of, 82
Kerckring, valves ol, 279, 28O L2 gangLonr 4l2 palpebralpart of, 82
Kidneys, 167, 179,272, 278, 338 Ll spinal nerve, 160 Lacrimal lake, 81, 82
anterior surface of, 335 ventralramusof, 177 Lacrimal nerye, 83, 86, 121, 122,131
base pyramidof, 334 Ll-3 spinal neryes, dorsal rami of, cutaneousbranchof, 45
blood vesselsin parenchymaot,334, 254 palpebralbranchof, 82
337 L5 spinal nerYe, 160,412 Lacrimal papilla
blood vesselsof, 332, 333, 347 anteriorramusof,410 inferior,81, 82
cortex of, 334, 336, 337 Ll vertebra, 153,160 superior,81, 82
cortical radiate arteries of, 335 body of, 273 Lacrimal sac, 81, 82
fibrouscapsuleof, 334 inferiorarticularprocessof, 156 fossa for, 2, 4
hilumof, 334 spinousprocessof, 179 Lactilerous duct, 182
inferiorpole of, 334 superiorarticularprocessof, 156 Lactiferous sinus, 182
in situ transverse process of, 338 Lacuna
anteriorviews of, 329 L2 vertebra lateral(venous),99, 100
posterior,330 body of, 179 magna,385
innervationof, 345 suoeriorview of. 155 Lacunar ligament (Gimbernat's|,
innerzone of, 336 L3 vertebra 250,251,259,263,546
interlobararteriesof, 335 b o d yo f , 1 5 6 , 3 3 6 , 3 3 7 Laimer, anea of. See V-shaped area (of
lateral border of, 334 pedicleof, 156 Laimer),234,235
left, 98, 197, 273, 299, 329, 331, 340, posteriorview of, 155 Lambda,7
347 spinousprocessof, 156 Lamina, lumbar, 155
axial CT imagesof, 350 transverse process of, 156 Lamina affixa, 111
frontal section of, 329 Lamina cribrosa,87
superiorpole of, 297 Lamina terminalis, 106, 107, 147

Langerhans, islets of, 298 Leg (Continued) Ligamenta flavat 21
Laryngeal vein, superior, 235 innervationof, 538, 539 Ligaments. See a/so specific ligaments
Laryngeal artery interosseousmembrane,522 of abdominalwall and viscera,348
recurrentright, 126 interosseousnerveof, 541 ol ankle,527
superior,34, 69, 74, 75, 136 medial cutaneous nerves of, 538 of elbow, 438
Laryngeal inlet, 63, 66, 235 musclesof of foot, plantar view of, 528
Laryngeal netve (Xl anteriorview of, 519, 520 of knee,508, 509
externalbranchto, 74 attachmentsof, 515 pelvic,352-353,372
inferior deep dissectionof, 518, 520 of wrist, 454,455
anomalousright, 80 lateralview of, 521 Ligamentum arteriosum, 206, 212,
anterior and posterior branches of, 80 posteriorview of, 516, 517 221.229.231
left, 80 superficialdissectionof, 5'16 node of, 208
internalbranch ol. 75. 235 posteriorintermuscularseptum of, 522 prcnatal,229
left, anterior and posterior branches of, right,bonesof, 513 Ligamentum flavum, in lumbar
80 surface anatomy of, 485 puncture, 162
recurrent,33, 71, 76, 130, 206, 2O9,21O, transverseintermuscularseptum of, 522 Ligamentum nuchae, 21, 152
211, 212, 226, 231,232, 240 Lens,81,88,90 Ligamentum teres, 229, 288,349
left, 74, 75, 76, 126, 193, 210, 211, axialMR imageof, 150 fissurefor, 287
243,244 axis of. 88. 89 orenatal,229
right, 74, 75, 80, 226, 235, 240 capsuleof, 87, 88 Ligamentum venosumr 229
superior,75, 76, 80, 130, 131, 235 cortex of, 87, 88 fissure fon 287
externalbranch of, 75,80, 126 equatorof, 87, 88 prenalal,229
fold over internalbranchof, 66 nucleusof, 88, 89 Light, cone of, 93
foramenfor internalbranchof, 78 supportingstructuresof, 88, 89 Limen, of insula, 141
internalbranchesof, 62, 65, 71, 74, suspensoryligamentof, 87, 88 Limen nasi,37
75,76,78,80,126 Lenticufostriate artery, 140, 141, 143 Linea alba, 181, 188, 247, 249, 250,
Laryngeal plominence, 77 anterolateralcentral,139 258,259,331
Laryngopharyngeal sympathetic Lentiform nucleus, 108, 141 axial CT images of, 350
branch, 130 globuspallidusof, 110 Linea aspera, 489
Laryngopharynx, 63 putamenof, 110 Linea terminalis, 157, 353, 364, 370
opened posteriorview of, 66 thalamusand, 110 Lingual artery, 23,32,34,59, 60, 69,
L a r y n x , 1 3 5 ,1 6 7 ,1 6 8 , 2 1 0 Leptomeninges, 170 7 5 , 1 3 3 ,1 3 6 , 1 3 8
carlilage o1,77 Lesser sac, 331 deep,51,59
innervationof, 168 Levator anguli oris mu$cle, 54,123 dorsal,59
intrinsicmusclesof, 78 Levator ani mu6cle, 263,284,312, tonsillarbranch of. 64
action of, 79 367,376,411, 499 Lingual glands lsercus glands of
lateraldissectionof, 78 fibersto anal canal longitudinalmuscle von Ebnerl, 58
medianview of, 77 from, 358 Lingual gyruE, 106
nerves of, 80 fibromuscularextensionsof. 359 Lingual nerve, 23, 40,53,55, 59, 60,
posteriorview ot, 77, 78 left, 356 1 2 2 ,1 2 3 ,1 3 1 ,1 3 3 ,1 3 4 ,1 3 5
right lateralview of, 77, 78 levator plate ot, 356, 357 deep, 51
sensorybranchesto, B0 medialborderof, 359 Lingual tonsil, 58
superiorview of, 80 nervesto. 267.499 Lingual vein
Lateral aperture (foranen of pelvic,360 common trunk for, 59
Luschkaf, 109 prerectalmusclesfrom, 359 deep, 59, 70
Lateral funiculus, 115 puborectalispart of, 391 dorsal,59
Lateral nectus muscle, 84 tendinousarch of, 263, 356, 357, 358, L i n g u l a , 1 5 , 1 1 3 , 1 1 5 ,1 4 4 ,1 9 9
Lateral rctus plane, 286 359, 364, 365, 370, 379, 392 bronchito, 202
left, 268 Levator costae muscle, 176 Lip
right,268 Levators costarum muscle frenulumof, 51
Lateral sulcus, 107 brevis,176 lower,51
anterior,ascending,and posteriorrami longus,176 ohiltrumof, 51
of, 105 Levator labii superioris alaeque tubercleof, superior,1
Latissimus dorsa tendon, 244, 245 nasi muscler26,54, 123 upper,51
left,244 Levator labii superioris muscle, 26, Lister's tubetcle. See Dorsaltubercle
Latissimus dorsi muscle, 152, 174, 54,123 of radius (Lister's)
177, 179, 180, 181, 188, 246, 249, Levator palpebrae superioris Liver, 126, 196, 197, 272,278,293,294,
250, 258, 293, 424, 428, 433 muscle, 81, 83, 84, 86, 121 297,331, 339,342,347
costal originof, digitationsof, 254 coronalCT imagesof, 151 anatomiclobes of, 289
fascia of, 428 fascialsheathof, 83 anteriorview o1,287
insertionof, 420 insertionof, 81 areator,329
small slip ol origino1,421 Levatof scapulae muscl'e, 27,32, arterial variations and collateral supply
Leg 174,177, 189,424,427,477 of, 305
anterior fascial compartment of, 522 insertionof, 421 arteries of, 300, 301
anteriorintermuscularseotum of. 522 nervesto, 129 bare area of,329,342
cross section of, 522 Levator veli palatini muscle, 47, 51, bed ot,287
deep fascia oI, 522,544, 546 55, 64, 65, 67, 68, 93, 126 caudatelobe of, 272,288
posteriorcompartment,522 interdigitagingfibers of, 52 central veins of. 290
fascialcompartmentsof, 522 Lieberk0hn, crypts ol, 283 coronaryligamentof, 274
late'al,522 Lienogastric trunk, 302 cross sectionof, 297, 338
superiorposterior,522 Lienomesenteric trunk, 302 distributingvein of, 291

Livet (Continued) Lower limb. See a/so Leg Lumbar vertebra (Continued)
duct distributionin, 289 arteriesof. 500-502. 504 superiorarticularprocessof, 155
falciformligamentof, 255 cutaneousinnervationot, 487489 superiorvertebralnotch of, 155
fibrousappendix ol, 287 dermatomesof, 543 superiorview of, 155
functionalsurgicalsegmentsof, 289 lymph nodes and vesselsof, 546 transverse processes of, 248
inferiorborderof,268,275 musclesof, 490-503 transverseprocess of, 248
in situ,288 neurovasculature of , 538-546 Lumbocostal ligament, 330
inletvenulaof, 291 segmentalinnervationof movementsof, Lumbocostal triangle, 195
innervationof, 168, 326 543 Lumborum muscle, interspinalis,
intrahepaticvascularand duct systems superficialnervesand veins of, 544 t/o
of, 290 anteriorview of, 545 Lumbosacral articular surface, 157
intralobulararterioleof, 291 oosteriorview of. 545 Lumbosacral fascial sheath, 462
left lobe ol, 269, 275, 288 surfaceanatomyof, 485 Lumbosacral trunk, 267, 496, 498,
left triangularligamentof, 274 Lumbar artery, 171 499, 538, 539
ligamentsot,287,312 fifth, 264 Lumbosacral vertebrae
lobes of, 289 lower,anastomosiswith, 255 inferiorarticularprocessof, 159
low-powersectionof, 292 right,264 invertebralforamenof, 159
lymph pathwaysto, 184 Lumbar curvature, 153 laminaof, 159
normallobularpatternof, 290 Lumbar disc herniation, 162 ligamentsof, 159
papillaryprocessof, 287 characteristicposturein, 161 ligamentumflavumof, 159
parietal surface of, 289 clinicalmanifestationsof, 161 pedicleof, 159
periportalarterioleof, 291 left-sidedlower,161 spinousprocessof, 159
perivascularfibrouscapsuleof, 290 levelof and clinicalfeaturesof. 161 superiorarticularprocessof, 159
portal arterioleof, 291 surgicalexposureof, 161 transverseprocessof, 159
posteriorlateralsegmentof, 289 Lumbar disc protrusion, 161 Lumbrical fascial sheath, 460
posteriorview of, 287 Lumbar enlargement, 161 Lumbrical muscle, 465, 533, 534, 536
prenatal,229 Lumbar ganglion, 167,318 deep tibial nervebranchto, 541
quadratelobe of, 275 Lumbar lymphatic trunk in fascialsheaths,460
rightlobeof, 269, 275,288 to cisternachyli and thoracicduct, 343 first, 541
axial CT imagesof, 350 right and left, 316 fourth,460
round ligamentot, 229, 256, 275, 349 Lumbar lymphatic trunk ganglion in fascialsheath,460
segmentsof, 289 lower,228 innervationof, 465, 541
structureof, 29 upper,228 schemaof, 463
sublobularlobes of, 290 Lumbar lymph nodes,266 second,460, 541
surfacesof, 287 Lumbar nerve, 161 in fascial sheath, 460
topographyof, 286 Lumbar nucleus pulposus, tendons of, 535
variations in form of, 288 herniated, 161 third, 460
vascularsystemof, 290 Lumbar plexus, 160, 496, 498, 538, 539 in fascialsheath,460
veins of, 291 muscufarbranchestrom, 267 third and fourth,476, 541
visceralperitoneumof, 331 Lumbar puncture, 162 Lumen,326
visceralsurfaceot. 287. 289 Lumbar region, 268 Lunate, 376,456,487
Liver plate cells, 290 Lumbar spinal nerve, 161,179 anterior(palmar)view of, 452
Lobule (earl, 1 dorsal and ventralroots of, 170 area for, 439
Locus ceruleus, 115 dorsalramiof, 177 coronalsectionof,455
Longissimus capitis muscle, 175, 178 originof, 170 posterior(dorsal)view of, 452
Longissimus cervacis muscle, 175 Lumbar triangle (of Petitf, 152,254 radiographof, 457
Longissimus erector spinae internalobliquemusclein, 174 Lunatesulcus,105
muscle,349 Lumbar trunk Lungs,167, 168, 170, 342
Longissimus muscle, 175, 331 ascending,195, 263, 265, 332 anteriorborderof, 196
Longissimus thoracic muscle, 175 left, 266 anteriorview of, 200
Longitudinal esophageal muscle, right,266 apex of, 196,197
cricoid attachment of, 65, 67 Lumbar vein, ascending, 332 areafor esophagusin, 196
Longitudinal intramuscular plexus, Lumbar Yertebra area for tracheain, 196
326 anteriorview of, 171 bronchopulmonary segmentsof, 200,
Longitudinal ligament arteriesof, 171 201
anterior,63, 65, 179, 187, 263, 331, 348, assembled,153 cardiacimpressionof, 196
349, 353, 362, 363 body of, 153 cardiacnotch of, 196, 198
posterior,22 cross sectionthrough,170 diaphragmaticsurfaceof, 196
Longitudinal muscle dura mater of, 162 great vessels of, 206
conjoined,392, 394 foramenof, 155 groovefor esophagusin, 196
conjoinedrectal,393 inferiorarticularprocessof, 155 hilumof, 196
of intestine,326 inferiorvertebralnotch of, 155 horizontal fissureof, 196, 197,198
rectal,393 intervertebraldisc of, 155 inferiorborderof, 196
of tongue laminadisc of, 155 inferiorlobe of, 198,200
inferior,60 left lateralview of, 155 medialview of, 199
superior,60 mammillaryprocessof, 155 in situ, anteriorview of, 198
Longus capitis muscle, 27, 30 musclesof, 179 left, 197, 211, 215, 243, 245
nervesto, 129 pedicle,sectionedof, 179 bronchopulmonary segmentsof, 200,
Longus colli muscle,30 posteriorview of, 153 201
Loops of Heiss, 367 radiographsof, 156 inferiorlobe ol,2O1,293
spinousprocessof, 155 medialview of, 199

Lunate (Continued) Lymph nodes (Continued) Malleolus,92
obliquefissureof, 244 of male pelvisand genitalia,408 arterialnetworkof, 520
superiorlobe of, 201,242 of mammarygland,184 lateral,485, 513, 514, 520, 521, 530, 531
left medial,198 mediastinal, 243 articularfacet of, 513, 514
lingulaof superiorlobe of, 198 pancreatic,3lS radiographof, 54
lobesof, 198 pancreaticoduodenal, 315 m e d i a l4, 8 5 ,5 1 3 ,5 1 4 ,5 1 7 ,5 1 8 ,5 1 9 ,
lymph nodes of, 208 paracolic,317 530, 531
lymph vesselsand nodes of, 208 of pelvisand genitalia,408 articularfacets of, 514
lymph vesselsof, 208 perianal, 317 radiographof, 54
medialview of. 198.199 of pharynxand tongue,73 Malleus,96
middlelobeof. 198.200 phrenic,184,266 anteriororocessof. 93
obliquefissureof, 196, 197 of posteriorabdominalwall, 266 handleof, 93
right,193, 196, 197, 198, 211, 243,244, pretracheal,74 h e a do f , 9 2 , 9 3 , 1 2 4
245 rectal,317 lateralprocessof, 93
bronchopulmonary segmentsof, 200, sigmoid,317 lateralview of, 93
201 sinuatrial,225 neck of, 93
inferiorlobe ot. 201. 293 of smallintestine, 316 superiorligamentof, 93
medialview of, 199 splenic,314 Malpighian corpuscle, 336
middlelobeof, 201 of stomach,314 Mammary gland
superiorlobe of, 201 subclavian, 184 anterolateraldissectionof, 182
root of, 193 submandibular, 60, 73 aderiesof, 183
spinalnervesto, 170 submental,73 lobulesof, 182
superiorlobeof, 198,2O0,242 subpyloric,314 lymph vesselsand nodes of, 184
topographyof superiortracheobronchial, 244 sagittalsectionof, 182
anteriorview of, 196 suprapyloric, 314 subcutaneoustissue layerof, 182
posteriorview of, 197 tracheobronchial suspensoryligamentsof, 182
Lunotriquetral ligament, 454 inIerior,245 Mammiffary body, 106, 107,112,114,
Lunula, 223 of upperlimb,483 147
Luschka, foramen of, 19, 108,109 visceral,266 llammillary pnocess, lumbar, 155
Lymphatic drainage, from prostate Lymphoid nodule llammillothalamic fasciculus, 106
gland, 408 aggregate,283 Mammillothalamic tract, 147
Lymphatic duct, 208 of ileum,280 Mandible, 15
Lymphatic pathway, hand, 468 of jejunum,280 of adult
Lymphatics Lymph vessels anterolateralsuperiorview of, 15
apicalcollectingvessels,73 drainageroutesof, 204 left posteriorview of, 15
basalcollectingvessels,73 of femaleperineum,407 ofaged persons,l5
centralcollectingvessels,73 of head and neck, 72 alveolarpart of, 15
marginalcollectingvessels,73 of kidneysand urinarybladder,343 angleof, 15
Lymphatic trunk, 316 of largeintestine,317 base of, 15
Lymph follicle,58 of liver,291 body of, 15,27
of stomach,276 of lowerlimb,546 condylarprocessof, 15
Lymph nodes of lung,208 coronoidprocessof, 15
aortic, lateral,266, 343, 406 of male pelvisand genitalia,408 temporalismuscleinsertionto, 54
axillary,428 of mammarygland,184 headof, 15
central,428 of pelvisand genitalia,408 of infant,15
pectoral(anterior),428 of posteriorabdominalwall, 266 lingulaof, 15
bronchopulmonary, 199, 208, 230,231 of smallintestine, 316 mentalprotuberanceof, 15
buccinator,72 of stomach,314 mentalspinesof, 15
celiac,266, 314, 315 of trachea,2O2 mentaltubercleof, 15
c e r v i c a l7, 2 , 7 3 , 2 0 8 of upperlimb,483 neckof, 15
anteriordeep,72 obliquelineof, 15
anteriorsuper{icial,72 M pterygoidfovea of, 15
deep lateral,73 ramusof, 15,25,27
rnferiordeep,72,208 Macula,90 Mandibular canal, 60
inferiordeep lateral,72 fovea centralisin, 90 Mandibular foramen, 15
posteriorlateralsuperficial,72 Macular arteriole inferioralveolarnerveentering,46
superiordeep lateral,72 inferior,90 llandibular fossa, 12, 16
superiorlateralsuperior,72 superior,90 llandibular lymph node, 72
transversechaino'f,72 Macular zone, 120 Mandibular nerve (V"1, 11,24, 46,86,
colic,317 llagendie, foramen of, 108 122, 125,131, 133, 134, 135
of femalepelvisand genitalia,406 Magnetic resonance imaging (MRII anteriordivisionof, 46
of femaleperineum,407 o f h e a d ,1 4 9 , 1 5 0 lateralview of, 46
gastro-omental, 314 pelvic,397 marginal,25,31
of head and neck, 72 Mallear fold medialview of, 46
heoatic.314 anterior,93 meningealbranchof, 10,86
inguinal,266 posterior,93 motor root of, 46
interoectoral.184 Mafleolar arlely posteriordivisionof, 46
of kidneysand urinarybladder,343 anteriorlateral,530 sensoryroot of, 46
of largeintestine,317 anteriormedial,530 Mandibular notch, 15
of lowerlimb,546 Manubriosternal joint, 186
of lung,208 llanubraosternal junction, 245

