AEM CO Nom Co) crei Elke Liitjen-Drecoll Color Atlas of Anatomy A Photographic Study of the Human BodyStructure of the human body and the skeleton. Bluc A Head (caput) B_ Thorax (thoracic cavity) C Abdom pelviee In contrast to most other mammals the human body is adapted for bipedal locomotion. Three general prin- ciples in the architecture of the human organism are recognizable: 1. The principle of segmentation, which dominates in the trunk. The vertebral column and the thorax consist of relatively equal, segmentally arranged elements 2. The principle of bilateral symmetry. Both sides of the body are separated by a midsagittal plane and resemble each other like image and mirror-image. 3. The principle of polarity between the head at one end of the body and the lower extremities at the other. As the center of the information system the head contains the main sensory organs and the brain, The head has a predominantly spherical form while the extremities consist of radially formed skeletal elements, the number of which increases distally. A. The skull consists of two parts: 1. a cranial part containing mainly the brain and the sensory organs and 2. a facial part which contains the nasal and oral cavity and the chewing apparatus. The cranial cavity is con- tinuous with the vertebral canal which contains the spinal cord. B. The thorax contains the respiratory and circulatory organs (lung, heart, etc.) but also some of the abdomi- nal organs which are located underneath the diaphragm, C. The abdominal cavity contains the organs of metabolism such as the liver, the stomach and the intestinal tract as well as the excretory and genital organs (kidney, uterus, urinary bladder, ete.). The latter are located primarily in the pelvic cavity with the exception of the testes. 1 Cranial prt 10 Radius 1 Cranage tut JP Ra | orca 3 Verbal column Pes (cereal part 13 West (Capa) yang 4 Chive 14 ings (phalanges) 3 Som 1S. Thigh Geman) & hie 1 Patella and Ke joint > Sicenum 17 Tia 8 Arm (humerus) 18, Fibula | '*® 9 Mertcbral column 19 Tae } foot (Geniber pasts 20. Metatarsals |Positon of the inner organs of the human body (anterior aspect) The main cavities of the body and their contents. ‘Median section through the trunk (female). 1 Sternum 21 Sacral promontory 2. Right ventricle of heart 22. -Sigmoid colon 3 Diaphragma 23. Anal canal 4 Liver 24 Anus 5. Stomach 25 Head (nevrocranium) with brain 6 Transverse mesocolon 26 Ascending colon 7. Transverse colon 27 Appendix 8. Umbilicus 28. Facial region (visceroeranium) 9° Mesentery with oral and nasal cavities, 10 Small intestine 29 Trachea and larynx 11 Uterus 30 ‘Thorax with the lungs 12 Urinary bladder 31 Heart 13. Pubie symphysis 32. Surface projection of the diaphragm 14 Left atrium of heart 33. Spleen 15 Caudate lobe of liver 34 Descending colon 16 Omental bursa or lesser sac 35 Testis 17 Conus medullaris 18 Pancreas 19 Cauda equina 20. Intervertebral discs (lumbar vertebral column)Sagittal section through the human body (female) Demonstration of the main cavities of the body. Internal organs are removed. Cranial cavity >> voos Diaphragm 4 Planes of the body Lines of direction 1 Transverse plane ant. 2. Frontal plane in, 3. Sagittal plane (midsagittal) lat Post. = posterior sup. superior Position of the inner organs of the human body (lateral aspect) The three main cavities of the body and their contents. 1 Head (neurocranium) with the br 2 ith oral and nas Stomach 10 Ascending colon 11. ‘Transverse colon 12 Ureter B nix 17 Uterus 18. Urinary bladderSkeleton of a female adult (anterior aspect).Axial skeleton a bone bone 3. Parietal bone 4 O%bit 5. Nasal cavity 6 Maxilla 7 Zygomatic bone 8 Mandible ‘Thorax 15. Sternum Upper limb and shoulder girdle Cha Uina 24 Carpal bones 25. Metacarpal bones 26. Phalanges ofthe hand Lower limb and pelvis "7 wm 28. Pubis Ischia ‘Symphysis pubis Femur 38 Caleaneus ld child (anterior aspect), aginous growth plates are scen (arrows) In contrast to the ad horizontal position.Ossification of the scapula (left: anterior aspect, right: posterior aspect), 1 Bone tissue (vertebral body) 2 Cartlaginous tissue (ateral epiphysis) 3. Intervertebral dises Ossification of the sacrum (anterior aspect Note the five vertebral bones, which are still separated from each other. 1. Subscapular fossa Coracoid process 3. Glenoid fossa 4 Acromion 5. Spine of scapula 6 Infraspinous fossa 1 Cart 2 Tum 3 Cartilage $ Pubis age of the iliac erest Ischium 6 Acetabulum 1 Bony tissue (center of ossification) Vertebral arch (not completely united) 3 Cartlaginous Cateral epiphysis) 4 Sa Ossification of the sacrum (posterior aspect)8 Diaphy of the femur (left; coronal section: of the femur). Arrows: distal epiphysis X-ray of the upper and lower limb of a newborn child. Left: upper limb, Right: lower limb. Arrows: ossification centers 4 Elbow joint ler joi 5 Ulna 3 Humerus 6 Radius 1 Ulna 4 Phalange 2 Radius 5 Tibia Metacarpals 6 Fibula X-ray of hand and foot of a newborn.1 Metaphysis 2. Spongy bone 3. Medullary cavity in the diaphysis Compact bone Nutrient eanal Diaphysis Epiphyseal line (remnants of the epiphyseal plate) Epiphysis (head ofthe femur) 9 Fovea of head Trabecuine of spongy bone Neck of the femur Greater trochanter hanter Lesse Articular surface Periosteum Skin 17 _Vastus medialis muscle 18 Sartorius muscle 19 Femoral artery and vein 20 Great saphenous vein 21 Gracilis muscle 22. Adductor longus muscle 23. Adductor magnus musele 24 Semimembranosus muscle 25. Semitendinosus muscle 26 Rectus femoris muscle 27 Vastus lateralis muscle 28. Femur and medullary cavity 29. Vastus intermedius muscle 30. Sciatic nerve 31 Biceps femoris muscle 32. Spongy bone trabeculae containing bone marrow 33. Compact bone 34 Osteon with Haversian lamellae 35 Periosteum 36 Blood vessels and nerves for periosteum and bone Femur of the adult, Left: the periosteum and the nutrient vessels are preserved. Right: coronal section of the proximal and distal epiphyses to display the spongy bone and the medullary cavity Coronal section through the proximal end ‘Three dim ion on the trajectorial of the adult femur, revealing the characteristic lines of the femoral head (according to B. Kummer) trajectorial structure of the spongy boneMR-Image of the thigh (axial section through the middle of the left thigh, the same level as the CT-Image). The bones of the skeletal system consist of two different parts, the spongy and the compact bone. The spongy bone trabeculae are highly adapted to mechanical forces revealing a trajectorial structure. The intertrabecular spaces are filled with bone marrow, the site of blood formation. The appearance of bones, muscles and soft tisssues is quite different in CT- and MR-Images. The CTimages relate well to radiographs in that areas of great absorption such as bones are white, and those with little adult tibia, Note the zone of dense bone at the site of the former epiphyseal plate (dotted line). (CTAmage of the section through the middle of the left thigh (axial section). Note the differences between the CT- and MR-Image (see text below). absorption such as fat appear black. In contrast, the intensity of signals in MR-Images, obtained without X-rays but by magnetic forces, is different so that dense areas of bones appear black and soft tissues such as bone marrow and fat appear white (for comparison see above figures). A highly innervated periosteum is an essential structure for bone nutrition, blood supply, growth and bone repair. Structure of bones of the skeletal system (after Benninghoff). Note that the compact bone reveals a lamellar structure with Haversian lamellae and canals,anterior part of theta tb and a synovial cavity (right side, anterior view). Coronal section throught the knee joint. Red line = Articular capsule with synovial membrane. Dotted red line = extension of articular capsule (suprapatellar bursa), Articulating bones: a) Femur, b) Tibia 2. Epiphysal line 3. Articular cartilage 4 Intraarticular ligaments (e.g. cruciate ligaments) 5. Fibrocartilaginous disk (e.g. meniscus) 6 Collateral ligaments 7. Articular capsule with synovial membrane 8. Tibiofibular articulation (example of gliding synovial joint) 9 Fibula Movement Examples A. Fibrous oints 1 Sutures No movements | Sutures ofthe skull 2. Syndesmoses | Nomovements. | Distal tibiofibular joint 3 Gomphosis Nomovements | Rootsof teeth in alveolar process 1B Carttaginous joints L Synchondroses | Nomovements | Epiphyscal pla 2. Symphyses zht movement | Symphysis pubis imervertebral discs € Synovial joints 1 Gliding Monaxial Interearpal joint Sacroiliacal joint 2. Hinge Monat Tnterphalangeal joint Humeroulnar joint “Talocrural joint 3 Pivot Monaial Atlantoaxial join Radioulnar joint 4 Eilipsoidal Bianial Radioearpal joint 5 Saddle Bianial Carpometacarpal joint ofthe thumb 6 Balkand-socket | Multiaxial Shoulder and hip joint " 10 & 128 128 13 Main types o ints. Arrows: axes of movement Fibrous joints (synarthroses) 10. Serrate suture 11 Syndesmosis Synovial joints (diartheoses) Hinge joints (monsxial ginglymus A Extension B Flexion 13. Sadalle joint (biaxial) 14 Pivot joint (monaial, rotation) 15 Ball-and socket joint (multiaxial)An articulation or joint is the functional connection between two or more bones. Joints can be divided into two categories depending upon whether the articulating surfaces of the bones are separated by a real cavity Goint cavity) so that they are movable against each other (synovial joints) or whether the bones are firmly connected by fibrous or cartilaginous tissue and practi cally immovable (fibrous joi i ts, symphysis, etc.). Synovial joints always possess a joint capsule (with a vascularized synovial membrane). articular cartilages, and a joint cavity. They are grouped according to the degree of movement they permit. A hinge joint (ginglymus) permits movement in only one plane about a single axis (uniaxial or mona ellipsoidal joint permits movements in two planes (bi- axial), and ball-and-socket joints permit a range of movements around several axes (multiaxial), The fol: lowing survey gives a few examples of these types of articulation. 1. Fibrousjoints A. Sutures a). Serrate or dentate suture b) Squamous suture (arrows) Parietal bone Sphenoid bone Squama of temporal bone ©) Plane suture (arrow) Nasal bonesFusiform Bicipital Tricipital (palmaris longus muscle) (biceps brachii muscle) (triceps surae muscle) trie Multiventral 2 Malticaudal (omohyoid muscle) (rectus absdominis muscle) (flexor prot. muscle) Bipennate Unipennate (tibialis anterior muscle) (semimembranous ‘Semitendinous Broad, flat muscle (semitendinous muscle) _(latissimus dorsi mus. Long head 4 Soleus muscle Short head 5. Achilles tendon 9 Rectus femoris muscle us intermedius muscle 8 Patella Vastus lateralis muscle 11 Intermediate tendon 10 _Vastus medialis muscle ‘Quadricipital (quadriceps femoris mu Serrated (serratus anterior mi Ringslke (external anal sphincter muscle) 12. Tendinous intersection 13 Aponeurosis 14 Tendinows intersectionLeft half of the pelvis (posterior aspect) Obturator internus musele as an example of a muscle, the tendon of which does not act in the direction of the main muscle fibers. Is fibers originate at the internal aspect of the obturator foramen, turn around the posterior rim of the ischium and insert at the greater trochanter of the femur, The ischium thereby serves as a pulley. 1 Tum 2. Greater trochanter 5 Pubis Femur 3 Coceyx 4 Obturator internus muscle 6 1. Digital synovial sheaths of the tendons of fle- xor digitorum superficial and profundus muscles 2 Digital synovial sheaths of the tendon of long, flexor pollicis longus 3 Common flexor synovial sheaths ‘of flexor digito- rum superficial and profundus muscles 4. Flexor retina- culum ‘The synovial sheaths of the tendons o of the left wrist (colored fluid has been injected). the palmar aspect Superior oblique muscle of the eyeball, right eye (superior aspect). The tendon of this muscle bends over the trochlea changing its direction so that it becomes attached to the posterior lateral quadrant of the eyeball Trochlea Medial rectus muscle Superior oblique muscle ‘Common annular tendon Eyeball Superior rectus muscle Lateral rectus muscle Superior rectus muscle (tendon) tor palpebrae superioris muscle (divided) Mesotendon Blood vessels Synovial sheath ‘Tendon Synovial bursa Bone (tuberosity) Structure of a tendon sheath. The synovial membrane whi also forms the mesotendon is indicated in red. (Schematic drawing.)Brain, the spinal cord and the spinal nerves in the fetus (posterior aspect), The nervous system can be divided into three, function ally distinct parts: 1. the cranial part which comprises the great sensory organs and the brain, 2. the spinal cord which shows a segmental structure and serves predomi- nantly as a reflex-organ, and 3. the autonomic nervous system which controls the unvoluntary functions (sub- conscious control) of organs and tissues. The autonomic part of the nervous system forms many delicate plexus within the organs. At c ‘egations of nerve cells (prevertebral and intramural ganglia), The spinal nerves leave the spinal cord at in places these plexus contain 1 Falseerebri 2. Cerebral hemispheres 3. Tentorium cerebell 4 Cerebellum 5 Medulla oblongat 6 Spinal cord, cervical enlargement Spinal ganglia 8. Spinal cord, amb 9. Conus medullaris 10 Ci 11 Cervical plexus (formed from ventral rami of CC.) ia equin 12 Brachial plexus (formed fom ventral rami of C5-T,) 13 Lumbosacral plexus (formed from ventral rami of Li-S.) 14 Sympathetic tsunk Ye NU] y K Le S Schematic drawing to illustrate the three main parts of the nervous system in general, regular intervals, forming the thoracic, 5 lumbar, 5 sacral and a. varyin; geal ‘The ventral rami of the first four cerv number of coc segments. spinal nerves (C,-C,) form the cervical plexus (for innervation of the anterior neck), the ventral rami of the lower cervical spinal nerves (Cs-T,) form the brachial plexus which innervates the upper leg, and the ventral rami of the lumbar and sacral spinal nerves form the lumbosacral plexus (L1~S.) which innervates the pelvic and gi ital organs and the lower extremity.three functional portions of th Yellow = sympathetic system; tie trunk and ganglion ‘of the autonomic nervous system Cranial nerves (9. I and, Vit) Superior cervical ganglion Sacral autonomic system Posterior part of the thorax. Cross-section at the level ofthe 5th thoracie Spinal nerves and their connections to the sympathetic trunk. Organization of the spinal cord in structurally equal segments A = connections to the which form the paired spinal n brain; B = connections to the connections to the trunk and extremities (intercostal nerves and plexus). (Schematic drawing.) jonomie nervous system; C= Spinal cord 12. Inferior vena cava Dorsal root 13 Dorsal ramus of spinal nerve Ventral root 14 Spinal (dorsal root) ganglion Intereostal nerves 15 Body of the vertebra Sympathetic trunk 16 Aorta ‘Ganglia of the sympathetic trunk 17 Azygos vein Rani communicantes, 8 Diaphragm Intercostal artery and vein 19 Left kidney Subcostalis muscle 20. Spinal nerve 21 Gray matter of the spinal cord 2. White matter of the spinal cord Lesser splanchnic nerve Greater splanchnic nerveSuperficial nerves and vessels of the lower leg, illustrating the structural differences between veins and nerves, 1 Crural fascia 3. Superficial cutaneous veins (fascia eruris) 4 Perforating vein 2. Cutaneous nerves Organization of the circulatory system. Arrows: direction of, the blood flow. Vessel wall inred = Arteries ‘Vessel wall in blue = Veins Yellow = Lymphatic vessels A. Systemic circulation B Hepatic portal circulation c 1 Pulmonary vein 12. Small imestine 2. Superior vena cava With capillary newwork 3. Thoracic duct 13. Portal vein 4 Inferior vena cava 14 Mesenteric artery 5 Hepatic vein 15. Superficial temporal artery 6 Liver 16 Superficial temporal vein 7 Lymph nodes and 7 Auriculotemporal nerve Iymphatie vessels 18. Perforating veins for 8 Lung subcutaneous fatty tissue 9. Pulmonary artery 19. Small aetery Superficial nerves and vessels. Temporal region. Note the W Aorta 20. Small nerve differences between arteries, veins and nerves. 1 Hear (branches of facial nerve)Major vessels of the trunk. The position of the heart is indicated by the dotted line. 0 n B 4 6 7 Internal jugular vein ‘Common carotid artery Vertebral artery Ascending aorta Descending aorta Inferior vena cava Celiac trunk Superior mesenteri artery Renal vein Common ile artery Larynx 2 Trachea Left subctavian artery Left axillary vein Pulmonary veins Diaphragm Suprarenal gland Major arteries of the human body. (Schematic drawing.) Kidney Ureter Inferior mesenteric artery Profunda femoris artery Femoral artery Popliteal artery Posterior tibial artery Plantar archlymph nodes in the body. Dotted line = border between lymphatic vessels draining towards the right venous angle and towards the left. ginate as blind-ending tubes in the ; aries) and unite to form larger vessels (lymphatics). These res veins but have a much thinner wall, more valves and are interrupted by lymph nodes at various intervals. Large groups of lymph nodes are located in the inguinal and axillary regions, deep to the mandible and sternocleidomastoid muscle and within the root of the mesentery of the intestine.1 Corpus callosum 2. Hypothalamus 3. Frontal sinus 4 Cribriform plate 5. Ethmoidal air cells 6 Middle nasal concha 7 Inferior nasal concha 8. Hard palate 9 Tongue 10 Epiglottis| 1 Mandible 12. Mylohyoid muscle 13 Tentorium of cerebellum 14 Calcarine fissure 15 Cerebral aqueduct ‘land 17 Fourth ventricle 18. Sphenoidal sinus 19. Medulla oblor 20 Nasopharynx 21 Uvula Dens of axis Constrictor muscle of pharynx Oral part of pharynx Cerebrum (right hemisphere) Calvaria Cerebellum Sagittal section through head and neck (MR-Scan. 23-year-old female, courtesy of PD Dr. A. Heuck, Munich) ===. 25 26 16 27 7 19 a Sagittal section through the head (schematic drawing). The red line represents the border between the neurocranium and viscerocranium forming the clivus angle. The neural cavity contains the brain; the viscerocranium comprises the orbit, the nasal cavity and the oral cavity arranged ‘one beneath the other.General arel in color (numbers ef. table) Lateral aspect of the disarticulated skull (palatine bone. ethmoid bone and vomer are not depicted). lacrimal bon scture of the skull (lateral aspect). The different bones 1 Coronal suture Frontal bone 3 Sphenoid bone 4 Sphenofrontal suture 5 Ethmoid bone 6 Nasal bone Nasomaxllary suture 8 Lacrimal bone 9 Lacrimomaxillary suture 10 Lacrimoethmoid suture 11 Zygomatic bone 12 Anterior nasal spine 13. Maxilla 14 Mandible 15 Mental fo 16 Mental protuberance 17 Sup 18 Inferior temporal line 19. Parietal bone 20 Temporal bone or temporal line 21 Squamous suture Lambdoid suture 23. Temporal fossa 24 Parietomastoid suture 25. Occipital bone 26 Zygomatic arch endbesled 27 Occipitomastoid suture 28 External acoustic meatus 29° Mastoid process 30 Tympanie portion of temporal bone 31 Condylar process of mandible 32 Coronoid process of mandible 2 Fromtal bone (orange) 19 Parietal bone (light green) 3. Greater wing of sphenokd bone (red) 25 Squama of occipital bone (blue) 20 Squama of temporal bone (brown) 5. Ethmoid bone (dark green) 3 Sphenoid bone (red) Temporal bone exclu 30 ‘Tympani portion of temporal bone (dark brown) Occipital bone excluding squama (blue) squama (brown) {6 Nasal bone (white) 8 Lacrimal bone (yellow) Inferior nasal eoncha Vomer LL Zygomatic bone (light yellow) Palatine bone 13 Maxilla (violet) 14 Mandible (white) To page 49: Blue = Occipital bone Light green = Parietal bone Light brown = Frontal bone Dark brown = T poral bone Red Sphenoid bone Dark green = Ethmoid bone Light blue = Nasal bone Pink Inferior concha Orange = Vomer Violet = Mavilla White Palatine bone Lateral wall of the nasal cavity. Median section through the skull White Mandible Inferior Concha and Vomer 1 Ethmoid process Anterior part of concha 3 Inferior border 4 Ala of vomer 5. Posterior border of nasal septum 6 Lacrimal process Posterior part of concha 8 Maxillary process Right inferior nasal concha (medial aspect). Anterior part tothe left Right inferior nasal cor to the right. a (lateral aspect). Anterior par Vomer (posterior aspect)1 Crista gal Cribritorm plate oid bone 3. Perpendicular plate of ethmoid bone 4 Vomer 5 Alaof the vomer 6 Palatine bone (perpendicular process) Palatine bone (horizontal plate) 8 Mandible 9 Nasal bone 10. Sphenoidal sinus LL Hypophysial fossa (sella tuciea) 12. Grooves for the middle ‘meningeal artery Cartilages of the nose 3 Li 16. Septaleartlage Location of nasal bone Cartilages of the nose (right anterior aspect). Arrow = nostril Cartilages of the nose. framed by Schematic diagram of the external noseBase of the skull (from below). The individual bones are indicated by different colours. Skull of the newborn (inferior aspect), 49 Prerygoid canal Foramen ovale Internal carotid artery within carotid canal and internal us part of jugular foramen mastoid foramen (facial nerve) vein within the foramen (glossopharyngeal, vagus and accessory nerves) Hypoglossal canal (hypoglossal nerve) Incisive canal Median palatine suture Palatine process of maxilla Palatomaxillary suture Greater and lesser palatine foramina Inferior orbital fissure Middle concha (process of ethmoid bone) Vomer Foramen ovale Groove for auditory tube Prerygoid canal Styloid process Carotid canal Stylomastoid foramen Jugular foram Groove for occipital Occipital condyle Condylar canal Nuchal plane External occipital protuberance Zygomatic arch Lateral pterygoid plate Medial pterygoid plate Mandibular fossa Pharyngeal tuberele Superior nuchal fine Mastoid process Inferior nuchal line Mastoid notch Foramen magnum Incisive bone or premaxilla (dark violet) Maxilla (violet) Palatine bone (shite) Vomer (orange) Sphenoid bone (red) ‘Zygomatic bone (yellow) Temporal bone (brown) ccipital bone (blue) Vomer Spltenoid bone Petrous part of temporal bone Basilar part Lateralpart —} ofoccipital bone Squamous part Mandible Zs Chouna Pterygoid process of sphenoid bone Carotid canal External acoustic meatus (tympanic annulus) Sphenoidalfontanelle Parietal bone Mastoid fontanelleCentral incisor Lateral incisor Canines 4 First premolars or bicuspids 5. Second premolars or bieuspids 6 First molars 7. Second molars 8 Third molars 9 Anticular tubercle 0. Mandibular f 1 Head of mandible 12 Condylar process Normal pos Table of dentition. Eruption of deciduous and permanent teeth (after C. Rise according to A. Krneke) Maxilla Mandible Primary det (Deciduous teeth) months post partum months 1. Central incisor 10.3 86 2. Lateral incisor 12.2 lad 3. Cuspid incisor 9s 20.1 4. First molar 15.5 16.5 5. Second molar 24.8 245 ondary dentition years and months years and months (Permanent teeth) 3 ¢ 1. Central incisor 78 S610 67 2. Lateral incisor sil 8677 3. Cuspid incisor pe 7a 0B 4. First premolar 1S tts 5. Second premolar m4 W127 6. First molar 07 66 6S 7. Second molar 9 1s 19 Lower teeth of the adult (superior aspect)Parietal tuber or emi Occipital tuber oF eminence 4 Squamous part Greater wing of sphenoid bone Facial skeleto 6 Maxilla Mandibie 8 Zygomatic bone 9 Nasal bone Sutures and 1 ture B id suture 14 Anterior fontanelle 15 Posterior fontanclle 16. Sphenoidal fontanelle 17 Mastoid fontanelle Base of the skull 18 Frontal bone 19 Ethmoid bone 20. Sphenoid bone 21 Hypophysial fossa (sella turcica) Dorsum sellae 3 Temporal bone Mastoid fontanelle Occipital bone In the newborn the facial skeleton, in contrast to the 43 cranial skeleton, appears relatively small. There are no teeth presenting, The bones of the cranium are sepa- rated by wide fontanelles, Skull of the svborn (superior aspect). Calvaria. Base of the skull of the newborn (internal aspect) lof the newborn (lateral aspect).Mandible of the adult (anterior aspect) eral aspect of the bones, Mandible and teeth in the position IC of mandible (medial aspect), of occlusion, Upper and lower jaw occluded. Temporal bone 7 Zygomatic bone Temporal fossa (greate (frontal process) wing of sphenoid bone) 8 Lacrimal bone Intratemporal crest Nasal bone Infratemporal fossa 10. Lacrimal groove Zygomatic arch 1 Maxi Frontal bone (canine fossa) 12 Alveolar process of maxilla Mand Condylar process Mandibular notch Ramus of the mandible Masseteric therosity Angle ofthe mandible Body ofthe mi Coronoid process Oblique line Mental foramen Mental protuberance Head of the mandible Genial tubercle or mental spin Mandibular foramen (entrance to mandibular canal Lingul Mylohyoid suleus Mylohyoid line Submandibular fossa dult (superior aspect), 31 Sublingual fossaTemporomandibular joint with ligaments. femporomandibular joint, sagittal section Ligaments of temporomandibular joint. Left half of the head (medial aspect) 0 Zygomatie arch Articular capsule External acoustic meatus Lateral igament Mandibular noteh Stylomandibulae ligament Ramus of the mandible Zygomatic bone Coronoid process Manilla Articular cartilage of condylar process Siyloid process Mandibular fossa Aticular dise Articular tubercle Lateral pterygoid muscle 7 Condylar process of mandible Groove for sigmoid sinus Mandibular nerve Lateral pterygoid muscle Styloid process Ethmoidal ai cells Ethmoidal bulla ‘Hiatus semilunaris Middle meatus Inferior nasal concha Limen nasi Vestibule with hai Inferior meatus Haru palate Solt palate Vestibule of oral cavity Lower lip Mandible1 Insular lobe and temporal lobe 2 Temporalis muscle 3. Articular dise of ‘emporomandibular joint Maxillary artery and pterygoid venous plexus 5 Parotid gland 6 Mandible 7. Medial pterygoid muscle 8 Masseter muscle 9. Submandibular gland 10 Thyroid gland 11 Stemnocleidomastoid muscle 12 Hippocampus 13. Internal carotid artery and sphenoid bone Pharyngeal tonsil Pharynx “Thyroid cartilage Rima glottidis| Cricoid cartilage Hard palate and palatine glands Oral eavity Upper molar Oral vestibule Lower molar Platysma muscle Maxillary sinus Superior longitudinal muscle of tongue ‘Transverse muscle of tongue Buccinator muscle Inferior longitudinal muscle of tongue Sublingual glan Genioglossus muscle Mastoid process Styloid process Stylomandibular ligament Articular capsule Lateral ligament Zygomatic arch 38. Sphenomandibular ligament 39 Mandibular foramen Coronal section through the head at the level of the temporomandibular Joint (right side, anterior aspect). 35 36 37 Ligaments related to the temporomandibular joint‘Temporalis and masseter muscles. The temporal fascia has been removed, the temporomandibular joint severed and the zygomatic arch displayed. 1 Galea aponeurotica 2 Temporalis muscle 3 Occipital belly of occipitofrontalis muscle 4 Temporoman 5 External acoustic meatus 6 Deep layer of 7. Superficial layer of masseter muscle 8 Stylohyoid muscle 9. Posterior belly of digast 10 Internal jugular vein and external carotid artery 11. Sternocleidomastoid muscle 12 Prontal belly of occpitofrontalis musele 13 Depressor supercilii muscle 14 Orbiculars oculi muscle 15 Transverse part of nasalis muscle 16 Levator labii superiors alaeque nasi smusele 17 Levatorlabii superioris muscle 18 Levator anguli oris muscle 20 21 Buccinator m 22 Depressor labiiinferioris muscle 23. Depressor angulioris muscle 24. Submandibutar gla 25. Lateral nasal cartilage 26 Greater alar cartilage (lateral part) 27 Lesser alar cartilages Greater alar cartilage (medial part) Infraorbital nerve 30. Anterior belly of digastrie muscle 31 Hypoglossal nerve and hyoglossus muscle 32. Superior thyroid artery 33. Zygomatic arch 34 Internal carotid artery 35 Common carotid artery femporalis muscle and tempo- romandibular joint. The zygomatic arch and the masseter muscle have been partially severed to display the insertion of the temporalis muscle.1 Periosteum 2 Temporalis muscle 3 Zygomatic arch 4 Articular capsule of temporomandibular joint 5. Lateral pterygoid muscle (upper and lower head) 6. Medial pterygoid muscle 7. Styloglossus muscle 8 Stylohyoid muscle 9 Posterior belly of ‘i 10 Masseter muscle (severed) 1 Mandible 12. Sternodleidomastoid muscle 13. Orbicularis oculi muscle 14 Orbicularis aris muscle 15 Buccinator muscle 16 Depressor anguli aris muscle 17 Depressorlabii inferioris muscle 18 Platysma muscle 19. Articulardise of tempo- 14 romandibular joint 20 Head of mandible 21 Anterior belly of digastric muscle 2 Mylohyoid muscle 3 Hyoid bone Medial and lateral pterygoid muscles. A portion of the mandible and the zygomatic arch has been removed revealing the pterygoid region or infratemporal fossa. ° i 1 « i m Newer a Effect of the muscles of ao 22 mastication on the 23 temporomandibular joint (arrows).1. Frontal belly of occipitofrontalis muscle 2 Corrugator super 3. Palpebral part of or muscle 4a Transverse part of nasalis muscle 4b Alar part of nasalis muscle 5. Levator labii superiorisalseque nasi muscle 6 Levator labii superioris muscle 7. Zygomaticus major muscle 8 Levator angulioris muscle 9. Parotid duct 10. Orbicalaris oris muscle 11 Masseter muscle 12 Depressor angulioris muscle 13. Mentalis muscle 14 Sternocleidomastoid muscle 15. Procerus muscle 16. Depressor supercilii muscle 17 Orbital pact of orbicularis ‘ocull muscle Zygomaticus minor muscle Buccinator muscle Risorius muscle Depressor labii inferioris muscle Platysma muscle Galea aponeurotica ‘Temporoparietalis muscle al belly of occipitofrontalis, 26 Parotid gland with fascia 27 Temporal fascia 28 Orbicularis oculi muscle 29. Parotid duct, masseter muscle Facial muscles (schematic drawing). Left side: Facial muscles. Sphincter-like muscles surround the orifices of superficial layer; right side: deeper layer. the head. Radially arranged muscles work as their antagonists.Facial muscles and parotid gland (lateral aspect), Platysma muscle (oblique lateral aspect). Superficial lamina of cervical fascia partly removed.10 1" ‘Supra- and infrahyoid muscles, pharynx I (lateral aspect). Ramus of mandible, pterygoid muscles and insertion of temporalis muscle removed Supra- and infrahyoid muscles. thematic diagram.) Galea aponeurotica ‘Temporal fascia Tendon of temporalis muscle Zygomatic arch Lateral pterygoid plate Tensor vel palatini muscle (styloid process) trictor muscle of pharynx cle Styloglossus Posterior belly of dig Stylohyoid muscle Longus capitis muscle Sternocleidomastoid muscle (reflected) muscle Inferior constrictor of pharynx Frontal belly of occipitofrontalis muscle Orbital part of orbiculars oculi muscle Buccinator muscle Depressor anguli oris muscle Mylohyoid muscle Anterior belly of digastric muscle ‘Thyrohyoid muscle Sternohyoid muscle Omohyoid muscle Hyoid bone Sternothyroid muscleSupra- and infrahyoid muscles, pharynx II. Buccinator muscle removed; oral cavity opened. 0 u R External acoustic meatus Tensor velipalatini muscle yloid process iperior constrictor muscle of pharynx Stylopharyngeus muscle (divided) Middle constrictor muscle of pharynx iernocleidomastoid muscle Greater horn of hyoid bone Longus capitis Inferior constrictor muscle of pharynx Temporal fascia, Tendon of temporalis muscle B 1a 15 16 7 Is 19 20 Orbicularis oculi muscle Zygomatic arch ateral pterygoid plate Parotid duct Gingiva of upper jaw (without teeth), buccinator muscle (divided) Plerygomandibular raphe Hyoglossus muscle Mylohyoi Anterior belly of digastric muscle (hyoid bone) ‘Sternohyoid and thyrohyoid muscles ‘Omohyoid muscle muscleCoronal section through cranial, nasal and oral cavity at the level of sphenoidal sinus, Pterygoid and palatine muscles (posterior aspect), 29 3 Temporalis muscle Sphenoidal sinus Nasopbarynx Masseter muscle Superior longitudinal, transverse and vertical muscles of tongue Hyoglossus muscle Geniohyoid musele Corpus callosum (caudate nucleus) Optic nerve Cavernous sinus Zygomatic arch Cross section of lateral pterygoid muscle and maxillary artery Section of medial pterygoid muscle Soft palate Mandible and inferior alveolar nerve Septum of the tongue Mylohyoid muscle Submandibular gland Platysma muscle Foramen magnum, vertebral artery and spinal cord Internal carotid artery Head of mandible Styloid process Inferior alveolar nerve Lingual nerve and chorda tympani M Uvula Anterior belly of digastric muscle (cut) ‘Condyle of occipital bone Mastoid process Lateral pterygo Auditory tube and levator veli palatin’ muscle ‘Tensor veli palatini muscle pterygoid muscleSuperticial temporal artery and auriculotemporal nerve Middle meningeal artery Maxillary artery Facial nerve (divided and reflected) External carotid artery Stylohyoid muscle Digastric muscle (posterior belly) Internal carotid artery and carotid sinus branch of glossopharyngeal Sternocleidomastoid muscle Common carotid artery “Temporalis muscle Prerygopalatine fossa Posterior superior alveolar artery Deep temporal artery Infraorbital artery Buccal nerve Inferior alveolar artery and nerve Facial artery ‘Submental artery Hyoid bone Superior thyroid artery (divided) Dissection of maxillary artery. Mandible and lateral pterygoid muscle partly removed. Main branches of ma lary artery. (Schematic drawing.) Superficial temporal artery res ofthe First part tery and anterior tympanic artery Middle meningeal artery Inferior alveolar artery Branches of the second part Deep temporal branches Pterygoid branches Masseteric artery Buccal artery Branches of the third part Post Infraor jor superior alveolar artery tal a ‘Sphenopalatine artery and branches tothe nasal cavity Descending palatine artery Artery ofthe pterygoid canalBase of the skull with cranial nerves (internal aspect). Both cerebral hemispheres and upper part of the brain stem removed. Incision on the right tentorium cerebelli to display the eranial nerves of the infratentorial ”? Superior sagittal sinus with falx cereb Olfactory bulb Olfactory tract Optic nerve and internal carotid artery Anterior clinoid process and anterior attachment of tentorium cerebs Ocalomotor nerve (0,111) Abducens nerve (n. VI) Tentorial notch (incisura tentori) ‘Trochlear nerve (0. 1V) ‘Tentorium cerebelli Falx cerebri and confluence of sinuses Hypophysial fossa, infundibulum, and diaphragma sellae Dorsum sellac Midlrain (divided) Trigeminal nerve (2. V) Facial nerve (a. VII), nervus intermedius, and vestibulocochlear nerve (n. Vill) Cerebral aqueduct Right hemisphere of cerebellum Vermis of cerebellumInferior aspect of the brain with cranial nerves. Midbrain divided. Frontal lobe Temporal lobe Pedunculus cerebri divided) Cerebral aqueduct Cranial nerves 8 Otfacory bulb | 9 fcory tat T= Olfactory nerves VII = Facial nerve 10. Optic nerve and optic I = Opticnerve VIII = Vestbulocochlear nerve 11 tnfundiblon UI = Oeulomotor nerve TX = Glossopharyngeal nerve 12 Ocalomotor nerve (0.1) 1¥. = hochlear sere xia wig 13 Mesiiny boty V = Trigeminal nerve XI = Accessory nerve 16 Substantia nigra Vi a-Ablocens nerve XI = Hypogloseal neve 15. Trochlear nerve (n. IV)Olfactory suleus (termination) Orbital gyri Temporal lobe aight gyrus Olfactory trigone and inferior temporal sulcus Medial occipitotemporal gyrus Parahippocampal gyrus, mamillary body, and imerpeduncular fossa Pons and cerebral peduncle Abducens nerve (9. VI) Pyramid Lower part of olive Cervical spinal nerves 13. Cerebellum 14 Tonsil of cerebellum 15 Occipital lobe (posterior pole) 16. Olfactory bulb 17 Orbital sulci of frontal lobe 18 Olfactory tract, 19. Optic nerve (a. 11) and anterio perforated substance 20 Optie chiasma 21 Optic tract 22 Oculomotor nerve (n. II) 23. Trochlear nerve (n. IV) 24 Tri al nerve (9. V) 25. Facial nerve (n. VI) Vestibulocochlear nerve (0. VII) Flocculs of cerebellum 28 Glossopharyngeal (0. 1X) and vagus 30 Accessory \Vermis of cerebellum Longitudinal fissurcstem and pharynx with crani Falx cerebri Occipital lobe Straight sinus Tentorium cerebelli colliculus of midbrain Rhomboid fossa Medulla oblongata Posterior belly of digastric mu Internal carotid art Pharynx (middle constrictor musele) Hyoid bone (greater horn) ‘Trochlear nerve (0. 1V) Facial nerve (a. VIN), sterior aspect). Cranial cavity opened and cerebellum removed Glossopharyngeal merve (on. IX) and vagus nerve (n. X) Accessory nerve (intracranial portion) (XD Hypoglossal nerve (intracranial portion) (n, XI) Accessory nerve (a. X1) Hypoglossal nerve (0. XII) ‘Vagus nerve (n. X) and internal e External carotid artery Sympathetic trunk and superior cervical ganglion ‘Ansa cervicalis (superior root of hypoglossal nerve) Glossopharyngeal nerve (n. IX) and stylopharyngeus muscle27 28 29 30 Cranial nerves of the orbit and pterygopalatine fossa. Left orbit (lateral aspect). Note the zygomaticolacrimal anastomosis (arrow). 1. Frontal lobe 2. Supraorbital nerve 3. Lacrimal gland 4 Lacrimal nerve 5. Lateral rectus muscle (divided) 6 Optic nerve and short ciliary nerves Cranial nerves innervating extraocular muscles (lateral aspect), (Schematic drawing.) 10 n 2 B 4 18 16 "7 18 ty 20 2 2 2B 24 25 26 2 28 29 31 2 Inferior oblique muscle Zygomatic nerve Interior branch of oculomotor nerve and inferior rectus muscle Infraorbital nerve Posterior superior alveolar nerves Branches of superior alveolar plexus adjacent to mucous membrane of maxillary sinus Central suleus of insula Superior rectus muscle Periorbita (roof of orbit) Nasociiary nerve Ciliary ganglion Ocalomotor nerve (0.111) ‘Trochlear nerve (1.1V) Ophthalmie nerve (n.V) [Abaucens nerve (0. VI) (divided) “Trigeminal merve (1. V) “Trigeminal ganglion “Mauillary nerve (9.3) and foramen rotundum Mandibular nerve (0.3) External acoustic meatus Prerygopalatine nerves Deep temporal nerves, Buccal nerve Masseteric nerve Auriculotemporal nerve “rochlea and superior oblique muscleCranial nerves of the orbit (superior aspect), Cranial nerves at the skull base. The brain stem fenestrated. Both hemispheres were removed. ight side: superficial layer; left side: middle layer of the orbit (superior rectus ‘muscle and frontal nerve divided and reflected). Tentorium and dura mater partly removed, and the tentorium Frontal sinus (enlarged) Frontal nerve (divided and reflected) Superior rectus muscle (divided) and eyeba Superior oblique musel Short ciliary nerves and optic nerve (n. 11) Nasociiary nerve Abducens nerve (n, VI) and lat Ciliary ganglion and superior rectus muse. (reflected) Oculomotor nerve (a. I) Trochlear nerve (a. 1V) Crus cerebri and midbrain Inferior wall of the third ventricle com with cerebral aqueduct Lateral and medial branch of supraorbital Supratrochlear nerve Superior rectus muscle Lacrimal nerve Fronta ‘Ophthalmic nerve (a. V1) ‘Optic chiasma and internal carotid artery Trigeminal ganglion ‘Trigeminal nerve (0. V) Tentorial notch Falx cerebri Cerebellum Infundibulum Olfactory tractFrontal lobe of cere Supraorbital nerve Lacrimal nerve Lacrimal gland Eyeball Opti nerve and short ciliary nerves 7 External nasal branch of " anterior ethmoidal nerve Ciliary ganglion Infraorbital Infraorbital foramen and terminal branches cof tatimarbhal nerve 4 15 16 7 18 9 » 2 Prerygopalatine ganglion and plerygopalatine nerv Posterior superior alve Superior dental plexus Buccinator muscle and buccal nerve Inferior dental plexus Mental foramen and mental nerve Anterior belly of digastric muscle Ophthalmic nerve(n. V,) Oculomotor nerve (0.111) Trochlear nerve (n. IV) Trigeminal nerve and pons Maxillary nerve (0. V:) Trigeminal ganglion Mandibular nerve (n. Vs) Auriculotemporal nerve External acoustic meatus (divided) [Lingual nerve and chorda tympani Mylohyoid nerve Medial pterygoid muscle Inferior alveolar ner Posterior belly of digastric muscle Stylohyoid muscle fernoeleidomastoid musCranial nerves in connection with the brain stem. Left side (lateral superior aspect). Left half of brain and head partly removed. Not trigeminal ganglion. ce the location of BR SBaakwe = & Main branches of trigeminal nerve. (Schematic drawing of figure on opposite page.) 9 a 2 zB u 35 36 ” 3 41 2 6 4 4s 46 a Frontal nerve Lacrimal sland and eyeball Lacrimal nerve Lateral rectus muscle Ciliary ganglion lateral t opticnerve Zygomaticnerve Inferior branch of oculomotor ne Ophthalmic nerve (0. V;) Maxillary nerve (9. V3) “Trigeminal gangtion Manaibalar nerve (n. V3) Posterior superior alveolar nerves “Tympanic cavity, external acoustic meatus, and tympanic membrane Inferior alveolar nerve Lingual nerve Facial nerve. VII) ‘Vagus nerve (0. X) ypoglosa nerve (0. XI) and superior root of ansa cervical External carotid artery Otfactory tract (0.1) Optic nerve (0.11) (intracranial part) Oculomotor nerve (0. 11) Abducens nerve (3. VI) “Troehlear nerve. 1V) Trigeminal nerve (0. V) Vestiulocochlear nerve (a. VII) and facia nerve (V1 Glossopharyngeal nerve (n. 1X) (eaving brainstem) Rhomboid fossa Vagus nerve (0. X) (leaving brain stem) Hypoglssal nerve (a. XI1) (leaving medulla oblongata) Accessory nerve (n. XI) (ascending from foramen magnum) Vertebral artery Spinal ganglion and dura mater ‘of spinal cord Accessory nerve (n. XI) Internal carotid artery Lateral and medial branch of supraorbital nerve Infratrachlear nerve Infraorbital nerve Peerygopalatne ganglion and middle superior alveolar nerve Middle superior alveolar nerves (entering superior dental plexus) Buccal nerve Mental nerve and mental foramen Auriculotemporal nerve ‘Otic ganglion (dotted line) Chord tympani Mylohyoid nerve Submandibular gland Hyoid boneDissection of facial nerve in its entirety. Cranial cavity fenestrated; temporal lobe partly removed. Facial canal and tympanic cavity opened, posterior wall of external acoustic meatus removed. Branches of facial nerve: a = temporal branch; b = zygomatic branches; ¢ = buccal branches; d= marginal mandibular branch. 2 ith geniculate ganglion 3. Cerebellum (right hemisphere) 4 Occipital belly of oceipitofrontais and ereater occipital nerve 5. Facial nerve at stylomastoid foramen 6 Splenius capitis muscle 7. Cervical branch of facial nerve 8 Sternocleidomastoid muscle and retromandibular vein 9 Orbicularis oculi muscle 10 Chorda tympani 14 Posterior auricular nerve 15. Nucleus and genu of facial nerve Facial nerve. (Schematic drawing of the dissection above.)Cranial nerves in connection with the brai The tympanic: mastication have been removed. Optic tract culomotor nerve (n. 111) Lateral rectus muscle and inferior branch of oculomotor nerve 4) Malleus and chorda tympani 5 Chorda tympani, facial nerve (n. VII), and vestibulocochlear nerve (n. VIII) 6 Glossopharyngeal nerve (a. X1) 7 Lingual nerve andl inferior alveolar 8. Styloid process and stylohyoid muscle 9. Stylog! 10 Lingual branches of glossopharyngeal stem (oblique-| skull, brain, neck and facial structures, lateral wall of orbit and oral e ity have be 11._Lingual branch of hypoglossal nerve 12 External eatotid artery le with choroid plexus and cerebral peduncle nerve (0. 