Sobotta Atlas of Human Anatomy Volume 1: Head, Neck, Upper Limb

Atlas of Human Anatomy Edited by R. Putz and R. Pabst

In collaboration with Renate Putz

Translation by S. Bedoui

Volume 1 Head, Neck, Upper Limb 14th edition, newly edited

727 colour plates with 1070 figures Booklet (tables of muscles, joints and nerves)

ELSEVIER

LJR[A I N &: FISCHER

URBAN & FISCHER Munchen . Jena

Sobotta Atlas of Human Anatomy Volume 1 Head, N eck, U pper Li m b

Correspondence and feedback should be addressed to:

Elsevier G m b H , Urban & Fischer Verlag, Department for Medical Student Info rmation, Alexa nder Gattn a rzik, Karlstrafle 45, 80333 Munich, Germany e - m a i l: medizinstudi u m@e lsevier.d e

Addresses o f the editors:

Professor Dr. med. R e i n h a rd Putz Vorstand des Anatomischen I nstituts der Ludwig- Maximilian s - U n iversitat Pettenkoferstrafle 11 80336 Munchen Germany e-mail: rei [email protected] n i -muenchen.de Professor D r. med. Reinhard Pabst Leiter der Abteilung Fu nktionelle und Angewandte Anatomie Medizinische Hochschule H a n n over Carl-Neu berg-Strafle 1 30625 H a n n over Germany e-mail: pabst . [email protected]

Bibliographic information published by Die Deutsche Bibliothek

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All rights reserved 14'h edition 2006 ©2006 Elsevier G m b H , M un ic h

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All rights, including translation, are reserved N o part of this p u b lication may be reproduced, stored i n a retrieval system, or transm itted in a ny other form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior written permission of the publisher.

The 1 4'h edition of the Sobotta Atlas consists of two volumes and a booklet conta i n i n g tables (enclosed in Volume 1): Volume 1: Head, Neck, Upper Limb Volume 2: Trunk, Viscera, Lower L i m b

Translation: Dr. med S a m m y Bedoui, H a nnover Editorial staff a t Elsevier: Dr. med. Dorothea H e n nessen Alexa nder Gattnarzik Dr. rer. nat. Andrea Richarz I llustrators: Ulrike Brugger, M u n ich; Rud iger H i m melhan, Heidelberg; Horst Run, M u n i c h; H e n riette R i ntelen, Velbern Book production: Renate Ha usdorf, Munich Com posed by: Typodata, M u n i c h Printed and bound by: A p p l , Wem d i n g Cover design: Carsten Tsc hirner, M u n i c h Printed o n N opacoat 115 g

Printed in Germany I S B N-13: 978-0-443-10348-3 I S B N - l 0: 0-443-10348-8 Current information by www.elsevier.com a nd www elsevier.de

This atlas was founded by Johannes Sobottat, former Professor of Anatomy and Director of the Anatomical Institute of the U niversity of Bonn, Germa ny, German Editions:

1" Edition: 1904-1907 J. F. Lehmanns Verlag, M unich 2nd_ll 'h Edition: 1913-1944 J. F, Leh m a n n s Ve rlag, M u nich 12'h_20'h Editi on: 1948-1993 Urban & Schwarzenberg, M u n i c h 13'h Edition: 1953, e d i t o r H Becher 14'h Edition: 1956, editor H , Becher 15'h Edition: 1957, ed itor H. Becher 16'h Edition: 1967, editor H Becher 17'h Edition: 1972, editors H. Ferner and J, Stau besand 18'h Edition: 1982, e ditors H. Ferner and J. Staubesand 19'h Edition: 1988, editor J . Staubesand 20th Edition: 1993, ed itors R. Putz and R. Pabst 21" Edition: 2000, editors R. Putz and R Pabst, U rban & Fischer Verlag,

Munich

22nd Edition: 2006, editors R. Putz and R Pabst, Elsevier G m b H, M u n i c h

Foreign Editions: Arabic Edition Modern Tec h n ical Center, Damascus C h i nese Edition (com plex characters) H o - C h i Book Publishing Co, Taiwan Chin ese Edition ( s i m plified Chi nese edition I Elsevier, Health Sci ences Asia, Singapore Croatian Edition Na klada Slap, Jastrebarsko Dutch Edition Bohn Stafleu van Loghum, Houten E n g lish Edition (with nomenclature i n Eng lish) Atlas of Human Anatomy Lippi ncott Willi a m s & Wilki ns English Edition (with nomenclature i n Latin) Atlas of Human Anatomy Elsevier GmbH, Urban & Fischer French Edition Atlas d'Anatomie Humaine Tec & Doc Lavoisier, Paris Greek Edition (with nomenclature i n Greek) Maria G, Parissianos, Ath e n s Greek E d i t i o n (with nomenclature i n Latin) Maria G. Parissia nos, Athens H u n garian Edition az ember anatomiajanak atlasza Alliter Kiadai, Bud a pest I ndonesian Edition Atlas Anatomi Manusia Penerbit Buku Kedokteran EGC, Ja karta Italian Edition Atlante d i Anatomia U mana UTET, Torino Ja panese Edition Igaku Shoin Ltd . . Tokyo Korean Edition S h i n g H e u n g MedScience, Seoul Polish Edition Atlas anatomii cztowieka U rban & Partner, Wroclaw Portuguese Ed i tion (with nomenclature i n English) Atlas de Anatomia H u mana Editora G u a n a bara Koo g a n , Rio de Janeiro Portuguese Edition (with nomencla ture in Lat i n ) Atlas de Anatomia H u m a n a Editora Guanabara Koogan, Rio de Janeiro Spanish Edition Atlas de Anatomia H u mana Editorial Med ica Pa namericana, Buenos Aires/Madrid Turkish Edition Insan Anatomisi Atlasi Beta Basim Yayim Dag itim, Ista nbul

Preface

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General anatomy , . .

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Parts and reg ions of the body . . . . . . . . Passive locomotor system . . . . . . . . . . . Active locomotor system . . . . . . . . . . . . Digestive and respiratory system . . . . . Urinary a n d gen ital system . . . . . . . . . . Su rface p rojection of i nternal orga ns . . Card i ovascular system . . . . . . . . .. Central and peripheral n e rvous system Endocrine organs . . . . . . . . . . . . . . . . . . Skin a n d a ppendages . . . . . . . . . . . . . . .

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Contents ,

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Head, Caput . . . . . . . . . . . . . . . . . . . . .. . . . . .

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1-5 6-10 11-13 14 15 16-17 18-23 24-29 30 31

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Regions o f head a n d neck, Regiones capitis et colli . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bones of the s ku ll, Ossa cra n i i . . . . . . . . . . . . . . . . . . . . Temporoma n d i b u la r j o i nt, Articulatio temporomandibularis, and masticatory m uscles . . . . . . . . . . Facial muscles . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . Vessels a n d nerves of head a n d neck . . . . . . . . . . . . . . . Nose, Nasus extern us, and nasal cavity, Cavitas nasi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pa ranasal s i n uses, S i n u s paranasa les . . . . . . . . . . . . . Oral cavity, Cavitas oris, and teeth, Dentes . . . . . . . . . Palate , Palatu m . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . Tongue, L i n g ua . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . Hyoi d bone, Os hyo i d e u m , and hyoidal musc les . . . . . . S u p rahyoid m uscles, M usculi s u p rahyoid e i , and external muscles of the tongue . . . . . . . . . . . . . . . . M ajor saliva ry g lands, G la n d u lae saliva riae m a jores . , Arteries and n e rves of the oral cavity . . . . . . . . . . . . . . . Vessels and nerves of the tongue . . . . .. . . . . . . . . , . . . Frontal sections through the head . . . . . . . . . . . . . . . . . ,

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Neck, Collum .

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M u scles of the neck . . . . . . . . . . . Larynx, Larynx . . . . . . . . . . . . . . . Thyroid gland, Glandu la thyroidea Pha rynx, Pharynx . . . . . . . . . . . . . Vessels and nerves of the neck . . Sections t h ro u g h head and neck . .

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32 33-61 62-69 70-73 74-85 86-88 89-91 92-101 1 02 103-104 105 1 06-108 109-112 113 114-115 116-117

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. 118-121 . 1 22-131 1 32- 1 35 . 136-141 . 142-1 53 . 154-156 .

Upper limb . . . . . . , . . . . . . . . . . . . . . . . . . . . . 1 57-257

S u rface a natomy . . . . . . . . . . . . . Bones, jo ints, ligaments . . . . . . . . M u sc les of the u pper l i m b . . . . . . . . . Vessels a n d n e rves of the upper limb Sections t h rough the arm . . . . . . . . . .

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157 158-177 1 78-213 214-251 252-257

Brain, Encephalon . . . . . . . . . . . . . . . . . . . . . 258-351

Vessels of the head . . . . . . . . . . . . . . . . . . . . . . . . . . . 258-261 C ranial cavity, Cavitas cra n i i , c ranial d u ra mater, D u ra mater c ra n ia lis . . . . . . . . . . . . . . . . . . . . . . 262-263 .

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C ranial base. Basis cra n i i . . . . . . . . . . . . . . . . . . . . . . . . C ranial nerves, Nervi cra n ia les . . . . . . . . . . . . . . . . . . . Parasympathetic g a n g lia of the head . . . . . . . . . . . . . . . C ranial n e rves, topog ra phy . . . . . . . . . . . . . . . . .. . . . . . Cranial base, vessels a n d nerves . . . . . . . . . . . . . . . . . . C ra n ial d u ra mater, D u ra mater c ra n ialis, and c ranial a rachnoid mater, Arachnoidea mater c ra n ialis . . . . . Structure of the bra i n a n d b ra i n d evelopment . . . . . . Telencephalon, Tele ncephalon . . . . . . . . . . . . . . . . . . . . D i e ncephalon, D i encephalon . . . . . . . . . . . . . . . . . . . . . . M esencephalon, Mesencephalo n . . . . . . . . . . . . . . . . . . B ra i nstem, Tru ncus encephali . . . . . . . . . . . . . . . . . . . . N u c le i of the c ranial nerves . . . . . . . . . . . . . . . . . . . . . . Cerebellum, Cerebellum . . . . . . . . . . . . . . . . . . . . . . . . Association a n d commissura l tracts . . . . . . . . . . . . . . . Internal capsule, Capsula i nterna, pyramidal tract and basa l ganglia . .. . . . . . . . . . . . . . . . . .. . . . . . . . . Ventricular system and s u ba rachnoid space . . . . . . . . . Vessels of the b ra i n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mag netic resonance tomographic images of the bra i n . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . Frontal sections t h rough the bra i n . . . . . . . . . . . . . . . . . H o rizontal sections through the b ra i n . . . . . . . . . . . . . . Sag itta l sections t h rough the bra i n . . . . . . . . . . . . . . . . Spinal cord, Med u lla spinalis . . . . . . . . . . . . . . . . . . . . . .

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Eye, Organum visus . . . .

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264-265 266-273 274-275 276-277 278-279 280-283 284 285-294 295-296 297 298-299 300-30 1 302-305 306 307-309 310-317 318-322 323-325 326-329 330-336 337-339 340-351

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Eyelids, Palpebrae, and orbit, O rbita . . . . . . . . . . . . Lacrimal appa ratus, Apparatus lacrimalis . . . . . . . Extra-ocula r muscles, M usculi externi bulbi oculi . Eyeball, Bulbus oculi . . . . . . . . . . . . . . . . . . . . . . . . . Vessels of the eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . I ris, Iris, and p u p i l, Pupilla . . . . . . . . . . . . . . . . . . . . Lens, Lens, and ocular fundus, Fu ndus oculi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Optic nerve, N e rvus opticus . . . . . . . . . . . . . . . . . . . Optic tract, Tractus o pticus . . . . . . . . . . . . . . . . . . . . M u scles, vessels and n e rves of the o rbit . . . . . . . . . Sections t h ro u g h the orbit . . . . . . . . .. . . . . . . . . .. .

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352-355 356-35 7 358-361 362 363 364-365

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Ear, Auris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379-400

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Au ricle, Auricula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Auricula r m uscles, Musculi a u ri c u la res . . . . . . . . . . . . External acoustic meatus, Meatus acusticus externus, and tympa n i c membrane, M e m b rana tympanica . . . Auditory ossic les, Ossicula auditoria . . . . . . . . . . . . . . . Tympanic cavity, Cavitas tympani . . . . . . . . . . . . . . . . . . Auditory tube, Tuba a uditiva . . . . . . . . . . . . . . . . . . . . . . I ntern a l ear, Auris interna . . . . . . . . . . . . . . . . . . . . . . . . Auditory and e q u i li brium o rgan . . . . . . . . . . . . . . . . . . . Auditory and e q u i librium pathway . . . . . . . . . . . . . . . . . N e rves and vessels of the ear . . . . . . . . . . . . . . . . . . . . . C o m puted tomogra p h i c sections t h rough the ear . . . . .

Appendix

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379 380 381 382 383-384 385-387 388-389 390-393 394-396 397 398-399 400

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I n d ex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401-419 .

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Preface It was just over a hundre d years ago that Johan nes S obotta set out to p u b lish the fi rst edition of his Atlas of H u m a n Anatomy. S i nce then, this piece of work has evolved step by step as a re­ s u lt of the constant i nteraction between students, lecturers a n d edito rs . It has not o n ly b e e n the most mod ern basis fo r the com­ plex subject of macroscopic a natomy t h roughout many genera­ tions of d octors, but has a lso develo pe d i nto a lasting work of reference for both clin ical t ra i n i n g and advanced medical educa­ t i o n . All in all, it has become a book for a medical doctor's life. Once a g a i n , in this new edition the additional fig u res have been d rawn strictly on the basis of o ri g i na l spec i mens. The 14th edition has been p a rticula rly designed to meet the de­ mands of a refo rmed medical c u rriculum, emphasizing the i nte­ g ration of clinical medicine i nto the preclinical curriculum. Fo r this purpose, the new edition has been extended to include the followi ng feat u res: - S u rface a natomy including p rojection of i nternal o rgans (45 colo u r p hotos) - Anatomical d i a g ra m s next to i m a g i n g fig u res - I ntegration of imaging tec h n iques to a g reater extent {u ltrasound, X-ray, CT, M R I ; 119 f i g u resl - Endoscopic, i nt raoperative colour images a n d figures exem plifyi n g tec h n iques o f p u ncture a n d exa m i nation (54 figu resl - Images of patients p resenting with typical palsies - Diagra m s of the most important a rteria l va riations (93 figures) - Frequent va riations in the location of i nternal o rgans {24 figu resl - I ntegration of h i stology at low magnification of i mportant i n­ ternal o rg a n s ( i ntestine, liver, k i d ney, etc.1 I n o rder to i m p rove the presentation of the knowledge, the fol­ lowing features have been i nt roduced : - Clea r-cut a rra ngement of the chapters accord i n g to the differ­ ent reg i o n s of the body - Thematically corresponding figures p resented on double pages - A concise, separate booklet ( i ncluded in Volume 1) conta i n s ta b les o f m uscles, joi nts a n d n e rves, enabling t h e reader t o place it next t o a n y figure i n t h e atlas One particular aim of the new edition i s to faci litate f i n d i n g of specific structures. The SOBOTTA depi cts anatomical structures p re c isely without the rea d e r loosin g the g reater p i cture . There­ fore, specific didactic tools have been i m p roved and new aspects included: - Each c ha pter has been a llocated to a p a rticula r colo u r - A " m e n u bar" o n each dou ble p a g e e n s u res precise orientation within a g iven chapter - The n u mber of outlines depicting spatial orientation has been s i g nifica ntly i ncreased (270 figures) - Overviews of tota l body reg i o n s ensure genera l o ri entation - New d i a g ra m s of p a rt i c u la r m uscles cla rify their location a n d course (24 figures)

- Confusion i s kept to a m i n i m u m by o n ly depicting limbs of the right side of the body - "Compass roses" point to adjacent figures, thus facilitating following a given structure over several pages - Continuous lea d e r lines faci litate f i n d i n g of structu res - Colo u red dots at the end of leader lines i n topographic diag ra m s mark a rteries. veins, n e rves, a n d m uscles - The figures in the booklet relate d i rectly to the figures in the atlas - The larger d i mensions of the book i m p rove cla rity With the exception of d iscussions about the gene ra l concept of the atla s a n d mutual correction, the editors have worked sepa­ rately o n i ndivi d u a l cha pters, with the work d ivided as follows: R. Putz: General a natomy, upper limb, b ra i n , eye, ear, back, lower l i m b ; R. Pabst: Head, n e c k , thoracic a n d a b d o m i n a l walls, thoracic, abdominal a n d pelvic viscera. The inclusion of a large n u mber of new figures i s the result of the extraord i n a ry capabi lity of the following medical i llu strators : U lr i ke Brugger, Rud iger H i mmelhan a n d Horst Rurl. It is to t h e i r cred it that the classic "SOBOTTA style" has been retained. Several of the d iagrams have been generated on the computer by H en riette R i ntele n . We also g ratefully a cknowledge our clini­ cal colleagues for making clinical i llustrations ava ilable to u s (see picture credits]. We owe a debt o f g ratitude t o o u r col­ leagues from the i nstitutes for their understa n d i n g and helpfu l suggestions. D r. N. Sokolov a n d A. Buch horn have put meticu­ lous efforts i nto g e n e rating the specimen preparations. S. Fryk a n d G. Hoppmann have s u p p o rted us in text p rocessing. The staff of the e d itorial office of Elsevier pu blishers, i n particu­ lar D r. D . H e n nessen a n d A. Gattna rzik, has our s i ncere thanks. Some of the crea tive development of the work i s a result of very fruitful discussions. We would a lso like to thank R. H a u sdorf for tremendous efforts in the p roduction of the atla s. R. Putz to­ gether with G. Meier were responsible for the p roofreading a n d s i m plification of page design a n d legends. O u r special thanks g o to D r. U . Oste rka mp-Ba ust for generating the index, a n d all others i nvolved i n the corrections. With our j o i nt efforts, the SOBOTTA has been once more modernized both i n contents a n d deSi g n . We have included many o f t h e helpful suggestions m a d e over the years by students and colleagues, and would therefore ask all readers of t h i s edition to pass o n to u s any criticism o r sug­ gestions on the new format of this atlas.