Manubriosternal synchondrosis, 419 Medial rectus muscle, 83 lleningeal artery (Continued)
Manubrium, 186, 198,243,244,419 Median apertune lloramen of middle,40, 55, 99, 100, 102, 131, 138
Marginal artery, 307, 323 Magendief, 109 posterior,11
of largeintestine,307 Median nerve, 429, 433, 446, 447, 454, lleningeal nerve, 45
left,216 460, 465,474,475 lleningeal plexus, middle, 131
Marginal plexus, 323 anteriorinterosseouspart oI, 476 teningeal vein, middle, 102
Marginal sulcus, 106 anteriorview of, 475 lleningeal vessel gnooves
Marshall, ligament ol, 221 articularbranchof, 475 anterior,9
Masseteric artery, 40, 54, 55 branchesto thenarand lumbricalmus- middle,6, 7, 9
Masseteric nerve, 40, 54, 55, 122 cles, 465 posterior,9
Masseter muscle, 25, 27, 28, 47, 60, 61 in carpaltunnel,461 Meningeal vessels, middle, 10
axial CT imageof, 150 common palmardigitalbranchesof, 460 Meninges, 10,136
axialMR imageof, 150 communicatingbranchwith ulnarnerve, arteriesof. 99, 136
deep part of, 54 4IO innervationof, 325
insertionof, 54 communicatingwith ulnar newe,475 spinal,102,324,325
superficialpart of, 54 to cutaneousinnervation,475 superficialveins of, 102
Mastication, muscles of, 54,55 palmarbranch ol, 446, 447, 475, 481 veins of. 99
Mastoid angle, 9 palmardigitalbranchesot,473, 481 Meningohypophyseal ttunk' 100
Mastoid antrum, 94 palmarview of, 475 Meniscofemo?al ligament,
Mastoid canaliculus, 10 posterior view of, 475 posterior,508, 509
Mastoid cells,94 properpalmardigitalbranchesof, 469 Meniscus,455
Mastoid emissary vein, 10, 137 recurrentbranch ol, 474 lateral,507, 508, 509, 511
Mastoid foramen, 10 to thenar muscles,460 horns of, 508
Mastoid process, 14, 25, 27, 28, 29, lledian sulcus, dorsal, 115 medial,507, 508, 509
3 0 , 3 4 , 5 3 , 5 91, 7 6 llediastinal lymph nodes, 184 horns of, 508
Maxilla,2, 6, 38 anterior,pathwayto, 184 Mental foramen, 15
alveolarprocessoI, 2, 4, 6, 13, 38, 48 posterior,266 Mentafis muscle, 26, 54, 123
anteriornasalspineol,2, 4,6, 36, 38 llediastinum Mental nerYe, 24, 46, 71, 122
at birth, 50 anteriorlung area lor, 194 Mental plotuberance, 1
frontalprocessot,2, 4,36, 38, 81 cross sectionof. 241 llesencephalic vein
incisivecanal of, 6, 38, 40 fat pad in, 231 lateral,144
incisivefossa of, 8 left lateral view of, 231 posterior,144, 146
infraorbitalforamen ot, 2, 4, 12 right lateralview of, 230 Mesenteric artery
infratemporalsurface of, 4 superior,great vesselsof, 206 inferior,270, 278, 307, 308, 318, 323,
maxillarysinus in, 50 tedufla oblongata, 11, 106, 124,134, 329,332,340, 341
medialpalatinesutureof, 8 1 3 5 ,1 6 8 , 3 2 4 , 3 4 5 superior,179,27O,281, 298, 301, 305,
nasalspine of, anterior,36 axial MR imageof, 150 306, 307,308, 319, 321,322,328,
nasal surface of, 6 cross sectionof, 124 332,339,340,342
orbital surface of, 2 lower part of, 135 common ongrnof, 302
palatineprocessof, 5, 6, 8, 14, 37, 38, nuclearlayerof, 113 relationsof,310
52,56 sagittalMR imageof, 149 in root of mesentery 270
tuberosityot,4, 14 lledullary artery llesenteric ganglion, 126
zygomaticprocessof, 2, 8 anteriorsegmental,171,172 inferior,165,167,318, 323,409
llaxiflary arte;y, 16,34, 40, 54,71, posteriorsegmental,171 superior,165, 167, 168, 267,298, 318,
100,131,134 tedullary lamina 320, 322, 323, 324, 325, 328, 344,
branchesof, 40 external,111 345, 346, 409
lfaxillary bone,47 internal,111 Mesenteric lymph nodes, 315
Maxillary nerve {Vrf, 45, 86, 121, lledullary (renall lymph vessels, inferior,266, 317
131,133,134,135 J4J superior,266, 314, 317, 321
dentaland gingivalbranchesof, 45 lledullary vein Mesentericoparietal necess, 179,
meningealbranchof, 86,122 anteromedian,144 270.271
nasalbranchof, 122 anteriorsegmental,173 Mesenteric plexus
pharyngealbranch ot, 122 anteromedian,144 inferior,165, 318, 323
posteriorsuperiorlateralnasal branchof, posterior,173 superio( 165, 166, 318, 319, 32O,322,
42,43 Medullary velum 328
llaxillary plexus, 131 inferior,106, 113 Mesenteric vein
Maxiflary sinus, 3, 5, 44, 47, 48, 49 superior,106, 113, 114, 115 inferiol''27O,298, 311, 312, 313, 315
alveolarrecessof, 48 lleibomian glands, 81 superior,179,279, 306, 311, 312, 313,
axial MR image of, 150 lleissnerts plexus. See Submucous 338, 339, 342
coronalCT imagesof, 151 (Meissner's)plexus cross section of, 338
growth of, 50 Membranous ampulla relationsof,310
infraorbitalrecessof, 48 anterior,95 Mesenteric vessels, supeTiotr 278,
mucous membraneof, 45 lateral,95 349
with openinginto semilunarhiatus,50 posterior,95 Mesentery
openingsof, 37, 38, 48, 49, 50 llembranous septum of ileum,280
postganglionicfibersto vesselsand atrioventricularparl ot, 222, 223, 225 of lejunum,280
glandsof, 44 interventricularpart ot, 223, 225 peritoneallayersof, 326
sagittalMR image of, 149 lleningeal artery, 99, 100 root of, 270, 274,278,296,298,310,
zygomatic recess of, 48 accessory,11, 40, 100 340, 362, 363
Maxillary vein, 85 anterior,85 superiormesentericvein and, 310
McBurney's point, 283 left middle,136 of small intestine,349

lf esoappendix, 281, 283, 322 Midclavicular line lfuscles (Continued)
llesocolic taenia, 281, 282, 284 left, 268 superficialdissection of
llesocolon right,268 anteriorview ot, 518, 519
sigmoid,271, 284, 3O7,329, 340 Midline gnoove, 58 posteriorview of, 516
attachmentof, 274 Midpalmar space, 460, 462 of lower limb, 485
transverse,269, 270, 271, 272, 273, 278, Minute arteries, of finger, 471 of mastication,54, 55
284,307 Mitral cell, 119 of neck
attachmentof, 298, 299 Mitraf valve, 213,225 anterior view of. 28
llesometrium, 371 anatomyof, 223 lateral view of, 27
llesonephric lwolffianl duct, 389 anteriorcusp of, 222,223,224 of pharynx,65, 67, 68
llesonephric tubule commissuralcusps of, 222 lateral view of, 68
vestigial, 390 fibrousring of, 222 of rotator cuff, 425
Mesosalpinx,369 leafletof, 246 of shoulder,424
laminaeof, 372 left fibrous ring ol,222 of small intestine.280
Mesothelial septum, 169 posteriorcusp of, 222,223,224 of sole of foot
llesovarium,370 Molar teeth first musclelayerof, 533
laminaeof, 372 first, 56 second musclelayerof, 534
Metacarpal artery growth of, 50 third muscle layerof, 535
dorsal.469. 530 second,56 of stomach,277
palmat 465 third,56 of thigh, 492495
Metacarpal bone,456 Monro, foramen of. See Interventricular of tongue,59, 60
anterior(palmar)view of, 452 foramen(of Monro) of vermiformappendix,283
base of, 456 llorgagni, hydatid of. See Vesicular Ituscular artery, 90, 91
tifth,444 appendix(hydalidof Margagni) lluscularis mucosae, 276
base of, radiograph of, 457 llorison's pouch. See Hepatorenal of anal canal and rectum,394
head of. 456 recess(Morison'spouch) tuscular vein, 90
posterior (dorsal)view of, 452 llouth nerve,429,43O,
second,445 afferent innervationof, 62 433, 435, 447, 449,474, 475, 480
shaft of, 456 floor of, 53 terminalpart of, 446, 469,479,482
third, 456 nerves of, 62 Musculophrenic artery' 189, 198, 211,
lletacarpal ligament roof of, 52 215
deep transverse,465 anteriorview of, 52 Musculophrenic vein, 189, 256
dorsal,455 posteriorview of, 52 ifyelencephalon, 423. See a/so
palmar,465 Mucosa, intestinal, 279, 280 Medullaoblongata
superficialtransverse,480 Mucous cell, stomach, 276 llyenteric (Auerbach'sl plexus' 326
lletacarpal vein, dorsal, 468 lltllerian duct. See Paramesonephric llylohyoid groove, 15
lletacarpophalangeal lMPl ioint, 458 (miillerian)duct llylohyoid line, 15
lletacarpophalangeal lllPl Multifidus mu3cle, 176 lfyfohyoid muscle, 27, 28, 29, 31, 32,
ligament,458 lluscles. See also specific rnuscles 34, 53, 59, 60
tetaphyseal arcuate ligament, 455 anorectal,394 medianraphe between,53
lletaphysis, nutrient arterial of arm nerveto, 55, 60
branch lor 471 anterior view of. 430 llylohyoid nerve, 16, 40, 46, 53, 122
lletatarsal artery posterior view of, 432 llyometriumr 371
dorsal,530, 535, 536 of back, 174,175,176
anterior perforating branches of, 535 deep layersof, 176 N
posterior perforating branches of, 535 intermediatelayersof, 175
plantar,535, 536 supediciallayersof, 174 Nail bed,471
anteriorperforatingbranchesof, 535 of dorsum of foot, 530 Nail matrix,471
Metatarsal bone, 523, 524, 536 of duodenum,279 Nail root, 471
base of, 523 of esophagus,234 Nares
fifth, 523 extrinsiceye,84 anterior,1
tuberosityot,523,530, 535, 536, 537 of face. 123 posterior,14
first,523, 524,537 of facialexpression,26, 60 Nasal artery
fourth, 523 of foot, 536 dorsal,23, 36, 40, 81, 85
head of, 523 of forearm,440, 441, 446, 447, 448 external, 36
plantarview of, 523 of hand,465 lateral,36
second,523 of hip and thigh, 492-493 Nasaf bone, 1, 2, 4, 6, 12, 36, 38, 39
shaft of, 523 lateral view of, 494 at birth,50
third,523 posteriorview of, 495 Nasal cavity, 82,83
tuberosityof, 523, 524,537 innervatedby femoralnerve,538 arteriesof, 41
lletatarsal ligament innervatedby obturatornerve,540 autonomicinnervationof. 44
deep transverse,536 of largeintestine,284 bones of, at birth,50
dorsal,536 of larynx,78 floor of. 37
plantar,528, 536 of leg growth of, 50
superficialtransverse,532 anteriorview of, 520 lateralwall of, 37, 38
Metatarsal vein, dorsal, 544 attachments of , 515 medialwall of, 39
Midbrain deep dissectionof, 516, 520 newes ot,4244
axial MR image of, 150 posteriorview of, 518 postganglionicfibersto vesselsand
sagittalMR imageof, 149 intermediatedissectionof. 517 glandsof, 44
lateralview of, 521 speculumview of, 37
posteriorview of, 517 Nasal cleft. See Interglutealcleft
Atlas of Human Anatomy l-27

Nasal concha Neck Newborn, skull of, 12
axialMR imageof, 150 arteriesof, 504 l{ippfe, 181, 182
highest,38 autonomicnervesin, 130 left,196
inferior,37, 38, 82 bony frameworkof, 185 right,196
coronalCT imagesof, 151 cervicalolexusin. 32 Nodose ganglion, 135
ethmoidalorocessof. 38 cutaneousnervesof, 24 Nodule
growth of, 50 fasciallayersof, 28 cerebellar,144
sagittalMR imageof, 149 lymph nodes and vesselsof, 72 inferiorvermis,113
middle,2, 6, 37, 38, 48, 50, 82 musclesof, 27 Nose. See a/so Nasalcavitv
growth of, 50 anteriorview of, 28 ala of, 1
superior,6, 37, 38 oosteriorview ot.27 anterolateralview of, 36
lower border of, 50 nervesof, 24 cross sectionof, 47
Nasalis muscle, 123 posteriortriangleol, 174, 188 inferiorview of, 36
alar part ol, 26,76 suoedicialveins and cutaneousnerves lateralcrus of, 36
transversepart of, 26, 36 of, 31 medialcrus of, 36
Nasal meatus surfaceanatomyof, 1 surfaceanatomyof, 1
atriumof middle,37 Nephron Nostril, 1
inferior.37. 82 Henle'sloop of, 337 Nuchal line
openinginto,50 schemaof, 336 inferior,14
middle,37 Nerves. See a/so specific nerves o f s k u l l ,1 7 4 , 1 7 5 , 1 7 6
atriumof, 37 abdominal,258 Nucleus ambiguus, 117, 126
openinginto,49 of abdominalwall,267 Nucleus pulposus, 155, 162
superior,37, 50 oI back,177 lumbar,19
l{asal nerve to blood vessels,228 l{utrient artery, femoral, 504, 513
external,36 cochlearfibers of, 96 ilutrient fotamen, 489, 513
inferiorlateral,131 cutaneous
posterior, 131, 133 of arm and shoulder,479 o
posteriorsuperior,131 of forearm,480
Nasal retinal arteriole of head and neck,224 Obex,115
inferior,90 of upperlimb,479, 481 Oblique aponeurosis, 261
superior,90 of wrist and hand,473 external,25O,251, 260, 261, 349
Nasal retinal venule of esophagus,240 internal.253.257
inferior,90 of externalgenitalia,409 Oblique cord, 438, 439
superior,90 of femalepelvicviscera,412 Oblique fissure, 198
Nasaf septum, 39, 41, 42,47, 48,63,66 of femaleoerineumand external external.188.331
axial MR imageof, 150 genitalia,413 internal,188,189
cartilageof, lateralprocessof, 38 of femalereproductiveorgans,415 of left lung, 244
coronalCT imagesof, 151 of fingers,471 Oblique muscle
groMh of, 48 of forearm,480 external,174, 175,177, 179, 182,192,
Nasal slit, 11 ot hand,472 247, 249, 250, 259, 263, 330, 424,
Nasal spine oalmarview of. 466 494
anterior,39 of heart,226,227 aponeurosisof, 250, 252, 259, 349
oosterior.39 of hip and buttock, 503 aponeurotic parl ot, 249
Nasal vein of kidneysand ureters,344,345 cross sectionof, 338
dorsal,23 of largeintestine,323,324 digitationsof, 254
external,T0 of larynx,80 muscularparl oI,249
Nasal yestibule, 37, 39 of liverand biliarytract, 327 inferiot121
Nasociliary nerve (V,f, 83, 86, 121, of lower limb. 544. 545 internal,175, 179, 25O,259, 261, 263,
122, 131, 132 of male externalgenitalia,409 330
infratrochlearnervefrom, 45 of malepelvicviscera,410 aponeurosisoI, 252, 349
Nasofrontal vein, 23, 85 of maleoerineum.411 in lumbartriangle,174
Nasolabial lymph node, 72 of mouth,62 tendonof originof, 179
Nasolabial sulcus, 1 of nasal cavily,42-44 superior, 83, 84, 86, 118,121
Nasolacrimal canal, opening of,38 of neck,130 Oblique popliteal ligament, 508
Nasolacrimal duct, 82 of pancreas,328 Oblique vein, left atrial, 214, 215, 221
in nasoopticfurrow,50 of shoulder,477 Obliquus capitis inferior muscle'
o p e n i n go f , 3 7 , 8 2 of smallintestine. 322.324 1 7 5 .1 7 6 . 1 7 8
Nasolacrimal foramen, at birth, 50 of spinalcord and vertebralcolumn,173 Obliquus capitis superior muscle'
Nasooptic furroq 50 of stomachand duodenum,319,320 175,176,178
Nasopafatine nerve lV2l, 10,42, 43, of suprarenal glands,345,346 Obturator anastomotac vein, 265
44,62 of thigh,500, 501, 540 Obturator anastomotic vessels,
communicatingwith greaterpalatine of tracheobronchial tree,210 262,363
nerye,42 of upperlimb,473 Obturator artery, 259, 264, 340, 369,
passingto septum,43 of urinarybladder,344 376, 398, 400,402,403,410, 504,
Nasopharynx, 92 of wrist. 461. 472 512
airwayto, 37 Neuroendocrine G ceaat276 acetabularbranchof, 487
sagittalMR imageof, 149 Neurohypophysis, 140, 147, 148 anteriorbranchof, 487
Navicular bone, 536, 537 Neuropathways, in partur:taonr 415 posteriorbranchof, 487
plantarview of, 523 Neurovasculature Obturator canal, 352, 358, 364, 365,
tuberosity of , 523, 524, 536 of arm, 435 369,402, 501
Navicular fossa, 361,385 of lower limb, 538-546 Obturator crest, 352, 486,487

