Sobotta Atlas of Human Anatomy: Trunk, Viscera, Lower Limb

AtLasof HumanAnatomy Editedby R. PutzandR. Pabst with RenatePutz ln collaboration T r a n s t a t i obny S . B e d o u i...

Author: Johannes Sobotta | R. Putz

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AtLasof HumanAnatomy Editedby R. PutzandR. Pabst with RenatePutz ln collaboration T r a n s t a t i obny S . B e d o u i

Volume2 Trurk, Viscera,LowerLimb 1 4 t he d i t i o nn, e w t ye d i t e d 7 0 4c o t o u rp t a t e sw i t h 9 1 4t i g u r e s

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Atlasof HumanAnatomy Volume2 LowerLimb Trunk,Viscera,'

Correspondenceand feedbackshould be addressedto: E l s e v i e rG m b H ,U r b a n& F i s c h e rV e r l a g ,D e p a r t m e n ft o r M e d r c aS I t u d e n tI n f o r m a t i o nA, l e x a n d e rG a t t n a r z i kK, a r l s t r a B e4 5 , 8 0 3 3 3M u n i c h ,G e r m a n y e - m a i t :m e d i z i n s t u d i u m @ e t s e v i e r d e

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A t t r i g h t s ,i n c t u d i n gt r a n s l a t i o n a , re reservedNo part of this pubtication m a y b e r e p r o d u c e d ,s t o r e d i n a r e t r i e v a Is y s t e m , o r t r a n s m i t t e d i n a n y o t h e r f o r m o r b y a n y m e a n s ,e l e c t r o n i c ,m e c h a n i c a [p, h o t o c o p y i n g , r e c o r d i n g ,o r o t h e r w i s e w i t h o u t t h e p r i o r w r i t t e n p e r m i s s i o n o f t h e pub l i s h er .

T h e 1 4 t he d i t i o no f t h e S o b o t t aA t t a sc o n s i s t so f t w o v o l u m e sa n o a b o o k l e tc o n t a i n i n gt a b l e s( e n c t o s e di n V o [ u m e1l ; V o t u m e1 : H e a d ,N e c k ,U p p e rL i m b V o t u m e2 : T r u n k ,V i s c e r a L , o w e rL i m b

T h i sa t t a sw a s f o u n d e db y J o h a n n e sS o b o t t a t f, o r m e rP r o f e s s oor f A n a t o m y a n d D i r e c t o ro f t h e A n a t o m i c aIln s t i t u t eo f t h e U n i v e r s i toy f B o n n ,G e r m a n y . German Editions: l s t E d i t i o n :1 9 0 4 - 1 9 0 7J . F . L e h m a n n sV e r [ a g ,M u n i c h 2 n d - 1 1 rEhd i t i o n :1 9 1 3 - 1 9 1 ,J1.,F . L e h m a n n sV e r t a g ,M u n i c h 12 r h - 2 0 rEhd i t i o n: 19 4 8 -19 9 3 Ur b a n & S c h w a r z e n b e r gM, u n i c h 1 3 t hE d i t i o n1: 9 5 3 e, d i t o rH . B e c h e r 1 4 t hE d i t i o n1: 9 5 6 e, d i t o rH B e c h e r 1Sth E d i t i o n1: 9 5 7 e, d i t o rH B e c h e r 1 6 t hE d i t i o n1: 9 6 7 e, d i t o rH B e c h e r 17 " E d i t i o n :1 9 7 2 ,e d i t o r sH F e r n e ra n d J S t a u b e s a n d 1 8 ' 'E d i t i o n1: 9 8 2 e, d i t o r sH F e r n e ra n d J S t a u b e s a n d 19 t hE d i t i o n1: 9 8 8 ,e d i t o rJ S t a u o e s a n o 2 0 r hE d i t i o n1: 9 9 3 e, d i t o r sR P u t za n d R P a b s t 2 1 ' tE d i t i o n : 2 0 0 0e ,d i t o r sR P u t za n d R P a b s t ,U r b a n& F i s c h e V r ertag, Mu n i c h 2 2 " dE d i t i o n2: 0 0 6 e , d i t o r sR P u t za n d R P a b s t E , t s e v i eG r m b H ,M u n i c h

Foreign Editions: A r a b i cE d i t i o n M o d e r nT e c h n i c aC I e n t e r ,D a m a s c u s C h i n e s eE d i t i o n[ c o m p t e cx h a r a c t e r s l H o - C hB i o o kP u b t i s h i nC g o ,T a i w a n C h i n e s eE d i t i o nI s i m p t i f i eC dhinese ditionl E l s e v i e rH , e a t t hS c i e n c e sA s i a ,S i n g a p o r e C r o a t i a nE d i t i o n N a k l a d aS t a p ,J a s t r e b a r s k o D u t c hE d i t i o n B o h n S t a f t e uv a n L o g h u m ,H o u t e n E n g t i s hE d i t i o nl w i t hn o m e n c l a t u rien E n g t i s h ) A t l a s o f H u m a nA n a t o m y L i p p i n c o tW t i t t i a m s& W i t k i n s E n g t i s hE d i t i o nl w i t h n o m e n c L a t u rien L a t r n l A t l a s o f H u m a nA n a t o m y E l s e v i eG r m b H ,U r b a n& F i s c h e r F r e n c hE d i t i o n A t t a sd A n a t o m i eH u m a i n e T e c& D o c L a v o i s i e rP , aris G r e e kE d i t i o n[ w i t hn o m e n c t a t u ri en G r e e k l M a r i aG P a r i s s i a n oA s ,t h e n s G r e e kE d i t i o n[ w i t h n o m e n c t a t u r ei n L a t i n l M a r i aG P a r r s s r a n o A s ,t h e n s Hungarian Edition a z e m b e ra n a t 6 m i 5 j 5 n aakt t a s z a A t t i t e rK i a d 5 iB , udapest I n d o n e s i aEn d i t i o n A t t a sA n a t o m M i anusia P e n e r b iB t u k u K e d o k t e r aE n G CJ, a k a r t a I t a t i a nE d i t i o n A t t a n t ed i A n a t o m i aU m a n a UTETT , orino lrnrnoco

T r a n s L a t i o nD: r . m e d S a m m yB e d o u i ,H a n n o v e r E d i t o r i a st t a f f a t E l s e v i e r :D r . m e d D o r o t h e aH e n n e s s e n AtexandeG r attnarzik D r . r e r .n a t A n d r e aR i c h a r z l t t u s t r a t o r sU: t r i k eB r u g g e r M , u n i c hR ; i j d i g eH r i m m e t h a nH, e i d e L b e r g ; H o r s tR u B ,M u n i c h H ; e n r i e t t eR i n t e l e nV, e t b e r n B o o kp r o d u c t i o nR: e n a t eH a u s d o r fM , unich C o m p o s e db y :T y p o d a t aM , unich P r i n t e da n d b o u n db y :A p p t ,W e m d i n g C o v e rd e s i g n C : a r s t e nT s c h i r n e rM , unich P r l n t e do n N o p a c o a1t 1 5 g

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Contents vl

Preface

Abdominat viscera

128-181

...128-133 1-1.5 Stomach,Gaster. . . 134-137 Smatl.intestine,Intestinumtenue . S u r f a c ea n a t o m y 1 138-141 L a r g ei n t e s t i n eI,n t e s t i n u mc r a s s u m Vertebralcotumn,Cotumnavertebratis 2-25 , e s i c ab i t i a r i s , L i v e r ,H e p a r ,g a t t b t a d d e rV M u s c L eos f t h e b a c k ,M u s c u t d i o r s i ,s u b o c c i p i t a L ..... 142-151 a n d b i t ed u c ts y s t e m m u s c t e sM , u s c u t si u b o c c i p i t a t easn, d m u s c l e s 152-155 P a n c r e a sP, a n c r e a s of the neck, MusculicoLl.i. . . 26-34 156 S p l e e nS , p t e n[ L i e n J C o m p u t e dt o m o g r a p h i cs e c t i o n st h r o u g ht h e v e r t e b r a I 157 , a v i t a sp e r i t o n e a t i sd,e v e t o p m e n.t . P e r i t o n e acI a v i t yC column 35 , i t u sv i s c e r u m . . . 1 5 8 - 1 6 7 L o c a t i o no f t h e a b d o m i n avI i s c e r aS V e s s e t sa n d n e r v e so f t h e b a c ka n d t h e o c c i p i t a L 168 A b d o m i n aal r t e r i e s o , verview regron . 3 6 - 4 0 A b d o m i n avl e i n s ,o v e r v i e w 169 V e s s e t sa n d n e r v e so f t h e v e r t e b r a cl a n a l . 4 1 - 1 + 5 C o e t i a ct r u n c a n d s u p e r i o ra s w e [ [ a s i n f e r i o r m e s e n t e r i ca r t e r i e sa n d v e i n s ,T r u n c u sc o e [ i a c u s , A r t e r i a ee t V e n a em e s e n t e r i c aseu p e r i o re t i n f e r i o r 170-178 1,6-73 Vessetsand nervesof the retroperitonealspace . . . . T h o r a c i ca n d a b d o m i n a w I a[[ 179 1 8 0 -181 h e p a t i s S u r f a caen a t o m y 46

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M u s c L eos f t h e t h o r a x ,M u s c u Lt ih o r a c i s a, n d a b d o m i n am I u s c t e sM , u s c u [a i bdominis I n g u i n acI a n a [. . D i a p h r a g mD, i a p h r a g m a B r e a s tM , amma .. V e s s e t sa n d n e r v e so f t h e t h o r a c i ca n d a b d o m i n aw I aLt S e g m e n t asI e n s o r yi n n e r v a t i o n , l e x u s[ u m b o s a c r a I i s L u m b o s a c r apLt e x u s P A n t e r i o ra b d o m i n aw l at[ . . S e c t i o n st h r o u g ht h e a b d o m i n aw I at[. . .

. Heart,Cor T r a c h e aT, r a c h e a L u n g sP, u L m o n e. s. . S h a o eo f t h e h e a r t Bronchoscopy Projection o f t r a c h e a [, u n g sa n d p [ e u r a Ib o r d e r s . . . . . 0 e s o p h a g u s0, e s o p h a g u s ThymusT , hymus P [ e u r a cI a v i t y C , a v i t a sp [ e u r a t i sa, n d m e d i a s t i n u m , Mediastinum Aorta,Aorta Posteriom r ediastinum A u t o n o m o unse r v o u s y s t e m P , a r s a u t o n o m i c. a. . . . . P h r e n i cn e r v e ,N e r y u sp h r e n i c u s S e c t i o n st h r o u q ht h e t h o r a x

1+7-49 50-51

space 182-251 PelvicvisceraandretroperitoneaI

52-59 K i d n e yR, e nl N e p h r o s l ...... 182-1BB 6 0 - 61 S u p r a r e n a I g l . a nGdL,a n d u it .r p . " r " n . i i r . . . : : : : : . . . 189 62-63 U r i n a r y b t a d d e r , V e s i c a u r i n a r i a .....150-191 64-65 M a L e u r i n a r y a n d g e n i t a l o r g a n s . ....192-199 6 6 Femaleurinaryand genitalorgans . . . 200-209 6 7 R e c t u m ,R e c t u m .. 210-215 6 B R e n a l a r t e r yA, r t e r i ar e n a t i s 216 69-71 O r g a n so f t h e r e t r o p e r i t o n e as lp a c e 217 7 2 - 7 3 Vessetsand nervesof the retroperitoneaIspace . . . . . 218-221 71-127 74-89 90-91

222 lnnervatioo n f m a t eg e n i t a t i a 223 lnnervatioo n f f e m a l eg e n i t a t i a ..... 224-225 l n t e r n a pl e t v i ca r t e r i e s .....226-229 Petvicviscera , a L ea n d f e m a t e P e L v idc i a p h r a g ma n d p e r i n e u m m 230-2/+1 e x t e r n ag l enitatia 242-261 S e c t i o n st h r o u g ha b d o m e na n d p e t v i s

92-100 101 102 103 Lowertimb.. 104-109 1 1 0 - 1 1 1 S u r f a c ea n a t o m y

B o n e s j,o i n t s ,[ t g a m e n t s 112-113 M u s c t e so f t h e L o w e rt i m b . . 1 1 / + Vessetsand nerves

11s-116 117 118 -127 119

Appendix tnoex

.....262-381 262 263-305 306-343 344-379 380-384

385-399 . . .. 385-399

Preface I t w a s j u s t o v e r a h u n d r e dy e a r sa g o t h a t J o h a n n e sS o b o t t as e t o u t t o p u b t i s ht h e f i r s t e d i t i o no f h i s A t [ a s o f H u m a nA n a t o m y . S i n c et h e n ,t h i s p i e c eo f w o r k h a s e v o l v e ds t e p b y s t e p a s a r e s u L to f t h e c o n s t a n ti n t e r a c t i o nb e t w e e ns t u d e n t s [, e c t u r e r sa n d e d i t o r s .l t h a s n o t o n t yb e e nt h e m o s t m o d e r nb a s i sf o r t h e c o m p t e xs u b j e c to f m a c r o s c o p i ac n a t o m yt h r o u g h o u m t a n yg e n e r a t i o n s o f d o c t o r s ,b u t h a s a L s od e v e t o p e di n t o a L a s t i n gw o r k o f reference f o r b o t hc t i n i c atIr a i n i n ga n d a d v a n c e dm e d i c a e Lducat i o n .A t Li n a L l .i ,t h a s b e c o m ea b o o kf o r a m e d i c a Id o c t o r ' sL i f e . 0 n c e a g a i n ,i n t h i s n e w e d i t i o nt h e a d d i t i o n afIi g u r e sh a v eb e e n d r a w ns t r i c t t yo n t h e b a s i so f o r i g i n a I s p e c i m e n s T h e 1 4 t he d i t i o nh a s b e e np a r t i c u t a r l .dye s i g n e dt o m e e t t h e d e m a n d so f a r e f o r m e dm e d i c a cI u r r i c u t u m e, m p h a s i z i n tgh e i n t e g r a t i o no f c L i n i c am I e d i c i n ei n t o t h e p r e c L i n i c acLu r r i c u L u mF. o r t h i s p u r p o s e t, h e n e w e d i t i o nh a s b e e ne x t e n d e dt o i n c l u d et h e f o l t o w i n gf e a t u r e s : - S u r f a c e a n a t o m y i n c l u d i n g p r o j e c t i o no f i n t e r n a I o r g a n s [ 4 5 c o L o u pr h o t o s ] - AnatomicaIdiagram n es x tt o i m a g i n gf i g u r e s - I n t e g r a t i o no f i m a g i n gt e c h n i q u e st o a g r e a t e re x t e n t{ u [ t r a s o u n d ,X - r a y ,C T ,M R I ;11 9 f i g u r e s l - E n d o s c o p i ci n , t r a o p e r a t i vceo [ o u ri m a g e sa n d f i g u r e se x e m p L i f y i ntge c h n i q u e so f p u n c t u r ea n d e x a m i n a t i o (n5 4f i g u r e s l - l m a g e so f p a t i e n t sp r e s e n t i n g w i t h t y p i c a lp. a [ s i e s - D i a g r a m so f t h e m o s t i m p o r t a n a t r t e r i a lv a r i a t i o n s( 9 3f i g u r e s l - F r e q u e nvt a r i a t i o n si n t h e [ o c a t i o no f i n t e r n a Lo r g a n s[ 2 1 f*i g uresl - I n t e g r a t i o no f h i s t o L o gayt l o w m a g n i f i c a t i o o n f i m p o r t a n ti n t e r n a Io r g a n s{ i n t e s t i n eL, i v e rk, i d n e y e, t c . ) l n o r d e r t o i m p r o v et h e p r e s e n t a t i o o n f t h e k n o w t e d g et,h e f o L l o w i n gf e a t u r e sh a v eb e e ni n t r o d u c e d : - C L e a r - c uatr r a n g e m e not f t h e c h a p t e r sa c c o r d i n g to the differe n t r e g i o n so f t h e b o d y - T h e m a t i c a t tcyo r r e s p o n d i nf g i g u r e sp r e s e n t e d pages ondoubLe - A c o n c i s e ,s e p a r a t eb o o k t e t( i n c t u d e di n V o t u m e1 l c o n t a i n s t a b t e so f m u s c t e s j, o i n t s a n d n e r v e s ,e n a b I i n gt h e r e a d e rt o p t a c ei t n e x tt o a n y f i g u r ei n t h e a t [ a s 0 n e p a r t i c u t a ra i m o f t h e n e w e d i t i o ni s t o f a c i t i t a t ef i n d i n go f s p e c i f i cs t r u c t u r e sT. h e S 0 B 0 T T Ad e p i c t sa n a t o m i c asI t r u c t u r e s precisetw y i t h o u tt h e r e a d e rL o o s i n tgh e g r e a t e rp r c t u r eT. h e r e f o r e ,s p e c i f i cd i d a c t i ct o o L sh a v eb e e ni m p r o v e da n d n e w a s p e c t s inc[uded: - E a c hc h a p t e rh a s b e e na t l o c a t e dt o a p a r t i c u L acro t o u r - A " m e n u b a r " o n e a c h d o u b t ep a g ee n s u r e sp r e c i s eo r i e n t a t i o n w i t h i na g i v e nc h a p t e r - T h e n u m b e ro f o u t t i n e sd e p i c t i n gs p a t i a Io r i e n t a t i o nh a s b e e n s i g n i f i c a n t tiyn c r e a s e d[ 2 7 0f i g u r e s l - O v e r v i e wos f t o t a I b o d yr e g i o n se n s u r eg e n e r a Io r i e n t a t i o n - N e w d i a g r a m so f p a r t i c u [ a rm u s c t e sc t a r i f yt h e i r L o c a t i oann d c o u r s e( 2 1f+i q u r e s l

- C o n f u s i o ni s k e p t t o a m i n i m u mb y o n t yd e p i c t i n gI i m b so f t h e r i g h t s i d eo f t h e b o d y - " C o m p a s sr o s e s " p o i n t t o a d j a c e n tf i g u r e s ,t h u s f a c i L i t a t i n g fotlowinga givenstructureover severaIpages - C o n t i n u o u [se a d e rI i n e sf a c i L i t a tfei n d i n go f s t r u c t u r e s - C o L o u r e d o t s a t t h e e n d o f l e a d e r[ i n e s i n t o p o g r a p h i cd i a g r a m s m a r k a r t e r i e s v, e i n s ,n e r v e s a , ndmusctes - T h e f i g u r e si n t h e b o o k t e tr e l a t ed i r e c t [ yt o t h e f i g u r e si n t h e attas - T h e [ a r g e rd i m e n s i o n so f t h e b o o ki m p r o v ec [ a r i t y W i t h t h e e x c e p t i o no f d i s c u s s i o n as b o u tt h e g e n e r a lc o n c e p to f t h e a t t a sa n d m u t u a Ic o r r e c t i o nt,h e e d i t o r sh a v ew o r k e ds e p a r a t e t yo n i n d i v i d u a t c h a p t e rws i, t h t h e w o r k d i v i d e da s f o t t o w s : R . P u t z : G e n e r a Ia n a t o m y ,u p p e r [ i m b , b r a i n ,e y e , e a r , b a c k , l o w e rt i m b ; R . P a b s t : H e a d ,n e c k ,t h o r a c i ca n d a b d o m i n a w I a t l s ,t h o r a c i c , a b d o m i n aaI n d p e L v ivci s c e r a . T h e i n c L u s i o on f a [ a r g e n u m b e r o f n e w f i g u r e si s t h e r e s u [ to f t h e e x t r a o r d i n a rcya p a b i l . i o t yf t h e f o t l o w i n gm e d i c a Ii L l u s t r a t o r s : U L r i k eB r u g g e r , R i . i d i g e H r i m m e l h a na n d H o r s t R u B . l t i s t o t h e i r c r e d i tt h a t t h e c t a s s i c" S 0 B 0 T T As t y l . e h" a s b e e nr e t a i n e d . Severao L f t h e d i a g r a m sh a v eb e e ng e n e r a t e do n t h e c o m p u t e r b y H e n r i e t t eR i n t e L e nW. e a l s o g r a t e f u t l ya c k n o w l e d g o eu r c t i n i c a I c o t L e a g u efso r m a k i n g c t i n i c a Ii t l u s t r a t i o n sa v a i L a b [teo u s l s e e p i c t u r ec r e d i t s l W e o w e a d e b t o f g r a t i t u d et o o u r c o [ L e a g u efsr o m t h e i n s t i t u t e sf o r t h e i r u n d e r s t a n d i nagn d h e l . p f u l . s u g g e s t i o n sD. r . N . S o k o L oav n d A . B u c h h o r nh a v ep u t m e t i c u l o u s e f f o r t si n t o g e n e r a t i n gt h e s p e c i m e np r e p a r a t i o n sS. . F r y k a n d G . H o p p m a n nh a v es u p p o r t e du s i n t e x t p r o c e s s i n g . T h e s t a f fo f t h e e d i t o r i a o I f f i c eo f E t s e v i epr u b L i s h e r si n, p a r t i c u [ a r D r . D . H e n n e s s e na n d A . G a t t n a r z i kh, a s o u r s i n c e r et h a n k s . S o m eo f t h e c r e a t i v ed e v e L o p m e o n ft t h e w o r k i s a r e s u t to f v e r y f r u i t f u Id i s c u s s i o n sW. e w o u I da t s o L i k et o t h a n k R . H a u s d o r f o r t r e m e n d o u se f f o r t s i n t h e o r o d u c t i o no f t h e a t t a s . R . P u t z t o g e t h e rw i t h G . M e i e rw e r e r e s p o n s i b l feo r t h e p r o o rf e a d i n ga n d simptificatioo n f p a g e d e s i g na n d l e g e n d s 0 u r s p e c i a [t h a n k s g o t o D r . U . O s t e r k a m p - B a u sf to r g e n e r a t i n gt h e i n d e x ,a n d a t [ o t h e r s i n v o t v e di n t h e c o r r e c t i o n sW i t h o u r j o i n t e f f o r t s ,t h e S 0 B 0 T T Ah a s b e e no n c em o r e m o d e r n i z e db o t h i n c o n t e n t sa n d d e s r gn . W e h a v e i n c t u d e dm a n y o f t h e h e t p f u ts u g g e s t i o n sm a d e o v e r t h e y e a r s b y s t u d e n t sa n d c o t l e a g u e sa, n d w o u L dt h e r e f o r ea s k a I Lr e a d e r so f t h i s e d i t i o nt o p a s so n t o u s a n y c r i t i c i s mo r s u g g e s t i o n so n t h e n e w f o r m a to f t h i s a t t a s .

M u n i c ha n d H a n n o v e rS, e p t e m b e 2r 0 0 5 R . P u t za n d R . P a b s t

Putz U n i v . - P r oD f .r .m e d .R e i n h a r d Bornin Innsbruck/Austria r sf iItnyn s b r u c k 1 9 6 2 - 1 9 6 8 S t u d i e dm e d i c i n ea t t h e L e o p o L d - F r a n z e n s - U n i v e o 19 6 8 Receiveda doctorate

1 9 6 8 - 1 9 8 2 U n i v e r s iat ys s i s t a natt t h eI n s t i t u toef A n a t o mayt t h eU n i v e r s iot yf I n n s b r u c k 1978 L e c t u r e ri n a n a t o m y 1979 C o n s u t t a nfto r a n a t o m y 1982-1989 s i n c e1 9 8 9 1992-1994

1993 1998-1999

1999 2002 2003

C h a i ro f t h e A n a t o m i c aItn s t i t u t ea t t h e A [ b e r t - L u d w i g s - U n i v e r soi tf yF r e i b u r g yunich C h a i ro f t h e A n a t o m i c aIln. s t i t u t ea t t h e L u d w i g - M a x i m i t i a n s - U n i v e ros fi tM P r e s i d e not f t h e E u r o o e a nA s s o c i a t i o on f C t i n i c aAt n a t o m i s t s R e g i s t r a t i otno p r a c t i s em e d i c i n e C h a i r m a no f t h e A n a t o m r c aSI o c i e t y M e m b e ro f t h e A k a d e m i ed e r N a t u r f o r s c h eur n d A r z t e( L e o p o [ d i n a ) D r .h . c .o f t h e U n i v e r s i t o y f C o n s t a n t aR, o m a n i a yunich P r o r e c t o rI o f t h e L u d w i g - M a x i m i t i a n s - U n i v e rosfi tM

Researchand fiel.dsof interest - F u n c t i o n aaI n a t o m yo f t h e p a s s i v et o c o m o t o sr y s t e m - Evotutioa n n d f u n c t i o n aaI n a t o m yo f t h e v e r t e b r a cI o t u m n - F o r m - f u n c t i o n - r e t a t i oonfsj o i n t s - A p p l . i e ad n a t o m yl a n a t o m i c abI a s i c so f o r t h o p a e d i c ss,u r g e r y r, a d i o l ' o g y J - Q u e s t i o n as b o u tt h e c o n t e n t sa n d o r g a n i s a t i oonf t h e m e d i c a L curricutum - D e v e t o p m e notf d i d a c t i ct r a i n i n gp r o g r a m m e sa t u n i v e r s i t i e s

Pabst U n i v . - P r oD f .r .m e d .R e i n h a r d B o r n i n P o s e ng , r o w nu p i n L i . i n e b u r g l c h o o ta, n d i n G l a s g o w / S c o t l a n d r e d i c aS 1 9 6 5 - 1 9 7 0 S t u d i e dm e d i c i n ea t t h e H a n n o v e M 1970 U n i v e r s i t dy e g r e ea n d d o c t o r a t e R e g i s t r a t i otno p r a c t i s em e d i c i n e 1971 yf Utm I h y s i o t o g yU,n i v e r s i t o Scientifia c s s o c i a t ei n t h e D e p a r t m e not f C [ i n i c aP 1971-76 pt t h e 1976 L e c t u r e rf o r C L i n i c aPl .h y s i o t o g yU,n i v e r s i t oy f U t m ,a n d n e w [ e c t u r e s h i a H a n n o v eM r e d i c aS I chooL S e n i o ra s s i s t a nitn t h e D e p a r t m e not f F u n c t i o n aaI n d A p p t i e dA n a t o m y , 1976-80 t chooI H a n n o v eM r e d i c aS o f t h e V e n i al e g e n d ti o i n c t u d ea n a t o m y 1978 Extension 1980-1992 H e a do f t h e D e p a r t m e not f T o p o g r a p h iAcn a t o m ya n d B i o m e c h a n i c s l chool r e d i c aS , a n n o v eM s i n c e1 9 9 2 H e a do f t h e D e p a r t m e not f F u n c t i o n aat n d A p p t i e dA n a t o m y H I chooI r e d i c aS 1986-1990 P r o r e c t o fr o r s t u d i e sa n d e d u c a t i o nH, a n n o v e M r e d i c aS I chool 1993-1997 D e a no f t h e H a n n o v e M 1997-1998 C h a i r m a no f t h e A n a t o m i c aSI o c i e t y l choot r e d i c aS 1999-2003 P r o r e c t o or f R e s e a r c ho f t h e H a n n o v e M 2001 M e m b e ro f t h e A k a d e m i ed e r N a t u r f o r s c h eur n d A r z t eI L e o p o t d i n a l

Researchand fietds of interest - F u n c t i o n a I a n a t o moyf l y m p h a t i co r g a n s - P r o l i f e r a t i oann d m i g r a t i o no f l y m p h o c y t e s - D e v e L o p m eo n ft t h e i n t e s t i n aitm m u n es y s t e m - F u n c t i o no f t h e p u I m o n a r yi m m u n es y s t e m - Q u e s t i o no l .ryi e n t a t e da n a t o m yi n t h e m e d i c a Ic u r r i c u t u m s f a c l . i n i c a to - E v a t u a t i oonf t e a c h i n g

P i c t u r ecr e di t s T h e e d i t o r ss i n c e r e t yt h a n k a t I c L i n i c acto L t e a g u et h s a t m a d eu [ t r a s o u n d c, o m p u t e dt o m o g r a p h i ca n d m a g n e t r cr e s o n a n c ei m a g e s a s w e t La s e n d o s c o p iac n d i n t r a o p e r a t i vpei c t u r e sa v a i t a b [ e :

P r o f .R a v e I tii, f o r m e r [ yI n s t i t u t eo f A n a t o m y U , n i v e r s i to yf l n n s b r u c kI F i g . 7 6 7 ) P D D r .R i e g e r R , a d i o L o gIyn, s t i t u t ef o r D i a g n o s t i R c adiol.ogy, U n i v e r s i to y f M u n i c ht F i g .1 3 9 5 1 P r o f .A t t a r a s C , e n t r ef o r R a d i o L o gU y ,n i v e r s i t oy f G i e B e n P r o f .R e i c h ,0 r o f a c i a L S u r g e rU y ,n i v e r s i t o y f B o n nI F i g .1 1 3a , b ] IFig.1009,1031,1032] P r o f .R e i s e r& D r .W a g n e r ,I n s t i t u t ef o r D i a g n o s t i R c adiotogy, D r .B a u m e i s t e rD, e p a r t m e not f R a d i o [ o g yU, n i v e r s i t oy f F r e i b u r g U n i v e r s i t oy f M u n r c hl F i g . 4 3 6 ,4 4 9 ,4 5 1, 4 5 3 , 5 7 1 , 5 7 2 , 5 7 3 , t F i s1.1 5 7 ) 5 76 , 5 7 7. 7 9 2 1 P D D r .B u r g k a r d tO , r t h o p a e d iC c I i n i cT , e c h n i c aULn i v e r s i t o yf P r o f .R u d z k i - J a n s o nD,e p a r t m e not f 0 r t h o d o n t i c sU, n i v e r s i t o yf M u n i c hI F i g .1 4 3 1 1 M u n i c h1 F i 9 . 7 2 , 7 3 ) P r o f .B r i i c k m a n n& D r .L i n n ,N e u r o r a d i o t o gIyn, s t i t u t ef o r D r .S c h e i b eD , e p a r t m e not f S u r g e r y R , o s m a nH o s p i t a tB , reisach D i a g n o s t iR c a d i o L o gU y ,n i v e r s i t o ( F i g .1 2 8 9a - c ) y f M u n i c h[ F i g . 6 6 2 , 7 2 6a , b , 7 2 7a , 6 l P r o f .S c h e u m a n nC, [ i n i cf o r A b d o m i n aaI n d T r a n s p l a n t a t i o n P r o f .D a n i e t D , e p a r t m e not f C a r d i o t o g yU, n i v e r s i t o yf Ertangen S u r g e r yH , a n n o v eM r e d i c aS L c h o o lI F i g .2 1 + 32,4 4 ,2 4 5 1 t F i s .8 9 9 ,9 0 0 ,9 0 1 ,9 7 3 1 P r o f .S c h i t l . i n g eDr ,e p a r t m e not f G y n a e c o t o gU y ,n i v e r s i t o yf P r o f D e g e n h a r dBt ,i e t e f e t{dF i g .1 1 3 3 1, 1 3 5 ) Freiburg I F i 9 .1 1 3 4 i P r o f .G a [ a n s k&i D r .K i r c h h o f fD, e p a r t m e not f D i a g n o s t i R c a d i o t - Prof. Schl.iepha ke, 0 rofaciaI Surgery, Gcittingen o g y ,H a n n o v e M r e d i c aS I c h o o t{ F i g .9 6 2 , 9 6 4 ,1 2 1 2 ,j 2 j 3 ) t F i g .1 5 2 ,1 9 6 , 1 9 7 1 P r o f .G a l a n s k& i D r .S c h d f e r D , e p a r t m e not f D i a g n o s t i R c adioLP r o f .S c h l c j s s e C r ,e n t r ef o r G y n a e c o [ o gH y ,a n n o v e M r edicaL o g y ,H a n n o v eM r e d i c aSLc h o o ILF i g .8 7 1a , b , 9 2 7 , 9 7 1 , 9 9 1 , S c h o o tI F i g .11 3 2 a ,b , 11 4 0 ,11 4 1 ,1 1 7 8 ] 1 1 9 4 ,1 2 0 4 , 1 2 0 7 , 1 2 0 9 1 P r o f S c h u m a c h e rN, e u r o r a d i o t o gD y ,e p a r t m e not f R a d i o t o g y , P r o f .G e b e t D , e p a r t m e not f G a s t r o e n t e r o L o H g ye,p a t o L o gayn d U n i v e r s i to y f F r e i b u r g( F i g .4 6 1 a , b ) E n d o c r i n o t o gHya, n n o v eM r e d i c aSt c h o o Il F i g .2 4 2 , 1 0 j 1 , D r .S o m m e r& P D D r .B a u e r ,R a d i o [ o g i s t M s ,u n i c h 1026,1027,1038, 1039, 1074, 1092) l F i 7 .6 6 2 , 1 2 9 0 - 1 2 9 2 ) D r .G o e i ,R a d i o L o gH y ,e e r l e nT , h e N e t h e r l a n d s( F i g .11 5 0 ,11 5 1 1 Prof.Stotz,Paediatrics,Universityof Munich[Fig. 1239,1240lt ( w i t hp e r m i s s i o nf r o m R a d i o l . o g1y7 3 ; 1 3 7 - 1 4 1i:g } g l P D D r .V o g LR , a d i o t o g yU, n i v e r s i t oy f M u n i c h( F i 9 4 3 6 ,4 5 3 , D r .G r e e v e nS, t . - E l . i z a b e t h - H o s p iNt aeLu,w i e d{ F i g 1 5 0 ,1 2 3 g 1 644,645) P r o f H o f f m a n n& P D D r .B e k t a s ,C L i n i cf o r A b d o m i n aar n o P r o f .V o [ [ r a t hE , a r -N o s e - T h r o aDt e p a r t m e n tM , iinchengtadbach '1 T r a n s p t a n t a t i oSnu r g e r y H , a n n o v eM r e d i c aS L c h o o l(.F i g . 0 2 8 , lFis 229,230,2311 101*01 P r o f W a g n e rt , D i a g n o s t i R c a d i o t o glyl , H a n n o v e M r edicaL P r o f .H o h L f e LC d ,[ i n i cf o r P n e u m o l o g yH, a n n o v e M r edicaLSchooL SchooL I F i g .9 5 2 , 1 0 6 1 *0, 15 5 ,10 6 9 ,1 0 7 2 ,1 1 5 2 ) (Fi9.929,9301 P r o f .W e n z ,f o r m e r t yD e p a r t m e not f R a d i o L o gU y ,n i v e r s i t o yf P r o f J o n a s ,U r o t o g yH , a n n o v eM r e d i c aS L c h o o lI F i g .1 1 0 2a , b , Freiburg {Fig.768l 11031 P r o f W i t t , D e p a r t m e not f N e u r o s u r g e r yU, n i v e r s i t o yf Munich P r o f .K a m p i k& P r o f .M i i L t e rO , p h t h a t m o t o gU y ,n i v e r s i t o yf tFis.a05) M u n i c hI F i g . 6 5 7 ) D r .W i L t f i j hfro, r m e r t C y I i n i cf o rA b d o m i n a In dT r a n s p l . a n t a t i o n D r .K i r c h h o f & f D r .W e i d e m a n nD, e p a r t m e not f D i a q n o s t i c S u r g e r yH, a n n o v eMr e d i c aSl c h o o{tF i g 1 . 0 5 1) R a d i o l . o gH y ,a n n o v e M r e d i c aS t c h o o l( F i g .1 O 4 i ,i 0 9 3 , j 1 0 2 , P DD r .W i m m e rD , epartmeo n ft R a d i o L o gUyn, i v e r s iot yf 1196,1198,1200,1202.12051 FreiburgIFig 7991 P r o f .K r e m e r s ,D e p a r t m e nfto r R e s t o r a t i vD e e n t i s t r ya n o P e r i o d o n t o t o gU y ,n i v e r s i t o y f M u n i c ht F i g .1 6 9 ) iLtustrations were obtainedfrom the fotl.owinq textP r o f .K u n z e v, o n H a u n e r s c h eC s h i L d r e n 'Hs o s p i t a lU . ,n i v e r s i t o yf fj.Ol,j:.., M u n i c hl F i g . 3 2 7 - 3 3 0 ) D r .M e y e r ,D e p a r t m e not f G a s t r o e n t e r o L o H g ye,p a t o l . o gayn d B e n n i n g h o f f - D r e n c kAh na ah tno: m i B e ,a n d1 [ D r e n c k h aD ., hn E n d o c r i n o t o gHya, n n o v eM r e d i c aSL c h o o lLF i g .g 4 4 , 9 8 7a , b , H r s g) , 1 6 .A u f t .U, r b a n& F i s c h eM r , i i n c h e2n0 0 3[ F i g . 8 2 3 , 992,1145,111+61 8 2 4B , / + 8 , 8 4895, 0 1 P r o f .M i j t l e r - V a h N L ,e u r o t o g yH, a n n o v e M r e d i c aS t chooL W e t s c hU, . :L e h r b u cH h i s t o L o gU i er,b a n& F i s c h e rM, i j n c h e n ( F i g .1 2 8a , b ) 2003{Fis.922,1020,1097,1122,11231 P r o f .P f e i f e r R , a d i o L o gIyn, s t i t u t ef o r D i a g n o s t i R l : o b o t t aA,t l . aH c adioLogy, W e L s cU h ,. ( H r s g . S s i s t o t o g i e ,A6u. f l . , U n i v e r s i t oy f M u n i c hl F i g 2 9 3 , 2 9 4 , 3 1 0 , 3 1 24,4 9 ,t + 5 ,1 U r b a n& F i s c h e rM, r i n c h e2n0 0 2l F i g .10 3 7 ,10 8 5 ,112 5a , b ) 7 6 9 - 7 7 28, 0 7 - 8 1 0 ,1 2 5 5 ,1 2 8 6 ,1 2 8 7 ,1 3 1 7 ,1 3 1 8 1 W i c k eL, . :A t l a sd e rR d n t g e n a n a t o m e ,u f L . , 3 i.A P D D r .R a u ,D e p a r t m e not f R a d i o L o gU y ,n i v e r s i t o yf Freiburg U r b a n& S c h w a r z e n b eM r qt ,i n c h e n - W i e n - B a L t i 1 m9o8r 5 e lFis. 912,925,9261 ( F i q9 4 3a l

Spinascapulae

Scapula, Angulusinferior

M. latissimus dorsi

M. erectorspinae

Articulatiosacroiliaca M gluteusmaximus VertebralumbalisV, Proc spinosus

Fig.728 Back,Dorsum; surfaceanatomv.

Regio cervicalis posteriol

Lineamedianaoosterior Lineaoaravertebralis

Lineascapularis Lineaaxillarisoosterior

Regiointrascapularis

Fig.729 Regionsand orientation[ines of the back.

> Back

M us c l es

Skeletonof thetrunk

Columnavertebralis (Parscervicalis)

Angulussuperior

Columnavertebralis (Parsthoracica)

Columnavertebralis (Parslumbalis)

Os sacrum lvertebraesacralesl-V] Spina iliaca posterior inferior

Os coccvois [Vertebra6coccygeael-lVl

Fig.730 Skel.etal. system,Systema skeleta[e, o f t h et r u n k .

Skeleton

Clavicula Vertebra cervicalis Vll

Iprominens] Vertebra thoracicaI Canalis vertebralis

HUmerus

Clavicula, Extremitas sternalis

Scapula

Manubrium sterni

Corpus stern i

Arcuscostalis Costaxl costaxll Costaxl Costaxll

Vertebra lumbalisI

Vertebralumbalis lll

Spina iliaca anterior superior

Promontorium

Os sacrum Os coccygrs

;, Facies symphysialis

Spina ischiadica

Tuberischiadicum

Tuberischiadicum

F i g . 7 3 1 V e r t e b r acI o t u m n ,C o l u m n av e r t e b r a L i s ; p e c t o r a gI i r d t e ,C i n g u t u mp e c t o r a t ea, n d p e [ v i cg i r d t e , C i n g u [ u mp e l v i c u m ; m e d i a ns e c t i o nt h r o u g ht h e v e r t e b r a t c o l u m n ; mediaLview.

Fig,732 VertebraIco[umn,Cotumnavertebra[is; p e c t o r a t ea, n d p e [ v i cg i r d [ e , p e c t o r agI i r d l . eC, i n g u L u m C i n g u [ u mp e l v i c u m ; m e d i a ns e c t i o nt h r o u g ht h e v e r t e b r a cI o t u m n ; viewedfrom the teft.

> Back

M us c l es

VertebraL column

Vertebrae cefvicales t-vtl

Disci intervertebrales

Vertebrae lumbales

Os sacrum

Promontorium

Os coccygis

F i g .7 3 3 V e r t e b r ac Io t u m n , C o [ u m nvae r t e b r a [ i s ; ventraIview.

Fig.73l, VertebraLcoLumn, C o l u m n av e r t e b r a t i s ; dorsaIview.

F i g .7 3 5 V e r t e b r ac Io t u m n , C o [ u m nvae r t e b r a t i s ; viewedfromthe teft.

VertebraI colLtmn, development

F i g . 7 3 6a - e R e g i o n acl h a r a c t e r i s t i cosf t h e v e r t e b r a e . 0 n t y i n t h e t h o r a c i cr e g i o no f t h e v e r t e b r a cI o l u m nd o t h e [ a t e r a Ip a r t s( t a b e t t e idn r e d ] r e m a i ns e p a r a t e da n d form ribs. vertebra,At[as a First cervicaL b FourthcervicaIvertebra,VertebracervicalislV , e r t e b r at h o r a c i c al , w i t h c F i r s tt h o r a c i cv e r t e b r aV c o r r e s p o n d i nrgi b s ,C o s t a ea, n d s t e r n u m ,S t e r n u m , e r t e b r aL u m b a l . li lsl d T h i r d[ u m b a rv e r t e b r aV e S a c r u m ,0 s s a c r u m

Epiphysis anularis*

Proc.articularis[Zygapophysis] supenor

Proc. sprnosus Epiphysis anularis' Proc costalis Proc accessorius

Fig. 737 VertebraIdevetopment. D e m o n s t r a t i oonf t h e a p p e a r a n c o e f p r i m a r yo s s i f i c a t i o n c e n t r e si n a [ u m b a rv e r t e b r aI p e d i c l es: e c o n df o e t a lm o n t h ; c o r p u s :t h i r d t o s i x t hf o e t a Lm o n t h J S y n o s t o s ios f t h e o s s i f i c a t i ocne n t r e so f t h e v e r t e b r a aI r c h w i t h t h o s eo f t h e c o r o u so c c u r sb e t w e e nt h e t h i r d a n d t h e s i x t hy e a r o f [ i f e .

Fig. 738 VertebraIdeve[opment C i r c u t a ro s s i ifc a t i o nc e n t r e s[ = r i m s * ]a p p e a ri n t h e e p i p h y s eos f t h e v e r t e b r a ed u r i n gt h e e i g h t hy e a ro f l i f ea n d l o d i e su n t i It h e e i g h t e e n t hy e a r o f f u s ew i t h t h e v e r t e b r a b Life. T h e c e n t r a Ip o r t i o n so f t h e e p i p h y s e rse m a i na s h y a L i n e c a r t i t a g i n o u[sa m i n a e* * t h r o u g h o u Lt i f e . S e c o n d a r oy s s i f i c a t i ocne n t r e s( a p o p h y s e sd)e v e t o pa t t h e orocesses.

> Back Atlasand axis

Tuberculum anterius

Arcusanterioratlantis Foramen vertebrale

Faciesarticularis supeflor

lvlassalateralis atlantis

Proc, Iransversus

Foramen magnum

Foramen Iransversanum

Sulcus arteriae vertebralis

occipitalis externa)

Arcusposterioratlantls posterius Tuberculum

F i g . 7 3 9 O c c i p i t abI o n e ,0 s o c c i p i t a l e ; s e c t i o ni t l u s t r a t i n g t h e f o r a m e nm a g n u ma n d t h e a r t i c u [ a rs u r f a c e so f t h e a t t a n t o - o c c i p i tjaoIi n t ; i n f e r i o rv i e w

Tuberculum anterius

Fig.710 First cervicaIvertebra,At[as; s u p e n o rv r e w . T h e s u p e r i o ra r t i c u t a rs u r f a c e so f t h e a t l a sa r e f r e q u e n t [ yd i v i d e d . * Canatis arteriae vertebratis asa variation

Arcusanterioratlantis Densaxis

Faciesarticularis inferior Foveadentis Massalateralis atlantis

Facies articularis anterior

Faciesarticularis superior l\4assa lateralis atlantis

ArcusDosterior atlantis

Fovea dentis

Proc articularis supeflor

Foramen vertebrale

Foramen transversarium posterius Tuberculum

Arcusposterior atlantis

Fig.711 First cervicaIvertebra,Attas; i n f e r i o rv i e w .

Proc sprnosus

Corpus vertebrae

Arcusvertebrae Foramen transversarium

Proc Proc articularisinferiol Iransversus

Fig.712 FirstandsecondcervicaI vertebrae, Atlaset Axis; median section. Apexdentis Faciesarticularis oosterior

Apexdentis Densaxis

Proc articularis supenor

Faciesarticularis anterior

Corpusvertebrae Foramen transversarium


Foramen transversarium Proc articularis inferior

Tuberculum posterius Corpus vertebrae

Arcusvertebrae Proc.spinosus

F i g . 7 1 3 S e c o n dc e r v i c avLe r t e b r aA , xis; ventraIview.

Proc,articularis inferior

Arcusvertebrae

Proc spinosus

Fig.711 SecondcervicaIvertebra,Axis; d o r s o s u o e r i ovri e w .

Cervicalvertebrae

Uncuscorporis IProc.uncinatus] Tuberculum anterius

Corpusvertebrae, Faciesintervertebralis

Corpusvertebrae, Epiphysis anularis

Uncicorporis lProccuncinati]

tsoramen Iransversaflum

Sulcus nerut spinalis

Tuberculum poslerius


Foramen transversaflum Proc transversus Proc, articularis supenor

Arcusvertebrae

Foramen vertebrale

Pediculus arcus vertebrae

Arcusvertebrae

Proc spinosus Proc spinosus

F i g , 7 1 5 F i f t hc e r v i c a I v e r t e b r V a ,e r t e b r ac e r v i c a L V i s; s u p e n o rv r e w . T h e t i p s o f t h e s p i n o u sp r o c e s s e o s f the cervicaL v e r t e b r a el l - V l a r e f r e q u e n t t yd i v i d e d .

Fig.746 SeventhcervicaIvertebra,VertebracervicatisVll; s u p e f l o rv r e w I n g e n e r a It h e s e v e n t hc e r v i c avI e r t e b r ac a n b e e a s i L y i d e n t i f i e db y i t s p r o t r u d i n gs p i n o u sp r o c e s sa n d i s r e f e r r e dt o a s v e r t e b r ap r o m i n e n sI.n f a c t ,t h e s p i n o u s processof the first thoracicvertebraoften protrudes evenfurther.

f Tuberculum anrenus

Proc 'II transversus I Tuberculum poslenus \

Corpusvertebrae

Foramen transversarium

Sulcusnervi spinalis

Uncicorporis IProccuncinati]

F i g . 7 t 7 S e c o n dt o s e v e n t hc e r v i c avI e r t e b r a e , V e r t e b r a ec e r v i c a t elsl - V l l ' ventraIview.

vertebrae, Fig,718 First to seventhcervicaL l-VlI I VertebraecervicaLes dorso[ateraLview.

tt

Thoracic and lumbarvertebrae

Corpusvertebrae, Faciesintervertebralis Epiphysis anularis*

Articulatio capitis costae

Fovea costalis supenor

Caputcostae Collumcostae

Pediculus arcus vertebrae

Foveacostalissuperior Proc transversus

Foramen costotransversarium

Foramen vertebrale Proc adicularis lZygapophysisl supenor

Costa

Fovea costalis processus transversi

Tuberculum costae Lamrnaarcus vertebrae

Proc transversus

Articulatio costotransversaria

Fovea costalis processus transversl

Corpus vertebrae Fovea costalis inferior

lncisuravertebralis inferior Proc articularisinterior Proc spinosus

Proc spinosus

Fig.719 Vertebra,Vertebra; t y p i c a sI t r u c t u r a fI e a t u r e se x e m p t i fe d b y t h e f i f t h t h o r a c i cv e r t e b r a; s u p e n o rv t e w . + Atso:rim of vertebraI body

F i g .7 5 0 S i x t ht h o r a c i cv e r t e b r aV , e r t e b r at h o r a c i c aV l ; viewedfrom the teft.

Proc.articularis supenor Arcusvertebrae Proc mamillaris Proc accessorius Corpus verlebrae Proc sptnosus Fovea costalis

Proc articularis inferior F i g . 7 5 2 T w e t f t h t h o r a c i c v e r t e b r a , V e r t e b r a t h o r a c i c a Xil; viewed f rom the Left. * R e g i o no f t h e v e r t e b r a Ia r c h b e t w e e nt h e s u p e r i o ra n d

F i g ,7 5 1 T e n t ht h o r a c i cv e r t e b r aV , e r t e b r at h o r a c i c aX ; ventraLview.

i n f e r i o ra r t i c u [ a rp r o c e s s e s ( " i s t h m u s =" i n t e r a r t i c u L p ao r rtionl

Corpusvertebrae

F i g .7 5 3 T h i r d[ u m b a rv e r t e b r aV , e r t e b r aL u m b a L il sl l ; m e d i a ns e c t i o ns; p e c i m e n o f a n o L d e irn d i v i d u a [ . * O s s i f i c a t ioofnt h e[ i q a m e n t o iunss e r t i o n s

;:ili'::.

Thoracicand lumbarvertebrae


Fovea costalis supenor

Foveacostalisprocessus transversi

Corpusvertebrae, Facies intervertebralis

Pediculus arcus vedebrae Proc sprnosus

Foramenvertebrale

Proc costalis

Proc articularis superlor Laminaarcusvertebrae Proc accessorius Proc spinosus

, e r t e b r aL u m b a t i lsV ; F i g .7 5 5 F o u r t h[ u m b a rv e r t e b r aV s u p e n o rv r e w

Proc,articularis supenor

Proc costalis

Proc mamillaris

Corpusvertebrae

Proc costalis

Proc accessorius Proc articularis inferior

Fig.751 Tenthto tweLfththoracicvertebrae, V e r t e b r a et h o r a c i c a e X - X l l ,a n d f i r s t t o s e c o n d[ u m b a rv e r t e b r a e , V e r t e b r a e[ u m b a L e ls- l l ; d o r s a Iv i e wf r o m t h e [ e f t .

Pediculus arcusvertebrae

Proc articularis inferior

inferior Faciesarticularis

, e r t e b r a[ u m b a L i lsV ; F i g .7 5 6 F o u r t h[ u m b a rv e r t e b r aV ventraIview

Proc articularis superior

Epiphysis anularis

Proc.spinosus Laminaarcusvertebrae Proc articularisinterior

Fig.757 Fifth[umbarvertebra,Vertebra[umbatisV; mediansection. Notethe characteristic wedge-shape of the bodyof the f ifth [umbarvertebra.

+ R e g i o no f t h e v e r t e b r aaI r c hb e t w e e nt h e s u p e r i o ra n d i n f e r i o ra r t i c u [ a r process.Herein the fifth and Lessfrequentlyin the fourth [umbarvertebra can be formed.This is a cteft,bridgedby connectivetissuelspondylolysisl the superlor probabtycausedby locatbendingstress.As a consequence, vertebramay stip [otisthesislonto the inferiorvertebralspondylotisthesis).

> Back

Muscles

Sacrum

Proc articularis superior Canalissacralis

Tuberositasossissacri Faciesauricularis Cristasacralislateralis

Crista sacralis mediana

Cristasacralismedialis

Foramina sacraliaposteriora Hiatussacralis Cornusacrale

F i g .7 5 8 S a c r u m ,0 s s a c r u m ; d o r s a Iv i e w Apexossissacri


Parslateralis

Promontorium

Foramina sacraliaanteriora

Lineaetransversae

F i g ,7 5 9 S a c r u m ,0 s s a c r u m ; v e n t r o i n f e r i ovri e w . Apexossissacri

Promontorium

Alaossissacri Parslateralis

Basisossissacri Proc articularis superior

F i g . 7 6 0 S a c r u m ,0 s s a c r u m ; t h e b o n eh a s b e e ns e c t i o n e da t t h e [ e v e [o f t h e s e c o n ds a c r a Lv e r t e b r a : s u D e n o rv t e w

Canalis sacralis

Crista sacralis medialis

Cristasacralismediana

Parslateralis Parslateralis

Proc articularissuperior------:r

Basisossissacri Canalissacralis

Cristasacralis medlana

Promontorium

Foramina sacralia posteriora Cristasacralis medtana

Facies pelvica

Cornusacrale Cornu coccygeum

Hiatussacralis

Apexossissacri

Os coccygis

F i g . 7 6 1 S a c r u m0, s s a c r u m ; v i e w e df r o mt h er i g h t .

F i g . 7 6 2 S a c r u m ,O s s a c r u m ; m e d i a ns e c t i o n . * Remnants disctissue of intervertebraI persistevenin theadutt.

F i g . 7 6 3 S a c r u m0,s s a c r u m ; g e n d edr i f f e r e n c e s .

F i g . 7 6 I , S a c r u m ,0 s s a c r u m ; o e n d e rd i f f e r e n c e s .

Cornucoccygeum Cornu coccygeum

Vertebra coccygeaI Vertebra coccygeall Vertebrae coccygeae lll-V

F i g . 7 6 5 C o c c y x0, s c o c c y g i s ; v e n t r o s u o e r i ovri e w .

Fig.765 Coccyx,0s coccygis; d o r s o i n f e r i ovri e w .

> Back

$\'oturs*{o*l

Cervicalpart of the vertebraL column,radiography

Ramus mandibulae

Proc mastoideus

Atlas, Arcus anterior

Os occipitale

Cavitas nasi, Sinus maxillaris

Atlas, Arcus posterior

Palatum osseum

Atlas, Tuberculum posterius

Axis, Dens

Axis, Proc sprnosus

A x i s ,C o r p u s vertebrae

Inctsura vedebralis inferior

Angulus mandibulae Ltngua

Inctsura vertebralis supenor

Vertebra c e r v i c a l i sl l l , Corpus vertebrae Epiglottis

Articulatio zygapophysialis

Os hyoideum

Proc articularis inlerior Proc articularis supeflor

Discus intervertebralis Cartilago cricoidea, Lamtna

Proc spinosus

Facies inter vertebrales

Pediculus arcus vene0rae Foramen intervertebrale

Vertebra c e r v i c a l i sV l l , Corpus vertebrae

F i g .7 6 7 C e r v i c avLe r t e b r a eV, e r t e b r a ec e r v i c a t e s ; L a t e r arIa d i o g r a p ho f t h e c e r v i c a pL a r t o f t h e v e r t e b r a cI o L u m n ; u p r i g h tp o s i t i o nt;h e c e n t r a Ib e a mi s d i r e c t e d o n t ot h e t h i r d c e r v i c avI e r t e b r a ; s h o u t d e r sa r e p u L t e d o w n w a r d s .

Topography Cervicalpart of the vertebralcolumn,radiography

Proc spinosus-

Proc transversus

-

VertebracervicalisVl, Corpusvertebrae

Fig, 768 CervicaIvertebrae,Vertebraecervicates; A P - r a d i o g r a pohf t h e c e r v i c a pI a r t o f t h e v e r t e b r a cI o t u m n ; u p r i g h tp o s i t i o nt;h e c e n t r a Lb e a mr s d i r e c t e d o n t ot h e t h i r d c e r v i c avI e r t e b r a . x IntervertebraI discsoaces

Uncicorporum [Proccuncinati]

> Back Thoracicpart of the vertebralcolumn,radiography

Corpusvertebrae

Foramenintervertebrale Facies intervertebrales""

Proc spinosus


F i g . 7 6 9 T h o r a c i cv e r t e b r a eV, e r t e b r a et h o r a c i c a e ; L a t e r arIa d i o g r a p ho f t h e t h o r a c i cp a r t o f t h e v e r t e b r a cLo L u m n ; u p r i g h tp o s i t i o w n i t h t h e t h o r a xi n i n s p i r a t i o n ; t h e c e n t r a Ib e a m i s d i r e c t e do n t o t h e s i x t ht h o r a c i cv e r t e b r a .

+ Intervertebra d Ii s cs p a c e * * C L i n i c at eLr m : e n d - p L a t e s

Pediculus arcusvertebrae a^r^,,c

v6d6hrr6

Costa Articulatiocostotransversaria Proc transversus

Articulatiocapitis costae Caput costae

Facies intervertebralis

F i g . 7 7 O T h o r a c i cv e r t e b r a eV, e r t e b r a et h o r a c i c a e A P - r a d i o g r a pohf t h e t h o r a c i cp a r t o f t h e v e r t e b r a cLo L u m n ; u p r i g h tp o s i t i o w n i t h t h e t h o r a xi n i n s p i r a t i o n ; t h e c e n t r a Lb e a m i s d i r e c t e do n t ot h e s i x t ht h o r a c i cv e r t e b r a

* Intervertebra d Ii s cs p a c e

Lumbarpart of the vertebralcolumn,radiography

Vertebra lumbalisl, Corpusvertebrae

Foraminaintervertebralia

Arcusvertebrae, Pediculusarcusvertebrae inferior lncisuravertebralis Faciesintervertebrales Incisuravertebralissuperior

Proc.spinosus Proc.articularissuperior Proc articularisinferior

Os ilium. Crista iliaca

Articulatiozygapophysialis

Basisossissacri Cristasacralismediana Promontorium Os sacrum

F i g . 7 7 1 L u m b a rv e r t e b r a eV, e r t e b r a eL u m b a t e s ; l a t e r a Ir a d i o g r a p ho f t h e [ u m b a rp a r t o f t h e v e r t e b r a cI o l u m n ; u p r i g h tp o s i t i o n ; t h e c e n t r a tb e a m i s d i r e c t e do n t ot h e s e c o n d[ u m b a rv e r t e b r a . I n t h i s c a s e ,t h e a n t e r i o re d g e so f t h e l o w e r [ u m b a rv e r t e b r a e a r e o b t i q u ed u e t o p a t h o L o g i caalIt e r a t i o n s .

* I n t e r v e r t e b r adI i s c s p a c e * * R e g i o no f t h e v e r t e b r a la r c h b e t w e e nt h e s u p e r i o ra n d i n f e r i o r a r t i c u [ a rp r o c e s s e ls" i s t h m u s '= i n t e r a r t i c u [ apro r t i o n l * * * T h e m a r k s i n d i c a t et h e p o s i t i o no f t h e t w e t f t h r i b , w h i c h i s p o o r t y v i s i b l ei n t h i s c o p yo f t h e r a d i o g r a p h .

M us c [es Lumbarpart of the vertebralcolumn,radiography

costaXll

Vertebra lumbalisl, Corpusvertebrae Proc.articularis superior Articulatiozygapophysialis

Procc. costales

Proc.articularis inferior


Faciesintervertebrales

Proccsplnosi

Proc. costalis

Os coxae; Osilium

Articulatiosacroiliaca

Foramina sacraliaanteriora

F i g , 7 7 2 L u m b a rv e r t e b r a eV, e r t e b r a eL u m b a l e s ; A P - r a d i o g r a p oh f t h e L u m b a rp a r t o f t h e v e r t e b r a cI o t u m n andthe sacrum; u p r i g h tp o s i t i o nt;h e c e n t r a Ib e a mi s d i r e c t e do n t ot h e s e c o n d L u m b a vr e r t e b r a . + IntervertebraI discspace

CraniocervicaI j unctions

Os occioitale.Parsbasilaris anterior Membranaatlantooccioitalis Parslateralis Os occiDitale. Os occioitale.Parslateralis + Articulatioatlantooccioitalis

Capsulaarticularis

Articulatioatlantoaxialis lateralis Lig longitudinaleanterius Axis

Discusintervertebralis Vertebra lll cervicalis Vertebra cervicalis lll, Corpus vertebrae

F i g . 7 7 3 C r a n i o c e r v i jcuanI c t i o nasn dt h eu p p e rc e r v i c apIa r t o f t h ev e r t e b r a l t o [ u m n ; ventratvtew.

Os occipitale

posterior Membranaatlantooccipitalis

Lig atlantooccipitale laterale

Atlas,Massalateralis

Sulcusarteriaevertebralis

Tuberculumoosterius

Articulatioatlantoaxialis

lateralis, Articulalioatlantoaxialis Caosulaarticularis

lateralis Axis, Arcus vertebrae

junctions; Fig.771 CraniocervicaI dorsaIview.

Back

M us c l es

Crani ocervicaI j unctions

Os occipitale,Clivus

Sulcus srnus sigmoidei

Os occipitale

Articulatio atlantooccipitalis, Capsulaarticularis Atlas Articulatio

Membranatectoria

atlantoaxialislateralis, Capsula articularis

Axis

Vertebra ceruicalis lll

F i g .7 7 5 C r a n i o c e r v i c jauIn c t r o n s , dcon

linemonf

c.

dorsaLview.

Fasciculilongitudinales Ligg alaria

Canalisnervihypoglossi Sulcussinussigmoidei Articulatio atlantooccipitalis

Capsulaarticularis

Atlas,Arcusposterior

Lig transversum atlantis

Articulatio atlantoaxialis lateralis

Lig cruciformeatlantis

Fasciculi longitudinales

F i g .7 7 6 C r a n i o c e r v i cjauIn c t i o n s , d e e pI i g a m e n t s ; dorsaLview.

Lig apicis dentis

Capsulae articulares

Densaxis

F i g .7 7 7 C r a n i o c e r v i cjauIn c t i o n s , doon

linrmanic.

dorsaIview. T h e a L a rL i g a m e n tfsr e q u e n t [ e y x t e n dt o t h e l a t e r a I m a s s e so f t h e a t t a s .

Topography CraniocervicaI j unctions

Os occioitale.Pars basilaris

Duramatercranialis Lig. apicis dentis

l\4embranaatlantooccioitalisanterior

DuramatersPinalis Membrana tectoria

Atlas,Arcusanterior Fasciculilongitudinales I atlantis atlantislLig cruciforme Lig.transversum

Articulatio atlantoaxialis medianaanterior

- Fasciculi longitudinales J medianaposterior Articulatio atlantoaxialis Squama occipitalis

Densaxis Membrana atlantooccipitalisposterior

Discusinteruertebralis Atlas,Arcusposteriol lll, Vertebra cervicalis Corpusvertebrae

Axis,Proc spinosus Nn cervicales,Badices

F i g .7 7 8 C r a n i o c e r v i c jauLn c t i o n s ; m e d i a ns e c t i o n

Os occipitale Atlas, Arcusanterior, Foveadentis Articulatioatlantoaxialis mediana posterior

atlantoArticulatio occipitalis

Articulatioatlantoaxialis mediana anterior

Densaxis Atlas,Arcusposterior

Densaxis

Atlas,Arcusanterior Atlas,Massalateralis Articulatioatlantoaxialislateralis Atlas,Facies articularis supenor

Axis,Corpus Axis,Proc spinosus

Membrana atlantooccipitalis posterior

Procspinosus F i g ,7 7 i C r a n i o c e r v i cjauIn c t i o n s ; s u p e n o rv t e w

F i g .7 8 0 C r a n i o c e r v i clauLn c t t o n s ; A P -r a di o gr ap h .

> Back li..-'-,,.+W

M us c l es

Ligaments of thevertebralcolumn

Foveacostalis inferior Foveacostalis supenor Pediculus arcus vertebrae

Lig costotransversaflum

Arcus vertebrae

Discus intervertebralis

Vertebra thoracica Xll, Corpus vertebrae Discus intervertebralis

F i g . 7 8 1 L i g a m e n t so f t h e v e r t e b r a I c o l u m n ; e x e m p t i fe d b y t h e L o w e tr h o r a c i cp a r t o f t h e vertebratco[umn; ventraLview.

F i g . 7 8 2 L i g a m e n t so f t h e v e r t e b r a I c o l u m n ; e x e m p l i fe d b y t h e l o w e rt h o r a c i ca n d t h e u p p e r[ u m b a rp a r t o f t h e v e r t e b r a cl o l u m n ; d o r s a Iv i e w .

Lig capitiscostaeradiatum Articulatiocapitis costae

Proc articularis superior Lig costotransversarium Collumcostae

Tuberculumcostae

Lig costotransversarium laterale

Proc transversus Lig flavum

F i g . 7 8 3 C o s t o v e r t e b r jaoI i n t s ,A r t i c u l a t i o n ecso s t o v e r t e b r a [ e s ; c r o s s - s e c t i oant t h e l e v e Io f t h e L o w e rp a r t o f t h e j o i n t a t a h e a do f a r i b ; s u p e f l o rv t e w .

To p o g ra p h y Lioamentsof the vertebralcolumn

superior Proc.articularis Foveacostalissuperior Corpusvertebrae

Foveacostalisprocessustransversi Foramencostotransversarium

laterale Lig costotransversarium

Lig longitudinaleanterius

superius Lig costotransversarium

Discusintervertebralis

Lig intertransversarium Lig capitiscostaeradiatum

F i g . 7 8 1 L i g a m e n t so f t h e v e r t e b r a cLo t u m na n d t h e joints, Articulationes costoverteb rates; costovertebraI [ a t e r a Ip a r t so f t h e a n t e r i o rL o n g i t u d i n [ai [g a m e n th a v e b e e nr e m o v e d ; viewedf rom the teft.

Fovea costalis processus transversl

Ligg flava

Capsula articularis

Lig costotransversarium Laminaarcusvertebrae

Pediculusarcusvertebrae

F i g . 7 8 5 J u n c t i o n sb e t w e e nt h e v e r t e b r aal r c h e s ; ventraIview.

> Back

M us c l es

joints Costovertebral

Foramenintervertebrale

Lig costotransversarium supenus Lig costotransversarium laterale Lig longitudinaleanterius

Articulatiocapitiscostae Tuberculum costae

Discusintervertebralis

Caputcostae

F i g . 7 8 6 C o s t o v e r t e b r jaoIi n t s ,A r t i c u [ a t i o n e s costovertebra[es; ventraL v i e wf r o m t h e l e f t .

Arcusvertebrae Ligg intertransversaria

Proc spinosus

Laminaarcusvertebrae

Lrg costotransversarium superius

Lig flavum

Lig costotransversarium laterale Proc transversus


Lig intertransversarium

Capsulaarticularis Lig,supraspinale"

F i g . 7 8 7 L i g a m e n t so f t h e v e r t e b r a aL r c h e sa n d t h e c o s t o v e r t e b r jaoI in t s ,A r t i c u l a t i o n ecso s t o v e r t e b r a t e s ; dorsaLview. * T h em e d i a n p o r t i oo n f t h et h o r a c o t u m bf a sr c i a r sr e f e r r e d t o a ss u p r a s p i n olui gsa m e n t

Ligamentsof the lumbarpart of the

arcusvertebrae Pediculus

posterius Lig longitudinale

Disciintervertebrales

V, Vertebra lumbalis Corpusvertebrae

Os sacrum

F i g .7 8 8 L i g a m e n t so f t h e [ u m b a rp a r t o f t h e v e r t e b r a cI o l u m n .

Proc costalis

inferior Proc articularis Proc articularis superior

Lig,transversum zygapophysialis; Articulatio

Laminaarcusvertebrae Lig flavum

Proc spinosus

F i g .7 8 9 V e r t e b r ajlo i n t so f t h e [ u m b a rp a r t o f t h e v e r t e b r a l cotumnA , r t i c u t a t i o n ezsy g a p o p h y s i a l [eusm b a l e s ; d o r s a lv r e wf r o m t h e r i q h t

r i n t s b y s t r o n ga n d R e i n f o r c e m e notf t h e i n t e r a r t i c u [ aj o t r a n s v e r s ef i b r e sI L i g g .t r a n s v e r s ai]s r e s t r i c t e dt o t h e [ u m b a r p a r t o f t h e v e r t e b r a cI o l u m n .

> Back

Mr.rsu[es

lntervertebraldiscs

Uncuscorporrs IProc uncinatus] A n u l u lsi b r o s u s

Pediculus arcus vertebrae Corpusvertebrae

Epiphysis anularis Anulusfibrosus

N spinalis, Ganglion sensoflum nervispinalis

F i g .7 9 0 a ,b I n t e r v e r t e b r adIi s c s ,D i s c ii n t e r v e r t e b r a L e s a C e r v i c aiIn t e r v e r t e b r adIi s c s ,D i s c ii n t e r v e r t e b r a l e s c e r v i c [ae s ; f r o n t a Ls e c t i o n b L u m b a ri n t e r v e r t e b r adl i s c ,D i s c u si n t e r v e r t e b r a Lt iusm b a L i s : m e d i a ns e c t i o n

Epiphysis anularis N u c l e upsu l p o s u s

Corpusvertebrae

* H y a t i n ec a r t i [ a g i n o ucso v e r i n go f t h e e n d - p L a t eosf t h e v e r t e b r abI o d i e sr e f [ e c t i n tgh e n o n - o s s i f i epdo r t i o no f t h e e prph y s e s * x I n t h e f i r s t d e c a d eo f I i f e ,s o - c a l t e du n c o v e r t e b r a c lI e f t s d e v e [ o pi n t h e L a t e r azI o n e so f t h e c e r v i c a L intervertebraI d i s c sw , h r c hc a n p r o g r e s sf u r t h e rt o w a r d st h e m i d d l ei n t h ef o t t o w i n g decades

Fascia thoracolumbalis

Vertebralumbalis l, Corpus vertebrae

Proc spinosus Discusinteruertebralis Canalisvedebralis; Caudaequina Spatium epidurale Vertebra lumbalis V, Corpusvertebrae Canalissacralis

F i g .7 9 1 L u m b a ri n t e r v e r t e b r adIi s c , D i s c u si n t e r v e r t e b r a L[ iusm b a I i s ; s u p e n 0 rv t e w

F i g . 7 9 2 L u m b a rp a r t so f t h e v e r t e b r a L c o l u m n ; m a g n e t i cr e s o n a n cteo m o g r a p h ii cm a g eI M R l ) ; m e d i a ns e c t i o n .

To pogr a p h y Motionsegments

Proc articularis suoerior Uncuscorporis [Proc uncinatus] Faciesintervertebralis

Foramenintervertebrale Articulatiozygapophysialis, Capsulaarticularis

Epiphysis anularis*

Lig flavum

Corpusvertebrae Lig interspinale

Lig.longitudinale anterius Faciesintervertebralis

Anulus

Oi"araJ' fibrosus intervertebralis Nucleus I pulposus Lig. nuchae (Foramen venae basivertebralis)

Proc articularis inlerior Laminaarcusvertebrae ' Proc soinosus Pediculusarcusvertebrae

Epiphysis anularis " * A l s o : r i m o f v e r t e b r a lb o d y * * H y a l i n ec a r t i l a g i n o u sc o v e r i n go f t h e e n d - p l a t eo f t h e v e r t e b r a tb o d y

Fig.793 CervicaImotion segment; s c h e m a t i cm e d i a ns e c t i o n .

r e f t e c t i n gt h e n o n - o s s i f i e dp o r t i o no f t h e e p i p h y s i s


Proc.articularissuoerior

Epiphysis anularis*

Lig flavum

Lig. interspinale

Lig longitudinale anterius Lig supraspinale Faciesintervertebralis

/

I Anulusfibrosus urscusI intervertebralis I I Nucleuspulposus

\


(Foramen venae basivertebralis)

Proc.spinosus

Lig. longitudinaleposterius

Pediculusarcusvertebrae

Lamina arcus vertebrae

Fig,79t, Lumbar motion segment; s c h e m a t i cm e d i a ns e c t i o n .

Proc articularisinferior

* A [ s o :r i m o f v e r t e b r a tb o d y * * H y a t i n ec a r t i l a g i n o u sc o v e r i n go f t h e e n d - p l a t eo f t h e v e r t e b r a Ib o d y r e f t e c t i n gt h e n o n - o s s i f i e dp o r t i o no f t h e e p i p h y s i s

> Back Superficialmusclesof the back

ProtuberantiaocciDitalisexterna

M sternocleidomastoideus

IVIspleniuscapitis M trapezius

Spina scapulae

Fascia deltoidea

prominens, Vertebra Proc spinosus

M teres malor

Scapula, Angulusinferior

M infraspinatus, Fasciainfraspinata M latissimus dorsi M, rhomboideus major

VertebrathoracicaXll. Proc. sDinosus

M obliquus externus abdominis


Cristailiaca

Os sacrum, Faciesdorsalis

F i g . 7 9 5 M u s c t e so f t h e b a c k ,M m . d o r s i ; s u p e r f i c i aLI a y e or f t h e t r u n k - a r ma n d t r u n k - s h o u l d e r o i r d l em u s c t e s .

To p o g r a p h y Superficialmusclesof the back

M trapezius l\4 sternocleidomastoideus l\4 splenius capitis

M splenius cervicis

Fascia deltoidea

M. trapezius

M.teresmaior M serratusposterior supenor

major M rhomboideus M infraspinatus, Fasciainfraspinata Scapula, Angulusinferior

M erectorspinae M latissimus dorsi

M latissimus dorsi

Fascia thoracolumbalis*

M obliquusexternus abdominis M obliquus e)dernusabdominis

M obliquusinternus abdominis lumbale Trigonum

Cristailiaca

F i g . 7 9 6 M u s c t e so f t h e b a c k ,M m . d o r s i ; d e e pl a y e ro f t h e t r u n k - a r ma n d t r u n k - s h o u t d e r g i r d l em u s c l e s . * Theso-catled thoracotumbar fasciaformsa dense ao0neur0sts

> Back i:'

tt

at"t

Deepmusclesof theback

M semisDinaliscaoitis

nuchae M splenius capitis

M splenius capitis M sternocleidomastoideus

l\4 longissimus capitis M splenius cervicis M. splenius cervicis

M. scalenusoosterior

M levatorscapulae M trapezius M longissimus ceruicis

M teresmajor

M semispinaliscervicis M serratusposteriorsuperior M iliocostaliscervicis

M rhomboideus major i/ inlraspinatus, Fasciainfraspinata M lliocostalisthoracis

M latissimus dorsi

M spinalisthoracis

thoracis M. longissimus

M iliocostalisthoracis

M. serratusanterior

M longissimus thoracis

M serratusoosteriorinlerior M iliocostalis lumborum M obliouus externusabdominis Fascia thoracolumbalis

M obliquus internusabdominis

M erectorspinae

F i g . 7 9 7 M u s c l e so f t h e b a c k ,M m . d o r s i ; s u p e r f i c i aLLa y e or f t h e d e e pI a u t o c h t h o n o u m s ]u s c L e s .