M u nich and Ha nnover, September 2005 R. Putz a n d R. Pabst

Univ.-Prof. Dr. med. Reinhard Putz Born in Innsbruck/Austria 1962-1 968 Stud i ed medicine at the Leopold- Franzens- U niversity of I n nsbruck Received a doctorate 1968 1 968- 1 982 U n iversity assistant at the Institute of Anatomy at the U n iversity of I n nsbruck 1 978 Lect u rer in anatomy 1 979 Consultant fo r anatomy 1982- 1 989 C ha i r of the Anatomical I nstitute at the Albert-Ludwigs-University of Fre i b u rg since 1989 Chair of the Anatomical I nstitute at the Ludwig- Maxi m i lian s - U n iversity of M u n ich 1 992-1994 President of the E u ropean Association of Cli nical Anatom ists 1 993 Reg istration to p ractise medicine 1998-1 999 C hai rman of the Anatomical Soc iety 1999 Member of the Akademie der Natu rforscher und A.rzte ( Leopold i na] 2002 D r. h.c. of the U niversity of Constanta, R o mania 2003 Prorector I of the Ludwig - Max i m i lians-University of M u n ich

Research and fields of interest

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Fu nctional anatomy of the passive locomotor system Evolution and f u n ctional anatomy of the vertebral col u m n Form -function-relations o f joints Applied anatomy (anatomical basics of ortho paed ics, s u rgery, radiology] Questions about the contents and organisation of the med i cal cu rriculum Development of d idactic trai n i ng programmes at u niversities

Univ.-Prof. Dr. med. Reinhard Pabst Born i n Posen, g rown u p i n Luneburg 1 965-1 970 Studied medicine at the Hannover M ed ical School, and in G lasgow/Scotland 1 970 U n iversity degree and doctorate 1 971 Registration to p ractise medicine 1971 -76 Scientific associate in the Department of Clin ical Physiology, U n iversity of Ulm 1976 Lecturer for Clin ical Physiology, U n iversity of Ulm, and new lectu reship at the Han n over Medical School 1 976-80 Senior assistant i n the Department of Functional and Applied Anatomy, Hannover Medical School 1978 Extension of the Venia leg e n d i to include anatomy 1 980-1 992 H ead of the Department of To pograph i c Anatomy and B iomechanics since 1 992 Head of the De partment of Functional and Applied Anatomy, Han nover M e d i cal School 1 986-1990 Prorector for studies and ed ucation, Hannover Medical School 1993- 1 997 Dean of the Hannover Medical School 1997-1 998 Chai rman of the Anatomical Society 1 999-2003 Prorector of Research of the Hannover M e dical School Member of the Akademie der Naturforscher u n d A.rzte ( Leopold i na] 2001

Research and fields of interest

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Functional anatomy of lymphatic organs Proliferation and m i g rat ion of lymphocytes Development of the i ntestinal i m m u n e system Function of the pulmonary i m m u n e system Questions of a c l i n i cally orientated anatomy i n the med ical curriculum Evaluation of teac h i ng

Picture credits The editors sincerely thank all clin ical colleagues that made u L­ trasou n d , computed tomogra p h i c a n d mag netic resonance i ma­ ges a s well a s endoscopic and intraoperative pictures ava i lable: Prof. ALta ras , Centre for Radiology, U niversity of G ieflen [Fig. 1 009, 1031 , 1032) D r. B a u me i ster, Department of Radiology, U niversity of Fre i b u rg ( F i g . 1 1 57J P O D r. B u rg ka rdt, O rthopaedic CLinic, Tech n ical U n iversity of M u nich [Fig. 1 431] Prof. B ruckmann & D r. L i n n , Neuro radiology, Institute for D i a g nostic Radiology, U n iversity of M u n ich [ F i g . 662, 726 a , b, 727 a , bJ Prof. Daniel, Department of Card iology, U n iversity of ErLa ngen [ F i g . 899, 900, 901, 973J Prof. Degenhardt, BieLefeld ( F i g . 1 133, 1 1 35J Prof. Gala nski & D r. K i rch hoff, Department of Diag nostic Radiol­ ogy, Han nover Med ical SchooL ( F i g . 962, 964, 1 2 1 2, 1 2 1 3J Prof. Galanski & D r. Schafer, Department of Diagnostic Radiol­ ogy, H a n nover Med icaL School [ Fi g . 8 7 1 a, b, 927, 971, 9 9 1 , 1194, 1204, 1 207, 1209J Prof. Gebel, Department of GastroenteroLogy, H e patology a n d Endocrinology, Han nove r MedicaL S c h o o l [Fig. 2 4 2 , 1 011 , 1 026, 1027, 1 038, 1039, 1074, 1 092J Dr. Goei, RadioLogy, HeerLen , The Nether la n d s [Fig. 11 50,1 1 5 1 J [with permission from Rad ioLogy 173; 1 37- 1 4 1 : 1989J D r. Greeven , St.- Elizabet h - H ospitaL, Neuwied [Fig . 1 50, 1238J Prof. Hoffmann & PO D r. Bektas, Clinic for Abd ominal a n d Tra nspLa ntation S u rg e ry, H a n nover Med icaL School [ Fig. 1 028, 1040J Prof. H o h lfeld, C l i n i c for Pneumology, Hannover M e d i ca l SchooL [ Fi g . 929, 930J Prof. Jonas, U rology, H a n nover Med ical School [Fig. 1 102 a , b, 1 1 03J Prof. Kampik & Prof. Muller, Ophtha lmology, U niversity of M u nich [ Fig. 657J D r. Kirc h h off & D r. Weidemann, Department of Diagnostic R a d iology, H a nnover M e d ical SchooL [ Fi g . 104 1 , 1 093, 1 1 0 2 , 1196, 1 1 98, 1 2 0 0 , 1202, 1205J Prof. Kremers, Department for Restorative D e ntistry and PeriodontoLogy, U n iversity of M u n ich [Fig. 169J Prof. Kunze, von H a u n e rsches C h iLd ren's Hospita l, U n iversity of M u nich [ Fi g . 327-330J D r. Meyer, Department of Gastroenterology, Hepatology a n d Endocri noLogy, H a nnover Med ical School [ Fig. 944, 987 a , b , 992, 1 145, 1 1 46J Prof. Muller-Va h L, Neu roLogy, H a n nover Med icaL SchooL [Fig. 128 a , bJ Prof. Pfeifer, Radio logy, I n stitute for Diag nostic Radiology, U n iversity of M un i c h [ F i g . 293, 294, 3 1 0 , 312,449, 451, 769-772, 807-8 10, 1255, 1286, 1 287, 1 3 1 7, 1 3 1 8J PO D r. R a u , Department of Radiology, U n iversity of Freiburg [Fig. 9 1 2, 925, 926J

Prof. Ravelli t, formerly Institute of Anatomy, U niversity of I n n sbruck [Fig. 767J PO D r. Rieger, R a d iology, I n stitute for Diag nostic Radiology, U n iversity of M u nich [Fig. 1395 J Prof. Reich, O rofac i a l S u rgery, U niversity of Bonn (Fig. 1 1 3 a , bJ Prof. Reiser & D r. Wagner, I nstitute for Diag nostic Radiology, U niversity of M un i c h (Fig. 436 , 449, 451, 453, 571, 572, 573, 576, 577, 792J Prof. R udzki-Ja n son, Department of O rthodontics, U n iversity of M u n ich (Fig. 72, 73J D r. Scheibe, Department of S u rgery, Rosman H ospital, B re i sa c h [Fig. 1289 a-cJ Prof. Scheu mann, Clinic for Abdominal a n d Transpla ntation S u rgery, H a n n over Med icaL School (Fig. 243, 244, 245J Prof. Schillinger, Department of Gynaecology, U n iversity of Fre i b u rg (Fig. 11 34J Prof. Schliephake, O rofacial S u rgery, Gottingen (Fig. 152, 1 96, 197) Prof. Schlosser, C e n tre for GynaecoLogy, H a nnover M e d i ca l School ( F i g . 1 1 32 a , b , 1140, 114 1 , 1 1 78J Prof. Schumacher, NeuroradioLogy, Department of RadioLogy, U n iversity of Fre i b u rg (Fig. 461 a, bJ D r. Sommer & P O D r. Bauer, Radiologists, M u n ich [Fig. 662, 1290- 1292J Prof. Stotz, Paediatrics, U niversity of M u ni ch [ Fi g . 1239, 1 240J PO D r. Vogl, Radiology, U n iversity of M u n ich [Fig. 436, 453, 644, 645) Prof. Vollrath, Ear-Nose-T h roat Department, Monchengladbach (Fig. 229, 230 , 231 J Prof. Wag n e r t, Diag nostic Radiology I I , H a n nover Med ical SchooL [Fig. 952, 1064, 1065, 1069, 1072, 1 1 52J Prof. Wenz, formerly D e pa rtment of R a d iology, U niversity of Fre i b u rg [Fig. 768J Prof. Witt, D epartment of Neurosurgery, U n iversity of M u n ich [ F i g . 405J D r. Wi llfuhr, formerly Clinic for Abdom i n a l a n d Tra n s plantation Su rgery, H a n n over Medical School [Fig. 105 1) PO D r. Wi m mer, Department of Radiology, U niversity of Fre i b u rg [Fig. 799) Additional i llustration s were obta ined from the following text­ books : B e n n i n g hoff- O re nc k h a h n : Anatom i e, B a n d 1 [ O renckhahn D., H rs g . l . 16. Auft., Urban & Fisc her, Munchen 2003 [ Fig . 823, 824, 848, 849, 850J WeLsch , U .: Lehrbuch H istoLogie, Urban & Fischer, Munchen 2003 [Fig. 922, 1020, 1 097, 1 1 22, 1 1 23J WeLsch, U. [ H rsg .): Sobotta, Atlas H istologie, 6. Auft., U rban & Fischer, Munchen 2002 [Fig. 1037, 1085, 112 5 a, bJ Wicke, L.: Atlas d e r Rontgenanatomie, 3. Aufl., Urban & Schwarzenberg , Munchen-Wien-Ba ltimore 1 985 [ Fi g . 943 a J

S u rface

Loco motor syste m ...

�

Genera L anatomy

Planes and axes 1 Sagittal plane 2 Median sagittal plane 3 Frontal plane 4 Transverse plane

a

5

6 7

Sagittal axis Transverse axis Longitudinal axis

c

b

Fig. 1 a-c Planes a n d axes. a Sagittal pLane, Pla n u m sag ittale, sag ittal and longitudinal axes b

Transverse p la n e [= horizontal plane!. Planum t ransversale, t ransverse and sagittal axes

c Frontal plane [= coronal p lane!. Pla n u m frontale, longitudinal a n d transverse axes

Linea mediana anterior

Linea mediana posterior Linea paravertebralis

Linea sternalis ---,,.,a--;---n Linea parasternalis -+-----'-..... Linea axillaris anterior --.f--i Linea medioclavicularis ---I--j-l,,.....,

o--'-�- Linea scapularis

Linea axiliaris posterior

dlstalls

palmaris

dorsalis proximalis dlstalls

caudalis (= inferior)

fibularis

tibialis

a

b

Fig. 2 a, b O rie ntation lines of the human body and terms of d i rection and posit i o n . a VentraL view [ve n tralis. anterior! b Dorsal view [ dorsalis, posteriori

plantaris

00:1

�

Ge n e ra L a natomy

Su rface

Loco motor syste m

Parts of the human body

.rr---- caput

!------ Collum

Brach�um

Membrum superlus

Thorax

Abdomen

Anle- --+­

brachium

Pelvis

Manus ---4..'1

Femur -----y.

Membrum Inlerius Crus ------oi!

Pes

--= ......

-----

Fig. 3

S u rface a natomy of t h e male.

Fig . 4

Surface a natomy of the female.

Truncus

Co ntrol systems

M eta b o l i c systems

Skin

Parts of the human body

i----- Caput

i'-;-----

Collum

Brachium

.------ Truncus. Dorsum Membrum superius

..

-\--< . . Ante- -

brachium

Manus---��

Femuf-----�_4.

Membrum

Inlerlus Crus

Pes

---......

---

.-.!!'*='--

-----

Fig . 5

Su rface a natomy of the male.

Fig. 6

S u rface anatomy of the female.

�

Gene ra l anatomy

Su rface

Regions of the human body

Regio deltoidea Regio axillaris Regio mammaria ----t--t�,... Regio brachii antenr --...... Regio cubitalis anterior, Fossa cubitalis

Regio antebrachii posterior Regio antebrachii anterior

Dorsum manus

Regio pectoralis Regio inframammaria Regio epigastrica Regio hypochondriaca Regio umbilicalis Regio abdominalis lateralis Regio inguinalis Regio pubica [Hypogastrium] Regio urogenitalis

Trigonum femoris

Regio femoris anterior Regio genus anterior Regie cruris posterior Regio cruris antenor

Fig.7

Regions of the human body, Regiones corporis.

Loco m o t o r syste m

M etabolic syste m s

Contro l syste m s

Skin

Regions of the human body

Regio parietalIs

Regio occipitalis

Regio deltoidea

Regio scapularis -----r-f-.....

�.

Regio axillaris ---...

....1--

,...-

Regio brachii posterior

Regio cubitalis posterior

Regio infrascapularis Reglo lumbafis

Regio antebrachii anterior -+-+>:1 Regio antebrachii posterior

\ ...r----l . '--.....-

Reglo sacralls

Regio analis

Regio femoris posterior ---:....-- . . .

Reglo genus posterior. Fossa popfilea Reglo suraa

Reglo cruris posterior

Regio cruris anlerlor

Fig.8

Regions of the h u man body, Regiones corporis.

005

�

Ge n e ra L a n atomy

S u rface ���

Loco motor system

Passive locomotor system

Skeleton �Ir------ Cranium --------,7-

'JId�I_----- Mandibula -------'i�::lI;

�----- Columna vertebralis ------_�;;,;.]� cervical is) -- -(Pars ��U�r-::�Y'\ - - Clavicula -------"'" �.__!HI__---- Scapula ----+--ft'r.-t'If----- Humerus;

nr-\------ Costae -

=-=-=-=-=-=-=-=-�rL����m�;

-

'-lb"!'E:--'t--- Columna vertebralis -jN'-IlJ-----I--:.....a:;n:,

(Pars lumbalis)

"r-'r----- Radius ---�. +-7.\----- Ulna ---�." �f. ..E----'\---;,..'--+--- Os coxae --""'---

..-.....,...-- 3.-4. Y

�-+-- 13.-1 7.Y

,,-,,0.-- 17 .-18. Y 7.EW 8.EW

7.EW

7.-8. EW -----l-+-lf--

20.-24.

�f-- 7.-8.Y 5.-7 Y

Y 6.M 17.-18.Y

--;'�__1- --tc::=r.......

17.-18.Y

2.-4.Y

� l_-3. Y � 9.EW

11.-����

;:=1/1"

2.-3 Y

3.-4.Y

,

9.EW---H-1-I

1 5.-2 1 .Y 5.EM

7.-8. E W

9.EW

Os Os Os Os

scaphoideum 3.-6.M lunatum 3.-6.Y trapezium 3.-8.Y trapezoideum 3.-7.Y

Os Os Os Os

pisiforme 8.-12. Y triquetrum 1 .-4.Y hamatum 2.-5.M capitatum 2.-4.M

Fig. 13 Appearance of ossification centres a n d synossification at the epiphyses of t h e upper limb ( means accord i ng to v. LANZ, 1956; EXNER, 1990; HEUCK a n d BAST, 1994].

Talus 7.EM Calcaneus 5.-6.EM Os naviculare 4.Y Os cuboideum 10. EM

Os cuneiforme mediale 2.-3.Y Os cuneiforme intermedium 3.-4.Y Os cuneiforme laterale 12.M

Fig. 1 4 Appea ra nce of ossification centres a n d synossification at the epiphyses of the lower l i m b ( m e a n s accord i ng to v . LANZ, 1956; EXNER, 1990; HEUCK a n d BAST, 1994].

M etab olic systems

Skin

C o ntrol systems

Active locomotor system

Bone joints

Fig.15 Fibrous joint, Articulatio fibrosa, exem plified by the sutures of the sku ll.

Fig.16 Cart i lag inous joint, Articulatio ca rtilaginea, exem plified by the pubic bone symphysis.

1 Synovial membrane la Synovial intima, Intima 1 b Subintimal layer, Subintima Fibrous membrane 3 A-cells (macropha ges) 4 8-cells (fibroblasts) 5 Fat cells 6 Capillary vessels with fenestration 7 Venules B lymphatics 9 Nerves 10 Collagen fibres

Fig.17 Osseous j o i nt, Articulatio ossea, exemplified by the sacru m .