Obturator externus muscle, 489, Occipital sinus, 103, 144 Omentum (Continued)
493, 539 groove for, I blood vessels to right margin of, 348
attachmentsof, 489, 491 Occipital sulcus, transyerse, 105 posteriorlayerof, 319
Obturator lotamen, 248 Occipital vein, 23 right free marginof, 278,279,298
anteroposteriorradiographof,488 internal,146 Omohyoid musole, 29,31 ,34,53, 189,
radiographof, 355 Occipitofrontalis muscle 198,420,424,428,429
Obturatorgroove,436 frontalbellyof, 123 inferiorbellyot,1,27,29,31 ,32, 128,
Obturator internus muscle, 263,376, occipitalbelly of, 123, 178 129,427
398, 411, 495, 499, 503 Occipitotemporal artery, 142 investedby cervicalfascia,188
attachmentsof, 489, 491 Occipitotemporal gyrus investedby fasciaof infrahyoidmuscle,
nerveto, 499, 503 lateral,106, 107 428
obturatorfasciaof, 364, 392, 402,411 medial,106, 107 nerveto, 32,71 31
Obturator internus tendon,359 Occipitotemporal sulcus, 106,107 originof,420
Obturator lymph node, 406 Oculomotor nerve (llll, 84, 86, 101, superiorbelly of , 27, 28, 29, 31, 32, 128,
Obturator membrane, 263, 352, 370, 114, 116, 117, 166 129
487 branchof, 168 Ophthalmic artery, 11, 23, 40, 83, 86,
Obturator nerve, 267,340,376, 498, distributionof, 118 132, 140, 143
499,538,539,540 inferiorbranchof,83,86 continuation of,85
accessory,267, 498 inferiordivisionof , 118, 121 muscularbranch off, 85
articularbranchof, 539 schemaof, 118 supraorbitalbranchfrom, 69
cutaneousbranchesof, 501, 544,545 superiorbranchof, 83, 86 supratrochlearbranchfrom, 69
cutaneousbranchof,539 superiordivision of, 118,121 Ophthalmic nerye (Vrl, 24,45, 121,
to kneejoint, 539 Oculomotor nucleus, 116, 117, 121, 122, 132, 133, 134, 135
posteriorbranch of, 539 437,438,441,444 externalnasalbranchesof, 122
Obturator-pubic arterial anastomo. accessory,132 internalnasalbranchesof, 122
sis, 259 Odontoblast layer, 57 lacrimal,frontal,and nasociliary
Obturator vein, 311, 376 Olecranon, 436 branchesof, 11
Obturator vessels, 259 Olfactory bulb, 107 tentorialbranch of, 86, 122
right,403 cellsof, 119 Ophthalmic vein
Occipitaf artery, 23, 34, 100, 178 contralateral,119 inferior,85, 91
descendingbranchof,34 Olfactory cells, 119 superior,83,85,91
mastoid branchof, 100 Olfactory mucosa, 119 Opponens digiti minimi muscle,
medial,142 Olfactory nerve (ll, 119 465, 476
meningealbranchof, 23 bundlesof, 11 Opponens pollicis muscle, 461, 465,
occasionalbranchof, 11 distributionof, 118 475
sternocleidomastoid branchof, 34 fibers of , 118, 119 Optic canal, 2, 6, 11, 83
Occipital bone, 4,7,8,9,12 s c h e m ao f , 1 1 8 ,1 1 9 O p t i c c h i a s m . 4 8 , 1 0 4 , 1 0 6 , 1 0 7 ,1 1 4 ,
basifarpart of, 6, 8, 9,22,30,37, 38, 39, Olfactory nucleus, anterior, 119 140, 141, 145, 146, 147
52, 65, 66, 67 Olfactory stria Optic disc, 90
clivus of, 22 tateral,119 Optic nerve (lll, 83, 86, 87, 90, 106,
condylarcanaland fossaof, 8 medial,119 107,113, 132,143,144
condyleo1,9, 30, 128 Olfactory sulcus, 107 coronalCT imagesof, 151
externaloccipitalcrest of, I Olfactory tract, 106, 107, 114 distributionof, 118
externaloccipitalprotuberance of,4,6,8 lateralnucleusof, 119 externalsheathof,91
foramenmagnumof, 6 Olfactory trigone, 119 internalsheathof, 91
hypoglossalcanal of, 6 Olfactory tubercle, 119 vesselsof, 91
i n f e r i onr u c h a l i n e o f ,S O l i v e , 1 1 4 ,1 1 7 o u t e r s h e a to
hf , 3 2 , 8 3 , 8 7
inferiorpetrosalsinus grooveof, 6 Omental appendices, 272,284 sagittalMR image of, 149
internaloccipitalcrest of, 9 Omental arterial arch,305 in visualpathway,120
internaloccipitalprotuberanceof, 9 Omental artery, 305 Optic radiation, 120
jugularforamenof , 6 Omental bursa, 272, 331 Optic tract, 107, 108, 112, 114, 144
jugularprocessof, 30 cross sectionof, 273 Oral cavity, 39, 48, 52-53,63. See a/so
pharyngealtubercle of, 8, 63 lesser sac of, 273 Lip; Mouth; Teeth; speclflc pans
superior nuchal line of, 83 posterior wall of, 349 of oral cavity
transversesinus grooveof, 6 posteriorwall of, parietalperitoneumon, coronalCT imagesof, 151
Occipital condylc, 9, 30, 128 331 inspectionof, 51
Occipital crest, external, 14 stomach reflectedin,2T2 Oral rcgion
Occipitaf fobe, 105 superiorrecessof, 272,274,287 arteriesof, 69
projectionon, 120 Omental foramen (of Winslowl, 272, nervesof,71
Occipital lymph node, 72 273,275,288,331 veinsof, 70
Occipital nerve probein,272 Ora serrata,87,89,90
greater,24, 177, 178 Omental taenia, 281, 284 Orbicularis ciliarls, 89
from C2 dorsal ramus, 129 Omentum Orbicularis ocula muscle, 123
lesser,32, 129,177,178 qreater,269,271,273,284,288,339 orbitalpart of, 26
third,24,177, 178 anteriorlayersof, 294, 319 palpebralpart of, 26
Occipitaf pole, 105 attachment of gastro-omentalvessels Orbicularis oris rnuccle, 26, 36, 54,
sagittalMR image of, 149 to, 274 81, 123
Occipital protuberance posteriorlayersof, 319 Orbiculus ciliaris, 89
external,14, 152 lesser,273, 275,288 Orbit
internal,9 anteriorlayerof, 319 arteriesand veins of, 85
attachmentof gastric aftery,274 fasciaof, 85
Atlas of Human Anatomy t-29

Orbil (Continued) Palatine artery (Continued) Palmar digital artery
fat in. 48. 83 greaterdescending,40 common. 462.465
axialMR imageof, 150 left, 40 proper,462,471
growth of, 50 lesser,40 Palmar digital nerve
lateraldissectionof, 49 lesserleft, 40 common,476
medialwall of, 48 lesserright,40 properpalmar,476
muscleattachmentsand nervesand right,40 Palmaris brevis muscle, 476
vesselsentering,83 Palatine bone, 39 Palmaris longus muscle, 442,446,
nerves of, 86 at birth,488 448.450.475
right,frontal,and slightlylateralview of, 2 greater,71 Palmaris longus tendon, 418,420,
Orbital fat body, 83 horizontalplateof, 14, 37,38,39, 52, 56 446, 447, 454, 460
Orbital fissure lesser,71 Palmarligament,471
inferior.14. 83 lesserpalatineforamenof, 39 Palmar venous arch, superficial,
superior,83 nasalcrest of, 39 460
Orbital gyrus, 107 orbital processof, 2, 38 Palpebral arterial arch, 85
Orbital muscler 43 perpendicularplate of, 38, 39 Palpebral artery
Orbital operculum, 105 posterior nasal crest of, 39 inferiorlateral,85
Orbital septum,81 posteriornasalspine of, 38 inferiormedial,85
Orbital sulcus, 107 pyramidalprocessof, 14 lateral,85
Orbital surface,2 sphenoidalprocessof, 38 median,85
Orbitofrontal artery, 1 41, 142 Palatine folds, transverse, 52 superiorlateral,85
lateral,139 Palatine foramen superiormedial,85
medial,139 g r e a t e rS, , 1 1 , 3 8 , 5 6 Palpebral coniunctiYa, 81
Oropharynx, 233 lesser,8, 11, 38, 39, 52, 56 Palpebral ligament
opened posteriorview of, 66 Pafatine gland, 52, 63, 64 lateral,81
(tsteomeatal unit, 37 Palatine nerve medial,81, 83
Otic capsule,96 communicatingwith nasopalatinenerve, Pafpebral nelver24
anterolateralview of, 95 42 Pampiniform plexus, 256
Otic ganglion, 55, 122, 123, 125, 131, descending, l33 venous,401,403
133,134,135,168 greater,11, 42, 43, 44, 45, 52, 62, 122, Pancreas, 126, 167, 179, 273, 29O,297,
schemaof, 134 131,133 347
Oval windoq 12,95 lesser,42, 43, 45, 52, 62, 122,131, 133 acini of, 298
base of stapes in, 92 oosteriorinferiorlateralnasalbranch anteriorview of, 315
fossa of, 94 from.42.43 arteries of, 301
stapes in, 93, 96 Palatine process, 14, 38, 52, 56 body ot,272
Ovarian artery, 341, 412 Palatine raphe, 52 common areasof pain in, 328
left, 329 Palatine suture cross sectionof, 297
right,318,322 median,S head of, 272, 278, 279, 294, 298, 304, 338
uretericbranchfrom, 341 transverse,8 arteries of, 304
Ovarian plexus, 344, 412, 415 Palatine tonsil, 51, 52, 58 in situ,347
right,318 Palatine vein, 70 innervationof, 168, 328
Ovarian vein external,70 lymph vesselsand nodes of, 315
left, 311, 329,332 Palatine vessels, greater, 10 neck of, 298
right,311, 332 Palatoglossal arch, 51, 58 posteriorview of, 304, 315
ovarian vessels, 332, 34O,362, 364, 4O4 Palatoglossus rnuscle, 52, 58, 59, 64, tail ot, 272, 298, 299, 329
left, 311 126 arteryto, 301
right,311 in palatoglossalarch, 60 with uncinateprocess,339
tubal branchesof, 404 Palatopharyngeal arch, 51, 58, 64, 66 uncinateprocessof, 298
Ovarn 340, 360, 362, 369, 370, 389, 410, Palatopharyngeal nuscle, 58 veins of, 309
412,415 Palatopharyngeal sphinctet Pancreatic artery
ligamentof, 360, 362, 369, 370, 371 lPassavant's ridgel, 65 dorsal,300, 301,305, 306
right,372 Palatopharyngeus muscle, 52, 59, greater,301
suspensoryligamentof, 360, 362, 369, 126,235 inferiot301,305, 306
3 7 0 , 3 7 1 , 3 7 2 , 3 8 94, 0 0 Pafmar aponeurosis, 442, 446, 454, Pancreatic ducl, 294, 295, 298
ovarianvesselsin, 364 462,480 accessory 279,298
reflected,460 principal,279
P septa from, 460 sphincterof, 295
Palmar arch, deep, 465 union of bile ducts and, 295
Pain Palmar arterial arch Pancreatic lymph nodes, superior,
pathwayof, 325 deeo. 465 314
referred,common areaso'f,327 superficial,460 left,314
Palate Palmar artery right,314
growth of, 50 deep, computedtomographyof, 484 Pancrcatic notch, 298
hard, 48, 63, 64 superficial,computedtomographyof, Pancreaticoduodenal artery
postsynapticfibersto vesselsand 484 anastomosisof, 306
glandsof, 44 Palmar carpal arterial arch, 465 anteriorsuperior,272, 30O,305, 306,
soft,37, 39, 51, 63, 64, 66 Pafmar carpal ligament, 446,447, 320,321
Palatine aponeurosis, 52 454,460 inferior,302, 305, 307, 322
Palatine artery Palmar credse, proximal, 418 anterior,306, 320, 321
ascending,40 common portionof, 306
greater,52 plexuson,319,320,322

Pancreaticoduodenal artery Parasympathetic nerve, in tracheo- Passavantts ridge. See
(Continued) bronchial tree,210 Palatopharyngeal sphincter
inlerior (Continued) Parasympathetic nervous system (Passavant'sridge)
posterior,306 schemaof, 168 Patella, 485, 492, 493, 494,501, 507,
posteriorinferiot 320, 321 topographyof, 166 511.519.521
posteriorsuperior,305, 306, 320, 321 Parathyroid gland, 76 anteroposteriorradiographof, 510
suoerior.321 inferior, 75, 76 radiographof, 510
plexuson, 319 right lateralview of, 75, 76 Patellar anastomosis, 500, 512
Pancreaticoduodenal lymph nodes, superior,75, 76 Patellar bursa, 508
315 superiorview of, 75, 76 Patellar capsule, iliotibial tract
Pancreaticoduodenal plexus, Paratracheal lymph nodes blended into, 508
inferior, 322,323 left, 208 Pateflar ligament, 485, 489, 492,493,
Pancreaticoduodenal vein right,208 4 9 4 ,5 0 8 ,5 1 1 ,5 1 4 ,5 2 0 , 5 2 1
anterior,312 Paraumbilical vein, 312 Patellar nerve plexus, 544
anteriorinferior,311 to round ligamentof liver,256 Patellar retinaculum
anteriorsuperior,311 tributariesof, 256 iliotibialtract blendedinto, 508
inferior,313 Paraurethral lSkene'sf glands, 389 lateral,492, 493, 507,508, 519, 520
posterior,312, 313 primordiumof, 389 medial,492,493,501,506,508,519,520
oosteriorinferior.311 Paraventricular nucleus, 147 Pecten, 393
superior,312 Paravertebral anastomosis, 172 Pecten pubis, 248,486
Pancreaticoduodenal artery Paravesical fossa, 369 Pectinate ligament, 88
anteriorsuperior,301 Parenchyma, blood vessels in, 337 Pectinate line, 393
inferior Parietal artery, 141 Pectinate muscle, 220
anteriorbranch of, 301 anterior.141. 142 Pectineal ligament lOooper'sl, 188,
posteriorbranch of, 301 anteriorparietal,142 250, 251, 259,262,263
phantom,301 posterior, 141, 142 Pectineal line, 248, 263, 352, 353, 486,
posteriorsuperior,301 Parietal bone, 2, 4,6,8,9 489. 505. 538
Pancreatic vein, 311, 313 tubereminenceof, 12 Pectineus muscle, 376, 489, 492,493,
dorsal or suoerior.313 Parietal cells, 9, 276 500, 538
great,313 Parietal emissary vein, 23 attachmentsot. 489, 491
Papilla Parietal foramen, 7 Pectoraf is maior muscle, 27,28, 181,
musclefibers to, 282 Parietal limb, 220 1 8 2 ,1 8 8 ,1 9 2 ,1 9 8 ,2 4 3 , 2 4 4 , 2 4 5 ,
of teeth, 57 Parietal lobe, 105 246, 247, 249, 250, 418, 419, 428
Papillary duct, 336 Parietal lobule abdominalpaftot,424
Papillary muscle inferior,105 clavicularhead of, 181
anterior,220, 223, 224, 225 superior,-t05 deep to pectoral fascia, 182
left anterior,224 Parietal operculum, 105 fasciaof, 26,428
left posterior,224 Parietal pleura insertionof, 420
posterior,220, 223, 225 cervical,196, 197,230 originof, 419
right anIerior,224 costal,194,198,206, 211, 230 sternocostal head o1,424
right posterior,224 left borderof, 197 tendon of, 433
septal,220,223, 224 right borderof, 197 Pectoralis minor muscle, 198,243,
Paracentral artery, 141, 142 diaphragmatic part of, 193,194,198, 244,245, 420,428,433
Paracentral lobule, 106 206,211 fasciaof, 428
Paracentral sulcus, 106 mediastinal part of, 193, 194, 198,206, insertionof, 420
Paracolic Autter 211,215,230 investedby clavicopectoralfascia,188
left,271,362,363 Parietooccipital artery, 142, 143 Pectorafis minol tendon, 429,430
righr,271, 281, 362, 363 Parietooccipital sulcus, 105, 106, Pectoralis muscle, 189
Paracolic lymph nodes, 317 143 Pectoral nerve
Paradidymus,389 Parolfactory area, 106 lateral,188,428,43O
Paraduodenal fossa, 270 Parotid duct, 25,54 medial,188, 428, 429, 43O
Parahippocampal gyrus, 106, 107, Parotid gland, 25, 26, 27, 28, 31, 32, median,428
108,119 5 5 , 1 2 5 ,1 3 4 , 1 6 61, 6 7 Pedicle, lumbar, 155
Paramedian artery, 140 accessory,61 Pelvic brim,370
Paramesonephric lm0llerian! duct, cholinergicand adrenergicsynapsesto sacraloart of, 157
389 Pelvic floor
Paramesonephric tubule, 389 horizontalsectionof, 25 contentsof, 354-366
Paranasal sinus Parotid lymph nodes female,356
age-relatedchangesin, 50 deep,72 Pelvic foramina, radiograph of, 355
bones of, at birth, 50 suoerficial.72 Pelvic inlet
coronalsectionof, 48 Parotid papilla, 51 diametersof, 354
cross sectionof, 47 Parotid space, 34 female,354
horizontalsectionof, 48 Pars distalis, 147 male,354
lateraldissectionof, 49 Pars flaccida, 93 radiographof, 355
sagittalsectionof, 49 Pars interarticularis, 155 Pelvic ligaments,372
Pararectal fossa, 362, 363, 369 Pars intermedia, 147 Pelvic organs, female, arteries and
floor of, 392 Pars tensa, 93 veins of,400
Pararenal fat, 179 Pars tuberalis, 147 Pelvic outlet
Parasternal lymph nodesr 184 Parturition, neuropathways in, 414 anteroposteriordiameter of, 354
Parasympathetic fibers female,354
postganglionic,44 transversediameter of. 354
preganglionic,44