Musclesof the back,sections

Caudaequina

Lig longitudinale anterius

Pediculus l arcus I a,.,," vertebrae | LamrnaarcusI ""il"urr" vertebrae )

Ben M psoasmajor

t\4m *" transversospinales Plexuslumbalis M. erectorspinae* Proc costalis (Lamina protunda)

M quadratus lumborum Costaxll M obliquus externus abdominis


lvl latissimus dorsi Proc spinosus

(Lamina superficialis)

F i g .7 9 8 M u s c t e so f t h e b a c k ,M m . d o r s i ; c r o s s - s e c t i oant t h e [ e v e [o f t h e s e c o n dL u m b a vr e r t e b r a : i n f e r i o rv i e w . Thedeep[autochthonousl musctes of the backliewithinan osteofibrous tubeformedbydorsatpartsof thevertebrae andthesurrounding intoa lateral* aredivided aponeurotic thoracoLumbar fasciaThemuscLes a n da m e d i a*[* t r a c t

Corpusvertebrae


Proc articularis superiof

Nucleuspulposus) ' I Discus f intervertebralis Anulusfibrosus / N spinalis M psoasmajor


Caudaequina Lig flavum*


M. erectorspinae

Proc spinosus

Mm transversospinales

Fasciathoracolumbalis

F i g . 7 9 9 M u s c l e so f t h e b a c k ,M m . d o r s i ; c o m p u t e dt o m o g r a p h i c r o s s - s e c t i o(nC T )a t t h e l e v e Io f t h e i n t e r v e r t e b r adli s c b e t w e e nt h e t h i r d a n d t h e f o u r t h[ u m b a r vertebra; inferiorview.

* C a t c i f i c a t i oo n r o s s i f i c a t i o nf r e q u e n t t yo c c u r sa t t h e s i t e s o f i n s e r t i o n o f t h e [ i g a m e n t af t a v a ,e v e ni n y o u n g e ri n d i v i d u a t s . * + A d i p o s et i s s u ed e p o s i t s

> Back

>>l

-

Surface lSketetonl Musctes

Deepmusclesof the back

Tract

LongitudinaI system

0btiquesystem

M longissimus -capitis -cervtcts -thoracis

M iliocostalls -cervtcts -thoracis -lumborum

M. semispinalis** -capitis -cervtcts

M. spinalis -capitis -cervtcts -thoracis

M. multifidus"* -cervtcts -thoracis -lumborum

Mm.interspinales -cervrcts -thoracis lumborum

Mm. rotatoresbreves** -cervrcrs -thoracis -lumborum


F i g . 8 0 0 D e e p[ a u t o c h t h o n o u m s )u s c t e so f t h e b a c k ; d i a g r a mo f t h e d i f f e r e n gt r o u p so f m u s c t e s . T h e d e e p[ a u t o c h t h o n o u m s Ju s c t e so f t h e b a c kc a n o e d i v i d e di n t o a t o n g i t u d i n aal n d a n o b t i q u es y s t e m a ,s w e t l a s i n t o a m e d i a la n d a l a t e r a lt r a c t . + Spinotransverse +*TransversosoinaI

Tract

To p o g r a p h y Deepmusclesof the back

l\4 semispinaliscapitis

l\4 rectuscapitisposterior minor M rectuscapitisposterior major posterius Atlas,Tuberculum

M obliquuscapitissuperior M spleniuscapitis capitis l\4 longissimus Venterposterior M digastricus,

Atlas,Proc transversus M obliquuscapitisinferior M semispinaliscapitis

posteriorescervicis l\4m intertransversarii

Mm multilidi

M semispinalis ceruicis Ligg intertransversaria

Mm interspinalescervicis

Lig supraspinale Ligg.interspinalia;

M spinaliscapitis

Mm rotatoresthoracisbreves thoracis Mm intertransversarii externi Mm,intercostales

Mm levatorescostarumbreves

thoracislongi Mm.rotatores M semispinalis thoracis

superius Lig costotransversarium Lig intertransversarium

lvlm lntercostales externi,Fascia

Mm levatores costarum breves

intercostalis interna Membrana interni Mm intercostales

Mm levatores costarumlongi

Mm intercostalesexterni

lvlm intertransversarii thoracis CostaXll

Fascia M quadratus lumborum,


lumborum Mm intertransversarii mediales M obliquusinternusabdominis

M transversus abdominis

Mm intertransversarii laterales tumoorum

Mm interspinaleslumborum

Fascialransversalis

Ligg intertransversaria

l\4 obliquusexternus abdominis

Lig iliolumbale

superior Spinailiacaposterior Lig sacrotuberale

Mm multilidi

F i g .8 0 1 M u s c l e so f t h e b a c k ,M m . d o r s i , a n d s u b o c c i p i t amI u s c t e s M , m.suboccipitates.

tt

musclesof theback

Lig. intertransversarium

Lig.costotransversarium Costalx

M levatorcostaelongus Mm.multifidi M levatorcostaebrevis

Mm rotatoresthoracis Lig intertransversarium

Vertebralumbalisl, Arcusvertebrae CostaXll

Ligg. flava

Vertebraelumbales, Procc.costales

Mm.intertransversarii lateraleslumborum Fasciathoracolumbalis (Laminaprofunda) Mm. intertransversarii mediales lumborum

Mm. multifidi

M erector spinae

Vertebraelumbales,Procc sDinosi

F i g . 8 0 2 M u s c l e so f t h e b a c k ,M m . d o r s i ; d e e p e s lt a y e ri n t h e r e g i o no f t h e l o w e rt h o r a c i ca n d t h e t u m b a r part of the vertebraIcolumn.

muscles Suboccipital

M rectuscaoitisoosteriorminor

M. trapezius caoitis M semisDinalis M rectuscapitisposteriormajor capitissuperior M. obliquus capitis M splenius

Atlas,Arcusposterior

M. spleniuscervicis

M splenius capitis

Proc mastoideus capitis M. longissimus M digastricus,Venterposteriot

M splenius cervicis

Proc styloideus

M longissimus capitis

capitisinferior M obliquus i,il semispinalis capitis capitis M. longissimus

posterius Atlas,Tuberculum Axis,Proc.spinosus

M semispinalis capitis

Mm.interspinales cervicis

Mm multifidi

M. semispinaliscervicis

M. longissimus cervicis

M iliocostalis cervicis

Lig supraspinale M semispinalis capitis

M. semispinalis thoracis

F i g . 8 0 3 M u s c t e so f t h e b a c k ,M m . d o r s i ,a n d , m.suboccipita[es. s u b o c c i p i t amI u s c t e s M

M obliquus capitissuperior

M rectuscapitis posterior minor

M. rectuscapitis posteriormajor Atlas.Arcusoosterior M obliquus capitisinferior

F i g .8 0 4 S u b o c c i p i tma ul .s c l e s , F M m .s u b o c c i o i t a t e s .

Tr0;l

> Back -:s

tt

Suboccipital muscLes

M spleniuscapitis

M longissimus capitis

M semispinaliscapitis

Lrg nucnae

splenius cervicis

lvl trapezius

levatorscapulae

prominens, Vertebra Proc,spinosus

l\4 longissimus cervicis M scalenusmedius

M iliocostaliscervicis

M semispinalisthoracis

M scalenusposterior

F i g .8 0 5 M u s c t e so f t h e b a c k ,M m . d o r s i , a n d m u s c l e so f t h e n e c k .M m . c o t L i .

M rectuscaoitisposterior minor

M semispinalis capitis

M rectuscapitis posteriormajor

M splenius capitis

Membrana atlantooccipitalis posterior

M obliquuscapitissuperior

A vertebralis, Pars atlantica

lvl longissimus capitis

Atlas, Proc transversus

M digastricus, Venterposterior M rectuscapitislateralis Proc styloideus

l\4 obliquus capitisinferior

M obliquus capitis inferior M longissimuscervicis M splenius cervicis

posteriorcervicis M intertransversarius Axis,Proc transversus M spleniuscervicis

M semispinaliscapitis Mm multifidi

Fig.806 SuboccipitaLmusc[es, M m .s u b o c c i p i t a t e s .

il-

P o s t e r i o tru b e r c [ eo f t h e a t t a s S p i n o u sp r o c e s so f t h e a x i s

Vertebral coIumn, sections

Larynx

Cartilagothyroidea

Corpus vertebrae

M sternocleidomastoideus VertebracervicalisV, Corpusvertebrae Uncuscorporis Proc.transversus, Tuberculum anterius Discus intervertebralis N spinalis Pediculus arcus vertebrae VertebracervicalisVl, Corpusvertebrae Proc.articularis

Foramen vertebrale Proc articularis inlerior Laminaarcus vertebrae Lig.flavum

Laminaarcus vertebrae Proc.spinosus

Proc.spinosus, Tubercula

F i g . 8 0 7 C e r v i c apI a r t o f t h e v e r t e b r a cI o t u m n ; computedtomographiccross-sectionICT]at the Level. o f t h e i n t e r v e r t e b r adLi s c b e t w e e nt h e f o u r t ha n d t h e f i f t h cervicaIvertebra. + EndotracheaI tubeandendoscooe

F i g .8 0 8 C e r v i c apI a r t o f t h e v e r t e b r a cl o t u m n ; computedtomographiccross-sectionICTJat the tevet o f t h e f i f t h a n d t h e s i x t hc e r v i c avI e r t e b r a .

)a--->-

/q. lrrl+-C* lA\ r.'-}y'

Aorta,Pars abdominalis V cava interior

V cava inferior Aorta,Pars abdominalis Corpusvertebrae

Discus intervertebralis M. psoas Ben Foramen intervertebrale Proc.articularis supeflor Articulatio zygapophysialis Proc articularis inferior Proc.mamillaris Mm dorsi Proc spinosus Fascia thoracolumbalis

F i g . 8 0 9 L u m b a rp a r t o f t h e v e r t e b r a cI o l u m n ; c o m p u t e dt o m o g r a p h i c r o s s - s e c t i o[nC T la t t h e L e v e t o f t h e i n t e r v e r t e b r adIi s c b e t w e e nt h e s e c o n da n d t h e t h i r d l u m b a rv e r t e b r a .

M. psoasmajor

Pediculus arcus vertebrae Lig flavum Proc costalis Proc.articularis inferior Proc articularis supeflor Lig interspinale Mm dorsi Fascia thoracolumbalis

F i g . 8 1 0 L u m b a rp a r t o f t h e v e r t e b r a I c o t u m n ; c o m p u t e dt o m o g r a p h i c r o s s - s e c t i o[nC T ]a t t h e L e v e l . o f t h e o e d i c l e so f t h e t h i r d [ u m b a rv e r t e b r a .

> Back Cutaneousinnervation

N. auricularismagnus,R posterior(Plexuscervicalis) N. occipitalisminor(Plexuscervicalis)

Nn.supraclaviculares laterales(Plexuscervicalis)

N. cutaneusbrachii lateralissuoerior (N. axillaris)

N. cutaneus brachiilateralis inforior(N. radialis)

N. cutaneusbrachii posterior(N. radialis) (Rr.cutaneimedialeset laterales) (Nn. spinalesC.$-L1,Rr. posteriores)

Rr.cutaneilaterales (Nn.spinales,Nn. intercostales)

R. cutaneuslateralis (Plexuslumbalis,N. iliohypogastricus) Nn.cluniumsuperiores (Nn.spinalesL1-13, Rr.posteriores)

L3 Nn.cluniummedii(Nn.spinales 51-S3, Rr. posteriores)

L4 L5

Nn. cluniuminferiores (N. cutaneusfemorisposterior)

S1

s2 S3

N. cutaneusfemorislaleralis(Plexuslumbalis) N. cutan€usfemorisposterior(Plexuslumbalis)

F i g .8 1 1 S e g m e n t ca uI t a n e o ui ns n e r v a t i ol dne r m a t o m e s ) andcutaneous nervesof the back.

andnervesof the Vessels

N occipitalis tertius(C3),

maior(C2);A.;Voccipitalis a a N. occipitalis .* N auricularis magnus(Plexuscervicalis)

N occipitalismajor (C2) ,

(Cl) ..' -- ' N suboccipitalis

(C6) & R, posterior

A vertebralisa N occipitalisminor (Plexuscervicalis)1l' N auricularismagnus (Plexus cervicalis)t

M longissimus capitisO M levator scapulae I

* R posterior(C7) ., B posterior (C8) (T1) , R posterior (Plexuscervicalis) lateralis t, N supraclavicularis a M. deltoideus brachiilateralis $ N cutaneus inlerior & N radiaiis; a o A.; (V) profundabrachii & N cutaneus brachiiposterior

M serratusposteriorsuperiorl'

Mm multilidit

Nn thoracici, Rr posteriores, , medialeset laterales

I M triceps brachii, Caputlongum

M iliocostalisthoracis a

& N intercostobrachialis c a a N axillaris;A; V circumflexa humeriposterior*'

M longissimus thoraciso

a M. teres major scapulae* a o A ; V circumtlexa a M teresminor a M infraspinatus major a M rhomboideus

M serratusposteriorinferiort

dorsi || M latissimus (T12). R posterior M latissimus dorsio M obliquusexternus abdominis a Trigonum lumbale; N iliohypogastricus : Crista iliaca

(Bursasubcutanea spinaeiliacae dosteriorissuperioris)

R posterior(T12) :

(Bursasubcutanea sacralis) Nn cluniumsuperiores

(Bursasubcutanea coccygea) M gluteusmaximust (S3) R posterior

(S4) : R posterior

813 81t, Fig,812 Vessetsand nervesof the back. * Vessels space andnervesof thetriangutar ** VesseLs space andnervesof thequadrangutar

> Back

M us c tes

Vessels and nervesof theposteriorcervicalregion

N occipitalismajor $

lvl semispinalis capitis*

O A occipitalis,Rr occipitales

A;VoccipitalisOO

a A occipitalis N occipitalismajor A occipitalisa O V occipitalis V auricularisposteriora : N occipitalisminor A occipitalis,a R mastoideus

* N auricularis magnus

N occipitalisminor i

posterior, a A auricularis R occipitalis

M longissimus capitis*

t M spleniuscapitis

N accessorius [Xl] { l\4 spleniuscapitis$ M levatorscapulae* N dorsalisscapulae:

I M sternocleidomastoideus O V jugularis externa ,] Rr cutaneiposteriores (Nn cervicales et thoracici, Rr posteriores)

B profundus O (A transversacolli) M levator scapulae O

V transversaO colli

M rhomboideus a mtnor

O lvl trapezius

N4trapezius* * Rr.cutaneiposteriores (Nn thoracici, Rr posteriores)

lvl rhomboideus O maJor

M latissimus dorsiE

{ Rr.cutaneilaterales pectorales (Nn thoracici, Nn,intercostales)

8',14 il r'"

,,.,'i, 812

F i g . 8 1 3 V e s s e Lasn d n e r v e so f t h e o c c i p i t arI e g i o n , R e g i oo c c i p i t a L itsh,e p o s t e r i o rc e r v i c a rI e g i o n , R e g i oc e r v i c a t i p s o s t e r i o ra, n d t h e u p p e rb a c k

Topography l/esselsand nerves

posteriorcervical

occioitalisexterna Protuberantia Venteroccipitalis M. occipitofrontalis, a M. epicranius;

maior a N. occipitalis l\4.semispinalis capitisa a A vertebralis M rectuscapitisposteriormajora

o V auricularisoosterior O V occipitalis

N suboccipitalis3 o V. vertebralis

A occipitalisO O A occipitalis

M o b l i q u uas capitissuperior A vertebralisa M spleniuscaoitiso M. longissimus capitiso M obliquuscaoitisinteriora O A. cervicalisprofunda

R posterior(C 2) a

o V cervicalisprofunda

M semispinalis capitisa R. posterior(C 3) ,

cervicis a M. semispinalis 3 N accessorius[Xl] e N dorsalisscaDulae

N accessorius [Xl]a R super{icialis a (A transversa colli) (4. transversa Fl profundus colli)a

c N dorsalisscaoulae majoret minor a Mm rhomboidei

15 F i g . 8 1 4 V e s s e t sa n d n e r v e so f t h e o c c i p i t arIe g i o n , R e g i oo c c i p i t a t i sa,n d t h e p o s t e r i o rc e r v i c a rI e g i o n , Regiocervicatisposterior.

81

> Back

tt

Cervicalpart of thevertebralcanal

i,!W

N occipitalis major&

tertius * N. occioitalis

M semispinalis capitisa

M obliquuscapitissuperiorI O M rectuscaoitisoosteriorminor M, rectuscapitisposterior majorI

Os temoorale.Proc mastoideus

A vertebralis,Parsatlanticaa

& N. suboccipitalis

N suboccipitalis $

Atlas,Arcusposlerior

M obliquuscapitisinferiora

a M obliquuscapitisinferior R posterior(C 2) *

a A vertebralis,Parstransversaria

N occipitalis tertius*

o M rectuscapitisposteriormajor

Plexus cervicalis {}

ceruicis a Mm intersoinales

&x

Y;,e ,dY 81tl

F i g . 8 1 5 N e r v e so f t h e p o s t e r i o rc e r v i c a rI e g i o n ,R e g i oc e r v i c a t i p sosterior, a n d t h e v e r t e b r a aI rrery, A . v e r t e b r a t i s

Sinussagittalis superioro Foramenmagnum Sinustransversus o Cisterna cerebellomedullaris

!&N suboccipitalis

Arachnoidea matercranialis; Cerebellum

Proc.transversusatlantis

Arachnoidea materspinalis

O A vertebralis

Duramaterspinalis Arachnoidea materspinalis

,t N. occipitalismajor & N occipitalistertius &N spinalis,R posterior

M, scalenusmediusa

I Lig denticulatum

VertebraceruicalisV Proc transversus

& N s p i n a l i s , Ra n t e r i o r

N, cervicalis [C7], r Filaradiculariaposteiior-a

& N spinalis, Ganglion sensorium aA vertebralis

Medullaspinalis

,s.t&{&

/4

F i g . 8 1 6 V e s s e t sa n d n e r v e so f t h e d e e pp o s t e r i o cr e r v i c a rI e g i o n , R e g i oc e r v i c a I i p s o s t e r i o ra, n d t h e c o n t e n to f t h e v e r t e b r a cI a n a L .

Lumbarpart of the vertebralcanaL

Corpusvertebrae Truncussympathicus, Ganglion truncisympathici

M e d u l l as p i n a l i s

R communicans R meningeus

Badixanterior

Ganglion neruispinalis sensorium ror"r"n intervertebrate

Truncusnervispinalis ] R posterior

Radixposterior

N intercostalis Canalisvertebralis Costa

Arcusvertebrae

R lateralis Proc spinosus R medialis

Mm.dorsi

(R cutaneuslateralis) (R cutaneusmedialis)

F i g . 8 1 7 S p i n a nL e r v e N , .spinatis; i n t h e t h o r a c i cr e o i o n Laminaarcusvertebrae lumbalisll, Proc.costalis Vertebra Spatiumepidurale Lig flavum

lumborum * l\4.quadratus a Plexusvenosus posterior vertebralis internus Duramaterspinalis 0 Mm intertransversarii mediales lumborum Rr dorsales(A ;V lumbalis) a a

materspinalis Arachnoidea

Radicesanterioret posterior

Piamaterspinalis Lig intertransversarium

V spinalisposterior a

Proc,articularis superior Caudaequina

s M intertransversarius lateralis lumborum

R anterior

t M. intertransversarius medialis lumborum

Radixanterior. Radixposterior,

Lig.iliolumbale Duramaterspinalis Os sacrum,Pars lateralis

Arachnoidea mater spinalis Spatiumepidurale; Plexusvenosusa vertebralis internus anterior (Spatium subdurale)

Os coxae,Os ilium Piamaterspinalis

Spatium subarachnoideum

F i g . 8 1 8 V e s s e t sa n d n e r v e so f t h e [ u m b a rp a r t o f t h e v e r t e b r a cI a n a LR , e g i o[ u m b a t i s .

Os sacrum,Proc articularis superior

> Back :,8

Veinsandnervesof thelumbarpart of the vertebralcolumn

Lig longitudinale

(V basivertebralis)

Plexusvenosusvertebralis externusanterior

Plexusvenosusvertebralis internus anterior

Plexusvenosusvertebralis internusposterior

V lumbalisascendens

intervertebralis)

Plexusvenosusvertebralis posterior externus

F i g . 8 1 9 V e i n so f t h e v e r t e b r a cLa n a [ ,C a n a t i sv e r t e b r a t i s ; v e n o u sp t e x u s

Discusintervertebralis, Anuluslibrosus


posterius Lig longitudinale

R. meningeus

Ganglion truncisympathici B communicans albus Capsulaarticularis

griseus R communicans

R anterior

B posterior (R medialis)

(R lateralis)

Truncusnervispinalis

G a n g l i osne n s o r i u m nervispinalis

F i g . 8 2 0 N e r v e so f t h e v e r t e b r a cI o l u m n ,C o t u m n av e r t e b r a l i s ; s o m a t i ca n da u t o n o m o uisn n e r v a t i o n

fl:ei Topography and nervesof the vertebralcanal Vessels

N spinalis,Radix anterior

Lig denticulatum

Truncusnervisoinalis.R communicans TruncusnervisDinalis, R anterior

nervispinalis sensorium Ganglion

Epineurium Truncusnervispinalis, R posterior

Duramaterspinalis Ganglion neruispinalis sensorium

N spinalis,Radixposterior Spatiumsubarachnoideum Piamaterspinalis

(Spatium subdurale) Dura mater spinalis

Plexusvenosus Spatiumepidurale; vertebralis inlernusoosterior Periosteum

Arachnoideamater spinalis

Fig.821 Conteno t f t h e v e r t e b r a cLa n a t ,C a n a t i sv e r t e b r a t i s ; c r o s s - s e c t i oant t h e l e v e Lo f t h e f i f t h c e r v i c avI e r t e b r a .

posterius Lig longitudinale Filumterminale Plexusvenosusvertebralis internus anterior Truncusnervispinalis, R meningeus Caudaequina

Ganglion trunci sympathici N spinalis,Fladixanteriot

Truncusneruisoinalis. B communicans

nervispinalis sensorium Ganglion

Truncus nervi soinalis.R anterior

Truncusnervispinalis,R, posterior

N, spinalis,Radix posterior

R lateralis

Arachnoideamater spinalis

R medialis

(Spatium subdurale)

SDatium subarachnoideum

Duramaterspinalis

Piamaterspinalis Lig flavum

Spatiumepidurale Periosteum

Fig,822 Conteno t f t h e v e r t e b r a cI a n a LC, a n a L ivse r t e b r a t i s ; c r o s s - s e c t i oant t h e l e v e Lo f t h e t h i r d [ u m b a rv e r t e b r a .

M us c tes Lumbarandsacralpuncture

F i g . 8 2 3 L u m b a rp u n c t u r et o o b t a i n c e r e b r o s p i n af lIu i d ,L i q u o rc e r e b r o s p i n a t i s , o r f o r [ u m b a La n a e s t h e s i a . p o s i t i o no f t h e o a t i e n t .

Caudaequina

Plexusvenosusvertebralis internusposterior

Vertebra lumbalislll, Proc.spinosus

Arachnoidea matersoinalis

Duramatersoinalis

Lig. flavum

Lig interspinale

LaminaarcusvenebraelV

Fig.824 Lumbarpuncture; g u i d a n coef t h ep u n c t u rnee e d L e .

Fig.825Sacratpuncture; g u i d a n coef t h ep u n c t u rnee e d t e .

Vessels andnervesof the vertebralcanal

Duramaterspinalis

N soinalis,Fila radicularia*

Arachnoidea matersoinalis anterior anterior, R radicularis O A sDinalis

Proc articularis superior Lig. denticulatum

o Truncusnervispinalis, R posterior Ganglion sensorium neruispinallsI

a Truncusnervispinalis, R anterior Spatium subarachnoideum

Arcusvertebrae

Arachnoidea materspinalis Rr.spinalesO (A intercostalis posterior)

& R meningeus a Plexusvenosus vertebralis internus anterior

Foveacostalisorocessustransversi R interganglionaris6

Lig longitudinale posterius Corpusvertebrae

Truncussympathicus; * Rr communicantes Ganglion truncisympathici &


Fig.825 Conteno t f t h e v e r t e b r a cLa n a t ,C a n a l i sv e r t e b r a t i s ; t h o r a c i cp o r t i o na f t e r s t e p w i s ee x p o s u r e ; ventraLview.

Soatiumsubarachnoideum Radixanterior

Radixposterior

Lig. flavum

R communicans I

Discusintervertebralis, Anulusfibrosus

Fig.827a, b IntervertebraI foramina,Foramlnaintervertebratia; a Viewedfrom the [eft [ u m b a ro a r t o f t h e v e r t e b r a cI o l u m n . b Sagittatsection

> T h o r a c i ca n da b d o m i n awl a l l

tt

Angulussterni

Angulusinfrasternalis Arcuscostalis

Anulusumbilicalis

Spinailiacaanteriorsuperior

Fig.828 Surfaceanatomyof the thoracicand a b d o m i n aw l a [ [ o f a y o u n gw o m a n .

M deltoideus

M. pectoralismajor

Lineaalba M. serratusanterior M. rectusabdominis M. rectusabdominis, Intersectio tendinea

Fig.829 Surfaceanatomyof the thoracicand a b d o m i n aw I a [ [ o f a y o u n gm a n .

Skeletonof the trunk

Extrel jugularis Incisura

Proc coracoideus

Corpussterni

Proc xiphoideus

Angulusinfrasternalis

Arcuscostalis

pubicum Tuberculum

of the skeleton Fig.830 Projection l a[t. o n t ot h e t h o r a c i ca n d a b d o m i n aw

> T h o r a c i ca n da b d o m i n awt a l [ Skeletonof the trunk

VertebracervicalisVl

VertebrathoracicaI

Proc.coracoideus Cavitasglenoidalis

Scapula

Costae verae !-vill

Costalv

Sternum

Costaespuriae vilt_xill

F i g . 8 3 1 T h o r a c i cc a g e ,C a v e at h o r a c i sa, n d l e f t s h o u t d e rg i r d l . eC, i n g u t u mp e c t o r a t e .

Caputcostae Tuberculum musculi scalenianterioris

Sulcusvenaesubclaviae

Sulcusarteriae subclaviae

Collumcostae

Collumcostae, Cristacollicostae

Corpuscostae

Anguluscostae

musculi Tuberositas serratianterioris

Anguluscostae

Corpuscostae

Faciesarticularis capitiscostae

Cristacaoitiscostae

Collumcostae

Tuberculumcostae

Sulcuscostae

F i g . 8 3 2 R i b s ,C o s t a e ; l . - l l l . r i b , s u p e r i o rv i e w ; V l l l .r i b , i n f e r i o rv i e w .

> T h o r a c i ca n da b d o m i n awl a l [

Musctes

Sternum

jugularis Incisura Incisura clavicularis

Manubrium sterni

Incisura costalisI

Incisura costalisll

Angulussterni Symphysis manubriosternalis

Incisura costalislll Corpussterni

Incisura costalislV

Incisura costalislV

Symphysis xiphosternalis Proc.xiphoideus

F i g .8 3 3 S t e r n u mS, t e r n u m .

F i g .8 3 4 S t e r n u mS, t e r n u m .

0rgans

Cartilago costalis I

Manubrium sterni

manubriosternalis Symphysis

intraarticulare Lig sternocostale Cartilagocostalis lll

Corpussterni

sternocostales Articulationes

Cartilago costalisV

cartilagocostalisvll

F i g ,8 3 5 S t e r n u m ,S t e r n u m ,a n d c o s t a Ic a r t i L a g e sC,a r t i [ a g i n ecso s t a [ e s ; s e c t i on .

Articulatio sternoclavicularis, Discusarticularis

Lig interclaviculare

Lig costoclaviculare

Lig costoclaviculare

Capsulaarticularis anterius Lig sternoclaviculare

Cartilaoocostalis l: Synchondr6siscostae i

radiatum Lig sternocostale

Cartilago costalis ll

manubriosternalis Symphysis

F i g .8 3 6 S t e r n o c l a v i c u t jaori n t , A r t i c u t a t i os t e r n o c L a v i c u [ a r t s .

> T h o r a c i ca n da b d o m i n awI a [ [

>>l

-


Musclesof thethoracicand theabdominalwaLL

M trapezius

Clavlcula

Spinascapulae M, infraspinatus

M pectoralismajor,Parssternocostalis

M teresminor M, teresmajor

M, deltoideus

Corpusmammae, Lobiglandulae mammariae Papilla mammaria

M serratusanterior

M.triceps 0,".n', {%TJ,,,,iJi3i#

M pectoralis major,Parsabdominalis

M brachlalis M. biceps brachii lvl latissimusdorsi

Arcuscostalis

M obliquus externusabdominis Anulusumbilicalis Fasciathoracolumbalis Trigonum lumbale Vaginamusculirectiabdominis, Laminaanterior Spinailiacaposterior superior

M obliquusexternus abdominis, Aponeurosis

(Fascia glutea)


M tensor fasciae latae

M gluteusmaxlmus M sartorius

) T 1 5 ,T 1 7 , T1 8 . T2 6

F i g .8 3 7 M u s c l e so f t h e t h o r a c i ca n d t h e a b d o m r n a L w a l . L . M m . t h o r a c i se t a b d o m i n i s .

Musclesof the thoracicand theabdominalwall

Trigonum clavipectorale Mm sternocleidomastoidei

Platysma

Fascia brachii

M deltoideus Fascia axillaris

M, pectoralismajor, Parsclavicularis

M. pectoralismajor, Parssternocostalis M. serratusanterior M. latissimus dorsi Ligg. costoxiphoidea

M pectoralis major, Parsabdominalis

Linea alba

M obliquus externusabdominis

Anulusumbilicalis

Vaginamusculirectiabdominis, Laminaanterior

Spina iliaca anterior supeflor

Telasubcutanea; Panniculus adiposus

Fibraeintercrurales

obliquusexternus abdominis, Aponeurosis Lig.reflexum

Funiculus spermaticus penis Lig.tundiforme

penis Lig suspensorium

F i g .8 3 8 M u s c t e so f t h e t h o r a c i ca n d t h e a b d o m i n a I w a t [ ; superficia[layer.

) T 1 5 ,T 1 7 , t 1 8 , 12 6

> T h o r a c i ca n da b d o m i n awl a t l

tt

a[",

Musclesof the thoracicand theabdominaL wall

M sternocleidomastoideus

lvl pectoralis major,Parsclavicularis

/

Vl intercostalis internus M deltoideus

(M sternalis,Var)

M subclavius V axillaris lvl pectoralis minor Plexus brachialis, Pars in{raclavicularis

M coracobrachialis

lvl biceps brachii, Caput breve

M pectoralis malor

A axillaris

lvl pectoralis mtnor M serratus antenor

Costa ll

M latissimus dorsi M serratusanterior

M pectoralismajor, Pars abdominalis

M, pectoralismajor,Parssternocostalis


) T 1 3 ,T ' . t s , T2 6

F i g . 8 3 9 M u s c t e so f t h e t h o r a c i cw a L t ,M m . t h o r a c r s .

CostaVlll M serratusanteri(

posterior V intercostalis posterior A intercostalis (T8) N intercostalis

M intercostalis internus Pulmo M intercostalis externus

Pleuravisceralis lpulmonalis]

Pleuraparietalis, Parscostalis Pleuraparietalis, Parsdiaphragmatica Parscostalisdiaphragmatis

Hepar

Peritoneum viscerale parietale Peritoneum Recessus costodiaphragmaticus

F i g .8 4 0 M u s c t e so f t h e t h o r a c i cw a t [ ,M m . t h o r a c i s ; f r o n t a Ls e c t i o n . * P o s i t i oonf t h en e e d l feo r p u n c t u roef t h ep l e u r acIa v i t Iyp L e u r o c e n t e s i s l

Musclesof the thoracicwall

Tuberculum anteriuslcaroticum] (Vertebra cervicalis Vl) M. scalenusanterior M longuscolli

Membrana intercostalis interna

Mm intercostales interni


Fig.841 Thoraciccage,Caveathoracis; o o s t e r i ow r aL[.

Cartilagocostalis I

M. sternothyroideus Manubrium sterni

Mm intercostalesinterni

M transversus thoracis

Diaphragma, Centrumtendineum Foramenvenaecavae Mm intercostales interni Proc.xiphoideus

F i g . 8 4 2 T h o r a c i cc a g e ,C a v e at h o r a c i s ; a n t e r i o rw a L t .

> T h o r a c i ca n da b d o m i n awl a l [

>>l


Abdominalmuscles

M, serratus antenor

M. pectoralismajor, Parsabdominalis


M rectusabdominis, Intersectio tendinea

Mm. intercostales interni

M. rectus abdominis

M rectusabdominis

M. obliquus externus abdominis

Anulusumbilicalis

M. obliquus externus abdominis, Aponeurosis

Fibraeintercrurales

Funiculus soermaticus: M. cremaster M pyramidalis

-> T 13-T15,T17,T26

Lig.reflexum

F i g . 8 4 3 M u s c l e so f t h e a b d o m i n a l w a tM [ , m .a b d o m i n i s ; s u p e r f i c i aaI n d m i d d t el a y e r .

0r gans AbdominalmuscLes

M pectoralis malor

lvl serratusanterior

lvl latissimus dorsi

tu v M obliquusexternus abdominis

Mm intercostales externi Vagina musculi recti abdominis, Lamina anterior

Mm intercostalesinterni

Cartilago costalis X

M rectusabdominis M obliquus externus abdominis

M obliquusinternus abdominis

Spina iliaca anterior supeflol

Lig inguinale

Anulus icialis inguinalis superf

M pyramidalis

Funiculus spermaticus; M cremaster

l a t t ,M m . a b d o m i n i s ; F i g . 8 1 1 M u s c t e so f t h e a b d o m i n aw middtelayer.

) T 1 3 - T1 5 , T1 7

> T h o r a c i ca n da b d o m i n awI a t l

tt

Abdominal muscles

M rectus abdominis

M pectoralis major

Mm intercostales extern i l\ilm intercostales interni

h,

M latissimus dorsl

M serratus anterior

l\il obliquus externus abdominis

lvl obliquus exlernus abdominis Intersectiones tendineae

C o s t a el X : X

Vaginamusculi rectiabdominis, Laminaanterior M rectus abdominis

Vaginamusculirecti abdominis, Laminaposterior

M obliquus internus abdominis

L i n e as e m i l u n a r i s

M transversus abdominis Intersectio tendinea

M obliquus internusabdominis M obliquus internus abdominis, Aponeurosis

Ltnea arcuata

Anulus inguinalis superficialis, Crusmediale

Vagina musculi recti abdominis, Lamina anterior

Fascia lransversalis

Funiculus spermalrcus

Anulus inguinalis superficialis, Cruslaterale M rectusabdominis

F i g .8 4 5 M u s c l e so f t h e a b d o m i n a t w a LMt ,m a b d o m i n i s ; deep layer.

[/ pyramidalis

Lig. falciforme

Diaphragma

Diaphragma

Lig.teres hepatis

M. transversus abdominis

M rectusabdominis Fasciatransversalis Plica umbilicalis lateralis Fossa inguinalislateralis

Plicaumbilicalis medialis

Fossa inguinalismedialis

Fossaparavesicalis

Plica umbilicalis mediana

l atl. F i g .8 4 6 I n t e r n a ls u r f a c eo f t h e a n t e r i o ra b d o m i n aw

> T 1 4 , T1 5 , T2 1

> T h o r a c i ca n da b d o m i n awl a t l

>>l

-

Surface lSkeletonl Muscles

lnguinalcanal


M .o b l i q u u s externus abdominis

M obliquus externus abdominis, Aponeurosis

Linea alba

M obliquus externusabdominis, Aponeurosis

[/. obliquus internus abdominis

L i g .i n g u i n a l e lvl cremaster

Lig reflexum

Lig fundiforme penrs

/ll.:i

Funiculus spermaticus

F i g . 8 1 7 S u p e r f i c i aiIn g u i n a rI i n g ,A n u I u si n g u i n a t i s u p e r f i c i a L i s

M. obliquusexternus abdominis, Aponeurosis M. obliquusinternus abdominis M lransversusabdominis A n u l u si n g u i n a l i s profundus

N ilioinguinalis Fasciatransversalis

A..;W epigastica(e) Inreflor(es)

A ductusdeferentis

Fascia transversalis

Ductusdeferens

N ilioinguinalis

Plexuspampiniformis

Anulus inguinalis superficialis

N. genitofemoralis, B genitalis Lig reflexum

M cremaster Lig inguinale Fascia spermatica

F i g .8 4 8 W a t t so f t h e i n g u i n a cLa n a [ .

N genitofemoralis, R genitalis

parietale Peritoneum

Lio. - umbilicalemedianum (Chorda urachi)

Fasciatransversalis

M rectusabdominis

inlerior A epigastrica

M transversusabdominis

Chorda arteriae umbilicalis

2

lAePigastricainferior

M obliquusinternusabdominis M obliquus externusabdominis (Fasciasuperticialis) M obliquusexternus Aponeurosis abdominis, Fascia spermaticaexterna Fascia cremaslerica;M cremaster

Fasciaspermaticainterna Ductusdeferens Septumscroti Epididymis

Cavitasserosascroti Testis

F i g .8 4 9 D i a g r a mo f t h e i n g u i n a cl a n a t . T h e i n g u i n a cLa n a t ,t h e s p e r m a t i cc o r da n d t h e s c r o t u ma r e i t t u s t r a t e di n t h e s a m e o t a n ef o r d i d a c t i c arIe a s o n s .

1 Fossasupravesicalis medialis 2 Fossainguinalis lateralis Fossainguinalis

inferior A epigastrica parietale Peritoneum

3 inferior A. epigastrica Anulusinguinalis supedicialis

Fascia transversalis M transversus abdominis

M. obliquus externus abdominis

M obliquus internusabdominis

Anulusinguinalis superficialis

(Fascia superficialis)

Fasciaspermatica externa Fascia transversalis

Ductusdeferens peritonei), (Procvaginalis parietale Peritoneum Fasciaspermatica interna Fasciacremasterica; M cremaster Fascia spermatica externa

F i g . 8 5 0 D i a g r a mo f i n g u i n ahl e r n i a s ; [ e f ts i d e :[ a t e r a Li ,n d i r e c th e r n i a ; r i g h t s i d e :m e d i a Ld, i r e c th e r n r a .

Ductusdeferens Fascia spermatica interna Fascia cremasterica; M cremaster

Cavitasserosascroti

* H e r n i a sI a cw i t h a n i n t e s t i n al Lo o p * * P e r i t o n e asIp a c e * * * N e w l yf o r m e d p e r i t o n e a h I e r n i a Is a c

> T h o r a c i ca n da b d o m i n awl a [ [

tt

Diaphragmandposteriorabdominalwall

Parssternalis diaphragmatis

FOramenvenae cavae

Parscostalisdiaphragmatis

Oesophagus, Pars abdominalis

M transversus abdominis

Hiatusoesophageus Centrum tendineum

Hiatusaorticus Truncus coeliacus Parsabdominalis aortae

Parslumbalis diaphraomatis. Cius d-extrum Lig arcuatum mediale Lig arcuatumlaterale

Fasciatransversalis

(lvl psoasminor)

Vertebrae lumbales lll: lV

M quadratus tum00rum

Cristailiaca l\4 transversus abdominis (M.psoasminor), tenoo

M psoas malor

M psoas maJor

M. iliacus

M iliacus Promontorium Lacuna vasorum A temoralis V femoralis Lig. inguinale

Vesica urinaria

M, rectus abdominis

) T 1 5 , 1 1 6 , 2T 1 , T/ + 2

F i g .8 5 1 D i a p h r a g mD , i a p h r a g m aa,n d m u s c t e so f t h e a b d o m i n awl a [ t ,M m . a b d o m r n r s

Parssternalis diaphragmatis W phrenicae inferiores

Proc xiphoideus

(Trioonum interna, A.; V thoracica sternocostale): R. phrenicoabdominalis N. olhrenicus sinister,

Centrumtendineum

Hiatus oesophageus:Oesophagus; Trunci vagales anterior et posterior

N. phrenicus sinister, R. bhrenicoabdominalis

Foramen v cavae: V cava inferior

inferior A phrenica

N phrenicusdexter, R phrenicoabdominalis

major N splanchnicus Pars costalisdiaphragmatis

V hemiazygos Lig arcuatum medianum

(Trigonum lumbocostale)

Pars lumbalisdiaphragmatis, Crus dextrum, (Pars lateralis)

minor N splanchnicus Lig arcuatum laterale Hiatus aorticus:Aorta abdominalis; Ductus thoracicus

Costa Xll Proc costalis vertebrae lumbalis I

lumborum l\4 quadratus l\4 psoas malor

Lig arcuatum mediale V azygos

Truncussympathicus Parslumbalis diaphragmatis, Crusdextrum,(Parsmedialis)

, iaphragma F i g .8 5 2 D i a p h r a g mD

V cava inferior,W hepaticae

Parssternalis diaphragmatis Pericardium

Oesophagus, Pars abdominalis Pars thoracica aortae

Parsthoracica Oesophagus,

Pleura parietalis,Pars diaphragmatica

Centrumtendineum

l\4 latissimus dorsi

Gaster.Parscardiaca

C o s t aV l l l diaphragmatis, Parslumbalis (Parslateralis) Crussinistrum,

CostaVll l\4 serralusanterior CostaVl

Hiatusaorticus (Trigonum Iumbocostale)* Lig arcuatumIaterale**

M rectusabdominis

C o s t aV l l l costaxll


M transversus abdominis Lig arcuatummediale Parslumbalis diaphragmatis, (Parsmedialis) Crussinistrum,

M psoas major

Lig lumbocostale lumborum M quadratus lumbalislll, Proc costalis Vertebra

(M psoas minor)

M iliacus

F i g .8 5 3 D i a p h r a g mD , i a p h r a g m aw, i t h a p e r t u r e s a n d m u s c t e so f t h e o o s t e r i o ra b d o m i n a I w a L [ * C [ i n i c at eI r m :B 0 C H D A L sE t rK ianqte * * P s o a as r c a d e

> T h o r a c i ca n da b d o m i n awl a 1 1

M us c tes

Breast

M pectoralis maJor Papilla mammana Areola mammae

Areola mammae Papilla mammana Glandulae areorares

F i g . 8 5 4 B r e a s t ,M a m m a

F i g . 8 5 5 B r e a s t ,M a m m a .

DuctusIactiferi

Papilla mammafla

s Sinuslactilerus

Lobuli glandulae mammariae

F i g .8 5 6 B r e a s t ,M a m m a ,o f a p r e g n a n w t oman

F i g .8 5 7 B r e a s t ,M a m m a ,o f a p r e g n a nw t oman.

F i g . 8 5 8 R a d i o g r a po hf t h e b r e a s t , m a m m o g r a p h yo, f a 4 7- y e a r - o l dw o m a n

Nodi lymphoideiceruicalesanteriores,Nodi profundi

Nodi lymphoideiparasternales

Nodi lymphoideisupraclaviculares Nodi lymphoideideltopectorales

Nodi lymphoidei axillares

Nodi lymphoidel brachiales

Nodus lymphoideus paramammaflus

'''l'ii'':'

F i g .8 5 9 L y m p h a t i cd r a i n a g eo f t h e b r e a s ta n d l o c a t i o no f t h e r e g i o n a lLy m p hn o d e s .

> T h o r a c i ca n da b d o m i n awI a l t

M us c l es

Vessels andnervesof the waLIof the trunk

Nn.supraclaviculares: & A ; V cervicalis superficialis Oa a V cephalica

Plexusvenosusareolaris o

V thoracica lateralis; a O N thoracicus [T2], N. intercostalis, R cutaneuslateralis pectoralis aA thoracicainterna*; a W thoracicae internae V thoraco-a epigastrica

* Nn thoracici, Nn. intercostales, Rr cutanei anteriores

superior a a A ; V epigastrica T5 T6 Nn thoracici, t, N n intercostales, Rr cutanei

T7

abdominis a M obliquusexternus

T8

pecrorares

T9 T10 T11

r12 Vv paraumbilicales o Anulusumbilicalis W subcutaneae abdominis a A ; V circumflexa iliumsuperficialis a a Chorda arteriae umbilicalis

genitofemoralis, &, R femoralis

O O A ;V epigasvica inferior

A;VepigastricaOo superficialis

& N, iliohypogastricus, R cutaneus anterior

A pudenda externa; a Vv pudendae externae a

a M rectusabdominis

N femoralis,i: R cutaneus anterior V saphena magna o

* N ilioinguinalis

F i g .8 6 0 V e s s e l sa n d n e r v e so f t h e t h o r a c i ca n d t h e a b d o m i n aw I aL[ * C t i n i c at eI r m ;i n t e r n amLa m m a rayr t e r v

0rqans

Topography I Sections Segmentalinnervation

F i g .8 6 1 S e g m e n t saeI n s o r iyn n e r v a t i oonf t h e a n t e r i otrh o r a c iac n da b d o m i n a wIa [ [[ d e r m a t o m e s ] .

(C4) Diaphragma Oesophagus(T4,T5)

Hepar;Vesicabiliaris (r8 -T11) tenue lntestinum (r10) lntestinumcrassum (T11) Ren;Testis ( T 1 0- L 1 )

Fig.862 SegmentaIsensoryinnervationof the a n t e r i o rt h o r a c i ca n d a b d o m i n aw I at[. R e g i o n st o w h i c h p a i nf r o m d i s e a s e dv i s c e r a (zonesof HEAD)is referredto are indicatedin grey.

> T h o r a c i ca n da b d o m i n awl a t t

Surface lSketetonl Muscles

plexus Lumbosacral

Parslumbalis diaphragmatis, Crusdextruma Lig arcuatum laterale

a N subcostalis

M quadratus lumborum I

a N iliohypogastricus

N subcostalis a

N iliohypogastricus, ! N. ilioinguinalis

N ilioinguinalis I o Plexus lumbalis

M. psoasmajora M obliquusa externusabdominis

O Truncussympathicus

M obliquuso internus abdominis M transversusa abdominis

o N femoralis

N. cutaneus* femorislateralis t Truncuslumbosacralis N femoralis *

t N genitofemoralis ,t N. obturatorius

N genitofemoralis,& R femoralis

0 Plexussacralis

N genitofemoralis,&

R genitalis

a N cutaneus femorislateralis

N obturatorius& N cutaneus& femorislateralis

N genitofemoralis,* Br. lemorales N femoralis, o

Rr cutaneianteriores Lamina cribrosa

V saphenamagnaa N. genitofemoralis,Rr genitales a


, [ e x u s[ u m b o s a c r a t i s . F i g ,8 6 3 L u m b o s a c r apI l e x u s P

O r g a n sI T o p o g r a p h yl S e c t i o n s anteriorwall of the

Manubrium sterni A, thoracica internaa A pericardiacophrenica a

interna a A thoracica interna a V thoracica Costa

Rr perforantesO anteriores a a Rr intercostales M transversus thoracisa ooA;Vmusculophrenica A. thoracica interna,O Rr intercostales anteriores

superior o aA ;V epigastrica

A musculophrenica a

C Diaphragma

Fasciatransversalis

M rectusabdominis a

Vaginamusculi rectiabdominis, Laminaposterior interior oA epigastrica inlerior a V epigastrica

Fig.86t, Vesselsof the a n t e r i o rt h o r a c i ca n d a b d o m i n a t

aA

iliacaexterna

A carotiscommunis dextra A subclavia dextra A thoracicainterna

Pars thoracica aortae [Aorta thoracica]

A. epigastrica superior

Pars abdominalisaortae [Aorta abdominalis]

M rectusabdominis

F i g . 8 6 5 D i a g r a mo f t h e c o t t a t e r a l c i r c u t a t i o vn i a t h e i n t e r n a It h o r a c i ca r t e r y , A t h o r a c i c ai n t e r n a t, h e s u p e r i o re p i g a s t r i c a r t e r y ,A . e p i g a s t r i c sau p e r i o r a , ndthe i n f e r i o re p i g a s t r i ca r t e r y ,A . e p i g a s t r i c a i n f e r i o r ,i n t h e c a s eo f a o r t i co c c I u s i o n ; v i e w e df r o m t h e r i g h t .

A epigastrica inferior

A iliaca externa Lig inguinale

A femoralis

> T h o r a c i ca n da b d o m i n awt a t l

M us c [es

Abdominal wallof a neonate

M rectusabdominis N

OOA;Vepigastrica supenor

M transversus abdominis C

Vagina musculi recti abdominis,Lamina posterior

N thoracicus[T8], ,' a O N intercostalis:A : V, intercostalis

Proc xiphoideus , Funiculus umbilicalis

a M serratusanterior

N thoracicus [T9],rr O o N intercostalis; A ; V intercostalis

Cartilago costalisVlll

Vaginamusculi rectiabdominis, Laminaanterior e M obliquus externus abdominis

N t h o r a c i c u s ar o lr10l, N intercostalis; A ; V intercostalis

a V umbilicalis N thoracicus r, a a lr11l, N intercostalis; A; V intercostalis O Aa umbilicales

M obliquusC exrernus abdominis Lineaarcuata N thoracicus [T12],, N intercostalis

Vaginamusculirecti abdominis, Laminaposterior

Urachus

Peritoneumviscerale

--. Anulus Ingurnails

dextra a A umbilicalis O A vesicalissuperior

.-a

errno*iniatic

Vesicaurinaria

M o b l i q u uO s internus abdominis lvl cremaster|)

Spatiumretropubicum

Fasciaspermatica interna a Vv vesicales

Fasciaspermatica externao M obliquusexternusabdominis, e Aponeurosis

a M rectusabdominis

A testicularis O * Mm pyramidales Plexus pampiniformisa

Ductusdeferens

l\4 cremastere Tunica vaginalistestis, Lamina parietalis Fascia soermaticainterna Tunica dartos, M dados t

externa t Fasciaspermatica (Gubernaculum testis)

F i g .8 6 6 A n t e r i o ra b d o m i n a L w aot Lf a n e o n a t e .

lnnercontourof the anteriorabdominalwall

M rectusabdominis Lig teres hepatis;V umbilicalis

Fossasupravesicalis Lineaarcuata


Plica umbilicalismediana

Plica umbilicalismedialis

Fossa inguinalislateralis

Plica umbilicalislateralis

Plica vesicalistransversa

V testicularis M iliacus

A;V

iliacaexterna

A:V iliacaexterna

A umbilicalis AmDUllaductus deferentis

Ureter,Parspelvica

F i g . 8 6 7 A n t e r i oa r b d o m r n a I w aot [f a n e o n a t e . Lig falciforme (hepatis)

M obliquusexternus abdominis M obliquusinternus abdominis Linea arcuata

M transversus abdominis Plica umbilicalis mediana


Plica umbilicalis medialis

M rectusabdominis femoris N cutaneus lateralis

Plica umbilicalis lateralis

inferior A ; V epigastrica l\4 iliopsoas

N femoralis

profundus Anulusinguinalis

A ;V femoralis Fossa inguinalislateralis

Arcusiliopectineus


Fossa acetabuli

Vasatesticularia

Ductusdeferens

N obturatorius; A ; V obturatoria

Fossasupravesicalis Ureter

Vesicaurinaria

F i g .8 6 8 A n t e r i o ra b d o m i n aw I a[t, i n t e r n a Ia s p e c t .

Lig interfoveolare

> T h o r a c i ca n da b d o m i n awl a l l

M us c [es

Abdominalwall,sections

M rectusabdominis

Telasubcutanea, Panniculus adiposus

A; Vv epigastrica(e) superio(es) Aponeurosis M obliquus externusabdominis,

Vaginamusculi rectiabdominis

Laminaanterior Vaginamusculirectiabdominis,

a

M obliouusinternus abdominis V paraumbilicalis Lig teres hepatis

Lig falcitorme

Umbilicus

M obliquusexternus abdominis

M lransversus abdominis, Aponeurosis

Mm intercostales M transversus abdominis

M rectusabdominis

Anulusumbilicalis

Fascia transversalis Plica umbilicalismediana; Lig umbilicalemedianum (Chorda urachi)

Vaginamusculirecti abdominis, Lamina

M. obliquusexternus abdominis

M pyramidalis

anlerior

z

M. rectus abdominis

M obliquus internus abdominis

A ; W epigastrica(e) inferior(es)

c

M transversus abdominis Chorda arteriae umbilicalis Plica umbilicalismedialis

Plica umbilicalis lateralis

Lig longitudinaleanterius M transversusabdominis M. obliquusinternus abdominis lvl obliquus externus abdominis

Vertebra lumbalis; Corpusvertebrae

(M psoasminor) M. psoasmajor M quadratus lumborum

Alaossisilium M iliocostalis tumoorum Fascia thoracolumbalis

M longissimus thoracis


M latissimus oorsl

M gluteusmedius M iliacus

869a 869b 869c

T 6 , I 2 0 a , b , T4 2 > T 1 I + -1

F i g .8 5 9 a - c M u s c t e so f t h e a b d o m i n aw l a t [ ,M m . a b d o m i n i s ; h o r i z o n t asI e c t i o n s .

Diaphragma, ParscostalisO a Diaphragma, Centrumtendineum

CostaVll CostaVlll

a a A.;V intercostalis; (T8) ,!, N intercostalis

CostalX

CostaX a, N subcostalis Fasciatransversalis parietale Peritoneum * N iliohypogastricus

M obliquus externusabdominis o l\4 obliquusinternusabdominis o

* N ilioinguinalis

M transversus abdominis a Crista iliaca

& N cutaneus femorislateralis M tensor fasciae latae O

& N femoralis

M iliopsoas a

a A. femoralis a V femoralis

pubica Symphysis

F i g .8 7 0 M u s c t eosf t h e a b d o m i n a I w a tM t ,m . a b d o m i n i s ; f r o n t asI e c t i o n .

M obliquus externusabdominis, Aponeurosis M obliquusinternus Aponeurosis abdominis,

M transversusabdominis M obliouusinternus abdominis

Aponeurosis M obliquus externusabdominis,

M transversusabdominis M obliouusinternusabdominis

F i g .8 7 1a , b M u s c [ eosf t h e a b d o m i n a I w a tM [ ,m . a b d o m i n i s ; c o m p u t etdo m o g r a p hci cr o s s - s e c t i o nl sC T l .

Heart

A carotiscommunis sinistra Truncus brachiocephalicus

A subclavia sinistra

Arcusaortae

Lig arteriosum

V cavasuperior

A. pulmonalis sinistra

Truncuspulmonalis A pulmonalis dextra Pericardium serosum, Laminaparietalis

Pericardium serosum, Laminaparietalis

Auriculasinistra V cardiaca [cordis] magna

Auriculadextra

A coronaria sinistra, R. circumllexus

Conusaderiosus

Atriumcordisdextrum

A. coronaria sinistra, R interventricularis anterior V interuentricularis anlenor

V cardiaca[cordis] parva

Ventriculus cordis sinister A coronariadextra

Ventriculus cordisdexter

Pericardium serosum, Laminavisceralis IEpicardium] Apexcordis

Pericardium serosum.LaminaDarietalis

Abb.872 Heart,Cor.

Pericardium fibrosum Pericardium serosum

P e r i c radi u m

L a m i n ap a r i e t a t i s L a m i n av i s c e r a L i s

Epicardium

V vertebralis

V brachiocephalicasinistra

sinistra A. carotiscommunis A subclavia sinistra

V brachioceohalica dextra

Truncusbrachioceohalicus Arcusaortae Aa intercostales oosteriores

v azygos

Parsascendensaortae [Aortaascendens]

Parsdescendens aortae[Aortadescendens]

V cavasuperior

Lig,arteriosum "**

trunciDulmonalis Bifurcatio A. pulmonalis sinistra Pericardium

dextra A. pulmonalis

Truncuspulmonalis W. pulmonalesdextrae W pulmonales sinistrae Auricula sinistra

V cardiaca [cordis] magna

Atriumcordissinistrum

Pericardium serosum, Laminaparietalis

W atrialessinistrae Atriumcordisdextrum Sulcusterminalis

V cavainferior Ventriculus cordissinister

Sinuscoronarius Sulcuscoronarius

Apexcordis

posterior A coronariadextra,B. interventricularis cordisdexter Ventriculus

F i g . 8 7 3 H e a r t ,C o r ,a n d g r e a tv e s s e t s ; dorsaIview.

* A r r o w i n t h e t r a n s v e r s eo e r i c a r d i asI i n u s * * D o u b t ea r r o w s i n t h e o b t i q u ep e r i c a r d i a sLi n u s * * + R e m n a n t so f t h e f o e t a td u c t u sa r t e r i o s u sI g o t l L L o ' s t i g a m e n t J

Myocardium

Truncuspulmonalis V cava supenor

Atrium cordis dextrum

Ventriculus cordissinister

Ventriculus cordis oexter Sulcus interuentricularis anterior

Sulcusinterventricularis anterior Vortexcordis

F i g .8 7 1 M y o c a r d i u mM, y o c a r d i u m ; ventraIview.

Apexcordis

posterior Sulcusinterventricularis

F i g .8 7 5 M y o c a r d i u mM, y o c a r d i u m ; v i e w e df r o m t h e a p e xo f t h e h e a r t . A. pulmonalis dextra Bifurcatiotruncipulmonalis

V cavasuperior W pulmonales dextrae

W pulmonales sinistrae

Atrium cordis oexlrum

Atriumcordissinistrum V cava inlerior

Sulcuscoronarius

Sinus coronarius

Ventriculus cordis dexter Sulcusinterventricularis posterior

F i g .8 7 6 M y o c a r d i u mM, y o c a r d i u m ; d o r s o i n f e r i ovri e w

0esopha

Valvatrunci pulmonalis

sinistra Valvulasemilunaris Valvulasemilunaris sinistra

Valvulasemilunaris dextra Valva aortae

Valvulasemilunaris posterior

Trigonum fibrosum sinistrum Trigonum fibrosumdextrum

Anulusfibrosussinister Anulus fibrosus dexter

Cuspis commissuralis sinistra Valva atrioventricularis Cuspisposterior sinistra IValvamitralisl Cuspisanterior

Valva atrioventricularis dextra [Valva tricuspidalisl

Cusoiscommissuralis dextra

Fig.877 Valvesof the heart,Valvaecordis; S U p e f l ovr t e w

V cavasuperior

Valvaaortae

Valvaatrioventricularis dextra Apex cordis

F i g . 8 7 8 C o n t o u ro f t h e h e a r t ,v a L v eosf t h e h e a r t ,a n d p o i n t so f a u s c u t t a t i o pn r o j e c t e do n t ot h e a n t e r i o rt h o r a c i cw a [ [ [ c i r c t e s ] .

ee l h e a r tm u r m u r s T h e h e a r ts o u n d sa n d l w h e r ea p p l . i c a b l t. h a r e s p r e a d i n gi n t h e d i r e c t i o no f t h e a r r o w s .

> Thoracicviscera

Lungs

lnternaL spacesof the heart

Ostiumatriovenviculare dextrum

Pars ascendens aortae

Septuminteratriale Mm pectinati

V cavasuperior Auriculadextra Foramina venarum mrnrmarum A coronaria dextra Limbus fossae ovalis

Atriumcordisdextrum

Valvaatrioventricularis dextra vu-Prr

Tuberculum Intervenosum

ar rrcr rul

l\4 papillarisseptalis

Fossaovalis

M papillaris anterior

V cava inferior

Valvaatrioventricularis dextra, Cuspisseptalis

Valvulavenae cavae inferioris

Ostiumsinuscoronarii Valvulasinuscoronarii Septuminterventriculare, Parsmuscularis

Valvaatrioventricularis dextra,Cuspisposterior posteriores Mm papillares

Trabecula septomarginalis


F i g . 8 7 9 R i g h ta t r i u m ,A t r i u m c o r d i sd e x t r u m , a n d r i g h tv e n t r i c [ eV, e n t r i c u [ u cs o r d i sd e x t e r ; V C N I T A LV I E W .

l\4yocardium Pericardium serosum, Lamina visceralisIEpicardium]

V cavasuperior

W pulmonales dextrae

Septuminteratriale Foramen ovale

Limbuslossaeovalis Ostiumsinuscoronarii V cavainferior

F i g . 8 8 0 R i g h ta t r i u m ,A t r i u m c o r d i sd e x t r u m , of a neonate; ventraL v i e wf r o m t h e r i q h r .

Apexcordis

Auriculadextra

Valvaatrioventricularis dextra IValvatricuspidalis] Ostiumatrioventriculare dextrum

V pulmonalis sinistrasuperior Myocardium dextrae W pulmonales

Auriculasinistra V cardiaca [cordis]magna

Atriumcordis sinistrum, Septum interatriale

Anulusfibrosussinister

Ostiumatrioventriculare sinistrum V pulmonalis sinistra inferior Valvula foraminis ovalis (Falx septi)


Anulusfibrosussinister Valvaatrioventricularis sinistra, Cuspis posterior

Pericardium serosum, Laminavisceralis IEpicardium]

Chordae tendineae

posterior M papillaris Ventriculus cordissinister Myocardium Parsmuscularis Seotuminterventriculare.

F i g .8 8 1 L e f ta t r i u mA , t r i u mc o r d i s i n i s t r u m , a n dL e fvt e n t r i c [ e V,e n t r i c u [ uc so r d i s i n i s t e r ; [ateraIview.

Bulbusaortae

Trabeculae carneae

Apexcordis

Lunulavalvulaesemilunaris Valvulasemilunaris sinistra A. coronaria sinistra A coronaria sinistra, R interventricularis anterior Pars Seotuminterventriculare, membranacea

Sinusaortae Truncuspulmonalis

lvlyocardium Chordae tendineae M papillaris posterior

Valvulasemilunaris sinistra A coronariadextra Nodulusvalvulaesemilunaris Auriculadextra Valvulasemilunaris dextra Valvulasemilunaris oosterior Ostiumatrioventriculare sinistrum Valvaatrioventricularis sinistra, Cusoisanterior

F i g .8 8 2 L e f t v e n t r i c [ eV, e n t r i c u L ucso r d i ss i n i s t e r , a n d a s c e n d i n ga o r t a ,A o r t aa s c e n d e n s ; o f t h e c u s p so f t h e a o r t i cv a t v e( a r r o w s i)n Dosition t h e i r p o s i t i o na t t h e f i L t i n g p h a s eo f t h e h e a r t( d i a s t o L e l ; LateraIview.



> Thoracic viscera lnternalspacesof the heart

Valvaaortae,Valvulasemilunaris sinistra

Valva aortae, Valvula semilunarisposterior

Akiumcordissinistrum

Parsascendens

Cuspisanterior vatuaatriouentricularis sinistra Cuspisposterior ) Sinusaortae Auriculadextra A coronariadextra Septuminterventriculare, Parsmembranacea M papillarisposterior Valvaatrioventricularis dextra, Cuspisposterior Valvaatrioventricularis dextra, Cuspisseptalis

l\/ papillarisanterior

M papillarisanteriol

M papillarisposterior Apexcordis Seotuminterventriculare. Parsmuscularis

F i g . 8 8 3 L e f t a n d r i g h tv e n t r i c t eV, e n t r i c u t ucso r d i s s i n i s t e re t d e x t e r .

V interventricularis anterior

Sulcusinteruentricularis anterior

A. coronaria sinistra, R interventricularis anterior

Pericardium serosum,Laminavisceralis IEpicardium] lvlyocardium Endocardium Ventriculus cordisdexter

axis of the heart

Trabecula septomarginalis M papillaris anterior

A. coronariadextra, R marginalis dexter Myocardium

A coronaria sinistra, R marginalis sinister

posterior M. papillaris Trabeculaecarneae


SeDtuminterventriculare. Parsmuscularis

posteriores Mm papillares

Chordae tendineae V cardiaca [cordisl media [V interventricularisposterior]

Valvaatrioventricularis dextraIValvatricuspidalis], uusprsseprails Sulcusinterventricularis oosterior posterior A coronariadextra,R. interventricularis

F i g . 8 8 4 L e f ta n dr i g h tv e n t r i c t e V,e n t r i c u [ uc so r d i s s i n i s t eer t d e x t e r ; s u p e n ovr r e w .

0esophagus lnternalspacesof theheart


posterior M. papillaris

F i g .8 8 5 L e f tv e n t r i c t eV, e n t r i c u [ u cs o r d i ss i n i s t e r ; ventrosuoeriorview from the teft.

Valvaatrioventricularis dextra,Cuspisposterior

M papillaris posterior

Trabecula septomarginalis

F i g . 8 8 6 R i g h tv e n t r i c L eV,e n t r i c u t u cs o r d i sd e x t e r ; dorsaLview.

l*ungs

Parsascendens aortae V cavasuperior

Truncuspulmonalis A coronaria sinistra Sinustruncipulmonalis

Ostiumvenaecavaesuperioris

Valvatruncipulmonalis, Valvulasemilunaris sinistra

Atriumcordisdextrum

Sinusaortae Valvaaortae,Valvulasemilunaris sinistra Nodus sinuatrialis

Fasciculus atrioventricularis Crusdextrum Ostium venae cavae inferioris

Nodusatrioventricularis

Valvulavenae cavae inferioris

Valvulasinuscoronarii lvl.papillaris anterior

Ostiumsinuscoronarii

Valvaatriovenlricularis dextra, Cuspisanterior

F i g .8 8 7 R i g h ta t r i u m ,A t r i u m c o r d i sd e x t r u m , a n d r i g h tv e n t r i c L eV,e n t r i c u L ucso r d i sd e x t e r ; conducting s y s t e m ,C o m p L e x usst i m u L a ncso r d i s l S y s t e m ac o n d u c e n t ce o r d i s ] h , ightighted inyeltow; ventraLview.

Pars ascendens aortae

Sinusaortae A coronariadextra

Valvula semilunaris ) posreflor I .. l Valva aortae ValVUlaSemllunarlsI dextra )

Septumatrioventriculare Valvaatrioventricularis sinistra, Cuspisanterior

Truncuspulmonalis A coronaria sinistra

Fasciculus atrioventricularis, Crussinistrum

M. papillaris anterior


F i g . 8 8 8 L e f tv e n t r i c L eV,e n t r i c u t ucso r d i ss i n i s t e r ; conducting s y s t e m ,C o m p t e x u s t i m u t a n sc o r d i s l S y s t e m ac o n d u c e n t ceo r d i s ] h , i g h l . i g h t ei d nyetLow; v e n t r a Iv i e wf r o m t h e l e f t

0esophagus

N vagus[X] Ganglion cervicale supenus N cardiacuscervicalis supenor cervicale Ganglion meorum N laryngeus recurrens

N. laryngeusrecurrens

Ganglion cervicothoracicum stellatuml [Ganglion N cardiacuscervicalis medius

N. cardiacuscervicalis inlerior

Plexuscardiacus

F i g . 8 8 9 I n n e r v a t i oonf t h e h e a r td, i a g r a m ; s y m p a t h e ttircu n k :g r e e nv; a g u sn e r y ep: u r p t e . * T h e b r a n c h e sb e y o n dt h e c a r d i a cp l e x u sc o n t a i n s y m p a t h e t i ca n d v a g a If i b r e s .

Fasciculus atrioventricularis

V cava inferior

Nodus sinuavialis

Crus sinistrum

Nodus atrioventricularis

of heart, ng F i g . 8 9 0 C o n d u c t i system cordis] conducente s ; C o m o l e x usst i m u [ a ncordis [Systema s e c t i oa n t t h eo t a n eo f t h ea x i so f t h eh e a r t .

Crus dextrum

Rr.subendocardiales

Septum interventriculare

Arcusaortae

Lig arteriosum Pericardium serosum, Laminaparietalis

V cavasuperior

A pulmonalissinistra

Pericardium serosum, Laminaparjetalis T r u n c upsu l m o n a l i s A, pulmonalis dextra Parsascendensaortae A coronaria sinistra Sinustransversus pericardli

Atriumcordissinistrum, Auriculasinistra V cardiaca [cordis]magna

coronaria dextra

A coronaria sinistra, R circumflexus

Auriculadextra Conusarteriosus Atriumcordisdextrum

A coronaria slnistra, R interuentricularisanterior

Vv ventriculidextri antenores

V interventricularis anterior

R atrialis

Fig,891 Coronaryarteries, A a .c o r o n a r i a e ; ventraL view A r r o w i n t h e t r a n s v e r s ep e r i c a r d i asLi n u s

R marginalisdexter

Apexcordis Incisura apiciscordis

Valvulasemilunaris anterior Valva semilunaris trunci Valvula dextra pulmonalis Valvulasemilunaris sinistra

Truncuspulmonalis

B interventricularis anterior A coronaria sinistra

A coronaria dextra R n o d is i n u a t r i a l i s

R circumflexus

Anulusfibrosus dexter

Trigonum fibrosum sinistrum

Trigonum fibrosum dextrum

V cardiaca[cordis] magna

Fasciculus atrioventricularis

Anulusfibrosus sinister

R marginalis dexter

R marginalis sinister

Fig. 8j2 Coronaryarieries, A a .c o r o n a r i a e ; s u p e n o rv t e w

Valvulasinuscoronarii

Ostium slnuscoronafll V cardiaca lcordis] media [V interventricuhrispdsterior]

A coronariadextra, R interventricularisposterior

A coronaria sinistra

A coronaria dextra, R interventricularis posterior

F i g . 8 9 3 V a r i a b i t i toy f t h e c o r o n a r ya r t e r i e s . T h e c o n u sa r t e r i o s u sb r a n c ha r i s e sf r o m t h e a o r t aa s a n i n d e p e n d e nat r t e r yt - 3 7 " / " ) .

of the heart

Arcusaortae A. pulmonalisdextra Pericardium

V cavasuperior

Bilurcatio trunciDulmonalis Pericardium A pulmonalis sinistra Atriumcordissinistrum

W pulmonalesdextrae

W oulmonales sinistrae

Sinusvenarumcavarum

Auriculasinistra V obliouaatriisinistra

Pericardium

V cardiaca magna

cordis Sulcusterminalis

A coronariasinistra, R circumllexus Sinuscoronarius

Atriumcordisdextrum

ventriculi sinistri poslenor V cava inferior

Sulcuscoronarius V cardiacalcordis]parva A coronariadextra Ventriculus cordissinister Ventriculuscordisdexter

V cardiaca [cordis] media [v interventricularis posterior]

posterior Sulcusinterventricularis

Apexcordis

Incisura apiciscordis

F i g . 8 9 4 V e i n so f t h e h e a r t ,V v .c o r d i s .

A coronaria sinistra, R circumllexus A coronaria sinistra, R posterior ventriculi sinistri A coronariadextra, R interventricularis posterior A. coronariadextra

F i g .8 9 5 a - c V a r i a t i o n isn t h e a r t e r i a Is u p p l . oy f t h e p o s t e r i o ra s p e c to f t h e h e a r t ; dorsaIview.

coronary arterysuPPtY a Batanced arterysupply [eftcoronary b Dominant c D o m i n a nr it g h tc o r o n a rayr t e r ys u p p t y

Coronaryarteries,variabilityof supply


A coronaria dextra

R circumflexus

R nodi sinuatrialis

R interventricularis anterior Flr interuentriculares seotales

R coni arteriosi

R lateralis

R marginalis sinister

R atrialis

F i g .8 9 6 C o r o n a r ya r t e r i e s A , a .c o r o n a r i a e ; posterioa r r t e r i a Ib r a n c h e sa r e s h o w ni n a L i g h t ecr o [ o u r ; t h e p o s t e r i o ri n t e r v e n t r i c u L ba r a n c ha r i s e s f r o m t h e r i g h t c o r o n a r ya r t e r yI b a L a n c ecdo r o n a r y a r t e r ys u p p L y ) ; v e n t r a tv t e w

B lateralis

R nodi atrioventncularis

Rr,atriales Rr interuentriculares seprares

R marginalis dexter ( R posterolateralis dexter)

R posterior ventriculi sinistri Rr atrioventriculares

posterior R interuentricularis

A coronaria sinistra A coronaria dextra

R, circumflexus R nodi sinuatrialis

R interventricularis anterior R atrialis

R coni arteriosi

R lateralis R marginalis sinister Rr interventriculares septales

R atrialis

F i g , 8 9 7 C o r o n a r ya r t e r i e s A , a .c o r o n a r i a e ; t h e p o s t e r i o ri n t e r v e n t r i c u l abrr a n c ha r i s e sf r o m t h e t e f tc o r o n a r ya r t e r yI d o m i n a n [t e f t c o r o n a r y a r t e r ys u p p l y l ; ventraLview.

Rr posteriores ventriculi sinistri

R marginalisdexter

Rr interuentriculares seotales posterior R interventricularis

A coronaria dextra R nodi sinuatrialis

R circumflexus B interventricularis anterior R atrialis

R coni arteriosi

atrioventriculares

R lateralis R marginalis sinister Rr interventriculares

R atrialis R nodi atriovenlricularis

F i g .8 9 8 C o r o n a r ya r t e r i e s A , a .c o r o n a r i a e ; r a L Io f t h e v e n t r i c L eiss t h e p o s t e r i ow m a i n [ ys u p p t i e db y b r a n c h e so f t h e r i g h t c o r o n a r ya r t e r y{ d o m i n a n rt i g h t c o r o n a r y a r t e r ys u p p t y ) ; v e n t r a Iv i e w


septales R lateralis

R posterior ventriculi sinistri R marginalisdexter

postenor R interventricularis Rr interuentriculares septales

(R posterolateralls dexte0

Coronary a rteries, radiography

A. coronaria sinistra A coronaria sinistra, R marginalis sinister

A coronaria sinistra, R circumflexus

sinistra, A coronaria Rr interventriculares septales

A coronariasinistra, anterior R. interventricularis A coronaria sinistra, B interventricularis posterior,var

Diaphragma

F i g ,8 9 9 L e f t c o r o n a r ya r t e r y ,A . c o r o n a r i as i n i s t r a . c o r o n a r ya n g i o g r a p h y ;

* C a t h e t e irn t h e a o r t aa n d i n t h e o p e n i n go { t h e t e f t c o r o n a r ya r t e r y

t h e b e a mi s d i r e c t e do b t i q u e t fyr o m r i g h t a n t e r i o rt o [ e f t o o s t e r i o r{ R A O J .

sinistra A. coronaria sinistra, A. coronaria B marginalis sinister A coronaria sinistra, R. circumllexus A. coronaria sinistra, R. interventricularis anterior

A coronaria sinistra, septales Rr interventriculares

A coronaria sinistra, posterior,Var R interventricularis

Diaphragma

F i g . 9 0 0 L e f t c o r o n a r ya r t e r y ,A . c o r o n a r i as i n i s t r a ; c o r o n a r ya n g i o g r a p h y ;

* C a t h e t e ri n t h e a o r t i c b u t b a n d i n t h e o p e n i n go f t h e l e f t c o r o n a r ya r t e r y * * S h a d o wo f t h e c a t h e t e ri n t h e d e s c e n d i n gt h o r a c i ca o r t a

t h e b e a m i s d i r e c t e do b t i q u e t fyr o m l e f t a n t e r i o rt o r i g h t o o s t e r i o rI L A O ] .

A coronaria dextra, R, coniarteriosi A coronariadextra, R atrioventricularis A coronariadextra

A coronariadextra, R marginalisdexter Diaphragma A coronaria dextra, posterior R interuentricularis A coronaria dextra, (R posterolateralis dexteo

F i g . 9 0 1 R i g hct o r o n a rayr t e r yA, . c o r o n a r i ad e x t r a ; c o r o n a rayn g i o g r a p h y ;

* C a t h e t e irn t h e a o r t aa n d i n t h e o p e n i n go f t h e r i g h t c o r o n a r y artery + +S h a d o wo f t h e c a t h e t e ri n t h e d e s c e n d i n gt h o r a c i ca o r t a

t h e b e a m i s d i r e c t e do b l . i q u e lf .ryo m l e f t a n t e r i o rt o r i g h t o o s t e r i o rI L A O l .