2

Membrana fibrosa [Stratum fibrosum]

Capsula articularis

.t-�;::;�:4;J�:.II!!�!Il-- Labrum arllculare b

Linea epiphysialis

----I.fII...,. ..::.,c...

���=�iIii=-- (Carfllago articularls) a--\>;:;;;� ; ..�:t-- Cavilas articulans' .(..��e!!3�-- Labrum articulare

Vagina synovialis

---��

Membrana synovialis [Stratum synoviale] Membrana fibrosa [Stratum fibrosum]

a

Fig. 18 a, b Synovial joint, Art i c u latio synovialis, exemplified by the shoulder j o i nt. a Section i n the sca pular plane b Struct u re of the join t capsule • The joint cavity, Cavitas articularis, is illustrated broader to enhance visibility.

Capsula artlcularis

�

Genera l a natomy

LI ___S_u_rf_a_c_e

��

�� �

a d

g

c

Fig. 19 a-g J o i nts, J u nctu rae synovi ales. H i nge j o i nt , Articu lat i o cyl i n d r i c a b Conoid j o i nt , Articu latio conoidea c Pivot j o i nt , Articu lat i o troc h o i d e a

d Condylar j o i nt, Art i c u lat i o ovoidea e

Sad d le j o i nt , Art i c u latio se llaris

f Sphero i d al j o i nt , Articulatio sphero i d e a

g Plane j o i nt, Art i cu lat i o p lan a

ExtenSlo,

Adducho

Relroversio

Planum sagittale, Axis transversalis

Abductfo Flexio, Anteversio

Fig. 20 Sphero i d al j o i n t [ h i p joi nt)' Articulatio sphero i d e a [Articulatio coxae I.

(j)

Rolatio externa

\

Rotatio intern a

I

I

Planum Irentale, Axis sagittalis

Planum transversale, Axis longitudinalis

__

__

Passive locomotor system

Joints

a

L_o _c o m o_t _ s_t e_m o r s� y_ _

__ -L

__

__

Metabolic systems

Control systems

[J 01

Skin

Active locomotor system

Muscles 1

Stratum Ilbrosum Stratum synoviala. Pars parletaliS

Line of force of the muscle

2 Virtual lever arm

of the muscle 3 Axis of rotation of the jOint

)

Stratumsynovlale. PatS lendlnea

����i�'� IS

Vagina r

(Cavitas synovialis)

1

Vagina

landlnls

Mesolendineum Tendo Epitendineum

:3

2

Fig. 2 1 O rg a n isation princi ple of skeletal m uscles. exe m p lified by the brachial muscle. M . b rachialis.

a Musculus fusiformis

e

M usculus i ntersectus

b

Musculus biceps

f Musculus semipennatus

Fig. 22 Stru ctu re of a tendon s h eath, Vag i n a tend i n i s , exe m p lified by a finger.

M u sc u lu s biventer

d Musculus planus

g M usculus pennatus

Fig. 23 a-g Types of m uscles . a S i n g le head, para llel m uscle fibres b Double head, para llel muscle fibres c Dou ble belly, para llel muscle fibres d M u lti-head, flat m uscle e M u lti-belly m u scle with tendinous i ntersectio n s U n i pennate m uscle g B i p e n nate m u scle

c

�

��

General a n a tomy

Surface ���

Locomotor system

Passive locomotor syste m

Skeletal muscles

Mm

capitis et colli

I � I/pp. 64ft, 7011,1051, 118ft I

Mm thoracis et Mm. abdominis

I � II/pp. 52 If I

Mm.

membn superions

I � I/pp. 178ft I

M m.

membri Inferioris

I � II/pp. 306 If I

Fig . 24

Overview of the s keletal m uscles.

Metabolic systems

Control systems

Skin

Active locomotor system

Skeletal muscles

Mm nuchae et Mm. dorsi

I � II/pp. 26ft I

Mm membn superlons

I � I/pp. 178ff I

Mm. membri Inferioris

I � II/pp. 306ff I

Fig. 25

Overview of the skeleta l m uscles.

(]'3

�

Surface

General a natomy ���

Digestive system

Digestive and respiratory system

Glandulae salivariae

malores

(

Os

(

Cavltas 0"5 propria

Vestibulum oris

Aima oris --_..?'

Glandula

Pars omlls pharyngls

parottdea

'R .J----l ..-

Glandula subllngualls

•

Glandula submandlbularis

Oesophagus

Pars laryngea pharyngis

)

Pharynx

-------+

----+-.fII.Hepar --1\-+---- Gaster -\---\l Pancreas e.-....� . ---'f-tllil! �_"'E��c,:,�=-.;;-f---- Duodenum Vesica biliaris [fellea] Colon transversum Colon ascandens

Intestinum crassum

Colon descandens

Colon

Intestlnum

:::;lil-li--\---- Jelunum

tenus

_..L.-'-�"""' 4-""", -+----- Ileum '.J,:;,;,� . jj� ....:.i! �F-..L� -/--'\-.:l,

sigmoldeum Caooum --If----"' _

Appendix vermtlormls -jr----��h.....? Rectum

Canalis analis Anus Fig. 26

Overview of the digestive system.

Sinus paranasales Pars nasalis pharynglS

M.m-t---\--- Pars lary�gea pharyng's Pars oralls pharyngls

---¥.--I--- Hepar -----+-4' 'U---'+---- Gaster -----I---I1i�='�� �___+-- Vesica biliaris Splen [Lien] ----1HI-"j�q..::; _.>--/--- Colon

------\---"-��:::::J

������-+_---Ren -----+----���� ">--1---- Intestinum tenue ----I-f Tr u ncus FasciN.culaxiusl apostris Ne"�,riosubcl r::...:;�avi�us����� ���=t-,I-�-h�Ii(:--=---- Trsuperuncusior medius thorculaucocor sralaliiss ---;::'9�-hr..(l�f. Fasci s l a t e N. thoraciNcusralodingusalis Trinfuencusrior musculocutaneus N medlanus C3

.::;; """'.,.. ----nf---....::;;,.:

C4

-­

--n-----,'"

C5

N.

----vii�--If

C6

---7T.¥ iiVlrP,f--1"'77'-------

--'7
Sulcus sinus sigmoidei Foramen mastoideum Porus et Meatus acusticus internus

styloideus pterygoideus, Lamina medialis Proc pterygoideus, Lamina lateral is Proc. pterygoideus, Fossa pterygoidea

Os frontale

Os sphenoidale

Os parietale

Os temporale

Os occipitale

Maxilla

Os nasale

Vomer

Os ethmoldale

Os palatinum

Bones of the sku ll, Ossa c ran i i ; medial view.

Fig. 66

Muscles

r Top o g ra p hy

Org a n areas

Secti o n s

Bones of the skull Crista frontalis

Sulcus sinus sagit alis superioris

Os

[rontale

Sutura coronalis anenoslel

Sulci

Os parletale

venosl

.•,.c.I-- Lamina Intema Lamina e)(lema

Sutura lambdoidea Os

lrontale

..

Os parietale

Fig. 67 Calva ria, Calva r i a ; internal aspect.

Os occipitale

.. 9

.. H ea d

Skeleton

S u rface

Bones of the skuLL Crista frontalis Sulcus sinus sagittalis superioris

Lamina et Foramina cribrosa Impressiones gyrorum

Os sphenoidale, Corpus

Proc clinoideus posterior

Canalis opticus

Fissura orbitalis superior Sutura sphenofrontalis Os sphenoidale, Ala minor Fossa hypophysial is Foramen rotundum

Proc. clinoideus anterior Sulcus caroticus

Lingula sphenoidalis

Sutura sphenosquamosa

Foramen lacerum

Sulcus arteriosus

Foramen ovale

Fissura petrooccipitalis

Foramen sp,nosum

Spina ossis sphenoidal is Sulcus sinus petrosi inferioris

Os temporale, Pars squamosa

Fissura petro­ squamosa

Sulcus nervi petrosi minoris

Porus acusticus internus

Sulcus nervi petrosi majoris

Margo superior partis petrosae

Margo superior partis petrosae

Foramen jugulare

Os temporale, Pars petrosa Sulcus sinus petrosi superioris

Canalis condylaris Foramen mastoideum Fossa subarcuata

Canalis nervi hypoglossi

Foramen jugulare Canalis nervi hypoglossi

Sulcus sinus transversi

Protuberantia occipitalis interna

Foramen magnum (Crista occipitalis internal

Os frontale

Os ethmoidale

Os temporale

Os parietale

Os sphenoidale

Os occipitale

I nternal su rface of the base of the skull, Basis c ra n i i i nterna,

Fig. 68

M u scles

Top o g ra p hy

O rg a n a re a s

Sections

Bones of the skull

Canalis opticuS

Fissura orbitalis superior

Fossa cranii anterior

Foramen rotundum

Foramen ovale

Foramen lace rum ; Fissura sphenopetrosa Fossa cranii media

Foramen spinosum

Canalis caroticus, Apertura interna

Porus acusticus internus Foramen jugulare Canalis nervi hypoglossi

Fossa cranii posterior

Foramen magnum

Fig. 69 I nternal su rface o f the base o f t h e skull, Basis c ra n i i i nterna, and foramina, Foramina .

�

Surface

H ea d

S keleton

Bones of the skull

Foramen incisivum Sutura palatina mediana

Vomer, Alae vomeris

Maxilla, Proc. palatinus Os palatinum, Proc. pyramidalis

Sutura palatina transversa Os palatinum, Lamina horizontalis

Proc pterygoideus, Lamina medialis

Foramen palatinum majus

Hamulus pterygoideus Fissura orbitalis inferior

Proc pterygoideus, Lamina lateralis

Arcus zygomaticus

Crista infratemporalis Proc. pterygoideus, Lamina medialis

Os temporale, Proc zygomaticus

Foramen ovale Tuberculum pharyngeum

Foramen lacerum Foramen spinosum

Spina ossis sphenoidal is

Tuberculum articulare

_--,l-.-".,���fJ'�--:�j�!:�l!���

CanaliculuS mastoideus

Proc. slyloideus Foramen stylo· mastoideum

Meatus acusticus externus Fossa jugularis

Proc. mastoideus Incisura mastoidea

Foramen jugulare

Canalis nervi hypoglossi

Os parietale Foramen mastoideum

Foramen magnum

Linea nuchal is superior Linea nuchalis inferior

Protuberantia occipitaliS externa

Maxilla as frontale as parietale

.. ..

as palatinum

as sphenoidale

Vomer

as temporale

Os zygomaticum

as occipitale

Fig. 70 Exte rnal s u rface of the base of the skull, Basis c ra n i i externa.

M u scles

Top o g ra p hy

O rg a n a reas

Sect i o n s

Bones of the skull Palatum durum

Foramen palatinum majus Foramina palmiantorinaa Foraovalmene spiFornaosummen Forsphenopet amen laFicersrsurousam;a

Arcus zygomaticus

Fossa infratemporalis -- Choana

�....� ...; -.,...;..

----,.:�....:.;.;..;::::I

Porus acust exterincusus

Proc.

masto ldsus

Canal Apertisurcara extotiecrus,na stylomastForoidaeummen

Condylus

occipitalis

Foramen jugulare Canalis nervi hypoglossi Foramen magnum Fig. 71 External su rface of the base of the skull, Basis cra n i i externa. and fora m ina, Fora m i na .

�

Hea d Skull,

Surface

Ske Leton

radiography

Sutura lambdoidea Sutura sagittalis

Cellulae ethmoidales Sinus frontales

Crista galli

Margo supraorbitalis Meatus nasi medius Fissura orbital is superior Os temporale, Pars petrosa

Meatus nasi superior Septum nasi

Meatus acusticus externus

Concha nasalis media

Cellulae mastoideae

Sinus maxillaris Concha nasalis inferior

Proc, mastoideus

Spina nasalis anterior Palatum durum

Ramus mandibulae

Axis, Dens Meatus nasi inferior Dens incisivus

Cavitas nasi

Corpus mandibulae

Fig. 72 Skull, C ra n i u m ; AP-telerad i o g ra p h .

* I n n o m i nate l i n e , L i n ea i n n o m i nata, a projection l i n e without a natomical correlate

Muscles

To p o g r a p h y

O rg a n

a re a s

D�5

Secti o n s

Skull, radiography

Lamina externa Diploe Lamina interna

Proc clinoideus anterior

Sutura coronalis

Proc. clinoideus posterior Fossa hypophysial is Os frontale, Pars orbitalis Sutura lambdoidea Fossa mandibularis

Sinus frontalis Cellulae ethmoidales

Cellulae mastoideae

Os nasale Sinus sphenoidal is

Meatus acusticus externus

Sinus maxillaris Caput mandibulae

Atlas, Arcus anterior

Palatum durum

Atlas, Tuberculum posterius Axis. Dens Corpus mandibulae Cartilago epiglottica Os hyoideum, Corpus

Fig. 73 Skull, C ra n i u m ; lateral telerad iograph . •

Posterior wall of the maxillary s i n u s

\ ''''''''

mBl'ldibula,a

Proc. splnosus vertebrae cervical is II Ramus mandibulae

�

H ea d

S u rface

Skeleton

Skull, development Fonticulus anterior (Sutura frontalis) Os frontale, Tuber frontale Maxil a, Proc. frontalis Os nasaIe Os sphenoidale, Ala major Septum nasi osseum ForamenDensinfraordecibitadlueus Foramen mentale

Fig. 74

�

Os lacrimale Os frontale Os parietale

Sutura coronalis Foramen supraorbitale Os temporale Os zygomaticum S k u ll, C ranium, of a neonate.

occipitale Maxil a, Os incisivum Os zygomaticum

Os

Sutura coronalis Os frontale, Tuber frontale Fonticulus sphenoidalis Os sphenoidale, Ala major Os zygomaticum Apertura piriformis Os temperale, Pars

Os ethmoidale Os sphenoidale Os nasale, Os temporale, Mandibula Os parietale, Tuber parietale Fonticulus posterior Squama occipitalis

Fonticulus mastoideus

squamo6a Fig. 75

Skull, Cra n i u m , of a neonate.

M u scles

To pog rap hy

O rg a n a rea s

Secti ons

Skull, development Sutura frontalis

Fonticulus anterior

Os frontale, Squama frontalis Sutura coronalis

----:::;"""
--+-----:-'--_--,-�t--4

Os parietale, Tuber panetale Fonticulus posterior

Sutura sagit alis Fig. 76

Os occipitale, Squama occipitalis

Skull, C ranium, of a n e onate .

..

Vomer Os frontale .. Os parietale Os occipitale, Squama occipitalis (Sutura occipitalis transversa, Var.) Fonticulus mastoideus Os temporale, Pars pel(ro';a -_--II!!':::::!\.....:...!.., Os temporale, Pars

Maxil a, Os incisivum Os occipitale, Os palatinum Os zygomaticum Os temporale Os sphenoidale Mandibula Fonticulus posterior

Os occipitale. Pars lateralis Foramen magnum

ChOana

Os sphenoidale, Proc. pterygoideus Fig. 77

Os parietate

Maxil a, Proc. palatinus S ku ll, C ra n i u m . of a neonate.

(] 4 7

,. H ea d

SkeLeton

S u rface

Frontal and ethmoidal bone

Margo parietalis

Squama frontalis, Facies externa

Tuber frontale

Facies lemporalis

Margo supraorbltalis

Proc.

Incisura

supraorbltalis

Pars

orbllahs. Facies orbltalis

Fig. 78

Lamina et Foramina cribrosa Fossa glandulae lacrimalis Margo supraorbitalis

Os frontale

Pars nasalis

Os

Spina nasalis

zygomaticus

Incisura frontalis

Glabella

Fro ntal bone, O s frontale.

Os frontale, Squama frontalis

nasa Ie

Lamina et Foramina cribrosa

...

Os ethmoidale

Incisura supraorbitalis Margo supraorbitalis Labyrinthus ethmoidalis Proc zygomaticus

Lamina perpendicularis

Fig. 79 Frontal bone. Os frontale; ethmoidal bone, O s ethmoidale, and nasal bones. Ossa nasalia.

Os nasa Ie

M u scles

Top o g ra p hy

O r g a n areas

Sect i o n s

Maxil a and paLatine bone

Proc. frontalis, Crista lacrimalis anterior

Incisura laMarcrimgaloislacrimalis Margo infraorbitalis Facies orbitalis Sulcus infraorbitalis Facies infratemporalis Foramina alveolaria Proc zygomaticus Tuber maxil ae

Foramen infraorbitale

__...:.:!o... --_

I

Fig. 8o

Maxil a, Proc. frontalis ----:-:":Sulcus lacrimalis Crista conchalis ----...Maxil a, Facies nasalis

--=-;----''----1(

Maxil a, Proc. palatinus Maxil a Os palatinum

Fig. 81

Maxi lla , Maxilla.

Margo lacrimalis

ncisura nasalis Spina nasalis anterior Juga alveolaria

Facies

anterior

Crista ethmoidalis sphEtnopalatlna Incisura

[��,��,-.--

Maxi lla, Maxi lla, a n d palatine bone,

a s palat i n u m .

