Aflasof HumanAnatomy

Editedby R.PutzandR.Pabst
Putz
withRenate
in collaboration

13th,revised
Edition
byDr.M.Lutz,K.Kopsieker
Translated
Budowick,
of Michael
Withtheassistance Dietz,
Sarah
Dr.DorotheaHennessen
768colouredplates
76tables

& FISCHER
URBAN . Jena
M unich
Addressesof the editors: This atlas was founded by Iohannes Sobottaf, former Professorof Anatomy
ProfessorDr. med. R. Putz and Director of the Anatomical Institute of the University of Bonn, Germany.
Vorstanddes AnatomischenInstituts
Ludwig-Maximilians-Universitat
PettenkoferstraBe1I
80336 Mtinchen, Germany GermanEditions:
1. Edition: 1904-7907I. F. LehmannsVerlag,Munich
2.-11.Edition:1913-19441. F LehmannsVerlag,Munich
frofessor Dr. med. R. Pabst
Leiter der Abteilung fiir Funktionelle und 12.Edition: 1948and following editions Urban & Schwarzenberg,Munich
Angewandte Anatomie 13.Edition:1953
MedizinischeHochschule,Hannover 14.Edition:1956
Carl-Neuberg-StraBe 15.Edition:1957
I
30625 Hannover.Germanv 16.Edition:1967(ISBN3-541{2816-5)
17.Edition:1972(ISBN3-541{2817-3)
18.Edition:1982(ISBN3-541-02818-1)
19.Edition:1988(ISBN3-541-02819-X)
This atlas consistsof two volumes: 20. Edition:1993flSBN3-541-1736GX)
Vol. 1: Head,neck, upper limb 21. Edition: 2000 (ISBN 3-437-4194U41

Vol. 2: Thorax, abdomen,pelvis, lower limb

Foreign Editions:
Arabic Edition
Translation: Dr.M. Lutz Modern TechnicalCenter,Damascus
K.Kopsieker ChineseEdition
Editorial staffat Dr. med. DorotheaHennessen HoChi Book Publishing,Taiwan
Urban & Fischer: AlexanderGattnarzik
CroatianEdition
Producer: RenateHausdorf Naklada Slap,Jastrebarsko
Coverdesign: CarctenTschirner
Coverillustration: MichaelBudowick Dutch Edition
Bohn Stafleu van Loghum,Houten
English Edition (with nomenclaturein English)
Lea& Febiger
previous English Edition (with nomenclaturein Latin)
Urban & Schwarzenberg,Munich
French Edition
Atlas dAnatomie Humaine
Tec& Doc Lavoisier,Paris
Greek Edition
GregoryParissianos,Athens
Hungarian Edition
az ember anat6miiijiinakatlasza
SemmelweisKiad6
IndonesianEdition
Nomenclaturein Latin
Atlas Anatomi Manusia
Vol. 1 Head,Neck, Upper Limb. - l3th Engl. ed. - 2001 PenerbitBuku KedokteranEGC.Iakarta
Vol. 2 Thorax, Abdomen,Pelvis,Lower Limb. - 13th Enel. ed. - 2001 Italian Edition
Atlante di AnatomiaUmana
UTEI Torino
IapaneseEdition
Igaku Shoin Ltd., Tokyo
Korean Edition
Panmun Book Company,Seoul
Polish Edition
Atlas anatomii cztowieka
Urban & Partner
PortugueseEdition (with nomenclaturein Portuguese)
Atlas de AnatomieHumana
Editoria GuanabaraKoogan,Rio de Ianeiro
All rights, including that of translation, reserved.No part of this publication PortugueseEdition (with nomenclaturein Latin)
may be reproduced, stored in a retrieval system, or transmitted in any other Atlas de AnatomieHumana
form or by any means,electronic,mechanical,recording,or otherwisewithout Editoria GuanabaraKoogan,Rio de Ianeiro
the prior written permission of the publisher. SpanishEdition
Atlas de Anatomia Humana
Typesetting:Typodata,Munich Editorial Medica Panamericana,BuenosAires/Madrid
Reproduction:Typodata,Munich Turkish Edition
Printed in Germanyby Appl, Wemding Insan Anatomisi Atlasi
@ Urban & Fischer 2001 Beta Basim Yayim Dagitim, Istanbul

Up-tGdateinformation you find under:

Urban & Fischer:http://wwwurbanfischer.de
 Preface
Following the extremely good illustrations in the last edition of R.Pabst:Head,neck, thoracicwall, abdominalwall, thorax,
the Atlas which was brought into being by I. Sobottain 1903,the abdomen,
Pelvis.
editors and publishers askedthemselveswhat could be improved
upon in such a classic work. It became clear from the many The followingartists haveearnedour thanks for the many new
letters and discussions with students and colleaguesthat the drawingswhich they have producedin their alreadyproven
concept obviously still fits into the panoramaof study, and that manner:Ulrike Brugger,RtidiSerHimmelhan,SonjaKlebe,and
the macroscopic anatomy remains without question, together Horst RuB.It is due to their effortsthat the tried and tested
with other basic sciences,one of the fundaments of medicine. "sobottaStyle"hasbeenmaintained. Thefreeelectronicprocess-
Although the Atlas is primarily directed at those studying pre- ing of the photographs aswell as the production of the printswas
clinical medicine, it has neverthelessas "The Book for life as a carriedout by MichaelBudowick.We are also gratefulto our
doctor" all that is necessary to be a companion through the colleagues in the variousclinicswho put the illustrationsat our
clinical studies and a reference book during working life. In disposalfor this editionaswell (seeAcknowledgements).
accordancewith the most importan/urgent wishes, the new
edition has a series of alterations. We wouldlike to thank the colleaguesfrom the instituteswho
were involvedmost sincerelyfor their understanding and for
In the new edition we have the very importantstimulus.Dr. N. Sokolovand A' Buchhorn
- a total of 133 new illustrations drawn based on original prepareddissectionsmeticulouslyto serveas a basisfor many
dissections,e.g.the series of sectionsof the brain and thorax, S.Fryk andG.Hoppmannassisted
newillustrations; us with our
- replacedthe black and white illustrations, word processing.
- brought illustrations ofclinical applicationup to date according
to the developmentof the technique,e.g.endoscopyor X-ray, The editorswouldfinally like to thank explicitlythe colleagues
- introduced the schematicofjoint strain and of the editorialoffice,especiallyDr. DorotheaHennessen and
- revisedthe tables of musclescompletely. A. Gattnarzik,w-hodespite external turbulence consistently
accompanied the productionof the new edition.The production
As the second important goal we have improved the readability was lookedafter in the initial stagesby P. Mazzettiand finally
by carriedout with greatcommitmentby R. Hausdorf.RenatePutz
- the introduction of conspiciouscolours for the chapters, was responsiblefor the conversionof the NominaAnatomica
- colour coding the labelling of topographicillustrations, and for the standardisation of the references and the texts'A
- the consistent addition of orientation sketches to the cross specialthanksto all the peoplewho devotedthemselves to the
sectionsand line of vision, nerve-rackingproof readingand the putting togetherof the
- the revision and new arrangement of the tried and tested index. If "Sobotta"is able to appearwith new contentsand
tables and by in new splendourthen it is due to the entirely constructive
- the introduction of small "wind mills" drawing your attention collaborationof all concerned. We wouldalsolike to thank our
t0 the surrounding illustrations. familiesfor their understanding of the lack 0f time we had for
them.
Of course, the new nomenclature (Terminologia Anatomica),
which has been valid since October1998,has been included.The Many innovationsin this atlas are basedon the critic and
glossaryaids th0se interestedin the backgroundof our specialist suggestionsmade by studentsand colleagues.The editors
languagc. were and are extremelythankfulfor theseand would ask the
users of this edition not to shy away from sendingus their
The division of the revision of the chapters, apart from the comments.
common discussionsover the conceptand the mutual correction,
was retained and is as follows:
R. Putz: General anatomy upper limb, brain, eye, ear, back, MunichandHannover, 1999
September
lower limb: R. PutzandR.Pabst
 Contents(volumel
)
Generalterms of direction and position in
the body VII Cranial Cavity,Cavitascranii, and Dura Mater
Referencesto the colouredillustration of the Brain, Dura mater cranialis 258-259
plates . VII Vesselsof the Head 260-266
A c k n o w l e d g e m e n.t.s. VIII Nerves of the Brain, Nervi craniales 2 6 7- 2 7 7
Dura Mater of the Brain, Dura mater cranialis, and
A r a c h n o i dA,r a c h n o i d emaa t e r c r a n i a l i s. . . . . . . . . 278-281
Vesselsof the Brain 282-285
B r a i n ,C e r e b r u m. . . . 286-293
Diencephalon 294-295
Parts and Regionsof the Body 1-5
PassiveLocomotorSystem
M i d b r a i n ,M e s e n c e p h a l o.n, . . . 296-298
6-10
Active LocomotorSystem
Brain Stem,Truncus encephali 299-300
1l-12
Digestiveand RespiratorySystem
Nuclei of the Cranial Nerves . 301
13
UrinaryTractandGenitalOrgans......
Cerebellum 302-305
14
EndocrineSystem
Ventricular Systemand SubarachnoidSpace 306-315
15
VascularSystem
DeepVesselsof the Brain 316-317
16-21
Fornix . 3lB-319
SurfaceProjectionof the InternalOrgans 22-23
Central and PeripheralNervous System
Associationand CommissuralFibres 320
24-27
Internal Capsule,Capsulainterna, Pyramidal Tract,
Skin and Appendages 28-29
Tractus pyramidalis,and BasalNuclei . 321-323
Frontal Sectionsof the Brain 324-327
Head,Caput, and Neck, Collum
Horizontal Sectionsof the Brain 328-334
30-r 63
Sagittal Sectionsof the Brain 335-338
Magnet ResonanceTomographySectionsof the
Regionsof the Head and Neck, Regiones
B r a i n. . .. 339-340
capitis et colli . . . 30-31
SpinalCord,Medullaspinalis . . . . . . 3 4 1- 3 5 5
Skull, Ossacranii, and TemporomandibularIoint,
Articulatio temporomandibularis 32-71
Muscles,Vesselsand Nervesof the Head 72-88 E y e ,O r g a n u vmi s u s . ..... 356-380
Nose,Nasus externus,and Nasal Cavity,
Cavitasnasi .. 89-91 Eyelid,Palpebrae, andOrbitalCavity,Orbita. 356-360
ParanasalSinuses,Sinusparanasales.. 92-94 LacrimalApparatus 361
Oral Cavity,Cavitasoris . . . 95-96 E x t r a o c u l a r M u s cM l euss, c u lbi u l b i . . ...... 362-365
Maxilla and Mandible,Mandibula 97-98 Eyeball, Bulbusoculi 366
Teeth,Dentes 99-106 Vessels of the Eye 367
Palate,Palatum t07 Iris andPupil. . 368
Tongue,Lingua . l 0 B -1 1 2 LenseandOcularFundus, Fundusoculi . . . . . 368-371
SuprahyoidMuscles,Mm. suprahyoidei, OpticNerve,N.opticus .... 372-373
and Hyoid Bone,Os hyoideum 113 V i s u aPl a t h w a .y. . . . 374-375
LargeSalivaryGlands,Glandulaesalivariae Muscles,Vessels andNervesof the Orbital
maJores 114-117 Cavity. 376-379
Arteries and Nerves of the Tongueand Palate t1B Sections of the OrbitalCavity . 380
Baseof the Skull, Basiscranii ll9
Vesselsand Nerves of the Tongue 120-l2l
Frontal Sectionsof the Head 122-123
Larynx 124-133
Overview 381
Thyroid Gland, Glandulathyroidea 1 3 4 -1 3 5
Auricre .::::::::::.:.::::::::.. 3Bz
Pharynx 1 3 6 -1 4 0
- 159 AuricularMuscles,Musculiauriculares 383
Muscles,Vesselsand Nerves of the Neck 141
ExternalAcousticMeatus,Meatusacusticus externus,
Sectionsof the Head and Neck 160-163
andTympanicMembrane, Membranatympani. . . . 384
AuditoryOssicles,Ossicula auditoria 385-386
TympanicCavity,Cavitastympani . . 387-389
AuditoryTube,Tubaauditiva ...... 390-391
InternalEar,Auris interna . . 392-396
AuditoryandVestibularPathways 397
TemporalBone,Ostemporale 398
SurfaceAnatomy 164
NervesoflnternalEar ...... 399-400
Bones, Ioints,Ligaments 165-185
Musclesof the UpperLimb . 186-222
V e s s e l s a n d N e r v e s o f t h e U p p e r .L.i m b .... 223-250 Appendix 401-417
CrossSections of the UpperLimb . . 251-256
Areasof Distributionof the CervicalPlexusand Index.. 401-417
the BrachialPlexus. 25a
 Contents(vrlumc
II)
PleuralCavity, Cavitas pleuralis, and
Generalterms of directionand positionin Mediastinum 1 1 4 1- 1 5
the body VII Aorta.. 116-117
Reference t ost h e c o l o u r e idl l u s t r a t i opnl a t e s. . . . . . . VII Posterior Mediastinum ll8-119
Acknowledeements... VIII i ce r v o uSs y s t e m , P aarus t o n o m i c a . . . . . . .
A u t o n o mN 120-l2l
Sections throughthe Thorax 122-131

Back t47

SurfaceAnatomy 1
VertebralColumn,Columnavertebralis 2-26 Stomach, Gaster. 132-136
Musclesof the Back,Mm. dorsi,Musclesof the Nape SmallIntestine, Intestinum tenue. 137-139
of the Neck,Mm. suboccipitales,
and Neck Muscles, Colon.. 140-141
Mm. colli 27 -40 LiveqHepar,Gallbladder, Vesicabiliaris,and
Sectionsthrough the VertebralColumn 4l BiliaryDucts 142-149
Vesselsand Nervesof the Backand of the Occipital Pancreas 150-152
Region. .. 42-45 Spleen, Splen[Lien] 153
Vesselsand Nervesof the VertebralCanal. 46-47 Peritoneal Cavity,Cavitasperitonealis, Development . 154-155
Positionof theAbdominalViscera,Situsviscerum . . 156-167
Truncuscoeliacus andAa.& Vv.mesentericae
ThoracicandAbdominalWalls . 48-75 superiorandinferior 168-177
Portalvein,V. portae 178-179
SurfaceAnatomy 48 Kidney, Ren[Nephros] 180-186
Ribs,Costae 49-50 a l a n dG, l a n d u lsau p r a r e n a l i.s. . . . . . . . .
S u p r a r e nG 187
Sternum .. 51-52 UrinaryBladder,Vesicaurinaria..... 187-188
Thoracic Cage,Caveathoracis 53 MaleUrogenital Organs 189-193
MammaryGland,Mamma... 54-55 FemaleUrogenital Organs 194-204
Vesselsand Nervesof the Thoracicand Abdominal Rectum ... 205-207
W a l l s. . 56 A. renalis 208
SegmentalSensoryInnervation 57 Vessels andNervesofthe Retroperitoneal Space. ... 209-221
Musclesof the Thorax,Mm. thoracis,and Abdominal PelvisandPerineum, ExteriorMaleandFemale
Muscles,Mm. abdominis 5B-66 GenitalOrgans ... 222-239
InguinalCanal,Canalis
inguinalis .. 67 Sections throushthe AbdomenandPelvis 240-261
Diaphragm,Diaphragma 68-70
LumbosacralPlexus,
Plexuslumbosacralis
. 71
AnteriorAbdominalWall 72-73
throuehtheAbdominal
Sections Wall . 74-75
SurfaceAnatomy 262
Thorax 76-131 Bones,IointsandLigaments 263-307
Muscles of theLowerLimb . 308-347
H e a r tC
, or .. 76-91 BloodVessels andNerves . . . 348-378
Trachea 92-93 Sectionsthroughthe LowerLimb . . 379-386
L u n g sP, u l m o n e.s. . . 94-102 Distributionof the Nervesof the Plexus
OutlineSilhouette of the Heart 103 lumbosacralis .... 387-388
Projection of the Tracheaand Bordersof the Lungs
a n dP l e u r a 104-105 Appendix 389-405
Oesophagus 106-110
Thymus lll-113 Index.. .'..389-40
 Generaltermsof directionandpositionin the body
The following terms indicate the relative location of organs
longitudinalis= running lengthways(e.g.Musculuslongitudina-
lis superiorof the tongue)
and parts of the body to each other, partly without taking
into considerationthe position of the body in space as well
sagittalis= lying on a sagittalplane
transversalis = lying on a transversal,/transverse
plane
as the location and direction to the extremities.This concept
=
transversusrunningtransversely (e.g. Processus
transversus
of
is not only acceptable for human anatomy but also for
practical medicine and the comparativeanatomy.
the thoracicvertebrae)

General terms
Terms of direction and position for the extremities

anterior - posterior = from the front - from the back (e.g.

proximalis - dktalis = at the base of the extremity - at the end of
Arteriae tibiales anterior et posterior)
the extremity (e.g. Articulationes radioulnares proximalis et
ventralis - dorsalis = lying ventral - dorsal
distalis)
superior- inferior = above- below (e.g. Conchaenasalessuperior
et inferior) For the upper limbs:
cranialis - caudalis = lying cranial - caudal radialis - ulnaris = relatinS to the radial - relating to the ulnar
dexter - stnister= right - left (e.g. Arteriae iliacae communes side (e.g. Arteriae radialis et ulnaris)
dextra et sinistra)
For the hand:
internus - externus = internal - external
palmaris - dorsalis = relating to the palm - relating to the back of
superficialis - profundus = superficial - deep
the hand (e.g. Aponeurosis palmaris, Musculus interosseus
medius, intermedius = lying in the middle between two other
dorsalis)
things (the Concha nasalis media lies in the middle between
the Conchanasalis superior and inferior) For the lower limbs:
medianus= lying on the middle line (Fissuramediana anterior of tibialis - fibularis = relating to the tibial side - relating to the
the spinal cord).By making a median sagittal sectionthe body fibular side (Arteria tibialis anterior)
is dividedinto two mirror images.
medialis - Iateralis = lying towards the middle of the body, lying For the foot:
towards the side (e.g.Fossaeinguinales medialis et lateralis) plantaris - dorsalis = relating to the sole of the foot - relating to
frontalis = relating to the plane of the forehead (frontal plane), the back of the foot (instep)(e.g. Arteriae plantareslateralis et
(e.g.Processusfrontalis of the maxilla) medialis,Arteria dorsalis pedis)

to the colouredillustrationplates
References
The multi-colouredillustrations of this book are basedon didactic Thefollowingplatenumbersindicatenewlydeveloped platesas
observations:The contrasts should be emphasized.Where it is well as drawingsdueto fundamental corrections:
difficult to differentiatebetweenstructures,they should be made U.Brugger
easily recognizable.The colours used for the different kinds of 3 6 - 3 8 ,5 2 , 5 3 ,6 1 ,1 3 6 ,1 3 7 , 2 3 5 - 2 3 7 , 2 8 4 , 3 9 6 - 349380, ,4 3 1 ,
tissue (such as tendons, cartilage, bone and muscles) and the 532- 534,537,539- 5 41,551,570- 577, 598
tracts (such as arteries, veins, lymphatic vessels,nerves) are M. Budowick
different from those found in a living, dead or preserved body. 449,452,474,486,498,548
Here, arteries are red, veins are blue, nerves yellow, lymphatic R. Himmelhan
vesselsand glands are generally representedas green. 437
In addition to the artists who createdthe basis for the complete S.Klebe
collection of illustrations with Prof. Sobotta and the following 138,460,507,508,511-514
editors Prof. Becher,Prof. Ferner and Prof. Staubesand(K. Hajek, H. Rintelen
Prof. E. Lepier,F. Batke,H. v. Eickstedt,K. Endtresser,I. Kosanke, 604-606
J. v. Marchtaler,I. Dimes, U. Brugger,N. Lechenbauer,L. Schnell- H. RulJ
biicher, and K. Schuhmacher),the following also drew for the 22 (insert),144,338-340,444,445,447,449,477,472,545,687
current edition: Ulrike Brugger, Rtidiger Himmelhan, Sonja
Klebe, and Horst RuR. A series of original photographs were
worked over electronically by Michael Budowick. A number of
computer diagrams were producedby Henriette Rintelen.
 Generaltermsof directionandpositionin the body
Iongitudinalis = runninglengthways (e.g. Musculuslongitudina-
The following terms indicate the relative location of organs
and parts of the body to each other, partly without taking
lis superiorof the tongue)
into considerationthe position of the body in space as well
sagittalis= lying on a sagittalplane
transversalis = lying on a transversalplane
as the location and direction to the extremities.This concept
transversus = runningtransversally (e.g.Processustransversus
is not only acceptable for human anatomy but also for
practical medicine and the comparativeanatomy. of the thoracicvertebrae)

Generalterms
Terms of direction and position for the extremities
anterior - posterior= from the front - from the back (e.g.
proximalis - distalis = at the base of the extremity - at the end of
Arteriaetibialesanterioret posterior)
the extremity (e.g. Articulationes radioulnares proximalis et
ventralis- dorsalis= lying ventral - dorsal
distalis)
superior- inferior= above- below(e.g. Conchaenasalessuperior
et inferior) For the upper limbs:
cranialis- caudalis= lying cranid - caudal radialis - ulnaris = relating to the radial - relating to the ulnar
dexter- sinister= right - left (e.g.Arteriaeiliacaecommunes side (e.g.Arteriae radialis et ulnaris)
dextraet sinistra)
For the hand:
internus- externus=internal- external
palmaris - dorsalk = relating to the palm - relating to the back of
superficialis- profundus= superficial- deep
the hand (e.g. Aponeurosis palmaris, Musculus interosseus
medius,intermedius= lying in the middle betweentwo other
dorsalis)
things(the Conchanasalismedialies in the middlebetween
the Conchanasalissuperiorandinferior) For the lower limbs:
medianus = lying on the middleIine (Fissuramedianaanteriorof tibialis - fibularis = relatinS to the tibial side / relating to the
the spinalcord).By makinga mediansagittalsectionthe body fibular side (Arteria tibialis anterior)
is dividedinto two mirror images.
medialis- Iaterdlis= lying towardsthe middleof the body,lying For the foot:
towardsthe side(e.g.Fossae inguinalesmedialiset lateralis) plantaris - dorsalis = relating to the sole of the foot - relating to
frontalis= relating to the plane of the forehead(frontal plane), the back of the foot (instep)(e.g. Arteriae plantareslateralis et
(e.9.Processus frontalisof the maxilla) medialis,Arteria dorsalis pedis)

to the colouredillustrationplates
References
Themulti-coloured illustrationsof this bookarebasedon didactic Thefollowingplatenumbersindicatenewlydevelopedplatesas
observations: The contrastsshouldbe emphasized. Whereit is well asdrawingsdueto fundamental corrections:
difficult to differentiatebetweenstructures,they shouldbe made U.Bruger
easilyrecognizable. The coloursusedfor the differentkinds of 707,923,924,927- 932,934, 936,937,1366,r37I
tissue(suchas tendons,cartilage,boneand muscles)and the R. Himmelhan
tracts (suchas arteries,veins,lymphaticvessels,nerves)are 1367,1368,1370, r372, 1374,1375
different from thosefound in a living, deador preservedbody. S.Klebe
Here,arteriesare red,veinsare blue,nervesyellow,lymphatic 1162,fi74, 1175, 1218,1222,1223,1250,1349
vesselsandglandsaregenerallyrepresented asgreen. H. Ru/)
In additionto the artistswho createdthe basisfor the complete 7 88,798, t28l - 1284,1302- 1304
collectionof illustrationswith Prof.Sobottaand the following
editorsProf.Becher, Prof.FernerandProf.Staubesand (K.Hajek,
Prof.E.Lepier,F.Batke,H.v. Eickstedt, K. Endtresser,
I. Kosanke,
I. v. Marchtaler, K. Dimes,U. Brugger, N. Lechenbauer,L. Schnell-
bdcher,and K. Schuhmacher), the followingalso drew for the
current edition: Ulrike Brugger,Riidiger Himmelhan,Sonja
Klebe,und Horst RuB.A seriesof original photographs were
workedover electronicallyby MichaelBudowick.A number of
computerdiagramswereproducedby HenrietteRintelen.
 Acknowledgements
The editors would like to thank the following colleaguesfor Prof. Reiser & Dr. Glaser, Institute of Clinical Radiology,
providing the pictures of ultrasound,computedtomography, Universityof Munich
magneticresonancetomographyas well as endoscopicand (figs.307,578-582,705a, b, 771,1369,1371,1373,1377)
colourphotographs of operationalpractice: Prof.Rudzki-Janson, Polyclinicfor Orthodontics,Universiryof
Munich
(figs.80,B1)
Prof.Altaras,RadiologyCentre,GieBenUniversity Dr. Scheibe,Departmentof Surgery,RosmanHospital,Breisach
(figs.964,979,980) (figs.1233a-c)
Dr.Baumeister, Department of Radiology,FreiburgUniversity Prof.Schillinger, Clinic,Universityof Freiburg
Gynaecological
(fig.1095) (figs.1072-1074)
Prof.Daniel,Departmentof Cardiology, Universityof Medicine, Dr. Dr. Schliephake,Facio-MaxillarySurgery,University of
Hannover Medicine,Hannover
(figs.862-864,935) (figs1 . 67,212,2131
Prof. Galanski & Dr. Kirchoff, Department 1 of Diagnostic Prof. SchliiBer,GynaecologyCenhe, University of Medicine,
Radiology, Universityof Medicine,Hannover Hannover
(figs.924,1144a,b,1154, 1155) (figs.1071a, b, 1080,1082,1083,1130)
Prof. Galanski & Dr. SchZifer,Department 1 of Diagnostic Prof. Schuhmacher, Neuroradiology,Departmentof Radiology,
Radiology, Universityof Medicine,Hannover Universityof Freiburg
(figs.838a,b, 888,933,958, 1139,1147,ll50, ll52l (figs.448a,b)
Prof. Gebef Departmentof Gastroenterology and Hepatology, Dr. Sommer& AssistentProf.Bauer,Radiologists, Munich
UniversityofMedicine,Hannover (figs.650,1234-12361
(figs.253a,b,966,975,976,981,990,991,1026, 1043) Prof.Stotz,Orthopaedic Polyclinic,
UniversityofMunich
Dr.Goei,Radiology, Heerlen,TheNetherlands (fig. 1193)
(figs.1010,101I) Prof.Vogl,Polyclinicfor Radiology,Universityof Munich
(with permissionfrom Radiology173:137-141,19891 (figs.440,442,631,6321
Dr.Greeven, St.ElizabethHospital,Neuwied Prof.Vollrath,ENTClinic,Mtinchengladbach
(figs.166,1182) (figs.246-2481
Prof.von der Hardt,PaediatricClinic,Universiryof Medicine, Prof. Wagner(dec.),DiagnosticalRadiologyII, Universityof
Hannover Medicine,Hannover
(figs.893) (figs.914, 1014,10121020,1023,1090)
Dr. Hennig,Departmentof Radiology, Universityof Freiburg Prof.Wenz,Departmentof Radiology,Universityof Freiburg
(fig.529) (fie.747l
Prof.Ionas,Urology,Universityof Medicine,Hannover Dr. Willftihr, Departmentfor Abdominaland Transplantation
(figs.1050a,b, 1051) Surgery,UniversityofMedicine,Hannover
Prof.Kremers,Polyclinicfor DehtalPreservation and Periodon- (fig. 1001)
tics,Universityof Munich AssistentProf.Wimmer,Department Universityof
of Radiology,
(fig. 182) Freiburg
Prof.Kunze,Paediatric Clinic,Universityof Munich (tig.778)
(figs.15-18)
Dr. Meyeq Department of Gastroenterologyand Hepatology,
Universityof Medicine,Hannover Additionalillustrationsweretakenfrom the followingbooks:
(figs.906.949a,b, 959,1086)
Prof.Pfeifer,RadiologyDepartmentof the SurgicalClinic,Uni- Birkner, R: The typical X-ray of the skeleton,Urban &
versityof Munich Schwarzenberg, Munich-Vienna-Baltimore 1990
(figs.306, 3r9,321,748-751,789-792,1199,1230,1231,1260, (fig.1200)
1261\ Welsch,U. (Editor):Sobotta- Histology,5th Edition,Urban&
AssistentProf. Rau, Departmentof Radiology,Universityof Schwarzenberg, Munich-Vienna-Baltimore 1985
Freiburg (figs.635,646)
(figs.875,SS6,S87) Wicke, L.: Atlas of X-ray Anatomy,3rd Edition, Urban &
Prof.Ravelli,Instituteof Anatomy,Universityof Innsbruck, Schwarzenberg, Munich-Vienna-Baltimore 1985
(tig.746l (figs.905a, b, 1076)
Prof. Reich,Clinic for Facio-Maxillary Surgery,Universityof Wilhelm,K.,R.Putz,R.Hierner,R.E.Giunta:Plasticsurgeryof the
Bonn hand,Urban& Schwarzenberg, Munich-Vienna-Baltimore 1997
(figs.133,134) (fig.s8)
 SurfaceAnatomyof theBack

Spinascapulae M.deltoideus
----

M. trapezius

---- M.teresmaior
Angulusinforior- - -
Scapula,

M. latissimusdorsi

M. erectorsoinae- - -

Cristailiaca

-
Arlicufatio sacroiliaca- -

M. gluteusmaximus

VertebralumbalisV,-
Proc spinosus

Fig. 706 The back,.Dorsum;

surfaceanatomy.

Regiocervicalisposterior- - - - - - - Lineamedianaoosteriol

- - -- Lineaparavertebralis

Rogioscapularis- -

R€gio deltoidea - -
-- Linea axillarispoGterior

--f-
Regiovertebralis

Fig.7O7 Regionsand orientation

lines on the back.
 Back,
Dorsum
2

Veriebrae
lhoracicae
t-xI

Veriebrae
lumbales
t--v

Os coccygis

Fig. 708 Vertebralcolumn, Fig.709 Vertebralcolumn, Fig. 710 Vertebralcolumn,

Columnavertebralis; Columnavertebralis; Columnavertebralis;
the intervertebraldiscs dorsalview (30%). the intervertebraldiscsare
are indicatedin blue; indicatedin blue;
ventralview (30%). left lateralview (30%).
 VertebralColumn,Columnavertebrdlis

Clavicula \ '7 Yedebra

cervicalis Vl
- VertebracervicalisVll
- Verlebra cervicalis Vll [prominensl
-- Vertebra
Iprominens]
lhoracicaI
z Canalis verlebralis
- Clavicula,
Extremitas
sternalis - Scapula
- Manubflum
sterni

- Corpus
)-
slernl

,..';:j

.,.",ii
- Arcuscostalis

:.::':i/ifl C o s t aX l - - r )../ /
CostaXll /
- Costaxl /
\ costa Xll Vertebralumbalis|
!.,,i/',

r;rjarn l .*.qr# -
Vertebra lumbalis lll
f
-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-..-.tv

:?iif-/
!-a
-i,,;rii

-- Spina iliaca
anterior superior

\
Promontorium -Os
sacrum

,l -Os
coccygrs
.\ /
-
Facies symphysialis
Sprna Femur-
ischiadica

'Tuber
ischiadicum

Fig. 711 Vertebralcolumn,Columnavertebralis; Fig.7l2 Vertebralcolumn,Columnavertebralis;

shouldergirdle,Cingulumpectorale;
pelvicgirdle, shouldergirdle,Cingulumpectorale;pelvicgirdle,
Cingulumpelvicum; Cingulumpelvicum;
the vertebralcolumnhasbeensectioned
in the median the vertebralcolumnhasbeensectionedin the median
plane;left medialview (25%). plane;left lateralview (25%).
 Back.Dorsum

LamtnaarcusI
Incisura
vertebralis
superior vertebrae
i
I Proc articularis
[Zygapophysis] Foramen. :
supenor costotransversarium Proc spinosus
Foveacostatis
superior i I i I
I
/ Pediculus
arcusverlebrae ArticulatroI Proc articularis
lzygapophysis]
costotransversaria supeflor
;
Costa
I i Proc transversus
Epiphysis.'
t; I
t
anulafls

- Fovea
/ Ptoc
/ costalis
spinosus processus
transversi
Corpus - I uoerculum
vertebrae costae Foramen
vertebrale
/
Epiphysrs '/ - Pediculus
anularis' Collum costae I

/t arcus
verlebrae
/t
Factes /
i Caputcostae
intervertebralis / Fovea
i / _-\ coslalis
Foveacostalisinterior/ Articulaliocapitis
/ supeflor
coslae Epiphysis
lncisuravertebralis
inferior / anularis *
/
Corpusvertebrae,
Faciesinteruertebralis

Fig. 713 Vertebra,Vertebra;the fifth thoracic Fig.7l4 Vertebra,Vertebra;the fifth thoracic

vertebra is shown as an example with the typical vertebra is shown as an example with the typical
structure; lateral view (80%). structure; superior view (80%).
' also, rim ' also. rim of vertebral
of vertebral bodv bodv

Structural characteristics of vertebrae (Atlasand Axis excluded)

7 cervical vertebrae,
12 thoracic vertebrae, 5 lumbar vertebrqp;, Sacralbone, Os sacrum
Vertebraecerviqoleg,
Vertebrae thoracieae Vertebraelumbalest:r:r:fornedby 5 vertebrae
I-vII r-xII I-V r,:.li:l
:ir [Vertebraesacralos]
rI...Vl
Upperand lowersurfaces Rectangular, small, Triangular,becoming Large,bean-shaped
of the vertebralbody with Uncicorporumon roundercaudally
the uppersurfaces
Vertebralforamen, Large,triangular Roundcrosssection Small, triangular Sacralcanal,Canalis
Foramenvertebrale crosssectt0n crosssection sacralis,
ovalcrosssection
Articular surfaces, Obliqueslope Frontalposition,slope Lateral part: Fusedto the Crista
Procc.articulares :1. towardsdorsal towardsdorsal sagittal position; sacralismedialis
:irr l
[Zygapophyses] medialpart:
ftontal position
Procc.transversi Containa Tuberculum Club-shaped,
with Procc.mammillares Fusedto theCrista
anterius,a Tuber- Foveae
costales et accessorii sacralislateralis
culumposterius,a
Sulcusnervispinalis
anda Foramen
transversarlum
Procc.
spinosi Horizontal,
short, Inclination towards Horizontal, Fusedto the Crista
biturcated caudalvaries laterallyflattened, sacralis
mediana
masslve
Rudiments
of ribs Ventralpart of the None,because the Procc.costales Parteslaterales
Proc.transversus and ribs aredeveloped
Tuberculum dorsale
Characteristic
feature Foramen Foveae
costales Procc.mammillares Synostosis
of
transversarium superioret inferior et accessorii vertebrae
 Vertebrae {
a-'/

Figs.715a-e Regionalcharacteristics of the vertebrae.Only

in the thoracicregionof the vertebralcolumndo the lateral
parts (colouredred) remainseparatedand form ribs.
a first cervicalvertebra,Atlas
b fourth cervicalvertebra,VertebracervicalisIV
c first thoracicvertebra,VertebrathoracicaI, shownwith
the adjacentribs, Costae;and the sternum,Sternum
d third lumbarvertebra,VertebralumbalisIII
e sacralbone,Ossacrum

Epiphysis
anularis'/

Proc.costalis
Proc.accessoriusl

Fig.716 Vertebraldevelopment. Fig.7l7 Vertebraldevelopment.

Appearanceofthe primary ossificationcentres(Pedicle, Ring-shaped ossificationcentres(*rims) appearin the
secondfetal month;body,3rd to 6th fetal months),as vertebralbodiesduring the 8th yearof life. Theyfuse
exemplifiedin a lumbarvertebra.Thesynostosisof the with the vertebralbodiesuntil the 18thyearof life. The
ossificationcentresof the vertebralarchwith thoseof the centralparts of the epiphysisremaincartilaginous
bodyoccursbetweenthe 3rd and 6th yearsof life. laminae" * throughoutlife. Secondary ossificationcentres
(apophyses) appearin the processes ofthe vertebra.
Back,Dorsum

Tuberculum
anterius.
I Arcusanterioratlantis
Foramen vertebrale
/

Massalateralis
Pars - - /_ atlantis
basilaris
Condylus--
occipitalis
Proc /
Foramen -- lransversus
magnum - Fossa /
condylaris Foramen /
lransversanum - - Sulcus
arteriae
(Crista - - vertebralis
occipitalis
externa) I Arcusoosterioratlantis
Tuberculumoosterius

Fig.718 Theoccipitalbone,Osoccipitale; Fig.719 Firstcervicalvertebra,Atlas;

Segmentshowingthe foramenmagnumandthe superiorview (85%).
joint;
articularsurfacesof the atlanto-occipital Thesuperiorarticularsurfacesof the atlasare
inferiorview (807o). frequentlydivided.
' Canalisarteriae vertebralis as a variation

Tuberculumanterius Arcusanterioratlantis
\
\ Densaxis \
. Facies articularis inferior / Faciesarlicularissuperior
Fovea dentis -_ Facies \
I
I , Massa lateralis articularis \ / Faciesarticularisinferior
| / atlantis anterior

Fovea - -- ArcusPosterioratlantis
dentis

Proc - -
articularis
supenor

I
Foramen / I -
I Corpus
vertebrale vertebrae
I Fora.en \
transversarium Arcusvertebrae
/
Foramen
Arcusoosterioratlantis transversarium \
l'o" Proc,articularisintenor
Tuberculumoosterius transversus

Fig.72O Firstcervicdlvertebra,Atlas; Fig.72l Firstandsecondcervicalvertebrae,

inferiorview185%). AtlasandAxis;
mediansection;
medialview (90%).

/ Apex dentis
,/ Faciesarticularisposterior

,/ Faciesarlicularis Proc articularis\ ,/ Corpusvertebrae

anlerior superior \
/ Foramen
Proc. 1 ,/ transversarium
.
/ Proc arlicularis transversus
supenor

Proc. / Tuberculum /
transversus anterius For^ -
"n
transversarium Foramen
vertebrale
/
I' \
Tubercrlu. I
Proc. I
articularis postenus Proc.articularis Arcusverlebrae
inferior inferior
Arcusvertebrae
Proc spinosus Proc spinosus

Fig.722 Secondcervicalvertebra,Axis; Fig.723 Secondcervical vertebra,Axis;

ventralview (90%). dorsosuperiorview (90%).
 vertebrae
7

Uncuscoporis.
lProc.uncinatus] Corpusvenebrae, Coryusvertebrae,.
\ Faciesinterverl€bralis Epiphysisanularis\\
Tuberculum-
antenus , Foramentransversarium
Pediculusarcus
Foramen\ verlebrae
Tuberculum- - Sulcus lransversarium
posl€rius netvl
spinalis

Proc.articularis/
sup€not Ptoc'
arlicularis Foramen
supenor vertebrale
Arcusvertebrae Foramenvertebrale
Arcusvertebrae
Laminaarcus
verEbrae
I Proc.spinosus
Proc.spinosusl

Fig.724 Fifth cervicalvertebra,VertebracervicalisVi Fig.725 7th cervicalvertebra,VertebracervicalisVII;

superiorview (100%). superiorview ( 100%).
Thespinousprocesses of the 2ndlo 6th cervical The7th cervicalvertebracaneasilybe identifiedby its
vertebraeareusuallysplit. prominentspinousprocessandis thereforealsocalled
the prominentvertebra,Vertebraprominens.However,the
spinousprocessof the first thoracicvertebraoften
protrudesevenfurther.