Pelvic plexus, 412 Perforated substance, 114 Perineal membrane, 263, 358, 365,
Pelvic scans, 397 anterior,107, 114, 119 366, 380, 381, 383, 391, 404, 405,
Pelvic Yiscera posterior,107, 114 411,413
female,360, 369 Perforating artery, 501 left, 354
nervesof, 412 anteromedialcentral,140 Perineal muscle
male,361 posteromedial,140 deep fasciaof, 356
nervesof, 410 radiate,335 deeptransverse, 356, 360, 361,381,
Pelvis, 351 from thigh,512 383, 404
anteriorview of, 352 Perforating artery, radiate, 335 superficialtransverse,356, 380, 381,
arcustendineousfasciae,372 Perforating cutaneous nerve, 411, 382,391, 404,405
bones and ligamentsof, 352-353 413 Perineal nerve, 410,411,413,503
false,351, 362 of hip, 503 deep,411, 413, 530
female,356 of lower limb, 545 lateralbranchof, 530, 531
arteriesand veins of, 402 sacral,499 deep branchesof, 411
contents of, 360 Perforating vean, 337 in males,411
lymph nodes and vesselsof, 407 of arm,479 posteriorscrotaland labialbranchesof,
radiographof, 355 of forearm,480 499
radiographsof, 355 Per hippocampus, 112 in pudendalcanal,392
sagittalMR imagesof, 397 Perianal skin, 394 superficial, 411,413
structuresin, 370-375 sweat glandsand hair in, 393 superficialbranchesof, 411
lateralview of, 352 Perianal space, 392, 393, 396 Perineal raphe, 388
lineaterminalis of.362.364 Perianal tissues, 388 Perineal space
male,354 Perianal venous plexus male,383
arteriesand veins of, 401, 403, 405 external, 392 superficial,361, 370, 378, 4O4,4Os
contentsof, 363, 387 internal,392 Perineal vein, 405
lymph nodes and vesselsof, 408 Pericaf losal artery, 141, 142 Perineopelvic space6, 396
radiographof, 355 posterior,143 Peraneum,347
radiographsof, 355 Pericardiacophrenic a;te;y, 194, abscessin, 396
sagittalMR imagesof, 397 206,211,230,241,255 female,360, 377,395
structuresof, 380-387 left,193 arteriesand veins of, 404
surfaceanatomyof, 351 right,193 deep, 379
medialsectionof, 352 Pericardiacophrenic vein, 194, 206, lymph vesselsand nodes of, 407
posteriorview of, 352 211, 212, 230, 231, 241 nervesof, 413
renal,339 Pericardiacophrenic yessels, 215 structureso1,371-375
sex differencesof, 354 Pericardial ]eflection, 214, 220 superficialdissectionof, 378
true, 352 Pericaldial sac interdigitatingfibers to, 357
visceraof, nervesof,412 anteriorview of, 215 male,361
Penis left lateralview of, 215 arteries and veins of, 405
b o d yo f , 3 5 1 , 3 8 8 Pericardial sinus deeperdissectionof, 381
bulb of, 382, 383, 385 oblique,215,246 frontalsection,anteriorview of, 383
arteryof, 383, 405 transverse,215, 220 nervesof, 411
cavernousnervesof, 410,412 Pericardial sinus, transverse, 212 structuresof, 380-387
crus of, 360, 366, 385 Pericardium, 211, 215, 233 superficialdissectionof, 380
deep arteriesof, 381, 383, 385, 404 bare area of, 196 surfaceanatomyof, 351
deep dorsal vein of, 249 diaphragmaticpart of, 215 Periodontium,57
deep fasciaof, 361, 380,381, 382, 385, fibrous.198.230 Periorbita,83
387,401,403,405 line of fusion to diaphragm,211 Periosteum
dorsal arteriesof, 381, 383, 401 over right atrium,230 alveolar,57
dorsal nele of, 411 mediastinalpart of, 194 mandibularor maxillary57
dorsal nervesof, 381, 383, 405, 409, reflectionof, 214, 220, 221 Periportal space,291
4 1 0 , 4 1 14 , 1 6 ,5 0 3 at site of great vesselsrellecIion,2l2 Perirenaf tal'179,342
dorsal veins of sternocostalpart of, 215 Perisinusoidal spaces, 291
deep,359, 361, 381, 383, 401, 403, 405 Perichoroidal space, 87, 88 Peritoneal fold
hiatusfor, 358 Pericranium, 102 hepatic arteryin,272
superficial, 351,381, 403 Perilormis muscle, 490 testicularvesselsin, 363
fetal developmentof, 388 Periglandular plexus, 326 Peritoneum, 179, 236, 252, 261, 284,
frenulumof, 382 Periglomerular cells, 119 322,329,342,412
fundiformligamentof, 259, 361 Perimuscular rectal venous plexus, female,365, 366, 378, 4OO,412
glans,351, 361, 382, 385, 388 3 11 inferior,415
corona of, 382 Perineal artery, 370, 403, 4O4,405 potential spaces of, 364
neck of, 382 transverse,405 forming pararectalfossa floor, 392
sagittalMR imagesof, 397 Perineal body, 359, 361, 365, 378, 380, male,361, 366
internalpudendalarteryof, 383 381, 382, 383,384, 391, 395,403, inferiorextentof, 415
lateralsuperficialvein of, 381 404,405 parietal,271, 273,331, 348, 362, 363, 373
rapheof, 388 Perineal compartment, superficial, of anteriorabdominalwall, 348
sectionthroughbody of, 381 396 on omentalbursa posteriorwall, 331
skin of, 380,381, 382, 387 Perineal flexure, 376 phrenicnerveto, 327
superficialfasciaof, 249,250,381, 382, Perineal ligament, transverse, 356, of posteriorabdominalwall,274
387 358, 361, 364, 380, 383, 405 visceral,273,326
suspensoryligamentof, 250, 361 Perineal lymph vessels, 317 Perivascular fibrous (Glisson'sf
capsule,290

Peroneal nerye, deep, 530 Pharyngobasilar fascia, 52 Pisiform' 442, 446,447,454,456, 460,
Peroneus brevis tendon, 535 Pharyngobasitar fossa, 59 465
PeronGus longus tendon, 535 Pharyngoepiglottic fold, 235 radiographof, 457
fibroussheathof, 535 fibersto, 65 Pituitaty gland' 107, 147
Pes anserinus, 489, 492, 493 Pharyngoesophageal junction, 235 anteriorlobe of, 14O,147,148
attachmentsof, 489, 515 Pharyngotympanic tube. See posteriorlobe of, 148
Pes hippocampus, 111, 112 Auditory(pharyngotympanic, posteriorlobe of, 140, 147
Petrosal ganglion, 131, 135 Eustachian)tube sagittalMR imageof, 149
Petrosal nerve Pharynx in sellaturcica,37
deep,123,125, 131, 133 afferentinnervation of,62 Pituitary stalkr 147
greater,86,123,124,125,131,133, 135 arteriesof, 69 Plantar aponeunosls' 533, 534,535
groovefor, 9, 97 lymphaticdrainageof, 73 digitalslips of' 535
hiatusfor, 11 lymph nodes and vesselsof, 73 lateralband of, 535
lesser,86, 93,122, 123, 125, 134 mediansectionof, 63 Plantar arterial atch' deep' 531, 536
groovefor, 9 musclesof posteriorpenetratingbranchesfrom,
hiatusfor, 11 lateralview of, 68 520, 536
Petrosal sinus median (sagittal)section of, 65 Plantat ailery
inferior,11, 103 partiallyopened posteriorview of, 67 deep, 530, 535, 536
groove for, 6, 9 nerves of, 62 lateral, 535, 536
superior,97, 103 opened posteriorview of, 66 cutaneousbranchesof, 535
groovefor, 9 posteriorview of, 75 medial,534
Petrosal vein, 144 posteriorwall of, 51 cutaneousbranchesof, 534, 535
drainingto petrosalsinus,144 veinsof,71 deep branchesof,534
Petrosquamous fissur, 12 Philtrum, 1 superficialbranch of, 533, 534, 535
Petrotympanic fissurc, 11 Phrenic artery posteriorperforatingbranchesof, 536
Peyer's patches, 280 inferior,237, 305, 318, 333, 347 Plantar calcaneonavicular
Phafanx, 524 ,eftinferior, 272,300,319,320, 332,333 ligament' 536
distal,456, 471 recurrentbranchof, 300 Plantar digital artery' common' 534
cross sectionof, 471 sympatheticfibers along,240 Plantar digital nenve' common' 534,
of great toe, 537 right inferior,300, 319, 320, 333, 346 541
ulnarnerveinnervationof, 476 Phrenic ganglion, 320,327 Plantar interosseous muscle' 537
dorsal,523 Phrcnic lymph nodes, inferior, 184, Plantaris muscle' 494, 495, 511, 515,
fourth, base of, radiographof,457 266 540,541
middle,456, 471, 523 Phrenic nerve, 30, 32, 74, 129, 130, attachmentsof , 491, 515
radiographof,457 189,193, 198,206,210,211,226, innervation of,541
ulnar nerveinnervationof, 476 230, 243, 429 Plantaris tendon' 495, 516, 517, 522
plantarview of, 523 anterior,195, 321 Plantar ligament' 536
proximal,456,523 efferentand afferentfibersof, 193 long, 528, 536
of great toe, 537 left, 193, 194,215,346 short, 527
radiographof, 457 nerveto, 430 Plantar nerve
of ring finger,distal,radiographot,457 pericardialbranchof, 193 lateral,534, 535, 540, 541
of thumb, distal,radiographof,457 phrenicoabdominal branchesof, 193 cutaneousbranchesof, 535
tuberosityof, 523 right,193, 194,215,244,318,327,346 deep branchesof, 535
Pharyngeal aponeurosis, 235 Phrenicocolic ligament, 272 plantarcutaneousbranchesof, 545
Pharyngeal artery, 40 Phrenic plexus, 410 proper plantardigitalbranchesof, 533,
a s c e n d i n g1,1 , 3 4 , 4 0 , 6 9 ,1 3 6 ,1 3 8 inferior,318 534,535
meningealbranchesof, 100 left inferior,319, 320, 323, 346 superficialbranch of, 535
pharyngeal branchof,64 rightinferior,319,320, 323,346 medial,534,540
posteriormeningealbranchof, 136 Phrenic vein deep branch of,534,535
tonsillar branch of, 64 inferior,320 plantarcutaneousbranchesof, 535, 545
Pharyngeal constrictor muscle left inferior,320 properplantardigitalbranchesof, 533,
glossopharyngeal part of,59 Phrenoesophagea! ligament' 236 534,535
inlerior,27,75,76, 80, 126,233,234 Pia.arachnoid mater, 91 superficialbranchof, 534
cricopharyngeuspart of, 233,234 Pial plexus, 171 Platysma muscler 26,28,60, 124
middle,27, 59,75, 126,235 arterial,173 Pleura' 331
superior,40,52,55,59,69,75,126,235 peripheral branchesfrom,173 abdominal,349
glossopharyngeal part of, 59, 65 venous,173 cupulaof, 74
Pharyngeal muscle, longitudinal, Pia mater, 91,99, 102 mediastinal,194
235 overlyingspinalcord, 169 parietal,206
Pharyngeal nerve, 133 thoracic,170 spinalnervesof, 170
Pharyngeaf pfexus,62,71,125, 126, Pigment cells, 120 thoracic,170
130, 131 Pillar cells, 94, 120 visceral,205
Pharyngeal raphe, 37,60,63,65,67, P i n e a l b o d y , 1 0 6 ,1 1 0 ,1 1 1 , 1 1 4 Pleural Gavity
75, 76, 234 Pineal recess, 108 costodiaphragmatic recessof, 196, 197,
Pharyngeal necess, 37,47,64,66 Piriform fossa,233 330,331
Pharyngeal region Piriformis muacte, 263,411,489, 495, left costodiaphragmatic recessof, 104,
arteriesof, 69 503 2Oo
nervesof, 71 nerveto, 499 left costomediastinalrecessof, 194
veins of, 70 Piriform lobe, 119 right costodiaphragmatic recessof, 194
Pharyngeal tonsil, 37, 63, 64, 66, 67 Pleural rcflection' 196
Pharyngeal tubercte, 64, 65, 67 Plica semilunarisr 81, 82

Pneumothorax, chest drainage Preganglionic sympathetic fibers, Proximal interphalangeal (PlP|
tube placement in, 190 J40 ioint, 418
P o n s , 1 0 6 ,1 1 4 ,1 3 4 , 1 3 5 ciliaryganglion,132 Psoas major fascia, 342
axialMR imageof, 150 femalereproductiveorgan innervation, Psoas major muscle, 179,267,278,
sagittalMR imageof, 149 415 329, 339,342,492,496,498, 499
Pontine artery, 14O,1 41, 143 male reproductiveorgan innervation,416 area for, 330
Pontine taste atea, 135 urinarybladderand lower ureter articularbranchof, 538
Pontine vein innervation,
417 fasciaof. 179.342
lateral,144 Premolars,56,57 lower part of, 538
transverse,144 Preoccipital notch, 105 originof, 489, 496
Pontomesencephalic vein, anterior, Prepatellar bursa, subcutaneous, Psoas minor muscle, 263,496
144 ctl originof, 496
Popliteal artery, 512 Prepontine cistern, 109 Psoas muscle, 376,496
Popliteal fossa, 485 Prepuce, 388 axial CT imagesof, 350
Popliteal ligament, arcuate, 511 of clitoris,388 muscularbranchof, 498
Popliteal ligament, oblique, 511 of penis,361 Psoas tendon, 376
Popliteal lymph nodes, 546 site of, 388 Pterion, 4
Popliteal surface, 489 site of future originof, 388 Pterygoid artery
Popliteal vein, 546 Preputial gland, opening otr 382 lateral,40
Popliteal vessels, 495 Prepyloric vein, 31'l medial,40
Popliteus muscle, 491, 511, 515, 541 Prerectal muscle fibers (of Pterygoid canal
attachmentsofS15,541 Luschkaf, 359 artery of, 40
nerveto, 541 Presacral space, 364, 396 nerveof, 122, 123,125, 131, 133, 135
Popliteus tendon, 508, 510 Presymphyseal node, 408 Pterygoid fossa, posterior view of,
origin of, 5O7 Pretracheal lymph node, 74 14
Pores of Kohn, 204 Prevertebral anastomosis, 172 Pterygoid fovea,15
Portacaval anastomosis, 312 Prevertebral muscle, 30 Pterygoid hamulus, 4,38, 46, 52, 55,
Porta hepatis, 287 Prevesical lymph node, lateral, 343 64, 65, 68
Portal space, limiting plate of, 291, Prevesical lymph plexus, 408 at birth,50
292 Prevesical plexus, 408 Pterygoid muscle
Portaf ltiad, 273,278,290,297, 298 Princeps pollicis artety, computed lateral,40, 54, 55
cross sectionof, 273 tomography ot,484 axialMR imageof, 150
Portaf vein,297 Procerus muscle, 26, 36, 123 medial,15, 25, 40, 52, 55
branchof. 291.292 Profunda brachii arlery, 429 nerveto, 71
cross sectionof, 297, 338 Profundus flexor tendon, in com. Pterygoid nerve
Postanal space mon flexor sheath, 460 lateral,46,122
deep, 396 Promontorial lymph nodes, 343,408 medial,46, 122
superficial, 396 Promontory, 92,93 Pterygoid plate
Postcaval lymph nodes, lateral, 343 Pronator quadratus muscle, 440, lateral,13, 47, 55, 68
Postcentral gyrus, 105 448, 449, 450, 465, 475 medial,52, 55, 64, 65
Postcentral sulcus, 105 Pronator teres musclet 420, 433,44O, hamulusof, 13
Posterior chamber, 81, 87, 88, 90 446,447 Pterygoid plexus, 70, 85
Posterior limiting lamina humeralhead of, 420,447,45O,474, 475 deep facial nervefrom, 23
(Descemet's membrane!, 88 originof, 420 Pterygoid process, 6,8
Posteromedial central artery, 140 ulnarheadof, 350, 420,447,448,475 h a m u l u so I , 1 2 , 1 3 ,1 4
Postganglionic sympathetic fibers, originof, 420 lateralplateot, 4, 12, 13, 14, 38, 39, 50
346 Prostate gland, 167, 384 medialplateof, 12, 13, 14, 38, 39, 50
ciliaryganglion,132 arterialsupply of, 403 of palatinebone, 13
femalereproductiveorgan innervation, capsuleof, 361, 366,384 platesof, 6
415 fibromuscularstromaof, 384 Pterygomandibular raphe, 15, 40, 52,
male reproductiveorgan innervation,416 hyperplasticlaterallobe of, 403 55, 65, 68
urinarybladderand lower ureter hyperplasticmiddle lobe of, 403 Pterygomaxillary fissure, 4
innervation, 417 inferolaterallobe of, 384 Pterygopalatine fossa, 4, 13, 14, 40,
Postlunate tissure, 113 inferooosteriorlobe of. 384 44,49
Poupart's ligament. See Inguinal innervationof, 168 Pterygopalatine ganglion, 122, 123,
ligament(Poupart's) isthmuslobe of, 384 1 2 5 ,1 3 1 ,1 3 3 ,1 3 5 ,1 6 6 ,1 6 8
Preaortic lymph nodes, 317, 4Og lymphaticdrainagefrom, 408 ganglionicbranchesof, 45
Precaval lymph nodes, lateral, 343 medianlobe of, 384 in pterygopalatine fossa, 44
Prececal lymph nodes, 317 primordiumof, 389 schemaof, 133
Precentral gyrus, 105 with orostaticurethra.376 Pubic arch, 248
Precentral sulcus, 105 sagittalMR imagesof, 397 female,354
Prechiasmatic groove, 9 skeletalmuscle band of, 384 male,354
Preculminate vein, 144 sphincterurethraemuscleascending Pubie bone, 348, 357, 383
Precuneal arlery,142 anterioraspect of, 359 Pubic crest, 259, 376
Precuneus,106 Prostatic duct, openings of, 384,385 Pubic hypogastric region, 268
Prefrontal arleryr l4l Prostatic plexus, 165, 344, 416 Pubic ligament, inferior, 248, 356,
Preganglionic sympathetic cell Prostatic sinus, 384, 385 359,360, 364, 365,378, 383
body,44,132 Prostatic urticle, 389 Pubic ramus
Prostatic vein, right, 311 inferior.248. 486
Plostatic venous plexus, 403 superior,248, 486, 496, 499
t.34 Atlas of Human Anatomy