-

Sinus maxillaris

OsLamipalnaatperinum.pendl­

cularls

sta conchal SpinCra inasal is postiesrior Sutura palatina transversa

�

H ea d

S u rface

S keleton

Nasal ca vity

Crista

as fronlale

gal

II

Lamina et Foramina cribrosa

froSintnauslis Suturias frontonasal

----+_�

Cnsta sphenoidal Sinus sphenoidalis Fossa hypophysialis asCorsphenoi pus dale, Ala vomeris

Lamina peras petendihmoiculdaalreis, as lacrimale Canalis

Incisivus

IS

....

-

Vomer

PrLamioc.npta elartyegoiraldiseus, Spina nasalis posterior Hamulus pterygoideus as palnaathorinum,izontalis PrMaxioc.l apal, atinus Lami

Maxil a as frontale nasale as sphenoidale AS

Fig. 82 Bony nasaL septum, Septum nasi osseum.

as palatinum as ethmoidale .. Vomer .. lacrimale AS

M uscles

To pog ra phy

Organ a reas

Sect i o n s

Nasal cavity Lamina et Foramina cribrosa Concha nasalis superior Sinus sphenoidalis Foramen sphenopalatinum Os sphenoidale, Corpus ��tt..���tUJ&,t.l!A�\'--- Hiatus maxil aris Clivus Os occi p i t a I e Os palnaatperinum,pendicularis Lami PrLamioc.npta emedirygoiadliseus, Hamulus pterygoideus Os palatinum, Lamina horizontalis

Crista galli Os nasale

Concha nasalis media Concha nasalis inferior Spina nasalis anterior Canalis incisivus Proc, palMaxiatinlusa,

Fig. 83 Lateral wall of the nasal cavity, Cavitas nasi.

Os parietale Maxil a Os frontale Os nasale

Concha nasalis inferior Os sphenoidale Os occipitale palatinum Os

Sinus frontalis

Conchasupernasalioisr Os nasale lacrimalOse -

Apertura sinus sphenoidalis Sinus sphenoidalis Foramen atinum sphenopal CrOsispalta etathinmoium,dalis Concha Proc ethnasalmoidisaliinsferior,

___�

-

antnasalSpiernioiasr InCanal cislvusis

... Os ethmoidale ... Os lacrimale

••L-�4-.----

Lateral wa ll of the nasal cavity, Cavitas nasi; the m i d d le nasal concha has been removed. Fig. 84

*

from

Probe located in the passage the frontal s i n u s to the middle nasal meatus

�

S u rfa c e

H ea d

S k e Leton

Hard palate Proc .

ptsrygoldsus

{lamina

Spina

madialis

Lamina laleralis

nasalis posterior Sutura palatine

Iransversa

---7"""---

(

Sinus maxil aris

Canalis nasolacrlmalis

��•.:,.,,;q..--

Foramen

Apertura piriformis

Spina nasaliS anterior

Incislvum

Fig. 85 H a rd palate. Pa latu m d u r u m ; maxi llary s i n u s , Sinus maxillaris, and i nferior n a s a l c o n c h a , Concha nasalis inferio r.

Proc. p lerygo,d eus

Os

(

Maxil a Os palatinum Lam,na

Os sphenoidale Concha nasalis inferior

medialis

lamina lataralls

palatlnum, Proc. pyramidalis

Foramen palatinum

---r:'-L''"'''Ii

Foramen

minus

palatinum malus

Maxil a, Proc. zygomaticus

Sulci palatinl

Spinae palatlnee

Maxilla, Proc. palatlnus

(Os incisivum) Foramen incisivum Fig. 86

Sutura pala!ina mediana

H a rd palate, Palatum d u r u m .

M uscles

To pog ra p hy

O rg a n a reas

Sect i o n s

Orbit and pterygopalatine fossa Os palatinum, Proc. orbitalis Fissura orbitalis inferior Os sphenoidale, Ala major

ethmoidales lamiOs ethmoi na orbdta s Cellulae

ale, i li

Os lacrlmale

sacci lacrFossa imalis

SulUfa Fig. 87

_ Os zygomaticum

Os temporale Os palatinum Os sphenoidale

zygomaticomaxillaris

Base of the orbit, O rbita .

Maxil a .. Os lacrimale Os ethmoidale Os frontale Arcus zygomaticus

zygomaticForofaacimenale

zygomaticoalveol(Craisritsa)

Fossa inForfrataemenmporovalalise Foramen spinosum AlSpianmaja ossior, s sphenoidalis Proc. pterygoideus OsLami endicaultianrais, Fossapalnaapttperienrum,ypgopal Os palatinum, Proc. pyramidalis OsHamul Proc.sphenoi ptuserptygoidealrydegoieus,, deus Ii..::::�'----

----�

Foramina alveolaria Fig. 88

PterygopaLati ne fossa, Fossa pterygopaLatina.

�

H ea d

S u rface

S keleton

Orbit

antForearmiiusnaetetposthmoierdiualsia

Canalis opticus orFisbsuritalias superior (Sutura icofrontalis) zygomat Ala minor 1 AlFacia majes ororb, italis Os sphenoidale OsFacizygomat es orbitaiclium,s Foramenicofaciale zygomat Fissura orbitalis inferior Sulcus infraorbitalis Sutura zygomaticomaxil aris

Incisura frontalis LamiOs etnahmoiorbditalaleis, Sutura frontomaxil aris Os nasale ---ICrista lacrimalis anterior Crista lacrimalis posterior OsPropalc, oratbinitum,alis

Fig . 89 Orbit, O rbita; probe located i n the i nfra-orbital canal, Canalis i nfraorbitalis .

Os nasale Os frontale Os palatinum Os ethmoidale

(

Ala minor sp�\enOld�: FacieAls aormajbltaolirs,

--+';-;';----'-'�T>,'!tI ---.---:�r--;.

Os palatinum

Maxil a, Proc, alveolaris Dens molaris

.. Vomer .. Os zygomaticum

Maxil a

Os temporale Concha nasalis inferior Os sphenoidale .. Os lacrimale

Cellulae ethmoidaleCrs ista galli Os ethmoidale, Lamina perpendicularis Os frontale, Pars orbitalis Fissuriaororbitalis super OsPartsesquamosa mporale, _�--- Fissura orbitalis inferior Os zygomaticum inlraorbltal s Concha nasalis media zygomaticomaxil aris Concha nasalis inferior Cavitas nasi, Meatus nasi inferior Maxil a, Proc. palatinus Canalis

Sutura

Fig. 90 Fac i a l skeleto n , Viscerocra n i u m ; frontal section.

M u sc le s

To p o g ra p hy

O rg a n a reas

Sect i o n s

all 5.,15··. ,.

Orbit fSquama roiFacinnttearlenisas,

_

Os parietale Sutura sphenofrontalis Os temporale, Pars squamosa Ala minor AlFacia maes ororb, italis } Os sphenoidale Corpus ForamenSinusrosphenoi tundumdalis Canalis pterygoideus Fossa pterygopalatina Proc, pterygoideus Hamulus pterygoideus Canalis palatinus ma or �.,..---

...tr.:r.-----

j

--

zygomaticForoorabmiitanliaa Canalis infraorbitalis Sinus maxil aris

Alveoli dentales

j

Fig. 91 Orbit, Orbita ; lateral wall.

Os frontale .. Os lacrimale Os sphenoidale Os nasale

Crista lacrimalis antMaxierlioar, Crista lacrimOsalislapostcrimealrioer, Sulcus infraorbitalis Maxil a, Proc. zygomaticus

Os nasale Os palatinum Os ethmoidale

____��...L_.....

Maxil a Os temporale _ Os zygomaticum

Sutura ethmoidolacrimalis Foramen ethmoidale anterius Os ethmoidale, Lamina orbitalis Foramen ethmoidale posterius Os palatinum, Proc. orbitalis Foramen sphenopalatinum Fossa pterygopalatina

Fig . 92 Orbit, O rbita ; medial wall.

Proc. pterygoideus, Lamina lateralis Hamulus pterygoideus Maxil a, Proc. alveolaris

--

),

. '

-- �. -4

,.

.. H e a d

Skeleton

S u rface

Sphenoidal bone Apersphenoi tura sidnalusis Ala

Corpus

Crista sphenoidalis AlFacia majes ororb, italis AlFacia majes toermpor , alis

major

Margo zygomaticus

Foramen rotundum Facies maxil aris Proc pterygoideus, Lamina medialis

Crista infratemporalis Concha sphenoidalis Spina ossis sphenoidalis PrLamioc,npta elarytegoiraldiseus, Incisura pterygoidea Hamulus pterygoideus

Fig. 93 Sphenoidal bone, Os sphe noidale ; a nterior view.

Sulcus caroticus Foramen rotundum Fissurioar orbitalis super Margo squamosus

Dorsum sellae Proc, clinoideus posterior Proc. clinoideus anterior

parMariegtoalis cerAlFaciaemajebrsaolisr, -.--- Sulcus arteriosus Li n gul a sphenoi d al i s �= L �' � � ;� i � ; � f� Sulcus tubae auditivae ������� Spina ossis sphenoidalis Fossa scaphoidea Proc pterygoideus, Lamina lateralis plerygoldeus E::��'-'-��"""--

Canalis pterygoideus

Rostrum sphenoidale ProLamic. ptenraygoimedideus,alis

Incisura

Hamulus

Fig. 94 Sphenoidal bone, Os sphenoidale ; posterior view.

plerygoldea

�-'----'-.I---

M uscles

To pog ra p hy

O rg a n a reas

,057

Sect i on s

Sphenoidal and occipital bone

Ala major, Margo frontalis

MargoAlpara majietaolirs,

Fissurioar orbitalis super

(Proc clinoideus medius) Proc. clinoideus posterior Proc. clinantoideeusrior

Sulcus prechiasmaticus

....--: .. r1��....L

Ala major, Margo squamosus

Incisura jugularis Proc. jugularis Foramen magnum Sulcus sinus sigmoidei

Fossa cerebellaris

AlOsasphenoi major dale, men rForotuandum SelFossala tuhypophysi rcica, alis Foramen ovale Foramen spinosum Sulcus caroticus Lingula sphenoidalis Tuberculum jugulare Os occipitale, Pars lateralis Margo mastoideus _ _ _

....� ., r-..t§.---

---��-"""::;-

-'L------

�__-

------,��

Sulcus sinus transversi (Crista occipitalis internaj Eminentia cruciformis Protuberantia occipitalis interna Fig. 95 Occi pital bone, Os occipita le, and sphenoidal bone, Os sphenoidale.

Margo lambdoideus

�

H ea d

S u rfa c e

S keleton

Temporal bone Sulcus arteriae temporalis mediae Foveola suprameatica Crista supramastoidea Incisura parietalis (Spina suprameatica) Pars petrosa Foramen mastoideum Fissura tympanomastoidea �:!C:-':Ii;;�rt�4i

/ Margo parietalis

Pars squamosa, Facies temporalis Margo sphenoidalis Proc zygomaticus

_ _

Proc, mastoideus

Fig. 96

Rssura

TubercUlum articulare

mandlbularis, Facies perrotympanica

Fossa Fissura

Meatus acustlcus

exlernus

Temporal bone. Os temporale.

Pars squamosa

petrosquamosa

Pars pe l rosa

Pars tympalllca

Fig. 97

Tem poral bone. Os temporale. of a neonate.

artlcularis

M u sc les

To p o g ra p hy

O rg a n a reas

Sect i o n s

Temporal bone Margo parietalis Pars squamosa, Facies cerebralis partMargisopetsuperrosaeior Foramen mastoideum Margo occipitalis Sulcus sinus sigmoidei Apertura canaliculi vestibuli Proc. inlrajugularis styloideus

Sulcus arteriosus Margo

sO�lenIJidllllsFossa subarcuata

Apex partis petrosae Porus acusticus internus

Fig. 98

Te m poral bone, as temporale.

Canalis musculotubarius Margo soh,enclldallis 1

Proc. zygomaticus Tuberculum articulare Fossa mandibularis Fissura petrotympanica Meatus acusticus externus Incisura mastoidea Fig. 99

Apex petrosaepartis Canalis caroticus Fossula petrosa ��_:--_ Apertura canaliculi cochleae processus slyloidei styloideus

Tem poral bone, as temporale.

�

Head

S u rface

S ke leton

Mandible Proc coronoideus ea

a1v

ol ria

menta Ie

Basis mandibulae

Fig. 1 00

Protuberantia mentalis

Arcus Pals

alveolaris

Ramus mandibulae Angulus

mandibulae

M an d i ble, M a n dibula.

Proc coronoideus

Incisura

--.,..:.,.

mandibulae

--F-'II'"

--!,;.:.-,:'O-----'-....:

Prcc.

condylans

alveolaris ---m-

Foramen mentals Protuberantia menlalls

Corpus mandibulae Fig. 1 01

M a n d i ble, M a n d ib u la .

Fovea sublingualis Spina

Ramus mandibulae

mentalis

d a

Fossa igastric

(Tuberositas masseterica) Angulus mandibulae

Linea

mylohyoidea

Fig. 1 02

M a n d i b le , M a n d i bula .

(Tuberositas pterygoidea)

Fovea submandibularis

M uscles

To pog ra p hy

O rg a n a reas

Sect i o n s

Mandible Proe. condylarls

Collum mandibulae

�----

H ea d

S u rface ���

Skeleton

N ose/Na s a l cavity

Openings of the salivary glands

Papilla ductus parotidei ---j='-'----

Fig. 1 96 Opening of the excretory d uct of the parotid gland, Papilla d u ctus parotidei.

Lingua, Facies inferior Plica fimbriata Frenulum linguae

--;-;:.....I;� ....;-

-

--":------'''+-- Dens molaris III [serotinus]

....� ... ...:.-=. .. �

-

Plica sublingualis ---;...----..,,...;:,---:--::---"'-,

Caruncula sublingualis --+---=:---- Articulationes metacarpophalangeae

Articulationes interphalangeae manus proximales _.:>----

Articulationes interphalangeae manus distales

Fig. 276 U p p e r l i m b , M e m br u m s u p e r i u s ; overview, b o n e s a n d j o i nts.

M uscles Arm

To pog ra p hy E lbow

Forea r m

Sections Hand

Cla vicle

Tuberculum canoideum

Carpus

Extremitas acromialis

claviculae

Extremltas

sternalis Fig. 277 C lavicle, C lavicula ; superior view.

Fa�les

artlcularis Is

acromial

Extremitas acromialis

Corpus claviculae

Extremitas sternalis

-----I

Foramen nutricium

Linea

trapexoidea

Tuberculum conoideum

Sulcus musculi subclavii

01----

Impresslo ligamenti costoclavicularis

Fig. 278 Clavicle, C lavicula ; i nferior view.

Ug.

costoclavlculare Capsula

Lig. costoclaviculare

articularis

Lig. sternoclaviculare anterius

Symphysis manubriosternalis Fig. 279 Sternoclavicular j o i n t , Art i c u la t i o sternoclavi c u laris; ventral view.

Cartilago costalis II

Facies articularis sternalis

�

U pper limb

S u rfac e ���

SkeLeton

Overview

S houlder

Scapula

Angulus superior

Acromion

Incisura scapulae Margo superior

"

supraspinata Spina scapulae

\

Acromion Angulus acromfi Cavitas glenoidalis Angulus lateralis

Margo medialis

Tuberculum supraglenoidale Proc, coracoideus

_-,:---

Cavitas glenoidalis

Tuberculum infraglenoidale

Facies posterior

Margo lateralis Angulus inferior Fig. 280 Sca p u la. Sca p u la ; d o rsal view.

Facies

Fig. 281

Scapula, Sca p u l a ; latera l view,

Proc, coracoideus Incisura scapulae

60'

Planum scapulara"

Scapula

=:>t--- Margo superior

articularis claviculans

,,:"",::-:,-....,...;a+-_

...,.

Fossa subscapularis

.,

/"

.

"

.",. "

:

Facies costalis Acromion Proc coracoideus

Fig. 282 Sca p u la , Sca p u l a ; ve ntra l view.

.

\ \ J,.. /�

----"c------;----

Clavicula

Costa I Articulatio sterno­ clavicularis 600 Sternum

Fig. 283 S h o u lder g i rd le , C i n g u l u m pectora le ; s u perior vi ew. The a n g les refer to t h e ave rag e relations in t h e a d u lt. *

Median plane

** Sca pular plane

M uscles Arm

To p o g ra p h y E lbow

Sect i o n s

Fore a rm

Hand

Humerus Caput humeri

Sulcus intertubercularis

Collum anatomicum

Tuberculum

Cnsta tubercull

Crista tuberculi majoris

Tuberositas

deltoidea

minoris

----II!'­

Corpus humeri Sulcus nervi radialis

Margo lateralis

Margo medialis

Facies anterolateral is

Facies anteromedialis

Crista supraepicondylaris lateralis Fossa radialis Epicondylus ----I[JIrl lateralis -............w Capitulum humeri

Crista supra­ epicondylaris medialis

-

Condylus humeri

Epicondylus medialis

Trochlea humeri

Facies posterior

Fossa olecrani ---_...:z: Sulcus nervi ulnaris

Fig_ 284 H u merus, H u merus; ventral view.

Insertions of the tendons of: 1 M. supraspinatus 2 M. infraspinatus 3 M. teres minor

o:§---- Tuberculum majus

Collum anatomicum

Trochlea humeri

Fig. 285 H u m e rus, H u m e ru s ; dorsal view.

!

Collum anatomicum Caput humeri Tuberculum majus

Fig. 286

H u m e rus, H u merus; p rox i m a l view.