'l
Tuberculum
posterius I
I Proc.transversus
7 TuberculumI
/ amenus ,t

CorDusvertebrae-

I
I
Uncicoporis
lProcc.uncinati]

Fig.726 Secondto seventhcervicalvertebrae,Vertebrae Flg.727 Fifth to seventhcervicalvertebrae,Vertebrae

cervicalesII-VII; ventralview (120%). cervicalesI-VII; dorsolateralview (110%).
 Back.Dorsum

Corpus-
vertebrae
Arcus
vertebrae
Foveacostalis -
processus
transversl
Arcusvertebrae/
/
Proc transversus
Foramenvertebrale/

/
Proc.spinosus
Fig.728 Tenth thoracic vertebra,Vertebra thoracicaX; Fig.729 Tenththoracicvertebra,
superior view (90%). VertebrathoracicaX;
ventralview (90%).

Proc accessorius\
,, Proc articularis z proc articularis
/ supet|ol \. / superlor
Foveacostalissuperior\
z - Proc transversus Arcusvertebrae\
-- Ptoc mammillaris
- -
Fovea costalis
processus transversi

Fovea costalis inlerior /

I =-.ryi
lncisuravertebralisinferior
Corpus/ Foveacostalis/
Proc arlicularis
inferior venebrae
Proc spinosus Proc articularis
inferior

Fig. 730 Sixththoracicvertebra,VertebrathoracicaVI; Fig. 731 Twelfth thoracicvertebra,

left lateralview (90%). VertebrathoracicaXII;
left lateralview (80%).
' part of the vertebralarchbetweenthe superior
and inferior articularprocess(sccalledisthmus=
interarticularportion)

Corousvertebrae -

Fig.732 Third lumbarvertebra,VertebralumbalisIII;

medialviewof a mediansection(110%).
Specimenfrom an elderlyperson.
' ossification of ligamentous insertions
 Vertebrae

/ Proc articularis
./ superior

/ Foveacostalisprocessus
/ transversi

Pediculusarcus - Foramen verlebrale

-
venebrae

Proc. .-_ / Ptoc.

- accessorius
coslalrs
)- erocc
sprnosl

/
Proc artrcularis \ Proc mammillaris
supeflor
/
Lamina arcus vertebrae '
Lamina arcus vertebrae

accessonus
Proc sprnosus/

Fig.734 Fourthlumbarvertebra,
VertebralumbalisIV;
superiorview(1007o).

*. Proc mammillaris

I
P r o cc o s t a l i s '
I
Proc accessoflus/
\ Proc
ariicularisinferror
articularesinleriores

Fig. 733 Tenth to twelfth thoracic vertebrae,Vertebrae Fig. 735 Fourth lumbar vertebra,
thoracicaeX-XII, and first and secondlumbar vertebrae, Vertebra lumbalis IV;
VertebraelumbalesI-ll; dorsolateralview (70%). ventralview (1007o).

- - Proc articularissuoerior
Pedrculusarcus verlebrae \

Epiphysisanularis ** \

- Proc spinosus
--
Lamrnaarcusvertebrae

\ Proc arlrcularisinferior

(Foramenvenae
basivertebralis)

Fig. 736 Fifth lumbar vertebra,Vertebralumbalis V; ' the regionof the vertebralarchbetweensuperiorandinferiorarticularprocesses
Herein the fifth andlessfrequentlyin the fourth lumbarvertebraa cleft,
medial view of a median section (110%). can be formed.This is probably
bridgedby connectivetissue(spondylolysis)
Note the characteristic wedge shape of the body of the fifth causedby localbendingstress.As a consequence the superiorvertebramay
lumbar vertebra. slip (olisthesis)ontothe inferiorvertebra(spondylolisthesis).
'* In this specimenthe anteriorrim is pathologically oblique.
 Back,
Dorsum
1 0

-- Tuberositas
ossissacri

--- Cristasacralislateralis

Cristasacralismediana- -
- Cristasacralismedialis

Foraminasacraliaposteriora

Fig.737 Sacralbone,Ossacrum; Cornusacrale

dorsalview (60%).
I
Apex ossis sacri
Proc.articularis
supenor

-\___ Pars lateralis

Lineae transversae - Foramina sacralia anteriora

Fig. 738 Sacralbone,Ossacrum;

view(60%).
ventroinferior
I
Apex ossis sacri

Promontorium
I

Parslateralis_ _ L -

/
/
Proc.arlicularissuperior
/
Canalis sacralis
Fig.739 Sacralbone,Os sacrum;
the bone has been sectionedat the level
ofthe secondsacral vertebra; superior view (55%).
 SacralBone,Ossacrum,and Coccyx,Oscoccygis
11
Proc adicularissupeflor - --;l
T u b e r o s r toasss i ss a c r i- - --.

-
Canalis sacralis

Cristasacralis- - -C-!. -
Foramrnasacralia - - Promontorium
meorana .\ t poslenora

Cnsta sacralis
meorana
Facies pelvica
Facies auriculans

Cornusacrale-- - -
Cornu- - -
coccygeum Apex ossis sacri

-
Apex ossrs sacri

Os coccygis

Fig.74l Sacralbone,Ossacrum;
Fig.740 Sacralbone, Os sacrum; medialviewof a mediansection(45%).
* Even in adults, remnants of intervertebral
lateral view from the right (45%). disc tissue Dersists

Fig.742 Sacralbone, Os sacrum;

Fig.743 Sacralbone,Ossacrum;
genderdifferences,lateralview.
ventralview.
genderdifferences,

/ Cornu coccygeum
7 Yetlebra
z coccygeal

- - Vertebra
coccygeaI

- - Vertebra
coccygeall - Vertebr""
zt-
Jrt coccygeae ll-lv
) vertebrae
coccygeae I v

Fig.744 Coccyx,Oscoccygis; Fig.745 Coccyx,Oscoccygis;

ventrosuperior view ( 105%). view ( 105%).
dorsoinferior
Despitevariationsin the formof the intervertebral
vertebraearejointly termedthe
discs,all postsacral
coccyx.
€
:. Back, Dorsum
=
-s

Fiamus- / P(oc
mandibulae .' mastoideus

Os occipitale
Atlas, Arcus - / /
anlerior

/ Atlas, Arcus
S i nu s
/ ..a
maxillaris

Palatum -
osseum
- Allas,
A x i s ,D e n s Tuberculum
posterius

- Axis, Proc
sprnosus

Axis,Corpus -
vertebrae Incrsura
vertebralis
inferior

Angulus ---- -- Inctsura

mandibulae vertebralis
supenor

Vertebra ----
cervicalislll,
Corpus
vertebrae

Eprglottis --

Os hyoideum -
- Proc articularis
inteflor

- Proc articularis
Drscus inter - supenor
vertebralis

Cartilago *
cflcoidea, -
Lamlna Proc spinosus

Facies intetr - - Pediculusarcus

vertebrales vertebrae

Vertebra -
ceruicalisVll,
Corpus
vertebrae

Fig.746 Cervical vertebrae, Vertebrae cervicales;

a lateral radiograph of the cervical vertebral column
in the upright position. The beam is directed at the
3rd cervical vertebra; shoulders are retracted inferiorly.
 VertebralColumn,Columnavertebralis
13

Proc spinosus

Proc transversus

UncicorDorum
IProcc.uncinatil

VertebracervicalisVl, - - -
Comusverlebrae

Fig.747 Cervicalvertebrae,Vertebraecervicales;
AP-radiograph in an upright position;the beamis focused
on the 3rd cervicalvertebra.
' spacesof the intervertebml discs
 Back,
Dorsum
14

Foramen interuertebrale
Facies interuertebrales - --

Proc spinosus

Pediculusarcus verlebrae

Fig. 748 Thoracicvertebrae, Vertebrae thoracicae;

lateralradiographin an upright position;
the beamis focusedon the sixth thoracicvertebra.
* soace of an intervertebral dis6

arcusvertebrae - -
Pedrculus

Corpusvertebrae --

Costa - -

Articulatiocostolransversafla- -

Proc transversus--

capitiscostae - -
Articulatio

Caputcostae - -

Fig.749 Thoracicvertebrae, Vertebrae thoracicae;AP-radiograph in

an uprightposition;the beamis focusedon the sixth thoracicvertebra.
" spaceof an intervertebraldisc
 n, Columna
vertebralis {
1 \')

Vertebralumbalis l,
Corpus verlebrae

-- Arcusverlebrae,
Pediculusarcusverlebrae
-- Incisura
vertebralis
Inferior

Faciesintervertebrales -

-- Incisura
vertebralis
superior

-- Proc spinosus

Proc arlicularissuoerior
-- Proc arlicularisinlerior

Os ilium, Crista iliaca -

Basisossissacri --
Cristasacralism€diana
Promontorium --j:-:
-=-'na-----
Os sacrum

Fig. 750 Lumbarvertebrae,Vertebraelumbales; ' spaceofan intervertebraldisc

'*
lateralradiographin an upright position;the beamis focused the regionof the vertebralarchbetweenthe superiorand inferiorarticular
pnocesses (so-calledisthmus- interarticularportion)
on the secondlumbarvertebra.Theobliqueanteriorrims of '" herethe courseof the l2th rib can faintlv be seen
the lowerlumbarvertebraeare a pathologicalalteration.
 Back,
Dorsum
16

lumbalisl, --
Vertebra
Corpusvertebrae

superior- -
Proc artrcularis

Articulatiozygapophysialis- -

inferior- *
Proc articularis

Pediculusarcusvertebrae- -

-
Faciesintervertebrales

Foraminasacraliaanteriora - -

Fig. 751 Lumbarvertebrae,Vertebraelumbales;

AP-radiograph in an upright position;the beamis focused
on the secondlumbarvertebra.
r spaceof an intervertebraldisc
 ulations
oftheHead
17

Os occipitale,Parsbasilaris
\
/ Membranaatlantooccipilalis
anterior

,z Os occipitale,Parslaleralis

Os occipitale,Parslateralis

Arliculatioatlantooccipitalis Capsulaarlicularis

- Lig.longitudinale
anterius

- Oiscusinterv€rtebralis
Vert€bra cervicalis lll - -

' Vertebracervicalislll,
Corpusverl€brae

Fig.752 Articulationsofthe headand uppervertebral

column;articularcapsuleshavebeenremovedon the right;
ventralview.

Os occipitale posteriol
, Membranaatlantooccipitalis
\

Lig. allanlooccipitale
lalerale

Tuberculumposterius

Axis.Arcusvertebrae/

Fig.753 Articulations ofthe head;

the articularcapsuleof the atlantcaxialjoint,Articulatioatlanto-
axialislateralis,hasbeenremovedon the left;
dorsalview.
 Back,
Dorsum
1 8
- Os occioitale.Clivus

Sulcussinussigmoidei - - - Os occipitale

Articulalio atlantooccipitalis, - -
Capsula articutaris
- Atlas

Articulatioatlantoaxialis
lateralis, - Membrana tectoria
Capsulaarlicularis

- - Vertebra ceruicalis lll

Vertebracervicalislll, --
Proc. transversus

Fig.754 Articulations ofthe head;

the foramenmagnumandvertebralcanalhavebeen
openedto exposethe deepligaments. Thearticular
capsuleson the right havebeenpartiallyremoved;
dorsalview.

Fasciculilongitudinales \
7 Os occipitale,
Pars basilaris
Li99, alaria \

- Canalis nerui hypoglossi

* Sulcussinussigmoidei

-
Ariiculatio atlantooccioitalis
Caosulaarticularis

\
r - Atlas,Arcusposterior
Articulatio atlantoaxialis lateralis

-
Axis

Fig.755 Articulations ofthe head;

the foramenmagnumandvertebralcanalhavebeen
openedto exposethe deepligaments. Thearticular
capsuleson the right havebeenpartiallyremoved;
dorsalview.

/ Ligg alatia

- *
Lig. apicis dentis

Axis, Oens

Axis,Corpus

Fig. 756 Articulations ofthe head; The alar ligaments,Ligg. alaria, often insert on the lateral
the foramen magnum and vertebral canal have been massesof the atlas as well.
openedto exposethe deep ligaments.The articular
capsules on the right have been removed;
dorsal view
 ,/ Duramatercranialis

Os occioitale,Parsbasilaris- -
.,/ Lig apicisdentis

/ Ouramaterspinalis
Membrana atlantooccioilalisanterior - -
/ Mernbranatectoria

Atlas,Arcusanterior- - rascicurilongitudinales I
\ -
Densaxis,Faciesarticularis .-
anterior - - lf Lrg.transversumatlantisI LiS crucilormeatlanlis
- Jasclcuti
tongituoinates,l
-t
- Nn cervicales, Radices
-
Axis.Dens
/
Dens axis, Facies articulafls oosterior

\\ Membranaatlantooccipitalisposterior
\
z
Discus inlervertebralis

Atlas.Arcusoosterior
/
Vertebracervicalislll,
Corpus vertebrae
Axis,Proc spinosus

Fig. 7 57 Articulations of the head;

mediansection;
medial view.

/ Os occipitale
,/ Densaxis,Facies
/ articularis
anterior - - Articulatioatlanto-
Oens axis, Facies \ occipitalis
articularisposterior \ / / Axis,Dens - - Axis,Dens

Atlas,Arcusanteriol

Atlas,Massalateralis
-
Arliculatioatlanto-
axialislaleralis
--
Axis,corpus
/
Membrana
atlanto- Axis,Proc spinosus
occipilalis
posterior -
Aria,
Proc spinosus

Fig. 758 Articulationsof the head; Fig.759 Articulationsof the head;

the occipital bone has been removed; AP-radiograph,
takenthroughthe openmouth.
suDeriorview.
 Back,
Dorsum
20
--- Fovea costalis
inferior

--- Foveacostalis
supenor
--- Pediculusarcus
vertebrae

Ligg.costo-
lransv€rsaria

Arcus
Discus verlebrae
inlerverlebralis

--- Verlebra
thoracica
Xll,
Corpus
venebrae

Disci
intervertebrales

Fig.760 Ligamentsof the vertebral Fig.761 Ligaments of the vertebralcolumn

columnin the lowerthoracicregion; in the lowerthoracicandupperlumbarregions;
ventralview. the vertebralcanalhasbeenexposed by a
frontalsectionthroughthe pedicles, Pediculi;
dorsal view.

Lig tlavum 7 Procspinosus / Proc transversus

Proc.arlicularissuperior \ / Lig. costo
/ laletale

-
Tuberculumcostae
Articulatiocoslotransversaria-

-
Collum costae
Lig coslolransversarium
-
Lig costotransversarium

'
Pediculus arcus vetlebrae
\
Foramen ve116brale Articulatiocapitiscostae

Lig capiliscostaeradialum

Corpusverlebrae

Fig.762 Costovertebral
articulations,
Articulationes
costo a crosssectionthroughthe lowerpart of the costovertebral
vertebrales: articulationat the headof a rib;
supenorvlew
 ofthevertebrat
cotumn
21
-- Proc articularissuperior

Foveacostalissuperior- -

Corousverlebrae--

- - Ligg @stolransversaria
superiora

-- laterale
Lig coslotransversarium

Lig longitudinale anlerius - -

Lig intertransversarium

Lig capitiscostaeradialum

Fig. 763 Ligamentsof the vertebral column and the costo- the lateralpart of the anteriorlongitudinalligamenthasbeen
vertebral articulations; removed:left lateralview.

Foveacostalis
orocessustransversi

Lagcostotransversarium---
laterale

----
Lig costolransversarium

Laminaarcusvertebrae
/
C o s t a e- - - - ( \

Pediculusarcusverlebrae

Fig.764 Ligaments ofthe vertebral

arches; Theligamentaflavaof the lumbarvertebralcolumnsurround
thevertebral
canalhasbeenopened by a frontalsectionthrough the vertebralarticulationsventrallyas well andtherebyformthe
the pedicles;
ventralview. posteriorwall of the intervertebral
foramina.
 Back,
Dorsum
22
_ / Lig.capitiscostaeintraarliculare

- / Forcmen interverlebrale

- -- Lig.costotransversarium
suoenus

Lig.costotransversarium
laterale

--
Lig longitudinaleanterius - Articulatiocapitiscoslae

- Tuberculumcostae

\ Capulcostae

Fig. 765 Costovertebralarticulations,Articulationes

costovertebrales;
obliqueverticalsectionthroughthe jointsat the headsof
the ribs (costovertebral
articulations);
left lateralview.

lArcusvertebrae

- Ligg.intertransvorsaria

Proc spinosus
- costr"
)-

Lig costotransversarium
superius

Lig.costotransversarium
laterale

Lig interlransversarium--

Laminaarcusvertebrae Lig supraspinale

Fig.766 Ligaments of the vertebralarchesandcosto.

vertebralarticulations,
Articulationescostovertebrales;
dorsalview.
 Ligamentsof the VertebralColumn
23
Pediculusarcusvertebrae

posterius--
Lig longitudinale

VertebralumbalisV --
Corousverlebrae

Fig.767 Ligaments of the lumbarvertebralcolumn; Belowthe secondor third lumbarvertebrae, the superficial
the vertebralcanalhasbeenopened; layerof the posteriorlongitudinalligamentbecomes a thin
dorsalview. strand.Thedeeplayerinsertslaterallyon the fibrousring of
the intervertebral
disc.

Proc costalis -

- - Capsulaarticularis*
Arliculaliozygapophysialis,

Laminaarcusvertebrae --

-
Lig.ttavum

Fig. 768 Articulationsbetweenthe articularprocessesof the Only in the lumbar vertebral column are the zygapophysialjoints reinforcedby
lumbarvertebralcolumn,Articulationeszygapophysiales strong,transversefibre bundles("transverseligaments").
lumbales;the ligamentaflava havebeenremovedon the left;
right dorsalview.
 Back.Dorsum

: pulposus
-Nucleus I
\
Uncuscorooris\
IProc.uncinhtus]

Anuluslibrosus- -

anularis
Epiphysis
Anulusfibrosus
anularis
Epiphysis
N spinalis, - -
Nucleuspulposus
Ganghon
sensonum
nerui spinalis Corpusveriebrae-
/ b
A vertebralis

'
Figs.769a, b Intervertebral discs,Disciintervertebrales. Hyaline cartilaginous covering of the end plates of the vertebral bodies,
a nonossified portion of its epiphyses
a cervicalintervertebraldiscs,Disciintervertebralescervicales; ** Within the first decade of life the sc{alled uncovertebral clefts appear in the
frontal sectionthroughthe middleof the vertebralbody; lateral zones of the cervical intervertebral discs Their progress rnedially in the
ventralview (115%) followins decades varies considerably between individuals

b lumbar intervertebraldisc,Discusintervertebralislumbalis,
mediansection(115%)

Fascia thoracolumbalis- -

Lig longitudinaleanterius Vertebralumbalis l, .- .-

Corpus vertebrae

Proc spinosus--

- *
scusInterverlebralis

- -
Canalisvertebralis;
Caudaequina

--
Spatiumepidurale

-. -
VerlebralumbalisV,
Corpusvertebrae

- -
Canalissacralis

I
N spinatis

Fig.77O Lumbarintervertebraldisc.Discusinter- Flg.77l Lumbar vertebral column;

vertebralislumbalis; magnetic resonancetomography (MRT) in the median plane.
ventrosuperiorview ( 115%).
 Segments
of Movement
25
Proc articularissuperior
I
Uncuscorporis.
\a
IProc.uncinaius]
Faciesintervertebralis
\ \
\
Epiphysisanularis t \

Corpusvertebrae-

Lig longitudinale anterius

/ Lig interspinale

Facies interuertebralis -

I
N
ll
ll

| eediculusarcusvertebrae
|
I Lig longrtudinale
posterius

Fig.772 Cervicalsegmentof movement; * Rim ofvertebral body.

*' Hyaline cartilaginous covering
schematic,
mediansection(160%). of the end plate of the vertebral body,
a nonossified portion of its epiphysis.

Foramen interuerlebrale
I Proc articularissuperior
/

Lig. flavum
/

Lig interspinale
/
Lig longitudinaleantenus \\

/ Lig supraspinale

Facies intervertebralis -
_

(Foramen venae --
basivertebralis)

**"*/' i
-r,"0,""'"
?-. I
\
Proc.spinosus

PediculusarcusverlebraeI
I
I
-
Laminaarcusvertebrae' Proc articularisinferior

Fig. 773 Lumbarsegmentof movement; * Rim ofvertebralbody.

schematic, '* Hyaline cartilaginouscoveringof the end plate of the vertebral body,
mediansection(120%1.
a nonossifiedportionof its epiphysis.
 Back,
Dorsum
26
, VertebracervicalisVl
Clavicula,Extremitasacromialis.

\ vertebra
thoracicaXll

Fig.774 Thoraciccage,Caveathoracis,
andleft shouldergirdle,Cingulumpectorale;
dorsalview.

Trunk-shouldergirdle muscles(Figs.775, 776l

Insertion

continuation -J p. 28
 2l
- - occipitalisexlerna
Protuberantia

sternocleidomastoideus

M splenius
capitis\
- M spleniuscapitis

_- M trapezius
Verlebraprominens,Proc spinosus\

Spina scapulae 1

Fascradeltoidea \

\ Acromion

-
M leres
malor \\
Angulusinferior
Scapula,

M inlraspinatus,
Fascrainlraspinata
/
major /
M rhomboideus - M latissimusdorsi

-
M latissimus
dorsi

lumbalesl; ll, -
Vertebrae
Procc spinosi \ VertebrathoracicaXll, Proc spinosus

--
M obliquusexternus
abdominis

-
Trigonum lumbale
- Fasciathoracolumbalis
/
M latissimusdorsi

\ Cristailiaca

- os sacrum,
Faciesdorsalis

Fig. 775 Musclesof the back,Mm. dorsi;

superficialmusclesconnectingthe trunk with
the shouldergirdle and the upperarm;
dorsalview.
 Back.Dorsum

Trunk-shouldergirdle mUSCleS (continuation)

Muscle Origin Insertion Function

Innervatton
2, M. levator scapulae Tuberculaposterioraof the Angulus superior and immediate Shouldergirdle:
Direct branchesof the Processustransversiof the adjacentregion of the scapula androtatesthe scapula
Depresses
Plexuscervicalisand upper4 cervicalvertebrae upwaros
N. dorsalisscapulae
(Plexusbrachialis)
3. M. rhomboidensr\ajor Proccspinosiof the upper4 Medial border of the scapula, Shouldergirdle:
N. dorsalisscapulae thoracicvertebrae (caudalto the Spina scapulae) With M. rhomboideus minor:
(Plexusbrachialis, adduction andelevation of the
Pars supracIavicuIa ris) scapula
With M. serratusanterior:
holdscapulato the trunk
4. M. rhonboideus minor Procc.spinosi of the 6th Medial border of the scapula Shouldergirdle:
N. dorsalisscapulae and 7th thoracic vertebrae (cranial to the Spina scapulae) With M. rhomboideus major:
(Plexusbrachialis, adduction andelevation of the
Parssupraclavicularis) scaDUla
With M. serratusanterior:hold
scapulato the trunk
5. M. serrafus anterior Parssuperior:1stand 2ndribs Parssuperior:Angulussuperior Shouldergirdle:
N. thomcicuslongus , (moderatelyconvergent) of the scapula All parts:adduction of thescapula;
(Platus brachialis, Parsmedia:2ndto 4th ribs Parsmedia:Margomedialisof the with Mm rhomboidei holdingthe
Pars supraclavicularis) (divergent) scapula scapulato the trunk (Scapula
alata:whenoneof the antagonists
Parsinferior: 5th to (8th) gth ribs Pars inferior: Angulusinferior of doesnotfunction)
(veryconvergent). Interdigitates the scapula Parssuperior:elevation
with theoriginof M. obliquus Parsmedia:deuression
abdominis externus Parsinferior:d-epression, exterior
rotation(elevation of the arm
abovethe horizontal)
Thorax:
Whenthescapulais stabilized:
elevation of the ribs (inspiration)

Trunk-arm muscles (Fig.775)

M. latissimusdorsiand M. pectoralismajorbelongto this group.Bothariseon the trunk and passto the arm. Basedon the locationof mostof its
mass,the M. latissimusdorsiis includedin the groupofsuperficialmusclesof the back,and like thosemuscles,it alsoderivatesfrom ventral,
M. pectoralismajorarisesfrom the chestwalland is desiribedin the groupof ventralmusclesof the shoulder. ,
Muscle Origln Insertion Function
Innervation
M. ladssimus dorsi Procc.spinosi of the 6 lower Cristatuberculiminoris(bya flat Shoulderjoint:
N. thoracodorsalis thoracic vertebrae,of the lumbar tendonspiralingaroundthe Adductionandmedialrotation,
(Plexusbrachtalis, vertebrae(by Fasciathoracolum- M. teresmajor;in betweenBursa retroversron
Parcsupmclavicularis) balis), Faciesdorsalis of the 0s subtendineamusculilatissimi
Shouldergirdle:
sacrum. Labium externum of dorsi) Adductsanddepressesthe
the Crista iliaca (dorsalthird),
scapula
ribs (9) 10 to 12; frequently
from the Angulus inferior of the
scapula

Spinocostalmuscles (Fig.776)
Thespinocostalmuscles,M. serratusposteriorsuperiorand M. semanlsposteriorinferior,are locatedon top of the autochthonous
musclesof
the back.
Muscle Origin Insertion Functlon
Innervation
1. M, serratus postedor:,, Procc.spinosiof the 6th and 7th 2nd to sth ribs (lateralof the Elevationof 2ndto sth ribs
superlor l:,'r:r cervicalvertebraeand lst and2nd Anguluscostae) (inspiration)
Ventralbmnchesof thoracicvertebrae
N. cervicafts[C6] to
N. thoraclcus[T2]
2. M, serratus posterior P r o c c .s p i n o s io f t h e 1 1 t ha n d 9th to 12thribs (inferiorrim) Pullsribs 9 to 12caudally
inferior 1 2 t h t h o r a c i cv e r t e b r a ea n d 1 s t (expiration).As an antagonist
Ventralbmncha of and 2nd lumbar vertebrae to the pullingforcesof the
N. thomcicus[TI1] to diaphragma, it is alsoactive
N. lunbalb [L2] duringforcedinspiration.
 79
/ M. trapezius

/ M. sternocleidomastoideus

M. splenius
capitis
//

M. rhomboideus
major

l', spleniusceruicis

Fascia delloidea /

---
M. taresmajor

serratusposterior/
supenor

- -.
Scapula,Angulusinferior

-
/ / M. erectorspinae
M latissimusdorsi

- M latissimus
dorsi
M serratusanlerior

M. serratusposterior
inlerior
- Fasciathoracolumbalis

M obliquus
externusabdominis

-
M. obliquusexternus
abdominis
M obliquusinternus
abdominis -
Trigonumlumbale

Cristailiaca

Fig.776 Musclesof the back,Mm.dorsi;

the deepmusclesconnecting the trunk with the shoulder
girdle and the upperarm havebeenexposedby removing
mostof the superficialmuscleson the left side;
dorsalview
 Back,
Dorsum
30

Caudaequina
anterius Heorcurus I
R e n- - gfl-s- -- [ Arcrs
vcrtculde
I vertebrae
Lamtna arcus I
M psoasmajor-- veneorae )

Mm
transversospinales*'
Plexuslumbalis- -
M ereclor spinae *

Proc costahs--

M q u a d r a t u-s- (Lamina
tumoorum prolunda)
CostaXll --
M obliquusinternus--
abdominis Fascia
thoracolumbalis
dorsi--
i/t latissimus

Proc spinosus-- (Lamina

superficialis)

Fig.777 Musclesof the back,Mm.dorsi; Thedeepmusclesofthe backlie within an osteofibrous tubewhich is formed
by the dorsal parts of thDvertebraeand the surrounding aponeumticthoracolumbar
crosssectionthroughthe secondlumbarvertebra; fascia.Themusclesaredividedinto a tlateral tract and a * *medialtract.
inferior view

- Aorla

-- Corqusvertebrae

-- N u c l e u s p u l p o s u_s )
Foramenintervertebrale \ I tJtscus
I interuertebralis
- - Anulusfibrosus ,/

-/ N ,s p i n a l i s
Proc articularis
superior-

-- M Psoasmajor

Ariiculatio zygapophysialis -- C a u d ae q u i n a

-- Lio flavum*
Proc articularisinferior

-- M ereclor spinae

--
Mm transversospinales
Proc spinosus

-
Fasciathoracolumbalis

Fig.778 Musclesof the back,Mm. dorsi; * Theareawherethe ligamentaflavainsert is oftencalcifiedor ossified,evenin

youngerindividuals.
computedtomography(CT)at the levelofthe intervertebral ** adipose
deposits
disc betweenthe 3rd and 4th lumbarvertebrae.
inferior view.
 3T
M semispinaliscapitis / Lig nuchae
\
\ M sPleniuscaoitis
M splenius
capitis \ i /,/
,J,
t,

Ft' I M sternocleidomastoideus
M longissimus
capilis \
\\
M spleniusceruicis \ ,/ M spleniusceruicis

M scalenusposterior:
/ M levatorscapulae

-
M levator scaoulae Fascia deltoidea

M longissimuscervicis / --
M teresmalor
/
M semrspinaliscervicis --
M tr"p"ri*
-
M iliocostalis
ceruicis -
M. serratusposteriorsuperior
\
M rhomboideusmajor
M infraspinatus,
Fasciainfraspinata
\
M iliocostalis thoracis

/ \
M spinalisthoracis M latissimusdorsi
- \
M rftocostalis
thoracis M longissimusthoracis
-
M serraiusanterior
\
M spinalisthoracis
M longissimus
thoracis
--
M serratusposteriorinferior
M iliocostalislumborum
-
- M obliquusexternusabdominis
M obliquusexternusaMominis
-
Fasciathoracolumbalis
Vertebraelumbales,/
Procc spinosi

\
M obliouusinternusabdominis M erectorspinae

Flg.779 Musclesof the back,Mm.dorsi;

muscleshasbeenexposed
the superficiallayerof the autochthonous
by removalof the thoracolumbarfasciaand the overlyingmuscles
which connectthe trunk with the upperarm and the shouldergirdle;
dorsalview.
nrl
1 I Back,Dorsum
-) 'L/

M spleniuscapitis\

M semispinaliscapitis -- - - caoitis
M. semisoinalis

Lig nuchae --

capitis- -
M longissimus -- M lonoissimusceruicis
M splenius
ceruicis-__
M levatorscapulae \\ :- M longissimuscapitis
M longissimuscervicis : _
M iliocoslalis cervicis \ - - Mm spinales cervicis et capitis
capitis-
M semispinalis
M scalenusoosterior*-
M longissimus
ceruicis\

superior---
M serratusposterior

Mm. levatorescostarum - - - M. iliocostalis ceruicis

--
M longissimusthoracis

Mm semisoinales ceruicis - -
et thoracis
externi - -
Mm intercostales

thoracis--
M, iliocostalis

Mm levatorescostarum--
--
M spinalisthoracis -- M soinalisthoracis
*-
M semispinalisthoracis
interior---
M serratusposterior

--
M. longissimusthoracis
-- lumborum
M, iliocostalis
M iliocostalislumborum

M latissimusdorsi

M serratusposteriorinferior
M obliquusexternusabdominis
M longissimusthoracis

M obliquusinternusabdominis

(Aponeurosis
musculi
latissimi
dorsi)
-
Fasciathoracolumbalis

M erectorspinae

M. gluteusmaximus
,-&-*|-'-n

Fig. 780 Musclesof the back,Mm. dorsi;

musclescan be seenafter the
the long fibres of the autochthonous
removalof the thoracolumbarfasciaand the overlyingmuscleswhich
connectthe trunk with the upperarm and the shouldergirdle;on the
right a diagramshowstheir course;the spinousprocesses of the cervical
vertebraeare outlinedin green,thoseof the thoracicvertebraein red,
and thoseof the lumbar vertebraein blue.II-XII = ribs;
dorsalview.
 '
l l t f t t c n r t l i dorsi
a
t
ir,,.^I--
Muscles of the Back,Musculi
^€ thn Dnalz dnr

Lateral autochthonous layer of the muscles of the back, Musculi dorsi (Figs.779, 780)
The lateraltract 0f the autochthonousmusclesof the backcoversthe medialtract and is thereforealsocalledthe superficial
portionof the autochthonous musclesofthe back.Includedhereinare the muscleswhosefibrestakea straight(upward)
The Mm. spleniirun oblique,divergingcranially
course:M. iliocostalis,the M. longissimusand the Mm. intertransversarii.
(spinotransversal). TheMm. levatorescostarumtakea caudo-oblique courseto the ribs.
Muscle/Innervation Origin Insertion Function
1. M. iliocostalislumborum i f t h er i b s5 t o l 2
Togetherwith M longissimus A n g u l o
Rr.posterioresof the thoracisfrom the Procc.
Nn.lumbales spinosiof the lumbar vertebrae,
Faciesdorsalisof the Os
sacrum,Cristailiaca(dorsal
third), Fasciathoracolumbalis
2. M. iliocostalisthoracis 1 2 t ht o 7 t h r i b s ( m e d i a tl o t h e A n g u l io f t h e r i b s ( 6 ) 7 t o 1 .
Rr.posterioresof the Anguluscostae)
Nn.tlrcracici
3. M. iliocostaliscervicis 7 t h t o ( 4 t h )3 r d r i b s ( m e d i a l Tuberculaposterioraof the
Rr.posterioresof the to the Anguluscostae) Procc.transversiof the 6th to
Nn.cervicales (4th) 3rd cervicalvertebrae
4. M. longissimusthoracis Togetherwith M. iliocostalis Medialpalt: Proc.mammillaris
Rr posterioresof the lumborum from the Procc. of 5th lumbar vertebra,Procc.
Nn.spinales spinoso i f thelumbar accessorii of 4th to 1st lumbar
vertebrae,Faciesdorsalisof vertebrae,Procc.transversiof
the Os sacrum;often from the the thoracicvertebrae;
P r o c .m a m m i l l a r i so f t h e Lateralpart: Procc.costalesof
2nd and 1st lumbar vertebrae 4th to 1st lumbar vertebrae,
Blendswith and Procc.transversiof the F a s c i at h o r a c o l u m b a l (i sd e e p
M. longissimus cervicis 12th to 6th thoracicvertebrae layer'),12thto 2nd ribs (medial
andM. spinalis to the Anguluscostae) Acting unilaterally:Latera-
5. M. longissimuscervicis Plocc transversiof the 6th to Tuberculumposteriusof PI'occ. flexion of the Columna
Rn posterioresof the lst thoracicvertebraeand 7th transversiof the 5th to 2nd vertebralisto this side
Nn.spinales to 3rd cervicalvertebrae cervicalvertebrae Acting bilaterally:Extention
of the Columnavertebralis
6. M. longissimuscapitis Procc.transversiof the 3rd Proc.mastoideus, posterior
Rr.posterioresof the thoracicto the 3rd cervical margln
Nn. spinales vertebrae
7. Mm. intertransversarii Tuberositasiliaca,Procc. Proc.costalisof the 5th
lateraleslumborum costalisand accessorius of lumbar vertebra,Procc.
Rr posterioresand ante- 5th to lst lumbar vertebrae, transversusof the I st thoracic
rioresof the Nn. spinales Proc.transversusof the 12th vertebra
thoracicvertebra
8. Mm. intertransversarii Ploc.accessoriusof the 4th to Proc.mammillarisof the 4th
medialeslumborum 1st lumbar vertebrae to 2nd lumbar vertebrae
(cf. to No.7)
9. Mm. intertransversarii Procc.transversiof 12th to Procc.accessorius and
thoracis 10th thoracicvertebrae m a m m i l l a r i so f t h e l s t l u m b a r
(cf. to No.7) vertebrato Proc.transversus
of the 11ththoracicvertebra
10.Mm. intertransversarii Tuberculumposteriusof Procc. Tuberculumposteriusof Procc.
posteriorescervicis transversiof the 6th to lst transversiof the 7th to 2nd
(cf. to No.7) cervicalvertebrae cervicalvertebrae
11.Mm. intertransversarii Tuberculumanteriusof Procc. Tuberculumanteriusof Procc.
anteriores cervicis transversiof the 6th to 1st transversiof the 7th to 2nd
(cf. to No.7) cen,icalvertebrae cerVicalvertebrae
12.M. spleniuscervicis Procc.spinosiof the 3rd thora- Tuberculumposteriusof the Acting unilaterally:
Rn posterioresof the cic to 7th cervicalvertebrae, Procc transversiof the Lateralflexion,rotationof the
Nn.cervicales Lig. nuchae(from 3rd cervical (3rd) 2nd to 1st cervical cervicalspineand headto the
vertebra) vertebrae sameside
13.M. spleniuscapitis Procc.spinosiof the 6th to Proc.mastoideus, Linea Acting bilaterally:
Rr.posterioresof the 3rd cervicalvertebrae, n u c h a l i ss u p e r i o r Extentionof the cervical
Nn.cervicales Lig. supraspinale splne

14.Mm. levatorescostarum Procc.transversiof the 11th 1 2 t ht o 1 s tr i b s ( l a t e r aol f Elevationof the ribs;

Rn posterioresof the thoracicto 7th cervicalverte- Angulus costae) lateralflexionand rotationof
N. cervi.calis brae (Mm. levatorescostarunr the columna vertebralis
[CB]and
Nn.thoracici longi:every other caudalrib,
Mm.levatores costarum Mm. levatoresbreves:to the
longiareabsentin the nearestcaudalrib)
middlethoracicregion
 Back,
Dorsum
34
M s e m l s p i n a l i s c a p i l i s- -
M obliquuscapitissuperior
M. rectuscapitisposleriorminor //
M obliquuscapitissuperior / M splenius
capitis
M splenius capitis
/ M longissimus
capitis
rectuscapitisposteriormajor
Atlas,Proc transversus Venterposterior
-- M digastricus,
Atlas,Tuberculum posterius - - M intertransversarius
posterior
cervicis
M obliquus
capitisinferior
M. semispinalis
capitis

Mm muliifidi - Mm intertransversarii
posteriores
ceruicis
)-
M semispinaliscervicis

/ Ligg intertransversaria
M scalenusposlerior -

cervicis -
Mm intersoinales -- Lisg inlerspinalia;
Lig supraspinale

-- thoracis
Mm.rotalores
M. spinaliscapitis--,

- Mm interlransversarii
lhoracis

*- - Mm intercostales
externi
Mm levatorescostarumbreves
Mm rolatoresthoracis
lhoracis -
M semisoinalis - Lig costotransversarium
superius
- Lio,intertransversarium
- Membrana intercostalis
interna
laleralia -
Ligg costotransversaria
- N. thoracicus,
N inlercostalis;
posterior
A ;V intercostalis
externi,Fascia -
Mm,intercostales
- Mm rolatores
lhoracis
Mm levatorescostarumbreves - - Membrana interna
intercostalis