Pubic symphysis, 247, 259, 263 Pufmonary trunk, 206, 212, 215, 220' Quadrigeminal cistern' 109
female,354 224,225 Quadrigemlnal plater 115
male,354 bifurcationof, 215
radiographof, 355 outflow to, 224 R
sagittalMR imagesof, 397 orenatal,229
superiorportionof, 376 Pulmonary valve, 213, 22O,222, 225 Radiaf artery' 433, 445, 446,447' 448,
Pubic tubercle, 247,250, 263, 486, semifunarcuspsof, 22O,222 449,454,460,461, 465,474
492,493 Pulmonary vein in anatomicalsnuffbox,469,470
Pubic vein, 265 left, 205, 206, 215, 221, 224, 231 computedtomograPhYof, 484
Pubis infetior,214, 241 palmarcarpal branchof, 448,465
anteroposteriorradiographof, 488 orenatal,229 superficialpalmar branch ot, 454' 460,
body of, 376 superior,214 465
radiographof, 355 right,206, 215, 225, 230 Radiaf bursa,460,462
superiorramus of, 488, 493 inferioc214, 220,246 Radiaf collateral artetY, 434
symphysealsurfaceof, 412 prenatal,229 Radial collateral ligament' 454' 455
Pubocervical tascia, 372 superior, 212, 214,220,224 Radiaf netve, 429, 430, 432, 435, 447,
Pubococcygeus muscle' 357, 358, Pulvinar, 110, 111 ,143,144,145 448,474,475,477
359, 360 lett.144 in arm,477
Pubofemoral ligament' 487 right,144 branch of, 469
Puboprostatic ligament' lateral' 366 of thalamus,114 communicatingbranch of, 468
Puborectalis muscle, 356, 357, 358, Pupil,81 deep branch ot, 445,447, 449, 474
359. 376, 398 dilatormuscleof, 88, 121,132 dorsaldigitalbranchof, 473,481
left, 356 musclesof, 132 inferiorlateral,481
Pubovesical l:gament sphinctermuscleof, 88, 121,132 oosteriorcutaneous,469,473, 481
lateral.364. 365 Pupillae muscle superficialbranch of, 444, 447, 449, 468,
medial.364. 365 dilator,121 469, 473, 474, 480, 481
Pudendal artery sphincter,121 dorsaldigitalbranch of, 469
deep external,512 Purkinie fibers,225 Radial tecurrent adery' 433,434' 447
internal,341, 376, 499 subendocardialbranchesof, 225 Radial styloid process' 452
superficialexternal,512 Putamenr 108 Radiate artery' Perforating' 335
Pudendal canal (Alcock'sl' 392, 411 Pyloric antrum' 275 Radiate capitate ligament' 454
internalpudendalarteryin, 402, 4O4 bariumradiographot, 279 Radiate ligament, 187
internalpudendalvein in, 399 Pyforic canaar 297 Radiate sternocostal ligament' 186
oudendalnervein, 413 cross sectionof, 297 Radicular artery
Pudendal canal, left internal Pyrloric gland' 276 anterior,172
pudendal vein in' 311 Pyloric lymph nodes' 315 posterior,172, 173
Pudendal cleftr377 Pyforic odfice' 276,279 Radicular vein' 173
Pudendal nerve, 160,267,41O,411, Pyrlorus, 275, 276, 278, 297 Radiocarpal ioint, 453, 455
412, 415,416,417,499, 500,503 bariumradiographot, 279 Badiocarpal ligamenl
block of, 413 cross section of, 297 dorsal, 455
internal,392 Pyramid, 114, 144 oalmar,454
Pudendal vein decussation of, 114 radiocapitate Parl of , 454
external.256,265 inferiorvermis,113 radioscaPholunate Partof, 454
internal,376 of vermisof cerebellum, 115 Radiograph
left internal.311 Pyrramidalis muscle' 25O,260 of ankle,526
right internal,311 Pyramidal process' 8, 12 barium
superficialexternal,544 of ileum,279
Pudendal vessels o of jejunum,279
deeo external,401 of long vermiformaPPendix,283
internal,392 Quadrangular lobule' 113 of stomach,duodenum,and Proximal
suoerficial,500 Quadrangular spacer Posterior ieiunum,279
superficialexternal,401 circumflex humeral artely of cervicalvertebrae,18
Pudendal vesselsn superficial' 249 in, 427 of chest, 213
Pudendum,377 Quadratus femoris muscle, 492, 493, of elbow, 437
Pulmonary attery' 213 495,503,511,538 of femalepelvis,355
axial CT imagesof, 242 attachments of, 489, 491, 515 of hand,457
left,206, 213,214, 231,245 nerveto. 499. 503 of hip joint,488
prenatal,229 Ouadratus lumborum muscler 176, of knee.510
radiographof, 213 179,263,267, 329,342, 496, 498 lateral,of skull, 5
right,205, 206, 21O,214, 220, 230, 245 area for, 330 of lumbarvertebrae
'156
prenatal,229 fasciaof, 179 anterooosterior,
Pulmonary ligament, 199, 208, 230, Quadratus plantae muscle' 534, 535' lateral,156
231 541 of male and femalePelvis,355
Pulmonary lymph nodes' 208 Quadratus Plantae netYe' 541 of male pelvis,355
Pulmonary plexus, 126,165, 166,168, Quadriceps femoris muscle' 538 oelvic
210 attachment of, 490 female,355
anterior,209 patellarligamentof, 515 male,355
posterior,209 Quadriceps femoris tendon' 485, of shoulder,422
492, 501, 506, 511, 520, 521 of wrist and hand, 457
Quadriceps tendon' 493

Badiolunate ligament Rectal Yenous plexus Rectus sheath, 83, 189, 249,250,349
long,454 communicationbetweeninternaland ex- anteriorlayerof, 188, 250, 252,259, 424
palmar,454 ternal,399 cross sectionof, 252
short, 454 external,311, 393, 394, 399 posteriorlayerof, 251,252,257,259
Radioscaphocapitate ligament, 454 internal,393, 394, 399 Red nucfeus, 1O7, 116, 117
Badioulnar joint, distal, 455 perimuscular, 399 Reil, island of. See Insula
Radioulnar ligament Rectal vessels, zupetior, 274 Renal artery, 335, 341, 345
dorsal,455 Bectineal ligament, 259 anteriorbranch of, 335
palmar,454 Rectocervical space, 369 in situ,332
Radius, 436, 438, 439,44O,442, 443, Rectococcygeus muscle, 263 left, 323, 329,339,347
465 Rectoperinealis muscle, 262 posteriorbranchof, 335
annularligamentof, 438 Rectoprostatic (Denonvilliers'| fas- right,318, 321,329
anteriorbranch of, 439 cia, 348, 359, 361, 386, 391, 396 uretericbranchof. 335. 336
anterior(palmar)view of, 452 Rectosigmoid artery, 307, 323, 398 variationsin, 333
anteriorsurfaceof, 439 Rectosigmoid iunction, 284, 391, 393, Renal column (of Bertinl,337
coronalsectionof, 439, 455 394 Renal corpuscle
cross sectionof, 470 Rectosigmoid plexus, 323 cortical,336
dorsaltubercleof, 452 Rectosigmoid vein, 311, 312, 399 juxtamedullary, 336
head of, 439 Rectourethralis superior mu3cle, Renal cortex, 336, 337, 346
right,439 359 Renal ganglion, 344, 345
interosseousborderof, 439 Rectouterine fold, 369 left, 346
neck of, 437,439 Rectouterine ligament, 369 right,346
posteriorcutaneousand inferiorlateral Rectouterine pouch lof Douglasl, Renal fascia, 339, 342, 347
cutaneous nervesof arm trom, 479 360,362, 369, 371, 391 anteriorlayerof, 179
posterior(dorsal)view of, 452 Rectovaginal space, 364, 369 Gerota's.342,347
radiographof, 437 Rectovesical pouch, 348, 361, 391 posteriorlayerof, 179,342
rotators of, 440 Rectovesical space sagittalsectionof, 342
tuberosityot,437,439 prerectal,396 transversesectionof, 342
ulnar notch of, 439 retroprostatic,396 Benal medulla, 336,337
Bami communicantes retrovesical,396 preganglionicfibers and, 346
g r a y ,1 3 0 , 1 3 2 ,1 3 3 ,1 3 4 , 1 6 5 ,1 6 7 ,1 6 9 , Rectum, 263, 271, 284, 329, 356, 357, Renal papilla,336
170, 180,196,209, 230, 240,258, 361, 363, 364, 365, 378, 384, 391, Renal parenchyma,334
267, 318, 324,325,327, 344,412, 393.400. 412 Renal pfexusr344,345
498, 499 anal canal and, 393 left, 323, 346
w h i t e ,1 3 0 ,1 3 2 , 1 3 3 ,1 3 4 ,1 6 5 , 1 6 7 ,1 6 9 , arteriesof, 398 right,318, 346
180, 196, 209, 230, 240, 258, 267, circularmuscle layerof, 393, 394 Renal segment
318, 321, 324,325,345,398, 412, in situ,391 arteriesof, 335
499 female,328, 396 vascular,335
Bathke's pouch, yestigial remnant male.328. 396 Renal sinus, 337
of, 50 innervationof, 168 fat in, 334
Bectal artery ischioanalfossaeof, 392 perirenalfat of, 337
inferior,307, 398, 402, 403,4O4,4O5 longitudinalmuscle layerof, 393, 394 Renal vein, 341
middle,264, 307,323,341,364,398, lymphaticpathwayalong,408 in situ,332
400,402,403 marginalarteryof, 398 left. 329. 333
superior,264,3O7,318, 323, 324, 340, muscularismucosaeof, 394 double.333
364, 398,400, 410 sagittalMR imagesof, 397 enteringinferiorvena cava, 339
bifurcationof, 307 terminationof, 376 multiple,333
branchof, 307 transversefolds of, 393 right,265,329, 332,339
Rectal lymph nodes,317 veinsof, 399 Reproductive organs, male, inner-
middle,317 Bectus abdominis muscle, 189,331 Yation of, 415
superior,317 sagittalMR imagesof, 397 Respiratory bronchiole, 204
Rectal nerve Bectus capitis anterior muscle, 73 Rete testis, area of, 390
inferior,411, 503 Rectus capitis muscle. See Capitis Reticular nucleus, 111
superioG503 muscle,rectus Retina, 91
Rectaf pfexus, 323, 344, 412 Rectus capitis posterior major ciliarypart of, 87, 88
communicationbetweeninternaland muscle, 175,176,178 iridialpart of, 88
perimuscular, 399 Rectus capitis posterior rninor, 175, non-pigmentedareasof, 91
middle,323 176,178 optic part of, 87, 89
superior, 318, 323 Rectus femoralis tendon, 492 pigmentedareasof, 91
Rectal vein originof, 492 projectionon, 120
inferior,312 Rectus femoris tendon, 485 structureof, 120
left, tributariesof, 311 Rectus muscle Retinacular artery, 504
left middle,311 inferior,83, 84, 121, 151 subsynovial,504
left superior,312 lateral,83, 84, 86, 121, 151 Retinal artery, 90
middle,312 axial MR imageof, 150 central,85, 87, 90, 91
right,tributariesof, 311 tendon of, 87 Betinal vein,90
right inferior,311 medial,axialMR imageof, 150 central,87, 91
rightmiddle,311 superior,83, 84, 86, 91, 121 Retinal vessels, right, 90
r i g h ts u p e r i o r , 3 1 2 tendon of, 91 Retrobulbar fat, 83
superior,311 Retrocecal necess, 271, 281
bifurcationof, 399

Retromandibular vein, 23, 31, 59, 85 s Sacrum (Sl-51 (Continued)
anteriot 61, 70 superiorarticularprocessof, 157
common trunk foc 59, 61, 70 Si spinal nerve, 160,410 transverseridgesof, 157
posterior,61, 70 anteriorramus of, 414 Sagittal sinus
Retropedtoneal artery, 331 52 spinal newe, 160 inferior,103, 145, 146
Retropharyngeal lymph nodes, 73 Saccule, 92,95,96, 124 superior,99, 100, 102, 103, 106, 109,
Retropubic lprevesicall space lof Sacral a[ery 144.145
Retziusf, 48, 348, 364, 396 lateral,171, 264, 341,398, 402, 403 axial MR imageof, 150
fat in, 251 median,307, 341, 364, 398, 402 Sagittal sutur, 7, 12
Retropubic venous plexus, 365 Sacraf Ganal, 157,358 Sagittal vein, inferior, 144
Retropyloric lymph nodes, 314 Sacral cornu, 157 Salivary glands, 61
Retrotonsillar fissurc, 113 Sacral crest frontalsectionof, 51, 60
Retrctonsillar Yein intermediate,157 horizontalsectionof, 51, 60
inferior.144 lateral,157 lingualminor,51
superior,144 median,157,352,357 molar minor,52
Retzius, cave of, 348 Sacral cutvature, 153 sublingual,51, 60
Retzius space. See Retropubic (pre- Sacral foramen submandibular, 51, 60
vesical)space (of Retzius) a n t e r i o r1,5 7 , 3 5 3 , 3 5 8 Salivatory nucleus
Rhinal sulcus, 106,107 fourth posterior,357 inferior,1 16, 117,125,134
Rhomboid maior fossa, 114 posterior, 157,353 superior,116,117, 123,133
Rhomboid major muscle, 174, 177, radiographof, 156 Salpingopharyngeus muscle, 126
180, 192, 243, 245, 424 Sacral ganglion, 167,318 Saphenous nerve, 500, 538, 544
insertionof, 421 Sacral hiatus,157 branchesof, 538, 545
Rhomboid minor muscae, 174, 177, Sacral lymph nodes infrapatellarbranchof, 500, 538
424,477 lateral,266, 408 Saphenous opening, 25O,544
insertionof, 421 middle,266, 408 cribriformfascia in, 249
Rhomboid muscle,244 Sacral nerYe, 161 Saphenous vein
Ribs, 186,244,245 perinealbranchof, 499 accessory 544,546
angleof, 185, 186 vertebraeand, 161 great,250, 485, 544, 545, 546
axialCT imagesof, 242,350 Sacral parasympathetic outfloq small,485, 544,545
body of, 185 toc Sartorius muscle, 376
eighth,241, 349 Sacraf plexus, 160,177,267,344,345, Sartorius muscle, 485, 492,495, 499,
eleventh,330 415.416.499 500, 538
false, 185 left,318 attachmentsof, 490, 491, 515
first,94, 160,186, 196, 197,211, 230, right,323 Sartorius tendon, 492, 493
419,429 Sacral pnomontory, 248, 412 Scala tympani, 91, 95, 96
costal cartilage of, 243 Sacral $ympathetic trunk Scala vestibuli, 91, 95, 96
groovefor, 199 left,412 Scalene muscle
synchondrosisof, 419 right,412 anterior,27, 30, 32, 74, 186, 189, 193,
floating,185 Sacral vein, median, 311 198, 206, 211, 230, 427, 429
headof, 185,t86 Sacrogenital fold, 340 slips of origin of, 30
'189
interarticularligamentof, 187 Sacroiliac joint, 358 middle,27, 30, 32, 69, 70, 186,
middle,186 female,354 nervesto, 129
neck of, 185, 186, 194 radiographof, 355 nervesto. 129. 430
ninth,299 Sacrospinous lagament, 352, 353, posterior,27,30, 186, 189,232
second1 , 8 2 ,1 8 5 , 4 1 9 357, 359, 410,495, 503 slips of origin of, 30
left, 186 Sacrotuberous lagament, 357, 376, Scalp
seventh,head of, 246 379, 395, 402, 410, 411, 495, 502, epicranialaponeurosisof, 26
sixth,182 503 skin and subcutaneoustissue of, 26
true,185 Sacrouterine ligament, 364 superficialarteriesand veins of, 23
t u b e r c l e , 1 8 51,8 6 Sacrum (51-51, 152,160 Scapha,93
twelfth, 160, 174, 195,342,349 ala of, radiographof, 355 Scaphocapitate ligament, 454
projectionof, 330 anteriorview of, 153,171 Scaphoid bone,456
Riolan, arc of, 308 aoexof. 157 anterior(palmar)view of, 452
Risorius muscle, 26, 123 arteriesof, 171 area for, 439
Rod cells, 94, 120 articularfacet for, 155 coronalsectionof, 455
Rods, 120 articularsurfaceof, 157, 486 posterior (dorsal)view of, 452
Rolando, sulcal artery ol, 142 base of, 157 tubercle ol, 452, 454, 456
Rolando, sulcus of, 105, 106 coronalsectionthrough,157 Scaphoid fossa,93
Rosenm0ller, node of, 266 dorsal surfaceof, 157 Scapholunate ligament, 455
Rosenthal, vin of, 144,145,146 facets of superiorarticularprocess,157 Scaphotrapeziotrapezoid, 454
Rotator cuff muscles, 425 left lateral view of, 153 Scapula, 29, 180, 185, 192, 243,244,245
Rotatores cervicis muscle medialsagittalsectionof, 157 acromionof, 185
brevis,176 pelvicsurfaceof, 157 anastomoses around,427
longus,176 posteriorview of , 153 anteriorview of, 420,427
Round ligament,372 promontoryof, 157 axillaryarteryand anastomosesaround,
of liver,288, 312 radiographof, 355 427
of uterus,389 sacralcrest of, 157 body of, 428
Round window (cochlearf, 92,95 sacral tuberosity of, 157 coracoidprocessof, 213
closed by secondarytympanicmem- sagittalMR imagesof, 397 glenoidcavity of, 420
brane,96 spinalnervesand, 161 anteroposteriorradiograph ol, 422
fossa of. 93

Scapula (Continued) Segmental artely (Continued) Serous glands of von Ebnea See
inferiorangleot,152,246, 420 posterior,335 Lingualglands(serousglandsof
infraglenoidtubercleof, 420 superior,335 von Ebner)
infraspinousfossa of, 185 Segmental medullary artery Serratus anterior muscle, 174, 180,
lateral border of, 420 anterior,171,172 181, 182, 186, 192, 243, 245, 246,
anteroposteriorradiograph ot, 422 malor anterior,171 247,249,250,258,418,420,424
medialborder ot, 152, 420 posterior,171 digitationsof, 186, 188,189
neck of, 420 Segmental medullary vein, 173 fasciaof, 428
posteriorview of, 421,427 Sella turcica, 6, 9, 39 insertionof, 420
spineof, 152,174, 177, 185, 197,213, hypophysisin, 37 Serratus posterior inferior muscle,
424,427, 428 Semicircular canal 175, 179,254,330
anteroposteriorradiograph ot, 422 anterior,95, 96, 97 Serratus posterior muscle, 174
subscapularfossa of, 185 axial MR image of, 150 Serratus posterior superior muscle,
superiorangle of, 420 lateral,95, 96, 97 174,175
superiorborderof, 42O,425 planeof, 97 Sesamoid bone, 456, 524, 534, 535,
suprascapularnotch of, 184 posterior,95, 96, 97 536, 537
supraspinousfossa of, 421 prominenceof, 92 lateral,523
Scapular ailery Semicirculai duct, 92 medial,523
circumflex,427, 429, 430, 434 ampullaot,92, 124 plantar view of, 523
dorsal,32, 137, 427, 429 anterior.95. 96 Shoulder
Scapular ligament, superior trans. lateral,95, 97, 124 anteriorview of, 423,474,479
verse, 423,425,427 posterior,96,97, 124 anteroposterior'adiograph of ,422
Scapular nerye, dorsal, 429 superior,ampullaof, 124 capsuleof, 432
Scapulohumeral dissection Semilunar lold,284 coronal section of, 423
anterior view of, 426 Senilunar hiatus, 37, 38 cutaneous nerves of, 479
lateral view of, 426 with anteriorethmoidalcell openings,38 glenohumeralloint, 423
posterior view of, 426 at birth, 50 lateral view of, 423
Scarpa's (membranousf layer, 249, Semifunar line,247 musclesof. 424
380 left, 268 nerves of, 429430
fascia latae attachment to, 249 right,268 Posterior,477
Schlemm's canal. See Scleralvenous Semilunar lobule posterior, neNes ol, 477
sinus (canalof Schlemm) inferior,113 posterior view of, 479
Sciatic foramen posterior,113 superficialveinsof, 479
greater,352, 353, 357, 540 Semilunar plane, 286 Sigmoid altery, 323, 340
lesser,352, 353, 357 Semilunar vale, nodule of,223 Sigmoid lymph nodes, 317
Sciatic nerve, 160, 495, 499, 503, 539, Semimembranous bursa, 511 Sigmoid plexus,323
540 Semimembranous muscle, 494, 495, S i g m o i d s i n u s , 1 1 , 9 7 ,1 0 3
articularbranch of, 502 540 groove for, 6, 9
branchesof, 499, 540 attachmentsof, 491 Sigmoid vein,31 1,312
common fibulardivisionof. 499. 540 tendinousexpansionof, 511 Sigmoid vessels, attachment ol, 274
left, 376 Semimembranous tendon, 506, 508, Sinuatrial lymph nodes, 225
muscles innervated by, 540 511,518 Sinuatriaf nodal artery, 216, 218, 225
right,376 groovefor insertionof, 513 Sinuses
tibial divisionof, 499, 540 Seminal colliculus, 366, 384 confluenceof,144,145
Sciatic notch Seminal yesicle, 361, 363, 384, 389, axial MR imageof, 150
greater,248,486 391 frontal,37, 38
lesser,248, 486 Seminiferous tubule, 390 maxillaryopeningof, 37
Sclera, 81, 83, 87, 88, 91 Semispinalis capitis muscle, 174, paranasal,47-50
bulbarconjunctiva,81 175,176,178,424 sphenoidal,37, 38
laminacribosaof, 87 in posteriortriangleof neck, 178 openingof, 37, 38
Scleral spur, 87 Semispinalis cervicis muscle, 178 straight,144
Scleral venous sanus (canal ot Semispinalis thoracis muscle, 176 transverse, 145
Schlemmf, 87,88,90,91 Semitendinosus muscle, 489, 495, transverseleft, 144
veins draining,91 503, 515, 540 Sinusoid, 290,291,292
Scrotal artery, posterior, 403, 406 attachmentsof. 489. 491 Skene's glands. See Paraurethral
Scrctal ligament,389 Semitendinosus tendon, 492, 493, (Skene's)glands
Scrotal nerve 506, 507 Skin
anterior,409 Sensory cortex, 135 over rectus sheath, 252
posterior,411, 503 Septal artery branches, 40 perianal,393, 394
Scrptal ne?Ye, posteraor, 41O,411, Septomarginal t?abecula, moderate Skull
503 band of,220,224,225 anteriorview of, 2
Scrotal vein, anterior, 256 Septum,205 anteroposteriorradiographof, 3
Scrotum, 351, 388 Septum pellucidum, 106,108, 110, b a s eo f , 6 6 , 1 6 0 ,1 6 1
cross sectionthrough,390 1 1 1 ,1 1 2 ,1 4 1 ,1 4 3 ,1 4 5 , 1 4 7 diploic and emissaryveins of, 99
skin of, 390 anteriorvein of. 145. 146 fractureof. 101
superficialfasciaof, 249 posteriorveins of, 146 horizontalsectionthrough,104
Sebaceous gland, 81 Serosa labyrinthorientationin, 97
Segmental artery of ileum,280 lateralview of, 4
anteriorinferior,335 jejunal,280 midsagittalsectionof, 6
anteriorsuperior,335 of spleen,299 of newborn,12
inferiorsuperior,335 of vermiformappendix,283 skin of, 102
superiornuchalline ol, 174, 175, 176
r.38 Atlas of Human Anatomy