.. U p p e r Li m b

S u rface

I S ke leton I

Overview

Shoulder

Shoulderjoint Articulatio acromioclavicularis, Lig, acromioclaviculare Acromion

Lig. coracoacromiale

M, supraspinatus

Proc, coracoideus

Lig, transversum scapulae supenus

Lig, coracohumerale --;.,-�:---=-_-;-_..:.._�

Tuberculum majus M

....-------- Incisura scapulae

---

Bursa subtendinea musculi subscapularis

subscapularis, Tendo ---='----.:,

Vagina tendinis intertubercularis --,:-,---"""; M. biceps brachii, Caput longum

Capsula arlicularis,

Ligg glenohumeralia: - (superius) - (medium) - (inferius)

----

m infraglenoidale

Sulcus intertubercularis

(Recessus axillaris)

Crista tuberculi minoris

Fig. 287 S h o u lder joint, Art i c u latio h u m e r i ; ventral view.

Proc, coracoideus

Spina scapulae ------'--,....:...---.--==--"7"-

Fig. 288 Shoulder joint. Articulatio h u m e r i ; the acro m i o n has been removed ; d o rsal view.

Tuberculum majus

M u sc les Arm

To p o g ra p h y E lbow

Sections

Fore a rm

Hand

Shoulderjoint Lig. acromloclavlculare

Clavicula, Extremitas acromialis

Lig. coracoacromiale

M. supraspinatus

Spina scapulae -=,==:if-- M

infraspinatus

M, teres minor M. triceps brachii, Caput longum

Capsula articularis Humerus Fig. 289 Shoulder j o i n t , Art i c u latio h u me r i ; d o rsal view.

Bursa subacromialis

Lig coracoacromiale

Acromion M

supraspinatus'

Tuberculum majus M.

infraspinatus'

M. supraspinatus

---.I.

------'=:--

M, teres minor'

Proc. coracoideus Lig. coracohumerale

Vagina tendinis intertubercularis M. biceps brachii, Caput longum M. subscapularis'

Fig. 290 Shoulder j o i nt, Art i c u latio h u m e r i ; latera l view.

Together, the m uscle tendons ma rked with rotator cuff.

•

form the so-ca lled

�

S u rface

U p per L i m b

I SkeLeton I

Overview

Shoulder

Shoulderjoint Acromion

Bursa subacromialis

Facies articularis clavicularis

M. supraspinatus

Lig. coracohumerale

""'�"";'�;.Q"",'.,;!,..o;'--- M. biceps brachii, Caput longum, Tendo

�4"'Tr*�Ir',"""�-- Labrum glenoidale

���i�i-- Cavitas glenoidalis Caput humeri

Vagina tendinis intertubercularis ----'IoU-} M

biceps brachii, Caput longum, Tendo

Scapula

(Recessus axillaris)

Fig. 291 Shoulder j o i n t , Art i c u latio humeri ; section at the level of t h e sca p u l a ; ventral view.

Lig. acromloclavlculare Acromion

M biceps brachii, Caput longum, Tendo

�..

.,.,--- Clavicula

Proc.

corElcoldeus

L'9. coracoacromlale

Cavitas glenoidal is Labrum glenoidale* M

triceps brachii, Caput longum Shoulder j o i n t , Art i c u latio h u m e r i ; lateral view. N ext to its o r i g i n at t h e s u p ra g le n o i d a l tu berc le, the tendon of t h e biceps muscle is pre d o m i n a n t ly attached to t h e g lenoid labrum.

Fig. 292

*

}

Lig trapezoideum Lig. coracoclaviculare �!!,�Q1Irr--- Lig conoideum

It forms a fibrocart i laginous collar a r o u n d the glen o id cavity

M uscles Arm

To p o g ra p hy E l b ow

Forearm

S e ct i o n s H a nd

Shoulderjoint, radiography Articulatio acromioclavicularis Acromion Caput humeri

Clavicula

Proc. coracoideus

Tuberculum majus

�-�------ Cavitas glenoidal is .,.------ Collum scapulae

Tuberculum minus

----�-

------

Sulcus intertubercularis

Tuberculum infraglenoidale Margo lateralis

Fig. 293 Shoulder j o i n t , Articulatio h u m e r i ; AP-ra d i o g ra p h .

t M. deltoideus, Pars clavicularis

Sulcus intertubercularis; M. biceps brachii, Caput longum, Tendo

Tuberculum minus

Tuberculum majus

M. deltoideus, Pars acromialis

M. coracobrachialis Labrum glenoidale

Caput humeri

Cavitas glenoidal is

Articulatio humeri, Cavitas articularis

M. subscapularis

M deltoideus, Pars spinalis

Scapula

M. infraspinatus

Fig. 294 S h o u l d e r joint, Art i c u latio h u me r i ; com puted tomog ra p h i c ICTI cross-secti o n ; t h e j o i nt cavity i s filled w i t h a i r I p ne u m o - CT] ; i nferior view.

�

U pper limb

S u r face

S keleton

Overview

S h o u ld e r

Ulna

Incisura

radialis

���::...-- Proc coronoideus ".�..,....--

Indsu ra froch

Olecranon

Proc. corono,deus

__'---- Incisura radialis

Crista musculi -�IO..:'" supinatoris

Tuberositas ulnae

Tuberositas ulnae

Proc. coronoideus Foramen

--::r---

nutrlclum

"":..L__

Facies anterior

Margo interosseus

Facies ---I­ posterior

Margo interosseus

Corpus --�­ ulnae

Margo posterior Facies medialis ---4Circumferentia articularis

10... .--=i--- Caput ulnae Proc.

Fig. 295 U l n a , U l n a ; ventral view.

stylOldeus ulnae

leans

Capul

ulnae

Proc. styloideus ulnae Facies poslerior

Fig. 296 U l n a , U l n a ; d orsa l view.

Circumferentia articularis Fig. 297 U l n a , U l n a ; rad i a l view.

M u scles Arm

To p o g r a p hy Elbow

Forearm

Sect i o n s H a nd

Radius

Caput radii, Circumferentia articularis

Caput radii, Circumferentia articularis

""""'t---

Collum radii ----l...

Collum radii

Tuberositas radii

..,.--- Caput radii Collum radii

Circumferenl l a

articularis

!II>----

Foramen nutricium Margo interosseus 1':-':---7--- Margo anterior

Facies anterior

Tuberositas radii

Fovea articularis ---�

-f----

Margo interosseus

Corpus radii

--1.1

Margo interosseus

Corpus radii ----�

Facies posterior ----I......

-

Margo posterior ----f_

Facies posterior

Facies anterior

Facies lateralis

Facies articularis carpalis

Proc. styloideus radii Fig. 298 Ra d iu s , Ra d iu s ; ventral view.

R a d i u s , Radius; ulnar view. Fig. 300

Tuberculum dorsale Radius, Rad i u s ; dorsa l view. Fig. 299 •

G rooves a n d crests for the attachment of the extensor tendons

,. U p pe r l i m b

S u rface ���

S keleton

Overview

S h o u ld e r

Elbowjoint

Epicondylus lateralis

Epicondylus medialis

Cap,tulum -.......,�­

-.:::11'--- Trochlea humeri

humeri

Incisura trochlearis ----..-....-

M biceps brach,l, Tendo

Bursa "",--,....- Proc

coronoideus

Llg anulare radii Collum radii

blciP,toradlalis

--t�"pL;#;r-- Incisura rad,alis

.,..,..-- Tuberositas ulnae

Collum radi'

Olecranon

Tuberosrtas __---J�..� radii

Lig . collaterale ulnare, (Pars posterior) Lig. collaterale ulnare, (Pars anterior) Tuberositas ulnae

Ulna

-",,*-- Corpus ulnae, Facies anterior

Corpus radii, Facies anterior

Fig. 302

Fig. 301 Elbow j o i nt, Art i culatio c u b i t i ; ventral view.

Elbow j o i nt, Art i cu la t i o c u b i t i , i n 90° flexion a n d 90° s u p i n a t i o n ; m e d i a l view.

--�--- Humerus

Humerus --- �L-�, Capsula articularis, ---1'-::73� Membrana fibrosa

Epicondylus --_A.of"\ medialis Lig collaterale ulnare

Lig, collaterale radiale ----"._... Collum radii Ulna

M. biceps brachii, Tendo

Epicondylus lateral is

Capsula articularis Olecranon

Lig. collaterale radiale

=.---

-;,----- Collum radii

"'---:1--- Chorda obliqua Fig. 303 E lbow j o i n t , Art ic u la t i o c u b i t i ; ventral vi ew.

Lig. anulare radii

Fig. 304 E lbow j o i n t , Art ic u latio c u b i t i ; dorsal vi ew.

M u sc les Arm

To p o g ra p hy Elbow

Se ctions

Forearm

Hand

Junctions of the bones of the forearm ":--....,..fl---

Circumferentia --\\-�.jj1���� articularis M biceps brachii, Tendo

Incisura trochlearis

,......;.. - Chorda obliqua

Tuberositas radii

Radius

&-+-4-- Membrana

interossea antebrachii

Ulna

Facies articularis carpal is

iI.!Jj;�lt,';;�r-- Articulatio radio­ ulnaris distalis,

Capsula articularis

Proc. styloideus

Fig. 305

Fig. 306 J u nctions of the bones of the forea r m ; i n pronat i o n ; ventral v i e w of the ulna, d o rsal view o f the rad i us.

J u nctions of the bones of the forea rm; i n s u p i nati o n ; ve ntral view.

Membrana interossea antebrachii

-::;--...-- Tuberositas

radii .,...-- Collum radii

Proc --t,�=��.�;o;;;:=�� coronoideus Incisura trochlearis Olecranon Fig. 307 Proxi m a l rad i o - u l n a r j o i n t , Art i c u latio rad i o - u lna ris prox i m a lis; ventroprox i m a l view.

Lig. anulare radii

Articulatio radioulnaris proximalis

Facies lateralis Margo posterior Facies posterior

Ulna Facies

posterior

Fig. 308 Cross-section t h ro u g h the bones of the forea rm; d i stal view.

�

S u rface

U pper limb

���

S keleton

Overview

Shoulder

Elbow join t, sections and radiography

M brachialis N radialis

N, ulnarls

M. brachioradialis

Septum intermusculare brachii mediale M pronator teres, Caput humerale Epicondylus medialis Trochlea humeri Sulcus nervi ulnaris Lig collaterale ulnare Mm. flexores, Caput commune Proc. coronoideus

Epicondylus lateralis

Lig collaterale radiale Capitulum humeri

Lig. anulare radii

___

Ir��������

Caput radii

M. extensor carpi radialis brevis M. supinator

Lig quadratum

M, pronator teres, Caput ulnare

M biceps brachii, Tendo

1 Crista supraepicondylaris 6 Tuberositas radii 7 Proc coronoideus lateral is 8 Trochlea humeri 2 Epicondylus lateralis 9 Olecranon 3 Capitulum humeri 4 Caput radii to Epicondyl u s medialis t 1 Crista supraepicondylaris 5 Collum radii medialis Fig. 3 1 0 Elbow joi nt, Art i c u latio c u b i t i ; AP-rad iogra p h.

Fig. 309 Elbow j o i n t , Art i c u latio c u b i t i ; frontal sectio n ,

Fossa olecrani Fossa

M triceps brachii, Tendo

coronoidea

,Jtfi-fll---- V, mediana cubiti

Bursa subcutanea olecrani

A brachialis IiIll\Hll��-.t- �;��onator --f-I�I;\-'H--

�!\!li:Tr';-- N,

Cavitas articularls Ulna

Trochlea humeri

Fig. 3 1 1

A.

ulnaris

A. radialis

Elbow joint. Articulatio c u b it i ; sagittal section,

medianus Humerus Fossa olecrani Olecranon 4 Incisura trochlearis 5 Ulna 1

2 3

6 Radius 7 Collum radii 8 Caput radii 9 Proc. coronoideus 10 Fossa coronoidea

Fig. 3 1 2 Elbow j o i nt, Art i c u latio c u b i t i ; lateral rad i o g ra p h ,

M u s c les

Arm

Top o g ra p hy Elbow

Secti o n s

Forearm

Hand

Skeleton of the hand Os scaphOideu m

Os lunatum

Tuberculum assis scaphaidei

Tuberculum assis trapezii

;;:;;;Piii ; iiil----

Os trapezaideum

_ _

Os capitatum Os hamatum Hamulus assis hamati Basis assis metacarpi

Os metacarpi I

Corpus assis metacarpi Phalanx proximal is --.1-.

.._..+-

Basis phalangls

'''�k'r-- Corpus phalangls L�_�- Caput pha1angls

Phalanx distalis

Phalanx proximalis ��-- Tuberositas

phalangis distalis

Phalanx madla

Phalanx dlstalls

I II III IV V

Pollex [ D i g i t u s p r i mus] I ndex [ D i g itus secund us] D i g i t u s medius [ D i g itus terti us] D i g i t u s a n u laris [ D i g itus q u a rt us] D i g i t u s m i n i m u s [ D i g i t u s q u i nt u s]

Fig. 3 1 3

Bones of t h e h a n d , Ossa m a n us; palmar view.

�

U p per li m b

S k e leton

S u rface

Overview

Shoulder

Skeleton o f the hand

Radius Os lunatum Proc. styloideus radii Proc styloideus ulnae Os scaphoideum Os capitatum l1li::::--- Os triquetrum Tuberculum ossis trapezii Ossa carpi Os trapezium __Ill 11"'""--- Os hamatum, Hamulus ossis hamatl Os trapezoideum ----'-:"�l��i�!!tJ Os metacarpi ---�... Ossa metacarpi I-V Ossa sesamoidea ----:lIIb. Caput ossis metacarpi _h--- Os sesamoideum Phalanx proximal is -

Os sesamoideum --..'-O\-----tAl.a. Phalanx distalis _--r'.;rr

Ossa digitorum

Caput ossis metacarpi Corpus phalangis Basis phalangis Corpus phalangis Caput phalangis Phalanx distalis

Fig. 3 1 4

Bones of the h a n d , Ossa m a n u s ; palmar view.

Ulna Caput ulnae Proc. styloideus ulnae Os hamatum -------' Basis ossis metacarpi ----

Proc, styloideus radii :i£.;rf'''A'mifo!E'"'''--- Os trapezoideum

�

� iculatio metacarpo· l �!. ��alangea pollicis**

Caput ossis metacarpi -----tlfo Basis phalangis ----I�l'\

•

Phalanx proximalis Phalanx distalis

---- Phalanx media ...---- Phalanx distalis

Fig. 3 1 5

Bones of the h a n d , Ossa m a n u s ; d o rsal view. * Also: saddle j o i n t of the t h u m b • • Also : proximal phalangeal j i n t of the t h u m b

o

....t'.,. :: �-iI.......,.-���� "" � --...,1t'-'"....:

M. biceps brachii. Caput breve

V cephalica

---lr.::-O--'---...JI.::L.-f. .

N

intercosto' brachialis

N

cutaneus brachii medialis

N. medianus --IF---"-..:.....:--=+.l l

V. basilica --t+--�-"jI�""'.

M biceps brachii

M brachialis

Septum intermusculare brachii laterale

--l!I'::-:--":-::'f-:�

M. triceps brachii. Caput longum

N. cutaneus antebrachii medialis

M triceps brachii Septum intermusculare brachii mediale

Epicondylus lateralis Bursa subcutanea olecrani M. extensor carpi radialis longus

M. flexor carpi ulnaris

.I'.�l,-;.l.,Ir-R

... -ff,:.",....�

M

M extensor carpi ulnaris M. flexor carpi radialis

M. palmaris longus

cutaneus --J'.--''-ll antebrachii medialis

N

Fascia __.L__ antebrachii

-::-:--'--f-- Aponeurosis palmaris

Fig. 331

Fa scia of the flexor aspect of the upper l i m b .

M. extensor digiti minimi

Caput ulnae, Proc. styloideus ulnae Mm . extensores carpi radialiS, Tendines

Fig. 332

\1��"'- M. extensor

pollicis brevis Retinaculum musculorum extensorum M. extensor pollicis longus, Tendo

Fascia of the exte n s o r a spect of the u p p e r l i m b .

M u scles Arm

To pog ra p hy Fore a r m

S e ct i o n s

Hand

Muscles of the upper limb _.----

Acromion

M. sternocleidomastoideus

Spina scapulae ---AL':"""

M. trapezius

Fascia infraspinata

M. teres minor M. pectoralis major, Pars abdominalis M. teres major M. serratus anterior

M. triceps brachii, Caput longum

Arcus costalis

M. triceps brachii, Caput laterale

Vagina musculi recti abdominis, Lamina anterior

M. latissimus dorsi

M. obliquus extern us abdominis

M. triceps brachii, Tendo

Septum intermusculare brachii laterale

M. triceps brachii, Caput mediale Epicondylus lateralis

M. anconeus M. extensor carpi radialis longus

M. extensor digitorum

W1H"f--

M. extensor carpi radialis brevis

M. flexor carpi radialis

M. flexor pollicis longus

M. extensor digitorum, Tendines

�"II.I--- M. abductor pollicis longus \\1-... r.��- M. extensor pollicis brevis M. extensor pollicis longus, Tendo

Retinaculum musculorum extensorum

M. abductor pollicis longus, Tendo M. extensor pollicis brevis, Tendo

Mm. interossei dorsales

Fig. 333

M uscles of the u p p e r l i m b , t h e t h o rax a n d the inferior reg i o n o f t h e neck.