1V) 19. Accessory nerve (1. XI) 20. Vertebral artery 21. Superior cervical ganglion feral aspect). Lateral portion of the removed wvity has been opened. The mandible has been divided and the muscles of 22 Hypoglossal nerve (a. X11) 23. Spinal ganglion with dural sheath 24 Dura mater of spinal cord 25. Internal carotid a ranch of glossopharyngeal y and carotid Dorsal roots of spinal nerve ‘Sympathetic trunk mich of cervical plexus (ventral mary ramus of thied cervical spinal nerve) 29 Ansa cervcalisLateral superfici a= temporal bra Superficial region of the face. Note the facial plexus within the parotid gland. (Semischematic drawing.) th; b = zygomatic branches; ¢ = buccal branches; d = mau 1 d= branches of facial nerve mandibular branch, Temporoparietalis muscle Parietal branch of super artery and vein and Occipital belly of occipitofrontalis artery Parotid gland and great auricular nerve Sternocleidomastoid muscle and external jugular vein Splenius eapitis muscle Branches of cervical plexus Trapezius muscle (terminal portion 6 Facial artery and zygomaticus ‘minor muscle Levator anguli oris muscle Zygomaticus major muscle COrbicularis oris muscle and superior abi Parotid duct Risorius musele and inferior labial1 Medial branch of supraorbital nerve 2. Nasalis muscle 3. Levator labii superioris alaeque nasi muscle 4 Orbicularis oculi muscle 5 Levator labii superioris, muscle 6 Facial artery and vein 7. Zygomaticus minor and major muscle 8 Transverse facial artery 9 Orbiculuts oris muscle 10 Buccal nerves, depressor lait inferioris muscle, facial artery and vein LL Parotid gland and duct and masseter muscle 12 Depressor anguli oris muscle 13 Transverse cervical nerve 14 External jugular vein 15 Platysma muscle 16. Supraclavicular nerve 17 Galea aponeurotica 18 Lateral branches of the supraorbital nerve 19 Frontal belly of ‘occipitofrontalis muscle and branches of superficial temporal vein and artery 20. Superficial temporal artery and vein 21 Auriculotemporal nerve 22. Zygomatico-orbital artery and temporoparietalis muscle Lesser occipital nerve 24 Occipital belly of ‘occipitofrontalis muscle 25 Occipital vein and occipital artery 26 Great auricular nerve and sternocleidomastoid muscle 27 Trapezius muscle Superficial layer of the head and neck. Parotid fascia removed. Branches of facial nerve: 28 Greater petrosal nerve temporal branch; b = zygomatic branches; ¢ = buccal branches; d = marginal 29. Geniculate ganglion ‘mandibular branch 30. Chorda tympani 31 Posterior auricular nerve 32. Stylomastoid foramen to page 76 Depressor labiiinferioris muscle Depressor angulioris muscle Platysma muscle ‘Terminal branches of transverse cervical nerve Cervical branch of facial nerve Orbicularisoris musele Facial artery and vein ja ‘Sternocleidomastoid muscle and Hesial nerves Main branches retromandibular vein (Schematic diagram.)Lateral superfi ae = branches of facial nerve branch; e = cervical branch. Superficial temporal artery and 0 auriculotemporal nerve un Posterior auricular artery and nerve and temporoparietalis muscle Occipital artery Facial nerve (n. Vil) (parotid plexus Temporal branches 'b Zygomatic branches «© Buccal branches « Marginal mandibular br © Cervical branch Posterior auricular nerve Posterior auricular artery Digastric muscle (post Lesser occipital nerve 0 Posterior auricular vein 2 aspect of the face. The parotid gland has been remo matic branches; ¢ = bu A= temporal branch; b = 2 to display the p Retromandibular vein Hypoglossal nerve and sternocleidomastoid artery Great auricular nerve Internal carotid artery External carotid artery ‘Common carotid arte Branches of cervical plexus Superior laryngeal artery and vein External jugular vein and rmocleidomastoid muscle Frontal branc lateral branch of supraorbital nerve, and frontal bely of occipitofrontalis musek Medial branch of supraorbital nerve Dorsal nasal artery Angular artery and nasalis muscle ‘of superficial temporal artery. rotid plexus of the facial nerve al branches; d = marginal mandibular Orbicularis oculi muscle Zygomaticus minor muscle ‘Buccal fat pad, zygomaticus major muscle, and infraorbital nerve Orbicularis oris muscle Parotid duct and masseter muscle Buccal Buccinator muscle Risorius must Facial artery and vein Submental artery and depressor anguli ery and ner oris muscle Mylohyoid nerve and mylohyoid muscle Digastric musele (anterior belly) Facial vein and submandibular gland Superior thyroid artery Sternohyoid muscleLateral superficial aspect of the face. Masseter muscle and temporal fascia have been partly remo artery and nerve, Head of mandible Masseterie artery and nerve Mandibular notch Masseter muscle (divided) 1 2 Temporal fascia 3 Temporalis muscle 4 Parietal branch of superficial temporal artery External carotid art Aurieulotemporal nerve Great auricular nerve Frontal branch of superficial temporal Facial nerve (reflected) artery Prontal bel Superficial temporal vein Medial branch of suprac 19 of temporomandibular 20. Orbicularis oculi muscle 21 Infraorbital nerve to display the masseteric Zygomaticus major muscle Maxillar artery Coronoid process Parotid duct (divided) Buccal nerve Facial artery and vein Mental nerve Mandibular branch of facial nerve Cervical branch of facial nerve Transve! (communicating nerve) and sternocleidomastoid muscleDeep dissection of facial and retromandibular regions. The coronoid process together with the insertions of temporalis muscle have bes if Parietal branch of the superficial temporal Frontal branch of the superficial temporal Auriculotemporal nerve Maxillary artery Superficial temporal artery ‘Communicating branches between facial and auriculotemporal nerves Facial nerve Posterior auricular artery and anterior auricular branch of superficial temporal artery Internal jugular vein Mylohyoid nerve Posterior belly of di Great auricular nery sternocleidomastoid External jugular vei Retromandibular vein Submandibular gland Temporal fascia ‘Temporalis tendon Deep temporal arteries Posterior superior alveolar Sphenopalatine artery Fentudhon supstor elec arenes removed to display the maxillary artery, The upper part of the mandibular canal has been opened. Masseteric artery and net Buccal nerve and artery Lateral pterygoid Transverse facial artery and parotid duct (divided) (mandibular canal opened)Retro Frontal belly of oceipitofrontalis muscle Depressor supercilii muscle Temporalis muscle Orbicularis oculi muscle Nasalis muscle Infraorbital artery Levator labi superioris alaeque nasi muscle Zygomaticus minor muscle Levator labii superioris muscle Infraorbital artery and nerve and posterior superior alveolar artery u sus major muscle 12 Lingual nerve 13. Inferior alveolar artery and nerve 14 Buccinator muscle inal nerve (n. V). Depressor angulioris muscle 2 Medial pterygoid muscle and mylohyoid 28 Depressor abil inferioris muscle Hypoglossal nerve and hyoglossus cle Mylohyoid muscle Anterior bely of diagastric muscle ‘Sternobyoid muscle “Thyrohyoid muscle Galea aponeurotica Cceipital belly of occipitotrontalis muscle Lateral pterygoid musele and deep temporal artery Internal jugular vein Styloglossus muscle Splenius capitis musele Posterior belly of diagastric muscle and occipital artery Superficial temporal artery Stylohyoid muscle External carotid artery Retromandibular vein Superior thyroid artery Inferior constrictor muscle of the pharynx Sternocleidomastoid muscle Omohyoid muscle ‘Common carotid artery and vagus nerve2 23 2, issection of deep facial and retromandibular regions after removal of mandible. Ptcrygoid muscles removed, temporalis muscle fenestrated Transverse section through oral cavity and pharynx. The location of needle, inferior alveolar nerve ind artery is indicated by 1 Sper tempoal nery and vein oes peste “enporai tendon, deep temporal ocr wy Mice meng ay Fourier aly af igutrc made Epcot mares nr wp Ester ort eter Sina atv nd dl bret of sapere rey Angin ay fr assent a ve Frei ary Parotid dt (vided) and bucenator mis eal aiiey aePara- and retropharyngeal regions. The mandible trigeminal nerve and its ganglion are displayed. Mylohyoid nerve Lingual nerve and submandibular ‘eamglion ‘Mental nerve and mental foramen Inferior alveolar ner Mylohyoid muscle (divided) and hypoglossal nerve Submental artery and vein Jomandibular gland Superior thyroid artery Common carotid artery Buccinator muscle Masseter muscle and mandible Entrance of mandibular canal Medial pterygoid muscle Palatine tonsil Oral vestibule Tong Inferior alveolar nerve, artery and vein Paryngeal constrictor muscle nd the lateral wall of the orbit have been removed. The main branches of the Pharynx Tentorium of cerebellum ‘Trigeminal nerve and ganglion Mandibular nerve ‘Superficial temporal artery Auriculotemporal nerve and middle meningeal artery Facial nerve (divided) Masseter muscle Superior root of a Lateral branch of supraorbital nerve Ophthalmic nerve Lacrimal gland Giliary ganglion and short ciliary nerves Angular artery Inferior branch of oculomotor nerv Maxillary nerve Posterior superior alveolar nerveRetropharyngeal and sublingual regions. The mandible has been completely removed, 1 Parietal branch of superficial temporal 2. Auriculotemporal nerve 3. Temporalis muscle tendon and zygomatic arch (cut) 4 Mandibular nerve (n. V3) 5 Middle meningeal artery 6 Chorda tympani Mylohyoid nerve 8 Inferior alveolar nerve 9) Lingual nerve 10 Posterior auricular artery 11 Facial nerve 12 Styloglossus muscle (eut) 13. Great auricular nerve 14 Maxillary artery, external carotid artery, and stylopharyngeus muscle 15. Posterior bely of digastric muscle 16. Styloid process and facial artery 17. Vagus nerve (a. X) 18 Accessory nerve (n. XI) 19. Hypoglossal nerve (a X11) and retromandibular vein (cut) 20 Stylohyoid muscle and slossopharyngeal nerve (n. 1X) 21 Facial vein Hypoglossal nerve (n, XII) and hyoglossus muscle 23. Superior thyroid artery 24. Superior laryny 25 Internal jugular vein 26 Common carotid artery and superior root of ansa cervicalis ryngeal artery and internal al nerve 27 Inferior pharyngeal constrictor muscle 28 Middle temporal artery 29 Deep temporal nerves and posterior deep temporal artery 3M) Anterior deep temporal artery MI Masseteric nerve 32. Posterior superior alveolar branches of maxillary artery and nerve 33. Pterygoid branches of mandibular M_ Posterior superior alveolar artery 35 Lateral pterygoid plate and medial pterygoid muscle 36 Infraorbital nerve and artery 37 Buccal nerve 38 Facial artery 39 Parotid ductNerves and blood vessels of the scalp. Scalp and meninges are demonstrated by a 24 series of window-like openings A coronal section through the vertex of the skull showing the arrangement of the meninges and vessels of the brain. Together the arachnoid mater and the pia mater form the leptomeninx 40 Levator veli palatini muscle 41 Gingiva and buccinator muscle 42 Ascending pharyngeal artery and superior pharyngeal constrictor muscle (pterygopharyngeal part) 43 Lingual nerve 44 Submandibular ganglion and tongue 45 Palatoglossus muscle 46 Deep lingual artery 1 Skin 2 Galea aponeurotica 3. Pericranium (periosteum) 4. Skull with diploe 5 Dara mater 6 Subdural space 7 Arachnoid mater 8 Subarachnoid space 9 Arachnoid granulations 10 Superior sagittal sinus 11 Pia mater with cerebral vessels 12 Falx cerebri 13 Cerebral cortex M4 Arachnoid and cortical vessels 15 Frontal belly of occipitofrontal muscle 16 Branch of middle meningeal artery 17. Lateral and medial branch of supraorbital nerve 18, Orbicularis oculi muscle 19 Zygomatico-orbital artery 20. Auriculotemporal nerve, superficial temporal artery and vein 21 Superior auricular muscle 22. Occipital belly of occpitofrontalis muscle 23. Branches of greater occipital nerve Occipital artery and vein 25. Greater occipital nerve 26 Sternocleidomastoid muscle mater with Cross spact ‘ection of the scalp and the meninges. The subarachnoid is shown, 47 Submandibular duet and genioglossus muscle 48. Geniohyoid nerve and muscle 49° Mylohyoid muscle 50. Anterior belly of digas 51 Hyoid bone 52. Thyrohyoid muscle 53 Omohyoid muscle (superior belly) 54 Sternohyoid muscle 55. Maxillary arteryMedian sagittal section through the hi 1 and neck. Falx cerebri 4 ‘Corpus callosum and septum pellucidun 1s Tnterventricular foramen and fornix ‘Choroid plexus of third ventricle and internal cerebral vein Third ventricle and interthalamic adhesion Pineal body an collicali of the midbrai Cerebral aqueduct Mamillary body and basilar artery Straight sinus Fourth ventricle and cerebe Pons and falx cerebelli Medulla oblongata Cerebellomedulary Dens of the axis (odontoid proces Spinal cord Superior sagital sinus ‘eal are Anterior commissure Frontal Crista gal Optic chiasma Pituitary gland (hypophysis) Supetior nasal concha “Middle nasal concha anc sphenoid Pharyngeal openi Superior longitu Vertical muscle of the tongu: Uvula Genioglossus muscle Pharynx Epiglott Geniohyoid muscle Mylohyoid muscle Hyoid bone ‘Vocal fold and sinus of larynx EsophagusDura mater and venous sinuses of the dura mater, The brain has been removed (oblique lateral aspect) 9 15 16 10 1 Fabs cerebri 2. Position of middle meningeal artery and vein 3 Internal carotid artery 4 Optic nerves (a. 11) 1 Frontal sinus 6 Oculomotor nerve (0.111) 7 Diploe 8 Dura mater 9) Superior sagittal sinus 10 Straight sinus, a 11. Trigeminal nerve (n. V) 4 12. Facial and vestibulocochlear nerve (a, Vil and n. VID) 13. Tentorium cerebelli 1 Pituitary gland (hypophysis) 15. Inferior sagital sinus 16 Sigmoid sinus 17 Confluence of sinuses a 18 ind intercavernous sinuses Dura mater and venous sinuses (left lateral aspect). (Schematic drawing.)‘Cranial cavity with dura mater (the right cerebral hemisphere hhas been removed) Frontal sinus Hypophysial fossa with pituitary sland Oral cavity Tongue Skin Calvatia Dura mater Tentorium cerebell Confluence of sinuses 4 Infratentorial space (cerebellum and part of the brain stem have been removed) Vertebral canal Frontal branch of middle meningeal artery and veins Middle meningeal artery Diploe 3 branch of middle al artery and vein Occipital pole of left hemisphere covered with dura mater Median section through the head. Demonstration of dura mater covering the cranial cavity, Brain and spinal cord are removed (right half of the head, as seen from medial). Dissection of dura mater and meningeal vessels. Left half of calvaria removed.Dissection of the brain with pia mater and arachnoid in situ. ‘The head is cut in half except for the brain, which is shown in its entirety. Brain with pia mater and arachnoi Frontal pole to the left (lateral aspect) 0 u 2 B CCalvaria and skin of the scalp ura mater (divided) Position of lateral sulcus Frontal lobe covered by arachnoid and pia Frontal sinus Olfactory bulb Sphenoidal sinus Dura mater on clivus and basilar artery Atlas (antetior arch, divided) Soft palate Tongue Epialotts Vocal fold Position of central suleus Supetior cerebral veins Tentorium (divided) Cerebellum Cercbellomedullary cistern Position of foramen ‘magnum and spinal cord Dens of axis Intervertebral dise Superior cerebral veins Position of centeal sulcus Position of I cistern of lateral cerebral fossa tal pole al sulcus (artow) Temporal pole Pons and basilar artery ral suleus and Inferior cerebral veins ello Hemisphere of ce Medulla oblongataw u 2 4 15 16 Brain and brain stem, median section, Frontal pole to the right Median section through the head. (MR-Scan, cf. section on opposite page.) Parietal lobe TThalamus, third ventricle nd intermediate mass 3. Great cerebral vein ccipit pital lobe CCollieali of the midbrain and cerebral aqueduct Cerebellum Medulla oblongata Central sulcus Corpus callos Frontal lobe Fornix and anterior commissure Hypothalamus 3. Optic chiasma Midbrain Temporal lobe Pons 7 Fourth ventricle 18 Spinal cord Inferior concha and nasal cavity Alveolar process of maxilla Tongue Dens of axis (Oral part of pharyns Alveolar process of mandible EpiglotisScheme of brain divisions (cf. table). Red = choroidal plexus. (Schematic drawing.) 1 Telencephalon (yellow) with lateral ventricles 2 Diencephalon (orange) with optic nerve and retina 3 Mesencephalon (blue) with cerebral aqueduct 4 Metencephalon (green) with IV ventricle 5 Myelencephalon (yellow-green) 1 Frontal lobe of cerebrum Occipital lobe of cerebrum Corpus callosum Anterior con nina termi Optic of 7 Hypothal 8 Thalamus and third ventric 9 Collicali of the midbeain 10. Midbrain (inferior portion) 11 Cerebellum 2 Pons 13. Fourth ventricle 14 Medulla oblongata 1S Central canal 16 I. Prosencephalon ___—~1. Telencephalon (cerebral (forebrain) <__ hemispheres, striatum, ete.) “> 2, Diencephalon (thalamus, halamus, hypothalamus, ete.) II, Mesencephalon — 3. Mesencephalon (colliculi, (midbrain) cerebral peduncles, tegmentum) IIL. Rhombencephalon___—~ 4. Metencephalon (pons, (hindbrain) = <__ cerebellum) Myelencephaton (medulla primary brain Midbrain, pons and medulla oblongata are collectively termed the brain stem.1 Superior cerebral veins and parietal lobe Frontal lobe Superficial middle cerebral vein and cistern of lateral cerebral fossa 4 Temporal lobe 5 Occipital lobe 6 Inferior cerebral veins and transverse occipital sulcus Inferior anastomotic vein 8 Cerel 9 Medulla oblongata lum with pia mater. Cerebral veins (bluish). In the lateral sulcus the cistern of ral fossa is recognizable. Frontal lobe to the left. Arteries of the brain. Coronal section. Areas supplied by cortical and arteries. Dotted lines indicate boundaries of arterial supply areas; arrows: direction of blood flow. Coronal section through the right hemisphere showing arachnoid, pia mater, and the arterial blood supply (anterior aspect), 1 8 Caudate nucleus 15. Palldosteiate artery 2 9 Internal capsule 16 Thalamic artery 3 Arachnoid 10 Insular lobe 17. Corpus eallosum 4 Cortex 11 Clausteum 18. Pellucid septum 5. Internal carotid artery 12 Putamen’ 19 Lateral ventricle 6 Frontal lobe (white matter) 15 Posterior striate branch 20 Optic chiasm Posterior cerebral artery 14 Insular arteryArteries of the brain, 16 Insula Middle cerebral artery [2 branches; a) Parietal branches, b) Temporal branches] Basilar artery Vertebral artery Central sulcus Occipital lobe Superior cerebellar artery Cerebellum Anterior cercbral artery Ethmoidal arteries Ophthal Internal carotid artery Posterior communicating artery Posterior cerebral artery Anterior inferior cerebellar artery Posterior inferior cerebellar artery Cerebral arteries. Lateral aspect of the left hemisphere. The upper part of the temporal lobe has been removed to display the insula and cerebral arteries. Interventricular foramen Septum pellucidum Anterior commissure Optic chiasma and infundibulum Mamillary body Oculomotor nerve (n. HI) Pons Basilar artery Corpus callosum Fornix Choroid plexus Third ventricle Pineal body Tectum and cerebral aqueduct Fourth ventricle Cerebellum (arbor vitae, vermis) Median aperture of Magendie Medilla oblongata section through the brain and brain stem. Cercbral arteries injected with red resin.1 3 Arteries of the brain (inferior aspect). Frontal pole above; right temporal lobe and cerebellum partly removed, (Schematic drawing.) Anterior communicating Left anterior cerebral artery Internal carotid artery Pons and left superior cerebellar artery Anterior inferior cerebellar artery Posterior inferior cerebellar artery Medulla oblongata Right anterior cerebral Otfactory tract Optic nerve Middle cerebral artery 2 Infundibalum Posterior cerebral artery Basilar artery and abducens nerve (n. VI) Anterior spinal artery Vertebral artery Cerebellum LLabyrinthine arteries Posterior spinal artery Right superior cerebellar artery 22. Olfactory bulb Arteries of the base of the brain, arterial circle of Willis.1 Anterior cerebral artery 2. Anterior communicating 3. Middle cerebral artery 4 Posterior communicating Ocalomotor nerve vagus nerve Hypoglossal nerve 13 Accessory nerve M4 Anterior inferior cerebellar 1S. Falx cerebri 16 Optic nerve Optic chiasma 18 Infundibulum and pituitary sland Anterior choroidal artery and choroid plexus 20 Basia artery Abducens nerve ertebral arteries Medulla oblongata 24 Inferior sagittal sinus atorium cerebell pitta sinus and confluence of sinuses Anterior spinal artery 28. Internal carotid artery 29 Superior corebellar artery 30 Anterior inferior cerebellar 31 Posterior inferior cerebellar 32. Posterior spinal artery 33. Ophthalmic artery ircle of Willis (superior aspect) drawing.)1 Central suleus 2. Procentral gyrus 3. Precentral sulcus 4 Frontal lobe 5. Anterior ascending ramus of lateral sulcus 6 Anterior horizontal ramus of lateral suleus 7 Lateral sulcus 8. Temporal lobe 9) Parietal lobe 10 Postcentral gyrus 11 Postcentral suleus 12 Occipital lobe 13. Cerebellum 14. Superior frontal suleus 15. Middle frontal gyrus 16 Lunate suleus 17, Longitudinal fissure 18 Arachnoid granulations Brain, left hemisphere (lateral aspect). Frontal pole to the left Pink Frontal lobe Blue Parietal lobe Green Occipital lobe Yellow = Temporal lobe Dark red = Precentral gyrus Dark blue = Postcentral gyrus in (superior aspect). Right hemisphere with arachnoid and pia Brain (superior aspect). Lobes of the left mater. hemisphere indicated by color; right hemisphere is covered with arachnoid and pia mater.1 3 4 Brain, left hemisphere (lateral aspect). Main cortical areas are colored The lateral sulcus has been opened to display the insula and the inner surface of the temporal lobe. 16 » Brain, left hemisphere (lateral aspect). Frontal pole to the left Premotor area Somatomotor area Motor speech ares of Broca Acoustic area (red: high tone; blue: low tone) Somatosensory area Sensory speech area of Wernicke Reading comprehension area Visuosensory area Precentral gyrus Precentral sulcus Superior frontal gyrus Central Middle frontal gyrus Inferior frontal gyrus Ascending MS) oy Horizontal ramus Posterior ramus Superior temporal g Middle temporal gyrus Inferior temporal gyrus Parietal lobule Postcentral sulcus Postcentral gyrus Supramarginal gyrus Angular gyrus Horizontal fissure of cerebellum Medulla oblongata1 Precentral gyrus = 3 Cingulate sulcus 4 Cingulate gyrus Suleus of corpus callosum 6 Fornix Gnu of corpus callosum 8 Interventricular foramen 9 Intermediate mass 10 Anterior commissure 11 Optic chiasma 12 Infunditatam, 13 Uncus hippocampi 14 Posteentral gyrus 15 Body of corpus callosum 16 Third ventricle and thalamus 17 Stria me 19. Spleniam of corpus callosum 20 Communication of ealeatine and parietooccipital suleus 21 Calcarine sulcus Brai (midbrain divided, cerebellum and inferior part of brainstem removed) Fight hemisphere (medial aspect). Frontal pole to the left 24. Parahippocampal gy 25 Olactory bulb 26 Olfactory txaet Gyrus rectus 28. Optic nerve 29 Infundibulum and optic chiasma Optic tract, Cculomotor nerve Pedunculus cerebri Red nucleus Cerebral aqueduct Corpus callosum Longitudinal fissure 37 Orbital gyri 38 Lateral root of olfactory tract 39 Medial root of olfactory tract 40 Olfactory tubercle and anterior perforated substance 41 Tuber cinerew 42 Interpeduncular fossa 43 Su nigra 44 Colliculi of the midbrain 45. Lateral occipitotemporal gyrus 46 Medial occipitotemporal gyrus Pink Frontal lobe Blue = Parietal lobe Green = Occipital lobe Yellow = Temporal lobe Dark red = Precentral lobe Dark blue = Postcentral lobe Orange Limbie cortex (cingulate and Brain (inferior aspect). Midbrain divided. Cerebellum and inferior part of brain parahippocampal stem removed. Frontal pole at the top, gyri) 98Brain (sagittal section). Frontal pole to the left. Brain, with pia mater and blood vessels (inferior aspect). 46 1 3. Cingulate sulcus 4 Septum pellucidum 5 Genuof corpus callosum 6 Fornix 7. Frontal lobe 8 Anterior commissure 9) Hypothalamus 10 Optiechiasma 11 Infundibulum 12 Oculomotor nerve 3 Uncus 14 Temporal lobe 15. Pons 16 Central sulcus Posteentral gyrus 18 Body of corpus callosum 19. Interventricular foramen (arrow) 20. Parietoocepital sulcus 21 Intermediate mass Splenium of corpus callosum Pineal body Calearine suleus 25. Collicali of midbrain 26 Ce Occipital lobe 28 Mamillary body 29. Fourth ventricle ebral aqueduct 30 Vermis of cerebellum Right hemisphere of cerebellum Median aperture of Magendie (arrow) Medulla oblongata Olfactory tact 35 Opticnerve 36 Internal carotid artery 37. Interpeduncular cistern 38. Superior cerebellar artery 39 Anterior inferior cerebellar artery 40. Vertebral a 41. Posterior inferior cerebellar artery 42. Basilar a B sve (n.V) 44 Facial nerve (n. VI) 45 Accessory nerve (n, XI) hypoglossal nerve (a. XII) 46 CerebellumSuperior cerebellar peduncle Middle cerebellar peduncle Cerebellar tonsil Inferior semilunar lobule Central lobule of vermis Inferior cerebellar peduncle Superior medullary velum Nodule of vermis Flocculus Biventral lobule Left cerebellar hemisphere Inferior semilunar lobule Biventral lobule Vermis of cerebellum “Tuber of vermis Pyramid of vermis Uvula of vermis Tonsil of cerebellum Floceule of cerebellum Right cerebellar hemisphere Cerebellum (inferior anterior aspect). The cerebellar peduncles have been severed. Vermis (cental lobule) lar ingula central lobule Fastigium Fourth ventricle Middle cerebellar peduncle Nodule of vermis Floccutus of cerebellum Cerebellar tonsil Culmen of vermis Declive of vermis Tuber of vermis Inferior semilunar lobule Pyramis of vermis Uvula of vermis Cerebellum (inferior posterior aspect), through the cerebellum. Right cerebellar hemisphere and rBrain and cerebellum (inferior aspect). Parts of the cerebellum have been removed to display the dentate nucleus and the main pathway to the midbrain (Cerebellorubral tract) Dissection of the cerebellar peduncles and their connection with midbrain and diencephalon. A small part of pulvinar thalami (*) has been cut to show inferior brachium, 16 9 20 2 2 B 24 25 26 28 29 30 3 32 3 u 35 36 37 38 Olfactory bulb Olfactory tract Lateral olfactory stria Anterior perf Infundibulum (divided) Mamillary body Substantia nigra Pedunculus cerebri Red nucleus Decussation of superior cerebellar peduncle Cerebellar hemisphere Medial olfactory stria Optic nerve Optic chiasma Optic tact Posterior perforated substance Interpeduncular fossa Superior cerebellar peduncle and cerebellorubral tract Dentate nucleus ‘Vermis of cerebellum CCingulate gyrus ‘Corpus callosum Stria terminalis Septum pellucidum Columns fornicis Cerebral peduncle at midbrain level Pons Inferior olive Medulla oblongata with lateral pyramidal tract Occipital lobe Calcarine suleus od substance colliculus with brachium Superior cerebellar peduncle Inferior cerebellar peduncle Middle cerebellar peduncle Cerebellar hemisphere1 Lateral longitudinal stria ofindusium griseum Medial longitudinal stria ofindusium griseum 3. Cerebellum 4 Radiating fibers ofthe corpus callosum 5. Forceps minor of corpus callosum 6 Forceps major of eorpus callosum Splenium of eorpus callosum n of the brain I. The fiber system of the corpus callosum has been displayed by removing the cortex lying above it. Frontal pole at top. Longitudinal cerebral fissure ay of corpus callosum of caudate nucleus and 4 Cavum of septum pellucidum Septum pellucidum ‘Choroid plexus of lateral ventricle 6 Stria terminalis 8. Splenium of corpus callosum 9 Calear avis 10. Posterior horn of lateral ventricle LL Thalamas (lamine affixa) 2 Commissute of fornix, 13. Vermis of cerebellum Dissection of the brain IL. The lateral ventricles and subcortical nuclei of the brain are dissected. The corpus callosum has been partly removed. Frontal pole at the top.Disses n of the brai 7 III (superior view of lateral ventricle and subcortical nuclei of the brain). Corpus callosum partly removed. At right, the entire lateral ventricle has been opened, the insula with claustrum, extreme and external capsules have been removed, exposing the lentiform nucleus and the internal capsule Lateral longitudinal stra 9 Medial longitudinal stria 0 Genu of corpus callosum 4 Head of caudate nucleus 2 pellucidum Stra terminalis B ‘Thalamas (lamina atfixa) M Choroid plexus of third ventricle is CChoroid plexus of lateral ventricle Splenium of corpus callosum Posterior horn of lateral ventricle Anterior horn of lateral venti (head of caudate nucleus) Patan Internal capsule Inferior horn of lateral ventricle of lentiform nucleus Pes hippocamy 7 Crus of fornix Vermis of cerebellum with arachnoid and pia Interventricular foramen Right column of fornix Collateral eminence1 Lateral longitudinal stria 2. Medial longitudinal stia 3 Corpus callosum 4 Septum pellucidum 5 Insular gyri 6 Thalamostriate vein 7. Anterior tubercle of thalamus 8 Thalamos 9) Medullary stra of thalamus 10 Habenular trigone 11 Habenular commis 12 Vermis of the cerebellum 13. Left hemisphere of cerebellum 14 Head of caudate nu 15 Columns of fornix 16 Putamen of lentiform nucleus 17 Internal capsule 18 Taenia of choroid plexus 19. Stra terminalis and thalamostriate 20 Lamina affixa 21. Third ventricle 22. Pineal body 23. Superior and inferior colliculus Dissection of the brain IVa. Temporal lobe, fornix and the posterior corpus callosum have been removed (this part of the specimen is depicted below). Frontal pole at top (superior aspect). | Inferior horn of lateral ventricle Hippocampal digtations 3 Collateral eminence 4 Splenium of corpus callosum 5 Calear avis 6 Posterior horn of lateral ventricle 7U 8 Body and crus of fornix 9. Parahippocampal gyrus 10. Pes hippocampi 11 Dentate gyrus 8 of parahippocampal gyrus 12. Hippocampal fimbria 13-_Lateral ventricle Dissection of the brain IVb. Depicted is the portion of the brain removed from the specimen above. Temporal lobe and limb system (superior aspect). Columns of fornix are served.Dissection of the limbic system. Left side, lateral aspect. Corpus callosum has been cut in the median plane. The left thalamus and the left hemisphere have been partly removed, 24 Mamillary body 25 Fimbria of hippocampus and pes hippocampi 4 Genu of corpus callosum 26 Left optic tract and 5 Column of fornix lateral geniculate body 6 Medial olfactory sttia 27 Lateral ventricle and 7 Olfactory bulb and parahippocampal gyrus ‘olfactory tract, 28 Collateral eminence 8 Optic nerve 29 Hippocampal digitations 9 Anterior commissure 30 Supracallosal gyrus (lett halt) longitudinal stria) 10. Right temporal lobe Stria medullaris thalami 11 Lateral olfactory stia Thalamus 12 Am Red nucleus 13 Body of allogam 34 Mamillotegmental tract, 14 Interthalamic adhesion 35. Dorsal longitudinal 15 Third ventricle and right fasciculus (Schutz) thalamus 16 Mamillothalamie tract 17. Part of the thalamus 18 Habenular commissure 19 Pineal body 20. Splenium of corpus ¢ and olfactory system. (Schematic drawing.) Blue = afferent pathways; red = efferent pathways. Collculi of midbrain mis of cerebellum1 Paraventricular nucleus 2. Preoptic nucleus 3 Ventromedial nucleus | Hypothalamic 4 Supraopticnucteus [nuclei 5 Posterior nucleus 6 Dorsomedial nucleus 7. Mamillary body 8 Compas callosum 9. Lateral ventricle (showing caudate nucleus) 10 Anterior commissure 11 Column of fornix 12 Optic chiasma 13. Crus of fornix 14 Medullary stra of thalamus 15 Thalamus and interthalamic adhesion 16 Mamillothalamic tract of Vieq d'Azyr 17. Cerebral peduncle 18 Pineal body " 19 Tectum of midbrain in section through the diencephalon. Medial part of the thalamus ap :Taiaina ayaa and septum pellucidum have been removed to show the fornix and. ‘mamillothalamic tract. Median section through the diencephalon and midbrain; location of hypothalamic nuclei.1 Circular sulews of insula us of insula 3. Short gyri of ins 4 Limen insulae 5 Opercula (cut) 2 Frontal operculum bb Fromtoparietal operculum Temporal operculum 6 Coron radiata Lentiform nucleus 8 Anterior commissure 9 Olfactory tract 10 Cerebral arcuate fibers 11 Optic radiation I peduncle 13. Trigeminal nerve (n. V) 12 Cereb 14. Floceulus of cerebellum 1S. Py allobes 16 Decussation of pyramidal tract Insula (Reili). The opercula of the frontal, parietal and temps have been removed to display the insular gyri. Left hemisphere 17 Internal capsule have b 110 display the insular gyri. Left hemisph ay, Soe 19 Opti nerve (a. 11) 20 Infuncibatura 21. Temporal tobe (right side) 22. Mamillay bodies 23. Oculomotor nerve (n. 11) 24 Transverse fibers of pons J Corona radiata and internal capsule, left hemisphere. Lentiform nucleus removed (frontal pole to the left).Dissection of the subcortical nuclei and internal capsule, Frontal pole to the left. The lateral ventricle has been opened, and the insular gyri and claustrum have been removed, revealing the lentiform nucleus and the internal capsule eft hemisphere (lateral aspect), Diss jon of the subcortical nuclei (lateral aspect). Lentiform nucleus removed, frontal pole to the left 1 Corona radia Anterior hor of lateral ventricle Head of caudate nucleus Pu Anterior commissure Olfactory tea Amygdala Hippocampal disitations Internal capsule Calear avis Posterior hor of lateral ventricle Choroid plexus of lateral Caudal extremity of caudate nucleus Thalamus Cerebral arcuate fibers Globus pallidus (remnants)1 3 6 7 8 Brain stem and the connections with the cerebellum, Internal capsule (lateral aspect). Red = py! middle cerebellar peduncle; green = inferior cerebellar i peduncle; pink cerebellar peduncle. a 7 8 x» 40 4 w £8 Internal capsule and subcortical nuclei. Left brain, frontal pole to the left, horizontal section, (Semischematic drawing.) Blue = afferent tracts; red = efferent tracts. Putamen Genw of corpus callosum Anterior cerebral artery ‘Anterior commissure Subcallosal area Amygdala Oifactory tract Opti nerve (n. 1) Internal carotid artery and ‘infundibulum culomotor nerve (ight and left nerve, 9. 111) Basilar artery Pons and trigeminal nerve (n. V) ‘Abducens nerve (a, VI) Facial nerve (a. VII) Vestibulocochlear nerve (n. VIII) Hypoglossal nerve (n, XII) Olive Pyramidal tract Internal capsule Posterior cerebral artery Cerebral peduncle Collicul of midbrain Trochlear nerve (a. IV) Superior cerebellar peduncle Inferior cerebellar peduncle Middle cerebellar peduncle Glossopharyngeal nerve (n. 1X) Vagus (n. X) and accessory nerves (n. XD) Corpus callosum Lateral ventricle (anterior horn) Caudate nucleus Internal eapsule (anterior limb) Tnsala Claustrum ‘Thalamus Superior and inferior colliculus ‘of midbrain Cerebellum Middle peduncle of cerebellum (cfterent tracts) Medulla oblongata (atferent tracts) samen of lentiform nucleus lobus pallidus of lentiform nucleus (2 Genu and posterior limb of internal capsule1 Central part of the lateral ventricle lar foramen of Monro for horn of the lateral ventricle 4 Site ofinterthalamic adhesion 5. Notch for anterior commissure 6 Thied ventricle 7 Optic reves 8 Notch for optic chiasma 9 Infundibular recess 10 Inferior horn of lateral ventricle with indentation of amygdaloid body 11 Lateral recess and lateral aperture of Luschka 12 Suprapineal resess 13 Pineal recess 14 Note for posterior commissure 15 Posterior horn of lateral ventricle 16 Cerebral aqueduct 7 Fe 18 Median aperture of Magendlie 19 Cerebellomedullary cistern 20. Superior sagittal sinus 21 Inferior sagittal sinus 22 Intervaginal space of optic nerve Cast of ventricular cavities of the brain (lateral aspect), frontal pole to the left 23 Arachnoid granulations of Pacchioni 24. Straight sinus teser some} o hyo bone 3 Body Hyoid bone (oblique lateral aspect). bone (anterior aspect). Muscles of the floor of the oral cavity (superior aspect), Oral diaphragm, muscles (inferior aspect). Cut on the base, 1Lesser cornu and body of hyoid bone 2. Hyoglossus muscle (divided) 7. Mylohyoid muscle 3 Ramus of mandible and inferior alveolar nerve 8 Anterior belly of digastric muscle 4 Geniohyoid muscle 9 Hyoid bone 5 Genioglossus muscle (divided) 10 Mandible 6 Stylohyoid muscle divided) trie muscle 11 Intermediate tendon ofParapharynge: eqvity opened. Arrow: submandibular duet. L_ Styloid process 4 2. Styloglossus muscle 5 3. Digastric muscle (posterior belly) 6 Vagus nerve (n. X) igual nerve (n. V,) Glossopharyngeal nerve (0. IX) Supra- and infrahyoid muscles and pharynx (schematic drawing) 20 id sublingual regions. Innervation of the tongue. Lateral part of face and mandible removed, oral Submandibular ganglion Hyoglossus muscle Hypoglossal nerve (XII) Stylohyoid muscle Internal branch of superior laryngeal nerve (branch of vagus nerve, not visible) Middle constrictor muscle of pharynx Omohyoid muscle (divided) Thyrohyoid muscle Sternothyroid muscle Esophagus Parotid duct (divided) Buesinator Superior constrictor muscle of pharynx Tongue Terminal branches of lingual nerve Mandible (divided) Genioglossus and geniohyoid muscles Mylohyoid muscle (divided and reflected) Sternohyoid muscle (divided) Thyroid cartilage Anterior belly of digastric muscle Hyoid boneSubmandibular tri ‘Submandibutar triangle, deep dissection. Right side. Mylohyoid muscle has been severed and reflected to display the lingual and hypoglossal nerves. 1 Parotid gland and retromandibular vein 2 Sternocleidomastoid 3. Retromandibular vein, submandibular gland and stylohyoid muscle 14 4 Hypoglossal nerve and lingual artery 5 6 7 Vagus nerve and internal jugular vein 5 Superior laryngeal artery 16 External carotid artery, thyrohyoid muscle, and superior thyroid 17 artery ls 8 Common carotid artery and superior root of ansa cervicais 9 9 Omohyoid and sternohyoid 2» 10 Masseter and marginal mandibular branch of facial nerve 2 11. Facial artery and vein 2 Mandible and submental artery and vein Mylohyoid nerve ibmandibular duct, sublingual gland, and anterior belly of digastric muscle -Mylohyoia (right side) Left mylohyoid and anterior belly of lett digastric muscle Hyoglossus muscle and lingual artery Lingual nerve Hypoglossal nerve Geniohyoid muscle Anterior belly of right digastric muscle Submandibular gland and duet,20 21 24 ene b 26 28 2 30 31 32 33 M4 35 Submandibular duct Sublingual gland [Lingual nerve Hypoglossal nerve Mylobyoid muscle Geniohyoid muscle Anterior belly of digastric muscle Inferior alveolar nerve Chorda tympani Internal carotid arte Parotid gland Sphenomandibular ligament ‘Vagus nerve Glossopharyngeal nerve Superficial temporal artery and ascending pharyngeal artery Styloglossus muscle Posterior belly of digastric muscle Facial artery ‘Submandibular gland External carotid artery Ling Middle pharyngeal constrictor muscle lohyoid ligament Hyoglossus muscle Deep lingual artery Epiglottis Hy Buccinator muscle Tongue Mandible (divided) Parotid duct Masseter muscle Right and left sublingual papilla bone Dissection of major salivary glands. Left mandible and buccinator Location of the major salivary glands in ‘muscle partly removed to view the oral cavity (inferior lateral aspect). relation to the oral cavitCervical spine (oblique lateral aspect) 1 Temporal bone 2. Head of mandible 3. Mandible 4 Occipital bone 5 Atlas 6 Axis 7. Third cervical vertebra 8 9 Spinous process of fourth cervical vertebra Transverse process of fifth cervical vert with groove for spinal nerve 10 Intervertebral foramen LL Vertebra prominens (C3) 12 First i 13. Sternum (manubrium stern’) 14 Atlantooecipital joint 15 Lateral atlantoaxial joint 16 Body of axis 17 Body of fourth cervical vertebra 18 Body of fifth cervical vertebra 19 Body of sixth cervieal vertebra 20. Body of seventh cervical vertebra Cervical vertebra and the organization of the neck. (Schematic drawing.) 1 Sternohyoid and sternothyroidl muscles 2 Omohyoid muscle 3. Thyroid gland and trachea 4 Sternocleidomastoid muscle 5 Recurrent laryngeal nerve 6 sur vein, common carotid artery and vagus 7. Longus coli and longus capitis muscles 8 9 thetic trunk Spinal nerve 10. Ventral and dorsal root of spinal nerve 11. True muscles of the neck 12 Trapezius muscle 13. Body of cervical vertebra 14 Anterior tubercle of transverse process and origin of scalenus anterior muscle 15. Vertebral artery and foramen transversarium 16 Posterior tubercle of transverse process and origin of scaleaus medius and posterior muscles 17 Superior facet of articular process 18. Spinal cord 19. Spinous process Sym1 Nasal septum 2 Uvula 3 Genioglossus muscle 4 Mandible 5 Geniohyoid muscle 6 Mylohyoid muscle Hyoid 8 Thyroid cartilage 9 Manubrium sterni 10 Sphenoidal sinus 11 Nasopharyme 14 Laryngopharymx 15 Arytenoid muscle 16 Vocal fold 17. Cricoid cartilage 1S Trachea 19. Left brachiocephalic vein 20. Thymus 21 Esophagus 22. Occipital lobe Cerebellum and sth ventricle 24 Medulla oblongata 25. Densof axis 26 Intervertebral dies ‘of cervical vertebral column, Median section through adult head and neck. Note the low position of the adult larynx when compared with that of the neonate (ef. with figure below). Median section through neonate head and neck. Note the high Sagittal section through the head. position of the larynx permitting the epiglottis nearly to reach the (MR-Scan.) uvula (cf. with the figure above).Muscles of the neck (anterior aspect) Cross-section of the neck at the level of the intervertebral dise between the Sth and 6th cervical vertebra (inferior aspect) yrahyoid muscles Anterior belly of digastrie muscle Mylohyoid muscle Posterior belly of digastric muscle Stylohyoid muscle ihyoid muscles Omohyoid musele Sternohyoid musele Thyrohyoid muscle Sternothyroid muscle Other structures Sternodleidomastoid muscle Scalenus muscles Trapevius muscle Clavicle Firstrib g Seapuls Mandible Hyoid bone Larynx (thyroid eartlage) Trachea Subclavius muscle ‘Manubsrium stem Mucous membrane of larynx (conus clasticus) Cricoid carts Inferior horn of thyroid cartl Esophagus Body of cervieal vertebra Posterior root ganglion Spinal cord Spinous process Internal jugular vein, common carotid artery, and vagus nerve True muscles ofthe neck (semispinalis cervicis and capitis muscles)1 Mandible 2. Masceter muscle and facil artery 3 Hyoi 4 Median thyrohyoid ligament 5 ‘Thyrohyoid muscle 6 Stemothyroid muscle 7 8 9 bone Thyroid gland (pyramidal lobe) Peetoratis major muscle Second rib 10. Parotid gland Anterior belly of digastric muscle 12 Submandibular gland (divided) 13 Myfohyoid musele and mylohyoid raphe 14 External carotid artery and vagus n 15, Omohyoid muscle 16 Thyroid cartilage 17 Stemocleidomastoid muscle 18 Stermohyoid muscle 19 Clavicle 20, Subelavius 21 Jugutar fossa or suprasternal notch ‘Muscles of the neck (anterior aspect). Sternocleidomastoid and sternohyoid muscles on the right have been divided and reflected. Regions and triangles of the neck. Sita domasid Sabana ane Sten en ae isc tangle omar fos asians i iangle1 4 Cartilages of the larynx and the hyoid Cartilages of the larynx and the hyoid bone bone (anterior aspect). (posterior aspect). 