Lungs Heartsitus

A; V thoracica interna a O

Nodi lymphoidei paratracheales

(Nodi lymphoideimediastinales anteriores)

N vagus[X]

(Nodilymphoidei mediastinales anteriores)

e N vagus[X] .* N laryngeus recurrens

Bronchus principalis dexter

Lig arteriosum Nodilymphoidei tracheobronchiales supeflores

Nodilymphoidei tracheobronchiales supenores

A pulmonalis dextraa

a V pulmonalis sinistrasuperior

is V p u l m o n a lO dextra

o A pulmonalis sinistra

Nodilymphoidei tracheobronchiales inferiores

a V pulmonalis sinistrainferior Nodilymphoidei tracheobronchiales inferiores

(Noduslymphoideus ligamenti arteriosi)

1 Nodi lymphoidei phrenicisuperiores

F i g .9 0 2 P o s i t i o no f t h e h e a r t i n t h e t h o r a x ,S i t u sc o r d i s

F i g .9 0 3 P o s i t i o no f t h e h e a r t ; i n s p ri a t i o n .

Nodi lymphoidei phrenicisuperiores

F i g . j 0 1 P o s i t i o no f t h e h e a r t ; exprrailon.

N laryngeus recurrens sinister a V brachiocephalica sinistra

Trachea V thyroidea inferiora brachiocephalicadextra a

sinistra a A carotiscommunis aA subclaviasinistra O Arcusaortae

thoracicainterna a

.: N phrenicus aaA;V

pericardiaco-

pnrenrca

Truncusa brachiocephalicus

Pulmosinister

V cavasuperiorO

.. Plexusaorticus thoracicus l N vagus[X]

Pleuraparietalis, Parsmediastinalis

i N laryngeus recurrens

Pulmodexter Sinus transversus pericardii

V p u l m o n a lai s dextrasuperior


V p u l m o n a lai s dextrainferior

a V pulmonalis sinistrasuperior a V pulmonalis sinistrainlerior S i n u so b l i q u u s pericardii Pericardium serosum, Laminaparietalis

Pleura parietalis, Pars diaphragmatica

V cava inferiora

Fig.905 Pericardium P,e r i c a r d i u m .

V brachiocephalicadextra

V jugularis internadextra

V brachiocephalica sinistra

V subclaviadextra V, cava superior

purmonares dextrae

Pericardium

W hepaticae

V cava inferior

Atriumcordis sinistrum Atriumcordisdextrum

F i g . 9 0 5 0 p e n i n g so f t h e L a r g ev e i n si n t ot h e h e a r t ; ventraLview.

> Thoracic viscera Trachea and bronchi

Right main bronchus, Bronchus principalis dexter Bronchus lobaris superior dexter apicalis[B l] 1 = Bronchus segmentalis posterior 2 = Bronchus segmentalis [B ll] = segmentalis anterior[B lll] 3 Bronchus

Cartilagothyroidea, Laminadextra

Bronchus lobaris medius dexter lateralis 4 = Bronchus segmentalis [B lV] segmentalis medialis[B V] 5 = Bronchus

Lig cricothyroideum medianum

Bronchus lobaris interior dexter segmentalis superior[B Vl] 6 = Bronchus basalismedialis[B Vlll 7 = Bronchus segmentalis segmentalis basalisanterior[B Vlll] I = Bronchus basalislateralis 9 = ronchussegmentalis [B lX] basalisposterior 10 = ronchussegmentalis [B Xl

Arcuscartilaginis cricoideae

Left mainbronchus,Bronchusprincipalissinister Cartilagines tracheales

Bronchuslobarissuperiorsinister apicoposterior 1,2 = Bronchus segmentalis [B | + lll segmentalis anterior[B lll] 3 = Bronchus 4 = Bronchus lingularis superior[B lV] lingularis inlerior[B V] 5 = Bronchus Bronchus lobaris inferior sinister superior[B Vll 6 = Bronchus segmentalis 7 = Bronchus segmentalis basalismedialis[B Vll] basalisanteriorIB Vlll] 8 = Bronchus segmentalis segmentalis basalislateralis 9 = Bronchus [B lX] basalisposterior 10 = Bronchus segmentalis [B X]

Ligg anularia

Bifurcatiotracheae 1 Bronchus principalis sinister

Bronchusorincioalisdexter Bronchus lobaris

3

superiorde)del

Bronchus lobarissuperiorsinister 3 Cartilagines bronchiales Bronchuslobaris mediusdexter

Bronchus lobarisinferiorsinister

4

Bronchus lobaris inferiordexter 8

Fig.907 Larynx,Larynx; t r a c h e aT,r a c h e a ,n db r o n c h i , Bronchi.

Bronchus lobaris supeflor dexter

Bronchus principalis sinister Bronchus lobaris supenor sinister

Bronchus principalis de)iter Bronchus lobaris medius dexter

Fig.908 Projection o f t h e t r a c h e aa n d t h e b r o n c h i o n t o t h e a n t e r i o rt h o r a c i cw a [ t .

Bronchus lobaris inferior dexter

Bronchus lobaris inferior sinister

0esophagus Trachea, structure

thyroidea, Laminadextra Cartilago

corniculata Cartilago Cartilagoarytenoidea

Lamina cartilaginiscricoideae

Pariesmembranaceus Cartilaginestracheales

Ligg anularia

M trachealis

Bifurcatiotracheae

Bronchus dexter orinciDalis lobarissuperiordexter Bronchus 1

Bronchus principalis sinister Bronchus lobaris superiorsinister Bronchus lobarisinferiordexter lobarismediusdexter Bronchus Bronchus lobaris inferiorsinister

Fig.909 Larynx,Larynx; +--Â^^ T-^^k^tt dLt tEo, | | oLt tco,

a n d b r o n c h iB, r o n c h i ; dorsaIview.

Tunica adventitia

Glandulaetracheales

Pariesmembranaceus

M trachealis

F i g .9 1 0 T r a c h e aT, r a c h e a ; c r o s s - s e c t rno; m i c r o s c o p i ec n t a r g e m e nat t lowmagnification

> Thoracicviscera Segmental bronchi

F i g . i 1 1 B r o n c h iB , ronchi; t h e [ o b a ra n d t h e s e g m e n t a bl r o n c h ih a v eb e e np r o j e c t e d o n t ot h e I u n g sa n d a r e i t L u s t r a t ewdi t h d i f f e r e n ct o t o u r s ; venlratvrew. N u m b e r si n d i c a t teh e s e g m e n t abI r o n c hlis e ep . 9 0 1 .

tt

0esophagus Bronchialtree,radiography

Bronchus segmentalis apicoposterior [B | + ll] principalis Bronchus sinister

Bronchus lobaris superiorsinister

Bronchus lobarisinferior sinister Bronchus segmentalis superiorIB Vl]

Bronchus lingularis superior[B lV]

lingularis Bronchus inferiorIB V]

Bronchus segmentalis basalislateralis [B lXl Bronchus segmentalis basalisposterior[B X]

Bronchus segmentalis basalisanterior[B Vlll]

F i g . 9 1 2 B r o n c h iB , ronchi; A P - r a d i o g r a p hb;r o n c h o g r a p hoyf t h e l e f t [ u n g . * Bronchography catheter in thetrachea

> Thoracicviscera

tt

Apexpulmonis

Lobussuperior, Faciescostalis

Margoanterior

pulmonis Fissurahorizontalis dextri

Lobusmediuspulmonis dextri, Faciescostalis

Lobusinlerior, Faciescostalis

Fissuraobliqua

Lobusinferior Margoinferior

F i g .9 1 3 R i g h Lt u n gP, u t m od e x t e r ; lateraIview.

Apexpulmonis

Lobussuperior,Faciescostalis

Fissuraobliqua

Lobusinferior, Faciescostalis

Incisura cardiacapulmonis sinistri

Lingulapulmonis sinistri

F i g . 9 1 t , L e f t [ u n g ,P u t m os i n i s t e r ; [ateraIview.

Fissuraobliqua Margo inlerior

0esophagus

Apexpulmonis Lobussuperior

Fissvaobliqua y'//

Lobussuperior

lobaris Bronchus superiordexter

A pulmonalis de)dra

principalis Bronchus dexter lobaris Bronchus mediusde)der et inferiordexter Noduslymphoideus tracheobronchialis inferior Pleuraparietalis, Parsmediastinalis

Margoanterior

W pulmonales dextrae

lmpressio cardiaca

Lobusinferior

pulmonis Fissurahorizontalis dextri

Lig pulmonale Lobusmediuspulmonis dextri

Facies diaphragmatica; Basispulmonis Margoinferior Fissuraobliqua

F i g .9 1 5 R i g h tt u n g ,P u t m od e x t e r ; s a g i t t a sI e c t i o na t t h e p [ a n eo f t h e h i t u m o f t h e[ u n g ; m e d i a Iv i e w . Fissuraobliqua A pulmonalis sinistra V pulmonalis sinistrasuperior Bronchus principalis sinister


V pulmonalis sinistrainterior

Margoanterior

Nodi lymphoidei tracheobronchiales

lmpresslocardiaca

sinistri Incisura cardiacaDUlmonis


Facies diaphragmatica; Basis pulmonis

F i g .9 1 6 L e f t [ u n g ,P u t m os i n i s t e r ; s a g i t t a sI e c t i o na t t h e p [ a n eo f t h e h i I u m of the [ung; m e d i a Iv i e w .

> Thoracicviscera

tt

Bro nchopulmonary segm e nts

Pulmodexter Pulmo dexter,Lobus superior

r I I

Segmentum apicale [S l] Segmentum posterius[S lll

segmentum anterius [s tttl

Pulmo dexter.Lobus medius

I

segmentum taterate [s tvl

I

segmentum mediate [s vl

Pulmo dexter,Lobus inferlor Segmentum superius[S V|] Segmentum basalemedialelcardiacum] [S Vll]Segmentum basaleanterius[S Vlll] il E

Segmentumbasalelaterale[S lxj Segmentumbasaleposterius[S Xl

* T h i ss e g m e n ti s g e n e r a L [nyo t a n i n d e p e n d e nste g m e n t , b u t r a t h e r f u s e dw i t h t h e a n t e r i o rb a s a Is e g m e n t[ S V l l l ] .

F i g . 9 1 7 R i g ht u n gP , u l m od e x t e r ; b r o n c h o p u l m o nsaer g y ments, S e g m e n tbar o n c h o p u t m o n;a l i a LateraIview.

Pulmo sinister Pulmosinister, Lobussuperlor

I I I I

r

)I

apicoposterius [S | + tt] I Segmentum

) Segmentum anterius[S lll] Segmentum lingulare superius[S lVl Segmentum lingulare inferius[S V]

Pulmosinlster,Lobus Interior Segmentum superius[S V|] Segmentum basalemedialelcardiacum] [S VlllSegmentum basaleanterius[S Vllll Segmentumbasalelaterale[S lX] Segmentumbasaleposterius[S X] + T h i s s e g m e n ti s g e n e r a [ [ yn o t a n i n d e p e n d e n t segment, b u t r a t h e r f u s e dw i t h t h e a n t e r i o rb a s a Ls e g m e n t[ S V l l l ]

F i g .9 1 8 L e f tt u n g ,P u l m os i n i s t e r ; b r o n c h o p u t m o nsaer gy m e n t s , S e g m e n tbar o n c h o p u t m o n a t i a ; lateraIview.

ilesophagus Bronchop ulmonary segments

F i g .9 1 9 R i g h t[ u n g ,P u L m od e x t e r ; b r o n c h o p u t m o n a sr ye g m e n t s , Segmentb aronchopulmonaLia; mediaLview.

F i g . 9 2 0 L e f t [ u n g ,P u l m os i n i s t e r ; b r o n c h o p u I m o n a sr ye gm e n t s , S e g m e n t ab r o n c h o p u t m o n a L i a ; mediaIview.

> Thoracic viscera

tt

Truncusbrachioceohalicus Arcusaortae VV brachioceohalicaedextra et siniska

V thoracica interna Apexpulmonis

A carotiscommunis A subclavia Apexpulmonis

Pulmodexter,Lobussuoerior V cavasuperior A pulmonalisdenra,Aa lobaressuperiores

A pulmonalis sinistra Pulmosinister. Lobussuoerior A. pulmonalis sinistra, Aa. lobaressuperiores Bronchus lobaris superiorsinister V pulmonalis sinistrasuperior, V apicoposterior

Pulmodexter, Lobusmedius A pulmonalis dextra, A lobarismedia

Nodi lymphoidei tracheobronchiales

V pulmonalis dextrasuperior, V lobimedii A. DUlmonalis dextra. Aa lobaresinferiores, Parsbasalis, A segmentalis basalisanterior

A pulmonalis sinistra, Aa lobaresinferiores

Auriculadextra A coronaria dextra

Bronchus lobaris inferiorsinister A pulmonalis sinistra, Aa lobaresinferiores, Parsbasalis, A. segmentalis basalisanterior Pulmosinister, Lobusinferior

Ventriculus cordisdexter Auriculasinistra Conusarteriosus Apexcordis

V Dulmonalis sinistrainferior

A coronariasinistra,R interventricularis anterior Ventriculus cordissinister

F i g . 9 2 1 L u n g s ,P u t m o n e sa, n d h e a r t ,C o r ; t h e a r t e r i e s t, h e v e i n sa n d t h e b r o n c h ih a v eb e e n d i s s e c t e du p t o t h e e x t e r n a sI u r f a c eo f t h e [ u n g s .

Ductusalveolaris

Bronchiolus terminalis Bronchus

Bronchiolus

F i g . 9 2 2 L u n gP , ulmo; o v e r v i e owf t h e[ u n gs t r u c t u r e ; m i c r o s c o pei cn t a r g e m eanttl o wm a g n i f i c a t i o n .

0esophagus

A. carotiscommunis

Apexpulmonis

Trachea.Pariesmembranaceus

Pulmosinister. Lobussuoerior

Truncusbrachiocephalicus

A subclavia

Fissuraobliqua

Arcusaortae

Pulmosinister, Lobusinferior V cavasuperior Lig arteriosum Bifurcatiotracheae

Bronchus lobarissuperiorsinister A pulmonalis sinistra

V azygos

principalis Bronchus sinister

.,r7

Bronchuslobarissuperiordexter principalis dexter Bronchus

Bronchisegmentales M bronchooesophageus Nodi lymphoideitracheobronchiales

A segmentalis basalislateralis A pulmonalis sinistra, Aa. lobares inferiores, Parsbasalis

delitrasuoerior V oulmonalis

A segmentalis basalismedialis

dextra A. pulmonalis V pulmonalis dextrainferiof

A segmentalis basalisposterior

Atriumcordissinistrum Atriumcordisdextrum

V. cava inferior

Pericardium Sinuscoronarius

Pulmosinister, Lobusinferior

V cardiaca[cordis]media Apexcordis


Fig.923 Vesselsof the LeftL u n gP, u L msoi n i s t e r ; d o r s a Iv i e w

A carotiscommunis sinistra A. subclavia dextra


Arcusaortae


dexter R. bronchialis Br bronchiales sinistri

Parsthoracicaaortae

F i g . 9 2 t , B r o n c h iB , ronchi; ^-+^-;^t ^..^^1., dr (Er rd( >uPPLy.

>> | l- lear tI T r ac hea I Lungs Vesselsof the lung,radiography

t

F i 9 . 9 2 5 A r t e r i e so f t h e r i g h tI u n g , sextrae; A a .p u I m o n a [ ed y n g i o g r a p h yal ;f t e r A P - r a d i o g r a p (hp u t m o n a r a injection o f a c o n t r a sm t e d i u mi n t ot h e r i g h tv e n t r i c L e ; ventraLview. T h e n u m b e r sd e s i g n a tteh e s e g m e n t a l a r t e r i e s p.961. Icompare

F i g . 9 2 6 V e i n so f t h e r i g h t L u n g , V v p u L m o n a l edse x t r a e ; A P - r a d i o g r a p lhr e t u r nv i a p u L m o n a rvye i n so f t h e c o n t r a s t m e d i u mi n j e c t e di n t o t h e r i g h tv e n t r i c t e l ; ventraIview. N u m b e r si n d i c a t et h e s e g m e n t a L v e i n{ sc o m p a r ep . 9 5 1 .

Thoracic

Corpuscostael; lll; lV

radiography

Bronchus Drincioalis dexter

Clavicula Scapula

V cava supenor

Truncus pulmonalis Atriumcordis sinistrum

cordis Ventriculus sinister

Diaphragma Apexcordis

Recessuscoslodiaphragmaticus

F i g , 9 2 7 T h o r a c i cc a g e ,C a v e at h o r a c i s a, n d t h o r a c i cv i s c e r a ; PA-radiographol a 27-year-otdmal.elthorax radiograph)

1 ="Aorticknob" 2 =Archof the pulmonary artery 3 =Archof the leftatrium =Arch 4 of the leftventricle 5 =Archof the rightvessels 6 =Archof the rightatrium Arcusaortae(l) V cava superior (5)

(2) Truncuspulmonalis Auriculasinistra(3) Ventriculus cordissinister(4)

\L

Atriumcordis dextrum(6) V, cava inferior

Dt

sApex cordis Diaphragma

F i g .9 2 8 0 u t l i n eo f t h e h e a r ts h a d o wi n t h e r a d i o g r a p h ; ei a m e t e r , D t = T r a n s v e r sd a b + c d = 1 3 - 1 4c m L = L o n g i t u d i n aaIx i so f t h e h e a r tl f r o m t h e s u p e r i o r b o r d e ro f t h e r i g h t a t r i a Ic o n t o u rt o t h e a p e xo f t h e h e a r t l= 1 5 - 1 6c m M = M e d i a np t a n eo f t h e b o d y

>> | Heart I Trachea I Lunqs

(Cartilago bronchialis)

Carina tracheae

principalis Bronchus dexter

Bronchus principalis sinister

Fig.929 BronchiB , ronchi; b r o n c h o s c o poyf a h e a [ t h yi n d i v i d u adI i s p t a y i n tgh e t r a c h e a I bifurcatioa n n d t h e c a r i n ao f t r a c h e a .

Bronchus segmentalis apicoposterior lB | + lll: Bronchus seginentati'C anterior lB ilrl

Bronchus lobaris superiorsinister

Bronchilingulares superioret inferior

lBrv-vl

Bronchus segmentalis supeflor lB vrl

Bronchus segmentalis basalisanterior [B Vilt]

Bronchus seomentalis basalislateralis

Bronchus segmentalis basalisposterior [B X]

lBrxl

Fig.930 Bronchi,Bronchi; b r o n c h o s c o p vi ci e w o f t h e l e f t s e g m e n t a bL r o n c h i .

0esophagus surfaceprojections

VertebracervicalisVll [prominens] Lobussuperior

Cupulapleurae

Spinascapulae Lobussuperior

Lobus supenor

lncisura cardraca purmonrs sinistri

Lobusmedius pulmonis dextri

Lobusinferior

Lobusinferior

Becessus costodiaphragmaticus

Costaxll

Cristailiaca

F i g .9 3 1 P r o j e c t i o n o f t h e p u l m o n a r ya n d t h e p t e u r a l b o r d e r so n t ot h e a n t e r i o rt h o r a c i cw a [ t .

Fig.932 P r o j e c t i o no f t h e p u l m o n a r ya n d t h e p l e u r a I borderso n t ot h e o o s t e r i o tr h o r a c i cw a [ t .

B o r d e r os f t h e[ u n g s- t i n e Bordersof the oteura- dashed[ine

Lobussuperior

Lobussuperior

Lobusinferior

Cristailiaca cristailiaca

Fig.933 Projection o f t h e p u l m o n a r ya n d t h e p t e u r a t b o r d e r so n t o t h e l a t e r a It h o r a c i cw a [ t .

o f t h e p u t m o n a r ya n d t h e p t e u r a L F i g .9 3 4 P r o j e c t i o n b o r d e r so n t ot h e l a t e r a It h o r a c i cw a L t .

> Thoracic viscera

Cartilagothyroidea, Laminadextra A carotis communrs

Glandula thyroidea, Lobusdexter

M cricothyroideus lsthmusglandulae thyroideae

A subclavia

_Oesophagus, Harscerytcalrs Truncus brachiocephalicus

Oesophagus, Parscervicalis

A carotiscommunis dextra A carotiscommunis sinistra A. subclavia dextra

Arcusaortae

Lig.arteriosum

Cartilagines tracheales

Truncus brachiocephalicus

Arcusaortae


Lig.arteriosum Bronchus lobaris superiordexter

Parsthoraclcaaortae OesoDhaous. Parsthoraiica

intercostales posteriores Pars thoracica aonae

Diaphraqma, Centrum tendin-eum

Foramen venae cavae

Parslumbalis diaphragmatis, Crusdextrum

Oesophagus, Pars abdominalis

Oesophagus, Parsthoracica

Gaster, Parscardiaca

Aa phrenicae inferiores Hiatusaorticus

Truncuscoeliacus

F i g .9 3 5 O e s o p h a g u s0,e s o p h a g u st ;r a c h e a T , rachea, a n d t h e t h o r a c i ca o r t a ,P a r st h o r a c i c aa o r t a e : ventratview.

F i g .9 3 5 O e s o p h a g u s0,e s o p h a g u st ;r a c h e a T , rachea, a n d t h e t h o r a c i ca o r t a ,P a r st h o r a c i c aa o r t a e : v i e w e df r o m t h e r i g h t .

structure 0esophagus,

Glandula thyroidea, Lobussinister Lobusdexter thvroidea. Glandula A carotiscommunis A carotiscommunis

V jugularisinterna

V jugularis interna

A subclavia

A subclavia

V subclavia

V.subclavia V brachiocephalicasinistra V, brachiocephalicadextra A. subclavia Truncus brachiocephalicus

Cartilagines tracheales Arcusaortae

V cavasuperior V azygos

Lig arteriosum

Bifurcatiotracheae B bronchialis

principalis dexter Bronchus A pulmonalis dextra

A pulmonalissinistra

principalis Bronchus sinister W pulmonales dextrae

W pulmonales sinistrae


Aa intercostales oosteriotes V cavainferior

Oesophagus,Parsthoracica Parsthoracicaaortae Diaphragma

Hiatusoesophageus

F i g . 9 3 7 O e s o p h a g u sO, e s o p h a g u sa ,n d t h e t h o r a c i ca o r t a , P a r st h o r a c i c aa o r t a e ; dorsaLview. Glandulaeoesophageae

Telasubmucosa Stratumcirculare Tunicamuscularis Stratumlongitudinale Tunica adventitia

Fig.938 0esophagus,0esophagus; m i c r o s c o p i ec n l a r g e m e nat t L o wm a g n i f i c a t i o n

> Thoracicviscera Vesselsof the oesophagus

V thyroidea inferior A thyroidea inferior

V vertebralis V jugularisinterna

A thyroidea inferior, Rr oesophageales A vertebralis

A carotis communrs dextra

A subclavia

Oesophagus, Pars ceruicalis V brachiocephalicasinistra

M, intercostalis externus

subclavia dextra

V hemiazygos accessofla

A carotis communis sinistra V cava supeflor Pars thoracicaaortae, Rr bronchiales

M intercostalis internus

W intercostales posteriores

W oesophageae

Oesophagus Parsthoracica aortae, Br oesophageales

A gastricasinistra, Rr oesophageales

Oesophagus, Parsthoracica V hemiazygos \/.7w^ê

Diaphragma

Diaphragma, Centrum tendineum

Diaphragma, Foramen venae

cavae Truncuscoeliacus

Parslumbalis diaphragmatis, Crusdextrumet Crussinistrum V phrenica interior

Oesophagus, Pars abdominalis V gastroomentalis sinistra

V cava inferior

V gastricasinistra

Fig.939 0esophagus,0esophagus;

Gaster

F i g . 9 4 0 V e i n so f t h e o e s o p h a g u sV,v .o e s o p h a g e a e

ctrnnlrrinn ertorioc.

v e n t r a Iv i e w .

W oesophageae

V hemiazygos

v. azygos (Plexus venosus suomucosus)

(R oesophagealis)

V oesophagea

(R oesophagealis)

V phrenicainferior V gastricasinistra

V cava inferior

V portae hepatis

F i g . 9 1 1 V e i n so f t h e o e s o p h a g u sV,v .o e s o p h a g e a e ; m a g n iifc a t i o no f F i g .9 4 0 ; d e m o n s t r a t i o on f a n a s t o m o s e bs e t w e e nb r a n c h e so f t h e h e p a t i cp o r t a Iv e i na n d t h e s u p e r i o rv e n ac a v a .

Thoraciclymphnodes

Glandula thyroidea,Lobus dexter

Oesophagus, Parscervicalis

A carotiscommunis

A carotiscommunis

Truncusbrachioceohalicus

A subclavia A subclavia

V cava superior Nodi lymphoideijuxtaoesophageales

Trachea.Pariesmembranaceus Arcusaortae Parsdescendensaortae Nodi lymphoideitracheobronchialessuperiores

V oulmonalis sinistrasuDerior Nodi lymphoideitracheobronchialessuperiores

Bifurcatiotracheae

A. pulmonalissinistra

Bronchus orinciDalisdexter

Nodi lymphoidei tracheobronchialesinferiores

Nodi lymphoidei

tracheobronchiales superiores A pulmonalis dextra

Bronchilobares V pulmonalis sinistrainferior

Bronchilobares

(Nodi lymphoideimediastinalesposteriores)

V pulmonalis dextrainlerior

Oesophagus, Parsthoracica posteriores) (Nodilymphoidei mediastinales

Pericardium librosum

V, cava inferior

Diaphragma

Hiatusoesophageus

F i g . 9 1 2 T h o r a c i cL y m p hn o d e s ; t hi o r a c i s ; N o d iL y m p h o i d e dorsaLview.

> Thoracicviscera 0esophagus, radiography and oesophagoscopy

Extremitassternalis

piriformis Becessus

lvlanubrium sterni

Oesophagus, * Parsthoracica

Oesophagus, ** Parsthoracica


Diaphragma

F i g . 9 4 3a , b 0 e s o p h a g u sO, e s o p h a g u s ; r a d i o g r a p ha f t e r s w a t t o w i n g o f a c o n t r a s tm e d i u m . a R i g h ta n t e r i o or b t i q u ep o s i t i o no, b L i q udei a m e t e |r [ b e a m d i r e c t e df r o m l e f t a n t e r i o rt o r i g h t p o s t e r i o r ) b L e f ta n t e r i o ro b t i q u ep o s i t i o no, b t i q u ed i a m e t e rl l I b e a m d i r e c t e df r o m r i g h t a n t e r i o rt o L e f tp o s t e r i o r )

* O e s o p h a g e acIo n s t r i c t i o nc a u s e db y t h e a o r t i c a r c h * * R e t r o c a r d i apI o r t i o no f t h e o e s o p h a g u s + * * O e s o p h a g ecaoI n s t r i c t i oant t h e j u n c t i o no f t h e p h a r y n xw i t h t h e oesophagus

Gaster,Parscardiaca, Tunicamucosa

Parsabdominalis, Oesophagus, tunrcamucosa

F i g . 9 1 1 O e s o p h a g u s0,e s o p h a g u s ; o e s o p h a g o s c o p( tye c h n i c adLe t a i [ ss e e F i g .9 8 6 ) ; s u o e n o rv t e w .

Mm pharyngis

Truncus brachiocephalicus

Parsdescendensaortae [Aortadescendens] Parsascendensaortae [Aortaascendens]


Parsthoracicaaortae, [Aortathoracica]

Diaphragma Hiatus oesophageus

Gaster.Cardia

Fig.945 0esophagus,0esophagus; constrcttons. * U p p e ro e s o p h a g e as Ip h i n c t e r + + N a r r o w i n gc a u s e db y t h e a o r t i ca r c h * * * D i a p h r a g m a t ci co n s t r i c t i o n

F i g . 9 1 6 0 e s o p h a g u sO, e s o p h a g u s ; l o c a t i o na n d f r e q u e n c yo f d i v e r t i c u | . a . typicaL * Cervicatdiverticu[um - 7l ,0 % l { Z E N K E Rd'isv e r t i c u L ulm * + M i d - o e s o p h a gdei vaeI r t i c u t ul -m2 2 % l +++ -8%] E p i p h r e ndi icv e r t i c u [ u( m

> Thoracic viscera Thymus

Cartilagothyroidea

(Lobuspyramidalis, Var) M sternothyroideus e M cricothvroideus o I Lobusdexter Glandula thyroidea { Lobussinister I W thyroideae inferiores o Arcusvenosusjugularis O

o lvl sternohyoldeus o M, thyrohyoideus Ventersuperior a M omohyoideus, superior a A thyroidea superior a V thyroidea Fascia cervicalis.Lamina suoerficialis

c M. sternocleidomastoideus o A carotiscommunis * Plexuscaroticus communis

N phrenicus o V jugularisinterna

M scalenusanterioro

a W brachioceDhalicae

Clavicula

o V thoracica interna

M, subclaviusO

Thymus

Apexpulmonis

Costall

o M pectoralis maJor

Pleuraparietalis, Parscostalis

Pulmosinister, Lobussuperior

Pulmodexter, lvlargoanterior Margoanterior

Pericardium Lobus medius

Incisura cardiaca pulmonis sinistri

LODUS

interior


Pleuraparietalis, Parsdiaphragmatica

Pulmosinister, Lobusinferior Margointerior

Recessus costodiaphragmaticus

t M obliquus externus abdominis

thoracica interna a

V thoracica internaa [,4 rectusabdominisa

thoracis 3 M transversus a Parssternalis diaphragmatis Recessus costomediastinalis

F i g . 9 1 7 T h y m u sT , h y m u s ;p e r i c a r d i u mP, e r i c a r d i u m , a n d [ u n g s ,P u l m o n e so, f a n a d o t e s c e n t . N o t et h e s i z eo f t h e a d o L e s c e n t ht y m u s .I n o L d e ri n d i v i d u a t s , t h e t h y m i ct i s s u ei s a l m o s te n t i r e t yr e p t a c e db y a d i p o s et i s s u e .

0esophagus

V thyroidea inferioro

Glandula thyroidea

Truncusbrachiocephalicus a V subclavia a A subclavia a a V brachiocephalicasinistra Plexus brachialis V thoracica interna a

& N vagus[X]

W pericardiacophrenicaeO

o A subclavia

V brachiocephalicadextra a

N phrenicus {t


V cavasuperiora

I N phrenicus Lobussinister\

t} _I N.V M U S

Pulmodexter, Lobussuperior

I Lobus dexter

/

Pulmosinister, l\4argoanterior

Pericardium fibrosum

diaphragmatis a Parssternalis

Fig.918 ThymusT , h y m u s ,o f a n a d o t e s c e n t .

Plexusbrachialis, Parsinfraclavicularis , Truncussympathicus, Ganglion thoracicum ll 3

a A. subclavia Clavicula O M subclavius

N vagus[X],N laryngeus recurrens s N vagus[X],Rr cardiacithoracici &

anterior o M scalenus

N, vagus[X],Plexuspulmonalis I

a V subclavia

V azygosa interna O A thoracica


r N. phrenicus

(Aorta);a a R bronchialis V, bronchialis

a V brachioceDhalica dextra

l'{ vagus[X]. . ^ Hr carotacr tnoracrcl

Thymus

posterioro V intercostalis

a V cavasuperior a Aa. pulmonales

N thoracicus[T 71,a N. intercostaiis

AaaN

Truncussympathicus, 8 Rr.communicantes

phrenicus;A;V oericardiacoohrenica

a W pulmonales Pericardium fibrosum; Pleuraparietalis, Parsmediastinalis

N splanchnicus o malor

Lig.pulmonale s N. vagus[X], Plexus oesophageus

Aa intercostales a posteriores

Pleuraparietalis, Parscostalis Pleuraparietalis, Parscostalis Oesophagus

Pleuraparietalis, Parsdiaphragmatica a Diaphragma; Diaphragma, Centrumtendineum a

Fig.919 PteuraIcavity,Cavitaspteuratis,and mediastinum, M e d i a s t i n u mo,f a n a d o t e s c e n t ; L a t e r atIh o r a c i cw a t [ a n d r i g h t t u n g h a v eb e e nr e m o v e d ; v i e w e df r o m t h e r i g h t . T h e x i n d i c a t et h e a r e a sa t t h e r o o t o f t h e [ u n ga n d t h e p u t m o n a r yL i g a m e n tr ,e s p e c t i v e tw y ,h e r et h e v i s c e r a p I [eura f o l . d sb a c ki n t ot h e p a r i e t a Ip [ e u r a .

Pleuralcavity

Plexusbrachialis. Parsin{raclavicularis

thoracicus R cardiacus Truncussympathicus, ,r N vagus [X], R cardiacusthoracicus

Clavicula

lvl subclavius a A axillarisa

Parsthoracica Oesophagus, Parsthoracica Ductusthoracicus,

V axillaris o A subclavia a

CostaI

(N.vagus) recurrens N laryngeus Lig arteriosum Nodi lymphoidei tracheobronchiales

A carotiscommunis a

a V hemiazygos accessofla

V brachiocephalicaO N vagus [X] t

N phrenicus.


Plexusaorticusthoracicus. Plexus cardiacus

: N. vagus[X], Plexuspulmonalis

P l e x u sp u l m o n a l i s

O Parsthoracicaaortae

A p u l m o n a l i s i n i s t r aO

Thymus

r* Plexusaorticus tnoracrcus

V pulmonalis sinistraa

aoA;Vintercostalis posterior

Bronchus principalis

, R communicans N phrenicus N splanchnicus malor

V pulmonalis sinistrao Pericardium fibrosum

oo

V pericardiacophrenica a

A;vintercostalis posterior; N. intercostalis

A pericardiacophrenica a Truncus sympathicus, Ganglion lX thoracicum

Recessus costomediastinalis Pleuraparietalis, Parsmediastinalis

Pleura parietalis, Parscostalis

(Nodi lymphoidei mediastinales anteriores)

Pleuraparietalis, Parsdiaphragmatica Centrumtendineum

s ,n d m e d i a s t i n u m , , a v i t a sp t e u r a L i a F i g .9 5 0 P t e u r a cLa v i t yC o f, a n a d o t e s c e n t ; Mediastinum v i e w e df r o m t h e l e f t . I n o t d e ri n d r v i d u a t tsh, e t h y m i ct i s s u ei s a t m o s te n t i r e [ y r e p [ a c e db y a d i p o s et i s s u e .

> Thoracic viscera Aortic arch

A carotisexternadextra A carotis internadextra

A. carotisexternasinistra A carotisinternasinistra

A. vertebralisdextra

A. vertebralis sinistra A. carotlscommunis sinistra

A carotis communis dextra


Truncus brachiocephalicus Arcusaortae Lig arteriosum

V cavasuperior

Truncuspulmonalis Atriumcordis sinistrum, Auriculaatrii

Parsascendens aortae Atriumcordis dextrum

Ventriculus cordis sinister V cavainferior

.l Arcus aortae A. thoracica interna Truncusbrachiocephalicus A. subclaviadextra A carotiscommunis dextra A vertebralisdextra Bimaglottidis A vertebralis sinistra

2 3 4 5 6 7 8

I 10 11 '12 13 14 15

Trachea A subclaviasinistra A. carotiscommunis sinistra Parsdescendensaortae Cor Valvaaortae Parsascendensaortae


F i g , 9 5 1 H e a r t ,C o r ,a n d a o r t i ca r c h ,A r c u sa o r t a e , w i t h t h e o r i g i n so f t h e m a j o ra r t e r i e s ; ventraIview.

A carotisexternadextra A carotisinternadextra

Fig.952 Aortic arch,Arcus aortae,and branches; A P - r a d i o g r a pahf t e r i n j e c t i o no f a c o n t r a s tm e d i u m i n t o t h e a o r t i cb u l b : ventraIview. * Catheter

A carotisexternasinistra A. carotisinternasinistra

A vertebralisdextra A carotis communis dextra

A vertebralissinistra A. subclavia sinistra

A subclavia dextra

- 13Vo

-9o/o

A subclavia sinistra A carotiscommunis sinistra

Truncus brachiocephalicus Arcusaortae Parsascendens aortae

a 70 Yo

Parsdescendens aortae, Parsthoracicaaortae

- 3To F i g .9 5 3 a - e V a r i a b i t i toy f t h e o r i g i no f t h e m a j o ra r t e r i e s f r o m t h e a o r t i ca r c h ,A r c u sa o r t a e . a "Textbookcase" b C o m m o no r i g i no f t h e b r a c h i o c e p h a ttircu n k a n d t h e L e f t c o m m o nc a r o t i da r t e r y c C o m m o nt r u n k f o r t h e b r a c h i o c e p h a lt.ri u c nkandthe teft c o m m o nc a r o t i da r t e r v

Left vertebraIartery branchingoff the aortic arch independently R i g h ts u b c t a v i a a n r t e r ya s t h e u t t i m a t eb r a n c ho f t h e a o r t i ca r c h T h i sa b n o r m a Ia r t e r yf r e q u e n t [ yp a s s e sb e h i n dt h e o e s o p h a g utso t h e r i g h t ,w h i c hc a n r e s u [ ti n s w a t l o w i n g d i f fi c u t t i e sI D y s p h a g ilau s o r i a ) .

Posteriormediastinum

Truncusbrachioceohalicus a N vagus[X] 0

Trachea

recurrens a N. laryngeus I N vagus[X]

profundaa A ceruicalis Truncuscostocervicalis O

o N phrenicus

A intercostalis suDremao

O A subclavia

A subclavia a

a A thoracicainterna

N laryngeus recurrens s

O Arcusaortae a Parsthoracicaaortae, Rr.bronchiales 3 N laryngeusrecurrens

Parsascendens aortaea IAortaascendens]

a N. vagus[X], Rr bronchiales


sinister Bronchusprincipalis

V azygosa a Parsthoracicaaortae, Rr.oesophageales Truncussympathicus 8 recurrens, a N. laryngeus Rr oesophageales

Mm intercostales O interni

Oesophagus,Pars thoracica

W intercostales a posteriores

a Aa. intercostales posteriores

Mm.intercostales o externi

o Parsthoracica aonae

Nn thoracici, a Nn intercostales

N splanchnicus o mtnor

a N splanchnicus maJor

a V azygos

Parslumbalis a diaphragmatis majorI N splanchnicus

CostaXl

CostaXl, Cartilagocostalis

a Truncuscoeliacus

N splanchnicus minort V lumbalis ascendens O

a A mesenterica supenor

A;Vsubcostalisaa N subcostalis,

a Parsabdominalis aonae o N iliohypogastricus

F i g .9 5 4 T h o r a c i ca n d a b d o m i n aal o r t a ,P a r st h o r a c i c a sortae a o r t a ee t P a r sa b d o m i n a l i a

> Thoracicviscera Posteriormediastinum

V thyroidea inferioro V brachiocephalicadextra o

a V brachiocephalica sinistra a V subclavia

Arcus venae azygos a


V cavasuperiora

Ductusthoracicus. Parsthoracica posteriores a Aa intercostales

a Mm intercostales interni

V azygosa

a V hemiazygos accessoria O V hemiazygos

a o Aa ; Vv intercostales posteriores Truncussympathicus, Ganglia

, Nn thoracici, Nn intercostales


N splanchnicus major

Vv intercostales a posteriores O V hemiazygos

subcostalis a O

Cisternachyli

Costa Xl

c Parslumbalis diaphragmatis, Crusdextrum et Crussinistrum

N subcoslalis

V cavainferiora

a V lumbalis ascendens

F i g .9 5 5 V e s s e Lasn d n e r v e so f t h e p o s t e r i o rm e d i a s t i n u m , Mediastinum oosterius.

Posteriormediastinum

cervicothoracicum * Ganglion [stellatuml A carotiscommunis O N vagus[X] e Truncussympathicus, t medium Ganglion cervicale

Trachea

anterior o M. scalenus recurrens {, N laryngeus O A subclavia

M scalenusanteriora

I Ansasubclavia

Ansasubclavias

* N vagus[X]

A subclavia O

Truncussympathicus, *r ll Ganglion thoracicum

thoracicus; & Plexusaorticus Plexuscardiacus

N vagus[X] & N laryngeus recurrens 8l recurrens 6 N laryngeus I N vagus[X],Rr.bronchiales sinister Bronchus orincioalis

Parsascendens a aonae N vagus(X),* Rr bronchiales

* Nn. thoracici, Nn intercostales


Truncus & sympathicus

I N vagus[X], Plexus oesophageus

Truncus* sympathicus, Gangliathoracica

t Truncus sympathicus, Rr.communicantes

Oesophagus, Parsabdominalis

splanchnicus s mrnor Diaphragma a

Parspylorica o N. iliohypogastricus

Duodenum

N subcostalis 8,

aortaeO Parsabdominalis

F i g r 9 5 6 A u t o n o m o unse r v o ussy s t e mo f t h e t h o r a c i cc a v i t y , P a r st h o r a c i caau t o n o m i c a .

> Thoracicviscera Phrenicnerve

V jugularis internaa

Glandulathyroidea

Truncusbrachiocephalicus a

Trachea

O A carotiscommunis ,, N laryngeus recurrens

N laryngeus recurrens. V subclavia a

Clavicula

N vagus[X]

a M scalenusanterior

V brachiocephalicasinistra a

o A thoracicainterna

V brachiocephalica a dextra

, N vagus[X]


N vagus[X], " Rr cardiacithoracici Pulmosinister, Lobussuperior

ArcusaortaeO V cava a supenor

s N phrenicus

Plexus.. cardtacus

O O A ; V pericardiacophrenica

N phrenicust

N phrenicus, ; R pericardiacus Pulmodexter, Lobusmedius

Pericardium

Pulmodexter, Lobusinferior Recessus costodiaphragmaticus Pleuraparietalis, pars diaphragmatica

* Diaphragma

F i g .9 5 7 T h o r a c i cv i s c e r ao f a n a d u L t ; t h e a n t e r i o rt h o r a c i cw a L [h a s b e e nr e m o v e d , a n d t h e r i g h t a n d t h e L e f t[ u n g h a v eb e e n s e c t i o n e di n t h e f r o n t a Ip L a n e ; ventraL view

l\4 scalenusanterior N phrenicus

A subclavia dextra V subclavia dextra

V cavasuperior

Pericardium

N phrenicus, R pericardiacus

Diaphragma

N phrenicus, Rr phrenicoabdominales

F i g .9 5 8 C o u r s eo f t h e p h r e n i cn e r v e , N.phrenicus

Mediastinum

Mediastinum supenus

Mediastinum inferius

F i g . 9 5 9 O r g a n i s a t i oonf t h e m e d i a s t i n u mM, e d i a s t i n u m .

l\4 arytenoideus transversusG Oesophagus,Pars cervicalis

Cartilagocricoidea,Lamina

Cavitas infraglottica Lig vocale

Trachea, Pariesmembranaceus

Cartilagothyroidea a l\4 sternothyroideus

VertebracervicalisVll Iprominens]

Fascia cervicalis,Lamina superticialis

anterior o V jugularis


thyroidea Glandula Nodi lymphoidei tracheobronchialessuperiores

Cartilaginestracheales

O M sternocleidomastoideus

VertebracervicalisVll [prominens],Proc spinosus

Articulatiosternoclavicularis

sterni l\4anubrium O Truncusbrachiocephalicus t lvl pectoralismajor sinistra a V brachiocephalica

Ligg interspinalia Bilurcatiotracheae, Carina tracheae

a Arcusaortae Corpussterni

W basivertebrales a principahs Bronchus dextel

aortae O Parsascendens Thymus

Noduslymphoideus inferior tracheobronchialis

semilunares Valvaaortae,Valvulae et dextra sinistra. oosterior sinistra a A coronaria

Plexusvenosusa vertebralis internusposterior M interspinalis t A pulmonalis dextraa Pars Oesophagus, thoracica V p u l m o n a lsi si n i s t ra Sinustransversus pericardii V hemiazygos a Atriumcordissinistrum

Myocardium

Valva atrioventricularis dextra [ValvatricusPidalis] C o s t a eV l ; V l l Cavitas pericardiaca

Septuminteratriale A coronaria dextra;O a V cardiacamedia Nledulla spinalis

Sternum, Proc xiphoideus e M rectus abdominis O Parssternalis diaphragmatis

Duramaterspinalis Spatiumsubarachnoideum

Oesophagus, Tunica muscularis Pars lumbalisdiaphragmatisI

phrenicus superior Noduslymphoideus

Hepar, Area nuda

Lamina visceralis lEpicardiuml Lamina parietalis

Atriumcordisdexlrum

, ediastinum; , a v i t a st h o r a c i s a, n d m e d i a s t i n u mM F i g .9 6 0 T h o r a c i cc a v i t yC m e d i a ns a g i t t a sI e c t i o nt h r o u g ht h e n e c ka n d t h e t h o r a x ; L a t e r avI i e wf r o m t h e r i g h t .

,",o.,. e",i.u,oi,' J

Thorax,frontalsections

Trachea

A vertebralis a Nodi lymphoideithoracis, Nodi paratracheales

Plexusbrachialis & A suprascapularis O

A thoracoacromialis

Oesophagus Nodi lymphoideicervicaleslaterales, Nodi orofundiinferiores

O A thoracicainterna a M. scalenusmedius sinistra O A, subclavia

Clavicula

a M. subclavius subclavia O dextra

CostaI O A. axillaris I N vagusslnister[X] a V axillaris

V cavasuperiora

o Arcusaortae minor o M. pectoralis

V pulmonalis dextrasuperior, a anterior, Parsintrasegmentalis A. intercostalis O

CostalV a) Parsascendensaortae O M. serratusanterior

Fissurahorizontalis pulmonis dextri

internus a M intercostalis

Atriumcordisdextrum sinistra o A coronaria Fissuraobliqua

Bronchus intrasegmentalis

Pleuraparietalis,Parscostalis


Pleuravisceralis

Laminavisceralis IEpicardium]

Diaphragma O

Laminaparietalis

Recessus costodiaphragmaticus Hepar, Lobussinister

parietale Peritoneum Peritoneum\ Flexuracoli V hepatica O Valva aortae

Truncuspulmonalis O Valvaatrioventricularis dextra

O A coronariadextra, B. interventricularis oosterior Fundusgastricus Ventriculus cordisdexter

F i g ,9 6 1 T h o r a c i cc a v i t yC , a v i t a st h o r a c i s .

A carotiscommunis Trachea Truncusbrachiocephalicus V cavasuperior

Parsascendensaortae

Truncuspulmonalis Pulmosinister

Pulmodexter Atriumcordisdextrum Ventriculus cordissinister Diaphragma Ventriculuscordisdexter Hepar Valvaatrioventricularis dextra

Fig.962 Thoraciccavity,Cavitasthoracis; m a g n e t i cr e s o n a n c e t o m o g r a p h i ci m a g el M R l ) ; f r o n t a Is e c t i o na t t h e [ e v e [o f t h e s u p e r i o rv e n ac a v a ; ventraIview.

0esophagus Thorax,

secttons

Pars thoracica aortae

posterius Mediastinum

Pleura visceralis Ipulmonalis]

Pulmosinister Oesophagus, Parsthoracica Cavitaspleuralis

Pulmo dexter, Lobus inferior

Diaphragma

Cavitas pleuralis


Diaphragma

Hepar

Corpusgastricum

V hepatica dextra

Recessuscostodiaphragmaticus

Becessus phrenicomediastinalis

Omentummajus V cava inferior

Parslumbalis diaphragmatis Gaster,Ostiumcardiacum

Tunicamucosa Pancreas

Flexuracolisinistra

Gaster. Pars cardiaca

F i g .9 5 3 D i a p h r a g mD , i a p h r a g m aa,n d o e s o p h a g u s , O e s o p h a g u sw,i t h i t s t r a n s i t i o ni n t ot h e s t o m a c h G , aster; f r o n t a Is e c t i o nt h r o u g ht h e L o w e rp a r t o f t h e t h o r a c i c c a v i t ya n d t h e u p p e rp a r t o f t h e a b d o m i n acI a v i t y .

Truncuspulmonalis

Atrium cordis dextrum

Ventriculus cordissinister Ventriculuscordisdexter

Diaphragma

Hepar

F i g . 9 6 t + T h o r a c i cc a v i t yC , a v i t a st h o r a c i s ; m a g n e t i cr e s o n a n cteo m o g r a p h ii cm a g eI M R l ) ; f r o n t a Is e c t i o na t t h e L e v eoLf t h e a o r t i cv a t v e : V C N I T A LV I C W .

> Thoracicviscera

tt

Thorax,frontalsections

M trapeziust

o M serratus anterior I M, suoraspinatus Articulatio acromioclavicularis o M subscapularis

lvl erectora sptnae

Scapula, Cavitas glenoidalis

M spleniusa

Caputhumeri t M deltoideus

Vertebrathoracicall

(Recessus axillaris) Cupulapleurae . N axillaris

Pleuravisceralis humeri a A circumflexa posterior lvl intercostalis internusa a M teresmajor ,!8Plexusbrachialis, posterior Fasciculus

C o s t al l l

a A axillaris AortaO

& Plexusbrachialis, Fasciculus medialis

V anterior, a Parsintrasegmentalis Bronchus segmentalis anterior[B lll]

& Plexusbrachialis, Fasciculus lateralis a V axillaris

N thoracodorsalis s M serratusI anterior

a A circumflexa scapurae

Nodus lymphoideus axillaris

a M coracobrachialis

F i g .9 5 5 T h o r a c i cc a v i t yC , a v i t a st h o r a c i s ; a x i t t aA , x i L t aa, n d s h o u L d eiro i n t , A r t i c u L a t ihou m e r i .

M scalenusmedius*

a V jugularisinterna o V cephalica Proc. coracoideus a M. biceps brachii,Caput longum, Tendo

Acromion Caputhumeri ,* Plexusbrachialis O M. deltoideus

Nodilymphoidei paratracheales a A axillaris

CostaI

c M subscapularis carotiscommunisa sinistra a V axillaris Noduslymphoideus tracheobronchialis a lvl teresmajor Arcusaortaea

longus & N thoracicus O l\4 serratusanterior

Pulmosinister

CostalV

F i g .9 6 6 T h o r a c icca v i t yC, a v i t atsh o r a c i s ; a x i t t aA, x i L t a ,n ds h o u t d ei ro i n t , A r t i c u L a thi ou m e r i .

lvl scalenusanteriore

t M sternocleidomastoideus * N vagusdexter[X]

M pectoralismajorC M subclavius *

a A carotiscommunis

Plexus brachialisx

Caput humeri

a A subclavia

Pulmodexter,Apex

Pleuravisceralis

Pleuraparietalis

Vertebra thoracicalll. Proc soinosus

Scapula

M infraspinatus t

t M serratusanterior

Clavicula

o M trapezius

a V subclavia

M sternocleidomastoideus o M sternohyoideus a

.M

scalenusanterior a M omohyoideus a A subclavia I M pectoralis major

Trachea

a M. deltoideus Oesophagus

Plexusvenosusvertebralis internusa

Spatiumsubarachnoideum

Medulla spinalis

a M infraspinatus ,! N suprascapularis M trapeziusa

M supraspinatus a

F i g .9 5 7 a , b T h o r a c i cc a v i t yC , a v i t a st h o r a c i s a; x i I L aA, x i t l a , a n d s h o u [ d e ri o i n t .A r t i c u t a t i oh u m e r i .

Scapula

Spinascapulae

a R i g h tp a r t o f t h e b o d y b Left part of the body

> Thoracicviscera

Lungs

transversesections

A\

Manubrium sterni Nodi lymphoideiparatracheales

O Truncusbrachiocephalicus a lvl sternothyroideus sinistra a A, carotiscommunis

V.thoracica internao N phrenicus dexter,,

Trachea .N

V cavasuperiora M pectoralismajora

phrenicus sinister sinistra a A subclavia ,* N vagussinister[X]

M pectoralis c mrnor

CostaI

Oesophagus


V pulmonalis a dexlrasuperior

,, N thoracicus longus

thoracicus longus? V axillarisa

*{ Plexusbrachialis

HUMETUS

a Arcusaortae

A axillarisa Noduslymphoideus axillaris, Nodusapicalis

a A subscapularis

l\4 subscapularis a

Bronchus segmentalis poslerior [B ll]

M teresmajorI M infraspinatus e


costa lll

Scapula

M trapeziusO V azygoso Lig longitudinaleanterius

s M serratusanterior * N, intercostalis Pleuravisceralis

* Truncussympathicus Ductusthoracicus Vertebra thoracicall. Proc soinosus

F i g . 9 5 8 T h o r a c i cc a v i t yC , a v i t a st h o r a c i s

Corpussterni Becessus costomediastinalis A thoracica interna O N phrenicusdexter {

a Truncusbrachiocephalicus sinistra a A carotiscommunis a Arcusaortae r N. phrenicus sinister I M pectoralismajor

V, cavasuperioro

Bronchus segmentalis anteriorIB llll

Nodi lymphoideiparatracheales

A pulmonalis sinistra,O A segmentalis anterior

minor , M pectoralis Pulmosinister. Lobussuoerior

V azygos O Trachea

N intercostalis i Bronchus intrasegmentalis

a M serratusanterior

N thoracicus longusa longus I N thoracicus Pulmodexter, Lobussuperior

Oesophagus

lvl intercostalis externusa a A thoracodorsalis vagusdexter[X] i. a M. teresmajor lvl subscapularis l| , N.vagussinister [X]

V azygosO lvl infraspinatus O

Scapula

Fissuraobliqua CostalV Truncussympathicus { M trapeziusa Vertebrathoracica lV

Fissuraobliqua Pulmosinister, Lobusinferior a Parsthoracicaaortae Recessus vertebromediaslinalis

Ductusthoracicus

F i g . 9 6 9 T h o r a c i cc a v i t y C , a v i t a st h o r a c i s .

Thorax, transversesections

Corpussterni A pulmonalis dextraa

O Parsascendensaortae Cavitas pericardiaca

N phrenicus dexter

Cartilago costalis

V cavasuperioro

a Truncuspulmonalis

l\4 pectoralismajor6

N phrenicus sinister

A lobarissuperiora sinistrasuperior a V oulmonalis Pulmodexter.LobussuDerior Bronchus sinister Drincioalis Nodi lymphoidei bronchopulmonales

Bronchus lobarissuperior

l\4 serratusanteriorO Glandula mammaria

Costalll N thoracicus longus

, N thoracicus longus

F i s s u roab l i q u a a A lobarissuperior principalis Bronchus dexter

I M serratusanterior

Pulmodexter, Lobusinferior Fissuraobliqua M teres major O

N vagus[X]

Truncus sympathicus

a Parsdescendens aonae

azygosa lvl trapezius c VertebrathoracicaV

Scapula

N vagus[X]

Oesophagus Ductusthoracicus

F i g . 9 7 O T h o r a c i cc a v i t yC , a v i t a st h o r a c i s .

Bronchus principalisdexter

Sternum Pleuraparietalis, Parsmediastinalis M pectoralis major

Bronchus segmentalis a n t e r i o r[ B l l l ]

Parsascendensaortae V cavasuperior

Bronchus segmentalis posterior[B ll]

principalis Bronchus sinister Parsdescendens aortae

Bronchus lobarissuperior dexler

Scapula

Bi{urcatiotracheae

M, infraspinatus

Oesophagus Vertebrathoracica lV, Corpus vertebrae Vertebra thoracica lV, Proc transversus

Foramen vertebrale

M erectorspinae

M trapezius Costae

F i g . 9 7 1 T h o r a c i cc a v i t yC , a v i t a st h o r a c i s ; c o m p u t e dt o m o g r a p h i c r o s s - s e c t i oInC T ] .

lvl serratusanterior

Lur r Es Thorax, transversesections

\ V cavasuperiora A thoracica internaa V pulmonalis dextrasuDerior a N phrenicusdexter , M pectoralismajor S

Corpussterni a Pars ascendens aortae

Atriumcordissinistrum Sinustransversus oericardii O Truncuspulmonalis Costalll

Bronchus lobarismedius

N phrenicus sinister Auriculaatriisinistri

Pulmodexte.,Lobusmedius

Pulmosinister. LobussuDerior

Bronchus lobarismedius

G l a n d u l am a m m a r i a

Bronchus lobarisinferior Oesophagus Nodi lymphoidei bronchopulmonales

N thoracicuslongus .r Aa lobares inferioresa

Fissura obliqua

Cavitaspleuralis

Pulmodexter, Lobusinferior

Bronchus segmentalis basalisposterior [B X]

M serratusanterior*

sinistra a V pulmonalis inferior

M latissimus dorsicr V pulmonalis dextrainferiorO M intercostalis externus*

Ductusthoracicus

N vagus dexter [X] : V intercostalisO

M trapezius *

aortae a Parsdescendens

Becessus vertebromediastinalis o V azygos VertebrathoracicaVl

F i g . 9 7 2 T h o r a c i cc a v i t yC , a v i t a st h o r a c i s .

Atriumcordissinistrum

Ostiumatrioventriculare sinistrum Aorta

Valva aortae

Valvulasemilunaris sinistra Valvulasemilunaris posterior

Cuspisanterior

I Valva atrioventricularis sinistra [Valva mitralis] 7 Cuspisposterior J Ventriculus cordissinister

Valvulasemilunaris dextra

Septuminterventriculare Ventriculus cordisdexter

Fig.973 Heart,Cor; u L t r a s o u nidm a g ev i e w e df r o m t h e o e s o p h a g u s ( t r a n s o e s o p h a g eeacIh o c ar d i o gr a p h y l .

transversesections

Atriumcordisdextrum

Sternum, Proc xiphoideus

sinistra a A coronaria

Cartilago costalis

a Sinusaortae Valva aortae

N phrenicus dexter


Pulmodexler,Lobusmedius

a A coronaria sinistra, R, interuentricularisanterior

Papilla mammaria

Ventriculus cordissinister Giandula mammaria

Valvaatrioventricularis sinistra[Valvamitralis] Pulmosinister, Lobussuperior

Fissuraobliqua

Atriumcordissinistrum l\4 serratusanteriorN sinister * N phrenicus V basalisinferior, a V pulmonalis dextra inferior

o V cardiacamagna

Noduslymphoideus bronchopulmonalis Costa Vl

N vagusdexter[X] ''t M latissimus dorsia Pulmodexter, Lobusinferior

VertebrathoracicaVll

N intercostalis & Oesophagus

Lobusinferior Pulmosinister, a V intercostalisa Parsdescendensaortae - Truncussympathicus Ductusthoracicus

, a v i t a st h o r a c i s . F i g . 9 7 1 T h o r a c i cc a v i t yC

M pectoralismajore V oulmonalis sinistrainferioro M transversus thoracisa

Sternum.Proc xiohoideus o A coronaria/ Atriumcordis Sinistra ,/ dextrum

Pulmodexter,Lobusmedius

Valvaatrioventricularis dextra [Valvatricuspidalis] Ventriculus cordisdexter

Fissuraobliqua

Ventriculus

Costa lll -\


N intercostalis* Mamma

Recessus coslomediastinalis

Fissuraobliqua a M serratusanterior

Nodi lymphoidei tracheobronchiales inferiores

s N, phrenicus a A coronariadextra

Pulmo dexter, Lobus inferior

Pulmosinister, Lobusinferior

M intercostalis externusa

a Parsdescendensaortae

Bronchus segmentalis basalis lateralis[B lX]

dorsi a M latissimus

Noduslymphoideus juxtaoesophagealis N vagusdexter[X] | VertebrathoracicaVlll

Oesophagus V azygosa

\ a A intercostalisDuctusthoracicus Truncussympathicus Vll. proc spinosus thoracica Vertebra

F i g ,9 7 5 T h o r a c i cc a v i t yC , a v i t a st h o r a c i s

> Abdominalviscera

>> | Stom achI SmattintestineI Lar gei ntes ti ne I Li v er

Oesoohaous. Parsabdomirialis

Incisura cardialis

Fundusgastricus

Curvatura minor

Duodenum, Parssuperior

Corpus gastricum

Incisura angularis

Curvaturamaior Duodenum, Parsdescendens

Fig.976 Stomach,Gaster; ventraIview.

Pancreas Musclesof thestomach

Fundusgastricus

Oesophagus, Tunicamuscularis

Tunicamuscularis, Stratumlongitudinale

Curvaturamajor Tunicamuscularis, Stratumlongitudinale Curuatura minor Tunicamuscularis, Stratumcirculare

Fig.977 Stomach,Gaster; externaImusc[etayers; ventraIview

Tunicamuscularis Stratumcirculare

Oesophagus, Tunicamuscularis

Tunicamuscularis, Stratumcirculare

Tunicamuscularis, Fibraeobliquae

, aster; F i g .9 7 8 S t o m a c h G t h e p e r i t o n e u mh a s b e e n removedto demonstratethe i n t e r n a Im u s c [ el a y e r s ; ventraIview.

> AbdominaIviscera Stomach,structure

Incisura cardialis

Oesophagus, Parsabdominalis CardiaIParscardiaca],Ostiumcardiacum

Duodenum, Parssuperior, Ampulla

Plicaecirculares Duodenum, Parsdescendens

Parspylorica, Canalispyloricus, Antrumpyloricum

F i g . 9 7 9 S t o m a c hG , a s t e r a, n d d u o d e n u mD , uodenum; ventraIview.

Areae gastricae Foveolae gastricae

Tunicamucosa

Epilhelium Laminapropriamucosae Noduluslymphoideus solitarius Glandulae gastricae

Laminamuscularis mucosae Telasubmucosa

F i g .9 8 0 D i a g r a mo f t h e s t o m a c hw a t [ ; the layersof the wa[[ havebeen removedstepwise; m i c r o s c o p i ec n t a r g e m e nat i L o wm a g n i f i c a t i o n .

Pancreas Vesselsof thestomach

A ; V gastricasinistra,Rr oesophageales CardiaIParscardiaca] A.; V.gastricasinistra A hepaticapropria

V portaehepatis Ductuscysticus Ductus hepaticuscommunis

Omentumminus, Lig hepatogastricum

Aa ;W. gastricae breves

Lig hepatoduodenale

A hepaticacommunis

A;V gastroomentalis sinistra

A;V gastricadextra Omentummaius A ;V gastroomentalis dextra Flexuraduodeniinferior

dextra,Rr.omentales A ; V gastroomentalis

, aster; F i g . 9 8 1 B L o o dv e s s e t so f t h e s t o m a c h G ventraIview.

Lobus hepatis sinister

Nodi lymphoidei gastrici dextri

Nodi lymphoidei pylorici

Nodi lymphoidei gastroomentales dextri

F i g .9 8 2 S t o m a c hG , a s t e r a, n d t i v e r ,H e p a r , w i t h L y m p hn o d e s ,N o d it y m p h o i d e i ; ventraIview.

Liver

1 = Oesophagus withcontrastmedium ( 1a) intothelundus At the transition o{ stomach,the groovesbetween theloldsappearas darkstriations 2 = Fundusof stomachwithairbubble 3 = Bodyof stomach 3a = Lessercuruature 3b = Greatercuruature. In the liningsof the latter,notches cotresponding to the contour of the mucousarevisible 4 = Peristalticconstrictionat the angularnotch 5 = Pyloricpartpriorto the progressionof a portionol the stomach'scontenl 6 =Ampullaofduodenum partof theduodenum 7 = Descending withcircularfolds 8 = Jejunum 9 = Left"dome"ofdiaphragm 10 = Leftcolicflexure(filledwithair)

F i g . 9 8 3 S t o m a c hG , a s t e ra, n d d u o d e n u mD, u o d e n u m ; A P - r a d i o g r a pahf t e r o r a I a d m i n i s t r a t i oonf a c o n t r a s m t edium; u p r i g h tp o s i t i o n ; ventraIview.

Sternum, Proc xiphoideus Cardia [Pars cardiacal

Sternum, Proc xiphoideus Gaster, CardiaIPars cardiacal

Fornix gastricus CostaX

Costa X

Fornix gastricus

Corpus gastricum Corpus gastricum Gaster, Parspylorica

Gaster, Parspylorica

Spinailiaca anterior supenor

Fig.984 Stomach,Gaster; p r o j e c t i o no f a " n o r m a t "s t o m a c ho n t ot h e a n t e r i o ra b d o m i n a I wa[t; u p r i g h tp o s i t i o n .


Fig.985 Stomach,Gaster; p r o j e c t i o no f a " l o n g "s t o m a c ho n t ot h e a n t e r i o ra b d o m i n a I watt; u p r i g h tp o s i t i o n .

Pan c r e a s Gastroscopy

Oesophagus

Corpusgastricum Antrumpyloricum

F i g . 9 8 6 T e c h n i c apt r o c e d u r eo f o e s o p h a g o s c o p y and gastroscopy. * Gastroscooe ** Thegastroscope's (compare Fig.987al in thebodyof stomach tip located **+Thegastroscope's Fig.987b) antrumlcompare in the pytoric tip located

Gaste( Pariesanterior

Gaster, Pariesanterior

Plicae gastricae

Pylorus

Gaster, Parspylorica, Antrumpyloricum

Gaster, Pariesposterior

, aster; F i g . 9 8 7a , b S t o m a c h G e n d o s c o p i icm a g eo f t h e stomachIgastroscopy) ; s u p e n o rv r e w .

Gaster, Pariesposterior

, ithdistinct , o r p u sg a s t r i c u mw a V i e wo f t h e b o d yo f s t o m a c h C L o n g i t u d i n faot L d so f t h e m u c o s a{ P t i c ag a s t r i c a e l b V i e wo f t h e p y t o r i ca n t r u m ,A n t r u m p y t o r i c u mp, r e d o m i n a n t t y coveredwith smooth mucosa

> Abdominalviscera

tt

Duodenum

Duodenum, AmpullaIBulbusl

Gaster,Parspylorica


Duodenum, Parsdescendens

Duodenum, Parsascendens

Duodenum, Parshorizontalis

Fig.988 Duodenum,Duodenum.

Duodenum, Parssuperior Duodenum, Parsdescendens Pancreas,Caput Duodenum, Parshorizontalis

F i g . 9 8 9 D u o d e n u mD , u o d e n u ma, n d p a n c r e a sP, a n c r e a s ; p r o j e c t e do n t ot h e a n t e r i o ra b d o m i n aw I a[t.

Pancreas

pyloricus M sphincter Pylorus, Ostiumpyloricum CanalisovloricusI I Harsovlorlca ' Antrumpyloncum)

Plicaecirculares

duodeni* M susoensorius Duodenum, Parsdescendens Flexuraduodenojejunalis

Ampullahepatopancreatica

Papilladuodenimajor""

Jejunum Tunicamuscularis Duodenum, Parsascendens Duodenum, Parshorizontalis

F i g . 9 9 0 D u o d e n u mD, u o d e n u m ; ventraIview. * C[inicaI of TREITZ term:muscLe ++CtinicaI term:papitlaof VATER Flexuraduodenojejunalis VertebrathoracicaXll Duodenum, Pars suPerior, Xll Costa \ Ampulla

Duodenum, Pars I Plicae descendens

minor Gaster,Curvatura Gaster, Incisura angularis

Duodenum,rJejunum Parsascendens Vertebra lumbalislll

Fig.991 Duodenum,Duodenum; A P - r a d i o g r a pahf t e r o r a I a d m i n i s t r a t i oonf a c o n t r a s tm e d i u m ; u p r i g h tp o s i t i o n ; ventraIview.

, uodenum; F i g . 9 9 2 D u o d e n u mD e n d o s c o p i icm a g e .

tt

SmalLintestine, structure

Telasubmucosa

Tunicamuscularis, Stratumcirculare

F i g . 9 9 3 S u p e r i o rp a r t o f t h e d u o d e n u m , P a r ss u p e r i o dr u o d e n i ; layersof the wa[1. * C t i n i c at eI r m :B R U N NsEgRL a n d s


Mesenterium Telasubmucosa Laminamuscularis mucosae Tunicaserosa Periloneum ( Teta viscerale 1 \ suoserosa

Villi intestinales

Nodulus lymphoideus solitarius

Stratum/ / Tunica longitudinale muscularis I I Stratumcirculare

F i g .9 j I S m a L i[ n t e s t i n eI,n t e s t i n u m tenue; c r o s s - s e c t i otnh r o u g ht h e u p p e rs m a t Li n t e s t i n e .

Villusintestinalis

Epithelium Lamina propria mucosae

Tunicamucosa

Vas lymphaticumcentrale Glandulae intestinales Lamina muscularismucosae

Tela submucosa

I Stratumcirculare

.l r unrca musculans { ^. srrarum --\ I llongitudinale Tela subserosa

Tunicaserosa

F i g .9 9 5 S m a t Ii n t e s t i n el,n i e s t i n u mt e n u e ; [ a y e r so f t h e w a L t ; m i c r o s c o p iec n l a r g e m e nat t l o w m a g n i f i c a t i o n

Tunicamucosa

Pancreas Mucosaof the small intestine

Telasubserosa Tunicamuscularis

Plicae circulares

Plicae crrcurares Noduli lymphoidei solitarii

F i g . 9 9 7 l l e u m ,l t e u m .

F i g . 9 9 6 J e j u n u m ,J e j u n u m .

Plicae circulares

Noduli lymphoidei aggregati*

Noduli lymphoideisolitarii

Mesenlerium

F i g .9 9 8 T e r m i n a iI [ e u m , P a r st e r m i n a t i si [ e i . * CtinicaI term:PEYER s patches

Mesenterium

itei]. s iverticu[um Fig.999 MECKEL'd {Diverticutum T h i sv e s t i g eo f t h e y o l . ks t a t kI D u c t u so m p h a t o e n t e r i c u s l o c c u r si n 1 - 3 % o f c a s e s .l t i s [ o c a t e d3 0 - 7 0c m o r a I t o t h e i t e o c a e c aj uI n c t i o no p p o s i t et o t h e a t t a c h m e n ot f t h e mesenrerv.

> AbdominaIviscera

tt

Largeintestine

Flexuracoli sinistra

Colontransversum Flexuracoli dextra Taenia libera

Colondescendens

Colonascendens Haustracoll

Appendices omentales

Appendix vermiformis

Colonsigmoideum

F i g .1 0 0 0 L a r g ei n t e s t i n eI n, t e s t i n u cmr a s s u m ; ventraL view.

Flexuracoli sinistra Colon Iransversum Colon ascendens

Colon oescenoens Colon slgmoideum Rectum

F i g . 1 0 0 1 L a r g ei n t e s t i n eI,n t e s t i n u mc r a s s u m ; p r o j e c t e do n t ot h e a n t e r i o ra b d o m i n a I w a l L . T h e p o s i t i o n so f t h e t r a n s v e r s ec o t o na n d o f t h e s i g m o i d c o t o na r e h i g h l .vya r i a b t e[ c o m p a r eF i g .1 0 1 0 ) .

Pa n c r e a s Large i ntestine, structure

Colonascendens

Taenia libera

Haustra coli Plicae semilunarescoli

Colon ascenoens

Appendix vermtformis

Papilla ilealis

Plicae semtlunares coll

lleum Noduli lymphoidei aggregati'

Ostium ileale

lleum

Frenulum ostii ilealis Caecum Taenia libera

Appendixvermilormis

vermiformis Ostiumappendicis

F i g . 1 0 0 3 A s c e n d i n gc o t o n ,C o l o na s c e n d e n s ; c a e c u m ,C a e c u m a, n d v e r m i f o r ma p p e n d i xA, p p e n d i xv e r m i f o r m i s ; ventraIview. * CtinicaI S oatches term:PEYER

F i g .1 0 0 2 C a e c u m C , a e c u m v; e r m i f o r ma p p e n d i x , A p p e n d i xv e r m i f o r m i sa, n d t e r m i n a Ii [ e u m , P a r st e r m i n a t i si t e i ; dorsalview.

Plicae semilunarescoli

Omentummajus

Taeniaomentalis

Haustracoli

Mesocolontransversum

Taenia mesocolica Taenia libera

Fig. 1004 Transversecolon,Co[ontransversum; ventroinferiorview.

Appendices omentales lepiploicael

intestinales Glandulae Epithelium Tunicamucosa

Laminapropriamucosae solitarius Noduluslymphoideus mucosae Laminamuscularis

Telasubmucosa

F i g .1 0 0 5 C o t o n C , oton; layersof the wa[t; m i c r o s c o p iec n [ a r g e m e n t at lowmagnification.

Telasubserosa Tunicaserosa

S t o m a c h Sm at[intestineLargeintestine Liver

SplenILienl Lobushepatisdexter

Gaster

Omentummajus Vesicabiliaris Colontransversum Duodenum, Parsdescendens Duodenum, Parsascendens Caputpancreatis Radixmesenterii

Colon descendens

Colon ascendens

Caecum Colonsigmoideum Ampullatubaeuterinae

Ovarium

Vesicaurinaria

F i g . 1 0 0 6 V e r m i f o r ma p p e n d i xA, p p e n d i xv e r m t f o r m i s ; v a r i a t i o n si n i t s p o s i t i o n ; ventraIview.

Anulus umbilicalis Colon ascendens

Colonascendens lleum Appendix vermiformis


Spinailiaca anteriorsuperior

-30%

Appendix vermiformis Caecum

- 65o/o

2 o/o

> | Stom ach I Sm at[intestineI Lar gei ntes ti ne I Li v er Liver

Lig coronarium

Lig.triangulare dextrum

Lig falciforme

Diaphragma

Lig triangulare sinistrum

LobusheDatis sinister. Faciesdiaphragmatica

Lobushepatisdexter, Faciesdiaphragmatica

Lig. talciforme

Lig tereshepatis Margoinferior

Vesica biliaris

Fi1.1012 Liver,Hepar; ventraIview.

lmpressiooesophagea

.. I Parssuperior; Factesoraonraomatca 1 \Area nuda

Appendixfibrosahepatis

V cava inferior

lmpressio suprarenalis

Lig.venosum Lig coronarium Lobuscaudatus V portaehepatis

lmpressio gasrnca

lmpressio renalis Tuber omentale Ductus choledochus lbiliarisl

Proc papillaris

Proc caudatus

A. lobicaudati lmpressio duodenalis

Lobushepatissinister

A cystica

Margo inferior

lmpressio colica

propria A hepatica

Lobushepatisdexter

Fissuraligamenti teretis Incisura ligamenti teretis

Lig teres hepatis

LOOUS quaoralus

Vesica biliaris

F i g . 1 0 1 3 L i v e r ,H e p a r ,a n d p o r t ah e p a t i s P , o r t ah e p a t i s ; dorsaIview. * Borders of thesuperiorrecessof theomentaIbursa

Pan c r e a s

Lig falciforme

Lobusheoatisdexter. Tunicaserosa

Lobushepatissinister, Tunicaserosa

Lig.coronarium

LOOUS

caudatus Appendixfibrosahepatis W hepaticae V. cava inferior (Lig. venae cavae)

F i g . 1 0 1 4 L i v e r ,H e p a r ; s u p e n o rv r e w .