1 -7 T 2 6 -T 3 S I

�

U p per li m b

S u rface ���

Overview

Muscles of the upper limb

M

deltoideus ---llr+�1

:... ..+. -- M. pectoralis major

�--- M. brach,aits

M. brachloradialls ----il�-

M. eX1ensor carpi

M. flexor carpi radialis

radlaUs longus

-I-,f--- M. flexor digitorum superficialis

11/" 1--- M, flexor carpi ulnaris

Thenar --=",�""'�

---,'--- Retlnilculum

musculorum nexorum

l1l---- Hypothenar

M flexor digitorum superficial is.

Tendines

Vagina tendinis

M. flexor digitorum profundus. Tendines

1--) T 26-T 38 1

Fig. 334

M u s cles of the flexor a s pect of the u pper l i m b .

S ke leton S h o u lder

M uscles Arm

To p o g ra p hy Forea rm

Sect i o n s

Hand

Muscles

of

t h e upper limb

Acromion

M.

trapezius

M. infraspinatus

----,:,.,,....

M teres minor

M. teres major

.�-- M. triceps brachii

M. latissimus dorsi

M. anconeus

--+-��

l--- M. extensor carpi radialis longus

I: �.-¥.--- M. extensor digitorum M. extensor carpi ulnaris

--�r..�.:

ra�i1.::>--- Mm. interossei dorsales

Fig. 335

M uscles of the extensor aspect of the u p pe r limb.

1 -7 T 26-T 38 1

U p per l i m b

�

S ke let o n

Su rface .. .. ..

Overview

Shoulder

Muscles of the shoulder M M levator scapulae

7J���:t1h'"-

M. scalenus medius

M. deltoideus

������r(...'f/A.�-- M. omohyOideus,

M biceps brachii, Caput longum M. biceps brachii, Caput breve

M. scalenus anterior

Venter inferfor

--�:"'.li!!���

Mm. sternocleidomastoidei

M. coraco­ brachialis M. teres major

M subclavius

M. subscapularis Mm. intercostales interni

M. serratus anterior

Mm. intercostales externi M_ serratus anterior M. pectoralis minor M. latissimus dorsi M. pectoralis major

M rectus abdominis

1 -7 204, 838, 839 1

M. obllquus externus abdominls

Fig_ 336 M uscles of the arm, the thorax a n d the i nferior reg ion of the neck. I, I I , IV-VII i n d icate the corresponding ribs.

M biceps brachii

{

Caput longum Caput breve

M coracobrachialis Clavicula

---t-Proc. coracoideus

-----"'.,,-------''r-+,,

Acromion M . infraspinatus

N. suprascapularis

Lig. transversum scapulae superius

Articulatio acromioclavicularis

--...=:1m

M subscapularis --�.-;

&""':::--- S pina scapulae

Fig. 337 Should e r a n d muscles of the s h o u lder. Together, the m u scle tendons ma rked with * form the so-ca lled rotator c uff.

M uscles U pper arm

To pog ra p hy Fore a r m

Sections

Hand

Muscles of the shoulder Clavicula

M subclavius M trapezius

M. deltoideus Lig. coracoclaviculare, Lig, trapezoideum

Articulatio acromioclavicularis, Capsula articularis Acromion Bursa subacromialis (Bursa musculi coracobrachialis)

-------.!1'Ij""""�

coracoclaviculare, Lig. conoideum

--=:t:;.,;,.�

M. omohyoideus, Venter inferior

-�....-------'---.;-r--t'1iIi

_-�fj�l---::::���?jrl�

M. pectoralis minor M. biceps brachii, Caput breve

M. rhomboideus minor

M coracobrachialis

M supraspinatus Lig transversum scapulae supenus

M. deltoideus Vagina tendinis intertubercularis

M. subscapularis

M pectoralis major M. rhomboideus major

M latissimus dorsi, Tendo M. triceps brachii, Caput laterale

Margo medialis

M. biceps brachii, Caput longum M. teres major M coracobrachialis M. serratus anterior M. biceps brachii, Caput breve

M. triceps brachii, Caput longum

Fig. 338

Shoulder and m uscles of the shoulder.

* Tri a ng u lar space, Spati u m axi lla re mediale * * Q u a d ra n g u la r space, Spat ium a x i l la re laterale

M omohyoideus, Venter inferior M levator scapulae

Angulus superior

Acromion

r:;2�����!!

-W�'--7

-

M rhomboideus

Bursa subdeltoidea deltoideus

M. supraspinatus

Humerus, Collum chirurgicum

M. trapezius

.,",,�....--- Articulatio humeri,

Spina scapulae

Capsula articularis

M rhomboideus major M. infraspinatus

M. triceps brachii. Caput longum

M. triceps brachii, Caput laterale

M Angulus inferior M. latissimus dorsi M . serratus anterior

Fig. 339

Shoulder and m uscles of the shoulder.

* Triangular space, Spatium axillare mediale ••

Quadra ng u lar space, Spatium axi llare laterale

.. U p p e r li m b

S u rface .. .. �

S ke leton

Overview

ShouLder

Muscles of the shoulder Lig , coracoacromiale

Lig. acromioclaviculare

Bursa subacromialis

Lig trapezoideum Lig, coracohumerale

M supraspinatus'

M. deltoideus Acromion

Fascia pectoralis

--',1!10�

Fascia pectoralis, (Hiatus venae cephalicae) Lig. conoideum Proc. coracoideus

M. infraspinatus'

(Bursa musculi coracobrachialis) Bursa subtendinea musculi subscapularis

Capsula articularis

M coracobrachialis M. teres minor'

M. biceps brachii, Caput breve

Cavitas glenoidal is Labrum glenoidale

M.

subscapularis'

M. triceps brachii, Caput longum

I � T 2 6 -T 28 1

Fig. 340 Shoulder j o i nt, Articulatio h u m e r i ; lateral view. Tog ether, the m uscle tendons ma rked with * form the so-ca lled rotator cuff.

Lig. coracoacromiale Acromion

"",,".,.---

Proc. coracoideus

M supraspinatus

M. infraspinatus

Tuberculum majus

M. biceps brachii, Caput longum, Tendo

M. teres minor Humerus, Corpus

I � T 26-T 28 1

Fig. 341 M uscles of the so-ca lled rotator cuff; lateral view.

M uscles Arm

Top o g ra phy Forea r m

Sectio ns

Hand

Muscles of the arm M. trapezius

_ _ -,_

Clavicula

li. !-!¥�F�Plt--t7.;;-:r.:t-

M deltoideus

Fascia infraspinata

M. pectoralis major M teres major

M. biceps brachii

M. triceps brachii, Caput longum

':"::'':''':'-;F-:-T-

M. triceps brachii, Caput laterale

����.1Hf--

Septum intermusculare brachii laterale

M. brachial is

M , brachioradialis

M. triceps brachii, Caput mediale

M. triceps brachii, Tendo

----lilf.-l-, It.\'''''� ' �..-'--'�tr-

M. extensor carpi radialis longus

Olecranon Epicondylus lateralis

M. extensor carpi radialis brevis

M uscles of the arm; superficial layer; d o rsolateral view. Fig. 342

I � T 27, T 30 I

�

S u rfa ce

U p per l i m b

���

Overview

Origins and insertions of the muscles of the shoulder and the arm /' M subclavius M, sternocleidomastoideus

M, pectoralis major, Pars clavicularis

M coracobrachialis M biceps brachii,

Caput breve

Lig, costoclaviculare

M. supraspinatus M, omohyoideus, Venter inferior

M subscapularis M, biceps brachii, Caput longum M latissimus dorsi

M subscapularis

M. teres major

M pectoralis major M deltoideus M. serratus anterior

M. coracobrachialis M. brachialis ---+-

M brachioradialis ----11(�

M pronator teres, Caput humerale M. flexor carpi radialis M extensor carpi radialis longus

M brachialis, M articularis cubiti ---hr,..c.£.:.2i� M extensor carpi radialis brevis ---IM"-

M. flexor carpi ulnaris, Caput humerale M. flexor digitorum superficialis, Caput humeroulnare M. pronator teres, Caput ulnare

M. flexor carpi ulnaris, Caput ulnare

I � T 26-T 30 I

Fig. 343 O r i g i n s and i nsertions of the muscles at the clavicle , Clavic u la , t h e sca pula , Sca pula, a n d the h u merus, H u merus (as well as ulnar origins of m u lti- head m u scles!'

S ke leton Shoulder

M u sc les Arm

To pog ra p hy Forea rm

S ect i o n s

Hand

Origins and insertions of the muscles of the shoulder and the arm M omohyoideus, Venter inferior M. trapezius

M. sternocleidomastoideus

M. subclavius M. sternohyoideus M pectoralis major, Pars clavicularis

�=l�--��;;;;;�i� ����:'::1:.�;;���

M. deltoideus

M. levator scapulae M infraspinatus M supraspinatus M. rhomboideus minor

M. teres minor

'Y�f----fjHL---

M. triceps brachii, Caput longum

M. infraspinatus

4\t.._-- M. deltoideus

M rhomboideus major

M brachialis

M. teres minor

�"""--

M teres major M. latissimus dorsi (Origo scapularis, Var )

M. triceps brachii, Caput mediale

Septum intermusculare brachii mediale M triceps brachii; M articularis cubiti

Foramen nutricium

,"-,J--- M. triceps brachii, Caput laterale ----tj,i§:"

M, brachioradialis

Septum intermusculare brachii laterale

M extensor carpi radialis longus

M. triceps brachii

Epicondylus lateralis

Epicondylus medialis -------if. Mm. flexores, Caput commune

M extensor carpi radialis brevis M. extensor digitorum

M. extensor carpi ulnaris

Fig. 344 O r i g i n s a n d i nsertions of the muscles at the clavicle , Clavicula, the scapula, Sca p u la, a n d the h u merus, H u me ru s (as well as ulnar origins o f m u lti-head musclesl.

1 -7 T 26-1 3 01

�

U p per l i m b

S u rface ���

Muscles of the

S ke leton

Overview

S houlder

arm

CapUI laterale

Caput mediale

Fig. 345

Deltoid muscle, M, d eltoideus,

Fig. 346 Triceps b rachii muscle , M . triceps b ra c h i i .

M coracobrachialis

--f--llfr·f

Capul

longum

M brachialis

Fig. 347

Biceps brach i i m u scle, M . biceps brachii.

Fig. 348 Brachial and coracobrachial m u scles, M m . b rachialis et coraco brachialis.

M uscles Arm

To pog ra p hy Forea rm

Sections

Hand

Muscles of the arm

Clavicula M. subclavius Lig. coracoclaviculare M supraspinatus M. omohyoideus, Venter inferior M. coracobrachialis

Lig. transversum scapulae superius

M. deltoideus

M biceps brachii, Caput breve, Tendo M. subscapularis

M. pectoralis major, Tendo M. teres major M. biceps brachii, Caput longum, Tendo

M. triceps brachii, Caput longum M. biceps brachii, Caput longum

M. biceps brachii, Caput breve

M, triceps brachii, Caput mediale

Septum intermusculare brachii mediale

M. biceps brachii, Tendo Epicondylus medialis

M. brachioradialis

Aponeurosis musculi bicipitis brachii

M M extensor carpi radialis brevis

Fascia antebrachii

Fig. 349 M uscles of the arm; flexor aspect, superficial layer. • ••

Tri angular space, Spatium axillare mediale Quadra n g u la r space, Spatium axi llare laterale

�

S u rface

U pper l i m b

���

S ke leton

Overview

Muscles of the arm

M. M.

M.

trapezius

Clavicula

pectoralis minor

deltoide\JS

-�;..--

Vagina tendinis intertubercularis

M.

biceps brachii, Caput breve

M.

M.

subscapularis

--...J.;al

biceps brachii, Caput longum

------ Nn. digitales palmares proprii

Nn. digitales --��ml=-I\.iI1\ palmares proprll

Fig. 387

overview.

N e rves of the upper l i m b ;

1-7 T 24, T 25 1

�

U pper li m b

S u rface ���

Overview

Cutaneous innervation

C3

T1

Fig. 388

T2

T3

Segmental c utaneous i n n e rvation IdermatomesJ of the u p pe r limb.

C3

C8

T3

Fig. 389

T2

Tl

Segmental cutaneous i n n e rvation Idermatomes) of t h e upper limb.

S ke leton S h o u ld e r

M u sc le s Arm

To po graphy C u bi t a l fossa

Sec t i o n s Forearm

Hand

Cutaneous innervation

N, medianus N. ulnaris

I

c o m mu n e s Nn. Nn

palmares

R.

digrtales

N musculocutaantneus,ebraN.chicuti lataeneusralis

brN.archiadiialaliste. rN.aliscutinafeneusrior is. N. iocutr aneus brachii lN.ateaxirallisarsuper

palmaris

dlgltales palmaros

prop,,1

N n.

..o:=:�:-""....,...=-+-

N.N.cutaneus

digltales palmares proprll

Nn digltales palmares communes

mter1;ostobrachlalls

N. cutaneus antmediebrachialisi { R. antR epostriorerior R. palmaris

Fig. 390

Nn.

supraclavlculares

--=-�-----

brachll medialis

Nn. supraclaviculares ��ipect�����; oralesi 1 Nn. intercostales Rrlpectat.ecutroarleaaslneies

C utaneous nerves of the upper limb.

N. cutaneusN.brcutachianeusl postbreariochlr l laterahs inferior N. radiahs N. cutaneus antebrachli posterior ) R. antN.N.latecutmuscul erbralaaneuschioicutaneus, dorsales superiiclalis

R. communicans

ulnans

N n. dlgltales

is

1

N.

radialis

;l;;�f:����!�:::=:2= ij=�;�I§���� NN.n. Nn.tpostRr.hcutoreraioacirneiecsi' � �;I��I�:: ��opml N. radialis. N. cutaneus brachii posterior N. N. cutaneus brachii medialis N cutaneus antebrachii medialis __

rnedianus. dig ilales

palmares propril

Nn. digitales dorsales

R. dorsalis

Fig. 391

Cutaneous nerves of the u p pe r limb.

u l narls

�

U p per L i m b

S u rfa ce ���

S k e Leton

Overview

Shoulder

Musculocutaneous nerve

N.

mUSCulOGulaneus --+--:--�i-Hl:rh'Jl C5

M. coracobrachialis --+--'t,-tlr;-tl...... C6

M. biceps brachii -----l-l,...

C7 -If--- M. brachialis

C8 Tl

N. CUlaneus ---\-H-f anlebracf111 laleralls

Muscu locutaneous nerve , N . musculoc uta neus; segmental o rg a n isat i o n . Fig. 393

1 � T 24, T 25 1

M usculocutaneous nerve , N. musculocuta neus; su pplyi ng a reas. The skin b ra n c hes and the cutaneous innervation a re i llustrated in blue. Fig. 392

1. � 46, 386, T 24, T 25 1 .

M u sc les Arm

Topogra phy Cubital fossa

S e ct i o n s Fore a r m

Hand

Median nerve

C5

C6

14;------'--

C7

N ulnarls

ca

1 ""+-1--- N

Tl

medianus

M-t--- Septum intermusculare

brachii mediale

Fig. 395 M e d i a n nerve, N. medianus; segmental o rgan i sation.

1 -7 '���,,",,1-+--

Median n e rve, N, medianus; s u p ply i n g a reas, Fig. 394

T 24, T 2S

I

M, pronator teres

I � 46, 386, T 24, T 25 1

Median nerve, N , medianus; p roximal pa lsy: typical post u re. Fig. 396

�

U p per L i m b

S u rfa ce ,.. ,.. ,..

Skeleto n

Overview

S h o u ld e r

Ulnar nerve

C5

1f-----7----

C6

N. cutaneus antebrachii medi alis N. cutaneus brachii medialis

PI-----;:.-----,--;-

1+---'--f:'-il---

C7

CB

II

N. medlanus

Sept brachiumi mediinteramleusculare

Fig. 398 Ulnar nerve, N . ulnari s ; segmental o rgan isation.

1-7 T 2 4 , T 25 1

ulnarfleisxor carpi

_1--- M.

R. protundus MlNlH---

Ulnar n e rve, N. ulnaris; sup plyi n g a reas. Fig. 397

R.

superficialis

1 -7 46, 386, T 24, T 25 1

Fig. 399 Ulnar nerve, N . u lnaris; proximal palsy.

T1

M us c les Arm

Sect ions

Topography C u b i t a l fossa

Fo rearm

Hand

Radial nerve

CS

C6 N.

radial,s

C7

postcuteraioneusr brachii

....iI-----JL--- N.

M.

M.

Caputtricepslaterbralaechii,

..::J..lJ.--- M.

tCaput riceps lbrongum achii,

A-I----

tCaput ricepsmedibrachialei,

postcuteraioneusr antebrachii N.

�tf���--- R.

Radial n e rve, N. radialis; su pplyi ng a reas. Fig. 400

CB

1-7 46, 386,

superficialis

T 24, T 25

1

T1

Fig. 401 Radial n e rve, N . radialis; segmental o rg a n i sation.

1 -7 T 24, T 2s l

. . .

•

•

•

•

.. '

•

. .. . .

#

. .

Radial nerve, N. radialis; p rox i m a l palsy.