1s 16 Cartilages of the larynx. Cartilages and li (anterior aspect). Thyroid cartilage is (lateral aspect). (Schema indicated by the outline, Cartitages of the larynx (oblique: Cartilages of the larynx (oblique-posterior posterior aspect), aspect). Epiglotis Lesser cornu of hyoid bone Greater cornu of hyoid bone Lateral thyrohyoid ligament Body of hyoid bone Supetior cornu of thyroid Thyroepiglo roid ligament Thyroid cartilage Cricoid cartilage Trachea Corniculate cartilage Arytenoid cartilage Posterior cricoarytenoid Hizamgt Cricothyroid joi Hyoid bone Epiglottis Thyrohyoid membrane Thyroid cartilage Vocal ligament Conus elasticus Arytenoid catilage Cricoid cartilage Cricoarytenoid joint Cricothyroid joint Tracheal cartilages Corniculate cartilage Muscular process of arytenoid cartilage Vocal process of arytenoid Lamina of ericoid cartilage Arch of ericoid cartilage Vocal igament (red) Lateral thyrohyoid ligament Greater comu of hyoid bone Epi Thyroid cartilage Corniculate cartilage Arytenoid cartilage Cricoarytenoid joint Cricothyroid joint Cricoid cartilageThyroid cartilage (anterior aspect) 12 Manubrium stern Position of the larynx in the neck (oblique lateral aspect).1 Epiglowtis Greater horn of hyoid bon. Transverse arytenoid muscle Oblique arytenoid muscle 6 Lamina of cricoid cartilage 7. Posterior cicoarytenoid muscle 8 Aryepiglottic fold and muscle 9 Lamina of thyroid cartilage 10. Thytoepislottic muscle LL Thytoarytenoid muscle 12 Lateral ericoarytenoid 13. Axticular facet of thyroid clgtilage 14 Cartilages of trachea 15 Membranous part of trachea 16 Lateral thyre Thyrohyoid membrane id ligament 18. Position of piriform recess Arytenoid cartilag Stem of epigottis Vestibular fold 22 Vocal folds and fissure of glottis Vocals muscle Arch of ericoid cartilage 26 Cricothyroid muscle Cricoid cartilage 8 Piriform recess 9 Super cartilage Laryngeal museles I (Iateral aspect). ngeal muscles II (lateral aspect) a) Neal iiament Thyroid cartilage and thyroarytenoid Half of the right side of the thyroid cartil muscle have been partly removed, has been removed, Laryngeal muscles, larynx (anterior Laryngeal muscles, larynx (posterior aspect), sabaee), es of the ree. (Schernatie dieawing,)~~ Sagittal section through the larynx. in vivo (superior aspect), Coronal section through larynx and trache Hyoid b Epigloutis Thyroid cartilage Cricoid cartilage Vocal ligament Thyrohyoid ligament Aryte ie Corniculate cartilage Vocal fold Vestibular fold Aryepiglottie fold Interarytenoid notch Mandible Anterior belly of digastric musele Mylohyoid muscle Pyranpidal process of thyroid gland Sternohyoid and sternothyroid muscles ‘Common carotid Sternocleidomastoid muscle Transverse arytenoid nuscle Pharyns and inferior constrictor muscle Ventriele of larynx Vocalis muscle Trach Superior cornu of thyroid cartilage Root of tongue (ingual tonsil) Piriform recess Vocalis muscle Lateral ericoarytenoid suscle Thyroid glandLarynx and its innervation (posterior aspect), Innervation of the larynx. (Schematic diagram.) Dissection of superior and inferior laryngeal nerves. Pharynx has been opened, 1 Scalenus anterior muscle 2 Scalenus medius and posterior muscles 3. Right recurrent laryngeal nerve 4 Right subclavian artery Brachiocephalic trunk Aortic arch Hyoid bone 8 Internal branch of superior laryngeal 9 ‘Thyrohyoid membrane 10. External branch of superior laryngeal Vagus nerve Thyroid cartilage Cricothyroid muscle Jarmygeal nerve Left subclavian artery Left common carotid artery Second rib Tongue Superior cervical ganglion Sympathetic trunk 23. Inferior constrictor muscle of pharynx 24 Inferior thyroid artery Glossopharyngeal nerve Epie 28 Posterior cricoarytenoid muscle and 29 Inferior ‘of recurrent 35. Hypoglossal nerve 36. Transverse cervie Larynx and thoracie organs (anterior aspect). Dissection of vagus and recurrent 37 Midalle cervic laryngeal nerve 38 Middle cervical cardiae nerves (Coranches of sympathetic trunk) 8 Liguecnien arterionnI cavity (posterior aspect). Mucous membrane on the right half of pharynx has been removed Midbrain (inferior colliculus) 13 Esophagus Rhomboid fossa and medulla oblongata 14 “Trochlear nerve Vestibulocochlear and facial ner 15 Occipital condyle Glossopharyngeal and acc 16 Nasal cavity (choana) nerve 17 Accessory nerve Occipital artery and pe of 18 Urata and soft palate digastric musele ryngeus muse Superior cervical gan 20 External carotid artery Internal carotid artery 21 Epiglotis Oral eavity (¥ongue) Internal branch of superior Aryepiglottic fold nerve Veus ner Inferior laryngeal nerve Piriform recess Ansa cervicalis Thyroid gland and common carotid1 Inferior colliculus of midbrain ulus in floor of Vestibulocochlear and facil 4 Glossopharyngeal nerve 5. Vagus nerve 6 Accessory nerve Hypoglossal nerve 8 Pharyngobusitar fascia 9 Superior constrictor muscle of pharymx 10 Sympathetic trunk and superior cervical ‘ganglion (medially displaced) LL Middle constrictor muscle of pharynx 12. Greater cornu of hyoid bone 13 Inferior constrictor muscle of pharynx 14 Trochlear nerve 15 Internal acoustic meatus with facial and vestibulocochlear nerves 16 Sugutar foramen with glossopharyngeal, vagus and assessory nerves 17 Occipital condyle 18 Occipital artery 19. Posterior belly of digastric muscle 20. Accessory nerve (extracranial part) 21 Hypoglossal nerve (extraeranial part) 22 External carotid artery 23. Carotid sinus nerve 24 Internal carotid artery 25. Carotid sinus and carotid body 26, Vagus nerve 7 ‘Thyroid gland 28 Esophay 29 Ch 30. Medial pterygoid plate 31 Foramen lacerum -yngeal tubercle 33. Hard palate M_ Greater and lesser palatine foramen 35. Prerygoid hamulus 36. Lateral pterygoid plate 37, Prerygoid canal 38 Foramen ovale 39 Mandibular fossa 40 Carotid cana 41. Styloid process and stylomastoid foramen harynx and parapharyngeal nerves in connection with brain stem (posterio) Inferior aspect of the skull. Red line = outline of superior constrictor muscle in continuation with buccinator muscle and orbicularis oris muscle. (Semischematic drawing.)Ascending pharyngeal artery 4 Superior cervical ganglion of sympathetic trunk 5. Superior laryngeal nerve 6 Carotid body and carotid sinus 7 Left vagus nerve 8 Common carotid artery and eardie 2 Posterior belly of digastric musele 3. Middle constrictor muscle of pharynx Right vagus nerve ‘Sympathetic trunk Internal jugular vein Inferior constrictor muscle of pharynx Larynx Buccinator muscle ate and palatine glands anterior arch of a Ds Spinal cord Dura mater of axis Incisive papilla Oral vest F muscle 3 Man Mandibular canal with vessels and 35 Medial plerygoid muscle 36 External carotid artery Internal carotid artery 38 Atlas 40. Splenius capitis muscle 4 Semispinalis capitis muscle an 8 Teseed nied enc xt thin vel oF tie ails (infotlon eases’.1 4 6 Dissecti f pharys (lateral aspect) Maxilla Prerygomandibular raphe Buccinator muscle Mandible (¢ivided) Depressor angulioris muscle Mylohyoiid muscle Anterior belly of digastric ‘muscle Hyoid bone Thyroid cartilage Cricothyroid muscle Styloid process Medial pterygoid muscle (divided) Posterior belly of digastric muscle Styloglossus muscle Stylohyoid muscle Thyropharyngeal part constrictor muscle of pharynx Thyrohyoid muscle Cricopharyngeal part of infer ‘constrictor muscle of pharynx Esophagus inferior Trachea First molar of maxilla Tongue Inferior longitudinal muscle of Genioglossus muscle Superior constrictor musele of pharynx Hypoglossal nerve Hyoplossus muscle Superior laryngeal nerve and superior laryngeal artery1 Sella turcica 2. Internal acoustic meatus and petrous part of temporal bone Pharyngobasilar fascia Fibrous raphe of pharynx Stylopharyngeus muscle Superior constrictor muscle of pharynx Posterior belly of digastric muscle Stylohyoid muscle Middle constrictor muscle of pharynx 10. Inferior constrictor musele of pharynx LL Muscle-free area (Killian’s triangle) 12 Esophagus 13. Trachea 14 Thyroid and parathyroid glands 15 Medial pterygoid muscle 16 Greater horn of hyoid bone 17 Internal jugular vein 18 Parotid gland 19 Accessory nerve 20 Superior cervical ganglion of sympathetic trunk 21 Vagus nerve 22. Laimer’ triangle (area prone to developing diverticula) 23. Orbicularis oculi muscle 24 Nasalis muscle 25. Levator labi superioris and levator labii alueque nasi muscles 26 Levator anguli oris muscle 27. Orbieularis oris musele 28 Buccinator muscle 29 Depressor labi inferioris muscle 30. Hyoglossus musele 31 Thyrohyoid muscle 32. Thyroid cartilage 38 Cricothyroid muscle 34 Prerygomangibular raphe 35. Tensor vel palatini muscle 36 Levator veli palatini muscle 37. Depressor angulioris muscle 38. Mentalis muscle 39. Styloglossus muscle Muscles of the pharynx (posterior aspect), Muscles of the pharynx. (Schematic drawing.) ‘Muscles of pharynx (lateral aspect). (Schematic drawing.)1" 13 2 16 Ww: ibiet dane eee We Kan of external carotid and subclavian artery. to page 165 > Galea aponeurotica Frontal branch of superficial Parietal branch temporal a Superior auricular muscle Superficial temporal artery and vein Middle temporal a Aurieulotemporal nerve Branches of facial nerve Facial nerve External earotid artery within the retromandibular fossa Posterior belly of digastric muscle Sternocleidomastoid artery Sympathetic trunk and superior cervical ganglion ‘Sternocleidomastoid muscle (divided and reflected) Clavicle (divided) ‘Transverse cervical artery Ascending cervical artery and phrenie nerve Scalenus anterior muscle Suprascapular artery Drareal acapatar aniecy 1S 16 7 18 9 » 2 2 24 25 6 a Frontal and pa temporal artery Superticial wemporal artery Occipital artery Maxillary artery Vertebral artery External carotid artery Internal carotid artery Common carotid artery (divided) Ascending eervical artery Inferior thyroid artery tery with 2 branches tal branches of superfici “Transverse cervi (superficial cervical artery and descending scapular artery) Suprascapul Costocervieal trunk with 2 branches (deep cervical artery and superior intercostal artery) Internal thoracie artery Axillary artery Supraorbital and supratrochlear arteries Angular artery Dorsal nasal artery Transverse facial artery Facial artery Superior labial artery Inferior labial artery Submental artery i Superior thyroid artery Brachiocephalic trunk wal artery Brachial plexus and ax “Thoracoacromial artery Lateral thoracie artery Median nerve (displaced) and pectoralis minor muscle (reflected) Frontal belly of occipitofrontalis muscle Orbital part of orbiculars oculi muscle Angular artery and vein Facial artery Superior labial artery Zypomaticus major muscle Inferior labial artery Parotid Buccal fat pad Masseter muscle Facial artery and mandible Submental artery Anterior belly of digastric musclejin branches of head and neck arteries (Jateral aspect). Anterior thoracic wall and clavicle partly removed; pectorali have been reflecte Superior laryngeal artery Superior thyroid arter Common carotid artery Thyroid ansa of sympathet tank acd Tallachin Capel ate the subclavian and axillary arteries. 46 z 48 9 Thyroid gland (right lobe) Vertebral artery Thyrocervical trunk Vagus nerve Ansa subclavia of sympathetic trunk Superior vena cava (divided) AbiieeahArteries of head and neck (anterior-lateral aspect). Clavicl veins have been partly removed, the arteries were colored, ‘eins of head and neck. Sternocleidomastoid muscle and anterior thoracie wall partly removed. Note the venous connection with the superior vena cava, 8 Cephalic Occipital vein Superficial temporal vein Sternocleidomastoid muscle Trapezius muscle nternal jugular vein External jugular vein Subelavian vein Supraorbital veins Angular vein Superior labial vein Inferior labial vein Facial vein Submental vein Superior thyroid vein Anterior jugular vein Thoracie duct Inferior thyroid vein Superior vena cava Occipital artery Internal carotid artery Cervical plexus Supraclavicular nerve Phrenic nerve and ascending ‘cervical artery on scalenus anterior muscle Superficial cervical artery Suprascapular artery and Brachial plexus and anterior circumflex humeral artery Lateral cord of brachial plexus ‘Thoracoucromial artery Lateral thoracic artery Superficial temporal artery “Transverse facial artery Facial artery External carotid artery Superior thyroid artery ‘Common carotid artery, ‘vagus nerve and thyroid gland nyrocervical trunk Subelavian artery and scalenus anterior muscle Parotid gland and facial nerve Great auricular nerve External jugular vein Brachial plexus Cephalic vein in deltopectoral groove ‘Axillary vein and artery Right brachiocephalic vein Superior vena eava Right lung (reflected) Superficial temporal artery and vein Facial artery and vein Cervical branch of facial nerve and submandibular gland Internal jugular vein, common carotid artery and omohyoid muscle ‘Anterior jugular vein and thyroid gland Tugular venous arch Lett brachiocephalic vein 55. Pericardium of heart 56 (ocation of right atrium) ‘Transverse cervical arteVeins of head and neck (anterior aspect). Part of the thoracic wall, clavicle and sternocleidomastoid muscle have been removed. Veins were colored blue, arteries red. The internal jugular vein is the continuation of the sigmoid sinus which drains most of the venous blood from the brain together with the external cerebrospinal fluid By joining the subclavian vein it forms the right brachio: phalic vein which continues on the right side directly into the superior vena cava. The common way to intro- duce the lead from a pacemaker device into the heart is by way of the cephalic vein, On the left side the thoracic duct joins the internal jugular vein at that point where the subclavian vein and the internal jugular vein form the left brachiocephalic vein, Note that the subclavian vein lies in front of the scalenus anterior muscle whereas the subclavian artery together with the plexus brachialis lies posterior to that muscle. The cephalic vein joins t llary vein by passing into the deltopectoral triangle, The subclavian vein is strongly fixed to the first rib so that it can be punctured with a needle at that point (underneath the sternal end of clavicle) to introduc catheter (subclavian line)_ymph nodes and lymph vessels of the neck, left side oblique (lateral aspect). The sternocleidomastoid muscle and the left half of the thoracic wall have been removed. Lower part of the internal jugular vein has been cut and laterally displaced to show the thoracic duct. Parotid gland Mandible I ‘Anterior belly of digastric muscle Submandibular gland ‘Submental lymph nodes Superior thyroid artery Thyroid cartilage Omohyoid muscle Sternohyoid muscle ‘Common carotid artery Supraclavicular lymph nodes Anterior jugular vein Thoracic duct Igular venous arch Left brachiocephalic vein Superior mediastinal Iymph nodes Retroauricular lymph nodes Submandibutar nodes Superficial cervical lymph nodes Jugulodigastric lymph nodes and jugular trunk ternal jugular v Extemal jugular vein Jugulo-omohyoid Iymph nodes Brachial plexus Cephalic vein Subelavian tank Infraclavicylar lymph nodes Subelavian vein Internal thoracic artery and veinCarotid triangle, left side (lateral aspect). Sternocleidomastoid muscle reflected Mylohyoid muscle and facial artery Anterior belly of digastric muscle Thyrohyoid External carotid artery, superior thyroid artery and vein Omohyoid muscle Thyroid cartilage Ansa cervical Sternohyoid muscle and superior thyroid artery 9. Stylohyoid muscle 10 Posterior belly of digastric muscle LL Sternocleidomastoid muscle (reflected) 12 Superior cervical lymph nodes and sternocleidomastoid artery 13 Hyoid bone and hypoglossal nerve (n. x) ae muscles 15. Superior laryngeal artery and internal branch of superior laryngeal nerve Accessory nerve 17. Cervical plexus 18 Internal jugular vein Facial vein Submental nodes Thoracie duct Retroauricular nodes Parotid nodes ‘Occipital nodes Jugulodigasiric nodes | deep cervical Tugulo-omohyoid nodes ar teunk nodes 31 External jugular vein between irrigation a direction of lymph flow,Neck (anterior aspect), The superficial removed, 1 Mandi 3. Anterior belly of digastric mu Facial artery and vein Mylohyoid muscle Infrahyoid muscles (sternohyoid, sternothyroid and omohyoid) Anterior jugular veins External jugular vein ‘Sternocteidomastoid m land land 1 branch of facial nerve 1 auricular nerve Cutaneous Transverse cervical ner branches a es cervical idle supraclavicular ne io Medial supraclavicular nerve a Chaviele Platysma mi Prevertebral lamina of cervical fascia, covering longus colli muscle Vertebral artery and vein Scalenus muscles ervical fascia Pretracheal lamina of cervical fa Prevertebral lamina of cervical fascia with sympathetic trunk ‘Carotid sheath with common carotid artery internal jugular vein and vagus nerve Cross-section of the neck at the level of the thyroid gland. ‘Cervical part of sympathetic trunk Notice the postion of the three laminae of cervical fascia (23,24,25) Carotid sheath,Anterior triangle (anterior aspect). The pretracheal lamina of cervical fascia and left sternocleidomastoid muscle have been removed. Supra- and infra id muscles. (Scher c drawing.) Mylohyoid muscle Anterior belly of digastric muscle Facial artery Submandibular gland Great auricular nerve Internal jugular vein and common carotid artery 7 ‘Transverse cervical nerve and omohyoid muscle 3 Stylobyoid ms snohyoid muscle and superior thyroid artery fnocleidomastoid muscle (sternal head) sternocleidomastoid muscle (reflected) oid muscle (clavicular head) L Sternocleidon and lateral supraclavicular nerves 2. Middle supraclavicular nerves 3. Medial supraclavicular nerves Mandible Hyoid bone Superficial cervical Iymph nodes Left superior thyroid artery and external earotid sohyoid muscle (superior belly) smal jugular vein and branches of ansa Thyroid gland snd unpaired inferior thyroid vein Posterior belly of digastric muscle Sternohyoid muscle Sternothyroid musclePosterior and carotid triangles (lateral aspect). Superficial dissection 1 Parotid gland and great to corvial brane 6 Trapezius muscle and superficial lamina of cervical fascia Lateral supraclavicular 11 Facial artery and yein and ‘mandibular branch of facial ical branch of facial d submandibular 16 Sternocieidomastoid muscle upraclavicular lar branch of facial 7 8 Cutaneous branches of cervical plexus. Erb’s point is indicated by an arrowhead. (Schematic diagram.)10 " 12 13 Posterior and carotid triangles (lateral aspect). Superficial dissection. The superficial lamina of cervical fascia has been removed to display the cutaneous branches of the cervical plexus and subcutaneous veins Lesser ocepital nerve {Internal jugular v Splenius capitis muscle Great auricular nerve Submandibular nodes Internal earotid artery and vagus nerve Accessory nerve Muscular branches of cervical plexus External jugular vein Posterior supraclavicular nerves u 2 B 1“ 15 6 "7 18 0 20 Middle supraclavicular nerves Suprascapular artery Pretracheal lamina of fascia of neck branch of facial nerve ibular gland External carotid artery Superior thyroid artery ‘Transverse cervical nerve Superior root of ansa cervical, Anterior jugular vein Omohyoid muscle Sternohyoid muscle Sternocleidomastoid muscle Intermediate tendon of omohyoid muscleNeck, superficial dissection (lateral aspect). Sternocleidomastoid muscle ha: lamina of the cervical fascia Sternocleidomastoid muscle (reflected) and branch of accessory nerve Facial artery External carotid artery and superior thyroid artery Deep cervical lymph nodes and external jugular vein Omohyoid muscle and pretracheal lamina of cervical fascia Anterior jugular vein Pectoralis major muscle Great auricular nerve is been cut and reflected to display the pretracheal Lesser occipital nerve Splenius capitis and levator scapulae muscles Trapezius muscle Scalenus medius muscle and brachial plexus Posterior supraclavicular Middle supraclavicular nerve (Clayicle and anterior supraclavicular nerves 7 Stemocleidomastoid muscleNeck, deep dissection (lateral aspect). The internal jugular vein has been reflected to expose the carotid artery and vagus nerve Stylohyoid muscle Facial artery and mylohyoid muscle ‘Anterior belly of digastrie muscle Internal jugular vein, hypoglossal nerve, and superficial cervical Iymph nodes Superior thyroid artery and vein and inferior pharyngeal constrictor muscle ‘Thyroid cartilage and vagus nerve ‘Ansa cervicalis, omohyoid muscle, and common carotid artery Right superior thyroid artery Scalenus anterior muscle Sternothyroid muscle and inferior thyroid artery “Muscular branches of ansa cervicalis to the infrahyoid muscles Inferior thyroid vein osterior belly of digastric muscle Sternocleidomastoid muscle and lesser occipital nerve Accessory nerve Splenius capitis muscle Scalenus posterior muscle Levator scapulae muse Posterior supraclavicular nerves Phrenic nerve Middle supraclavicular nerve Brachial plexus Anterior supraclavicular nerves Stermucieiiommadidl muscleJn (la id muscles are displayed Masseter muscle 9 Sternothyroid mus Hypoglossal nerve Thyrohyoid muscle internal jugular artly removed. Ansa cervicalisFacial artery and mandible Submental artery Mylohyoid muscle and nerve Hypoglossal nerve (lingual branches) Thyrohyoid b nerve (a, XID) Anterior belly of digastric muscle Hyoid bone Omohyoid branch of hypoglossal nerve (n. XII) ‘Omohyoid muscle and superior thyroid artery ‘Ansa cervicalis Posterior belly of digastric muscle Hypoglossal nerve (n. XI1) ‘Vagus nerve (a, X) Internal carotid artery Superior root of ansa cervicalis External carotid artery Cervical plexus ‘Common carotid artery of hypoglossal Neck, subman Mandible slightly elevated. | Hypoglossal nerve (n. XU) 2 Communication from the ventral ramus of the first cervical spinal nerve 3 Atlas 4 Axis 5 Third cervical vertebra 6 Superior root of ansa cervicalis 1 hyoid branch of hypoglossal nerve 8 9 Inferior root of ansa cervic: Ansa cervical 10 Internal jugular vein Ah of hypoglossal nerve 13. Geniohyoid muscle 14 Hyoid bone 15. Thyrohyoid muscle 16 Superior belly of omohyoid muscle 17 Sternohyoid muscle 18 Sternothyroid muscle 19 Clavicle Innervation of infrahyoid muscles. Cervical plexus and its communication with the hypoglossal nerve. C1-Cy = ventral rami of cervical spinal nerves of the first four segiieats.10 Neck, deep dissection (lateral aspect). Clavicle partly removed to show the slit between the scalenus muscles. Internal jugular vein removed. Masseter muscle Mylohyoid muscle and facial artery Anterior belly of digastric muscle Hypoglossal nerve ‘Sternohyoid muscle ‘Omohyoid muscle, superior thyroid artery and vein Sternothyroid muscle, thyroid cartilage, and pyramidal lobe of thyroid gland ‘Common carotid artery and sympathetic trunk Ansa cervical Phrenic nerve, ascending cervical artery and anterior scalenus muscle n 1 1B 14 18 16 7 18 19 Inferior thyroid artery, vagus nerve and internal jugular vein (cut) Thyrofd gland and unpaired inferior thyroid venous plexus Thoracic duct and left subclavian trunk Subclavius muscle (reflected) Sternocleidomastoid muscle (reflected) Posterior belly of digastric muscle Superior cervical ganglion and splenius muscle Lesser occipital nerve Internal carotid artery and branch of the slossopharyngeal nerve to the carotid body External carotid artery Cervical plexus and accessory nerve Inferior root of ansa cervical, Supraclavicular nerve Scalenus medius muscle and clavicle Transverse cervical artery, brachial plexus, and scalenus posterior muscle Subclavian artery and vein Thoracoacromial artery and pectoralis ‘minor muscle Pectoralis major muscleNeck, deepest dissection (anterolateral aspect). Thyroid gland reflected to expose the esophagus and the recurrent laryngeal 1 Superior cervical ganglion of sympathetic trunk and posterior belly of digastric muscle 1 Anterior belly of digastric muscle 2. Facial artery and common carotid artery (reflected anteriorly) 3. Ascending cervical artery and longus colli muscle 4 Omohyoid muscle and superior thyroid artery 5. Sympathetic trunk and sternohyoid muscle 6 Middle cervical ganglion and inferior pharyngeal constrictor muscle 7. Scalenus anterior muscle and phrenic nerve 8 Thyroid gland and inferior thyroid artery 9. Vagus nerve and esophagus 10 Stellate ganglion 11 Recurrent laryngeal nerve and trachea 1B 14 1s 16 7 18 19 20 21 ‘Common carotid artery and cervical cardiae branch of vagus Sternocleidomastoid muscle and accessory nerve Splenius capitis muscle Lesser occipital nerve, longus capitis muscle and cervical plexus Phrenic nerve, scalenus posterior muscle and levator seapulae muscle Supraclavicular nerves and scalenus medius muscle Brachial plexus and pectoralis major muscle (clavicular head) Transverse cervical artery and clavicle Thoracoacromial artéry and pectoralis minor muscle First rib, accessory phrenic nerve and subclavian vein Internal jugular vein, thoracic duct and subclavius muscle‘Neck and arm, deepest dissection (ante jor lateral aspect). Cervical and brachial plexus and their relation to the blood vessels, are shown. Note the location and content of scalene triangle, Sternocleidomastoid muscle and clavicle have been removed; the internal jugular vein was divided to display the roots of cervical and brachial plexus. 1 Lesser occipital nerve 2. Great auricular nerve 3. Cutaneous branches of cervical plexus 4 Supraclavicular nerve S- Suprascapular nerve and artery 6 7 8 Brachial plexus Median nerve (with two roots) and musculocutaneous nerve Axillary artery 9 Axillary vein 10 Medial brachial cutaneous nerve 11 Ulnar nerve 12 Thoracodorsal nerve 13 Parotid gland and facial nerve (cervical branch) 14 Cervical plexus 15. Submandibular gland 16 Superior thyroid artery ‘Common carotid artery dividing in internal and external carotid artery and superior root of ansa cervicalis ‘Omohyoid muscle and cervical branch of facial nerve joining the transverse cervical nerve (C:,C3) ‘Sternohyoid muscle Transverse cervical nerve and sternothyroid muscle ‘Common carotid artery and vagus nerve Phrenic nerve and scalenus anterior muscle Internal jugular vein Intercostobrachial nerves Long thoracic nerveHorizontal section through the neck at the level of the fissure of glottis, viewed from above. Thyroid cartilage ‘Vocal fold and glottis (cima glottdis) Arytenoid cartilage Common carotid artery Internal jugular vein Infrahyoid muscles Lateral thyroarytenoid muscle Sternocleidomastoid muscle Transverse arytenoid muscle Laryngopharynx and inferior constricor muscle of pharynx Longus colli muscle External jugular vein Body of cervical vertebra (C:) Spinal cord Vertebra arch Deep muscles of neck (semispinaliscervicis muscle) Trapezius muscle Rima glottidis Levator scapulae muscle Lymph node Semispinalis capitis muscle Splenius capitis muscle Section through the neck at the level of larynx. (MR-Scan,) Hyoid bone ‘Thyroid cartilage Cervical plexus (C.-C) Phrenic nerve (C.) Sealenus anterior muscle Brachial plexus (Cy-T;) ‘Scalenus medius and posterior muscles Subclavian artery Subelavian vein Superior vena cava Cricoid cartilage Thyroid gland Internal jugular vein artery Inferior thyroid vein Ascending aorta Descending aorta Second rib ‘Common caratic Scalene triangle, arrangements of blood vessels, and brachial plexus at the lower part of the neck. (Schematic diagram.)1 Manubrium stern Claviele 3. Acromion & Coracoid process 5 Glenoid cavity 6 Body of sternum 7 Costal cartilage 8 Body of the twelfth thoracic vertebra 9 Body of the first lambar vertebra 10 Hip bone 11 Sacral promontory 12 Sacrum 13 Anterior superior iliac spine 14 Obturator foramen 15 Atlas 16. Seventh cervieal vertebra 17 First ib 18. Xiphoid process 19 Twelth rib 20. Body ofthe fifth lumbar vertebra 21 Miaccrest 22 Coccyx 23. Symphysis pubis Skeleton of the trunk, vertebral column, pelvis, thorax, and shoulder girdle (anterior aspect), ments best visible in the ment consists of a pair of ribs connected anteriorly by the sternum and posteriorly by a thoracic vertebra, In the lumbar vertebral column only vestiges of ribs are present which The trunk is divided into se thoracic region, where each s part of the form what appear to be the transverse processes, In cervical vertebrae, remnants of ribs are part of the transverse processes. Each segment also. comprises muscles (c.g. intercostal muscles), nerves, and vessels. However, in the cervical and lumbar region the muscu nents fuse with each other forming large muscle plates, for example, the oblique muscles of the abdo. men, while vessels and nerves still retain their segmental patt lar si1 Foramen transversarium 2. Vertebral foramen 3. Body of vertebra 4 Superior articular facet Base of serum 6 Anterior tubercle of atlas Superior articular facet of alas 8 Transverse process 9. Posterior tubercle of atlas WW Densof axis 1. Superior articular surface Transverse process 3. Arch of vertebra 4 Anterior tubercle of transverse process 15. Posterior tubercle of transverse process 16. Spinous process 17 Shattot nb 18 Body of vertebra and head of rib articulating with each other (costovertebral joint) 19 Superior articular process 20 Transverse process and tubercle of rib articulating with each other (costotransverse joint) Auricular surface Lateral part of sacrum 24. Lateral sacral crest 25 Intermediate sacral eres Jedian sacral crest 27- Inferior articular facet 28_ Superior demifacet for head of ib 29 Inferior demifacet for head of rib) 30 Inferior vertebral notch 31. Supetior vertebral notch 32. Apex of the suerum 33. Sacral cornu General characteristics of the vertebra Mi Coceys ‘Typical cervical, thoracic, lumbar vertebrae 35 Dorsal saeral foramina and sacrum. 36 Mamillary process 37. Pedicle Gres = Ribs or homologous processes Red = Muscular processes (transverse and spinous processes) General characteristics of lumbar vertebrae r ‘and sacrum (posterior aspect). Yellow = Articular facets Laminae and articular processesSkeleton of the thorax (pos Costovertebral articulation (right laSkeleton of the thorax (right lateral aspect), Atlas 2 Axis 3. Cervical vertebrae {Seventh cervical vertebra (vertebra prominens) 5. First rib 6 Facet for clavicle 7. Manubrium sterni 8 Sternal an 9) Body of sternum 10 Costa arch ML Tenth ab 12 Eleventh rib 13 Twelfth rib M1 Spinous proc Spinous process L 22 Lumbar curvature Sacrum Covey1. The twelve ribs arranged in a craniocaudal direction, first rib at top. I-XII = pairs of ribs; L = tubercle of rib; 4 = body of rib, The head of a typical rib articulates with the bodies of _ ribs) while the remaining five ribs are only adjacent vertebrae and the inte ertebral_ connected to the sternum (false ribs, ribs VIII to X) disc. The first seven ribs are di rc or end freely in the lateral wall of the trunk (floating ribs the costal cartilages (not depicted) to the sternum (true _ ribs XI and XII),Two thoracic vertebrae (left lateral aspect) Location of costovertebral joints (superior aspect) e with an stovertebral joints. Two thoracie vertebr articulating rib (separated). Axis of movement indicated by dotted line. Blue = articular facets. (Schematic diagram.) Superior articular process 7. Shatt or body of rib Vertebral canal 8 Transverse process Body of thoracie vertebra with articular facet Costovertebral joint (articular facets) 9 Spinous process Tubercle of rib 10 Costotransverse joint Head of rib (anticular facets) yaments of thoracic vertebrae and costovertebral joints (left anterolateral aspect) In the upper joint, most of the radiate ligament and the anterior part of the head of the rib have been removed to expose the two joint cavities and the interposed intra- articular ligament. Superior demifacet for head ofrib 9 Inferior articular provess Body of vertebra 10. Intervertebral foramen Inferior demifacet for head of ib 11. Spinous process Intervertebral dise 12. Anterior longitudinal ligament Inferior vertebral notch 13. Intraarticular ligament Superior articular facet and 14 Ragiate ligament superior articular process 15 Superior costotransverse ligament Pedicle 16 Body of rib Intertransverse i Transverse process and facet fe for tubercle of rib‘of which consists ofan outer laminated portion 1 Body of vertebra 2 Intervertebral d ‘amulus fibrosus) by Inner core (aueleus pulposus) a Outer portior 3 Anterior longitudinal ligament inal ligament and spinal dura mater 5. Transverse process of lumbar vertebra Supraspinous i Ligaments of the vertebral column (dorsal aspect) 8 Interspinous ligament 11 Transverse 12 Rib 13 Liga 14 Spinous process 15. Intervertebral foramen Ligaments of the vertebral column, thoracic part (left lateral aspect). The two caudal lumbar vertebrae and the sacrum with their intervertebral dises (anterior aspect). Anterior longitudinal eiciasiait sacneeidd.Atlas and axis (from above), Anterior arch of atlas with anterior tubercle cular facet of atlas 1 3. Foramen transversarium and transverse process Superior Posterior arch of atlas and vertebral artery Posterior tubercle of atlas Superior articular surface of axis 8 Body of axis 9. Pedicle and lamina of axis 10. Spinous process LL Inferior articular process 12 Transverse process and vertebrarterial foramen (foramen transversarium) 3. Median atlantoaxial joint (anterior part) A axis have been removed to show the cruciform ligament. lantooccipital and atlantoaxial joints (posterior aspect). Posterior part of occipital bone, posterior arch of atlas and Median atlantoaxial joint a (110m above). Dens of axis pa transverse ligament of atlas ly severed. 14 Articular capsule of atlantooceipital joint 15 Transverse ligament of atlas (Occipital bone Atlantooccipi Lateral alantoaxial joint 9 Third cervical vertebra 20. Superior ‘ruciform ligament 21 Alar ligaments Transverse ligament of atlas Inferior longitudinal band of cruciform ligament Spinous process of axis Atlas and axis. Left oblique posterolateral aspect demonstrating the articulation of the dens of axis with atlas (cf. arrows),External occipital protuberance 9 Foramen magnum 10 Atlantooccipital joint n 4 Transverse process of atlas 2 Membrana tectoria 1B 6 Posterior longitudinal figament 4 7. Spinous process of third cervical vertebra 15 8 Occipital condyle 6 Cervical vertebral column and skull wi nents (posterior aspect). Posterior arch of atlas and axis removed to show the membrana tectoria. tal bone, atlas and axis (left lat ) Lateral atlantoaxal joint Cccipital bone Atlas Axis Dens of axis Hypoglossal canal Spinous processes of axis Anterior longitudinal ligament Cervical vertebral column and skull with ligaments (anterior aspect). Anterior part of occipital bone removed,1 Axillary vein 2. Intercostobrachial nerves 3. Subscapularis muscle and thoracodorsal nerve 4 Long thoracicnerve, lateral thoracic artery and vein 5. Latissimus dorsi muscle 6 External intercostal muscles 7. Serratus anterior muscle ‘8. Lateral cutaneous branches of intercostal nerves 9 External abdominal oblique muscle 10 Clavicle (divided) 11. Second rib (costo-chondral junction) 12 Internal intercostal muscles 13 External intercostal membrane 14 Position of xiphoid process 15 Costal arch or margin 16 Anterior layer of rectus sheath ‘Muscles of the thorax, superficial layer (lateral aspect). Upper limb elevated. Pectoralis major and minor muscles have been removed, Effect of intercostal muscles on the costovertebral and A Action of internal intercostal muscles (expiration) costotransverse joints. Axes of movement indicated by lines: B_ Action of external intercostal muscles (inspiration) direction of movements indicated by arrows.Anterior thoraci IN (posterior aspect). Diaphragm partly rated on both sides. fenes ‘Sternocleidomastoid muscle (divided) Claviele Sternothyroid muscle Internal intercostal muscle Transversus thoracis muscle Intercostal arteries and nerves jusculophrenic artery Superior epigastric artery and vein Diaphragm (divided) Recuieatdondinie mente moved, posterior layer of rectus sheath Subetavian artery and brachial plexus First rib Internal thoracie artery and vein Innermost intercostal mu Intercostal artery and vein Xiphe 1 process and posterior layer ofSuperficial muscles of the anterior thoracic and abdominal wall. The fascia of pectoralis major muscle and the abdominal wall have been removed; the anterior layer of the sheath of the rectus abdominis muscle is displayed, 1 Sternohyoid muscle ° I Sternocleidomastoid muscle 0 3. Supraclavicular nerves (branches of cervical plexus) u 4 Deltoid muscle 2 5. Pectoralis major muscle B 4 terior cutaneous branches of intercostal External abdominal oblique mi 8. Lateral cutaneous t Unbilicus and umbilical ring Claviele Cephalie vein Serratus anterior muscle Linea alba Sheath of reetus abdominis muscle (anterior layer) 5 Inguinal ligamentMandible Facial artery Submandibular gland Hyoid bone ‘Thyroid cartilage and sternohyoid muscle 6 Clavicle 7. Subelavius muscle 8 9 Second rib ‘Anterior cutaneous branches of 10 External in 11. Parotid gland 12. External caroti 13. Sternocleidomastoid muscle and cutaneous branches of cervical plexus 14 Supraclavicular nerves 15 Pectoralis major muscle and lateral pectoral nerves 16 Thoracoacromial artery and subclavian ve 17 Pectorals minor muscle 18. Median and ulnar nerve 19 Thoracoepigasric vein 20 Cephalic vein and long head of biceps brachii muscle 21 Lateral thoracic artery and long. thoracic nerve 22, Lateral cutaneous branches of intercostal nerve 23 Latissimus dorsi musele 24 Median nerve Thoracic wall (anterior aspect) Left pectorais major muscle has been divided 8 pe cota and reflected. Note the connection of the cephalic vein with the subclavian vein, fe iehieatonseien wate ‘Arrow: medial pectoral nerve. 28 Long thoracic nerve 29 Latissimus dorsi muscle 30. Serratus anterior muscle 31. Thoracoacromial artery 32. Clavicle 33. External intercostal muscle 34 Third rib 35 Infernal intercostal muscle 36 Anterior intercostal arte 37 Costal arch or margin costal membrane and vein ‘Thoracic wall (lateral aspect). Pectoralis major and minor muscles have been removed. A section of the 4th rib has been cut and removed to display the intercostal vessels and nerve.10 n 2 B “ 1s 16 "7 18 9 2 a 2 “Thoracic wall II (anterior aspect) Dissection of the internal thoracic artery and vein, Left pectoralis major muscle partly removed. Anterior lamina of the rectus, sheath on the left side has been removed. Main arteries of thoracic and abdominal wall. Anterior perforating branches ‘of intercostal nerve Mammary gland External abdominal oblique muscle Rectus sheath (anterior layer) ‘Sternocleidomastoid muscle Cavicle Lateral thoracic artery and vein Pectoralis major muscle Internal thoracic artery and vein Serratus anterior muscle Superior epigastric artery and vein Costal margin Rectus abdominis muscle Cut edge of the anterior layer of the rectus sheath Subelavian artery Highest intercostal artery Internal thoracic artery “Musculophrenie artery Superficial epigastric artery Deep circumflex iliac artery Superior epigastric artery Inferior epigastric artery Superficial i nflexiiae arteryDeltoid muscle Cephalic vein toralis major muscle (divided) Internal intercostal musele Intercostal artery and vein (interco space, fenestrated) Serratus anterior muscle External abdominal oblique muscle terior layer of reetus sheath Miac crest Superticial epigastric Superficial circumflex iliac vein Saphenous opening Superficial inguinal lymph nodes Superficial external pudendal veins Great saphenous vein Nipple ‘Costal margin Subcutaneous fatty tissue Umbilic Anterior layer of rectus sheath Rectus abdominis muscle sterior layer of rectus sheath Internal abdo que muscle External abdominal oblique muscle ‘Transversus abdominis muscle Transversal fascia and peritoneum Psoas major muscle Body of lumbar vertebra (Ls) ‘Quadratus lumborum muscle Medial tract of erector spinae muscle Lateral tract of erector spinae muscle (ongissimus and iliocostalis muscles) Small intestine Left ureter and abdominal wall I. Right alis major and minor muscles are divided. Muscles of thoraci and abdominal wall on right side are displayed, Horizontal section of the trunk at the level of the umbilicus, superior to arcuate line (inferior aspect).Deltoid musele Pectoralis major muscle (divided) Internal intercostal muscle Intercostal artery and vein Rectus abdominis muscle fendinous intersections External abdominal oblique muse Anterior superior iliac spine Superficial circumflex iiae vein Superficial epigastric vein Great saphenous vein Cephalic vein Pectoralis major muscle Anterior cutaneous branches of intercostal nerves Nipple Linea alba Anterior layer of rectus sheath Umbilicus Inguinal ligament Pyramidalis muscle Superficial inguinal ring and s rd Suspensory ligament of penis Longissimus and iliocostlis muscles Mulfidus muscle (Quadratus lumborum muscle mus dorsi muscle Psoas major muscle Internal abdominal oblique muscle Thoracic and abdominal wall IL Right poctoralis major and minor muscles and anterior layer of rectus sheath have been removed on the right side. Horizontal section through the body at the level of 4th lumbar vertebra cen from below‘Thoracic and abdominal wall I. oblique muscle has been divided and reflected on both sides. The right rectus muscle has been reflected medially to display the posterior layer of rectus sheath. Arrow: location of arcuate line. 1 Horizontal-section of the trunk superior to arcuate line. (Schematic drawing.) Costal margin Rectus abdominis muscle External abdominal oblique muscle (reflected) ‘Thoracoabdominal (intercostal) nerves ‘with accompanying vessels Internal abdominal oblique muscle Arcuate line (arrow) Inferior epigastric artery and vein Iioinguinal nerve Position of deep inguinal ring Superficial inguinal lymph nodes Great saphenous vein Linea alba iohypogastrie nerve Pyramidalis muscle Spermatic cord Fundiform ligament of penis ‘Medial column of intrinsic muscles of the back Lateral column of erestor spinae muscle Thoracolumbar fascia with superficial and deep layer External oblique muscle Internal oblique muscle Transversus abdominis muscle “Transversalis fascia Posterior layer of rectus sheath Rectus abdominis muscle ‘Anterior layer of rectus sheath‘Thoracie and abdominal wall IV. External abdominal oblique muscle has been divided and reflected on both sides. The right rectus muscle has been cut and 1 Rectus abdominis muscle (reflected) External abdominal oblique muscle (divided) Posterior layer of rectus sheath Umbilical ring Internal abdominal oblique muscle Arcuate line (arrow) Inguinal ligament Inferior epigastric artery and vein and rectus abdominis muscle (divided and reflected) 9 Costal margin 10 Linea alba 11. Tendinous intersection 12. iohypogastric nerve 13 Moinguinal nerve 14 Pyramidalis muscle 15. Spermatic cord reflected to display the posterior layer of rectus sheath, Arrow: location of arcuate line. Peritoneum “Transversalis fascia (green) “Transversus abdominis muscle Internal abdominal oblique muscle External abdominal oblique muscle Fascia of external abdominal oblique muscle (green) Skin Linea alba 9 Rectus abdominis muscle ‘Transverse sections through the abdominal wall superior (a) and inferior (b) to arcuate line 201“Thoracic and abdominal wall (schematic drawing). Note the segmental organization of the blood vessels and nerves. Right side: superficial layers; left side: deeper layers, tal section of the abdominal wall (from above) showing the location of the intercostal arteries (left side) and nerves (right side), 30 Sternocleidomastoid muscle Deltoid muscle Pectoralis major muscle Anterior cutaneous branches of costal nerves Cut edge of anterior layer of rectus sheath Rectus abdominis muscle Tendinous intersection External abdominal oblique muscle Lateral femoral cutaneous nerve Femoral vein Great saphenous vein Medial supraclavicular nerves Pectoralis minor muscle (reflected) ‘and medial pectoral nerves Axillary vein Long thoracic nerve and lateral thor Internal thoracic artery Intercostal nerves Lateral cutaneous branches of costal nerves perior epigastric artery TThoracoabdominal (intercostal) “Transversus abdominis muscle Posterior layer of rectus sheath Inferior epigastric artery Lateral femoral eutancous nerve Inguinal ligament and iioinguinat Femoral nerve Femoral artery cond Posterior intercostal arteries Internal abdominal oblique muscle Lateral cutaneous branch of intercostal nerve Dorsal branch of spinal nerve Latissimus dorsi muscle Deep muscles of the back (medial and lateral tract) [Anterior layer of rectus sheath Posterior layer of rectus sheath Thoracolumbar fascia Spinal cord Aorta Ventral root ) of spinal Dorsal root | nerveRectus abdominis muscle 1 abdominal oblique muscle External abdominal oblique muscle (reflected) 5 Anterior superior iliac spine 7. Spermatic cord 8. Costal margin 9. Superior epigastric artery 12. Transversus abdominis muscle 13. Semilunar line M4 Arcuate line 15. Inferior epigastri 16 Inguinal ligament Abdominal wall with vessels and nerves. The left rectus abdominis muscle has been divided and reflected to display the inferior epigastric vessels The left internal abdominal oblique muscle has been removed to show the thoracoabdominal nerves. 2 a 1 Internal thoracic artery * 1 2 Intercostal artery 5 3. Superior epigastric artery . 4 Musculophrenic artery 44 5. Gallbladder 7 6 Rectus abdominis muscle 18 7 External abdominal oblique muscle 8 Deep circumflex ize artery 16 9 Superficial epigastric artery 8 10 Inferior epigastric artery e 7 11 Superficial circumflex iliac artery a 18 1 1B Intercostal nerve 19 14 Thoracoabdominal nerve (To) 15 Transversus abdominis muscle 2 ea 16 Posterior layer of the rectus sheath 17 Hliohypogastric nerve (L;) 2ob 18 Hlioinguinal nerve (L,) 19. Spermatic cord 20 Genitofemoral nerve (Ls. Ls) Arteries and nerves which supply the thoracic and abdominal wall, Note their 4 Femoral branch segmental arrangement. (Schematic drawing.) bb Genital branchInguinal canal in the male I. Dissection of superfi (anterior aspect), layer, right side Inguinal canal in the male Il, right side (anterior aspect). ‘The external abdominal oblique muscle has been divided to display the inguinal canal. Regions and reference lines for delineating surface proj. Reference lines and regions Median ine 1 2 Lateral sternal line 3. Parasternal line 4 Left lateral or midclavicular line 5. Midaxillary tine © Transpyloric plane 7 Transtubercular plane 8 Hypochondriac region 9 Epigastric region 10 Lumbar region 11 Umbilical region 12 Tliaeregion 13 Hypogastricregion Ant 1 Anterior superior ile spine 2. Medial erus of inguinal ring 3. Inguinal ligament 4 Lateral erusof inguinal ring 5. Superficial epigastric vein 6 Saphenous opening 7. Superficial inguinal lymph nodes 8. Great saphenous 9 Anterior eutancous branches of femoral nerve 10 Anterior layer of rectus sheath 11 Intererural fibers 12 Superfici al ring 13 Spermatic cord and genital branch of genitofemoral nerve 14 Penis 15. Aponeurosis of external abdominal oblique muscle (divided and reflected) 16 Internal abdominal oblique musele 17 Thioinguinal nerve 18 Anterior cutaneous branches of liohypogastric 19 Superficial external pustendal veins1 Internal abdominal oblique muscle (reflected) 2. Transversus abdominis muscle Inguinal ligament ‘Spermatic cord with the exception of the ductus deferens (divided and reflected) 5 Ductus deferens and interfoveolar ligament 6 Su 7 Femoral artery and vein 8. Superficial inguinal lymph nodes and inguinal Iymph vessel 9. Inferior epigastric artery and vein 10 Fabx inguinalis or conjoint tendon (cut) 11. Pubic branch of inferior epigastric artery 12. Superficial inguinal ring 13. Penis 14 External abdominal oblique muscle 15 Anterior superior iliac spine 16 Intercrural fibers 17 Fascia lata and sartorius muscle 18. Saphenous opening and great saphenous vein 19 Deep inguinal ring 20. Skin of scrotum and dartos muscle 21 Cremaster muscle Internal spermatic fascia 23. Ductus deferens 24. Epididymis 2. Peritoneum (blue) 26 Remnant of processus vaginalis 7 Tunica vaginalis testis, 28 Reetus abdominis muscle Inguinal canal in the male III. Deep dissection (anterior aspect, right » fost iclon oer heal side), Spermatic cord with exception of ductus deferens (probe) has 30. Anterior layer of rectus sheath been divided and reflected. 