Mm levatorescostarumlongi - Mm intercostales
interni
- Mm inlercostales
externi
Mm intertransversarii
thoracis
CostaXll - M obliouusinternus
abdominis
-
Fasciathoracolumbalis -
M quadratus lumbolum, Fascia
- Mm intertransversarii
medialeslumborum
M obliquusinternus
abdominis
- M transversusabdominis
Mm interlransversarii
laterales
tumoorum - Mm interspinales
lumborum
Fasciatransversalis
-
Lig iliolumbale
/
M obliouusexternusabdominis - Ligg, inlertransversaria

--
Mm multitidi Spinailiacaposterior
superior
M. gluteus maximus

Spinailiacaposteriorsuperior - -
Lio sacroluberale

Fig. 781 Musclesof the back,Mm. dorsi,

and suboccipitalmuscles,Mm. suboccipitales;
after the removalof all superficialmuscles
and the thoracolumbarfasciathe deepestlayer
is exposed.
Dorsalview.
The 9th intercostalspacehasbeenpartly opened.
TheRomannumeralsindicatethe spinousprocesses
of the respectivevertebrae.
 Musclesof theBack,Musculidorsi
35
Medialautochthonousmusclesof the back,Musculi dorsi (Figs.780,7Bl)
The mediattract of the autochthonousmusclesof the backis coveredby the lateraltract and is thereforealsocalledthe deep
layerof the autochthonous musclesof the back.Includedhereinare the muscleswhosefibres takea straightupwardcourse:
Mm. interspinalesand the M. spinalis.TheMm. rotatores,Mm. multifidi andthe M. semispinalisrun oblique,convergingcranially
(transversospinal).
Muscle Origin Insertion Function
Innervation
1. Mm. interspinales Procc.spinosiof the sth to Cristasacralis mediana
lumborum lst lumbarvertebrae (superior spinosi
rim),Procc.
Rn posterioresof the of the 5th to 2ndlumbar
Nn. spinales vertebrae
2. Mm. interspinales Procc.spinosiofthe (12th) Procc.spinosiofthe
thoracis llth to 2nd(1st)thoracic (1stlumbarvertebra) 12thto extention
Segmental of the
Rr.posterioresof the vertebrae 3rd (2nd)thoracicvertebrae Columnavertebralis
Nn. spinales
3. Mm. interspinales Procc.
spinosiofthe 7th to spinosiofthe lst
Procc.
cervicis 2ndcervicalvertebrae thoracicto the 3rd cervical
Rn posteriora of the vertebrae
Nn. spinales
4. M. spinalis thoracis Procc.spinosiof the (3rd) Procc. spinosiof the ( 10th)
Rr.posterioresof the 2nd,1stlumbarvertebrae, and 9th to 2ndthoracicvertebrae
Nn. spinales the 12thto 10ththoracic (closelycorrelated with Mm.
vertebrae(closelycorrelatedmultifidi)
with M. latissimusthoracis)
5. M. spinaliscervicis Procc.spinosiof the (4th)3rd Procc.spinosiof the (6th)5th Actingunilaterally:Lateral
Rn posterioresof the to lst thoracicvertebrae,and to 2nd cervicalvertebrae flexion.ofthe spineto the
Nn. spinales 7th to 6th cervicalvertebrae samesloe
procc.spinosiof the 3rd to Extention
6. M. spinalis capitis squamaossisoccipitalis ffjilt:1'::t*llv:
Rn posterioresof the 1stthoracicvertebrae, and7th (between Lineaenuchales
Nn. spinales to 6th cervicalvertebrae supremaandsuperior,close
(inconstant) to Protuberantia occipitalis
extefna;associated with
M. semispinalis capitis)
7. Mm. rotatores Procc.mammillares of the Procc.spinosi(roots)of the
Rnposterioresofthe lumbarvertebrae, Procc.trans- 3rd to 1stlumbarvertebrae,
Nn.spinales versiof the thoracicvertebrae, 12thto lst thoracicvertebrae
Tothe Mm. rotatores Procc.articularesinferiores and7th to 2ndcervical
belong:Mm.rotatores of the cervicalvertebrae(Mm. vertebrae
cervicis,Mm. rotatores rotatores brevesrun to the
thoracisandMm.rotatores adjacenthighervertebrae;
lumborum(inconstant) Mm.rotatores longiskip every Actingunilaterally:Lateral
othervertebra) flexionofthe spine
to the sameside,rotation
8. Mm. nultifidi Facies dorsalis
oftheOssacrum, Procc.spinosiof the 5th to Actingbilaterally:Extentionof
Rn posterioresof the Lig.sacroiliacum posterius, 1stlumbarvertebrae, 12thto the sDine
Nn. spinales Cristailiaca(dorsalpart), vertebrae
lst thoracic and7th
Procc.mammillares of thelum- to 2nd cervicalvertebrae
barvertebrae. Procc.transversi
of the thoracicvertebrae, Proc.
articularisinferiorof the7th
to 4th cervicalvertebrae(The
fibresskip 2 to 4 vertebrae.)
9. M. semispinalisthoracis Procc.transversiof (12th) Procc.spinosiof the (4th)
Rn posteriores
ofthe 11thto 7th (6th)thoracic 3rd thoracicto 6th cervical
Nn. spinales vertebrae vertebrae
10.M. semispinaliscervicis Procc.transversiof (7th) procc.
spinosi 6thto
orthe lffi:lfi.?l,o,T.'iffJ$11?
Rr.posteriores
ofthe 6th thoracicto 7th cervical 2ndcervicalvertebrae andheadto the otherside
Nn. spinalu vertebrae Muscleson bothsidesacting
11.M. semispinaliscapitis Procc.transversiof (8th) Squamaossisoccipitalis Extentionof the
together:
Rnposterioresoftlrc 7th thoracicto 3rd cervical (betweenLineanuchalis spine
Nn. spinales vertebrae supremaandLineanuchalis
superior,medialpart)
 Back,
Dorsum
36

Lig.costotrans-
versariumlaterale
Proc.transversus

M. semispinalis
thoracis
M. longissimus
thoracis
M. iliocoslalis
lhoracis
Mm multifidi
- M spinalisthoracis
M. levator
coslaebrevis - Mm.multifidi
- M levator
costaelongus
Membrana
intercostalisinterna - M. levator
Mm. intercostales costaebrevis
externi
M serratus -
posteriorinferior Verlebra
lhoracicaXl,
M. iliocostalis Proc.transversus
lhoracis -
Mm rolatores Lio.
int'ertransversarium
M longissimus
thoracis
V.;4. intercostalis
posterior
N thoracicus,
N intercostalis
Mm.intercoslales -
intimi M. serratus
posteriorinferior
Mm. intercostales
externi
-- lumbalisl,
Vertebra
Mm. intercostales
interni Proc.costalis

M longissimus - - M. obliquus
thoracis internusabdominis
M. iliocostalis
thoracis -- M transversus
/ abdominis
M. intertransversarius
medialislumborum

Fascia
thoracolumbalis
/
Mm intertransversarii
lateraleslumborum - M erectorsoinae

M. longissimus
thoracis
Mm.multitidi

Fig.782 Musclesof the back,Mm. dorsi;

the layerofautochthonous musclesandthe thoracicmuscles
are shownherebetweenthe 8th and 12ththoracicvertebrae
(VIII to XII) and betweenthe lst and 3rd lumbarvertebrae
spacehasbeenpartly opened;
(I to III); the 11thintercostal
dorsalview.
 Musclesof theBack,Muscultdorsi
31
M levatorcostae brevis

Lig.interlransversarium

Mm rotatoresthoracis - -

--
M levatorcostaelongus

Lig. interlransversarium

Verlebralumbalisl,
Arcusvertebrae

--
Ligg flava
Verlebraolumbales,
Procc costales

Mm intertransversarii
lateraleslumborum

Fascialhoracolumbalis
(Laminaprofunda)

Mm. intedransversarii
medialeslumborum

Mm. multitidi

M. ereclof spinae

Vertebraelumbales,Procc spinosi

Fig. 783 Musclesof the back,Mm. dorsi;

the deepestlayeris exposedherein the regionof the lower
thoracicand the lumbarvertebralcolumn;the thoracolumbar
fasciahasbeenremoved;
dorsalview.
 Back,
Dorsum
3 8

M rectuscapitisposterior
minor lvl trapezius
\ I
/, i,4 semispinaliscaprtis
/ -M- rectuscaprtisposteriormajor
/.
: /, M obhquus
capitrssupenor
/ M spleniuscapitis

M splenius
capitis \ \
// Atlas,Arcusposterior

/ M splenius
ceruicis

t--- Proc maslordeus

--
M longissimuscapitis
- Venlerposterior
l / s p l e n i u s c e r v i c i s- - M digastricus,
- Proc
capitis /
M longissimus styloideus
/ - M obliquuscapitisinferior
capitis /
M semispinalis
-
posterius/
Atlas,Tuberculum M longrssimuscapilrs

Axis,Proc spinosus -
.-
M semispinalis
capitis
Mm interspinalescervicis -

\ Mm multifidi

-
M longissimuscervicrs / M semispinaliscervicis

M iliocoslalis cervicis -

\
Lig supraspinale

capitis /
M semispinalis

thoracrs '
M, semispinalis

Fig. 784 Musclesof the back,Mm. dorsi,and

suboccipital
muscles,Mm. suboccipitales;
varioussuperficialmuscleshavebeenremoved;
dorsalview.
 'tt **
r
-f $ ]
Back.Musculidorsi t u{ q -- f , $
.f J'

lvl spleniuscapitis \

M longissimuscapitis -

Lrg nuchae

M trapezius

lvl levator scapulae

- - Vertebraprominens,
Proc spinosus

Fig. 785 Musclesof the back,Mm dorsi,and muscles

o f t h e n e c k .M m . c o l l i :
the superficialmusclesof the back havebeenremoved;
left lateralview.

The deep autochthonousmusclesof the neck (Figs.784,786)

Mm. recticapitisposteriorminorandmajorandMm.obliquicapitissuperiorandinferiorbelong - to the medialtractof the
autochthonousmusclesof the back,while M. rectuscapitii lateialisbelbngsto the lateraltract
Mtuscle/Innervation Origin Insertion Function
1. M. rectuscapitisposterior Proc.spinosusof the axis Inferiornuchalline
mator (middlethird)
Suboccipital n. (dorcal
divisionof lst cervicaln.
tClD
2. M. rectus capitis posterior Atlas,Arcus posterior, Inferiornuchalline
minor Tuberculum Dosterius (medialthird)
Suboccipitaln. (cf. to No.I) Actingin concertduring
3. M. obliquus capitis Atlas,Proc.transversus, Inferiornuchalline subtlepositioningand
superior Tuberculumposterius (lateralthird) kinematicsof the head
Suboccipitaln. (cf. to No.1)
4. M. obliquus capitis Axis,Proc.spinosus Atlas(posterior
rim),
inferior Proc.transversus
Suboccipitaln. (cf. to No.1)
5. M. rectus capitis lateralis Atlas (anteriorrim), Proc.jugularis
Osoccipitale,
N. ceruicalis(ventruldivistotts Proc.transversus
of lst cervicaln. [C(])
(cf. to No.1)
 Back,
Dorsum
40

- M rectuscapilisposteriormrnor
M semisDinaliscaoitis

t, l,,H
M. recluscaoitis
- - posterior
caoitis --
M solenius major
- Membrana atlantooccipitalis
obliquus capitis superior - - postelior

- - A. vertebralis,
capitrs- -
M, longissrmus Parsatlantica
- Atlas.Proc,transversus
M digaslncus.Venter posterior --

M rectuscapitislateralis/
-- M obliquuscapitisinferior

M splenius
ceruicis

Articulatio Capsulaarticularis
zygapophysralis,

- Mm multilidi

- M scalenus medius

\\ \ Mm interlransversariiposteriorescervicrs
\
Mm multlfidr
M iliocostalisceruicis / \
\
l\4 longissimuscapitis M semispinaliscapiris

Fig.786 Suboccipital muscles,Mm. suboccipitales;

dorsalview.
I = posteriortuberclesof the atlas
II = spinousprocessof the axis

- M obliquus capitis superior

-- M rectuscapitis
posterior
minor

- M rectuscapitis tt

posteriormajor lr
\ Atlas,Arcusposterior
-
capitisinlerior
M. obliquus

Fig.787 Suboccipital muscles,Mrn.suboccipitales, 53 Centreof gravityfor 3/6 of the bodyweight

F$ Forceof bodyweighton the affectedportionof tho lumbarvertebralcolumn
semischematic drawing, Rr4 Resultingforceon the segmentof movoment
left dorsolateralview. FM Forceof the backmuscles
E, Ventralcomponentof shearingstressthat has to be absorbedby the vertebralioints
F. discsand vertebralcolumn
Pressurethat has to be absorb€dby intervertebral
I, Leverarm of the bodiesweightson the vertebralcolumnin the uprightposition
l, Loverarm of the musclesof the back

Fig. 788 Stresson the lumbarvertebralcolumnin the upright

position.
 CrossSectionsof the VertebralColumn
4T

-- Larynx
_ - Cartilagothyroidea
Corpus \
venebrae
M. stemocleido-
- z mastoideus
- - Vert€bra cervicalisV,
Corpusvertebrae
-- Uncus@rporis
-- Ptoc transversus,
Tub€rculumanterius
-- Discus
Foramen- intervertebralis
vertebrale -- N. spinalis
-- Pediculusarcus
Proc articularis-
inlerior verlebrae
- -
Lamrnaarcus ' Vertebracervicalisvl,
verlebrae -- Comusvertebrae
Proi. articularis
Lig flavum' - Laminaarcus
vertebrae
Proc spinosus,- -
Tubercula Proc.spinosus

Fig. 789 Cervical vertebral column; Fig. 790 Cervicalvertebralcolumn;

computedtomography(CT) at the level of the computedtomography (CT)at the levelof the
intervertebral disc betweenthe 4th and 5th cervical intervertebral discbetweenthe 5th and6th cervical
vertebrae; vertebrae;i nferiorview.
' Intubationtubeandendoscopic
instrument
inferior view.

Aorla,Pars - ----
V.e,vainletio(
abdominalis
-- Aorta,Pars
V cavainferior- aMominalis

-- Corpusv€rtebrae
Discus -
interuertebralis -- M. psoasmaior
M Psoas -
Ren -
Foramen- -- P€diculusarcus
interuerlebrale vertebrae
Proc articularis* -- Lig.flavum
supeflor
-- Proc.costalis
Articulatio-
zygapophysialis - - Proc.articularis
Proc articularis- inlerior
inferior --
Proc articularis
Proc mammillaris' sup€nor
--
Mm dorsi - Lig. interspinal€
- -
Proc spinosus- Mm.dorsi

*-
Fascia - Fascia
thoracolumbalis thoracolumbalis

Fig. 791 Lumbarvertebralcolumn; Fig.792 Lumbarvertebralcolumn;

computedtomography (CT)at the levelof the computedtomography (CT)at the levelof the
intervertebral
discbetweenthe 2nd and3rd pedicleof the 3rd lumbarvertebra:
lumbarvertebrae:
inferiorview. inferior view.
 Back,
Dorsum
42

- - N aurrculaflsmagnus, R posterior (Plexusceruicalis)

- - N occipitalisminor (Plexus cervicalis)
.L

- - - Nn supraclavrculareslaterales(Plexus ceruicalis)
)

- - N- cutaneus brachrl
laleralissuperior
(N axillaris)

N cutaneus
brachii lateralis
inferior(N radialis)

-
N cutaneus brachil
posterior(N radialis)

(Rr cutanei mediales et laterales)

(Nn spinales C4-L1, Rr posleflores)

- Rr cutanei laterales
(Nn spinales,Nn intercostales)

-- R cutaneuslateralis
(Plexuslumbalis,
N iliohypogaslricus)

-- Nn cluniumsuperiores
( N n s p i n a l eLs1 - L 3 ,
Flr posteriores)

- - Nn clunium medii (Nn spinales

---/ S1-S3, Rr posteriores)
't-
-t'

-- / / - -
_-1 Nn clunium inferiores
(N cutaneus femofls posterior)

- -
N cutaneus lemoris lateralis(Plexus lumbalis)
- -
N cutaneus femoris posterior (Plexus lumbalis)
S3

Fig.793 Segmental cutaneous innervation(dermatomes)

andcutaneousnervesof the back;
dorsalview.
 43
N occipitalistertius (C3) / a a N o c c r p i t a l i s m a j o r ( C 2 ) ; Ao;cVc i p i t a l i s

N occipitalismajor (C2) /, magnus(Plexusceruicalis)

N auricularis
\
\ l

N suboccipitalis(C1) \ R posterior
(CO)
\ /

A vertebralis
O -
N occipitalisminor (Plexus cervicalis)
/ R poslerior
(C7)

N auricularismagnus (Plexusceruicalis) //
R posterior(CB)
capitisa /
M longissimus
/ R posterior
(T1)
M levatorscapulaeA / - N supraclavicularislateralis(Plexus cervicalis)

M deltoideus
||
| | N. cutaneus brachii lateralis
I : inlerior

, ,. N radialis;
M serratusposteriorsuperiora \ (V.)Profundabrachii
i o an.;
/ N. cutaneus
r +_a
i brachiiPosterior
M m m u l t i f i d Ii -- \

Nn thoracrci,Rr, posteriores.
mediales et lalerales - a M triceps
brachii,
Caputlongum
M iliocostalisthoracis a - -

lhoracisa --
M longissimus

t, \1M teresminor
t, t
a
\ 1M ".infraspinatus
rhomboideusmajor
M serralusposleriorinleriora - -

\ 1 M. latissimus
dorsi
R posterior
(T12)

| --
M latissimusdorsi

M obliquusexternusabdominisa --

Trigonum lumbale;
N ifiohypogastricus

Crista iliaca -- -- (Bursa subcutaneaspinae iliacae

posteriorissuperioris)
R posterior
(T12)
-- (Bursasubcutanea
sacralis)

Nn cluniumsuperiores

M gluteusmaximusa /

R posterior
(S3) \ R posterior
(Sa;

Fig.794 Blood vesselsand nerves of the back;

the superficial musclesand the shoulder girdle
have been removed on the left side;
dorsal view.
* Blood vessels and nerves of the triangular space
* * Blood vessels and nerves of the quadrangular space
 Back,
Dorsum
44

N occipitatismajor
/ O A occipitalis, Rr occipitales
M semispinalis
capitisa \
\ / t M. epicranius;M occipitofrontalis,Venter occipitalis
A; VoccipitalisO*\ I
\ I
/ O A occipitalis

A occipitalis
a \
\
\
V auricularisposterior:r 1
\ N occipitalisminor
A. occipitalis, a \r i
R. mastoideus
N auriculaismagnus
---
N. occipilalisminor
+-- O A auricularisposlerior,R
occioitalis

capitisa ---
M longissimus - aM spleniuscapitis
- a M slernocleidomastoideus
N accessorius
[Xtl \

. V jugularis exlerna
M spleniuscapitis O \\

M levatorscapulae
a \ Rr cutaneiposteriores(Nn cervicaleset
ta- thoracici,Rr posteriores)
N. dorsalisscapulae -
--- W M traoezius
l o -_
qqlu!9y:
(A lransversa
colli)
M levatorscapulaea -

V transversa! --
colli

M rhomboideus * --
mtnor
-
Fascia a
deltoidea

M traoeziusa ---

M. teresmaior a - a M infraspinalus,
Fasciainlraspinata

M. rhomboideus{ -
mapr Rr.cutaneiposleriores
(Nn.thoracici,
Rr posteriores)

M latissimusdorsi | -

Rr cutaneilaterales
pectorales(Nn thoracici,
Nn intercostales)

Fig.795 Bloodvesselsand neryesofthe occipitalregion,

Regiooccipitalis,the nuchalregion,Regiocervicalis
posterior,and the upperpart of the back;
the superficialmusclesof the backhavebeenpartially
removedon the left;
dorsalview.
 45
Proluberantia
occipitalisextema

M. semispinalis
capitisa \ 7 O R. muscularis(A. vertebralis)

z o A. vertebralis
M. rectuscapitisposleriormal)r O \\ / I a V. auricularisposterior
,/ a V occipilalis
/' / a Pl€xusvenosus
r // suboccipitalis
N. suboccipitalis -r
o Y. verlebralis
R. masloideus(4. occipitalis)a -- ..
/ O A. occipitalis
R occipilalis (A. occipitalis) O -

A. occipitalis O ---
-- o M. splenius
M. obliquusO ---
capilisSuperior capilis

A verl€braliso -- --
Atlas,Arcus
2
posterior

M. spleniuscapitisO /
-
/ (R. communicans)
M longissimuscapilis o / o M. multifidus
--
M. obliquuscapitisinferiorO Fascianuchae
' -- o A. c€Mcalisprotunda
R. posterior(C 2)
R muscularis(A. vertebralis)O / -- a V. c€rvicalisprofunda
M. semispinaliscapitisa /
--
R. posterior(C 3) / o M. semispinaliscervicis
A. cervicalisprofundaO ---- - ,.
N. dorsalisscapulae
R. musculatis . N. accessorius[XU
(N dorsalisscapulae) -- ..
N accessorius / a Mm. rhomboidei
/ major6l minor

z o M. lraoezius

B.superficialis o / I
(A. transiersacollil I
!
'I I
R. profundus(A transv€rsacolli) O I
N. dofsalisscapulae a Mm. rhomboid€imaloret minor

7ssx

Fig.796 Bloodvesselsand nervesofthe occipitalregion,

Regiooccipitalis,the nuchalregion,Regiocervicalisposterior;
dorsalview.
+ Tuberculaof the Prcc,spinosusof the axrs
46 Back,Dorsum

N occipitalismajor / tertius
N occipitalis

M semisprnahscaprtis a \

\-\
\ i \

M, obliquus capitis supeflor | \

)1 - _z O M rectuscapitisposterior
mrnor

M rectus capitis posteriormajor | \

ParsatlanticaO - -
A vertebralis, , - Proc mastoideus
Os temporale,

N subocciprtalis
N suboccipitalis
* - Atlas,Arcusposterior
M o b l i q u ucsa p i t i Isn f e r i oar - - - K
--- | M o b l i q u ucsa p i t i isn t e r i o r
R posterior(C 2) --- O A vertebralis.Pars lransversaria

N occipitalistertius -
O M rectus capitis posteriormalor

Plexus cervicalis

O Mm interspinalesceruicis

Fig.797 Nerves ofthe nuchal region, Regiocervicalis posterior,and vertebral artery;

dorsal view.

/ Foramenmagnum

N subocciprtalis

Proc transversusatlantis

O A vertebralis

Duramaterspinalis- -

-
malerspinalis- -
Arachnoidea N occrpitalrsmalor

N occipilahstertius

N spinalis,R, posterior

M scalenus medius

Vertebra ceruicalis V,
Proc transversus

N ceruicalis[C7],
Fila radiculariaposleriora
---
a A vertebralis
Medullaspinalis

Fig. 798 Bloodvesselsandnervesof the deepposterior the vertebral arches have been completely removed as well as a
andthe contentsof
cervicalregion,Regiocervicalisposterior, portion of the occipital bone.The meningesof the spinal cord are
the vertebralcanal; shown in several laYers;
dorsal view.
 canal
ofthevertebral
47

- Lamina arcusvertebrae
_-
-- Vertebralumbalisll, Proc costalis

,'.,
*,*,'"
Spatiumepidurale- _

I
sensorium'i --
Ganglion --
nervisoinalis o M psoasmajor
-- o Plexusvenosus
R anterior vertebralisinternusposterior
R posterior"r - - Ouramatersoinalis

- O Mm intertransversarii
medialeslumborum

R r d o r s a l e(sA ; V l u m b a l i sO) a - - - - Arachnoidea maler spinalis

- - Pia mater spinalis

Radicesanteriorel oosterior{ --
--
V spinalisposteriora -- Lig intertransversarium
-* Proc articularissuperior

Caudaequina *, --
i-- O M interiransversarius
lateralislumborum
- O M. interlransversarius
medialislumboriJm
Radixanterior. --

Radixposterior
- Lig iliolumbale

Duramaterspinalis--
- Os sacrum,Pars
Arachnoideamater - -
spinalis lateralis

Spatiumepidurale; - - Os coxae,Os rlium

Plexusvenosusa
verlebralisinternus \
anlenor \ Os sacrum,Proc
subdurale)/
(Spatium Pia malersoinalis Spatium
subarachnoideum articularissuperior

Fig.799 Bloodvesselsandnervesofthe vertebral

canalin the lumbarregion,Regiolumbalis;
the vertebralarcheshavebeenremovedand the
meningesof the spinalcordareshownin severallayers;
dorsalview.
48 Thoracicand AbdominalWaIIs

malor --
M. pectoralis

M serratusanterior - -

M obliquusexternusabdominis - -

Spinailiacaant€riorsuperior- - -

Fig.800 Surfaceanatomyofthe thoracicandabdominal Notethe upperlimit of the pubichair.It extendsto the umbilicus
wallsof a youngmale;the prominentmusclesareindicated. andhasa triangularshapein the male.In the female,the upper
limit is horizontal.Theregionsof the thoracicandabdominal
walls are shownin Fig. 7.

Articulatiosternoclavicularis
: Incisurajugularis
\
Clavicula,Corpus

*- Angulussterni

Arcuscostalis -

- Anulusumbilicalis

Spinailiacaanteriorsuperior - -

Fig. 801 Surfaceanatomyofthe thoracicand abdominal

walls of a young female;the prominent bonesare indicated.
 Ribs,Costae

Caput costae \

Tuberculummusculi \ - - Sulcus venae subclaviae

scalenranterioris \

Sulcus.arleriae\
subclavrae \

Collum costae, - -
Crista colli costae Corpus costae \

// Anguluscostae

'Tuberositas
musculi
serralranteflofls

F a c i e s a r t r c u l a r i -s- -
lubercuI costae

Tuberculumcostae /

Facies articularis- - -- Cristacaoitrscostae

capilis costae

Crista colli costae - -

Facies articularis - -
tuberculicostae

Fig.802 Ribs,Costae.
RibsI to III, superiorview
RibVIII. inferiorview
Thoracicand Abdominal Walls

Angulicostarum

--t
- Carlilaginescostales

Fig.803 Ribs,Costae;
viewedfrom the right.
Thedistancebetweenthe ribs is as in nature.
 Incisuraclavicularis\

Manubrium
slerni-

- Symphysis
Incisura
costalisll -
manubriosternalis lncisuracostalisll

-- costalislll
Incisura
costalislll ---
Incisura

--
costalislV - -
Incisura lncisuracostalislV

costalisV --
Incisura -- lncisuracostalisV

costalisVl ---
Incisura

Incisura - - -
costalisVll

Symphysis
xiphosternalis

Proc xiphoideus

Fig. 804 Sternum, Sternum; Fig. 805 Sternum,Sternum;

ventral view. left lateralview.
Form, length and dorsal or ventral direction of the Orientationof ribs andintercostal spaceson the anterior
xiphoid process,Proc.xiphoideus,differ very much. thoracicwatl is facilitatedby the Angulussterni,which
demarcates the articulationof the 2nd rib.
q{i:r
Thoracicand Abdomi.nal

-
Cartilagocostalis ll

manubriosternalis
Symphysis

-
Canilago costalis lll
Lig sternocostaleintraarticulare

Canilago costalis lV -
\...
\-..
\ Artrculationes
sternocostales

costalisV -
Cartilago

Cartilagocostalis Vll - *

Fig.806 Sternum, Sternum;costalcartilages, Notethat the xiphoid processis not seenin this figure due to
Cartilagines
costales;
frontalsection; the curvatureof the sternumin the sagittalaxis.
ventralview.

Capsulaarticularis--
- Lio sternoclaviculareanteflus
Cartilago
costalisl;
SynchondrosiscoslaeI

/ Lig slernocostale radiatum

\ Cartilagocostalis ll
Symphysis
manubriosternalis

Fig. 807 Sternoclavicular joint, Articulatiosternoclavicularis;

the right ioint has beenexposedby a frontal sectionto show
the articulardisc;
ventral view.
 Caveathoracis

/ Vedebta ceruicalisVl

/ vedebta thoracica I

Acromron

C o s t al l

Proc coracordeus

Costalll \
Cavitas glenoidalis

Coslae verae
l-vill

Cosla lV

Costa vl

Costa vlll

Costae spuriae
lvilr-xlll

Cosla Xl

/ \ costa Xll
Venebra lhoracica Xll

Vertebralumbalis | / \ Proc costalis

Fig. B0B Thoraciccage,Caveathoracis;left shoulder

g i r d l e ,C i n g u l u mp e c t o r a l e ;
ventralview.
The thoraciccageis shown in a morlerateinhalation
p o s i t i o nT h e b o n e so f t h e s h o u l d e g
r i r d l ea r e s h o w n
i n g r e e n ,t h e c a r t i l a g e isn b l u e .
The length of ribs XI and XII can var) Sreatl-v
Thoracicand Abdominal Walls

-- M. pectoralis
major
pectoralis
major

Areola
mammae

Papilla
mammana
Glandulae
areolares

-r- M serratus
anterior

Fig. 809 Mammary gland, Mamma; Fig. 810 Mammary gland,Mamma;

ventral view risht lateral view.

Papilla mammaria

Ductuslactiferi t.

Papilla
mammana

Sinuslactilerus/

Lobuli glandulae mammariae

Fig. 811 Mammary gland, Mamma, of a pregnant Fig. 812 Mammary gland, Mamma, of a pregnant woman;
woman; the mammary gland has been sectionedin the the skin of the areola,Areola mammae,has been removed,
sagittal plane; the skin around the nipple has been retracted;
lateral view. ventral view.
 Mammarv Gland.Mamma

Fig. 813 Radiographof the mammarygland,

mammographyof a 47-year-oldwoman;
beamdirectedlaterally.

--'";r{
i
Nodrlymphoidei
ceruicales Nodiprotundi- _
anteriores,
/ Nodi lymphoideiparaslernales
Nodilymphoidei -
supraclaviculares
l>_.--. 7\".
Nodilymphoidei -
deltopectorales
l><: _ .-
r .-s-

(Nodr lymphoideisubmammarii)/

Fig. 814 Lymphaticdrainageof the femalemammarygland Notethe communicationsbetweenthe lymphaticvesselsof

and locationof the regionallymph nodes both sidesand lymphaticdrainageinto the intrathoraciclymph
(From BEruNrrvr;uor,r/Gornrrlrn:
Textbookof Human Anatomy. nodes.
19791
Vol. 2, l2th ed. Muni<;h:Urban& Schwarzenberg,
 Thoracicand Abdominal Walls

Nn. supraclaviculares,
A ; V cerurcilis suoerfrcialisa a'
l'..
I
/ at V cephalica

Plexus venosus areolaris o I

a I t\

i{\

A ; V t h o r a c i c al a t e r a l i s a, t
N thoracicus[T2],
N intercostalis,
R culaneus lateralis
Pectoralrs --
a A t h o r a c i c ai n t e r n a * ;
o Vv thoracicaeinternae

V thoraco- a Nn thoracici,
epigastrica Nn intercoslales,
Rr cutanei anteriores

T3 - a GA ; V epigastricasuperior
14- /
t5

16- --
Nn thoracici, a M obliquus exlernus abdominis
Nn intercostales,
Rr cutanei

pectorales

Nn thoracici,Nn intercostales,
Rr cutanei anterioresabdominales

Vv paraumbilicales*

Vv subcutaneaeabdomrnrs 5 -

A ; V circumflexarliumsuperlicialis3 g -

- - - Chorda arteriaeumbilicalis"

---
N genitofemoralis, - a o A : V e p r g a s t r i c ian t e r i o r
R femoralis
----,&M pyramidalis
A ; V e p i g a s t r i c aa , -
superficialis

A pudenda externa; O - R- Hi3,?'.???T#i3;

W pudendae externae *
--
oM rectusabdominis
N femoralis,
R cutaneus anterior

V saphena magna $ ,
\ N ilioinguinalis

Fig. 815 Blood vesselsand nerves of the thoracic and branchesofthe

Thearabicnumeralsindicatethe cutaneous
abdominal walls. The superficial layer is shown on the right corresponding nerves.
intercostal
* Clinical: internal mammary artery
side of the body; ventral view.
** The Chorda arteriae umbilicalis protectsinternally as the Plica umbilicalis
medialis
 57

Fig.816 Segmental sensoryinnervationofthe anterior

thoracicandabdominal walls(dermatomes).
Lettersand numbersindicatethe cornesponding
segmentsof
the spinalcord.

,/ Diaphragma(c4)

// O€sophagusCf4,TS)

Cor (T3,T4)

T6/
w-
T8 -' - Gasler (T8)

- Hepar;vesica biliaris
( T 8- 1 1 1 )
T10
T11 - lntestinumlenue
(r10)
T12
-- lntestinumcrassum
L1 (r1r)
Ren;Testis
Fig.817 Segmental sensoryinnervationofthe thoracic ( T 1 0- L l )
andabdominalwalls.
- Vesicaurinaria
Theregionson the left half of the bodyarethosewhere ( T 1 r- L r )
pain causedby diseasedinternalorgansis projected
(HE,l,o's
zones).
 Thoracicand Abdominal Walls

Mm sternocleidomastoidei\
rj
Plalysma \
,.\

Fascia clavipectoralis\ \

V cephalica \ -<,_.. \

M deltoideus --
\ Fascia axillans

M pectoralismajor, - -
Pars sternocostalis

- M serratusanteflor

M serratusanterior-

dorsi-
M latissimus
- Ligg costoxiphoidea

Nl pectoralis malot, '

Pars abdominalis
\:
externusabdomrnrs
M obliouus
'-
L i n e aa l b a

M obliouus exlernus abdominis -

Vagina musculi recti abdominis,

Anulus umbilicalis - Lamrnaantenor

- Spina ilracaantenor superior

Spina rhacaanterior -
supeflor

Tela subculanea: - z Fibrae intercrurales

Panniculusadiposus

- Crus mediale
M obliquusexternus- -
abdominis, - -
Aponeurosis M cremaster

---
Funrculus
spermaticus Lig retlexum

- Lrg suspensonumpenls
Lrg lundiforme penis

Fig. 818 Musclesof the thoracicandabdominalwalls;

superficiallayer;
ventralview.
( ThoracicMuscles,Musculithoracis

M sternocleidomasloideus
/ M pectoralis major, Pars sternocostalis
M pectoralismajor, Pars claviculafls
\

Mm intercoslalesinterni \ V axillaris
/
/ . M pectoralisminor
M deltoideus \

/ Plexus brachialis,
M coracobrachialis \
L..' Parsrntraclavicularis

biceps brachii,
Caput breve A axrllaris

M pectoralis--
malor

M pectoralis -
mrnor

Costae ll-V --

-
M latrssrmusdorsr -
i/4 serratusanlenor -

\ M serratusanterior

M pectoralrsmaior, Pars abdominalis /

\ M pectoralismajor,Parssternocostahs

M obliquus exlernus abdominis - \ M obliquus€xternus

abdominis

Fig. 819 Thoracicmuscles,Mm. thoracis; On the left side the M. pectoralisminor has beensectionedand
the right M. pectoralismajor has beenpartially'removed. reflected;the Membranaintercostalisexternahas beenremoved;
ventralview.

M serratusanterior- - -
-- posterior
V intercostalis
-- posterior
A intercostalis
--- N intercoslalis(T8)

- - Pleura visceralislpulmonalis]

C o s t al x - - - - Parscostalis
- - - Pleuraoarietalis.
- - - Pleurapaflelalis,
Parsdiaphragmalica

- - - Parscostalisdiaphragmatis

M i n t e r c o s l a l iisn l e r n u s - - - -
M inlercostalisexternus ----

- - - Recessuscosiodiaphragmaticus
--- Hepar

Fig. 820 Thoracicmuscles,Mm. thoracis; During punctureof the liver or aspirationof accumulatedfluid
frontal sectionshowingthe thoracicwall and the thoracic in the pleural cavity,the courseof the intercostalnerves and
and abdominalcavities; vessels,the positionof the diaphragmand the expansionof the
right lateralview. lung into the costodiaphragmatic recessmust be taken into
account.
 Thoracicand AbdominaLWalls

Ventral musclesof the shoulder (Figs.81B,819)

TheM. pectoralismajoris a muscleof boththe arm andthe trunk. It definesthe superficialreliefof the upperanteriorthoracic
wa.ll.Underneathit liesthe M. pectoralis girdle.TheM. subclavius
minor,a muscleof the trunk-shoulder is alsoa muscleof the
girdie.Its courseto the clavicleis fromcaudal.Thedeepestmuscleof the shouldergirdleis M. subscapularis,
trunk-shoulder
whichruns fromthe anterior(ventral)surfaceof the scapulato the humerus.
Mtscle I Innervatiort Origin Insertion Function
1. M. pectoralis major Pars clavicularis: Clavicula Cristatuberculimajorisof Shoulder joint:
Nn.pectorales medialiset (sternalhalf) thehumerus adduction(very effectivewhen
Iateralis(Plexasbrachialis, internal
the arm is elevated),
Pars sternocostalis:
Parsinfi'a-/ supraclav
icu- Manubriumand Corpussterni,
r0tanon;
Iaris) costalcartilagesof ribs I -6 Parsclavicularis:
anteversion
Pars abdominalis: Reclus Shoulder girdle:
sheath(aponeurosis of the depression,anteversion
externalobliqueabdominal Thorax:
muscle) elevationof the sternum,en-
largementof the thorax (when
Thefibres convergetowards the arms are supportedit
a flat tendon assistsin extreme inspiration)
2. M. pectoralisminor Ribs (2) 3 to 5 (closeto the Apex of the Proc.coracoideus Shoulder girdle:
Nn.pectorales medi.aliset ^F +L^ ^^^^,,1^
iunctionof boneand cartilage) u l t l l t r s l d P u r d depression,anteversion
Iaterolis (Plexusbrachia lis, Thorax:
Pars infra-/ supraclavicu- elevation o f t h e u p p e rr i b s ,
Iaris) enlargementof the thorax
(when the arms are supported
and the shouldergirdle is
fixed it assistsin extreme
inspiration)
3. M. subclavius lst rib (closeto the junction Clavicula(lateralthird), the Shoulder girdle:
N. subclavius of boneand cartilage) fasciais mergedwith the depression(mild effect),
(Plexusbrochialis,Pars adventitiaof V. subclavia resistanceto lateralpull on
supraclavicularis) the clavicle
4. M. subscapularis Faciescostalis,Fossa Tuberculumminus and Shoulder joint:
Nn.subscapulares ^,,k^^^^,,1^-i^
JUUJUdlrUldl l5 adjacentpart of the Crista internalrotation,abductionin
(Plexusbrachtalis,Pars tuberculiminoris (inferiorto the scapularplane (cranial
infraclavicularis) the insertionof Bursasubten- portion),adductionin the
dinea musculisubscapularis) scapularplane (caudalportion)

Muscles of the thoracic wall (Fig.819)

Theintercostalspacesaretakenup by the Mm. intercostales externiandinterni.Theinner surfaceofthe thoracicwall is covered
by Mm.subcostales andby M. transversus thoracis.An occasionalsuperficialvariantis the M. sternalis.M. pectoralismajor,
which dominatesthe superficialcontourof the upperthoracicwall, is a trunk-armmuscle.It overliesM. pectoralisminor,a trunk-
shouldergirdle muscle.Both are describedwith the musclesof the shoulder.
Muscle/ Innervation Origin Insertion Function
1. M. sternalis R.imof sternum(onthe fascia lntothe fascia Contracts
theskin of the chest
(inconstant,existsin 5%of pectoralis)
the population)
Divisionsof Nn.pectorales
(Plexusbrachialis,Pars
supraclaviculans.)or Nn
inierco states(Nn.'thorci ici)
2.Mm. intercostalesexterni Ribs1 to 1l (lon,erborclerfrom Ribs 2 to 12 (upperborderof Elevatethe ribs,expandthe
Nn.intercostales Tuberculumcostaeto the the rib below) intercostal
spacesduring
(Nn.thoracici) junctionof boneandcartilage) inspiration
3. Mm. intercostalesinterni Ribs2 to 12(upperborder Borderof Mm. intercostales Lowerthe ribs andexpandthe
Nn.intercostales fromsternalendof Cartilago intimi on the inner surfaceby intercostal
spacesduring
(Nn.thoracici) costalisto Anguluscostae) Vasaintercostaliaposteriora expiration
and N. intercostalis
4. Mm. subcostales Lowerribs (upperborder Lower ribs (lower border,
(inconstant) betweenTuberculum and alwaysskippingone rib)
Nn, intercostales Anguluscostae)
(Nn. thoracici) Expandthe thoracicwall
5. M, transyersusthoracis Corpussterni,Proc.xipho- Costalcartilagesof ribs 2 to 6 during expiration
(inconstant) ideus(dorsallateralrim), (closeto the junction of bone
Nn. intercostales Cartilago
costalisof rib (6)7 and cartilage)
(Nn. thotucici)
( Thoracic'Muscles.Musculi thoracis

---
M sternothvroideus
- - Mm intercostalesInterni
Manubrium sterni --

--
M transversusthoracis

- - Diaphragma,
Centrum tendineum
-- Foramen venae cavae
- - Mm intercostalesinternl

Fig. 821 Thoraciccage,Caveathoracis;

internalaspectof the anteriorthoracicwall with
the diaphragmin placeon the right side;
dorsalview.