F i g . 1 0 1 5 L i v e r ,H e p a r ,o f a f o e t u s ; oxygencontentof the btoodis shown b y d i f f e r e n ct o [ o u r sa n d t h e d i r e c t i o n of ftow by arrows; dorsaIview. * Atso:DuctusARANTII

> AbdominaIviscera

tt

Liverpuncture

CostaV

Diaphragma Hepar,Lobussinister Hepar,Lobusdexter

Lig teres hepatis

Fig.1016 LiverH , epar; p r o j e c t i o no n t ot h e a n t e r i o r abdominaLwa[t; intermediate p o s i t i o nb e t w e e n i n s p i r a t i oann d e x p i r a t i o n . + Position of the needte for liverpuncture

M intercostalis externus M intercostalis internus

F i g . 1 0 1 7 L a y e r so f t h e a b d o m i n a l w a [ La n d t h e L i v e rH , epar; f r o n t a Ls e c t i o n . * Position of theneedte for liverouncture

F i g . 1 0 1 8a - d L i v e r ,H e p a r ; v a r i a t i o n si n s h a p e a S m a t L[ e f t [ o b eo f I i v e r ,L o b u sh e p a t i ss i n i s t e r b T o n g u e - s h a p epdr o c e s so f t h e r i g h t l o b eo f L i v e r , L o b u sh e o a t i sd e x t e r c B r i d g e df l a t s h a p e d D i a p h r a g m a t ifcu r r o w s

Vesica biliaris

Fancreas structure

coronanum Areanuda

Lt9

coronanum

Facies visceralis

Margo inferior

, epar; F i g . 1 0 1 9 L i v e rH s a g i t t a L s e c t i ot h n r o u g ht h e r i g h t [ o b eo f I i v e rt o d e m o n s t r a t e t h e b r a n c h e so f t h e h e p a t i cv e i n sa n d t h e h e p a t i cp o r t a Iv e i n . * I n t r a h e p a bt irca n c h eosf t h eh e p a t ivce i n s + +I n t r a h e p a bt irca n c h eosf t h eh e p a t ipco r t avI e i na n dt h eh e p a t iacr t e r y

V centralis

Ductusbilifer interlobularis V interlobularis A interlobularis

, epar; Fig.1020 LiverH m i c r o s c o p isct r u c t u r eI m i c r o s c o p iecn t a r g e m e nat t l o w m a qn i fi c a t i o n l ;

t r i a s o f G L I S S OI N c o n s i s t so f a b r a n c ho f t h e h e p a t i cp o r t a L [ i t ed u c t l , v e i n ,a b r a n c ho f t h e h e p a t i ca r t e r yp r o p e ra n d a s m a L b a n d a s m a [ tL i v e lro b u [ es u r r o u n d i n ga c e n t r a lv e i n '

> AbdominaIviscera

tt

Bloodyesselsof the liver

V cava inferior

W hepaticae dextrae

W hepaticae sinistrae

W hepaticaeintermediae

Vesicabiliaris

Ductuscholedochus lbiliarisl

F i g . 1 0 2 1 L i v e r ,H e p a r ,a n d h e p a t i cv e i n s ,V v .h e p a r r c a e ; ventraLview.

Ductushepaticus sinister

V cava inlerior

V portaehepatis,R sinister

A hepatica proprja, R dexter

V portae hepatis, R. dexter

A hepatica propria,R. sinister Ductus hepaticusdexter

Ductuscholedochus lbitiarisl

F i g . 1 0 2 2 L i v e r ,H e p a r ,a n d t h e h e p a t i cp o r t a tv e i n ,V p o r t a eh e p a t i s ; ventraLview.

Pancreas

FissuraportalisprinciPalis Segmentum !l Fissuraumbilicalis Fissuraoortalisdextra Seomentumposterius sinisiruml ll late-rale Seomentumoosterius laleraledexirum[Vll] Lig.falciforme

anterius Seomentum sinistrumIlll] late-rale anterius Seomentum latEraledextrum[Vll Lig tereshepatis

anterius Seomentum m6dialedextrum[Vj

mediale Seomentum sinistrum[V]

Vesicabiliaris

, epar; F i g . 1 0 2 3 L i v e rH areshownin differentcolours; of the Lobes the segments ventratview.

V. cava inferior Lig.triangulare sinistrum (Lig. venae cavae)

Segmentumill Seomentumoosterius la-terale sinistrumilll Lig.venosum

Seomentumanterius ld;ale sinistrum !lll

Seomentumanterius latdraledextrum[Vl]

Seomentumanterius meaialedextrum[V] Lig.tereshepatis Vesicabiliaris

Fig. 1021 Liver,Hepar; of the tobesareshownin differentcotours; the segments dorsaIview.

> Abdominalviscera

tt

Liver,ultrasound

V. hepatica sinistra

V hepatica intermedia

V hepatica dextra

V cava inferior

Diaphragma

Pulmodexter, Lobusinferior

F i g . 1 0 2 5 H e p a t i cv e i n s ,V v .h e p a t i c a e ; u t t r a s o u n di m a g es h o w i n gt h e o p e n i n go f t h e h e p a t i cv e i n s i n t ot h e i n f e r i o rv e n ac a v a i n f e r i o rv i e w . * Abdominatwat[

--t

V portaehepatis, R dexter portaehepatis V portaehepatis, R sinister R anterlor V portaehepatis, R dexter Pars abdominalis aortae

Parslumbalis diaphragmatis

V cava inferior

Parscostalis diaphragmatis

F i 1 . 1 0 2 6 H e p a t i cp o r t a Lv e i n ,V . p o r t a eh e p a t i s ; u t t r a s o u n di m a g es h o w i n gt h e d i v i s i o no f t h e h e p a t i cp o r t a Iv e i n i n t ot h e m a i nb r a n c h e s ; i n f e r i o rv i e w . * A b d o m i nw a Ia [ [

Fancreas Liver,laparoscopy

Diaphragma

Fundusvesicae bitiaris

Colontransversum

Hepar,Lobusdexter

Omentummajus

, s i c ab i l . i a r i lsf e l l . e a ] ; F i g .1 O 2 l L i v e r ,H e p a r ,a n d g a t L b t a d d eVr e l-^--^--^^.,. LdPor uJLUPy,

o b t i o u ei n f e r i o rv i e wf r o m t h e L e f t

Fundus vesicae biliaris

Lobushepatissinister Corpus vesicae biliaris

A ; V cystica

Peritoneumparietale Collum vesicae biliaris Lobus hepatis dexter Duodenum, Pars superior

Fundusgastricus

F i g .1 0 2 8 G a L t b L a d d V e re,s i c ab i L i a r i sl f e t t e a ]a, n d I i v e r ,H e p a r ; Laparoscopy; v e n t r a Iv i e w .

> A b d o m i n avt i s c e r a

tt

Gallbtadder and biLeductsvstem

Lig falciforme Vesica biliaris

Ductuscysticus Ductushepaticus communts Ductushepaticus dexter



Lig hepatoduodenale

Duodenum

Papilladuodeni major

Collum vesicae biliaris

Ductushepaticus communrs Plicae mucosae

Plicaspiralis*

Corpus vesrcae biliaris

Ductus choledochus lbiliarisl


Plicae circulares

Noduli lymphoidei solitarii

Plica longitudinalis duodeni

(Oriliciumductus pancreatici) Papilladuodeni major ""

F i 9 . 1 0 2 9 G a L l . b L a d dVeer s, i c ab i L i a r i sl f e t L e a ] , a n d b i [ ed u c t s y s t e m ; ventraL view * C I i n i c at eI r m :H E I S TsEvRa l v e ** Ctinicalterm t u:b e r c loef V A T E R

F i g . 1 0 3 0a - c V a r i a t i o n si n t h e b i L ed u c t s y s t e m : c o m m o nh e p a t i cd u c t ,D u c t u sh e p a t i c ucso m m u n i s , a n d b i [ ed u c t ,D u c t u sc h o t e d o c h u s . a H i g hu n i o no f t h e c o m m o nh e p a t i cd u c t ,D u c t u sh e p a t i c u s c o m m u n i s a, n d t h e c y s t i cd u c t ,D u c t u sc y s t i c u s b L o w u n i o no f t h e c o m m o nh e p a t i cd u c t ,D u c t u sh e p a t i c u s c o m m u n i s a, n d t h e c y s t i cd u c t ,D u c t u sc y s t i c u s c L o w u n i o na f t e rt h e c y s t i cd u c t ,D u c t u sc y s i i c u sc, r o s s e s o v e rt h e c o m m o nh e p a t i cd u c t ,D u c t u sh e p a t i c u sc o m m u n i s

Pancreas Bileduct system,radiography


Ductushepaticus dexter

Ductushepaticus communrs

Ductuscysticus

Vesicabiliaris


Duodenum

F i g . 1 0 3 1 B i t ed u c t s y s t e m ; A P - r a d i o g r a pahf t e r a d m i n i s t r a t i oonf a c o n t r a s tm e d i u m ; u p r i g h tp o s i t i o n ; ventraIview.

DuctusheDaticus communis Ductuscysticus, Plicaspiralis Collumvesicaebiliaris


Duodenum

Corpusvesicaebiliaris

F i g . 1 0 3 2 G a L t b t a d d eVre, s i c ab i I i a r i s[ f e l . t e a ] , a n d b i l . ed u c t s y s t e m ; A P - r a d i o g r a pahf t e r a d m i n i s t r a t i oonf a c o n t r a s tm e d i u m ; u p r i g h tp o s i t i o n ; ventraIview.

> A b d o m i n avI i s c e r a Pancreas

V cava inferior

V gastricasinistra

Pars thoracicaaortae

A hepatica propria

A gastricasinistra

V portae hepatis

Glandula suprarenalis

Diaphragma


A;V splenicailienalisl

Ductushepaticus communrs Ductus cysticus

Caudapancreatis

A gastroduodenalis Ren

Truncus coeliacus

A ; V mesenterica supeflor

A hepatica communrs

(V gastroduodenalis)

A renalis

Caputpancreatis V renalis Duodenum, Pars descendens A ;V colica medta

l\4 suspensorius duodeni

A ;V colica dextra

Duodenum, Parshorizontalis

Jejunum

M quadratus lumborum i M, psoas major

V mesenterica inferior

A ; V ovarica/testicularis

A mesenterica inferior

Aa ; W jejunaleset ileales

F i g ,1 0 3 3 R e t r o p e r i t o n e a oL r g a n sa n d v e s s e t so f t h e u p p e ra b d o m e n ; ventraLview.

Canalis pyloricus

pyloricus l\4 sphincter Corpuspancreatis Ductuspancreaticus* Ductus choledochus[biliaris]

Cauda pancreatis

Ductus oancreaticusaccessorius'* Papilladuodeni minor NI suspensoriusduodeni"***

Ductus choledochus[biliaris]

Incisurapancreatis

Duodenum, Pars descendens Plica longitudinalisduodeni

Flexuraduodenojejunalis

Papilladuodeni maior**r

Duodenum, Pars ascendens

Plicae circulares

Caputpancreatis Duodenum. Parshorizontalis Proc uncinatus

F i g .1 0 3 4 D u o d e n u mD, u o d e n u m , a n d p a n c r e a sP, a n c r e a s ; v e n t r a Iv i e w * C t i n i c at eI r m :d u c to f W T R S U N G ** Ctinicatterm SA : N T o Rsl N d ul c t *** CtinicaI term:tubercleof VATER *+*+ C [ i n i c at eI r m :m u s c l o e fT R E t T z

Duodenum. Parssuoerior V portaehepatis

communis Ductusheoaticus Ductuscysticus

V splenica lienalis]

FlexuraduodenisuDerior

(Sulcusarteriaesplenicae)

Ductuscholedochus lbiliaris] Corpuspancreatis Ductuspancreaticus Parsdescendens Duodenum, V. mesenterica superior A. mesenterica superior

Caputpancreatis

Proc uncinatus Flexuraduodeni inferior

F i g .1 0 3 5 D u o d e n u mD, u o d e n u m , a n d p a n c r e a sP, a n c r e a s ; dorsaIview.

Parshorizontalis Duodenum,

Ductuscholedochus lbiliarisl Ductus pancreaticus

Pancreas Papilla duodeni mator

e F i g . 1 0 3 5a - f V a r i a t i o n isn t h e o p e n i n go f t h e b i t ed u c t , cuct, D u c t u sc h o t e d o c h u sa,n d t h e p a n c r e a t i d D u c t u sp a n c r e a t i c u s . a L o n gc o m m o np a r r b A m p u [ [ a r ye n t a r g e m e nat t t h e t e r m i n a lp a r t

c d e f

S h o r tc o m m o np a r t S e p a r a t eo p e n i n g S i n g l .o e p e n i n gw i t h a s e p t u md i v i d i n gt h e c o m m o nd u c t A c c e s s o rd y u c t ,D u c t u sp a n c r e a t i c uasc c e s s o r i u s

Pancreatocyticus exocnnus

Insula pancreatica Acini pancreatici

F i g , 1 0 3 7 P a n c r e a sP, a n c r e a s ; m i c r o s c o p recn t a r g e m e nat t l o w m a g n iifc a t i o n .

Ductus excretorius

> A b d o m i n avt i s c e r a Pancreas,

Ductuspancreaticus; Caudapancrealis

Ductushepaticus communts Ductuscysticus

Jelunum

Vesicabiliaris

Ductuscholedochus Ibiliaris]

Duodenum. Pars descendens Ampulla hepatopancreatica

Ductuspancreaticus

F i g .1 0 3 8 P a n c r e a t i c d u c D t , u c t u sp a n c r e a t i c u s ; b i [ ed u c t ,D u c t u sc h o t e d o c h u sa,n d g a L L b t a d d e r , V e s i c ab i L i a r i s[ f e t t e a ] ; A P - r a d i o g r a pshu; p i n ep o s i t i o na; f t e re n d o s c o p i c i n t u b a t i o no f t h e c o m m o ne x c r e t o r vd u c t o f t h e l i v e r

a n d t h e p a n c r e a sa, s w e L [a s i n j e c t i o no f a c o n t r a s tm e d i u m ; ventraIview C t i n i c atLe r m : E R C PI e n d o s c o p irce t r o g r a d ec h o [ a n g i o pancreaticographyi.

V portaehepatis,R sinister Hepar,Lobussinister A mesenterica superior A splenica

Lig teres hepatis

Corpuspancreatis V portaehepatis Hepar, Lobus caudatus

Corpuspancreatis V, splenica

V renalissinistra V cava inferior Cauda pancreatis

Pars abdominalisaortae

Vertebra lumbalisI

F i g . 1 0 3 9 P a n c r e a sP, a n c r e a s ; u [ t r a s o u n di m a g es h o w i n gt h e p a n c r e a sa n d a d j a c e n t [ a r g ev e s s e L isn d e e pi n s p i r a t i o n ;

o b t i q u ei n f e r i o rv i e w . * A b d o m i nw a Ia l L

Pancreas,

Gaster, (Pariesposterio0

Caudapancreatis

Corpuspancreatis

Colontransversum

Flexuracoli dextra

F i g . 1 0 4 0 P a n c r e a sP, a n c r e a s ; t h e g a s t r o c o L li icg a m e n to f t h e g r e a t e ro m e n t u mh a s b e e n d i s s e c t e dt o e x p o s et h e o m e n t a Ib u r s a ; photograph t a k e nd u r i n gs u r g e r y . * D i s s e c t i o[ inn ea t t h eq r e a t eor m e n t u m

M. rectusabdominis

Gaster

Cavitaspleuralis A splenica A gastricasinistra

uapur I CorpusI pancreatis Cauda )

propria A hepatica V cava inferior

V splenica

Hepar

SplenILien] Pars lumbalisdiaphragmatis, Crus dextrum Ren

Truncuscoeliacus

Corpus vertebrae

Parsabdominalisaortae [Aortaabdominalis]

F i g . 1 0 4 1 P a n c r e a sP, a n c r e a s ; c o m p u t e dt o m o g r a p h i ch o r i z o n t asI e c t i o nI C T ] ;

i n f e r i o rv l e w . I n t h i s s u b j e c t t, h e c o e t i a ct r u n k i s [ o c a t e dr e m a r k a b t y[ o w . * A i r b u b b t ien t h es t o m a c h

> Abdominalviscera

, 4--\

Margosuperior

V.splenicalienalisl Facies visceralis.Facies colica

A splenica lienalisl

Hilumsplenicum

Facies visceralis, Facies gastrica

Lig splenorenale

Lig gastrosplenicum

Extremitasanterior

Facies visceralis, Facies renalis

Fi1.1012 Spleen,S p t e n ILienJ; v e n t r o m e d i avIi e w .

Margoinferior

Facies diaphragmatica

Extremitas anterior Extremitasposterior

F i 9 . 1 0 4 3 S p [ e e nS , p L e nI L i e n J ; superolateraIview.

Facies diaphragmatica Tunica serosa; Tunica fibrosa

Facies renalis

TrabeculaesDlenicae

Pulpa splenica

V splenica Iienalis]

Fig. 10t+t+Spleen,SpLen[LienJ; c r o s s - s e c t i otnh r o u g ht h e s p [ e n i ch i t u m ; superomediatview

A splenica lienalis]

H i l u ms p l e n i c u m Facies gastrica

Pancreas

Gaster

Pancreas

Cavitas peritonealis Duodenum Bursa omentalis

Bursa omentalis Colon transversum Jejunum

Omentummajus

aonae

F i g . 1 0 4 5 D e v e l o p m e notf t h e p e r i t o n e acI a v i t yC , avitas p e r i t o n e a [ i sa,n d t h e v i s c e r a rLe L a t i o n s h i p s ; s c h e m a t i cm e d i a ns e c t i o n : Lateratview.

Fig. 1016 Devetopmentof the peritoneaIcavity,Cavitas peritoneatis; s c h e m a t i ch o r i z o n t asI e c t i o n : S U p e n ovr t e w .

Hepar Diaphragma Lig hepatogastricum

Parsthoracicaaortae Oesophagus

Pancreas Bursaomentalis

Cavitasperitonealis Gaster Mesocolontransversum Lig gastrocolicum

Colontransversum Duodenum

Jejunum

Omentummajus Cavitas peritonealis

Colonsigmoideum

Excavatio vesicouterina

Fig. 1017 Devetopmentof the peritoneaL cavity,Cavitas p e r i t o n e a t i sa,n d t h e v i s c e r a rLe L a t i o n s h i posf t h e f e m a L e ; f i n a Is t a t eo f t h e p e r i t o n e acLa v i t yw i t h a d h e s i o no f t h e g r e a t e ro m e n t u mt o t h e t r a n s v e r s ec o l o n ;

Excavatiorectouterina"

s c h e m a t i cm e d i a ns e c t i o n , LateraIview. s i t h t h e p e r i t o n e acI a v i t yv i a T h e o m e n t a Ib u r s ac o r r e s p o n dw t h e o m e n t a If o r a m e n . * C t i n i c at eI r m :p o u c ho f D 0 U G L A S

> AbdominaIviscera Greateromentum

Lig. falciforme

Parspylorica

Lobushepatissinister Gaster,Curvaturamajor Corpusgastricum

Lobushepatisdexter

Lig. teres hepatis

M rectusabdominis

Fundus vesicaebiliaris

Lig gastrocolicum

Colontransversum M. transversus abdominis

Taenia omentalis

M transversusabdominis Omentummajus M. obliquusinternus abdominis M obliquus externusabdominis

Colonascendens, Taenialibera

Colonsigmoideum

Peritoneum parietale

Plica umbilicalislateralis (A ; V epigastricainferior) Linea arcuata Plica umbilicalismedialis (Chorda arteriae umbilicalis) Plica umbilicalismediana (Lig umbilicalemedianum)

F i g . 1 0 4 8 P o s i t i o no f t h e a b d o m i n avl i s c e r a S , i t u sv i s c e r u m , a n d g r e a t e ro m e n t u m ,0 m e n t u m m a j u s .

Pancreas

S p l e e n Topography

Sections Abdominalvisceraof the neonate

Clavicula

fibrosum Pericardium




Pulmodexter,Lobusmedius Pleura Darietalis.Pars mediastinalis

Pulmodexter,Lobusinferior

Lobusinferior Pulmosinister,

Pleuraf Parsmediastinalis parietalis 1' \Harsorapnragmatca Diaphragma

anteriot Splen[Lien],Extremitas Lobushepatissinister

Lig falciforme

major Gaster,Curvatura Colon descendens Lobus hepatis dexter

Omentummajus

V umbilicalis

Intestinum tenue

Plica umbilicalislateralis (A.; V epigastricainferior)

Plica umbilicalismedialis (A umbilicalis)

Vesica urinaria

Plica umbilicalismediana (Urachus) Lig falciforme

Anulus umbilicalis V umbilicalis

F i g . 1 0 4 9 P o s i t i o no f t h e a b d o m i n avl i s c e r ao f t h e n e o n a t e .

> A b d o m i n avI i s c e r a Abdominalviscerain the upperabdomen

Lig falciforme

Lrg coronanum

Diaphragma

Lobushepatissinister, Faciesdiaphragmatica Lobushepatissinister, Faciesvisceralis Lobushepatisdexter, Faciesdiaphragmatica

Fundus gastricus

Lobusquadratus Appendix fibrosahepatis

Omentum minus, Ltg

hepatogastricum

Cardia Recessus costodiaphragmaticus

Vesica biliaris Omentum minus, Llq.

Corpusgastricum, Pariesanterior

hepatoduodenaie Foramen omentale * lepiploicuml

Splen[Lien] Gaster,Curvaturaminor

Lobus hepatis dexter, Facies visceralis

Lig gastrosplenicum


Lig phrenicocolicum Incisura angularis

Ren,Extremitas supenor

Gaster,Curuatura major

Pylorus

Omentummajus Jd- A.: V. gastroJi omentalis sinistra

Flexuracoli dextra Taeniaomentalis

A;Vgastricasinistra

Colontransversum

Mesocolon transversum

Omentummajus,Lig gastrocolicum

F i g .1 0 5 0 P o s i t i o o n f t h e a b d o m i n avIi s c e r ai n t h e u p p e ra b d o m e n ; v e n t r a Iv i e w * A[so:foramenof WtNSLoW

Gaster,Curvatura minor

Hepar,Lobussinister Corpusgastricum

Gaster, Pars pylorica

Gaster,Curvaturamajor

Hepar, Lobus dexter

Vesica biliaris

V gastroomentalis slnistra, B omentalis

V gastroomentalis dextra,Br gastrici Omentummajus

F i g .1 0 5 1 S t o m a c hG , a s t e ra, n d g r e a t e ro m e n t u m ,O m e n t u mm a j u s ; photograph t a k e nd u r i n gs u r g e r y ; ventraLview. * S u r g i c ad Lr a p e ** SurglcaI retractor

Pan c r e a s Abdominalviscerain the upperabdomen

Lobus hepatis dexter, Facies diaphragmatica

Lobushepatissinister,Faciesdiaphragmatica Lig teres hepatis

Recessus supenorDursae omentalis SplenILien], Margosuperior

Lobus quadratus

Plica gastropancreatica LOOUS

caudatus Recessus sprenrcus Vesicabiliaris Corpusgastricum, Pariesanterior Omentumminus, Lig. hepatogastricum

Omentumminus, Lig. hepatoduodenale

Mesocolon Iransversum

Tuber Corpus omentale pancreatis Facies anrerosupeflor

Flexura coli dextra

Gaster, Curvaturamaior inferior Recessus bursaeomentalis Omentummajus,Lig.gastrocolicum

Gaster.Curvaturaminor

F i g . 1 0 5 2 A b d o m i n a I v i s c e rian t h e u p p e ra b d o m e n ; parts of the lesser omentum havebeen removedto expose t h e o m e n t a lb u r s aa n d t h e p a n c r e a s ; o b t i q u ev i e wf r o m s u p e r i o r .

Plica gastropancreatica

Lig. gastrocolicum

Glandula suprarenalis Hepar, Lobus caudatus

Lig gastrosplenicum

Vestibulum bursae omentalis

SplenILien], Margo supenor

Lig.hepatoduodenale

A;V splenica

Pylorus Hilum splenicum


Cauda pancreatis Corpus pancreatis, Facies anterosuperior Taeniaomentalis

Colon transversum

Colonascendens Mesocolon transversum Taenialibera Omentummajus,Lig.gastrocolicum

A.: V colica media

F i g .1 0 5 3 0 m e n t abt u r s aB , u r s ao m e n t a t i s ; a f t e rd i s s e c t i oonf t h eg a s t r o c o [[iicg a m e n t ; o b t i o uvei e wf r o mi n f e r i o r .

Taenia mesocolica

> AbdominaIviscera Abdominalviscerain thelowerabdomen

Omentummajus

Colontransversum

Taenia libera

Appendices omentales [epiploicae]

Flexuracolisinistra

Flexuracoli dextra

Colon ascendens

Taenia libera Colon sigmoideum

Sulci paracolici

Plica ileocaecalis

F i g . 1 0 5 4 P o s i t i o no f t h e a b d o m i n avl i s c e r a S , i t u sv l s c e r u m .

Pancreas Abdominalviscerain the lowerabdomen

Omentummajus Taenia omentalis


Taenia libera

Flexuracolidextra

A ; V c o l i c am e d i a


Lobushepatis dexter, Margoinferior

Pancreas

Duodenum, Pars horizontalis

Jejunum

Taenia libera

Recessus ileocaecales superior et inlerior

Radix mesenterii

Plicae semilunarescoli

lleum, Parsterminalis Sulci paracolici

lleum

Plica ileocaecalis

Caecum Ureter,Parsabdominalis Mesoappendix


F i g . 1 0 5 5 S m a l Li n t e s t i n eI,n t e s t i n u mt e n u e , a n d [ a r q ei n t e s t i n eI,n t e s t i n u mc r a s s u m .

>AbdominaI viscera Abdominalviscerain the lowerabdomen

Colontransversum

Omentummajus Taenialibera

A ; V c o l i c am e d i a

Pancreas, Faciesanteroinferior

Mesenterium

Ureter

Recessus duodenales superioret inferior

Ren, Extremitas inferior Sulci paracolici

Recessus intersigmoideus

Mesoappendix Appendix vermiformis

F i g . 1 0 5 6 S m a t Ii n t e s t i n eI,n t e s t i n u mt e n u e , a n d t a r g ei n t e s t i n el,n t e s t i n u mc r a s s u m .

Pancreas Mesenteric root

Omentummaius

Colontransversum


Flexura coli dextra

Colon ascendens

Duodenum, Parsascendens Duodenum, Pars horizontalis

Plica duodenalis inlerior Taenia libera

Colon ascendens

lvlesenterium Recessus ileocaecalis supenor

Colondescendens


Taenia libera

Recessus ileocaecalis interior Mesoappendix

Vesica urinaria

Colon sigmoideum

F i g . 1 0 5 7 M e s e n t e r yM , esenterium, a n d L a r q ei n t e s t i n eI.n t e s t i n u mc r a s s u m .

> A b d o m i n avI i s c e r a

tt

Mesentericrootand retroperitoneal space

Plica gastropancreatica Lig, hepatogastricum Vestibulumbursae omentalis

Lobus hepatis sinister Ostium cardiacum

Bursaomentalis

Lobuscaudatus, Proc papillaris

A;V

gastricabrevis

Lobus hepatis dexter

Lig gastrosplenicum

Lig falcilorme Lig teres hepatis

Omentum minus Caudapancreatis Fundusvesicaebiliaris

Flexuracolisinistra

Lig hepatoduodenale Corpuspancreatis

l\4esocolon transversum Lig gastrocolicum


Lig. phrenicocolicum

Ren,Extremilas superior Flexuracolidextra

Omentum majus

Gaster,Parspylorica Colon transversum j Flexuraduodenojejunalis Recessus duodenales superioret inlerior

Omentummajus, Lig gastrocolicum Omentummajus

Colon descendens

Colonascendens Colontransversum

Mesenterium

Recessus ileocaecalis superior ileum

Recessus ileocaecalis inferior Colon sigmoideum

Caecum

Recessus retrocaecalis

Mesocolon sigmoideum

Appendix vermilormis

Ureter,Pars pelvica

Ductusdeferens

Mesoappendix

Excavatiorectovesicalis

Vesicaurinaria

F i g .1 0 5 8 P o s i t i o o n f t h e a b d o m i n a L v i s c eSr ai t,u sv i s c e r u m , a n d t h e o m e n t a bI u r s a ,B u r s ao m e n t a L r s A n a r r o w i n d i c a t e st h e o m e n t a Il e p i p l o i cf]o r a m e n .

FnncneaE Retroperitoneal

Lig gastrophrenicum Plica gastropancreatica

Recessus superiorbursaeomentalis

Ostiumcardiacum Lig coronarium,Lig triangularesinistrum Lig gastrophrenicum

W hepaticae

Glandula suorarenalis:Bursa omentalis

V cava inferior

A ;V splenica

Foramen omentale [epiploicum]

Lig gastrosplenicum

Diaphragma


Lig coronarium V portaehepatis; A hepaticapropria Ductushepaticus communts Ducluscysticus

Caudapancreatis

Li9 hepatoduodenale Mesocolon transversum

Ren Duodenum, Pars superior

inferior V mesenterica

Peritoneumparietale

Flexura Duodenum, duodenojejunalis


A ; V gastroomentalis dextra

inferior Ren,Extremitas

Duodenum, Parsdescendens

Recessus duodenales superioret inferior

Ren, Extremitasinterior

Plicaduodenalis inferior

Caput pancreatis

Duodenum, Pars ascendens

A ; V mesenterica supenor Duodenum, Pars horizontalis

A:Vcolicasinistra A mesentericainferior

Radix mesenterii

Aa sigmoideae Plica ileocaecalis A rectalissuperior Recessus ileocaecalis supenor

Becessus intersigmoideus

Recessus ileocaecalis inferior

Ureler, Pars pelvica

l\ilesoappendix

Mesocolon sigmoideum A; V ovarica; Lig suspensorium ovaflt

A ;V iliaca communts

Ampullatubaeuterinae

Linea terminalis

Ovarium

Colon sigmoideum Excavatiorectouterina"

Ltg

Excavatiovesicouterina Vesica urinaria,Fundus vesicae

Tubauterina[Salpinx] teresuteri"'

Pelvis minor

Fundusuteri

, avitas F i g . 1 0 5 9 P o s t e r i ow r a L Lo f t h e p e r i t o n e acLa v i t y C p e r i t o n e a L iasn, d s p l e e n S , p L e nI L i e n Jo, f t h e f e m a L e S i t e so f a t t a c h m e n ot f t h e a s c e n d i n ga n d d e s c e n d i n cg o L o n a r e i n d i c a t e d[ * ] * C l i n i c at eI r m :p o u c ho f D 0 U G L A S * +C t i n i c at eI r m :r o u n d[ i g a m e n t

> Abdominalviscera Abdomi naI arteri es, overview

Truncuscoeliacus

ParsabdominalisaortaelAortaabdominalis] B oesophagealis

A. splenicailienalisl

A. hepatica communis

A gastricasinistra

A. cystica

A. gastroomentalis sinistra

A hepaticapropria A. gastricadextra

A. pancreaticamagna

A. gastroduodenalis

A. caudaepancreatis (A supraduodenalis)

A gastroomentalis dextra

A. pancreaticoduodenalis superior posleflor

A pancreaticadorsalis

A prepancreatica

A mesenterica supenor A pancreaticoduodenalis inferior

A. marginalis coli

A colica media A. colica dextra

A ileocolica

Aa. sigmoideae

Aa jejunales A. rectalissuoerior

A. appendicularis

F i g . 1 0 6 0 A r t e r i e so f t h e a b d o m i n avI i s c e r a ; comi- AbdominaIviscera Coeliactrunk

Lobushepatissinister Lig.tereshepatis

DuctusheDaticus communis

Truncuscoeliacus

A hepaticapropria

Truncuscoeliacus A gastricasinistra

Vesica biliaris

Gaster A. cystica Splen ILien]

Ductus cysticus

A splenicalienalisl A gastricasinistra A hepaticacommunis A hepaticapropria

A gastroduodenalis A gastricadextra

A hepatica communrs

V portaehepatis Ductuscholedochus lbitiarisl

A splenica

A gastrica dextra

A gastroomentalis sinlstra

A pancreaticoduodenalis superiorposterior

A gastroomentalis dextra

A gastroomentalis sinistra

Duodenum

-s0%

A gastroduodenalis

a

A mesenterica superior A gastroomentalis dextra

mesenterica supeflor A hepatica propna, R dexter

A hepatica communrs

-3%

_10

- 3fo

- 12Yo e

d

A gastrica posterior

7To t

F i 9 . 1 0 6 2a - f V a r i a b i L i o t yf t h e a r t e r i a tb L o o ds u p p l . oy f t h e L i v e r . a "Textbookcase" b T h e s u p e r i o rm e s e n t e r i ca r t e r y ,A . m e s e n t e r i c a superior, p a r t i c i p a t eisn t h e s u p p [ yo f t h e r i g h t [ o b eo f t h e L i v e r . c T h e c o m m o nh e p a t i ca r t e r y ,A . h e p a t i c ac o m m u n i s a, r i s e sf r o m t h e s u p e r i o rm e s e n t e r i ca r t e r y ,A . m e s e n t e r i c a superior. d T h e t e f t [ o b eo f t h e l i v e ri s s u p p l . i e bd y t h e l e f t g a s t r i ca r t e r y , A . g a s t r i c as i n i s t r a . e A b r a n c ho f t h e L e f tg a s t r i ca r t e r y ,A g a s t r i c as i n i s t r a s, u p p t i e s t h e L e f t[ o b eo f t h e I i v e ra t o n gw i t h t h e t e f t b r a n c ho f t h e h e p a t i c a r t e r yp r o p e r ,A . h e p a t i c ap r o p r i a . f An accessorb y r a n c ho f t h e h e p a t i ca r t e r yp r o p e r , A . h e p a t i c ap r o p r i a s, u p p t i e st h e l e s s e rc u r v a t u r eo f t h e s t o m a c h .

F i g . 1 0 6 3a - e V a r i a b i t i toy f t h e a r t e r i a Ib L o o ds u p p l . y of the stomach. a " T e x t b o o ck a s e " ,c t o s e da r t e r i a Ia r c a d es u p p L y i n g b o t ht h e l e s s e ra n d t h e g r e a t e rc u r v a t u r e b T h e t e f tg a s t r i ca r t e r y ,A . g a s t r i c as i n i s t r a , p a r t i c i p a t eisn t h e s u p p [ yo f t h e L e f t[ o b eo f t h e L i v e r . c A n a s t o m o s ibs e t w e e nt h e r i g h ta n d l e f t g a s t r o - o m e n t a I a r t e r i e sA , a . g a s t r o o m e n t a t edse x t r ae t s i n i s t r a , at the greater curvature d A b s e n c eo f a n a n a s t o m o s i b s e t w e e nt h e r i g h t a n d l e f t g a s t r o - o m e n t aaLr t e r i e s A , a .g a s t r o o m e n t a L e s d e x t r ae t s i n i s t r a a, t t h e g r e a t e rc u r v a t u r e e An accessoryposteriorgastricartery,A. gastrica p o s t e r i o ra, r i s i n gf r o m t h e s p t e n i ca r t e r y ,A . s p t e n i c a , r a t [o f t h e s t o m a c h . s u p p t i e st h e p o s t e r i o w

Pancreas Arteriesof the upperabdomen,radiography

A hepatica propria

A gastricasinistra

A. hepaticacommunis

Truncuscoeliacus A gastroduodenalis

A. splenica A. gastroomentalis sinistra Pelvisrenalis

Uretersinister

F i g . 1 0 6 4 A r t e r i e so f t h e s t o m a c h ,G a s t e r t; h e s p L e e n , S p t e nI L i e n l ,a n d t h e I i v e r ,H e p a r ; t e d i u mi n t o A P - r a d i o g r a pahf t e rs e t e c t i v e i n j e c t i o no f a c o n t r a s m t h e c o e t i a ct r u n k I c o e [ i a c o g r a p hwyi)t h c o n c o m i t a nvti s u a t i z a t i o n

o f t h e r e n a tp e l v i sd u e t o t h e r e n a te x c r e t i o no f t h e m e d i u m ; ventraIview. * Catheter [oopin theaorta ** Catheter in theaorta

A hepaticapropria, Aa segmenti anterioriset posterioris A hepaticapropria,R dexter

communis A. hepatica

A gastroduodenalis A pancreaticoduodenalis superiorposterior

A. gastroomentalis dextra

A pancreaticoduodenalis superioranterior

F i g . 1 0 6 5 C o m m o nh e p a t i ca r t e r y ,A . h e p a t i c ac o m m u n i s ; A P - r a d i o g r a pahf t e rs e t e c t i v ei n j e c t i o no f a c o n t r a s tm e d i u m i n t ot h e c o m m o nh e p a t i ca r t e r y ; ventraIview.

A pancreaticadorsalis inferior A. pancreatica

*

B r a n c h e st o t h e t e f t t o b eo f t h e t i v e r r e p t a c i n ga s i n g L eL e f tb r a n c h o f t h e h e p a t i ca r t e r y P r o P e r * * A n a c c e s s o r yb r a n c ho f t h e h e p a t i ca r t e r y t o t h e l e s s e rc u r v a t u r e of the stomach * + * C a t h e t e ri n t h e a o r t a

> AbdominaIviscera Vesselsof the upperabdomen

Lobuscaudatus

Lobushepatissinister

Lig teres hepatis

diaphragmatis a Parslumbalis a A gastricasinistra

V cava inferior o

a Truncus coeliacus Vesica biliaris

a A phrenica inferior

Lobushepatis dexter; Lobus

a Parsabdominalis aortae

9uqur drur

A;VcysticaOo

a A. splenica

A hepaticao propna SplenILien]

V portaea hepatis

a V gastricasinistra

Ductus choledochus lbiliarisl A gastroduodenalisa

OaA;V gastroomentalis sinistra

A hepatica a communrs

Omentummajus A gastrica dextra a

Pancreas V prepyloricaO

A;vaa gastroomentalis dextra

a O Rr omentales

F i g . 1 0 6 6 V e s s e l so f t h e u p p e ra b d o m e n .

Pancreas Vesselsof the upperabdomen

A hepatica communis a

a Truncuscoeliacus O A gastricasinistra a o A.;V gastroomentalis sinistra

V cavainferioro

O A phrenica inferior

a A gastrica brevis

aaA;V splenica

a a Rr sDlenici A;Vgastro-aa omentalis dextra A gastro-a duodenalis

Corpus pancreatis

V portaehepatisa A pancreaticoa duodenalis superioranterior

a A pancreaticoduodenalis inferior

Caputpancreatis a A mesenterica supeflor

V mesenterica O supeflor Proc uncinatus

Lig gastrocolicum

a A. epigastrica inferior

F i g . 1 0 6 7 V e s s e Losf t h e u p p e ra b d o m e n

> A b d o m i n avl i s c e r a Superior m esenteric artery

A colica media

A mesenterica superior

a jejunales Aa ileales A. ileocolica

A mesentericainlerior

A caecalis posterior

A appendicularis

200k F i g . ' 1 0 6 8a - d V a r i a b i t i toyf t h e b r a n c h e so f t h e s u p e r i o r m e s e n t e r i ca r t e r y ,A . m e s e n t e r i c a s u p e r i o r s, u p p l . y i ntgh e l a r g e i n t e s tni e a " T e x t b o o ck a s e " ,t h e a s c e n d i n ga n d t h e t r a n s v e r s ec o L o n , C o t o na s c e n d e n se t t r a n s v e r s u ma, r e s u p p l . i e bd y t h r e e Drancnes

1 0% o

6%o

T h e i t e o c o I ia c r t e r y ,A i t e o c o I i c aa,n d t h e r i g h t c o t i ca r t e r y , A . c o L i c ad e x t r a ,f o r m a c o m m o nt r u n k 0 n L yt w o b r a n c h e sa r i s ef r o m t h e m e s e n t e r i ca r t e r yw h i t e t h e r i g h t c o t i ca r t e r y ,A . c o t i c ad e x t r a ,i s a b s e n t D u p t i c a t i oonf t h e r i g h t c o t i ca r t e r y ,A . c o t i c ad e x t r a

A mesenterica superior

Aa jejunaies A colica dextra

Aa. ileales

F i g .1 0 6 9 S u p e r i o rm e s e n t e r i ca r t e r y A , . m e s e n t e r i c sau p e r i o r ; A P - r a d i o g r a pahf t e r i n j e c t i o no f a c o n t r a s tm e d i u mi n t ot h e o r i g i no f t h e s u p e r i o rm e s e n t e r i ca r t e r y ; v e n t r a Iv i e w

* C a t h e t e ri n t h e a o r t a * * C a t h e t e irn t h e c o m m o ni I i a ca r t e r y

Fancreas Vessels


coli a A marginalis

V mesentericasuperior a

superior a A mesenterica aaA;Vcolicasinistra

A colica media a

a Aa jejunales

Flexura coli dextra

JeJunum

Flexura duodeni inferior

a W jejunales

A ;V colica dextra a A ileocolica Aa ileales a

W i l e a l e sa

A ; V epigastrica inferioro a

Caecum


F i g , 1 0 7 0 S u p e r i o rm e s e n t e r i ca r t e r ya n d v e i n ,A . e t V m e s e n t e r i c sa u p e r i o r . T h e a r t e r i e ss u p p L y i ntgh e s m a t Li n t e s t i n ef o r m a s e r i e so f a r c a d e s .

Colon sigmoideum

Liven Inferior m esenteric arterv

A colicamedia A marginalis coli A mesenterica superior

A mesenterica inferior

A colica sinistra

Aa sigmoideae A rectalissuperior

F i 9 . 1 0 7 1a - c V a r i a t i o ni sn t h e b r a n c h e o s f t h ei n f e r r o r m e s e n t e r i ca r t e r y ,A . m e s e n t e r i c ai n f e r i o r . a T h e i n f e r i o rm e s e n t e r i ca r t e r y ,A . m e s e n t e r i c ai n f e r i o r , d i v i d e si n t o t h r e e p a r t ss u p p t y i n gt h e d e s c e n d i n a gn d s i g m o i dc o l o n ,a s w e [ La s t h e r e c t u m

b A n a c c e s s o r ym i d d t ec o t i ca r t e r y ,A . c o t i c am e d i a ,a n s e s f r o m t h e i n f e r i o rm e s e n t e r i ca r t e r y ,A m e s e n t e r i c ai n f e r i o r , c An accessorm y i d d t ec o I i ca r t e r y ,A . c o I i c am e d i a ,a r i s e s f r o m t h e L e f tc o l i ca r t e r y ,A . c o L i c a sinistra. * CtinicaIterm : DECK p o' si n t SU

V mesentericainferior A ascendens

V colica sinistra

A marginaliscoli Crista iliaca Aa sigmoideae


A rectalissuperior

F i g . 1 0 7 2 I n f e r i o rm e s e n t e r i ca r t e r y ,A m e s e n t e r i c ai n f e r i o r ; A P - r a d i o g r a pahf t e r s e t e c t i v ei n l e c t i o no f a c o n t r a s tm e d i u mi n t o t h e o r i g i no f t h e i n f e r i o rm e s e n t e r i ca r t e r y ; v e n t r a Iv i e w * C a t h e t ei nr t h ea o r t a

Fancreas Vesselsof the lowerabdomen

A pancreaticoduodenalisinferiora Flexura duodenoieiunalis

superior a A mesenterica a V splenica

V mesentericaa supenor

Pancreas

a V mesenterica inferior a A mesenterica inferior

aA colicasinistra A a ; V va o jejunales

a OAa;W sigmoideae aoA;Vrectalis supenor Radix mesenterii

Colon sigmoideum

A sacralismedianaa

F i g . 1 0 7 3 I n f e r i o rm e s e n t e r i ca r t e r ya n d v e i n , A . e t V m e s e n t e r i c ai n f e r i o r .

>Abdominat viscera Coeliactrunk

Truncuscoeliacus


A mesenterica superior Parsabdominalisaortae

Discusinteruertebralis Vertebra lumbalisI Discusintervertebralis

F i g , 1 0 7 1 A b d o m i n aaI o r t a ,P a r sa b d o m i n a t i as o r t a e w , i t h t h e c o e l i a ct r u n k , T r u n c u sc o e t i a c u sa, n d t h e s u p e r i o rm e s e n t e r i ca r t e r y ,A . m e s e n t e r i c sa u p e n o r ; u l t r a s o u n di m a g e ;a L m o s itn t h e s a g i t t a p I lane. * A b d o m l nw a Ia t L

Truncuscoeliacus A hepatica communis

A gastricasinistra A splenica A. mesenterica superior

A pancreaticoduodenalis superior posterior

1 0Y o

F i g . 1 0 7 5a - e V a r i a b i L i o t yf t h e c o e I i a ct r u n k , T r u n c u sc o e t i a c u s . a " T e x t b o o ck a s e " ,d i v i s i o no f t h e t r u n k i n t ot h r e e b r a n c h e s b D i v i s i o no f t h e t r u n k i n t of o u r b r a n c h e s c D e v e L o p m eo n ft a h e p a t o s p [ e n ti cr u n k ,T r u n c u s hepatospLe i cnu s

d D e v e t o p m e notf a g a s t r o s p [ e n it cr u n k ,T r u n c u s g a s t r o s p L ei cnu s D e v e [ o p m e notf a g a s t r o s p t e n it cr u n k ,T r u n c u s g a s t r o s p t e n i c uasn, d a h e p a t o m e s e n t e rtircu n k , T r u n c u sh e p a t o m e s e n t e r i c u s

Pancreas space Vesselsof the retroperitoneal

A heoaticacommunis a Vv hepaticaea

Hiatusaorticus Hiatus oesophageus

a a A ; V gastricasinistra

V cava inferiora A hepatica propria a

Gaster,Parscardiaca O Truncuscoeliacus

V portae hepatis O Pars costalis S diaphragmatis


Glandula suprarenalts

oaA;Vsplenica

Ductushepaticus communrs

Caudapancreatis

Ductuscysticus a V mesenterica inferior


aoA;Vmesenterica supenor

Rendexter Duodenum, Pars superior, Ampulla

Jelunum

Duodenum, Pars oescen0ens

Rensinister

Caputpancreatis, Proc uncinatus Duodenum, Parshorizontalis

a Parsabdominalis aortae

N iliohypogastricus {

aA colicasinistra

N i l i o i n g u i n a l i,s

o Bifurcatioaortae

V cava inferior a O O A ; V l u m b a l i sl V

A;V testicularisaa

aoA;Vmesenterica inferior

N cutaneus femoris lateralis

ooA;Vsacralis mediana

([/ psoas mino0, Q Tendo

a A rectalissuperior

A;Viliacaao communrs Mesocolon sigmoideum

N femoralis.:

Fascia iliaca

A ; V c i r c u m f l e x aO a i l i u mp r o f u n d a

A;V iliacaexlernaaO

a a Aa ;W sigmoideae

Ductusdelerens A ; V epigastrica inferiorO a parietale Peritoneum

pace, F i g . 1 0 7 6 V e s s e t so f t h e r e t r o p e r i t o n e as L S i t u sr e t r o p e r i t o n e a Loi sf t, h e m a t e .

> AbdominaIviscera Hepaticportal vein,overview

Oesophagus

W oesophageae

V cava inferior W hepaticae

V splenicaIienalisl

V gastricasinistra

V portaehepatis W gastricaebreves V gastricadextra SplenILien] V cystica V oastroomentalis sinistra Vesica biliaris[fellea]

V mesentericasuperior

V mesenterica inferior

V gastroomentalis dextra V colica media

Vv pancreaticoduodenales

V colica sinistra

Colonascendens

V colicadextra W jejunales; W ileales V ileocolica Colon descendens

V appendicularis

F i g . 1 0 7 7 H e p a t i cp o r t a Iv e i n ,V . p o r t a eh e p a t i s ; v e n t r a Iv i e w

PortocavaI anastomoses

V. hemiazygos

(Plexusvenosussubmucosus) V phrenicainferior V. hepatica

(R.oesophagealis)

V gastricasinistra

V portaehepatis V splenicailienalisl V. renalissinistra V mesenterica supenor

V lumbalis ascendens

V mesenterica inferior V paraumbilicalis

V. cavainterior V colicasinistra V epigastrica superficialis

V iliacacommunis V sigmoidea

V rectalissuperior

V epigastrica inferior V iliaca interna

Vv rectalesinteriores

F i g . 1 0 7 8 H e p a t i cp o r t a Lv e i n ,V . p o r t a eh e p a t i s , and inferiorvena cava,V. cavainferior; semi-schematic; t r i b u t a r i e so f t h e i n f e r i o rv e n ac a v ai n b t u e ; t r i b u t a r i e so f t h e h e p a t i cp o r t a Iv e i ni n p u r p t e ; p o t e n t i apI o r t o c a v aaIn a s t o m o s eas r e i n d i c a t e d bvcirctes.

> Petvicviscera and retroperitoneaI space

U r i n a n yb l a d d e r

Kidney

Margosuperior Aa suprarenales supenores

Capsulaadiposa Capsula fibrosa

I\4argomedialis

Aa suprarenales mediae

Glandula suprarenalis V suprarenalis A suprarenalis interior Margo lateralis

A renalis,B posterior V renalis Hilum renale A renalis,R anterior

Pelvis renalis

V,teslicularis/ovarica sinistra

F i g . 1 0 7 9 K i d n e yR, e n[ N e p h r o s aJ n , d s u p r a r e n agIL a n dG, L a n d u L ap r a r e n a L i s ; su v e n t r a tv i e w I t e f t l . Aa suprarenalessuperiores

Margosuperior


Glandula suorarenalis.Hilum

Capsulaadiposa Capsula fibrosa

Aa suprarenalesmediae W suprarenales

Margo medialis

A suprarenalis inferior Margo medialis

A renalis

V renalis

F i g . 1 0 8 0 K i d n e yR, e n[ N e p h r o s al ,n d s u p r a r e n agI t a n d ,G [ a n d u t a suprarenalis; ventraL v i e w{ r i g h t l .

Genitatia

Cortexrenalis Papillaerenales lMedullarenalis, Pyramides renales

(Basispyramidis)

F i g . 1 0 8 1 K i d n e yR, e n[ N e p h r o s l ; o b L i q ua e n d v e r t i c a Ih e m i s e c t i o n d i s p t a y i n tgh e r e n a Ic o r t e x ,t h e m e d u t [ a a n dt h e p e t v i s ; ventraL v i e w( t e f t J . Arrows point from the pyramidsto the calyces.

Cortexrenalis Calyxrenalismajor

Sinusrenalis

Columnae renales

Pelvisrenalis Calyx renalis major

Medulla renalrs

Calices renales minores

Costa Xl

Costaxll Ren sinister

Ren dexter

Crista iliaca Spina iliaca posterior supeflor

Cortexrenalis

Medulla renalis, Pyramides renales

(Basispyramidis)

Fig. 1082 Projectionof the kidneys o n t ot h e b a c k .

Capsula fibrosa Cortexrenalis

Columnarenalis Areacribrosa, papillaria Foramina Aa interlobares A renalis V renalis

Sinusrenalis;Corpus

Pelvis renalis

Sinusrenalis; adiposum renales Columnae

A arcuata

F i g . 1 0 8 3 K i d n e yR, e n[ N e p h r o s l ; o b t i q u ae n dv e r t i c ahI e m i s e c t i o n ; ventraIviewIteftl.

> Pelvicviscera

U r i nar ybl adder

space andretroperitoneaI Kidney,structure

n

Capsulalibrosa

Cortexrenalis l\4edullarenalis

Aa. interlobares

renales Pyramides

Papilla renalis

Calyxrenalisminor

F i g . 1 0 8 4 K i d n e yR , e n[ N e p h r o s l ; t r a n s v e r s es e c t i o nt h r o u g ht h e r e n a Is i n u s ; i n f e r i o rv i e w I l . e f t ] .

Polusurinarius

Corpusculum renale

Tubulusproximalis

Tubulusdistalis

F i g . 1 0 8 5 K i d n e yR, e n[ N e p h r o s l ; m i c r o s c o o i sc e c t i o no f t h e c o r t e xt 1 0 0 x J .

Genita[ia

Glandula suprarenalis Glandula suprarenalis V cavainferior V renalis Ren

M. psoasmaior Pars abdominalis aortae Ren

Ureter Ureter

Promontorium M. psoasmajor

Epididymis Testis

Urachus A. umbilicalis

A umbilicalis Vesicaurinaria

F i g . 1 0 8 6 K i d n e yR , e n[ N e p h r o s la, n d , t a n d u t as u p r a r e n a t i s , t h e s u p r a r e n agl .L a n dG o f a - 5 - m o n t h - o t df o e t u s

F i g . 1 0 8 7 K i d n e yR , e nl N e p h r o s l ; dorsaIview. T h e l o w e rp o t e so f b o t h k i d n e y sa r e f u s e d ( = h o r s e s h o ek i d n e v ) .

Pelvicviscera andretroperitoneaI space Renalpelvisand calyces

F i g . 1 0 8 8a , b

R e n a Lp e L v i sP, e t v i sr e n a t i s ;

enrrncinn e:ctc.

v e n t r a Iv i e w I L e f t ] a D e n d r i t i ct y p e b A m p u l t a rt y p e

Vertebra thoracicaXll

Papilla renalis

Colon ascendens

Pelvis renalis

Calyx renalis malor

Calyxrenalis mtnor

Papilla renails

Rensinister, Extremitas inferior Colon descendens

M psoas maJor

F i g . 1 0 8 9 K i d n e yR, e n[ N e p h r o s l ; r e n a Lp e L v i sP, e [ v i sr e n a t i sa, n d u r e t e r ,U r e t e r ; A P - r a d i o g r a pahf t e r r e t r o g r a d ei n j e c t i o no f a c o n t r a s tm e d i u mv i a b o t h u r e t e r s

GenitaIia

Segmentum superius

Segmentum anterius supeflus

A. renalis V-renalis Segmentum anteriusinferius

Segmentum inferius

F i g .1 0 9 0a , b R e n asl e g m e n t s , S e g m e n trae n a [ i a .

Truncuscoeliacus

a VentraIview Irightl b D o r s a Iv i e w ( r i g h t l

A. mesenterica suoerior

Parsabdominalisaortae

V suprarenalis sinistra

V. cava inferior

A renalissinistra

A renalis dextra V. renalis sinistra

V renalis dextra

Uretersinister V testicularis/ovarica sinistra Ureterdexter

V. testicularis/ovarica dextra

F i g . 1 0 9 1 K i d n e yR, e n ; areasof contactwith adjacentorgans; ventraIview.

Areasof contactof the kidneys

I I I

Glandulaesuprarenales Hepar Duodenum, Parsdescendens

il I

Colon,Flexuradextra

SplenILienl

Jejunum

Pancreas

Gaster

Colondescendens

> Pelvicviscera andretroperitoneaI space

[-.$nirientrr b[ndder

Kidney,imaging

Ben, Facies anterior

lvledullarenalis,Pyramis renalis

Pelvis renalis

Extremitas superior Diaphragma Extremitasinferior

l\4 psoasmajor

pararenale Corpusadiposum Cortex renalis Ren, Facies posterior

F i g . 1 0 9 2 K i d n e yR , e n[ N e p h r o s J ; u t t r a s o u n idm a g e ; t h e t r a n s d u c e ri s d i r e c t e df r o m v e n t r o i n f e r i ot ro d o r s o s u p e r i o r ; Lateratview Iright). * A b d o m i nw a La [ [

Hepar, Lobus dexter V cava inferior

Cutis

Pars abdominalis aortae

Ren V renalisdextra abdominales

Corpus vertebrae

Ben, Capsula adiposa

Fascia renalis

Proc spinosus Costa Xll

F i g . 1 0 9 3 K i d n e yR, e n[ N e p h r o s l ; p u n c t u r eo f t h e r i g h t k i d n e y ; computed t o m o g r a p h iccr o s s - s e c t i oI C n T]; i n f e r i o rv i e w * G u i d a n coef a n e e d tfeo r k i d n e b yiopsy

GenitaIia Suprarenalgland

A. phrenicainferior Aa suprarenales mediae A. suprarenalis inferior A. renalis Aorta abdominalis Faciesanterior

b - 260/o

a - 34o/o

V.suprarenalis sinistra

c -33%

F i g .1 0 9 4 S u p r a r e ngatIa n o , G [ a n d u [sau p r a r e n a l i s ; v e n t r avI i e wI r i g h t ) .

d

F i g . 1 0 9 5a - d V a r i a b i t i toyf t h e s u p r a r e n aaI r t e r i e s A , a .s u p r a r e n a [ e s , a n d c o u r s eo f t h e s u p r a r e n avt e i n s ,V v .s u p r a r e n a [ e s . a ArteriaI supptyby three arteries ("textbookcase"] b Arterial supplywithout a branchfrom the renaI artery,A. renatis c A r t e r i a ls u p p l yw i t h o u ta d i r e c tb r a n c hf r o m t h e a o r t a ,A o r t a d Courseof the suprarenalveins,Vv.suprarenates

V centralis

F i g . 1 0 9 6 S u p r a r e n agI t a n d ,G [ a n d u t as u p r a r e n a t i s ; crditf2l

confinn.

t a t e r avl i. e wl r i g h t ) .

F i g . 1 0 9 7 S u p r a r e n agI t a n d ,G l a n d u [ as u p r a r e n a l i s ; m i c r o s c o p i ec n [ a r g e m e nat t l o w m a g n i f i c a t i o n .

> Pelvicviscera andretroperitoneat space Urinarybladder

Lig umbilicalemedianum Apex vesicae

Tunicamuscularis

Tunicamucosa

(Plicaemucosae)

Trigonum vesicae internum Ostiumurethrae

Uvula vesicae

Prostata Cristaurethralis

I Urethramasculina, J Parsprostatica I Sinusprostaticus seminalis \ Colliculus prostaticus Utriculus Ductusdeferentes, Ductusejaculatorii

Ductuliprostatici

F i g . 1 0 9 8 U r i n a r yb t a d d e rV , e s i c au r i n a r i a ; p r o s t a t eP , r o s t a t aa, n d u r e t h r a ,U r e t h r a ; venlratvtew.

Peritoneum parietale Vesica unnana Peritoneum parietale

Vesica unnafla

Excavatio rectovesicalis

Symphysis pubrca


Prostata

F i g . 1 0 9 9 U r i n a r yb t a d d e rV , e s i c au r i n a r i a , a [ m o s tc o m p l e t e Lvyo i d e d

, e s i c au r i n a r i a f, i I t e d . F i g . 1 1 0 0 U r i n a r yb t a d d e rV I n t h i s s i t u a t i o nt,h e b t a d d e rc a n b e p u n c t u r e df r o m j u s t a b o v et h e p u b i cb o n ew i t h o u tp a s s i n gt h r o u g ht h e peritoneaIcavity. * P u n c t u rnee e d [ e

Genita[ia Urinarybladder,ductusdeferensandseminalvesicle

Apex vesicae

Lig umbilicalemedianum

Corpusvesicae, Tunicamuscularis

Ductusdeferens

AmDullaductus deferentis

Ampullaductusdeferentis, Diverticula ampullae Glandula vesiculosa

Glandula vesiculosa

Prostata. Facies Dosterior

F i 9 . 1 1 0 1 U r i n a r yb t a d d e rV , e s i c au r i n a r i a d ; u c t u sd e f e r e n t e s , D u c t u sd e f e r e n t e ss;e m i n a Iv e s i c L e sG, L a n d u t avee s i c u L o s a e , and prostate,Prostata; d o r s a Iv i e w .

vestcae Plica interureterica

Corpus vesrcae Plica interureterica Ostium ureteris

Ostium ureteris Trigonum vestcae

Trigonum vestcae

, e s i c au r i n a r i a ; F i 9 . 1 1 0 2a , b U r i n a r yb t a d d e rV e n d o s c o p ivci e wo f t h e o p e n i n go f t h e u r e t e r IcystoscopyJ. a O p e no s t i u mo f t h e u r e t e rw i t h a p e r i s t a t t i c w a v et r a n s p o r t r n u g r i n ei n t o t h e b l a d d e r b C l o s e do s t i u mo f t h e u r e t e r

, e s i c au r i n a r i a ; F i g . 1 1 0 3 U r i n a r yb t a d d e rV e n d o s c o p ivci e wo f t h e m u c o s ai n t h e b o d yo f t h e b L a d d eIrc y s t o s c o p;y l i n f e r i o rv i e w .

Pelvicviscera andretroperitoneaI space

U r i nar ybl adder

Maleurinaryandgenitalorgans,overview

Pelvis renalis

(lnfundibulum ductusparamesonephrici)**

Epididymis

Testislorchisl

(Paradidymis)

-i Ductusmesoneohricus* testis Gubernaculum

DuctusDaramesoneohricus**

Ureier Urachus Ductusdeferens

Vesicaurinaria

Glandula vesiculosa

prostaticus Ulriculus

Ductusejaculatorius

Corpora cavernosa penis

Glandula bulbourethralis Ductusglandulae bulbourethralis

penis Corpusspongiosum (Paradidymis)

Caput epididymidis

Glanspenis (Ductulus aberransinferior)

Appendix testis Testis[Orchis]

Cauda epididymidis

F i g . 1 1 0 4 M a t eu r i n a r ya n d g e n i t a L organs; 0 r g a n au r o g e n i t a I i m a ascutina; d i a g r a mo f t h e d e v e l o p m e n t h : e p a r t st h a t d e g e n e r a t e are d i s p L a y eidn p a t ep i n k ,a n d t h e p o s i t i o no f t h e t e s t i sp r i o r t o i t s d e s c e n ti s i n d i c a t e db y t h e d a s h e d[ i n e ; v i e w e df r o m t h e r i g h t

E p i d i d y m i s = g e n i t a Ip a r t o f t h e m e s o n e p h r o s ; Paradidymi= s r e m n a n t so f t u b u l e so f t h e m e s o n e p h r o s '

W o L F F i a nd u c t * * M U L L E R i a nd u c t + * * J u n c t i o n o f t h e M U L L E R i adnu c t s . Ductus oaramesoneohric

F e m a t eg e n i t a t i a

Fascia cremasterica; M cremaster

Fascia spermaticainterna

Tunica vaginalistestis, Lamina parietalis

Caput epididymidis testis Appendix

Lig epididymidis supenus


(Appendix epididymidis) Extremitas supenor

Sinus epididymidis

testis lvlediastinum

Facies lateralis Margo POSteriOr Lig epididymidis inferius Cauda epididymidis

inferior Extremitas

F i 9 .1 1 0 5 T e s t i sT, e s t i [s0 r c h i s ]a, n d e p i d i d y m iEs p , ididymis; f r o mt h er i g h t viewed

F i 9 . 1 1 0 6 T e s t i sT, e s t i s[ 0 r c h i s ]a,n d e p i d i d y m iEs p , ididymis; f r o mt h er i g h t . viewed

A ; V testicularis Plexuspampiniformis

Caputepididymidis

Fig.11O7 BLoodvessetsof the testis,Testis' t h e e p i d i d y m i sE, p i d i d y m i sa,n d t h e s p e r m a t i cc o r d , Funicutusoermaticus; v i e w e df r o m t h e r i g h t .


U r i nar ybl adder

Testisand epididymis

Plexuspampiniformis

A testicularis

Ductuliefferentestestis

Caputepididymidis

Tunica albuginea

Ductusdeferens Lobulitestis

Corpusepididymidis Septulatestis (Ductulus abetransinferior)

Cauda epididymidis

F i 9 .1 1 0 8 T e s t i sT, e s t i se; p i d i d y m iEs p , ididymis, a n dd u c t u sd e f e r e nlsv a sd e f e r e n sD) ,u c t u sd e f e r e n s ; [ateraIview.

Septumscroti Raphe scroti Lamina visceralist Tunica vaginalistestis

Lobulitestis

Lamina parietalis** Fascia spermaticainterna

M cremaster Septulatestis Fasciacremasterica Fasciaspermatica externa (Cavumserosumscroti)

Tunicadartos Mediastinum testis

Tunicadartos Sinus epididymidis

Corpusepididymidis

Corpus epididymidis

Ductusdeferens Plexuspampiniformis Ductusdeferens

A testicularis

F i 9 . 1 1 0 9 T e s t i sT, e s t i s e; p i d i d y m i sE, p i d i d y m i s , a n d s c r o t u m ,S c r o t u m ; supeflorvrew. * A[so:Epiorchium * * A t s oP : eriorchium

G en i t a t i a Femategenitatia

Ductusdeferensandseminalvesicle

Ductusdelerens

Glandula vesiculosa

vesiculosa Glandula

Amoullaductusdeferentis

Lobusprostataemedius Lobusorostataedexter Lobusorostataesinister Basisprostatae

Urethramasculina

s ,u c t u sd e f e r e n t esse, m i n avIe s i c t e s , F i g .111 0 D u c t u sd e f e r e n t eD G [ a n d u t av e s i c u t o s aaen,dp r o s t a t eP,r o s t a t a ; supeflorvtew

Ductusdeferens

Glandula vesiculosa

Ampullaductusdeferentis

s ,u c t u s d e f e r e n t e s , F i g ,1 1 1 1 D u c t u sd e f e r e n t eD a n ds e m i n avIe s i c l e sG, t a n d u l avee s i c u t o s a e ; t e d i u mv t a A P - r a d i o g r aapfht e ri n j e c t i oonf a c o n t r a sm t h ee j a c u t a t odr yu c t s ; ventraIview.

Fundus vesicae

T h o u g ht h i s t e c h n i q u ed e m o n s t r a t e s i z ea n d p o s i t i o n u n d e rc l i n i c a l o f t h e s e m i n a lv e s i c l e si,t i s n o m o r e a p p L i e d c i r c um s t an c e s .

Ductusdeferens

Ostiumureteris

vesiculosa Glandula

Trigonumvesicae


internum Ostiumurethrae

Urethramasculina.Parsorostatica Prostata Parsintermedia Urethramasculina, Imembranacea]

Cervix vesicae

Prostata Ductuseiaculatorius

, rostata; , e s i c au r i n a r i a ;p r o s t a t eP F i g . 1 1 1 2 U r i n a r yb t a d d e rV vesicutosa; , tanduta d u c t u sd e f e r e n s( v a sd e f e r e n s JD, u c t u sd e f e r e n sa, n d s e m i n a Iv e s i c [ eG v i e w e df r o m t h e r i q h t .

Pelvicviscera andretroperitoneat space

U r i n a r yb t a d d e r

UrinarybLadder andmalegenitalia

Lig umbilicalemedianum Plica umbilicalismediana

Vesicaurinaria

Peritoneumparietale Chorda arleriae umbilicalis

A ; V epigastricainferior A iliaca externa

Ductusdeferens

V iliaca externa Lig inguinale

Plica umbilicalismedialis

Ductus delerens

Ureter Os pubis,Ramussuperior


Excavatio rectovesicalis Glandula vesiculosa

Glandula vesiculosa Ductusexcretorius Ductusejaculatorius

Fundus vesicae

Prostata Os oubis,Bamusinferior

Urethra,Parsintermedia Imembranacea] Cruspenis

Glandula bulbourethralis Bulbuspenis

Corporacavernosapenis

penis Corpusspongiosum

Corona glandis

Glanspenis

F i g , 1 1 1 3 U r i n a r yb t a d d e rV , e s i c au r i n a r i a ;d u c t u sd e f e r e n t e s , D u c t u sd e f e r e n t e ss;e m i n a Iv e s i c t e sG , l . a n d u t avee s i c u t o s a e ; p r o s t a t eP , r o s t a t aa, n d m a [ eu r e t h r a ,U r e t h r am a s c u u n a : dorsaIview.

Genitalia Femategenital.ia

\/

SDina iliaca anteriorsuoerior

Penis,Dorsum

penis Preputium Glanspenis

F i g . 1 1 1 1 , M a t ee x t e r n a g I e n i t a l i a0, r g a n ag e n i t a l i a m a s c u t i n ae x t e r n a .

A ductusdeferentisa

a Plexus deferentialis

Ductusdeferens

a N genitofemoralis, R genitalis

penis Corpuscavernosum

Vasalymphatica Tunicaalbuginea corporum cavernosorum

a A testicularis

Plexuspampiniformis a

o Plexustesticularis Fasciaspermaticainterna

Fasciapenis(prolunda) M. cremaster a Fasciacremasterica; W pudendae externaea

a Fasciaspermaticaexterna a Tunicadartos


F i g .1 1 1 5 S p e r m a t i cc o r d ,F u n i c u L ussp e r m a t i c u s ; f r o n t a Is e c t i o n ; v e n t r a Iv i e w I L e f t2, 5 0 % 1 .

> Pelvicviscera andretroperitoneal space Maleurethra

(Plicae mucosae)

Fundusvesicae Plica interureterica

Trigonum vesicae Ostiumureteris

Uvulavesicae

Pars intramuralis Pars prostatica

Pars intermedia Imembranacea]

Ostiumurethrae internum Colliculus prostaticus seminalis; Utriculus Ductusejaculatorii

Ductuliprostatici Cristaurethralis

Glandula bulbourethralis, Ductusglandulae bulbourethralis

Bulbuspenis Cruspenis Ductusglandulae bulbourethralis

Tunicaalbuginea corporum cavernosorum

Urethra masculina

Corpusspongiosum penis Trabeculaecorporumcavernosorum A profundapenis Pars spongrosa

Aa helicinae

Cavernaecorporumcavernosorum Lacunaeurethrales

Corona glandis

(Valvula tossaenavicularis)

Glanspenis penis Preputium

Fossa navicularisurethrae

Ostiumurethrae externum

F i g . 1 1 1 6 U r r n a r yb [ a d d e rV , e s i c au r i n a r i a ; p r o s t a t eP , r o s t a t aa, n d m a l e u r e t h r a ,U r e t h r am a s c u L i n a ; ventraIview.

Femategenital.ia

V.dorsalis profunda penis V.dorsalis penis superficialis A dorsalispenis

penis A profunda Fascia penis (profunda)

Glanspenis, Coronaglandis Preputium penrs

Tunica albuginea corpons spongrosl

Cutis Tunicaalbuginea corporum cavernosorum

Corpus cavernosum penrs Tunica albuginea corporum cavernosorum

Septumpenis

Fascia penis (profunda)

Corpusspongiosum penrs

Urethra Pars masculina, spongrosa A urelhralis Septumpenis

a Glanspenis; Corpus spongrosum penis,Cavernae corpoflsspongrosl

penis Preputium

Urethramasculina, Fossanavicularis urethrae

Corpus cavernosum penis,Cavernae corpons cavernosl Septumglandis Urethra masculrna

penis Corpusspongiosum preputii Frenulum

d

c

F i g .1 1 1 7a - d P e n i s P , enis; c r o s s - s e c t i o n sp;L a n e si n d i c a t e di n F i g .1118 ; venlraLvtew.

a C r o s s - s e c t i otnh r o u g ht h e m i d d t eo f t h e s h a f t l artof the b C r o s s - s e c t i oant t h e L e v eol f t h e p r o x i m a p g t a n sp e n i s c C r o s s - s e c t i otnh r o u g ht h e m i d d t eo f t h e g t a n sp e n i s d C r o s s - s e c t i oant t h e l e v e Io f t h e d i s t a Ip a r t o f t h e g [ a n sp e n i s

externum Ostiumurethrae Fascia penis (profunda)

Fascia penis (superficialis)

penis Preputium

preputii Frenulum

, t a n sp e n i s , , e n i sw F i g .1 1 1 8 P e n i s P , i t h g t a n sp e n i s G , r e p u t i u mp e n i s . a n d p r e p u c eP

* L e v e lo f s e c t i o no f F i g . 1117 a + + L e v e lo f s e c t i o no f F i g . 1117 b * * + L e v e lo f s e c t i o no f F i g . 1 1 1 7 c * * * * L e v e lo f s e c t i o no f F i g 111 7 d

Pelvicviscera andretroperitoneal space

U r i nar vbtadder

Femaleurinaryandgenitalorgans,overvtew

Pelvis renalis

Ovarium Epoophoron Ductuslongitudinalis,

Ductulitransversi

Ductusmesonephricus*

1t :ut,

Paroophoron

.. .. Lrg Ovarllproprlum

Tuba uterina [Salpinx]

Epoophoron

"\7 Vesicaurinaria

Infundibulum tubaeuterinae

Urachus Appendix vesiculosa

Ovarium Lrg ovanr propflum

Lig teresuteri Ductusmesonephricus*

Urethrafeminina

Glans clitoridis Oslium urethraeexternum

Crusclitoridis Ostium vaginae

Bulbusvestibuli

F i g .1 1 1 9 F e m a t eu r i n a r ya n d g e n i t aoLr g a n s , O r g a n au r o g e n i t a L fi e aminina; d i a g r a mo f t h e d e v e t o p m e ntth: e p a r t st h a t d e g e n e r a t a ere d i s p L a y eidn p a t ep i n k ,a n d t h e p o s i t i o no f t h e o v a r yp r i o r t o i t s d e s c e n ti s i n d i c a t e db y t h e d a s h e dI i n e ; ventraIview.

Glandulae vestibulares majores***

E p o o p h o r o n= g e n i t a Lp a r t o f t h e m e s o n e p h r o s ; P a r o o p h o r o n= r e m n a n t so f t h e t u b u t e so f t h e m e s o n e p h r o s *

W 0 L F F i a nd u c t * * N 4 U L L E R Tdaunc t * * x B A R T H 0 L I N 'gst a n d s

Femalegenitatia

Fimbriaovarica

Ovarium,Extremitas tubaria

Ampullatubaeuterinae

Amoullatubaeuterinae

Margomesovaricus

Ostiumabdominale tubaeuterinae; Infundibulum tubae uterinae

Mesosalpinx

A; Vv ovarica(e)

lsthmustubae uterinae

Fundusuteri

Fimbriae tubaeuterinae

Tubauterina[Salpinx]

Appendix vesiculosa Ovarium. Facies medialis

Ovarium

Lig suspensoriumovarii A.; Vv ovarica(e)

Extremitasuterina Lig.ovariiproprium

Ovarium,Margoliber Ureter

Lig latumuteri

Corpusuteri, Faciesintestinalis lsthmusuteri cervicis Portiosupravaginalis [il. rectouterinus** Plicarectouterina

Excavatiorectouterina; TunicaserosaIPerimetrium]

* C t i n i c atIe r m : c a r d i n a[[i g a m e n t + +C t i n i c a It e r m : s a c r o u t e r i n e[ i q a m e n t

F i 1 . 1 1 2 0 U t e r u sU, t e r u s ; o v a r y , O v aarn, du t e r i n et u b e T , u b au t e r i n a ; dorsatview.

Lig ovariiproprium Stromaovarii lsthmustubaeuterinae Fundusuteri

Mesosalpinx

Ductuslongitudinalis Amoullatubaeuterinae Ductulitransversi

Tubauterina lSalpinxl

Plicaetubariae

Lig.teres uteri*** Lig ovarii propflum

lnfundibulum tubaeuterinae; Fimbriae tubae uterinae

Tunicaserosa IPerimetrium] Cavitasuteri;Tunica mucosaIEndometrium] Tunicamuscularis IMyometrium]

Appendixvesiculosa Fimbriaovarica Corpusalbicans Vv ovaricae;A ovarica ovarici vesiculosi* Corpus luteum

Canalisceruicis uteri, Plicaepalmatae Portiovaginaliscervicis

Ostiumuteri

Lig latumuteri Parsuterina; \Ostiumuterinum,l " ^ . . . ^ . , - ^ Corpusuteri lsthmusuteri Portiosupravaginalis ceruicis

Rugae vaginales

Fi1.1121 Uterus,Uterus; o v a r y , O v aarn, du t e r i n et u b e T , u b au t e r i n a ; dorsalview.