31 Suspensory li 32, Testis and epididymis 33 Ductus deferens 34 Pampiniform venous plexus and testicular artery 35 Inferior epigastric artery 36. Lateral femoral cutaneous nerve ficial circumflex iliac artery ment of penis 37 Hioinguinal nerve 38 Femoral nerve 9 40. Deep dorsal vein of penis forius muscle Inguinal hernias may either pass through the inguinal canal lateral to the inferior epigastric artery (indirect or lateral inguinal hernias, A and C) or directly penetrate the abdominal wall through the inguinal triangle located medial to the inferior epigastric artery (direct or medial inguinal hernias, B). The lateral hernias can be congenital if the vaginal process remains open (C) or acquired (A) if the hernia develops independently of a patent processus vaginalis. Femoral hernias generally protrude through the femoral ring below the nguinal ligament. Proper assessment of the site of herniation requires the General characteristics of lower part of anterior abdominal identification of both the inguinal wall and inguinal canal. (Schematic drawing.) ligament and the epigastric artery.Inguinal and femoral region in the male (anterior aspect). On the right, the spermatic cord was dissected to display the ductus deferens and the accompanying vessels and nerves. The fascia lata on the left side has been removed Layers of spermatic cord and types of hernias. Left: Normal situation; middle: Location of acquired inguinal hernias: ‘A= indirect; B = direct inguinal hernia. Right: congenital indirect inguinal hernia (C); the vaginal process remained open. 1 = Median umbilical fold, containing urachus chord, II = Medial umbilical fold with remnants of umbilical artery and vein, IIL = Lateral umbilical fold with inferior epigastric artery and vein,BronSve ENE a Inguinal region in the female (anterior aspect). Left side: superficial layer: right side: external and internal abdominal oblique muscle divided and reflected. ‘Aponeurosis of external abdominal ‘oblique muscle Internal abdominal oblique muscle (divided and reflected) ‘Transversus abdominis muscle Superficial circumflex iliac artery and Superficial inguinal ring with fat pad Medial and lateral erural fibers Round ligament (ligamentum teres wri) Labium majus pudendi Anterior layer of rectus sheath Superficial epigastric artery and vein nguinal ligament 12. Cutaneous branch of ilioinguinal nerve Superficial inguinal lymph noses Entrance of round ligament into the Jabium majus External pudendal artery and vein Position of deep inguinal ring ioinguinal nerve Internal abdominal oblique muscle Pubic branch of inferior epigastric artery Genital branch of genitofemoral nerve Fat pad of inguinal canal Hioinguinal nerve Sheath of round ligament (inguinal canal) “Transversal fascia Inguinal canal of the female I (anterior aspect, right side). Inguinal canal of the female II (anterior aspect, right side). ‘The external abdominal oblique muscle has been divided and __The external and internal abdominal oblique muscle have reflected, to display the ilioinguinal nerve and the round been divided and reflected to show the content of the inguinal ligament, canal.‘Muscles of the back I. Superficial layer on the left, deeper layer on the right, Right latissimus dorsi and trapezius muscles are removed. Occipital belly of occipitofrontalis muscle Splenius capitis muscle Sternocleidomastoid muscle ‘Trapezius muscle Deltoid musele ‘Teres minor muscle ‘Medial margin of scapula Rhomboid major muscle ‘eres major muscle Latissimus dorsi muscle Thoracolumbar fascia External abdominal oblique muscle ie crest Gluteus maximus muscle Position of last coceygeal vertebra Anus Semispinalis capitis muscle Splenius cervicis muscle Levator seapulae muscle Spine of scapula Rhomboideus minor muscle Infraspinatus muscle ‘Triceps brachii muscle Serratus anterior muscle jocostalis muscle External intercostal muscle Serratus posterior inferior muscle Latissimus dorsi muscle (cut edge) Fascia over glutcus medius muscle Long head of biceps femoris muscleMuscles of the back II. Dissection of deep muscles. Erector spinae muscle. simus muscles. (Schematic rawing.) Rectus capitis posterior minor muscle ‘major muscle 3 Semispinalis Longissimus 1S Levator scaph le Longissimus cervicis muscle Rhomboid major muscle yoracis muscle or inferior muscle Spinous process of second lumbar vertebra Tlic crest Mastoid processnsversospinal and versal system. (Schematic inte drawing.) Rectus capitis posterior minor muscle Obliquus capitis superior muscle Rectus capitis posterior major muscle Obliquus capitis inferior muscle Spinous process of axis Longissimus capitis muscle ‘Trapezius muscle (reflected) and accessory nerve (1, XI) Spinous processes Rhomboid major muscle Transverse processes of thoracic vertebrae 1 Teres major muscle 12. Intertransverse ligaments 13 Levatores costarum muscles 14. Rotatores muscles 15. Tendons of iiocostalis muscle 16 Intertransversarii lumborum muscle (lateral) 17 Hliaccrest 18. Gluteus maximus muscle 19 Semispinatis capitis muscle 20 Semispinaliscervicis muscle 21, Semispinalis thoracis muscle 22 External intercostal muscles 23 Multiidus muscle 24 Intertransversarii posterior cervicis muscle 25. Spinalis thoracis muscle Museles of the back III. Transversospinal muscles, deepest layer on the right, where all parts of semispinalis and multifidus muscles have been removed., e i Bee Innervation of the back I. Superficial (left) and deeper (right) layers. Right trapezius and latissimus dorsi muscles removed, 16 BSRER Occipital belly of occipitofrontalis musch Splenius capitis muscle “Trapezius muscle “Medial cutanncous branches of dorsal rami of spinal nerves: Medial margin of seapula Rhomboid major muscle Latissimus dorsi muscle Lateral cutaneous branches of dorsal ra spinal Thoracolumbar fascia External abdominal oblique muscle Hie crest Last coceygeal vertebra ‘Anus Greater occipital nerve Third occipital nerve Lesser occipital nerve Cutaneous branches of cervical plexus Levator seapulae muscle Deltoid muscle Rhomboid major and minor muscles Upper lateral cutaneous nerve of arm (branch of axillary nerve) ‘Teres major muscle iocostalis thoracis muscle Serratus posterior inferior muscle Superior eluneal nerves Middle cluneal nerves Inferior cluneal nerves Posterior femoral cutancous nerve > ‘To page 213: ‘Trapezius muscle Infraspinatus muscle Left latissimus dorsi muscle Thoracolumbar fascia Splenius cervicis muscle Serratus posterior superior muscle Medial branches of dorsal rami of thoracie spinal nerves Lateral branches of dorsal rami of thoracie spinal nerves Hiocostalis muscle Serratus posterior inferior muscle Latissimus dorsi muscle (reflected)9 10 u 2 B 4 1s 6 0 Is i) 2» 2 2 General characteristics of the innervation of the back. Distribution of dorsal branches of spinal nerves. Note the segmental arrangement of the innervation of the dorsal part of the trunk. (Schematic drawing.) Position and branches of spinal nerves in one segment of thoracic wall. (Schematic drawing.) Suboseiptal nerve (C)) Medial branches of dorsal rami of spinal nerves Lateral branches of dorsal rami of spinal nerves Superior cuneal nerves (La-La) Mid cluneat nerves (81-83) Inferior cincal nerves (derived from branches othe sara pesos, ventral rami) Lesser occipital nerve Great auricular nerve Traperivs muscle Deltoid muscle Latissimns dorsi muscle Giuteus maximus muscle Extemal intercostal muscle Internat intercostal muscle Innermost intercostal muscle Dorsal ramus of spinal nerve Spinal nerve snd spinal ganglion Sympathetic trunk with ganglion Intercostal nerve La ets ach eat me Anterior cutaneous ranchInnervation of the back IIT. Deeper layer (dorsal aspect),on of spinal cord. Note the the nervous and mu ar segments ‘cord. Dura removed, wervation of the back IV. Spinal cord in the vertebral canal (opened). Longissimus dorsi muscle has been removed and iliocostal muscle reflected. Cerebellomedullar lum Conus medullaris ‘Cauda equina Spinal ganglion 8 Spinal dura mater1 Arch of vertebra (divided) Spinal nerve with meningeal coverings Dorsal roots of thoracie spinal nerves Spinal cord (thoraci portion) Spinal ganglia with meningeal covering Pia mater with blood vessels Dura mater (opened) § Denticulate ligament Lateral branch of dorsal ramus Dorsal ramus of spinal nerve (Gividing into a medial and lateral branch) Medial branch of dorsal ramus of spinal nerve Spinal dura mater Spinal nerves of sacral Film terminate Thoracic portion of spinal cord (dorsal aspect). Vertebral canal and dura mater opened, ‘Terminal part of spinal cord with dura ater (dorsal aspect), Dorsal part of sacrum removed.1 Trapezius muscle 2 Semispinals capitis muscle 3. Dorsal ramus of spinal Sullurat space nerve Extradural or epidural 4 Sternocleidomastoid muscle space with venous plexus 5. Platysma muscle and fatty 6 Dorsal and ventral roots 30 Arachaoid (green) of spinal nerves 31. Subarachnoid space 7 Spinal gangl 32 Pia mater (pink) 8 Posterior belly of digastric 33. Nucleus pulposus muscle M4 Crus of diaphragm 9 Ventral ramus of spinal 35. Intervertebral dise nerve 36 Body of first lumbar 10. Vertebral artery vertebra 11 Great auricular nerve 37 Spinal cord 12. Superficial temporal artery yaus medullaris 13. Styloid process 39 Cauda equina 14 Internal jugular vein and 40 Filum terminale internal carotid artery 41. Spinous process 15 Rectus capitis posterior major muscle 16 Dura mater and Horizontal section of the neck. Dissection of the second cervical spinal nerve. Posterior surface at top of figure. 7, Denticuate ligament 18 Vertebral artery 19) Parotid gland 20 Dens of axis (divided) and inferior articular facet of atlas Longus capitis muscle Pharyngeal cavity Medial pterygoid muscle 24 Periosteum of vertebral canal 25. Posterior spinal arteries 26 Anterior spinal artery ingeal coverings of the spinal cord ( matic drawing.) through vertebral canal, T row (unfixed). (MR-Scan.) Notice red boneMedian section of the head and trunk in the Med adult (female). Th cdullaris of the that in the neonate the spinal cord is located at the level of L extends far more caudal 20. Spinal cordDorsal aspect of the neck I. Superficial layer. Nuchal region and shoulder. 1 Sternocleidomastoid muscle 10. Occipital belly ofrontalis muscle 2. Lesser occipital nerve 11 Greater occipital nerve 3. Descending fibers of trapezius muscle 2. Third occipital nerve 4 Spine of scapula jplenius capitis muscle 5 Medial cutaneous branches of dorsal rami of spinal nerves 14 Great auricular nerve 6 Medial margin of scapula 15. Cutancous nerves of cervical plexus 7 Rhomboid major muscle 16 Transverse fibers of trapezius muscle 8 Latissimus dorsi muscle 17 Ascending fibers of trapezius muscle 9 Galea aponeurotica 18 Teres major muscleDeeper layer. The left trapezius muscle has been divided and reflected. On the right, trapezius, rhomboid and splenius muscles have been divided. Right levator scapulae muscle has been slightly reflected. 1. Galea aponeurotica 2 Occipital belly of occipitofrontalis mus 3 Occipital artery 4 Greater occipital nerve (C:) smispinalis capitis muscle snocleidomastoid musele Lesser occipital nerv Lett splenius capitis muscle Third occipital nerve (C)) Spinous process of verte siaamaain HOM Left trapezius muscle and accessory nerve 20. Splenius cervicis muscle Levator scapulae mus Right accessory nerve and superficial Superficial branch of transverse cervical branch of teansverse cervical artery tery Right levator scapulae muse Thomboid minor muscle Dorsal scapular nerve and deep branch Rhomboid major muscle of transverse cefvical artery Medial margin of scapula 24 Serratus posterior superior muscle Medial branches of dorsal rami of spinal Right trapezius muscle (divided and Ligamentum nuchae Right rhomboid major muscle Splenius capitis muscle (divided) (divided and reflectDorsal aspect of neck II]. Deepest layer. Nuchal region, Trap, ‘muscles have been divided and partly removed or reflected, kin Occipital belly of occipitofrontali muscle 4 0% 5 Greater eve dorsal rami of spinal nerves 6 Third w 1 Medial la Rhomboid muscles (divided) 5. Splenius Tiocostals thoracis muscle1. Semispinalis capitis muscle (divided) 2 External occipital protuberance 3 Obliquus capitis superior muscle 4. Rectus capitis posterior minor ‘muscle 5. Rectus capitis posterior major ‘muscle 6 Vertebral artery 7. Obliquus capitis inferior muscle 8. Spinous process of axis 9 Third cervical vertebra 10. Occipital belly of occipitofrontalis muscle 11 Greater occipital nerve 12 Suboccipital nerve (C;) 13 Lesser occipital nerve 14 Third occipital nerve (C;) 15. Mastoid process and splenius capitis muscle 16 Atlas 17 Axis 18. Spinous process of third cervical vertebra 19 Right semispinalis cervicis 20 Deep ee 21. Left sper (divided) 22 Left sternocleidomastoid capitis muscle muscle 2 ricular nerve nals capitis muscle 25. Left longissimus cervicis muscle 26 Levator scapulae muscle 27 Muscular branch of vertebral artery 28 Left semispinalis cervicis muscle (divided) 29 Medial branches of dorsal Dorsal aspect of neck IV. Deepest layer, suboccipital triangle; right semispinalis capitis muscle ami of spinal nerves divited and reflected, 30 Occipital artery 31 Dorsal scapular nerve 15 16 7 Suboccipital triangle and position of the verte! (Schematic drawing.)Dorsal aspect of neck V. iuchal region. Deepest ital belly of occipitofront jon of semispinalis capitis muscle (divided) Lesser occipital nerve (from cervical plexus) Suboceipital nerve (C\) Greater occipital nerve (C:) Splenius capitis muscle Splenius Levator seapulae muscle Accessory nerve (n. XI), trapezius muscle yer. Dissection of suboccipital triangle on both sides. Longissimus cervicis muscle iocostalis cervicis muse “Medial eutaneus branches of dorsal rami spinal nerves (C>,C4) Longissimus thoracis muscle Medial margin of seapula Rectus capitis posterior minor musc ‘Obliquus capitis superior muscle Rectus capitis posterior major Obliquus capitis inferior muscle Spinous process of axis 21 Semispinalis cervicis muscle 22. Semispinalis capitis mus (divided and reflected) 23. Transverse cervical artery (superficial branch) 24. Serratus posterior superior muscle (divided and reflected) 25. Rhomboid minor muse (divided and reflected) 26 Rhomboid major muscle (divided and ted)Neck, deepest I 1 Vermis ofthe cerebellum Medulla oblongata and posterior spinal artery Vertebral artery Spinal ganglion Cerebellum Cerebellonvedullary cistern Greater occipital nerve (C,) Levator scapulae muscle and intertransverse ligament Dorsal roots of spinal nerves Vertebral arch Denticulate ligament and arachnoid mater Avea where pia mater has been removed Dura mater Dorsal rami of spinal nervesDeeper layer of the dorsal neck (oblique lateral aspect). Trapezius and semispinalis capitis muscles have been divided and partly removed, Great auricular nerve Accessory nerve (a X1) Sealenus posterior muscle Transverse cervical artery Omobyoid muscle Muscular branch of cervical plexus Trapezius muscle ‘Occipital artery Greater occipital ner Semispinalis capitis muscle yssimus capitis muscle Splenius cervicis muscle Serratus posterior superior muscle Deep cervical vein (variant Rhomboid minor muscle Levator scapulae muscle Searanehaidbeubstcid wists‘Thoracic organs, heart and lungs in situ (ventral aspect). Anterior thoracie wall, pari pleura and pericardium had been removed. ‘Sagittal section through thoracic cavity. The divisions of the mediastinum are indicated by colors. 1 Thyroid gland 2 Internal jugular vein 3. Right common car 4 Right axillary vein 5 Right brachiocephalic vein 6 7 8 9 id artery Superior lobe of right lung Right atrium Right coronary artery Middle lobe of right lung 10 Right ventricle 11 Diaphragm 12. Liver (lett lobe) and faleiform liga 13 Left interna jugular vein 14 Trach 15 Left brachiocephalic vein rior lobe of left lung 2 of pericardium 18 Ascending aorta 19 Pulmonary trunk 20. Inferior lobe of left lung, 21 Left ventricle 22 Costal margin Right pulmonary artery 24 Esophagus 25. Descending aorta 26 Pericardium 27. Aortic valve 28 Thymus 29 Diaphragm Divisions of Main content mediastinum Superior ‘Trachea, brachiocephalic veins, mediastinum, thymus, aortic arch, esophagus, (yellow) thoracic duct Middle Heart, ascending aorta, pulmonary| ‘mediastinum trunk, pulmonary veins, phrenic Gight blue) nerves Posterior Esophagus with vagus nerves, mediastinum. descending aorta, thoracic duct, (red) sympathetic trunks ‘Anterior mediastinum (pink) ‘Small vessels, connective and fatty tissue, and thymus in a child1 Cricothyroid muscle 2. Right internal jugular vein 3. Vagus nerve Right common carotid artery 5 Right subclavian vein Right brachiocephalic vein Superior vena cava Upper lobe of right lung Right auricl Middle lobe of right lang Oblique fissure of right lun Lower lobe of right lu Diapt Faleiform ligament Costal margin Transverse Thyroid gland Trachea Left internal jugular vein Left cephalic vein Left brachiocephalic vein Pericardium (cut edge) Upper lobe of left lung Right ventricle Left ventricle Anterior interventricular of let lung Stomach Pectoralis major muscle nntal section through the thorax at the level of the 7th thoracic vertebra (from below),tal section through the left thorax, 2 cm lateral to the median plane. Sagittal section through the left thorax, 3.5 cm lateral to the median plane. o 70 Sternum Pulmonary trunk Left ventricle and bulb of aorta Left atrium Lett main bronchus Esophagus Descending aorta Serratus anterior muscle Teres major muscle Rib Trapezius muscle Right atrium Lelt pulmonary vein Right pulmonary vein Right main bronchus Azygos vein Body of vertebra Spinal cord Seapula Left common carotid artery Sternoclavicular articulation with dise Right pulmonary artery Remnants of thymus Aortic bull Entrance of inferior savin tight atrium Pancreas Left renal vein Duodenum Transverse colon (dilated) Small intestine Umbilicus ft subelavian artery Aortic arch ‘Thoracie aorta Abdominal aorta Intervertebral dise Body of lumbar vertebra Aortic valve ca Suprarenal gland Splenic veinRespiratory system. laterally. Head bisected and turned laterally The lungs have been fixed in expiration and turned Bronchial tree (ventral aspect). The lung tissue has been removed. The bronchopulmonary segments are numbered 1-10, ‘Sphenoid sinus Pharyngeal opening of auditory tube Spinal cord Dens of axis Orophas Fpiglotis nx (oropharyngeal isthmus) Entrance of laryny Esophagus Upper lobe of right lung Branches of pul Right main bronchus Bifureat Tributaries ot pulmonary veins Middle lobe of right lun Lower lobe of right lung Frontal sinus Superior nasal conch: Middle nasal concha Inferior nasal concha Hard palate Soft palate with wvuls Ton Vocal fold Larynx Trachea Upper lobe of eft lung Left pulmonary artery Left main bronehus Left pulmonaey veins To page Pharynx Larynx (thyroid cartilage) Trachea Upper lobe of right lung Bifurcation of trachea Right main bronchus Horizontal fissure of right lun Middle lobe of right lung 10. Oblique fissures of lungs 11 Lower lobe of right lung 12. Chaviete 13. Upper lobe of lett lung 14_Left main bronchus 15. Bronchi supplying bronchopulmonary 16 Lower lobe of left lun 7 Costal margin 18 Hyoid bone 19 Right superior lobe bronchus 20. Right middie lobe bronchus 21 Right inferior lobe bronchus 22 Left superior lobe bronchus 23. Left inferior lobe bronchus 24 Segmental bronchi 25 Branches of pulmonary arteries 26 Branches of pulmonary veinsLarynx, trachea and bronchial tr nization and positions of respiratory or (Schematic drawing.) Meeiastinal dissection of the bronchial tree, pulmonary veins, and pulmonary (medial aspect). Segmental bronchi are numbered 1-10. arteries of right lung (left) and left lung (right)Surface projections of lungs and pleura on the thoracic wall, Left: anterior aspect; right: right-lateral aspect Red = margins of the lung; blue = margins of pleura. The numbers indicate ribs. Surface projections of lungs and pleura on thoracic wall, Left: posterior aspect; right: left-lateral aspect. Red = margins of ung; blue = margins of pleura. The number indicate ribs 11 Costal margin 12. Spine of seapula 13 Istlumbar vertebra 14 Space between border of lung and pleura s) (costodiaphragm:Right lung (lateral as Left lung (Ia Right lung (medial aspect) Left lung (medial aspect). Apex of lung 8 Upper lobe of lft lang 15 Bronchi Left secondary br@nehi 16. Right pulmonary veins Groove of thoracie aorta Upper lobe of right lung 9 Impressions of ribs Horizontal fissure of right lung 10 Oblique fissure of left lung Pulmonary ligament Groove of esophagus Oblique fissure of rightlung 11 lobe of left ung 18 Diaphragmatic surface 25. Cardiacimpression Middle lobe of right ung avian artery Groove of aortic arch Lingula Lower lobe of right hung 3 arch Left pulmonary artery Inferior borde Branches of right pulmonary artery Branches of leftRight lung (medial aspect), Left lung (medial aspect). Right lung (lateral Left lung (lateral a that there is no segmer ‘ompare with the schematic drawing on the ‘The bronchopulmonary segments of the lungs are differentiated by the various colors. Noti in the left lung that corresponds to the 7th segment of the right lung, facing page.Distribution of bronchopulmonary segments of the lungs and their relation to the bronchial tree (after J. F. Huber), ‘The bronchopulmonary segments are morphologically and functionally separate independent respiratory units of the lun, Each segment is surrounded by connective tissue which is continuous with the visceral pleura, The segmental bronchi in a segment are central, closely accompanied by branches of the pulmonary arteries whereas the tributaries of the pulmonary veins run between the segments. Thus, the veins serve two adjacent segments which drain for the most part into more than one vein A bronchopulmonary segment is therefore not a complete vascular unit, but segmentation is the result of a specific architecture of the lung vastulature mates anny 1 Agata os 142. Ano on 2 Ponteriorsepment } UPPEIobe pesteriorsegment | SuPer 3. Anterior segment re 3. Anterior segment ‘ Upper lobe pear 6 Sepaior pkajoogcnt sige enc 2 Anttortaaliegnent | Wer be 2 Autrocsedalbast segue | Ler 9 tan belsapent 9 Later sal epmenHeart of 30-year-old woman (anterior aspect). 1 Left subclavian artery 2. Left common carotid artery 3. Brachiocephalic trunk $ Superior vena cava 5 Ascending aorta 6 Bulbofthe aorta Right auricle Right atrium 10 u 2 B 14 6 i Coronary suleus ventricle Ao Ligamentum arteriosum Left pulmonary veins arch Left auricle Pulmonary trunk Sinus of pulmonary trunk Anterior interventricular suleus Position of heart and its vessels within the thorax. (Schematic drawing.) Heart of 30; vs ar-old woman (oblique posterior view). Apex of the hear Left atrium Epicardial {at overlying coronary sinus Posterior interventricular suleus Right pulmonary artery Right pulmona Inferior vena cava Right brachiocephalic vein Superior vena cava Ascending aorta Right atrium Right ventricle Inferior vena cava Left internal jugular vein Left common carotid artery Let Left brachiocephalic vein Pulmonary unk axillary artery and vein Left auricle Left ventr Descending aorta1 Larynx (thyroid cartilage) 2 Sternocleidomastoid muscle (divided) 3. Trachea (divided) and right internal jugular vein 4 Vagus nerve 5 Right common carotid artery ‘and cephalic vein 6 Esophagus Right axilary vein Right and left brachiocephalic 9 Superior vena cava 10 Right auricle 1 Right coronary artery 12 Right atriam 13. Diaphragm 14. Pericardium (cut edges) 15 Costal ma 16 Omohyoid musele 17 Left common carotid artery 18 Left internal jugular vein 19. Cavicle (divided) 20. Left recurrent laryngeal nerve 21, Subelavian vein 22 Pericardial refletion 23. Pulmonary trunk 24 Ascending aorta 25 Anterior interventricular sulcus and anterior interventricular branch of left coronary artery 26 Right ventricle 27 Left venrile 28. Aortic valve 29 Tricuspid or right atrioventricular valve 30 Inferior vena cava 31, Pulmonary veins Heart and related vessels in situ (anterior aspect). Anterior thoracic wall, pericardium 32. Pulmonary valve ‘and epicardium have been removed: trachea di a eS Heart in situ. Position of valves (anterior aspect). (Schematic drawing.)1 Brachiocephalic trunk 2. Superior vena cava 3. Sulcus terminalis 4 Right auricle S- Right atsium 6 Aortic valve 7 Conus arteriosus (interventricular septum) 8 Right (tricuspid) valve 9 Anterior papillary muscle 10 Myocardium of right ventricle 11 Left common carotid artery 12. Left subclavian artery 13. Aortic arch 4 Ligamentum arteriosum (remnant of ductus oven arteriosus) 15 ‘Thoracic aorta (descending aorta) 16 Ascending sorta 17 Left pulmonary vein 18 Pulmonary trunk 19 Left auricle 20. Pulmonie valve 21. Anterior papillary muscle with chordae tendincae Myocardium of left ventricle Posterior papillary muscle Interventricular septum Right and let brachiocephalic veins Chordae tendinene Papillary muscles of right ventricle Lett atrium 29. Infundibulum A) Anterior papillary muscle of left ventricle 31 Left atrioventricular (bicuspid or mitral) valve and chordae tend 32 Apex of heart Anterior aspect of the heart. The anterior walls of the ventricles and of the aorta and pulmonary trunk have been fenestrated to show the aortic valve. Circulation within the heart. (Schematic drawing.) The arrows indicate the direction of the blood flow through the heart Blue = right heart; red = left heart.Heart in situ. Myocardium and coronary arteries (anterior aspect). 1 Internal jugular vein 2. Common carotid artery 3. Brachiocephalic trunk 4 Ascending aorta 5 Right lung 6 Right auricle 7 Right coronary artery 8. Myocardium of right ventricle 9 Diaphragm 10 Costal margin 11 Thyroid gland and internal jugular vein 12 Trachea and left common carotid artery 13. Lett brachiocephalic vein 14 Left 15. Pericardium (cut edge) 16 Pulmonary trunk 17 Anterior interventricular artery 18 Myocardium of let ventricle 19 Museular vortex (right ventricle) 20. Posterior interventricular suleus 21 Anterior interventricular sulcus 22 Muscular vortex (left ventricle) 23. Aortic arch 24 Left atrium 25 Coronary sinus 26 Superior vena cava 27, Right pulmonary vein 28 Right atrium 29 Inferior vena cava 30 Coronary suleus 31 Myocardium of left ventricle 32 Left pulmonary artery 33. Left pulmonary vein 34 Apex of heart 23) 29 19 Heart (posterior aspect). The myocardium of the left Vortex of cardiac muscle fibers (irom below). ventricle has been fenestrated to show the muscle fiber bundles of the deeper layer with their more circular course.1 Superior vena cava 2 Crista terminalis 3. Fossa ovalis 4 Opening of inferior vena cava 5. Opening of coronary sinus 6 Right auricle ht coronary artery and coronary suleus 8 Anterior cusp of tricuspid valve 9 Chordae 10 Anterior papillary muscle LL Myocardium rndinee 12. Pulmonary trunk 13 Ascending aorta 14 Pulmonie valve 15 Conus arteriosus (interventricular septum) 16 Septal papillary muscles 17 Septomarginal or moderator band 18, Apex ofheart 19 Left auricle 20 Aortic valve 21 Left ventricle Pulmonary veins Position of fossa ovalis Left atrium, Left atrioventricular (bicuspid or mitral) valve Coronary sinus 27” Left coronary artery 28 Posterior papillary muscle 29. Left subclavian artery 30 Descending aorta 31. Left pulmonary artery Right heart (anterior aspect). Anterior wall of right atrium and ventricle removed. Left heart. Left atrium and ventricle opened. Aortic and Left heart. Aortic valve cut open. Left atrium and mitral valve cut open. ventricle opened. The atrial wall was cut near the anulus fibrosus of the mitral valveImonic valve Sinus of pulmonary trunk Left coronary artery Great cardiac vein Left atrioventricular Coronary sinus Aortic valve Right coronary artery Right atrioventricular (tricuspid) valve Bulb of aorta Anterior semilunar cusp of pulmonie valve Left semilunar cusp of pulmonic valve ht semilunar cusp of pulmonic valve Left semilunar cusp of aortic valve Right semilunar cusp of aortic valve Posterior semilunar cusp of aortic valve Right atcium Anterior cusp of tricuspid valve Chordae tendineae Trabeculae carneae Interventricalar septum Valves of heart (superior aspect). Left and right atrium removed. Dissection of Septal cusp of tricuspid valve coronary arteries. Above: anterior wall of the heart. Myocardium of right ventric Pulmonic and aortic valves (from above). Ani all of Right atrioventricular (tricuspid) valve (anterior aspect after the heart at the top. Both valves are closed. removal of the anterior wall of the right ventrielHeart, fixed in diastole (anterior aspect). The ventricles are relaxed, atria contracted. Heart, fixed in systole (anterolateral aspect). The ventricles are contracted, atria dilated. 1 Ascending aorta 2. Superior ve 3. Right auricle 4 Right atrium 5 Coronary sulcas 6 Right ventricle Pulmonary trunk 8 Leftauricle 9 Anterior interventricular sulcus 10. Left ventricle pulmonary artery 12. Sulcus terminalis with sinuatrial node 13. Line indicating plane of position of valves 14 Myocardium of right atrium 15 Inferior vena cava 16 Valve of pulmonary trunk Tricuspid valve 18 Myocardium of right ventsicle 15 Morphological changes during heart movements, Note the changes in positon of the valves (arrows). Contracted portions of heart are indicated in red. A. Diastole, muscles of the ventricles relaxed; atrioventricular valves open, semilunar valves closed. B. Systole, muscles of ventricles contracted; atrioventricular valves closed, semilunar valves open.Right ventricle, dissection of atrioventricular node, Left ventricle, dissection of the left limb or bundle branch atrioventricular bundle (bundle of His) and right limb or of conducting system (probes) bundle branch (probes). 1 Superior vena cava 5. Musee fiber bundles of right atrium 9 Aortic valve 2 Soleus terminalis 6 Coronary suleus (with right coronary artery) 10. Branches of left bundle branch Bulb of aorta 7 Aonticsinus LL Purkinje fibers 4 Sinuatrial node (arrows) 8 Entrance to left coronary artery 12 Leftauricle 13 Interventricular septum 14 Papillary muscles 15 Ascendi 16 Right at 17. Opening of coronary sinus 18 Atrioventricular node 19. Septal eusp of tricuspid valve 20. Pulmonary trunk Atrioventricular bundle (bundle of His) Bifurcation of atrioventricular bundle Right bundle branch In Left atrium Left bundle branch Papillary muscles with Purkinje fibers Right atrium, anterior wall, showing the location of the Conducting system of the heart. 1atrial node (arrows), (Schematic drawing.)Coronary arteries (anterior aspect). The epicardium and subepicardial fatty tissue have been removed. The arteries have been injected with red resin from the aorta, Ascending aorta Aortic bulb and (in the above specimen) sinuatrial branch of right coronary artery 3 Right auricle Right corona 5 Right atrium 6 Coronary suleus 7. Right ventricle 8 Left auricle 9 Pulmonary trunk ‘essels of the heart. Coronary arteries (red) and veins (blue) of the heart (anterior aspect). Right coronary artery and veins of the heart (dorsal aspect), The epicardium and subepicardial fatty tissue have been removed. 10 Citcumiflex branch of left coronary artery 11 Left coronary artery 12. Diagonal branch of left artery 13. Great cardiae vein 14 Anterior interventricular artery 15 Anterior interventricular suleus 16 Left ventricle 17 Apex of heart 18 Right pulmonary vein 19 Leftatsium 20. Left pulmonary veins 21 Oblique vein of lft atrium (Marshall's vein) 22. Coronary sinus 23. Great ea 24 Coronary suleus (posterior portion) 25. Posterior vein of left ventricle 26 Middle eardiae vein 27 Left pulmonary artery 28 Inferior vena cava, 29 Right atrium 30. Posterior interventricular branch of right coronary artery M_ Posterior interventricular suleus 32 Superior vena cava 33 Right marginal branch M_ Branch of sinuatrial node 35 Minimal cardiac veins 36 Small cardiae vein1 Platysma muscle Chavicle Deltoid muscle Pectoralis major muscle Deltopectoral groove and cephalic vein 6 Latissimus dorsi muscle 7) Medial mamarian branches of intercostal nerves 8 Breast tissue 9 Arcola 10. Nipple (papilla) 11. Costal margin 12. Pectoral fascia 13. Mammary gland 14 Serratus anterior muscle 15 Lactiferous sinus 16 Lactiferous ducts Dissection of mammary gland (anterior aspect). Mammary gland (sagittal section; pregnant female), Galactogram of mammary gland (adult female). Notice multiple duct cysts.Thoracic wall and organs (ventral aspect). The left clavicle and ribs have been partially removed, and the right inte have been opened to show the internal thoracic vein and artery. Right in ‘Omohyoid muscle Right internal thoracic artery and vein Brachial plexus ‘Sternohyoid muscle and external Fascicles of transversus thoracis muscle jugular vein Internal intercostal muscles 3 Left axillary vein Cavicle Serratus anterior muscle Left internal thoracic artery and ve Thoracoacromial artery Costal margin Ribs and thoracic wall (cut) Right subelavian vein External abdominal oblique muse Costal pe major mi Anterior sheath of rectus abdomi Xiphoid pr External intercostal musele Stemocleidomastoid muscle Superior epigastric artery Pectoralis minor muscle Left internal jugular vein Diaphragm Body of sternum 20. Transverse cervical arter Rectus abdominis muscleiothyroid muscle and its nerve (a branch of the ansa cervicalis) Right internal jugular vein Right common carotid artery Cephalic vein Right subelavian ve Right brachiocephalic vein Pectoralis major muscle (divided) Pectoralis minor muscle (divided) Parasternal lymph nodes - Ribs, clavicle and sternum have been partly remov Iymph vessels and nodes. Anterior margin of costal pleura Pericardium 13. Sth and éth ribs (divided) and serratus anterior muscle 14 Costodiaphragmatic recess 15 External abdominal oblique muscle 16 Rectus abdominis mus Larynx (thyroid cartilage) Thytoid gland Trachea Left vagus nerve 1 Left brachiocephalic vein Left internal thoracic artery and vein Thymus Costal pleura Costal margin Superior epigastric artery Margin of costal pleura Diaphragm Linea alba Cut edge of anterior sheath of rectus abdominis muscleLarynx (thyroid cartila Thyroid gland Trachea Internal jugular vein Brachial plexus Right brachiocephalic vein and common carotid 7. Right phrenic nerve 8 Ascending aorta 9) Pectoralis minor muscle (divided) 10 Pulmonary trunk (covered by pericardium) 11 Costal pleura 12 Pericardium and heart 13. Serratus anterior muscle 14 Xiphoid process 15 Costal margin 16 External abdominal oblique musice 17 Sternothyroid muscle (divided and reflected) 18 Vagus nerve 19 Left common earotid artery 20. Left sympathetic tru 21 Left recurrent laryngeal nerve 22 Left internal thoracic artery and vein (divided) 23. Marginof costal pleura 24 Intercostal nerves and vessels 25. Superior epigastric artery 26 Rectus abdominis muscle 27, Diaphragm 28 Ansa cervicalis 29. Phrenic nerve and scalenus anterior muscle 30 External jugular vein (divided) 31 Right subclavian vein 32. Right brachiocephalic vein 38 Internal thoracic artery (divided) 34, Internal thoracic vein (divided) 35 Right ung 36 Cricothyroid muscle 37 Omohyoid muscle 38 Thymus 39 Leftlung ‘Thoracic organs (ventral aspect). The internal thoracic vessels have been removed, and the anterior margins of the pleura and Jungs have been slightly reflected to display the anterior and middle mediastinum, including the heart and great vessels.‘Thoracic organs (ventral aspect). The pleura has been opened and the lun; pericardium are seen. Right internal jugular vein 11. Middle lobe of right lung et carotid artery and Phrenic nerve and scalenus anterior muscle ue fissure of right lang Claviele (divided) “ achiocephalic ve Right subelavian artery and vein Xiphoid process 22 Internal thoraci artery and vein (divi Internal thoracic artery Diaphragm Ascending aorta and sortie arch t brachiocephalic vein 16 Thyroid gland Upper lobe of lett tung Brachiocephalic trunk 17 Left internal jugular vein 25. Pericardiu Thymus (atrophic) 18. Brachial plexus Oblique fissure of left ling Upper lobe of right lung 19 Left cephalic vein Lower lobe of left lung Horizontal fissure of right lung (incomplete) 28 Costal marginThoracic organs (ventral aspect). The thoracic wall, costal ple Internal jugular vein Pericardium (cut edges) External jugular vein (displaced medially) 3 Oblique fissure of lung Lower lobe of right lung Diaphragm 6 Falciform ligament Brachial plexus Trachea Right common carotid artery Claviele (divided) 7 Liver Right brachiocephalic Location of laryax Upper lobe of right lung ‘Thymus (atrophic) Horizontal fissure of right lung a Middle lobe of tight lung Vagus nerve Left internal jugular vein 20. Thyroid gland Omohyoid muscle (divided) icardium and diaphragm have been partly removed. Left subelavian vein Ist rib (divided) 25 Internal thoracic artery and vein 26. Pectoralis major and pectoralis minor muscles eat edges) Upper lobe of eft lung, Right ventricle Cardiac notch of lft lung Interventricular sulcus of Left ventricle Lingula Lower lobe of left lung‘organs, position of pleura and the pericardium have be Thyroid gland u Phrenic nerve and scalenus anterior muscle 12 ve and internal jugular vein 13, CClavicle (divided) 4 Brachial plexus and subclavian artery 15, Vagus ne 1 4 6 Subclavian vein 16 7. Internal thoracic artery 0 8 Brachiocephalic trunk and right 18 brachiocephalic in 9 Superior vena cava and thymic vein 10 Right phre heart, middle mediastinum (ventral aspect). The ed and the lungs slightly reflected. “Transw Right aurile Middle lobe of right lung Right ventricle Cuted Diaphragm Internal jugula Trachea se pericardial sinus (probe) of pericardium Left recurrent laryngeal nerve Lett common carotid artery and a nterior wall of the thorax, the costal Loft t inferior thyroid vein chiocephalie vein and Left internal thoracic artery and vein (divided) Upper margin of pericardial Ascending aorta Pal Left phrenic nerve and let pork cardiacophee Un Left ventricle onary trunk artery and vein + lobe of lett lungvessels in situ (ventral aspect). The anterior wall of thorax, costal pleura and pericardium have been removed. Intermediate supraclavicular nerve Internal jugular vein Right phrenic nerve Right vagus nerve Right common carotid artery Right subclavian vein Right brachiocephalic vein Right internal thoracic artery Superior vena eava Ascending aorta Right lung Right atrium Right coronary ar small cardiac vein Right ventricle Thymic veins Cut edge of pericardium Margin of pericardial sac Costal margin Pulmonary trunk Larynx (cricothyroid muscle and thyroid Left lung, cartilage) Left ventricle Thyroid gland 29 Anterior interventricular artery and vein Left common carotid artery and 30 Lingula left vagus nerve 31 Liver‘Thoracic organs, heart with valvesin situ (ventral aspect). Anterior wall of thorax, pleura and anterior portion of pericardium have been removed. The right atrium and ventricle have been opened to show the right atrioventricular and pulmonary valves. 1 Omohyoid muse Branches of pulmonary artery Left common carotid artery 2. Pyramidal lobe of thyroid gland Right auricle Left subclavian artery 3. Internal jugular vein Right atrium Left internal thoracic artery 4 Thyroid gland Right atrioventricular (tricuspid) valve Apexof eft lang Right subclavian vein Right lung Left recurrent laryngeal nerve 6 Brachiocephalic trunk Posterior papillary muscle Cut edge of pericardium 7. Right brachiocephalic vein Diaphragm Pulmonary trunk (fenestrated) 8 Right internal thoracic artery Left vagus nerve Pulmonie valve 9 Right phrenic nerve Left phrenic nerve Supraventricular crest 10 Superior vena cava Scalenus anterior muscle Anterior papillary muscle 11 Pulmonary vein Brachial plexus Left ventricle Thyrocervical trunku Thoracic organs, pericardi removed and the lungs s Right internal jugular vein and 2 right vagus ne Right phrenic nerve and Right common carotid artery 4 Brachial plexus 1s Right subclavian artery and vein Right brachiocephalic vein 0 Right internal thorac Brachiocephalie trunk Upper lobe of right ling Superior vena cava Transverse pericardial sinus (probe) silenus anterior muscle 13 artery (divided) 18 m and mediastinum (ventral aspect). Anterior ly reflected. Note probe within transverse pericardial sinus, Right phrenic nerve and right peri cardi Right pulmonary veins ophrenic artery and vein Oblique sinus of pericardium Inferior vena cava Diaphragmatic part of pericardium Diaphragm Costal margin Thyroid gland Trachea Left recurrent laryngeal nerve and inferior thyroid vein I of thorax and heart have been Left common carotid artery and left vagus nerve Left internal thoracie artery and vein (divided) Vagus nerve at aortie arch Cut edge of peri Ascending aorta Pulmonary trunk (divided) Left pulmonary veins Left phrenic nerve and lett pericardiacophrenic artery and vein Contour of esophagus beneath pericardiumInternal thoracic vein Superior vena cava Oblique sinus of pericardium Right pulmonary veins Esophagt Branches of right vagus Mesocardium Diaphragm Upperlobe of left lung Ascending aorta Pulmonary trunk Transverse pericardial sinus Left pulmonary veins Descending aorta and left vagus nerve Left lung (adjacent to pericardium) Pericardium Left subclavian artery Left recurrent lary Descending aorta Left common carotid art Brachiocephalic trunk Pericardial sae (ventral aspect). The heart has been removed, and the posterior wall of the pericardium has been opened to show the adjacent esophagus and aorta. Heart with epicardium (posterior aspect). Arrows: oblique sinus. ith epicardium (anterior aspect). Arrow pericardial reflection.jcular nerves Internal jugular vein Omohyoid muscle Right vagus nerve Right common carotid Right subclavian artery Brachiocephialic trunk Right brachiocephalic vein Superior cervical cardiac branch fof vagus nerve Inferior cervical cardiae branches pi rt and pericardium (ventral aspect). Both lungs ha Aaygos arch (divided) Bifurcation of trachea Right lu Esophagus and branches of right vagus n Inferior vena cava Pericardium Larynx (thyroid cartilage, cricothyroid muscle) Thyroid gland Internal jogular vein: been slightly reflected, Esophagus and left recurrent laryngeal nerve Trachea Left vagus nerve Left common carotid artery Aortic arch Left recurrent laryngeal nerve branching off from vagus nerve Left pulmonary veins ‘Thoracte aorta and let vagus nerve Left lung Lefiphesele cares {texsast)1 Internal jugular vein 2 Right vagus nerve 3 Thyroid gland 4 Right recurrent laryngeal nerve 5. Brachiocephalic trunk 6 Trachea 7. Bifurcation of trachea 8 Right phrenic nerve 9. Inferior vena cava 10 Diaphragm 11 Leftsubclavian artery 12. Left common carotid artery 13 Left vagus 14 Aortic arch 15 Esophagus 16 Esophageal plexus 17 Thoracic aorta 18 Left phrenie nerve 19) Pericardium at the central tendon of diaphragm 20, Right pulmonary artery 21. Left pulmonary artery 22. Tracheal lymph nodes 23. Superior tracheobronchial Iymph nodes 24 Bronchopulmonary lymph nodes Bronchial tree in situ (ventral aspect). Heart and pericardium have been removed; the bronchi of the bronchopulmonary segments are dissected. 1-10 = numbers of segments. Relation of aorta, pulmonary trunk and esophagus to trachea and bronchial tree. (Schematic drawing.) 