,- Tuberculumanteflus lcaroticum]
(Verlebra cervicalis Vi)
M scalenusoosterior --

--- M scalenusanlerior
M scalenus medrus - -

M s c a l e n u s a n l e r i o r- -
M longus colh

Membrana inlercostalisinlerna - -

-- Membrana inlercostalisinterna

Fig.B22 Thoracic cage,Caveathoracis;

posteriorpart; frontal section;
the musclesof the neck are partly in place;
ventral view.
Thoracicand Abdominal Walls

l\4 trapezius-- - Clavrcula

Spinascapulae--
---- M pectoralismajor, Pars slernocostalis
M infraspinatus--
M teres minor - -
Corpus mammae,
M teres maior -- Lobi glandulaemammariae

--- P a p i l l am a m m a r i a

-- M serralusanlerior

--- M pecloralismaior, Pars abdominalis

M brachialis /
M biceps brachii /

dorsi-
M latissimus

M obliquus externus abdominis - -

- - Anulus umbilicalis
Fascia thoracolumbalis---

lumbale--
Trigonum
-- Vagina musculi recti abdominis,Lamina anterior

Spina iliaca posteriorsuperior --- -- M obliquus Aponeurosis

exlernusabdominis,

- -
Sp'nailiacaanteriorsuperior

--
M tensorfasciae latae
s a x i m u s- -
M , g l u t e um

walls,
Fig. 823 Musclesof the thoracicandabdominal
Mm.thoracisandMm. abdominis. Themammarygland
hasbeendissected:
lateralview.
 AbdominalMuscles,Musculi abdominis

- Ligg costoxrphoidea

M. pectoralis
maior
Parssternocostalis

M. pectoralismajor,
- Pars abdominalis
Vagina musculi recli
abdominis,
Lamrnaanterior

M obliquus
externus
abdominis

M reclus abdominis -
Inlersectiotendinea Mm
intercoslales
interna

M reclus
l\,4rectus abdominis - - abdominis

- M obliquus
internus
abdominis,
Aponeurosis

Anulus umbilicahs -

r1
l
Lrnea alba
T
I"
S p i n ai l i a c a
anlerior superior
-
I M obliquus
internus
abdominis

- -
M obliquus
exlernus

M reclus abdominis. '

-
/r'( abdominis,
Aponeurosis
Tendo
- _-
Anulus lnguinalls( Cruslaterale .
superlicrahsl /
/ - Funiculussoermaticus:M cremasrer
\urus meor3;g
/
M pyramidatrs Lig reflexum

Fig. 824 Abdominal muscles,Mm. abdominis;

on the right side of the body,the anterior layer of the rectus
sheath has been openedto display the M. rectus abdominis
and the M. pyramidalis.On the left side of the body,the
M. obliquus externus abdominis has been sectionedto show
the M. obliquus internus abdominis;
ventral view.
Thoracicand Abdominal

M serratusanterior\

-
M latissimus\ M serralus anterior
dorsl

M obliquus
externus abdomtnis

obliquusexternus-- -
abdominis

[,4m intercostalesexlerni - .-

-
Mm intercostalesinterni

-l
costatisX
Cartitago
- M rectus abdomrnis

obliquus externus
abdominis

M obliquusinternus
abdominis

-
Lig ingurnale

Funiculus - M pyramidalas
spermalrcus;
M cremaster

Fig. 825 Abdominal muscles,Mm. abdominis;

on the left side of the body,the anterior layer of the rectus
sheath has been opened.On the right side of the body,the
M. obliquus externus abdominis has been sectioned;
the Membrana intercostalisexterna has been removed;
ventrolateralview.
(
AbdominalMuscles,Musculiabdominis

M rectus abdominis \
,, M pectoralis major

7 M latissimus
oorsl

M obliquus -
exlernus
abdominis

Mm intercostales-
externi

Cartilagines - - M obliquus
costales
externus
abdominis
- Intersectiones
Costaelx; x - lendineae

- Vaginamusculi
rectiabdominis,
Laminaanterior

Vagina musculi recti - -- M rectus

abdominis, abdominis
Lamina posteflor
-- M obliquus
internus
-
Lineasemilunaris abdominis
- M transversus
abdominis

- Intersectio
lendinea

-- M obliquus
internus
M obhquus.- abdominis
internus
abdomrnis

M obtiquus-
inlernusabdominis,
Aponeurosts

Anulus- -
inguinalis
superlicialis,
Crusmedrale

Anulus -
inguinalis
superficialis,
Crus laterale \ M pyramidalis

Fig. 826 Abdominalmuscles,Mm. abdominis;

on the left side of the body,the M. pyramidalis has been
sectioned.On the right side of the body,the M. rectus
abdominis is reflectedupwards and downwards;
the M. obliquusexternusabdominishas beensectioned;
the anterior layer of the rectus sheath has been pulled
to the right over the midline;
ventral view.
 Thoracicand Abdominal Walts

Anterior muscles of the abdominal wall (Fig.826)

The anterior muscles of the abdominal wall, M. rectus abdominis and M. pyramidalis, Iay within the rectus sheath.

Muscle Origin Insertion Function

Innervation
1. M. rectus abdominis Ventral surfaceof costal Crista pubica of Os coxae, Flexesthe trunk towards the
Nn. intercostales(Nn. thora- cartilagesof the 5th to Symphysispubica pelvis, compressesthe
cici); rarely ventral divtsions 7th ribs, Proc. xiphoideus, abdomen,abdominal
of upper Nn. Iumbales Ligg. costoxiphoidea breathing (expiration)
2. M. pyramidalis Crista pubica of Os coxae, Linea alba Tensesthe Linea alba
(inconstant) Symphysispubica (ventral of
caudal Nn. intercostales M. rectus abdominis)
(Nn. thoracici)

Lateral muscles of the abdominal wall (Figs.824, 826)

The lateral muscles of the abdominalwall are: M. obliquus internus abdominis,M. obliquus externus abdominis,and
M. transversusabdominis.
In the male the M. cremasterbranchesoff from M. obliquus internus and M. transversus.

Muscle Origin Insertion Function

Innervation
1. M. obliquus externus Ribs 5 to 12 (external surface, Labium externum of Crista Unilaterally acting, rotatesthe
abdominis interdigitateswith M. serratus iliaca, Lig. inguinale, thorax to the oppositeside and
Caudal Nn. intercostales anterior) Tuberculum pubicum, Crista bends the Columnavertebralis
(Nn. thoracici); pubica, Linea alba (part of laterally.Acting bilaterally,
N. iliohypogastricus; the anterior layer of rectus bends the thorax towards the
N. ilioinguinalis(Plexus sheath) pelvis, compressesthe
Iumbalis) abdomen,abdominal
breathing(expiration)
2. M. obliguus internus Fasciathoracolumbalis Inferior border of the costal Uniiaterally acting, rotatesthe
abdominis (superficiallayer),Linea cartilagesof ribs (9) 10 to i2. thorax to the sameside and
Caudal Nn. intercostales intermedia of Crista iiiaca, Linea alba (aboveLinea bends the Columnavertebralis
(Nn. thoracici); Lig. inguinale (lateral tlvo- arcuata it conhibutes to the laterally.
N. iliohypogastricus; thirds) anterior and posterior layer Acting bilaterally,bends the
N. ilioinguinalis (Plexus of the rectus sheath; inferior thorax towards the pelvis, com-
Iumbalis) of Linea arcuataall fibres pressesthe abdomen,abdo
contributeto the anteriorlayer). minal breathing (expiration).
In the male the inferior fibres M. cremasterdraws the testis
becomeM. cremasterand and its tunics up towards the
extend to the spermatic cord. superficial inguinal ring.
3. M, transversus abdomtris Inner surfaceof the costal Linea alba (aboveLinea Compressesthe abdomen,
Caudal Nn. intercostales cartilagesof ribs (5, 6) 7 to 12. arcuatathis muscle contrib- abdominal breathing
(Nn. thoracici); Procc.costalesof the lumbar utes to the posterior layer of (expiration)
N. iliohypogastricus; vertebrae (by way of the the rectus sheath; inferior to
N. ilioinguinalis thoracolumbarfascia),Labium Linea arcuata all fibres con-
(Plexuslumbalis); internum of Crista iliaca, tribute to the anterior layer).
N. genitofemoralis Lig. inguinale (lateral third) In the male the inferior fibres
becomeM. cremasterand
extend to the spermatic cord.

Posterior muscles of the abdominal wall (Fig.829)

Thefoundationof the musclesof the posteriorabdominalwall is formedsuperiorlyby Parslumbalisof ttre diaphragm,inferiorly

by M. quadratuslumborum,and with participationof the M. psoasmajor medially.
Muscle Origin Insertion Function
Innervation
M. quadratuslumborum Labiuminternumof Crista 12thrib (medialpart),Procc. Depresses the ribs
Rn musculares (Plexus iliaca(posteriorthird),Lig. costalesof the lumbar (expiration),
laterallyflexes
lumbali.s);
N. tntercostalis iliolumbale vertebrae4 to one. the lumbarvertebralcolumn
(N, thoracicus[T12])
( Inguinal Canal,Canalisinguinalis

M oblquus--
e x l e r n u sa b d o m r n r s ,
Aponeurosrs

-- M oblquus
i,4ob|quus-- exlernusabdominis.
i n t e r n u sa b d o m r n r s Aponeurosis
zi:'
z :y'".

- - Fibrae intercrurales

-- Crus l
lateraleI Anulus,
l In9urnars
-.- Crus I superfrcialis
mediale
J
- -
Funiculusspermalicus

F i g . 8 2 7 S u p e r f i c i ai ln g u i n a lr i n g ,A n u l u si n g u i n a l i s T h ea p o n e u r o s iosf t h e r i g h t M . o b l i q u u se x t e r n u sa b d o m i n i si s
s u p e r f i c i a l i st h; e r i g h t s l l e r m a t i c o r r l ,F u n i c u l u ss p e r m a t i c u s , openerl;ventralview.
is retractedbv a hook C o m p a r et o F i g 8 3 5 .

Lrg falcilorme
M rectus abdominis
/ Lrg teres hepatis:V umbrftcalis
)

Fossa supravesrcalis
Linea arcuata

F o s s ai n g u i n a l i sm e d r a l r s
\ Plica umbilicalismediana

F o s s a I n g u r n a I sl a l e r a l i s Plica umbilicahsmedialis
\

Pftcaumbilicahslateralis

/ Plica vesicalistransversa

A ; V t e s t i c u l a r i-s- - -
M iliacus

A ; V i l i a c ae x l e r n a - -
---- Osilium
/
A u m b i l i c a t i/s / \ \ A,V tltacaexterna
Ampulla duclus delerentis/ \ Ureler, Pars pelvica

F i g . 8 2 B A n t e r i o ra b d o m i n aw
l allin a newborn; The \'. umbilicalisobliteratesafter birth. In portal hypertension
drlrsalview this vein can onceagainenlargeCompareto Fig 1029,portocaval
anastomosls.
 Thoracicand Abdominal Walls

Oesophagus,Pars abdominahs \ , - Pars slernahsdiaphragmalrs

Foramen venae cavae \ / / Pars costalisdiaphragmatis

/ N4 transversusabdominis

- - Centrum tendineum

- - Hiatusaorticus

- - Pars abdominalisaortae

- - Pars lumbalisdiaphraomatis,
Crus dextrum
Lig arcuatum --
mediale

Lig arcuatum lalerale - - - - - i,4 quadratus

lumborum

-- - Fascralransversalrs
( M p s o a s m i n o r.)- -
- -- Vertebraelumbales lll: lV
M. quadratus-
lumborum
- - Crista iliaca

M transversus-
abdominis
-- (M psoasminor),
Tendo
M psoas - --
malor M psoas
malor
M iliacus - --
M iliacus

- -
Promontorium

Periloneum .- - .- Lacuna
parietale vasorum

- - A temoralis
Rectum -
- -
V femoralis

Pecten ossis --
pubrs Lig inguinale

Lig lacunare -

Fig. 829 Diaphragm,Diaphragma;

abdominalmuscles,Mm. abdominis;
ventral view.
 Diaphragm,Diaphragma i't-E

Proc.xiphoideus
- - - - --.
Parssternalisdiaphragmatis

/ Hiatusoesophageus
- - - - z
Centrumtendineum

Foramen venae cavae - -

- -
Parscostalisdiaphragmatis

Parslumbalis
diaphragmatis,-
Crusdextrum,(Parslateralis) | . Parslumbalisdiaphragmatis,
Crussinistrum,(Parslaleralis)
Lig arcuatum mediale -

Lig arcuatumtaterate

C o s t ax l l - - -
-- M quadratuslumborum
lumbalis,. ,ro" .or,",," r')[-
Vertebra
-\
Parslumbalisdiaphragmatis,
Pars lumbalis diaphragmatis, Crus dexlrum, // Crussinistrum,
(Pars medialis) (Parsmedialis)
M. psoasmaior
\ VerlebralumbalislV

Fig.830 Diaphragm, andposteriorabdominal

Diaphragma, TheCrusdextrum,Parsmedialisoftenconsistsof threeparts
wall; andreachesfurthercaudallvthanthe Crussinistrum.
inferiorview. ' Clinical:Bocuo,r.r-tx's
triangle

Foramenvenaecavae

Mm intercostales
interni
Parssternalisdiaphragmatis

Parscostalisdiaphragmatis

- - Vaginamusculirecliabdominis,
Laminaposlerior

--- Inters€ctiotendinea

M lransversus
abdominis
--- - - Linea alba
M obliouusexternus
abdominis
---
M obhouus
inlernusabdominis
---
,-- Anulusumbilicalis

-- Lineaarcuata

--_ M transversusabdominis

&- - - Lig. intertoveolare

7Z
-- -- profundus
Anulusinguinalis
Adminiculumlineae albae --- ----
Os pubis,Ramussupenor

Fig. B3l Anterior abdominal wall and parts of the

diaphragm,Diaphragma;
dorsal view.
 Thoracicand Abdominal

V cava inferior,Vv hepalicae \

Pars sternalisdiaphragmatis \ \
Pericardium y
Pleura parietalis,Pars diaphragmatica - -
\
l\,1latissimus dorsi - - -
- Gaster, Pars cardiaca
c o s t av l l l - -
Pars lumbalisdiaphragmalis,
C o s t a V l-l - - - --
Crus sinrstrum,(Pars lateralis)
serratusanleflor - -

Costa Vl - -
- - Hiatus aorticus

_-- tig arcuatum laterale"

M rectus abdominis --- C o s t aV l l l

--*
CoslaXll

M obliquus transversusabdominis
externus abdominis
- .-
Lig arcuatum mediale**

-
Pars lumbalisdiaphragmatis,
Crus sinistrum,(Pars medialis)
' -
M psoas majot ' Lig lumbocostale
-
M quadratus lumborum
-
Vertebralumbalis lll, Proc
(i,4 psoas mtnot) -- - M iliacus

Fig. 832 Diaphragm,Diaphragma,with its aperturesand the ' Clinical: BocHDALEK's triangle, Trigonum lumbocoslalediaphragmatis,
a region free of muscles
musclesof the posteriorabdominalwall; the trunk has been *
" also psoasarch, Arcus musculi psoatis,and quadratus arch {also called Hnllrn's
sectionedat the levelof the 1Oththoracicvertebra: a r c h ) ,A r c u s m u s c u l iq u a d r a t i ;
ventralview \ ' , \ ' 1 ,\ ' l l - r i b s 5 , 6 , 7

Diaphragm, Diaphragma (Fig.832)

Thediaphragmseparatesthe thoracicfrom the abdominalcavides.Its domesform the floor of the right andleft pleural cavities,
TheParslumbalisbordersthe retroperitoneumdorsallyand,in a strict sense,representsa portion of the posteriorabdominalwall.
Muscle Origin Insertion Function
Innervation
Diaphragma Parssternalis:Proc. All partsuniteat the central Respiratorymuscle,
N. phrenicus(Plestus
cervicalis) xiphoideus(innersurface), tendon,Centrumtendineum diaphragmatic breathing
rectussheath(aponeurosis of Weakpointsand (inspiration),
increases
M. transversus abdominis) diaphragmatic openings: abdominalpressure
Parscostalis:costalcartilages Trigonumsternocostale,
of ribs 12to 6 (innersurface, Trigonumlumbocostale,
connected to the originof M. Foramenvenaecavae,Hiafus
transversus abdominis) oesophageus, Hiatusaorticus
Parslumbalis, Crus dextrum,
- Parsmedialis:bodiesof
lumbarvertebrae 1 to 3,
Disciintervertebrales
- Parslateralis:Ligg.arcuata
mediale(archof the psoas
muscle)andlaterale(archof
the quadratuslumborum
muscle)
Parslumbalis, Crus sinistrum,
- Parsmediaiis:bodiesof
lumbarvertebrae1 to 4,
Disciintervertebrales
- Parslateralis:Ligg.arcuata
mediale(archof the psoas
muscle)andlaterale(archof
the quadratuslumborum
musclel
 Lumbosacral
Plexus,Plexusfumbosacralis

Pars lumbalisdiaphragmatis,Crus dextrumO

Lig arcuatum laterale - - -

i,4 ouadratus lumborumO

N iliohypogastricus--

N ilioinguinalis

M psoasmaloio --
M o b l i q u u s o- -
externusabdominis
M obliquuso --
internusabdominis

M lransversusa --
abdominis
N cutaneus
femoris lateralis

N g e n i t o f e m o r a l,i s - ' 1 : '

Fl. femoralis ,
,;i
-)*+'
- e n i t o t e m o r a l.i s - ' 7 - -
N o
R genitals ,t': ,t N culaneus
femons laleralis
-'
N obturatonus \
i-1;i -
8"nn",,. N.
N cutaneus l-t- I ] femoraris
senito_
remorisiaGririi
" -

';'i:ilfi-;;ril*]j] :!-mw'.llidt 0,
ilE ,lBX4 l- [,no,"ri",,J

/
-
V saphena magnaa
I
N genitofemoralis,Rr genitates / I Funiculusspermaticus

Fig. 833 The lumbosacralplexus,Plexuslumbosacralis;

the psoasmajor,the pectineusand the adductorlongus
muscleshavebeenremovedon the left;
ventralview

Diaphragmaticopenings
Name Position Structures
Hiatusaorticus Parslumbalis, Aorta;
betweenCrusdextrumandCrussinistrum Ductusthoracicus
Hiatusoesophageus Parslumbalis,Crusdextrum Oesophagus; Nn.vagi;N. phrenicus,
R.phrenicoabdominalis sinister
Foramenvenaecavae Centrumtendineum V. cavainferior;N. phrenicus,
R.phrenicoabdominalis dexter
[.lnnry's fissure betweenParssternalisandParscostalis A. andV. epigastrica
superior
Unnamed Parslumbalis, N. splanchnicusmajorand minor;
betweenCrusdextrum,/sinistrum,
Parsmedialis Y. azygos;V. hemiazygos
Unnamed Parslumbalis, Truncussympathicus
betweenParsmedialisandParslateralis
 Thoracicand Abdominal

Manubrium
sterni / aA thoracicaintef,na'
A thoracicainterna' O --
:.i
I
;<
/ aV thoracica interna
a --
A pericardiacophrenica

a --
Rr pertorantes

/ a {A( intercostales
anleriores

thoracist --
M transversus

z O o A ; V musculophrenica

A thoracica interna,
Rr intercostales
anteriores
a $A ; V, epigaslrica
suPeflor

a --
A musculoohrenica - o Diaphragma

A epigastricaO --
supeflor

* --
M rectusabdominis

Vaginamusculi--
rectiabdominis,
Laminaposterior

-- epigastricainferior
oA

--
* V epigastricainferior

--
aA iliacaexlerna
interiora -
A epigastrica

Fig. 834 Bloodvesselsof the anteriorthoracicand abdominalwalls;

the right transversethoracicmusclehas beenremoved;
dorsalview.
* Clinical:internalmammaryartery
 Antenior
AbdominalWallandInguinal'Canal,
Canalisinguinalis

O\
M rectusabdominis
M transversus a \
abdomrnrs
s 8], O. \
. N .t h o r a c i c u[ T \
N inlercostalis;
A I V. intercostalis \ \ / aM serratusantsrior
N thoracicus [T 9], O O ..
N intercostalis; \ ' Cartilago
A : V Intercoslalis costalisVlll

Vaginamusculi\
rectiabdominis,
Laminaanterior

N t h o r a c i c u sO o : - a M obliquus
rr 101, enernus
N intercostafts; aMominis
A; V intercostalis
- a V umbilicalis
N t h o r a c i c u so o :
[r 11],
N intercostalis;
A : V intercostalis
- aAa umbilicales'*
M obliquus O :
exteinus \
abdomrnrs
- Cutis
Lrnea arcuata \

N thoracicus
[T 12],
N intercostalis

Vagina musculi recti - -'

abdominis,
Lamina posterior
- Urachus

Peritoneumu'.""r"t" - -
OA umbilicalisd6xtra
\r*_\
t. t-
aA vesicalissuperior
A n u l u s- - - - - - -
inguinalis
superlicialis
-----.4
--
0 ,A'
Il l/l Vesicaurinaria
M obliquus
a
internus
abdominis
M cremaslera - / tl\
---
l'--- sp"tirrretropubicum
Fasciaspermaticainterna-' t4.
- -
externaa '-'-4F
Fasciaspermatrca -
aW.vesicales

M obliquus
externusabdominis.a - \
Aponeurosis aM rectusabdominis
A testicularis /
o
- o Mm.pyramidares
= /
Plexuspampiniformis

\ Duclusdefersns
o /
M cremaster

testis,Laminaparielalis/
Tunicavagrnalis

Fascia soermatica inlerna / '

/ a Fasciaspermaticaexterna
Tunica dartos, M darlos o / I
lGubernaculumtestrs;

Fig. 835 The anterior abdominalwall of a newborn. ' bulge caused by looping of the umbilical blood vessels
The rectus abdominis muscle has been retractedsuperiorly and (also called false umbilical cord knot)
'* blood clot, thrombus in the umbilical arteries
the abdominalcavity has been openedin the median plane to
show the urinary bladder and the urachus.The right inguinal
canal has been dissected;
ventral view.
Thoracicand Abdominal Walls \

I M rectus abdominis
I Linea alba
I I I A;w epigastrica(e)superio(es)
I I M obliquus externus abdominis,Aponeurosis
| / Vaoina musculi recti abdominis,Lamina anterior

/ M obliauus internusabdominis

// M. obliquus externus
- t aDoomrnrs
V paraumbihcalis Lig f"l"iforr" M transversusj
i
Lig teres hepatis abdominis,
UmbilicusI Aponeurosis _ - Mm intercostales

- M transversus
M reclus abdominis
/ abdominis

\
/ Fascia transversahs
Anulusumbiticalis pri
I mediana;
L's
".bir,fdl""f,:til"rr{i] / M. obliquus externus
/ abdominis

-- M obliquus
internus
abdominis
--
fvl transversus
abdominis
i
Fasciatransversalis \\ Chorda arteriae umbilicalis
//
\ /
Plica umbilicalismedialis

M transversusabdomlnts --

M obliquus internus -
Vertebralumbalis; -
abdominis
Corpus vertebrae /
M obliquus externus
abdominis

\ (M psoas minor)

- M psoas major

quadratus lumborum
/ M

\
Ala ossis ilium

I \
M iliocostals M gluteus medius
I
/ lumborum
Fasciathoracolumbalis
Fascia \
M iri".r.
M longissimusthoracis thoracolumbalis

Figs. 836 a-c Abdominalmuscles,Mm. abdominis;

horizontalsections.

a abovethe umbilicus
b at the levelof the umbilicus
c belowthe umbilicusand the arcuateline
 AbdominalMuscles.Musculi abdominis

Draphragma,Pars costalis a - -
a Diaphragma,
Centrumtendineum
- -
Costavll

- -
C o s t aV l l l
ooA;V intercostalis;
(T8)
N intercostalis
C o s t al X - -

N subcostalis

- - Fascratransversalis
- - Peritoneum parietale

N iliohypogastricus
M obliquus externuS
aor
abdominis
-
rusinlernus
M obliquu us abdominis N ilioinguinalis

M transversus
us abdominrs

Crista ilii
N cutaneus femoris lateralis

M lensor lasciae latae

N femoralis

M iliopsoas --- aA temoralis

--*.
a V femoralis

Fig. 837 Abdominalmuscles,Mm. abdominis;

froiltal section;
ventral view.
Compareto Fig. 1134

M obliquus externus abdominis,Aponeurosis

I M obliquus externus abdominis,AponeurosrsI
M obliquus internusabdominis,Aponeurosis, I
M obliquus internusabdominis,Aponeurosis:, I
M transversusabdomrnrs,Aponeurosrs I i
' M. transversusabdominrs,Aponeurosis I I

M.rectusabdominis, jii M. rectus abdomrnis

I

M quadratusl I M. transversusabdominis' I I |' M transversusabdominis

lumborum I ,' l I
M. obliquus internusabdomrnrs I M obliqura internusabdominis
M erector spinael
M obhouusexternus abdominisr obliquus externus abdominis

Figs.B3Ba, b Abdominalmuscles,Mm. abdominis; Theparticipation of the aponeurosisin formingthe rectus

computedtomography(CT). sheathis clearlydiscernible(cf.to Figs.B3Z1148).
a at the levelof the umbilicus
b at the level of the fifth lumbar vertebra
 ThoracicViscera

A carotis communis sinistra

\ \
Truncusbrachiocephalicus A subclaviasinistra

,- Arcus aorlae

V cavasuperior- - - - Lig arteriosum*

// A pulmonalissinistra

- - Truncuspulmonalis
A, pulmonalisdexlra --

serosum,\ \ \
Pericardium - Pericardium
serosum,
Lamrnaparietalis Laminaparietalis

'- - Auriculasinistra

-- V cardiacamagna
Auricula
dextra
.-.-
A coronariasinistra
R circumflexus
Conusarteriosus

- -
Atriumcordisdexlrum- - A. coronaria sinistra,
R intervenlricularis
anterior
- V,interventricularis
' anterior
V cardiaca media
.-
Ventriculuscordis
sinister
-
A coronariadextra

Ventriculus cordis dexle( /

Apex cordis
Pericardium Laminaoarietalis/
serosum,

Fig.839 Theheart,Cor;
the pericardiumhasbeenopenedand mostof its
parietallayerhasbeenremoved;the major branches Pericardiumfibrosum
of the coronaryarterieshavebeendissected; Pericardium
serosum pericardium
and on the
the epicardiumon the Aorta ascendens
Laminaparietalis
Truncuspulmonalisis not shown;
ventralview. Laminavisceralis epicardium
* Bor^Iro's ligment, a remnantof the fetalductusarteriosus.
 Heart,Cor

V brachiocephalica sinistra / V vertebralis

A carotiscommunis srnrstra
\ V brachiocephalica dextra
/,
A subclaviasinislra\ \,
/, Truncus brachiocephalicus

Arcusaortae \

posteriores\
Aa intercoslales

/, V. azygos

Pars descendens aortae lAorta descendens] Parsascendensaortae

IAortaascendens]

Lig arteriosum't' - -- V cavasuperior

- - truncipulmonalis
Bilurcatio

-- A oulmonalisdextra

T r u n c u s o u l m o n a-f-t-s

V v D u l m o n a l e s r n r s l r a e- - - -

Auflcula sinistra ---

{i::--- - - Atriumcordissinistrum
V cardiaca magna

- - Sinusvenarumcavarum

A coronana sinrslra, -
R crrcumflexus -- Peflcardiumserosum,

Vzt Lamina parietalis

- -.
Vv airiales sinistrae
'/-,
Vv ventriculi - - .-
sinistriposteriores - Atriur cordrsdextrum

- --
Pericardiumserosum, - Sulcusterminalis
Lamina visceralisIEpicardium]

\ V cava inferioP
-
Ventriculuscordrs sinister / t sinuscoronanus
\
Sulcuscoronarius
APexcordis /
'A coronaria posterior
dextra,R interventflcularis
' Ventriculus
V interuentncularisposlerior / cordisdexter

Fig. 840 The heart,Cor,and adjacentvessels; ' arrow in the transversepericardialsinus,Sinustransversuspericardii

'* doublearrowsin the obliquepericardialsinus,Sinusobliquuspericardii
the pericardiumhas beensectionedcloseto the reflected
" " BorALLo's ligament,a remnantof the fetalductusarteriosus
foldson the great vessels;the major coronaryarterieshave
beendissected;
dorsal view.
 ThoracicViscera

- Aorta

_- Truncuspulmonalis
V cava .--
supenor

- - Sinustruncipulmonalis
_ - Auricula sinislra

- Venlriculuscordis sinrster

cordis-
Venlriculus
dexter

Sulcus Fig. 841 Musculature of the heart,

interventricularis
anlerior Myocardium;a part of the superficialmuscle
layer has been removedfrom the wall of the
right ventricle to exposethe deep layer;
ventral view.

A pulmonalis
dextra
truncipulmonalis
Bifurcatio - -
--- V cavasuoerior

W pulmonales dextrae

Vv pulmonalessinistrae --- A t r i u mc o r d i s
dextrum

Atriumcordissinistrum----
-- V cava inferior

Sulcuscoronarius - - Sinus coronarius

-- Ventriculus
cordis
dexter

Fig. 842 Musculature of the heart, Sulcusinteruentricularis

Posterior
Myocardium;
a part of the superficial muscle layer
has been removedfrom the wall of the
Ieft ventricle to exposethe deep layer;
dorsoinferiorview.
(
Heart,Cor

Sulcusinteruentricularis
anterior

Apex cordis

oosterior/
Sulcusinterventricularis

Fig.843 Musculature of the heart,Myocardium;

viewedfromthe apexof the heart.

Valvulasemilunaflsdextra \

Valva trunci Valvulasemilunaris \

pulmonalis anleflor \ / Valvulasemilunarissinistra

/ Valvulasemilunarisdexlra

Trigonum
fibrosumsinistrum\

Tflgonum
librosumdextrum\

Anulusfibrosussinister

Cusprs/
commissurahs
Srnrstra
Valva I Valva
/
atrioventriculars Cuspisposterior
I Cuspisanterior alrioventricularis
sinistra dextra lvalva
IValva mrtralis] tricuspidalisl
Cuspisanterior/ I cuspisseptatis
/
Cuspis commissuralisdextra /

Fig. 844 Musculatureof the heart,Myocardium;

valves,Valvaecordis:
the dissectionplane after removalof the atrial septum
as well as the point of entry of the bundleof Hrs are
not shown.
Systolicphasewith atrial valvesopenand
atrioventricularvalvesclosed;superiorview.
 ThoracicViscera

Ostium atrioventricularedextrum r
- - Pars ascendens aortae
Septum interatriale\
\

V cava supenor
- Auriculadextra

Foraminavenarum - --- A coronariadextra

mtntmarum

-- Alriumcordisdextrum

Limbus fossae ovalis -

- - - Valva atrioventricularisdextra.
Cuspisanterior
Tuberculum
Interyenosum
-- M papillaris
septalis
-
Fossa ovalis
-- M papillarisanlerior

V cavainlerior / - -
Valva atrioventricularisdextra,
Cuspis septalis
Valvulavenae cavae inlerioris* /

Osliumsinuscoronarii
/
sinuscoronarii/
Valvula
-- -
Septuminteruentnculare,
Parsmuscularis
Valva atrioventricularisdextra, Cuspis posterior /

Mm papillaresposteflores \ Trabecula
/ septomarginalis'*
Fig. 845 Right atrium, Atrium cordis Ventriculuscordis dexter /
dextrum, and right ventricle, Ventriculus I
/
Myocardium
cordis dexter; I
the heart has been openedby a longitudinal Pericardiuma"roarr, / \ Apex cordis
Lamina visceralisIEpicardium]
section;the right atrioventricular valve is open;
ventral view.
* also:EusrlcHtan valve
* * also: Moderator band
Fig. 846 Right atrium, Atrium cordis
dextrum,of a newborn;
the anterior wall of the atrium has been
V cava superior retracteilto show the oval foramen;
right ventral view.
Auriculadextra For the significanceof the oval foramen
beforebirth seeFig. 41.

Septum interalflale

V v p u l m o n a l e-s- (
dextrae 1:; - - - Valva atrioventricularisdextra
IValvatricuspidalis]

Ostiumvenae cavae
supeflofls" Ostium alrioventriculare
oextrum

Foramen ovale -

Ostiumsinus
- coronaflr
Limbusfossaeovalis -

-
V cava inlerior -
 Heart,Cor

V oulmonalis
srnislra - - - -
suoerior Myocardium
/

Auncula sinistra Vv oulmonalesdextrae

\

V cardiaca magna \
/, Alriumcordis
,/ srnrstrum,
Septum
Anulusfrbrosus
srnisler\ interatriale

Ostium atfloventricularesinistrum -

- V pulmonalis
sinistra
inferior
- Valvulatoraminis
M papillarisanterior - ovalis(Falxsepti)

\ Anulusfibrosussinister

- Valva
atrioventricularis
sinistra,
Cuspis
Pericardiumserosum..- posterior
Laminavisceralis
IEpicardium]
Chordaelendineae

M papillarisposterior
Venlriculuscordis sinister -

Fig. 847 Left atrium, Atrium cordis \ Myocardrum

sinistrum,and left ventricle,Ventriculus \ Seolum interventriculare. Pars muscularis
cordissinister; \ Trabeculae carneae
the heart has been openedby a Apexcordrs-
longrtudinalsection;
lateralview.
I Lunula valvulae semilunaris

Bulbusaortae-__

Sinus aortae -

Truncuspulmonalas
\

/ / M papillaris
,.\ Posterlor
L:r
Valvula semilunarissrnislra - -
\
A coronaria dexlta -'
\\,

Nodulus valvulae semilunaris -

Auriculadextra -
/
Valvulasemilunarisdextra /

Valvulasemrlunarisoosteflor /
\ Ostiu. atrioventriculare
sinistrum

Valvaatrioventricularis
sinistra,
Fig. B4B Left ventricle,Ventriculuscordissinister. Cuspisanterior
ascendingpart of the aorta,Aorta ascendens;
longitudinalsectionthrough the middleof the left ventricle
-
and in the anteriorinterventricularsulcus;the aorticvalve M papillarisanterior
(arrow)is shownduring the filling phase(diastole)of the
heart: Ventriculus
cordissinister
lateral view.
 ThoracicViscera

/ Valva aortae, Valvula semilunaris sinistra

Atriumcordissinistrum

Pars ascendens aortae --

Valva aortae, Valvula -- 7 Cuspisanterior

/ vatvaatrioventricularis
sinistra
semilunarisposterior z Cuspisposterior )

Sinusaorlae --

Auriculadextra - -

A coronariadextra - -

Septumintervenkiculare,
Parsmembranacea"
posterior
papillaris

Valvaatrioventricularis -
dextra,
Cuspisposlerior

Valvaatrioventricularis
dextra,
Cuspisseplalis
.-*
M papillarisanteriot

M papillarisanterior
/

M papillaris
posterior

I
SeDtuminteruentriculare.
Parsmuscularis

Fig.849 Leftandright ventricle,Ventriculuscordissinister Note the differencein thickness of the myocardiumof the right
and dextra; and left ventricle.
longitudinalsectionthroughthe longaxisof the heart; * Plane of section of Fig 850

left ventrolateralview.

anterior
/ V interventricularis
,/ 7 Pericardiumserosum, LaminavisceralislEpicardium]
A coronariasinistra,
R interventricularis
anterior /, Myocardium
anterior--
Sulcusinterventricularis / Endocardium
/ Ventriculuscordis dexter

/ Trabeculaseptomarginalis

--- A coronaria dextra,

M. papillarisanterior -
R marginalis dexter

- - Myocardium
A. coronariasinistra,- -
R marginalissinister -- M papillarisposterior

- Trabeculae carneae
cordissinister-
Vontriculus

- Seotuminterventriculare,
Mm papillaresposleriores- Parsmuscularis
\ Valvaatrioventricularis
dextralvalvatricuspidalis],
- Cuspisseptalis
Chordaetendineae \- \ posterior
Sulcusinterventricularis
/ \ A coronaria posterior
R interuentricularis
dextra,
V interventricularis.Dosterior

Fig. 850 Leftandright ventricle,Ventriculuscordissinister Note the differencein thickness of the myocardium of the right
and dextra; and left ventricle.
to the longitudinalaxisof the heart;
crosssectionperpendicular
supenorvlew.
 Heart,Cor

Valva atrioventricularissinistra,
Cuspis poslerior

Chordae tendineae

M papillarisanterior

M papillaris posterior

Fig. 851 Left ventricle,Ventriculuscordissinister.