Fig. 402

�

S u rfa ce

Upper limb

���

Skelet o n

Overview

S h o u ld e r

Axil ary nerve

C5

N. axlilaris

C6

H-H--- M. deliolde\Js

C7

���ff�oIA'-_ M. leres major

1r1�M'-�W'l-__ N. culaneus brachii laleralis superior N.

CB

radialis

Tl

Fig. 404 Axi llary nerve, N . axilla ri s ; segmental o rg a n isation .

1 � T 24, T 25 1

Fig. 403 Axi llary nerve, N. axillaris; s u pp lying a reas. The axi llary n e rve passes to the d o rsal side of the arm throu g h the q u a d ra n g u la r space alo n g with the posterior c i rcu mflex humeral a rtery.

1 � 46, 386, T 24, T 25 1

Axillary n e rve, N. axillaris; palsy: d eltoid m u scle atrophy.

Fig. 405

M uscles Arm

To p o g ra p h y C u b it a l fossa

S e ct i o n s Fo re a rm

Hand

Arteries of the upper limb

a.,..--�:---"jr#-------,t----

A. circi umfantelerxaior humer A profunda brachii A, collateralis media

-r-�"'Yf---O.... ----f---

---7"-----1""---Y

__------------:----r�

A collateralis radialis

Asupercolilaotreralis brachialis ulnaris

A.

--,.......---f

A radialis A. recurrens radialis A. interossea recurrens A. interossea posterior A. radialis

It--l---'-":-:--'----

A. thoracoacromialis A axil aris A. brachialis

..""'+----- A. coliateraUs

----J'--\)ut�

•, ..----

IJlnaMs

Inferior

anterior posterior A.ulnrarecuris rens A. ulnaris A.communi interosseas

R. 111--,,-- R.

------i.. -..JE;/---';-Illl--::f----:-

.t-:-t----;--

A.antientreiorrossea A.nercomivi meditansani R, carpalis dorsalis

H-+----,:.....n-l-.....,;i---

R

Arcusprpalofumndusaris --J'-!7JfS.-"br.. A A prpolincepslicis

'�""'';-;.+il--

Arsupercusfipalciamlisaris Aa.palmdiargeitaslecommunes s

".-+t�-41t--_

Aa.palmdiargeitasleprsopriae

Fig. 406 Arteries of the upper l i m b ; overv i ew. Arteries a djacent to the elbow joint form the c u bital a nastomosis.

�

U p per li m b

S u rface ... ... ...

I S ke Leton I

Ove rview

Shoulder

Lymphatics of the axil a

Vasa Iymphatica superticialia

V. thoracoepigastrica

Nodi Iymphoi axil ardeeis (Plexus Iymphataxil aicriuss)

Papil a ia mammar Vasa Isupert ymphaticiiacalia

superIymphattiVasa ciaicliaa V. basilica Nodi Iymphoidei cubitales V. cephalica

408

Superf i c i a l lym phatics. lym ph nodes a n d vei n t ru n ks in the regions of the arm. the latera l thoracic wall and the axi lla.

Fig. 407

Ihoraco­ epigastricae

Vv.

M uscles Arm

To p o g ra p hy C u b it a l fossa

S ec t i o n s Forea r m

Hand

Fascia of the chest, the shoulder and the axil a

Nn. supraclaviculares intermedii Nn. supraclaviculares laterales

III

•

deltoideus, Fascia . A, thoracoacromialis, R, pectoralis M.

•

_

_ _ L-

Nn, supralesaclaviculares medi

• ---f--"....,.'----,-,,...;-.�---;:'L..,4,�

V, cephallca

Fascipecta oralis major,

>-----Ilt---'C--- • M,

Rrpect. orales anterlores

• --��-'-;7-:�

cutanei

(Nn. inlertostales)

Nodi IymphoidFasci ei axial abrreaschisuperfi iciales lRr, cutatiasneisimuslatedorralessi, Fasci a . (Nn, intepectrcostoraaleles)s. serratus anterior, Fascia .

exteoblrnus,iquusFasciabdomia nis

.,{(,!rltti:---::--';-- • M, �;,:"",-,--,":,:",'---

M,

M,

Fig. 408 Vessels a n d nerves in the regions of the upper a rm as well as the shoulder, a n d the clavi pectoral t ri a n g le. Tri g o n u m clavi pectora le.

-ijl'/----:---

407

Vagiabdomina nmuscul is i recti

2 53 409 �t++

,. U p p e r l i m b

S keleton

S u rface ���

Overview

Shoulder

Cla vipecto ra l triangle

Rele acromlale

Fasciculus posterior Fasciculus lateralis Fasciculus medialis Clavicula

•

• A. subclavia

Acromion

•

M deltoideus, . Pars clavicularis

M deltoideus, • Pars acromialis

V cephalica .

------'lI,..,.-' . ....� .. -----I-' +hl_'_J'-4'­

V. subclavia

•M

subclavius

1Ii�D!��\I,l�---- Fascia clavipectoralis

--+-f-,.

+H':"';':-\-

-

Nn pectorales mediales • A. thoracoacromialis,

Rr. pectorales

pectoralis major, Pars clavicularis

• M,

•

254

t

258

408

Rete acromiale

R. deltoideus

Fig. 409 Clavi pectora l triangle . Tri g o n u m clavi pectorale .

Clavicula ----- A. subclavia

R. olavicularis A. IhoracoacromlaJls Rr, pectorales

Fig. 41 0 B ranc h i n g pattern of the th oraco-acromial a rtery, A. thoracoacro m ialis.

M. pectoralis major, Pars sternocostalis

M uscles Arm

Topogra p hy C u b i t a l fossa

Sections Forea rm

Hand

Axillary

thoraxiacoepil arisgastrica subscapularis . v.

v.

ParPls einxusfraclbraviachiculaalrisis, N inbrtearcchiostalois­ N. axil aris umfleaxae A.; V. circscapul

V.

N intercostobrachialis

•

•

fossa

� Nn. thoracici, � intercostialleas,terales Nn.Rr. mammar

••

N. thoracodorsalls N. NnRr. cutthoraneiaciclai, tNn.eraleinstepectrcostoraaleles,s IhoraGicu5 longus

Fig. 4 1 1

R.

Vv thoracoepigastricae

Axilla ry fossa, Fossa axillaris.

acromialis

A.

860 __

408

suprascapularis ....,, '''' ---- A . --cr.__-----"�..."ar:,."=-' ....::-

humerA. ciircpostumfelerxaior A. circumflexa ----'l"' ��:=11 i anterior humer A thoracica lateralis A. subscapularis ./ A. brachlal s profund" / ,4j ...

A.

'

A.

brachll

Fig. 4 1 2

Arteries o f t h e shoulder reg i o n.

!

2 55

•

413

.... 4 1 7

thoracica superior thoracoacromialis

�

S u rface

U p per Li m b

���

Neck

S ke leton

Overview

Shoulder

and axil ary fossa Plexus N.braphrchieanilisc.usPars supraclavicularis • A.

Pls einxusfraclbraviachiculaalrisis. Par A. thoraco- { Rr. pectorales. acromlails R. acromial s •

M

U-.l1-�-'-----;:';-;:�-- .

N. vagus [Xl 1'4I1'---;-::-;-----::-;-�T- V. brachiocephalica maststoeirdneusocleido­ majpector oralis RrpectantNn.Nn.. ecuttiornhiortoraearelrneiaecssciostci.ales.

deltoideus.

cephalica A. axil aris

V.

• HI....,.:-:----;-7::�_c::_- . M_

�-''--:;'o:?Ir:--,----:\-:=-t . M.

• •

carotis communis

---'.....

-

N. intercostobrachialis N. thoracodorsalis thoracica lateralis A V. thoracodorsalis N. thoracicus longus

••

A. ; v.

••

;

N. thR.orcutaciacusneus[T4)la.teN.railnistepectrcostoraalilsis, v.

256

.-t , 41 1 417

thoracoepigastrica Rr. mammari laterales •

•

414

Fig. 4 1 3 Lateral thoracic wall; infraclavicular fossa, Fossa infraclavi cula ris, and axi llary fossa, Fossa axillaris.

M u sc les Arm

Topogra p hy C u bital fossa

Sect i o n s Fore a r m

Hand

Neck and axil ary fossa

Nodi IymphoiNodidsuper ei cerfviciciaalleess etantpreroiofurendis, sternocleidomastoideus Ventomohyoi er superdeus,ior A.R.; V.supertransverficcoliaslilasi, NodicervIfyiiccmphoi al. etesprantdoeif.. super scalanteenus. rior jugularisTrsiunncusister Nodus cerNodusvicIalymphoi isprloaitfneufdndus reaeusrliiosr, Bulbusjuigulnfeariroisr. venae ParsthceroraDuctvciiccalus,uiss venosus jugulAracrus.is V. jugularis externa et Trbrouncinchomedi nalsubclis sinaaivissttueisr· •

M.

•

M.

••

scalenus medius NodilateraIylemphoi s, Nodideisupercervfiiccaliaeless

•

•

•

---,rt£.N�.Tlf-+--"""":

• M. •

•

• A.

•

• V.

•

pectoralis major.

trapezius

• M.

M.

M

Nn.latersupralesaclaviculares N. suprascapularis minpector oralis V. cephalica Nodi Iymphoiaredsei subscapul majpector oralis F--:::;;;I-�IIIE�- N. radialis cutN. muscul acineusrcumfol·exa humeri posterior • N. medianus V_ cephal iclias br a chi a • N_ ulnaris axiNodil arIyemphoi s laterdaeiles • N. cutaneus brachii medialis Nodi Iymphoidei intercostales N. thoracicus longus A.; thoracica lateralis N. intercostobrachialis • M.

Nodi Ipectymphoioradleeis

••

•

V.

"'--'1261

Fig. 4 1 4 Axillary fossa, Fossa axi llaris, and deep cervical reg i o n ; exe mpla ry i llustration o f lym phatics and lym p h nodes.

408 261

41 7

25 8

.. ..

.. U p pe r L i m b

S u rface • • •

Overv i ew

Vessels and nerves of the arm

Nn. supraclaviculares laterales . r','IJ��"i!
N. medianus

-l--���i��1

• V. basilica

_ _

radialis

A. profunda brachii

N. ulnaris

•

M triceps brachii, Caput laterale

Septum intermusculare brachii mediale

•

• M. triceps brachii, Caput longum •M

triceps brachii, Caput mediale

Fig. 446 Arm, B ra c h i u m ; t ransverse sectio n .

V. cephalica M. biceps brachii

M. brachiali s

----1I==!J

Humerus ---==::::c

V. brachialis

:.1: =1---- V. basilica

Septum intermusculare brachii mediale

Septum intermusculare brachii laterale M. triceps brachii

Fig. 447 Arm, B rac h i u m ; mag netic resonance tomogra p h i c image I M R I ) ; c ross-section at t h e level o f t h e m i d d le o f t h e a r m ; d ista l view.

M uscles Arm

To p o g ra p hy C u b i t a l fossa

Sections Fore a rm

Hand

Arm. transverse sections biceps brachii

V.

cephalica • N

M brachioradialis .

cutaneus antebrachii medialis

• V. brachialis N.

N.

medianus

radialis N.

cutaneus brachii medialis

• V. basilica

M. extensor carpi radialis longus .

• A. coliateralis ulnaris superior

Crista supraepicondylaris lateralis

Septum intermusculare brachii mediale Humerus

N.

M. triceps brachii

ulnaris

•

Fig. 448 Arm, B rach i u m ; transverse section through t h e lower t h i rd of the arm.

M . biceps brachii

A brachialis V cephalica V. basilica

M. brachialis M. brachioradialis Humerus

Ulna

M. triceps brachii

Fig. 449 Arm, Brach i u m ; magnetic resonance tomographic image I M R l i ; cross-section a t t h e level o f t h e lower t h i rd o f t h e a r m ; d ista l view.

.. U p p e r l i m b

.. ..

S ke le t o n

S u rfa ce ���

Overview

S h o u ld e r

Forearm. transverse sections Fascia antebrachii V. mediana cubiti .

N. medianus

• M. pronator teres

M . biceps brachii, Tendo . • M. flexor carpi radialis V. cephalica •

• V. basilica

M. brachloradlalis N radlalls

M extensor carpi radialis longus

.,

. .. ,.v,"��i��iii�iii����f.4m��---

---'�-\l*+1tr":"""�"" JI� •.",�4...;;e;o��

\."AIHI---rl----

· M. flexor digitorum superficialis

• M. palmaris longus

_

M supinator .

N. ulnaris

• M. flexor carpi ulnaris

M. extensor carpi radialis brevis .

Ulna

Radius, Caput radii M

Articulatio radioulnaris proximalis • M anconeus

Fig. 450 Forearm, Antebra c h i u m ; tra n sverse section at the level o f the proximal rad i o - u lnar j o i n t .

V.

basilica

V. mediana cubiti M. brachialis M. biceps, Tendo M, pronator teres V cephalica M. flexor carpi radialis M brachioradialis M. flexor digitorum superficial is

M. extensor carpi radialis longus

Ulna

M. extensor carpi radialis brevis Radius, Caput radii

M. anconeus

F i g . 451 Forearm, Antebrachiu m ; mag n etic reso nance tomographic image [ M R I ) ; cross-section a t the level o f t h e elbow j o i n t ; distal view.

M u sc les Arm

To p o g ra p hy :ubital fossa

Sect i o n s

Forearm

Hand

Forearm. transverse sections M. palmaris longus, Tendo . M. flexor digitorum superficial is

N. median us M. flexor pollicis longus .

N. radialis . M pronator teres .

• V. mediana antebrachii

•

. A ulnaris

• N. ulnaris

•

M. brachioradialis A radialis .

•

-��-:Jrc��H�i�rJ

_

M. flexor dlgltorum pr�Ofundus

Ulna M. extensor carpi radialis longus .

N. interosseus antebrachii anterior .

• M. extensor carpi ulnaris

M_ extensor carpi radialis brevis . Radius

M extensor digitorum

•

M abductor pollicis longus _

• M. extensor pollicis longus

_ M. extensor digiti minimi

interosseus antebrachii posterior

Membrana interossea

Fig. 452 Forearm, Antebra c h i u m ; t ransverse section t h rough the lower t h i rd o f the forea rm.

-+hrt+- 453 -:t:-lttt tt- 452 J

J.-'"

M. palmaris longus, Tendo M. flexor carpi radialis

M. flexor carpi ulnaris

M. flexor digitorum superficialis M brachioradialis

M. flexor digitorum profundus

M. flexor pollicis longus Radius

Ulna

Mm extensores

Membrana interossea antebrachii

Fig. 453 Fo rearm, Antebra c h i u m ; magnetic resonance tomogra p h i c i mage [ M R I I ; c ross-section at t h e level o f t h e m i dd le o f t h e forea rm; d ista l view.

�

U p p e r lim b

S ke leto n

S u rfa ce

Overview

Forearm and hand. transverse sections

M. palmaris longus, Tendo . M. flexor digitorum superficial is, Tendines'

N

medianus, R palmaris

•

flexor digitorum superficialis'

•

N. medianus M flexor carpi radialis, Tendo' • M flexor poliicis longus, Tendo' •

M

V. cephalica;

N. radialis, R

superficialis .

M. extensor pollicis brevis, Tendo'

•

N. ulnaris

• M. flexor carpi ulnaris

= = = � 4 � � � � � � ; � � � � ---1!''Jt�����;!

• M. flexor digitorum profundus' N. ulnaris, R. dorsalis

---�"'£l'".a

A radialis .

N musculocutaneus, N. cutaneus antebrachii lateralis abductor poliicis longus, Tendines' •

A. ;

M. pronator quadratus

i'i!-�r-+---- Articulatio radioulnaris distalis, ·

Recessus sacciform is

L--�-- Fascia antebrachii

Ulna

M brachioradialis, Tendo .

Mm. extenso res carpi radiales longus et brevis, Tendines'

•

• M. extensor carpi ulnaris, Tendo'

Articulatio radioulnaris distalis

• M. extensor digiti minimi'

Radius

Fascia antebrachii

extensor indicis'

•

M, extensor poliicis longus, Tendo' V. basilica .

Retinaculum musculorum extensorum

Fig. 454 Forea rm, Antebra c h i u m ; transverse section at the level o f t h e distal rad io-ulnar j o i nt. At this level. the m uscle tendons ma rked with • ru n with i n t e n d o n sheaths, Vag i nae tend i n u m.

M. palmaris longus, Tendo . Retinaculum musculorum flexorum

N

medianus '

M flexor poliicis longus, Tendo . M. flexor carpi radialis, Tendo . -_-'I> Os trapezium

M abductor poliicis longus, Tendo . ---J,-!§ M. extensor poliicis brevis, Tendo .

--�"Q:�_.:a.:l;';'.�;�t...� '''''�ff,!t!II:.!I':Ii'l.l'ti

----.-__

V. cephalica •

Hypothenar

������J-- .

• Mm. flexores digitorum, Tendines

.�In�..i;lP.f�-- Os triquetrum

"""i'---- • M. extensor carpi ulnaris, Tendo

A radialis .

Mm. extensores carpi radiales. Tendines .

• V. basilica

M. extensor poliicis longus, Tendo . extensor digitorum, Tendo

Fig. 455 Wrist, Carpus; transverse sectio n at the level of the hook of the ha mate bone, Hamu lus ossis hamati. * **

CarpaL t u n n e L uLnar ca n aL I Lo g e d e GUYON]

A. ; N ulnaris "

M uscles

S h o u ld e r

Arm

To pog ra p hy C u b i t a l fossa

Sections Forearm

Hand

Hand, transverse sections e Aa digitales palmares communes; medianus

N.