Soleal line,513 Sphincter urethroyaginalis musclet Spinal tract,125, 126
Sole lfootf 366,370,378,379 trigeminalnerveand, 116, 117
cutaneousinnervationof, 541 Spinal artery Spinal vein
musclelayersot, 532,533, 535 anterior,11, 141,171,172 anterior,144, 173
Sofeus muscle, 506,516, 517,520, anastomoticloops to, 171 posterior,144, 173
521, 522, 540 posterior, 11, 172 Spinous pnocess
attachments of,515 anastomoticloops to, 171 lumbar,155
innervationof, 541 left,143,172 radiographof, 156
insertionof, 517 righl,172 thoracic,154
nerveto, 516,517 Spinaf cotd,243,244 Spiral ganglion,96
tendinousarch of, 495,517 arteriesof, 171 Spiral lamina
Solitary tract nucleus, 116, 117, 123, intrinsicdistributionof. 172 hamulusof, 95
125, 126, 135, 345 ascendingfibers of, 416 osseous,95, 96
Sound rception, pathway of,92 axial CT images ot,242 Spiral ligament,96
Spermatic cold, 260, 261,376 centralcanal of, 108, 109 Spiral organ (of Gortil' 92, 96
cremastericfasciaon, 260 descendingfibers of, 416 Splanchnic nerve
cremastericmuscleof, 257 descendingtracts in, 108 abdominopelvi c, 228, 324, 325
ductus deferensin, 255 i n s i t u ,1 6 0 cardiopulmonary228
externalspermaticfasciaof, 249,257, sacral, 324 first lumbar,323
259 sagittalMR imageof, 149 fourth lumbar,318
externalspermaticfasciaon, 249 schemaof. 167.346 greaterthoracic,167, 2O9,230, 24O,
externalspermaticfasciaover,405 thoracic,134, 210, 327, 328 258, 263,267,320,324,327,409
internalspermaticfascia on,262 thoracic part of, 132 left,194,318, 321, 323,327, 328,346
Sphenoethmoidal recess, 37, 38 thoracolumbar,324 right, 194, 240, 318, 32O,321, 327,
Sphenoidal fontanelle, 12 veinsof, 173 328,346
Sphenoidal sanus, 6, 37, 38, 39, 48, 49, Spinal dura mater, 160 leastthoracic,209, 263, 267, 320, 322,
63, 64, 83 Spinal ganglion, dorsal, 170 323, 324, 325, 344, 345, 409
axial MR imageof, 150 Spinalis cervicis muscle, 175 left. 323. 346
within bony shell,50 Spinalis cervicis muscle, 175 right,318, 320, 346
coronalCT imagesof, 151 Spinalis enector muscle, 349 lesserthoracic,165, 167, 2O9,258,263,
openingof, 6, 37, 38, 49 Spinalis muscle, 175, 331 267, 318, 320, 321, 322, 324, 325,
sagittalMR image of, 149 Spinalis thoracis muscle, 175 345. 409
Sphenoid bone, 9,38 Spinal membranes, 169 left,318, 319, 323,346
body of, 6, 9, 50 Spinal meninges,325 right, 346
carotid groove of, 9 Spinal nerve,258 lumbar,160, 165,318, 345,409,412
clivusof, 9 anteriorcutaneousbranchof. 180 left first. 346
foramen ovale of, I cervical,127, 160 right first, 346
foramen spinosum off, 8 collateralbranchof, 258 second, 344
greaterwing o1,2, 3, 4, 5, 8, 9, '151 dorsal branch of, 258 upper,415
orbital surface of, 2 dorsal ramusof, 169, 170 pelvic,166, 168, 323, 344,345, 412, 499
infratemporalcrest of, 4 groovefor, 19 sacral,165, 273,344,412, 499
lesserwing of, 2, 3, 6, 9 intervertebralforamen for. 18 thoracic,346
orbital surface of, 2 lumbar,179 Spfeen, 196, 197, 272,273,288,29O,
pterygoidhamulusof, 6 meningealbranchof, 258,325 293, 297,331,347,349
pterygoidprocessof, 4,8, 12,38 originof, 17O,258 anterior extremity of, 299
lateral plate of, 39 recurrentmeningealbranchesof, 170 area for, 329
medialplate of, 39 recurrentmeningealbranchesof, 170 arteriesof, 300, 301
sphenoidalsinus of, 38 segmentalmedullarybranchesof, 138 axial CT imagesof, 350
spineof, 14 to skin vesselsand glands,325 colic impressionof, 299
Sphenoid emissary foramen, 11 thoracic,180,258 cross sectionof, 297, 299, 338
Sphenomandibular ligament, 40, 55 ventralramusof. 169.258 diaphragmaticsurfaceof, 299
Sphenooccipital synchondrosis, 63 Spinal nerve roots fibrouscapsuleof, 299
Sphenopalatine artery, 40, 41, 69 anterior,321 gastricimpressionof, 299
posteriorlateralnasalbranchof, 40 anteriorview of , 169 hilum of. 299
posteriorseptal branchof, 40 dorsal,114,169 in situ, 299, 347
Sphenopafatine foramen, 4, 6, 13, 14, filamentsof, 160 posterior extremity of, 299
38,40,42 posteriorview of, 169 pulp of, 299
Sphenopalatine vessels, 11 relationto vertebrae,161 renalimpressionof, 299
Sphenoparietal sinus, 103, 145 ventral,114, 17O,180, 321 serosa of, 299
Sphincter muscle Spinal nerve trunk, 258 superiorborderof, 299
external,367 Spinal perivascular plexusr 322 veins of, 309
externalanal,284, 288, 388, 395 Spinal sensory ganglion, 258, 321, visceral surface of, 299
internal,367 324,327 Splenic artery, 237, 278, 297, 298, 299,
of pupil,132 anteriorcutaneousfibers of, 258 300, 301, 305,306, 318, 319,320,
Sphincter of ampulla, variations in, ascendingfibersof, 345 32',t,327,328
295 communicatingbranch of, 258 arteriogramof, 303
Sphincter urcthrae, 396 descendingfibers of, 345 lefl,264
Sphincter urcthrae muscle, 356, 359, dorsal root of, 180, 325,327,328, 345 originof,302
361, 365, 366, 378, 379, 383, 384, lateralcutaneousbranchof, 258 oancreasand,274
385,403, 416 ventral root of. 258 splenic branches of, 300

Splenic capitis muscle, 174, 175, Sternothyroid muscle, 27, 28, 29, 31, Stylohyoid ligament, 13, 59, 64, 65, 68
178,424 32, 128, 129, 198 Stylohyoid muscle, 27, 28, 29, 34, 40,
Splenic cervicis muscle, 175, 178 nerveto, 71 59, 60, 61, 67,68, 123
Splenic f,exure, 269,271. See a/so Sternum, 26,29, 18O,194,233,246, 424 nerveto, 25
Colic flexure,left angleof, 185 Styloid pnocess, 14, 27, 29, 30, 34, 53,
Splenic lymph nodes, 314,315 axial CT images ol,242 59
Splenic plexus, 318,319, 320 body of, 181, 185,247, 248 radial,439
Splenic pulp, 299 head of, 181 ulnar,439
Splenic trabeculae, 299 jugularnotchof, 185 Stylomandibular ligament, 15
Splenic vein, 273,297, 299,303,306, manubriumot, 27, 28, 185 Styfomastoid foramen, 25, 123, 125
311,312,313,315 xiphoidprocessof, 181, 184, 185,247 Stylopharyngeus muocle, 59, 65, 68,
cross sectionof, 338 Stomach, 167, 215, 237, 269, 273, 276, 125, 126,235
Spfenic vessels, 274, 348, 349 294,297,298,331 Subacromial bursa,423
Splenium, of corpus callosum, 143, angularnotch of, 275 Subaponeurctic space, 468
145 area tor, 329 Subarachnoid space, 87, 99, 102, 109
Splenius capitis muscle, 174,178, arteries of, 300 in lumbarpuncture,162
424 atonic,275 thoracic,170
in posteriortriangleof neck, 178 axialCT imagesof, 350 Subcallosal area, 106, 119
Splenius cervicis muscle, 178 body of, 275,279 Subcallosal gyrus, 106
Splenius muscler 2T cardiacparts of, 233,236,277 Subcfavian artery, 30,32,74,76, 130,
Splenorenal ligament, 272, 299, 329 cardiaczone of,276 171, 183, 189, 198, 206, 211, 237,
with splenicvessels,331 chief cells of, 276 427
Squarnous suture, 12 circularmuscle layerof, 236 anomalous,80
Si spinal nerve,160 cross sectionof, 297 groovesfor, 186
55 spinal nerve, 160 fundus of, 233, 236, 275, 293 left, 75, 80, 137, 193, 243
Stapes, 92,93 barium radiographot, 279 right, 75, 126, 137, 193, 230
anteriorlimb of, 93 vagal branchto, 240 anteriordissectionof, 33
base of, 92, 93 gastriczone of, 276 obliqueschematicview of, 33
footplateof, 93 greatercurvatureot, 275 Subclavian lymphatic trunk, 208
head of, 93 hypertonic,275 Subclavian lymph node, 184
limbs of, 92 hypotonic,275 Subclavian trunk
in oval window,96 in situ,275 left, 266
posteriorlimb of, 93 innervationof, 321 right,266
Stapius muscle fessercurvatureot, 275 Subclavian Yein, 30, 32, 74, 189, 198,
nerveto, 123 posteriorvagal branchto, 240 206,211
tendon of, 93 longitudinalmusclelayer o1,236, 277 groovesfor, 186
Stellate ganglion. See Cervicothoracic lymph follicleof, 276 l e f t , 7 5 1, 3 7 , 1 8 6
ganglion lymph vesselsand nodes of, 314 right,75, 137, 230
Stellate veins, 334 mucosaof, 276 Subclavius muscle, 186, 189,230,
Sternaf angler 245 mucous cells of, 276 419.428.429
Sternalis muscle, inconstant, 188 muscularismucosaeof, 276 fascia investing,428
Sternoclavicular joint, 196 musculatureot. 236. 277 fasciaof, 428
adicularcavitiesof, 419 nervesof. 319. 320 insertionof,419
articulardisc of, 419 obliquemusclelayerof, 236 investedby clavicopectoralfascia,188
transversesectionof, 243 or.thotonic, 275 nerveto, 430
Sternoclavicular ligament, anteraor, posterior surlace ol, 272 Subcostaf anletyr264
419 reflected,272 lower anastomoseswith, 255
Sternocleidomastoid artery submucosaof, 276 Subcostal muscle,258
branch,34 surfaceepithelialcells of, 276 Subcostal nerve, 160, 267, 409, 498
Sternocleidomastoid lymph node, variationsin positionand contourof, 275 lateralcutaneousbranch of, 267
veins of, 309 lateralfemoralcutaneousbranchof, 544
Sternocleidomastoid muscle, 27, 31, zigzag line of,236 right,329
3 2 , 3 4 , 7 3 , 7 4 ,1 2 7 ,1 2 9 ,1 7 4 ,1 7 8 , Straight artery, 307 Subcostal plane, 268
188, 198, 247, 419,424, 429 branchof, 326 Subcostal vein, 498
accessorynerveto, 127 of ileum,280 Subcutaneous bursa, 511
clavicularhead of, 27, 28, 181,247 of lejunum,280 Subcutaneous olecranon bursa, 438
medialmarginof, 74 Straight gyrus, 107 Subcutaneous space, dorsal hand,
originof, 419 Straight sinus, 144, 146 462
sternalhead o1,27, 28, 181, 247 in tentoriumcerebelli,103 Subcutaneous tissue
Sternocostal articulations, 186 Strap muscle, 118 of abdomen.249.252
Sternocostal joint, 419 Stratified squamous epithelium, Camper'sand Scarpa'slayersof, 249
Sternocostal ligament, 186 tongue, 58 deep membranous,380, 381
intraarticular, 186 Stretch receptors, 210 fatty layerof, 348, 361, 378
r a d i a t e1, 8 6 , 4 1 9 Stretch reflex pathway, 325 superficial,380
Sternocostal triangle, 195 Stria medullaris, 106 of mammarygland,182
Sternohyoid muscle, 27, 28, 29, 31, Striate artery, distal medial, 140, membranous, 348,361, 378
32, 53, 128,129, 189,198 141, 142 of rectussheath,252
investedby cervicalfascia,188 Stria terminalis, 108, 111,112 Subdeltoid butsa, 423
nerveto, 71 Striatum, 110 Subdural hematoma, site of, 101
originof, 419 Styfoglossus muscle, 27,32, 59, 60, Subendocardial branch, 225
128 Subependymal vein, 146

Subhiatal fat ringr 236 Sulcal vein Suprascapular artery, 32, 74, 75, 76,
Sublingual artery, 59, 61 anterior,173 427, 429
Sublingual caruncle' 51 oosterior.173 infraspinousbranch ol, 427
with openingsof submandibular ducts,51 Sulcus Suprascapulan nel e' 429
Sublingual duct, 51 dorsal median,mesothelialseptum in, Suprascapular notch, 184, 185,42O'
openingsof, 61 169 421, 423,427
Sublingual fold, 51 hippocampal, 112 Suprascapular veinr 70
with openingsof sublingual ducts,51 hypothalamic, 147 Supraspinatus ligament' 179
Sublingual fossa, 15 intraparietal,105 Supraspinatus muscle, 177, 423,427
Sublingual gland, 51, 53, 61, 123, 133, occipitaltransverse,105 428,428
167 occipitotemporal,107 insertionof, 420
mucous,61 olfactory,107 originof, 420
Sublingual nerve,46 Sulcus limitans' 115 Supraspinatus tendon, 423, 425
Sublobular vein, 290, 291 Sulcus terminalis' 214 Suprasternal spacer 28
Submandibular duct' 51, 53, 59, 60 Superciliary arch' 1 Supratrcchlear artery' 23, 40, 81, 85
Submandibular fossa' 15 Superffcialis flexor tendon, in com' Supratrochlear crest' 220, 224
Submandibular ganglion | 59, 122, mon tendon sheath' 460 Supratrochlear nerver 81, 122
123, 131, 133, 166, 168 Superficial perineal {Colles'f fascia, Supratrochlear vein, 23, 24, 85
schemafor, 133 358,361,366,370,378,380,411 Sural cutaneous nelve
Submandibular gland' 27, 28, 31, 32, attachmentof, 380 articularbranchesot, 541, 542
5 3 , 1 2 3 , 1 3 31
, 6 6 ,1 6 7 Supinator arlery' 447 communicatingbranchof, 540
mucous,61 Supinator muscle, 42O,440 Iateral,540, 541, 542,545
serous,61 insertionof, 420 branchesof, 544
Submandibular lymph nodes' 73 originof, 420 communicatingbranchof, 545
Submental arteryr 40 Supraclavicular nele, 24, 31 medial,540, 541, 545
Submental vein, 70 intermediate.129, 479 Sural nerve, 534, 540, 541, 545
Submucosa lateral.129.479 lateralcalcanealbranch of, 541
of intestine,326 medial,129,479 medialcalcanealbranchof, 541
of stomach,277 Supracondylar ridge, 436 via lateralcalcanealand lateraldorsal
of vermiformappendix,283 Sugraduodenal artery, 300, 301, 306 cutaneousbranches,541
Submucosal gland' 326 Supraglenoid tubercle, 420 Sustentaculum tali' 523, 524
Submucosal plexus,326 Suprahyoid artery, 59 Sweat gland' 9, 167
Submucous (Meissner's! plexus, 326 Suprahyoid muscle, action ofr 29 Syfvius, sulcus ol, 141
Submucous space, 392 Supramarginal gyrus' 105 Sympathetic Aanglionr 409
internalrectalvenousplexusin, 393 Supraoptic nucleus' 147 lumbar,170
perianal,396 Supraopticohypophyseal ttact' 147 superiorcervical,130, 132
Suboecipital netve' 21, 178 Supraoptic necess' 106, 108 superiorganglion,125, 128, 131, 133,
Suboccipital triangle, 178 Supraorbital attery' 23, 36, 40, 81, 85 134,210,226
Subparotid noderT2 Supraorbital nerye' 24, 36, 81, 122 thoracic,209
Subpleural capillary, 205 branchesof, 86 thoracic,third, 240
Subpleural lymphatic plexus, 208 medialand lateralbranchesof, 86 Sympathetic nervous sYstem
Subpopliteal recess, 507, 508 Supraorbital notch' 1 generaltopographyof, 165
Subpubic angle, radiograph of' 355 foramen,2 schemaof,-167
Subpyloric lymph nodes, 314 Supraorbital vein' 23, 70, 85 Sympathetic trunk' 125, 133,192,
Subscapular artery' 427, 434 Suprapatellar synovial bursa' 511 210,230, 258, 263, 267,290,324,
computedtomographyof, 484 Suprapineal recess' 108 325,327, 344, 409, 412, 499
Subscapular fossar 185 Suprapleural membrane' 230 cervical,165
Subscapufaris muscle, 180, 192, 243, cervical,231 gangliaof, 321,325,344,345
244, 245, 425, 428, 433 Suprapyloric lymph nodes' 314 ganglionof, first thoracic,132
insertionof, 420 Suprarenal gland' 197,278, 298, 299, |eft,194, 318,324,346
originof, 420 329.340.342 left lumbac323
subtendinousbursaof, 423 arteriesand veins of, 332, 333 right,194, 318, 328,331, 346
Subscapularis tendinous muscle cross sectionof, 347 sacral,323
openingsof, 423 dissectionof, 346 left,412
oositionof. 423 in situ, 332 right,412
Subscapularis tendon, 423, 425 |eft,197, 272, 297, 329, 331, 338, 346 thoracic,240
Subscapular nerve nervesof, 344,346 thoracicgangliaof, 321
lower,429, 43O,477 dissectionof, 346 Synovial cavities' 22, 187
upper,429,43O right, 197, 297, 329, 346 Synovial membrane, 423, 471
Subserous fasciar 412 schemaof, 346 attachment of to femur, 511
Subserous plexus, 326 dissectionof, 346 of hip joint,487
Substantia nigra, 107 Suprarenal impressionr 287
Subtendinous bursa, 511 Suprarenal-phrenic vein T
Subtrapezial plexus' 177 anastomosis,265
Subungual space, 471 Suprarenal plexus Tl spinal netve' 132,133,134,160
Sulcal artery, 141 left, 323 T2 spinal nerve' 133, 133
central,141,142 right,318 T7 spinal netve, 414
oostcentral. 142 Suprarenal vein' 333, 347 lateralcutaneousbranchof, 254
precentral, l4l inferior,347 medialcutaneousbranch of, 254
orefrontal.142 middle,347
right,332, 338