A segmenthas been removedto show the papillary
musclesand the Chordaetendineae;
left ventrosuperiorview.

Valva alrioventricularisdextra,
Cusois anlerior

/ Arcusaortae
>
r'l
I

-- Atriumcordisdextrum

Sulcus-
interuenlricularis cordis
Ventriculus
posterior dexter

Trabecula -
septomarginalis

Fig. 852 Right ventricle, Ventriculus cordis dexter.

A segmenthas been removedto show the papillary
musclesand the Chordaetendineae;
dorsal view.
" outline of removedsegment
 ThoracicViscera

Parsascendensaortae / Truncuspulmonalis
V cavasuperior\
sinislra
,/ A coronaria
/
z Sinus lrunci pulmonalis
Ostiumvenaocavaesuperioris /
-- Yalvalruncrpulmonalis,Valvula semilunarissinistra
Atriumcordisdextrum\
- - Sinusaortae
- Valva aortae, Valvulasemilunarissinistra

- - Ostium sinus colonarii

-
Nodussinualrialis*
.-- Fasciculusatrioventricularis'**

- Ciusdextrum

Ostiumvenaecavae -
inferioris

Valvula venae cavae

inferioris

Valvulasinuscoronarii
.*-
M papillaris
anterior

-
Valva atrioventricularis dextra,
Cuspis anterior
Ventriculus
cordisdexter

Fig. 853 Rightatrium,Atrium cordisdextrum,andright ' Clinical:Krrru-FLAcKnode,sinus node

't Clinical:AscttoFF-TAwARA node,atrioventricular (AV) nod€
ventricle,Ventriculuscordisdexter,with the conductingsystem; t * * Clinicalb: u n d l eo f H I s
the atrium,the ventricleandthe arterialorificeshavebeen
opened,the conductingsystemis displayed in yellow;
ventralview.

Parsascendensaortae -
/ Sinusaortae
'l
-- Valv.ula
semilunaris
A coronariadexlra - 'Poslerlor I
I Valvaaortae
. - - Valvulasemilunaris
I
t dextra )
- -- septumatrioventriculare
- - -
Valva atriovenlricularissinistra,
Cuspis anterior
Truncuspulmonalis/

A. coronariasinistra

/
Fascrculus
atrioventricularis,
Crussinistrum -
M papillarisanterior

Fig.854 Leftventricle,Ventriculuscordis ' Venkiculus

cordissinister
sinister;the ventriclehasbeenopenedby
a longitudinalsection;the left branchof the
conductingsystemis displayedin yellow;
left ventralview.
 Heart,Cor

Arcus aortae - - / Lrg artenosum Fig.855 Coronaryarteries,

Aa.coronariae;cardiacveins,Vv.cordis;
/ Pericardium
serosum
,/ Laminapafletals semischematic;
V cava supenor -
/ A pulmonalissinislra ventralview.
Pericardrumserosum,- Thearrowis in the transversepericardial
Lamina parielalis
t// Iruncus Pulmonalis sinus,Sinustransversus pericardii.
A pulmonalis -
dextra
Parsascendens -
aortae / A coronariasinistra
Sinuslransversus- -
- Atrium cordis sinistrum,Auflcula sinislra
pericardii
/ V cardracamagna

A coronaria- - I- A coronar,a R circumflexus

srnistra,
dextra

- -
Conusarteriosus
Atrium cordis dextrum - - -
A coronaria sinistra, R interuentricularis anterior

- V interuentricularis
anterior
Vv ventriculidextri
anleriores

R atrialis -

R marginalisdexter - Apexcordis

Incisura cordis
aoicis

/, Truncuspulmonahs
Valvaaortae:
Fig. 856 The cardiacvalves,Valvaecordis,
/ Valvulasemilunaris
sinistra
and coronary arteries,Aa. coronariae;
Valvulasemilunaris
dextra
/ the atria have been removed;the pulmonary
/ Valv.ulasemrlunaris trunk and the ascendingpart of the aorta
// posteflor
have been sectioned;the valvesare shown
anteflor A coronaria
' , during filling of the ventricle (diastole);
A coronaria sinistra - - J: dexl'a
suoerior view.
R crrcumflexus - - Anulus
librosus
Trigonum - 1 dexler
fibrosum _.- Trigonum
srnrslrum fibrosum
Y cardraca-- dextrum
magna
-- Fasciculus
Anuluslrbrosus/ atriovenlricularis
sinister
- R maroinalisdexter
R m a r g i n a l i s/
sinisler

Valvulasinus coronarii
/
Ostiumsinuscoronarii \ V cardaacamedia
posterior,'
V interyentricularis \ A coronariadextra,
R intervenlricularisposterior

Fig. 857 Variability of the coronary arteries.

The conusarteriosusbranch,R. coni arteriosi,
originatesfrom the aortaas an independent
A coronaria de)dra,
artery with a frequency of approximately37o/o. R interuentricularis poslerior
 ThoracicViscera \

/ A coronaria sinistra
A coronariadextra \
7 Fl crrcumtlexus
R nodi sinuatrialis - / R interuentricularis
anterior
/ Rr interventriculares
seotales
R coni arleriosi - -- R lateralis
-- R m a r g i n a l i ss i n i s t e r Fig. 858 Coronaryarteries,Aa. coronariae;
R atrialis - --*
R lateralis posteriorarterial branchesare shownin pink.
R nodi -_ The posteriorinterventricularbrancharises
- Rr atriales
atrioventricularis \
from the right coronary artery (balancedsupply);
R marginalis - - - Rr intervenlriculares
dexter ventral view.
seplales
(R posterolateralis --- Compareto Fig. 861 a.
dexter) \
R posterior
\ ventncultsrnrstrl
I \
R Intervenlricularisposterior I Rr atrioventriculares
I
Rr interuentriculares
septales / A coronariasinislra

/ B circumllexus
A coronariadextra \
/ R interuentricularis
anterior
-
R nodi sinualriafts .-.- - R atrialis
- R lateralis
R coni arteriosi -
-- R marginalissinister
- - Rr Interuentriculares

Fig. 859 Coronaryarteries,Aa. coronariae; --

R lateralis
the posterior interventricular branch arises from
the left coronaryartery (left dominantsupply);
ventral view R marginalisdexter -

Compareto Fig. 861 b.

ll\
\ Rr.interventriculares
septales
I I
I posterior
R interventflcularis
' (R nodiatrioventricularis)
A coronariadextra \ / A coronaria sinistra

R nodi sinuatrialis \ / R circumflexus

\ J/
_/ R intervenlricularisanterior
R coniarteflosi -\ ' R alflalis
- R lateralis
Rr atrioventriculares-
-- R marginalis inister
--
R atrialis -* Rr interventriculares
seprares
.- R laleralis Fig. 860 Coronaryarteries,Aa. coronariae;
R nodi -
alrioventriCularis the posteriorwall of the ventriclesis mainly
- R posterior
(R posterolateralis - suppliedby branchesof the right coronary
dexter) ventriculi
sinrstri
artery (right dominantsupply);
R marginalisdexter / ventral view.
Compareto Fig. 861 c.
t
R interventricularisposterior /
/
Rr. interuentricularesseptales

1 A coronaria
sinistra,
R circumflexus
2 A coronaria
sinistra,
R poslenor
ventriculisrnrstrl
3 A coronariadextra,
R Interuentricularis
posterior
4 A coronaria dextra

Figs. 861a-c Variationsin the arterial supply of the posterior a balancedsupply

wall of the heart; b left dominantsupply
dorsal view. c right dominant supply
 Heart,Cor

A coronaraa
sinistra,
R marginalis
sinister

A coronariasrnislra,
Rr interventriculares
septales
A coronana srnistra,-
R crrcumflexus

A coronariasinistra,
R intervenficularis
anterior
A coronaria sinislra, -
R inlerventricularis
poslerior, Var
* Catheterin the aorta and in the
orifice of the right coronary artery
Diaphragma

Fig.862 Leftcoronaryartery,A. coronariasinistra.Coronaryarteriography (radiograph injection0f a contrast

afterselective
medium);the beamis directedobliquelyfrom right anteriorto left posterior(MO).

A coronariasanislra

A coronariasinistra,
R. marginalis
sinister

A coronariasinistra,
R circumflexus

A coronariasinislra,
Rr intervenkicularesseptales

A coronariasinistra,
posteflor,Var
R interventricularis
* Catheterin the bulb of the aorta
and in the orifice of the left
Oiaphragma coronary artery
'* Shadowof the catheter in the
descendinSthoracic aorta, Aorta
thoracica,Pars descendens

Fig. 863 Left coronary artery, A. coronaria sinistra. Coronary arteriography(radiographafter selectiveinjection of a contrast
medium); the beam is directed obliquely from left anterior to right posterior (LAO).Samepatient as in Fig. 862.

* Catheterin the aorta and in the

orifice of the right coronary
artery
^' Shadowof the catheterin the
descendinBthoracic aorta, Aorta
A coronafla dextra, - thoracica.Pars descendens
R coni arleriosi
A coronaria dextra, -
R atrioveniricularas
A coronaria dexlra -

A coronaria dexlra, -
R marginalisdexter

Diaphragma -
A. coronariadextra,
posterior
R interveniricularis
A coronariadextra,
(R posterolaleralis
dexter)

Fig. 864 Right coronary artery, A. coronariadextra. Coronary arteriography (radiographafter selectiveinjection of a contrast
medium); the beam is directed obliquely from left anterior to right posterior (LAO).Samepatient as in Figs. 862 and 863.
 ThoracicVi.scera

/ Arcusaortae

/, A pulmonalisdextra

Pericardium \ / V cava superiol

truncipulmonalis\
Bifurcatio
\ / Pericardium

A pulmonalis
sinistra- \

Atriumcordissinrstruri\\
/ Vv pulmonalesdextrae

sinistrae- -
W pulmonales - Srnusvenarum cavarum

Auriculasinistra- -
v oblrquaatflr srnrstra .- -

V cardiaca magna ..-.-

- - Sulcus terminaliscordis
A coronariasrnrstra,---
R circumflexus

-
Srnuscoronarius- - - Atrium cordis dextrum

--
V cava interror
-
Sulcuscoronarius

- V cardracaparua

\ A coronariadexlra

cordissinister-
Ventriculus
\
Ventriculuscordis dexter

V cardiaca media [V interuentricularisposlerior]

Apex cordis
I Incisuraapicis cordis

Fig. 865 Cardiacveins,Vv. cordis;

the pericardium has been removeddown to the
pericardial reflections around the great vessels;
dorsoinferiorview.
The coronary sinus is often coveredby thin strands
of muscle(compareto Fig. 840).
 Hearrcor
E9

al--
t'

,, V. obliqua attii sinistri

V. cardiacamagna \
Sinus coronarius

V ventdculisinistriposterior--
-- valvula sinus coronatii
r
I
\
anterior /
v. inlerv€ntricularis - -
- u. inteNentricularisposlerior

V marginalissinistra / .\
\.

v-;-4
Flg. 866 Cardiacveins,Vv.cordis;
the diagramshowsthe branchesof the largecardiacveins
(afterv. LUottcH.l,usEt);
left inferior view.
Thesizeand courseof the cardiacveinsvary considerably.

W. atrialesdextrae

t,

/ Vv.ventriculidextri anlo.iores

,' \ V. cardiaca media

v. ventriculisinistriposterior-

Fig. 867 Cardiacveins,Vv. cordis;

the right atrium hasbeenremovedto showthe
orifice of the cardiacveins (afterv. LUolndnusrx);
superior view.
* Oriflces of the anterior atrial veins - I^ANNELoNGUE'S
crypts.
The orifices of the cardiac veins vary considerably.
 ThoracicViscera

A; V thoracica
internaoa V thyroideainferioro

N vagus[X] \ aaA;Vaxillaris

Plexus brachialis
N phrenicus \

N. phrenicus
sinisler
--- O a A; V. Pericardiaco-
(Nodi lymphoidei: pnrenrca
mediaslinales
anteriores) N vagus [X]

Bronchus: N. laryngeus
principalis dexter recurrens

Lig arteriosum**
Nodi lymphoidei-
tracheobronchiales
superiores'
Nodi lymphoidei
tracheobronchiales
superiores'

-
A pulmonalisdextraa -
0 V pulmonalis
sinistrasuperior

-
a A pulmonalis
V pulmonalisa- sinistra
dextra

Nodilymphoidei/
tracheobronchiales \ 1, V pulmonalis
inferiores' sinistrainterior

\ Nodilymphoidei
tracheobronchrales
*
interiores
/
(Noduslymphoideus
ligamenti
artenosi)

Nodi lymphoadei
Nodi lymphoidei/ phrenici superiores
phrenici superiores

Fig. 868 Positionof the heart in the thorax, Situs cordis;

the thymus has been removed;the Manubrium sterni
retractedsuperiorly; the pericardium partially removedand
the hilum of the lungs dissectedto exposethe mediastinal
lymph nodes;
ventral view.
* Clinical: lymph nodes of the hilum
" liSamentousremnant of the fetal ductus arteriosus (BorALLo)

Aorta

V cava superior -
Valva trunci
pulmonalis
Valva aortae - Valva
Valva - atriovenlflcularis
atrioventriculans sinistra
dextra
Apex cordis

Proc xiphoideus -

Fig. 869 Projectionof the contour ofthe heart and the

cardiac valves onto the anterior thoracic wall.
( Heart, Cor

V thymicaa , N laryngeusrecurrenssinister

Trachea
V thyroidea inlerior o I
dextra a - - _ il.
V brachiocephalica vagus[X] ra \
_ \
V thoracicainterna a --- - N phrenicus
)
- aaA.;Vpericardiaco-
a -.-t'.:
Truncus phrenica
brachiocephalicus ;

- - Pulmosinister
v c a v a s u p e r i o-r-"- f :
Plexusaorticus
thoracicus
N vagus[Xl
Pleura oaflelalis. - --
Pars mediastinalis
N laryngeusrecurrens

Pulmodexter - -

Sinus - -
Iransversus
pericardii

V pulmonaliso -- --
dexlrasuperior Pleuraparietalis,
Parsmediastinalis

is --
V p u l m o n a lO --
dexlraInlerior o V.pulmonalis
sinistrasuperior
--
o v pulmonalis
sinistrainterior
- -
Sinusobliquus
pericardii

Pleura parielalis, -
Pars diaphragmatica - -
Pericardium
fibrosum
V cava inferior a -
(z'
1
Pericardium/
serosum,
Lamrna
parietalis

Fig.870 Pericardium,Pericardium;
the anteriorpartsof the pericardiumandthe heart
with its greatvesselshavebeenremoved;
/ V brachiocephalica dextra ventralview.
V lugularis interna dexlra \ ' reflection of the visceral layer, Lamina visceralis
lEpicardium],
into the parietal layer, lamina parietalis, of the serous pericardium,
Pericardium serosum.
V subclaviadexlra -- V brachiocephalica
sinistra

V cavasuoerior

Vv pulmonales
dexlrae

Vv heoalicae

ofthe greatveinsinto the heart;

Fig. 871 Openings
\ Atrium ventralview.
1 cordrs
V cava inlerior I \ Slnlslrum 'Venouscross':the pulmonaryveinsform the horizontalarms,the
' Atriumcordisdextrum
superiorand inferiorVenaecavaethe verticalbranches.
ThoracicViscera

Bronchus principalis dexter

Bronchus lobaris supetior dexter
01 = Bronchussegmenlalis apicalis[B l]
O2= Bronchus segmentalis posteriorIB ll]
O3= Bronchus segmentalis anteriorIB lll]
Cartilagolhyroidea, - Bronchusloba.ismediusdexter
Lamina dextra
E4 = Bronchus IB lV]
lateralis
segmentalis
05 = Bronchus medialis
segmentalis IB V]
Lig cricothyroideum
medianum Bronchus lobaris inferior dexter
DO= Bronchus segmentalis superior[B Vl]
- E 7 = Bronchus
segmentalis basalismedialis [B Vll]
Arcus cartilaginiscricoideae o 8 = Bronchus
segmentalis basalisanterior[B Vlll]
E9 = Bronchussegmentalis IB lX]
basalislateralis
1o = Bronchus
segmentahs basalisposteriorIB X]

Bronchusprincipalissinister
Bronchuslobarissuperiorsinistet
Cartilagines tracheales - 1,2= Bronchus
segmentahs apicoposteflor [B | + ll]
E 3 = Bronchus
segmentalis anterior[B lll]
O 4 = Bronchus superior[B lV]
lingularis
0 5 = Bronchus Inferior
lingularis [B Vl

Bronchuslobarisinteriorsinister
E 6 = Bronchus
segmentalis superior[B Vl]
E 7 = Bronchus
segmentalis basalismedialis [B Vll]
o 8 = Bronchus
segmentalis basalisanterior[B Vlll]
E 9 = Bronchus
segmenta[s basalislateralis
[B lX]
1o = Bronchus
segmentafis basalisposterior[B X]

Bifurcatio tracheae \

1
Bronchusprincipalisdexter\
Bronchus
1 princrpalis
sinister
lobaris\
Bronchus
super|or

z Bronchus
lobarissuoeriorsinister

3
-
bronchiales
Cartilagines

lobaris-
Bronchus
mediusdexter lobarisinferiorsinister
Bronchus

Bronchus lobaris
inferiordexler
8

Fig.872 Larynx, Larynx;trachea,Trachea;

bronchi. Bronchi:
ventral view.
The Bronchus segmentalisbasalis medialis
[B VII] is often missing on the left.
 Bronchiand Trachea

/ Cartilagothyroidea,Lamina dextra

- Carlilaoocornrculata

- - Carlilago aMenoidea

- Lamina carlilaginiscricoideae

Bifurcatiotracheae
\

Bronchus\
principalis
sinister

-- lobarisinleriordexter
Bronchus
/ Bronchus lobaris medius dexler

\
Bronchus lobaris 4
Inferiorsinister

Fig.873 Larynx,Larynx;trachea,Trachea;
bronchi.Bronchi:
belowthe arrow,the superficiallayerof the membranous
wall has been removedto show the musclesof the trachea:
dorsal view.
The numbersindicatethe segmentalbronchi(seepage92).
ThoracicViscera

Fig.874 Lungs,Pulmones,bronchi,Bronchi;
the lobar and segmentalbronchi have been projectedonto
the lung in different colours;ventral view.
The numbersindicatethe segmentalbronchi(seepage92).
On the left side the segmentsI and II frequently arise
from a commonprimary bronchus;the mediobasalsegment
S VII is often absent.
 Bronchi

- - - Bronchussegmentalis
apicoposterior
[B | + ll]

principalis
Bronchus
sinister

Bronchus lobaris - - --- Bronchus segmentalis

suDerior sinistgr anteriorIB llll

Bronchuslobarisinferior -- -
stntsler

Bronchussegmentalis- -
superior[B Vll

- Bronchus lingularis
Bronchus inferior[B V]
segmentalis
basalislateralis
[B lX]

Bronchussegmentalis
basalisposterior[B X]
-- Bronchussegmentalis
basalisanterior[B Vlll]

Fig.875 Bronchi,Bronchi;
AP-radiograph; bronchography
(the divisionsof the bronchialtree are madevisibleby
inhalationof powdercontainingcontrastmedium);
left ventralview
* Bronchographic catheter in the trachea
 ThoracicViscera

- - Lobussuoerior,
Faciescostalis

Fissura horizontalispulmonis dextrr

- - Lobus medius PUlmonisdextri, Facies coslalrs

Lobus inferior
- Margo interior

Fig. 876 Right lung, Pulmo dexter; Apex pulmonis

/
lateral view.
Note the grey-blackspottedpattern of the lung.
This is due to depositsof inhaled dust particles Lobus suoerior,Facies costaiis
under the pleura ("anthracoticpiSment").

Fissura obliqua

Margo anterior

Lobus superior

Lobus Inferior,
Facies costalis

Incisuracardtaca oulmontssinistrl

Lingula Pulmonrssrnrstrl

Fissuraobhqua I
Fig.B77 Left lung,Pulmosinister;
I
lr4argoinferior
lateral view.
 Lungs,Pulmones

,, Fissuraobliqua
Lobussuperior\
-- Bronchuslobaris
superiordexler
A pulmonalis
dextra--
---- Bronchus
principalisdext6r

_-- Bronchuslobaris
Margoanterior- - mediusdexter
et inferiordexter
--- Noduslymphoideus
VV oulmonales dextrae - - -
tracheobronchialis
inferior
--- Pleuraparietalis,
--- Parsmediastinalis
lmoressiocardiaca

- ---
Fissurahorizontalis dextri-
pulmonis Lobusinferior

--- Lig.pulmonale
-
dextri-
Lobusmediuspulmonis

Facies
diaphragmatica;
Basispulmonis
Margoinferior
- Fissuraobliqua

Fig.878 Rightlung,Pulmodexter;
medialview.
In olderpeopleor personsexposed to dust,the lymph
Fissuraobliqua\
nodesof the hilum areoftenblackened by depositsof
sootor otherparticles("anthracotic
lymphnodes").
A pulmonalissinistra \

Pleuraparietalis,
Parsmediastinalis

Facies---
costalis .-.--
Nodi lymphoidei
tracheobronchiales

Lrg ---
pulmonale
- -
lmpressio cardiaca
Lobus -'-
Inlerioa

- Incisuracardiaca pulmonis sinistri

t
- Lingula pulmonis sinistri

\ Fissura
Fig.879 Leftlung,Pulmosinister;
obliqua medialview.
 rhoracicviscera
9 8
Pulmo dexter
Pulmo dexter, Iobus superior

lt apicale[SI]
Segmentum

I posteriusISII]
SeSmentum

I anterius[S III]
Segmentum

Pulmo dexter, Lobus medius

I Segmentumlaterale[s IV]

t mediale[SV]
Segmentum

Pulmo dexteq Lobus inferior

I superius[SV!
Segmentum

I basalemediale[cardiacum][SvII]
Segmentum

ffi segmentumbasaleanterius[S vlll]

basalelaterale[SIX]
Segmentum
W
basaleposterius[SX]
Segmentum
f

Fig. 880 Rightlung, Pulmodexter;

bronchopulmonal segments,
Segmenta bronchopulmonalia.
Lateralview.

Pulmo sinister
Pulmosinister,Lobussuperior

,r*r"n*. [S I + II]
apicoposterius
)
I Segmentum
anterius[SIII]

I irnguiaresuperrus[S lvi
Segmenrum

I Segmentum inferius[s V]
lingulare

Pulmo sinister,lobus inferior

I superius[SVI]
Segmentum

I basalemediale[cardiacum][SVII] -
Segmentum

ilffi basaleanterius[SVIII]
Segmentum

W basalelaterale[SIX]
Segmentum

r basaleposterius[SX]
Segmentum

Flg. 881 Ieft lung, Pulmo slnister;

bronchopulmonalsegments,
Segmentabronchopulmonalia,
Lateralview.
r Ttls segmentls generally not lndependentbut ls fusedwith the
antedor basal seepent, Segmentumbasaleanterius lS VIU.
 Lungs,
Pulmones
99

Fig. 882 Right lung, Pulmodexter;

bronchopulmonal segments,
Segmentabronchopulmonalia.
Medial view.
For colourcodesand segmentnamesseepage98.

Fig. 883 Left lung, Pulmosinister;

bronchopulmonary segments,
Segmentabronchopulmonalia.
Medial view.
Forcolourcodesand segmentnamessee
 ThoracicVtscera

Pericardium

Trachea
Truncusbrachioceohalicus
W brachioceohalicae / Arcusaorlae
dextraet sinistra
I ,A carotiscommunis
V thoracica interna
I i /Asubclavia
Apexpulmonis '
/ // / APexPulmonis
Pulmodexter,Lobussuperior\
\ / A pulmonalissinistra
V. cavasuperior1
A. pulmonalisdextra,Aa. lobaressuperiores\ t..
Pulmosinister,
Lobussuperior
.z

- / A. Dulmonalis
sinistra.
Aa. lobaressuoeriores

Bronchus lobaris
' /
superior sinister

- V pulmonalis
Pulmodexter,- sinistrasuperior,
Lobusmedius V apicoposlerior

A pulmonalis- -- Nodi
dextra, lymphoidei
A. lobarismedia tracheo-
bronchiales
V. pulmonalis-
dextrasuperior,
V lobi medii

A. pulmonalisdextra, z
Aa. lobaresinferiores,
Parsbasalis,A. segmentalis
basalisanterior
/ \
Auriculadextra / A oulmonalissinislra.
/ Aa lobares inferiores
A coronariadextra /
\ Bronchus lobaris
inlerior sinisler

\ A oulmonalissinistra.
Truncuspulmonalis, / Aa lobares infeflores,
Sinuslruncipulmonalis Pars basalis,A segmenlalis
basalis anterior
\ Pulmo sinisler,
Lobus rnferior
\ Auriculasinistra
\ V oulmonalissinistra inlerior

'A coronaria
sinislra,Fl interuentricularis
anterior
Ventriculus
cordissinister

Fig.884 Heart,Cor;lungs,Pulmones;
the arteries,veinsandbronchiof the lungshavebeen
dissectedfreeto the externalsurfaceof the lungs.
Theapexof the hearthasbeenretractedto the right to
permita betterview of the structuresof the left lung;
ventralview.
(
Lungs,Pulmones

A. carotiscommunis
Apexpulmonis
I
Pulmosinister,
Lobussuperior - -l Trachea,Pariesmembranaceus
\ ,l
A s u b c l a v i a\ . , \ ,/ Truncusbrachioceohalicus
""
,/t
Fissuraobliqua\ -
\ T / Arcusaortae
Pulmosinister,Lobusinferior\ _ \;
7 V cavasuperior
Lig arteriosum\
Bronchuslobarissuoeriorsinister- ,, Bilurcatiotracheae
sinistra-
A Dulmonalis
7 V. azygos
Bronchusprincipalissinister-. / Bronchuslobarissuperiordexter

Bronchi segmentales -
4i-
- - - - M. bronchooesophageus
_ _ - :
A segmenlalis - ; - Nodi lymphoidei tracheobronchiales'
basalis lateralis
- - V pulmonalisdextrasuperior
A segmentalis -
basalis medialis
\
A pulmonalisdextra
\
V pulmonalisd€xtrainferiol

\ Atrium
cordissinistrum

V pulmonalis sinistra -
\
suPenor Atriumcordisdextrum
V pulmonalissinistra/
interior \ V cavainferior
\
F \ Pericardium
lsinuscoronarius
Pulmosinister,/ \ \\
Lobusinferior i V cardiacamedia
posleriol
V interuenlricularis
Ventriculus
cordisdexter

Fig.885 Left lung,Pulmosinister;

the largebronchi,pulmonaryveinsand arteriesas
well as the lymph nodesof the hilum are dissected.
" Clinical: hilum lymph nodes
 ThoracicViscera

Fig. 886 Arteries of the right lung, Fig. BB7 Veinsofthe right lung,
Aa. pulmonalesdextrae; Vv. pulmonalesdextrae;
AP-radiograph(pulmonary angiography),contrast AP-radiograph(pulmonarv angiography),reflux of contrast
media injected into the right ventricle; media iniectedinto the right ventricle;
ventral view. ventral view.
Note the similar course of the arteries and the Note the different courseof the pulmonary veins compared
bronchi (seeFigs. 874,875l'.The numbers indicate to the arteries(seeFig. 886).
the arterial segmentalbranches(compareto p. 9B)
 Cage,Caveathoracis

Trachea

Corpus costae l: lV, V \ Bronchus pflncipalisdexier

I

C l a v r c u l a-

-
Scapula

Angulus
costae V

Truncus
p u l m o na l i s

Alflum cordts
srnrslrum

Ventflculuscordis
srntster

A pulmonalisdexlra, .--
Aa lobares inleriores Diaphragma
Apex cordis

Flecessuscosto-
draphragmalicus

Fig. BBB Thorax, Caveathoracis, and thoracic viscera;

PA-radiographof a 27-year-oldman; the beam is directed
sagittally onto the middle of the sternum.
The position and size of the heart, the lungs, and the
bony parts of the thoracic cageas well as the vertebral
column and ribs can be identified.
1 = aortrcknob"
2 = pulmonaryarch
3 = left atrial contour
4 = letl ventncularcontour
5 = right vascular arch
6 = right atrial contour

v cava -
superior (5) - -
Truncus pulmonalis(2)

- -
Auricula sinistra (3)

Atnum cordis -
+ - -
Ventriculuscordis sinister (4)
dextrum (6)
__-\ Fig. 889 Diagramof the outlinesilhouetteof the heart
v cava--_ in a radiograph
inlerior
Dt = transversediameter(Diametertransversa),
Diaphragma
a b p l u s c d = 1 3 -1 4c m
L = longitudinalaxis of the heart (from the superiorborder
of the right atrium to the apexof the heart)= 15- 16 cm
M = medianplaneof the body
 ThoracicViscera

Fig. 890 Positionof the heartin the thoraxduring Fig. 891 Positionof the heartin the thoraxduring
expiration; inspiration;
ventralview. ventralview.
Theheartis moreelongated, the cardiacapexis directed
mediallyandcaudallY.

Clavicula
I Bronchuslobarisinteriorsinister
I I Bronchus princiPalissinister
/ Bronchus
principalis i | | Biturcatiotracheae,Carinatracheae
sinister i ; | | Bronchuslobarisinleriordexter
Bronchus
lobaris
suPenor - Bronchus
dexter lobaris
supenor
sinister
Bronchus
principalis -
Carlilagines
dexter -- tracheales
Bronchus
lobaris
- inferior
Bronchus srnrster
lobaris -
Bronchus
meorus - lobaris
dexler Corpussterni superDr
/ dexter
Bronchus
lobaris .*
Bronchus
inferior principalis
dexter dexter
- Trachea,Paries
membranaceus

Fig. 892 Trachea, Trachea, andbronchi,Bronchi; Fig.893 Endoscopicimage(bronchoscopy)

projectionontothe anteriorthoracicwall. of the bifurcation of the trachea'
 Pulmonaryand PleuralBoundaries

VertebracervicalisVll lprominensl\\
Cupulapleura€ - - Lobussuperior\

Spinascapulae -

Lobussuoerior

- Lobus
supenol
Lobusm€dius
pulmonisdexlri

Lobusinferior -
Lobus
inferior

/
Recessuscoslo-
diaphragmalicus

/
Incisuracardiacapulmonissinistri Cristailiaca

Fig. 894 Projection ofthe pulmonary(solidline) Fig. 895 Projectionof the pulmonary(solidline)
and pleural(brokenline) boundariesontothe anterior and pleural(brokenline) boundariesontothe back;
thoracicwall; dorsalview.
ventralview.

Fig. 896 Pnojection of the pulmonary(solidline) Fig. 897 Projectionof the pulmonary(solidline)
andpleural(brokenline)boundaries ontothe right andpleural(brokenline) boundariesontothe left lateral
lateralthoracicwall; thoracicwall:
viewedfrom the right. viewedfrom the left.
 ThoracicVtscera

I Membran€
/ fachea
o'
l..1

A subclavia

Glandula thyroidea, - --M

brachioceohalicus - Lobus dexler
Arcusaortae
zl<
rl.
-
Lig arteriosum - -
Oesophagus,
Parscervicalis - At
der
- .- /A
Bronchus Bifurcatio tracheae
principalis
dexter sln
-
Bronchus
Bronchuslobaris principalissinister
superiordexter

-
Pars thoracica aortae

----
oesophagus,
Parsthoracica
Diaphragma,\ ,, Hiatus
Centrumtendineum'.\ oesophageus
/\ ,,

Foramen --
venae
cavae --- Oesophagus, intercostales
Pars posleriores tJroncl
abdominalis superlr

Pars- Cartilago
thoracrca
-
Pars lumbalis -- -- Gaster,
diaohraomatis. Parscardiaca
Cius d-exkum

Aa phrenicae -
inleriores

-
Hiatus aorticus

-
Truncuscoeliacus
-
Pars lumbalis
draphragmatis,
Crus sinislrum

Fig. 898 Oesophagus,Oesophagus;trachea,Trachea; Fig.899 Oesophagus,OesoPhagus;tr

thoracic aorta, Pars thoracica aortae; aortae;
thoracicaorta,Parsthoracica
parts of the diaphragm have been preservedto show viewedfrom thc right.
the openingsfor the aorta, the inferior vena cavaand
the oesophagus;
ventral view.
 / Mm pharyngeiffunica muscularispharyngisl

Glandulathyroidea,Lobussinister \
/ Glandulathyroidea,Lobusdexter

A carotiscommunis\
\\
,/ A carotiscommunis
interna--
V jugularis

A subclavia - ,/ V jugularis
interna

/ A. subclavia
V subclavia -
/ V subclavia

V brachioceohalica sinistra -
-- V brachiocephalica dextra
A subclavia
/ - Truncus brachiocephalicus
Cartilagines tracheales

Arcusaortae - - - - v. cavasuperior

-- v azygos

R bronchialis
- - -
Bronchusprincipalisdexter
- -- A pulmonalisdextra
sinistra-
A pulmonalis

- -
principalis
Bronchus sinister .J
--
t W oulmonal€sdextras

Vv.pulmonalessinistrae-

Ventflculuscordissinister -

Aa intercostales
oosteriores

- Parsthoracicaaortae

Diaphragma Hiatus oesophageus vusuPrrcgus' rdrs ururduru

Fig.900 Oesophagus,Oesophagus;thoracicaorta,
Parsthoracicaaortae;pericardium,
Pericardium;
dorsalview.
 ThoracicViscera

- - - - -91=
Glandulaeoesophageae - --: --..
Epithetium- - - - - \ __-P1...
_ _a
Tunicamucosa Lamrnapropnamucosae\\
mucosae- -
Laminamuscularis ;

-
Telasubmucosa
D
Stratumcirculare- - -\- -
Tunica muscularis
--\\
Stratum longitudinale

Tunica adventitia \\
--
Fig.901 Oesophagus,Oesophagus;
crosssectionshowingthe layersof
wall (ca.400%).
the oesophageal

V thyroideainferior\ Parsceruicalis
Oesophagus,
A. thyroidea
inferior\ ,, A thvroidea inferior, V vertebralis \
,'- Br obsophageales
internaq t
V jugularis / V brachiocephalica
sinistra

/ M intercoslalis
-- A verlebralis V subclavia-- // externus
- dextr€
A subclavia
/ V hemiazygos
-- A carotis
accessofla
communis sinistra
V cava -- - M intercostalis
supenor tnlernus

-- Pars thoracica aorlae, --

Vv intercostales
Rr bronchiales posteriores - Vv. oesophageae

Oesophagus,-
Parsthoracica

/ A gastricasinistra,

- Diaphragma,
Diaphragma,- Cenlrum
Foramen venae tendineum
cavae
Parslumbalis-
diaphragmatis, - Oesophagus,
Crusdextrumet Pars
Crussinislrum abdominalis
-
V phrenica inferior - V.gaskoomentalis
A gastrica srnrstra
sinistra Y cavainlerior/
/
V,gastricasinistra

Fig.902 Oesophagus,Oesophagus; Fig. 903 Veins of the oesophagus,Vv. oesophageae;

arterialsupply; parts of the diaphragm and stomachhave been removedto
ventralview. show the oesophagealveins; the anterior wall of the lower
thoracic oesophagushas been excised.
* Veins in the mucous membrane of the oesophagus
* * Branch connectingthe veins of the stomachand the veins of the oesophagus

Venousdrainage of the oesophagus

The abdominaloesophageal veins providecommunicationbe- lowerthoracicoesophagus. However,this causesnot only expan-
tweenthe tributary veins of the portal venoussystemand the sionofthe Vv.oesophageae in the adventitiabut dilationof the
V. cavasuperior(portocavalanastomosis). In portalhypertension veinsof the mucosa(-) as well (oesophageal varices).Rupture
they areof considerable
clinicalsignificanceas they allowblood varicescanleadto massivebleeding
of the seralled oesophageal
drainagevia the veinsof the stomach(. . ) andthe veinsof the in the oesophagus. Portocaval
anastomoses - seeFig. 1029.
 ThoracicLymphNodes,Nodilymphoideithoracis

/ Glandulalhyroidea,Lobusdexter
Oesophagus,Parscorvicalis\ 7 A carotiscommunis

A. carotiscommunis\

A subclavia\

Nodi lymphoidei Juxtaoesophageales \

- - Trachea,Pariesmembranaceus
Arcusaortae \

Parsdescendensaortae \
/ Nodilymphoidei sup€riores
tracheobronchiales
V pulmonalis
sinistrasuperior\
\\ _- v. azygos
Nodilymphoideitracheobronchiales
sup€riores\ - Bifurcatiotracheae
\t

A oulmonalis
sinistra-
- - Bronchusprincipalisdexter
Nodi lymphoidei -
)hiales inferiores -- Nodi lymphoidei
superiores
tracheobronchiales

Bronchilobares - -( -- A oulmonalis
dextra

V oulmonalissinistrainlerior-
-- Bronchilobares

-
(Nodi lymphoidei mediastinales posteriores) - -
- V pulmonalisdextrainferior

Oesophagus,Parsthoracica--
- posteriores)
(Nodilymphoideimediastinales

Pericardium fibrosum -

- V. cava inferior

- Diaphragma
Hiatusoesophageus-

Fig. 904 Thoracic lymph nodes,

Nodi lymphoidei thoracis;
the bronchi have been removedbeyondthe branching of the
lobar bronchi while the great vesselsof the mediastinum
remaln.
The lymph nodes in the healthy adult are usually smaller
than shown here.
 ThoracicViscera

Scapula -

Clavicula,-
Extremilasslernalis - Recessus
pirilormis

Manubrium slerni -

Oesophagus,
*
Parsthoracica

Oesophagus, -
Pars thoracica**

Oesophagus,
Pars thoracica

Diaphragma -

Figs. 905 a, b Oesophagus, Oesophagus; b) Left anterioroblique(LAO)position,obliquediameterII

radiograph (after swallowing contrast medium). (beam directed from right anterior to left posterior)
a) Right anterioroblique(RAO)position,obliquediameterI ' Oesophagealnarrowing causedby the aortic arch
*" Retrocardiacportion
(beamdirected from left anterior to right posterior) * . * O e s o p h a g e anla r r o w i n ga t t h e b e g i n n i n go f t h e o e s o p h a g u s

Gaster,Parscardiaca,
Tunicamucosa

Oesophagus, Pars abdominalis,

I unrca mucosa

Fig.906 Oesophagus,Oesophagus;
the mucous membrane is viewed through an
endoscope(oesophagoscopy);
suDerlorvlew.
 Thymus

1'
}..
,)

),i
.J

Fig. 907 Thymus,Thymus,of a 2-yearoldchild;

ventral view.

Fig. 908 Thymus,Thymus,of a 24-year-old.