* C t i n i c a tI e r m : G R l A F i afno t [ i c [ e * * S t a t k e dh y d a t i d * * * C t i n i c a l t e r mr:o u n d[ i g a m e n t

Appendix vesiculosa**

> Petvicviscera andretroperitoneal space

Urinaryhi.aelder

]varies and uterus Folliculiovarici primarii

Fi1.1122 Ovary,Ovar; m i c r o s c o p iecn t a r g e m e natt l o w m a g n i f i c a t i o n Facies intestinalis

/

Cavitas uteri

lsthmusuteri Canalis ceruicisuteri

Fundusuteri TunicamucosaIEndometrium]

Fornixvaginae,Parsposterior

Tunicamuscularis lVyometriuml

Peritoneum urogenitale

TunicaserosaIPerimetrium] Facies vesicalis Peritoneumurogenitale,Excavatiovesicouterina Portio supravaginalisceruicis Fornixvaginae, Pars anterior

Excavatiorectouterina Labiumposterius Ostiumuteri Labiumanterius Vagina

F i 1 . 1 1 2 3 U t e r u sU, t e r u sa, n dv a g i n aV, a g i n a ; viewed f r o mt h er i q h t .

Stratum functionale endometriale

Stratum basale endometriale Tunica muscularis

F i g . 1 1 2 1 M u c o s ao f t h e u t e r u s ,U t e r u s ; e a r l yp h a s eo f p r o t i f e r a t i o n

F i 1 , 1 1 2 5 M u c o s oa f t h eu t e r u sU , terus; L a t ep h a s eo f p r o L i f e r a t iwoint he x c r e t o rgy[ a n d s

Femategenitalia

, agina; F i g . 1 1 2 6 U t e r u s ,U t e r u s ,a n d v a g i n aV , n dt h e n o r m a Ia n g t e sb e t w e e nt h e v a g i n at,h e c e r v i x a b o d yo f u t e r u s ; v i e w e df r o m t h e r i g h t . * L o n g i t u d i naaxIi so f t h ev a g i n a ** LongitudinaI axisof thecervixof uterus *** LongitudinaI axisof the bodyof uterus A n g t eb e t w e e nv a g i n aa n d c e r v i xo f u t e r u s= v e r s i o n A n g [ eb e t w e e nc e r v i xa n d b o d yo f u t e r u s= f l e x i o n f the uterus: N o r m a It o p o g r a p h i c a I s i t u a t i o n a n t e v e r s i o na,n t e fl e x i o n R e t a t i o nt o t h e m e d i a np t a n e= p o s i t i o n

Fundus uteri

Fig.1127 a-c Uterus,Uterus,and vagina,Vagrna a A n t e v e r s i o na,n t e f t e x i o=n n o r m a Ip o s i t i o n b A n t e v e r s i o nb,u t n o a n t e f t e x i o n c Retroversion,retrofLexion

tubae Ostiumuterinum uterinae Tubauterina ISalpinx] Cavitasuteri Ampullatubae uterinae

Canaliscervicis uteri

F i 1 , 1 1 2 8 U t e r u sU, t e r u sa, n du t e r i n e t u b eT , u b au t e r i n a ; A P - r a d i o g r aapfht e ri n j e c t i oonf t o c o n t r a sm t e d i u mi n t ot h e c e r v i xo f u t e r u sI h y s t e r o s a I p i n g o g r a p h y l ; u t e r u si n d e x t r o p o s i t i o n ; ventraL view.

T h i sf o r m e r l yc t i n i c a [ Layp p t i e dt e c h n i q u ea t l o w st o d e t e r m i n e t h e p o s i t i o no f t h e o r g a n sa n d t h e p a t e n c yo f t h e t u b e s . K = t u b e a d a p t o rf o r i n j e c t i o no f t h e c o n t r a s tm e d i u m

> Pelvicviscera andretroperitoneat space

U r i nar ybl adder

Arteriesof the femaleinternalqenitalia

Lig ovariiproprium A uterina,R tubarius

Lig teresuteri*

Ovarium

A uterina,R ovaricus

Fundusuteri A ovarica

A ovarica

Llg suspensoflum ovanl

Appendix vesiculosa

Corpusuteri

Ostiumabdominale tubaeuterinae; lnfundibulum tubae uterinae

Ovarium

Lig teresuteri*

Rr helicini

A uterina

A uterina Rr vaginales

Cervix uteri

A vaginalis

A vaginalis

F i g . 1 1 2 9 A r t e r i e so f t h e f e m a L ei n t e r n a Ig e n i t a l i a , 0 r g a n ag e n i t a L ifae m i n i n ai n t e r n a ; dorsaLview. + C [ i n i c at eI r m :r o u n d[ i o a m e n t

Tubauterina

Lrg suspensonum ovafll

R tubarius Fundus uteri (R fundi uteri)

R ovaricus Lig,ovariiproprium Rr helicini

A uterina R vaginalis

> 90%

F i g . 1 1 3 0a - f V a r i b i l . i toyf t h e a r t e r i a Is u p p t yo f t h e f e m a [ ei n t e r n a Ig e n i t a l i a ; dorsaLview. a S u p p l .oy f t h e u t e r u s ,U t e r u s[ " t e x t b o o kc a s e " ] b , c , d S u p p t yo f t h e o v a r i e sO , v a r i aI b , " t e x t b o o kc a s e ] €,f S u p p t yo f t h e f u n d u so f u t e r u s ,F u n d u su t e r i I e . " t e x t b o o kc a s e " ]

Femalegenitatia

Articulatio sacroiliaca (Spatiumretrorectale) (Spatiumpararectale)* Rectum Lig rectouterinum Excavatiorectouterina

Lig.cardinale cervicis]** ILig.transversum

Ceruixuteri vesicouterina Excavatio

(Spatium paravesicale)***

Ureter

Vesicaurinaria Spatiumretropubicum

Ostiumureteris internum Ostiumurethrae

pubica Symphysis

F i g . 1 1 3 1 U t e r u s ,U t e r u s ; u t e r i n eL i g a m e n tasn d c o n n e c t i v tei s s u es p a c e s ; s e m i - s c h e m a t itcr a n s v e r s es e c t i o na t t h e L e v eoLf t h e c e r v i xo f u t e r u s : s u o e n o rv t e w

* C [ i n i c atIe r m : P a r a p r o c t i u m * + C L i n i c at eI r m : P a r a m e t r i u m l e x i s t e n c eo f t h i s s t r u c t u r ei s c o n t r o v e r s i a I l * * * C l i n i c atLe r m : P a r a c y s t i u m

Cervixuteri

Portio vaginalis cervtcts

raoium I anlenus

usilum ] ulefl

I

Labium postenus

Portio vaginalis cervrcts

I l"uiu.

ostiumI anlerlus ulerrl Labium I poslenus

Rugae vagrnares

I o r t i o no f t h e c e r v i xo f u t e r u s ,P o r t i o F i g . 1 1 3 2a , b V a g i n a p v a g i n a l i sc e r v i c i s . s oman a Photograph o f t h e c e r v i xo f a y o u n gn u l t i p a r o u w b Photograph o f t h e c e r v i xo f a y o u n gw o m a nw h o h a s g i v e n b i r t ht o t w o c h i l d r e n

L o r t i o no f t h e c e r v i xt h e of thevaginap F o rt h e i n s p e c t i o n n o r m a t l ys l i t - t i k ev a g i n ai s s p r e a d e db y m e a n so f a b i v a l v e s p e c u t u m{ * ) ; i n f e r i o rv i e w .

.,:'j:.i .


and retroperitoneaI space

F u n i c u l uusm b i l i c a l i s Truncus Caput Membrum inferius

F i g . 1 1 3 3 U t e r u s ,U t e r u s w , ith an embryo; u t t r a s o u n di m a g et a k e ni n t h e e i g h t hw e e k o f p r e g n a n c y ; [ a t e r a Iv i e w ( r i q h t l .

T h e e m b r y oi s i m m e r s e di n t h e a m n i o t i cf t u i do f t h e c h or i o ni c cavity

Caput,Frons Nasus Membruminferius

Labiumsuperius Regiomentalis

Truncus

F i g . 1 1 3 4U t e r u sU, t e r u sw,i t h a f o e t u s ; uLtrasoun d a g et a k e ni n t h e 2 8 t hw e e k o f p r e g n a n c y ; im L a t e r av Ii e w[ l e f t ] .

U L t r a s o u nedx a m i n a t i o a n l t o w st h e v i s u a I i z a t i oonf m o v e m e n r s of the extremitiea s n d t h e o o e n i n oo f t h e m o u t h

D i g i t il l - V Palma Antebrachium

Pollex IDigitusI]

Humerus

F i g .1 1 3 5 H a n d ,M a n u s o, f a f o e t u s; u [ t r a s o u n di m a g et a k e ni n t h e 1B t hw e e ko f p r e g n a n c y ; L a t e r avI i e w

D e t a i [ ss u c ha s f i n q e r sc a n b e o b s e r v e d .

Femalegenitatia

V umbilicalis

Aa umbilicales

Fundusuteri Colonsigmoideum

Fornix vaginae, Pars posteriol

Placenta

Os coccygis

Fascia rectovaoinalis ISepturi'rectovaginale]

Linea alba

CorpusanococcygeumILig anococcygeuml

Excavatio vesicouterina

pubica,Discusinterpubicus Symphysis Vesicaurinaria Clitoris, Corpuscavernosum clitoridis M sphincter aniexternus

Glans clitoridis

perineiprolundus M transversus Labium majus pudendi

Urethrafeminina

Labiumminuspudendi urethrae M sphincter

F i g .1 1 3 6 U t e r u sU, t e r u sw, i t ha f o e t u s ; n t h em e d i a np t a n e . t h ep e l v i sh a sb e e ns e c t i o n ei d * M u c o u sp L u gI o f K R I S T E L L Ei nRtIh e c e r v i c a Ic a n a Lo f t h e u t e r u s * * C [ i n i c atLe r m : p o u c ho f D 0 U G L A S * * * C [ i n i c atLe r m :v e s i c o v a g i nsael p t u m * * + *C [ i n i c a tI e r m : c a v eo f R E T Z | u s


Fig.1137 Uterus,Uterus; p o s i t i o no f t h e f u n d u so f u t e r u sd u r i n gp r e g n a n c y N u m b e r sr e f e rt o t h e e n d o f t h e r e s p e c t i v e m o n t ho f p r e g n a n c y[ = 2 8 d a y s ) .

> Petvicviscera andretroperitoneaI space Placenta

F i g . 1 1 3 8 a ,b P l a c e n t aP, l a c e n t aa, n d u m b i t i c acI o r d ,F u n i c u I u su m b i t i c a l i s . a View of the foetaIsurface b V i e wo f t h e m a t e r n a Is u r f a c eo f a p a r t u r i e n tp [ a c e n t a

U r i nar ybtadder

Genitalia Femategenitalia

tubes

Appendix vermilormis

Fimbriae tubae uterinae A; V ovarica

Caecum Lig suspensorium ovarii* lnfundibulum tubaeuterinae Ampulla tubae uterinae

Ampullatubae uterinae l\4esosalpinx

Ovarium, Facies medialis

lsthmustubae uterinae l\4argo mesovaricus

Lig latumuteri

Lrg ovarii proprium

I id

tarac

' 'tAri

Excavatio vesicouterina Plica umbilicalismedialis Plica umbilicalismediana

Uterus, Facies vesicalis

Vesica urinana

genitaLia, F i g . 1 1 3 9 F e m a [ ei n t e r n a L e m i n i n ai n t e r n a ; 0 r g a n ag e n i t a L fi a ventraIview. * C t i n i c at et r m :i n f u n d i b u [ o p eI Li gvai cm e n t

Colon sigmoideum

Fimbriae

Tuba uterina

Ovarium

Ampulla

Lrg ovanl propflum Facies intestinalis

Uterus

Fundus

Fimbriae tubae uterinae

Lig teres uteri

Facies vesicalis

Ovarium

Fig.I1t0 FemaLe i n t e r n a Ig e n i t a L i a , 0 r g a n ag e n i t a I ifae m i n i n ai n t e r n a ; s u r g i c ae I x p o s u r ei n a y o u n gw o m a n ; o v a r i e sd i s p t a c e db o t h m e d i a L Layn d s u p e r i o r l yb y c o m p r e s s e s[ * Ji n t h e p o u c ho f D 0 U G L A S ; v e n l r o s u p e f l ovrt e w ** Swab

F i g . ' 1 1 1 1 A b d o m i n aol s t i u mo f t h e u t e r i n et u b e , 0 s t i u m a b d o m i n a t teu b a eu t e r i n a e ; s u r g i c a L e x p o s u irnea y o u n gw o m a n ; t h e p e t v i cc a v i t yi s f i t t e dw i t h s a t i n et o d e m o n s t r a t e t h ef i m b r i a ; d o r s o s u p e r i ovri e w . * P l a s t itcr a yt o s u p p o rt th eu t e r i n teu b e


U r i nar ybtadder

Rectum

Flexura sacralrs

Tunica muscularis, Stratum longitudinale

M. levator ani

Flexura anorectalis lperinealisj Telasubcutanea, Panniculus adiposus

F i g . 1 1 t + 2 R e c t u m ,R e c t u m ; viewedfrom the Left.

A rectalissuperior V. iliaca communis V cava inlerior V sigmoidea


V. sacralis mediana

Plicatransversarecti"*

V. rectalissuperior

Ampullarecti

Ampullarecti

(Spatium pararectale) Plexusvenosus rectalis M levatorani Columnae anales M sphincter ani internus

Junctioanorectalis W rectales meorae Sinusanales A pudenda interna Columnae anales W rectales inferiores Pectenanalis

M. sphincter aniexternus

F i g . 1 1 1 3 R e c t u m ,R e c t u m ; b l o o ds u p p [ y t; h e m u c o s aa n d t h e p a r a r e c t a L a d i p o s et i s s u e sh a v eb e e np a r t t yr e m o v e d ; o p e n i n g si n t ot h e h e p a t i cp o r t a Iv e i ni n p u r p t e .

Noduli lymphoidei solitarii

M. levator ani M sphincterani internus

Valvulaeanales M. sphincter ani externus Linea anocutanea

F i 1 . 1 1 1 1 R e c t u m ,R e c t u m ,a n d a n u s ,A n u s ; ventraL view * H a e m o r r h o i dn ao Id e X * K O H L R A U S C H ,f so [ d

G en i t a l i a

Columnaanalis Canalisanalis

Sinus analis

F i g . 1 1 4 5 R e c t u m ,R e c t u m ; e n d o s c o p i icm a g eo f t h e a n a Ic a n a [w i t h s i x e n L a r g e d n o d e so f t h e c a v e r n o u sr e c t a Ib o d y ,h a e m o r r h o i d s ; suoeflorvtew. * Co[onoscope +*ThreehaemorrhoidaI nodes

Plicatransversarecti

F i $ . 1 1 1 6 R e c t u mR, e c t u m ; e n d o s c o pi im c a g eo f t h er e c t a I a m p u [ILr a ectoscopy); i n f e r i ovr i e w .

> Pelvicviscera

U r i nar ybtadder

andretroperitoneaI space Arteriesof the rectum

A mesenterica inferior Parsabdominalisaortae A rectalissuperior* A. sacralis mediana

A. iliaca communis

A. gluteasuperior

A iliaca interna

Canalisobturatorius A. iliaca externa

Spinaischiadica

A gluteainferior M obturatorius internus A. pudenda interna

Rectum

A obturatoria

M levatorani

A. rectalismedia A. rectalisinferior

Tuberischiadicum M. sohincter ani externus

Fig.11t7 Rectaa I r t e r i e sA , a .r e c t a t e s ; dorsaIview. * C [ i n i c at eI r m :S U D E c Kp'osi n ltf r o mt h i sp o i not nt h e r ea r e nof urtheranastomoses withthesiqmoidarteriesl

GenitaIia

V iliaca communts

V cava inferior

W sigmoideae

V rectalis supenor

Colon sigmoideum

V gluteasuperior

Canalis obturatorius

V. iliaca interna

V. iliaca externa Spina ischiadica

V.gluteainferior

V obturatoria V pudenda interna

M. obturatorius internus

V rectalismedia M. levator ani

W rectalesinferiores

Plexusvenosus rectalis

Tuberischiadicum

ani M. sphincter externus

Fig. 1148 RectaIveins,Vv.recta[es; d i a g r a mw i t h p a r t so f t h e p e l v i sa n d t h e p e t v i c diaphragm; dorsaIview. T h e r ea r e n u m e r o u sc o n n e c t i o nbs e t w e e nt h e v e i n s d r a i n i n gi n t ot h e h e p a t i cp o r t a Iv e i nI s u p e r i o r r e c t a Lv e i n Ja n d t h o s ed r a i n i n gi n t ot h e i n f e r i o rv e n a . h e yf o r m c a v aI m i d d [ ea n d i n f e r i o rr e c t a tv e i n s l T t h e p o r t o c a v aaIn a s t o m o s e sw, h i c ha r e o f p a r t i c u t a r c t i n i c a iIm p o r t a n c e .


U r i nar ybl adder

lnnervation of the rectum

Plexus coeliacus;Ganglia coeliaca

Truncuscoeliacus

Pars abdominalisaortae

Gangliatruncisympathici

A mesentericainferior

Plexushypogastricus superior

A iliaca communis

(S 2-S 5) Radices anteriores

N hypogastricus dexter Plexushypogastricus inferior

Plexusrectalissuperior Plexusrectalismedius Plexusrectalisinferior

M ievator ani

N pudendus Nn. anales

N4.sphincter aniexternus

Fig. 111+9 Rectum,Rectum; s c h e m a t i co v e r v i e wo f t h e i n n e r v a t i o n ; ventratview. Green = sympatheticnervoussysiem Purpte = parasympatheticnervoussystem

Genita!.ia Rectum,radiography

Os sacrum Colonsigmoideum

, a m u si n f e r i o r O s p u b i sR

Ampullarecti

Os coccygis

M gluleusmaximus Tuberischiadicum

Canalisanalis

T h e t r a n s i t i o n azI o n eb e t w e e nt h e a n u sa n d t h e r e c t u m[ a r r o w l i s [ o c a t e da t t h e L e v eoI f t h e t i p o f t h e c o c c y x[ t r i a n g t e ) . T h e a n g L eb e t w e e nt h e a x e so f t h e a n u sa n d t h e r e c t u m[ 4 ] 9 y0 ' a n d d e p e n d su p o nt h e c u r v a t u r eo f t h e is approximateL . c a t ei n c m l e v a t o ra n i m u s c [ e{ p u b o r e c t amLu s c t e )S

F i g .1 1 5 0 R e c t u mR , ectum; I a t e r a Lr a d i o g r a p hi n v o L u n t a rcyt o s u r eo f t h e a n u sa f t e rf i L t i n g w i t h a c o n t r a s tm e d i u mI d e f a e c o g r a p h y l .

Iemoris Caout Os sacrum Femur,Corpustemoris

Colonsigmoideum

Os pubis,Ramusinferior Os coccygis

Ampulla recti

Tuber ischiadicum l\il gluteus maximus

, ectum; F i g .1 1 5 1 R e c t u mR g ith a contrast t a t e r a Lr a d i o g r a p ho f t h e d e f a e c a t i oanf t e rf i L t r n w m e d i u mI d e f a e c o g r a p h y )

I n c o m p a r i s otno F i g 1 1 5 0t,h e a n o r e c t a L t r a n s i t i oznoanI eh a s [ 4 ] i n c r e a s etdo 1 3 7 od u et o t h e d e s c e n d eadn dt h e a n g L e r e L a x a t i oonf t h e c u r v a t u r eo f t h e l e v a t o ra n i m u s c L eA s t h e , e e t o n g a t i o rne s u L t si n a n u n i m p e d e d b e n d i n ga c t st i k ea v a L v et h p r e s s u r eo f t h e f a e c e so n t h e a n a Ic a n a Ll e a d i n gt o d e f a e c a t i o n .

Pelvicviscera andretroperitoneaI space Arterial supplyof the kidney

Ren.Extremitassuoerior

, Vertebralumbalisl, Proc costalis A arcuata A. renalis A. interlobaris

Ren,Margomedialis

A. segmenti A. renalis Calyxrenalis

Ren, Margo lateralis

Pelvisrenalis

Ureter,Parsabdominalis Ben,Extremitas inferior

Crista iliaca

Fig.1152 Kidney,Ren; A P - r a d i o g r a pahf t e r i n t r a v e n o u isn j e c t i o no f a c o n t r a s t m e d i u mw h i c h i s e x c r e t e dv i a t h e k i d n e y st o d e m o n s t r a t e the renaI petvisand the ureters IintravenouspyeLographyl;

c o n c o m i t a nvti s u a t i z a t i oonf t h e a r t e r i e sb y i n j e c t i o n o f a c o n t r a s tm e d i u mi n t ot h e r e n a Ia r t e r yt h r o u g h a c a t h e t e r *i n t r o d u c e di n t ot h e a o r t a( a r t e r i o g r a p h y l .

(A.renalispolarisinferior)

F i g . 1 1 5 3a - d V a r i a t i o n isn t h e a r t e r i a ls u p p t yo f t h e k i d n e y . a O n er e n a Ia r t e r y ,A . r e n a [ i sw , i t h a b r a n c ht o t h e s u p e r i o rp o l e b T w o r e n a Ia r t e r i e st o t h e r e n a Ih r t u m c T w o r e n a Ia r t e r i e s o , n e o f w h i c hs u p p l i e st h e s u p e r i o rp o t e d T w o r e n a ta r t e r i e s o , n e o f w h i c h s u p p L i etsh e i n f e r i o rp o l e

Genitalia peritoneaI space,overview Retro

A , : V p h r e n i cian f e r i oar a Vv hepaticae o

A phrenicaa inferior

(Facies contacta hepatis)


Gaster, Hiatus oesophageus Parscardiaca O aA ; V phrenicainferior media; a A suDrarenalis sinistra a V suprarenalis Glandula suprarenalis

Peritoneum parietale

OaA;V.renalis Truncuscoeliacus a) a Mm.intercostales

A mesentericaa supenor

Ren inferior;a A suprarenalis V suprarenalis dextraO (A renalis a accessona) V cava inferiorO

a a A ; V testicularis Costa Xl

A;V renalisOa Ren, Capsulaadiposa

* N subcostalis

Ureter

a a A.; V lumbalisI

M obliquusexternusa abdominis

& N. iliohypogastricus

M obliquusinternusa abdominis

a A. mesenterica inferior

M transversust abdominis

* N. ilioinguinalis

V;A testicularis o a

o M. quadratus tumoorum

M psoasmajora

Lig iliolumbale

Aa sigmoideae a

a A colicasinistra

(M psoasminor)a

& N cutaneus femorislateralis

Aa ;Vv iliacae a a communes

a lvl iliacus

/-

I H. remorails, f . oentto-1 Temorails I

a

ooA;Viliolumbalis, Rr iliaci

naniratic

$ N femoralis

A;V iliacainternaaa

'' \

o H. remorails N. genitoI * R. genitalisJ femoralis

Mesocolon sigmoideum

a A iliacainterna

Excavatio rectovesicalis Plica umbilicalismedialis

Vesicaurinaria

O A rectalissuperior inferior o a A ; V epigastrica aaA;Vsacralismediana

M. rectus abdominis a

Colonsigmoideum

Plica umbilicalismediana

Pars abdominalis aortae

V renalissinistra

V cava inferior

a V renalis dextra A testicularis dextra A testicularis sinistra

-80%

tructures, F i 1 . 1 1 5 1 P o s i t i o no f t h e r e t r o p e r i t o n e as L S i t u sr e t r o o e r i t o n e a t iosf,t h e m a t e . W h e r e a st h e L e f t e s t i c u L avre i no p e n si n t o t h e l e f t r e n a lv e i n , t h e r i g h t t e s t i c u t a vr e i nd r a i n sd i r e c t t yi n t o t h e i n f e r i o rv e n a c a v a .T h e s a m ea p o t i e st o t h e o v a r i a nv e i n s .

F i g . 1 1 5 5a , b V a r i a b i t i toyf t h e c o u r s eo f t h e t e s t i c u t a r a r t e r i e sA , a .t e s t i c u L a r e s . a "Textbookcase" , a .t e s t i c u t a r e sb,r a n c ho f f r r t e r i e sA b B o t ht e s t i c u t a a c r a n i a t Ltyo t h e r e n a Iv e i n s ,V v .r e n a t e st;h e r i g h t a r t e r y passesposteriorto the inferiorvenacava,V.cavainferior, a n d t h e l e f t a r t e r yp a s s e sa n t e r i o rt o t h e l e f t r e n a Iv e i n , V . r e n a t i ss i n i s t r a .

> Pelvicviscera

U r i nar vbtadder

andretroperitoneal space Lymphatics of the retroperitoneal space

W hepaticae a V cava inferiorO

A phrenica a inferior

Nodi lymphoidei phrenici inferiores

a A renalis Truncusintestinalis a A mesenterica supenor

Cisterna chyli

a Parsabdominalis aonae

Truncuslumbalis dexter

Nodi lymphoidei lumbales intermedii

Nodilymphoidei lumbales dextri

V cavainferiora a A iliaca communrs Ureter o V iliaca communts Nodi lymphoidei iliaci interni Mesocolon sigmoideum

Colonsigmoideum

Nodi lymphoidei inguinales superficiales,Nodi superolaterales*

A femoralis o

Fascia cribrosa

V femoralis a

N femoralis l Nodi lymphoideiinguinales,(Nodi profundi)

a V saphena magna

V saphena magna O

ilioinguinalis


F i g . 1 1 5 5 L y m p hn o d e s ,N o d it y m p h o i d e ai ,n d L y m p h a t i c s , V a s al y m p h a t i c ao, f t h e p o s t e r i o a r b d o m i n aw I a | .a [ ndthe i n g u i n arLe g i o n ; v e n t r a Iv i e w

T h e n u m b e r sX a n d X l l i n d i c a t et h e r e s p e c t i v rei b s . * C t i n i c at eI r m : h o r i z o n tcahI a i n "d, r a i n i ntgh eL o w earb d o m i n a t w a t l t h eg l u t e arIe g i o nt h , ep e r i n e u m a n dt h ee x t e r n agte n i t a l

GenitaIia Lymphatics of theretroperitoneal

radiography

Truncuslumbalis sinister

Vas lymphaticum efferens

Noduslymphoideus icialis inguinalis superf

Vasa lymphatica afferentia

, d l y m p hn o d e s , F i g . 1 1 5 7 L y m p h a t i c sV, a s aL y m p h a t i c a n N o d iL y m p h o i d eo if,t h e i n g u i n a [t ,h e p e L v iacn dt h e Lumbaregion; A P - r a d i o g r a pahf t e r b i l a t e r a itn j e c t i o no f a c o n t r a s t m e d i u mi n t o L y m p h a t i cosf t h e f o o t ( t y m p h o g r a p h y ) . nnd t hse p o s i t i o a T h i sf o r m e r t ya p p L i etde c h n i q u vei s u a L i z e s i z eo f l y m p h a t i c sa n d L y m p hn o d e s .

> Petvicviscera andretroperitoneat space

U n i n a r yb l a d d e r

Neryesof the retroperitoneal space

& N vagus[X],Plexusoesophageus N splanchnicus major,*

Oesophagus ." Plexus coeliacus

Costa Xll

N subcostalis ,

O Truncuscoeliacus

lumborum O l\4.quadratus

N iliohypogastricus *

6 Truncussympathicus

N ilioinguinalis{

* Plexusmesentericus inferior

Cristailiaca

N genitofemoralis{

,* N temoralis

a M. iliacus

N obturatorius{9

Truncuslumbosacralis * & Plexussacralis

F i g . 1 1 5 8 N e r v e so f t h e p o s t e r i o a r b d o m i n aw Lat[, , t e x u s[ u m b o s a c r a t i sa,n d t h e L u m b o s a c r apLt e x u s P t h e a b d o m i n apI a r t o f t h e a u t o n o m o u sn e r v o u ss y s t e m , P a r sa b d o m i n a I iasu t o n o m i c a : ventraLview.

Genitatia Vessels and

A Dhrenica inferioro N. splanchnicusmajor ''

V cavainferiora A t V r e n a l i so* a

retroperitoneal

Hiatus oesophageus

superior a A mesenterica a Truncuscoeliacus ascendens a V lumbalis lumborum o l\il quadratus * N subcostalis

A;VtesticularisOo * Truncus sympathicus a Parsabdominalis aortae O A mesenterica inferior

aaA;Viliaca communls

N iliohypogastricus,

a A lumbalislV I Truncus lumbosacralis

genitolemoralis ,

a A iliolumbalis, R iliacus N ilioinguinalis.

,r, N obturatorius

a A iliolumbalis M psoasmajora * Rr musculares

s N ilioinguinalis N femoralis ,.,

a M transversus abdominis & N. cutaneus femorislateralis

& N genitofemoralis, R genitalis aaA;Vcircumflexa iliumprotunda

Ureter,Parspelvica

Ductusdeferens A ;V sacralismedianaa a

r bdominal F i g . 115 9 V e s s e Lasn d n e r v e so f t h e p o s t e r i o a watlof the male. * I n - 1 0 %t h e[ e f tr e n avI e i np a s s epso s t e r i ot or t h ea o r t a .


U r i nar ybl adder

lnnervation of the maleaenitalia

F i 9 . 1 1 5 0 M a t eg e n i t a t i a , a ascutina; 0 r g a n ag e n i t a L im d i a g r a md e m o n s t r a t i n tgh e a u t o n o m o u si n n e r v a t i o n o f t h e [ e f ts i d e ; ventraIand LateraIview, respective[y. Green= sympatheticneryoussystem Purpte= parasympatheticnervoussystem

Medulla spinalis

eflgent nerves

S u r g i c a rI e m o v a o I f p a r a a o r t i cl y m p hn o d e so r o p e r a t i o n sa t t h e a b d o m i n aaI o r t aa n d t h e [ a r g ea r t e r i e so f t h e p e t v i sc a n c a u s ed a m a g et o t h e s y m p a t h e t i n c e r v e sw i t h t h e c o n s e q u e n c e o f e j a c u L a t o ri m y p o t e n c yI l m p o t e n t i ag e n e r a n d i lP. r o s t a t e o p e r a t i o n si ,n t u r n , m a y d a m a g et h e p a r a s y m p a t h e tfi icb r e s i n n e r v a t l n tgh e p e n i s ,t h u s [ e a d i n gt o e r e c t i t ei m p o t e n c y l l m p o t e n t icao e u n d i J .

Piexushypogastricus superior Plexustesticularis A. testicularis Ductusdeferens

Glandula vesiculosa Vesicaurinaria Prostata Glandula bulbourethralis penis Corpusspongiosum N hypogastricus sinister


Plexus deferentialis

Plexusprostaticus Plexus hypogastricus inferior Ganglia pelvica, Radix

Urethramasculina

parasympathica INn splanchnicipelvici]*

Glanspenis

Plexustesticularis Plexus deferentialis

l n n e r v a ti o no f th e ma teg e n i ta ti a Parasympathetic

Sympathetic

SacraLpart of t h es p i n a l c o r d l S 2- 5 4 l Thoracicpart of the s p i n a Ic o r d t T 1 0- T 1 2 l

G a n g l . ipae L v i c aR,a d i x para parntca nchnicp i elviciJ lNn.

Penis C o r p u sc a v e T n o s u m

Vasodi[atation Erection

P [ e x u sm e s e n t e r i c i s u p e r i o re t i n f e r i o r J

Testis

Regulatioo n f b l o o df t o w

T-,,^^,,-

-,,-^^+ki^,,^ Jyt t tPoU ilLu>

.1,

P t e x utse s t i c u L a r i s J

L u m b a rp a r t o ft h es p i n a L c o r dl L 1 - L 2 l

P t e x uhs y p o g a s t r i csuusp e r r o r J

N hypogastricus J

P L e x uhsy p o g a s t r i c u s rnreTror

Somatomotor, somatosensory

C-^-^l ^^-+ ^{ JOUr dL Pdr I Ul

N pudendus

t h e s p i n a cL o r d

ts2- s4l

N n . s c r o t a l e sp o s t e r i o r e s N . d o r s a L ipse n i s

Fvnrrlcinn ^f itc flrirl G L a n d u tbau L b o u rethra[is D u c t u s( v a s ld e f e r e n s C o n t r a c t i o nt r, a n s p o r to f t h e s p e r m si n t ot h e u r e t h r a G L a n d u tvae s i c u L o s a E x p u L s i oonf i t s c o n t e n ti n t o Prostata the urethra I M s p h i n c t evre s i c a e ] C t o s u r eo f t h e u r i n a r y btadd to preventretrograde eJacu ron M i s c h i o c a v e r n o s u s E x p u L s i oonf t h e e j a c u L a t e M bulbospongiosus outofthe urethraS c r o t a sI k i n P e n i [ es k i n

G en i t a I i a lnnervation

Medulla spinalis

F i g . 1 1 6 1 F e m a l eg e n i t a t i a , 0 r g a n ag e n i t a t i af e m i n i n a . d i a g r a md e m o n s t r a t i n tgh e a u t o n o m o u si n n e r v a t i o n ; ventraIview. c e r v o u ss y s t e m G r e e n= s y m p a t h e t i n Purp[e= parasympatheticnervoussystem * C t i n i c at eLr m :F R A N K E N H A UgSaEnR g L' si o n ** A[so:erigentnerves

Rr communicantes

R interganglionaris

d ith gangLia. T h e a u t o n o m i cp t e x u sa r e i n t e r s p e r s e w T h e h y p o g a s t r iac n d u t e r o v a g i n apLt e x u sc o n t a i nb o t h s y m p a t h e t i ac n d p a r a s y m p a t h e tfi icb r e s .

Radices anteflores

(s2-s5)

Plexusovaricus

Gangliatrunci sympathici A ovarica

N hypogastricus

Tubauterina[Salpinx]

Plexushypogastricus inferior Plexusuterovaoinalis*

N. sacralis[S1l

N vaginalis

Ganglia pelvica, Radix parasympathica lNn. splanchnicipelvicil

Ganglia pelvica, Radix parasympathica INn. splanchnicipelvici]**

Plexussacralis Labiumminuspudendi

N pudendus Nn.labialesoosteriores

(lntroitus vaginae)

Innervationof the femalegenitatia Parasympathetic JCo^ L^ '- ôl L ^Pô-' +L of the

-^;^-t ^^-n

ts2- s4l

Sympathetic

G a n g t i ap e L v i c aR,a d i x parasvmpatnIca I N n .s p t a n c h n i cpi e t v i c i J J N n . c a v e r n o sci L i t o r i d i s

T u b au t e r i n a U t e r us

Vasodi [atation Vasodi[atation

Vaqi na CL i i o r i s

Transsudation Erection

Ovar

Vasoconstriction

T u b au t e r i n a Uterus Vagina

C o n t r ac t i o n

TL^-^^;^ ^^-+ I rrvrouru Por L nf tho cninal

P t e x u sm e s e n t e r i c u s ! supenor Ptexus c o r d[ T ' 1-0T 1 2 l ovancuS v P l e x u sr e n a L i s T-.,^^,,^ I I UilLU5

^.,-^^+hi^,,>yil rPOLr ilLU>

J

L u m b a rp a r t o ft h es p i n a L c o r d[ 1 1 - L 2 ]

Somatomotor, somatosensory

S a c r a Lp a r t of the s p i n a Ic o r d

ts2- s4l

P L e x u hs y p o g a s t r i c u s s up e n 0r J N hypogastrrcus P t e x u sh y p o g a s t r i c u s inferior J P l e x u su t e r o v a q i n a L i s I F R A NK E N H A U S T N ' S g an gL i o n ) N dorsatis z cLitoridis N.pudendus :r Nn LabiaLes posteriores

Clitoris L a b i am a j o r a M . i s c h i o c a v e r n o s u sC o n t r a c t ino M buLbospongiosus

U r i nar ybl adder

andretroperitoneaI space Pelvicarteries

A iliaca communis A iliolumbalis

A. sacralislateralis

A iliaca interna

gluteasuperior

M piriformls A gluteainferior A iliaca externa

Lig sacrosplnale

A obturatoria

A pudendainterna

A umbilicalis

vesicalis superior

Lig sacrotuberale A rectalismedia

A uterina

F i g . 1 1 6 2a - d V a r i a b i L i o t yf t h e b r a n c h i n gp a t t e r no f t h e i n t e r n a Ii t i a ca r t e r y ,A . i t i a c ai n t e r n a ; viewedfrom the Left. a A t [ b r a n c h e sa r i s ef r o m t h e s a m e s t e m . b T h e i n t e r n a Ii t i a ca r t e r y ,A . i L i a c ai n t e r n a ,d i v i d e si n t ot w o m a j o r b r a n c h e s[ " t e x t b o o kc a s e " J . c T h e i n t e r n a Ii t i a ca r t e r y ,A . i t i a c ai n t e r n a ,d i v i d e si n t ot h r e e m a j o r b r a n c h e s . d T h e i n t e r n a Ii t i a ca r t e r y ,A . i L i a c ai n t e r n a ,d i v i d e si n t o m o r e t h a n t h r e e m a j o r b r a n c h e s .

Genitatia Vessels andnervesof the pelvicwall

Parsabdominalis aortaea A, mesentericainferiora

Plexussacralis, Truncus lumbosacralis A iliacacommunis sinistraa V iliacacommunis O

o A sacralislateralis

A sacralis mediana O ,i N sacralis [S1], R anterior

A iliaca communis dextra a A iliaca interna a A iliolumbalisO

a A gluteasuperior

A iliaca externa a A umbilicalis,Pars oatens a

,, Truncussympathicus, Gangliasacralia

A obturatoria a N obturatorius N genitofemoralis, R genitalis

r N sacralis [S2], B anterior O A glutea inferior

A n u l u si n g u i n a l i s profundus

, N sacralis [S3], R anterior

A cremasterica O

6 Nn anales [rectales] inferiores

A epigastrica O inferior

R pubicusa

R obturatorius a Lig sacrospinale

a A pudendainterna

pubica Symphysis

*, N pudendus A obturatoria, R oubicusa M obturatorius internusa

O A rectalis media

A vesicalis interiora

: Plexussacralis

F i g . 1 1 6 3 I n t e r n a Ii t i a ca r t e r y ,A . i I i a c ai n t e r n a , , t e x u ss a c r a L i s ; a n d s a c r a Ip l e x u s P viewedfrom the left


U r i nar vbtadder

)rgans of the malepeLvis

A ;V sacralis lateralis,Rr spinales O a N sacralis [S1], R anterior *

Os sacrum ,* N sacralis[S2],R anterior

N lumbalis[L5], R anterior i V iliaca interna O


V iliaca externa a) A iliaca communis O

a M piriformis Mesocolon sigmoideum

O M gluteusmaximus

Colon sigmoideum

Rectum,Flexurasacralis

Appendicesomentales [epiploicae]

Ductusdeferens Vesica u n n a n aI


funicaserosa

muscularis I Tunica \ Articulatio sacrococcygea

l/ rectusabdominis O Os pubis

Ureter

Lig puboprostaticum

Glandula vesiculosa Corpus anococcygeum ILig anococcygeum]


a M levator ani

Ductusdeferens Corpusanococcygeum [Lig anococcygeum]

lvl cremasterC Tunicadartos,M dartosa

Rectum,Flexuraanorectalis Iperinealis]

Cruspenis

ani externus a M sphincter

A profundapenisa l\4 ischiocavernosus 0

perineiprofundus l\4 transversus a

perineiprofundus a I/l transversus

l\4 sphincter urethraea Prostata

Glandula bulbourethralis'

a M bulbospongiosus

F i g . 1 1 6 1 + 0 r g a n so f t h e m a [ ep e L v i s . * C t i n i c at eI r m :C O W P EgR[ 'asn d

Genitatia

Rectunn

Topography

Sseti0ns of themalepelvis

a A sacralismediana a A iliaca interna

Promontorium Pars abdominalisaortae a

Parspatens a A umbilicalis,

A mesentericainferiora

superior a a A ; V.vesicalis

A i l i a c ac o m m u n i sO V i l i a c ac o m m u n i so

Canalissacralis O a A ; V rectalissuperior

Ureterdexter A;VobturatoriaOo V iliaca externa a A iliaca externa a \

a V iliaca interna ki

inferior a a A.; V vesicalis

Ductusdelerensdexter

a A ductusdeferentis

A ; V c i r c u m f l e xOao iliumprofunda

a l\4.piriformis

Plicaumbilicalis lateralis; A;V epigastricaaa inferior Plica umbilicalismedialis

Vesicaurinaria

Ductusdeferenssinister

Uretersinister

vesiculosa Glandula A vesicalis superiora aaA;Vrectalismedia

V dorsalisprofundaa penrs

inferior a A vesicalis o M levatorani

A dorsalispenisa Plexus venosus vesicalisa

Prostata

a aA ; V rectalisinferior pudendainterna

ooA;V

' A profunda Funiculus penisO spermaticus penis Corpuscavernosum

posteriores a a A ; V pudendainterna,Rr.scrotales

F i g . 1 1 6 5 B L o o ds u p p l . oy f t h e m a t ep e t v i s

> Pelvicviscera and retroperitoneaI space

g t a n dI U r i n a r yb l a d d e r K i d n e yI S u p r a r e n a

Vesselsof the femalepelvis

a A iliacainterna o V iliaca interna

V i l i a c ac o m m u n ios

O A sacralismediana

a o A ; V rectalissuoerior

A iliaca communis O

Tunicamuscularis, rl\ / Rectum, .11\/ Stratumlongitudinale A umbilicalis,Pars patens a

o A uterina

A ; V, ovarica a O

a a A :V rectalismedia

Plicarectouterina

Uretersinister

Tubauterina Lig teresuteri

OOA;Vuterina

A;V iliacaexternaaa

a a A ;V rectalismedia

Vesicaurinaria o A vaginalis

Ovarium sinistrum

o A vesicalisinferior

a M levatorani A uterina,a R tubarius a o A ; V rectalisinferior o Plexusvenosusvaginalis B u l b u vs e s t i b uol i aoA:V Lig teres uteri

a W vesicales

Fig. 1156 BtoodsuppLyof the fema|.epetvis

oudendainterna

Genitatia

R e ctu m

Topography

S e et i o n s femalepelvis

Nodi lymphoidei preaortici, aortici laterales et retroaortici

a Pars abdominalisaortae Nodi lymphoideiiliaci communes

a a A :V sacralismediana Nodus lymphoideusprecavalis

a A iliolumbalis

a aA : V rectalissuoerior

A;Vovaricaoo Nodi lymphoideiiliaci interni

Rectum

Noduslymphoideus iliacusexternus OoA;V uterina

N genitofemoralis,,

,: N obturatorius A ; V i l i a c ae x l e r n aa O

Noduslymphoideus rectalissuperior

A;V obturatoriaOa

a A vaginalis

Nodi lymphoideiiliaci externi mediales et laterales

o A pudendainterna

A umbilicalls,Pars occlusa O

a A rectalismedia

A;VepigastricaaO inferior

Lig sacrospinale Nodi lymphoidei pararectales


Excavatio rectouterina* Plica rectouterina

Lig teres ul

Anulusfemoralis

oaA;Vrectalismedia

Nodi lymphoideiiliaciexterni obturatorii a A. umbilicalis,Pars patens

Lig teresuteri

a M levatorani Uterus,Faciesintestinalis

Aa vesicales superiores a Vesica urinaria

Lig umbilicalemedianum

F i 1 . 1 1 6 7 L y m p h a t i c sV, a s aL y m p h a t i c a n , d l y m p hn o d e s , N o d iL y m p h o i d eoi ,f t h e p e t v i cw a t [ o f t h e f e m a l e .

T h eL y m p hn o d e sa r e f r e q u e n t l ym u c h s m a t t e rt h a n i t t u s t r a t e d . u m o u rc e t l sf r o m t h e u t e r u sc a n b u t t h e ya r e a l w a y sp r e s e n tT r e a c ht h e s u p e r f i c i aiIn g u i n a l y m p hn o d e sv i a l y m p h a t i c so f t h e r o u n dl i g a m e n to f u t e r u s . * C I i n i c at eI r m :p o u c h ofD0UGLAS * * C [ i n i c at eI r m :r o u n dl i g a m e n t

A iliaca interna A iliaca externa eprgastflca inferior

obturatoria Foramen obturatum

250k F i g . I 1 6 8a - c V a r i a b i t i toyf t h e o r i g i no f t h e o b t u r a t o ra r t e r y ,A obturatoria; mediaLview a O r i g i nf r o m t h e a n t e r i o rb r a n c ho f t h e i n t e r n a Li L i a ca r t e r y , A . i t i a c ai n t e r n a[ " t e x t b o o kc a s e " ]

b O r i g i na s a n i n d e p e n d e nbt r a n c hf r o m t h e i n t e r n a Li I i a c a r t e r y ,A . i t i a c ai n t e r n a externa c 0 r i g i nf r o m t h e e x t e r n a iI I i a ca r t e r y ,A . i L i a c a 0 n L yi n 7 5 %o f t h e c a s e s t, h e o b t u r a t o ra r t e r yo r i g i n a t e sf r o m t h e t r u n k o f t h e i n t e r n a Ii t i a ca r t e r v .


g i " andI U r i nar ybLadder Kidney| $ur pr anenat

Female pelvicdiaphragm

pubica Symphysis pubicum Tuberculum

Lrg pubicuminferius

Urethrafeminina, Tunicamuscularis

perinei Lig transversum lvl transversus oerineiorofundus

Vagina

Fascia perinei IFascia investiensperinei superficialisl

Spina iliaca anterior inferior Spina iliaca anteriorsuperior

Fossa acetabuli

Crista iliaca Lig transversum acetabuli

Os ilium Fascia perinei IFascia investiens perinei superficialisl

Facies lunata

M transversus perineisuperficialis M obturatorius internus

Fascia inferior diaphragmatispelvis

Tuber ischiadicum

Fascia obturatoria Fascia obturatoria

Lig sacrotuberale

Fascia inferior diaphragmatispelvis

M levator ani, l\/l puborectalis Spina ischiadica l\4 levator ani, M iliococcygeus

Lt9

M ischiococcygeus[M coccygeus]

sacrotuberale

M sphincterani externus

Centrumperinei

Lig sacrotuberale Spina iliaca posteriorsuperior

M sphincter ani externus

Corpus anococcygeumILig anococcygeum]

Ossacrum F i g .1 1 6 9 P e r i n e am I u s c L e sM, m . p e r i n e i , a n d t h e p e t v i cd i a p h r a g mD , i a p h r a g m ap e t v i so, f t h e f e m a l e ; i n f e r i o rv i e w . pubicum Tuberculum

Os coccygis

P r o b ei n t h e p u d e n d acI a n a [I A L C O C Kc 'asn a [ ]

Symphysis pubica

L i n e at e r m i n a l i s Eminentia iliopubica

M levator ani, l\4 pubococcygeus

Corpusossispubis

I I!

Fossa acetabuli-1

Canalisobturatorius

Os sacrum

Ligg sacroiliacaanteriora


Ligg sacroiliacainterossea

l\4 levator ani, M iliococcygeus

(Arcustendineus musculilevatoris ani)

l\4 rectococcygeus M ischiococcygeus [M coccygeus] Foramen ischiadicum maJus

Lig sacrotuberale

Os ilium

Proc articularissuperior

F i g . 1 1 7 0 P e L v idc i a p h r a g mD , i a p h r a g m ap e t v i so, f t h e f e m a L e ; s u p e n o rv t e w .

* C t i n i c atIe r m : l e v a t o rh i a t u sI H i a t u su r o q e n i t a t iest a n i l

Genitatia Female pelvicdiaphragm

A i l i a c ac o m m u n i so

V iliacacommunis o A;ViliacainternaaO

Ureter N obturatorius

a M piriformis

M transversus a abdominis o M. levator ani

M obliquusG internus abdominis M o b l i q u uas exlernus abdominis M iliacus a V iliaca externa O a

a (M sacrococcygeus) A ;V circumllexa a a iliumprofunda A ; V epigastrica inferiorO a N obturatorius: Pectenossispubis A;VobturatoriaOa-'{ M obturatorius a Internus (Arcustendineus musculilevatoris ani)

a M rectococcygeus

; V pudendainternaa a

a M levator ani

Clitoris, Corpusclitoridis aniexternus o l\4 sohincter V dorsalisprofundaa cliloridis I M sphincterani internus

M sphincter urethraea Ostiumurethrae externum

Pecten analis

Labiumminuspudendi Vagina

Centrum perinei

Labium majus pudendi

F i g . 1 1 7 1 M u s c t e so f t h e p e L v i dc i a p h r a g m , D i a p h r a g m ap e L v i so,f t h e f e m a t e

aniexternus e M sDhincter



Malepelvicdiaphragm

penis Corpusspongiosum M bulbospongiosus Tunicadartos.l\4.dartos * Glandula bulbourethralis

lvl ischiocavernosus

Raphe perinei

perinei M transversus profundus lvl transversus perineisuperlicialis

Fascia obturatoria

Tela subcutanea, Panniculus adrposus

Lig sacrotuberale

Fasciaobturatoria

M sphincter ani externus

l\4 gluteusmaximus l\4.levator ani

Os coccygis

Corpusanococcygeum [Lig anococcygeum]

F i g . 1 1 7 2 P e r i n e u mP , e r i n e u ma, n d p e L v i dc i a p h r a g mD , i a p h r a g m ap e l v i s o, f t h e m a t e ; i n f e r i o rv i e w . * C l i n i c at eLr m :c o w P E Rg' st a n d

Genita[ia Femalepelvicdiaphragm

Preputium clitoridis Ostiumurethrae externum M gracilis

Glans clitoridis

Ostiumvaginae; Carunculae hymenales

Rugae vaginales

Labiumminuspudendi Glandula vestibularis major,(Ostium)*

M. ischiocavernosus M bulbospongrosus

M bulbospongrosus

Baphe peflnel

Fasciaperinei IFasciainvestiens perineisuperf icialisl

M. transversus peflnel

superficialis

Fascia obturatoria

Fossa ischioanalis

M. sphincter anrexernus M, gluteusmaximus M levatorani

Anus

perineisuperficialis Mm transversi et profundus Os coccygis

F i g . ' l ' 1 7 3 P e r i n e u mP , e r i n e u mp ; e t v i cd i a p h r a g m , D i a p h r a g m ap e t v i sa, n d f e m a [ ee x t e r n a gI e n i t a t i a , 0 r g a n ag e n i t a l i af e m i n i n ae x r e r n a ; i n f e r i o rv i e w . + C t i n i c at eI r m :B A R T H 0 L g t N[ a' sn d

Corpusanococcygeum ILig.anococcygeum]

T h ev a g i n a a I n d t h e a n a Io r i f i c e sa r e l o c a t e di n c t o s ep r o x i m i t y . D u r i n gd e t r v e r tyh e s k i n a n d m u s c l e so f t h e p e r i n e u mc a n r u p t u r eu p t o t h e s p h i n c t e rm u s c t e so f t h e a n u s i l . - l l l . d e g r e e p e r i n e a lLa c e r a t i o n sT l .h e s ec a n b e p r e v e n t e db y s u r g i c a l i n c i s i o n sd i r e c t e de i t h e r[ a t e r a t [ yo r i n t h e m e d i a np [ a n e I p e r i n e aiIn c i s i o n= l a t e r a Io r m e d i a I e p i s i o t o m y l .

L J r i n a r vb t m q i d e r

Lig inguinale

pubica Symphysis

penis a V dorsalisprofunda A;N dorsalispenisO{a

Lig pubicuminferius perinei Lig transversum

Urethramasculina Glandula bulbourethralis*

ll l\il,sphincter urethrae

perineiprofundus M transversus N

Ductusolandulae bulbourethralis

A : V b u l b oi e n i so a

perineiprofundus a M transversus perineisuperficialis] FasciaperineiIFasciainvestiens

AiV oerinealisaa N perinealisi,

Ramus ossis ischii

A:Vpudendainternaaa N pudendus

a M transversus peflnel

superficialis

F i g . 1 1 7 1 U r o g e n i t adI i a p h r a g m , D i a p h r a g m au r o g e n i t a t eo,f t h e m a [ e ; i n f e r i o rv i e w . * C l i n i c at eI r m :c o w P E Rg' st a n d

pubicum Tuberculum

Lig pubicum superius

Lig inguinale

Os pubis,Ramussuperior pubica Symphysis

clitoridis a V dorsalisorofunda A ; N dorsalisclitoridis O r:

Lig pubicuminferius

Vagina

perinei Lig transversum

Os pubis, Ramus inferior

Urethrafeminina

A bulbivestibuli a

perineiorofundus C M transversus

Bamus ossis ischli

Fasciaperinei perinei IFasciainvestiens

M transversus a Tuberischiadicum

peflnel superficialis

F i g .1 1 7 5 U r o g e n i t adLi a p h r a g m , D i a p h r a g m au r o g e n i t a t eo,f t h e f e m a L e ; i n f e r i o rv i e w .

- i."

Genitatia Female externaI genitalia

pubica Symphysis pubicum Tuberculum

Lig.suspensorium clitoridis Lig. inguinale

clitoridis Corouscavernosum Preputium clitoridis

Glansclitoridis

Frenulum clitoridis

Crusclitoridis Labiumminuspudendi

externum Ostiumurethrae

Ostiumvaginae;Columnarugarumanterior

hvmenales Carunculae

Bulbusvestibuli

M. ischiocavernosus

Glandula vestibularis maior*, (Ostium)

M. bulbospongiosus FasciaperineiIFasciainvestiens perineisuperficialisl

M transversus oerineiorotundus Vestibulum vagrnae

Tuberischiadicum

labiorum Frenulum pudendi

M. transversus perineisuperficialis M. sohincter Parssubcutanea aniexternus.

Anus Corpusanococcygeum ILig.anococcygeum]

Fig. 1176 FemateexternaIgenita[ia, 0 r g a n ag e n i t a t i af e m i n i n ae x t e r n a ; v e n t r o i n f e r i ovri e w . + C [ i n i c at eI r m :B A R T H O LqI N L a' sn d

Monspubis labiorum Commissura anterior Preputium clitoridis Frenulum clitoridis (Ductusparaurethralis) Ostium urethrae externum Glandula vestibularis malor, (Ostium) Fossa vestibuli vagrnae Commissura labiorum poslenor

Fi1.1177 FemateexternaIgenitatia, 0 r g a n ag e n i t a t i af e m i n i n ae x t e r n a ; inferiorview.

Commissura labiorum anterior

Preputium clitoridis

Glans clitoridis

Labiummajuspudendi

Labiummajus pudendi

Rimapudendi

Labiumminus pudendi

Labiumminuspudendi

Ostium vagrnae Hymen Frenulum labiorum pudendi

Perineum

Perineum, Raphe peflnel

Fig. 1178 Fema[eexternaIgenitatia, 0 r g a n ag e n i t a l . ifae m i n i n ae x t e r n a ; inferiorview.

> Pelvicviscera

U r i nar ybtadder

andretroperitoneaI space Malepelvicorgansand retroperitoneal space

Fossasuoravesicalis

Plica umbilicalismedialis (Chorda arteriae umbilicalis)

Plica umbilicalismediana (Lig. umbilicalemedianum, Chorda urachi)

O Plica umbilicalislateralis (A ; V. epigastrica inferior)

Plicavesicalistransversa Fossainguinalis lateralis o N. femoralis

M. psoasmajorO

a N genitofemoralis

A;V iliacaexternaaa Ductusdeferens


Nodilympholdei iliaciexterni

Nodi lymphoidei iliaci externi O A. umbilicalis,Pars occlusa

N obturatoriuso

Linea terminalis

A;V obturatoriaOO \

Ductusdeterens

Lig. capitis femoris

Ureter

Ductusdeferens Glandula vesiculosa Amoullaductusdeferentis

M obturatorius internusa M obturatorius externusO

a Plexusvenosusvesicalis;Plexusvenosusprostaticus


Membranaobturatoria

Fossaischioanalis

M. levator ani O

Prostata

Os ischii

A ; V pudendainterna;N. pudendus OOC

Cruspenis

Cruspenis

Glandula bulbourethralis perineiprofundus M. transversus a

Bulbuspenis

F i g . 1 1 7 9 P e t v i cd i a p h r a g mD , i a p h r a g m ap e l v i s ; p e l v i co r g a n sa n d a n t e r i o ra b d o m i n a I w a [ [ , 0 r g a n aa b d o m i n i se t p e t v i so, f t h e m a [ e ; f r o n t a ls e c t i o nt h r o u g ht h e h e a do f t h e f e m u r a n d t h e u r i n a r yb | . a d d eor n t h e L e f t ; dorsaIview

Genita[ia space Femalepelvicorgansandretroperitoneal

Fascia pelvis visceralis

Excavatiovesicouterina

t N. obturatorius o A obturatoria

M obturatorius internusO

Vesica urinaria

N pudendus internusj

o Plexusvenosus vesicalis

A. pudendainternaa

a M. levatorani

Diaphragma urogenitale Crusclitoridis

Glandula vestibularismajor Bulbus vestibull

O M ischiocavernosus Ostiumvaginae

Urethrafeminina

Labiumminuspudendi externum Ostiumurethrae

p e t v i sa, n d F i g . 1 1 8 0 P e L v idc i a p h r a g mD , iaphragma p e t v i co r g a n s ,O r g a n ap e l v i s o, f t h e f e m a [ e ; f r o n t a L s e c t i ol onn t h e r i g h t lc o m b i n e w d i t h a m e d i a ns e c t i o n ; ventraIview.


U ni nar bl y " adder

genitaLia MaIe external

A dorsalis penis a

penis Lig fundilorme

a V dorsalis profunda penis

A n u l u si n g u i n a l i s superficialis

:t N ilioinguinalis

Funiculus spermaticus N genitofemoralis,{ B genitalis

a A cremasterica; a (V cremasterica)

N dorsalis penis

a o A.; V, pudendaexterna Plexuspamoiniformis a

Ductusdeferens

A testicularis a

anteriores a Rr scrotales

a V dorsalisprofundapenis

penis a V dorsalissuperficialis Fascia penis (profunda)

F i g . 1 1 8 1 M a L ee x t e r n a g I enitatia, 0 r g a n ag e n i t a t i am a s c u L i neax t e r n a .

Genitalia Maleexternal

Anulusinguinalis superficialis, Crusmediale Telasubcutanea, Panniculus adiposus

Aponeurosis a M obliquusexternusabdominis, abdominis a M obliquusinternus

* N ilioinguinalis

a V dorsalisprofunda penrs; oeA;N dorsalispenis

Fascia spermatica exlerna a

Fasciacremasterica; a M cremaster

penis 1 A. profunda

Plexus pampiniformisa

penis Corpuscavernosum Ductusdeferens Urethramasculina A testicularis a

I Epididymis j

caput


| (APPendix) Appendix testis a Fasciacremasterica; M cremasler Tunicavaginalis testis, Laminavisceralis a Fasciaspermaticaexterna Tunica vaginalistestis, Lamina parietalis Fascia sDermaticainterna

a Tunicadartos,M dartos

M cremastera Fascia spermaticaexterna o

Septumscroti

Raphe scroti

Fig. 1182 MaLegenitaLia 0 r q a n aq e n i t a t i am a s c u L i n a .

> Pelvicviscera and retroperitonealspace

t l r i n a r yb l a d d e r

Maleperinealregion

perinealis,Rr scrotalesposteriores

A, dorsalispenisa I M bulbospongiosus

A bulbipenisa l| l\4 ischiocavernosus

N dorsalis penis ,

a A perinealis

Rr perineales : (N cutaneus femoris posterior)

I l\4.transversus peflnel superficialis

Nnclunium: inferiores (N cutaneus femoris posterior)

Nn anales: Irectales] inferiores N oerinealis Lig sacrospinale

O A rectalisinferior

N pudendus, A pudenda interna O

' Nn.cluniuminferiores (N cutaneus femorisposterio0

Lig. sacrotuberale

M gluteusmaximus+t Corpus anococcygeumILig anococcygeum]

il M levator ani Nn anococcygei

F i g . 1 1 8 3 V e s s e l sa n d n e r v e so f t h e p e r i n e u m , R e g i op e r i n e a L iasn, dt h e m a L ee x t e r n a L g e n i t a L i a , 0 r g a n ag e n i t a t i am a s c u I i n ae x t e r n a .

i.:liir i:.:rl:i

Genitalia

M bulbospongiosus I Ostiumurelhraeexternum V bulbi O vestibuli

posteriores a A pudendainterna,Rr labiales

L a b i u mm i n u sp u d e n d i

Bulbusvestibuli

O M ischiocavernosus

A dorsalis O clitoridis A perinealisa

s Nn.labiales posleflores

N dorsalis , clitoridis A pudenda o interna

Rr perineales (N cutaneus femoris posterior)

a M transversus pennel superficialis

N dorsalis clitoridis

Nn clunium interiores (N cutaneus lemoris posterior)

I M gluteus maxtmus

Nn perineales

OoA;V Pudenda inlerna a A. rectalisinlerior

N pudendus

* Nn anales lrectales]inferiores

A pudendainternaa lvl levatorani a M sDhincter aniexternuss

* Nn cluniuminferiores (N cutaneus femorisposterio0 t, Nn anococcygei

Corpusanococcygeum [Lig anococcygeum]

F i g , 1 1 8 4 V e s s e t sa n d n e r v e so f t h e p e r i n e u m , R e g i op e r i n e a L iasn, dt h e f e m a t ee x t e r n a I g e n i t a I i a , 0 r g a n ag e n i t a [ i af e m i n i n ae x t e r n a .


N , . J n i n ba tray d d e r

Abdomen,mediansection

Oesophagus Plexusvenosusa vertebralis internus anterior, V basivertebralis

Aorta,a Pars abdominalis

Hepar,Area nuda

Centrumtendineum a Diaphragma, Hepar,Lobussinister Cor

Sternum, Corpus Sternum,Proc xiphoideus Gaster,Cardia Fornixgastricus A gastroduodenalis O

Pancreas, Ductuspancreaticus

A mesenterica superiora Colontransversum Pars lumbalis a diaphragmatis

Lineaalba V renalis dextra a A renalisdextra a

JeJUnum Filum terminale ,,

Omentummajus

Aa jejunales O

Peritoneum viscerale

V mesentericasuperior a


A iliaca communis a dextra V iliaca communis O oexlra Cauda equina ,

a A jejunalis Promontorium

Colon sigmoideum

Plica transversa recti

a M rectusabdominis

Os sacrum

Vesicaurinaria a l\4 pyramidalis

Glandula vesiculosa Ampullarecti

O sp u b i s

Os coccygis Lig fundiforme penis

Prostata M sphincterani I externus


lvl,sphincter ani a internus


Columnae anales

Tunicaalbuginea corporum cavernosorum

M levator ani, t M pubococcygeus

Septumscroti

l\4 transversusperineia profundus

penis Preputium

l\4 ischiocavernosus O Glans penis lV bulbospongiosusj

Epididymis

Tunica vaginalistestis, Lamina visceralis

a M cremaster a Tunicadartos

F i g . 1 1 8 5 A b d o m e nA , b d o m e n a, n d p e t v i sP , eLvis, ofthemate; m e d i a ns e c t i o n .

Genita[ia

Pulmodexter,Lobusinferior V hepaticasinistraO Lig falciforme

Recessus phrenicomediastinalis

Hepar, Lobus sinister

M rectusabdominis o

diaphragmatis O Parslumbalis

Parssternalisa diaphragmatis

a V cavainferior

Gaster

retrocavales Nodilymphoidei

A hepatica propria O Caput pancreatis; Ductus pancreaticus

a V renalisdextra a A. renalisdextra

Ductus choledochus lbiliarisl

V portaehepatisO Omentummajus, Lig.gastrocolicum Colontransversum Omentummajus Caputpancreatis, Proc uncinatus V mesenterica O supenor

a M erectorsoinae a A iliacacommunis

A mesenlerica a supenor

a V. iliacacommunis

Lineaalba

Os sacrum Nodi lymphoideiileocolici

6 N .s a c r a l i[sS 1 ] Rectum a M piriformis M rectus abdominis a


Ductusdeferens Cavitas perilonealis

vesiculosa Glandula Rectum

Vesicaurinaria

a (M sacrococcygeus) a M gluteusmaximus

Corpusossispubis

Prostata

penis Lig fundiforme

a lvl levatorani,M. iliococcygeus

(l\4madductores) O

o M levatorani,M pubococcygeus Septumpenis

urogenitale) a (Diaphragma

penis Corouscavernosum

G l a n sp e n i s penis Preputium A testicularis a

a M cremaster Epididymis o Plexuspampiniformis

, etvis, F i g .1 1 8 6 A b d o m e nA, b d o m e na, n d p e t v i sP of the mate; s a g i t t a sI e c t i o nt o t h e r i g h t o f t h e m e d i a nP [ a n e .


U r i n a r yb l a d d e r

Abdomen, frontal section

Hepar,Lobuscaudatus V hepaticasinistra O

a V cavainferior Atriumcordisdextrum Ventriculus cordisdexter

V portae hepatis O


V portaehepatis,O R dexter Gaster,Ostium cardlacum A hepaticapropriaO O O A.; V gastricasinistra Duodenum, Parssuperior

Colontransversum

Hepar,Lobusdexter

Caudapancreatis

Colontransversum

a A. gastroduodenalis a V splenica

Caputpancreatis

Duodenum, Flexura duodenojejunalis

Colonascendens

O A mesenterica supeflor

A,;V mesenteria c aa supeflor

a Aa jejunales

Colon ascendens

lleum Cavitas peritonealis

O si l i u m Colon descendens

M sartoriusa M. tensorfasciaelataeI l\4 iliacus a N femoralis .l

Colon sigmoideum

A femoralis o Os pubis

lvl rectuslemorisa V femoralis o

pubica Symphysis

M pectineus a

Lig.fundiforme penis

N4,adductor brevis a

M adductorlongusa Penis,Tunica albuginea

a A profundapenis

F i g . 1 1 8 7 A b d o m e nA , bdomen; f r o n t a ls e c t i o nt h r o u g ht h e m o s t a n t e r i o rp a r t o f t h e a b d o m i n a t c a v r t y .

Genitatia

Ostiumcardiacum f Loous PulmoJ superlor sinisterI r ^n,," |

Parsthoracica Oesophagus, V. pulmonalis O sinistrainferior

dextrainferior a V pulmonalis Pulmodexter,Lobusinferior Pulmodexter, Lobusmedius

.-l-':"

\ Inreflor

Lobushepatis sinister



o Diaphragma Lobushepatis dexter

Diaphragma O

Ductusthoracicus

Lig gastrosplenicum Corpusgastricum

(Noduslymphoideus mediastinalis posterioo

SplenILien]

O A subcostalis

Glandula suprarenalis o Parsabdominalis aortae

Lig splenorenale Nodilymphoidei splenici

a Nn splanchnici majoret minor

A ; V s p l e n i caa a


Pancreas Omentummajus Pyramisrenalis Colondescendens Papillarenalis

a o A.; V lumbalisI

o Truncus sympathicus

CostaXl Ren A : V r e n a l ios a

Pelvis renalis, Calyx renalis major

Pelvisrenalis Ureter M psoasmajora

o V hemiazygos

aoA;V

lumbalisll

Parslumbaliso diaphragmatis

, bdomen; F i g . 1 1 8 8 A b d o m e nA f r o n t a Is e c t i o nd e m o n s t r a t i n tgh e d i a p h r a g m , t h e o r g a n so f t h e u p p e ra b d o m e na n d t h e k i d n e y s ; dorsaIview.

Ren, Capsula adiposa

::.-

a:


[-]rir"lany hi,**ia$*r

Upperabdomen,sagittalsection

iwl Diaphragma,{} Centrum tendineum nepar, Lobus dexter

Pleuravisceralis [pulmonalis] Pleura parietalis, Pars costalis

Q Pars costalis diaphragmatis

Parscostalisa diaphragmatis

a V hepatica dextra

Recessus costodiaphragmaticus

l\4 erectorc sptnae

a V portae hepatis, R dexter, R anterior

Columnarenalis V renaliso A renalisa

Pelvis renalis

t l\4 rectus abdominis

l\4edullarenalis

Peritoneum vrscerale

Calyx renalis mtnor M quadratus C rumDorum Cortex renalis

R e n ,C a p s u l a adrposa Ren,Capsulafibrosa

M psoas major * Fascia renalis

F i g .1 1 8 9 A b d o m e nA, b d o m e n ; s a g i t t asI e c t i o nt h r o u g ht h e u p p e ra b d o m e n a t t h e L e v eoLf t h e r i g h t k i d n e y ; v i e w e df r o m t h e r i g h t .

ffienitalia Upperabdomen,sagittalsection

Gaster,Cardia, Ostium cardiacum

Gaster,Fornixgastricus Omentumminus,Lig hepatogastricum

Pleuravisceralis [pulmonalis] Pleuraparietalis, Parscostalis

Pars costalis t diaphragmatis

SplenILien]


Lig gastrosplenicum

A gastrica sinistra a

Bursaomentalis

R intercostalis anterior; a) V intercostalis anterior; o N intercostalis a

Recessus costodiaphragmaticus o M erectorspinae CostaXll

lumborum a lvl quadratus gastroomentalis a sinistra Fasciarenalis Omentummajus Lig gastrocolicum lvl rectus abdominis a

Omentummajus

c lvl psoasmajor Cavitasperitonealis Colontransversum

F i g .1 1 9 0 A b d o m e nA, b d o m e n ; s a g i t t a sLe c t i o nt h r o u g ht h e u p p e ra b d o m e na t t h e [ e v e [o f t h e s p l e e n ; viewedfrom the left

> Petvicviscera andretroperitoneaI space

{.J ni nnr y dder b{m

Upperabdomen, transversesections

1,4rectusabdominis *

Lig falcilorme

V cava inferiora

CostaVll

Linea alba

Hepar,Lobussinister

Costa Vl

O Pars thoracicaaortae

Pleura parietalis, Pars costalis

Pleuraparietalis, Parsdiaphragmatica Cavitaspleuralis, Becessus costodiaphragmaticus

Pars costalisdiaphragmatisI Costa Vl Peritoneumparietale

* lV],obliquus externus abdominis

Peritoneumviscerale

CostaVll

Mm intercostales *

SplenILien]

Costa Vlll

V hepaticadextra a

Cavitasperitonealis

M latissimus dorsi& Costa lX

N intercostalis(T 9) a V splenica

V portae hepatis, R dexter, O R posterior

a A splenica

CostaX Vertebrathoracica Xl, Proc articularissuoerior VertebrathoracicaXl l\4edullaspinalis

Spatiumepidurale

Bursaomentalis diaphragmatis, S Parslumbalis Crussinistrum ' Truncussympathicus {i M erector spinae N intercostalis(T 10)

Ductusthoracicus

F i g .1 1 9 1 A b d o m e nA, b d o m e n ; t r a n s v e r s es e c t i o nt h r o u g ht h e u p p e ra b d o m e n a t t h e l e v e Io f t h e e L e v e n tthh o r a c i cv e r t e b r a .

Proc xiphoideus

M rectusabdominis


Pars costalisdiaphragmatis

Costa Vll Gaster

Hepar,Lobusdexter

Splen [Lien]

VertebrathoracicaX


M erectorspinae

Pars lumbalisdiaphragmatis

F i 9 . 1 1 9 2 A b d o m e nA , bdomen; c o m p u t e dt o m o g r a p h i c r o s s - s e c t i oInC T J a t t h e l e v e Io f t h e t e n t ht h o r a c i cv e r t e b r a : i n f e r i o rv i e w .

Genitalia

Rectum

T o p o g raphy Sections Upperabdomen,transversesections

Lig falciforme M rectus abdominis,Vagina musculi recti abdominis o

Lrnea

Lig tereshepatis;Lobushepatissinister communis a A heDatica

M transversus abdominis o Hepar,Lobusquadratus

Omentumminus,Lig hepatogastricum

Ductuscysticus; Duclus choledochus Ibiliaris]

sinistra; o oA; V gasvica Nodi coeliacum; * Ganglion gastroomentales lymphoidei

Lig hepatoduodenale A hepalica propria, o R dexter; V portae hepatis o

Bursaomentalis

Lobuscaudatus, Proc papillaris; Recessus superiorbursaeomentalis

Omentummajus Recessus splenicus

V portaehepatis,O R dexter f Parscostalis: pars Diaphragma ?1 lumbalis, ( Crusdextrum

Hilumsplenicum; Nodilymphoidei splenici

Lobushepatisdexter

SplenILien]

V cavainferiorO Cauda pancreatis

Ductusthoracicus V azygosa

Peritoneumviscerale

Cavitas pleuralis

Cavitasperitonealis

Pleuraparietalis, Parsdiaphragmatica PleuraDarietalis. Parscostalis Mm intercostales externiet interni|}

Peritoneumoarietale

aaA;V

splenica

Ben:Glandula suprarenalis

Ben

Ren,Capsulaadiposa major N. splanchnicus a * V hemiazygos; minor N. splanchnicus a Q i, Aorta;Diaphragma; s N thoracicus [T12]

M latissimus dorsit M serratusoosterior inferiora M iliocostalisthoracis N

N splanchnicus minor,, M longissimus thoracis|}

Medulla spinalis

Xll. Proc.soinosus Vertebra thoracica

j \

$ l\,4m multifidi

F i g .1 1 9 3 A b d o m e nA, b d o m e n ; t r a n s v e r s es e c t i o nt h r o u g ht h e u p p e ra b d o m e na t t h e [ e v e [ o f t h e i n t e r v e r t e b r adIi s c b e t w e e nt h e e l e v e n t ht h o r a c i c a n d f i r s t L u m b a vr e r t e b r a ; withthe exception o f t h e o m e n t a Lb u r s ah i g h l . i g h t ei n dyetLow g r e e nt h e p e r i t o n e u mi s c o L o u r eidn b t u e .