TIO spinal nerve, 410 Teeth (Continued) Tensor fasciae latae muscle,36,
Tl f spinal nele, 414 motar 485,492,494, 503
Tl2 spinal nerve, 160 first, 56 attachmentsof, 491
ventralramus of, 254 growth of, 50 originof, 492
TIO ventral ramus, 345, 410 second,56 Tensor tympani muscle, 93
Tl vertebra,13, 153, 160 third, 56 tendon of, 93
spinousprocessof, 197 molars.56. 57 Tensor tympani nele, 122
T4 veitebra,230 neck of, 57 Tensor veli papatini muscle, 52,93,
T6 vertebra nervesto, 57 122
lateralview of, 154 odontoblastlayerof, 57 tendon of, 52
superiorview of, 154 papillaof, 57 Tensor veli papatini nerve, 55
TB vertebra, 241 permanent,56, 57 Tentorium celcbella,86, 101,103, 144,
TIO vertebra, 241 left lower, 57 145
Tl2 vertebra, 153, 160 left upper, 57 sagittalMR imageof, 149
body of, 349 lower, 56 straightsinus in, 106
lateralview of, 154 upper,56 Teres major muscle, 152, 174, 177,
spinousprocessot, 152,174, 175,177 premolars,56, 57 180, 244, 245, 424, 427, 428, 433
Taenia root canalsof, 57 insertionof, 420
free,271,281,282 roots of, 57 lower marginof, 434
mesocolic,281, 282, 284 Tegmen tympani, 92,93 Teres minor muscle, 174,177,243,
omental,281.284 Tela choroideae, 108,111, 145 244,245, 423, 424, 425, 427, 428
Talofibular ligament Temporal a?tery Terminal sulcus,58
anterior,514 deep, 99 ?esticular artery, 387, 403, 409, 416
posterior,514 anterior,40 left, 329, 332
Talus oosterior.40 right,332
dorsalview of, 523 posterior,40 Testicular plexus, 409, 416
head of, 523,524 middle.23. 99 right,318
lateraltubercleof, 523 parietalbranchof, 23 Testicular vein, 311, 329, 332
medialtubercleof, 523 pola',142 right,311, 322
neck of, 523.524 superficial,23, 34, 40, 99, 100, 134 Testicular vessels, 340, 363
plantarview of, 523 frontalbranchof. 23. 85 left, 332
posterior process of, 523 Temporal bone,9 lymphaticpathwaysalong,408
groovefor tendon of flexor hallucis petrouspart of, 9, 97 in spermaticcord, 401
longus,523 squamouspart of, 997 Testis, 361, 386, 389, 390, 416
lateraltubercle.523 Temporal fossa, hematoma of, 101 appendixof, 387, 389
medialtubercle,523 Temporal gyrus arteries and veins of, 401
trochleaot,523,524 inferior,105,107 cross section of, 390
Tarsal artery middle,105 cross sectionthrough,390
lateral,530, 536 superior,105 descent of, 386
medial,530,536 Temporalis muscle, 54 external spermatic fascia over, 405
Tarsal gland, 81 axial MR image of, 150 lobulesof, 390
openingsof, 81 insertionof, 15. 54 lymphaticpathwaysfrom, 408
Tarsal joint, transverse, 523 nervesto, 122 pathways from, 408
Tarsal sinus, 523,524 Temporal lobe, 105, 1O7,141 sagittalMR imagesof, 397
Ta?sometatarsal ioint, 523 axial MR imageof, 150 schemaof, 390
Tarsometatarsal ligament, dorsal, hematomaof, 101 septa of, 390
536 herniationof, 101 tunica albugineaof, 390
Tarsus Temporal nerve visceral layer over, 387
of eyelid,81 branchesof, 122 Thalamic vein, superior, 146
inferior,81 deep,122 Thalamogeniculate artery' 143
superior,81 anterior,40 Thalamoperlorating artery, 140, 143
Taste buds, 58 posterior,40 Thalamostriate Yean
sectionof, 58 schemaof, 122 inferior.144.146
Taste pathways, 135 Temporal sulcus posteriorpart of, 146
Tectal plate, 106 inferior,107 superior,108, 111, 145, 146
Tectorial membrane, 22, 96 Temporal vein Thalamotuberal aitery, 140
deeper part of, 22 deep, 99 Thalamus, 106, 108, 11O,112, 114, 145,
Tectospinal tract, 132 middle.23. 99 147,324
Teeth superficial,99 left, 144
apicalforaminaof, 57 branchesof. 23. 99 geniculatebodies of, 143
canine,57 frontal and parietal branches of, 99 nucleiof, 111
cement of, 57 tributaryof, 102 pulvinarsof, 107,111, 143, 145
crown of, 57 Temporomandibular ioint sagittalMR imageof, 149
deciduous,56 articulardisc of, 54, 55 schemaof, 111
dentinaltubulesof, 57 lateralligamentof, 40 stria medullarisof, 106
dentineof, 57 Tendinous intersection, 83, 84, 86, striaterminalisof, 111
enamelof, 57 1 2 1 ,1 8 1 , 2 4 7 ventralposteromedialnucleusof, 135
incisors,56, 57, 233 Tenon's capsule. See Fascial sheath of Thecal sac, sagattal MR images of,
interglobularspaces between,57 eyeballfienon's capsule) 397
interproximalspaces between,57 Thenar eminence,418
labiobuccalview of, 57

Thenar muscle, 446,460 Thorax Tibiafis anterior tendon' 485, 494,
innervationof, 460 autonomicnervesin, 209 536,542
suppliedby median newe,476 bony frameworkof, 185 attachmentof, 515
Thenar spac'e,462 cross sectionsof, 246 tendinoussheathof, 530
dorsal extensionof, 460 at T3-4 disc level,244 tendon of, 530
Thigh at T4-5 disc level,245 Tibiafis posterior rnuscle' 534, 541
anterior cutaneous nerve of, 545 at T7 disc level,246 attachmentof,515
arteriesof, 500, 501,512 at T3 lower level,243 tendon of, 535, 536
bony attachments of surfaceanatomyof, 181 Tibial nerve, 495, 540, 541
anteriorview of, 490 Thumb articularbranchesof, 540
posteriorview of, 491 distal phalanxof, 457 lateralplantar,541
cutaneousinnervationof, 538, 540 innervationof, 460 medialcalcanealbranch of, 533, 535,
lateral cutaneous nerve of, 538 proper palmardigitalnervesof, 460 540, 541, 545
musclesof T h y m u s , 2 1 1, 2 3 0 , 2 4 4 medialplantar,541
anteriorviews of. 491, 493 Thyroarytenoid muscle, 78, 79, 80 musclesinnervatedby, 541
lateralviews of, 494 Thyrocervical trunk, 32, 74, 75, 76, posterior,534
posteriorviews of, 495 237,427 Tibiofibular ligament
neruesof, 500, 501, 538, 540 right,137 anterior,514
anteriorview of, 501 Thyroepiglottic ligament, 77 posterior,514
posteriorview of, 502 Thyroepiglottic muscle, 80 Toe
serialcross sectionsof, 505 Thyrohyoid membrane, 29, 74, 77, 235 fifth
Thoracentesis, 190 Thyrohyoid muscle, 27, 28, 29, 31, 32, distal,middle,and proximalphalanxes
Thoracic aortic plexus, 209 53,128,129 ot,537
Thoracic aitery Thyroid artery vein of, 544
anteriorintercostalbranchesof, 189 inferior,32, 74, 76, 427 great
interior,198,206, 211, 305 esophagealbranchof, 237 distal phalanxof, 537
internal,189,237, 244, 245, 246 superior,31, 32, 34, 74, 75, 76 medialside of, 544
perforatingarteriesof, 188 superiorlaryngealbranchof, 34 proximalphalanxof, 537
lateral,183, 188, 189, 427, 434 T h y r o i d g l a n d , 2 9 , 3 1 , 1 9 6 ,1 9 8 , 2 0 6 T o n g u e , 3 7 , 3 9 , 5 9 ,1 2 5
left,193,194 anteriorview o1,74 apex of, 58
perforatingbranchesof, 183 articularsurfaceof, 78, 80 body of, 58
right,193,230 fibrouscapsuleof, 76 crypt of, 58
superior,189,427, 429, 434 isthmusof, 74 dorsum of, 58
Thoracic cardiac netve, 193, 209 posteriorview of, 75 frenulumoJ,51
Thoracic constriction, 233 pyramidallobe of,74 frontalsectionof, 60
Thoracic duct, 189, 194, 198,206,209, r i g h tl o b eo f, 7 4 , 7 5 , 7 6 horizontalsection of, 60
211, 244, 245, 246, 263, 266, 293, Thyroid notch, superior, 77 inferiorlongitudinalmuscleof, 128
318 Thyroid vein intrinsicmusclesof, 128
Thoracic ganglion, 167 inferior,74, 75, 198 lateral view of, 59
Thoracic muscle, transversus, 194 middle,74 lymphaticdrainageof, 73
Thoracic nerYe, 161 superior,31, 74 lymph vesselsand nodes of, 73
dorsal ramus of, 192 Tibia, 511, 530 musclesof, 59, 60
l o n g , 1 8 81, 8 9 , 1 9 2 anteriorborderof, 485, 513, 514 verticaland transverse,60
Thoracic spinal nerve, 133 anteriorview of, 513 posterior,125
.133 with posteriorligamentattachments, root of, 58, 235
dorsal root of,
ventralroot of, 133 513 sagittalMR imageof, 149
Thoracic sympathetic nerves, 130 cross sectionof, 514 salivaryglandsand, 60
Thoracic vein inferiorarticularsurfaceof, 513, 514 schematic stereogram of, 58
internal,189, 198, 244,245,246 interosseousborderof, 513, 514 superiorlongitudinalmuscleof, 128
left, 194 lateralcondyleo1,494,510,513 taste anteriorof, 125
right,194 lateralsurfaceof, 513, 514 Tonsil, palatine, 58
Thoracic vertebrae, 21 medialborderof. 513.514 Tonsillar artery' 40
anteriorview of, 171 medialcondyleof, 513,514 Torus tubarius, 37, 39
arteriesof, 171 medialsurfaceof, 513, 514 ftabecula, 148
cross sectionthrough,170 obliouelineof" 513 arteryof, 148
Thoracic visceral nerves, 165 posteriorsurfaceof, 514 Ilabecufae calneae, 22O
Thoracic wall posteriorview of, 513 l?achea, 29, 74, 75, 77, 126,168,196,
anterior,188-189 radiographof, 510 198, 202, 211, 213, 230, 234, 237,
Thoracis muscle, transversus, 189 superiorarticularsudace of, 514 243,244
Thoracoabdominal nerve, cuta- superiorview of, 514 aderiesof, 202
neous branch of, 188 tuberosityo'f, 492,493, 511, 513, 514 bifurcation of
Thoracoacromial artery, 424, 427, Tibial artery axial CT imagesof, 242
428 anterior.512. 530 car.tilageot,28,202
acromialbranchof, 424, 427, 429 posterior,512,534 cross sectionthrough,202
clavicularbranch of, 424, 427, 429 medialcalcanealbranch of, 533, 535 elasticfibers of, 202
deltoid branch ot, 424, 427, 429 posteriormedialmalleolarbranchof, epitheliumof, 202
pectoralbranchof, 424,427, 429 534 mucosaof posteriorwall ol,2O2
Thoracodorsal artery, 427, 434 Tibial collateral ligamentn 511 nerveo1,202
Thoracoepigastric vein, 249 I?achealis muscle' 202
Ilacheobronchial lymph nodest 244
inferior,245

Ilacheobronchial nodes, 266 Tiigeminal nucleus, 122 Ulnar bursa, 460
Ilacheobronchial tree, innervation T?igone Ulnar collateral artery
ol,210 collateral, 111 inferior.433. 434
Ilanspyloric plane, 268 habenular, 111 superior,433,434,444
Ilansverse pnocess, lumbar, 19, 179 left fibrous,222 Ulnar nerve, 429, 433, 444, 446, 447
Ilansvelse pnocess, lumbar, 155 right fibrous,222 454,460,465,476
llansverse sinus, 97, 103 of urinarybladder,361, 365, 366, 385 anteriorview of, 476
groove for, 9 Iliquetrocapitate ligamenl, 454 adicularbranch of, 476
left, 144 Triquetrohamate ligament, 454, 455 communicatingbranch of, 468
Ilansversospinalis muscle, 243 Iliquetrum bone,456 communicatingbranch with median
Ilansversus abdominis muscle, anterior(palmar)view of, 452 nerve,476
180,192,261 posterior(dorsal)view of, 452 communicatingwith mediannerve,476
Ilansvelsus thoracis muscle, 180, Tlochanter in cutaneousinnervation,476
192 greater,248, 376, 485, 487, 489, 492, to cutaneousinnervation,476
Trapeziocapitate ligamenl, 454, 455 495. 496. 503 deep branch,476
fiapeziotrapezoid ligament, 455 anteroposteriorradiographof, 488 deep branch ol, 447, 454, 465, 476
Ttapezium,456 radiographof, 355 dorsal branchesof
anterior(palmar)view of, 452 lesser to dorsum of middle and distal oha-
coronalsectionof, 455 radiographof, 355 langes,476
posterior(dorsal)view of, 452 Trochlea, 420 dorsal branch ot, 444, 446, 468, 469,
tubercleot, 452, 454, 456 Ilochlear nerve llVf, 83, 84, 86, 114, 476
I?apezius muscle, 27,29, 127, 129, 116,121 dorsaldigitalbranchesof, 469
152, 174,177, 180,188, 189, 192, schemaof, 186 groove for, 436
244,246,247,418,419, 420, 428, Ilochlear nucleus, 117 inconstantcontributionof, 476
429 Tnber cinereum, 106, 107, 114 musclesinnervatedby, 476
insertionof, 420 m e d i a ne m i n e n c o
e f, 1 4 7 palmarbranch ol, 447, 476
Trapezoid bone, 456 lUberculum sellae, I palmarview of, 476
anterior(palmar)view of, 452 Tirberohypophyseal ltacl, 147 posterior(dorsal)view of, 476
coronalsectionof, 455 Tirfted cell, 119 posteriorview of, 476
posterior(dorsal)view of, 452 lbnica albuginea,390 proper palmardigitalbranchesof, 469
Ttapezoid ligament, 423 fUnica vaginalis superficialbranch of, 447, 460, 476
Treitz, ligament of, 270 parietallayerof, 390 Ulnar recurrent artery
Tliangfe of auscultation, 152, 246, viscerallayerof, 390 anterior,434
424 lUrbinates, 37 posterior,434,444
Tliangle of Petit. See Lumbartriangle [lmpanic artery, anterior, 40 Ulnar styloid p?iocess, 452
(of Petit) fimpanic canaliculus, 10 Ulnocapitate ligament, 454
lliangular fossa, 93 Ilrmpanic cavity, 92, 93, 96, 124, 125 Ulnolunate lagament, 454
Iliceps brachii muscle, 152,429, Ilmpanic membrane, 92, 93, 96 Ulnotriquetral ligament, 40, 454
444,446 right,93 Umbilical artery, 340, 341, 396
lateralhead of, 152, 181, 245, 418,424, Ilmpanic nerve, 93, 123, 125, 134 distal,402
427 Ilmpanic plexus, 93, 123, 125,132,134 obliterated,372
long head of, 152, 243, 244, 418,42O, tubal branch of, 125 occluded pa1 o1,229, 362, 363, 364,
424, 427, 433 400, 403
tendonof. 152.438 u patent part of, 400, 4O2,403
Ilicuspid valve orenalal.229
anatomyof, 223 Ulna, 436, 438, 439, 440, 441,442, 443, Umbilical ligament
anteriorcusp of, 222,223,224 454,465 medial,229,259,341, 401, 402, 403
orificeof, 246 anteriorborderof, 436 median,340, 364, 365, 400, 403, 409
posteriorof, 222, 223, 224 anterior(palmar)view of, 452 Umbilical rcgion,268
rightfibrousringof,222,225 anteriorsurfaceof, 436 Umbilical vein
septalcusp of, 222, 223, 224 coronalsectionof, 455 obliterated,288
Tiigeminal ganglion of,86, 116, 117, coronoidprocessof, 437 Umbilicus, 247, 3O5,312
132,133,134,135 dorsaltubercleof, 436 Umbo, 93,96
Tiigeminal impression, 9 interosseousborderof, 436 Umbrical muscle
Tiigeminal nerye, 24, 97, 114,116, lateralsurfaceot. 429.436 fourth,476
1 1 7 ,1 2 2 ,1 3 3 ,1 3 4 ,1 3 5 ,1 4 4 olecranonot,418,444 third,476
ganglionof, 131 posteriorborderof, 436, 439 Uncal vein, 145
maxillarydivisionof, 24 posterior(dorsal)view of, 452 Uncinate pnocess, 19, 37, 38, 339
mesencephalic nucleusof, 116, 117 posteriorsurfaceof, 436, 439 Uncovertebral ioints, 19
motornucleusof, 116, 117,122, 135 radialnotch of, 436 U n c u s , 1 0 6 , 1 0 71, 1 9
motor root of, 131 radiographof, 437 Upper limb
ophthalmicdivisionof, 24 tuberosityof, 436, 439 anteriorview of. 418.473
parotid branchesot, 122 Ulnar artery, 433, 434, 446, 447, 454, arteriesof, 473
principlesensorynucleusot, 116,122 460, 465 computed tomography of, 484
schemaof, 122 anterior recurrent,447 lymph nodes of, 483
sensorynucleusof, 117 computedtomographyof, 484 lymph vesselsand nodes of, 483
sensoryroot of, 118,131 deep palmarbranch of, 447, 454,460, 465 lymph vesselsof, 483
spinalnucleusof, 116, 117, 122, 125, dorsalcarpal branchof, 469 nervesof, 473
126 palmarcarpal branchof, 465 posteriorview of, 418
spinaltract ot, 117, 126 with venaecomitantesand ulnar nerve, surfaceanatomyof, 418
superficialbranchesof, 122 460