Thesurroundingfat hasbeenextensively
removed;ventralview.
' Parathymic adipose tissue
The shape and size of the thymus in this specimen are
unusually well preserved.
 ThoracicViscera

V thyroidea inferiora . Glandula Trachea

\a thyroidea\,
Truncusbrachiocephalicus
o \ N laryngeusrecurrens
tt I
Vsubclaviaa\ /, aA carotiscommunis
A subclavia a -
- a V brachiocephalicasinislra
Plexusbrachialis

V thoracica
internaa --

N vagus [X]
Vv. pericardiacophrenicaea --t

--
V brachiocephalica dexta a - - 1A. subclavia

N phrenicus - --
Pleuraparietalis,
Parsmediastinalis

Vcavasuperiorl -- N phrenicus
i:i
tl. - - Lobussinister
'\
)z*.
Pulmo dexler, -
Thymus
Lobus superior
-- I
Lobusdexter
/

- - librosum
Pericardium

Pleura parietalis,-
Pars diaphragmatica

\\
(Nodi lymphoidei / d, Pars sternallsdiaphragmatis
mediastinales anteriores)

\ st"rnu.

Fig.909 Thymus,Thymus,ofan adolescent;

the anterior thoracicwall has been removed,the pleural
cavity openedand the left Iung retractedlaterally;
ventral view.
Comparethe size of the thymus of a newborn
child (Fig.907).
(Fig.999) to that of a 2-year-old
(
ThoracicCavity

/ a M sternohyoideus
Carlilagothyroidea\
\ / laMthyrohyoideus
(Lobus pyramidalis,Var )
\
/, t M omohyoideus, Venter superior

/ a A thyroideasuperior

_/ a V thyroideasuperior

/ Fascra ceruicalis, Lamina superficialis

- I M sternocleidomastoideus
Vv thyroideae infeflores a \
/ a A carotiscommunis
Arcus venosus;ugularisa \
- Plexuscaroticus
communis
N phrenicus
)!r". .> a v. iugularis
interna
--
M scalenus anteriora -
- a Vv brachioceohalicae
C l a v i c u l a- - - _
a V thoracica
M s u b c l a v r u s O- - - Interna

Apexpufmonls -----
.

C o s l al l - - - -
malor
Pleura oarietalis. -
Pars costalis Pulmosinister,
Lobussuperior
Pulmo dexler,
Margo anteflor
- Margoanterior

--'!1
i
-- lncisuracardiaca
pulmonis sinistri
- - Lingulapulmonis
sinistri
- - -
Pleuraparietalis, Pulmosinister,
Parsdiaphragmatica Lobusinferior

\ Margoinferior
Recessus-
costodiaphragmaticus
\ o M obliquus
externus
abdominis

A thoracicainternao' / t, \ a M transversusthoracis
V thoracrcainternaa / \
1 Parssternalisdiaphragmalis
M rectus abdominis al
Recessuscostomediastinalis

Fig. 910 Thymus, Thymus; pericardium, Pericardium;

lungs,Pulmones;
the anterior thoracic wall has been removed,the pleural
cavity opened;
ventral view.
Note the size of the thymus in the young adult. In older
individuals the thymic tissue is almost completelyreplaced
by adiposetissue.
 ThoracicViscera \

Plexusbrachialis,
Parsintraclavicularis\ / oA subclavia

/ Clavicula
Truncussympathicus, thoracicum
Ganglion ll \
eM subclavius
,' z/
N vagus[Xl, N laryngeusrecutrens --

N vagus [Xl, Rr. cardiaci thoracici -- -' NoM scalenusanterior

N vagus[Xl,Plexuspulmonalis -- -- - {V subclavia

V azygos * -
-- aA thoracicainterna
principalis
Bronchus dexter -
N phrenicus
R bronchialis(Aortd; a $ \\
v, oroncnrails --- $ V brachioceohalicadextra

N. vagus [X], - a *A ; V pericardracophrenica

Rr cardiaci ihoracici
- Thymus

V intercostalisposterior { -- - sV cava superior

- OAa oulmonales
N thoracicusff 71, -
N intercostalis O * N p h r e n i c u sA; ; V
pericardiacophrenica

Truncussympathicus, - *w pulmonales
Br communicantes
- Pericardium
fibrosum;
Pleura parielalis,
N splanchnicus Pars mediastinalis
maJor - Lig pulmonale

* N vagus IXl,
Aa intercostales o -- Plexus
poslenores oesophageus
-- Pleura parietalis,
Pars costahs

Pleura parietalis, --
Pars costalis - Oesophagus

\ parietalis,Pars draphragmatica
6 Oraphragma;Pleura

Fig. 911 Pleuralcavity,Cavitaspleuralis;mediastinum,

Mediastinum;
the right lateral thoracic wall and right lung have been
removed;partsrofthe mediastinaland costal pleura have
been dissectedto exposethe vesselsand nerves;
viewed from the right.
The xxx indicate the reflection of the visceral pleura into
the parietal pleura at the root of the lung and the pulmonary
ligament.
 PleuralCavity,Cavitaspleuralis,and Mediastinum

I R cardiacusthoracicus
Truncussympathicus,
Plexus brachialis.Pars inlraclavicularis
I
I / N. vagus[Xl, Fl.cardiacusthoracicus
ClaviculaI I

M subclavius 7 Oesophagus,Parsthoracica

A axillarisO: Ductusthoracicus,Parsthoracica
\
V axillaris. \ / N. laryngeusrecurrens(N vagus)
\
A caroliscommunis
a \\ Lig.arleriosum
,z

/ Nodi lymphoidei
/ tracheobrochiales

V brachioceohalica: -- | Y. hemiazygosaccessoria
--
N vagus[X]
N phrenicus oesophagus'
--
i,ars tnoractca
Plexusaorticusthoracicus.
Plexuscardiacus N. vagus [X],
-z-
Plexuspulmonalis Plexus pulmonalis

A pulmonalissinislraI - - -- o Parsthoracicaaortae

Plexusaorticus
thoracicus
-- Oa A;V intercostalis
posterior

R communicans

sinistra. - -
V pulmonalis N splanchnicus
maJor
fibrosum--
Pericardium
aoA;V intercostalis
posleflor
V pericardiacophrenica 6 -
N intercoslalis
A pencardiacophrenica O -

- Truncus
sympathicus,
Ganglion
thoracicumlX

\ Pleura
pariotalis,
Parscostalis

- Pleuraoarietalis.
Parsdiaphragmatica
/
Centrumtendineum

Fig.9l2 Pleuralcavity,Cavitaspleuralis;mediastinum,
Mediastinum;
the left lateralthoracicwall and left lung havebeen
removed; partsof the mediastinal andcostalpleurahave
beendissected to exposethe vesselsandnerves;
viewedfromthe left.
 ThoracicViscera

A carotis exlerna dextra \ carotis exlerna sinislra

A carotis \ / A carotis interna sinislra
inlerna dexlra

A vertebralisdexlra - ' A verlebrahssinistra

- A carotis communis
A carotis -r sinistra
communrsdexlra
- A subclavia
sinislra

- Lig arteriosum
V cava superior -

-- Atriumcordis
Pars ascendens -
aortae
sinistrum,
Auriculaatrii

Atrium cordis - 1 Arcus aortae 9 Trachea

dextrum 2 A thoracrcainterna 10 A subclaviasinistra
3 Truncusbrachrocephalicus 11 A carotiscommunis sinistra
- Venlriculus 4 A subclaviadexlra 12 Pars descendensaortae
cordrs 5 A carotrscommunis dextra 13 Cor
sinister 6 A- vertebralisdexlra 14 Valva aorlae
7 Rima glottidis 15 Pars ascendens aortae
/ I A vertebralis sinistra
V cava inferior \ Ventriculus
cordis dexter

Fig. 913 Heart,Cor;aortic arch,Arcus aortae, Fig. 914 Aortic arch,Arcus aortae,with its branches;
with origins of the large arteries; AP-radiograph(after injection of contrast medium into
ventral view. the aortic bulb);
ventral view.
* Catheter

A carotis externadextra
\
A carolis Internadextra \ \

A verlebralisdextra \
- A vertebralissinistra
A carolrs -_
communis dextra 13y,
A subclavia - - A subclaviasinistra
0exlra
- A subclaviasinistra
Truncus- -
brachiocephahcus - A carotiscommunrs
srnrstra
Arcus aortae --

Pars ascendens --
aorlae

-- Pars descendensaortae
Pars thoracicaaorlae

Figs.915a-e Variationsin the originsof the main arterial left vertebralartery as an indepenrlentbranchof the aortic
branchesfrom the aortic arch. arch
a "textbookcase"or "normal case" right subclavianartery as the last branchof the aorticarch.
b commonorigin of the brachiocephalictrunk and the left In this variationthe artery usuallypassesto the right, behind
commoncarotidartery the oesophagusThis may causedifficultiesin swallowing
c commonstem from the left commoncarotidartery and the (dysphagialusoria).
trunk
brachiocephalic
(
Thoracicand AbdominalAorta, and Mediastinum

Truncusbrachioceohalicus
N vagus [X] Trachea
/
A cervicahs prolunda a \ N laryngeusrecurrens
\ .-
N vagus[X]
a \\
Truncuscostoceruicalis
t_ N phrenicus
suoremaa --
A intercostalis
--. _-- OA subclavia
A subclavia a
-- aA thoracicainterna
N laryngeus
recurrens
_- aArcusaonae

-- a Pars thoracicaaorlae,
Rr bronchiales
Pars ascendens aorlae O --
IAorta ascendens] N laryngeusrecurrens
N vagus[X],
Bronchus principalis - *. Rr bronchiales
dexler
- - Bronchusprincipalis
sinister
V azygos a ---
-- a Parslhoracica
aortae,
Rr oesophageales
Truncussympalhicus

recurrens,
N laryngeus
Mm intercostales* Br oesophageales
lnternl
-- Pars
Oesophagus,
a --
Vv intercostales thoracrca
posteriores

* -- --
Nrminlercostales aAa intercostales
exlerni posleriores

Truncus sympathicus,
Ganglion

Nn thoracici,
Nn intercostales

N splanchnicus N splanchnacus
mrnor malor

--
P a r s l u m b a l i sa - - 1V azygos
diaphragmatis

N splanchnicusmaior - --
CostaXl

Costa Xl, -
Carlilagocostalis --
j Truncuscoeliacus
N splanchnicusminor

V lumbalisascendens a --
\ a A mesenlerica
supenor

A ; V s u b c o s t a l i s aa - - \
o Pars abdominalis
aonae
subcostalis N iliohypogaslricus

Fig.916 Thoracicand abdominalaorta,Parsthoracica

aortaeand Parsabdominalisaortae;
posteriormediastinum,Mediastinumposterius;
the pleurahas beenremovedto exposethe intercostal
nervesand the sympathetictrunk;
ventralview.
 ThoracicViscera \

V thyroidea inferior
lTrachea / f V brachiocephalica sinistra
V brachiocephalica dextra ' \
\ a V subclavia
\ t
Arcusvenaeazygos \ / Oesophaous, Pars lhoracica

V cavasuperior \ . / Ductusthoracicus,Parsthoracica
i'/

posteriores
/ aAa inlercostales

_ - aMm intercostales
interni
V. azygos

-- ''Y. hemiazygos
accessoria

-- *V, hemiazygos

Truncussympathicus,
Ganglia

N. splanchnicus
major

Vv. intercostales
posteriores

- - Cisterna
chyli
A :V subcostalisO --

CostaXl

--
nPars lumbalis
diaphragmatis,
N subcostalis Crusdextrum
et Crussinistrum

\ rV
V lumbalisascendens lumbalisascendens
qV cava inferior

Fig.9l7 Blood vesselsand nerves of the posterior

mediastinum,Mediastinum posterius:
the pleura, the aorta and the oesophagushave been
removedto exposethe thoracic duct, the azygosvein and
the blood vesselsand nerves in the intercostalspaces;
ventral view.
 / Ganglioncervicothoracicumlstellaluml
A. carotiscommunis
a \
/, f@chea
N vagusIXI .. ,,
'
, o M scalenusantetior
Truncussympathicus,
Ganglion
ceruicale
medium / N laryngeusrecurrens
M scalenus
anleriort / a A. subclavia'
Ansasubclavia Ansa subclavia

A s u b c l a v i a o- - _ N vagus[Xl
Truncussympathicus,
Ganglion
thoracicum ll Plexusaorticusthoracicus;
Plexuscardiacus
N vagus[X]
N laryngeusrecurrens

N laryngeusrecurrens

- N. vagus [Xl, Rr bronchiales

Parsascendensal - Bronchusprincipalissinister
aortae
N. vagus(X),
Rr.bronchrales
Nn intercostalgs
Bronchus--
principalisdexter

Truncus
sympathicus

-- o Parsthoracica
aortae

N vagus[Xl,
Plexus
Truncus oesopna9eus
sympalhicus,
Gangliathoracica

splanchnicus
malor

splanchnicus
mrnor

*
Oiaphragma

- Gaster
Pars pylorica -

Duodenum- N. iliohypo-
gasrncus

N subcostalis Pars abdominalis aodaea / \ Truncusvagalisanterior,

Rr.gastricianteriores

Fig.918 Oesophagus, Oesophagus; aorta,Aorta;thoracic

autonomicnervoussystem,Parsthoracicaautonomica;
stomach, Gaster.
Thedorsalportion0f the diaphragmhasbeenretained.
Thepleurahasbeenremoved to exposethe sympathetic
trunk
and its connections
with the intercostalnerves.
Ventralview.
 ThoracicViscera

N phrenicus \
N cervicalis
[C 4], R anterior \
N ceruicalis
[C 3], R anterior ,4,
z B communicans
N ceruicalis[C 5], R anleflor \
' - - Cartilago thyroidea
R communicans a.
N ceruicalisIC 61.R anlerior
Ganglion ceruicothoracicumIstellatum] - Truncussympathicus,
Ganolion medium
ceruicale
N cervicalis[C 7], R anterior
tr. -- * M cricothyroideus
N cervicalis[C 8], R anterior /
\ .-
' Rr tracheales
N thoracicus[T1], .
N. intercostalis \ N laryngeus
recurrens
-.- Oesophagus
N cardiacus cervicalismedius
Plexusbrachialis - - -i ,
Truncussympathicus, thoracicum
Ganglion I
N laryngeus
recurrens
Ansa subclavia
R cardiacusceruicalisinferior

N laryngeus
recurrens
N thoracrcus[T 2],
N inlercostalis N vagus[X]
Ganglion thoracicumll --
.- O Truncus
N cardiacuscerurcalisinferior brachiocephalicus

N thoracicus[T 3], Ganglion cardiacum

N intercostalis
Rr bronchrales
Ganglion thoracicum lll o V cava superior

Rr oesophageales
R trachealis
Rr bronchiales
N thoracicus[T 4],
N intercostalis

Ganglion thoracicum lV Rr bronchiales

- Bronchus principalis
dexter, Pafles
memoranaceus
N thoracicus[T 5],
N intercostalis - Bronchus lobarisinferiordexter

Ganglion thoracicumV - -
Plexuspulmonalis

Truncusvagalis
posterior
N thoracicus
[T 6],
N intercostalis

- o Vv.pulmonales

N thoracicus[T 7],
N intercostalis \ oesophagus

Ganglion thoracicumVll / major

N splanchnicus

l./
4-
920
Fig. 919 Lowercervicaland upper thoracicparts of the
autonomic nervous system,Pars thoracicaautonomica;
the vagus nerve and the right lung have been retractedto
exposethe oesophagus;
viewed from the right.
 Oesophagus N vagus [X]
/,
V azygos a \ / O
R blonchialis - Bronchuslobaris
\ // / mediusdexter
N vagus [X],
Truncussympathicus,
^' Rr bronchiales
Ganglion
lhoracicum
V
- Bronchus lobarls
interiordexter

N. vagus[X],
Plexuspulmonalis

-- avv pulmonales
Ganglion thoracicumVl
dextrae

Br interganglionares - Pulmo dexter

Ganghon thoracicumVll

- Pericardium
fibrosum

Rr interganglionares

- Plexusoesophageus

- Truncusvagalis
Poslerior
Ganglion thoracicum lX
- OV cavainferior

N phrenicus
Ganglion thoracicum X
ii{
.- Oesophagus
N thoracicus[T 101,
N intercoslalis

Duclus thoracicus /

N splanchnicusmaior

N splanchnicusminor

\
lDiaphragma

919
-t
/l

Fig. 920 Lowerthoracicpart of the autonomic

nervoussystem,Parsthoracicaautonomica;
the dissectionis similar to Fig. 919,but the aorta,
the thoracicduct and the azygosvein havebeen
retained anteriorly;
viewed from the rieht
 ThoracicViscera

O
Truncusbrachioceohalicus
Glandula thyroidea
V, brachiocephalicasinistras
N laryngeus recurrens
V jugularis interna4i!\
/ a A. carotiscommunis
N laryngeusrecurrens \ | N phrenicus
/
tt / l*M scalenusanterior
N. vagus[X] r
* a tt \
V subclavia
V brachiocephalica dextra € \ \
\\
N ohrenicus \
'
\ -_---!::

M pectoralisminor * :- .'-\..
\\

N vagqg [X]l
Hr car0racrlnoracrcl

Pulmosrnister,
ArcusaortaeO Lobussuperior

V cavao N phrenicus
supenor

Plexus - -- a I A ; V PericardiacoPhrenica
caroracus
I

-'t' costa lv
A ; V p e r i c a r d i a c-oa a
phrenica :

N phrenicus,
R pericardiacus

- -
Pulmo dexter,
Lobusmedius

--
Pulmo dexter,
Lobus inferior N, phrenicus

N phrenicus

Recessus
costodiaphragmaticus
/
Pleuraparietalis,
Pars I Pericardium \
diaphragmatica \
\
N phrenrcus,Rr phrenicoabdominales

Fig. 921 Thoraciccavity,Cavitasthoracis,in an adult.

The anterior thoracic wall has been removed;
the right and left lung have been sectionedin the frontal plane;
the mediastinaland diaphragmaticpleura have been removed
t0 exposethe pericardiacophrenicartery, A. pericardiacophrenica,
and the branchesof the phrenic nerve;
ventral view.
(
Median Sagittal Sectionof Neck and Thorax

M arytenoideus *, \
transversus / Cavitas Infraglotlica
Cartilago Lamina\ \\
cricordea, .t z Lig. vocale
Oesophagus,Parscervicalist tr't / / cartitago thyrordea
.r'
Trachea, Paries membranaceus \ l,'./
').," / * M sternothyroideus

VertebraceruicalisVll \ /. Glandula thyroidea

/
LpromtnensJ \ , Fascia cewicalis, Lamina superficialis
V jugularis anlerior
. . Ngdi lymphoidei \ /.
tracneooroncntatessuoeflores \

Bronchus principalissrnisler
\ /, * M sternocleidomastoideus
VerlebraceruicalisVll _ -- Carlilaginestracheales
.
uroc. sptnosus
IpromrnensJ, - Articulatiosternoclavicularis
-- Manubrium sterni

ft
Lrgg interspinalia\
-- O Truncus brachiocephalicus
-- *M pectoralismaior
Bifurcatiotracheae, -
Carina tracheae .-- $ V brachioceohalicasinistra
Vv basivertebralesi \\ -- O Arcusaortae
Bronchus principalis -_
oexler -- Corpussternl
i'<-
;1 i,. -- a Parsascendens
aortae
Nodus lymphoideus -
'.acheobronchialisinf Thymus
erior r-{ _ -

Plexus venosus * .-
vertebralis
J- _ - Valva aolae, Valvulae semilunares
sinistra, posterior et dextra
exlernus posleriOr
M Inlerspinalis& - - - a A coronaria
sinistra
A pulmonalisdextra O - -J _- Myocardium
Oesophagus,Pars - :) , I
lhoracica l/
L,- - Valva atrioventricularis
V pulmonalissinistra s - dextra lvalva tricuspidalisl
Sinus transversus - :,- ii
pericardii
V hemiazygos ,, - u'l - C o s t a eV l ; V l l

Atrium cordis sinistrum -

L-
- Cavitas
pericardiaca
SePtum inleratriale -
- Sternum,
A coronariadextra: O Proc xiphoideus
V cardiaca media
Medulla -- ' \ t - aMabdominis
rectus
spinalis
\ a Parssternalis
diaphragmalis
lLaminavisceratis
oura materspinatis/ // I i I
/ i i lEpicardium] | Pericardium
serosum
Spaliumsubarachnoideum
/ Laminaparietatrs
Tunicamuscularis
Oesophagus, 'i,H,e D a r )
Pars lumbalisdiaphragmatis a
phrenicus
Noduslymphoideus superior
Atrium cordis dextrum
Hepar,Area nuda

Fig.922 Thoraciccavity,Cavitasthoracis;mediastinum, Due to the close topographicalrelationship betweenthe left

Mediastinum; atrium and the oesophagus, an enlargementof the left atrium
mediansagittalsectionthroughthe neck and thorax, can be assessedby a displacementof the oesophagusin a
becauseof the slight asymmetryof this thorax,the sternoclavicu- radiograph.
lar joint has beensectionedabovethe Manubrium sterni; The heart can-beexaminedwith ultrasound from the oesophagus
risht lateralview. (transoesophageal sonography).
 ThoracicViscera

I Oesophagus
Trachea
A vertebralis
a I r Nodilymphoidei laterales.
ceruicales
profundr
Inferiores
Nodi lymphoideithoracis, I i Nodi
Nodi paratracheales
Plexus brachi
I
A thoraco- a \\A suprascapularis , - Clavicula
acromialis I i
& M subclavius
---
A subclavia O Coslal
---
dextra
-- O A axillaris
N vagus sinister [X]

.-- € V axillaris
V cavasuperior': .-
.-- a Arcus aortae

- - & t\4 pectoralisminor

V pulmonalis
dextrasuperior,* .-
V anterior,
Parsintrasegmentalis
A intercostalisO ---- -- Costalv
--- a Pars ascendens aortae

- - 6$N4 serratus anterior

Fissura horizontalis .- --
pulmonis dextri - - * N4 intercostalisinternus
Atrium cordrsdexlrum -'-
-- a A coronaria srnistra
Fissuraobliqua
*- Bronchus inlrasegmentalis
Pleura parietalis,Pars costalis - - Ventnculuscordis sinister

Pleura visceralis -- Lamina visceralisIEpicardium]*

D i a p h r a g m a6 - - -t -
Lamina parietalis'

/
Recessus costodiaphragmaticus z
\ Peritoneumparietale
Hepar, / t !
I Peritoneum \ Flexuracoli
Lobussinister V n"0",,""s* /,/ i,l
Uhepatrca I
viscerale sinistra
i i coronariadextra
Valvaaorlae / in-r"lt6ni,iiJi"iis'po.r"'io'
i ri F u n
Truncuspulmonalis a I astricus
I Venlriculuscordis dexter

Fig. 923 Thoraciccavity,Cavitasthoracis;

frontal section;
ventral view.
* Pericardium serosum

- A carolrscommunis
Trachea -

- Truncus brachiocephalicus
V cava supeflor -

Pars ascendens aortae - - Truncus pulmonalis

- Pulmo sinister

Pulmo dexter

Atrium cordis dexlrum

- Ventnculuscordis sinisler
Draphragma
-- Ventriculuscordis dexler
Hepar
.- Valva atrioventricularisdextra

Fig.924 Thoraciccavity,Cavitasthoracis;
magneticresonancetomography(MRT);
frontal sectionat the levelof the superiorvena cava;
ventral view.
Compareto Fig. 913.
 Frontal Sectionsof the Thorax

Mediastrnumposterius\
\ \ Vertebra
-l
thoracical / Pars thoracicaaortae

Fissura obhqua \ O
t::ii,'r

- Pulmo sinisler

-
,s Cavilas pleuralis
it\ \^a- I
,'o\

"d'!,'q
Diaphragma - - - Pleura parietalis,
Pars coslalis

Hepar -
- Corpusgastricum

V hepalica dexlra -

\ Recessuscoslo-
diaphragmaticus
Recessus -
phrenicomediastrnalis

\ Omentum majus
V cava nletio( /

Gasler Pars cardraca /

Fig.925 Diaphragm,Diaphragma;oesophagus,Oesophagus; frontal sectionthroughthe lowerpart of the thoraciccavityand

with transitioninto the stomach.Gaster: the upper part of the abdominalcavity;
ventralview.

___ A carotiscommunis sinistra

-_ V jugulafls inlerna
-- V subclavia
Truncusbrachioceohalicus- - -

Pars ascendens aortae- -

- - Truncus pulmonalis

Atflum cordis dexlrum_ _

_ _ Ventriculuscordis srntster
_ _ Ventflculuscordrsdexler

Fig.926 Thoraciccavity,Cavitasthoracis;
magneticresonancetomography(MRT);
frontalsectionat the levelof the aorticvalve:
ventralview.
C o m p a r et o F i g s .9 1 3a n d 9 2 3 .
 ThoracicViscera \

I/ trapezius@| l* M..setratus
I anreilor
Clavicula,
.-.l Extremitas / * M supraspinatus
acromialis Articulatioacromioclavicularis
M erector* -- /
sprnae a / I M subscapularis
z Scapula, Cavitas glenoidalis

M s p l e n i uas - - / Caput humeri

caprtrs

/ E M deltoideus
Venebra thcracica ll - -

/ (Recessusaxillaris)

- N axillafls

-- a A circumflexahumerl
posterior

M l n l e r c o s l a l r sn l e r n u s -- a M teresmajor

qT, Plexus brachialis,

Fasciculusposterior
:- o A axillaris
I
I
I Plexus brachralis,
I Fasciculusmedialis

V anterior,* Plexus brachialis,

Pars intrasegmentalis Fasciculuslateralis
/ -
Bronchussegmentalis / N thoracodorsalis | lvl coracobrachralis
a n t e r i o rI B l l l ]

anleriof scapulae

Fig.927 Neck,Collum;left axillary region,Axilla;

thoraciccavity,Cavitasthoracis;
frontal section;
ventral view.

M s c a l e n um
s e d i u ss l*Viugularisinterna
I
I

lClavrcula / aM subclavius /, aV cephallca

,, Proc. coracoideus
- - 7 -,' ---.1= /
a M. biceps brachii,Capul longum, Tendo
,/ -rl _/
," / Acromion

/ -:- ,- C a p u th u m e r i

-- * M deltordeus

A c a r o l i s c o m m u nai s - - -
sinister *-
J o V axillaris
Noduslymphoideus- - -.r-.-
tracheobronchralis -a
--
l} M teres major

Arcusaortaeo -- N thoracicuslongus

--
aM serralusanterior
Pulmo sinister -
---
c o s t al V

Fig.928 Neck,Collum;Ieft axillary region,Axilla;

thoraciccavity,Cavitasthoracis;
frontal section;
ventralview.
 CrossSectionof the I'horax

M scalenusanterior N | * M sternocleidomastoideus
M pecloralismaior * 1 ,,
N vagus dexler [X]

M subclaviust \
\ -t oA caroliscommunis
Plexus brachialis \

Capul humeri \ -- OA subclavia

- -
Pulmo dexter,Apex

* -
Pleura visceralis

- -
Pterra panelalis

-
Vertebrathoracicalll. Proc soinosus

tl
M rnfraspinatus4 / | *M serratusanterior | &M lrapezrus

Clavicula subclavia
I I av

/ fM deltoideus

Plexus venosus vertebralisinlernus __

a

Spalium sulrarachnoideum z-

lMedullasplnalis /

aM infraspinatus

N suprascapularis
lSpina scapulae

Figs.929a, b Thoraciccavity,Cavitasthoracis; a rightside

transversesectionshowingthe pleuraldomeand the apexof b leftside
the lung;
inferior view.
 ThoracicViscera

Manubriumsterni O Truncus brachiocePhalicus

I

)A s u b c l a v i as i n i s t r a
--
N vagussinister[X]

_- Pulmosinister,
Lobussuperlol
V Pulmonahs * .--
dextrasuPerior N thoracicus
rongus
longus
N thoracicus
.--- Plexus brachialis
! syillsris #
-$
Humerus --
--
)eo O Arcus aorlae
A a x i l l a r i sO - - :

- -
Nodus lymphoideus
axillaris,
Nodus apicalis

C /
M subscapularis
/ --
M leresmajora / a M serratusanterior
\\ -
- N. intercostalis
O /
M intraspinatus .\ \ \ Pleura visceralis
Pleura parietalis,
Scapula / Costa lll /
Pars costalis

Ld trapeziusC
\ TruncussymPathicus
V azygost Ductusthoracicus
Lig longitudinaleanterius Vertebrathoracrcall, Proc spinosus

Fig.930 Thoracic cavitY,Cavitasthoracis;

transversesectlon at the level of the aortic arch;
inferior view.

Corpus sterni, , O Truncus brachiocephalicus

Recessus costomediastinalls
\
A thoracica internao \
N phrenicusdexler \
V cava superiora \
- Bronchus segmentalisanterior [B lll]
Nodi lymphoideiparatracheales--_

sinistra,
A. oulmonalis o - -- a M Pectoralismlnor
anterior
A. sbgmentalis Lobussuperlor
.- -. Pulmosintster,
V azygosa --

N intercostalis
-- -- I M serratusanterlor
intrasegmentalis
Bronchus
longus
N thoracicus N lhoracicuslongus
-
Pulmodexter,-
Lobussuperior .-.- Oesophagus
externusa--
M Intercostalis
.-- A thoracodorsalis
a
N vagusdexter[X] -
.-.-
O M leresmajor
M subscapulansa- -- N vagussinister
[X]
V azygosa /
/
M infraspinatusa Fissuraobliqua/ i '\ t Pulmo sinister,Lobus inferior
costa lV / t
\
Truncussympathicus I a Pars thoracica aortae
M trapeziust Recessus vertebromediastinalis
I Ductus thoracrcus
Vertebrathoracica lVl

Fig.93l Thoracic cavity, Cavitasthoracis;

transversesectionat the level of the 4th thoracic vertebra;
inferior view.
 CrossSectionsof the Thorax

Corpusslerni
A pulmonalisdextraa

N p h r e n t c u sd e x l e r
\
V cava superior '. \
N4 pecloralismajor \
\ N phrenicus
sinister
A l o b a r i s s u p e r i o r O:
,,

.. V pulmonalis
sinistrasuperior
Pulmo dexler, Lobus superior :
- - Bronchus principahssinister

N o d i l y m p h o i d e i- -
bronchopulmonales - -. Bronchuslobarissuoerior

L4 serratusanteflor

N lhoracicuslongus
N thoracicuslongus
-
Fissuraobliqua .-
- aA
lobarissuperior
Bronchus principalis -
dexler
M serratusanterior
-
Pulmo dexter, -
Lobus inlenor
\ Fissura
obliqua
M teres major ," -
l\\\
7/ \. -
/ v / I \.oParedescendens Scapula
N vagus [X] I runcus arygos aonae N vagus [X]
sympalhrcus \
M trapezius I o""opt"gr.
Vertebralhoracica V ' Ductus thoracicus

Fig.932 Thoraciccavity,Cavirasthoracis;
transversesectionat the levelof the bifurcationof the
T r u n c u sp u l m o n a l i s :
inferior view.

B r o n c h u sp n n c t p a l i d
s e x t e r\

- Slernum

- Pleura parietalis,
Bronchus segmentalis-
anteflor lB llll Pars mediaslinalis
- M pectoralismajor

- Pars ascendens aortae

Bronchus segmentalis - V cava superior

p o s l e r i o rI B l l ]
Bronchus orinciDalissinister

Pars descendensaonae
- -
Bronchus lobals superior--
._--- Scapula
dexter
\
B i l u r c a l r ot r a c h e a e \ ---- M intraspinatus
vc-uP, rcgus

VertebrathoracicalV, -
Corpus vertebrae

Vertebralhoracica lV, '

Proc transversus
I \\\
Foramen vertebrale / M erector sprnae
I l M t r a p e z i u s\ c o s r a e \ M s e r r a t u s a n r e n o r

Fig. 933 Thoracicca\,it)',Cavitasthoracis; I)rocessing of the CT,either the lungs or the skeletalsystemcan
computedtomography(CT)at the levelof the bifurcationof the be emllhasized;
trachea.Dependingon the electronlc inferior view
 ThoracicViscera

A\
V cava supeflor l C c - ; . : 3s t e r n i
A thoracrcainterna O
V p u l m o n a l i sd e x l r as u p e r i o ra \
tt
N phrenrcusdexter t
tt \
M pectoralismajor a \

Bronchus lobaris medius \ / N phrenicussinister

z Auriculaalrii sinislri
Pulmo dexter. Lobus medius \

- - Pulmo sinister,Lobus supenor

B r o n c h u sl o b a r i sm e d i u s - \

Bronchus lobaris inferior - -

-- Nodilymphoidei
N lhoracrcuslongus bronchopulmonales

- -
Aa lobares inferiores O - - F i s s u r ao b l i q u a

* -
- Cavitas pleuralis
Pulmo dexter. .-
Lobus inleraor
- -
Bronchus segmentalis
basahsposteriorIB Xl
M serratus anlerior C
"
- aV pulmonalis inistra
M latissimusdorsr a - inlenor

\ OPars descendens aortae

\
Ductus thoracicus
'
Recessusvertebromediaslinalis
s
V rntercostalis *V azygos
M trapezius a acica vl

Fig. 934 Thoraciccavit),Cavitasthoracis;

transversesectionat the levelof the left atrium;
inferior view.

- Atrium cordis sinistrum

- Ostium atriovenlricularesrnlstrum
- -

-- cuspis anlenor I Valva atrioventrrcularrs

i -srnistra[Valva milrahs]
C u s p r sP o s t e r r oJr
| _--
Valvula semilunaflssrnrslra - - -
- -1
Valva Valvulasemilunaris - / Ventriculuscordis sinrsler
aortae Oosteriol
-/
Valvula semilunaris -
dextra

Seplum interuentriculare

Venlriculuscordis dexler

F i g . 9 3 5 H e a r t ,C o r ; heart and its valvescan be depicted.

sonographicimage;the transducerhas been introducedinto The positionof the transduceris at the apexof the triangle;
the oesophagus using this techniquethe left
by an endoscope; left superiorview.
 AtriumcordrsdextrumI

CarlilagocostalisI
I
I
Proc xiohoideus
Sternum.
O A coronanasinistra A \
I I / o Sinusaortae
N phrenicus I l l/ Valva aorlae
dexter I
/ Ventriculus
Pulmodexler,Lobusmedius\ .t cordisdexter
\
-- a A coronaria
Papilla mammafla - sinistra,
B interventri-
cularisanterior
- - - Ventriculus
cordissinister
Glandula mammaria - -
-- Valvaatrioventricularis
sinistra [Valva mitralis]

- - Pulmosinister,
Frssuraobliqua -
Lobussuperior
-- Atriumcordissinistrum
M serratusanteriorl -'
N phrenicus
sinister
V basalis rnferror,o --
V pulmonahsdexlra
inlerior - o V cardiacamagna
Nodus lymphoideus-- l\
bronchopulmonalis ,
\ Costa Vl
N vagusdexter[X] /
-
M latissimusdorsio / \ Pulmosinister.
//,/l Lobusinferior
Pulmo dexter./ Verlebra thoracica Vll / i' a v i n t e r c o s t aat i sP\ a r s d e s c e n d e n s a o r t a e
Lobus inferior
N rntercostatis
I ' Truncussympathicus
Oesophagusl I Ductusthoracrcus

Fig.936 Thoraciccavity,Cavitasthoracis;
transversesectionat the levelof the 7th thoracicvertebra:
inferiorview.
A
M pectoralis majora Sternum. Proc xiohoideus
V pulmonalissiniska inleriora Valva atrioventricularis
\ dextra
M transversusthoraciso \ [Valva tricuspidalis]
Pulmodexler,Lobusmedius\ / Ventriculus
cordisdexter
Fissuraobliqua\
\\ / Ventriculus
cordissinister
Cosialll -_ Pulmosinister,
/ -- Lobussuoeror
N inlercostalis

_- Mamma
Recessus- - -
costomediastinalis
-- Fissuraoblioua

--- O M serratusanterior
Nodr lymphoidei---
tracheobronchiales
interiores N phrenicus

- --
Pulmodexter,- O A coronariadextra
Lobusinterior
---
Pulmosinister,
externusf /
M intercostalis Lobusinlerior

Bronchussegmentalis/ \ O Parsdescendensaorlae
basalislalerafts
IB lX]
\ a M latissimusdorsi
Noduslymphoideus/ }4_l--i-i
juxtaoesophagealis /' I t.. --.
,/ i II
N. vagusdexter[X] / 7' Oesophagrsl i Trun"ra ayrpathicus\ o A intercostalii Duclusthoracicus
Vertebra lhoracica Vlll / V azygosa | | VerrebrathoracicaVll, Proc.spinosus

Fig. 937 Thoraciccavity, Cavitasthoracis;

transversesection at the level of the Bth thoracic vertebra;
inferior view.
 Abdominatviscera
I32

Incisuracardialis \ - Fundusgastricus

Parsabdominalis-
Oesophagus,

Ostiumcardiacum--
CardialParscardiacal,

- Corpusgastricum

Curvaturaminor \ _

Plicaegastricae\\

angularis\
Incisura

I I
j 'Pars pylorica, Antrumpyloricum
Canalispyloricus,
'Pvlorus

Fig. 938 Stomach, Gaster;duodenum,Duodenum;

the anteriorwall hasbeenremovedto showthe foldsof
the mucosaof the stomachandthe intestine;
ventralview.
is particularlywell
Thecircularlayerof the musculature
developed in the pylorus.
' C l i n i c a l :B u l b u sd u o d e n i

Areae gastncae \

Foveolae gastricae \\

Epithelium r...
Tunicamucosa
propria
Lamina --\
T1"o"""-
Noduluslymphoideus
solitarius - _
Glandulaegastrica" -- - ----
Laminamusculansmucosae- -

Telasubmucosa

str"tur circulare----
Tunicamuscularis
{
\ Stratumlongitudinale \-

Telasubserosa

Tunicaserosa

Fig. 939 Diagramof the wall of the stomach;

the wall has been dissectedlayer by layer;
microscopicenlargement.
 stomach,Gaster
I33
:----- Fundusgastricus

Oesophagus,
Tunicamuscularisr

-- Tunicamuscularis,
Stralumlongitudinale

Tunicamuscularis,Stratumlongitudinale--

- - Tunicamuscularis.
Stralumcirculare

Fig. 940 Stomach,Gaster;

the peritoneumhasbeenremovedto showthe external
muscularlayerof the anteriorwall of the stomach;
ventralview

Tunicamuscularis,Fibraeobliquae. Tunicamuscularis,
Stralumcircular€
Oesophagus.
Tunicamuscularis
\

Tunicamuscularis,Stralumcirculare- -

Tunicamuscularis.Fibraeobliouae---

Fig.941 Stomach,Gaster;
the peritoneumhasbeenremoved;
the externalmusculrr layerhasbeenpartially dissected
to shbwthe internalobliquemuscularlayer;
ventralview.
 Abdominatviscera
I34
/ Fornix gastricus
Incisuracardialis
\
A ;V gastricasinislra, Rr oesophageales \\

- Fundus gastflcus
Oesophagus. Pars abdominalis -

A , V gastricasinistra \\
A ; V gastricadextra
\
A hepaticacommunis \. t,

Cardia lPars cardiaca] /

Curuaturaminor
\ )-Aa; Vv gastncae
breves
Ouctus hepaticuscommunls - -
\
\
Lig hepatoduodenale -1 \ Curvatura
maior

-\
Omentumminus,
Duodenum, Pars - Lig hepatogastncum
Ampulla
superior,
- \A ; V gastroomentalis
Pylorus - sinistra
Duodenum, Pars
descendens " \ Corpus gastricum

Tunrcamuscularis, --
Stratum longitudinale
- \ Omentummajus
Pars pylorrca, /
Antrum pyloricum
/
A t V g a s t r o o m e n t a/l i s
dexlra lA V gaslroomentallsdextra, Flr omentales
;
Flexura duodeni inlerior /

view'
Fig.942 Stomach,Gaster;duodenum,Duodenum;the peritonetlmhas beenpartiallyremoved;ventral

Nodt
lymphoidei
gastrici
sinistri

Nodi ---
lymphoidei
hepatici - Gaster

-- Nodr lymphoidei
gastricidextri

--
Nodi lymphoidei
pylorici
--. Nodi lymphoidei
gast;oomenlales
sinistrl

- - omenlum malus
--
Nodi lymphoidei
gastroomentales dextri

Fig. 943 Stomach,Gaster,and liver,Hepar,with lymph nodes' of the stomachto show the lymph nodes;
Nodi lymphoidei; ventralview.
the left lobeof the liver has beenretractedsuperiorly;the The number and sizeof the gastriclymph nodesvary
omentum has beenremovedfrom the greaterand lessercurvature considerablY.
 stomach,
Gaster
1 35

're1*{ii:
.w',

1 = Oesophaguswith contrast medium

In the transitionalregion between lhe
o e s o p h a g u sa n d l h e l u n d u so l t h e
stomach (1a) lhe grooves between the
folds can be seen as dark striations
2 = Fundus ol the slomach wilh air bubble
3 = Body of lhe stomach, Corpus gastricum
3a = Lesser curuatureof stomach, Curuatura
mrnor
3b = Greatercurualureof stomach,Curvalura
malor
In the border between 3a and 3b
nolches correspondinglo the conlour ol
the mucous lolds are vrsible
4 = Perislalticconstrictionsat the Incisura
angularis
5 = Pars pyloflca pflor lo lhe progressronof
a portion of slomach's contenl
6 = Ampulla duodeni
7 = Pars descendensduodeni with Plicae
crrculares
8 = Jeiunum
9 = Len dome ol diaphragm
1 0 = F l e x u r ac o l i s i n i s l r a( fi l l e dw i l h a i r )

F i g . 9 4 4 S t o m a c h(,i a s t e r ; D u n n g r a d i o g r a p hoy f a s t a n d i n gp a t i e n t a , g a sb u b b l ea p p e a r s
r l u o r l e n u mI ), u o t l t ' n t r m ; i n t h e f u n r l u sr r h i c hi s b o u n d e db y t h e l i q u i d b e l o w
A [ ) r a r l i o g r a p ah f t e ro r a l a r l m i n i s t r a t i oonf a c o n t r a s m
t erlium; t h e s t r i p e si n t h e t r a n s i t i o n arle g i o nb e t w e e nt h e o e s o p h a g u s
t h e p a t i e n ti s s t a n r l i n gL r p r i g h t ; a n r lt h e s t o m a c ha n d i n t h e p y l o r u sa r e c a u s e db y l o n g i t u d i n a l
\ e n t r a l\ l e \ \ . l i r l r l so f t h e m u c o u sm e m b r a n e

F i g .9 { 5 S t o m a r ; h( i,a s t e r ; Fig. 946 Stomach,Gaster;

o u t l i n e( l r a \ ri n q o f t h e m u c o u sm e m l r r a n e topugraphr o u t l i n ed r a w i n go f t h e m u c o u sm e m b r a n et o p o g r a p h y
b a s e rol n a n A P r a r l i o g r a l rohf a s t a n t l i n gp a t i e n t : baserlon an AP-radiograllh of a standingpatient;
r e n t r a lr t e u v e n t r a lv i e w
'f '
h e 1 r lyo r i cy r a r ot f t h e s t u m a r ; ihs c 0 n s t r i c t eadn ( lt h e \ ! a l l C { } n s tir( t i o n d t t h ( ' a n g u l a rn o t th
* * C r ) n s t n t(r o n d l t h ( ' l o r i ( :a n t r u m
o f t h e p l l o r i ca n t r u m i s r e l a x e r l I)\
I ] o t ha r c s i g n so l a l ) r o g r o s s i \ rl x ' r i s t a l t i (u a \ ( '
 Abdominatviscera
136

z Slernum,
Proc
xiphoideus
Gaster,
CardiaIPars
cardiacal

CostaX - Fornix
gastricUS

Gaster,
Gaster, Parsovlorica
Parspylorica --
corpus
gastricum
--
Spinaitiaca
anteriorsuperior

Fig. 947 Stomach,Gaster; Fig. 948 Stomach,Gaster;

a projectionof a "normal"stomachontothe anteriorabdominal projection of a "long" stomachonto the anterior abdominal wall
wall in the uprightstandingposition. in the upright standingposition.
The stomachis fixed at its inlet and outlet. The size and the
position of the other segmentsvary considerablydependingon
the amount of contents and the position of the body.In addition
there are considerablevariations amone individuals.