1-10 = number of segments (ef. p. 230 and 235).Organs of poster aortic arch have been slightly reflected to show the ¥: Supraclavicular nerves Right internal jo Omohyoid muscle Right vagus nerve Claviete vein with ansa cervialis ght subclavian artery and recurrent laryngeal nerve Right subclavian vein Superior cervical cardiac branch of vagus ner Inferior cervical cardiae branch of vagus nerve Azygos arch (divi Right lung is nerves and their branches, Right pulmonary artery Right pulmonary veins Esophagus Esophageal plexus Right phrenic nerve (divided) Inferior vena cava Pericardium covering the diaphragm Larynx (thyroid cartilage and cricothyroid muscle) ‘Thyroid gland ft internal jugular vein Esophagus and left rec al nerve Trachea ‘mediastinum (ventral aspect). The heart with the pericardium has been removed. and the lu Aortic arch Left recurrent laryngeal nerve Bifurcation of trachea Left pulmonary artery Lett primary bronchus Descending aorta Lett pulmonary veins Branch of left vagus nerve Lett lung Lett pheenic nerve (divided)Mediastinal organs (ventral aspect), Heart and distal part of esophagus have been removed to display the vessels and nerves of the posterior mediastinum. Thyroid gland 1 Agygos vei 21 Brachiocephalic trunk Right internal jugular ve 12 Thoracic duct 2 Lett vagus ne Right vagus nerve 13 Posterior intercostal artery and vein 23. Aortic arch Point, where right recurrent laryngeal nerve in front of the vertebral column) 24 Left reeurtent laryngeal n is branching off the vagus nerve 14 Right Left bronchial arte Right brachiocephalic vein 15. Inferior ven Lymph node Trachea 16 Diaphragm °7- Thoracic aorta Left brachiocephalic vein (reflected 17 Left vagus nerve Esophagus 18 Thyrocervical trunk Right bronchial artery 19 Left subclavian artery 40° Peskerioe intexheiial actay 20. Left common carat10 n 2 B Diaphragm and organs of mediastinum (anterior aspect). Heart and lungs have been removed; the costal margin remains in place. Note the different courses of left and right vagus. Right subclovian artery 14 Liver (quadrate tobe) Right recurrent laryngeal nerve 15 non carotid artery Right brachiocephalic vein 16 current laryngeal nerve Superior cervical cardiac nerve 7 al branches of left vagus Inferior cervical cardiac nerves nerve and esophagus and pulmonary branches 18 Trachea Bifurcation of trach 19 Aortic arch Esophagus (thoracic part) 20. Left vagus nerve Bronchi of lateral and medial segments 21 Left recurrent laryngeal nerve with of middle lobe inferior cardiac nerve Esophageal plexus and branches of right vagus nerve Left primary bronchus Superior and inferior lingular bronchi Inferior vena eava and right phrenic Esophageal plexus of left vagus nerve nerve (cut) Descending aorta Sternal part of diaphragm 26 Central tendon of diaphragm, Costal part of diaphragm covered with pericardium Fabsdoew kaunent a tint 27 Left phrenic nerve (divided) 2% a 3% 31 33 30 18 i Organs of posterior me (ventral aspect). (Schematic draw- ing.) Three regions in which the esophagus is narrowed are shown: ‘A. at the level of the ericoid car tilage: B atthe level of the aortic arch; at the level of the diaphragm. Costa margin Liver, left lobe Pharynx Secondary bronchi Esophagus (abdominal part) Diaphragm Abdominal aortaInferior segment of posterior nediastinum (anterior aspect) Intercostal nerve Aortic arch Azygos vein Posterior intercostal art reater splanchnic nerve Diaphragm L Proper hepatic artery and hepatic plexus Left recurrent laryngeal nerve Inferior cervical cardiac nerves Left vagus nerve and left recurrent lary Left primary bronchus Thoracic aorta and left vagus nerve Esophagus and Thoracic duct Spleen Anterior gastric plexus and stomach (di Splenic artery and splenie plexus (Celine trunk and celine plexus Pancreas Ramus communicans Sympathetic trunk and sympathetic ganglion Posterior intercostal vein and artery and intercostal nerve Right brachiocephalic ve Superior vena cava Ascending lumbar vein [Lumbar veins Right external iliac vei Trachea Posterior intercostal veins Hemiazygos vein Inferior vena cava Median sacral veinMediastinal organs (right lateral aspect). Right lung and pleura of right half of the thorax have been removed, 1 Posterior intercostal arteries 7 Esophageal plexus (branches 2. Ganglion of sympathetic trunk ht vagus nerve) 3. Sympathetic trank 8. Pulmonary veins 4 Vessels and nerves of the intercostal space 9 Posterior intercostal vein (fom above: Posterior intercostal vein a 10. Azygos vein artery and intercostal nerve) 11 Bsophagus 5) Right primary bronchus 12 Greater splanchnic nerve 6 Ramus communicans of sympathetic trunk 13 Right vagus nerve rm 1s 16 a 8 9 20 Right phrenic nerve Inferior cervical cardiac branches of vagus nerve ‘Aortic arch Sup Right pulmonary artery Heart with periea DiaphragmOrgans of posterior and superior mediastinum (left lateral aspect). Subelavian artery Subelavian vein Caviele (divided) Left vagus nerve First rib (div diacophrenic artery and vein Esophageal plexus (branches derived from left vagus nerve) wo u 2 1B 4 Is 16 7 Apex of 1 with pericardium Scapula (divided) Posterior intercostal arteries Ramus communicans of sympathetic t Sympathetic trunk Aortic arch Left vagus nerve and left recurrent ta Lek puledcaryanery geal nerve bronchus 4 Pulmonary vein Esophagus (thoracic pat) Diaphragm Posterior intercostal artery and vein and intercostal nerveSuperior vena cava Right atrium Right ventricle Costal part of diaphragm Costal margin Position of costodiaphragmatic recess ligament Medial arcuate ligament Right crus of lumbar part of diaphragm ‘Quadatus lumborum muscle Ascending aorta Pulmonary trunk sl hiatus and abdominal part of esophagus (cu) Lumbar part of diaphrage Aortic hiatus Psoas major muscle Lumbar vertebra and abdominal eavities have aphragm is Diaphragm in situ (anterior aspect). Anterior walls of thor: been removed. Natural position of the heart above the central tendon on the shown, Changes in the position of the diaphragm and thor during respiration. Left: lateral aspect; right: anterior aspect. During inspiration the diaphragm moves downwards, and the lower part of the thoracic cage expands forward and laterally, causing the costodiaphragmatic recess (R) to enlarge (CL. dotted arrows),Azygos venous arch Right pulmonary artery Superior vena cava Right pulmonary vein Fossa ovalis Hepatic veins Inferior vena cava Right crus of lumbar part of digphrage © Medial arcuate ligament 10 Psoas major muscle 11 Left brachiocephalic vein 12 Terminal erista 13 Right atriam 14 Right auricle 15. Central tendon of diaphragm 16 Esophagus 17 Celiac trunk and superior mesenteric artery 18 Aorta 19 Costal part of diaphragm 20, Costal margin 21 Transversus abdominis muscle Diaphragm, Paramedian section to the right of the median plane through thoracic and upper abdominal cavity. The plane passes through the superior and inferior vena cava just to the right of the vertebral bodies. Most of the heart remains in situ to the left of this plane (specimen is viewed from the right side), 1 Sternocostal triangle 2 Central tendon (from above) 3. Esophagus 4 Aorta 5) Lumbar part of diaphrs 6 Sternum 7. Sternal patt of diaphragm 12 § Costalpartof diaphragm 9. Entrance of hepatie veins 10 Inferior vena cava LL Body of 9th thoracie vertebra 12. Spinal cordClaviete Left brachiocephalic vein Superior lobe of right lung ‘Aortic arch Superior vena cava Right atrium (entranc of inferior vena cava) Liver Second rib Superior lobe of left lung Pulmonary trunk Ascending aorta and left coronary Aortic valve Pericardium “Myocardium of left ventric Lower lobe of left lung, Diaphragm Colie lexures Coronal section through the thorax at the level of ascending aorta. (MR-Scan.) Brachiocephalic trunkCoronal section through the thorax at the level of superior vena cava. (MR-Scan.) and tight atrium Left common carotid artery Left subclavian vein Upper lobe of lft ung Aortic arch Left pulmonary artery Left auricle 3 Left atrium with orifices pulmonary veins Left ventricle (myocardium) Pericardium Diaphragm Left colie flexure Stomach Litcipidichetan aleeHorizontal section through the thorax at level I (from below). Horizontal section through the thorax at level 1 (from below). (MR-Sean.) 1 Internal thoracie artery and vein 12 Pectoralis major and minor muscles 2 Right atrium 13. Conus arteriosus (right ventricle) 3 Lung pulmonic valve 4 Pulmonary artery 14 Ascending aorta and left coronary artery S- Pulmonary vein (only in upper figure) 6 Primary bronchus 15 Leftatrium 7. Esophagus 16 Desce 8. Serratus anterior muscle 17 Thoracic vertebra 9 Scapuila 18 Spinal cord 10 Longissimus thoracis muscle 19. Latissimus dorsi muscle 1 Sternum 20 Trapezius muscleHorizontal section through the thorax at level 2 (from below) rax at level 2 (from below) Levels of sections. Right ventricle 31 cle Right coronary at 2 Pericardium Right atsioventricular valve 33. Left atrioventricular valve Lung (upper lobe) M4 Left coronary artery and coronary sinus Left atrium, 35. Accessory hemiazygos vein Pulmonary vein ratus anterior muscle Lung (lower lobe) 7 Pulmonary trunk Erector muscle of spine Third costal cartilage NipHeart and right lung of the fetus (viewed from left side). The left lung has been removed. Note the ductus arteriosus (Botall Shunts in the fetal circulation system ‘between umbilical vein and inferior vena cava 1, Ductus venosus (of Arantius) bypass of liver circulation 2, Foramen ovale | between right and left atrium 3. Ductus arteriosus] (Botalli) between pulmonary trunk and aorta bypass of pulmonary 9 Heart of the fetus (anterior aspect), Right atrium and ventricle opened. Right common carotid artery brachiocephalic vein Left brachiocephalic vein Superior vena cava ‘Ascending aorta Right Pulmonary trunk Left primary bronchus Left auricle Right ventricle Left ventricle rile Left common carotid artery Trachea ‘Superior lobe of right lung Left subclavian artery Aortic arch Ductus arteriosus (Botalli Interior lobe of right lung Left pulmonary artery with branches to the left lang Descending aorta Left pulmonary veins Inferior vena cava Foramen ovale Right atrium Opening of inferior vena cava ‘Valve of inferior vena cava (Eustachian valve) Opening of coronary sinus Anterior papillary muscle of right ventricle Heart of the fetus (schematic drawing), Direction of blood flow indicated by arrows, Note the change in oxygenation of blood after ductus arteriosus entry into1 Internal jugular vein and right common 7 Ductus venosus 8 Liver 9 Umbilical vein 10. Small intestine LL Umbilical artery 12 Urachus 23° Placenta ‘Thoracic and abdominal organs in the newborn (anterior aspect). ‘The right atrium has been opened to show the foramen ovale. The left lobe of the liver has been removed. Fetal cireulatory system. (Schematic draw indicated by color. The oxygen gradient isorgans. 1 Hara palate 2 Soft palate with wula 3 Vestibule of the mouth 4 Oral cavity proper 5 Tongue 6 Epi 7 Vocal ligament and larynx 8 Trache 9 Right hung 10 Superior part of duodenum 1 Pylorus 12 Pyloric antrum 13. Nasopharyns 14 Dens of axis 15 Oropharynx aryngopharynx -sophagus (thoracic part) 18. Left primary bronchus 0 2» 30 31 Left lung Abdominal part of esophagus and cardia Fundus of stomach Body of stomach Pancreas Transverse colon (divided) Descending colon Jejunum Sigmoid colon Rectum Liver Gall bladder Duodenum Ascending colon eum Vermitorm appendix of upper portion of digestive system. Oral cavity, pharynx, esophagus, and stomach.Abdominal organs in situ, The greater omentum has been partly removed or reflected. 2% Thyroid gland Upper lobe of right lung Middle lobe of right lung Heart Diaphragm Round ligament of liver (ligamentum teres) Transverse colon Cecum ‘Small intestine (leur) Thy Upper lobe of left lung Lower lobe of left lung Pericardium (cut edge) Liver (lft lobe) testine (jejunum) Sigmoid colon Rectus abxlominis muscle ‘Small intestine (section) Rib ‘Common bile duct, duodenum and panereas Inferior vena cava Liver Body of second lumbar vertebra Right kidney Cauda equina and dura mater Linea alba tomach and pylorus Superior mesemterie artery and vei Abdominal aorta Left renal artery and vein Left kidney soas major muscle Deep muscles of the back Pancreas adjacent to lesser sae (bursa ‘omentalis) 17 Faleiform ligament with ligamentum teres ‘Transverse section through the abdominal cavity at the level of the second lumbar vertebra (from below).0 n 2 Midsagittal section through the trunk (female). Sternum Right ventricle of heart Diaphragm Tra Umbiliews Mesentery Small intestine Uterus Urinary bladder I section through the tunk (female). drawing.) Blue = omental bursa; red = peritoneum. 13. Pubie symphysis 14 Leftatrium of heart 15 Caudate lobe of liver 16 Omental bursa of lesser sue 17 Conus medullaris, 18 Pancreas 19 Cauda equina 20) Intervertebral discs (lumbar vertebral column) 21. Sacral promontory gmoid colon 23. Anal eanal Anus 5 Lesser omentum Gi Vesicouterine pouch Urethra Epiploic (omental) foramen 0 Duodenum Rectum 2 Reetouterine pouch 3 Vaginal part of cervix of uterus Vaginaae es Vi : , Anterior abdominal wal with pvc cavity and high (Frontal setion, male) (internal aspes) Left ventricle with pericardium Diaphragm Remnant of liver Ligamentum teres (ree margin of faleiform ligament) Site of umbilicus 6 Medial umbilical fold (Containing the obliterated umbilical artery) 7 Lateral umbilical fold (containing inferior ‘epigastric artery and vein) 8 Median umbilical fold (Containing remnant of urachus) 9 Head of femur and pelvie bone 10 Urinary bladder LL Root of penis 12 Faleiformii 13 Rib(divided) 14 Tlia eres (divided) 15. Site of deep inguinal ring and lateral inguinal fossa 16 Tliopsoas muscle (divided) 17 Medial inguinal fossa 18 Supravesical fossa 19 Posterior layer of rectus sheath 20. Transversus abdominis muscle 21 Umbilicus and arcuate line 22 Inferior epigastric artery 23. Femoral nerve 24 Miopsoas muscle 25 Remnant of umbilical artery 26. Femoral artery and vein 27 Tendinous intersection of rectus abdominis muscle 28 Rectus abdominis muscle 29 Interfoveolar ligament 30 Pubic symphysis (divided) 31 External iliac artery and vein Anterior abdominal wall (male) (internal aspect). The peritoneum and parts of the posterior layer of rectus sheath have been removed. Dissection of inferior epigastric arteries and veins.Stomach (ventral aspect) Parasagittal section through upper part of left abdominal 3.5 em lateral to median plane. Cardiac notch Cardiac part of stomach er curvature of stomach Pylori sphincter Angular notch (incisura angulais) Pyloric canal Pyloric anteum Fundus of stomach Greater curvature of stomach of stomach Folds of mucous membrane (gastric uy ic canal 1 ventricle of heart Diaphragm (cut edge) Abdominal portion of esophagus Position of pyloric cana Body of stomach Transverse colon ‘Small intestine Lung (cut edge) Fundus of stomach (section) Lumbar portion of diaphragm (cuted Suprarenal gland Superior mesenteric artery and vein Intervertebral diseMuscular coat of stomach, outer layer (ventral aspect) Muscular coat of stomach, middle layer (Ventral aspect). 1 Esophagus (abstominal part) 2 Cardiac notch 3. Cardiae part of stomach Longitudinal muscle layer at lesser curvature of stomach Lesser curvature 6 Incisura angularis, Circular muscle layer of pyloric part of stomach Pyloriesphineter mus Fundusof stomach Circular muscle layer of fundus of stomach Longitudinal muscle ter curvature of stomach Greater curvature of stomach Longitudinal muscle layer (transition from body to pyloric part of stomach) Pylorie part of stomach Oblique muscle fibers Muscular coat of stomach, inner layer (ventral aspect).Pancreas with adjacent duodenum, spleen, liver and related arteries. The pancreatic ducts have been partly dissected, The duodenal papillae are indicated by probes. Left half of liver has been removed. Pancreas, duodenum and extrahepatic bile duets. (Schematic drawing.) 1 Liver Left and right hepatic duets ‘Common hepatic duct Cystic duet Gall bladder Pancreatic duct and head of pancreas Pylorus (cut) 8. Right gastro-oinental (gastroepiploic) artery Minor duodenal papilla (probe) Major duodenal papilla (probe) Superior mesenteric artery and vein Inferior vena cava and ilicolic artery Portal vein, ig teres of liver and lig venosum Aorta Common hepatic artery let branch of hepatie artery proper, and right gastric artery Gastroduodenal artery and right branch of hepatic artery proper Spleen Splenic artery and vein Tail of pancreas Lett gastro-omental artery Middle colic artery Jejunum Jejunal arteries Aorta and inferior mesenteric artery 5 Common bile duct Horizontal part of duodenum Esophagus Stomach Pancreatic duct Duodenojejunal flexure Lumbal vertebraeLeft hepatic duct atic duct stie duct of gallbladder Body of gallbladder Fundus of gallbladder ‘Common $ Common bile duct Pancreatic duct Greater duodenal papilla Second lumbar vertebra Folds of mucous membrane of gallbladder “Muscular coat of gallbladder Neck of gallbladder (ops Cystic duct with spiral fold Lesser duodenal papilla Radiograph of biliary ducts, gallbladder and pancreatic duct Accravory pancreatic dect (anterior-posterior view). Uneinate process Pica circulars of duodenum (Kerckrings's fold) Head of pancreas Body of panereas Tail of pancreas Descending part of duodenum Incisure of pancreas Isolated gallbladder and cystic duet (anterior aspect), The gallbladder has been opened to display the mucous membrane Pancreas with descending part of duodenum (posterior aspect). "The duodenum was opened to display the duodenal papillae. Pancreatic duct has been dissected, the common bile duct has been divided. The sphincter of Oddi is shown.oa Liver in situ (ventral aspect). Part of the diaphragm has been removed Liver in situ. Parasagittal section through the left side of the abdomen 2 em lateral to median plane. Ribs (cut edges) Diaphragm Diaph Falciform ligament of liver Right lobe of liver Fundus of gallbladder Gastrocolic ligament Greater omentum Aorta Esophagus Left lobe of liver Stomach Ligamentum teres “Transverse colon ight atrium of heart Central tend portion of diaphragm Liver (cut edge) Entrance to duodenum (pylorus) Stomach Duodenum Transverse colon (divided, dilated) ‘Small intestine atic surface of liver id sternal 3 Thoracic aora longitudinally divided) Esophagus (longitudinally divided) Esophageal hiatus of diaphragm Omental bursa (lesser sac) Splenic artery Pancreas Left renal vein Intervertebral dise Abdominal sorta Congitudinally divided)Liver (inferior aspect). Dissection of porta hepatis. Gallbladder partly collapsed. Ventral margin of liver above Segmentation of the liver (anterior aspect). Liver segments indicated by roman numerals, 13, 23. 10 " 14 16 15 Liver (ventral aspect) (transparent drawing illustrating margins of peritoneal folds). 1 Fundus of gallbladder 2 Peritoneum (cut edges) 3. Cysticartery 4 Cystie duet 5. Right lobe of liver 6 Inferior vena cava 7. Bare area of liver 8 Notch for ligamentum teres and faleiform ligament © Ligamentum teres 10 Faleiform ligament of iver 11 Quadrate lobe of liver Common hepatie duct Left lobe of iver Hepatic artery proper Common bile duct Portal triad Portal vein Caudate lobe of liver Ligamentam venosum Ligament of ing Appendix fibrosa (lft triangular ligament) 21 Coronary ligament of liver 22. Hepatic veins 23. Porta hepatis It should be noted that the anatom- ical left and right lobes of the liver do not reflect the internal distribu- tion of the hepatic artery, portal vein, and biliary ducts. Using these structures as criteria the left lobe includes both the caudate and qua- drate lobes and thus the line divid- ing the liver into left and right functional lobes passes through the gallbladder and inferior vena cava. ‘The three main hepatic veins drain segments of the liver which have no visible external markings.Location of the spleen in situ (left-ateral aspect), Intercostal spaces and diaphragm have been fenestrated. Spleen (visceral surface), hilum of spleen with vessels, nerves and ligaments, 1 Serratus anterior muscle 2 Left lung 3. Diaphragm 4 Spleen 5 External abdominal oblique muscle 6 Gastrosplenic ligament 7. Splenic artery 8 Pancreas till 9 Superior margin of spleen 10. Anterior border of spleen 11 Inferior vena cava 12 Hepatic veins 13 Liver 14 Portal vein 15 Paraumbilical veins within faleiform ligament 16 Superior mesenteric vein 17. Midale colic vein 18 Right colic vein 19 Ascending colon 20 eocolie vein 21 Vermiform appendix and appendicular vein oepiploic vein 28 Descending colon 29 Heum 30 Sigmoid veins 31 Superior recta veins Main tributaries of portal vein. (Schematic drawing of portal circulation.) X = sites of portocaval anastomoses,‘Tributaries of portal vein and branches of superior mes veins; red = arteries, One layer of peritoncum has been removed to display the vascular arcades of the intestine. Part of the head of the pancreas and the mesocolon have also been removed to show the deeper vessels Greater omentum (reflected) iocolic arte Jejunum erse colon (raised eranially) Appendicular artery Jejunal arteries trunk Cecum i Transve snterie vein ci Heal arteries Superior mesen Teal Right colic vein Renal artery and v Teum with mesentery Tiocolie vein Duodenojejunal flexure Middle colic arter1 Ligamentum teres, 2 Lier 3 Caudat lobe ofiver 4 Proper heptie artery and portal vein 5 Gallbladder and common bite duct 6 Right ea artery and ors 1 Pancreas 8 Ascending colon 9 Gastoduodene artery 10 Sopeior mesenteric atey 1 Duodewum 12 Meo artery 13. Termin! pr ofieum 14 Mesemere mph noes 15. Rign common iin artery Te cecum 17 Let abe otter 18 Spleen 19. Let gasto-omental (eastoeppiol)anery 20 Stomach 21 Let pase anery 22 Lette nur (ca) 23 Splenic artery 24 Right gasteromentl (easvoripok) artery 2s. ena artery 26 eat ateics 2 Lettiiney 2 Lettcoeanery 29. Midaecote artery 30. Superior mesentrevla Superior mesenteric artery in relation to pancreas and duodenum. Stomach and transverse 31 Jejunum colon as been removed and th lve elevated. Note the location ofthe spleen. A yellow 32 una arteries robe is inserted through the omental foramen, aa Inlerior vens cata ® Ente 34. Sigmoid colon 35. Right colic artery 36 Appendicular artery 37. Inferior mesenteric artery 38. Sigmoid arteries 39. Superior rectal artery 40 Fundus of gallbladder 41 Common bile duet 42 Portal vein 43 Beginning of jejunum 44 Duodenojejunal flexure 45 Ureter 46 Splenic artery 47. Celiac trunk 48. Renal vein 49 Abdominal aorta 50 Descending colon 51 Left common iliac artery 52. Transverse mesocalon Main branches of superior and inferior mesenteric arteries. (Schematic drawing.)‘Vessels of abdominal organs; dissection of Blue = veins; red = arteries. The small int ferior mesenteric artery and celiac trunk (injected with colored solutions). tine including the duodenojejunal flexure has been reflected laterally and t stomach and liver have been raised. The peritoneum of the posterior abdominal wall has been removed to display the inferior mesenteric artery and its branches to the colon. ‘The superior mesenteric artery arises at the level of Ly vertebra branching of the abdominal aorta. It supplies jejunum and ileum as the ascending and transverse colon. At the left colic flexure branches of the middle colic artery (from the superior mesenteric artery) and of the left colic artery (from the inferior mesenteric artery) anastomose (so-called Riol anastomosis). The arteries unite to form loops or arches called arterial arcades from which straight vessels (vasa rect vasa recta do not anastomose within the mesentery. Thus occlusion of these vessels may lead to necrosis of the segment of bowel concerned and ileus, Within the wall of the intestine there are many anastomoses of blood ves so that blockage of a single vessel is usually not dange- ous, The arteries are paralleled by veins which ci blood to the portal vein, Closely related to the venous drainage are the lymph vessels which pass th lymph nodes and finally enter the cisterna chyli. nvey mesenteric1 Middle lobe of right lung. 2. Xiphoid process 3. Costal margin 4 Faleiform ligament of liver 5 Quadrate lobe of liver 6 Greater omentum Upper lobe of left lung. 8 Heart 9 Diaphragm Lett lobe of liver Ligamentum teres Stomach Gastrocolie ligament Transverse colon Taenia coli Appendices epiploicae 7 Cecum ‘Taenia coli ‘Transverse mesocolon Position of root of mesentery Vermiform appendix Duodenojejunal flexure Mesentery Abdominal organs. The anterior thoracic and abdominal walls, have been removed Abdominal organs. The greater omentum which is fixed to the Abdominal organs (anterior aspect). The transverse colon has been reflected transverse colon has been raised,1 Diaphragm 2 Costal margin 3. Transverse colon 4 Ascending colon with haustea 5. Free taenia of cecum 6 Meum 7 Cecum 8 Fakiform ligament of iver 9. Liver 10 Stomach 11 Gastrocolic ligament 12 Jejunum 13. Sigmoid colon 114 Vermiform appendix 15 Terminal ileum 16 Mesoappendix 17 Mesentery Ascending colon, cecum and ver (detail of the preceding figure). iform appendix Variations in the position of the vermiform appendix. a= retrocecal; b = paracolic; ¢ = retroileal; d = pre ubcecal.Abdominal organs. Dissection 0 ‘mesocolon has been raised and the small intestine reflected. idle colic artery Tejunal art 5. Inferior mesenteric arterf ves and ganglia iliac artery Small intestine (ileum) Tran ted) Transverse mesoe stomasis between middle ferior mesenteric artery and autonomic plexus. The transverse colon with spleen Abdominal aorta Left colic artery Duodenojejunal flexure taenia of colon) Superior hypogastric plexus Superior rectal artery Sigmo Sigmoid mesocolon Sigmoid colonAbdominal organs. Superi reflected, ed with a param; subs jadolinium); courtesy of Dr. W. Rodl, Erlangen.) Liver Middle cole artery Horizontal part of ‘duodenum (extended) Superior mesenteric artery and vein Right colic artery Hiocolic artery Ascending colon Cecum Greater omentum (reflected) mesocolon Duodes flexure Iejunum Heal arteries Mesenteric Lymph nodes and lymph vessels eum Abdominal aorta Inferior vena cava Stomach Spleen Splenic artery Head of pancreas Superior mesenteric the intestinal stanceLung Diaphragm Faleiform ligament of iver Jejunum al fold Mesoappendi Vermitorm appendi Heocecaljunctio Cecum Pericardial sac Xiphoid pra Costa ma Liver Stomach Transverss Duodenojejunal Nexure Inferior duodenal fold Mesentery Position of lft kidne Descending colon Position of left common iliac a Rectum Beginning of jejunum Peritoneum of posterior Superior du Superior duodenal recess luodenal recess Free tnenia of ascending colon Orifice of vermitorm appendix (probe) Heocolie artery ‘Vermiform appendix with appendicular artery ending colon Abdominal cavity. Mesenteries. The small intestine has been reflected laterally to demonstrate the mesentery. Duodenojejunal flexure Heocecal valve (ventral aspect). The cecum and terminal part (enlargement of preceding figure). i thie iene hove been opened.Uppe' i . Thorax and anterior part of diaphragm have been removed and the liver raised to display the lesset omentum. A probe has been inserted into the epiploic foramen and lesser sac Faleiform ligament and ligamentum teres wing part of duodenum Caudate lobe of iver (behind lesser omc Lesser curvature of stomach Superior part of duodenum ch with gas Twelfth thoracie ver Right kidney 1 suprarenal g Inferior vena cava Faleiform ligament of liver Abdominal aorta Horizontal section thro Gastrosplenie ligament of epiploic foramen (black arrow). Viewed from above. R Pancreas arrows: routes of the arterial branches of celiac trunk to liver Lesser sac stomach, duodenum, and pancreas. (Schematic drawing.)Upper abdominal organs, lesser sac, omental bursa (anterior aspect). Lesser omentum partly removed, liver and stomach slightly reflected. 1 Falciform ligament and ligamentum teres 19. Greatercurvature with gastrocpiploic 2 Liver vessels 3 Hepatoduodenal i Head of pancreas and gastropancreatic fold 4 Gallbladder Spleen 5. Probe within the epiploie foramen ‘ail of pancreas Left cole flexure Root of transverse mesocolon “Transverse mesocolon Gastrocolic ligament (cut edge) Transverse colon Umbilicus ‘Small intestine Lesser omentum Lesser sac (omental bursa) 6 Superior part of duodenum 7 Pylorus 8 Descending part of duodenum 9) Right colic Rexure 10 Gastrocolic ligament LL Greater omentum 12 Caudate lobe of liver 13 Fundus of stomach 14 Probeatthelevelofthe vestibule oflesersac 15 Head of panereas Duodenum 16 Lesser curvature of stomach Mesentery 17 Body of stomach BM Sigmoid colon 18 Diaphragmnent has been divided Midsagittal section through abdominal cavity site of lesser sac (blue). epiploic foramen,Arteries of upper abdominal organs; dissection of celiac trunk. ‘The lesser omentum has been removed and the lesser curvatureBranches of celiac trunk; blood supply of liver, pancreas and spleen. The stomach, superior part of duodenum and celiac ‘ganglion have b -n removed to reveal the anterior aspect of the posterior wall of the lesser sac (omental bursa) and the vessels. and ducts of the hepatoduodenal ligament. The panereas has been slightly reflected anteriorly. Lung Liver (visceral surface) Lymph node Inferior vena cava Ligamentum teres (reflected) Right branch of hepatic artery proper Diaphragm ‘Common hepatic duct (dlisted) Cystic duct and artery Gallbladder Probe in epiploie foram Right lobe oftiver Portal vein Right gastric artery Duodenum Pylorus ight colic lexure Right gastro-omental (gastroepiploic) artery “Transverse colon ‘Abdominal part of esophagus (cardiac part of stomach) Fundus of stomach Esophageal branches of left gastric artery 2B 24 2 26 2 28 2» 30 31 32 3 4 36 v7 38 9 0 41 2 4B 44 “Lumbar part of diaphragm Left gastric artery Celine trunk Splenic artery Pancreas ‘Common hepatic artery Left gastro-omental (gastroepiploic) artery Gastroduodenal artery Pylorie part ofstomach Greater curvature of stomach Gastrocolic ligament Superior pancreaticoduodenal artery ‘Short gastrie arteries Aorta Spleen ‘Caudate lobe of liver Left branch of hepatic artery proper Descending part of duodenum (cut) Left inferior phrenic artery Suprarenal gland Kidney Transverse mesocolonPancreas and extrahepatic bile ducts in situ (anterior aspect). The gastrocolic ligament has been divided, the transverse colon and the stomach were replaced to display pancreas and superior mesenteric vessels. Stomach (pyloric part) and pylorus Right gastro-omental (gastroepiploic) artery Fundus of gall bladder Liver, right lobe Head of pancreas ‘Superior mesenteric artery and vein Duodenum u 2 B Middle colic artery ‘Transverse colon Greater curvature of stomach (remnants of gastrocolic ligament) Body of stomach Body of pancreas Left gastro-omental (gastroepiploic) artery Splenic artery Blood supply of upper abdominal organs (branches of the celiac trunk and superior mesenteric artery). (Schematic drawing.) Spleen Tail of pancreas Left colic flexure Jejunum Lung (inferior lobe of right ung) ‘Common hepatic duet and caudate lobe of iver Portal vein and hepatic artery proper Cystie duct and right gastrie artery Common bile duct and gastroduodenal Pylorus (cut) Major and minor duodenal papillas (probes) Duodenum (inferior part) Right kidney, ureter and ovarian artery lliocolie artery and inferior vena cava Right and left vagal trunk Esophagus Diaphragm Cut edge of esophagus left gastric artery with esophageal branch Celiac trunk ‘Common hepatic artery, main pancreatic duct and panereas Renal vein Duodenojejunal flexure Left kidney Jejunal arteries ‘Abdominal aorta and left ureter Cystic artery Hepatic proper artery Celiac trunk Right ga ‘Common hepatic artery Gastroduodenal artery ‘Superior mesenteric artery Superior posterior pancreaticoduodenal artery Superior anterior panereaticoduodenal artery 9 Short gastric arteries Left gastric artery Posterior pancreatic branch of splenic Inferior pancreaticoduodenal arteryPancreas, extrahepatic bile ducts, spleen and liver with their ves Jitu. The stomach has been removed, the liver elevated, and the descending part of duodenum opened to display the openings of p cts. The pancreatic ducts were dissected. Note the location of superior mesenteric artery and vein between duodenum and pancreas. Arrow: probe within the epiploic foramen, covered by the body of the pancreas), and the main arterial supply of liver, spleen, stomach, and duodenum,Liver Falciform ligament Hepatoduodenal ligament Pylorus (divided) Gallbladder Probe within the epiploic foramen Duodenojejunal flexure (divided) § Greater omentum Root of mesentery Ascending colon Free colic taenia End of ileum (divided) Vermiform appendix with mesoappendix ‘Cocum Ps Diaphragm si a8 and site of leser sac Jia (part of stomach, divided) Head of pancreas Body and tail of pan “Transverse mesocolon ‘Transverse colon (divided) Descending colon Cut edge of mesentery Sigmoid colon Rectum Attachment of bare area of liver Inferior vena Kidney Attachment of right coe flexure Root of transverse mesocolon Junction between descending and horizontal parts ‘of duodenum Bare surface for ascending colon HM Meocecal recess 35 Retrocecal recess 36 Root of mesoappendix 37 Superior recess | Abdominal cavity after removal of stomach, jejunum, ileum ‘and part of the transverse colon. Liver has been slightly raised. zs of lesser sae SO eee See omental bursa) superior duodenal recess 441 fnferior duodenal recess 42. Bare surface for descending colon 43 Paracoie recesses 44 Root of mesentery 45. Root of mesosigmoid 4G Intersigmoid recess 47 Hepatic veins 48. Duodenojejunal flexure 49. Attachment of let cole Mesure 50° Esophagus 51 Entrance to lesser sac through the epiploic foramen Peritoneal reflections from organs and the position of root of mesentry and peritoneal recesses on the posterior abdominal wall. (Schematic drawing.)Peritoneal recesses on the posterior abdominal wall,‘The liver, stomach, jejunum, ileum, and colon have been removed. The duodenum, pancreas, and spleen have been left in place.9 10 " 2 13 8 “4 Horizontal section through the abdominal cavity at level 1 (from below). Horizontal section through the body. MR-Scan. corresponding to level 1 Arrow: stomach. 1 Rectus abdominis muscle 20. Greater duodenal papilla 2. Faleiform ligament 21 Duodenum 3. Liver (right lobe) 22 Suprarenal gland and ureter 4 Inferior vena cava 23. Kidney 5 Diaphragm 24 Round ligament of liver 6 Intervertebral disc 25. Superior mesenteric artery and vein 7. Liver (left lobe) 26 Psoas major muscle 8 Rib 27, Descending coton 9. Liver (caudate lobe) 28 Quadratus lumborum muscle 10 Abdominal (descending) aorta 29 Cauda equina 11. Stomach 30 Right renal vein 12 Spleen 31 Small intestine 13. Spinal cord 32. Tliacus muscle 4 Longissimus and iliocostalis muscles 33_Mium 1S. Body of vertebra 34 Tleocecal valve Cocum ‘Common iliac artery and vein luteus medius muscle Vertebral canal and dura mater 16 Abdominal rectus muscle 17 External abdominal oblique muscle 18 Transverse colon 19. Head of pancreasgreater duodenal papilla (from bel Horizontal sect the body.sand spleen (anterior aspect). Dissection of pancreatic and common bile duct. num anteriorly opened. 1 Ligamentum teres 13. Horizontal part of duodenum (distended) Gallbladder and eystie artery 14 Superior mesenteric artery Common hepatic duct and portal vein 1S Liver (lft lobe) Cystic duct 16 Caudate lobe of liver and hepatic artery proper Right gastric artery (pylorus with superior part of duodenum, 17 Abdominal part of esophagus (cut) ccut and reflected) 18 Probe in epiploic foramen and lymph m Left gastric artery Spleen Probe within the minor duodenal p Splenic vein and branches of splenic artery Accessory pancreatic duct Pancreatic duet and head of pancreas Probe within the major duodenal papilla Left colie Mexure and tail of pancreas Descending part of duodenum (opened) Duodenojejunal flexure Middle colic artery and inferior pancreaticoduodenal artParasagittal section through the thoracic and abdominal cavities (right side, medial aspect) Parasagittal section through the abdominal cavity. (MR-Scan, courtesy of Prof. W. Rod, Erlangen), Position of kidneys and urinary system (anterior view). ‘The excursions of the kidneys with the respiratory ‘movements of the diaphragm are indicated, (Schematic drawing.) 1 Right lung (superior and middle Lobes) Transverse colon Jejunum Abdominal wall Fourth rib Right lung (inferior lobe) Diaphragm Liver Suprarenal gland 10 Kidney LL Renal pelvis 12. Small intestine 13 Perirenal fat pad M4 Eleventh rib IS Ureter (abdominal part) 16 Ureter (pelvic part) 17 Urinary bladder 18 Urethra 19 ColonPylorie antrum troduodenal artery Descending part of duodenum Vestibule of lesser sac Inferior vena cava and liver Body of frst umbat vertebra, Cauda equina Right kidney Latissimus dorsi muscle iocostalis muscle 11. Reetus abdominis muscle h 1 3 14 Splenic vei 15 Superior mesenteric artery 16 Pancreas 17. Aorta and left renal artery 18 Transverse colon 19 Renalartery and vein 20. Spleen Left kidney Psoas major muscle Muhtifidus muscle Margin of tung Margin of pleura Renal pelvis Left ureter Descending colon Rectum Right suprarenal gland rath ib Ascending colon ht ureter iform appendix 36 Urinary bladder 37 Liver 38 Anterior layer of renal fascia Horizontal section through the abdominal cavity at the level of the first lumbar vertebra (from below). 41. Posterior layer of renal fascia 42. Abdominal cavity Positions of urlaary organs (posterior view), Notice that the Retroperitoneal tissue, location of the right upper part of the kidney reaches the level of the margin of kidney. (Schematic drawing.) Yellow = pleura and img. adipose capsule of kidney.1. Scalenus anterior, medius and posterior muscles 2 Left subclavian artery 3. Left subclavian vein 4 alve al cone Pulmonic 5 Ane 6 Right ventricle of heart, Liver 8 Stomach 9 Transverse colon 11 Leftlung 12. Left main bronchus 13. Branches of pulmonary vein 4 Left ventricle of heart 15. Spleen 16 Splenic artery and vein and pancreas Left kidney soas major muscle Inferior vena c: Renal vein Body of 12th th Right kidney Superior mesenteric artery Superior mesenteri Panereas Abdominal aorta Left psoas major and quadratus lumborum muscles Anterior layer of renal fascia Posterior layer of renal fascia je vertebra and ver ral canal } of Gerota Perirenal fatty tissue Abdominal a 32 Descending and sigmoid colon Parasagittal section through the thoracic and abdominal cavities at the level of the left kidney (55 cm left of median plane), Horizontal section through the retroperitoneal region Retroperitoneal tissue, position of left kidney at level of 12th thoracic vertebra, (CT-Scan, from below.) __ (Schematic drawing.)Coronal section through right kidney and suprarenal gland (posterior view). The renal pelvis has been opened and the fatty tissue removed to display the renal vessels. Right kidney (posterior view). Partial coronal section to expose internal aspect of the kidney. tenal vein Renal artery Renal pelvis Abdominal part of ureter S- Major renal ealyx CCribriform area of renal papilla Cortex of suprarenal gland Medulla of suprarenal gland Cortex of kidney ‘Medulla of kidney Renal papilla Minor renal calyx Renal sinus Renal columns rous capsule of kidney ich kidney can be divided in five s supplied by individual interlobar arteries considered as end arteries. Thus, 0 tion leads to infarcts marking the segment borders. The anterior kidney face reveals four segments, the posterior only three (No. 1,4 and 5). Cast of renal pelvis and calices. 1-4 = Renal segments on anterior surface.6 8 20 Left kidney and suprarensl gland in situ. The anterior cortical layer 3 of the kidney has been removed to display the renal pelvis and Ey papillae. mM ok! Hepatic vein Anterior and posterior vagal trunk Inferior vena cava Lumbar part of diaphragm Right greater and lesser splanchnic nerves Celiac trunk Celiac ganglion and plexus Superior mesenteric artery Left renal vein Right sympathetic trunk and ganglion ‘Abdominal aorta Left sympathetic trunk Esophagus (cut), left greater splanchnic nerve Left suprarenal gland Left renal artery Renal pelvis Renal papilla with minor calyx Left testicular vein Left ureter Psoas major muscle ‘Quadratus lumborum muscle Glomerulus Afferent arteriole of glomerulus Glomeruli Radiating cortical artery Subcortical or arcuate artey ‘Subcortical or arcuate vein Interlobular vein Interlobular artery Interlobar artery and vein Vessels of renal capsule Efferent arteriole of glomerulus ‘Vasa recta of renal medulla Spiral arteries of renal pelvis Glomeruli (210%). Scanning electron micrograph showing glomeruli Architecture of vascular system of kidney. and associated arteries. (Schematic drawing.)Left kidney. (Arteriogram.) Abdominal aorta. (Subtr.1 Right common carotid artery 2. Right subclavian artery 3 Brachiocephalic trunk 4 Thoracic aorta 5 Diaphragm 6 Coline trunk 7 Right renal artery 8. Superior mesenteric artery 9 Lumbar arteries 7 10 Right common iliac artery 11 Internal iliac artery 12 External iliac artery 13. Left common carotid artery / 14 Left subclavian artery 15 Highest intercostal artery 16 Aortic arch 17. Posterior intercostal arteries 18 Left renal artery 19 Left testicular (or ovarian) artery 20 Inferior mesenteric artery 21 Median sa 22. Superior 23. Upper capsular artery 24 Anterior branch of renal artery 49: 25. Perforating artery 20 13 4 18 16 18 26 Lower capsular artery 27. Ureter 28 Right inferior phrenic artery 29 Let inferior phrenic artery 24 30. Midale suprarenal artery 31 Inferior suprarenal artery 32. Posterior branch of renal artery 10: 1” 12 Main branches of descending aorta, (Schematic drawing.) Ultrasound image of the right kidney (upper and lower border of the kidney marked by crosses. Arteries of kidney and suprarenal gland. (Schematic drawing.) = small cortical cyst).Retroperitoneal organs, urinary syster removed, 1 Costat 2 Right 3. Right kidney Inferior venacava iohyp quadratus lumborum 6. Ureter (abdominal part) astre nerve and Psoas major muscle and genitofemoral nerve 8 Hiacus muscle the male (anterior " 2 B 4 15 \ r The peritoneum has been Ur Ductus deferens Rectum (cut) Medial umbilical ligament vdder Testis and epididymis Celiac trunk Superior mesenteric artery Lett i Abdominal Penis Inferior mesentericRetroperitoneal removed. Red = arteries; blue = veins. Diaphragm 12. Quadratus lumborum muscle 3M Testicular artery and vein Tae 32 Transversus abdominis muscle Hepatic veins B Inferior vena cava 14 Tliacus muscle ‘Common hepatic art Right lateral femoral Splenic artery Right sup sland taneous nerve Lett suprarenal gland Lateral femoral cutaneous Celiac trunk External iliac artery Left renal artery nerve Left kidney Genitofemoral nerve Spleen 33. Left common iiae artery Left common iliac vein Right renal vein Femoral nerve Right kidne Right inferior epigastric artery Superior mesenteric artery a Abdominal aorta Central tendon of diaphragm 28 Psoas major muscle Subcostal nerve Inferior phrenic artery Inferior mesenteric artery Urinary bh iobypogastric nerve Cardiae part of stomach and UreterInternal jugular vein Right common carotid artery and right vagus Iu id lymph Right lymphatic duct Subclavian trunk ght subclavian vein Bronchomediastinal trunk Right kidney Right lumbar trunk Right ureter Common iliac lymph 1 Right internal lac artery External iliac lymph nodes Right external iliac artery ft common carotid 2 and left vagus ner Tacernal jugular vein Deep cervical Iymph ns Thoracic duet enteri left jugular angle Left subelavian vein Left brachiocephalic vein Thoracic duct Mediastnal Iymph nodes Thoracic aorta Left suprarenal gland Left renal arter Left kidney Cisterna chyli Lumbar lymph nodes Abdominal aorta Left ureter Sacral lymph node Rectum (cut edge)Vessels and nerves of posterior abdominal wall (anterior aspect). Part of the left psoas major ‘muscle has been removed to display the lumbar plexus. Red = arteries, blue = veins. Diaphragm Hepatic Inferior vena cava Inferior phrenic artery ight renal hypogastric nerve ‘Quadratus lumborum muscle Subcostal nerve Inferior mesenteric artery Right genitofemoral nerve and psoas major muscle Right ureter (divided) Lateral femoral cutaneous nerve Internal iia artery Femoral nerve External iliac artery Inferior epigastric Cardiac part of stomach and ‘oesophageal branches of left gastric artery Splenicartery Celiac trunk Superior mesenteric artery Left renal artery ioinguinal nerve Sympathetic trunk ‘Transversus abclominis musele Hac crest Left ge Left obturator nerve Medien sacral artery femoral nerve 31 Psoas major muscle (divided) with supplying artery 32. Rectum (cut) 33. Urinary bladderabdominal organs remoGanglia and plexus of the autonomic nervous system ithin the retroperitoneal space (anterior view). The kidneys and the inferior vena cava with its tributaries have been removed (compare pp. 264 and 265), Right vagus nerve Right subelavian artery Esophag Aortic arch Sympathetic trunk G ater splanchnic nerve Intercostal nerve Abdominal part of esophagus and vagal trunk Celiac trunk with celiac anelion Superior and ganglion Psoas major muscle and ric artery enitofemoral nerve ‘Common iiae artery Superior hypogastric ple and ganglion Left vagus: 59 Brachial plexus Left subclavian artery Left recurrent laryngeal Thoracic art 1 plexus Esoph Aygos vei Diaphragm Splenic artery Left renal artery and plesus Inferior mesenteric ganglio and artery Left externa iliac artery ‘Superior cervical ganglion of sympathetic trunk Superior eardineb sympathetic tunk Middle cervical ganglion of sympathetie tank Inferior cervical ganglion of sympathetic trunk Right recurrent laryngea hot Lesser splanchnie nerve Lumbar sptanetnie nerves Sacral splanchnic nerves Inferior hypogastric ganglion and plexus Left recurrent laryngeal Aorticorenal plexus and Ganglion inpar age i rio Hepat win ght crus of diaphragm Inferior phrenic artery Right vagus nerve entering Right lumbar [ymph trunk Lumbar part of right sympathetic trunk Lumbar artery and vein Psoas major muscle Mie crest Inferior vena cava Tiacus muscle Ureter Left vagus nerve forming the esophageal plexus Left v us nerve forming the sastric plexus Esophagus continui the eardiae pat of stomach L Position of 12h rib Left lumbar lymph trunk Ganglion of sympathetic trunk ‘Quadeatus lumborum muscle Lumbar part of left sympatheti trunk ine tymph vesselsMale genital organs in situ (right lateral aspect). 1 Ureter 2 Seminal vesicle 3 Prostate gland 4 Urogenital diaphragm 5 Bulbo 6 Bu embranous part of urethra thal or Cowper's gland Left and right ous penis | OG Sid is |e" RK horas in tse [iat sonal 12 Duras deferens 12 Caapa everson aa 14 Corpus spongiosum of penis 15 Glans penis, 16 Ampulla of rectum Levator ani muscle Anal can 9 Spermatic cord (cut) Sacral promontory external anal sphincter muscle Sigmoid colon Peritoneum (cut edge) Rectovesical pouch 4 Bjaculatory duct Lateral umbilical fold Medial umbilical fold Deep inguinal ring ane ductus deferens Pubie symphysis Prostatic part of urethra Positions of male genital organs (right lateral aspect) (Schematic drawin Spongy urethraMale urogenital system. (Schematic drawing.) 