Urcter, 271, 334, 341, 362, 363, 364, 365, Urinary bladder (Continued) Vagal trunk (Continued)
366, 391, 400, 402, 403,410, 412 uretericorificeof, 366 posterior, 166, 318, 32O,321,322,323'
arteriesof, 341 uvulaof. 366. 385 327, 328,344,346
diagonalcourseof, 340 voidingcystourethrography of, 368 branchto celiac Plexus,240
female,340 Urogenital fold' 388 celiacbranchesof, 216, 319, 320,
left, 340 Urogenatal groove,388 321,322
male,340 Urogenital hiatus' 367 posteriorgastricbranch ot, 32O,328
nervesof, 344,345 Urogenital sinus' 389 Vaginar 367
retroperitoneal, 340 Urogenital triangle, 380 horizontalportion of, 372
right,318, 329, 340,372 Urticfe, 92,95,96, 124 musculofascialextensionsto, 356
upper,innervationof, 345 Uterine artery, 34O,341, 372 sagittalMR imagesof, 397
U]teral plexus, right, 318 cardinalligamentwith, 364 supportingstructuresof, 370
Ureteric told, 362, 363, 369 vaginalbranchesof, 404 upper four-fifths of, 389
Urcteric nerve, middle' 344 Uterlne ostium' 371 vertical portion of, 372
Ureteric orifice, 384 Uterine lfallopianf tube' 360, 362, vestibuleo1,37O,377
left, 366 369, 370, 389,400, 412,415 Vaginal artery, 340
right,366 abdominalostium of, 371 Vaginal fornix' 371
Ureteric plexus,410 a m p u l l ao f, 3 7 1 , 3 7 2 anteriorpart of, 360
Ureteropelvic junction, 339 fimbriaeot,371,372 posterior part of, 360
Urethra, 263, 367, 372, 389 folds of, 371 Vaginal orifice' 388
beginningof, 376 infundibulum o'f. 371. 372 Vaginal vein,398
cavernous,368, 385 isthmusof, 371 Vaginal venous plexus' 398
bulbousportion of, 371 uterinepart of, 371 Vaginal vestibuler 389
pendulousportionof, 371 Uterlne vein, 404 arteryof bulb of, 370
in children,368 superior,399 bulb of, 370.404
fema|e,356, 357, 360, 361, 389 Uterine venous plexusr 399 artery to, 404
frontalsection,anteriorview of, 379 Uterlne vessels, 360, 361,371 Vaginal wall, 370,373
schematicreconstructionof, 379 ovarianbranchesol, 372 Vagus nerve (Xf' 32,34,74,75,76,
male.381,383 Uterosacral fold' 362, 392 114, 116, 117, 118, 125, 126,127,
floor of, 385 Uterosacral ligament, 360, 371, 372, 130, 131, 135,206, 209,210, 211,
hiatusfor, 358 373 325, 345
roof of, 385 Uterovaginal venous plexusr 412 auricularbranchof, 10,24,126
membranous,368, 385, 408 Uterovesical pouch, 372 cardiacbranch of, 209
lymphaticpathwayfrom, 408 Uterus, 370, 380,388, 389, 400,412 celiacbranch of, 321
musculofascialextensionsto, 357 age changesand musclepatternof, 373 cervicalcardiacbranchof
prostatic,366, 368, 376, 384, 385 anteflexionof, 377 inferior,126
spongy,bulbousportionof, 366 arteriesand veins of, 404 superior,126
Urethral artery, 384, 405 body of, 360, 371 cholinergic,2l0
Urethral crest, 384 cervixof, 360, 364, 369, 370, 371 communicatingbranch of, 126
Urethral fold, 388 degreesof retroversionof, 377 communication to, 32
partlyfused, 388 externalos of, 371 distribution of, 118
Urcthral gland, 380,385 frontalsectionof, 371 inferiorganglionof, 126, 127, 128, 135
lacunaeand openingsof, 379 fundusof, 360, 362, 365,369,371 left,243,244
Urcthral lacuna' 385 internalos of, 371 meningealbranchof, 126
Urethral meatus, externalr 361 retracted,412 nucleusof, 324
Urethral orifice,388 round ligamentof, 340, 389 pharyngealbranch of, 125,126,13O
external,360, 377, 379, 382, 385, 388 sagittalMR imagesof, 397 posteriornucleusof, 116, 117, 126, 324,
a^R
femaleexternal,395 U.V junction, 372
Urethral raphe, 388 Uvula,51 pulmonaryplexusbranch of, 209
Urethral sphincter, internal' 366, of urinarybladder,366, 385 right,75, 80, 193,226, 230
367, 384, 385 Uvular muscler 52 s c h e m ao f , 1 1 8 ,1 2 6
Urethrovaginal sphincter, 367 suoerior cervical cardiac branch of,
Urinary bladder, 167, 269, 323, 329, v 130,131
340, 367, 412 superiorganglionol, 126, 127
a p e xo f , 3 6 1 , 3 6 5 Vagal cardiac nerve, 130 thoraciccardiacbranch of, 126,226
arteriesof, 34'l Vagal fibers, 126 Vallate papillae' 58, 135
b o d yo f , 3 6 1 , 3 6 5 , 3 6 6 Vagal nucleus, dorsal, 116 Vallecula, 58
f a s c i ao f . 3 6 1 . 3 6 4 Vagal trunk, 263, 321, 322, 323, 328 Vane comitantes' 59,60
female,366 anterior,126, 166,209, 318,319, 320, Vasa rectae sPuriar 337
fundusof, 361, 365, 366 321,327,344,346 Vasa rectae verar 337
innervationof, 168, 417 anteriorgastricbranch of, 319 Vastus interrnedius muscle' 489,
interiorof, 376 celiac branchesof, 216 493, 507, 538
lateralligamentof, 364 celiac branchof, 319, 320, 321, 322 attachmentsof, 489, 491
lymph vesselsand nodes of, 343 gastricbranchesof, 126 Vastus lateralis muscle' 485,489,
male,366 hepaticbranchof, 126, 319, 320, 323, 491, 492, 493, 494,500, 507, 538
mucosaof, 340 327 attachmentsof, 489, 491
neck of, 362, 365, 366 celiac branchesof, 320 Vastus medialis muscle, 485,489,
nervesof, 344 492,493,500,538
orientationand supportsof, 365 attachmentsof, 489, 491, 538
sagittalMR imagesof, 397 nerveto, 500
trigoneof, 361, 365, 366, 385

Vater Ventricf e (cerebrall (Continued) Vertebral vein, 137
ampullaof, 294 right lateral,108 anterior,137
major duodenalpapillaof, 294 t h i r d1, 0 6 ,1 0 8 ,1 1 0 ,1 1 1 ,1 4 6 Vertebral Yenous plexus, 137
Vein choroid plexusof, 106, 108 external,173
brain,146 tela choroideae of, 108, 111, 145 interna1 l ,7 O , 1 7 3
of brain,145 Ventricle (heartf Vertebra prominens, 19, 21
of forearm, 480 left,213, 214,221,224,246 Vesical artery
of hypophysis, 148 axial CT imagesof,242 inferior,340
of hypothalamus, 148 posteriorvein of, 216 uretericbranchesof, 340
of largeintestine,311 posteriorwall ol,221 superior,340,341
of pancreas,309 right,214, 215, 224, 246 uretericbranchesof, 341
of posteriorcranialfossa, 144 axial CT imagesof, 242 Vesicaf fold, transverse, 372
of small intestine,309 opened,220 Vesical pfexus, 323, 344, 412
of spleen,309 Ventricular vein Vesical vein
superficial,of lower limb, 545 hippocampal, 146 right,311
of suprarenalglands,347 inferior,146 superior,265, 399
vertebral,137 Ventromedial nucleus, 147 Vesical venous plexus, 366,403
Velum Venulae rcctae, 337 in retropubicspace,361
inferiormedullary113 Vermian artery Vesical vessels, lymphatic
superiormedullary 113 inferior,143 pathway along,408
Vena cava superior,143 Vesicocervical fascial fibers, 364
inferior,179, 194, 206, 2O9,213, 215, Vermian vein Vesicocervical space, 364
220, 225, 230, 272, 273, 278, 293, inlerior,144 Vesicosacral fold, 363
297, 298, 330, 331, 333, 339, 342, superior,144, 146 Vesicouterine pouch, 372
347, 412 Vermis, 113 Vesicovaginal pouch, 362, 365, 391
axial CT imagesof, 242,35O inferior,113 Vesicovaginal space, 364
cross sectionof, 297, 338 n o d u l eo f , 1 1 3 Vesicular appendix (hydatid of
openinglor,223 pyramidof, 113 Morgagnif, 371, 389
persistent left, 333 tuber of, 113 Vesicular yean, :nferior, 399
right renalvein entering,339 u v u l a o f ,1 1 3 Vestibular aqueduct
valve ol,22O superior,113 endolymphaticduct in, 96
superior,74, 75, 206, 211, 213, 215, 220, centrallobuleof, 113 externalopeningof, 97
224,225, 230,244,245,246 c u l m e no f , 1 1 3 Vestibular area, 115
axialCT imagesof, 242 decliveof, 113 Vestibular lo.sa,377
prenatal,229 foliumof, 113 Vestibular ganglion, 95
Venae comitantes,460 l i n g u l ao f , 1 1 3 Vestibular gland, 389
Venous arch, dorsal, 544 tuberof, 115 greater,389, 404
Venous plexus, 372 uvulaof, 115 openingof, 377
vertebral,10 Vertebra. See a/so specific veriebrae orimordiumof. 389
Ventral ramus, 170,193 body of, axial CT imagesof, 242,350 Vestibular membrane, 96
i n s i t u ,1 6 0 lumbar,155 Vestibufar nerve, 95, 97, 124
Ventricle lcerebralf radiographsof, 156 inferior, 95, 97,124
choroid plexusof, 109 relationto spinalnerves,161 superior,95, 124
fourth,113, 115, 144, 146 spinousprocessof, axial CT imagesof, Uestibular nuclei, 117
axial MR imageof, 150 242 Vestibular nucleus, 116, 124
choroidplexusof, 106, 114 thoracic,154 diagrammatic, 124
lateraland medianaperturesof, 146 Vertebral artery, 10, 21, 32, 75, 76, 100, Vestibular lovall window, 95
mediansagittalsectionof, 114, 115 130, 140, 141, 171, 178,226, 237 Vestibule, 95,389
outlineof, 143 anteriormeningealbranch of, 143 cochlearrecessof, 92, 95
posteriorview of , 115 atlanticpart of, 178 ellipticalrecessof, 95
rhomboidfossa of, 114 left, 143 spherical recess of, 95
sagittalMR imageof, 149 meningealbranchesof, 10 Uestibulocochlear nerve, 117
vein of lateralrecessof, 144 posteriormeningealbranchof, 100, 143 Vestibulocochlear nerve (Vlllf, 92,
lateral,108, 110, 146 right,143 9 5 ,9 7 , 1 1 4 ,1 1 6 ,1 3 1
choroid plexus,109 venus plexusof, 137 s c h e m ao f , 1 1 6 ,1 1 8 , 1 2 4
choroidplexusof, 99, 108,110, 143, Vertebral body, 19 Vestigial mesonephric tubule, 390
145 articularfacets for, 186 Vidian nerve, 122
lateralvein of, 146 fourth thoracic,230 Viscera
o c c i p i t ahl o r no f , 1 1 0 ,1 1 1 ,1 4 6 lumbar,155 abdominal,269
right,occipitalhorn of, 143 Vertebral canal, lumbar, 155 median sagittal section of, 348
sagittalMR imageof, 149 Vertebral column Pelvic
t e m p o r ahl o r no f , 1 0 8 ,1 1 1 , 1 4 6 anteriorview of, 153 female,360
veins of, 146 left lateralview of, 153 male,361
left lateral,108 posteriorview of, 153 nervesof, 412
aoertureof. 108 veinsof, 137 vasculatureof, 300-315
centralpart of, 108 Vertebral ganglion, 130, 226 Visceral lymph nodes
frontalhorn of, 108 Vertebral notch celiac,266
occipitalhorn of, 108 inferior,lumbat 155 inferiormesenteric,266
phantomview of, 108 superior,lumbar,155 superiormesenteric,266
temporalhorn of, 108 Vertebral plexus, 130 Visceral nerve, thoracic, 165
Visceral pleura, 205

Visual fields, overlapping' 120 Wolffian duct. See Mesonephric x
Visual pathway, 120 (wolffian)duct)
Vitreous body, 87 Wrist Xiphoid process' 185, 191, 196, 198,
Vitreous chamber, 90 anterior(palmar)view of, 472 247, 248, 249, 285, 286, 293,
coronalCT imagesof, 151 anteriorview of, 460 297,298
Vocalis muscle, 78, 80 arteries of, 461 cross sectionof, 297
action of, 79 articulardisc of, 455
Vocaf ligamenl,77,78 bones of, 456 z
abductionof, 79 coronalsectionof, 455
adductionof, 79 cross section,transverse,461 Zigzag (Zf line, 236
lengtheningof, 79 cutaneousinnervationof, 472 Zona orbicularis' 487
shorteningof, 79 deep dorsaldissectionof, 469 Zonular fibers, 87, 88, 89, 90
Voiding cystourethrograms, male deeperpalmardissectionof, 460 Zygapophyseal (facetl ioinl, 246
and female, 368 extensormusclesof, 441 c2-3, 19,21,22
Vomer,39 extensortendonsat, 470 c a p s u l eo 1 , 2 1 , 2 2
Vomerine groove, 39 flexor musclesof, 442 c34,21
Vorticose vein, 85, 90, 91 flexortendons,arteries,and nervesat, Zygomatic alch, 14,54, 151
anteriortributariesof, 91 461 Zygomatic bone' 81
bulb of, 91 ligamentsof, 454, 455 Zygomatic nerve' 121
oosteriortributariesof. 91 movementsof, 453 Zygomaticolacial atlery, 23
suprachoroidaltributariesof, 91 nerves at, 461 Zygomaticofacial nerve, 24, 122
V.shaped area (of Laimerf, 234,235 palmardissection,deeper,460 Zygomaticofaclal vein' 23
Vulva, 377 posterior(dorsal)view of, 455, 470, 472 Zygomaticotemporal arlery, 23
radialdissection,superficial,467 Zygomaticotemporal nerve' 24, 122
w radiographof, anteroposterior, 457 Zygomaticotemporal vein' 23
sagittal section of, 453 Zygomaticus maior muscle' 26, 54,
White matter, spinal, 169 superficialdorsaldissectionof, 468 123
Willis, circle of. See Cerebralarterial superficialpalmardissectionof, 459 Zygomaticus minol muscler 26,54,
circle (of Willis) tendonsof, 461 123
Winslow, foramen of. See Omental
foramen (of Winslow)

Atlas Human Anatobhnjklmy Ciba Netter

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n rl f

JenniferK. Brueckner,PhD NoelleA. Granger,PhD

StephenW. Garmichael,PhD, DSc John T. Hansen,PhD

ThomasR. Gest,PhD AnilH. Walji,MD,PhD

Atlas of Human Anatomy Editionwith StudentConsultAccess: ISBN-13:978-1-4160-3385-1

Copyright @ 2006, 2003, 1997, 1989 by Saunders, an imprint of Elsevier lnc.

Previouseditionscopyrighted2003, 1997, 1989.

AcquisitionsEditor: Anne Lenehan

Superficial Face Oral Region

Atlas of l{uman Anatomy

Bones and Ligaments

Atlas of Human Anatomy

Thyroid Gland and Larynx Meninges and Brain

Atlas of l{uman Anatomy

Atlas of Human Anatomy

-John T Hansen, PhD

I am deeply grateful to my colleaguesat Universityof North -AnilH. Walji, MD, PhD

Supraorbital Zygomatic bone

Topographic Anatomy Plate I

Plate 2 Bones and Ligaments

Bones and Ligaments Plate 3

S p h e n o i db o n e Parietalbone Temporalfossa Iemporal bone

Plate 4 Bones and Ligaments

Anterior arch of atlas C Creater wing of

Bones and Ligaments Plate 5

View of lateral nasalwall with nasalseptum removed

Parietalforamen (for emissaryvein)

Bones and Ligaments Plate 7

Bones and Ligaments Plate 9

Chordatympaniof facialnerve(Vll)------ Petrotympanic

Plate I O Bones and Ligaments

Foramencecum----- vein to superiorsagittalsinus

Bones and Ligaments Plate I t

Occipital bone Lambdoidsuture

Lateralpterygoid plate (broken line)

2nd cervicalto 1stthoracicvertebrae:

Articularpillarformed by for spinal

Bones and Ligaments Plate t 3

Plate 14 Bones and Ligaments

Attachmentsfor major Condylar process Lateralpterygoid

Alveolar part (crest)

Mandibleof adult: Mandibleof aged

Bones and Ligaments Plate 15

n{r (openlnduth odontoidview)

Bones and Ligaments Plate 17

Inferioraspectof C3 and superioraspectof C4 showine

Area for articulationof left uncinate processof C4

Body Articularsurfaceof uncinateorocess

Plate | 8 Bones and Ligaments

joints of the cervicalspine:anteriorview

Bones and Ligaments Plate 19

Degenerativechangesin the cervical spine

Complete transversecleft Uncovertebraljoint

Spreadof cleft formation into

Advanced spondylophyte(osteophyte) Markedly narrowed

Uncovertebra.ljoint fused due to extensivespondylophytei Croove for spinal nerve

Plate 2O Bones and Ligaments

Anterior atlantooccipitalmembrane Transverse

Capsuleof Capsuleof lateral

Zygapophysealjoints (C4-5 and cs-6)

Anterior tubercle of C6 vertebra (carotidtubercle)

Bones and Ligaments Plate 21

Principal part of tectorial membrane removed