Gaster, - Gaster,
Pariesanterior
Pariesanterior

Plicae gastricae

- Pylorus

- Gasler,
Pars pylorica,
Antrum pyloricum

Gaste( - Gaster,
Pariesposterior Pariesposterior

Figs.949a, b Stomach, Gaster; a view of the body with the distinct longitudinal mucosalfolds
endoscopicviewinto the stomach(gastroscopy); (Plicaegastricae)
superiorview. t> view of the antrum with predominantly smoother mucosa
 SmallIntestine.Intestinumtenue
r37
- Mesenlerium

z Tela submucosa

- Lamina muscularis
mucosae runrcamucosa
I'Tunica serosa
H e n t o n e u mI _. - Villiinleslinales
viscerale I lela
\ suoserosa

Noduluslymphoideus
solitarius

Fig.950 Smallintestine,Intestinumtenue;
crosssectionthroughthe uppersmallintestine.

Villusintestinalis

Epilhelium \

Lamina propfla mucosae \

Tunicamucosa Vas lymphaticum centrale \

Glandulaeintestinales-

Laminamuscularismucosae
\

Fig.951 Smallintestine,Intestinumtenue;
layerby layer;
the intestinalwall hasbeendissected
microscopic enlargement.

Mesenlerium

- Mesenterium
diverticuli
Fig.952 Mscrel's diverticulum(Diverticulum ilei).
- (Diverticulumilei) Thisremnantof the Ductusomphalo-entericus occursin 1-3%
In 90%ofthecasesit is I to 10cm longand
ofall individuals.
situatedbetween30 and70 cm oralto the ileocaecal valve.
 Abdominat
138

Telasubmucosa \

Glandulae
duodenales'

Tunica muscularis Stralum longiludinale \

Tunica muscularis,
Stratum circulale

Fig. 953 Superiorpart of the duodenum,Parssuperior

duodeni;the duodenalwall has beendissectedlayerb1'
layerto show the tluodenalglands.The glandson the right
sideare near the pylorus.
' r l i n i c a l :I l n u r r r t r ' s g l a n d s

Tela subserosa

- T u n i c am u s c u l a r i s Tunica serosa

- Tunica serosa

Plicae
crrculares

Noduli
lymphoidet
solitarii

F i g . 9 5 4 l e j u n u m ,l e j u n u m ; F i g . 9 5 5 T e r m i n a il l e u m ,P a r st e r m i n a l i si l e i ;
t h e w a l l a t t h e m e s e n t e r i icn s e r t i o nh a s b e e n the u'all at the mesentericinsertionhas been
partiallyopenedto show the mucousmembrane. partialll openedto shou'the mucousmemllrane.
Comparethe number of folds to Fig 955 C o m p a r et o F i g 9 5 4 .

- Plicae circulares

Noduli lymphoideisolitarii --

Fig. 956 Terminalileum, Parsterminalisilei; PLvr:n'sllatchesare alsofound in the tluodenumantl the

portion of intestineopeneda t t h e m e s e n t e r i icn s e r l i O n i e j u n u m ,a n d a r e n o t 0 h a r a c t e r i s toi cf t h e i l e u m .
* r : l j n i ra l : l ) t , v t , H
s p a t th t ' s
 Duodenum
I39
Duodenum, Pars superior,Ampulla' \ / N4 sphincterpyloricus

- - Pylorus,Ostium pyloflcum

-- Canalis pyloricus I -
Plicae circulares \ -- I Fars ovronca
Anrrum pyroncumJ

Ouodenum, Pars descendens \

Ampulla hepalopancreatca --

Papllladuodenr major "a -'

-
Tunicamuscularis-

-
Duodenum. Pars horizonlalis -

Fig.957 Duodenum,Duodenum;
the anteriornall has beenremovedto show the mucousmembrane:
v e n t r a lv i e u .
The sulleriorpart coursesto the right dorsosuperiorly
from the
stomachan(l s\4ingsventroinferiorlyat the duodenojejunalflexure.
' r I i n i ra l : [ ] u l l r u sr l u r x l c n i
't r I i n i ra l : I R u r z ' sn l u s c l ( ,
Flexuraduodeno,ejunalis * * * r I i n i t a l :l ) a l i l l ao f \ r r l H

VertebrathoracrcaXll Gaster Curuaturaminor

Duodenum,, Gaster. I
P.rc t
IncisuraanqularrsI
CostaXll , trperioi \ Pylorus
'\ Ampulla \ I i

Duodenum, Pars I Plicae circulares i i D u o d e n u m .Jl e l u n u m l

descendens lPlicae circulares
I I Pars ascendens
lv".r"Or" lumbatis ttl
I
'
Duodenum, Pars horizonlahs

Fig. 95ti l)uodenum,Duorlenum; Fig.959 Duodenum,Duodenum;

AP-rarliograph after oral administrationof a contrastmedium; endoscopicview of the mucousmembranewith the circular
l ) o s i t i o ns:t a n ( l i n gu l ) r i g h t ; folds;
ventralview supenorvtew.
 Abdominat
I40

/ Plicae semilunarescoli
Omentummaius
I

/ Taeniaomentalis

/ Taenia mesocolica
/ - Mesocolonlransversum
a--

Fig. 960 Transverse colon,Colontransversum;

the greateromentumhasbeenretractedsuperiorly
in orderto showthe freetaenia;the mucousfolds
in the openedpart of the intestinecanbe clearlyseen;
view.
ventroinferior
Appendices '
omentales
[epiploicae]
- Colon ascendens

Taenia omenlalis
I

Plicae -
semts
tunates
coll

Oslium-
ileale

Frenulumostii/
ilealis

Fig. 961 Caecum, Caecum; vermiform Fig.962 Ascendingcolon,Colonascendens; caecum,

appendix,Appendixvermiformis; Caecum;vermiform appendix,Appendix vermiformis;
terminalpart of the smallintestine, sectionof intestine openedby a frontal section to show
Parsterminalisilei; the ileocaecalvalve;hooks hold the orifice apart;
dorsalview. ventral view.
* clinical: PEYER's
Datches

Glandulae inlestinales \

Epithelium
\
Tunicamucosa
Laminapropriamucosae- -.--
Noduluslymphoideus
solitarius-
Laminamuscularismuoosae

Telasubmucosa - -s
\-

Fig.963 Colon,Colon; Telasubserosa

\\
the intestinalwall hasbeen
Tunicaserosa
dissectedlayerby layer;
microscopic enlargement.
 cotonI4
Flexuracoli dextra -
-
Flexura coli sinistra

Caecum
Appendix vermilormis Colontransversum
Haustracoli

Colon sigmoideum
- Colon descendens

- Rectum

Fig. 964 Colon,Colon;rectum,Rectum; (doublecontrastmethod).

AP-radiograph
after filling with contrastmedium and air Comparethe topographyof the colon in Figs.1005and 1008.

Figs.965 a-d Transversecolon,Colontransversum; The positionof the transversecolonalsodependson the

f r e q u e n vt a r i a t i o n si n p o s i t i o n . amountof contentsand on the positionof the body;
a normal position,b serpentine,c U-shaped, d V-shaped ventralview.

Flexuracoli
sinrslra

----- Colon
transversum

---- Colon
descendens

- - Colon
sigmordeum
-- Rectum

F i g . 9 6 6 A s c e n d i n gc o l o n ,C o l o na s c e n d e n s ; Fig.967 Colon,Colon;
vieu'throughan entloscope rvhichhas beenintr<lduced projectiononto the anteriorabdominalwall;
t h r o u g ht h e r e c t u m ,t h e s i g m o i d t, h e d e s c e n d i ncgo l o n ventralview.
and the transversecolon (coloscopy). The positionsof the transversecolonand the sigmoid
vary considerably(seeFig. 965).
 Abdominatviscera
I42
/ Lrg coronanum

/ Lig lalcilotme
/ Diaphragma

-
Lig triangularedextrum
Lrg tnangulare
sinislrum

Lobus hepatis sinister,

Lobus hepatis dexter, Facies draphragmatrca
Facresdiaphragmatica

Lig talcrlorme

Lig teres hepatrs

'
i' V e s i c ab i l i a r i s
Margo inferior

Fig.968 l.iver,Ileptrr;
lrartsof the diallhragmhavelleenpresenetlto sholr the
hepatisand the round
attachmentto the liler; the l.ig.falcifrrrme
ligament(Lig.tereshellatis)havebeensectionetl;
ventralvie\4
lmpressiooesophagea \ f Parssuoerror;
,
\ ,, //
Facresdiaphragmatica
I Areanuda
nepatls--1,
tiOrosa
Appendix i \ V cava rnfeflor\
\
\ / lmpressiosuprarenalts

Lrg venosum ---

Lobus caudatus - -

- V portae hepatrs
lmpressro-
gastflca
-- lmpressio renalis
Tubet'-
omentale
-- Ductus
-- choledochus
Proc papillaris
lbiliarisl

- - A lobicaudatl
Proc caudatus
- lmpressio
/ duodenalis
Lobus hepatis sinistet
- A cystica
/
Margo inferior
-
propfla
,,-- lmpressrocolrca
A neparrca j
/ --
Frssura
ligamenti
teretrs Lobus hepatis dexler
I
Incisuraligamenli
terelis' Lig teres
hepatis Lobus Vesica biliaris
quadratus

Fig.969 Liver,I{epar;hepatichilum, Portahepatis;

ligamentousattachmentsof the liver vesselshavebeensectioned;
dorsalview.
* ( : l i n i ( : a l :L i g v c n a t , r : a v a c
** lx)rd(!rofth(f sut)orior re(rssus (lfthe om(!ntal l)ursa
 Liver;Hepa,
I43

- - Lobus heoatis dexter.

Tunicaserosa

Lig coronarium -

/
Lobus I
caudalus I
I
Appendix fibrosa hepatis - I
Vv hepaticae/ Peritoneum
'
V cava inlerior

Fig. 970 I.irer,hellar; The peritoneum-free areaof the liver surface,Area nuda,
the peritonealreflectionshaveheense(:tione(l; is rlist;erniblehl its rougherte\ture.
sulleriorview. * r l i n i ra l : I i , . {r r , n a cr a r a c

Lrg coronanum

/ V cava inferior
_-- Areanuda

V umbilicalis - - Facies visceralis

V porlae hepatis

Fig. 971 Liver,Hepar,of a fetus;

the oxygencontentsof the bloodis shownby.colours,
arrows indicatethe directionof bloorlflow:
dorsalview.
The liver parenchymais bl,llassedby wal of the Ductus
venosuswhich directshighly oxygenizetlblootlfrom the
yrlacentato the inferior venacava.
* a l s ot a l k ' r l l ) u (
tus i\RANill

Fig.972 Liver,Hepar;
sagittalsectionthroughthe right lobe to show the
branchesof the hepaticand the portal veins.
' intrahepati(;bran(:h()sof the hepati(:veins
* * intrahepati(:branchosof thc portal vein and the hepatic artery
 Abdominat
I44
Fissura portalisPrinciPalis
Seomentumoosterius.'r Segmentum mediale sinistrumllvl
me-diale
dextium[Vlll] /
Fissuraumbilicalis

Fissuraportalisdextra\ _

Seomentum oosterius ---

laieraledexirum[Vlll

Seomentum anlerius
latelalesinistrum
lltl
Segmentum anterius ---
laterale dextrum [Vll

Segmentum anletius -" \ Lig teres hepatis

mediale dextrum [V]
Vesica biliaris

Fig.973 Liver,Hepar; From a surgical point of view, SegmentumIV is subdividedinto

segmentsof the liver lobes are emphasizedin colour; an upper segment (IVa) and a lower segment (lVb).
ventral view.

Lig. venosum V cava inlerior

/
Lig lriangularesinistrum- _
_

Segmenlumfll - -

Segmentumposterius- -
laleralesinistrumul Seomentumposteraus
latiale dextrum[Vlll

Seomentumanterius
ladrab dextrum[Vl]

-- Seomentum anterius
dextrum[Vl
me-diale

Lig teres hepatis/

Vesica biliaris/

Fig.974 Liver,Hepar;
segments of the liver lobesareemphasized
in colourasin Fig.973;
dorsalview.

Parts of the liver,

Parsposteri0rhepatis,Lobuscaudatus Segmentum[]
Divisiolateralissinistra SegmentumposteriumlateralesinistrumIll]
anteriuslateralesinistrum[III]
Segmentum
Divisiomedialissinistra medialesinistrum[lVl
Segmentum
Divisiomedialisdextra anteriusmedialedextrumffi
Segmentum
posteriusmedialedextrumfvlll]
Segmentum
Divisiolateralisdextra anteriuslateraledextrum[VI]
Segmentum
posteriuslateraledextrum[VII]
Segmentum
considerations,i.e. the requirements of surgical resection,
and, moreover, takes into account developmental stand-
points. The individual sections are separatedby fissures
which are not, howeveq discernible by external visible
clefts.
 Liver,Hepa,
I45

Diaphragma ---

Pulmo dexter. ---

Lobus intenor

Fig.975 Hepatic veins, Vv. hepaticae;

ultrasound image of the confluenceof the hepaticveins
into the inferior vena cava:
inferior view.
* abdominal wall

V portae hepatis, \-
R. dexter

- - Parsabdominalis
aortae

- - Parslumbalis
diaphragmalis

Pars costalis - -
diaphragmatis

Fig. 976 Portal vein, V. portae hepatis;

ultrasound image of the division of the portal vein
into its main branches;
inferior view.
Compare to Fig. 982.
I abdominalwall
 Abdominatviscera
146
/, Lig falciforme
Vesica biliaris

/ Lobushepatrs
Lobus hepatis / r sinisler
dextel

i.-Lig hepatoduodenale

Ductus hepaticusdexler

Collum vesicae biliaris 1

-Paprlla duodeni major

Plicae mucosae \

Tunica - -

Fundus vesicae biliaris

/Ductus
pancrealicus

-(Orificium ductus
pancrealrcr)

-Papilla duodeni major "

Fig.977 Gallbladder,Vesicabiliaris [fellea],

andbiliaryducts;
partsof the anteriorwall of the gallbladder,the biliary
ductsand the duodenumhavebeenremovedto showthe
mucousmembrane;
ventralview.
* clinical: Hrtsten's valve
* * clinical: Papilla ofVrrrn

Figs. 978 a-c Variations of the biliary ducts;

common hepatic duct, Ductus hepaticuscommunis,
and common bile duct, Ductus choledochus.
a high union of the common hepatic duct with the
cystic duct
b low union of the common hepatic duct with the
cystic duct
c low union with crossingof the common hepatic
duct and the cystic duct
 vesicabitiaris
I47

Ductushepaticus
srnrster

Ductushepaticus
dexler

Ductushepaticus
communrs

- Ductus cyslrcus

- Vesica biliaris

- Ductus choledochus
Ibiliaris]

- Ouodenum

Fig.979 Biliaryducts;
AP-radiographin the uprightpositionafter
administration
of a contrastmedium:
ventralview.

- Duclusheoaticus
communrs
Duclus cysticus,Plica spiralis

Collum vesicae biliafls

Fig.980 Gallbladder, Vesicabiliaris[fellea],

andbiliaryducts;
AP-radiograph in the uprightpositionafter
administration of a contrastmedium;
the patientis standingupright;
ventralview.
 Abdominatviscera
L48

Draphragma -.

Fundus vesicae biliaris -

Colon transversum - - Hepar, Lobus dexter

Omentum maius -

Fig. 981 Liver, Hepar; gallbladder,Vesicabiliaris; Insufflation of gas into the abdominal cavity createsa space
through an endoscope,the liver can be assessedin terms of betweenthe liver and the diaphragm,which enablesa thorough
colour,the surfaceand the shape (laparoscopy); examinationof the liver and the sallbladder.
left ventroinferior view.

- - Ductus hepaticussinister

- V portae hepatis, Fl sinister

A hepatica propria, - A hepatrcapropria, R sinister

R dexter
V portae hepatis, R dexter -

Ouctus hepaticusdexter -

-- A hepaticapropria
-- V porlae hepatis

Fig. 982 Liver, Hepar; portal vein, Vena portae hepatis;

diagram of the branchesof the portal vein projectedonto
the surfaceof the liver;
ventral view.

-- V cava rnlerror

Vv heoaticaedexlrae --
- Vv hepaticaesinistrae

W heDaticaeintermediae --

Ductus choledochus -
lbiliarisl

Fig. 983 Liver, Hepar; hepaticveins, Vv. hepaticae;

diagram of the branchesof the hepatic veins projected
onto the surfaceof the liver;
ventral view.
 Positionof the UpperAbdominalOrgans
r4g

Hepar,Lobussinister --

Hepar,Lobusdexter -

Vesicabiliaris

Fig.984 Liver,Hepar; cycle.During inspiration,the diaphragmflattensout and the

projectionontothe anteriorabdominalwall; domedescendsdistinctlycaudally.Thereby,the healthyliver is
mid-respiratoryphase. pressedinferiorly down to the costalarch and the lower border
Thepositionofthe liver dependsessentiallyon the respiratory becomespalpable.

Duodenum.Parssuoeriol Pancreas,Cauda
--

Duodenum.Parsdescendens-- -- Pancreas,Corpus
-- Flexuraduodenoiejunalis
Pancreas. CaDut -
--
Duodenum,Parsascendens
Duodenum.Parshorizontalis--

Fig.985 Duodenum,Duodenum;
pancreas,Pancreas;
projectionontothe anteriorabdominalwall.
 Abdominatviscera
150
pyloricus
/ Canalis
M sphincler pyloflcus \
Corpus pancrealrs
/

Ductus Pancreaticus'
/
Ductus choledochuslbiliaris] \_

nuctus oancrealicusaccessorius"'
Incisurapancreatts

Papilladuodenr mrnor

= - - - - - - - M susoensortusduodeni'tt'
Ouctus choledochuslbihansl - -
D u o d e n u m ,P a r s d e s c e n d e n s - -

- FlexuraduodenojeJUnalis
Plica longitudinahsduodeni -
P a p i l l ad u o d e n im a i o r . . t -
=---- D u o d e n u m ,P a r s a s c e n d e n s

Plicae circulares /

caputpancreatisi
i i
Parshorizontalis
Duodenum, i
I
P r o c u n c i n a t uIs

Fig.9B6 Duodenum,Duodenum;pancreas,Pancreas; The formation and size of the accessorypancreaticduct vary

parts of the anterior wall of the duodenum have been removed considerably(in about 30%in the form of an accessorybranch,
to show the entry of the pancreaticduct; the pancreaticduct in less than 10%in the form of a major excretoryduct)'
* clinical: WtnsuNc'sduct
has been dissected;
clinical: SANToRINI's duct
ventral view. *"* clinical: Papilla ofVArER
* " * * c l i n i c a l :T R E l r z ' sm u s c l e

t\

9 7\
9
7 7
I 5/
5 5
7
7 7

5-

d f

Figs. 9B7a-f Variations in the confluenceof 1 = Duodenum

2 = Ouctus choledochus(biliaris)
the common bile duct and the pancreaticduct. 3 = Ductus oancreaticus
4 = Pancreas
a long common segment 5 = Papilladuodeni major
b ampullary expansionof the terminal part 6 = Pabilla duodeni minor, Duclus pancreaticus accessorlus
7 = M. sohincter ampullae hepatopancreaticae
c short common segment 8 = Ducius oancreaiicus(on "Papillabipartita")
9 = Ampulla hepatopancreatica
d separateorifices confluence
e single orifice with a septatedcommon duct
f additional duct, Ductus pancreaticusaccessorius
 Pancreas
151
V cava inlerior\ gastricasinistrl pars
I v thoracicaaorlae
A hepaticapropria,
\ \ i / Hiatusaorticus
V portaehepatis\ / A gastricasinistra
\
/ Glandula
suprarenalis
Diaphragma \\

Glandula \
suorarenalis / A ;V splenica0ienalisl

-
Ductushepatrcus
communrs
Oucluscystrcus-

A gastro-- Cauda oancreatis

duodenalis
Ben - - Truncus coeliacus

mesenteflca - A hepatica
superDr communts
(V gaslro- - - A. renalrs
duodenalis)
-
Caputpancreatis
- V renalis
Ouodenum,-
Parsdescendens
\ Ureter
A : V c o l i c a-
medra
\ M suspensorius
duodeni
A : V c o l i c a- < - :
dexlra '-l

Duodenum, - -- \ Jejunum
Parshorizonlalis
M ouadratus /
lumborum
\ Ureter
Ureler/
':
M psoasmalor/ i \ inferior
v mesenterica
A ; V ovarica,/testicularis' \ A mesenterica
inferior
Aa ; W jeiunaleset ilealest

Fig. 988 Retroperitoneal

organsandvesselsof the upper ventral view.
abdomen: Lymph nodes not depicted.

Duodenum,Parssuperior
\
V.portaehepatis\ \ Ductusheoaticus
communis
-- Ouctuacysticus
V splenicalienalisl\
(Sulcusarteriaesplenicae) \, -- Flexuraduodenisuoerior
,
-- Ouctuscholedochus
[biliaris]
Corpuspancreatis\

-
Duclusoancreaticus

Duodenum,
Parsdescendens
superiot-1
V mesenterica
A mesenlerica supeflor Caputpancreatis

Proc uncinalus'

-- Flexuraduodeniinferior

--
Duodenum, Pars horizontalis

Fig.989 Duodenum,Duodenum;pancreas,Pancreas; Thecommonbile ductpassesthroughthe pancreas; the headof

the bodyof the pancreas
hasbeensectioned
to showthe the pancreasreachesaroundthe superiormesentericvein.
pancreaticduct;
dorsalview.
 Abdominatviscera
I52

- Ductus pancreaticus:
Cauda pancreatis

Ductushepalicus
communrs
Ouctuscysticus

- Je,unum
Vesica biliaris -

Ductus choledochus
lbitiarisl

Duodenum, Pars descendens I lvertebra lumbalis ll

A m p u l l ah e p a t o p a n c r e a t i c a '
Duclus pancrealicus

Fig.990 Pancreaticduct, Ductus pancreaticus;common bile Clinical: ERCP(endoscopicretrogradecholangio-pancreaticG

duct, Ductus choledochus;gallbladder,Vesicabiliaris; graphy).The whole extent of the pancreaticduct up to the hilum
AP-radiograph;the patient is in the supine position; a cannula of the spleenis visible. It shows a typical oblique course to the
has been introduced endoscopicallyinto the common orifice of Ieft and superiorly.Someof the contrast medium has entered
the pancreaticduct and the common bile duct and a conrrasr the small intestine and thereforeparts of the duodenum and the
medium has been injected; jejunum can be seen.If the contrast medium is inlected under
ventral view. higher pressure,the branchesofthe pancreaticduct may also be
demonstrated(compareto Fig. 986). A danger exists however,
that the pancreascould be damaged.

V porlae hepalis, R sinister

Hepar, Lobus sinisler \

Lig teres hepatis \ mesentencasuperior

/A
/A splenrca
Corpus pancrealis -
V portae hepalis \

Hepar, Lobus \
cauoatus

V renalis sinislra -

V cava inlerior --

Pars abdominalisaortae - - - Cauda pancreatis

-Flen sinister

Fig. 991 Pancreas, Pancreas; the tail of the pancreasextendsquite far posteriorly;
ultrasoundimageto showthe pancreas andthe adjacent inferior view.
greatvesselsduringdeepinspirationof the patient; ' abdominalvall
 teen,
spten
[Lien]1 53

Margosuperior
/ V splenica [ienalis]

/ Facies visceralis,Facies colica

A splenica lrenatis; --_

/ Hilum splenicum

/ Lig splenorenale
Lig gaslrosplenicum --

- Extremitasanlerior
Exlremrlas -
poslerior
- -
Facies vrscerahs,
Facies renalis

Fig.992 Spleen,Splen[Lienl;
the vesselsat the hilum of the spleen
Margo interior
havebeendissected;
ventromedialvieu'.
I Margo superior

Facresdiaphragmatica

- -
Extremitas
anleflor

lMargo rnferior
Fig. 993 Spleen,Splen[Lien];
vien'.
superolateral

Tunrcaserosa:
Tunrcalibrosa

Facies renalis --

- - rtabeculae splenicae

Fig.994 Spleen,Splen [Lien];

crosssectionshowingthe structure and the
hilum of the spleen;
medialsuperiorview.
V splenrcalienalisl )
In this crosssection no lymph nodes can be
A splenrcalienalisJ / seen at the hilum. Horever, they regularly
occur here and drain parts of the stomach
and the tail of the pancreasas well.
I54 Abdominat

Pars abdominalis
aorlae

-- Pars abdominalis
aorlae

-- Pancreas

-- Duodenum,
Pars
horizontalis

Omentummajus--

Figs.995a, b Development and topographyof the

peritonealcavity,Cavitasperitonealis;
schematic mediansection:
lateralview.
a earlydevelopment
b development of the greateromentum

Pars abdominalisaortae ---_

' 1--l----

H e P a r- - -

B u r s a o m e n l a l i s- - -
Lig hepatogastricum---

l l e u m- - - -

--
Colonsigmordeum

Fig. 996 Development andtopography ofthe peritoneal

cavity,Cavitasperitonealis,in the female:
schematicmediansection;
lateralview.
The smallwhite arrow marksthe positionof the omental
foramen[epiploicor WIrsLow'sforamen].Thearrow-head
is locatedin the vestibuleof the omentalbursa.
 PeritonealCavity,Cavitasperitonealis
155
Pars abdominalis aortae \
Oesophagus \
Hepar \

Diaphragma \

Lig hepatogastracum-,

Pancreas --_.

Bursa omenlalis --_-

Cavitas peritonealis --_

Gaster ---
Mesocolontransversum-- -

Lig gastrocolicum --

----
Colontransversum
-
Duodenum-

Jejunumz'

/
Omentummaius/
/
Cavitas peritonealis/

/
lleum /

/
Colonsigmoideum

Excavatiovesicoulerina/ \ Excavatioreclouterina'

Fig.997 Development andtopography ofthe peritoneal

cavity,Cavitasperitonealis,in the female;
final developmentalstagewith the adhesionof the greater
omentumto the transversecolon;
schematic mediansection;
lateralview.
* clinical: DoucLAs's space

Figs.995-997 Thedevelopment of the intestinesis presented Theperitonealfluid amountsto only a few milliliters.
schematically. In realitymany developmental stagesoccur Peritonealcavity:red dottedarea;omentalbursa:olive;
concurrently. Theperitonealcavityis enlargedin the drawings originalcourseof the peritoneum: red dashedline.
for didacticreasons. Normallythe visceraarevery closetogether Thearrowis in the omental foramen [Foramen epiploicum].
andareonly separated by a smallcapillaryspace.
L56 Abdominat

Lig lalciforme

Pars pylorica \

Lobus hepalis dexler \

Lig leres hepatis \ ,/ M rectus abdominis

- Lig gastrocolicum

Taeniaomentalis

-- M l r a n s v e r s u sa b d o m r n r s

-
Omentum malus
-- M o b l i q u u sI n t e r n u s
a000mlnls

- M obliquus
externus abdomrnrs
-
Colon ascendens,
Taenia libera

-
Colon srgmoideum

Caecum - Peflloneum
paflerare

\
Plica urnbrlrcalislateral's
(A V eprgaslncdiii.rro')
\
L i n e aa r c . , a t a

\
P l i c au m b i l i c a l i sn r c d r a | s
(Chorda arleriae umbilicalis)

Fig. 998 Positionof the abdominalviscera, Situs viscerum;

greateromentum,Omentummaius;
ventral view.
The lower part of the abdominal cavity is also called the
"intestinal abdomen".
 Thoracicand Abdominal Organsin a Newborn
51

// fhymus
Pleura parietalis \ / Pericardiumfibrosum
Pars costalis

{.
Pulmo sinisler.
Pulmo dexter - -- Lobus superior
Lobus supenor

- -
Pleura oarietalis.Pars mediastinalis
Pulmo dexler Lobus rnferior--

Pleura Pars mediastinatis - - Lobusinferior

Pulmosinister,
J
P a r r e t a l r sI parsdiaphragmalrca

D r a p hr a g m a - - SplenILien].Exlremrtas
anterior

-- --
Lig faloforme Lobus heoalis sinister

---
major
Gasler,Curuatura
--
- Colon descendens
Lobus hepatis dexter
- -
omenlum ma;us

l-- u umbrricaris

$ Intestrnumtenue

Plica umbilicalislalerahs
(A : V epigastricaInfeflor)
/ Plica umbilicalismedialis
Vesica urinarra / (A umbrlicalis)

Plica umbilicalis mediana / \

(Urachus) Anulus umbilicalis

Fig.999 Positionof the abdominal viscera,Situsviscerum,

in a newborn;
the anteriorthoracicandabdominal wallsandpartsof the
diaphragmhavebeenremoved;
ventralview.
Notethe sizesof the liver,the greateromentum,the medial
umbilicalfoldsandthe umbilicalvein in comparison with an
adult(Fig.998).
 Abdominatviscera
15 8
Lrg coronaflum \
Lig falciforme 1

Lig teres
hepatis

Lobus hepatis dexter, -

Facies diaphragmatica - Fundus

Lobus quadratus -
- Appendrx
Omentum minus, - fibrosa hepatis
Lr9 -
hepatogastricum Cardia
- Recessus
V e s i c ab i l i a r i s- costodraphra9-
maticus
m i n u s -,
Omentum
Lrg Corpus gastricum,
hepatoduodenale Paries anterior
Foramen omentale -
' Splen ILien]
[epiploicum]
Gaster, Curyatura minor
Lobus hepatis .-
dexter. Facies
visceralis Lrg gastrosplenrcum

D u o d e n u m ,-
Pars superior Lig phrenicocolicum
I n c i s u r aa n g u l a r i s
Ren, Extremitas '
supeflor Gasler, Curvaturama,or

Pylorus- - Omentum majus

A ; V gastro
Flexuracoli dexlra / ffill{frH iJi omentalissinistra
t Colon transversum --.
- - **
A;Vgaslflcasinislra a Mesocolon lransversum
Taeniaomenlalis \
Omenlum majus Lig gastrocolicum

Fig. 1000 Positionof the viscera in the upper abdomen; This part of the abdomenis also known as the "glandular
parts of the diaphragm as well as the anterior thoracic and abdomen".
abdominal walls have been removed: * also called WtNstow's foramen
ventral view. " " omental bursa slightly exposed

Gaster, Curualura minor

tt\
/ Corpus gastricum

Gasler, - Gaster, Curuaturamalot

Pars pylorica

Hepar, Lobus
dexter

Vesica brlraris /

*@fi

V gaslroomentalis /
dextra, Flr gastrici
O m e n l u mm a j u s

Fig. 1001 Stomach,Gaster;greateromentum,Omentum majus; surgical drape

surgical retractor
surgical photograph;the viscera are in their natura[ position;
ventral view.
 Organsof the UpperAbdomen
159
Lobus hepatis dexler, Facies diaphragmatica I Vestibulum
i bursaeomentalis / Lobushepatissinister,Faciesdiaphragmatica

Lig teres hepalis -

/ Recessus
superiorbursae
omenlalis
Lobus z Splen [Lien],
quadralus Margo superior

- Plica
gaslropancreatrca

- Recessus
splenrcus

- Corpusgastricum,
Pariesanterior

Omentumminus, - Omentumminus,
Lrg hepato- Lig hepatogastri-
duodenale cum

- Mesocolon
| uoer ransversum
|
corou. I otental9
- Gaster,
pancreatis
I Facies
anrero_ Curvaluramajor
I
I supeflor
- Recessusinferior
bursaeomentalis
Flexuracoh dextra / Omentum majus. Lig gastrocotrcum/ I Gaster.Curuatura
minor

Fig. 1002 Visceraof the upperabdomen; pancreas; the lessercurvatureof the stomachhasbeenreracted
the lesseromentum(hepatogastric
ligament)hasbeenpartially to the right and inferiorly;
removedto demonstratethe omentalbursaand the bodyof the ventralview.

gaslropancreatica
Lig gastrocolicum \ / Plica
Glandula
suprarenalis

Hepar.
Lobus Lig
caudalus gaslrosplenicum

Veslibulum
oursae
omentalis

Lig hepato-
duodenale A;V
splenica
Pylorus

Hilum
Duodenum, sprenrcum
Parssuperior
Cauda
pancreatis
Colon
lransversum
Corpus
pancreatis,
Facies
anterosuperior
Taeniaomentalis
- Colon
lransversum

Colonascendens
- Mesocolon
lransversum
Taenialibera

Omentum majus, Lig gaslrocolicum / \ A :V colica media \ Taenia mesocolica

Fig. f003 Liver,Hepar;stomach,Gaster;pancreas,Pancreas; ligament;the greatercurvatureof the stomachhasbeenretracted

spleen,Splen; superiorlywith hooks,view into the omentalbursa;
the greateromentumhasbeensectionedat the gastrocolic ventralview.
 Abdominal
160

Omentummaius\
\

\
Colontransversum

- Appendices
Taenialibera - omentales Iepiploicae]

- Flexuracoli sinistla
Flexuracoli - -
dextra

Colonascendens-

Taenia libera '

Sulci paracolici /

Plica ileocaecalis /

Caecum/

Fig. 1004 Positionof the abdominalviscera,Situsviscerum;

the greateromentumand the transversecolonhavebeenretractedsuperiorly;
ventralview.
 viscerum
cera,situs
16I

Omentummaius\

,, Taeniaom€ntalis

Haustracoli :