Colontransversum Lig falciforme Jejunum

Lig tereshepatis

Pancreas Hepar,Lobuscaudatus Colondescendens Hepar,Lobusdexter V portaehepatis

Aorta

V cavainterior Vertebra lumbalis, Corpusvertebrae

Parslumbalis diaphragmatis Costa X

Splen[Lien] Rensinister

M latissimusdorsi Costa Xl

M. erectorspinae

Ben dexter

Costa Xll

F i g . 1 1 9 1 A b d o m e nA , bdomen; c o m p u t e dt o m o g r a p h i cs e c t i o nI C T ] a t t h e l e v e Lo f t h e f i r s t I u m b a rv e r t e b r a T h e i n t e s t i n ei s p a r t i a t t yf i t t e dw i t h a c o n t r a s tm e d i u m .


htadder KidneyI Supr ar enagltand . I U r i nany

Upper abdomen, transversesections Hepar,Lobussinister V portae hepalis a

costavlll

Lig teres hepatis

Colontransversum * l\4 rectusabdominis suoerior O A mesenterica

Peritoneumparietale Cavitas peritonealis

Pancreas

Pars costalisdiaphragmatis

Becessus

Noduslymphoideus pancreaticus

costodiaphragmaticus


JeJunum

Pleura parietalis, Pars costalis C o s t aV l l l Costa lX

Hepar, Lobus dexter Colon descendens aA. renalis

* M latissimus dorsi

V cavainferioro

Pelvis renalts

Pars lumbalisdiaphragmatlss

CostaXll Truncus sympathicus l\4 erector spinae *

Medulla renalis Calyx renalis minor

Sinusrenalis

Vertebra lumbalisI

Cortexrenalis Cauda equina , A mesentericainlerior a

o V renalis a Pars abdominalisaortae

F i g .1 1 9 5 A b d o m e nA, b d o m e n ; t r a n s v e r s es e c t i o nt h r o u g ht h e u p p e ra b d o m e n a t t h e l e v e Io f t h e f i r s t I u m b a rv e r t e b r a . A mesentericasuperior Hepar, Lobus sinister

Jejunum Vesica biliaris A renalis V cava inferior

Corpus vertebrae lumbalis I Hepar, Lobus dexter

F i g . 1 1 9 6 A b d o m e nA , bdomen; c o m p u t e dt o m o g r a p h i cs e c t i o nI C T ] a t t h e l e v e Io f t h e f i r s t [ u m b a rv e r t e b r a ; i n f e r i o rv i e w * I n t e s t i ngaaI s

Rectum

Genitalia

T o p o E r aphy Sections Lowerabdomen,transversesections Linea alba

* M rectusabdominis

mesenterica superior, Aa ; Vv ilealesO o

lleum A mesentericainferiorO

Cavitasperitonealis Peritoneumviscerale

Peritoneum oarietale f M. transversus abdominis Colon sigmoideum

c l\4.obliquus internus abdominis * M obliquus exlernus abdominis

aaA.;V mesenterica supeflor, Aa.;W. ileales

Pars O abdominalis aonae

Colon descendens Colon ascendens

1,4latissimus dorsi*

6 M psoasmajor aoA;Vtesticularis

Vertebra lumbalis lll Cauda equina t

t M erector spinae N spinalis

Vertebralumbalis lV. Proc sprnosus

Fig.1197 Abdomen,Abdomen; t r a n s v e r s es e c t i o nt h r o u g ht h e l o w e ra b d o m e n a t t h e l e v e Io f t h e t h i r d L u m b a vr e r t e b r a .

r l/ M rectus abdominis

Linea alba

Jejunum*

Colondescendens M obliquus externusabdominis l\4 obliquusinternusabdominis Caecum

abdominis M. transversus Appendix vermiformis

Parsabdominalis aortae

l\4 psoas major

V cava inferior

lumbalislll Corpusvertebrae

F i g .1 1 9 8 A b d o m e nA, b d o m e n ; c o m p u t e dt o m o g r a p h i cs e c t i o nI C T l a t t h e l e v e Io f t h e t h i r d L u m b a vr e r t e b r a ; i n f e r i o rv i e w . * Jejunum f i t l e dw i t ha c o n t r a smt e d i u m


K r e i n e yI S u p r a r e r r aEI t a n d I l . J n i n * riy: L n d c l e n

Malepelvis,mediansections

Mesenterium

Ostiumurethrae internum \

Colon sigmoideum

,ro 1[\l' Filum terminale

lntestinumtenue

Ostiumureteris

Omentummajus Apex vesicae Plica umbilicalismediana ( L i g u m b i l i c a l em e d i a n u m )

Plica transversarecti*

,4' Lrg sacrococcygeum posteriussuperficiale

Spatium retropubicum""


Lrneaalba

Articulatio sacrococcygea Symphysis pubica

Ampulla recti

Lig lundiforme penis

Fascia rectoprostatica

V dorsalis profunda penis a

Prostata

Fasciapelvisvisceralis dorsalis superficialispenis o

Corpusanococcygeum [Lig anococcygeum] Urethra,Pars spongiosa

6 M sphincterani externus

Duclus delerens

ani * M sphincter internus

Caputepididymidis Tunicaalbuginea corporum cavernosorum

Columnae anales: Sinus anales


(Pecten analis)


ani externus * M sphincter perineiprofundus & M transversus

Septulatestis

Membrana perinei

Coronaglandis Glanspenis

Ductuliefferentes testis

Fossa navicularisurethrae

Mediastinumtestis

P r e p u t i upme n i s

Ductusdeferens; Caudaepididymidis

Ostiumurethrae externum

Urethra,Parsintermedia Imembranacea] Lig puboprostaticum penis Bulbuspenis,Corpusspongiosum

Tunicadartos.M dartos S Scrotum.

M cremaster; Fasciacremasterica & Lobuli testis

F i g . 1 1 9 9 P e L v i sP, e L v i so,f t h e m a l e ; m e d i a ns e c t i o n ; viewedfrom the [eft. * C l i n i c at eI r m :K o H L R A U sSfCoH td * * C t i n i c at eI T mc: a v eo f R E T Z I U S

Vertebra l u m b a l i sV Canalis sacrails

M rectus abdominis

Colon sigmoideum

Vesica urinaria

Symphysis pubica

Bulbus penis

F i g . 1 2 0 0 P e L v i sP, e t v i so, f t h e m a [ e ; m a g n e t i cr e s o n a n c teo m o g r a p h i c i m a g eI M R l l ; p a r a m e d i a ns e c t i o n ; viewedfrom the left

Testrs

Os sacrum

Ampullarecti Os coccygis

Prostata

Canalisanalis

Rectum

Genitatia

T n p o E r aphy Sections Femalepelvis,

sections

Fimbriaetubae uterinae

Infundibulum tubaeuterinae

Uterus.Faciesintestinalis Cavitas uteri; Canalis ceruicisuteri, Plicae palmatae

A sacralismediana a

Lig suspensorium ovarii;A; V ovaricaa o Colon sigmoideum

A.; V iliacaexternaa o Ampullatubaeuterinae Ovarium,Folliculus ovaricus vesiculosus

a A. sacralis mediana

lsthmustubaeuterinae Fundusuteri Lig teresuteri A ; V epigastricainferiorO a Plica umbilicalismedialis (Chorda a umbilicalis) Ampulla recti; Plicae transversae recti

Peritoneumparietale Linea alba

Excavatiorectouterina***

Plica umbilicalismediana (Lig umbilicalemedianum)

Fornix vaginae, Pars posterior

Fascia pelvis parietalis lsthmus uteri

Portiovaginalisceruicis

Uterus, Facies vesicalis

Ostium uteri

Excavatiovesicouterina Glomus coccygeum

Fascia rectovaginalis [Septum rectovaginalel

Ostiumurethraeinternum

Corpuscijtoridis, Corpuscavernosum clitoridis Frenulum clitoridis Ostiumureteris

Labium m i n u sp u d e n d i Labium majus pudendi

externum Ostiumurethrae

Os sacrum Promontorium lvl erectorspinae

Fig. 1201 Petvis,Petvis,of the femate; m e d i a ns e c t i o n ; t h e i n t e s t i n eh a s b e e na l m o s tc o m p l e t e t y r e m o v e dw i t h s o m e r e m n a n t so f t h e s i g m o i da n d r e c t u m ; v i e w e df r o m t h e L e f t . * C t i n i c at eI r m :v e s i c o v a g isneapI t u m + * C l i n i c at eI T ms: a c r o u t e r iLnieg a m e n t *** C[inicaI term:pouchof DOUGLAS

lntestinum lenue l\,4rectus abdominis Corpusuteri Vesica unnafla Symphysis

Portiovaginalisceruicis Vagina Spatium rectovaginale

urethra

Fig. 1202 pelvis,pelvis,of the female; tomographic m a g n e t i cr e s o n a n c e i m a g eI M R l ) ; p a r a m e d i asne c t i o n ; viewedfrom the [eft.


g tand y ndder KidneyI Supr nr enal . | [.l r i narbl

Lowerabdomen,transversesections

a A rectalissuperior Colon sigmoideum

a Aa sigmoideae

& l\4 rectusabdominis

A iliacacommunis a)

o A epigastricainferior

V iliacacommunis a Ureter

lleum

A testicularis a

* M obliquusinternus abdominis l\4 transversus abdominis * M obliquus externus abdominis

Colon ascendens

Crista iliaca

M psoas.s malor

Colon oescenoens

P l e x u sl u m b a l i s # M iliacus

A l ao s s i si l i u m Vertebra lumbalisV

S M gluteus medtus

A;Vgluteasuperioraa Os sacrum, Proc articularissuperior s l\4 gluteusmaximus

Ligg sacroiliacainterossea C a u d ae q u i n a

superior Spinailiacaposterior Vertebra lumbalisV, Proc articularis inferior

F i g . 1 2 0 3 P e t v i sP , e[vis; t r a n s v e r s es e c t i o na t t h e l e v e Io f t h e f i f t h L u m b a vr e r t e b r a . T h i s m a l e s p e c i m e ni s d i f f e r e nftr o m F i g . 1 1 9 1 ,1 1 9 3 ,1 1 9 5 a n d 119 7 .

A s t h e s i g m o i dr e a c h e sf a r i n t ot h e u p p e ra b d o m e nt h e f i g u r e a L s od i s p L a ytsh e d o m eo f c o L o n ifct e x u r eT. h e t h i c k n e s so f t h e a d i p o s et i s s u eL a y e or n t h e g t u t e u sm e d i u sm u s c L em u s t b e t a k e ni n t o c o n s i d e r a t i ownh e n i n j e c t i ng i n t r a m u s c u [ a r l y .

M rectus Colon a b d o m i n i s 0escenoens

M transversusabdominis M obliquusinternus abdominis

Colon sigmoideum


Caecum

Cristailiaca

A i l i a c ac o m m u n i s

M iliacus V iliaca interna

M gluteusmedius l\4 psoas major

M gluteusmaximus

V iliaca externa

l\4 erector spinae

Fig. 1201 PeLvis,Petvis; c o m p u t e dt o m o g r a p h i c r o s s - s e c t i o{nC T la t t h e l e v e I o f t h e f i r s t s a c r a Iv e r t e b r aa f t e r a d m i n i s t r a t i o n


o f a c o n t r a sm t e d i u mi n t ot h e c o t o n ; s u p i npeo s i t i o n ; i n f e r i o rv i e w . * Calcificatio n tnh ew a t lo f t h ei l i a ca r t e r y

' p a t e l n u e Jr6e o d d e 'ourlsolur l l P L Ua s q l ] o s l J e dp u e J a ^ r la q t ' q l e u r o l sa q l ' l J e a qo q l s e q r n s s u e 6 J o s a u e l du o r l l a so q l Jo 'IICl p a l n d u r o s u o r l ] e s l r q d e r 6 o u r o ] lre ] u o z r J o uq o p a s e q a u e l dl e l u o J la q l u r u o r l l n J l s u o l a p l aprn6-aurnlo^ u a u r o p q v ' u a u r o p q v9 0 z l ' 6 l J

suopuassEuoloc suepuacsopuoloc rouap ueu

unueponc

urnun[af

Ecuol^dsred lolse9 roueons ecuelueseulv

reuap snqol 'rPdaH

slledoqsarel 6Fl

luar'tluotdS

lalstuts snqo"lrEdeH

relsPc

euOerqderO ralsrurs srprocsnlnc!.lluon urruuapsrpJocurnulv

'uawopqeJa$o-l

suo!llas

fiqder6odol

u n lla u

er l el r ua9

fualre1e.rou-ra; aqlJolJedletpaulaql ut uotleltJnleO * 'uorlrsod a u r d n su r ] ) a f q n se q ] q l l Ms t A l a dJ o s s a a l q] Ll6noJqi lf Cl uorlras-ssorllr qder 6ourolpelndurol :aleLUaql ,o 'st^led'st^lod LOZL'6lt

[sna6^ccoc l l] snab^ccocortlcsr li\ srlPueorqcsr Pssol

ruP rolEêl y!

ecrperqcsr euros

sncrperqcsr N

y1 snurxeusna1n16

snurolxasnuole.rnlqol :ofeu :elueqcoll'rnLual PSOInCTSAA elnpuelc snuirurr! la snrpauirep16tuyl EUeUUneStSAn

suourajlnoPc rlnqPlace essol

ePlel aercsel rosual y!

y! snuJalur snrJoleJnlqo

suor.r.rajsnlcar !\

snuouPs|/\ sBosdorlr |/\

snaurlcaoyI

+ srleJotlaj V

srlerotr]aln snc[euroossnlncrunl

srqnoso

ecrqndsrs^qdu^S srururopqE snlcar n

l o r l l e sa s r a ^ s u e r l s r ^ l a dJ a s s o e l q l q 6 n o J qu :oleul aql jo 'sr^led'sr^lad gOZa'6lJ

PSOlnCrSa^ elnpuelg

PuJolurepuap An: vda o

snquir"l'unlnqElacv

uinlceH

suoual exauuincrcn o srlPrpauJ srlPrpaui suoual a exauurncrsv

st6,{ccoc s6

suaralapsnlcno

ruralurilrolPrnlqorlncsnu EourpualqnseslnE ilr.lcsrso

roua;uree1n16 1 O eelnl6V o

sncrperqcstN * snutxeut snelnlo y! a

snrpeuJ a snelnloy! ilpoLU ralnl0rlncsnu PCUAlUeqCOrl eSrng

srlecrsaA

snsouo^snxalda

roleu JAlUeqcorl rnual

snurolur snuolPrnlqou\ o

eercsel a rosual n suelncrqro euoz

ecPrll eeurpuelqns esrng

srJouiallnoPc 'lnutal

seosoorl|.u\ a

suourol surdec6q

suor.lajepunloJov o

o o euolernlqon: v o suoual snpal yI O sPosdorlrU\ o snlrouesn

srleroualN t,

P3erI POUrpualqns eslng

srlerouialv a

snqur"l'unlnqelacv

stleloulojn a srlerporxoredns snpoN 'srlercUadns srleurnOur snaproqdLu^l snpoN snauncedy1I sncrlPrurods snlncrunl

* snuolErnlqo N

& sr;eluabg 'sr;eroualolrue6 I suajalopsnlcno

srqnoso pueut./nP3rsan

a suelnc[salv ecrqndsrs^qdur^S

srurrlropqe snlcor r{ a snDadns uncrqnd0r-l

suo\Jas asJaAsueJJ'stqad aFN

pue aleds leauoltJedollel eJalsl^ I^lad
Petvicviscera andretroperitoneaI space

U r i nar ybl adder

Malepelvis,obliquefrontalsection

o Aa sigmoideae a V iliaca interna

Peritoneumparietale

Osilium


Colonsigmoideum

Ureter Ductusdeferens Glandula vesiculosa

internus M obturatorius

o M levatorani

o o V;A pudendainterna*

Tuberischiadicum

a M bicepslemoris; M semitendinosus; M semimembranosus

Cutis lvl sphincterani internusa

a M levator ani, M puborectalis I M sphincterani externus

Fig. 1210 Petvis,PeLvis, of the ma[e; o b I i q u ef r o n t a Ls e c t i o nt h r o u g ht h e [ e s s e rp e t v i s . * C L i n i ctaeIr m A : L C 0 C sKc a n a t

Genitatia

Discusintervertebralis Vesicaurinaria M gluteusmaximus Corpusossisilium

M gluteusmedius Caputfemoris

internus M obturatorius Prostata

externus M obturatorius

Urethramasculina

M vastuslateralis


(Mm.adductores)


Fig. 1211 Petvis,Petvis,of the mate; t o m o g r a p h i ci m a g el M R l l ; m a g n e t i cr e s o n a n c e f r o n t a Ls e c t i o na t t h e l e v e Io f t h e h i p j o i n t s ; ventraIview.

M. psoasmajor

Cavitasuteri

Corpusuteri

Corpusossisilium

M iliacus

M. gluteusmaximus

M gluteusmedius

Caputfemoris internus M. obturatorius Collumfemoris

Tubauterina

externus M. obturatorius

Vesicaurinaria (Mm adductores)

Fig. 1212 Petvis,Petvis,of the femaLe; t o m o g r a p h i ci m a g eI M R l l ; m a g n e t i cr e s o n a n c e f r o n t a Is e c t i o na t t h e l e v e Io f t h e h i p i o i n t s ; ventraIview

W h e nt h eu r i n a r yb t a d d ei rs e m p t yt,h eu t e r u s[ i e so nt h ea p e x o f t h eb [ a d d edr u et o i t sa n t e f t e x r o n .


U r i nar ybtadder

Malepelvicdiaphragm, angled-frontalsection

Vesicaurinaria, Plicainterureterica Ostiumurethrae internum Ostiumureteris

o M. levatorani Peritoneum urogenitale, Fossaoaravesicalis O M. obturatoriusinternus Fossaacetabuli Lig capitis femoris

a N. pudendus Caput femoris

a M obturatorius eXlernus

a a A.;V

M. iliopsoas, O Tendo

circumflexa femoris medialis

M. quadratus O femoris Ramusinferior ossispubis

M adductora) mlntmus M adductorO ma9nus

oOA;V.pudenda interna

MmO ischiocrurales M. ischiocavernosus a

O M. transversus perineiprofundus

M. bulbospongiosus O Urethra masculina Penis, Corpus spongiosum

a N. perinealis

O M transversusperineisuperficialis Fascia perinei (superficialis)

Fig. 1213 Petvis,Petvis,of the ma[e; a n g l e d - f r o n t asIe c t i o nt h r o u g ht h e u r i n a r yb L a d d e r . * C t i n i c at eLr m :p a r a c y s t i u m ** CLinical term:prostatic venousptexus

FemaIe pelvic diaphragm, angled-frontaI section

Urethrafeminina Vesicaurinaria, Tunicamuscularis

N obturatorius;aOa A.; V obturatoria

M obturatorius internusa

Vesicaurinaria

a M levatorani Peritoneumurogenitale,Fossaparavesicalis Acetabulum Caputfemoris

Membrana obturatoria

. O V;4. pudenda interna; a N pudendus

M obturatoriusO exlernus N perinealis a

o (Diaphragma urogenitale)

M. iliopsoas a

Ramusossis ischii

M adductora orevts

Crusclitoridis

A. profundaa femoris, Aa circumflexae lemorismedialis et lateralis

a M ischiocavernosus Bulbus vestibuli

V profundaa femoris, Vv circumflexae femorismedialis et lateralis

a M bulbospon9rosus

M adductorO longus M. gracilis o

Labiummajuspudendi

Labiumminuspudendi

Fi$.1211 Pelvis,Pelvis,of the fema[e; a n g t e d - f r o n t asIe c t i o nt h r o u g ht h e u r i n a r yb t a d d e r . * Paracystium withvenousptexus

Urethrafeminina, Ostiumurethraeeldernum

> Lowertimb Surfaceanatomy

Os sacrum Spina iliaca anterior superior

(Sulcusanalis) M tensor fasciae latae R e g i oi n g u i n a l i s , Lig inguinale

Regioglutealis, M gluteusmaximus Trochanter major(Femu0

Trochanter major(Femur)

Sulcusglutealis

Begio

anterior lvl sartorius

M quadriceps femoris Regiogenusposterior, Fossapoplitea Caputlibulae Flegiogenus anterior, Patella Caput libulae

Tuberositas tibiae M gastrocnemius

Regio cruris anterior

Regiocrurisposterior, Sura

l\4argoanterior (l'lbia) Malleolusmedialis (Tibia) Malleolusmedialis (Tibia Malleoluslateralis(Fibula) Malleoluslateralis(Fibula)

Dorsumpedis Dorsumpedis D i g i t um s inimus lquintusl Digitusquartus Digitustertius Digitussecundus Hallux[Digitusprimus]

F i g . 1 2 1 5 L o w e r[ i m b ,M e m b r u mi n f e r i u s .

F i g . 1 2 1 6 L o w e rL i m b M , e m b r u mi n f e r i u s .

Thigh

Knee

Leg

Foot

Skeletonof the lowerlimb,overview

Articulatiosacroiliaca Cingulum pelvicum

Articulatio coxae

(Articulatio femoropatellaris) | (Articulatiomeniscofemoralis) Articulatiogenus I meniscotibialis) [ (Articutatio Parslibera membriinferioris Articulatio tibiofibularis

tibiofibularis Syndesmosis Articulatiotalocruralis Articulatiocalcaneocuboidea Tarsus,Ossatarsi

t

Metatarsus, Ossa metatarsi

Articulatiosubtalaris l. .. . j (Anlculaao'"lolarsalls) Articulatiotalocalcaneonavicularis Articulatiocuneonavicularis (Articulatio cuneocuboidea) intercuneiformes Articulationes Articulationes tarsometatarsales

Digitipedis, Ossadigitorum: - Phalanxproximalis - Phalanxmedia - Phalanxdistalis

Articulationes metatarsophalangeae Articulationesinterphalangeaepedis

Fig. 1217 Lower [imb, Membrum inferius; s k e l e t o na n d j o i n t s .

> Lowertimb

M us c [es

Pelvis

Promontorium

Aperturapelvissuperior t?tn^ iliaca posteriorsuperior

Tuberositasiliaca /

Os sacrum,Parslateralis

^L-:


Alaossisilium, Fossailiaca

Linea terminalis

Labium internum

Linea Crista intermedia iliaca Labium exlernum Tuberculum iliacum Linea arcuata

Os ilium Spina iliaca anterior supenor Spina iliaca anteriorinferior Spina ischiadica Os ischii

Eminentiailiopubica

Pectenossispubis Ramussuoeriorossisoubis

Articulatio sacrococcygea

Ospubis Aperturapelvisinferior

pubicum Tuberculum pubica Symphysis

F i g . 1 2 1 8 S a c r u m ,O s s a c r u m ,a n d p e l v i cg i r d t e , pelvicum CinguLum T h e r e g i o nc r a n i a It o t h e I i n e at e r m i n a t i si s r e f e r r e d , e t v i sm a j o r ,a n d t h e r e g i o n t o a s t h e g r e a t e rp e [ v i sP , e L v im c a u d a It o i t i s k n o w na s [ e s s e rp e t v i sP s inor.

Diameler o b l i q u al l

Fig. 1219 PeLvis, PeLvis; s h a p ea n d d i m e n s i o n so f t h e p e L v i icn L e t of thefemaLe.

Lineaterminalis

Fig. 1220 PeLvis, PeLvis; s h a p eo f t h e p e t v i ci n L e t ot the mate.

Topography Thigh

Knee

Leg

Foot

Pelvis

h-d = Sagittaldiameter of the pelvic brim 12-12.5 cm e-g = Sagittaldiameter of the pelvic constriction 11-l l 5 cm e-f = Sagittaldiameterof the pelvic outlet (=,Distantia puoococcygea) 9-1 0 cm

k-k = Pelvic axis a-b = Anatomicalconjugate a-e = Diagonalconjugate 12 5-13 cm a-c = True conjugate 104-11cm

Spina iliaca anteriorsuperior

Spinailiacaanteriorinferior maius Foramenischiadicum Linea terminalis

pelvissuperior Apertura Li9 sacrospinale

sacrotuberale Foramen ischiadicumminus

Aperturapelvisinferior Foramen obturatum Tuber ischiadicum

Fig. 1221 Pelvis,Petvis; d i m e n s i o nisn t h e f e m a [ e ; m e d i a ns e c t i o n .

a-a = Crestal distance 28-29 cm. b-b = Anterior spinal distance 25-26 cmc-c = Posteriorspinal distance (width of the sacrum) 10cm " In this perspective,the crestal distance appears shorter than the anterior spinal distance

Fig. 1222 Petvis,PeLvis, d i m e n s i o nisn t h e f e m a t e

d-d = Transversediameter of the pelvic brim (= interacetabularline) 12-12 5 cm e-e = Transversediameter of the oelvic constriction (= iriterspinalline) '10 5 cm l-f = Transversediameterol the pelvic outlet (= tuberal diameter) '11-.12 cm)

> Lowertimb

h4r-rEe[es

Hipbone

Crista iliaca Linea intermedia

A l a o s s i si l i u m

Labiuminternum Facies sacropelvica

Fossa iliaca

Tuberositas iliaca

Spina iliaca anteriorsuperior

Faciesauricularis Spinailiacaposterior superior Spina iliaca anterior inferior Linea arcuata

Spina iliaca posteriorinferior

Incisuraischiadicamajor E m i n e n t i ai l i o p u b i c a

Sulcusobturatorius Corpus ossis ischii

Ramussuperior ossispubis, Pectenossispubis

Spina ischiadica Incisuraischiadicaminor

Foramen obturatum

(Tuberculumobturatoriumposterius)

Faciessymphysialis Bamus ossis ischii

Flamusinferiorossis pubis

Tuberischiadicum

F i 1 . 1 2 2 3 H i p b o n e , 0 sc o x a e ; m e d i a Iv i e w T h et h i n r e g i o ni n t h e c e n t r eo f t h e a [ ao f i t i u m i s c h a r a c t e r r s t r c for itsframe-Like structure.

Tuberositasiliaca

Crista iliaca


Facies sacropelvica

Facies auricularis

Sulcussupraacetabularis Spinailiacaanteriorinferior

Corpusossisilium Eminentia iliopubica Corpusossispubis Ramussuperior ossisDubis Cristaobturatoria Pecten ossis pubis

pubicum Tuberculum Cristapubica

(Tuberculum posterius) obturatorium Foramen obturatum

F i g . 1 2 2 1 H i p b o n e , 0 sc o x a e ; v e n t r a Iv i e w

Facies symphysialis

(Angulus ossispubis) Ramusinferiorossispubis

Tuber ischiadicum

Ramus ossis ischii

T op o gn ap h y ThiEh Knee

Leg

Foot

Hip bone

Labiuminternum Linea intermedia Linea glulea anterior

Facies glutea

Labiumexternum iliacum Tuberculum

Crista iliaca

Linea glutea inferior

Alaossisilium Soina iliaca anteriorsuoerior

(Tuberositas musculi gluteimaximi)

Spinailiacaposterior superior Corpusossisilium Spina iliaca anterior inferior

Spina iliaca posteriorinferior

SulcussuDraacetabularis

Incisuraischiadicamajol

Facies lunata

Limbus acetabuliIMargo acetabuli]

Fossa acetabuli

Incisura acetabuli

Pectenossispubis Cristaobturatoria

Spina ischiadica

pubicum Tuberculum

Incisuraischiadicaminor

Ramusinferiorossisoubis Corpusossisischii anterius Tuberculum obturatorium posterius) (Tuberculum obturalorium

Tuber ischiadicum

Ramusossisischii

F i 1 . 1 2 2 5 H i p b o n e , 0 sc o x a e ; dorsotateraLview.


Corpusossisilium Eminentia iliopubica

Corpusossis puors Corpusossisischii Tuberischladicum (cartilagineum) Ramus ossis ischii

F i 1 . 1 2 2 6 H i p b o n e , 0 sc o x a e ; devetopment * A p p r o x i m a t seitxyt hy e a ro f [ i f e

Ramussuperior ossispubis Ramusinferior ossispubis

F i g . 1 2 2 7 H i p b o n e , 0 sc o x a e ; i nt a 6 - y e a r - o l dc h i t d . s t a g eo f d e v e L o p m e n I n t h e a c e t a b u t u mt ,h e t h r e e p a r t so f t h e h i p b o n ea r e f u s e d . h i sj u n c t i o no s s i if e s a t t o a Y - s h a p e dc a r t i t a g i n o uj su n c t i o n T t h e a g e o f 13 - 18 y e a r s .

> Lowertimb

M us c l es

Jointsof thepelvicgirdle

Vertebra lumbalislV


Discusintervertebralisnrticutatio \ lumbosacralis Lig iliolumbale J

Ligg sacroiliacaanteriora

Soina iliaca anteriorsuoerior

Lig pubicumsuperius

Lig iliofemorale

Canalisobturatorius

Articulatio coxae, Capsulaarticularis Trochanter major Membrana obturatoria

Angulus subpubicus

Fig. 1228 Jointsof the petvicAirdLe, J u n c t u r a ec i n g u t ip e [ v i c ia, n d t h e I u m b o s a c r a L j o i n t A r t i c u t a t i oL u m b o s a c r a t iosf.t h e m a t e .

Vertebra lumbalislV Discus intervedebralis) Articulatiolumbosacralis / Lig. iliolumbate /

Lig inguinale Articulatiosacroiliaca


Lig iliofemorale Trochantermajor

Tuber ischiadicum

Arcuspubicus

Fi1. 1229 Joints of the peLvicairdLe, J u n c t u r a ec i n g u Lpi e t v i c ia, n d t h e I u m b o s a c r aj o I int, A r t i c u t a t i o[ u m b o s a c r a I i so.f t h e f e m a [ e

Topography Thigh

Knee

Leg

Foot


Vertebra lumbalislV CorDus Lig iliolumbale

Vertebralumbalis V Proc costalis

Articulatio sacroiliaca, anterius Lig sacroiliacum

majus Foramenischiadicum Spinailiacaanteriorsuperior Lig sacrotuberale

Lig inguinale Lig.sacrospinale M rectusfemoris,Tendo

Lacunamusculorum

minus Foramenischiadicum

Arcusiliopectineus

Articulatiocoxae, Lig iliofemorale

Lig Lacuna vasorum pubrcum supenus

F i g . 1 2 3 0 J o i n t so f t h e p e t v i cg i r d t e , I int, J u n c t u r a ec i n g u Lpi e [ v i c ia, n d t h e I u m b o s a c r aj o A r t i c u l a t i o[ u m b o s a c r a t i so,f t h e m a t e

Vertebra lumbalislV.Corous Vertebra lumbalis V, Proc costalis

Lig iliolumbale

Articulatio sacroiliaca, Lig sacroiliacumanterius

majus Foramenischiadicum Lig sacrospinale

Soina iliaca anteriorsuoerior Lig inguinale

Lig sacrotuberale minus Foramenischiadicum

Lacuna musculorum

M rectusfemoris,Tendo Arcusiliopectineus Articulatiocoxae, Lig iliofemorale Ltg

pubrcum supenus

Fig. 1231 Joints of the peLvicgirdte, j oI i n t , J u n c t u r a ec i n g u l ip e [ v i c ia, n d t h e L u m b o s a c r a A r t i c u l a t i oI u m b o s a c r a t i so,f t h e f e m a [ e .

> Lowertimb

Musc[es

Jointsof thepeLvic girdle

Lig supraspinale

Lig iliolumbale

Ligg sacroiliacaposteriora

Ligg sacroiliacaposteriora Ligg sacroiliaca Interossea

Lig sacrotuberale

Proc falcilormis

Lig sacrospinale

Lrg sacrococcygeum posteriusprofundum

Lrg. sacrococcygeum posteriussuperficiale

Lig.pubicuminferius

+

F i g . 1 2 3 2 J o i n t so f t h e p e t v i cg i r d t e , j oI i n t , J u n c t u r a ec i n g u t ip e t v i c ia, n d t h e L u m b o s a c r a A r t i c u t a t i o[ u m b o s a c r a L iosf,t h e f e m a t e .

Spinailiacaposterior superior

Foramenischiadicum majus

Foramenischiadicum minus Proc falciformis

Articulatio coxae, Capsula articularis

Lig inguinale

Tuberischiadicum Lig pubicum inferius

€ F i 9 . 1 2 3 3 J o i n t so f t h e p e t v i cA i r d [ e , J u n c t u r a ec i n g u t ip e [ v i c io, f t h e f e m a [ e .

To pogr a p h y Thigh

Knee

Leg

Foot


Canalis sacralis Ligg sacroiliacainterossea

Ligg sacroiliacaposteriora

Articulatiosacroiliaca Ligg sacroiliacaanteriora

Lig sacrospinale Foramen ischiadicum maJus

Lig capitis femoris Lig sacrotuberale

Caputfemoris Lig capitis femoris

Cavitasarticularis

Foramen ischiadicum

Zonaorbicularis

MINUS

Membrana obturatoria Lig pubicum inferius

Articulatiocoxae, Capsulaarticularis

pubica, Symphysis Discusinterpubicus

Fig. 123t, Jointsof the pelvicgird[e, J u n c t u r a ec i n g u Lpi e [ v i c io, f t h e f e m a [ e

Vertebra lumbalis V Corpus

Forameninteruertebrale

Articulatiolumbosacralis, Discus interuertebralis

Os sacrum Crista iliaca Fossa iliaca


Spina iliaca anterior inferior Foramen ischiadicummajus

Lineaarcuata Lig sacrospinale

Linea terminalis

Pectenossispubis

Os coccygis Foramen ischiadicumminus

pubicum Tuberculum Lig sacrotuberale

Faciessymphysialis Foramenobturatum

F i 9 . 1 2 3 5 J o i n t so f t h e p e [ v i cg i r d [ e , J u n c t u r a ec i n g u Lpi e L v i cai ,n d t h e [ u m b o s a c r a I j o i n t , A r t i c u t a t i o[ u m b o s a c r a t i so,f t h e f e m a [ e ; m e d i a ns e c t i o n .

N o r m a [ t yt,h e a n t e r i o rb o r d e ro f t h e l o w e s ti n t e r v e r t e b r adLi s c forms the furthestprojectingpointof the posteriorcircumference o f t h e p e l . v iicn [ e t .R a d i o g r a p h i c a ttlh. ye,m o s t a n t e r i o rp a r t o f t h e sacrum is referredto as promontory.

> Lowertimb

M us c l es

Jointsof thepelvicgirdLe


Ligg sacroiliacainterossea

Os sacrum Ligg sacroiliacaanteriora

F i g . 1 2 3 6 S a c r o i t i ajco i n t ,A r t i c u L a t isoa c r o i I i a c a ; f r o n t a Is e c t i o n

Discusinterpubicus, Cartilago tibrosa (Cavitas symphysialis)*

Ramussuoeriorossisoubis

Cartilagohyalina

i

Lig. pubicum inferius

Ramusinferiorossispubis

Fig. 1237 Pubicsymphysis,Symphysispubica; o b t i q u es e c t i o ni n t h e d i r e c t i o no f t h e L o n g i t u d i n a L a x i so f t h e s y m p h y s i s T h e i n t e r p u b i cd i s c c o n s i s t so f f i b r o u sc a r t i L a g ew,i t h the exception o f t h e a r t i c u L asr y m p h y s i asI u r f a c e so f b o t h p u b i cb o n e st h a t a r e c o v e r e dw i t h h y a t i n e c a r t i t a g eA. [ o n g i t u d i n af lLa t c l e f to c c u r sa f t e r t h e f i r s t d e c a d eo f L i f e[ * ] .

TopographyI Sections Thigh

Knee

Leg

Foot

Pelvis,radiography

Basis ossis sacri

Proc spinosus Proc articularissuperior lumbalislV Vertebra Pediculus arcusvertebrae

Crista iliaca

Proc costalis

Spina iliaca posterior supenor

Os sacrum, Pars lateralis

Spina iliaca posterior inlerior

Articulatio sacroiliaca

Ala ossis ilium Spina iliaca anterior supenor Linea arcuala Spina iliaca anterior inlerior

Os sacrum

Articulatio coxae, Cavitas articularis

Spina ischiadica

Fossa acetabuli Fovea capitis femoris

Caput femoris

Eminentia iliopubica

Trochanter maJor Collum femoris Cristaintertrochanterica

Tuber ischiadicum

Trochanter mtnor

Foramen obturatum

pubicum Tuberculum Os coccygis

Ramusossisischii Ramussuperiorossispubis

pubica Symphysis

Ramus inferiorossis pubis

F i g . 1 2 3 8 P e L v i sP, e t v i so, f t h e m a l e ; A P - r a d i o g r a pw h i t h t h e c e n t r a Ib e a md i r e c t e d o n t ot h e t h i r d s a c r a Is e g m e n t ;u p r i g h tp o s i t i o n

> Lowertimb

$urnfnae lSketetonl

MLrscles Petvis

Pelvis,development

Os ilium

Vertebraesacrales

Trochantermajor * Symphysis pubica

Os pubis Trochanter minor+

Os ischii

Fig. 123i Pelvis,PeLvis, and femur, Femur; A P - r a d i o g r a pohf a f e m a t e ,p r e m a t u r eb a b y [ e i g h t hm o n t h o f p r e g n a n c y )

*

O s s e o u sr o o fo f t h e a c e t a b u L u m * * Y - s h a p e jdu n c t i o ni n t h e a c e t a b u L af or s s a * * + T h eo s s i f i c a t i ocne n t r ei n t h e h e a do f t h e f e m u r d o e sn o t a o p e a r b e f o r et h e t h i r d t o f i f t h m o n t h o f [ i f e + A t t h i s a g e , b o t h g r e a t e rt r o c h a n t e r so n L yb e c o m ea p p a r e n ta s s m a t I p r o t u b e r a n c eosf t h e b o n eo f t h e d i a p h y s i s

Os ilium

Vertebrae sacrales

Trochantermajor + Symphysis pubica Os pubis Foramen obturatum Os ischii Trochanterminor + Femur, Diaphysis

Fig."1210 Petvis,PeLvis, and femur, Femur; A P - r a d i o g r a pohf a 1 2 - m o n t h - o Lbdo y

*

0 s s e o u sr o o fo f t h e a c e t a b u L u m ** Y-shaped j u n c t i o ni n t h e a c e t a b u L af or s s a * * * O s s i f i c a t l ocne n t r ei n t h e e p i p h y s i os f t h e h e a do f t h e f e m u r + A t t h i s a g e ,b o t hg r e a t e rt r o c h a n t e r os n t yb e c o m ea p p a r e n at s s m a t t p r o t u b e r a n c eosf t h e b o n eo f t h e d i a p h y s i s .

Hip

Thigh

Knee

Leg

Foot

Femur

Foveacapitis femoris Caputfemoris

Caputfemoris

Trochantermajor

Fovea capitis femoris

Tuberculum quadratum Collumfemoris

Collumfemoris Crista intertrochanterica

Linea intertrochanterica Trochanterminor

Trochanter minor (Trochanter tertius)

Lineapectinea

Tuberositas grurea

Corpusfemoris

Lineasupracondylaris lateralis Linea supracondylaris medialis

Facies poplitea

Epicondylus lateralis Epicondylus lateralis

Fig.1211 Femur,Femur; ventraIview.

Fig. 1212 Femur,Femur; dorsaIview.

> Lowerlimb

tt

Hip

Femur

Fossa trochanterica

Caput femoris Fovea capitis femoris

Trochanter malor

Collumfemoris

Tuberculum quadratum

I

Cristaintertrochanterica Trochanter minor Tuberositas grurea Linea pectinea

Lrnea aspera, Labium mediale

F i g . 1 2 t 3 F e m u r ,F e m u r ; p r o x i m ae I xtremity; dorsaLview.

Fig. 1215 Femur, Femur; t r a b e c u t a sr t r u c t u r eo f t h e f e m o r a Lb o n ew i t h a L a r g e n e c k - s h a fat n g [ el c o x av a [ g a Js; e c t i o ni n t h e p [ a n eo f t h e a n g [ eo f a n t e r i o rt o r s i o n[ 6 0 % ] . T h e l a t e r a Ip t a t e so f t h e t r a b e c u L abro n e *[ " t e n s i Lsey s t e m " l a r e o n L yp o o r l yd e v e l o p e dw, h e r e a st h e m e d i a Lp t a t e s * + ( " c o m p r e s s i vsey s t e m " )a r e m u c h s t r o n g e r .

Fig. 1211 Femur, Femur; v a r i a b i L i toyf t h e a n g [ eo f t h e n e c ko f t h e f e m u r ; d o r s a Iv i e w . T h e a n g t eb e t w e e nt h e n e c ka n d t h e s h a f to f t h e f e m u r l s r e f e r r e dt o a s n e c k - s h a fat n o t e l t i s 15 0 " i n i n f a n t sa n d a b o u t 1 2 6 "i n t h e a d u [ t .

Fig. 1216 Femur, Femur; t r a b e c u L asrt r u c t u r eo f t h e f e m o r a Ib o n ew i t h a s m a L [ n e c k - s h a fat n g L el c o x av a r a l ;s e c t i o ni n t h e p t a n eo f t h e a n g [ eo f a n t e r i o rt o r s i o n[ 6 0 % ) . T h e l a t e r a Ip l a t e so f t h e t r a b e c u [ a br o n e* l " t e n s i l es y s t e m " l a r e w e t l d e v e l o p e dw, h i t et h e m e d i a Ip l a t e s* * L e s ss t r o n g .A s a l " c o m p r e s s i vsey s t e m ' la r e d e v e l o p e d r e s u Lot f t h e h i g hd e m a n do f f t e x i o nt,h e c o r t e xo n t h e i n n e r s i d eo f t h e f e m o r a In e c k i s o a r t i c u [ a r ltvh i c k .

Thigh

Knee

Leg

Foot

Caputfemoris

Foveacapitisfemoris Trochantermajor

Fossatrochanterica Collum femoris

Trochanter minor

Lrnea aspera

Fig. 121,8 Femur, Femur; v a r i a b i t i to y f t h e a n g [ eo f a n t e r i o rt o r s i o n ;t h e p r o x i m a I e n d o f t h e f e m u r h a s b e e np r o j e c t e do v e rt h e d i s t a Ie n d ; o r o x i m avI i e w T h e a n g [ eo f a n t e r i o rt o r s i o ni s a b o u t3 0 oi n i n f a n t s a n d a b o u t1 4 oi n a d u L t s .

Corpusfemoris

Substantia compacra Facies poplitea

Substantia spongrosa

Tuberculum adductorium Fossaintercondylaris Epicondylus medialis

Cavitasmedullaris Condyluslateralis

Condylus medialis

Fig.121l Femur,Femur; mediaIview.

Fig.121,9 Femur,Femur; t h em i d d t eo f t h es h a f t ; c r o s s - s e c t i tohnr o u g h d i s t avI i e w .

> Lowertimb

M us c tes

Hipjoint

l\il rectus femoris, Tendo

Membranaobturatoria

Trochanter minor

F i g . 1 2 5 0 H i pj o i n t ,A r t i c u t a t i oc o x a e ; v e n t r o d i s t avIi e w .

Lig sacrospinale

caPutrellexumJ M. rectus femoris'Tendo caputrectum J Lig iliofemorale Lig sacrotuberale Collum femoris

Lig ischiofemorale

Trochanter major

Trochanter minor

glutea Tuberositas

F i g . 1 2 5 1 H i pj o i n t ,A r t i c u t a t i oc o x a e ; d o r s a Iv i e w .

T o p o g r a p h yI S e c t i o n s Thigh

Knee

LeE

Font

Hipjoint

Caputrectum l\4 rectus temoris, Tendo

Lig iliolemorale Labrum acetabuli Lig capitis femoris

Caputreflexum

Canalisobturatorius

Os pubis, Faciessymphysialis Caput femoris Lig pubofemorale Lig capitis femoris

N4embranaobturatoria

Trochanter minor

F i g . 1 2 5 2 H i pj o i n t ,A r t i c u l a t i oc o x a e ; t h e a r t i c u t a rc a p s u t eh a s b e e no p e n e da n d t h e h e a do f t h e f e m u r h a s b e e np a r t l ye x a r t i c u L a t e d ; [aterodistaLview. Facies lunata Fossa acetabuli

Lig capitis femoris

F i 9 . 1 2 5 3 H i pj o i n t ,A r t i c u [ a t i oc o x a e ; a s p e c to f t h e a c e t a b u [ u ma f t e r r e m o v a o I f thearticuLar c a p s u L ae n d e x a r t i c u l a t i oonf t h e h e a do f t h e f e m u r . IaterodistaLview.


Lig transversum acetabuli Lig ischiofemorale; Capsula adicularis

Facies lunata


Cavitas articularis M gluteus medius

Caputfemoris Fossa acetabuli

s inimus M g l u t e um

Lig capitis femoris

Zonaorbicularis

Fovea capitis femoris

Fossatrochanterica

M obturatorius internus

Trochanter major Collum femoris

M gluteusmaximus, Tendo*

Laorum acetabuli

Bursatrochanterica musculi gluteimaximi Bursa lrochantericamusculi glulei medii

M obturatorius externus

Tractus iliotibialis

M iliopsoas, Tendo Trochanter minor

M vastuslateralis

F i g . 1 2 5 1 H i pj o i n t ,A r t i c u t a t i oc o x a e ; v e r t i c a sI e c t i o na t t h e p l a n eo f t h e a n g L eo f a n t e t o r s i o n * R a d i a t i o innst ot h ei t i o t i b i tarIa c t

> Lowertimb

$ur{ace

lSkeletonl

Hipjoint, radiography

Corpusossisilium

Fossa acetabuli Caput femoris Fovea capitis fgmoris

C o l l u mf e m o r i s Trochantermajor

Foramenobturatum

Tuberischiadicum Femur,Corpus

F i g . 1 2 5 5 H i pj o i n t ,A r t i c u [ a t i oc o x a e ; A P - r a d i o g r a p uh p; r i g h p t osition o n b o t h[ e g s

Trochanter minor

* C [ i n i c atIe r m : a c e t a b u l arro o f= t a n g e n t i apI r o j e c t i o o n f t h e [ u n a t es u r f a c e * x C t i n i c atIe r m : e d g eo f t h e a c e t a b u t arro o f= t h e m o s t l a t e r a Ip r o j e c t i o n of theacetabu[um * * * C L i n i c at eI r m : K O H L E Rt 'esa r d r o p= p r o j e c t i o o n f t h e a c e t a b u t af ro s s a

Os ilium

lncisura ischiadica maJor

Cavitasarticularis*

Caputfemoris

Trochanter major

Spina ischiadica

Incisuraischiadica mrnor

Foramen obturatum Trochanterminor

F i g . 1 2 5 6 H i pj o i n t ,A r t i c u L a t rcoo x a e ; n i t ht h e t h i g ha b d u c t e d A P - r a d i o g r a pshu; p i n ep o s i t r ow a n d f l e x e dI s o - c a L L eLdA U E N S T EoIrNo i e c t i o n ]

Tuberischiadicum

* D u et o m i n i m a Ia b s o r p t i o n o l X - r a y sb y c a r t i t a g e t, h e a r t i c u L a rc t e f t a p p e a r sa b n o r m a t l yb r o a d

Musctes

To poE r a p h y Thigh

Knee

LeE

Fsot

Femur

Epicondyluslateralis

Condylus lateralis

Sulcus popliteus

Fig. 1257 Femur, Femur; distaLextremity; [ateraLview.

Epicondylusmedialis

Epicondylus lateralis

Condylus medialis

Condylus lateralis

F i g . 1 2 5 8 F e m u r ,F e m u r ; d i s t a Ie x t r e m i t y ; distaLview.

Cavitasmedullaris

Substantiaspongiosa Linea epiphysialis

EpicondylusIateralis

Epicondylusmedialis

Sulcus popliteus Condylus lateralis

Condylus medialis (Cartilagoarticularis)

Fig. 1259 Femur, Femur; f r o n t a Is e c t i o nt h r o u g ht h e d i s t a Ip a r t ; v e n t r a Iv i e w

> Lowertimb

Muscl.es

Tibia

Facies articularis supenor

Tuberculum intercondylare laterale

Area intercondylarisanterior intercondylaremediale Facies articularis supeflor

Condylus medialis

Condylus lateralis

Facies articularis fibularis

Eminentia intercondylaris

Area intercondylaris posleflor

Tuberositas tibiae

Ltnea muscutl solei

Corpus tibiae

Margoanterior Foramen nutricium

l\4argomedialis Facies lateralis

Facies lateralis

Facies posteflor

Faciesposterior

Facies medialis

Corpus tibiae

Sulcus malleolaris

Incrsura fibularis Facies articularisin{erior

tnctsura fibularis

Faciesarticularis inferior

Facies articularismalleoli Facies articularis inlerior

F i g . 1 2 6 0 T i b i a ,T i b i a ; v e n t r a Iv i e w

Facies articularismalleoli medialis

ma

F i q . 1 2 6 1 T i b i a ,T i b i a ; Lateratview.

F i g . 1 2 6 2 T i b i a ,T i b i a ; d o r s a Iv i e w

Tuberositastibiae

Areaintercondylaris anterior

Tuberculumintercondylarelaterale

Condyluslateralis" Condylus medialis.

Caputfibulae Articulatio tibiofibularis Tuberculumintercondylaremediale Area intercondvlarisoosterior

F i g . 1 2 6 3 T i b i a ,T i b i a ,a n d f i b u t a ,F i b u t a ; p r o x i m avI i e w . * Theartrcutar surfaces of thecondyles together are referred to as suoeriorarlicutarsurface

To p o g r a p h y Thigh

Knee

Leg

Foot

Tibiaand fibula

Apex capitis fibulae

Apex capitis tibulae

Facies articularis capitis fibulae

Caput fibulae

Caput fibulae

Collum fibulae

Crista medialis

Margo posterior

l/argo anterior Margo Inlerosseus

Foramennutricium

Facies medialis

Corpusfibulae

Facies lateralis

Margo anlerior

Facies posterior

Facies articularis malleoli lateralis

Sulcus malleolaris

F i g .1 2 6 t + F i b u t a F , ibuta; medialview

lvlalleolus lateralis

F i g . 1 2 6 5 F i b u L aF, i b u L a ; [ a t e r a vt i e w .

F i 1 . 1 2 6 6 T i b i a ,T i b i a ,a n d f i b u l . aF, i b u L a ; dorsaLview.

Facieslateralis Margoanterior

Faciesmedialis Corpustibiae lvlargoanterior Facies lateralis Facies medialis

Corpusfibulae Margointerosseus Facies poslerior Crista medialis

F i g . 1 2 6 7 T i b i a ,T i b i a ,a n d f i b u L aF, i b u L a ; c r o s s - s e c t i ow n i t h t h e i n t e r o s s e o um s e m b r a n eo f l e g ; distaIview. * 0 p e n i nfgo rt h ea n t e r i ot ri b i aaI r t e r y

> Lowerlimb

M us c [es

Patellaand kneejoint

Facies articularis Facies anterior

Fig. 1269 Patelta,Patelta: d o r s a Iv i e w .

Fig. 1268 Pate[La, PateLta; ventraIview.

Faciesanterior Facies articularis,Cadilago articularis

Retinaculumpatellaemediale

Articulatiogenus (Articulatio femoropatellaris)

(Plica synovialismediopatellaris) Betinaculumpatellaelaterale Facies patellaris,Cartilagoarticularis

Epicondylus lateralis

M biceps femoris

Tendo M sartorius, M gastrocnemius, Caput laterale V saphena magna

A poplitea V poplitea

M gracilis,Tendo

1 N l i b u l a r icso m m u n i/s N ischiadicus { N .t i b i a l i s \

M semimembranosus,Tendo

Tendo M. semitendinosus, V saphenaparva

M gastrocnemius, Caputmediale

F i g . 1 2 7 0 K n e ej o i n t ,A r t i c u L a t igoe n u s ; c r o s s - s e c t ino. * M e d i abl o r d efra c e t


Knee

Leg

Foot

Kneejoint

genus M articularis

Facies patellaris

M quadriceps femoris,Tendo Plica synovialis infrapatellaris M. quadriceps femoris

Condylus lateralis

Lig collaterale fibulare

Betinaculum patellae laterale Corpus adiposum intrapatellare

Betinaculum patellae mediale Capsula articularis

Lt9 collaterale tibiale Lig patellae

Caput fibulae

Tuberositas tibiae

F i g . 1 2 7 1 K n e ej o i n t ,A r t i c u l a t i og e n u s ; i n t a c ta r t i c u t a rc a p s u t e : ventraIview.

F i g . 1 2 7 2 K n e ej o i n t ,A r t i c u l a t i og e n u s ; t h e a n t e r i o rp a r t o f t h e a r t i c u [ a rc a p s u t eh a s of b e e nr e f[ e c t e dd o w n w a r d sa f t e r d i s s e c t i o n s uscte; the quadricepm t h e s u p r a p a t e t l abr u r s ah a s b e e no p e n e d ; ventraIview.

> Lowertimb

M us c l es

Kneejoint

Faciespatellaris ** posterius Lig cruciatum Condylusmedialis

Condylus lateralis

Meniscus medialis l\4eniscus lateralis

* Lig cruciatum anterius

Lig,capitisfibulaeanterius

genus Lrg transversum Caput fibulae

Tuberositas tibiae

F i g . 1 2 7 3 K n e ej o i n t ,A r t i c u t a t i og e n u s ; i n 9 0 of L e x i o n ; t h ae r t i c u t a rc a p s u L a en dt h e [ a t e r a L t i g a m e n t sh a v eb e e nr e m o v e d ; ventraLview.

* C l i n i c a l t e r mA; C L { = a n t e r i o rc r u c i a t et i g a m e n t l * * C t i n i c a l t e r mP: C Ll = p o s t e r i o cr r u c i a t et i g a m e n t )

M. adductormagnus,Tendo M plantaris lV.gastrocnemius, Caputmediale

Lig popliteum obliquum

M gastrocnemius, Caputlaterale Lig, collateralefibulare Lig popliteumarcuatum

Lig collateraletibiale M semimembranosus,Tendo

M biceps femoris, Tendo

M popliteus

F i g . 1 2 7 1 K n e ej o i n t ,A r t i c u L a t igoe n u s : i n t a c ta r t i c u L acr a p s u t ew i t h m u s c u t a ro r i g i n s ; dorsaIview.

To p o g r a p h yI S e cti o n s Thigh

Knee

Leg

Foot

Kneejoint

lvl adductormagnus, Tendo l/ gastrocnemius, Caputmediale, Tendo

M gastrocnemius, Tendo Caputlaterale,

Femur, Condylus medialis

Lig cruciatum anterius Lig meniscofemoraleposterius

Femur,Condyluslateralis

Lig collateraletibiale

M popliteus, Tendo

l\il semimembranosus,Tendo

Meniscus lateralis fibulare Lig collaterale

L r g p o p l i t e u mo b l i q u u m

Tibia,Condyluslateralis posterius Lig cruciatum

Lig capitisfibulaeposterius Caputlibulae

M popliteus, Aponeurosis M popliteus

F i g . 1 2 7 5 K n e ej o i n t ,A r t i c u L a t igoe n u s ; e x p o s u r eo f t h e c r u c i a t eL i g a m e n tasn d t h e m e n i s c i ; d o r s a Lv i e w

lvl quadricepsfemoris, Tendo

Femur

Lig patellae l\4eniscusmedialis Lig collateraletibiale

Tuberositas tibiae

F i g . 1 2 1 6 T i b i a lc o L [ a t e r aI iLg a m e n t L, i g .c o [ [ a t e r a ttei b i a [ e ; k n e ei n e x t e n d e p do s i t i o n : mediatview 0 n L yt h e p o s t e r i o rf i b r e so f t h e t i b i a L c o t [ a t e r Iai L gamena t re attached t o t h e m e d i a Im e n i s c u s

F i g . 1 2 7 7 T i b i a Lc o t l a t e r aLI i g a m e n tL, i g .c o l t a t e r a t tei b i a [ e ; p o s i t i o n[ 9 0 ' ] ; k n e ei n f L e x e d m e d i a Iv i e w I n t h e c o u r s eo f f t e x i o nt,h e p o s t e r i o ra n d p r o x i m a fI i b r e so f t h e t i b i a Ic o t L a t e r at iLg a m e n tb e c o m et w i s t e d t, h e r e b ys t a b i L i z i n g meniscus. themediaL

> Lowertimb

M us c l es

Kneejoint

Bursasuprapatellaris l\4 quadricepsfemoris,Tendo

Bursa subfascialisoreoatellaris

Lig collaterale fibulare

Lig patellae

l\4eniscus lateralis l\il popliteus, Tendo

profunda Bursainfrapatellaris Lig popliteum arcuatum

M biceps femoris,Tendo

F i g . 1 2 7 8 K n e ej o i n t ,A r t i c u t a t i og e n u s ; s y n o v i am L e m b r a n et i g h t t yf i l . l . eadf t e r i n j e c t i o no f p t a s t i cm a t e r i a L ; LateraIview. S u b p o p t i t e ar e L c e s sn o t s h o w nI c o m p ar e F i g . 1 2 7 9 ) .

M. adductormagnus,Tendo

posterius Lig cruciatum posterius Lig meniscofemorale M gastrocnemius, Caputlaterale Lig collateralefibulare**

Lig collateraletibiale*

Meniscus lateralis M. semimembranosus,Tendo

lvl popliteus, Tendo Meniscus medialis Lig popliteumobliquum

F i g . 1 2 7 9 K n e ej o i n t ,A r t i c u L a t igoe n u s ; s y n o v i am L e m b r a n et h i g h t t yf i L t e da f t e r i n j e c t i o no f p L a s t i m c ateriat; d o r s a Iv i e w * C t i n i c at eI r m :M C Ll = m e d i act o l t a t e r L a iIg a m e n t l * +C t i n i c at eI r m :L C L[ =L a t e r ac Io [ [ a t e rlai q[ a m e n t ]

M bicepsfemoris,Tendo Lig.popliteum arcuatum

Topography Thigh

Knee

Leg

Foot

Lig. patellae

profunda Bursainfrapatellaris

Lig.cruciatumanterius

Lig.transversum genus

A. mediagenus, (R. anterior)

Meniscus medialis A. mediagenus, (R. posterio0

M. popliteus, Tendo

Lig.cruciatum anterius Meniscus lateralis Lig.cruciatumposterius

A. poplitea Lig.cruciatumposterius

Lig. collaterale fibulare

A. inferiorlateralisgenus

, r t i c u t a t igoe n u s , F i g .1 2 8 0 M e n i s coif t h ek n e ej o i n t A a n dc r u c i a t [ei g a m e n t L s ,i g g c. r u c i a t a ; oroximaI view.

genus; Fi1.1281 Menisciof the kneejoint,Articutatio a r t e r i asI u p p t y ; view. oroximaI

F i g . 1 2 8 2 a , b D i s p t a c e m e notf t h e m e n i s c id u r i n gf t e x i o n ; lateraIview.

a Extendedposition b Ftexedposition

F i g .1 2 8 3 D i s p t a c e m eonf t h em e n i s cdi u r i n gf l e x i o n ; proximaI view. posteriorty overthe bothmenisciaredisp[aced In f Lexion, of the lateraI Thegreatermobil.ity edgesof thetibial.condyles. for its lesserrisk of damage. accounts meniscus

> Lowertimb Kneejoint,sections

M vastuslateralis

Epicondylusmedialis Epicondyluslateralis Lig collateraletibiale Lig cruciatumposterius

Lig cruciatum anterius

Femur, Condylus medialis

M popliteus, Tendo Femur,Condyluslateralis

lvleniscusmedialis

Capsulaarticularis

Tibia, Condylus medialis

Meniscus lateralis Tibia,Condyluslateralis Eminentia intercondylaris

M soleus M tibialisanterior

F i g . 1 2 8 1 K n e ej o i n t ,A r t i c u t a t i og e n u s ; f r o n t a Ls e c t i o n

Bursasuprapatellaris M quadricepsfemoris, Tendo

Femur, Facies patellaris

Corpusadiposum infrapatellare Femur,Condyluslateralis lvleniscus lateralis, (Cornuanterius)

Capsulaarticularis, Lig popliteum arcuatum (Cornuposterius) Meniscus lateralis,

Lig patellae

l\4 popliteus, Tendo Recessus subpopliteus

Tibia, Condylus lateralis

Lig capitisfibulaeposterius Articulatio tibiofibularis

M tibialisanterior

M soleus

F i 9 . 1 2 8 5 K n e ej o i n t ,A r t i c u L a t igoe n u s ; s a g i t t a sI e c t i o nt h r o u g ht h e [ a t e r a Lp a r t o f t h e j o i n t


Knee

Leg

Foot

Kneejoint, radi ography

Corpusfemoris Basis patellae

Epicondyluslateralis

medialis Epicondylus

Fossa intercondylaris

Apexpatellae

Sulcus popliteus Femur, Condylus lateralis

Femur,Condylusmedialis

Tibia, Condylus lateralis

Tibia,Condylusmedialis

Tuberculum mediale intercondylare

Apex capitis fibulae

Eminentia intercondylaris Tuberculum intercondylare laterale

Articulatiotibiofibularis

Lineaepiphysialis

Caput fibulae

Corpusfibulae Corpustibiae

F i g . 1 2 8 6 K n e ej o i n t ,A r t i c u t a t i og e n u s ; A P - r a d i o g r a pw h i t h t h e c e n t r a Ib e a md i r e c t e do n t o t h e m i d d t eo f t h e j o i n t ;s u b j e c rt e c L i n e d .

Corpusfemoris

Patella,Facies articularis Facies poplitea

Apex patellae Fossa intercondylaris Femur, Condylus medialis

Femur, Condylus lateralis Eminentiaintercondylaris

Linea epiphysialis Apex capitislibulae

Tuberositastibiae

Articulatiotibiofibularis

Caput fibulae

Corpustibiae Corpus libulae

F i g . 1 2 8 7 K n e ej o i n t ,A r t i c u L a t igoe n u s ; [ a t e r a Lr a d i o g r a p h w i t h t h e c e n t r a Lb e a md i r e c t e do n t o t h e m i d d L eo f t h e j o i n t ;s u b j e c tr e c t i n e d

> Lowertimb

M us e[es

Kneejoi nt,arthroscopy

Patella,Facies articularis*

'1 2 3 4 5 6 7

** suprapatellaris Arthroscope Inlet or outlet for the rinsinqfluid Cold light source Ocular or connectorfor the video system Anterolateralaccess Anteromedialaccess Additionalinstrument

Femur. Facies oatellaris

F i g . 1 2 8 9a - c K n e ej o i n t ,A r t i c u L a t igoe n u s ; a rth roscopy a DistaL v i e w i n t ot h e f e m o r o p a t e I Ljaori n t * P a t e L t raor o fr i d g er:i d g eb e t w e etnh em e d i aaI n d l^+^-^l

F i g . 1 2 8 8 A c c e s s e sf o r a r t h r o s c o p y

^-+;-.,1^- -,,-t^^^^

* * C [ i n i c atIe r m : s u o r a o a t e t t ar e r cess

Femur, Condylus lateralis

M e d i a tv i e wo f t h e f r e e i n n e re d g eo f t h e L a t e r a L mentScuS; r e t r a c t o r[ * l s t i g h t Ldy e p r e s s i n tgh e a n t e r i o rp a r t o f t n e menrscus

A n t e r o L a t e r vaiIe w o f t h e d i s t a Lo a r t o f t h e a n t e r i o rc r u c i a t e t i g a m e n tL, i g .c r u c i a t u ma n t e r i u s T h e l i g a m e n ti s c o v e r e db y a r i c h L yv a s c u L a r i z esdy n o v i a I m e m b r a n e l t i s d r a w n m e d i a t Lbyy a r e t r a c t o r[ + )

Topography Thigh

Knee

Leg

Fnnt

Kneejoint, imaging

l\il vastus lateralis

Condylus lateralis Fossa intercondylaris

Capsula articularis; M gastrocnemius, Tendo

Femur, Condylus medialis Lig collaterale tibiale

l\4eniscus lateralis,(Cornu

l\ileniscus medialis

Caput fibulae

M popliteus, Tendo

Adiculatio tibiofibularis


Tibia

infrapatellare Corpusadiposum

F i g . 1 2 9 1 K n e ej o i n t ,A r t i c u t a t i og e n u s ; m a g n e t i cr e s o n a n cteo m o g r a p h ii cm a g eI M R l l ; s a g i t t a sI e c t i o nt h r o u g ht h e [ a t e r a Ip a r t o f t h e j o i n t ; k n e ei n t h e e x t e n d e dp o s i t i o n .

F i g . 1 2 9 0 K n e ej o i n t ,A r t i c u t a t i og e n u s ; m a g n e t i cr e s o n a n cteo m o g r a p h ii cm a g eI M R l ) ; f r o n t a Is e c t i o n ; k n e ei n t h e e x t e n d e dp o s i t i o n . I n t h i s i m a g i n gt e c h n i q u ec,o m p a c bt o n ea p p e a r sb L a c k

Capsula articularis, Lig popliteum obliquum Lig cruciatum anterius Lig cruciatum posterius Area intercondylaris anterior

Fossa intercondylaris Capsula articularis, Lig popliteum obliquum Lig cruciatum posterius* Area intercondylaris posterior

Tibia

F i g . 1 2 9 2a , b K n e ej o i n t ,A r t i c u t a t i og e n u s ; m a g n e t i cr e s o n a n cteo m o g r a p h ii cm a g eI M R l ) ; the cruciate s a g i t t a sI e c t i o n st o d e m o n s t r a t e [rgaments; k n e ei n t h e e x t e n d e do o s i t i o n

a A n t e r i o rc r u c i a t eL i g a m e n tL, i g c r u c i a t u ma n t e r i u s I, A C L ] b P o s t e r i o cr r u c i a t et i g a m e n t L, i g .c r u c i a t u mp o s t e r i u sI,P C L ) T h ei n h o m o g e n ei si tdyu et o o b l i q u see c t i o n i nogf t h ef i b r eb u n d l e s

> Lowertimb Jointsof thebonesof the leq

Articulatio tibiofibularis, Lig.capitisfibulaeanterius

Tuberositas tibiae

Membranainterosseacruris

Malleolusmedialis Malleoluslateralis

Syndesmosls tibiofibularis, Lig tibiolibulare anterius

F i g . 1 2 9 3 J o i n t so f t h e b o n e so f t h e L e g ; ventralview.

Faciesarticularis inferior

Facies articularismalleolimedialis Malleoluslateralis

Facies articularismalleolilateralis

Malleolusmedialis

F i g . 1 2 9 1 T i b i a ,T i b i a ,a n d f i b u l . aF, i b u l . a ; distaIview.

To pogn a p h y Thigh

Knee

Leg

Foot

of thefoot Skeleton

Phalanx distalis

Fi1.1295 Skeletono f t h e f o o t ,O s s ap e d i s ; proximaIview.

Phalanx proximalis

Caputphalangis Corpusphalangis Caputossismetatarsi

Basisphalangis

Corpusossismetatarsi

Basisossismetatarsi

Os cuneiforme mediale Os cuneiforme I HalluxlDigitusprimus] ll Digitussecundus lll Digitustertius lV Digitusquartus V Digitusminimus[quintus]

Os cuneiforme intermedium

ossis Tuberositas quinti metatarsi Os cuboideum

Os naviculare Caputtali Calcaneus

Tuberositasphalangisdistalis

Proc lateralistali

Trochleatali

Caput phalangis l-lll

Calcaneus Phalanx distalis Phalanx media Phalanx proximalis Basis phalangis l-lll

Ossa sesamoidea

Ossametatarsil-V

Basisossis metatarsi lll-V Tuberositas ossis quinti metatarsi

Tuberositas ossis primi metatarsi

Os cuneiformemediale Os cuneiformeintermedium Os cuneiformelaterale

s usculi S u l c u st e n d i n im f i b u l a r il so n g i Tuberositas ossis cuboidei

Calcaneus

Tuberositasossis navicularis

Caputtali Talus tali Sustentaculum

o f t h e f o o t ,O s s ap e d i s ; Fig. 1296 SkeLeton p [ a n t a rv r e w .

> Lowertimb

MuscN.es

Skeletonof the foot

Caput tali Collum tali Facies malleolaris medialis

Corpustali Proc posterior tali,Tuberculum mediale Sustentaculum tali

Phalanx proximalis Phalanx media Phalanx distalis

Tuberositas metatarsiV

Ossasesamoidea medialeet laterale Basisossis metatarsi hallucis

Os cuboideum, Tuberositas ossiscuboidei

F i g . 1 2 9 7 S k e t e t o no f t h e f o o t ,O s s ap e d i s ; mediatview

Ossatarsi

Articulatiotarsi transversa* navtcutare

Os cuneiforme intermedium Os cuneiforme laterale Articulationes tarsometatarsales** Ossa metatarsi Ossa digitorum IPhalanges] Calcaneus Trochlea

Tuber calcanei

Sinustarsi

Articulatiotarsi transversa*

O sc u b o i d e u m

Tuberositas ossis metatarsiV

Articulationes tarsometatarsales**

F i g . 1 2 9 8 S k e L e t oonf t h e f o o t ,O s s ap e d i s ; [ateraIview. * A t s oc: H o P A RjTo'isn t + +A t s o L: | S F R A Nj oCi'nst

Caputossismetatarsi V

Topogr a p h y Thigh

Knee

Leg

Foot

Talusand calcaneus

Caputtali

Faciesarticularis navicularis

Caput tali

Collumtali Proc lateralis tali

Facies malleolaris medialis

C o l l u mt a l i

sulcustali Facies malleolaris lateralis

Corpustali

Corpustali Proc lateralis tali

Proc.posterior tal Tuberculum medial Sulcustendinis

Trochleatali, Facies superior

I I ./

Sulcustendinis musculiflexoris hallucislongi

Facies articularis calcanea posterior

Proc posterior tali, Tuberculum laterale

hallucislongi

Proc posterior tali

F i g . 1 3 0 0 T a L u sT,a L u s ; p [ a n t avri e w .

Fig.1299 Tatus,Tatus; p r o x i m avIi e w .

Sustentaculum tali Faciesarticularistalarisposterior

Facies articularistalaris media

Faciesarticularis talarisanterior

Sulcustendinismusculi flexorishallucislongi

Facies articulariscuboidea

Proc. medialistuberis calcanei Tuber calcanei

F i g . 1 3 0 1 C a l c a n e u sC, a L c a n e u s ; medialview.

Faciesarticularis talarisoosterior Facies articularistalaris media Trochleafibularis

talarisanterior Faciesarticularis

Sulcuscalcanei

Faciesarticularis cuboidea

Sulcustendinismusculi fibularislongi

Tuber calcanei Proc lateralistuberis calcanei

F i g . 1 3 0 2 C a L c a n e uC s ,a l c a n e u s ; lateraIview.

> Lowertimb

MurscLes

Tarsalbones

Os metatarsi ll Os metatarsilll

Os metatarsiI

Os metatarsilV

Caputossis metatarsi

US

Corpusossis metatarsi

Os cuneiformemediale

metatarsi V

I

s ossrs rtarsi

Os cuneiformeintermedium

)rositas metatarsi

Os cuneiforme laterale

ti S u l cu us st e n d i n i s musculi iculifibulari fibularis

Os naviculare

Tuberositas erositasos! ossi cuboidei oidei

Tuberositas ossisnavicularis

S

rboideum*

Facies articularisnavicularis Caput tali

(Facies al articularis catcanea)

Collum tali

Facies malleolarismedialis

Facies articulariscuboidea

Faciesarticularis talaris anterior

Trochleatali Facies malleolarislateralis

Facies articularistalaris media

Proc lateralistali

Proc postenor tali

Sulcus calcanei

Tuberculum mediale Sulcustendinismusculi flexorishallucislongi Tuberculum laterale

Facies articularistalaris posterior Calcaneus

Sustentaculum tali Sulcustendinismusculiflexorishallucislonoi

Proc. lateralis ) tuberis calcanei I r,,xo.

Proc.medialisI iir"""."i

tuberis calcanei/

F i g . 1 3 0 3 T a r s a bI o n e s , O s staa r s i , a n d m e t a t a r s abI o n e s ,O s s am e t a t a r s i ; proximaLview. * T h ec u b o i b d o n ei s s h o w ni n a m e d i a I v i e w

To p o g r a p h y Knee

Leg

Foot

Ossacuneiformia

Os naviculare

Os cuboideum

Os cuboideum

Calcaneus

Fig. 1304a, b Skeletonof the foot, Ossapedis; structurao I rganisation. a ProximaIview b P L a n t avr i e w

T h e h e a d so f a [ [ m e t a t a r s abl o n e sL i ei n t h e p t a n t a rp l a n e .T h e r o n ea n d t h e t a l u s r e s t u p o nt h e c u n e i f o r mb o n e s t, h e n a v i c u l a b [ateraIparts of the sketeton,especiat[yin the posteriorpart of the foot.The talus is thereforesituatedabovethe calcaneusand t h e L o n g i t u d i n a rI c h i s f o r m e d . T h ew e d g e - s h a p ecdr o s s - s e c t i oonf t h e c u n e i f o r mb o n e sa n d t h e b a s e so f t h e m e t a t a r s abI o n e sc o n t r i b u t et o t h e f o r m a t i o n of the transversevau[t.

Os naviculare Ossacuneiformia Os metatarsill Os metatarsiI Calcaneus

Aponeurosisplantaris

F i g . 1 3 0 5 S u p p o r t i n gs t r u c t u r e so f t h e m e d i a la r c h o f t h e t o n g i t u d i n avta u t to f t h e f o o t ; m e d i a Iv i e w .

M. abductorhallucis, Fascia

Lig.plantare longum

Lig. calcaneonaviculare plantare

are mostlydirectedin The ligamentsshown in this itl.ustration t h e t o n g i t u d i n aaIx i so f t h e f o o t a n d s u p p o r tp a s s i v e ttyh e t o n g i t u d i n a L v a uotftt h e f o o t .T h e s h o r t m u s c t e so f t h e f o o t p r i m a r i t ys u p p o r t h i s c o n s t r u c t i o n .

> Lowertimb

M us c l es

Jointsof the foot

ParstibiotalarisDosterior

Pars tibionavicularis M tibialisposterior,Tendo

M tibialisanterior, Tendo posterius Lig tibiolibulare

Tuber calcanei

Ligg tarsometatarsalia plantaria

Sulcus tendinis musculi libularis longi

Lig calcaneonaviculareplantare

Lig plantare longum

F i g . 1 3 0 6 J o i n t so f t h e f o o t ,A r t i c u L a t i o n epse d i s ; L i g a m e n tasn d t e n d o n s ; m e d i a tv i e w

Lig tibiofibulare anterius Lig talofibulareanterius

Lig talocalcaneum interosseum L4alleoluslateralis

Lio. cuboideonavicularedorsale Ligg cuneonaviculariadorsalia Ligg metatarsaliadorsalia

Lig calcaneofibulare

Tendo calcaneus'

Ligg metatarsalia transversa profunda Lig plantare longum

Lig calcaneonavtcurare

Lig calcaneocuboideum

Ligg tarsometatarsalia dorsalia

M libularisIperoneus] brevis,Tendo

Lig bifurcatum

F i g . 1 3 0 7 J o i n t so f t h e f o o t ,A r t i c u t a t i o n epse d i s ; L i g a m e n tasn d t e n d o n s ; Lateratview. * ALso: Achitles tendon

Topog r a p h yI S e c ti o n s Thigh

Knee

LeE

Foot

Anklejoint

Lig tibiolibulareposterius

posterius Lig talofibulare

l\4alleolusmedialis

Lig collateralemediale, Pars tibiotalarisposterior Malleoluslateralis Lig collateralemediale, Pars tibiocalcanea

posterius Lig talocalcaneum Talus Lig calcaneolibulare Lig talocalcaneummediale

Tendo calcaneus"

Calcaneus

Tuber calcanei

F i g . 1 3 0 8 J o i n t so f t h e f o o t ,A r t i c u t a t i o n epse d i s ; l i g a m e n t sa n d t e n d o n so f t h e p o s t e r i o rp a r t o f t h e f o o t * A l s oA : c h i [ [ et se n d o n

Fibula

Membrana interossea cruris

Facies articularisinferior

Lig tibiofibulare anterius Facies articularismalleolimedialis

Malleolusmedialis

Facies articularismalleoli lateralis

Sulcus malleolaris Malleoluslateralis

Plica synovialis

Lig tibiofibulareposterius

F i g . 1 3 0 9 A n k t ej o i n t ,A r t i c u L a t itoa t o c r u r a [ i s ; p r o x i m aa L r t i c u t a rs u r f a c e s ; distaLview.