1 Sigmoid colon 2. Ampulla of rectum 3 Ampulla of duetus deferens 4 External anal sphincter muscle 5 Internal anal sphincter muscle 6 Anal canal 7. Bulb of penis 8 Testis (cut surface) 9 Median umbilical ligament 10. Urinary bladder 1 Internal urethral orifice and sphincter muscle (sphincter vesieae) 12. Pubic symphysis 13. Prostatic part of urethra 14 Prostate gland 15. Membranous urethra and external urethral sphincter muscle 16 Corpus cavernosum of penis 17 Spongy urethra 18 Corpus spongiosum of penis 19 Foreskin or prepuce 20 Glans penis 21 Kidney 22. Renal pelvis 23. Abdominal part of ureter 24 Pelvic part of ureter 25. Seminal vesicle 26 Ejaculatory duct 27, Bulbourethralor Cowper's gland 28 Duetus deferens » Fa 31 Trigone of bladder and ureter orifice 32. Navicular fossa of urethra 33 External urethral orifice 3b Testis ‘The prostate is located between bladder and urogenital diaphragm. The penis includes the urethra and thus serves, for both ejaculation and micturition. The internal (involuntary) and external (voluntary) urethral sphincters are widely separated. The ureter having crossed the ductus deferens enters the urinary bladder at its base. The peritoneum is reflected off the posterior surface of the bladder onto the rectum thus forming the rectovesical pouch,1 Ureter 2 Ductus deferens 3. Interurcterie fold 4 Ureterie orifice 5. Seminal vesicle 6 Trigone of bladder Prostatie urethra with seminal colliculus and urethral eres 8 Deep transverse perineal muscle 9 Membeanous urethra 10 Spongy urethra LL Mucous membrane of urinary bladder 12. Internal urethral orifice and uvula of bladder 13. Prost 14 Prostatie trite 15. Right and lett corpus eavernosum of penis 16 Ejaculatory duct 17. Sphincter urethrae muscle 18 Median umbilical fold with remnant of urachus 19 Medial umbilical fold with remnant of umbilical 20 Urinary bladder Rectovesical pouch Rectum 23. Sacrum Deep iliac circumflex artery 5 Deep inguinal ring and ductus deferens External iliac artery and vein Femoral nerve Obturator nerve IMjum and sacrum Inferior epigastric artery iopsoas muscle Male urogenital organs; isolated (anterior view). Urinary bladder, prostate and urethra have been opened. The urinary bladder is contracted Posterior half of male urethra and prostate in continuity with neck of bladder (anterior view).Urinary bladder, urethra and penis (anterior view, open longitudinally). on of peni (anterior view), 1 Apex of urinary bladder with urachus Urinary badd Ureter tus deferens Ampulla of ductus defer Seminal Prost Bulbourethral or Cowper's gland Corpus cavernosum of penis Testis and epididymis with coverings Fundus of bladder Head of ep Testis Mucous membrane of bladder Trigone of bl Ureteric orf Internal urethral orifice Seminal colliculus Prostate Prostatic urethra Memibeanous urethra Spongy (penile) urethra Skin of penis Deep dorsal vein of penis (unpai Dorsal artery of penis (pair 4 albuginea of corpors Septum of penis Deep artery of penis Tunica albuginea of corpus Deep fascia of penis16 19 Male external genital organs (lateral view). The corpus spongiosum of the penis with the glans penis has been isolated and reflected. Resin cast of erected penis. glands. (Schematic drawing.) Corpus spongi Corona of glans penis Gtans penis Suspensory ligament of penis Inferior pubie ramus Crus penis, Bulb of penis Deep dorsal vein of penis Septum pectiniforme Dorsal artery of penis Bulbourethal or Cowper's gland Urinary bladder Seminal vesicle Ampulla of ductus deferens Ductus deferens Membranous urethra Prostate Ureter Male external genital organs and accessory‘Testis and epididymis with investing layers (lateral view), 1 Spermatic cord covered with cremasterie fascia ‘Cremaster muscle 3. Position of epididymis 4 Internal spermatic fascia 5. Position of testis 6 Internal spermatic fascia with adjacent Testis and epididymis (lateral view). The tun aginalis has been opened. Head of epididymis 8 Tes ith tunien vaginalis (iseeral layer) 9 Body of epididymis 10 Pampiniform venous plexus (amerior veins) LI Testicular artery Iymis. The left figure shows the testicular septa after removal of the seminiferous tubules. ‘Testis, epididymis and sperm: cord. Dissection of spermatic cord and ductus deferens (left side, posterolateral aspect), Tunica vaginalis (parietal layer, cut edge) 13. Skin and dartos muscle (reflected) 4 Ductus deferens 15 Artery of ductus deferens 16 Posterior veins of pampiniform plexus 17. Tal of epididymis 18 Transition of epididymal duct to ductus deferens and venous plexus 19. Parietal layer of tunica vaginalis 20. Appendix of epididymis 21 Appendix of testis 22. Gubernaculum testis 1 Spermatie cord (cut surface) Head of epididymis (cut surface) 3 Septaoftestis 4 Mediastinum testis 5 Tunica albuginea 6 Superior pole of testis Convolated seminiterous tubules 8 Inferior pole of testisAccessory glands of cavity. Posterior as genital or ct of urinary bladder, prostate and ion through th eminal vesicle Ureter Ductus deferens Seminal vesicle Ampulla of ductus defer jaculatory duct (proximal portion) Prost Membranous urethra Bulbourethral oF Cowper's land Bulb of pe Penis Gians penis Urinary bladder Levator ani muscle ‘Obturator internus muscle Head of epididymis Beginning of ductus deferens Test Tail of epididymis 40 Spermatic cord Peetineus and muscles Pubic bor Prostatic part of urethr: (Geminal colliculus) Rectum Great saphenous vein Sartorius muscle Femoral artery and vein Rectus femoris musc Tensor fasciae latae muscle Pectineus muscle Tiiopsoas muscle ustus lateralis muscle ‘Obturator externus muscle Feinur chial tuberosity Giuteus maximus muscle5 Prostate Seminal colliculus ‘Obturator internus muscle 8 Ischiorectal f Membranous Coron evel of prostate and hip joint (anterior aspect), 10 Deep transverse perineus muscle 11 Crus penis and ischiocavernost 12 Prostatic part of ureth 13. Prostatic plexus 14 Levator ani muscle 15. Obturator externus muscle 16 Bulb of penis 17 Ampulla of rectum 18 Anal ea 19. Seminal vesicle Internal anal sphincter muscle Extemal anal sphincter muscle Anus 048 major muscle Intervertebral ad of the femurPelvic cavity in the male (right half of parasagittal section). The arteries have been injected with red resin. The parietal layer of peritoneum has been removed. The urinary bladder is filled to a great extent. 1 Left common ilae artery 2 Right common iliac artery 3 Right ureter 4 Right internal iiae artery 5 Right externa iliac artery and vein Right obturator artery and nerve Umbilical artery 8 Sigmoid and superior vesical artery 9. Left duetus deferens 10 Urinary bladder 11. Pubic bone (cut) 12 Prostate 13. Vesicoprostatie venous plexus 14 Deep dorsal vein of penis and dorsal artery of penis 15. Penis and superficial dorsal vein 16 Spermatic cord and testicular artery 17 Bell of penis and deep artery of penis 18 9 » 0 31 ‘Cauda equina and dura mater (divided) Intervertebral dise between fith lumbar vertebra and sacrum Sacral Left ureter Left internal pudendal artery Ischial spine (cut), sacrospinal ligament, inferior gluteal artery Let i Seminal vesicle Levator ani muscle Branches of inferior ectal artery serior vesical artery Perineal artery Anus Posterior scrotal branches Pudendal nerve and sucrotuberal ligament‘Vessels of pelvic cavity in the male (midsagittal section, right side, medial aspect). Urinary bladder and rectum have been partly removed; the hypogastric plexus is displayed. (Schematic drawing.) Intervertebral dise between Sth lumbar vert Right common iliac a Sacral promontory Right internal iliac artery Femoral nerve Right external iliac artery Psoas major muscle Right external iliae vein Umbilical artery ‘Medial umbilical ligament with obliterated umbilical artery Obturator nerve Superior hypogastric plexus Sacral spinal nerve (of sacral plexus) Inferior hypogastric plexus Rectum Hiolumbar artery Lateral sacral artery Superior gluteal artery and sacral spinal nerve Pudendal and coceygeal plexus Inferior gluteal artery Internal pudendal artery Coceygeus muscle overlying sacrospinows ligament 23. Anal canal 24 Middle rectal artery 25. Superior vesica artery and 9 30 branch to the ductus deferens Pubie bone (cut) Bulbospongiosus muscle Right a Right ductus deferens Lett ureter Urinary bladder Prostate Urogenital diaphragm Deep artery of penis Dorsal artery of penis Penis Testis Left common iliac artery Obturator artery Inferior vesical arteryBe Male external genital organs with penis, testis, and spermatic cord, superficial layers (anterior view). ‘Vessels of male genital organs. (Schematic drawing.) A = lateral aspect: B cross-section of penis. Femoral nerve Femoral artery and vein neh of genitofemoral nerve ord with genital branch ‘of genitofemoral nerve 9) Superficial inguinal ring 10 Internal spermatic fascia (eut edge) 11 ioinguinal nerve 13 Pampiniform venous plexus 14 External spermatic fasciaMale external genital organs with penis, testis and spermatic cord, cia of the penis has been opened to display the dorsal nerve Male genital organs (lateral aspect). (Arteriogram.) a 18 9 20 a 2 B 24 8 26 28 29 30 31 3 38 36 37 40 41 per layers (ventral aspect). Testicular vein ‘Testicular artery Deep dorsal vein of penis Dorsal artery of penis Helicine arteries Prepuce ‘Testis with tunica albuginea uctus deferens Ureter Urinary bladder Sesminal vesicle Prostate Vesicoprostatic venous plexus artery of penis y of bulb of penis Internal pudendal artery Corpus spongiosum of penis Corpus cavernosum of penis Urethra CCremasteric fascia with cremaster muscle Tunica vaginalis (visceral layer) “Tunica vaginalis (parietal layer) Testis with vascular loops.1 Glans penis: 2. Corpus spongiosum of penis 3 Corpus eavernosum of penis 4 Gracilis muscle 5. Adductor muscles 6 Ischiocavernosus muscle overlying crus of penis body ‘Gluteus maximus muscle 9 Coccyx 10 Bulbospongiosus muscle 11 Deep transverse perineus ‘muscle covered by inferior fascia of urogenital diaphragm 12 Superficial transverse perineus muscle 13. Anus. 14 External anal sphincter muscle 15 Levator ani muscle 16 Anococeygeal ligament 17. Obturator internus muscle 18. Urethra 19 Deep transverse perineus muscle Muscles of urogenital and pelvic diaphragms in the male (from below). Muscles of urogenital and pelvic diaphragms in the male (from below). The penis has been divided. (Schematic drawing.)Right testis (reflected laterally and upward) Bulbospongiosus muscle -avernosus muscle Posterior scrotal nerves and superficial perineal arteries Posterior scrotal artery and vein Right artery of bulb of penis Perineal body Perineal branches of pudendal Pudendal nerve and internal pudendal artery Inferior rectal arteries and Inferior cluneal nerve ‘Coccyx (location) Penis Left tests (reflected laterally) Left posterior srotal artery Deep transverse perineal muscle Left artery of bulb of penis Posterior femoral cutaneous External anal sphincter muscle ‘Anus luteus maximus muscle Anococeygeal nerves Acetabulum (femur removed) Ligament of femoral head Body of schium (cut) Coceygeus muscle Levator ani muscle 8 iligcoceygeus muscle 'b pubococeygeus muscle © puborectalis muscle Prostatic venous plexus Body of pubis Testis Urogenital diaphragm and external genital organs in the male with vessels and nerves, (from below). The testes have been reflected laterally Pelvic diaphragm and external genital organs in the male. The right half of the pelvis including obturator internus muscle and femur had been removed to display the right half of levator ani muscle.1 Right testis (reflected) 2. Posterior scrotal nerves 3. Left erus penis with ischioeavernosus muscle 4 Anus 5. Inferior cluncal nerves 6 Penis 7 Lett testis (reflected) 8 Dorsal artery and nerve of penis 9 Urethra 10 Deep transverse perineus ‘muscle LI Perineal branch of pudendal 12 Artery of bulb of penis (reflected) 15. Branch of posterior femoral 14 Internal pudendal artery and pudendal nerve 15. Inferior rectal arteries and 16 Gluicus maximus muscle Dorsal nerve of penis 18. Posterior femoral cutaneous 19 Perineal branches of pudendal 20, Inferior rectal nerves 21 Bulbocavernosus muscle (inside: dorsal artery of penis) 22 Perineal 23. External anal sphincter muscle 24. Inferior reetal artery and veins Urogenital diaphragm and external genital organs in the male (from below). The left erus penis has been isolated and reflected laterally together with the bulb of the penis. The urethra has been cut (from below). Right sid arteries and veins.19 0 2 2 2B 24 26 n 28 » 30 31 2 Anal and urogenital region in the male (from below). ‘The root of penis has been cut. Dissection of the urogenital diaphragm. Urogenital and pelvic diaphragms in the male (from below). The penis has been removed. The arrows indicate the course of vessels and nerves. (Schematic drawing.) Right tests (reflected) Compas spongiosum of penis Coxpos cavernosum of penis Perineal branch of posterior femoral cutaneous nerve Posterior scrotal arteries and Deep artery of penis Deep transverse perineal muscle Anococeyge! Left spermatic ord Left tests (cut surface) Dorsal artery and nerve of penis Deep dorsal vein of penis Urethra (cut) Artery of bulb of penis ‘Superficial transverse perineus ‘muscle Left artery of bulb of penis Perincal branch of pudendal nerve ‘Anus External anal sphincter muscle Giuteus maximus muscle Internal pudendal artery and pudendal nerve Sacrotuberous ligament Coveys Urogenital diaphragm (deep transverse perineus muscle) Tendinous center of perineum (perineal body) Levator ani muscle Anococcygeal ligament ‘Obturator internus muscle Dorsal artery of penisCoronal section through the female urinary bladder and urethra (anterior view). Femal internal genital organs. Pelvic cavity (from above), 1 Muscular coat of urinary bladder 2 Folds of mucous membrane of urinary bladder 3. Right ureteric orifice 4 Interureteric fold 5. Internal urethral orifice {6 Vesicouterine venous plexus 7 Urethea 8 Pubic bone (cut edge) 9 External urethral orifice 10 Vestibule of vagina 11 Leftureteric orifice 12 Tegone of bladder 13, Obturator internus muscle 14 Levator ani muscle 15. Bulb of the vestibule 16 Left labium minus 17. Uterine tube 18 Mesosalpinx 19 Ovary 20. Sigmoid colon 21 Saphenous opening 22. Urinary bladder 23. Vesicouterine pouch 24 Fundus of uterus 25. Rectouterine pouch (of Douglas) 26 Ampulla of rectum 27. Kidney 28 Abdominal part of ureter 29 Pelvic part of ureter 30 Anal canal 31 Perineum (perineal body) 32 Umbilicus 33. Infundibulum of uterine tube 34 Vaginal portion of cervix of uterus 35 Vagina 36 Pubie symphysis 37 Clitoris 38 Deep transverse perineus muscle Female urogenital system (midsagittal section) {Schematic deawing,)Regional relations of female internal genital organs (medial aspect). (Schematic drawing.) 0 u 2 B 1“ 15 16 7 18 19 20 2 2 2 24 25 26 2 28 The uterus has been reflected to the right. Body of Sth lumbar vertebra Sacral promontory Left ureter Peritoneum (cut edge) Right ureter (divided) Recto-uterine pouch (of Dovelas) Rectum Umbilicus Sigmoid colon Median umbilical fold with urachus Ampulla of uterine tube Fimbriae of uterine tube Ovary ‘Uterine tube (isthmus) Uterus Yesico-uterine pouch Urinary bladder Vagina Pubic symphysis Urethra Clitoris Labi minus Insertion of uterine tube at fundus of uterus Round ligament of uterus Ligament of the ovary Suspensory ligament of ovary Right common iliac artery (covered by peritoneum) Infundibulum of uterine tubeFemale internal genital organs in removed, Body of Sth lumbar vertebra, suspensory ligament of ovary and sacral promontory Ureter Medial umbilical ligament (remnant of umbilical artery) (cut) Infundibulum of uterine tube Ampulla of ulerine tube Ovary Uterine artery Uterine tube Rectum Levator ani muscle (pelvic diaphragm — cut edge) External anal sphincter muscle Anus (probe) Internal iliac artery Remnant of urachus (median umbilical ligament) Uterus Round ligament of uterus Urinary bladder 8 Vagina 9 Clitoris » 30 Labium minus External orifice of urethra (red probe) ‘Vaginal orifice (green probe) Lateral umbilical ligament Inferior epigastric artery ery, vein and nerve artery Recto-uterine pouch (of Douglas) Recto-uterine fold Vesico-uterine pouch ispensory ligament of ovary Greater vestibular gland and bulb of the vestibule Female internal genital organs in situ (seen from above). The peritoneum at the left half of pelvic cavity has be: moved to yy uterine tube, vessels, andCoronal section through the pelvic cavity of the female. (MR- Midsagittal section through the female trunk. The urinary bladder is empty, the position and shape of the uterus are normal. Psoas major muscle Ampulla of rectum Uterus Urinary bladder Obturator internus muscle Promontory Sigmoid colon Uterine tube Head of femur Urethra Vagina Labjum minus Umbilicus Duodenum Ascending part of duodenum Root of mesentery Mesentery Vesico-uterine pouch Urinary bladder (collapsed) Pubie symphysis Anterior fornix of vagina Glitoris Labium minus Labium majus Vertebral canal with cauda equina Intervertebral disc Body of Sth lumbar vertebra Sacral promontory Mesosigmoid Recto-uterine pouch (of Douglas) Posterior fornix of vagina Cervix of uterus External anal sphincter muscle Anal canal Internal anal sphincter muscle Anus Hymen Small intestine Rectus abdominis musclethe vaginal portion of Female genital organs, isolated (anterior view). The anterior wall of the vagina has been opened to display the cervix. Ovary Mesovarium Fundus of uterus 4 Vesico-uterine pouch 5. Cervix of uterus 6 Va inal portion of cervix Vai 8 Crusof clitoris 9 La 10. Fimbriae of uterine tube 11 Infundibulum of uterine tube 12 Ligament of the ovary 13. Mesosalpinx 14 Uterine tube 15 Suspensory ligament of ovaty (caudally displaced) 16 Broad ligament of uterus 17 Round ligament of uterus 18 Corpus cavernosum of clitoris Glansof clitoris Hymen, vaginal orifice Promontory Linea terminalis of pelvis Femal Pablcepuiptyas internal genital organs. (Schematic drawing.)Right ovary and uterine tube, isolated (superior posterior view). The fimbriae of the uterine tube have been reflected to show the abdominal ostium. Uterus and related organs (posterior view). The posterior wall of the uterus has been opened. 18 19 20 Uterine tube Ligament of the ovary Ovary Infundibulum of w Fimbriae of uterine tube Ureter Rectum Apex of urinary bladder and median umbilical ligan Urinary bladder Round ligament of uterus Mesosalpinx Mesovarium Rectouterine pouch (of Douglas) Suspensory ligament of ovary Scarring of ovary (following ovulation) Abdominal opening of uterine tube Body of uterus ‘Cervical can ‘Vaginal portion of cervix of uterus (congestion) Vagina Mucous membrane of uterus Anterior fornix of vaginaArteries of female ge tal organs. (Schematic drawing.) ‘Ovarian branch of uterine artery (anastomoses Tubal branch of ovarian artery Ovarian branch of evarian artery Uterine artery Internal hac artery rior gluteal artery Vaginal orifice Infundibulum of uterine tube Ovary Fundus of uterus Uterine tube 6 Vaginal portion of cervix of uterus Vagina Clitoris Corpus cavernosum of litoris Bulb of vestibule Greater vestibular gland ligament of ovary Suspensor Artery of round ligamentFull term uterus with placenta (anterior view). The anterior wall of the uterus has been removed to show the location of the placenta. Pelvic vessels in the female (anterior-posterior view). (Arteriogram.) Main drainage routes of lymph vessel iterus and its adnexa (indicated by arrows). (Schematic drawing.) Red = arteries; black = lymph vessels and nodes: yellow = internal genital organs. 2% Placenta Amnion and chorion AAdnexa of uterus (uterine tube and ovaries) Myometrium Rousid ligament of uterus Internal orifice of uterus Cervix of uterus Umbilical cord Lumbar lymph nodes External iliac lymph nodes Inguinal lymph nodes Abdominal aorta Suspensory ligament of ovary External iliac artery Sacral lymph nodes Internal iliac artery Ovary Uterine tube Internal iliac lymph nodes External genital organs Superior Obturator artery Inferior gluteal artery Uterine artery sternal pudendal artery Middle sacral artery Uterine cavity Femoral artery ‘Vessels of labium majus FemurExternal genital organs in the female (anterior aspect). Labia reflected, Female external genital organs in relation to internal genital organs and urinary system (isolated, anterior aspect) Glans clitoris Labium majus Vestibule of vagina Hymen Posterior labi Body of clitoris Labium minus External orifice of urethra Vaginal orifice Ureter Adnexa of uterus Prepuce of clitoris Crus of clitoris Greater vestibular glands ‘Anus and internal anal sphincter muscle Median umbilical ligament containing urachus Urinary bladder Infundibulum of uterine tube Ovary Ampulla of uterine tube Suspensory ligament of the ovary Bulbospongiosus muscle and bulb of vestibule Central tendon of perineum (perineal body) External anal sphincter muscleCayernous tissue of female external genital organs, Urogenital and pelvic diaphragms (anterior aspect). isolated (anterior aspect) (Schematic drawing.) Blue = cavernous tissue of clitoris and bulb of vestibule, Body of clitoris Crus of eitoris 3. Bulb of vestibule Prepuce of clitoris Glans of clitoris Frenulum of clitoris Greater vestibular gland Lateral crus of superficial inguinal ring ioinguinal ne 2 Intercrural fi 3. Superficial inguinal ring Round ligament of uterus Medial crus of superficial inguinal ring Aponeurosis of external abdominal oblique muscle Deep transverse perineus muscle with fascia Greater vestibular gland Superficial transverse perineus muscle Levator ani muscle luteus maximus muscle Suspensory ligament of clitoris External orifice of urethra Bulb of vestibule eal body External anal sphi Anus, muscle Inguinal canal and round ligament of uterus in situ (right side, ventral aspect).Muscles of pelvic and urogenital diaphragms (from below). (Schematic drawing.) Fatty tissue encasing round ligament Position of pubie symphysis Clitoris Labium minus Bulb of vestibule Ischiocavernosus muscle Greater vestibular gland Perineal branches of pudendal nerve Levator ani muscle Inferior rectal nerves External anal sphincter muscle zs luteus maximus muscle Coceys Fatty tissue of mons pubis External orifice of urethra Urogenital diaphragm with fascia of deep transverse perineus muscle Vaginal orifice Superficial transverse perineal muscle ‘Anus Bulbospongiosus muscle Obturator internus muscleUrogenital diaphragm and external genital organs in the female, superficial layer ({rom blow). On the right side the bulb of vestibule has been removed. External female genital organs. Position of art nerves; bulb of vestibule in blue. (Schematic drawing.) 10 u 2 B 4 1s 16 7 18 19 a Prepuce of clitoris Labium minus Posterior labial nerves Great adductor muscle Perineal branches of pudendal nerve ‘Anus and external anal sphincter muscle Inferior cluneal nerves ‘Mons pubis (Crus of clitoris with ischiocavernosus muscle Bulb of vestibule Superficial transverse perineus muscle Padendal nerve and internal pudendal artery Inferior rectal nerves Levator ani muscle luteus maximus muscle ‘Anococeygeal ligament External urethral orifice Glans of clitorisExternal female genital organs (inferior aspect). The clitoris has been dissected and slightly reflected to the right. The prepuce of clitoris has been divided to display the glans. Poxition of pubic symphysis Body of clitoris Prepuce of clitoris Adductor longus and gracilis muscles External orifice of vagina and labium minus Posterior labial nerve Perineal body Deep artery of clitoris and dorsal nerve of clitoris Adductor brevis muscle Glans of clitoris (Crus of clitoris and {schiocavernosus muscle Bubb of vestibule and bulbospongiosus muscle Anterior branch of obturator nerve Labium minus Vaginal orifice Posterior labial nerves Branches of pudendal nerve External sphincter of anus Anus Bulb of vestibule (divided) Dorsal artery of clitoris Superficial transverse perinews muscle Perineal branch of posterior femoral ‘cutaneous nerve Levator ani muscle Pudendal nerve and internal pudendal artery Inferior rectal nerves luteus maximus muscle Anocoet Urogenital diaphragm and external organs in the female (lateral or view). The bulb of vestibule partly been removed, the left Jabium minus was cut away.2» 30 31 2 B 35 ; Hovizomal section through plc cavity at velo tens (rom below). The era e retroverted to the left. Horizontal section through the pelvic cavity at level of the urethral sphincter and vagina (Grom below). ium Rectum Rectouterine fold Ovary Uterine tube Urinary bladder Urethra Labium minus Rectouterine pouch of Douglas Uterus (uterovesica pouch) Ligament ofthe head of the femur Head of femur Vestibule of vagina Labium majus Anal cleft Coccyx. Rectum! “Myometrium of uterus Uterine cavity Obturator internus muscle iopsoas muscle Sartorius muscle Sciaticnerve and ‘luteus maximus muscle Uterine venous plexus Broad ligament Small intestine Femoral artery and vein Vagina Urethral sphincter muscle (base of urinary bladder) Pubic symphysis Levator ani muscle Obturator externus muscle Mons pubis Peetineus muscleSkeleton of shoulder girdle and thorax (anterior aspect). The cartilagi- nous parts of the ribs appear dark brown. 138 12 " 14 Right clavicle (superior aspect) s/f &. 17 ‘i 16 12 15 Right clavicle (inferior a ‘Vertebral column 3rd-7th cervical vertebrae Ist thoracic vertebra 2 lumbar vertebra Ribs Ist-3ed ribs 8 4th-7th nbs Homan } Ree Clavicle 11 Sternal end 12. Articular facet for sternum 13 Acrom 14 Articular facet for aeromion 15 Impression for costoclavicular ligament 16 Conoid tubercle 17 Trapezoid line 18. Site of acromioclavicuar joint 19. Site of sternoclavicular joint Scapala 20, Acromion 21 Coracoid process 22. Gienoid cavity 3 Costal surface Sternum 24 Manubrium 25. Body 26. Xiphoid pr Because of his upris upper limb has developed a h of mobility. The shoulder girdle nl posture, man’s gre is to a great extent movable in the thorax and is connected with the trunk only by the sternoclavicular joint, A further characteristic of man’s forearm is the capacity for rotation (i.e., prona- tion and supination).Skeleton of shoulder girdle and thorax (posterior view), Vertebral column, Atlas Axis 3rcl-6th cervical vertebrae 7th vertebra (vertebra prominens) Ist thoracie vertebra 6th thor 12th thoracic vertebra Ist lumbar vertebra 10 u Clavicte Sternal end Acromial end Site of acromioclavicular joint Scapu Acromion Spine of scapula Skeleton of shoulder girdle and thorax (lateral view), Lateral angle Posterior surface Inferior angle Coracoid process Supraglenoid tubercle Glenoid cavity Infraglenoid tubercle 25. Free ribsRight scapula (posterior aspect). 13 Right scapula (lateral view). ert Ts 0 u 2 B Right scapula (anterior aspect costal surface), Scapula Superior border Medial border Latera Superior angle Inferior angle Lateral a ‘Acromion Coracoid process Scapularnotch Glenoid cavity Infraglenoid tubercle Supraspinous fossa Spine Infraspinous fossa Articular facet for acromion Neck Supraglenoid tubercle Costal (anterior) surface Base of coracoid processBones of shoulder joint (posterior aspect). Bones of shoulder joint (anterior aspect). Astrid: Position of eostotransverse joints sah-Tuh ribs Clavicle Position of acromioclavieular joint Acromion Scapular notch Spine of scapula Head of humerus Glenoid cavity Surgical neck of humerus Posterior surface of scapula Coracoid process Infraglenoid tubercle Greater tubercle of humerus Anatomical neck of humerusRight humerus (anterior aspect), Humerus Greater tubercle Lesser tubercle Crest of lesser tubercle Crest of greater tubercle Intertubercularsuleus ‘Surgical neck \ u i Right humerus (medial aspect), Deltoid tuberosity Anterolateral surface Radial fossa Lateral epicondyle Capitwlum 20 16 3 18 a 19 Anatomical neck Anteromedial surface 16 Medial supracondylar ridge Coronoid foss 8 Medial epicondyle 2 ~s 1" Right humerus (posterior aspect), Tiochlea Posterior surface Groove for ulnar nerve Groove for radial nerve Olecranon fossaBones of right forearm, radius and Bones of right for Ina (anterior aspect). ulna (posterior aspect) and A 20.21 22 BoC Bones of right elbow joint (ateral aspect). 15 16 a 18 » Radius Head Articular circumference Neck Radial tuberosity Shaft Anterior surface Styloid process Articular surface Posterior surface Ulnar notch Una Trochlear notch Coronoid process Radial noteh Ulnar tuberosity Head Artcular circumference Styloid process Posterior surface Olecranon, Articulations atthe Site of humeroulnae joint Site of humeroradial joint Site of proximal radioulnar joint Humerus Radius UlnaHumerus Trochlea of humerus Capitulum of humerus Articular eicumference of radius Radial tuberosity Anterior surface of wina Posterior surface of radius Anterior surface of radius Articular circumference of ulna Carpal bones Middle phalan Distal phalanges 5 Metacurpal bo Proximal phalanx of thumb Sites of joints Humeroradial joint Humeroulnar jor Proximal radioulnar joint Distal radioulnar joint Radiocarpal joint Midcarpal joint Carpometacarpal joint (Carpometacarpal joints Metacarpophalangeal joint Interphalangeal joints of fingersSkeleton of right wrist and hand (dorsal aspect) Radius Ulna Styloid proce LLunate bone Triquetral bone Capitate bone Hamate bone J Base of third metacarpal bone Metacarpal bones Head of metacarpal bone Proximal phalanges of hand Midile phalanges of hand Distal phalanges of hand Styloid process of radius Skeleton of right wrist and h: (medial aspect)Skeleton of right wrist and hand (palmar aspect) The human hand is one of the most admirable structures of the human body. The carpometacarpal joint of the thumb, a saddle joint, enjoys wide mobility, so that the thumb can get in contact with all other fingers, thus enabling the hand to become an instrument for grasping and psychologic expression. During evolution these 1 Radius 2. Styloid process of radius 3. Scaphoid bone 4 Capitate bone 5 Trapezium 6 Trapezoid bone Carpal First metacarpal bone 8. Second to fourth metacar 9 Proximal phalanx of thumb 10 Distal phalanx of thumb 11 Base of second proximal phalanx 12 Proximal phalanges 13. Head of second proximal phalanx 14 Middle phalanges 15 Distal phalanx 16 UIna Styloid process of ulna 18 Lunate bone 19. Pisiform bone 20 Triquetralbone | Carat hones Hamatetone [ CP Hamulus or hook ‘of hamate bone 3 Base of third metacarpal bone 24 Head of metacarpal bone Tuberosity of distal phalanx newly developed functions appeared after the erect posture of the human body was achieved. An inevitable prerequisite for the development of human cultures is not only the differentiation of the brain but also the develop- ment of an organ capable of realizing its ideas: the human hand.Right sternoclavicular joint (anterior aspect). On the right side the joint has been opened by a coronal section. Note the articular disk. Right shoulder joint. The anterior part of the articular capsule has been removed and the head of the humerus has been slightly cotta wetincd to dane ties 26 Sternocleidomastoid muscle, cervical branch of facial nerve and anterior jugular vein External jugular vein and transverse cervical nerve (inferior branch) Chviele ‘Sternoclavicular joint (opened) with articular disk Pectoralis major muscle ‘Omohyoid muscle and external jugular vein Jugular venous arch and sternohyoid muscle ‘Stemoclavicular joint (not opened) ‘Acromial end of clavicle ‘Acromioclavicular joint ‘Acromion Tendon of supraspinatus muscle {attached to the articular capsule) Coraco-acromial ligament ‘Tendon of long head of biceps brachii muscle Tendon of subscapularis muscle (attached to the articular capsule) Intertubercular sulcus ticular capsule of shoulder joint Humerus ‘Trapezoid ligament Coracoid process Glenoid labrum ‘Shoulder joint (joint cavity) Scapula ‘Supraspinatus musele Cartilage of glenoid cavity Tendon of long head of triceps brachii muscl ‘Head of humerus (articular cartilage) Epiphyseal line Coronal seetion of the right shoulder joint (anterior aspect)Elbow joint with ligaments (anterior aspect). Articular capsule has been removed to show the ‘annular ligament. 1 4 : 19 Humerus Lateral epicondyle of humerus Articul: Annular i sment of proximal radioulnar joint Radius Tendon of biceps brachii muscle Medial epicondyle of humerus Ulnar collateral ligament Oblique Ulna Interosseous membrane Radial fossa Capitulum of humerus Head of radius Radial collateral ligament Coronoid fossa ‘Trochlea of humerus Coronoid process of ulna Olecranon Radial tuberosity cord al ligaments (medial aspetsaments of hand and wrist (palmar aspect). Una Exostoss (pathological) Head of ulna Ulnar carpal collateral ligament Decp interearpal ligaments Dorsal carpometacarpal lig Dorsal metac Interosseous membrane Radius Styloid process of radi Dorsal radiocarpa Radial collateral ligament Aticular capsule and dorsal interearpal al ‘Tendon of flexor carpi radialis musele (cut) Ri Palmar carpometacarpal ligaments Ist metaearpal bone Palmar ulnocarpal ligament Tendon of flexor carpi ulnaris muscle (cut) Pisohamate ligament Piso pal ligame Palmar metacarpal ligaments,Ligaments of right forearm, hand and fing The arrow indic: ers (palmar as} the location of the carpal tunnel ct). Styloid process of radius 3. Palmar radiocarpal lig Tendon of flexor carpi radialis muscle (cut) Radiating carpal ligament Articular capsule of earpometacarpal Articular capsule of metacarpophalangeal of thumb Palmar ligaments and articular capsule of metacarpophalangea joints amar ligaments and articular capsule of interphalangeal joints Articular capsule sseous membrane oulnar joint Styloid process of ulna Palmar ulnocarpal ligament Pisiform bone with tendon of flexor carpi ulnaris muscle Pisometacarpal ligament Pisohamate ligament Metacatpal bon transverse metacarpal ligament Tendons of extensor muscles and articular capsule Collateral ligament of interphalangeal j Collateral tigaments of ‘metacarpophalangeal joints 1d metacarpal Ligaments of fingers (lateral aspect).1 Descending fibers of trapezius muscle 2. Spinous processes of thoracic vertebrae 3 Ascending fibers of trapezius muscle 4 Rhomboid major muscle 5 Inferior angle of scapula 6 Latissimus dorsi muscle 7. Transverse fibers of trapezius muscle 8. Spine of scapula 9. Posterior fibers of deltoid muscle 10 Infraspinatus muscle and infraspinous fascia 11 Teres minor muscle and fascia 12 Long head of triceps brachii muscle 13. Teres major musele 14 Lateral head of triceps brachii muscle 15 Medial head of triceps brachii muscle 16 Medial intermuscular septum 17 Ulnar nerve 18. Olecranon 1 Trapezius muscle (reflected) 2 Levator scapulae muscle 3. Supraspinatus muscle 4 Rhomboid minor muscle 5 Medial border of seap 6 7 8 Rhomboid major muscle Infraspinatus muscle ‘Teres major muscle 9 Inferior angle of scapula 10 Cut edge of trapezius muscle 11 Intrinsic muscles of back with facia 12. Latissimus dorsi muscle 13. Acromion 14 Spine of scapula 15. Deltoid muscle 16. Teres minor 17 Long head of triceps brachii muscle 18, Lateral head of triceps brachii muscle 19 Medial head of triceps brachii muscle 20. Medial itermuscular septum 21 “Tendon of triceps brachii muscle Museles of shoulder and arm, deeper layer (right side, dorsal aspect). The trapezius hgs been cut near its origin at the vertebral column and reflected upward.1 Splenius capitis muscle 2. Stemocleidomastoideus muscle 3 Trapezius muscle (reflected) 4. Lateral supraclavicular nerves 5 Chaviele 6 Levator scapulae muscle 7. Supraspinatus muscle 8 Spine of scapula 9 Deltoid muscle (reflected) 10 Rhomboid minor muscle 11 Rhomboid major muscle 12 Axillary nerve and posterior ‘circumflex humeral artery 13, Infraspinatus muscle 14. Teres minor muscle 15 Long head of triceps brachii muscle 16 Teres major muscle 17 Inferior angle of scapula 18 Triceps brachii muscle 19 Latissimus dorsi muscle Mascles of shoulder and arm, deeper layer, right side (dorsal aspect). ‘The trapezius and deltoid muscles have been divided and reflected. Rhomboid minor muscle (red) Rhomboid major muscle (red) Levator scapulae muscle (red) Supraspinatus muscle (blue) Deltoid muscle (red) Infraspinatus muscle (blue) ‘Teres minor muscle (red) Teres major musele (red) Shoulder muscles, schematic diagram illustrating the course of the ‘main muscles of the dorsal aspect of the shoulder.1 Trapezius muscle Acromion Deltopectoral triangle CClavicular part of deltoid muscle (anterior fibers) 5. Acromial part of deltoid muscle (central fibers) 6 Clavicular part of pectoralis major muscle 7. Sternocostal part of pectoralis major muscle 8 Short head of biceps brachii muscle 9. Long head of biceps brachii muscle 10 Abdominal part of pectoralis major muscle 11. Brachialis musele 12. Serratus anterior muscle 13. External abdominal oblique muscle 14 Sternocleidomastoid muscle 15 Infrahyoid muscles 16 Clavicle 17 Manubsium sterni 18 Body of sternum 19. Xiphoid process 20 Anterior layer of sheath of rectus abdominis muscle ‘arm, superficial layer (ventral aspect) ‘Subclavius muscle (blue) Pectoralis minor muscle (blue) Pectoralis major muscle (red) Subscapularis muscle (red) Coracobrachialis muscle (light-blue) Serratus anterior muscle (green) Arrangement of pectoral and shoulder muscles (ventral aspect) (Schematic drawing.) 1 2 3 4 Ei 6Acromion CClavicular part of deltoid muscle Pectoralis major muscle (reflected) Coracobrachialis muscle ‘Short head of biceps brachii muscle Deltoid muscle (insertion on humerus) Long head of biceps brachii muscle Brachialis muscle Sternocleidomastoid muscle a Subclavius muscle Pectoralis minor muscle ile Sternum 3rd rib Pectoralis major muscle Platysma muscle Pectoralis major muscle forming the anterior axillary fold ‘Anterior cutaneous branches of intercostal nerves Lateral cutaneous branches of intercostal nerves Rectus abdominis muscle Subscapularis muscle Latissimus dorsi musele forming the posterior axillary fold Serratus anterior muscle forming the medial wall ofthe axilla External abdominal oblique muscle Axillary fossa and serratus anterior muscle (left side, lateral aspect).Muscles of right arm (lateral aspect) Museles of rightarm (ventral is ect). The arm with the scapula and attached muscleshasbeen removed fromthe trunk. | 3 Diagram illustrating the position of the flexor and extensor muscles of the arm and their effect on the elbow joint.Flexor muscles of right arm (ventral aspect) Part of the biceps brachii muscle has been removed. Arrow: tendon of long head of biceps brachii muscle. 1 Acromial part of deltoid muscle (central fibers) 2 Scapular part of deltoid muscle (posterior fibers) 3. Triceps brachii muscle 4 Tendon of triceps brachii muscle 5 Olecranon 6 Clavicular part of deltoid muscle (anterior fibers) 7. Deltopectoral groove 8 Biceps brachii musele 9. Brachials muscle 10. Brachioradialis muscle 11 Extensor earpiradialis longus muscle 12. Caaviele (divided) 13. Pectoralis major muscle 14 Medial intermuscular septum with vessels and nerves 15 Lateral intermuscular septum 16 Tendon of biceps brachii muscle 17 Bicipital aponeurosis Position and course of flexors of arm. 18 19 20 2 2 24 25 26 n 2s 29 » 31 2 3 34 Schematic drawing.) ‘Subscapularis muscle (red) 3 Biceps brachii muscle (red) Coracobrachialis muscle (blue) 4 Brachialis muscle (blue) Axillary artery Rhomboid major muscle Subseapalaris muscle Latisimus dorsi musele (divided) Medial intermuscular septum Medial epicondyle of humerus Brachial artery and median nerve Pronator teres muscle ‘Tendon of short head of biceps brachii muscle Coracobrachialis muscle Distal part of biceps brachii muscle Teres major muscle Long head of triceps brachii muscle Medial head of triceps brachii muscle Radius Uina Scapula6 10 u Forearm muscles, superficial layer (ventral aspect), Biceps brachii muscle Radial artery Flexor digitorum superficials muscle Median nerve Antebrachial fascia and tendon of palmaris longus musele ‘Tendon of abductor pollicis longus muscle Tendon of extensor pollicis brevis muse Abductor pollicis brevis muscle Forearm muscles, superficial layer (ventral aspect). The palmaris longus and flexor carpi ulnaris muscles ha removed, Palmar aponeurosis Superficial head of flexor pollicis brevis muscle Tendon of flexor pollicis longus muscle Medial intermuscular septum Medial epicondyle of humerus Humeral head of pronator teres muscle Palmaris longus muscle Flexor carpi ulnaris muscle Ulnar artery Tendon of flexor carpi ulnaris muscle Palmaris brevis muscle2 24 25 26 2 28 2 30 31 2 3 4 Forearm muscles, middie layer (ventral aspect). The palmaris| longus, flexor carpi radialis and ulnaris muscles have been partly removed. The flexor retinaculum has been divided. Abductor digiti minimi muscle ‘Transverse fasciculi of palmar aponeurosis Digital fibrous sheaths of tendons of flexor digitorum muscle Brachialis muscle Flexor pollicis longus muscle Carpal tunnel (canalis earpi, probe) Triceps Flexor digitorum superfcialis muscle Pisiform bone Opponens digiti minimi muscle Flexor digiti minimi brevis muscle Tendons of flexor digitorum superfiialis muscle “4 Position of flexors of fingers and hand. ‘Schematic drawing.) A Deep layer B Superficial layer A 1 Flexor pollicis longus muscle (blue) 2. Flexor digitorum profundus muscle (red) 3. Pronator teres muscle (red) 4. Flexor earpi radials muscle (red) 5 Flexor carpi ulnaris muscle (red) 6 Flexor digitorum superficalis muscle (blue) Supinator muscle Extensor carpi radials brevis muscle Flexor pollicis longus muscle Tendon of flexor earpi ra Pronator teres muscle (insertion of radius) Flexor digitorum profundus muscle smbrical muscles fendons of flexor digitorum profundus muscle ‘Tendons of flexor digitorum profundus muscle having passed through the divided tendons of the flexor digitorum superficialis Flexor ret" 12 14 18 19 Muscles of the forearm, deep layer (ventral aspect). All flexors have been removed to display the pronator quadratus and pronator teres muscles together with the interosseous membrane. Forearm in supination 2 2» Biceps brachii muscle Brachialis muscle Pronator teres muscle Brachioradialis muscle Radius ‘Tendon of flexor carpi radialis muscle Tendon of abductor pollicis longus muscle Opponens pollicis muscle Adauctor pollicis muscle Tendon of flexor pollicis longus muscle Triceps brachii muscle Medial intermuscular septum Medial epicondyle of humerus Common flexor mass (divided) Ulna Inferosseous membrane Pronator quadratus muscle Tendon of flexor carpi ulnaris muscle Pisiform bone Abductor digiti minimi muscle Flexor digiti minimi brevis muscle Tendons of flexor digitorum profundus muscle Tendons of flexor digitorum superfcialis muscle Flexor retinaculum Hypothenar muscles Thenar muscles ‘Common synovial sheath of flexor tendons Synovial sheath of tendon of flexor pollicis. longus muscle Digital synovial sheaths of flexor tendons Synovial sheaths of flexor tendons (palmar aspect of right hand). (Semischematic drawing.)Humerus Lateral epicondyle of humerus Anticular capsule Position of capitulum of humerus Deep branch of radial nerve Supinator muscle Entrance of deep branch of radial nerve to extensor muscles Radius and insertion of pronator teres muscle Interosseous membrane Median nerve Triceps brachii muscle Trochlea of humerus Tendon of biceps brachii muscle Brachial artery Pronator teres muscle “Tendon of pronator teres muscle Uina Pronator quadratus muscle Tendon of flexor carpi radialis muscle Thenar muscles Synovial sheath of tendon of flexor pollicis longus muscle Fibrous sheath of flexor tendons Digital synovial sheath of flexor tendons Flexor digitorum superfcialis muscle Tendon of flexor carpi ulnaris musc ‘Common synovial sheath of flexor tendons Position of pisiform bone Flexor retinaculum Hypothenar muscles Right supinator and elbow joint (anterior aspect). Forearm in pronation. A Axisof flexion and extension B Axis of rotation Arrows S Supination P Pronation Synovial sheaths of flexor muscles Diagram illustrating the two axes of the elbow joint. (palmar aspect of right hand). Blue PVA-solution has been injected into the sheaths.u 2 B 4 Muscles of thumb and index finger (medial Muscles of hand (palmar aspect). The tendons of the flexor muscles and ). The tendons of the extensor muscles of parts of the thumb muscles have been removed. The carpal tunnel has aspe the thumb and the insertion of the flexor tendons been opened of the index finger are displayed Tendons of extensor pollicis brevis, 15 Extensor expansion of extensor of thumb 29 Lumbrical muscles (cut) and abductor pollicis longus muscle 16 Vineulum longum 30. First dorsal interosseous muscle Extensor retineculum 17 Tendons of flexor digitorum 31. Position of carpal tunnel Tendon of extensor pollicis longus muscle superficialis muscle dividing to allow 32. Tendon of flexor carpi ulnaris muscle Tendons of extensor carpi radialis longus passage of deep tendons 33 Location of pisiform bone and brevis muscles 18. Vinculaof flexor tendons 34 Hook of hamate bone First dorsal interosseous muscle 19 ‘Tendon of flexor digitorum profundus muscle 35 Abductor digiti minimi muscle Tendon of extensor digitorum muscle for 20 Vinculum brev 36 Flexor digi minimi brevis muscle index finger 21 Radial carpal eminence (cut edge of 37, Opponens digiti minimi muscle Location of metacarpophalangeal joint flexor retinaculum) 38 2nd palmar interosseous muscle ‘Tendon of lumbrical muscle 22. Opponens pollicis muscle 39 3rd palmar interosseous muscle Extensor expansion of index finger 23. Deep head of flexor pollicis brevis muscle 40. th dorsal interosseous muscle Tendon of flexor Carpi radialis muscle 24 Abductor pollicis brevis muscle (cut) 41 3rd dorsal interosseous muscle (cu) 25. Superficial head of flexor pollicis brevis 42. Tendon of flexor digitorum Anatomical snuffbox muscle (cut) profundus muscle (cut) Tendon of abductor pollicis longus muscle 26 Oblique head of adductor pollicis muscle __43,_Tendons of flexor digitorum ‘Tendon of extensor pollicis brevis muscle 27 Transverse head of adductor pollicis muscle superfcilis muscle (cut) Tendon of abductor pollicis brevis muscle 28 Tendon of flexor pollicis longus muscle (cut) 44 Fibrous flexor sheathsActions of interosseous muscles in abduction and adduction of fingers (palmar aspect, schematic drawing), Arrow: carpal tunnel. Red = abduction (dorsal interosseous muscles, abductor digiti luscles of right hand, deep layer (palmar aspect). The thenar and hypothenar muscles have been removed to display the interosseous muscles. minimi and abductor pollicis brevis muscles). Black = adduction (palmar interosseous muscles, adductor pollicis muscle). 