Mm. lumbricales e M. flexor pollicis brevis, Caput superficiale

e M. flexor digitorum superficialis, Tendines

e

e M abductor digiti minimi e M, opponens digiti minimi

M. flexor pollicis longus, Tendo, e Vagina tendinis M. abductor pollicis longus e ---"''--.'�''-:-A M. opponens pollicis e

Os metacarpi V

--+-#i:�;,a.

e M. flexor digitorum profundus, Tendines

Os metacarpi pollicis ---I-...!I!..-". M extensor pollicis brevis e -_-"-'011

e M. extensor digiti minimi

M. extensor pollicis longus, e Tendo, Vagina tendinis M. flexor pollicis brevis, e Caput profundum

e M, interosseus palmaris III e M, interosseus dorsalis IV

M, adductor pollicis e

Os metacarpi IV

M interosseus dorsalis I e A metacarpal is palmaris e Os metacarpi indicis M, interosseus palmaris I e M. interosseus dorsalis II e Os metacarpi I I I

Fig. 456

e M, interosseus palmaris I I interosseus dorsalis III M, extensor d'gitorum, Tendines

M etacarpus, M etacarpus ; t ra n sverse sectio n at the level of the t h i rd metacarpal bone. e M. extensor digitorum, Tendo'

Corpus phalangis

N digitalis dorsalis

• N, digitalis dorsalis

Periosteum

Mesotendineum

---'--,h4>i,.-j..Y

.uh���;::�����;;::--:;�-..!I

e M. flexor digitorum profundus, Tendo

-

_"-"'''''1---- e A digitalis palmaris propria

N, digitalis palmaris proprius

Vagina tendinum digiti

M flexor digitorum superficial is, Tendo e

Fig. 457 M id d le finger, Digitus m e d i u s [ I I I ] ; t ransverse sectio n through t h e shaft o f t h e p roximal phalanx,

•

So-called dorsal aponeurosis into which the branc h i n g te n do n of the extensor d i g itorum muscle, as well as the tendons of the i nterosseous and lumbrical muscles radiate

Periosteum

Corpus phalangis Mesotendineum

--I-J...� .s. w_

--U!�.����=:;::;;7.;'f/

N. digitalis palmaris proprius

M. flexor digitorum profundus, Tendo

S+-iMl--- e A digitalis palmaris propria

Vagina tendinum digiti e

Fig. 458 M id d le finger, Digitus m e d i u s [ I I I ] ; tra n sverse section t h ro u g h the s haft of the m i d d le phalanx.

•

So-ca lled dorsal a po n e u rosis

.... I

.. B ra i n

Blood vessels

I

C ra n i a l base

I C ra n ia l n e rves I

Pa rts o f t h e b ra i n

M e n i n g es

Arteries of the head

A.supertemporficiaalliiss { pariefrtoantlisalis A. menimedingeaa { frontalis parietalis A.ophmitha-ca { A A.suprsupratraoorchlbeitaraliiss Aa, temporaAleangul s profaurndaeis A.Ainsphenopal fraorbitalisatina A, infraorbitalis menimedingeaa A. labialis superior A. transversa faciei A. alveolaris inferior A, maxil aris A labialis inferior A. facialis A, carotis extAernthayroidea superior R

R.

A.Parcars caver otis inntosaerna,

R.

R.

supertemporficialaislis A.

I

A. basilaris

-�h:-----Jil-I

--I-------"..-:-"'l

==----r---

A.

Fig. 459

A. vertebralis

A.postaureriicoulr aris

A. pharyngea ascendens A carotis interna, Sinus caroticus External a rteries of the head.

A. vertebralis

Ventricles

To pog ra p hy

S e ct i o ns

I

S p i n a l cord

Pathways

Arteries of the head

A. callosomarginalis

--=-----'-;-:------::-:---;-:i�Y-I

vestibulocochlearis [VI IJ glossopharyngeus [IXJ vagus [XJ accessorius [XIJ hypoglossus [XI J N.

N.

N

N.

N.

Fig. 5 1 6 Anterior commissure . Commissura a nterior, and bra i nstem, Tru ncus e ncephali ; after partial removal of the basal parts of the cere b r u m ; a nterior-i nferior view.

Fornix, Corpus {(Pars

Foramina Interventrlcularla

Fornix, Columna

anterior

Commi&sura

I

Pars

lateraJes Commissura Corpus callosum, Splenium Gyrus fasciolaris

Ilbera)

(Pars tecta)

Fornix,

anterior

Pars posterior

Corpus amygdaloideum Corpus mamil are

Taenia fornlels

Pes hippocampi

1 grlseum

Striae longitudinaJes Indusium mediaJes Striae longitudinates

Fimbria hippocampi Gyrus dentatus

Fig. 5 1 7 B ot h fornices, Fornices, and a nterior commissure , Commiss u ra anteri or; viewed from the left.

... B ra i n

...

...

B lo o d vessels ... ... ...

C ra n i a l base

Overview

Forebrain

I Cra n i a l n e rves I M i d b ra i n

M e n i n g es

Parts of the bra i n

C e re b r a l tracts

H in d b ra i n

8asalganglia Sinus sagittal is superior V. thalamostriata superior Corpus callosum, Truncus Ventriculus lateralis, Pars centralis Caput nuclei caudati

Fornix, Corpus Plexus choroideus ventriculi lateralis

V. interna cerebri Thalamus

Capsula interna Capsula externa

Putamen

Capsula extrema Globi pallidi lateralis et medialis

Aa. insulares

Vv. mediae superficiales cerebri

A cerebri media, Rr. terminales

Insula Aa centrales anterolaterales Ventriculus tertius Corpus amygdaloideum

V. media profunda cerebri

Ventriculus lateral is, Cornu temporale

Hippocampus Vv inferiores cerebri

A. cerebri media, Pars sphenoidalis

Fig. 5 1 8 B lood supply of the basal ganglia; fro ntal sect i o n ; t h e a rteries a re shown o n the right a n d the vei ns o n the left; posterior view.

Nucleus caudatus, Corpus Ventriculus lateralis, Pars centralis Thalamus

Ventriculus lateral is, Cornu frontale

-�-

Nucleus caudatus, Caput

Ventriculus lateralis, Cornu occipitale

Nucleus caudatus. Cauda Ventriculus lateralis, Cornu temporale

Fig. 5 1 9 Basal ganglia and thala m u s , Thala m u s ; viewed from the left.

Ventricles

To p o g ra p hy

Sect i o n s

S p i n a l c o rd

Pathways

Diencephalon _______ Fornix, Commissura .---____ _ Corpus callosum, Splenium --Fornix, Corpus

Fornix, Colu mna

=���===�;:::=:::=���

Tela choroidea ventriculi tertii

Gyrus paraterminalis ---=��i----=-Commissura anterior

-+"'-

--= '-

----l+ -; �'--

-

Area subcallosa ----0:-:*,.--­ Lamina terminalis --::'--:f-'-----::ii�

Hypothalamus -.....!.-\1r:--::-,'-,,:iiIIF:r-'---­ Recessus supraopticus ---i=-'''���tc,;,..."c Recessus infundibuli

t,!:...c---- Sulcus hypothalamicus

.:..:=-�---- Commissura habenularum Recessus suprapinealis

---",;!�t;.c...�..::­

Recessus pinealis Glandula pinealis

Chiasma opticum --...;:..�-­ Corpus mamiliare sinistrum

Commissura posterior Tectum mesencephali

Cisterna chiasmatica

Tegmentum mesencephali

A. cerebri posterior

Aqueductus mesencephali

Sinus intercavernosus

Cisterna interpeduncularis

Adenohypophysis Neurohypophysis

Velum medullare superius

A. basilaris Plexus basilaris

Fig. 520 T h i rd ventricle, Ventriculus tertius; median secti o n.

� , �

Fornix, Corpus Corpus callosum, Rostrum Columna fornicis Commissura anterior Lamina terminalis

Foramen interventriculare

Adhesio interthalamica Plexus choroideus Stria medullaris thalami Nucleus dorsomedialis

Nuclei paraventriculares

Nucleus dorsalis hypothalami

Area hypothalamica lateralis

Area hypothalamica lateralis

Nuclei preoptici Nucleus anterior hypothalami Tractus paraventriculohypophysial is Nucleus suprachiasmaticus

.....

--T---�---�-J.��

�::=;:�::::,::::::"...."

Nuclei tegmentales

Chiasma opticum N . opticus [II] A hypophysialis superior (A carotis interna, Pars cerebralis)

------;-- Nucleus posterior hypothalami ,:-__L_ Fasciculus mamillotegmentalis

_ _ _ _

--'---�---::;;;-"'-:�

Recessus supraopticus Nucleus supraopticus

Fasciculus mamillothalamicus

(Nuclei corporis mamillaris)

�

Nucleus ruber Substantia pertorala posterior

Tractus hypothalamo­ hypophysialis

Nucleus ventromedialis hypothalami

Adenohypophysis Nuclei tuberales et arcuati Vv. portales hypophysiales A_ hypophysialis inferior (A

Neurohypophysis

Fig. 521 Hypothalamus, Hypothalamus; overview; nucle i a re illustrated translucently ; medial view.

Tractus supra­ opticohypophysialis

�

B ra i n

B lo o d vessels ���

C ra n ia l base

Overview

Forebrain

I C ra n i a l n e rves I M id b rain

Meninges

H i n d b ra i n

Parts of t h e bra i n

C e rebral t racts

Thalamic nuclei Ventnculus lateralis.

Cornu Irontale

Capsula interna

b

Left cerebraL hem isphere ; viewed from the Left

c

Right cere b ra L hemisp here; mediaL view

Nuclei reticulares Nuclei anteriores

b.!...:u ... t=:��--

Nuclei mediales Nuclei mediani; Adhesio interthalamica Nuclei ventrales: Nucleus ventralis anterior; Nucleus ventralis intermedius; Nucleus ventralis posterolateralis; Nucleus ventralis posteromedial is Nucleus parafascicularis Nucleus centromedianus Nucle, dorsales:

,

Nucleus posterior; Nuclei pulvinares ( Nucle, metalhalami): Nucleus corporis geniculati lateral/s Nuoleus corporis genlculati medialis

a

H orizonta L section throug h the Left cerebraL hemisphere

Fig. 522 a-c N uclei and corticaL p roj ections of the thaLamus, ThaLa m u s. Corresponding nuclei a n d corticaL projections a re ind icated by the same coLo u r.

Fibrae corticospinales; Fibrae corticorubrales; Fibrae corticoreticulares; Fibrae corticothalamicae; Fibrae thalamoparietales

Nucleus caudatus, Corpus

Crus antenus capsulae ,nternae

(

Fig. 523 ThaLa m i c nucle i ; o b Li q u e view from posterior. Fo r coLo u r coding see Fig. 522.

Genu capsulae internae. Fibrae corticonucleares Thalamus

r;--r-""�=---- Radiationes thalami centrales

�:::-���-- Radiatianes

Radlat,ones thalam, antenores Tractus frontapantonus

thalami peste rio res

----t-;.+_ Maxilla,

1

Proe. frontalis Canalis nasolacrimal is

Fissura orbitalis inferior

Facies orbitalis Fossa pterygopalatina

Corpus maxillae

as sphenoidale, Proc pterygoideus

Pars orbltalls

{

Proc. as palatinum pyramidalis Proc. orbitalis

Fig. 625 Medial wall, Paries medialis, of the orbit, O rbita ; lateral vi ew.

Foramen zygomaticoorbitale Fissura orbital is superior . _ as zygomaticum, t----!o..._ Facies orbitalis Ala major Corpus

Maxilla

}

as sphenoidale

Fissura orbital is inferior Fissura pterygomaxillaris Maxilla, Facies orbital is Sinus maxillaris Canalis infraorbitalis

Fig. 626 Lateral wall, Paries latera lis, of the orbit, Orbita ; medial view.

� Eye

S u rfa ce

Ske leton

Eyelids

Lac r i m a l a pp a ratus

Eyelids M. occipitofrontalis. Venter frontalis

M depressor supercilii

M. corrugator supercilii

M. procerus

Os nasale M. orbicularis oculi. Pars palpebralis

Lig. palpebrale mediale M. orbicularis oculi, Pars orbital is

M. levator labii superioris alaeque nasi

M levator labii superioris alaeque nasi

M. orbicularis oculi. Pars orbitalis

M. nasalis

M. levator labii superioris

M. levator labii superioris M. zygomaticus rna/or

M zygomaticus minor

M, zygomaticus minor . -,�. M. zygomaticus -....� major M . levator anguli oris

1 -7

1 1 9, 1 20 ,

T 1 a , c, d, e

M orbicularis oris, Pars marginalis

1

Fig. 627

M depressor septi nasi

M levator anguli oris

Fac i a l m u scles. M m . fac i e i .

M levator palpebrae superioris

Fornix conjunctivae superior

M obliquus superior, Tendo Corpus adiposum orbitae

Glandula lacrimalis, Pars orbitalis Tarsus superior

(Raphe palpebral is lateralis); Lig. palpebrale laterale

Lig palpebrale mediale

--+.""",.a

--I.L._-:i;::-..:;:: .......Iilll!!!!! lii

Saccus lacrimalis

Lig palpebraIe mediale

Rima palpebrarum Fornix conjunctivae inferior

M. obliquus inferior

Fig. 628 Orbital open i n g . Aditus o rbitalis. with eyelids. Palpebrae.

M uscles of t h e eye

Eye b a ll

Optic pathway

Top o g ra p hy

Eyelids, structure

Tunica conjunctiva palpebrarum Glandulae tarsales* Facies anterior palpebrae

_

Cilia M. orbicularis oculi, Pars palpebralis Limbus anterior palpebrae

Fig, 629 U pper eyelid, Palpebra superior; photograph of a m i c roscopi c spec i m e n ; a z a n sta i n ; sag ittal sect i o n , magnified . •

Clinical t er m : MEIBOM ian glands

Glandulae tarsales Angulus oculi lateralis

Angulus oculi medialis Commissura medialis palpebrarum

Commissura lateralis palpebrarum

Rima palpebrarum

Tarsus inferior

Glandulae tarsales

Fig. 630 Eyelids, Palpebrae; t ra nslucent specimen i llustrating the excretory ductules of the tarsa l g lands; posterior view.

3i5�

� Eye

I

� �

Skeleton

S u rface

Eye l i d s

Lacrimal apparatus Septum orbitale M levator palpebrae superioris, Tendo

Tarsus superior

Pars erbltalis

Glandula

lacrl mahs

Pars palpebralis

-;;;���iit

Lig. palpebrale mediale

Ductuli excreterii (Raphe paipebralis iateralis):

L i g . !lalpebrale lateraIe

Maxilla, Proc. frontalis

Septum orbitale

Tarsus inferior Fig. 631 O rbital o p e n i n g , Aditus orbitalis, with eyelids, Pa lpebrae, a n d lacrimal gland, Gla n d u la lacrimalis.

N. lacrimalis Glandula lacrimalis. Pars orbitalis

R. communicans cum nervo zygomatico

Palpebra superior ----'�--IU

Sutura sphenozygomatica M. rectus lateralis N. opticus [II]

Palpebra inferior

Os sphenoidale, AJa major

R. communicans cum nervo zygomatico

Fissura orbltalls Inferior N.

Foramen zygomaticoorbitale

Infraerblmlls

zygomaticus

Fig. 632 I n nervation of the lacrimal gland, Glandula lacrimalis; medial view.

Lacri mal apparatus

I M u scles of t h e eye I

Eye b a ll

Optic pathway

To p o g ra p hy

Lacrimal apparatus Fornix conjunctivae superior

Papilla lacrimalis; Punctum lacrimale Plica semilunaris conjunctivae Canaliculus lacrimalis superior M orbicularis oculi

Glandula lacrimalis, Ductuli excretorii

Fornix sacci lacrimalis Caruncula lacrimalis Saccus lacrimal is

--

-

I-i-+-__

Fornix conjunctivae inferior

>+4---__

N. infraorbital is Sinus maxillaris, Tunica mucosa

Canaliculus lacrimalis inferior Papilla lacrimalis; Punctum lacrimale Concha nasalis media Ductus nasolacrimalis Plica lacrimalis Meatus nasi inferior Concha nasalis inferior

Fig. 633 Lac rimal a pparatus, Apparatus lac rimalis; the eyelids have been pu lled away fro m the eyeball; the nasolacrimal duct has been ope ned u p to the i nferio r nasal meatus.

Caruncula lacrimalis

Canaliculus lacrimalis superior Saccus lacrimalis

Fornix saccI lacrimalis

Maxilla, Proc frontalis

M orbicularis oculi Papilla lacrimal is; Punctum lacrimale Fig. 634

Canaliculus lacrimalis inferior M obliquus inferior

Ductus nasolacrimalis

Lac rimal a pparatus, Apparatus lacrimalis.

M obliquus inferior Sinus maxillaris

Ductus nasolacrimal is

Fig. 635 Lacrimal a pparatus, Appa ratus lac rimalis; the nasolacrimal duct and the nasolacrimal canal have been opened.

Eye

S ke leton

Eye l i d s

M.

obliquus inferior

mf---f-':"':J�----';----------

M

M. obliquus superior --------tlevator palpebrae superioris -------�",.;;._ if""