> Lowertimb

$urfaee

lSkeletonl

Musci.es Hip

Joints of the foot

F i g . 1 3 1 0 J o i n t so f t h e f o o t ,A r t i c u t a t i o n epse d i s ; p t a n t a rv i e w . * W i t ht h el o n gp t a n t aLr i g a m etnhteg r o o vfeo rt h et e n d o n o f t h ef i b u [ a r i[so n g u m s uscte i s e n c t o s ei n da c a n a L

Ligg collateralia

Ligg plantaria

Lig metatarsale transversum profundum Basisossismetatarsi I plantaria Ligg tarsometatarsalia Os cuneiforme mediale

Tuberositas ossis quinti metatarsi

Ligg cuneonaviculariaplantaria

S u l c u st e n d i n im s usculi fibularis longi* lperonei] L'V

P'ar r(are

longum

L'V

Lig cuboideonaviculareplantare

Tuberositasossis navicularis

vo,Lorrvu-

cuboideum plantare

Lig calcaneonaviculareplantare

Lrg calcaneofibulare Lrg plantare rongum

Sustentaculum tali Lig collateralemediale, Pars tibiocalcanea

Proc medialis tuberis calcanei

Articulationesmetatarsophalangeae

Sulcustendinismusculi flexorishallucislongi

Os sesamoideum

Tuber calcanei

Lig metatarsale transversumprofundum

M fibularis longus, [peroneus] Tendo Ligg metatarsalia Prar

Ligg tarsometatarsaliaplantaria

rLdr ra

lV1tibialisanterior, Tendo Ligg tarsi plantaria

fibularis[peroneus] brevis,Tendo

Lig cuboideonaviculareplantare

Tuberositas ossis cuboidei

M tibialisposterior, Tendo Lig calcaneonaviculare plantare

F i g . 1 3 1 1 J o i n t so f t h e f o o t ,A r t i c u l a t i o n eps e d i s : L i g a m e n tasn d t e n d o n so f t h e t a r s u sa n d m e t a t a r s u s , p L a n t avr i e w .

Lrg calcaneocuboideum plantare Tuber calcanei

Topng r a p h y Thigh

Knee

LeE

Foot

joint Talotorsal

Ligg tarsometatarsaliadorsalia Os metatarsi ll

Os metatarsi lV

V Os metatarsi

Os metatarsiI

Ligg intercuneiformia dorsalia

quinti ossismetatarsi Tuberositas dorsale Lig cuneocuboideum

Ligg cuneonavicularia dorsalia

Os cuboideum Lig calcaneonavicutare I r.o bifurcatum Lig.calcaneocuboideum l

Os naviculare

M fibularis[peroneus]brevis,Tendo Lig calcaneonaviculare plantare

Facies articularis talaris anterior Lig talofibulare anterius

Facies articularistalaris media Lig talocalcaneuminterosseum

Facies articularistalaris posterior Ltg deltoideum

Lig calcaneofibulare Calcaneus

F i g .1 3 1 3 T a t o t a r s a t j o i n t , Articu[atio ta lotarsaIis; p r o x i m aa I r t i c u L asr u r f a c e s ; d i s t a Lv i e w .

Fig. 1312 TalotarsaIjoint, A r t i c u t a t i ot a l o t a r s a [ i s ; d i s t a La r t i c u t a rs u r f a c e s ; proximaLview.

(Faciesarticularis talaris) Os naviculare Facies articularistalaris media

Lig cuboideonavicularedorsale

Facies articularistalaris posterior

Lrg talocalcaneumInterosseum

Lig calcaneonaviculare Lig calcaneocuboideum

F i g . 1 3 1 t , T a l o t a r s aj o I i n t ,A r t i c u L a t itoa t o t a r s a L i s ; t h e t a t u sa n d t h e l a t e r a IL i g a m e n ths a v eb e e nr e m o v e d ; l a t e r a Iv i e w . T h e t w o a r r o w sp o i n to u t t h e h e I i c a dL i s t o r s i o no f t h e t a L o c a L c a n ei natIe r o s s e o u[si o a m e n t .

I

lio oitr,"ut*

T i g h t c o n n e c t i v et i s s u el a y e rb e t w e e nt h e p t a n t a rc a t c a n e o n a v l c u L a r p ra r t o f t h e d e t t o i dt i g a m e n It i m i t i n g t i g a m e n at n d t h e t i b i o n a v t c u [ a gf this a m e d i a L tdyi r e c t e dg t i d i n go f t h e h e a do f t h e t a l u s ;s l a c k e n i n o , e sv a L g u s l l a y e rr e s u [ t si n f t a t t e n i n go f t h e t o n g i t u d i n avt a u t t I f t a t - f o o t p

> Lowertimb

M us c tes

Ankleand talotarsaljoint,sectlons

Metaphysis,Linea epiphysialis

Articulatio talocruralis Tibia, Malleolusmedialis

Nletaphysis, Lineaepiphysialis

Lig collateralemediale, Pars tibiocalcanea

Corpustali

M tibialisposterior,Tendo

Fibula, Malleoluslateralis

Vagina tendinis musculitibialis posterioris

Lig talolibulareposterius

M flexordigitorum longus,Tendo Vaginatendinismusculiflexoris digitorum longi

Lig, calcaneofibulare

Betinaculum musculorum llexorum

Articulatiosubtalaris

Articulatio subtalaris

Retinaculum musculorum fibularium superius lperoneorum]

Lig talocalcaneum interosseum

M fibularis[peroneusj brevis,Tendo V a g i n cao m m u n itse n d i n u m musculorum fibularium lperoneorum]

N plantarismedialis

M libularis[peroneus] longus,Tendo

(v plantarismedialis) plantarismedialis

Retinaculum musculorum fibularium inferius lperoneorum]

M abductor hallucis

Calcaneus plantae M quadratus M abductordigiti minimi

(V plantaris A; N plantaris lateralis; lateralis)

plantaris Aponeurosis

M flexor digitorumbrevis

F i g .1 3 1 5 A n k L ea n dt a L o t a r s a t j o i n t , A r t i c u t a t i o n etsa L o c r u r a t iest t a l o t a r s a t i s : f r o n t a Is e c t i o n .

I\4 flexor hallucislongus

l\4 extensor hallucislongus

M tricepssurae, Tendocalcaneus

Articulatiotalocruralis Articulatio subtalaris /

I (Articulatio talotarsalis) ./ Articulatio | talocalcaneonavicularis./ Os naviculare Os cuneiformeintermedium

Articulatiotarsometatarsalis Lig talocalcaneum Interosseum

M fibularis longus,Tendo [peroneus] Os metatarsi ll M interosseus dorsalisoedisI

Calcaneus

Tuber calcanei

Aponeurosisplantaris

Lig plantarelongum

plantae M quadratus

M flexor digitorum brevis

1,4adductor hallucis, Caput obliquum

F i g .1 3 1 6 A n k t ea n d t a t o t a r s a L j o i n t , A r t i c u [ a t i o n etsa [ o c r u r a L e i st t a t o t a r s a t i s ; crîit2l

cortinn

* F a t p a do f t h e h e e l

T* p:uqr* prhy ThiEh f{n*e

i-e.q Foot

joint,radiography Ankleand taLotarsal

Linea epiphysialis

Syndesmosistibiofibularis Trochleatali

Articulatiotalocruralis

l\4alleoluslateralis

j o i n t ,A r t i c u L a tti ao L o c r u r a L i s ; F i g .1 3 1 7 A n k L e A P - r a d i o g r a pw h i t h t h e s u b j e c tr e c L i n eadn d t h e c e n t r a Ib e a m d i r e c t e dt a n g e n t i a L o [ yn t ot h e t r o c h L e o af t a I u s .

Malleolusmedialis

Talus

C l i n i c a L [ yt h, e p o s t e r i o rb o r d e ro f t h e f i b u L a rn o t c hi s a L s or e f e r r e dt o a s t h e t h i r dm a t t e o t u s .

Fibula

Linea epiphysialis-.

Articulatiotalocruralis Trochleatali

Malleolusmedialis Proc posteriortali Malleoluslateralis Articulatiosubtalaris. Collum tali

Sinustarsi Sustentaculum tali

Caput tali Articulatio * talocalcaneonavicularis Os naviculare

Tuber calcanei

F i g .1 3 1 8 A n k L ea n dt a t o t a r s a L j o i n t , A r t i c uL a t i o n etsa L o c r u r a t e i st t a L o t a r sI a is; A P - r a d i o g r a pwhi t ht h e s u b j e c rt e c L i n eadn dt h e c e n t r a b I eam d i r e c t e dt a n g e n t i a [ yo n t ot h e a p e xo f t h e t r o c h L e o af t a L u s

* D u e t o t h e i rh e I i c a dI i s t o r s i o nt h , e j o i n t c t e f t sa r e n o t d i s p t a y e d orthogonatty * * O v e r [ a p p i negp i p h y s e aI it n e so f t h e t i b i aa n d f i b u t a

> Lowertimb

>>lttl


Fasciaeof thelowerlimb

Spina iliaca ------i-

anteriorsuperior

M tensorlasciae latae CornusuPerius MargeI falciformis Cornuinferius I


Lig inguinale

Funiculus spermaticus Hiatussaphenus, Fasciacribrosa

V saphena magna

Fascia lata

Patella Retinaculum patellaelaterale Caput fibulae

Bursasubcutanea prepatellaris Lig patellae Bursasubcutanea infrapatellaris

Fasciacruris Fasciacruris Tibia,Margoanterior

Tibia, Facies medialis M tibialisanterior, Tendo

Retinaculum musculorum extensorum supeflus M extensor digitorum longus,Tendines

Betinaculummusculorum extensorum inferius M extensor hallucisbrevis M. extensor hallucislongus, tenoo Fascia dorsalis pedis

F i g . 1 3 1 9 F a s c i al a t a ,F a s c i al a t a ,a n d d e e pf a s c i ao f [ e g , F a s c i ac r u r i s . T h e t r a n s i t i o nz o n eb e t w e e nt h e a p o n e u r o s ios f t h e e x t e r n a l o b t i o u ea b d o m i n a m I u s c t ea n d t h e f a s c i al a t a i s k n o w na s i n g u i n a ILi g a m e n tT. h i s I i g a m e n te x t e n d s[ a t e r a L tfyr o m t h e a n t e r i o rs u p e r i o ri I i a cs p i n et o i t s a t t a c h m e n ot n t h e p u b i c t u b e r c [ em e d i a t L y . * 0 p e n i n gi sn t h ef a s c i fao rt h ep e r f o r a t o s insl r i n s( D o D Dv' e ve

Topography Thigh

Leg

Foot

Fasciaeof the lowerlimb

(Fascia glutea)

M tensor fasciaelatae

Sulcusglutealis

Fossapoplitea

(Fascia poplitea)

M gastrocnemius

M. gastrocnemius, Tendo

lvlalleolusmedialis

Tendocalcaneus

F i g . 1 3 2 0 F a s c i a[ a t a ,F a s c i a[ a t a , a n d d e e pf a s c i ao f l e g ,F a s c i ac r u r i s .

> Lowertimb Musclesof thelowerlimb,overview

lvl iliacus

vr irioo.o". {,

psoas major


M pectineus M sartorius M adductor longus

M vastuslateralis M gracilis quadflceps femoris

M rectusfemoris

M vastus medialis

M fibularis[peroneus] longus

M gastrocnemius, Caput mediale

M tibialisanterior M soleus

M extensor digitorum longus

lvl extensor hallucis longus

, l+5, > T r + 2 , f! + 4T T l+7,Tl+8

F i g , 1 3 2 1 M u s c L eos f t h e l o w e r I i m b ,M m e x t r e m i t a t i si n f e r i o r i s ; overvtew.

Tn pogr a p h y Thigh

Leg

Foot

Musclesof the lowerlimb,overview

s edius M g l u t e um

M gluteusmaximus

lvl semitendinosus l\il biceps femoris

M semimembranosus

M gastrocnemius

Tendo calcaneus

F i g . 1 3 2 2 M u s c t e so f t h e l o w e rt i m b ,M m . e x t r e m i t a t i isn f e r i o r i s ; overvtew.

) T 43, T I+6,Tt+9

> Lowertimb

tt

0riginsand insertionsof the musclesof the hip,the thighand the leg

lvl quadratus lumborum M obliouusinternus abdominis l\4 transversus abdominis

M. psoasmajor

lvl,iliacus

l\4 sartorius

M obturatorius internus M piriformis

M rectusfemoris

Lig sacrospinale; [4.anococcygeus

(Bursa iliopectinea)

pectineus l\,1.

M gluteusminimus

M obturatoriusexternus

l\il vastuslateralis

l\4 adductorlongus M adductor brevis

M iliopsoas M gracilis M vastus intermedius

M. vastus medialis

M adductormagnus M quadratus femoris M biceps femoris

M semimembranosus

genus M articularis

M quadriceps femoris

M adductormagnus M vastus medialis

M bicepsfemoris Lig collaterale fibulare patellae Retinaculum

M sartorius

laterale Tractus iliotibialis

M gracilis lvl semitendinosus

l\4 extensor digitorum tongus M fibularis [peroneus]longus

Lig patellae

[/ tibialis anterior

F i g . ' 1 3 2 3 O r i g i n sa n d i n s e r t i o n so f t h e m u s c t e sa t t h e L o w e r[ u m b a rv e r t e b r a et,h e p e L v i b c o n e s t, h e f e m u r a n d I x t r e m i t i e so f t h e b o n e so f t h e [ e g ; t h e p r o x i m ae ventraIview.

til

To pogr a p h y Thigh

Leg

,i]r;

Foot r titlr

)rigins and insertionsof the musclesof the hip,the thighand the leg

abdominis M. obliouus externus M. gluteusmedius M, gluteusminimus

l\il piriformis l\4 tensor fasciae latae

l\4 gluteusmaximus

M obturatorius internus M piriformis

lvl rectusfemoris

M obturatorius externus M gluteusmedius

l\4 gemellus superior

l\4.gluteusminimus M. obturatorius internus

musculigluteimedii Bursatrochanterica

M. levatorani l\4 quadratusfemoris

perineiprofundus M transversus

Bursasubculaneatrochanterica M gluteusmaximus Bursaischiadica musculi obturatorii interni M gemellus inferior

M, semitendinosus M iliopsoas

M pectineus M. adductormagnus M adductorbrevis M vastus medialis

M vastusintermedius M adductorlongus M biceps femoris

l\4 vastuslateralis l\4 adductormagnus

Bursasubtendinea musculigastrocnemii medialis

M gastrocnemius

M plantaris M semimembranosus M sartorius l\/ gracilis M semitendinosus M semimembranosus

Lig collateralefibulare M biceps femoris

l\4,popliteus M. soleus musculisolei Arcustendineus

Foramennutricium lvl soleus M tibialisposterior

M flexordigitorum longus

F i g , 1 3 2 t , 0 r i g i n sa n d i n s e r t i o n so f t h e m u s c t e sa t c o n e s t, h e f e m u r a n d t h e p r o x i m a eI x t r e m i t i e s t h e p e L v ib o f t h e b o n e so f t h e [ e g ; dorsaIview.

) T 4 3 - T4 6 , T4 9 , T5 0

> Lowertimb

>>l

Surfmce l$[ceLertnnl Muscles

Musclesof thethigh

F i g . 1 3 2 5 T e n s o rf a s c i a e [ a t a em u s c t e ,M t e n s o r f a s c i a eI a t a e ,a n d s a r t o r i u s m u s c t e ,M . s a r t o r i u s .

Q u a d r i c e pfse m o r i sm u s c L eM , . q u a d r i c e p fse m o r i s

l\il pectineus

l\4 adductorlongus M adductor brevis

M adductor magnus

l\4 gracilis

A d d u c t o rm u s c t e s M . m.adductores

l I i o p s o a sm u s c t e ,M i I i o p s o a s


Leg

Foot

Musclesof the thigh

psoas major M iliopsoas

{.

(M psoasminor)

iliacus

Lig inguinale

Arcusiliopectineus l/ iliopsoas

Lig pectineum

M tensor tasciae latae

M pectineus

M rectusfemoris M adduclorlongus

M. sartorius

M gracilis

M vastuslateralis

M vastusmedialis Fascia lata, Tractus iliotibialis

prepatellaris Bursasubtendinea


Lig patellae Caput libulae

Bursa subcutaneainfrapatellaris

%,

Fig. 1329 Musctesof the thigh and the hip; a f t e r r e m o v a L o f t h e f a s c i a [ a t a e x c e o t f o r t h e i l i o t i b i a It r a c t . * C o m m o ni n s e r t i o no f t h e s a r t o r i u sg, r a c i l i sa n d s e m i t e n d i n o s u s m u s c t e sj u s t b e t o wt h e m e d i a Ic o n d y l eo f t h e t i b i a l f o r m e r t yk n o w n a s t h e s u p e r f i c i apI e s a n s e r i n u sP, e sa n s e r i n u s u p e r f i c i a t i s )

)T

l + 2 , Tl r / , , T1 , 5

> Lowertimb

>>l

Surface

lSkeletsnl

Muscles Hip

Musclesof the thigh

M iliacus

l\4 psoas major

Promontorium

M sartorius

M tensor tasciae latae

l\4 piriformis

Lig sacrospinale

M gluteusmedius Pecten ossis pubis

Lig pubicumsuperius M iliopsoas

l\4 pectineus

lvl adductor longus

M gracilis

Canalis adductorius;A ; V femoralis

Septumintermusculare vastoadductorium M quadricepsIemoris*

M sartorius Fascia lata

M, rectus femoris,Tendo


Lig patellae

> I I + 2 , I l + l + , lT+ 5

s f t h e t h i g ha n d t h e h i p ; F i g .1 3 3 0 M u s c t e o a f t e r r e m o v a L otfh e f a s c i a[ a t a ,t h e t e n s o rf a s c i a e[ a t a e m u s c l ea n d t h e s a r t o r i u sm u s c t e . * T h ef o u r t hh e a do f t h eq u a d r i c e p msu s c l et h , ev a s t u isn t e r m e d i u s is covered musc[e, bythe rectusfemorismuscle

To p o g r a p h yI Se c ti o n s Thigh

Leg

Foot

Musclesof the thigh

M iliopsoas Soina iliaca anteriorsuoerior

M. piriformis M sartorius

(

iliaca Bursasubtendinea

caPutrectumM rectusfemoris**.i rellexum luaput

Pectenossispubis M gluteusmedius Lig iliolemorale M pectineus

M iliopsoas

M adductor brevis

M vastus lateralis

M gracilis M adductorlongus

M adductormagnus

Hiatusadductorius Fascia lata

M vastusmedialis M vastusintermedius

M rectus femoris,Tendo

Tendo M sartorius, medialis Femur,Epicondylus

Lig patellae

F i g .1 3 3 1 M u s c L eosf t h e t h i g ha n dt h e h i p ; d e e pL a y e ar f t e r r e m o v a o I f t h e s a r t o r i u st,h e r e c t u sf e m o r i s a n d t h e a d d u c t o rL o n g u sm u s c t e sa s w e I La s p a r t so f t h e i t i o p s o am s u s c t ei n t h e j o i n tr e g i o n .

+

C o m m o ni n s e r t i o no f t h e s a r t o r i u sg, r a c i t i sa n d s e m i t e n d i n o s u s m u s c t e sj u s t b e t o wt h e m e d i a Ic o n d y l eo f t h e t i b i a * * T h e o r i g i n o f t h e r e c t u sf e m o r i s m u s c t eh a s b e e nf t a p p e dt a t e r a l t y upwards * * * A p a r t o f t h e a d d u c t o r[ o n g u sm u s c t eh a s b e e nf t a p p e du p w a r d s .

> T I + 2 , Tl + 4 , I t + 5

> Lowertimb

Surface lSkeletonl Muscles

Musclesof the thigh

M iliopsoas

lvl sartorius M piriformis M. rectustemoris

Canalisobturatorius M pectineus

Bursa subtendineailiaca

M adductorlongus

gluteusmedius

M obturatoriusexternus

l\4 iliopsoas

M adductor brevis

Trochanter minor

M pectineus

M adductorminimus M adductorbrevis M adductormagnus M vastuslateralis M adductorlongus

M gracilis M vastus medialis

Hiatusadductorius

lvl vastusintermedius

M adductor magnus, Tendo

M gracilis,Tendo

l\4 sartorius,Tendo

Bursa subtendineamusculi sartorii

M gracilis, Tendo lvl semitendinosus,Tendo

T5 > I 4 2 , T4 / + , 4

Bursaanserina

F i g . 1 3 3 2 M u s c t e so f t h e t h i g ha n d t h e h i p ; a f t e r a t m o s tc o m p t e t er e m o v a I o fs u p e r f i c i aaI n d s e v e r ad I e e p e rm u s c t e s ; ventratview.

9 ' L - Z ' L ' e Z ZL ?

'M0rA lerpau.r : d ! qa q l p u e r . l 6 r qe]q t j o s a l r s n N e e e l ' 6 l l

snuDeuropnppe'nl suoural snlca|lil

y! snsourpualru.ros unouol1nde3'suouelsdactqy\

sr;rcer6 y1

sn0uolJopnppE'yI snurxeusneln;6y1 srqndsrsso JOlralur snueu ilqcsrsrssosnuleH

srlerouro]V (!uBslJoleâl!lncsnuJ sneu!puelsncJV)

urncrpErqcsr leqnl

ecrqndsrs^qdu^S snurelur snuolernlqoy!

snuouesyI

elPieqnlorces6r'l

snuolernlqo srlPue3

snutLl.l urncrperqcsruaurelol

areunce;611

slqnosrsso roueonssnureu

Isne6[ccoc] snao^ccocorqJst li\

Euolerntqo n:'v :snuolPJnlqo'N

EUOlernlqo etcsel

e u r e u a B c e lnl !: V

(aurolurdeJlur ueulero3)

snaulsaoorIsncJV sruuolurdli\

sllaoulol N sllErouol u 'srlerourelolruoo N

Proualue erlErcPsEUrureJol

'611 e;eurnbur

(auro;urdetdnsuoujelol)

srlPlelPlsuor.uel snauelncN ro!JoonsrolJaluP ece!t!eutos

s!lerces srlEuEc srqnosrssoualcad

opual '(roufl-u seosd'W)

unJcesso eroualuE ecerltolces 66t"1 'ecerlrorceso[elnsruv

roleu seosd !\

srlerqeua^ srpue3

tt6!qlaql Jo sapsn4 looj

6at

q6!ql

suorllas | ,{qder6odol

dltt

s!^lad

'olq a q l lo sallsnur r '6!r l e s J o pd a a o 4ec

' s n r p a t us n a l n l 6 ' t / { ' a l l s n u Js n r p a u sr n a l n l e g e e l ' 6 l l

suoualsnlPrpenby! roualursnllaua0 y!

snulalul snuolPJnlqo y!

rouadnssnllauao y!

srrlroluro y! snururur snalnloti\

snrpau snalnlon

'snuJrxeu s n a l n lo hl ' a l l s n u rs n L u r x e us n o l n l g g e e ' 6 l l t

' q O l q lo q ]

J os a l l s n u r lesroo teel'6ll

snsourpuelruos l

snutxpul snalnl0 y\

dltl atil pue q6gl aLlllo sapsnry MaTAJAA0

solrsnr{ luo}alo{sl

qull JattAo'l
Lowertimb

Muscles

Musclesof the thighandthe hip

Crista iliaca

M gluteusmedius

s inimus M g l u t e um (Foramen suprapiriforme) I/ gluteusmaximus M piriformis N4gemellus superior

(Foramen infrapiriforme)

lvl tensorfasciaelatae l\il obturatorius internus M gemellus inferior

Lig sacrotuberale

M quadratus femoris M obturatoriusinternus

M gluteusmedius

Tuberischiadicum

Trochanter major Bursalrochanterica musculigluteimaximi

M adductormagnus lvl gluteusmaximus M adductorminimus

M adductormagnus M gracilis M semitendinosus

M vastuslateralis

M biceps temoris, Caput longum

M. bicepsfemoris,Caputbreve

M biceps femoris,Caput longum l\4 semimembranosus

M semitendinosus,Tendo

A poplilea

lvl semimembranosus, Tendo M gastrocnemius,Caput laterale M gastrocnemius,Caput mediale

-> T 43, T r+5,Tt+6

F i g . 1 3 4 0 M u s c t e so f t h e t h i g ha n d t h e h i p ; t h e g l u t e u sm a x i m u sa n d m e d i u sm u s c t e sh a v e b e e np a r t i a L [rye m o v e d ; d o r s a Iv i e w .

Topogr a p h yI S e c ti o n s Thigh

Leg

Foot

Musclesof the thighand the hiP

lvl gluteusmedius

M gluteusminimus

L4 gemellusinferior

M gluteusmaximus

Tendo internus, M obturatorius M piriformis musculigluteimedii Bursatrochanterica (Foramen infrapiriforme) Trochantermajor M gemellus superior externus M obturatorius

M obturatorius inlernus

femoris M quadratus

Bursaischiadica musculiobturatorii interni

musculi Bursatrochanterica

Lig sacrotuberale

glutei maximi

M biceps femoris, Caput longum

M iliopsoas,Tendo

M semitendinosus

Trochanterminor

Foramenischiadicum minus M

M gluteusmaximus M adductorminimus

M gracilis

M adductor magnus

M vastuslateralis M semimembranosus lV bicepsfemoris,Caputlongum M biceps femoris, Caput breve

M semitendinosus.Tendo

Fossapoplitea

M semimembranosus,Tendo


Caputlaterale M. gastrocnemius,

s f t h e t h i g ha n dt h e h i p ; F i g .1 3 4 1 M u s c t e o I f the d e e pL a y e ar f t e ra t m o s tc o m p l e t er e m o v a o s u p e rifc i a L g t u t e aa nI dt h e i s c h i o c r u r amLu s c L e s ; dorsaIview.

)I

t + 3 , T4 5 , Tt 6

> Lowerlimb

Surfaee lSkeletonl Muscles Hip

Musclesof the thighand the hip

M obliquus externusabdominis Cristailiaca.Labiumexternum

SDinailiaca anteriorsuoerior

M gluteusmaximus

M. reclus femoris


M vastuslateralis M biceps femoris, Caput longum


M semimembranosus

M bicepsfemoris,Caputbreve

l\4 gastrocnemius, Caputlaterale

-> T 43, r t+/+,T46

F i g . 1 3 1 2 M u s c t e so f t h e t h i g ha n d t h e h i p ; a f t e rr e m o v a o l f t h e f a s c i a[ a t ae x c e o tf o r t h e i t i o t i b i atLr a c t

Topography Thigh

Leg

Foot

Musclesof the thigh

l\4 vastus medialis

lvl sartorius

l\4 gracilis, Tendo M semimembranosus,Tendo

Tendo M semitendinosus, Retinaculumoatellaemediale

Corpusadiposum infrapatellare Lig patellae


F i g . 1 3 4 3 M u s c t e si n t h e r e g i o no f t h e k n e ej o i n t ; > f I r 4 - Tt 6 , T4 9 mediaLview * C o m m o inn s e r t i oj u n s tb e t o w t h em e d i acI o n d y toef t h et i b i a s ,e sa n s e r i n ussu p e r f i c i a [ i s l l f o r m e r tkyn o w na ss u p e r f i c ipaet sa n s e r i n uP

M vastuslateralis M adductor magnus

lvl bicepsfemoris,Caputbreve M gracilis

Femur,Lineaaspera Hiatusadductorius M vastusmedialis lvl bicepsfemoris,Caputlongum M adductormagnus,Tendo

Femur, Facies poplitea

M semimembranosus M plantaris Articulatiogenus, Capsula articularis

M sartorius M biceps femoris,Tendo

M semimembranosus,Tendo lvl gracilis,Tendo

M semitendinosus. Tendo

lvl gastrocnemius, Caputmediale Caputlaterale M gastrocnemius,

Fig, 13t+t+ Musctes in t h e r e g i o no f t h e k n e ej o i n t ; a f t e r a t m o s tc o m p t e t er e m o v a o L f t h e i s c h i o c r u r am I usctes: dorsaLview.

)T

l + 4 - Tl + 6 , Tl + 9

> Lowertimb

tt

)rigins andinsertionsof the musclesof the thighand the ventralpart of the leg

Tractusiliotibialis

l\/ gracilis M quadricepsfemoris M. biceps femoris

l\4 semitendinosus M sartorius

lvl tibialisanterior l\4 fibularis[peroneus] tongus

M. extensor digitorum tongus

fibularisIperoneusl brevis

F i g . 1 3 4 5 0 r i g i n sa n d i n s e r t i o n so f t h e m u s c t e s a t t h e b o n e so f t h e l e g ; v e n t r a Iv i e w

tat"t

To p o g r a p h y Thigh Leg

Foot

}rigins and insertions of themusclesof thethighand the dorsalpart of the leg

M popliteus

M soleus

M tibialisposterior


M. fibularis[peroneus] rongus

M flexorhallucislongus

M fibularislperoneus] orevts

M. flexorhallucislongus,Tendo

M fibularislperoneus] brevis,Tendo lvl.tibialisposterior,Tendo

M llexordigitorum longus,Tendo

F i g . 1 3 1 6 0 r i g i n sa n d i n s e r t i o n so f t h e m u s c l e s a t t h e b o n e so f t h e l e g ; dorsaIview.

> T r,6,T 48-T 50

> Lowertimb

tt

Musclesof theLeg

Fig.1317 Extensor m u s c L eosf t h e[ e g .

M tibialisanterior

M fibularis[peroneus] longus

Iperoneus]

L a t e r a [[ fi b u l . a rm ] uscLes

Caput laterale

I t o".uo"n".'r" Caput mediale )

M flexordigitorum rongus M tibialisposterior

M flexorhallucis l o n gu s

(Chiasma crurale)

lvl.soleus (Chiasma tarsale)

Tendo calcaneus

Fig. 1319 Tricepssurae muscte, M . t r i c e o ss u r a e .

D e e pf l e x o rm u s c L e o sf the leg

Topog r a p h y Thigh

Leg

Fcot

Musclesof the Leg


Tuberositastibiae

M gaslrocnemius

M extensor digitorum longus

M fibularis [peroneus]brevis

Tibia, Facies medialis

Septumintermusculare crurisanterius M extensor longus digitorum

M tibialisanterior,Tendo

M extensor h a l l u c i sl o n g u s

Malleolusmedialis lvlalleoluslateralis

l\il extensor digitorum longus,Tendines

M fibularislperoneus] tertius,Tendo

Retinaculummusculorum extensoruminferius

M extensor hallucis longus,Tendo

M exlensor digitorum brevis

F i g . 1 3 5 1 M u s c L eos f t h e [ e ga n d t h e f o o t .

lvl extensor hallucisbrevis

> Lowertimb

Surface lSkel.etonl Muscles Hip

Musclesof the leg

M semitendinosus M semimembranosus M gracilis Femur, Facies poplitea M semitendinosus,Tendo

M semimembranosus,Tendo M gaslrocnemius, Caputmediale

M gastrocnemius,Caput laterale

Fasciacruris

N4alleolusmedialis -------------t-

Malleoluslateralis

Tendo calcaneus*

Tuber calcanei

F i g . 1 3 5 2 M u s c l e so f t h e L e g ; s r r n p rifr i a l l r v c r * A l s o : A c h i t l e st e n d o n

Topngraphy Thigh Leg

Font

Musclesof the leg

l\4 gastrocnemius, Caputmediale M biceps femoris

M semimembranosus Bursasubtendinea musculi gastrocnemii medialis

lvl gastrocnemius, Capullaterale

Bursamusculisemimembranosi Lig popliteum obliquum

Lig popliteum arcuatum

Tibia,Condylus medialis l\4 plantaris

A ; V poplitea;Arcus tendineus musculisolei

M soleus

M plantaris, Tendo

M gastrocnemius

longus M libularislperoneus]

M gastrocnemius,Tendo

M llexor hallucislongus M flexor digitorum longus

M tibialisposterior.Tendo

Seotumintermusculare crurisDosterius

Malleolusmedialis

Tendo calcaneus*

Retinaculummusculorumflexorum

Tuber calcanei

F i g . 1 3 5 3 M u s c L eos f t h e l e g ; s u p e r f i c i a[[a y e ra f t e r p a r t i a Ir e m o v a I s uscLe. o f t h e g a s t r o c n e m i um * ALso: Achi[[es tendon

Retinaculum musculorum fibularium superius lperoneorum]

> Lowertimb


Musclesof theleg

Femur, Facies poplitea

M gastrocnemius,Caput mediale

M biceps femoris

Bursasubtendinea musculi gastrocnemii medialis

M gastrocnemius, Caputlaterale

Bursamusculisemimembranosi M plantaris

M semimembranosus,Tendo Lig popliteumobliquum

M popliteus

M tibialisposterior

M soleus

Fibula,Margointerosseus


l\4 tibialisposterior M fibularis[peroneus] longus

M flexor hallucislongus

M flexor digitorum longus,Tendo

M a l l e o l ums e d i a l i s M tibialisposterior, Tendo M flexor hallucislongus,Tendo

Retinaculum musculorum flexorum

Betinaculum musculorum fibularium superius [peroneorum] Tendo calcaneus" Tuber calcanei

F i g . 1 3 5 4 M u s c [ e so f t h e l e g ; deep tayer. * A t s oA: c h i [ [ et se n d o n

To p o g r a p h y ThiEh Leg

Foot

Musclesof the leg

Caputmediale lil gastrocnemius, Bursasubtendinea musculi gastrocnemii medialis M plantaris Bursamusculisemimembranosi

-----f Tibia,CondylusmeOialis

M popliteus Tendo M. bicepsfemoris, i,, , Recessus suboooliteus

M popliteus


l\4tibialisposterior M flexor hallucislongus

l\,4tibialisposterior,Tendo

M flexor hallucislongus,Tendo

lvl flexordigitorum longus,Tendo

M fibularislperoneus] brevis


f ibularium Retinaculum musculorum superius [peroneorum] Tendo calcaneus

F i g .1 3 5 5 M u s c L eos f t h e l e g ; doonoqt

lerror

> Lowertimb Musclesof the leg

l\/ biceps femoris

M quadriceps temoris,M vastus lateralis


M fibularis longus lperoneus]

M gastrocnemius

l\4 tibialisanterior

Septumintermusculare crurisanterius l\4 extensor digitorum longus

M fibularis[peroneus] brevis M tibialisanterior,Tendo

M extensor hallucislongus Tendo calcaneus

Retinaculum musculorum extensorum inferius Malleolus lateralis Retinaculum musculorum fibularium superius lperoneoruml M extensor hallucisbrevis

Tuber calcanei

M fibularis[peroneus] longus,Tendo M. extensor digitorum longus,Tendines

Betinaculum musculorum fibularium inferius Iperoneorum] M fibularis[peroneus] brevis,Tendo M extensor brevis diqitorum

- T 4 9 , T5 1 > I t+7

F i g . 1 3 5 6 M u s c l e so f t h e L e ga n d t h e f o o t .

Topography Thigh Leg

1riginsand insertions of the musclesof the thefootand the leg

M. tricepssurae,Tendocalcanous

M. extensordioitorumbrevis: M. extensorhallucis brevi6

M. fibularislperoneus]brevis M. fibularislporoneus]tertius

M. abductor digitiminimi

Mm. interosseidorsalespedis

Mm.interosseiplantares

M. abductorhallucis

Mm.extensoreshallucislongusst brevis Mm.extensorgsdigitorumlonguset brevis

F i g .1 3 5 7 O r i g i nas n di n s e r t i o nosf t h em u s c t e s a t t h eb o n e so f t h ef o o t ; dorsaIview.

>T4t,T48,T51, T53,T54

> Lowertimb

tt

Tendonsheaths of thefoot

longus M extensordigitorum

Lig tibiofibulare anterius

Retinaculum musculorum extensorum interius Malleoluslateralis


l\4 extensorhallucislongus

Malleolus medialis Vaginatendinismusculitibialisanterioris

hallucislongi Vaginatendinismusculiextensoris Retinaculum fibularium musculorum inferius Iperoneorum]

Vaginacommunis tendinummusculorum fibularium lperoneorum] M fibularislperoneus] brevis,Tendo l\4 extensor digitorum brevis Tendo M tibialisanterior, quinti Tuberositas ossismetatarsi M extensorhallucisbrevis M abductor digitiminimi Ligg tarsometatarsaliadorsalia

f ibularislperoneus] tertius,Tendo (M opponens digitiminimi) I Corpusossismetatarsi M extensor longus,Tendines digitorum l\il extensor hallucisbrevis,Tendo

Mm interossei dorsalesoedis lvl extensorhallucislongus, Tendo

, a g i n a et e n d i n u m , F i g . 1 3 5 8 T e n d o ns h e a t h sV of the foot

T o p o g r a p h yI Se cti o n s Thigh Leg

Foot

Tendon sheathsof the foot

M. extensor hallucislongus,Tendo

lvl extensor digitorum longus Vagina tendinum musculi extensorisdigitorum longi

Nil fibularis lperoneus]brevis

inferius musculorum extensorum Retinaculum Vaginatendinis musculi extensorishallucislongi

Fibula

l\4 extensor hallucisbrevis M fibularis [peroneus]longus

Tendo calcaneus

R e t i n a c u l ummu s c u l o r u m fibularium superius Iperoneorum]

l\il extensor digitorum longus, Tendines

Retinaculum musculorum fibularium inlerius lperoneorum]

I/ extensor digitorum brevis

Vaginacommunis tendinummusculorum fibularium lperoneorum]

M fibularislperoneus] tertius,Tendo brevis,Tendo M fibularislperoneus]

F i g . 1 3 5 9 T e n d o ns h e a t h sV , f thefoot. , a g i n a et e n d i n u m o

Vaginatendinismusculi tibialisposterioris

Vagina tendinis musculi tibialisanterioris

Vaginatendinismusculi llexorisdigitorum longi Retinaculum musculorum extensorum inferius

Vaginatendinismusculi flexorishallucislongi

Vagina tendinis musculi extensorishallucislongi

Tendo calcaneus

\-


Vagina tendinis musculi flexoris hallucislongi

abductor hallucis, Tendo

Vagina tendinis musculi tibialisposterioris

/'a

M abductor hallucis

Vagina tendinis musculi flexorisdigitorum longi

M flexor digitorum brevis

, f thefoot. F i g . 1 3 6 0 T e n d o ns h e a t h sV , a g i n a et e n d i n u m o

> Lowertimb

Sunface lSkel.etonl

Musclesof thefoot


M extensorhallucislongus

lil extensor digitorum longus Malleolusmedialis l\4alleolus lateralis Retinaculummusculorumextensorum inlerius

M fibularis[peroneus] brevis,Tendo Retinaculum musculorum fibularium inferius [peroneorum]

lvl extensordigitorumbrevis


lM fibularislperoneus] tertius,Tendo

M extensorhallucislongus, Tendo l\4 extensor digitorum longus,Tendines

M extensorhallucisbrevis M abductordigiti minimi

Articulatiometatarsophalanqea hallucis.Caosula articularis-

Mm interossei dorsalesoedis

)r47,T51,T53

F i g . 1 3 6 1 M u s c t e so f t h e f o o t ; a f t e rr e m o v a o I f t h e t e n d o ns h e a t h s .

Muscles

Tnpogr a p h y Thigh LeU

Foot

Musclesof the foot

M fibularislperoneus] tertius M tibialisanterior,Tendo

[/ extensor longus digitorum M extensor hallucislongus

Malleoluslateralis

extensorum Retinaculum musculorum inferius l\4 tibularis[peroneus] brevis,Tendo

l\4 extensor hallucisbrevis

l\il extensor digitorum brevis

M fibularislperoneus] tertius,Tendo

Nil abductordigiti minimi

Mm interossei dorsales pedrs

brevis, M extensor digitorum Tendines M extensor digitorum longus, Tendines

I

F i g . 1 3 6 2 M u s c L eos f t h e f o o t : a f t e rs e c t i o no f t h e i n f e r i o r extensor etinacutum.

>T47,T51,T53

> Lowerlimb

tt

tat"t Hip

Musclesof the foot

Lig metatarsale transversum superficiale

Fasciculitransversi


(Eminentiaplantarislateralis) (Eminentiaplantarismedialis)

Malleolusmedialis

M abductor hallucis l\4alleoluslateralis

Bursasubcutanea calcanea

F i g . 1 3 6 3 M u s c l e so f t h e f o o t ; p L a n t aar p o n e u r o s i sA,p o n e u r o s i ps t a n t a r i s .

T o p o g r a p h yI Se cti o n s Thigh Leg

Foot

0riginsandinsertionsof the musclesof the footand the leg

M. flexordigitorum brevis


M flexorhallucislongus,Tendo M adductorhallucis, Caputtransversum Caputobliquum M adductorhallucis,

Mm interosseiplantares l\il abductor hallucis lvl flexor digiti minimi brevis

Ossasesamoidea M abductor digiti minimi

M abductor hallucis,Tendo

M flexor hallucisbrevis t I I

+ I I al fl

Mm interossei dorsalespedis

longus M fibularis[peroneus]

M tibialisanterior

M flexordigitiminimibrevis

M abductorhallucis

lvl abductor digitiminimi

l\4 flexor hallucis brevis

t

, M adductorhallucis, Caputobliquum M. tibialisposterior

M fibularis longus,Tendo lperoneus]

M quadratus plantae

M abductor digiti minimi

M abductorhallucis

brevis M flexordigitorum

F i g . 1 3 6 1 0 r i g i n sa n d i n s e r t i o n so f t h e m u s c l e s a t t h e b o n e so f t h e f o o t ; plantarview.

)T47,T48,T50, T 52-T 54

> Lowertimb

Surface lSke[etonl Muscles Hip

Musclesof the foot

Vaginaetendinum digitorumpedis

Parscruciformis Vaginatendinismusculi flexorishallucislongi Parsanularis


Mm lumbricales pedislv-l M flexor hallucisbrevis

M adductorhallucis, Caput transversum

plantaris M interosseus lll

l\4 abductorhallucis

l\4 flexor digitorumbrevis


Tuber calcanei

F i g . 1 3 5 5 M u s c t e so f t h e f o o t ; t h e p t a n t a ra 0 o n e u r o s i hs a s b e e nr e m o v e d

T o p o g r a p h yI S e c t i o n s Thinh

I- v :o, n

Foot

Musclesof the foot

flexor hallucislongus,Tendo Vaginaetendinum digitorumpedis

M flexordigitorum longus, Tendines M adductor hallucis, Caput transversum

M llexordigitorum brevis, Tendines

M flexor hallucisbrevis

l/m lumbricalespedis lv-l M flexor digitorum longus,Tendo M flexor digiti minimi brevis Vagina plantaristendinis musculi fibularis [peronei]longi M abductordigiti minimi M llexor hallucislongus,Tendo

l\il interosseusplantarislll

M interosseus dorsalispedislV

M fibularis[peroneus]longus,Tendo M abductor hallucis

plantae M quadratus

l\4 abductor digitiminimi

l/ flexordigitorum brevis

Tuber calcanei

F i g . 1 3 6 6 M u s c l e so f t h e f o o t ; m i d d t eL a y ear f t e r a L m o sct o m p t e t er e m o v a o Lf t h e f t e x o rd i g i t o r u mb r e v i sm u s c L e .

) T 50,T 52-T stl

> Lowertimb

Surface lSkeletonl Musctes

Musclesof thefoot

M flexor digitorum longus,Tendines


M, flexordigitorum brevis,Tendines

l\ilm lumbricalespedis lv-l

M adductor hallucis

l\4 interosseusdorsalis pedis lll

Caputobliquum Mm inlerosseiplantares lll et ll

l\4 interosseus dorsalispedislV

lvl flexorhallucisbrevis

(M opponens digitiminimi) M flexordigitiminimibrevis

M abductor hallucis

M abductor digiti minimi M flexor hallucislongus,Tendo

M libularislperoneus] longus,Tendo

plantae M quadratus

M flexor digitorum longus,Tendo* M tibialisposterior,Tendo

Retinaculum musculorum flexorum Lig plantarelongum

M flexorhallucislongus,Tendo* M abductor digiti minimi l\4 abductor hallucis

plantaris Aponeurosis f,4 flexor digitorumbrevis

) T 50,T 52-T str

Fig. 1367 MuscLesof the foot; oeep rayer. * T h es i t ew h e r et h et e n d o o n f t h ef L e x odri g i t o r u m [ o n g um s usc[e c r o s s etsh et e n d o n o f t h ef t e x ohr a t t u c i[so n g u m s u s c t ies c o m m o n rt ye f e r r etdo a s p t a n t acrh i a s mC, h i a s mpaL a n t a r e

Topognaphy Thigh Leg

Foot

Musclesof the foot

Mm.interossei dorsalespedisl-lV

F i g . 1 3 6 8 D o r s a Ii n t e r o s s em i u s c L e sM, m i n t e r o s s edi o r s a t e sp e d i s ; dorsaLview.

Mm inlerossei p l a n t a r el sl l - l

F i g . 1 3 6 9 P L a n t airn t e r o s s em i u s c L e sM, m i n t e r o s s epi L a n t a r e s ; p L a n t avr i e w .

> Lowertimb plexus Lumbosacral

N, subcostalis

R cutaneuslateralis

N i l i o h y p o g a s t r i(cTu1s2 ,L 1 ) Plexuslumbalis

N i l i o i n g u i n a l i(sT 1 2 , L 1 )

/^.

I H, Iemorails N o e n i t o f e m o r a l i(sL 1 . 2') { R. genitalis \ N. cutaneus femoris lateralis(L2, 3)

N femoralis (L2-4)

(L2-4) N. obturatorius

N gluteussuperior(L4,5; Sl ) Truncuslumbosacralis

Plexussacralis

N .g l u t e u isn f e r i o(r1 5 ;S 1 ,2 )

I N ,f i b u l a r i s tcommunts N. tscnradrcus I ( L a ,5 ; S 1- 3 ) I I \ N. tibialis

Plexus coccygeus DC

N cutaneus (S1-3) femorisposterior

Co

(S2-4) N pudendus Nn analeslrectales] inferiores N, coccygeus

tredtl

N anococcygeus

F i g .1 3 7 0 L u m b o s a c raanI dc o c c y g epaLI e x u s , P t e x u[su m b o s a c r a(t P i st e x u[su m b a Lei st s a c r a t i se]t c o c c y g e u s ; s e g m e n t aoIr g a n i s a t i o n fnerves.

Thigh Poplitealfossa Leg

Foot

Nervesof the lower limb

N iliohypogastricus N ilioinguinalis N. cutaneus femorislateralis N. genitofemoralis N. femoralis N. gluteussup€rior N. gluteusinferior

N obturatorius

N. pudendus N. cutaneus lemorisposterior N. ischiadicus

N. saphenus

N. cutaneussurae medialis

N. cutaneussuraelateralis tibularis R. communicans N. saphenus N. suralis N cutaneusdorsalis intermedius N. cutaneus dorsalismedialis

N. cutan€usdorsalislateralis N. olantarislateralis N. Dlantaris medialis

Nn.digitales dorsalespedis

F i g . 1 3 7 1 N e r v e so f t h e l o w e r[ i m b ; overyrew.

Fig.1372 Nervesof the lower [imb; overvtew.

> Lowertimb Cutaneous innervation

S2 DJ

S4

DC

F i g , 1 3 7 3 S e g m e n t acI u t a n e o u si n n e r v a t i o n ldermatomes] of the lower [imb.

F i g , 1 3 7 4 S e g m e n t acI u t a n e o u si n n e r v a t i o (nd e r m a t o m e s ] o f t h e l o w e r[ i m b .

Thigh

F o p l l t e a if n s s a

Leg

Fn*t

Cutaneous innervation

N iliohypogastricus, R cutaneus lateralis

N iliohypogastricus, R cutaneus lateralis

N cutaneus femoris posterior, Nn clunium inferiores

N cutaneus lemorisposterior N femoralis, Rr cutanei anleriores

N obturatorius, R cutaneus

N obturatorius, R cutaneus

N saphenus, R infrapatellaris (N femoralis)

N fibularis communrs, N cutaneus surae lateralis (N ischiadicus)

N fibularis communrs, N cutaneus suraelateralis (N ischiadicus)

N saphenus, Rr cutaneicruris mediales (N temoralis)

N saphenus, Rr cutanei cruris mediales (N femoralis)

N suralis. N cutaneus dorsalislaleralis N. cutaneus I oorsalls N. fibularisI superficialisl Inlermeolus (N ischiadicus) N..ut"n"r. | \ dorsalismedialis N f i b u l a r ipsr o f u n d u s , Nn digitales dorsalespedis (N ischiadicus)

I I

Nn lumbales Nn sacrales

I I

N iliohypogastricus N cutaneus lemorislateralis

F i g . 1 3 7 5 C u t a n e o u sn e r v e so f t h e l o w e r L i m b .

N genitofemoralis N femoralis

I

N obturatorius

N fibularis

N cutaneus femorisposterior

N suralis

F i g .1 3 7 6 C u t a n e o u n s e r v e so f t h e l o w e r [ i m b

> Lowertimb

M us c l es

Femoraland obturatornerve

N iliohypogastricus

M psoasmajor N. ilioinguinalis

N genitofemoralis

N lemoralis

N cutaneus femoris lateralis

Rr.cutaneianteriores Membrana vastoadductoria

F i g .1 3 7 7 F e m o r a a I n d o b t u r a t o rn e r v e ,N n . f e m o r a L i es t o b t u r a t o r i u s ; overvtew; c u t a n e o u si n n e r v a t i o n i L [ u s t r a t ewdi t h p u r p t e .

Thigh Poptitealfossa Leg

Foot

Glutealnervesandsciaticnerve

N. gluteussuperior

Plexussacralis

N gluteusinferior

N. ischiadicus

N. cutaneus femorisposterior

F i g . 1 3 7 8 G t u t e a nI e r v e s N , n . g t u t e i ,a n d s c i a t i cn e r v e ,N . i s c h i a d i c u s ; overvtew; c u t a n e o u si n n e r v a t i o int l u s t r a t e dw i t h p u r p t e

> Lowertimb Tibialand fibuLarnerve

N ischiadicus

N tibialis

N fibulariscommunis

Arcustendineus musculisolei

N suralis

N suralis

N plantaris lateralis

N plantarismedialis

F i 9 . 1 3 7 9 T i b i a Ln e r v e ,N . t i b i a t i s ; overvtew; c u t a n e o u si n n e r v a t i o int L u s t r a t ewdi t h o u r o [ e .

F i g . 1 3 8 0 F i b u [ a rn e r v e ,N . f i b u t a r i s ; OVCTVIEW:

c u t a n e o u si n n e r v a t i o n i[tustrated with purpLe

Topography T h i g h F o p t i t e af Io s s a L e g

Fuot

Arteriesof thelowerlimb

A glutea inferiot A femoralis A circumflexa femoris lateralis

A circumflexa femoris medialis

R ascendens

A profunda femoris

R descendens AA Aa. perforantes ll; ll;lll)

0""fri?ii?'j

A descendens genus

R saphenus

A poplitea

R articularis

A superior genus lateralis

A inferior genus lateralis

A superior medialisgenus Rete articularegenus

A inferior medialisgenus

A superior m e d i a l igse n u s

A superiorlateralis genus A suralis

A suralis A inferior m e d i a l i sg e n u s

A tibialisposterior

A mediagenus A inferiorlateralis genus (A recurrens tibialis posterior) A tibialisanterior

A tibialisanterior A fibularis

R communicans

A fibularis, R pertorans A malleolaris anteriorlateralis A tarsalislateralis

A malleolaris anteriormedialis A tarsalis medialis A dorsalis pedis

(A arcuata)

Aa metatarsales oorsales

F i g . 1 3 8 1 A r t e r i e so f t h e L o w e r[ i m b ; overvtew; v e n t r a Iv i e w T h e s e g m e n to f t h e f e m o r a La r t e r yb e t w e e nt h e p o i n tw h e r e t h e d e e pa r t e r yo f t h i g h b r a n c h e so f f a n d t h e p o i n to f e n t r y i n t o t h e a d d u c t o rc a n a [[ * ] i s k n o w nc t i n i c a t Lavs s u p e r f i c i a I femoralarterv.

Rr malleolares mediales

A plantaris medialis

Rr malleolareslaterales

A plantarislateralis

profundus Arcusplantaris

F i g . 1 3 8 2 A r t e r i e so f t h e l o w e r L i m b ; overvtew; dorsaIview.

> Lowertimb

M us c tes Pelvis

Veinsand lymphaticsof the lowerlimb

Nodi lymphoidei inguinales

sapnenamagna

V. saphenaparva

F i g . 1 3 8 3a , b overytew

V e i n sa n d l y m p h a t i c so f t h e l o w e r [ i m o ;

a MediaLview b D o r s a tv i e w

V superficialis Valvula

V.communicans

Valvula V perforans 1 DODD'S veins 2 HUNTER'S vein 3 BoYD's vein 4 V arcuatacrurisposterior 5 SHERMAN'S vein 6 cocKETT'sveins 7 Deepperforatingvein

V profunda

Fascia

Of HACH 8 Popliteal perforating vein 9 MAY'Svein 10 Lateral perforatingvein

Fig. 1384a, b Perforatingveins,Vv.perforantes; o v e r v i e w( a c c o r d i ntgo H A C H1,9 8 6 1 . a M e d i a vI i e w b Dorsatview

F i g . 1 3 8 5 V e i n so f t h e [ o w e r[ i m b ; p r i n c i p [ eo f o r g a n i s a t i o n . D i s t u r b a n c eosf t h e v e n o u sf [ o w o f t h e l o w e r l i m b ,e s p e c i a t t y v a r i c o s i sa, r e a c o m m o nc a u s eo f v a s c u t a rd i s o r d e r s . l f o n e o f t h e v e n o u ss y s t e m si s e n t i r e t yo c c L u d e dt h, e perforating v e i n sm a y b e o f c r u c i a Ii m p o r t a n c et o m a i n t a i n t h e v e n o u sd r a i n a o e .

Hip

T o p o g r a p h yI Se c ti o n s Thigh PopliteaIfossa Leg

Font

Vessels andnervesof the thiqh

A femoralisa

R cutaneusanterior(N iliohypogastricus)

A : V epigastrica superficialis a a i N ilioinguinalis

a V femoralis

N cutaneus femorislateralis o a Aa : VV pudendaeexternae (N genitofemoralis) B, femoralis (lateralis) o V saphenaaccessoria A ;V circumllexa iliumsuperlicialis a a

a V saphenamagna

(N femoralis) o Br cutaneianteriores

, Rr cutanei(N obturatorius)

genus a A descendens

, R infrapatellaris(N saphenus) Bete patellarea

1391 F i g . 1 3 8 6 E p i f a s c i avLe s s e l sa n d n e r v e so f t h e i n g u i n a l r e g i o nR , e g i oi n g u i n a t i tsh, e a n t e r i o r e g i o no f t h i g h , R e g i of e m o r i sa n t e r i o r a , n d t h e a n t e r i o rr e g i o no f k n e e , R e g i og e n u sa n t e r i o r .

> Lowertimb

Surfaee lSkeletonl Musctes Petvis

Lymphatics of theinguinalregion

Lig inguina

V circumflexailium superficialis

V epigastricasuperficialis

Nodi lymphoideiinguinales superficiales

Funiculusspermaticus V saphena magna Vv pudendae externae

V saphena accessoria (medialis) V saphena magna

M adductor longus

F i g . 1 3 8 7 S u p e r f i c i aLI y m p h a t i c sL ,y m p hn o d e s a n d m a j o rv e i n so f t h e i n g u i n arIe g i o nR , e g i oi n g u i n a t i s

M, psoas major

Nodilymphoidei iliaciinterni

Nodi lymphoideiiliaciexterni, Nodi laterales

A ; V i l i a c ai n t e r n a

Nodi lymphoideiiliaciexterni, Nodi mediales

Rectum

A;V

iliacaexterna

Ovarium Uterus

Nodi lymphoideiinguinales superficiales,Nodi superolaterales

Vesicaurinaria

Lig inguinale Nodi lymphoideiinguinales superficiales,Nodi superomediales Hiatus saphenus

Nodi lymphoideiinguinales, (Nodi profundi)

Nodi lymphoideiinguinales supediciales,Nodi inferiores

F i g . 1 3 8 8 D r a i n i n ga r e a so f t h e L y m p hn o d e si n t h e i n g u i n arLe g i o nR , e g i oi n g u i n a L iosf,t h e f e m a L e ; overvtew. T h e a r r o w si n d i c a t ep o s s i b Ldei r e c t i o n so f t h e f t o w o f t y m p h . * I n s o m eT a r ec a s e st ,h em e d i apI a r t so f t h eu t e r i n teu b ea n d t h ef u n d u so f t h eu t e r u sm a yb ed r a i n e bd ys u p e r f i c i[aytm p hn o d e s i n t h ei n g u i n ar e I g i o vn i at h er o u n dL i g a m eonftu t e r u s

Hip

T o p o g r a p h yI Se c ti o n s Thigh PoptiteaI fossa Leg

Foot

Vessels andnervesof theinguinalregion

0 M psoas major

M iliacus O

t (M psoasmino0,Tendo N femoralis t

Arcusiliopectineus Lig inguinale

OaA;Vfemoralis (Nodus lymphoideuslacunarismedialis)" Lig lacunare** Fascia lata a V, circumflexailium superficialis

Lig pubicumsuperius a V epigastrica superficialis Fascialata Cornuinferius

a W pudendae externae

V saphena magna O

F i g .1 3 8 9 S a p h e n o uosp e n i n gH, i a t u ss a p h e n u s , a n dv a s c u t asr p a c e L, a c u n av a s o r u m ; a f t e rr e m o v aoI f t h e a n t e r i o ar b d o m i n a L w aa[nLdt h e c o n t e n t so f t h e a b d o m e n a, s w e [ La s d i s s e c t i o n of the i t i a cf a s c i aa n d t h e f e m o r a t s e p t u ml c l o o u r r ] * A t s oR : o S E N M U L LnEoR d 'es * * A t s oG : I M B E R N [Ai gTa' sm e n t

Vaginamusculirecti Laminaanterior abdominis, a M obliquusexternus Aponeurosis abdominis, femorislateralis cutaneus Spina iliaca anteriorsuDerior Lig inguinale M iliopsoasO

, N genitofemoralis, R femoralis aoA;Vlemoralis Septum femorale (Nodi lymphoideilacunares)

N femoralis..

Arcusiliopectineus

Lig lacunare


(Bursa iliopectinea) Lig inguinale M ilioosoas.Tendo a Tuberculum pubicum

pubica Symphysis

Lig pectineum

Membrana obturatoria

M pectineus o

Canalisobturatorius $ N obturatorlus a a V;A obturatoria

F i g ,1 3 9 0 M u s c u t aar n dv a s c u t asr p a c e , L a c u n a em u s c u t o r u me t v a s o r u m ; o b t i q u es e c t i o na t t h e l e v e to f t h e i n g u i n a ILi g a m e n t .

> Lowertimb

$urface

lSkeletonl

Vessels and nervesof the thigh

O A iliaca externa

N femoralis.

a V iliaca externa cutaneus femoris lateralis : a A iliaca interna Lig inguinale

A circumflexailium profunda O M iliacus&

I M pectineus

N femoralis: a V saphena magna A profundafemoris a : R muscularis(N femoralis) A, femoralis* O

. V femoralis

l\4 tensor fasciae latae S

C lvl adductorlongus

M rectuslemorisi s N4gracilis

G l\4 sartorius

l\4 vastuslateralis a

a M vastus medialis

R articularis a (A descendens genus)

1154 11 5 6

Rete patellarea

Lig, patellae

F i g . 1 3 9 1 V e s s e Lasn d n e r v e so f t h e a n t e r i o rr e g i o no f t h i g h R e g i of e m o r i sa n t e r i o r ; a f t e r r e m o v a L otfh e f a s c i a[ a t ae x c e o tf o r t h e i I i o t i b i a L t r a c t .

* C [ i n i c a [ [t yh e f e m o r a t a r t e r yi s c o m m o n [ yr e f e r r e dt o a s s u p e r f i c i a t f e m o r a Ia r t e r y t o d i s t i n g u i s hi t f r o m t h e d e e pa r t e r y o f t h i g h

Muscles

To p o g r a p h yI S e c ti o n s Thigh PopliteaIfossa [-eg

Fc*t

Vesse/s and nervesof the thiqh

N obturatorius N cutaneuslemoris lateralis :

N temoralis

M i l i a c ua s

a A femoralis

* l\4 pectineus (A obturatoria) a R acetabularis

a R anterior(A obturatoria) ., N. obturatorius A circumflexafemoris lateralisa

femorismedialis o A circumtlexa

A profunda femoris a

a R superficialis (A circumflexa femorismedialis) M sartorius A

R descendens a (A circumflexa femoris lateralis)

o V femoralis a A femoralis

M rectusfemorisi

,, R cutaneus(N obturatorius) ; N saphenus

R m u s c u l a r(i N s femoralis) vastoadductorium* Septumintermusculare li M gracilis

N saphenus

M vastusmedialist

I l\4 sartorius

R articularis(A descendensgenus) O

Fig.1392 Vesselsand n e r v e so f t h e a n t e r i o rr e g i o no f t h i g h , R e g i of e m o r i sa n t e r i o r ; a f t e r p a r t i a Ir e m o v a o I f t h e s a r t o r i u sm u s c [ ea n d d i s s e c t i o n of t h e p e c t i n e u sm u s c l e .

+ T h ee n t r a n c ei n t ot h e a d d u c t o cr a n a Ii s f o r m e db y t h e v a s t u sm e d i a [ i s a n d a d d u c t o [r o n g u sm u s c l e sa s w e t l a s b y t h e a n t e r o m e d i a L se intermuscuLa r p t u ms p a n n i n gb e t w e e nt h e m

> Lowertimb

SurrfaeelSkeletonl

I/esselsand nervesof thethigh

.. N obturatorius V iliaca externa a o V saphena magna A iliaca externa a

a A circumflexafemoris medialis

N femoralis i

M i l i a c ucs

o V femoralis

A profunda femorisa

o V profunda femoris

R ascendens O

A circumflexa femoris lateralis

c} M adductorbrevis R descendens a

c N4adductorlongus a A pertorans (N femoralis) Rr musculares ,

M rectustemoris$

R cutaneus(N obturatorius) s l\4 adductorlongus

A perforans a

o V femoralis * M gracilis

l\il vastus lateralis I R muscularis(N femoralis) ,

M rectus femoris €t

I M adductor magnus a A femoralis Hiatus adductorius

vastus medialis fl O A descendens genus, R saphenus

N saphenusa, O l\4 sartorius

genus a A superiormedialis

A poplitea

genusa Retearticulare genus o A inferiormedialis

1'l5I+ 11 5 6 11 5 9

t, t'-

V 1392 1408

F i g . 1 3 9 3 V e s s e Lasn d n e r v e so f t h e a n t e r i o rr e g i o no f t h i g h , R e g i of e m o r i sa n t e r i o r ; d e e pl a y e ra f t e r p a r t i a Lr e m o v a o I f t h e s a r t o r i u sa n d r e c t u sf e m o r i s m u s c l e s t, h e p e c t i n e u sa n d a d d u c t o rl o n g u sm u s c t e sh a v eb e e n d i s s e c t e d ; t haed d u c t ocr a n a L i s a L m o set n t i r e Loyp e n e d .

Muscles

Topography I Sections Thigh PoptiteaI fossa Leg

Foot

Arteriesof thepelvisand thehip

Aorta,Bifurcatioaortae A. iliacacommunis

A. iliaca interna

A. epigastricainferior A epigastricasuperficialis

R. obturatorius

A circumflexailiumsuperficialis

R. pubicus

A. femoralis

Lig.inguinale Aa. pudendaeexternae

R. ascendenset R. transversus

R. acetabularis

R. ascendens

R. anterior

A. profundafemoris

R. posterior

A. circumflexafemorislateralis A. obturatoria

R. transversus

R. acetabularis

A. circumflexafemorismedialis

R. profundus

R. descendens

R. superficialis Aa perforantes R descendens

Fig.1394 Arteriesof the hipandthe thigh; overvtew.

patternof thesearteriesvariesconsiderab[y. Thebranching T h i st y p eo f o r i g i na n da r b o r i s a t i oonf t h ed e e pa r t e r yo f t h i g h occursin approximate[y 58%of cases.

A. lumbalis V

Parsabdominalisaortae lAortaabdominalisl

A. sacralismediana A. iliacacommunis

A. iliacaexterna A iliacainterna

A. gluteasuperior

Caputfemoris

A. obturatoria

F i g .1 3 9 5 A r t e r i e o s f t h ep e t v ias n dt h et h i g h ; d i g i t asI u b t r a c t i oann g i o g r a p h I Dy S A I .

> LowerLimb


Veinsand nervesof the thigh

(Ll -L3) Nn cluniumsuperiores

(N iliohypogastricus) R culaneuslateralis N n c l u n i u mm e d i i ( S 1 - S 3 )

Sulcusglutealis (N cutaneus Nn cluniuminferiores temorisposterior)

N cutaneus femorislateralis

Fascia lata

R cutaneus(N obturatorius) femorisoosterior N cutaneus

V saphena magna

V saphenaparva

F i g , 1 3 9 6 E p i f a s c i avte i n sa n d n e r v e so f t h e p o s t e r i o r e g i o n o f t h i g h ,R e g i of e m o r i sp o s t e r i o rt,h e g L u t e arIe g i o n . R e g i og L u t e a I i sa,n d t h e p o p l . i t e af ot s s a ,F o s s ap o p L i t e a .

Crista iliaca

Soina iliaca anteriorsuoerior

Spinailiacaposterior superior

Cristasacralismediana (Foramen suprapiriforme)Foramen

N gluteussuperior

ischiadicum

(Foramen infrapiriforme) maJus

Foramenischiadicum majus N ischiadicus N gluteus inferior

M piriformis

N pudendus Lig sacrospinale

Trochantermajor

N cutaneus femorisoosterior Tuberischiadicum

Lig sacrotuberale Tuberischiadicum

F i g . 1 3 9 7 S k e t e t o nc o n t o u ra n d s c i a t i cn e r v e , N . i s c h i a d i c u sp,r o j e c t e do n t ot h e s u r f a c eo f t h e g t u t e a Lr e g i o n ,R e g i og t u t e a t i s .

Thigh PopliteaIfossa Leg

Foot

Vessels andnervesof the thigh

a M gluteusmedius,Fascia

N n c l u n i u mm e d i i ( S 1 - 5 3 ) : r

M gluteusmaximusa

is Nn cluniuminferiores (N cutaneus femorisposterior)

Tractusiliotibialis

femorisoosterior * N cutaneus M gracilisI

M semitendinosus a

a M.vastuslateralis

M. semimembranosus a a M bicepsfemoris V popliteao M semimembranosus a

* N tibialis d N. fibulariscommunis

A. popliteaa

suraelateralis {i N cutaneus (N fibularis communis) M gastrocnemius a N cutaneussuraemedialist

a V saphena parva

a M biceps femoris, Tendo

F i g . 1 3 9 8 V e s s e t sa n d n e r v e so f t h e g L u t e arLe g i o n , R e g i og t u t e a t i st,h e p o s t e r i o r e g i o no f t h i g h ,R e g i of e m o r i s p o s t e r i o ra, n d t h e p o p t i t e aflo. s s a ,F o s s ap o p [ i t e a .

> Lowertimb

Muscles

Vessels and nervesof the thigh

(L1-L3) " Nn cluniumsuperiores

N n c l u n i u mm e d i i( S 1 - S 3 ) { ,

(Fascia glutea)

o M gluteusmaximus

N n c l u n i u mi n f e r i o r e s , (N cutaneus femoris posterior)

,r N ischiadicus

N cutaneus femorisposterior t, a A perforans

e lvl bicepsfemoris,Caputlongum N t i b i a l i,s,

semitendinosus I

a Aa,perforanles

Hiatusadductoris N fibularis communis M. gracilisC l\4 semimembranosus a A popliteaa l\il sartorius O V popliteao

,. N cutaneussuraelateralis N cutaneussuraemedialis

A superiormedialis genusa (N tibialis)* Rr musculares M gastrocnemius, |l Caputmediale

N .s u r a l i s

Caputlaterale O M gastrocnemius,

r400

13 9 8

F i g . 1 3 9 9 V e s s e l sa n d n e r v e so f t h e g l u t e a Ir e g i o n ,R e g i og l u t e a [ i s , t h e p o s t e r i o r e g i o no f t h i g h ,R e g i of e m o r i sp o s t e r i o r , a n d t h e p o p t i t e afLo s s a ,F o s s ap o p L i t e a ; t h e l o n g h e a do f t h e b i c e p sf e m o r i sm u s c [ eh a s b e e nr e t r a c t e d IateraLty. I n t h i s s p e c i m e nt ,h e m e d i a L a n[da t e r a I s u r a I c u t a n e onuesr v e sb r a n c h o f f q u i t ef a r p r o x i m a t L y

Thigh Poptitealfossa Leg

and nervesof the thigh Vessels

A glutea superior,R superticialis1

* M gluteusmedius M gluteusmaximuso

I M piriformis superior a l\4 gemellus internus c M obturatorius c lvl gemellusinferior

N gluteus inferiok

O R ascendens (A. circumflexa femoris medialis)

A gluteainferior a

a R superficialis(A circumflexa femoris medialis)

A ; V p u d e n dian t e r n a o a M. quadratus temoris

N cutaneus Iemorisposterior

N ischiadicus*

a A perforans

a M. adductormagnus (N tibialis)* Br musculares M bicepstemoris,Caputlongums O Aa perforantes

M semitendinosus o

o M bicepstemoris,Caputlongum

t l\il biceps lemoris, Caput breve M semimembranosusa

V popliteao communis !, N fibularis

N cutaneus surae medialis :

V saphenaparvaa

F i g . 1 4 0 0 V e s s e Lasn d n e r v e so f t h e g t u t e a Ir e g i o n ,R e g i og L u t e a l ' i s , t h e p o s t e r r or e g i o no f t h i g h ,R e g i of e m o r i sp o s t e r i o r , a n d t h e p o p L i t e af oI s s a ,F o s s ap o p L i t e a ; o f t h e g L u t e u sm a x i m u sm u s c l ea n d t h e L o n gh e a d a f t e rd i s s e c t i o n o f t h e b i c e o sf e m o r i sm u s c L e

1399 11113 '14'lIr

> Lowertimb Hip

Vessels and nervesof theglutealregion

Trigonum lumbale l, R cutaneus lateralis(N iliohypogastricus)

Rr profundia a (A ; V.gluteasuperior)

abdominis a M obliquusexternus Cristailiaca

N gluteussuperior& a M gluteusmedius s inimus a M .g l u t e u m N gluteusinferior* a M gluteusmedius A;Vgluteainferioraa I M gluteusmaximus

lVI.gluteusmaximusI

o M piriformis

cutaneus temorisposterior {t

superior a M gemellus

N. ischiadicusE

internus a M. obturatorius a l\4.gemellusinferior

A ; V. pudenda interna a a Lig sacrotuberale

a M obturatoriusexternus femoris a M quadratus Trochanter minor

Rr.profundi(A circumflexa femorismedialis) O

a M adductormagnus

F i g . 1 4 0 1 V e s s e t sa n d n e r v e so f t h e g t u t e a lr.e g i o n ,R e g i og l . u t e a l . i s ; a f t e rd i s s e c t i o n a n d p a r t i a Ir e m o v a o I f t h e g l u t e u sm a x i m u sa n d m e d i u sm u s c L e s ; t h e s c i a t i cn e r v eh a s b e e nr e m o v e da f t e r i t s p a s s a g et h r o u g ht h e i n f r a p i r i f o r mf o r a m e n

Crista iliaca

Spinailiacaanteriorsuperior M gluteusmedius gluteussuperior

N. ischiadicus Trochantermajor

Fig.1102 VentrogtuteaI injection(accordingto v HOCHSTETTERJ. a n d t h e p a l m o f t h e h a n do n t h e g r e a t e rt r o c h a n t e rS. i n c et h e I n o r d e rt o a v o i dt h e s u p e r i o rg I u t e a In e r v ea n d ,i n p a r t i c u l . a r , i n j e c t e dm a t e r i a Is h o u I db e d e p o s i t e d w i t h i nt h e b e t | . oy f t h e t h e s u p e r i o rg t u t e a Ia r t e r yt h e i n j e c t i o ni s m a d e i n t ot h e g l u t e u sm e d i u sm u s c l ea s f a r a w a ya s p o s s i b l ef r o m a n yv e s s e l , t r i a n g u [ a rf i e t df o r m e db y t h e t w o s p r e a df i n g e r sa n d t h e i l . i a c t h e n e e d t es h o u t dn o t c r o s st h e [ i n e so f t h e t r i a n g t e H . owever, c r e s t .T h e i n d e xf i n g e r- o r w h e n u s i n gt h e r i g h t h a n d ,t h e s o m e r i s k r e m a i n sf o r t h e n e r v eb r a n c ht h a t r u n s f r o m t h e m i d d [ ef i n g e r- i s p t a c e do n t h e a n t e r r o rs u p e r i o ri L i a cs p i n e s u p e r i o rg t u t e a In e r v et o t h e t e n s o rf a s c i a el a t a em u s c L e .

Topography Thigh PopliteaIfossa Leg

Foot

Veinsandnervesof the leq

V saphena magna N saphenus V saphena parua R infrapatellaris (N saphenus) N cutaneus surae lateralis (N fibularis communrs)

N saphenus

V perforans V pedorans* Rr cutanei crurismediales (N saphenus)

Rr cutaneicrurismediales (N saphenus)

N cutaneus suraemedialis (N tibialis)

V saphena parua

(V arcuatacrurisposterior)

R communicans fibularis

N suralis Fasciacruris Fasciacruris

Rr cutaneicrurismediales (N saphenus)

V marginalis lateralis Arcusvenosus dorsalispedis

N fibularis superficialis N cutaneus dorsalismedialis cutaneus dorsalis intermedius

Rete venosum dorsale pedis V marginalismedialis V saphena parva

13 8 6

+ I

:-;' ' - ' -

F i g . 1 4 0 3 E p i f a s c i avle. i n sa n d n e r v e so f t h e [ e g a n d t h e f o o t ,R e g i o n e cs r u r i s e t p e d i s .