1 Pronator quadratus muscle 2 Tendon of flexor carpi radialis muscle 3. Abductor pollicis brevis muscle (divided) 4 Adductor pollicis muscle (divided) 5 Tendon of flexor polis longus muscle 6 Lumbrical muscles (cut) 7. Tendon of flexor carpi ulnaris muscle 8 Pisiform bone 9 Abductordigiti minimi muscle (divided) 10 Dorsal interosseous muscles 11 Palmar intr 12. Radius 13 Ulna 14 Flexor retinaculum 15 Tendons of flexor digitorum profundus muscle 16 Tendons of flexor digitorum superficial muscle 17 Capitate vone 18 Trapezium bone and trapezoid bone 19 Radial artery 20. Tendon of flexor muscles 21. First metacarpal bone 22. Median 23. Thenar muscles 24 Hamate bone 25. Hypothenar muscles mn through the right hand, showing the carpal tunnel 26 Ulnar artery and nerve 27 Carpal tunnel (canalis carpi) seous musclesExtensor muse (dorsal aspect). Tunnels for extensor tendons indicated of forearm and hand, superficial layer by probes. Synovial sheaths of extensor ‘Synovial sheaths of extensor tendons. The sheaths have tendons on the back of right been injected with blue wrist (indicated in blue), gelatin Notice the six tunnels for the passage of the extensor tendons beneath the extensor retinaculum. (Semischematic drawing.) 1 Lateral intermuscular septum 2 ‘Tendon of triceps brachii muscle 3 Lateral epicondyle of humerus 4 Olecranon 5 Anconeus {6 Extensor carpi ulnaris muscle 7. Extensor digitorum muscle 8 Extensor digiti minimi muscle 9 Extensor retinaculum 10 Tendons of extensor digiti minimi muscle 11. Tendons of extensor digitorum muscle 12. Intertendinous connections 13. Brachioradialis muscle 14 Extensor carpi radialis longus muscle 15 Extensor carpi radials brevis musele 16 Abduetor pollicis longus muscle 17 Extensor pollicis brevis muscle 18 Tendon of extensor pollicis longus muscle 19 Tendons of both extensor carpi radials longus and extensor carpi radials brevis muscle 20. Tendon of extensor indicis muscle 21 Isttunnel: Abductor pollicis longus muscle Extensor pollicis brevis muscle 2nd tunnel: Extensor carpi radials longus and brevis muscles 3rd tunnel: Extensor pollicis longus muscle 24 4th tunnel: Extensor digitorum muscle Extensor indicis muscle Sth tunnel: Extensor digiti minimi muscle ‘th tunnel: Extensor carpi ulnaris muscleExtensor muscles of forearm and hand, deep layer (dorsal aspect), 1 Ticeps brachii muscle 2. Lateral intermuscular septum 3. Lateral epicondyle of humerus 4 Anconeus muscle 5 Extensor digitorum and extensor digiti minim muscles (cut) 6 Supinator muscle 7. Extensor carpi ulnaris muscle 8 Extensor retinaculum 9 3rd and 4th dorsal interosseous muscles 10 Tendons of extensor digitorum muscle (cut) 11. Biceps brachii muscle 12 Brachialis muscle 13. Brachioradialis muscle 14 Extensor carpi radials longus muscle 15. Extensor carpi radials brevis muscle 16 Abductor polics longus muscle 17 Extensor pollicis longus muscle 18 Extensor pollicis brevis muscle 19 Extensor indicis muscle 20 Tendons of the extensor carpi radalis longus and extensor carpi radials brevis muscles, 21 Ist dorsal interosseous muscle Position of extensor muscles of forearm and hand. (Semischematic drawing.) B_ Extensorsof fingers and hand Abductor pollicis longus muscle 5 Extensor carpi ulnaris muscle A. Extensors of thumb (red) (blue) Extensor pollicis brevis muscle 6 Extensor digitorum muscle (blue) (red) Extensor pollicis longus muscle 7 Extensor carpi radials brevis muscle (red) (blue) Extensor indicis muscle 8 Extensor carpi radials longus muscle (blue) (blue)31 10 11121314 15 16 17 35:34 967 Main branches of right subclavian and axillary arteries (anterior aspect). Pectoralis muscles have been reflected, clavicle and anterior wall of thorax removed display aortic arch and common carotid artery with their branches. 1 Pectoralis minor muscle (reflected) 2 Anterior circumflex humeral artery 3 Musculacutaneous nerve (divided) 4 Axillary artery 5. Posterior circumflex humeral artery 6 Profunda brachii artery 7 Median nerve (var.) 8. Brachial artery 9 Biceps brachii muscle 10. Thoracoacromial artery 11 Suprascapular artery 12 Descending seapular artery 13. Brachial plexus (middle trunk) 14 Transverse cervical artery 15 Scalenus anterior muscle and phrenic nerve 16 Right internal carotid artery 17 Right external carotid artery ‘arotid sinus 19 Superior thyroid artery 20) Right common carotid artery 21 Ascending cervical artery 23 24 26 a 28 29 30 31 3 u 36 7 9 0 at 2 “Thyroid gland Inferior thyroid artery Internal thoracic artery Right subclavian artery Brachiocephalic trunk Left brachiocephalic vein (divided) Left vagus nerve Superior vens cava (divided) ‘Ascending aorta Median nerve (divided) Pheer Right lung (divided) and pulmonary pleura Thoracodorsal artery Subscapular artery Lateral mammary branches (variant) Lateral thoracic artery ‘Thyrocervie Superior thoracic artery trunk crior ulnar collateral artery ior ulnar collateral artery Middle collateral artery 8 4 45 46 ” 49 50 SI 3 3 8 56 37 38 9 o 6 a nd right lung divided. Left lung with pleura and thyroid gland have been reflected laterally to Radial collateral arte Radial recurrent arte Radial artery Anterior and posterior interosseous Princeps pollicis artery Deep palmar arch ‘Common palmar digital. Ulnar recurrent artery Recurrent interosscous artery Common interosseous artery Ulnar artery Superficial palmar arch Median nerve and brachial artery Biceps brachii muscle Ulnarnerve Flexor pollicis longus muscle Palmar digital arteries Anterior Flexor carpi ulnaris muscle Superficial palmar branch of radial nterosseous arteryDissection of the arteries of forearm and hand. The superficial flexor muscles have been remov. tunnel opened and the flexor retinaculum cut. The arteries have been filled with colored resin. Arteries of the upper limb. (Schematic drawing.)Veins of the head, neck and upper extremity and their connection with the heart (anterior-lateral aspect: anterior thoracic wall) has been opened). 1 Superficial temporal artery and vein 2 Occipital vein 3. Parotid gland 4 Great auricular nerve and mastoid muscle 5 jugular vein 6 Internal jugular vein and common carotid artery 7. Deltoid muscle 8 Axillary ve 9 Right cephalic vein within the deltopectoral groove 10. Right lung (middle lobe) 11. Serratus anterior muscle and Exte lateral thoracie vein 12. Cephalic vein on forearm 13. Venous network on dorsum of hand ipper limb. 14 Dorsal metacarpal veins 15 Facial artery and vein 16 Submandibular gland 17 Anterior jugular and omohyoid muscle 18 Jugular venous arch and thyroid gland 19 Right and left brachiocephalic veins 20 Retrosternal body (remnant of thymus gland) 21 Internal thoracic artery and vein 22 Heart with pericardium 23 Right venous angle 24 Brachial vein 25. Basilic vein 26 Median cubital vein 27 Di hyoid bone10 un 2 Main branches of radial nerve. (Schematic drawing.) Posterior divisions of trunks and posterior cord and its branches are indicated in green. Brachial plexus Lateral cord of brachisl plexus Posterior cord of brachial plexus Medial cord of brachial plexus Axillary nerve Radial nerve Posterior cutaneous nerve of arm Lower lateral cutaneous nerve of arm Posterior cutaneous nerve of forearm ‘Superficial branch of radial nerve Deep branch of radial nerve Dorsal digital nerves Main branches of musculocutaneous, median and ulnar nerves. (Schematic drawing.) ‘Anterior divisions of the trunks and all the components. arising from them are indicated in yellow. Roots of median nerve Musculocutancous nerve Median nerve Ulnar nerve Medial cutancous nerves of arm and forearm Lateral cutaneous nerve of forearm ‘Anterior interosseous nerve Palmar branch of median nerve Dorsal branch of wlnae nerve Deep branch of ulnar nerve ‘Common palmar digital nerves of median nerve Superficial branch of ulnar nerve10 n 2 Cutancous nerves of right upper limb (ventral aspect), (Semischematic drawing.) Medial supraclavicular nerve Intermediate supraclavicular nerve Upper lateral cutaneous nerve of arm ‘Terminal branches of intercostobrachial nerves Lower lateral cutaneous nerve of arm Lateral cutaneous nerve of forearm ‘Terminal branch of superficial branch of radial nerve Palmar digital nerve of thumb (branch of median nerve) Palmar digital branches of median nerve Anterior cutancous branches of intercostal nerves Lateral cutaneous branches of intercostal nerves ‘Medial cutaneous nerve of forearm Cutaneous nerves of the upper limb (dorsal aspect) (Semischematic drawing.) Palmar cutaneous branch of ulnar nerve Palmar branch of median nerve Palmar digital branches of ulnar nerve Cutaneous branches of dorsal rami of spinal nerves Dorsal branch of ulnar nerve Dorsal digital nerves Posterior supraclavicular nerve Posterior cutaneous nerve of arm Posterior cutaneous nerve of forearm Superficial branch Dorsal digital branches from radial nerve2 24 2 6 Dorsal region of shoulder, superficial layer. Note the segmental arrangement of the cutaneous nerves of the back, Trapezius muscle Dorsal branches of posterior intercostal artery and vein (medial cutaneous branches) ‘Medial branches of dorsal rami of spinal nerves Rhomboid major muscle Lateral branches of dorsal rami of spinal nerves Latissimus dorsi musele Posterior supraclavicular nerves Spine of seapula Deltoid muscle Infraspinatus muscle TTeres minor muscle Triangular space with circumflex seapular artery and vein uj ‘Teres major muscle “Terminal branches of intercostobrachial nerve Medial cutaneous nerve of arm Tendon of triceps brachii muscle Lateral cutaneous branches of intercostal nerves lateral cutaneous nerve of arm with artery Medial cutaneous nerve of forearm Long head of triceps brachii muscle ‘Quadrangular space with axillary nerve and posterior humeral circumflex artery Anastomosis between profunda brachii artery and posterior humeral circumflex artery Course of radial nerve and profunda brachil artery Lateral head of triceps brachii muscle Course of descending scapular artery and dorsal seapular nerve ‘Course of suprascapular nerve, artery and vein Shoulder and arm (dorsal aspect). Dissection of the ‘quadrangular and triangular spaces of the axillary region Course of vessels and nerves to shoulder and upper limb. (Schematic drawing.)‘Scapular region, arm and shoulder, deep layer (dorsal aspect). Part of deltoid muscle has been cut and reflected to display the quadrangular and triangular spaces of the axillary region Traperius muscle Spine of seapula Infraspinatus muscle ‘Teres minor muscle Triangular space containing circumflex scapular artery and vein “Teres major muscle Latissimus dorsi muscle Deltoid muscle (cut and reflected) Quadrangular space containing axillary nerve and posterior circumflex humeral artery and vein Long head of triceps brachii muscle ‘Cutaneous branch of axillary nerve Lateral head of triceps brachii muscle Terminal branches of intercostobrachial nerve L utaneous branches of intercostal nerves, Medial eutancous nerve of arm Medial cutaneous nerve of foreaem Upper later Anastomosis bet humeral circumflex artery Humerus Profunda brachii artery nerve ‘cutaneous nerve of arm profunda brachii artery and posterior Lower lateral cutaneous nerve of arm Posterior cutaneous nerve of forearm Resa ot Weide cies acto Scapular region and posterior brachial regions arm and shoulder, deep layer (dorsal aspect). The lateral head of the triceps brachii muscle has been cut to display the radial nerve and accompanying vessels.Dorsal regions of neck and shoulder (dorsal aspect). Left side: superficial layer. Right side: trapezius and latissimus dorsi muscles have been removed. Dissection of dorsal branches of spinal nerves. Greater occipital nerve Ligamentum nuchae Splenius capitis muscle Sternocleidomastoid muscle Lesser occipital nerve Splenius cervicis muscle Descending and transverse fibers of trapezius muscle ‘Medial cutancous branches of dorsal rami of spinal nerves Ascending fibers of trapezius muscle Latissimus dorsi muscle Cutaneous branch of third occipital nerve Great auricular nerve Accessory nerve (n. XI) Posterior supraclavicular nerve and levator scapulae muscle Branches of suprascapular artery 6 7 18 9 2» a 2 2 24 25 26 2 2% 2» Deltoid muscle Rhomboid major muscle Infraspinatus muscle “Teres minor muscle Upper lateral cutaneous nerve of arm (branch of a TTeres major muscle Medial margin of scapula Long head of triceps muscle Posterior cutaneous nerve of arm (branch of radial nerve) Latissimus dorsi muscle (divided) ‘Ulnar nerve and brachial artery Lateral cutaneous branches of dorsal rami of spinal nerves and iliocostalis thoracis muscle External intercostal muscle and seventh rib Serratus posterior inferior muscleClavicle Deltoid muscle Suprascapulae artery Suprascapular nerve Superior transverse scapular ligament 6 Teres minor muscle 7. Axillary nerve and posterior circumflex humeral artery 8 Long head of triceps muscle 9 Circumflex scapalar artery 10 Teres major muscle LL Greater occipital nerve 12 Lesser occipital nerve 13 Great auricular nerve 14 Splenius capitis muscle 15 Accessory nerve (n. XI) 16 Third occipital nerve and levator scapulae muscle 17 Serratus posterior superior muscle 18. Spine of scapula 19. Descending scapular artery and dorsal scapular nerve 20. Rhomboid major muscle 21 Infraspinatus musele and ‘medial margin of scapula 22. Radial nerve and profunda brachii artery 23. Thoracodorsal artery 24. Thyrocervical trunk 25. Roots of brachial plexus Dorsal fegion of shoulder; deepest layer. Rhomboid and scapular muscles fenestrated: posterior part of deltoid muscle reflected Collateral circulation of shoulder. ‘Anastomosis of suprascapular and circumflex scapular arteries, (Semischematic drawing.)Scapular r jon, arm and shoulder (dorsal aspect). Arteries of scapular region are injected. ‘Trapezius, deltoid and infraspinatus muscles are partially removed or reflected. ‘Sternocleidomastoid muscle Lesser occipital nerve Splenius capitis muscle and third occipital nerve Accessory nerve (N.X1) Splenius cervicis muscle and transverse cervical artery (deep branch) Levator of scapula muscle Transverse cervical artery (superficial branch) Spine of scapula and serratus posterior superior muscle Rhomboid major muscle ‘Trapezius muscle u R B rr 15 16 7 18 19 20 Latissimus dorsi muscle Facial artery Acromion Deltoid muscle Suprascapular artery and supraspinatus muscle (reflected) Axillary nerve, posterior circumflex humeral artery and lateral head of triceps, brachii muscle Teres minor muscle Long head of triceps brachii muscle ‘Circumflex scapular artery and teres major Infraspinatus muscleRight shoulder and thoracic wall, superiicial layer (anterior aspeet). Dissection of Superficial the cutaneous nerves and veins 1 Trapezius muscle 2 Posterior supraclavicular nerve 3 Middle supraclavicular nerve Deltopectoral triangle Deltoid muscle Cephalic vein within the deltopectoral groove Upper lateral cutaneous nerve of arm (branch of axillary nerve) 8 Latissimus dorsi muscle 9 Cephai vei 10 Biceps brachii muscle LL Triceps brachii muscle 12. Lateral cutaneous branches of intercostal nerves 13. Transverse cervical nerve and external jugular vein ins of right arm have been injected with blue gelatin, Sternocleidomastoid muscle Anterior jugular vein clavicular nerve jor muscle major muscle Perforating branch of internal thoracie artery Anterior cutancous branches of intercostal nerves ‘Abdominal part of pectoralis major muscle Accessory cephalic vein Bs Median cubital vein Median vein of forearm Cephalic vein inthe forearmRight deltopectoral triangle, infraclavicular region (anterior aspect). The pectoralis major muscle has been cut and reflected. Accessory nerve “Trapezius muscle Pectoralis major muscle (clavicular part) Acromial branch of thoracoacromial artery Pectoralis major muscle Lateral pectoral nerves Abdominal part of pectoralis major muscle External jugular vein Cutaneous branches of cervical plexus Sternocleidomastoid muscle Clavicle Clavipectoral fascia Cephalic ve Subclavius muscle Cavicular branch of thoracoacromial artery Subelavian vein ‘Thoracoacromial artery Pectoral branch of tho Medial pectoral nerve 2nd rib 2 2 2 4 25 26 2 28 29 30 31 2 3B 6 7 ‘Thoracic wall and shoulder, deep layer. Right axillary region (anterior aspect). The pectoralis major muscle has been cut and partly removed. Pectoralis minor muscle 3rd nib Deltoid muscle Pectoralis major muscle (reflected), brachial artery and Short head of biceps brachii muscle ‘Thoracodorsal artery and nerve Medial cutaneous nerve of arm Intercostobrachial nerve (T:) Long head of biceps brachii muscle Medial cutaneous nerve of forearm Latissimus dorsi muscle Lateral cutaneous branches of intercostal nerves (posterior branches) Serratus anterior muscle Medial pectoral nerve Long thoracic nerve and lateral thoracic artery Intercostobrachial nerve (Ts) Lateral cutaneous branches of (anterior branches) costal nervest axillary region (inferior aspect). Dissection of superficial axillary nodes and lymphatic vessels. ‘The pectoralis major muscle has been slightly elevated, Deltoid muscle bus nerves of arm and forearm Basie Vein Intercostobrachial nerves ircumiflex scapular artery Superficial axillary nodes Lateral thoracic artery Thoracodorsal aren Lateral cutaneous branch of intercostal nerve Latissimus dorsi muscle ‘Thoracoepigastrie vein Serratus anterior muscle Museulocutaneous ner Radial nerve Pectoralis major muscle Nippledivided and reflected. Shoulder girdle and arm elevated and reflected 1. Deltoid muscle 13 Museulocutancous nerve 2. Insertion of pectoralis major muscle 14 Subelavius musele 3 Coracobrachialis muscle 15 ‘Thoracoacromial artery 4. Roots of median nerve, axillary artery 16 Axillary vein 5 Short head of biceps brachii muscle 7 Clavicle 6 Ulnar nerve and medial cutaneous nerve 18 Pectoralis major and minor muscles (reflected) of forearm 19. Nipple 7 Thoracoepigastric vein 20 Anterior cutaneous branches of intercostal nerves 8 Deep axillary node 21 Anterior layer of rectus sheaths 9 Latissimus dorsi muscle 10. Serratus anterior muscle 11. Cephalic vein 12. Insertion of pectoralis minor muscle (coracoid process)Right axillary region (anterior aspect). The pectoralis major and minor muscles have been cut and reflected to display the vessels and nerves of the axilla Sternocleidomastoid muscle cut and reflected) Cervical plexus “Trapezius muscle Pectoralis minor muscle and medial pectoral nerve Deltoid muscle Pectoralis major muscle and lateral pectoral nerve Median nerve and brachial artery Circumiflex scapular artery Short head of biceps brachii muscle ‘Thoracodorsal artery and nerve Long head of biceps brachii muscle Latissimus dorsi muscle Serratus anterior muscle Internal jugular Scalenus anterior musele Phrenic nerve and ascending cervical artery Brachial plexus (at the levels ofthe trunks) Chaviele Subclavius muscle Thoracoacromial artery Subeclavian vein cut) Axillary artery 3. Subscapulararter Superior thoracie artery Lateral thoracic artery and long tho External intercostal muscle Insertion of pectoralis minor muscle Intercostobrachial nerves Lateral cutaneous braniches of intercostal nerves Insertion of pectoralis major muscleShoulder and arm. Axillary re} partly removed. The clavicle has been cut. Trapezius muscle and accessory nerve Brachial plexus viele (eut) Pectoralis minor muscle Axillary (subclavian) artery Deltoid muscle Muscalocs Asilla Radial nerve 10 Medial and later LL Median nerve and bead 12 Ulnar nerve 13. Short head of bioeps brachii muscle 14 Medial cutaneous nerves of arm and forearm 15 Long head of biceps brachii muscle 16 Latissimus dorsi muscle roots of the median plexus (anterior aspect). The pectoralis major and minor muscles he 7 Cephalic vein i 19 ” 31 2 Cervical plenus Phrenic nerve and scale Descending: ss anterior muscle ular artery Suprascapular artery Internal thoracic artery Subeavian vein Thoracoacromial artery Lateral thoracic artery and long thoracic nerve Intercostobrachial nerves Insertion of the pectoralis minor muscle into t Lateral cutaneous branches of intercostal nerves ‘Abdominal part of pectoralis major muscle (cut) Suprascapular nerve and artery 2nd-Sth ribsMain branches of brachial plexus. Posterior cord in red, lateral cord in yellow and medial cord in purple. (Schematic drawing.) 1 Accessory nerve 2 Dorsal scapular artery Su © 6 Musculocutancous nerve 7 Axillary nerve 8. Median nerve 26 Scalenus anterior muscle 27 Scalenus medius muscle 28 Intercostal nerve (Ty) 29. Axillary artery5678910 11 12 13 14 8 1 15 16 O17 Right arm, Dissection of vessels and nerves (medial aspect). Shoulder girdle has been reflected slightly. Radial artery and superficial branch of radial nerve Lateral cutaneous nerve of forearm Brachioradialis muscle Ulnar artery Tendon of biceps brachii muscle Brachialis muscle Pronator teres muscle Median nerve Medial epicondyle of humerus Inferior ulnar collateral artery Ulnar nerve Medial cutan Brachial art Biceps brachii muscle Intercostobrachial nerve (T:) Latissimus dorsi muscle Thoracodo Serratus ante Subscapular artery Pectoralis major muscle (reflected) and la Radial nerve and profunda brachii artery Axillary nerve of forearm nerve and artery muscle Roots of the median nerve with axillary artery Musculocutaneous nerve Pectoralis minor muscle (reflected) and medial pect dof brachial plexus Clavie (cut) Lateral cord of brachial plexus “Medial cord of brachial plexus Posterior Subelavian artery Brake sein 13, 16 Right arm. Dissection of vessels and nerves, det Biceps muscle has been reflected.fore: cutaneous nerves of rm and hand (anteromedial aspect). Sagittal section through the forearm at the level of the humeroulnar articulation (MR-Scan, after A. Heuck, G. Luttke, and J. W. Rohen, 1994). Cephalic vei Brachioradialis muscle covered by its or cutaneous nerve of forearm (branch of radialis nerve) Cephalic vein of forearm Extensor pollicis longus and brevis muscles covered by their fascia Median cubital vein L utaneous nerves of forearm (branch of musculocutancous nerve) Intermedian vein of forearm Superficial branch of radial nerve 10 u 2 B 4 6B 6 i 18 9 20 Dorsal digital br ‘Triceps brachii mus rk on the dorsum of the hand Olecranon Humeroulnar articulation Uina Radiocarpal articulation eps brachii muscle Trochlea of humerus Flexor muscles of forearm Carpal bones‘Vessels and nerves of right forearm, superficial layer Yessels and nerves of (dorsal aspect). ‘Tendon of tricep Oleeranon Anconcus muscle Extensor digitorum muscle Extensor carpi ulnaris muscle Deep branch of radial nerve Posterior interasscous artery Extensor pollicis longus muscle Extensor indicis muscle ‘Tendon of extensor carpi ulnaris muscle (dorsal aspect). Extensor retinaculum Dorsal branch of ulnar nerve brachii muscle jas musele Brachioradialis muscle Lateral epicondyle of humerus Extensor carpi raialis longus Extensor carpi radials brevis muscle Abductor pollicis lnigus muscle Tendons of extensor digitorum muscle Extensor pollicis brevis mu Superficial branch of radial nerve Radial artery Posterior interosseous nerve Posterior interosseous branch of radial ne Posterior branch of anterior interosseous artery 7 Supinator mCutaneous nerves and veins of forearm and hand (superficial layer, dorsal aspect). Tnnervation pattern of dorsal surfaces of hand 2" digits by radial nerve, 2!» digits by ulnar nerve. Note that the terminal branches to the dorsal surfaces of the distal phalanges are derived from the palmar digital nerves, The cutaneous distribution varies; often 3!/ digits are innervated by the radial and 1, digits by the ulnar Dorsal region of forearm and hand (deeper layer), Extensor digitorum muscle has been partly removed, Posterior cutaneous nerve of forearm (branch of radial nerve) Extensor digitorum muscle Tendon of extensor carpi ulnaris muscle Extensor retinaculum Ulnar nerve ‘Venous network of dorsum of hand Abductor pollicis longus muscle MERESY potficis brevis muscle Radial nerve, superficial branch Radial artery Tendon of extensor pollicis lngus muscle Dorsal d Tendons of extensor digitorum muscle with intertendinous connections Posterior interosseus nerve (branch of the deep radial nerve) tal branches of radial nerve Posterior interosseous artery Styloid process of ulna Dorsal interosseus muscle IV Dorsal carpal branch of radial artery Lateral cutaneous Dorsal metacarpal artery Proper dorsal digital branches of ulnar nerve Regions supplied by palmar digital nerves (ulnar nerve) Regions supplied by palmar digital nerves (median nerve) ve of forearm (branch of musculocutaneous nerve) ‘Communicating branch with ulnar nerveCubital region (anterior aspect), dissection of cutaneous nerves Cubital region, superficial layer (anterior aspect). The and veins, fasciae of the muscles have been removed Biceps brachii muscle with fascia 16 Tendon 0 rach muscle Tendon and aponeurosis of (covered by the antebrachial fascia) 1 medial cutaneous nerve Biceps brachii muscleor aspect). The bieipital Cubital region, middle layer (anterior aspect). The pronator teres and brachioradialis muscles have been slightly reflected. Median nerve Inferior ulnar collateral artery Biceps brachii muscle ous nerve of forearm Brachial artery ondyle of humerus Lateral cutaneous nerve of forearm ian nerve with branches to pronator teres muscle (Cerminal branch of musculocutaneous nerve) Pronator teres muscle Brachialis musele Flexor carpi radialis muscle Tendon of biceps br dl Deep branch of radial nerve Brachioradialis muscle Radial recurrent artery Radial artery 23. Supinator muscle u 24 Medial intermuscular septum of arm Superficial branch of radial nerve Lateral cutaneous nerve of forearm Medial cutaneous nerve of forearmjon, deep layer (anterior aspect). The pronator teres and flexor carpi ulnaris muscles have been cut and flected, Biceps brachii muscle Brachialis muscle Brachioradialis muscle Superficial branch of radial nerve Deep branch of radial nerve Tendon of biceps brachii muscle Radial recurrent artery Supinator muscle Insertion of pronator t Radial artery Ulnar nerve Medial intermascular septum of atm and superior ulnar collateral artery Brachial artery Cubital region, deepest layer (anterior aspect). The flexor digitorum superficialis and the ulnar head of the pronator teres have been cut and reflected Median nerve Medial epicondyle of humerus Humeral head of pronator teres mu Ulnar artery Ulnar head of pronator teres muse Ulnar recurrent artery Anterior interosseous nerve Tendinous arch of flexor digitorum superficalis muscle Anterior interosseous artery Flexor digitorum superficialis muscle Flexor digitorum profundus muscle Flexor pollicis longus muscleo 29 31 x 33 4 36 37 38 39 40 Vessels and nerves of forearm and hand, deep layer (anterior aspect). The superficial layer of the flexor muscles has been removed Biceps brachii muscle Brachialis muscle Brachioradialis muscle Deep branch of radial nerve Superficial branch of radial nerve Flexor retinaculum Thenar muscles ‘Common palmar digital branches of median nerve ‘Common palmar digital arteries Proper palmar digital nerves (median nerve) Ulnar nerve “Medial intermuscular septum of arm Superior ulnar collateral artery Brachial artery Medial epicondyle of humerus Pronator teres muscle Bicipital aponcurosis Ulnar artery Palmaris longus muscle Flexor carpi radialis muscle Flexor digitorum superficialis muscle Flexor carpi ulnaris muscle Tendon of palmaris longus muscle Remnant of antebrachial fascia Superficial branch of ulnar nerve Palmaris brevis muscle Palmar aponcurosis Hypothenar muscles Superficial palmar arch Superficial transverse metacarpal ligament Common palmar digital branch of ulnar nerve Proper palmar digital branches of ulnar nerve Anterior interosseous artery and nerve Flexor digitorum profundus muscle ‘Common palmar digital arteries Palmar branch of median nerve Flexor pollicis longus muscle Palmar branch of ulnar nerve Cutaneous innervation of hand (palmar aspect) (Schematic drawing.) ‘Cutaneous innervation of palmar surface: ¥/ digits by median nerve, U4 digits by ulnar nerveRight hand, superficial layer, dissection of vessels and nerves palmar aspect) ‘Tendon of palmaris longus muscle Radial artery Tendon of flexor carpi radialis muscle and median nerve Distal part of antebrachial fascia Radial artery passing into the anatomical snutfbox Abductor pollicis brevis muscle Superficial head of flexor pollicis brevis muscle Palmar digital artery of thumb Common palmar digital arteries Proper palmar digital nerves (median nerve) Ulmar nerve Tendon of flexor carpi ulnaris muscle ‘Ulnar artery Superficial branch of ulnar nerve Palmaris brevis muscle Palmar aponcurosis Right hand, superticial layer, dissection of vessels and nerves (palmar aspect). The palmar aponeurosis has been removed to display the superficial palmar arch, Palmar digital nerves (ulnar nerve) 18 Superficial transverse metacarpal ligament 19. Proper palmar digital arteries 20. Superticial palmar branch of radial artery (contributing to the superficial palmar arch) 21 Flexor retinaculum 2 Median nerve 23. Abductor digiti minimi muscle 24 Flexor digti minimi brevis muscle 25. Opponens digiti mi 26 Superficial palmar arch 27 ‘Tendons of flexor digitorum superticialis muscle 28 Common palmar digital branch of ulnar nerve 29 Common palmar digital branch of median nerve 3 Fibrous sheath of flexor tendonsCoronal section through the right hand (palmar aspect). Radius Radiocarpal articulation ‘Scaphoid (navicular) bone Radial artery ‘Trapezoid bone ‘Trapezium bone First metacarpal bone Metacarpophalangeal articulation of thumb Interosseous muscles Proximal phalanx of thumb Proximal phalanx of fingers Interphalangeal articulations Middle phalanx Distal phalanx. Uina Distal radioulnar articulation "7 =18 2 Coronal section through the right hand (palmar aspect) (MR-Scan, courtesy of Dr. A. Heuck, Munich). Articular disk Lunate bone Triangular bone Capitate bone Hamate bone Carpometacarpal articulations Abductor digiti minimi muscle Fifth metacarpal bone Metacarpophalangeal articulation Adductor pollicis musele cigital arteries Proper palsection through shoulder joint (section 1; MR-Image; inferior aspect). Upper extremity, location of sections 1-5 (MR Scans, courtesy of Dr. A. Heuck, Munich} 1. Pectoralis major muscle 2. Greater tubercle and tendon of biceps muscle 3. Lesser tubercle fead of humerus and articular cavity of shoulder joint 5. Dehtoid muscle © Seapula 7. Infraspinatus muscle 8 Serratus anterior muscle 9. Sternum 0. Infrahyoid muscles M1 Trachea 12 Body of thoracie ve 13 Vertebral eanal and spinal cord 14 Deep muscles of the back 15 Trapedius muscle 16 Brachialis musele ht shoulder at the level of T, Radial nerve and profunda (section 1; inferior aspect). * = Upper lobe of lung. bach Axial section through the middle of the I section through the middle of the right arm (section 2; MR-Image, inferior aspect). right arm (section 2; inferior aspect),18 Triceps brachii muscle 19 Cephalic vein 20. Biceps brachii muscle 21 Museulocutancous nerve 24. Brachial artery and vein 25. Shaft of humerus 26 Brachioradialis muscle 27 Radial nerve 28. Olecranon and articu of elbow joint 29 Basile vit 30. Humerus 31 Pronator teres muscle 32. Extensor muscles of forearm 33. Ramus profundus of radialis nerve 34 Anterior interosseus vessels and nerve 35 Interosseous membrane Axial section through the elbow Axial section through the right elbow 36 Ulna Joint (section 3; MR-Image; inferior Joint (section 3; inferior aspect) 37 Radius aspect). 38 Radial artery and superficial branch of radial nerve 39 Flexor pollicis longus muscle 40. Flexor digitorum superticalis and profundus muscles 41 Ulnar nerve, ulnar artery and 42. Flexor carpi ulnaris muscle 43. Radial artery 44 Metacarpal bones HL and IV 45. Carpal canal with tendons of flexor digitorum muscles 46 Hypothenar muscle 47 Median nerve 48 Interossous muscles 49. First metacarpal bone 50. Thenar muscles 51 Articular cavity of hhumeroradial joint 52 Median cubital vein Axial section through the middle Axial section through the right of the forearm (section 4; MR-Image; forearm (section 4; inferior aspect), inferior aspect) Axial section through the right hand (metacarpus; Axial section through the right hand at the level of the MR-Image; section 5; inferior aspect). metacarpus (section 5; inferior aspect).Arteries and nerves of the right hand (palmar aspect). (Schematic drawing.) < Right hand, superficial layer (palmar aspect). Dissection of the superficial palmar arch, Longitudinal section through the hand at the level of the third finger Longitudinal section through the hand at the level of the third finger (MR-Sean, courtesy of Dr. A. Heuck, Munich).Right hand, middle layer (palmar aspect). The flexor retinaculum has been removed. al branch of radial nerve 1 Super 2 Tendon of flexor carpi radials muscle 3. Radial artery 4 Median nerve Tendon of flexor digitorum superficialis muscle 6 Tendon of abductor pollicis longus muscle 7. Tendon of extensor pollicis brevis muscle 8 Superficial palmar branch of radial artery 9. Abductor pollicis brevis muscle 10 Superficial head of flexor pollicis brevis muscle 11 Terminal branches of superficial branch of radial nerve 12 Common palmar digital nerves (median nerve) 13 Proper palmar digital arteries of thumb 14 Proper palmar digital nerves (median nerve) 15 Tendon of flexor carpi ulnaris muscle 16 Ulnar artery 17 Position of pisiform bone 18 Superficial branch of ulnar nerve 19 Flexor retinaculum 20 Deep branch of ulnar nerve Arteriogram of the right hand (palmar aspeét) a 2 2 4 25 26 28 29 x” 3 2 3 8 36 3 38 8 0 41 2 4B Abductor digti minimi muscle ‘Common palmar digital nerves (ulnar nerve) Superficial palmar arch “Tendons of flexor digitorum muscles ‘Common palmar digital arteries Palmar digital nerves (ulnar nerve) Proper palmar digital arteries (Carpal tunnel Fibrous sheaths for the tendons of flexor digitorum muscles Deep palmar arch Princeps pollicis artery Palmar branch of median nerve ‘Common digital palmar arte Ulnar nerve Capillary network of finger Radius Carpal bones Metacarpal bone Interosseus muscles Proximal phalanx Midale phalanx Distal phalanx Dorsal branch of ulnar nerve Tendons of flexor digitorum profundus (upper) and superficialis (lower) muscles1 4 Right hand, deep layer (palmar aspect). The carpal tunnel has been opened, the tendons of the flexor muscles have been removed and the superficial palmar arch has be Right hand, deep layer (palmar aspect). Dissection of the deep palmar arch. Tendon of flexor carpi radialis muscle Radial artery Tendon of abductor pollicis longus muscle Abductor pollicis brevis muscle ‘Superficial and deep heads of flexor pollicis brevis muscle Oblique and transverse heads of adductor pollicis muscle Median nerve ‘Tendons of flexor digitorum superfcialis and profundus muscles Tendon of flexor pollicis longus muscle Pronator quadratus muscle Tendon of flexor carpi ulnaris muscle Ulnar artery Superficial branch of ulnar nerve Deep branch of ulnar nerve Abductor digiti minim muscle Superficial palmar arch (cut end) ‘Common palmar digital nerves (ulnar nerve) Palmar metacarpal arteries of deep palmar arch Palmar digital artery of the Sth finger ibrous sheaths of tendons of flexor muscles Palmar interosseous muscles Opponens pollicis muscle (cut) Deep palmar arch Ist dorsal interosseous muscle Ist lumbrical muscleCoronal section through the legs (MR-Scan, courtesy of Dr. A. Heuck, Munich), 16 Sacral promontory Gluteus medius muscle Small intestine and urinary bladder Acetabulum Head of fem Greater trochanter of femur Vastus lateralis muscle Femur ‘Adductor muscles Ki Tibia Soleus muscle Joint with menisci Tibial anterior muscle Distal tibiofibular articulation Talocruralarticulati Fibula (Lateral malleolus) The lower limb (extremity) is specialized for support of the upright posture, locomotion and maintaining balance. In contrast to the upper limb, the lower limb is more restricted in its movements, and the joints a t and fixed by strong ligaments. The hip joint is a ball, and socket type of synovial joint between head of femur and acetabulum. The knee joint is a hinge type of synovial joint that permits only limited rotation, The talocrural joint is a hinge joint between talus, fibula, and tibia only allow- ing movements of flexion and extension. The long axis of the foot is at right angle to that of the leg, thus, forming an effective the upright stance of man more ti rch forSkeleton of pelvic girdle and lower limb (anterior aspect). The talocrural joint has been dislocated. A B c D Pelvic girdle Thigh Leg Foot Right hip bone Sactum Femur Patel Fibula Tibia Tarsal bones Metatarsal bones Phalanges Sacroiliac joint Hip joint Knee joint Proximal tibiofibular joint Distal tibiofbular joint Talocrural joint Talocaleaneonavicular join Tarsometatarsal joints Metatarsophalangeal joints The pelvic girdle is firmly connected to the vertebral column at the sacroiliac joint. Therefore the body can be kept upright more easily even if only one limb is used for support (as in walking). The mobility of the lower limb is more limited than that of the upper limb, Organization of pelvic girdle and lower liRight hip bone (ateral aspect). Sac im and coceyx (lateral aspect). 10 a hip bone (medial aspect) Hur Ischium Pubis Posterior inferior lia spine Greater sciatic noteh Ischial spine Lesser sciatic noteh Body of schium Ischial tuberosity Obcurator foramen Tac erest Anterior ghitea line Internal lip of lac eres External ip of iliac crest Anterior superior iliac spine Inferior gluteal line Anterior inferior iliac spine Lnate surface of acetabul Acetabular fossa Acetabular notch Pecten pubis Pubic tubercle Body of pubis Tlie fossa Arcuate line Lop Articular surface of pubis Auricular surface of saerurn Pelvic surface of sacrum Superior articular process of saerum Lateral sacral eres Median sacral crest Obturator groove CoccyxSacrum (anterior aspect) Sacrum (posterior aspect) Sacrum (superior aspect), tic drawing.) Superior articular process of serum 0 Base of sacrum 10. Sacral promontory 11 Anterior sacral foramina 2 Lateral part of sacrum (ala) ransverse line of sacrum eral canal Linea terminalis(superior aspect). Note the differences between the male and the female pelvis, predominantly in the form and dimensions of the sacrum, the Superior and inferior apertures and the alae of the ilium, Male pelvis (superior aspect). Compare with the Superior articular process of sacrum Posterior superior iliac spine Base of sacrum Sacral promontory Coccyx Ischial spine External lip Intermediate line | NA Internal ip Stes Areuate line Anterior superior iliac spine female pelvis (depicted above) Anterior inferior iliae spine iopubie eminence Pecten pubis Pubic tubercle Pubic symphysis Sacral canal Ala of sacrum Position of sacroiliac jim Hie fossa Linea terminalisale pelvis (anterior aspect). Note the differences between the form and dimensions of the male and the female pelvis. The female pubic arch is wider than the male. The obturator foramen in the female pelvis is triangular, while that in the male pelvis is ovoid Anterior superior iliac spine 1 2 Wine fossa 9 Pubie arch 3. Position of sacroiliac joint 10 Anterior inferior iliac spine 4 Tliopubie eminence 11 Sacrum 5. Lunate surface of acetabulum 12_Linea terminalis (at margin of superior aperture) 6 Acetabular notch 13. Pubiesymphysis, CObturator foramen 14 Isehial spine ial tuberosit 5 CoccyxFemale pelvis (posterior inferior aspe and ma ). Note the differences between the female pelvis, especially with respect to the inferior aperture, the shape of the sacrum, the two sciatic notches and the pubie arch. Male pelvis (posterior inferior aspect). Compare with the female pelvis (depicted above), 1 Tlie crest 10 Coveys 2 Sacral canal LL Superior articular process of sacrum Posterior gluteal line 12 Gluteal surface of ium 4 Posterior superior iliac spine 13 Median sacral erest 5. Position of sacroiliac joint 14. Greater sciatic note 6 Dorsal sacral foramina 15. Position of acetabulum 7 Sacral hiatus 16 Ischial spine 8 Obturator foramen 17 Lessersciatic notch 9 Ramus ofischium 18. Ischial tuberosity1 Bones of right hip joint (posterior aspect). ae erest Lateral part of sacrum (ala Position of sacroiliac joint Anterior superior iliac spine Linea terminalis iopubic eminence Bony margin of acetabulum Head of femur Greater trochanter Neck of femur 2 Shatt of femur Imitation intervertebral dise between Sth lumbar Sacral promontory Anterior sacral foramin Pubic tubercle Obturator foramen Ramus of ischium Lesser trochante Dorsal sacral foramina Greater sciatic notch Ischial spine Pubic symphysis Pubis Ischial tuberosity Intertrochantericerest Symphysial surface Diameters of the pelvis True conjugate (11-L1.S em) (Conjugata vera) Diagonal conjugate (125-13 em) Largest diameter of pelvis Inferior pelvic aperture Pelvic inclination (60°) Inclination and diameters of the female pelvis, right half (medial aspect)F (anterior aspect) Greater wochanter Intertrochanterc ine Natrient foramina Shaft of femur (diaphysis) Lateral epi Patella surfs 7 Head Right femur (posterior aspect) head 15. Lateral condyle 16 Medial condyle ant 17 Intertrochanteric erest Medial epicon 18. Third trochanter 19. Medial ip of linea aspera Lateral lip of linea aspera Linea aspera Popliteal surfa Intercondylar fos.1 Lateral condyle of tii 2 Position of tibiofbular joint 3. Head of fibula 4 Interos ous border of tibia 6 Interosseous border of fibula Lateral surface of fibula 8. Position of tibiofbular joint 9 Lateral malleolus 10 Medial condyle of tibia LL Tuberosit of tibia 12. Shaft of tibia (diaphysis) Anterior margin of tibia 14 Medial malleolus 5. Inferior articular surface oftibia 16 Intercondylar eminence 17 Sol 18 Medial border of tibia 19 Posterior surface of tibia 20. Malleolar sulcus of tibia 21 Malleolae articular surface of fibula 22. Apex of head of i bua 23. Posterior surface of fibula 24 Posterior border of fibula 25. Medial intercondylar tubercle 26 Posterior intercondylar area 27. Anterior intersondylae area 28 Lateral intercondylar tubercle Bones of leg, right tibia and fibula Bones of leg, right tibia and fibula (anterior aspect). (posterior aspect), Upper end of right tibia with fibula (from above), anterior margin of tibia above Superior articular surface of tibia.Right patella (anterior aspect) 1 4 6 Femur Patellar surface of femur Lateral epicondyle of femur Intercondylar eminence of tibia Lateral condyle of tibia Position oftibiofibular joint 7 Headof fibula Tuberosity of tibia F (posterior aspect), 16 7 0 u B 4 1s 6 Bones of right knee j (lateral aspect) nt patella (posterior aspect). Shaft of tibia Popliteal surface of femur Intercondylar fossa of femur Lateral condyle of femur Patella Base of patella Anterior surface of patella Apex of patella Articular surface of patellaBones of right foot (dorsal aspect) 36 37 38 39 40 Bones of right foot together with tibia and fibula (posterior aspect), 1 4 Tuberosity of distal phalanx of great toe Distal phalanx of great toe Proximal phalanx of great toe Head of first metatarsal bone Base of frst metatarsal bone Medial cuneiform bone Intermediate cuneiform bone navicular joint Navicular bone32 27-80 27 2625 24.23 22 Bones of right foo Head of talus Neck of talus Trochleaof talus Posterior tala process Distal phalanges Middle phalanges Position of interphalangeal joints Proximal phalanges Position of metatarsophalangeal joints ia and fibula (lateral aspect) 28 Metatarsal bones tarsometatarsal joints Lateral cuneiform bone Tuberosity of Sth metatarsal bone Cuboid bone Ponition of ealeaneocuboid joint Caleaneus Tarsal sinus Lateral malleolar surface of talus Peronealtrochlea of caleaneus Groove for tendon of peroneus longus Caleancal therosity Sustentaculun tal MM Tibia 35 Medial malleolus 36. Fibula Position of tibioibular syndesmosis ‘sition of talocrural joint 39 Lateral malleolus 40 Position of subtalar jointLigaments of pelvis and hip joint (anterior aspect) 1 Hiolumbar ligament 13. Sacrum 25 Femur 2 Iliac rest 14 iopectinesl arch 26 Articular capsule of hip joint 3. Fifth lumbar vertebra 15 Miofemoral ligament (horizontal band) 27-_Dorsal sacroiliac ligaments 4 Sacral promontory 16 Obturator canal 28 Coceyx with superficial dorsal 5. Anterior superior iliac spine 17 Obturator membrane sacrococeygea! ligament 6 Inguinal ligament 18 Greater sciatic foramen 29. Head of femur 7. Sacrospinous ligament 19. Sacrespinous ligament 30 Anticular cartilage of head of femur 8. Greater trochanter 20. Sacrotuberous ligament 31 Axticular cavity of hip joint 9. Wiofemoral ligament (vertical band) 21 Lesser sciatic foramen 32. Acetabular lip 10 Lesser trochanter 22 Ischial tuberosity 33. Spongy bone 11 Forth lumbar vertebra M Ligament of head of femur 12. iolumbar and ventral sacroiliac Intertrochanteric crest 35 Pubofernoral ligament rents 36 Zona orbicularis Ligaments of pelvis and hip joint (left anterior aspect) Coronal section of right hip joint (anterior view),1 Femur 2 Lesser trochanter 3 Neck of femur 4 Head of femur 5. Fovea of head with remnants of ligament of head 6 Lunate surface of acetabulum 7. Acetabular lip 8 Acetabular fossa 9 ‘Transverse acetabular ligament 10 Inguinal ligament 11 Tliopectineal arch 12. Pubie symphysis 13. Pubie bone 14 Obturator canal 15 Ligament of head of femur 16 Obturator membrane 17 Ischium 18 Anterior longitudinal ligament (level of fifth lumbar vertebra) 19 Sacral promontory a at ss ere es 20 Miolumbar ligament Right hip joint, opened (lateral anterior aspect). The ligament of the head of the femur 21. liae erst has been divided and the femur has been posteriorly reflected, 22 Anterior superior iia spine 23. Miofemoral ligament (horizontal band) 24 Iiofemoral ligament (vertical band) 25. Greater trochanter 26 Puboemoral ligament Anterior inferior iliac spine Ventral sacroiliac ligaments 30 Sacrotuberous ligament 31. Imtertrochanteric line 32 _Ischiofemoral ligament 33. Zona orbicularis Ligaments of the pelvis and hip joint tero-lateral aspect), Ligaments of hip joint (anterior aspect). (Schematic Ligaments of hip joints (posterior aspect). drawing.) (Schematic drawing.)Right knee joint (opened) with lig The patella and articular capsule have been removed and the femur slightly flexed. Articular surface of right tibia, menisci, and cruciate lig (superior aspect). Anterior margin of tibia above. ight knee joint with ligaments (posterior aspect). The joint is extended and the articular capsule has been removed. 1 Femur Articular capsule with suprapatellar ours Patellar surface ateral condyle of femur Lateral meniscus of knee joint ibular collateral ligament Lateral condyle of tibia (superior articular surface) Fibula fedial condyle of femur Tibial collateral ligament A ate ligament Medial meniseus of knee joint Transverse ligament of knee Patella ligament Common tendon of sartorius, semitendinosus and gracilis m Tibia Nol conve o i Poeror meniscofemoral ligament Head fila pete tee a 25 Lateral epicondyle of femur18 2 Right knee joint, opened (anterior aspect). Patellar ligament with patella reflected. Right knee joint. Frontal section through the central part of the joint (posterior aspect, MR-Scan). (See also p. 10.) iotibial tract Articular muscle of knee Patellar surface Lateral condyle of femur Articular capsule Infrapatellar ft pad stella (articular surface) Suprapatellar bursa ‘Quadriceps muscle of thigh (divided) Anterior cruciate i Medial condyle of femur Fiular eotlat Posterior cruciate ligament Medial epicondyle of femur Intereondylar fossa of femur Tibial collateral ligament Medial meniseus of knee joint Medial intercondylar tubercle Femur Lateral epicondyle of femur Lateral meniscus of knee joint Epiphyseal line of tibia Tibia1 Femur 2 Quadriceps femoris muscle 3. Suprapatellar bursa and articular cavity 4 Patella 5. Patellar surface (articular cartilage) 6 Infrapatellar fat pad Patella ligament 8 Tibi 9) Tibial nerve 10 Adduetor magnus muscle 11 Popliteal vein 12 Semitendinosus muscle 13 Semimembranosus muscle 14 Popliteat artery 15 Gastrocnemius muscle 16 Anterior cruciate ligament 17 Posterior cruciate ligament 18 Popliteus muscle 19. Soleus muscle 20, Deep flexor muscles of 21 Caleaneal tendon Epiphyseal line of tibia Caleaneus Talocrural joint Talus Lateral meni Epiphysial line Anterior surface to the left. Sagittal section through the knee j ‘Talocrural joint, Sagittal section; anterior part to the left. (MR- Left knee joint. Anterior cruciate ligament Sean.) (lateral aspect).2 27 29 20 28} 26 igaments of talocrural joint, right leg Deep ligaments of the foot, right foot (plantar (posterior aspect). aspect). The toes have been removed. 1 Quadriceps femoris muscle 2 Femur 3 Patellar surface 4. Lateral epicondyle of fermur 5. Fibular collateral igament 6 Head of fibula 7. Fibula 8 Patella 9 Articular cavity of knee joint 10 Infrapatellar fat pad 11 Patellar ligament 12. Lateral meniscus of knee jo 13. Lateral condyle of tibia (superior articular facet) 14 Tibiofibular joint 1S Tibia 16 Trochlea of talus (superior surface) 17 Deltoid ligament of ankle (posterior tbiotalar part) 18 Talus 19. Sustentaculum tal 20 Navicular bone 2 Ist metatarsal bone fibular ligament 22 Posterior ti 3 Lateral malleolus 24 Posterior talfibular ligament 25. Calcancofibular igament Calcaneal tuberosity and tibiofibular joint with ligaments. Note the position of the lateral meniscus, lamar tarsometatarsal ligaments Long pl Planter cuneonaiicalar ar ligamentFibula Tibia Tochlea of talus and talocraral joint Anterior tibiofibular ligament Anterior talofibular ligament Lateral malleolus alcaneofibular ligament Lateral talocaleaneal ligament Subtalar jo Tuber ealeanei Interosseous talocaleaneal ligament Bifurcate ligament Long plantar ligament Caleaneoeuboid joint Tuberosity of Sth metatarsal bone Dorsal tarsometatarsal ligaments Keceaseal beni igaments of right foot (lateral aspect), Ligaments of right foot (medial aspect) 18 Head of talus and talocaleanconavicular joint 19. Navieular bone 20 Dorsal cuneonavicular ligaments 21 Heads of metatarsal bones sament of ankle (tibionavicular part) zament of ankle (tibiocalcaneal part) Dorsal cuneonavicular ligaments Navicular bone 26 Plantar cunconavicular ligament Ist metatarsal bone Head of Ist metatarsal bone arsal Plantar tarsomet ments Plantar caleaneonavicular ligament Sustentaculum tal Caleaneus Medial malleolus Medial or deltoid ligament of ankle (posterior part) 35. Talus35 63738 Longitudinal section through the foot at the level of first phalanx, Sagittal section through the f (MR-Scan after A. Heuck, 1 Tibia 2 Deep flexor muscles 3. Superficial flexor muscles 5. Interosseous talocalcancal ligament 6 Subtaar joint 7. Caleaneal or Achilles tendon and burse 8 Calcaneus 9 Vessels and nerves of foot 10 Talus 11 Talocalcaneonavicular joint 12 Navicular bone 13 Cuneonavicular joint 14 Intermediate cuneiform bone 15 Tarsometatarsal joi 16 Metatasal bones: a 2 24 26 2 Luttke and J. W. Rohen, 1994), Metatarsophalangeal and interphalangeal joints Quadratus plantae muscle with flexor tendons Flexor digitorum brevis musice Plantar aponeurosis Articular capsules of interphalangeal joints Articular capsules of metatarsophalangeal joints Articular surface of navicular bone Plantar ealeaneonavicular ligament Middle talar articular surface of calcaneus Navicular articular surface of talus Anterior and middle calcaneal surfaces of talus 28 29 30 31 32 3 M4 38 39 Talocalcanconavicular joint. The talus has been rotated to show the articular surfaces of the joint. Posterior caleaneal surface of talus Dorsal tarsometatarsal ligaments Talonavicular ligament Bifurcate ligament Anterior talar articular surface of caleaneus Posterior talar articular surface of calcaneus Axis for inversion and eversion ‘Tendon of tibialis posterior muscle Tendon of flexor hallucis longus muscle Flexor hallucis brevis muscle Sesamoid bone Cuboid boneExtensor and adductor muscles of ‘thigh, right thigh (anterior aspect), 1 4 6 u 2 B 4 ‘Quadriceps muscle and superficial layer of adductor muscles, right thigh (anterior aspect). The sartorius muscle Course of extensor muscles of thigh and muscles inserting with common tendon on tibia. has been divided, ‘Anterior superior iliac spine Inguinal ligament iopsoas muscle Femoral artery “Tensor fasciae latae muscle Sartorius muscle Rectus femoris muscle Hiotibial tract ‘Vastus lateralis muscle Patella Patellar ligament “Aponeurasis of external abdominal oblique muscle ‘Spermatic cord Femoral vein 1s 16 0 18 19 20 2 2 24 25 7 Pectineus muscle Adduetor longus muscle Gracilis muscle ‘Vastus medialis muscle ‘Common tendon of sartorius gracilis, and semitendinosus muscles (pes anserinus) Adductor brevis muscle Femoral artery Femoral vein Saphenous nerve Fascia of adductor canal ‘Vastus intermedius muscle Articularis genus muscle Semitendinosus muscle cemtering the adductor canalDeep layer of adductor muscles. Adductor magnus muscle (anterior aspect). Pectineus, adductor longus and. brevis muscles have been divided. Anterior superior iliae spine Inguinal ligament Hiopsoas muscle Sartorius muscle CObturator externus muscle “Tensor fasciae latae muscle Rectus femoris muscle iotibial tract ‘Adductor longus muscle (divided) YVastus lateralis muscle Vastus medialis muscle Pectineus muscle (divided) Adductor minimus muscle ‘Adductor brevis muscle (cut) 18 16 7 18 19 a 2 2 24 6 a Course of adductor muscles. (Schematic drawing.) 2 Pectineus muscle (blue) ‘Adductor minimus muscle (red) ‘Adductor brevis muscle (blue) ‘Adductor longus muscle (blue) ‘Adductor magnus muscle (red) Gracilis musele (blue) Hiopsoas muscle (ed/blue) Adductor magnus Grailis muscle Addductor hiatus Vastoadductor membrane Diaphragm Miiopsoas and adductor muscles; deepest layer ‘Quadsarue bedbocust orcs (anterior aspect). Pectineus, adductor longus and iacus muscle brevis, rectus femoris muscles have been divided. ‘Vastus intermedius muscle Aorta in aortic hiatus Twelfth vib Psoas minor muscle Psoas major musele iopectinea! archCourse of gluteal muscles (posterior aspect; schematic drawing). 2————__\\\@ 4 Course of gluteal muscles (deeper layer) and of ischiocrural muscles (posterior aspect), Sartorius muscle is indicated by dotted line (schematic drawing),1 Thoracolumbar fascia 2 Spinous processes of lumbar vertebrae 3. Coccyx 4 Anus 5 Adductor magnus muscle 6 7. Tliaccrest 8 Gluteus medius muscle 9 Greater trochanter 10 Glutews maximus muscle 11 Wiotibial tract 12. Piriformis muscle 13. Superior gemellus muscle 14 Obturator internus muscle 15 Inferior gemellus muscle 16 Ischial tuberosity 17 Biceps femoris muscle 18 Tensor fasciae latae muscle “19 Quadratus femoris muscle 20 Gluteus minimus muscle 21. Sartorius muscle 22. Semimembranosus muscle 23. Tendon of gracilis muscle 24 Tibial nerve 25. Medial head of gastrocnemius muscle 26 Common peroneal nerve 27 Tes ps femoris muscle 28. Lateral head of gastrocnemius muscle 29 Rectus femoris muscle 30. Vastus medialis muscle 31. Vastus intermedius musele 32. Vastus lateralis muscle 33. Sciatic nerve 34 Gluteus maximus muscle (insertion) 35. Great saphenous vein emoral artery 37 Femoral vein, 38 Adductor longus muscle 39. Femur 40. Gracilis muscle 41 Septum between semitendinosus and semimembranosus muscles itendinosus musele lon of bi Flexors of the right thigh, superficial layer (dorsal aspect), Cross section of right thigh (inferior aspect). Anterior side on top.Dorsal muscles of right thigh (posterior aspect). The gluteus maximus muscle has been cut and reflected. Giuteus maximus muscle (divided) Position of coceyx Piriformis muscle Superior gemellus muscle CObturator internus muscle Inferior gemellus muscle Ischial tuberosity Quadratus femoris muscle Dorsal muscles of right thigh (posterior aspect). ‘The gluteus maximus muscle and the long head of biceps. femoris muscle have been divided and displaced. Semitendinosus muscle with intermediate tendon Semimembranosus muscle Medial head of gastrocnemius muscle luteus medius muscle ‘Adductor minimus muscle ‘Adductor magnus muscle Long head of biceps femoris muscle tibial tr 18 19 20 21 ‘Short head of biceps femoris muscle Poplitea! surface of femur Plantaris muscle “Tendon of biceps femoris muscle Lateral head of gastrocnemius muscle Membranous part of semimembranosus muscleFlexor muscles of right leg (posterior aspect). Semitendinosus muscle ‘Semimembranosus muscle Sartorius muscle Tendon of gracilis muscle Medial head of gustrocnemius muscle ‘Common tendon of gracilis, sartorius, and semitendinosus muscles ‘Caleaneal or Achilles tendon, Medial malleolus 0 u 2 B 4 1s 16 7 Flexor muscles of right leg (posterior aspe muscle have been cut and reflected, Calcaneal tuberosity Tibial nerve Biceps femoris muscle Plantaris muscle ‘Common peroneal nerve Lateral head of gastrocnes Soleus muscle Peroneus longus and brevis muscles Lateral malleolus muscle Both heads of the gastrocnemius 18 19 20 2 2 2B 24 Flexor muscles of the leg (right side). Popliteal fossa Tibial nerve and posterior tibial artery Popliteus muscle Tendinous arch of soleus muscle Femur Fibula Tibia10 u 2 B “4 15 Popliteal region with plantaris and soleus, right side (dorsal aspect). Notice the insertion of the tendon of semimembranosus. Muscles of right leg and foot (medial aspect), 16. Medial head of gastrocnemius muscle ‘Vastus medialis muscle Patella 17 Soleus muscle Patellar ligament 18 Calcaneal or Achilles tendon ‘Tibial tuberosity 19 Calcaneus muscle Tibia 20. Tendon of flexor hallucis longus muscle Tendons of deep flexor muscles (from anterior to posterior 21 Quadriceps femoris muscle (divided) 1 tibialis posterior;2. flexor digitorum longus; 3. flexor hallucis 22. Tendon of adductor magnus muscle (divided) longus muscles) 23 Medial condyle of femur Flexor retinaculum 24 Popliteal artery and vein, tibial nerve Tendon of tibialis anterior muscle 25. Tibia Tendon of extensor hallucis longus muscle 26 Femur Abductor hallucis muscle 27. Lateral epicondyle of femur Semimembranosus muscle 28 Oblique popliteal ligament 29 Lateral (fibular) collateral ligament Tendon gracilis muscle 30. Plantaris muscle Tendon of semitendinosus muscle 31 Tendon of biceps femoris muscle (divided) ‘Common tendon of gracilis semitendinosus and sartorius| 32. ‘Tendinous arch of soleus muscle muscles Sartorius muscleMuscles of ri leg and foot (lateral aspect) Right foot with synovial sheaths of extensor muscles (dorsal aspect). ‘The synovial sheaths have been injected with blue solution. Common peroneal nerve Head of fibula Lateral head of gastrocnemius muscle Soleus muscle Peroneus longus muscle Peroneus brevis muscle Caleaneal or Achilles tendon Lateral malleolus muscle ‘Tendon of peroneus longus muscle Extensor digitorum brevis muscle “Tendon of peroneus brevis muscle Patella Patellar ligament Tuberosity of tibia ‘Tbialis anterior muscle Extensor digitorum longus muscle ‘Superior extensor retinaculum Inferior extensor retinaculum Tendon of extensor hallucis longus muscle Tendons of extensor digitorum longus muscle ‘Common synovial sheath of extensor digitorum longus muscle ‘Tendon of peroneus tertius muscle to the lateral margin of foot ‘Tendons of extensor digitorum brevis muscle Medial malleolus Synovial sheath of tendon of tibialis anterior muscle Tendon of tibialis anterior muscle ‘Synovial sheath of tendon of extensor hallucis longus muscle1 Medial condyle of femur 2. Popliteus muscle 3. Flexor digitorum longus muscle 4 Cros endons in leg 5 Tendon of tibialis posterior muscle 6 Tendon of flexor digitorum longus muscle 7 Medial malleolus 8 Lateral condyle of femur 9) Head of fibula 10. Tibialis posterior muscle 11 Flexor hallucis longus muscle 12. Peroneus longus muscle 13. Peroneus brevis muscle 14 Tendon of flexor hallucis longus muscle 15 Calcaneal tendon (divided) 16 Lateral malleolus Popliteus muscle (blue) Flexor digitorum longus muscle (blue) Tibialis posterior muscle (red) Crossing of tendons in leg Flexor allucis longus muscle (blue) Crossing of tendons in sole Deep flexor muscles of right leg Course of deep flexor muscle of leg. (Schematic drawing.) (posterior aspect).Medial condyle of femur Tibia Flexor digitorum longus muscle Crossing of tendons in leg Tendon of tibialis posterior muscle Abductor hallucis musele Tendon of flexor hallucs longus muscle Lateral condyle of femur Head of fibula Tibialis posterior muscle Tendon of flexor digitorum longus muscle Flexor retinaculum CCalcaneal tendon Caleaneal tuberosity Crossing of tendons in sole ‘Quadratus plantae muscle ‘Tendons of flexor digitorum longus muscle ‘Tendon of tibialis anterior muscle Area of insertion of tibialis posterior muscle Lumbrical muscles Flexor hallucis longus muscle Deep flexor muscles of right leg and foot (posterior Sole of foot; tendons of long flexor muscles (oblique medial and inferior oblique medial aspect). Felxor digitorum brevis aspect) and flexor hallucis longus muscles have been removed.Extensor muscles of right leg and foot Extensors of the right leg and fo (oblique anterolateral aspect) (anterior aspect). Part of the tibialis anterior muscle hhas been removed. Patella Tendon of peroneus tertius muscle Tendon of tibialis anterior muscle Patellar ligament Extensor digitorum brevis muscle Extensor hallucis brevis muscle terior margin of tibia Tendons of extensor digitorum Tendon of extensor hallucis bali anterior muscle Tongus muscle longus muscle Extensor digitorum longus muscle Soleus ‘Common tendon of grails, iperior extensor retinaculum 2 Extensor hallucis longus muscle semitendinosus and sartoris muscles Inferior extensor retinaculum Medial malleolus TibiaExtensor muscles of the leg Sole of foot, first layer of muscles (from below). (right side). The plantar aponeurosis and the fascine of the superficial muscles have been removed, Longitudinal bands of plantar aponeurosis Plantar aponcurosis Position of tuberosity of Sth metatarsal bone Muscles of Sth toe with fascia Caleaneal tuberosity Muscles of great toe with fascia Tendons of flexor digitorum longus muscle ‘Tendons of flexor digitorum brevis muscle Lumbrical muscle Flexor digit minimi brevis muscle Flexor digitorum brevis muscle 2 B 1“ 15 16 7 18 19 2 2 2 Tendon of peroneus longus muscle Abductor digit minimi muscle Tendon of flexor hallucis longus muscle Flexor hallucis brevis muscle Abductor hallucis muscle Plantar aponeuross (cut) Peroneus longus muscle Peroneus brevis muscle ‘Tibialis anterior musele Extensor halluc longus muscle Extensor digitorum longus muscle 6 Sole of foot, plantar aponeu- rosis (from below), Sli Course of abductor and adductor muscles of foot. (Schematic drawing.) Red arrows = abduction, Black arrows = adduction, Plantar iterossei muscles (black) Abbductor digiti minimi muscles (red) Dorsal interossei muscle (red) Transverse head of adductor muscle (black) ‘Oblique head of adductor muscle (black) ‘Abductor hallucis muscle (red)Muscles of sole of foot, second layer (from below). The flexor digitorum brevis muscle has been divided. 4 Tendons of flexor digitorum brevis muscle ‘Tendons of flexor digitorum longus muscle Lumbrical muscles Interossei muscles Flexor dgiti minimi brevis muscle 9 10 ul 2 Muscles of sole of foot, second layer (from below). The tendons of the flexor muscles and the crossing of tendons are displayed. The flexor digitorum brevis muscle has been divided and reflected. Abductor digiti minimi muscle B Quadratus plantae muscle 4 Caleaneal tuberosity 1s Tendon of flexor hallucis longus muscle Flexor hallucis brevis muscle 16 Abductor hallucis muscle 17 Flexor digitorum brevis muscle (divided) 18 Tuberosity of Sth metatarsal bone ‘Tendon of peroneus longus muscle Transverse head of adductor hallucis muscle Crossing of tendons in sole of foot Medial malleolus Plantar aponeurosis (divided)Muscles of sole of foot, third layer (from below). The flexor digitorum brevis muscle has been removed, and the quadratus plantae muscle and the abductor hallucis and digiti minimi muscles have been divided. Tendons of flexor digitorum brevis muscle Transverse head of adductor hallucis muscle Abductor digiti minimi muscle Interosseous muscles Flexor digiti minimi brevis muscle Opponens digiti minimi muscle Tendon of peroneus longus muscle 9 0 u 2 B “4 (Quadratus plantae muscle with tendon of flexor digitorum longus musele Calcaneal tuberosity Tendons of flexor hallucis longus muscle (divided) Tendon of flexor digitorum longus muscle Flexor hallucis brevis muscle Oblique head of adductor hallucis muscle Abbductor hallucis muscle (cut) 1s ra 18 19 Muscles of sole of foot, fourth layer (from below). The interosseous muscles and the canal for the tendon of peroneus longus muscle are shown, Tendon of tibialis posterior muscle Dorsal interossei muscles Plantar interossei muscles Tuberosity of Sth metatarsal bone ‘Tendon of flexor digitorum longus muscle (crossing of plantar tendons) Long plantar ligament‘The femoral vein has been partly re deep femoral artery. Notice: the vessels enter the adductor canal to reach the popliteal fossa. Main arteries of lower extre t side (ventral aspect) (Schematic drawing.)Arteries of the right leg (posterior aspect), 1 15 . 18 9 21 Femoral a Profunda femoris artery Ascending branch of lateral circumflex femoral artery Descending branch of lateral circumflex femoral artery Lateral superior genicular artery Popliteal artery Lateral inferior genicular artery Arcuate artery with dorsal metatarsal arteries Plantar arch with plantar metatarsal arteries Medial circumflex femoral artery Profunda femoris artery with perforating Descending genicular artery Medial superior genicular artery Midale genicular artery Medial inferior genicular artery Posterior tibial artery Dorsal Medial plantar artery Superficial and deep circumflex iliac arteries Femoral nerve Lateral circumflex femoral artery Sartorius muscle (cut and reflected) Rectus femoris muscle Vastus medialis muscle Inguinal ligamen Femoral vein (cut) External pudendal artery and vein Adductor longus muscle Great saphenous vein Obturator artery and nerve Gracilis muscle Saphenous nerve Tendinous wall of adductor canal Anterior cutaneous branch of femoral nerve Infrapatellar branch of saphenous nerve Popliteal vein Tibial nerve Medial head of gastrocnemius muscle Biceps femoris muscle ‘Common peron: Lateral head of gastrocnemius muscle Plantaris muscle Soleus muscle Flexor hallucis longus muscle Spermatic cordSuperficial veins of lower limb, right side (medial anterior aspect).’The veins have been injected with red solution. Medial malleolar region. Dissection of tibial nerve, posterior tibial vessels, and great saphenous vein (veins injected with blue resin), Main veins of lower limb, right side (anterior aspect) (Schematic drawing.) 1 Superficial epigastric vein 2. Superficial circumflex iliac vein 3. Femoral vein 4s saphenous vein 5. External iliac vein 6 External pudendal vein 7 Great saphenous vein 8 Dorsal venous arch 9 Saphenous opening with femoral vein 10 Venous anastomoses of small saphenous va with great saphenous vein Patella Penis Medial malleolus Popliteal fossa Perforating veins Lateral malleolus Dorsal digital veins of foot Dorsal venous arch of foot Dorsal metatarsal veins of foot Anterior tibial artery and veins Tibia Posterior tibial artery and veins Fibula Peroneal artery and vein Deep layer of erural fascia Superticial layer of crural fascia 27. Perforating veins -1I (of Cockett) 28 Tibial nerve 29 Arcuate vein 30 Saphenou 31 Medial dorsal cutaneous nerve (branch of superficial peroneal nerve) 32 Posterior tibial veinSuperficial veins of leg (posterior aspect; injected with blue resin). Superficial veins of leg. The ‘Veins of leg. The anastomoses between perforating veins of Cockett have superficial and deeper veins are been dissected, dissected, Anastomoses between superficial and deep veins ofthe leg (after Aigner). (Schematic drawing.) Arrows: directions of blood flow. D>Lumbosacral plexus i Pelvic organs with per 1, right side (medial aspect). toneum and part of the levator ani muscle have been removed. Transversus abdominis mus Tiohypogastric n llioinguinal nerve Femoral nerve Lateral femoral cuta Obturator ner CObturator internus muscle Pubic bone (cut edge) Levator ani muscle (remnant) Dorsal nerve of penis Posterior scrotal nerves Addductor longus muscle cis muscle Body of 4th lumbar vertebra Cauda equina Intervertebral i Sacrum Lumbosacral trunk Sacrospinous lig Pudendal nerve Inferior rectal ner Perineal Subcutaneous fat tissueMain branches of lumbosacral plexus (ventral aspect). (Schematic drawing.)vertebrae removed, dural sheath opened and spinal cord slightly reflected to the right to display the dorsal and ventral roots. 1 Dura mater 6 Eleventh ib Anterior root filaments Spinal cord 7 Intercostal nerve Spinal (dorsal root) ganglion 3. Costotransverse li $ Collateral branch of intercostal nerve ot filaments ter and denticulate ligament 4 Innermost intercostal muscle Intereostal nerve (entering the Arachaoid m 5 Vertebral arches (cut surfaces) intermuscular interval) Anterior spinal arteryCrCy DD Lets SrSs co Organization of spinal cord segments in relation to the vertebral column (anterior aspect). C = cervical: D = thora ambar; S = sacral segments; Co = coceygeal bone. 1 ‘Conus medullaris, 4 Miohypogastricnerve 7. Lateral femoral cutaneous nerve Filum terminale 5 Hlioinguinal nerve 8 Femoral nerve Subcostal nerve 6 Genitofemoral nerve 9 Obturator nerve1 Inguinal igament 2 Superficial circumflex iliac vein 3. Femoral branch of genitofemoral nerve 4 Superficial inguinal lymph nodes 5. Saphenous opening with femoral artery and vein 6 Lateral femoral cutaneous nerve 8 7 Great saphenous vein Anterior cutaneous branches of femoral nerve 9 Patel Terminal branches of subcostal nerve 11 Terminal branches of iiohypogastric nerve 12 Superficial inguinal ring 13. External pudendal vein 14. Spermatic cord wit genital branch of genitofemoral nerve 15 Penis with superficial dorsal vein of penis 16 Testis and its coverings 17 Saphenous nerve 18 Infrapatellar branch of saphenous nerve 19 Lateral sural cutaneous nerves 20. Intermediate dorsal cutaneous branch of superficial peroneal nerve 21 Cutaneous branch of obturator nerve 22. Superficial peroneal nerve 23. Medial dorsal cutaneous branch of superficial peroneal 24 Deep peroneal nerve 25 Femoral nerve 26 Femoral artery Cutaneous nerves and veins of thigh (anterior aspect) Inguinal nodes with lymphatic vessels (anterior ‘The fascia lata and fasciae of the thigh muscles have been aspect) removed,Anterior region of right thigh (anterior aspect). The fascia lata has been removed, and the sartorius muscle has been slightly reflected. Anterior superior iliae spine Inguinal Higament Deep cireumitex iliac artery iopsoas muscle ‘Tensor fasciae latae muscle Fe Lateral circumflex femoral artery Sartorius muscle Rectus femoris muscle iotibial tract Vastus lateralis muscle Anterior sheath of rectus abdominis muscle Inferior epigastric artery Spermatic cord Femoral artery 16 7 18 19 20 29 30 thigh (anterior aspect). The fascia lata has been removed, and the sartorius muscle has been divided, Pectineus muscle Femoral vein Great saphenous vein (divided) Adductor longus muscle Saphenous nerve Muscular branch of femoral nerve Gracilis muscle Vastus medialis muscle Ascending branch of lateral circumflex femoral artery Descending branch of lateral circusnflex femoral artery Medial circumflex femoral artery Adductor longus muscle Penis Entrance to adductor canal ‘Vastoadductory lamina of fascia beneath sartorius muscleAnterior region of right thigh (anterior aspect). ‘The fascia lata has been removed. Sartorius muscle, pectineus muscle and femoral artery have been cut to display the deep femoral artery with its branches. The rectus femoris muscle has been slightly reflected. Anterior superior iliac spine Inguinal ligament Tensor fasciae latac muscle Deep circumflex iliac artery iopsoas muscle Sartorius muscle (cut) Femoral nerve Lateral circumflex femoral artery Ascending branch of lateral circumflex femoral artery Descending branch of lateral circumflex femoral artery Rectus femoris muscle ‘Vastus medialis muscle Vastus lateralis muscle Femoral vein Peetineus muscle (cut) Femoral artery (cut) 2» Anterior region of right thigh (anterior aspect), ‘The sartorius, pectineus, adductor longus and rectus femoris muscles have been divided and reflected. The greater part of the femoral artery has been removed. Obturator nerve Profunda femoris artery Ascending branch of medial ircumilex femoral artery “Medial cicumflex femoral artery Adductor longus muscle Gracilis muscle Saphenous nerve Distal part of vastoadductory lamina Rectus femoris muscle with muscular branch of femoral nerve Adductor longus muscle (divided) Posterior branch of obturator nerve Anterior branch of obturator nerve Point at which perforating artery branches off from profunda femoris artery “Muscular branch to vastus medialis muscleGluteal region, right side (posterior aspect), luteal region, right side (posterolateral aspect). Location of sciatic foramina in relation to the bones. (Schematic drawing.) 1 Miaccrest 2. Giluteus maximus muscle 3 Middle cluneal nerves 4 Anococeygeal nerves Pe 5 al branch of posterior femoral cutaneous nerve 6 Adductor magnus muscle 7. Superior cluneal nerves 8 Position of greater trochanter 9. Inferior cluncal nerves 10 Semitendinosus muscle 11. Posterior femoral cutaneous nerve 12 Long head of biceps femoris muscle A. Suprapiriform foramen of greater sciatic foramen Superior gluteal artery, vein and nerve Bi Infrapiviform foramen of greater sciatic foramen Sciatic nerw Inferior gluteal artery, vein and nerve Posterior femoral cutaneous nerve Internat pudendal artery and vein Pudendal nerve © Lesser sciatic foramen Pudendal nerve Internal pudendal artery and vein Red lines Spine-tuber line, Inthe middle of this line the infrapiriform foram situated Spine-trochanter line. In the upper third the suprapiviform foramen is located ‘Tubertrochanter fi Between the middle and posterior third, the ischiadic nerve can be found Other structures Posterior superior iiae spine ie erest Greater trochanter Ischial tuberosity SacrumGluteal region, right side (dorsal aspect). T and reflected. Notice the position of the forami iac crest Gluteus maximus musele (cut) Inferior gluteal nerve Piriformis muscle Muscular branches of inferior gluteal artery Pudendal nerve and internal pudendal artery within the lesser sciatic foramen (entra Sacrotuberous ligament Inferior cluneal nerve Inferior rectal nerv Inferior rectal arteries Perforating cutaneous Long head of biceps femoris muscle Juteus maximus and gluteus medius muscles have been divided ina above and below piriformis muscles and the lesser sciatic foramen luteus medius muscle (cut) Deep branch of superior glutea (Gluteus minimus muscle or gluteal nerve Saprapiciform foramen} ater sciatic foramen } er . Tendon of obturator internus and superior gemellus muscles Posterior femoral cutaneous nerve smellus muscle ‘Quadatus femoris muscle Tensor fasciae latae muscleCutaneous nerves of thi a as 16 16 The ata and the fasciae of muscles have been removed. Middle cluneal nerves, Perineal branch of posterior femoral cutaneous nerve Posterior femoral cutaneous nerve Semimembranosus muscle Semitendinosus muscle nerve Medial sural cutancous nerve ‘Small saphenous vein Medial head of gastrocnemius muscle luteus maximus musele Cutaneous veins Long head of biceps femoris muscle Hiotibial tract Short head of biceps femoris muscle Popliteal fossa Lateral sural cutaneous nerve Lateral head of gastrocnemius muscle ‘Common peroneal nerve ‘Tendon of biceps femoris muscle Inferior gluteal nerve Sacrotuberous ligament Inferior rectal branches of pudendal nerve Anus luteus medius muscle Piriformis muscle Sciatic nerve Inferior gluteal artery luteus maximus muscle (cut) ‘Quadratus femoris muscle Sciatic nerve dividing into its wo branches: the common peroneal nerve and the tibial nerve Muscula Poplist a Popliteal vein Small saphenous vein (cut) Long head of biceps femoris muscle (cut) ‘Superficial peroneal nerve ranches of sciatic nerve to hamstring musclesPosterior femoral region and gluteal regi e Posterior femoral region and gluteal region, right side (poste- (posterior aspect). The gluteus maximus muscle has been rior aspect). The gluteus maximus muscle and the long head divided and reflected. of biceps femoris muscle have been divided and reflected.Anterior region of right knee; cutaneous nerves and veins (anterior aspect). 1 Fascia lata 2. Terminal branches of anterior cutaneous branches of femoral nerve 3 Venous network around knee 4. Position of head of fibula 8 Position of medial epicondyle of femur 9 Saphenous nerve 10. Infrapatellar branches of saphenous nerve LL Patella ligament Posterior region of right s cutaneous nerves and veins (posterior aspect), Cutaneous veins (tributaries of great saphenous vein) 2 Great saphenous vein 3. Cutaneous branch of femoral nerve 4. Position of medial epicondyle of fermur 5. Position of smal saphenous vein 6 Fascia lata Terminal branches Cutaneous veins 0 9. Position of head of fibuka 10. Superficial layer 11 Lateral sural cutaneous nerve9 10 u i B Right leg, posterior crural region (posterior aspect), ‘The gastrocnemius muscle has been divided and reflected, Semitendinosus muscle Gracitis muscle Semimembranosus muscle Sartorius muscle Tendon of semitendinosus muscle Position of medial condyle of femur “Muscular branches of tibial nerve Sural arteries and veins Tendon of semimembranosus muscle ‘Common tendon of gracilis, semitendinosus and sartorius| muscles Medial head of gastrocnemius muscle Biceps femoris muscle Muscular branch of popliteal artery Right leg, posterior crural regi ‘The gastrocnemius and the soleus muscles have been divided and reflected. . deep layer (posterior aspect) Poplitel artery 15 Popliteal vein 16 Tibial nerve 17 Common peroneal nerve Lateral head of gastrocnemius muscle Medi nicular artery gastrocnemius muscle (cut and reflected) 22. Medial inferior genicular artery 23. Soleus muscle 7 Plantaris muscleRight leg, popliteal fossa, deep layer (posterior aspect) The muscles have been reflected to display the genicular 1 Semitendinosus muscle 2. Semimembranosus muscle 3 Medial superior genicular artery 4 Popliteal artery Medial head of gastrocnemius muscle Middle genicular artery Muscular branches. 8. Medial inferior genicular 9 Tendon of plantaris muscle 10 Tibial nerve (cut) 11. Biceps femoris muscle Right leg, popliteal fossa, deepest layer (posterior aspect) Tibial nerve and popliteal vein have been partly removed and a portion of the soleus muscle was cut away to display the anterior tibial artery Popliteal vein (cut) 13 Lateral superior genicular artery 14 Lateral inferior genicular ater 15. Lateral head of gastrocnemius muscle 16 Common peroneal nerve 17 Head of fibula 18 Lateral sural cutaneous nerves 19 Soleus muscle 20 Medial sural 21 Anterior tibial artery 22 Posterior til teryRight leg. Cutaneous veins and nerves (posterior aspect), Great saphenous vein Venous anastomosis between small and great saphenous veins Medial malleolus Popliteal fossa Position of head of fibula Lateral sural cutaneous nerve Small saphenous ight leg. Cutaneous nerves and veins (posterior aspect. The superficial layer of the ‘ural fascia has been removed, Sural nerve Caleaneal tendon Lateral malleolus Semitendinosus muscle Medial head of gastrocnemius mus Common peroneal nerve Medial sural cutaneous nerve Cutaneous veins and nerves of the right leg (anterior-medial aspe veins are colored). Perforating veins Superficial peroneal Dorsal venous arch Intermediate dorsal cutaneous nerve Infrapatellar branches of saphenous Terminal branches of saphenous nerve Medial dorsal cutancous nerveRight poplit Sie Right popliteal fossa, deep layer Thee e1 Semimembranosus muscle 2. Semitendinosus muscle 3. Popliteal vein 4 Popliteal artery 5) Tibial ner 6 Small saphenous vein (cut) 7. Muscular branch of tibial nerve 8. Medial head of gastrocnemius muscle 9 Tendon of plantaris muscle 10 Posterior tibial artery 11 Medial malleolus 12. Biceps femoris muscle 13 Common peroneal nerve 14 Sural arteries 15 Plantaris muscle 16 Lateral head of gastrocnemius muscle 17 Soleus muscle 18 Caleaneal tendon 19 Lateral malleolus 20. Calcaneal tuberosity 21. Sartorius muscle 22. Popliteal artery 23. Tendinous arch of soleus muscle 24. Flexor digitorum longus muscle 25. Flexor retinaculum 26 Peroneal artery 27 Soleus muscle 28 Flexor hallucis longus muscle 29. Anterior tibial artery 30 Muscular branches of tibial nerve 31 Tibialis posterior muscle 32 Communicating branch of peroneal artery 33. Tendon of tibialis anterior muscle 34 Tibia 35. Tendon of extensor hallucis longus muscle 36. Tendons of extensor digitorum longus muscle 37. Anterior tibialis artery 38. Fibula 39 Tendons of peroneus longus and brevis muscles Right leg, posterior crural region, deepest layer (posterior Cross-section of the leg, superior to the malleoli aspect). Triceps surae (gastrocnemius and soleus) and flexor (from below). hallucis longus muscles have been cut and reflected.Right leg and foot, anterior crural es ; cutaneous nerves and veins ‘cutaneous nerves and veins (ante of foot of sapher at saphenous vein dial mallht leg and dorsum of foot; cutaneous nerves and veins (lateral aspe Position of fibula 10. Fascia enuri 11 Superficial peroneal nerve 12. Position of tibia Lateral cutaneous branch Sural nerve ‘Small saphenous vein Caleaneal tendon B Lateral calcaneal branches of sural nerve Medial cutaneous branch ‘Venous network a lateral malleolus Lateral malleo Cutaneous branch of sural nerve Dorsal digit Tendon of peroneus brevis muscle Dorsal venous arch Tendons of extensor digitorum longus muscle Deep peroneal nerve16 19 20 26 Coronal section through the foot and talocrural joint (anterior aspect), iotibial tract ‘Common peroneal nerve Position of head of fibula Extensor digitorum longus muscle Muscular branches of deep peroncal nerve Superficial peroneal Tendon of extensor digitorum longus muscle Lateral malleolus Extensor digitorum brevis muscle Tendons of extensor digitorum longus muscle Patella Patellar ligament Anterior margin of tibia jor muscle Deep peroneal nerve Extensor hallucis longus muscle ‘Tendon of tibialis anterior muscle Extensor retinaculum Dorsalis pedis artery Extensor hallucis brevis muscle Deep peroneal nerve (on dorsum of foot) Dorsal digital nerves (terminal branches of deep peroneal nerve) Deep peroneal nerve Peroneus longus muscle (cut) Superficial peroneal nerve (with peroneal muscles laterally reflected) 29 30 31 2 B 4 35 36 7 39 40 41 2 a 44 45 46 i 8 49 0 Coronal section through the foot (MR-Scan after A. Heuck, G. Luttke and J. W. Rohen, 1994) Peroneus brevis muscle Lateral anterior malleolar artery Fibula Distal tibiofibular joint (syndesmosis) Interosseous talocalcaneal ligament Caleaneus Tendon of peroneus brevis muscle Cuboid bone Lateral cuneiform bone Metatarsal bones Dorsal interosseous muscles Tibia Talocrural joint Medial malleolus Talus Talocalean lar joint Navieular bone Medial cuneiform bone Intermediate cuneiform bone First metatarsal bone Metatarsophalangeal joint of great toe Proximal phalanx of g Distal phalanx of great toc Heads of metatarsal bones I-IVDorsum of the right foot, superficial layer (anterior Dorsum of the right foot, superficial layer. ‘The fascia of the aspect). dorsum has been removed 1 peroneal nerve clon of tibialis anterior muscle Dorsal digital arte Superior extensor retinaculum Saphenous nerve Peroncal muscles Lateral malleolus Venous network of medial malled 19 Deep plantar branch of dorsalis pedis Venous network of lateral malleolus and tributaries of great saphenous vein ety anastomosing with plantar arch tributaries of small saphenous vein Medial malleolus Extensor digitorum longus muscle Lateral dorsal eutancous nerve (branch of Medial dorsal cutaneous nerves Extensor hallucis longus muscle ral ner Dorsal venous arch Inferior extensor retinaculum Intermediate dorsal cutancous nerve 1 ital nerve (of deep peroneal Extensor hallucis brevis muscle Tendons of extensor digitorum longus muscle 8 Dorsal digital nerves endon of extensor hallucis longus muscleDorsum of right foot, middle layer (anterior lateral aspect). ‘The cutaneous nerves have been removed. 26 3 Extensor retinaculum Lateral malleolus Lateral anterior malleolar artery Tendons of peroneal muscles Tendon of peroneus tertus muscle Extens Tendons of extensor digitorum longus muscle Dorsal metatarsal arteries Medial malleolus ‘Tendon of tibialis anterior muscle Dorsal pedis artery Deep peroneal nerve (on dorsum of foot) Extensor hallucis brevis muscle Tendon of extensor hallucis longus muscle Dorsal pedis artery with deep plantar branch 10 the plantar arch Dorsal digital nerves (terminal branches of deep peroneal nerve) Lateral tarsal artery Extensor digitorum brevis muscle (divided) Arcuate artery Dorsal interosscous muscles Deep peroneal nerve Medial cuneiform and Ist metatarsal bone Tendon of peroneus longus muscle Absuctor hallucis and flexor hallucis brevis muscles Medial plantar artery, vein and nerve Fourth and fifth metatarsal bone ‘Adductorhallucis (oblique head) Tendons of flexor digitorum longus muscle Lateral plantar artery, ein and nerve Flexor digitorum brevis muscle Plantar aponeurosis Dorsum of right foot, deep layer (anterior lateral aspect), The extensor digitorum and hallucis breves muscles have been removed. Cross-section of the rigt foot at the level of the tarsal bones (posterior aspect)1011 1213) 14 6 Lower extremity, location of section 1-5. (MR-Images, courtesy of Dr. A. Heuck, Munich). Axial section through the pelvis and the hip joints (ection 1; MR-Image; inferior aspect). - 1 Sartorius muscle 2 Femoral artery and vein 3 Iliopsoas musele 4 Pelvic bone Femoral head with ligament of femoral head 6 Articular eavity Rectum § Sciatic nerve and accompanying artery 9. Gluceus maximus muscle 10 Obturator vessels and obturator nerve 11 Rectus abdominis muscle 12 Pyramidalis muscle 13. Urinary bladder 14 Obturator internus musele 15 Rectus femoris muscle 16 Vastus intermedius and vastus lateralis Axial section through the pelvis and hip joints in the female of quadriceps femoris muscle (section 1, inferior aspect). (Arrows: uterus, myometrium with myoma). “ Axial section through the middle of the thigh (section 2; MR-Image, inferior aspect). Axial section through the middle of the right thigh (section 2, inferior aspect).Axial section through the knee joi (section 3; MR-Im: Axial seetion through the right knee inferior aspect) Joint (section 3, inferior aspect) Axial section through the middle of, Axial section through the middle of the the leg (section 4, MR-Image, inferior ht leg (section 4, inferior aspect. aspect) Axial section through the end of the Axial seetion through the end of the right leg (section 5; MR-Image; inferior right leg (section 5; inferior aspect). aspect), 9 2» st 56 cy ot o 6 os 66 Femur Perforating Sciatic nerve Giuteus maximus muscle (insertion) Vastus medialis muscle Sartorius muscle Femoral artery and vein Gracils muscle Adductor muscles Biceps femoris muscle Patella ligament Lateral condyle of femur Posterior cruciate ligament mI Popliteal artery and vein Lateral head of gastrocnemius muscle Medial condyle of femur Medial head of gastrocnemius muscle Tibialis anterior muscle 7" Deep peroneal nerve anterior tibial artery and Peroneus longus and brevis muscles Fi Soleus muscle Flexor d itorum longs muscle THbialis posterior muscle Posterior tibial artery and vein and tibial nerve Peroneal artery Small saphenous vein and sural nerve Extensor hallucis longus muscle Extensor digitorum longus muscle Tendon of peroneus longus muscle Lateral malleolus (fibula) Peroneus brevis muscle Tibials anterior muscle (tendon) Dorsalis pedis artery Medial malleolus (tibia) Tbialis posterior muscle (tendon) Flexor di (tendon with synovial sheath) Flexor hallucis longus muscle Posterior tibial artery and and medial planta Keaneal tendon. Semitendinosus muscle Semimembranosus muscle Anterior cruciate ligament Plantaris muscle Small intestineSole of the right foot, middle layer (from below); dissection of vessels and nerves. The flexor digitorum brevis muscle has been divided and anteriorly reflected. |. Synovial sheaths of drawin (ed in light blue. (Schematic is brevis muscle wrartery al plantar nerve jtorum brevis muscle (cut) 28. Synorial sheaths 29: Plantar arch 28Sole of the right foot, deep layer (from below); dissection of vessels and nerves. The flexor digitorum brevis muscle, the quadratus plantae muscle with the tendons of the flexor digitorum longus muscle and some branches of the medial plantar nerve have been removed. The flexor hallucis brevis and adductor hallucis muscles have been cut and portions removed to show the somewhat atypical course of the medial plantar artery and deep muscles of the foot. Proper plantar digital arteries Proper plantar digital nerves, Tendons of flexor digitorum brevis muscle Tendons of flexor digitorum longus muscle Superficial branch of lateral plantar artery Deep branch of lateral plantar nerve Superficial branch of lateral plantar nerve Lateral plantar nerve Lateral plantar artery Abductor digi minimi muscle Caleaneal tuberosity Common plantar digital arteries Tendon of flexor hallucis longus muscle Insertion of both heads of adductor hallucis muscle Plantar metatarsal arteries Medial plantar nerve of great toc Deep plantar branch of dorsalis pedis artery (perforating branch) Plantar arch Oblique head of adductor hallucis muscle (cut) Medial plantar artery Medial plantar Crossing of tendons in sole of foot (flexor hallucis Jongus and flexor digitorum longus muscles) ‘Abductor allucis muscle Origin of flexor digitorum brevis muscle