N cutaneus dorsalis (N suralis) lateralis

1396

*k veinsand nervesof the [eg Fig, 1t Ot, Epifascial. a n d t h e f o o t ,R e g i o n e sc r u r i se t p e d i s ; t h e d e e pf a s c i ao f [ e g h a s b e e nd i s s e c t e d proximatty. * C t i n i c at eI r m :M A Yv' se i n

> Lowertimb Vessels andnervesof the leg

o (V femoropoplitea) V saphena magna a

V saohena oarva O

A. popliteaa & N tibialis Nodi lymphoideipopliteiprofundi

a V. poplitea Vasa lymphaticasuperficialia

Fasciacruris M gastrocnemiusil

a V saphenaparua

V saphenamagnaa

F i g . 1 4 0 5 V e s s e Lasn d n e r v e so f t h e p o p t i t e afIo s s a , Fn Lowertimb

$unface lSke[etonl

Arteriesand nervesof the leg

A popliteao inferiormedialisgenus a

N tibialis

t M plantaris

l\4 popliteus *

A tibialisanteriorO (Truncus tibiofibularis) a * M soleus M soleus dt M tibialisposteriorI

A. tibialisposterior a

a A fibularis

N tibialis

l\4 flexordigitorum longus& f M fibularis[peroneus]longus

o l\4 llexor hallucislongus

A tibialisposteriora

brevis s [/] fibularis[peroneus] lvl tibialisposterior,Tendo @

Rr malleolaresmediales a

M flexor hallucislongus,Tendo *

a Rr malleolareslaterales

Tendo calcaneus Rr calcanei O

a Retecalcaneum

F i g . 1 1 1 1 A r t e r i e sa n d n e r v e so f t h e p o p l i t e afIo s s a ,F o s s a p o p I i t e aa, n d t h e p o s t e r i o r e g i o no f L e g R , e g i oc r u r i s p o s t e r i o r ; d e e o e s lt a v e r .

Muscl"es

To p o g r a p h yI Se cti o n s Thigh Poptitealfossa Leg

Foot

Veinsandnervesof the foot

t: N saphenus , N cutaneus surae medialis (N tibialis)

N fibularissuperficialis

a V saphena magna

Malleolusmedialis

Malleoluslateralis

o V saphenamagna N cutaneusdorsalismedialis , N. saphenus N culaneusdorsalisintermedius

V saohenaparvao

medialis o V maroinalis cutaneus dorsalis lateralis

a V pertorans

V marginalislateralisO

Nn digitales t N tibularisprofundus, rl^rcalac

Arcusvenosusdorsalispediso

Vv digitalesdorsales pedis a

Nn digitalesdorsales pedis

F i g , 1 4 1 5 E p i f a s c i avLe i n sa n d n e r v e so f t h e d o r s u mo f f o o t , D o r s u mp e d i s .

na.lic

> L o w e rt i m b

Surface lSkeletonl Musctes

Arteriesand nervesof the foot

M extensor digitorum longusfi

s M tibialisanterior,Tendo

l\4 extensorhallucislongus*

o A malleolarisanterior medialis R perforans(A fibularis)a

A tibialisanlerior a

A malleolarisanterior lateralisa

a Rete malleolaremediale

a A malleolarisanteriormedialis

Rete malleolarelateralea

; N fibularisprolundus

(N fibularisprofundus) * Rr musculares L4mextensores digitorum et hallucisbrevisO a Aa tarsalesmediales A tarsalislateralis a

a A dorsalispedis

(A arcuata)a profunda o A plantaris

Aa metatarsales dorsalesa

|) l\4 extensor hallucisbrevis,Tendo

a M extensor hallucislongus,Tendo

', Nn digitalesdorsales pedis

Aa digitalesdorsales a

1408

,r-l: /1,' 'lI+15

F i g , 1 1 1 6 A r t e r i e sa n d n e r v e so f t h e d o r s u mo f f o o t . D o r s u mo e d i s .

Topography I Sections Thigh PopliteaIfossa Leg

Foot

Aa digitalesplantarespropriae

Aa. digitalesplantarescommunes

Aa metatarsalesolantares A. plantarisprofunda(A. dorsalispedis) Arcusplantarisprofundus R superficialis

R. profundus

A. olantarismedialis A olantarislateralis

A. tibialisposterior

Fig. 1117 Arteriesof the soteof foot, Planta; overytew.

27 To

26 o/o

F i g .1 4 1 8a - d V a r i a t i o ni nst h ea r t e r i asI u p p Loyf t h es o l eo f f o o t ,P t a n t a . a Dorsalispedisartery,A. dorsatispedis,as majorsupptyfor t h ed e e pp l a n t aar r c hA , r c u sp t a n t a r ipsr o f u n d u s b Posterior tibiaLartery,A. tibiatisposterior, as majorsuppl.y for the deepptantararch,Arcusptantaris profundus c Thefifthtoeand[ateraIpartsof thefourthtoearesupp[ied by r ,h e r e atsh e t h ep o s t e r i ot irb i a a I r t e r yA, . t i b i a t i p s o s t e r i ow

o/o

13 Vo

mediatty locatedtoesreceive theirarteriatsuppty remaining throughthe dorsalispedisartery,A. dorsatispedis. Thefifthandfourthtoeaswet[as lateraIoartsof thethird l .r t e r yA, .t i b i a t i s t o ea r es u p p t i ebdyt h ep o s t e r i ot irb i a a posterior, mediaLl.y locatedtoes whereasat[ remaining throughthedorsatispedis receive theirarteriaIsuppl.y artery,A. dorsatispedis.

> Lowertimb

Surface lSkel.etonl Musctes

Arteriesand nervesof thefoot

plantares propriaea Aa digitales

plantares proprii:: Nn digitales

Nn digitates.i ptanlarescommunes

Aa metatarsales plantares a

N plantarislateralis,*, R superficialis

plantaris proprius a N digitalis


Retinaculum musculorum f lexorum

Rr calcanei mediales (N tibialis) { N plantarismedialis

a A tibialisposterior

N plantarislateralis

Fi1.1119 Arteries and nervesof the soteof foot, Ptanta

T o p o g r a p h yI Se cti o n s Thigh Poplitealfossa Leg

Foot

Arteriesandnervesof the foot

M flexordigitorum brevis,Tendines a

o Aa digitalesplantarespropriae

plantares communes o Aa.digitales

o M flexor hallucislongus,Tendo

Nn. digitales € planlarescommunes

a M flexor hallucisbrevis

longus a M. flexordigitorum

a M. abductorhallucis

a M quadratusplantae

.9 (B cutaneus)

A. plantarislateralisa

medialis s N plantaris M abductor digitiminimia Betinaculum musculorum flexorum

ADoneurosis olantaris

* (R muscularis)

M flexordigitorum breviso

a A tibialis posterior

lateralis & N. olantaris

o M. abductorhallucis* Retecalcaneum a)

1t+13 1t+21 Fig.112O Arteries and nervesof the so[e of foot, Ptanta; oeep rayer. * ThedistaIextension space of themediaIretromatteolar beneath theabductor hallucismuscteis atsoknownastarsaI tunne[.

1419

> L o w e rt i m b

Surfnc*

lSkeletcnl

Arteriesof the foot

plantares proprii Nn digitales

e M flexor hallucislongus.Tendo

Nn digitalesplantares : communes

* Caputtransversum I I a caputobtiquum )

plantares Aa metatarsales a

M adductorhallucis

C [,,]flexorhallucisbrevis profundus Arcusplantaris a

o R perforans*

, f R. superficialis I N plantaris lateralis 1t \ H. proTunous

a A plantarismedialis,R superticialis c lvl flexor hallucislongus,Tendo

l\4 adductor hallucis,Caput obliquum {l

o M llexor digitorum longus,Tendo

A plantarislateralisa

6 l\4 quadratusplantae

lvl abductordigiti minimi I

o M abductor hallucis

,' N. plantaris medialis flexordigitorum brevisa Retinaculum musculorum tlexorum



Rete calcaneum a

1r+1l+

tI t, 1I+20

Fig,It21 doonoci

A r t e r i e sa n d n e r v e so f t h e s o L eo f f o o t ,P t a n t a ;

larrer

+ A n a s t o m o s iws i t h t h e d o r s a [ i sp e d i sartery

Muscles

To p o g r a p h yI Se rtro rrs T h i q h P n p l i t e a I f o s s aL e U F o o t

of the foot Compartments

/ : / t''r'/''''

N fibularissuperficialis

V saphena magna

Fascia dorsalis pedis

N fibularisprofundus

M extensor digitorum longus,Tendines

A dorsalispedis

M extensordigitorum brevis

l\4 extensor hallucislongus, Tendo

Ossametatarsi

Lig plantarelongum

(Septa longitudinalia)


l\4 flexor hallucislongus,Tendo

Fig. 1122 Compartmentsof the foot; qionuriqo

r ** *** ****

Lowertimb

Surface

lSkeletonl

MuscLes Leg

Thigh,obliquesection

a lvl tensor fasciae latae

a l\4 gluteusminimus a M sartorius M gluteusmediusa a l\4 rectusfemoris,Tendo A ; V.gluteasuperiora a C M iliopsoas

, N femoralis

N gluteussuperior.,,

Lig iliofemorale

a A femoralis Bursasubtendinea iliaca l\4 piriformis, Tendoa

o V femoralis a M pectineus

l\4 gemellus superior a

M obturatorius internus, TendoO

femoris a A profunda

M gluteusmaximusc

g N obturatorius

M gemellus inferiora

o M adductorlongus

A; V glutea inferiora O

N gluteusinferior

a M adductorbrevis

M obturatorius externusa a M adductormagnus N ischiadicus,

N cutaneus femorisDosterior ,

femoris t M quadratus t l\4 semitendinosus

N4semimembranosus, Tendos

F i q . 1 1 2 3 T h i g h ,F e m u r ; o b L i q usee c t i o nt h r o u g ht h e h i pj o i n t

To p o q r a p h yI S e cti o n s Font

Thighand leg,cross-sections

a M rectusfemoris M vastusintermedius a Fascia lata

M vastuslateralist

a l\4 vastusmedialis

o v saphenamagna

Femur

ooA;Vfemoralis I l\4 sartorius

Tractusiliotibialis

M bicepsfemoris.CaputbreveO

M biceps femoris, Caput longum O

a M gracilis

N ischiadicus

o M adductormagnus o M adductorlongus

M semitendinosusC

O l\4 semimembranosus

F i g . I t 2 1 T h i g h ,F e m u r ; c r o s s - s e c t i otnh r o u g ht h e m i d d t eo f t h e t h i g h .

M tibialisanteriore

Fasciacruris

l\4 extensor hallucislongus I

a A tibialisanterior M extensor digitorum longusI N fibularissuperficialis

profundus N fibularis

Septumintermusculare crurisanterius lr4fibularislperoneusl brevisI

I M flexor digitorum longus a v saphena magna

M fibularis[peroneus] longusa

Membrana interossea

Septumintermusculare crurisposterius

a M tibialisposterior

Fibula

O A tibialisposterior M {lexor hallucislongus a

o M gastrocnemius, Caputmediale

M soleuso

N tibialis

A fibularisa

o V saphenaparva

F i g . 1 t 2 5 L e g ,C r u s ; c r o s s - s e c t i otnh r o u g ht h e m i d d t eo f t h e L e g .

I

> Lowertimb

M us c tes

Legand foot,sections

N fibularisprofundus *

A dorsalispedisa

a l\4 extensor hallucislongus,Tendo

N libularissuperficialis I

a M tibialisanterior,Tendo

M extensor digitorum longus,Tendoa

Syndesmosistibiofibularis

O V saphenamagna N saphenus NI fibularis[peroneus] | longus,Tendo a Nil tibialisoosterior,Tendo

M fibularislperoneus] breviso

longus,Tendo a lvl flexordigitorum

A fibularis O

6 N tibialis M flexor hallucislonous I


V saphena parva a

Tendo a M plantaris, Tendocalcaneus

F i 1 . 1 1 2 6 L e g ,C r u s ; c r o s s - s e c t ijouns ta b o v et h ea n k [ ej o i n t .

t l\4 extensorhallucislongus,Tendo M extensor digitorum brevis,Tendoa l\4 extensor digitorum longus,Tendoa M fibularislperoneus] tertius,Tendo*

Tendo a M tibialisanterior, ,, N saphenus o V saphenamagna Lig collaterale mediale

Caput tali

Sustentaculum tali Fasciapedis I

l\4,tibialisposterior,Tendo

Proc lateralistali c M flexor digitorumlongus,Tendo a M llexor hallucislongus,Tendo

M fibularis[peroneus] brevis,Tendoc

O A plantarismedialis

M fibularis[peroneus] longus,Tendot

medialis s N plantaris E N plantarislateralis

lateralis o A plantaris

0 l\4 ouadratusolantae Tendo calcaneus

Fi1.1127 Foot,Pes; o b I i q u es e c t i o nt h r o u g ht h e c a t c a n e u as n d t h e h e a do f t h e t a t u s

Topogr a p h yI Se c ti o n s Foot

Foot,sagittalsections

Articulatiotalocruralis

Tendocalcaneus

Os cuneiforme intermedium Os cuboideum

M fibularis[peroneus] longus,Tendo Articulatio subtalaris Os metatarsill

M interosseus dorsalispedisI Lig talocalcaneum Interosseum

M extensordigitorum longus,Tendo Phalanx proximalis

Calcaneus

plantae M quadratus

M llexor digitorum longus, Tendo

M adductor hallucis, Caputobliquum

l\4 flexor digitorum brevis

N plantaris lateralis

Lig plantare longum


F i g . 1 t 2 8 F o o t ,P e s ; s a q i t t a sL e c t i o nt h r o u q ht h e s e c o n dt o e .

N4 libialis anterior, Tendo

l\4.flexor hallucislongus

Tibia Linea epiphysialis

Articulatio talocruralis M triceps surae, Tendo calcaneus

Talus Articulatiosubtalaris

(Articulatio talonavicularis)

Lig talocalcaneum interosseum

Os naviculare

Calcaneus

Lig plantarelongum

Fig.1t29 Foot,Pes; m a g n e t i cr e s o n a n c teo m o g r a p h yi m a g e{ M R l ) s; a g i t t a sI e c t i o n

> Lowertimb

...Top ogr aphy I Sec ti ons Foot

Foot,cross-section andpedograms

l\4 interosseusdorsalis oedis ll

Mm extensores hallucislonguset brevis,Tendines

l/m extensores digitorum longus et brevis,Tendines

M interosseus dorsalispedisI

Fasciadorsalispedis M interosseus dorsalisDedislll

plantaris M. interosseus I

M interosseusdorsalis oedis lV

l\4,adductorhallucis, Caputobliquum

(M opponens digiti minimi)

M abductorhallucis

M abductordigiti minimi lvl flexor digiti minimi brevis

M flexorhallucislongus,Tendo

(Eminentia plantaris lateralis) plantaris M interosseus lll l\4 inlerosseusplantarisll

(Eminentia plantaris medialis) M. flexorhallucisbrevis Mm flexoresdigitorum longuset brevis,Tendines

F i g . 1 4 3 0 O s t e o f i b r o utsu b e so f t h e f o o t ; f r o n t a Ls e c t i o nt h r o u g ht h e m e t a t a r s u s

F i g . 1 4 3 1a - c F o o tp r i n t s ,p e d o g r a m s . a NormaIfoot b Pes cavus c Ftat foot

tnoex II

T h e n u m b e r sr e f e rt o t h e p a g en u m b e r s . T h e n u m b e r sw i t h , T " r e f e rt o t h e n u m b e r so f t h e t a b t e si n t h e s e p a r a t eb o o k t e te n c t o s e di n V o l u m e1 .

Arteria[-ae] Arcus Anulus - e p i g a s t r i icnaf e r i o 6r 0 - 6 1 , 6 6 , - inguinalis ani levatoris muscu[i profundus60,71,225 - tendineus - - s u p e r f i c i a [5i 5 69,71-72,158-159,173,175, 230-231,317 s-58,50-61, Abdomen - - - s o l e i3 1 1 , 3 2 9 , 3 5 0 , 3 7 0 - computedtomography 248-21+9, 179,196,217, 221, 225,227 ,229, 70,238-239 - venaeazygos115 - umbilicaLis 231, 236,253-254,359 46,52,56,58,6o, 251,255 - - - collateraI - venosus 69 - cross-section 248-251 circutation pedis365, dorsalis 70, 72-73,140,159,2/+2 - - superficiatis 66,353,359 - frontal section 244-245 373 Anus 210, 212-21/+,230,232-233, - - s u p e r i o6r 6 , 6 9 - 7 0 , 7 2 - - j u g u t a r i1 - median section 2/+2 s10 235 - v e r t e b r a5e- 8 ,1 5 ,1 7 , 2 0 , 2 2 , 2 9 , - - - collateratcirculation 69 - s a g i t t a Is e c t i o n 2 4 3 ,2 4 6 - 2 4 7 Aorta29,35,76-77,83,87,122, - femoralis62,69,73,218,244, 32,41,45 126,174,242,249,359 A b d o m i n a I v i s c e r1a5 8 ,1 6 2 ,1 6 6 , - abdominalis 314, 317,351,353, 256-257, Area(-ael 172 s. Parsabdomi- cnDrosa - arteries 168 380-381 355-359, lKenJluJ natisaortae - - superficia3 - gastricae130 - ascendens t i 5s 1 , 3 5 6 s. Parsascendens A b d o m i n aw l a [ [ 5 8 , 6 6 ,6 9 - 7 1 - fibu[aris351,366,368-372, - intercondylaris - a n t e r i o r ,v i e w e df r o m i n s i d e 5 9 , anterior282, aortae - congestion, 381-382 293 circu[a71 cottateraL - gastrica[-ael - - posterior282 breves131,166, - i n n e r v a t i o ns, e g m e n t a ts, e n s o r y t i o n6 9 - descendens 168,170,173 67 s. Parsdescendens - n u d a1 1 9 , 1 4 2 , 1 4 5 , 2 4 2 - - d e x t r a1 3 1 , 1 6 8 , 1 7 0 , 1 7 2 - m u s c l e s 5 2 , 5 1 +5,6 - 5 8 ,6 0 - 5 1 , Areolamammae64 aortae - - posterior170 - thoracica Arteria s. Parsthoracica [-ae) 66,72-73, T1 4-r1 6 - - s i n i s t r a1 0 61, 3 11, 5 21, 5 5 , - appendicutaris - posterior 220-221 168,17/+ aortae - arcuata183,215,351,374 - s k e t e t o np r o j e c t i o n4 7 160,168,170-173,178-179, Apertura - a s c e n d e n1s7 6 - s u r f a c ea n a t o m y 4 6 - petvisinferior264-265 218,2l+l+,247,2l+9 - gastroduodenatis - auricutaris 152,168 - - superior264-265 posterior38 A c e t a b u t a frl o o r 2 7 4 - axittaris54,113,120,122,12/+ 170-173,242,244 Acetabular root 274, 280 Apex - gastroomentatis - bulbipenis234,240 dextra131, - capitisfibutae283,291 A c e t a b u t u m2 5 6 ,2 6 1 ,2 6 6 - - vestibuti234 167-168,170-173 84-85,98-99, A c h i l t e st e n d o ns . T e n d oc a t c a n e u s - cordis7/+-80, - - s i n i s t r a1 3 11, 6 0 1, 6 8 , - caecatis posterior174 101 A c i n ip a n c r e a t i c i1 5 3 - carotiscommunis69,74-75, - dentis5 170-173,2/+7 A c r o m i o n 1 - 2 , 2 6 , l + 7 - / + 81,2 2 - gtuteainterior212,224-225, - ossissacri 10-11 110-111, 89,98-99,104-107, A d d u c t o rc a n a l 3 5 7 - 3 5 8 380 - patellae284,290-291 256-257 ,351, 363-364, 113-114, 117-1 18,120-124 Ata - - superior212,224-225,254, - - e x t e r n a1 1 4 - o s s i si t i u m 7 2 , 2 5 4 , 2 6 4 , - pulmonis94-95,98-99,110, - - i n t e r n a1 1 4 359,363,380 2 6 6 - 2 6 ,72 7 3 123 - h e [ i c i n a1e9 8 - caudae - vesicae190-191,252 - - sacri 10 pancreatis 168 - hepatica - c e r v i c a lpi sr o f u n d3a9 , 1 1 5 communis131,152, Aponeurosis A l c o c K ' sc a n a t 2 3 0 ,2 5 8 - - superficialis 218,249 - muscu[i 178-179, 168,170-173, 66 obtiqui externiabdoAmputta ---AP-radiographlTl - circumflexa - d u c t u sd e f e r e n t i s7 1 ,1 9 1 , femorislateralis m i n i s6 0 - 6 1 - - propria131,142,1t+6,152, - plantaris299,30t+, 261,351,357-359 338,340, 195-196,236 '132, - - - medialis260-261,351, 179, - l D u o d e n u m1 155,167-168,170-172, 6-379,383-384 134-135, 342,37 l 30, 2l+3-244,2/+9 363-364 357-359, Appendix(-cesl 179 - - variabitity - - humeriposterior 170 - epididymidis - h e p a t o p a n c r e a t i c1a3 5 ,1 5 4 37,122 193,239 - - i t i u m p r o f u n d1a7 9 , 2 2 1 , 2 2 7 , - iteates152,168,174-175, 251 - epiptoicae - recti 210, 215, 242, 252-253, s.Appendixl-cesl - iteoco[ica168,17/+-175, 255 231, 356,359 omentates 257-258 - - - s u p e r f i c i a t5i 5 - fibrosahepatis142-143, - t u b a eu t e r i n a e 1 4 0 , 1 6 7 , 2 0 1 , s , 3 5 3 , 3 5 9 - iliacacommunis167,179,212, 160, - - s c a p u l a3e7 , 1 2 2 231, 214, 217_218, 221,22/+_229, 166 203,209,253 - colicadextra152,168, - omentales 242-243,254,359 138-'139, 162,165, A n a [h i a t u s 2 3 0 - - e x t e r n a6 9 , 7 1 , 1 7 9 , 1 9 6 , 2 1 2 , 174-175 226,258 A n a s t o m o s e sp, o r t o c a v a [1 8 1 , - - media152,161,163-164, - t e s t i s1 9 2 - 1 9 3 , 2 3 9 221, 22t+-225 , 227-229, 231, ttJ - v e r m i f o r m i1s3 8 - 1 4 0 236,253,317,354,356, 168,174-177 1 ,6 3 - 1 6 6 , Angte - - sinistra167-168,175-177, 358-359 - between 175,209,251 neckandshaftof the - - i n t e r n a2 1 2 , 2 1 7 , 2 2 4 - 2 2 5 . - - projection 1 7 ,92 1 7 140 lemur 276 - coronaria(-ael - - variations 227-229,231,354,356,359 - of antetorsion, 84,86 in position140 femur277 ---variations224 - - dextra74-75,78-80,82, - vesiculosae 200-201, 204 Angutus(-i) - iliolumbaLis 217,221.224-225, - costae49,101 127 8t -87,98, 119-120, Arachnoidea mater 229 - i n f e r i o1 87 angiograPhY coronary 40 craniaLis r -2,26-27 - inferiorlateralis - - sinistra74-75,79-80,82, genus289, - spina[is40-41,43-45 - infrasternalis 46-47 351,368-369 - m a n d i b u l a1e2 98,119-1 20' 127 8/+-87, Arcus - - medialisgenu - - - coronaryangiograPhY 2 s8 9 , 3 5 1 , 3 5 8 , - a n t e r i oart l a n t i s6 , 1 2 , 1 9 - ossispubis266 87 - aortae74-75,8l+-85, 369-372 - sterni46,50 89,98-99, - cremasterica193,225,238 - intercostatislesl 70,99,120, - subpubicus 168,170,172 10 1, 10 4 - 10 5 ,10 7 - 10 8 ,1 1 t + - 1 1 5 ,- cystica142,1/+9, 268 - d e s c e n d egnesn u s3 5 13, 5 3 , 127 - superior2 118-120,122,124 - - posteriores l+5,54,73,75, - - A P - r a d i o g r a 1p 1h 4 369 356-358, Ansasubclavia 117,120 - digitates (Pesl374 115-116 - - b r a n c h e1s 1 4 104-105,112-113, dorsates Anteftexio {Uterus)203 - - s u p r e m a1 1 5 - - ptantares - - v a r i a t i o n1s1 4 375, communes Anteversio IUterus]203 - i n t e r t o b a r(eRse n )1 8 3 - 1 8 4 , 2 1 6 - cartitaginis 377 90 cricoideae Antrumpyloricum130,133,135, - intertobutares ---propriae375-377 - costa[is3, 46-47,52,207 [Heparl145 247 - jejunates152,168,174-175, - dorsalis - itiopectineus clitoridis234 71,269,313,317, AnuLus - - p e d i s3 5 1 , 3 6 8 , 3 7 t + - 3 7 5 , 3 7 9177 - femoralis229 , , 242,244 355 - tienatis splenica s. Arterial-ael - plantaris - fibrosus24-25,29,42 382 profundus 351,375, - lobarisl-es) - - penis199,227,23t+,238-240, 98-99, inferiores - - dexterlCorl 77,8t, 378 - posterior 101,126 - - lDiscus 2l+4 attantis6, 12,18-19, intervertebratisl - ductusdeferentis 60,193,197, - - media98 /+5 33,39-40 - - superiores 98,125 - pubicus268 - - sinisterlCorl 77,79,84 227

A

Arteria(-ael - t o b ic a u d a t i1 4 2 - l u m b a l e s 4 1 , 1 7 9 ,2 1 7 ,2 2 1 ,2 4 5 , 359 - m a t t e o t a r i sa n t e r i o r[ a t e r a l i s 3 5 1 ,3 6 8 ,3 7 4 ---medialis351,374 - m a r g i n a t i sc o t i 1 6 8 ,1 7 4 - 1 7 6 - m e d i ag e n u s2 8 9 , 3 5 1 , 3 6 9 - m e s e n t e r i c ai n f e r i o r 1 5 2 , 16 7- 1 6 8 ,1 74 , 1 76 - 1 7 7, 1 7 9, 2 1 2 , 2 1 4 , 2 1 ,72 2 1, 2 2 5 , 2 2 7, 2 5 0 - 2 5 1 ---AP-radiographlT6 ---variationslT6 - - superior 115,152-154, 16 7- 1 6 8 , 1 7 0 ,1 7 3 - 1 7 9 1 , 87, 217-2182 , 21,242-244, 250-251,255 ---AP-radiographlTt+ ---variationslT4 - m e t a t a r s a t e sd o r s a t e s3 5 1 ,3 6 8 , -

-

-

-

Arterial-ael - r e c u r r e n st i b i a t i sa n t e r i o r3 5 1 , 368 - - - p o s t e r i o r3 5 1 , 3 6 9 - 3 7 0 - r e n a t i s 1 5 2 ,1 8 2 - 1 8 3 ,1 8 5 ,1 8 7 , 18 9 , 2 16 - 2 18 , 2 2 1 ,2 t + 2 - 2 4 3 , 245-246,250 - - a c c e s s o r i a2 1 7 - - a r t e r i o g r a p h y2 1 6 - - p o [ a r i si n f e r i o r2 1 6 ---superior216 - - v a r i a t i o n s2 1 6 - s a c r a L i s[ a t e r a t i s2 2 4 - 2 2 6 - - m e d i a n a1 7 7 , 1 7 9 , 2 1 2 , 2 1 7 , 2 2 1 ,2 2 5 ,2 2 7- 2 2 9 , 2 5 3 ,3 5 9 - s e g m e n t a l i sb a s a l i sa n t e r i o r 9 8 ---lateratis99 ---mediatis99 ---posterior99 - s e g m e n tliA r e n a t i s )2 1 6 - - a n t e r i o r i sh e p a t i c i1 2 4 ---renatis171 374 - p l a n t a r e s3 7 5 - 3 7 6 , 3 7 8 - - p o s t e r i o r ihse p a t i c i1 2 4 - - - r e n a l i s1 7 1 m u s c u L o p h r e n i6 ca 9 - s i g m o i d e a e16 7- 1 6 8 ,1 76 - 1 7 7 , o b t u r a t o r i a7 1 ,2 1 2 ,2 2 l r - 2 2 5 , 2 2 7, 2 2 9 , 2 3 1 , 2 3 6 - 2 3 ,72 5 6 - 2 5 7, 1 7 9 2, 1 2 , 2 1,72 5 4 , 2 s 8 - s p i n a l i sa n t e r i o r 4 5 261,317,355,357-359 - v a r i a b i t i t y2 2 9 - s p [ e n i c a1 5 2 ,1 5 4 - 1 5 6 1 , 61 o c c i p i t a t i3 s7-39 16 7- 1 6 8 ,1 7 0 - 1 7 3 ,1 7 8 - 1 7 9, 2 1 8 , ovarica 152, 167, 201, 204,209, 245,248-249 - s u b c t a v i a74 - 7 5 , 8 9 , 9 8 - 9 9 , 223,228-229,253 p a n c r e a t i cdao r s a t i s1 6 8 ,1 7 1 104-1071 , 11- 1 1 3 ,11 5 ,11 7 , 1 2 3 - i n f e r i o r1 7 1 - - d e x t r a 6 9 , 9 9 ,1 1 / r ,1 1 8 ,1 2 0 - magna168 - - s i n i s t r a9 9 , 1 1 4 , 1 2 0 , 1 2 4 - s u b c o s t a t i s11 5 - 116 , 2 1 + 5 p a n c r e a t i c o d u o d e n aitni sf e r r o r - s u b s c a p u [ a r i1s 2 4 168,173,177 - s u p e r i o r a n t e r i o1r 7 1 , 1 7 3 - s u p e r i o rl a t e r a l i sg e n u s 3 5 1 , - - p o s t e r i o r1 6 8 , 1 7 0 - 1 7 1 , 1 7 8 366,368-369 - - m e d i a t i sg e n u s 3 5 1 ,3 5 8 ,3 6 2 , p e r f o r a n t e s3 5 1 ,3 5 8 - 3 5 9 , 362-363,369 368-369 - s u p r a d u o d e n a t1 p e r i c a r d i a c o p h r e n i c6a9 , 8 9 , i s6 8 - s u p r a r e n a t i s1 8 9 112-113,118 - - i n f e r i o r1 8 2 , 1 8 9 , 2 1 7 p e r i n e a t i s2 3 4 , 2 4 0 - - m e d i a 1 8 2 ,1 8 9 , 2 1 7 p h r e n i c ai n f e r i o r6 3 , 1 0 4 , - - superior 182,189 1 7 2 - 1 7 3 ,1 8 9, 2 1 7- 2 1 8 , 2 2 1 - - v a r i a t i o n s1 8 9 p t a n t a r i sL a t e r a t i s3 0 4 ,3 5 1 ,3 7 5 , - s u p r a s c a p u l a r i1s2 0 3 7 7- 3 7 8 , 3 8 2 - m e d i a t i s3 0 1 + , 3 5317, 5 , 3 7 8 , - s u r a [ e s3 5 1 , 3 6 9 - 3 7 0 - t a r s a t i s l - e s [l a t e r a t i s3 5 1 , 3 7 4 382 - p r o f u n d a3 7 / + - 3 7 5 - - m e d i a t e s3 5 1 , 3 7 4 - t e s t i c u t a r i s7 0 - 7 1 ,1 5 2 ,1 7 9 , p o p l i t e a2 8 4 ,2 8 9 ,3 2 0 ,3 2 9 ,3 5 1 , 3 5 8 ,3 6 1- 3 6 3 , 3 6 6 ,3 6 9- 3 7 2 1 9 3 - 1 9 4 ,1 9 7, 2 1 7, 2 2 1- 2 2 2 - v a r i a t i o n s3 7 0 238-239,243, 251, 254, 256 nron:nrre:tire 1AQ - - v a r i a t i o n s2 1 7 - t h o r a c i c ai n t e r n a 6 3 , 6 6 , 6 9 , 8 8 , p r o f u n d ab r a c h i i3 7 - femoris 256-257,261,351, 1 1 0 ,11 2 , 114 - 11 5 ,11 8 , 1 2 0 ,1 2 4 , 356-3593 , 80 126 - p e n i s 1 9 8 - 1 9 9 , 2 2 6 - 2 2 7 , 2 3 9 , - - - c o t t a t e r acI i r c u l a t i o n 69 - - l a t e r a [ i s6 6 244 - t h o r a c o a c r o m i a t1i s2 0 p u d e n d ae x t e r n a 6 6 , 2 3 8 , 3 5 3 , - t h o r a c o d o r s a t i s1 2 4 359 - i n t e r n a2 1 0 , 2 1 2 , 2 2 / + - 2 2 5 , - t h y r o i d e ai n f e r i o r 1 0 6 - - s u p e r i o r1 1 0 227-229 , 231, 234, 236-237, - t i b i a t i sa n t e r i o r2 8 3 ,3 5 1 , 240-241, 256-258, 260-261, 363-364 366-370,372,37/+,381 - - p o s t e r i o r3 5 1 , 3 6 6 , 3 6 9 - 3 7 2 , p u t m o n a t i s l - e s1l1 2 - dextra 7t-76,84-85,88-89, 375-378,381-382 - t r a n s v e r s ac o t t i 3 8 - 3 9 9 5 , 9 8 - 10 1, 10 5 , 10 7 , 1 1 9 ,1 2 5 - s i n i s t r a 7 / + - 7 5 , 8 4 - 8 5 , 8 8 - 8 9 , - u m b i t i c a t i s7 0 - 7 1 1 5 9 ,1 8 5 , , 9 5 , 9 8 - 9 9 ,10 5 , 10 7 , 1 1 3 ,1 2 / 1 2 0 7, 2 2 4 - 2 2 5 ,? 2 7 - 2 2 9 ,2 3 6 - u r e t h r a [ i s1 9 9 r e c t a l i s2 1 2 - i n f e r i o r1 6 8 , 2 1 2 , 2 2 7 - 2 2 8 , - u t e r i n a 2 0 4 ,2 2 4 ,2 2 8 - 2 2 9 - - V a r i a b i t i t d t2 0 4 240-241 - m e d i a 2 1 2 , 2 2 4 - 2 2 5 , 2 2 7 - 2 2 9 - - v a r i a b i t i t y2 0 4 - superior 167-168,176-177, - v a g i n a l i s2 0 4 ,2 2 8 - 2 2 9 - v e r t e b r a t i s2 4 , 3 4 , 3 7 , 3 9 - 4 0 , 1 7 9 ,2 1 0 ,2 1 2 ,2 1 7 ,2 2 7- 2 2 9 , 25/1 106,114.120

Arterial-ael - v e s i c a t i s ( - e si nl f e r i o r 2 2 5 , 227-228 - - s u p e r i o r e s7 0 , 2 2 4 , 2 2 7 , 2 2 9 , 260 A r t e r i e sh, i p 3 5 9 A r t e r l o g r a p h y2 1 6 A r t h r o s c o p yA, r t i c u t a t i og e n u s 292 Articutatiol-nesl - a c r o m i o c t a v i c u l a r i1s 2 2 - a t t a n t o a x i a t ilsa t e r a L i s1 7 - 1 9 - - m e d i a n aa n t e r i o r1 9 ---posterior19 - a t t a n t o o c c i p i t a t1i 7 s -19 - c a t c a n e o c u b o i d e2a6 3 ,T 3 9 - c a p i t i sc o s t a e8 , 1 4 , 2 0 , 2 2 - c o s t o t r a n s v e r s a r i8a, 1 4 , 2 0 - c o s t o v e r t e b r a l e2s 0 - 2 2 - coxae 257, 263, 268-271,273,

Attas4-7,12,17-19,31, 33-34, 39-40 Atrium - cordisdextrum74-76,78,82, 84-85,89,99,101,114,119-121 , 127,2/+3-244,255 - - sinistrum 75-76,79,82 84-85,89,99,101,114,119, 126-127 AuricuIa - dextra74, 78-80,8l+,98,114 - sinistra7/+-76, 79,84-85,98, 101,114,126 Axitta 122-123 Axis4, 6-7,12,17-19,33 - petvis265

278-279,139 - A P - r a d i o g r a p h2 8 0 - L A U E N S T EpTr N o j e c t i o n2 8 0 c u n e o c u b o i d e a2 f f i , f 3 9 c u n e o n a v i c u L a r2 i s6 3 ,T 3 9 f e m o r o p a t e l l a r i s2 6 3 ,2 8 4 g e n u s 2 6 3 ,2 8 t + - 2 8 92,9 2 ,3 2 3 , T39 - - A P - r a d r o g r a p2h9 1 - - a r t h r o s c o p y2 9 2 - - c r o s s - s e c t i o n2 8 4 - - f r o n t a Is e c t i o n 2 9 0 - - [ a t e r a Ir a d i o g r a p h2 9 1 - - MRt 293 - - s a g i t t a Is e c t i o n 2 9 0 - humeri 122-123,T39 - i n t e r c u n e i f o r m e s2 6 3 ,T 3 9 - i n t e r m e t a t a r s a t e s3 0 4 ,T 3 9 - i n t e r p h a L a n g epaeed i s 2 6 3 , I 3 9 - l u m b o s a c r a t i s2 6 8 - 2 7 1 - m e m b r ii n f e r i o r i s2 $ , f 3 9 ---tiberi263,139 - m e n i s c o f e m o r a t i s2 6 3 - meniscotibial2 i s6 3 - m e t a t a r s o p h a t a n g e a { - a2e5l 3 ,

B a c k1 ,3 7 - cutaneous innervation, segmentat 36 - dermatomes 36 - [ i n e so f o r i e n t a t i o1n - muscles26-34 - regions1

-

-

-

3 0 2 ,3 0 4 ,T 3 9 - h a t t u c i s3 3 6 pedis 300-303 sacrococcyge2 a 2 6 ,2 5 2 ,2 6 4 s a c r o i t i a c a1 , 16 , 1 76 , 2 0 5 ,2 3 0 , 254, 263-264, 268-269,271-27 3, 280, 317,139 s t e r n o c t a v i c u L a r4i s6 , 5 1 , 119 s t e r n o c o s t a l e s5 1 s u b t a t a r i s2 6 3 , 3 0 4 - 3 0 5 , 3 8 3 , T39 t a l o c a t c a n e o n a v i c u t a r2i 6 s3, 303-305T , 39 - A P - r a d i o g r a p h3 0 5 - f r o n t a ls e c t i o n 3 0 4 - t a t e r a lr a d i o g r a p h3 0 5 - s a g i t t a Is e c t i o n 3 0 4 t a l o c r u r a t i s2 6 3 ,3 0 1 ,3 0 4 - 3 0 5 , 3 8 3 ,T 3 9 - A P - r a d i o g r a p h3 0 5 - f r o n t a Is e c t i o n 3 0 4 - l a t e r a Ir a d i o g r a p h3 0 5 - s a g i t t a ls e c t i o n 3 0 4 ta[onavicutari3 s 8 3 ,T 3 9 t a L o t a r s a t i s2 6 3 ,3 0 4 ,I 3 9 t a r s i t r a n s v e r s a2 9 6 , f 3 9 tarsometatarsaLes263,296 3 0 4 ,T 3 9 t i b i o f i b u t a r i s2 6 3 ,2 8 2 ,2 9 0 - 2 91 , 293-294,T39 z y g a p o p h y s i a t i1s2 , 1 5 - 1 6 ,2 3 , 2 5 ,2 9 , 3 5 . 2 7 2

B

-

-,,-l^-^ ^^^r^-., JUr rdLg oi rdtut I ty

I I

B A R T H o L I Ng'tsa n d 2 0 0 ,2 3 3 , 2 3 5 Basis - o s s i sm e t a t a r s i 2 9 5 , 2 9 8 , 3 0 2 ---hattucis296 - - sacri 10-11,15,273 - pateltae 284,290-291 - p r o s t a t a e1 9 5 - p u t m o n i s9 5 - p y r a m i d i s1 8 3 B i f ur c a t i o - aortae177,179,359 - t r a c h e a e 9 0 - 9 1 ,9 9 , 1 0 2 , 104-105,107,119,125 - t r u n c ip u t m o n a t i s7 5 - 7 6 , 8 5 , 8 9 BoCHDALE SK triangte63 BOYD s vern 352 B r o n c h is, e g m e n t asI . B r o n c h u s [ - i ] s e gm en t a[ i s ( - e s ] B r o n c h i o t u s l -9i J8 - t e r m i n a [ i s9 8 B r o n c h o g r a p h y / B r o n c h o s c o9p3y - B i f u r c a t i ot r a c h e a e 1 0 2 - s e g m e n t abI r o n c h i1 0 2 B r o n c h u s [ - i J9 0 - 9 2 , 9 8 - a r t e r i a Is u p p t y 9 9 - b r o n c h o g r a p h y9 3 - b r o n c h o s c o p y1 0 2 - i n t r a s e g m e n t a t i s1 2 0 ,1 2 4 - [ i n g u [ a r i si n f e r i o r( B V ) 9 0 , 9 3 , 102 - - s u p e r i o rt B l v l 9 0 ,9 3 , 1 0 2 - t o b a r i s l - e s9l 2 , 1 0 7 - - i n f e r i o r1 2 6 - - - dexter 90-91,95,120-121 - - - s i n i s t e r9 0 - 9 1 , 9 3 , 9 8 - - m e d i u s9 0 - 9 1 , 9 51, 2 1 , 1 2 6 - - s u p e r i o r1 2 5 - - - d e x t e r 9 0 - 9 1 , 9 5 , 9 91, 0 4 , tz3

- - - s i n i s t e9r 0 - 9 1 , 9 3 , 9 8 - 9 9 , 102 - p r i n c i p a tdi e s xte8 r 8 ,9 0 - 9 19, 5 , 99,101-102,104-105,107,109, 112,115,117, 119-120, 125 - - s r n i s t e9r 0 - 9 1 , 9 3 , 9 5 , 9 9 102,104-105, 113,115,117 , 119,125 - projection 90

lndex

Canalis[-es] - i n g u i n a t i s2 3 9 - n e r v ih y p o g t o s s i1 8 - obturatorius 212-213,230, 268, 278-279,316-317,355 - pudendati2 s 30 - p y t o r i c u s1 3 0 ,1 3 5 ,1 5 2 - s a c r a t i s 1 0 - 1 1 ,2 4 , 2 2 7 ,2 5 2 , 2 7 1, 3 1 7 - v e r t e b r a [ i s3 , 2 4 ,4 1- 4 3 , 4 5 ,3 1 7 - - v e i n s4 2 C ap s u[ a - a d i p o s a1 8 2 ,1 8 8 ,2 1 7 ,2 4 5 - 2 L 7 , 249 - a r t i c u L a r i {sA r t i c u l a t i o l 7-18 a t L a n t o a x i a LLias t e r a t i s 1 - - { A r t i c u L a t iaot l a n t o o c c l p i t a [ i s ) 18 - - [ A r t i c u t a t i oc o s t o v e r t e b r a [ i s ] 21-22 - - l A r t i c u t a t i oc o x a e J2 6 8 , 270-271 - - l A r t i c u L a tgi oe n u s )2 8 5 ,2 9 0 , 293,323 - - [ A r t i c u l a t i om e t a t a r s o p h a [ a n g e ah a t t u c i s 3l 3 6 - - [ A r t i c u L a t isot e r n o c l a v i c u t a r i s )5 1 - - ( A r t i c u t a t i oz y g a p o p h y s i a t i s l 25 - - { C o t u m n av e r t e b r a L i s4) 2 - f i b r o s a( R e n l 1 8 2 - 1 8 4 , 2 4 6 - 2 4 7 - i n f r a p a t e t l a r ip s r o f u n d a2 8 5 , Caput 288-289 - b r e v e( M b i c e p sb r a c h i i l 5 4 - i s c h i a d i cm a usculo i bturatonl - - { M b i c e p sf e m o r i s l3 1 8 , i n t e r n i3 11 - m u s c u [ si e m i m e m b r a n o s i 320-3233 , 6 3 ,3 8 1 ,r 4 0 ,r 4 6 - c o s t a e8 , 1 4 , 2 2 ,/ , 9 32 9 - 3 31 - e p i d i d y m i d i s1 9 2 - 1 9 4 2 - o m e n t a t i s1 5 7 ,1 6 1 , 1 6 6 - 1 6 7 , , 3 9 ,2 5 2 - f e m o r i s 2 5 6 ,2 5 9- 2 6 1 ,2 71 , 2 7 3 , 247-21+9 - s u b c u t a n ecaa l c a n e a3 3 8 2 7 5 - 2 7 7, 2 7 9 - 2 8 0 , 3 5 9 - f ibuLae262, 282-283,285-281, - - c o c c y g e a3 7 - - i n f r a p a t e I L a r3i s0 6 , 3 1 3 291, 293-29/+,306, 3 13, 322, 332, - - p r e p a t e [ [ a r i s2 8 4 , 3 0 6 367 - humeri 122-123 - - sacralis37 - [ a t e r a l el M g a s t r o c n e m i u s l - - s p i n a ei t i a c a ep o s t e r i o r issu p e r i o r i s3 7 284, 286 -288, 320-323, 326, - - t r o c h a n t e r i c3 3 2 8 - 3 3 0 ,3 6 2 ,3 6 9- 3 7 0 , T4 9 a1 1 - - l M t r i c e p sb r a c h i i l5 2 - s u b f a s c i a t ip s88 s r e p a t e L [ a r i2 - [ o n g u m{ M b i c e p sb r a c h i i ]1 2 2 - s u b t e n d i n eiaL i a c a2 5 6 , - - [ M b i c e p s f e m o r i s ]3 1 7 - 3 2 3 , 3 15 - 3 16 , 3 8 0 - - m u s c u t gi a s t r o c n e mm iiedi3 6 2 - 3 6 3 , 3 8 0 - 3 8 1T,4 6 - - l M . t r i c e p sb r a c h i i l3 7 ,5 2 a l i s 3 11 , 3 2 9 - 3 3 1 - m e d i a L (eM g a s t r o c n e m i u s ) - - - obturatoriinterni 256-257 ---sartorii316 2 8 4 ,2 8 6 - 2 8 7 , 3 0 83, 2 0 - 3 2 1 ,3 2 3 , - - p r e p a t e t l a r i3s1 3 , 6 2 , 3 6 9- 3 70 , 3 8 1 , 3 2 6 ,3 2 8 - 3 3 1 3 - s u p r a p a t e t t asr i 2 8 5 , 2 8 8 , 2 9 0 , r49 - o b t i q u u mI M a d d u c t o hr a [ [ u c i s ] 292 - t r o c h a n t e r i cm 3 0 4 ,3 3 9 ,3 4 2 , 3 7 8 , 3 8 3 - 3 8T4 5, 2 a u s c u t gi L u t e i - o s s i sm e t a t a r s i 2 9 5 , 2 9 8 m a x i m i 2 7 9 ,3 1 9 - 3 2 1 m e d i i2 5 6 , 2 7 9 , 3 1 1 , 3 2 1 - - - q u i n t i 2 9 6 - p a n c r e a t i s1 3 4 , 1 4 0 ,512 - 15 3 , 16 7, 1 7 3 ,1 7 9 , 2 4 3 - 2 4 4 - p h a t a n g ilsP e s l 2 9 5 - rectum 278-2793 , 1 5 ,f / + 4 - r e f l e x u m 2 7 8 - 2 7 9 , 3 1 5T. 4 4 C a e c u m1 3 8 - 1 4 01, 5 8 ,1 6 2 - 1 6 6 , - rali 295-298,305, 382-383 1 7 5 , 2 0 ,92 5 1, 2 5 4 - transversum - p r o j e c t i o n1 4 0 { M a d d u c t o hr a t , 7 8 ,T 4 0 ,T 5 2 lucisl 339-3423 C a t c a n e u s2 9 5 - 3 0 13, 0 3 - 3 0 43, 8 3 C a r d i a1 0 9 ,1 3 0 - 1 3 11, 6 0 ,2 4 2 ,2 4 7 C a I i c e sr e n a l e s2 1 6 - majores 183,186,245 C a r i n at r a c h e a e 1 0 2 ,1 1 9 - m i n o r e s 1 8 3 - 1 8 4 ,1 8 6 ,2 4 6 ,2 5 0 Carti[ago[-inesl - a r t l c u t a r i s2 8 4 Calx 262 - a r y t e n o i d e9 a1 C a n a fo f A L C O C K2 3 0 , 2 5 8 - b r o n c h l a t e9s 0 , 1 0 2 C an at i s[ - e s ] - cornicutata - a d d u c t o r i u s3 1 4 , 3 5 ' 1 91 - c o s t a l i s5 1 ,5 5 ,5 7 - 5 8 ,7 0 , 115 , - a n a t i s2 1 1 , 2 1 5 , 2 5 2 - c e r v i c i su t e r i 2 0 1 - 2 0 3 ,2 5 3 125.127

Bronchus[-iI - s e o m e n t a l i s l - e s9l0 - 9 2 9 9 - - a n t e r i o[rB l l l ] 9 0 , 9 3 ,1 0 2 , 122,124-125 - - a p i c a t l s[ B l J 9 0 - - a p i c o p o s t e r i [oBr | + l l ] 9 0 , 93,102 - - b a s a t i sa n t e r i o rI B V l l l ] 9 0 , 93,102 - - - c a r d i a c u [sB V l l ]s R r n n r hrrc [ - i ls c n m e n t a t i s b a s a L im s e d i a L iIsB V l l ] - - - l a t e r a l i s[ B l X ] 9 0 , 9 3 , 1 0 2 , 127 - - - m e d i a l i st B V l l l 9 0 - - - p o s t e r i o [rB X ] 9 0 , 9 3 ,1 0 2 , 126 - - b r o n c h o s c o p1y0 2 - - L a t e r a L itsB l v l 9 0 - - m e d i a t i st B V l 9 0 - - p o s t e r i o rt B l l l 9 0 , 1 2 4 - 1 2 5 - - s u p e r i o rI B V l ] 9 0 ,9 3 , 1 0 2 B R U N N E Rg 'tsa n d s 13 6 Butbus - a o r t a e 7 9 ,8 7 , - p e n i s ' 1 9 61 98,236,252 - v e s t i b u l i 2 0 0 ,2 2 8 ,2 3 5 ,2 3 7 ,2 4 1 , 261 Bursa[-ae] - a n s e r i n a3 1 6

c

CartiLagol-ines) - c r i c o i d e a1 2 ,11 9 - e p i p h y s i a L2i s7 4 - f i b r o s aI D i s c u si n t e r v e r t e b r a L i s l 272 - h y a [ i n aI D i s c u si n t e r v e r t e b r a t i s l 272 - t h y r o i d e a3 5 ,5 8 ,9 0 - 9 1 ,1 0 4 , 110,119-120 - t r a c h e a [ e s9 0 - 9 1 ,1 0 4 - 1 0 51, 1 9 C a r u n c u L ahey m e n a l e s2 3 3 ,2 3 5 Cauda - e p i d i d y m i d i s1 9 2 - 1 94 , 2 5 2 - e q u i n a 2 4 , 2 9 , 4 1 ,1 , 3 - 4 42, 4 2 , 250-251,25/+ - p a n c r e a t i s1 3 / ' , 1 5 2 ,514 - 15 5 , j 6 j , 1 6 6 _ 16 7, 1 7 9, Z t + 4 , 2 4 9 C a v eo f R E T Z l u s2 0 7 , 2 5 2 Cavea - thoracis48,55 - - A P - r a d i o g r a p 'h1 0 1 Caverna(-ael - c o r p o r i sc a v e r n o s i1 9 8 - 1 9 9 - - s p o n g i o s 1i 9 9 C a v i t a s-(t e s l - a r t i c u l a r i {sA r t i c u L a tci o x a e l 2 71, 2 7 3 , 2 7 9 - 2 8 0 - g t e n o i d a t i4s 8 , 1 2 2 - i n f r a g L o t t i c1a1 9 - m e d u t t a r i 2s 7 7 , 2 8 1 - nasi12 - p e r i c a r d i a c1 a1 9 , 1 2 5 - p e r i t o n e a l i s1 5 7 ,16 7 , 2 4 2 - 2 4 1 + , 247-251 - - d e v e t o p m e n1t 5 7 - p t e u r a I i s1 1 2 - 1 1 31, 1 7 ,1 2 1 , 1 2 6 ,1 5 5 , 2 4 8 - 2 4 9 - s e r o s as c r o t i 6 1 - s y m p h y s i a L i2s 7 2 - t h o r a c i s 1 1 9 ,1 2 4 - 1 2 5 1 , 27

--cr129 -

-

frontal section 120-122 m e d i a ns a g i t t asI e c t i o n11 9 MRt 120-121 t r a n s v e T s see c t i o n 1 2 3 , 125-126 - u t e r i 2 0 1- 2 0 3 , 2 3 7 ,2 5 3 ,2 5 9 C a v u ms e r o s u ms c r o t i 6 1 , 1 9 4 C e n t r um - perinei 230-231 - t e n d i n e u m 5 5 , 6 2 - 6 3 ,7 3 , 1 0 4 , 1 0 6 ,1 1 2 - 1 1 3 , 2 4 2 , 2 4 6 40 CerebeL[um C e r e b r o s p i nfaLIu i dp, u n c t u r e4 4 C e r v i c a pI a r t o f t h e v e r t e b r a l c o t u m n1 7 , 4 3 - A P - r a d i o g r a p 'h1 3 AT

'E

- l a t e r a Ir a d i o g r a P h1 2 Cervix - u t e r i 2 0 3 - 2 0 52, 3 7 - v e s i c a e1 9 5 Chiasma - crurate 326 - p t a n t a r e3 4 2 - tarsate326 c H o P A R Tj 'osi n t 2 96 , f 3 9 Chordat-ael - a r t e r i a eu m b i t i c a t i 6 s 1 ,6 6 , 7 1- 7 2 , 15 8 , 196 , 2 2 9 ,2 3 6 ,2 5 3 - t e n d i n e a e7 9 - 8 1 - urachl61,72,236 C i n g uI u m - m e m b r ii n f e r i o r i s C i n g u t u m p e t v r cm u - - s u p e r i o r i s C i n g u t u mP e c torate

Cingutum - p e c t o r a t e3 , 4 8 - p e t v i c u m3 , 2 6 3 - 2 6 4 Ci s t e r n a - c e r e b e l l o m e d u [ [ a r i4s0 - c h y t i1 1 6 , 2 1 8 C L a v i c u t3a, 4 6 - 1 , 8 , 5-15 2 ,9 0 , 10 1, 1 0 8 ,11 0 ,1 1 2 - 11 3 ,1 1 8 ,1 2 0 , 122-123,159 C t e f t ,u n c o v e r t e b r a2[ 4 C t i t o r i s2 0 7 , 2 2 3 , 2 3 1 C l i v u s1 8 eins 352 C o c K E T Tv' S C o e l i a c o g r a p h1y7 ' 1 C o l t i c u L usse m i n a l i s1 9 0 ,1 9 8 C o t t u m2 5 7 - c o s t a e8 , 2 0 , 4 9 - femoris 259, 273, 275-280 - fibutae283 - tati 296-298,305 - v e s i c a eb i t i a r i s1 4 9 - 1 5 1 C o t o n1 3 8 - 1 3 9 , 1 8 8 - AP-radiograp1 h41 - a s c e n d e n s1 3 8 - 1 4 11, 5 8 , 1 6 1 - 16 2 , 1 6 5 - 16 6 , 1 8 0 ,1 8 6 , 2 1 4 , 251,254 - d e s c e n d e n s1 3 8 ,1 4 0 ,1 5 9 , 1 6 5 - 16 6 ,177 , 1 8 0 ,1 8 6 ,2 4 4 - 2 4 5 , 21,9-251,25/'-255 - L a y e r so f t h e w a t t 1 3 9 - p r o j e c t i o n1 3 8 - s i g m o i d e u m' 1 3 81, 4 0 ,1 5 7 - 1 5 8 , 16 2 , 1 6 4 - 1 6 ,71 7 5 ,1 7 7, 1 7 9, 2 0 7, 27 1 8 ,2 2 6 , 2 0 9 ,2 1 2 - 2 1 3 , 2 1 5 , 2- 1 2 4 2 ,2 4 / + , 2 5-12 5 4 , 2 5 8 - t r a n s v e r s u m 1 3 8 - 14 0 ,1 4 9 , 15 7 - 15 8 , 1 6 0 - 1 6 2 , 1 6 4 - 1 6 6 , 1 7 5 , 242-21,4,246-247,249-250 - - v a r i a t i o nisn p o s i t i o n1 4 1 C o L o n o s c o p1y4 1 ,2 11 CoLumna[-ael - a n a t e s 2 1 0 - 2 11 , 2 4 2 ,2 5 2 ,2 5 8 - renales 183,246 - r u g a r u ma n t e r i o r2 3 5 - verlehralis 2-4, L2 - - nerves42 Commissura - [ a b i o r u ma n t e r i o r2 3 5 - - p o s t e r i o r2 3 5 Compartimentum - c r u r i sa n t e r i u s3 6 6 - - laterale366 - - p o s t e r i u s3 5 6 C o m p l e x usst i m u t a n sc o r d i s 82-83 C o m p u t e dt o m o g r a p h yI C T ) - a b d o m e n2 4 9 , 2 5 1 - c e r v i c a Ip a r t o f t h e v e r t e b r a I c o t u m n3 5 - L u m b a rp a r t o f t h e v e r t e b r a L c o t u m n3 5 - M m a b d o m i n i s7 3 - Mm dorsi 29 - p e t v i s2 5 4 - - of the femate 257 - - of the mate 256 - t h o r a c i c a v i t y1 2 5 C o n d u c t i n gs y s t e m 8 2 - 8 3 C on d y t u s - l a t e r a L iIsF e m u r ]2 7 5 , 2 7 7 , 2 8 1 , 285-287,290-293 - - lTibia] 282,287,290-293 - m e d i a l i sl F e m u r l 2 7 5 , 2 7 7 , 2 8 1 , 285-287,290-293,3',l3-3 14 - - [ T i b i a ]2 8 2 , 2 9 0 - 2 9 1 , 2 9 3 , 3 2 7, 3 2 9, 3 3 1- 3 3 2 - o c c i p i t a t i6 s

Index

Conjugata - a n a t o m i c a2 6 5 - d i a g o n a t i s2 6 5 - vera 264-265

Corpus(-ora) - s t e r n i 3 , 4 7, 5 0 - 5 1, 5 5 , 9 0 , 119 , 124-126,242 - rati 296-297,304 - tibiae 282-283,291 C o n u sa r t e r i o s u s7 4 ,8 4 ,i 8 - u t e r i 2 0 1 ,2 0 3 - 2 0 4 2 C o r 6 7 , 74 - 7 5 , 9 8 , 11/ + ,2 6 2 , 3 7 ,2 5 3 , - a r t e r i a Is u p p t y 8 5 259 - a t r i u m ,l e f t 7 9 - v e r t e b r a e 5 - 9 , 1 2 - 2 5 ,2 9 , 3 5 , - - r i g h t 7 8 ,8 2 4 1 ,1 + 57,2 ,1 2 5 ,1 5 5 ,1 8 8 ,2 4 9 , - b a t a n c e dc o r o n a r ya r t e r ys u p p l y 251 - v e s i c a e1 9 0 - 1 9 1 85-86 - c o n d u c t i n gs y s t e m 8 2 - 8 3 - - b i t i a r i s1 4 9 - 1 5 1 - c o r o n a r ya r t e r i e s 8 4 , 8 6 - 8 7 - - c y s t o s c o p y1 9 0 - - c o r o n a r y a n g i o g r a p8 h7 y Corpuscutum r e n a l e1 8 4 - d o m i n a n t[ e f t c o r o n a r ya r t e r y Cortex - [ G t a n d u tsau p r a r e n a [ i s1] 8 9 s u p p t y8 5 - 8 6 - d o m i n a n tr i g h t c o r o n a r ya r t e r y - r e n a t i s1 8 3 - 1 8 41, 8 8 , 2 4 6 - 2 4 7 , s u p p t y8 5 - 8 6 250 - i n n e r v a t i o n8 3 C o s t a [ - a e ]2 - 3 , 5 , 8 , 1 1 + -61, 2 0 - 2 2 , - p o s i t i o n7 7 2 7, 2 9 , 3 1- 3 2 , 3 / +4, 1, 4 8 - 4 9 , 5 4 , - - d u r i n ge x s p i r a t i o n / i n s p i r a t i o n 5 8 ,6 3 ,6 9 ,7 3 , 10 3 , 1 10 , 113 , 88 11 5 - 116 , 118 - 1 2 0 ,12 2 , 12 4 - 12 7 , - p r o j e c t i o n1 0 1 1 3 2 ,14 1 , 1 8 3 ,1 8 8 ,2 16 - 2 1 7 ,2 2 0 , - ultrasound image 126 245-250 - valvesp - f t u c t u a n t e[sX l ;X l l ] 4 8 , o i n t so f a u s c u l t a t i o n7 7 - - p r o j e c t i o n7 7 - s p u r i a e[ V l l l - X l l 4] 8 - v e n t r i c t e l,e l t 7 9 - 8 2 - v e r a e[ l - V l l ] 4 8 - - r i g h t 7 8 ,8 0 - 8 2 C o W P EsRg l a n d 2 2 6 , 2 3 2 ,2 3 1 Cornu Coxa - a n t e r i u s( M e n i s c utsa t e r a t i s ) - valga 276 - vara 276 290,293 - c o c c y g e u m1 1 uL n c t i o n s17 - 1 9 C r a n i o c e r v i cj a - i n f e r i u s( M a r g of a t c i f o r m i s3) 0 6 , - AP-radiograp1 h9 355 Crista - p o s t e r i u sI M e n i s c u lsa t e r a t i s ] - c a p i t i sc o s t a e 4 9 - c o t [ ic o s t a e 4 9 290,293 - s a c r a t e1 0 - 1 1 - i t i a c a1 - 2 , 1 5 ,2 6 - 2 7 ,3 7 , 4 4 ,4 7 , - s u p e r i u sl M a r g of a t c i f o r m i s l 6 2 ,7 3 , 1 0 3 ,1 76 , 1 8 3 , 2 1 6,220, 305,355 2 3 0 ,2 5 4 ,2 6 4 ,2 6 6 - 2 6 7, 2 7 1, 2 7 3 , C o r o n ag l a n d i s1 96 , 1 9 8 - 1 9 92, 5 2 3 0 7 ,3 1 7 ,3 1 9- 3 2 0 , 3 2 2 ,3 6 0 ,3 6 1 + - i n t e r t r o c h a n trei c a 2 7 3 ,2 7 5 - 2 76 C o r o n a r ay n g i o g r a p h 8y 7 - m e d i a t i s2 8 3 C o r o n a r ya r t e r i e s 8 4 , 8 6 - o b t u r a t o r i a2 6 6 - 2 6 7 C or p u s {- o r aI - a d i p o s u mi n f r a p a t e t [ a r2e8 5 , - o c c i p i t a t iesx t e r n a6 - p u b i c a2 6 6 290, 293,323 - - p a r a r e n a t e1 8 8 - s a c r a l i st a t e r a t i s1 0 - - ( R e n l1 8 3 - - m e d i a l i s1 0 - a t b i c a n s2 0 1 - - m e d i a n a1 0 - 1 1 1, 5 , 3 6 0 - a n o c o c c y g e u m2 0 7 ,2 2 6 , - urethraLi1 s 9 0 ,1 9 8 230-233,235, 240-241,252,257 C r u s [ - r a ]2 6 3 - cavernosum - c t i t o r i d r s2 0 0 ,2 3 5 ,2 3 7 ,2 6 1 c l i t o r i d i s2 0 7 , 2 3 5 , - c o m p a r t m e n t s3 6 6 253 - - penis192,196-197,199,222, - cross-section 381-382 - c u t a n e o u isn n e r v a t i o n 227, 239, 242-243, 252, 259 350 - - recti211 - d e x t r u m{ F a s c i c u t uast r i o v e n - [ C t a v i c u t a4l 6 - 4 7 tricutaris8 l 2-83 - c t i t o r i d i s2 3 1 , 2 5 3 - - [ P a r sl u m b a l i sD , iaphragmal - c o s t a e4 9 , 1 0 1 6 2 - 6 3 ,6 8 , 10 4 , 10 6 , 116 , 15 5 , - e p i d i d y m i d i 1s 9 1 ,1 9 1 + 249, r21 - f e m o r i s 2 1 5 ,2 7 5 ,2 7 7 ,2 9 1 - e x t e n s o r s3 2 6 - fibutae 283,291 - f t e x o r s3 2 6 - g a s t r i c u m 1 2 1 ,1 2 8 ,1 3 0 , - [ a t e r a t e[ A n u l u si n g u i n a t i s 132-133,158,160-161, 245 s u p e r f i c i a t i s5l6 ,5 8 ,6 0 ,2 3 9 - luteum 201-202 - m e d i a t el A n u t u si n g u i n a t i s - - m e n s t r u a t i o n i2s0 2 s u p e r f i c i a t i s5l6 ,5 8 ,6 0 ,2 3 9 - m a m m a e5 2 - muscles 324-332,I 47-T50 - o s s i si [ i u m 2 5 9 , 2 6 7 - - l a t e r a l3 6 6 - - i s c h i i2 6 6 - 2 6 7 - - o r i g i n sa n d i n s e r t i o n s - - m e t a t a r s i2 9 5 , 2 9 8 , 3 3 4 310-311,32/+-325 - - pubis 230,243,266-267 - o s t e o f i b r o u tsu b e s 3 6 6 - p a n c r e a t i s1 3 4 ,1 5 2 - 1 5 5 ,1 6 1 , - p e n i s1 9 6 ,1 9 8 , 2 2 6 , 2 3 6 , 2 6 0 - s i n i s t r u mI F a s c i c u t uast r i o v e n 166,173 - p e n i s1 9 7 t r i c u t a r i s8 l 2-83 - p h a l a n g i {sP e s l 2 9 5 - - l p a r st u m b a t i sD, i a p h r a g m a ) - spongrosum penis192, 63,j04,106,11|6,2/+9.f21 1 9 6 - 1 9 9 , 2 2 2 , 2 3 2 , 2 3 9 , 2 4 2 , 2 5 2C, r y p t a ei n t e s t i n a [ ess G t a n d u t a e 259-260 intestinates

C u m u L uos o p h o r u s2 0 2 C u p u l ap l e u r a e1 0 3 , 1 2 2 Curvatura - m a j o r 1 2 8 - 1 3 01,3 2 ,1 5 8 - 1 6 1 - m i n o r 1 2 8 - 1 3 01,3 2 ,1 3 5 , 16 0 - 16 1 Cuspis - a n t e r i o r{ V a l v aa t r i o v e n t r i c u t a r i s dextral77-78,81-82 - - [ V a l v aa t r i o v e n t r i c u [ a r issi n i s tra) 77,79-80,82,126 - commissura[d i se x t r a 7 7 - - sinistra 77 - p o s t e r i o r[ V a l v aa t r i o v e n t r i c u [ a r i s d e x t r a ] 7 7- 7 8 , 8 0 - 8 1 - - l V a t v aa t r i o v e n t r i c u t a r issr n r s Ira) 77,79-81,126 - s e p t a t i sl V a l v aa t r i o v e n t r i c u L a r i s d e x t r a J7 7 - 7 8 , 8 0 C u t a n e o uisn n e r v a t i o n , gmentat se - back 36 - lowerlimb 346 C u t a n e o u sn e r v e s ,l o w e r [ i m o 349 C u t i s 7 0 ,1 8 8 ,2 1 0 C y s t o s c o p y19 0 - 19 1

D D e f a e c o g r a p h2y15 D e n sa x i s 6 - 7 , 1 2 , 1 8 - 1 9 Dermatomes - back36 - l o w e rl i m b 3 4 6 D i am e t e r l s l - o b t i q u a| 2 6 4 - o b L i q u lal 2 6 4 DiameterIs] - l o f t h e p e t v i si n t h e f e m a l e 265 - s a g i t t a t i s2 6 5 - transversa 26L-265 - t u b e r a t i s2 6 5 D i a p h r a g m a5 4 - 5 5 ,5 9 , 6 2 - 6 3 , 6 7 , 6 9 ,7 3 ,8 7, 1 0 1, 1 0 4 - 1 1 2 , 116 - 1 2 1 ,1 4 2 ,1 4 4 ,1 4 8 - 14 9, 1 5 2 , 15 7 , 15 9 - 16 0 , 2 5 5 , r 2 1 - p e t v i s 1 8 8 ,2 3 7 ,2 4 2 ,2 4 5 - 2 4 6 , 249-250,T22 - - o f t h e f e m a t e2 3 0 - 2 3 12, 3 3 - - ofthe male 232,236 - urogenita[e 2 3 1 ,2 4 1 ,2 4 3 ,2 6 1 , 122 - - of the femate 234-235 - - of the mate 234 Di gi t us ( -i l - m i n i m u sl P e s )2 6 2 , 2 9 5 - p e d i s2 6 3 - p r i m u sI P e s ls H a t [ u x - q u a r t u sl P e s l 2 6 2 , 2 9 5 - q u i n t u sI P e s Js D i g i t u sm i n i m u s - s e c u n d u sl P e s ) 2 6 2 , 2 9 5 - t e r t i u sl P e s l 2 6 2 , 2 9 5 Dr s c u s - a r t i c u t a r i s[ A r t i c u t a t i os t e r n o c L a v i c u t a r i5s1l - interpubicu2 s 0 7 ,2 6 8 ,2 71- 2 72 , T39 - i n t e r v e r t e b r a L i4s, 1 2 , 1 7 , 1 9- 2 5 , 2 9 , 3 5 ,4 2 , 4 5 , 1 7 8 ,2 5 9 , 268, 271 D i s t an ti a - i n t e r c r i s t a l i s2 6 5 - i n t e r s p i n o saan t e r i o r2 6 5 - - posterior265 - pubococcygea 265

Diverticutum(-al - a m p u t l a e1 9 1 - c e r v i c a t1 0 9 - e p i p h r e n i c1 0 9 - i L e i1 3 7 - mid-oesophagea 1 [0 9 - o f M E C K E1L3 7 _ o f Z E N K E1R0 9 D O D D 'vse i n s 3 0 6 ,3 5 2 Dorsum - t i n e so f o r i e n t a t i o n' 1 - o f t h e f o o t ,m u s c l e s 3 3 3 - 3 3 7 , T 51- T 5 2 - pedis 262, 368, 373-374 - p e n i s1 9 7 - r e g i o n s1 - s u r f a c ea n a t o m y 1 D O U G L APSo,u c ho f 1 5 7 , 1 6 7 , 2 0 7 , 229,253 Duct - o f M U L L E R1 9 2 , 2 0 0 _ O f S A N T O R I1N5I2 - o f W I R S U N1G5 2 - o f W o L F F1 9 2 , 2 0 0 Duc t u[ u s l- i J - a b e r r a n si n f e r i o r 1 9 2 , 1 9 4 - e f f e r e n t e st e s t i s 1 9 4 , 2 5 2 - p r o s t a t i c 1i 9 0 ,1 9 8 - transversi 200-201 Ductus[-us] - a L v e o l a r e9 s8 - a r t e r i o s u sI B O T A L L 0 ]7 5 - b i t i a r i ss D u c t u sc h o t e d o c h u s - b i t i f e ri n t e r l o b u t a r i1s 4 5 - c h o t e d o c h u 1s 4 2 , 1 4 6 , 51 0 - 15 4 , 1 7 0 ,1 7 2 ,1 7 9 , 2 4 32, 4 9 - - AP-radiograp1 h 5 1 ,1 5 4 - - v a r i a b i t i t y1 5 0 ,1 5 3 - c y s t i c u s1 3 1 ,1 5 0 - 1 5 41, 6 7 ,1 7 0 , 1 7 9 ,2 4 9 - d e f e r e n s{ V a sd e f e r e n s 6 l 0-61, 7 0 - 71 , 16 6 ,1 7 9 ,1 9 0 - 1 9 2 , 1 94 - 1 9 7, 2 2 1- 2 2 2 , 2 2 6 - 2 2 7, 2 3 6 , 238-239, 2/,3, 252, 256, 258 - - AP-radiograp1 h95 - e j a c u L a t o r i u1s9 0 ,1 9 2 ,1 9 5 - 1 9 6 , 198 - e p o o p h o r o n tliosn g i t u d i n a tsi s D u c t u s[ o n g i t u d i n a t i s - e x c r e t o r i u s1 5 3 ,1 9 6 - g t a n d u t ab e u t b o u r e t h r a l i1s9 2 , 198,234 - h e p a t i c u cs o m m u n i s1 3 1 , 15 0 - 15 4 ,1 6 7 , 1 7 0 , 1 7 9 - - d e x t e r 1 4 6 ,' 1 5 0 - 1 5 1 - - s i n i s t e r1 5 0 - 1 5 1 - t a c t i f e r i6 4 - t o n g i t u d i n a t i s2 0 0 - 2 0 1 - m e s o n e p h r i c u s1 9 2 ,2 0 0 - o m p h a l o e n t e r i c u1s3 7 - p a n c r e a t i c u 1s 5 0 ,1 5 2 - 1 5 4 , 242-243 - - accessoriu1 s 52-153 - - AP-radiograp1 h54 - - v a r i a b i t i t y1 5 3 - p a r a m e s o n e p h r i c u1s9 2 ,2 0 0 -

nererrrothrelic

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- t h o r a c i c u s6 3 , 11 3 ,11 5 - 1 ' 1 6 , 1 2 1 ,1 2 4 - 1 2 7, 2 4 5 , 2 4 8 - 2 4 9 - v e n o s u sI A R A N I u s ]1 4 3 D u o d e n u m1 1 7 ,1 2 8 - 1 3 01, 3 3 - 1 3 6 , 14 0 ,14 9- 1 5 4 , 1 5 7 ,1 6 0 - 16 1 ,1 6 3 , 16 5 - 16 7 , 1 70 , 17I - 1 8 0 , 2 4 3 - 2 4 4 ,

25s - A P - r a d i o g r a p h1 3 2 ,1 3 5 - e n d o s c o p y1 3 5 - l a y e r so f t h e w a l 1 3 6

lndex

Fissura(-ae) - p o r t a l i sd e x t r a 1 4 7 - - p r i n c i p a L i1s4 7 D u r am a t e r - u m b i t i c a t i s1 1 r 7 - c r a n i a l i s1 9 F t a t f o o t3 0 3 , 3 8 4 - s p i n a l i s 1 9 , 4 0 - 4 1 ,4 3 - 4 5 ,1 1 9 F L e x i oI U t e r u s ] 2 0 3 F t e x ur a - a n o r e c t a [ i s2 1 0 , 2 2 6 E - c o l id e x t r a' 1 3 8 , 1 5 5 , 1 6 0 - 1 6 3 , 165-166,175 E m b r y ou, t t r a s o u n idm a g e 2 0 6 - - s i n i s t r a1 2 0 - 1 2 1 , 1 3 21,3 8 , Eminentia 162,165-166,175 - i [ i o p u b i c a2 3 0 ,2 6 4 ,2 6 6 - 2 6 7 , - d u o d e ni in f e r i o r1 3 1 , 1 5 3 , 1 7 5 273 - - s u p e r i o r1 5 3 - rortnnrn

Sobotta Atlas of Human Anatomy: Trunk, Viscera, Lower Limb

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