Fundusvesicae\
biliaris Taenialibera

Flexuracoli dextra- - - A.: V. colica media

- Mesocolon
Lobushepatis- transvelsum
dexler,
Margoinferior - Pancreas

Taenia libera - -
- Jejunum

Haustracoli - - Duodenum,Pars
horizontalis

Recessus- Badixmesent€rii
ileocaecales
superioret inferior
Plicaesemilunarescoli -
lleum,
Parslerminalis
Sulci paracolici -

- lleum
Plica ileocaecalis

-
Caecum

-
Ureter,Parsabdominalis

/
Mesoappendix

Appendixvermiformis/

Fig. 1005 Smallintestine,Intestinumtenue;

largeintestine,Intestinumcrassum;
the greateromentumand the transversecolonhavebeen
retractedsuperiorly;the smallintestinehasbeenpulledto
the left to showthe caecumand the vermiformappendix;
ventralview.
Notethe thin Iayerof subcutaneous fat and the fat deposits
in the mesenterv.
 Abdominatviscera
162

Colontransversum / Omentummajus
/ Taenia libera

A : V colica media -

/ Pancreas,
Facies anteroinferior

- Flexura coli
Mesenterium- sinistra

- Recessus
duodenales
el inferior
superior

- Ren, Extremitas
lntestinum inlerior
Ienue

- Sulci paracolici

- Colon sigmoideum

- Mesocolon sigmoideum

\ Recessus
intersigmoideus

,.r'
\ Ureter

Fig. 1006 Smallintestine,Intestinumtenue;

largeintestine,Intestinumcrassum;
the greateromentumand the transversecolonhavebeen
retractedsuperiorly;the smallintestinehasbeenpulled
to the right; the sigmoidcolonhasbeenretractedto the
right by two hooks;
ventralview.
The recessesat the transitionalregionbetweenthe
retroperitoneal partsof the intestine
andintraperitoneal
varv considerablv betweenindividuals.
 Positionof theAbdominalViscera,Situsviscerum
r63
/ Omenlummajus / Colontransversum

Mesocolon\
transversum
I
-' FlexUIa coli
sinistra

Flexuracoli dextra \\
- - Taenia libera

- Colon
descendens
Colon ascendens \-
----tti '. ).
!l

-\_ ..;
. Mesocolon
transversum

DuodenumP,a r s- - -
horizontalis

- - Mesenterium

- -
Recessus ileocaecalis
supeflof
Colondescendens

--
Appendices
omentales
lepiploicael - Taenia libera

Caecum'

/
Becessus
/ /, ' /
rleocaecalis
inlerior
/ / / \ Vesica
Mesoappendix Appendix Rectum urinaria 331i1,0"",
vermiformis

Fig. 1007 Mesentery, Mesenterium;

largeintestine,Intestinumcrassum;
the greateromentumand the transversecolonhave
beenretractedsuperiorly;the smallintestinehas
beensectioned flexure,
closeto the duodenojejunal
at the terminalileum,and at the mesentery;
ventralview.
 Abdominatvisce
164

Plica gastropancreatica Lobus heoatis sinistel

Lig. hepatogastricum Ostiumcardiacum
/
Vestibulumbursaeomentalis\ I 1 Bursaomentalis
Lobuscaudatus,Proc.papillaris\ \ A; V gastricabrevis
I 1
Lobushepatisdexter \ It'

Lig falciforme --_ / Lig.gastrosplenicum

Li9 tereshepatis-J
/ Appendix fibrosa
hepatis

Omenlumminus-
- Caudapancreatis
Fundusvesicaebiliaris -
- Mesocolontransversum
-
Lig. hepatoduodenale
Corpuspancreatis- -
- Lig. gasirocolicum
Ouodenum,Parssuoerior- -
- Lig phrenicocolicum
Ren,Extremitassuperiot--
- Omentummajus
Flexuracolidextra -.-
- Flexuracoli sinistra
Gaster, Pars pylorica --
- Colon transversum

Omentummaius,-- - Flexura duodenojejunalis;

Lig.gastrocolicum Recessus duodenales
superior et inferior
omentummaius - -
--
Colonascendens-{ Colon descendens

--f
Colontransversum
- Mesenterium
Recessus--
ileocaecalis
superior

lleum

Recessus
ileocaecalis
inlerior
- -
Colon
sigmoideum
Caecum-'

Recessus--
relrocaecalis \ Mesocolon
sigmoideum
Appendixvermiformis/ \ Urete( Parspelvica
'/l \ Duclusdeferens
Mesoappendix/
\
\ Rectum
Excavatio rectovesicalis \ Vesicaurinaria

Fig. 1008 Positionof the abdominalviscera,Situsviscerum;

the stomachhasbeenremovedbetweenthe cardiaand the
pylorus,the smallintestinebetweenthe duodenojejunal
flexureand the terminal ileum:the transversecolonand
sigmoidcolonhavebeenpartially removed;the omentalbursa
is visible with all its recesses:
ventralview.
An arrow lies in the omental[epiploic]foramen.
 165
Lig gastrophrenicuml Ostrumcardiacum
Plica gastropancrealica Lig coronaraum,Lig triangularesinistrum
I
/ Lrg gaslrophrenicum
/ Glandulasuprarenalis;
Bursaomentalis

/ A ;V splenica
Diaphragma \ /, Lig gastrosplenicum
Glandula suorarenalis\ Matgosupetiol
\
I
// Splen
Facies gastflca lLienl
//
--f
t-lgcoronarlrm
V porlae
hepatis; n Eursaomentalis,
A hepaticapropria-- Recessussolenicus
- -
Duclushepaticus
communts
Ductuscysticus- - Caudaoancreatis

Lig hepatoduodenale--
Ren -- -- Mesocolontransversum
Parssuperior--
Duodenum,
-- V mesenterica inlerior
parietale- -
Peritoneum
Mesocolon lransversuffi - - -- Ouodenum,Flexura
duodenojejunalis
A : V gastroomentalisdextra --
-- Ren,Extremitas
inlerior
Duodenum, Pars descendens -
- Recessusduodenales
Ren, Extremrtasinlerior- - suoerioret inferior
- -
Caput pancreatis- Plicaduodenalisinferior
--
A : V m e s e n t e r i c a- - Duodenum,Pars
supeflor ascenoens
Duodenum,- - - A: V colica sinistra
Parshorizontalis
- A mesenterica inferiot
Radix mesenterii-
- Aa sigmoideae
Plica ileocaecalis- -
- A rectalissuoerior
Recessus-
ileocaecals
supeflor - Recessus
intersigmoideus
Recessus - -
ileocaecalis -
interior Ureler,
Pars pelvica
/
Mesoappendix - Mesocolon
sigmoideum

A;Viliaca/
communrs
/
Linea terminalis /
Colon sigmoideum /

Excavatio rectouterina' /
Lig leres uteri"
Excavatiovesicouterina/ // Pelvis minor
Vesica urinaria,Fundus vesrcae/
\ Fundusuleri

Fig. 1009 Dorsalwall ofthe peritonealcavity,Cavitas

peritonealis,andspleen,Splen[Lien],in the female;
the liver,the stomach, the smallintestine(exceptfor
the duodenum)andthe colonhavebeenremovedto show
the pancreas, the rootof the mesenteryaswell as
the fixationsitesof the ascending anddescending colon.
Thesitesof fixationof the ascending anddescending
colonhavebeenmarked(1).
* clinical: DouclAs's space
*' clinical: Lig. rotundum
 Abdominatviscera
166

- -
Lobus hepatis dexter

Duodenum,
Pars descendens -- Duodenum,
Parsascendens

Caput pancreatis

Colon ascendens

I
I
I
I
I

Caecum-

Ampullatubaeuterinae-
t--$
7.;

/ 'r- i'{r.-\\\
ovarium vesrcaurina.a

Fig. 1010 Vermiformappendix,Appendixvermiformis,

variationsin position;
ventralview.
Majordeviations from the normalpositionareusually
dueto an atypicalpositionof the caecum(e.g.high caecum)
or minimalperitonealfixationof the caecum(e.g.mobile
caecum).
 endixvermiformis
167

-- Tunicamuscularis,
Taenia libera

Appendixvermiformis
- 30%

Figs.1011a-d Vermiformappendix,Appendixvermiformis,
variationsin position.
a descending into the smallpelvis
b retrocaecal
c preileal
d retro-ileal

/ Anulusumbilicalis

Colonascendens

Spinailiacaanteriorsuperior

Spinailiaca-
anteriorsup€rior
Appendix/
vermiformis
Eig. 1012 Caecurn,Caecum,andvermiform
Caecum'
appendix,Appendix vermiformis;
./ projection onto the anterior abdumlnalwall.
* clinical: v lenz's polnt, the end polnt of the right thid of a
llne connectingthe tryoanterior superlor lliac spin$ as locator
of the tip of the downwardhanglng vermlform appendlx.
r r cllnlcal McBURNEy's point, the beglnnlngpoint of the outer
thhd ofa line connectlngthe navoland the rBht anbrlor superior
lllac spine as locatorof the baseof the vennlftrm appendlr
 Abd,ominatviscera
168

/ Lobushepatissinister
Lig teres hepatis \
/ Ductushepaticuscommunis A mesenterica\
superior
/ A hepatica propria
A heoatica \
7 Truncuscoeliacus piopria,
B dexter
Vesicabiliaris- / A, gastricasinistra

- - - Gaster -,loo/o
A cyslica - ---SplenlLienl b
Ductus - --
cysticus A hepatica
communts
V portaehepatis -
- A splenica
Ductuscholedochus
lbiliarisl
/
A. gastricadextra / A. hepatica -
communrs
Duodenum/
-50"h -3o/o
A gastroduodenalis rA gastroomentalis
a dextra
c

-3"/"
d

Figs. 1013a-f Variationsin the arterialbloodsupplyof the liver. e A branchof the left gastricartery suppliesthe left lobeof the
a "textbookcase" liver in additionto the left branchof the properhepaticartery.
b Thesuperiormesentericartery contributesto the supplyof f An accessorybranchofthe properhepaticartery supplies
the right lobeof the liver. the lessercurvatureof the stomach.
c Thecommonhepaticartery originatesfrom the superior
mesentericartery. In about25%of casesthe superiormesentericartery contributes
d Theleft gastricartery suppliesthe left lobeofthe liver. to the arterial supplyof the liver.

A. hepaticapropria,
Aa. segmenti
anterioriset posterioris

A hepaticapropria,R dexter - A heoaticacommunis

A. gastroduodenalis

A pancreaticoduodenalis
superiorposterior - A gastroomentalis
dextra
A pancreaticoduodenalis --
A pancreaticadorsalis
superioranterior --
A pancreaticainlerior

Fig. 1014 Commonhepaticartery,A. hepaticacommunis; * branchesto the left lobeof the liver insteadof a left branchof the proper
hepaticartery
AP-radiographafter selectiveinjectionof a contrastmediuminto branchfrom the hepaticarteryto the lessercurvatureof the stomach
" accessory
the commoqhepaticartery; '** catheterin the aorta
a^
venral vlew.
 Vessels
of the UpperAbdomen
169
r Lobuscaudatus / Lobus hepatis sinister
Lig teres hepatis \
7 OPars lumbalisdiaphragmatis
,/
V cava inferior O \
/ / aA. gastricasinistra
\\ / //
z OTruncus
\ coelacus

Vesica biliaris \ / OA phrenica

/t inferior

L o b u s h e p a t -i s. - * z/ )Pars abdominalis
oexter; -t- aortae
Lobus
quadratus

A;VcysticaOO---

A hepatica a --
propna

V portaeO --
hepatis

-t
Ductus -- OV gastrica sinistra
choledochus
lbiliarisl
A gastroduodenalis a / --
ooA;v
gastroomentalis
AhepaticaO/ j sinistra
communrs
--
/ omentummalus
A gastrica dextra O /

- Pancreas

o /
V prepylorica

A:v aa/
gastroomentalis
dextra

\
a aRr omentales

Fig. 1015 Vessels ofthe upperabdomen;

the lesseromentumhasbeenremovedto showthe coeliactrunk
and its branches;the gastrocolicligamentand the gastro.
omentalarteriesand veinshavebeendissectedalongthe greater
curvatureofthe stomach; the vestibuleofthe omentalbursa
has beenexposed;
ventralview.
Thedistanceof the arteriesfrom the wall of the lesserand
greatercurvaturesof the stomachvariesconsiderably.
 Abdominatviscera
17 0
A gastricasinistra\
Truncus coeliacus1 .\
.\
A hepalica communis 1 \ fJ Aa gastncae breves
\
A h e p a t i c ap r o p r i a : - q

A g a s l r o d u o d e n a l s\ \ _
-
A gastnca dextra - -_: A splenica
llienalisl
il
t
t '-\
{ :,
/ A gastroomentalissinistra
pancreatrcoduodenalis
/il
supeflor posleflor
A gastroomentalisdextra
I A gastflcapostenor
I
I
I
I
J
P

Figs. 1016a-e Variationsin the arterialsupply of the stomach, arteriesat the greatercurvature of the stomach(closedarterial
Gaster. arcade).
a normal situation, "textbook case":the arterial arcadeson the no connectionbetweenthe left and the right gastroomental
greater and lessercurvatures of the stomachare closed arteries at the greater curvature of the stomach(open arterial
b contribution of the left gastric artery to the arterial supply arcade).
of the left lobe of the liver a branch of the splenic artery, the posterior gastric artert
c anastomosisbetweenthe left and the right gastroomental suppliesparts of the posteriorwall of the stomach

A hepalrcapropfla - -
A gastricasinistra
A h e p a l i c ac o m m u n i s -
-Truncus coeliacus
A g a s t r o d u o d e n a l r -s
-A
splenica

A gastroomentalis -
oexlra -
A gastroomentalrs
srnrstra

Pelvis renalis

P e l v i sr e n a l t s - - Ureler srn ster

Fig. 1017 Arteriesof the stomach,Gaster;spleen,Splenflien], medium,which can be excretedby the kidneys;
and liver, Hepar; ventral view.
AP-radiograph after selectiveinjectionof a contrastmedium into
the coeliactrunk (coeliography)with simultaneousdemonstration * loop of the catheter in the aorta
of the renal pelvis after intravenousinlectionof a contrast * * c a t h e t e ri n t h c a o r t a
 of the UpperAbdomen
Vessels
17T
A hepaticacommunisO I I O Truncuscoeliacus
I
V cava inferiora \ 1 i t OA gastricasinistra
\ t OO A:Y gaslroomentalis
\ / sinistra
\ oL}lrreaica
\ ,r' ,z

___:__ :
aA. gaslrica
' _/ brevis

-'aaA:V.
splenica

-- aOBr sPlenici

A;Vgastro-Oa-
omentalis
dexlra

A gastro-O
duodenalis
V Dortae heoalis o -

A pancrealico- O -
duodenalis --
OA pancreatico-
supenor antenor duodenalis
inferior
Caputpancreatis--
-
OA mesenterica
-
V mesentericaa supeflor
supeflor

Proc uncinatus /

Lig gastrocolicum/

O V epigastrica
inferior

aA. epigastrica
inferior

Fig. 1018 Vessels of the upperabdomen;

the gastrocolic ligamenthasbeensectioned; the stomachhas
beenretractedsuperiorlyby hooksto demonstratethe
coeliactrunlr; a portionof the bodyof the pancreashasbeen
removedto showthejunctionof the splenicandthe superior
mesenteric veins;the omentalbursahasbeenopened;
ventralview.
Theuncinateprocessof the pancreasoftenreachesfar
behindthe mesenteric vessels.
 Abdominatviscera
17 2

A colica media \

A marginaliscoli - _

A colica dexlra -

---
A mesenlericainlerior

24 "/"

20%

Figs. 1019a-d Variationsin the branchesof the superior The ileocolicartery and the right colic artery sharea
mesentericartery to the colon. commontrunk.
a "textbookcase":the Colonascendensand the Colon c There are only two branchesfrom the mesentericartery,
transversumare supplied by three branches. the right colic artery is absent.
d Duplicationof the right colic artery

A mesentericasuperior

A colica medra -

Aorta, Pars abdominalis -

- Aa jejunales
A colica dextra -

- Aa ileales

Fig. 1020 Superiormesenteric artery,A. mesenterica

superior; * catheterin the aorta
** catheter in the common iliac artery
AP-radiograph afterinjectionof a contrastmediuminto the
originof the superiormesenteric artery;
ventralview.
 SuperiorMesenteric
Arteryand Vein
173
Mesocolon
transversum\ marginaliscoli
V mesenterica
superioro\ \ / o A mesentericasuperior
A colica mediao \ I tooA;Vcoticasinistra

Colon ..
transversum \

'- o Aa jejunates

V colica o
media

-- Flexuracoli
sinistra

Flexuracoli---
dextra

Flexuraduodeni-
inferior
-- GVv jejunales

A ; V c o l i c aa a -
dextra

Aa ilealesO '

Vv ileales a -

caecuml Appendix vermiformis \

Colonsigmoideum

Fig. 1021 Vesselsof the lowerabdomen;

the greateromentumand the transversecolonhavebeen
reflectedsuperiorly;the small intestinehasbeenpulled
to the left; the visceralperitoneumhasbeenpartially
removedto demonstratethe branchesof the vessels:
ventralview.
Thearteriesofthe small intestineform severalarcades.
 Abdominatviscera
17 4

--* A marginaliscoli
A colica media - - - --- A mesentericasuoerior

- - - A mesenterica Interior

--- A colica sinistra

--- Aa sigmoideae
--- A rectalissuperior

-25%

Figs.1022a-c Variationsin the branchesof the inferior b accessorymiddlecolicarteryfromthe maintrunk of the

mesentericartery. inferiormesenteric
artery
a trifurcationof the inferiormesenteric
arterysupplying c accessorymiddlecolicarterybranchingfrom the Ieft colic
Colondescendens, Colonsigmoideum andRectum artery
" clinical: SUDEcK's
Doint

A mesentericainferior

A colica sinistra

-- V colicasinistra

-- A m a r g i n a l i sc o l i
- - Crista iliaca
Aa sigmoideae -

- - Arliculatiosacroiliaca

A rectalissuperior -

Fig. 1023 Inferior mesentericartery, A. mesentericainferior; Someof the contrast medium has already left the colon,
AP-radiographafter selectiveinjection of a contrast medium into thereforeveins are visible as well.
the origin of the inferior mesentericartery; * catheterin the aorta

ventral view.
 InferiorMesenteric
Arteryand
175
A pancreaticoduodenalis
inferiorO
I I OA mesentenca
superior 7 OPars abdominalis
I / aodae
Vmesenlericao\
supeflor
i ! t 'V sPlenica
\ I t/

/ Pancreas

A V colica O o
meora

- -
ov mesenlerica
inlerior
--
on mesenterica
inlerior

---
on colicasinistra

Aa;W O a
jejunales
- Colon
descendens

-
oaAa;vv
stgmoideae

-
O OA ;V rectalis
supenor

Radix mesenterii /

\ Colon
sigmoideum

A sacralis medrana 1 /

Fig. 1024 Inferiormesenteric arteryandvein,

A. et V. mesentericainferior;
the smallintestinehasbeenpulledto the right;the transverse
colonhasbeenreflectedsuperiorly;the peritoneumhasbeen
removedfrom the descendingand the sigmoidcolonto show
the bloodvessels;
ventralview.
TheA. marginaliscolijoinsthe left colicartery.andthe
middlecolicartery.
 Abdomtnatviscera
17 6

- Truncuscoeliacus

- A gastricasinistra
A heoaticacommunis -
- A splenica
A. oancreaticoduodenalis
superiorposterior
mesenterica
superior

Figs.1025a-e Variationsof the coeliactrunk. d formationof a Truncusgastrosplenicus

a "textbookcase":coeliactrunk dividedinto threebranches e formationof a Truncusgastrosplenicus
and Truncus
b trunk with four branches hepatomesentericus
c formationof a Truncushepatosplenicus

Truncuscoeliacus
\

Pars thoracica aortae \

/
Discusintervertebralis

Vertebralumbalis| /
/
Discusintervertebralis

Fig. 1026 Abdominalaorta,Parsabdominalis aortae; artery.Thelaterruns a short

that of the superiormesenteric
ultrasoundimagetakenalmostin the sagittalplane;notethe distanceparallelto the abdominalaorta.
* abdominal wall
closeproximity betweenthe origin of the coeliactrunk and
 177
A hepaticacommunisa Hiatusaorlicus
W. hepaticaeo \ Hiatusoesophageus
V. cava inferiorO 1
7 O O A.; V gastricasinistra
A. hepaticapropriaO\
V portaeh€patiso \. ta
ParscostalisO:
diaphragmatis

Glandula\ -
suprarenalis )O A;V.splenica
.z
Ductushepaticus-
communrs // Caudapancrsatis

Ductuscysticus- -
-/ O V..mes€nlerica
Ductuscholedochus- - tmenor
lbiliarisl
Rendexter- - -- a a A.; v. mesenlerica
supenor
Duodenum,Pars --
superior,Ampulla -- Jeiunum

Duodenum, --
Pars
descendens - - Rensinister

Caputpancreatis,- -
Proc.uncinatus -- Urclel

Duodenum, --
- O Parsabdominalis
Parshorizontalis
aorta€
- - a A. colba sinistra

-- a Bifurcatioaortae
V c a v a i n f e r i o r o- - -
-- a O A.; V. lumbalislV
-- ao A;Vmesonlerica
- inferior
femoris -
N. cutaneus
lateralis -- O O A.: V. sacralis
- m6diana
* -
(M-psoasminor),
Tendo -- -
O A. rectalissuporior
-
A.; V. iliacaO O
communrs
/ --
N. temoralis Mesocolon
sigmoideum

Fasciailiaca-

/
A.;V.circumllexafO
iliumprolunda
\
A.; V. iliaca extemaO O
/ \ t
\ o o Aa.;Vv.sigmoideae
\
'
Colon sigmoideum;Appondicesomontal€s
\
vesica urinaria

Fig.lO27 Retroperitonealspace,Situsretroperitonealis,
in the male;
the parietalp€ritoneumhas beenextensivelyremoved;
ventralview
 Abd.ominatviscera
17 8

Oesophagus
/ W. oesophageae

V cava inferior

Vv hepalicae

7 Gaster
Hepar

V gastricasinistra\\ / V. splenica

V portaehepatis --
- - Vv gastricaebreves

\,. gastricadextra --_

V. cystica
--
V gastroomentalis
sinistra
Vesica biliaris [felleal - -

--
V mesenterica supetior -- V mesentericainferior

V gastroomentalis
dextra

Vv.pancreaticoduodenales

--
V. colicasinistra
Colonascendens--

- Ouodenum

V colicadextra -

- W
ieiunales;Vv ileales

V ileocolica
- -
Colon descendens

\ Vv sigmoideae

V appendicularis-
\
V rectalis superior
Rectum -

Fig. 1028 Tributariesof the portalvein,

V. portaehepatis;
partsof the stomach, colonas well
the transverse
as the greaterpart of thejejunumandthe ileum
havebeenremoved;
ventralview.
 portaehepatis;Inferior VenaCava,v.cavainferior
I79
V hemiazygosaccessoria\

V.azygos--_
Vv oesophageae
/,/
V hemiazygos

V cava inferior
/ Vv phrenicae inferiores sinistrae
Vv hepaticae --_
/ V splenica

,/ V. renalis

V gastricasinistra--

V cava inlerior - -

V portaehepatis--

V gastricadextra- - V gastroomentalis
srnrstra

V cystica--

--
Vv paraumbilicales
-- V mesenterica
superior
V mesenterica--
inferior
- -
V. colica media
dextra
-
Vv pancreatico- -
duodenales
-- V colicasinistra

- - - - Vv jejunales;W ileales
Umbilicus;
Vv paraumbilicales

- -
V.testicularis/ovarica
sinistra

-
Vv sigmoideae
V epigastrica inferior sinistra /

V. epigastrica inlerior dexta'

,
--
Y. appendicut6tis, //
-"- ---' - I V. rectalissuperior
/ --
/ v pudendaintema
/
V iliaca externa
\
V rectalisinferior
/
V epigastricasuperlicialis 9 \
Plexusvenosusrectalis
/
V. iliaca interna

Fig. 1029 Anastomosesbetweenthe tributary vessels

of the portal vein, V. portae hepatis,and the inferior vena
cava, V. cava inferior;
ventral view.
Theseanastomosesare called "portacavalanastomoses".
They are marked by circles.
 Abdominatvtscera
180
I Aa. suprarenales
superiores

Maqo superiorr
Glandulasuprarenalis
Glandulasuprarenalis,
Hilum \
\

Capsulaadiposa -- Aa. suprarenales

m€diae

Capsulatibrosa -- )- - vv. suprarenales

--- A. suorarenalis
inferior

-- Margomedialis

--
A. renalis

Fig. 1030 Kidney,Ren[Nephros];

suprarenal[adrenal]gland,Glandulasuprarenalis;
partsof the adiposeand fibrouscapsulesof the kidney
havebeenpreservedat its upperpole;the renalartery
andvein as well as the ureterhavebeensectioned close
to the hilum;
ventralview (r.).

Margosuperior
1 I Capsulaadiposa
Capsulafibrosa

Margom€dialis- -

Aa suprarenalesmediae--f

Glandulasuprarenalis

V. suprarenalis

A. suprarenalisinferior--(

A. renalis,R. posterior- Margo

lateralis
V. renalis -

Hilumrenale

A. renalis,R. anterior--
Pelvisrenalis
V.testicularis,/ovarica
sinislra

Fig. 1031 Kidney,Ren[Nephros];

suprarenal[adrenal]gland,Glandulasuprarenalis;
parts of the adiposeand fibrouscapsulesof the kidney
havebeenpreservedat its upperpole;
ventralview (1.).
 RenrNephrost
181
Cortex renalis \

/ Papillae renales
Medullarenalis,Pyramidesrenales\
/ (Basispyramidis)

Calyxrenalismajor *

Sinusrenalis- - Columnae
renares

- Medulla
Calicesrenalesminores- renalis

Fig. 1032 Kidney,Ren[Nephros];

oblique,verticalsecti0nthroughthe centreof the
kidneydemonstrating the cortex,medullaand
renalpelvis;the vesselsandthe adiposetissuein
the renalsinushavebeenremoved;
ventralview(1.).
Arrowspointfromthe renalpyramidsinto the
renalcalyces.

Cortexrenalis\ z Medulla renalis, Pyramides renales

/ (Basispyramidis)

- Cortexrenalis

- Columnarenalis
Areacribrosa,-
Fotamina papillaria
Aa interlobares-

A. renalis--

V renalis-
Pelvis renalis --

Sinusrenalis;/
Corpus
adiposum

- Columnaerenales
lJrcler'
Fig.1033 Kidney,Ren[Nephros];
oblique,verticalsectionthroughthe centreof the kidney;
with subsequentopeningof the renalpelvisdemonstrating
the cortex,medulla,pelvisand hilum of the kidney;
\
A arcuala ventralview(1.).
 Abdominatviscera
I82

Caosulafibrosa / Cortexrenalis

interlobares

Pelvis renalis - -

Sinus renalis;Corpus adiposum ---

-
Papilla renalis

Fig. 1034 Kidney,Ren[Nephros];

transverse the renalsinus,
sectiondemonstrating
Sinusrenalis:
inferiorview (1.).

Fie. 1035 Kidney,Ren[Nephros]; Fig. 1036 Kidney,Ren[Nephros];

ventralview (r.). ventralview(r.).
In this specimenof an adultthe fetallobulationhas Thekidneysarefusedat their lowerpoles
beenpreservedas a variant. (horseshoekidney).
Compareto Fig. 1037.
 Kidney,Ren[Nephros]
183
Glandula
suprarenalis

V. renalis

l; - M. psoasmaior
Parsabdominalisaortae-

- i
Promontorium

-
Epididymis- M. psoasmaior

--
urachus

- A. umbilicalis
-
A. umbilicalis
/'/,j

Rectum' \ Vesicaurinaria

Fig. 1037 Kidney,Ren[Nephros]; Typicalfeaturesat this stageof developmentare the lobulation

supiarenal[adrenal]gland,Glandulasuprarenalis,of a of the kidneys,the relativesizeof the suprarenalglands
5-month-oldfetus; compared with the kidneys,the positionof the testiclesand
the abdominalwall,stomach,intestineandliver havebeen the epididymisin the smallpelvisaswell asthe conical-shaped
removed; transitionalregionbetweenthe bladderand the urachus.
ventralview.

Fig. 1038 Renalpelvis,Pelvisrenalis; long,tree.like,branchingcalyces(dendritictype).Thecalyces

corrosioncastspecimen; can alsobe short,openinginto a broad,sack-likerenal pelvis
ventralview (1.). (ampullarytype).Betweenthesetwo types,thereare many
Therenal pelvisvariesconsiderablyin shape.This figure shows transitionalshapespossible.
 .rbdomtnalViscera
I84

Segmentumanterius
supenus

Segm€ntum--
anleriusinterius

------ Urelet
interius--
Segmentum

Figs.1039a,b Renalsegments, Segmenta renalia; a right kidney,ventralview

the segmentsare indicatedby differentcolours. b right kidney,dorsalview

Truncuscoeliacus
ParsaMominalisaortae \
\
V. cavainlerior--b--

A. renalis -
dextra

- V. renalis
sinistra

V. renalis - -
dextra

\ uretersinis]J

sinistra
V. testiculariYovarica
Urelerdexter /

Fig. 1040 Kidney,Ren[Nephros],and adjacentorgans;

ventralview (r.).

contactwith the kidneys

Suprarenalglands
I
Rightcoticftexure
I Spleen

Liver
I Jeiunum
T Pancreas

Oescendingparl of lh€ duodenum

I Slomach Descendingcolon
 Ren
rNephrost
185

Fig. 1041 Renalarteries,Aa.renales;renalveins, Fig. 1042 Renalarteries,Aa.renales;renalpelvis,

Vv.renales;renalpelvis,Pelvisrenalis; Pelvisrenalis;
corrosioncastspecimen; plasticmaterialof different corrosioncastspecimen;red plasticmaterialhasbeen
colourshasbeeninjectedinto the renalvesselsand injectedinto the renal artery andyellowplasticmaterial
renalpelvis(arteries:red,veins:blue,renalpelvis: into the ureter;
yellow); ventralview (r.).
ventralview (r.).

, Ren.Faciesanterior

Medullarenalis,Pyramisrenalis \

Extremitassuperior\

Diaphragma \

-
Corpusadiposumpararenale/ M. psoasmaior
/
Cortexrenalis

Ren,Faciesoosterior/

Fig. 1043 Kidney,Ren[Nephros]; Therenalpelvis,the cortexandthe medullacanbe differentiated;

ulfasound imageof the kidney; lateralview (r.).
the transduceris directedfrom ventroinferiorto dorsosuperior. * abdominal wall
186 Abdominaland Pelvic

Papilla
renalis

Pelvis
renalis

Papilla
renaIs

Rensinister,
Extremitas
interior

M. psoas M psoas
maJor mapr
Colon
d6scendens

Ureter

Fig. 1044 Kidney,Ren[Nephros]; renalpelvis,Pelvisrenalis; portions of the kidney becomevisible as well;

ureter,Ureter; ventral view.
AP-radiograph after retrogradeinjectionof a contrastmedium XII = Vertebra thoracica XII
throughboth ureters,as a result of which the urine{onducting

- - costa Xl
- Costaxll

- Rendexter

/ Crista iliaca

- SpinailiacaposteriorsuPeriol

Fig. 1045 Projection ofthe kidneysontothe back.

Thelongitudinalaxesof the kidneysdiverge
inferolaterally.The right kidney is usuallylocated
moreinferiorly than the left.
Compare to Fig. 1092.
 Suprarenal
Gland,
Gland"ula
suprarenalts,
andIlrinaryBladd.er, urinaria
Vesica
I87

Margosuperior--

-- Cortex

Facies anterior

V. centralis
- Medulla

Margomedialis -

Fig. 1046 Suprarenalgland,Glandulasuprarenalis; Fig. 1047 Suprarenalgland,Glandulasuprarenalis;

sagittalsection; the inferior part hasbeensectionedsagittally;
lateralview(r.). ventralview (r.).
The illustrationshowsa freshspecimen.In preserved Seecommentto Fig.1046.
specimens,the differencesin colourbetweenthe medulla
and the cortexare lesspronounced.

Apexvesica€\\ -- Lig. umbilical€ medianum

Corpusvesicae,Tunicamuscularis

- Ductusdeferens

- -
Amoullaductusd€ferentis
Ampullaductusdef€rentis,-
Diverticulaampullae

Glandulavesiculosa Glandulavesiculosa

Prostata,Faciesposterior /

Fig. 1048 Urinary bladder,Vesicaurinaria; deferentduct, on the left the seminalvesicleand the deferentduct havebeen
Ductusdeferens;seminalvesicles,Glandulaevesiculosae; opened;
prostategland,Prostata; dorsalview.
the externalmuscularlayerof the bladderhasbeendissected;
 Petuicviscera
188
- Lig umbilicalemedianum

Apex vesicae
_-

- Tunicamuscularis

- Tunicamucosa

-- (Plicae mucosae)

Uvulavesicae-

Cristaurethralis-

Fig. 1049 Urinarybladder,Vesicaurinaria;prostategland, the externalmuscularlayerof the bladderhasbeendissected;

Prostata;urethra,Urethra; ventralview.
openedby a longitudinalsectionin the medianplane;

Corpus
vesrcae
Plica
interurelerica

Oslium
ureteris
- Ostium
ureteris
Trigonum
- Trigonum vesrcae
vesrcae

Figs.1050a,b Urinarybladder,Vesicaurinaria;
demonstrationof the orifice of the ureterby way of an
endoscope introducedthroughthe urethra(cystoscopy).
a orifice the ureteropen,a peristalticwave
of
transportsurine into the bladder
b orificeof the ureterclosed

Fig. 1051 Urinarybladder,Vesicaurinaria;

endoscopic image(cystoscopy) of the mucosain
the bodyof the bladder;
inferior view
In the full, healthybladder,no mucousfoldsare
visible.
 urogenitatorgans
189

/ Pelvisrenalis

(lnlundibulum
ductusparamesonephrici)*'
\ \

Epididymis
/ / Testis[orchisl

(Paradidymis)

- Gubernaculum
lestis

Ureler \ \
- Urachus
\\
Duclusdeferens
-- Vesicaurinaria
---
vesiculosa
Glandula
_-' Utriculusproslaticus

- - -
Ductusejaculatorius

- -
Glandulabulbourelhralis-

- -
Ductusglandulaebulbourethralis

- Corpusspongiosumpenis
/
(Paradidymis)

\
/
Caputepididymidis
- -
Glanspenis

(Ductulusaberransinferior)'
Appendixtestis
Testislorchisl

Fig. 1052 Male urogenital organs,Organaurogenitalia Epididymis= derivedfrom the mesonephricduct

masculina; Paradidymis= derivedfrom the mesonephros
schematicdepiction of development;light pink portions in the female.
Compareto Fig. 1062,whichshowsthe development
which degenerate;dashedlines: location of the testiclebefore * WoLFFianduct
MULLERianduct
descending; ***
iunction of MtiLLERianducts, Ductus paramesonephrici !
lateral view.
 Petvicviscera
190

Fasciacremasterica;\
M crsmaster

/ Fascia spermatica intema

Caputepididymidis
I
Tunicavaqinalistestis.- -
Laminaparietalis 7 Caput
epididymidis
/ Appendixlesiis
Lig epididymidis - / (Appendix
supenus epididymidis)

Sinus -
- Extremitas testis -
Mediastinum - Lobuli
epididymidis sup€nor leslis

- Septula
Margo - tesiis
posterior

Lig epididymidis -
inferius

-
Cauda epididymidis

\
Extremitasinferior

Fig. 1053 Testicle,Testis[Orchis]; Testis[Orchis];

Fig. 1054 Testicle,
epididymis,Epididymis; epididymis,Epididymis;
the scrotumhasbeenexposedin layers; sagittalsection;
lateralview (r.). lateralview (r.).

A. cromaslerica- - A.; V teslicularis

- Plexuspampiniformis
A ductusdeferentis-

- Caputepididymidis

Cauda
epididymidis

Fig. 1055 Bloodvesselsofthe testicle,Testis[Orchis];

epididymis,Epididymis,andspermaticcord,
Funiculusspermaticus;
lateralview.
The arteriesform anastomoses.
 isl,
andEpidtdymts
I9I

Plexuspampiniformis / A testicularis

7 Ductuliefferentestestis

/ Tunica albuginea

- - Septulatestis

aberransinferior)--
(Ductulus

Fig. 1056 Testicle,Testis [Orchis];epididymis, fromthe testicle;its duct(Ductusepididymis)hasbeendissected

Epididymis; deferentduct, Ductus deferens; to showits windingcourse(length= 5-6 m);
most ofthe tunica albugineahas been removedto show the lateralview.
septaof the testicle;the epididymis has been pulled away

Septumscroti
/ Raphe scroti

/ Lobulitestis

Fascia spermatica interna \

M cremaster -
- Septulatestis
Fasciacremasterica-

Fasciaspermaticaexterna -
-- (Cavumserosumscroti)
Tunicadartos /

Mediastinum
testis

Sinusepididymidis/
- Corpusepididymidis
Corpusepididymid," -\
Ductusdeferens
" I ! \ A testicularis

Fig. 1057 Testicle, Testis[Orchis];epididymis,Epididymis; Thecross-sectional areasof the testiclesvary,because

theyare
scrotum,Scrotum; not situatedat the samelevelin the scrotum.
transverse sectiondemonstrating the layersof the scrotumand * alsotermedEpiorchium
tunicaeof the testicle; *' alsotermedPeriorchium
superiorview.
 Petvicviscera
I92

Glandulavesiculosa-

Fig. 1058 Deferentduct (Vasdeferens),Ductusdeferens; AP-radiographafter injectionof a contrastmediumthroughthe

seininalvesicles,Glandulaevesiculosae; ducts;
ejaculatory
ventralview.

// Ductusdeferens

Glandulavesiculosa--

- Lobusorostalaemedius
Lobus proslataedexter -
t Lobusprostalaesinistel

Basisprostatae/ Urelhramasculina

Fig. 1059 Deferentduct (Vasdeferens),Ductusdeferens; belowthe urinary bladder;the deferentduct and the seminal
seminalvesicles, Glandulae vesiculosae;pr0state,Prostata; vesicleshavebeensectionedon the left;
representationof the prostateby sectioningthe urethra superiorview.

Fundusvesicae\

Ostiumureteris\

Trigonumvgsicae -

- - - Ampullaductusdelersntis
Osliumurethraeinternum

- -
Urethramasculina,Parsprostatica-r Cervix vesicae

- -
Prostata Prostata

-
Urcthramasculina,Parsintermedia Ductusejaculatorius
lmembranaceal

Fig. 1060 Urinary bladder,Vesicaurinaria; prostate,Prostata; into the urethra;

deferentduct,Ductusdeferens;seminalvesicle,Glandula lateralview (r.).
vesiculosa; Thethicknessof the musculatureof the bladderindicatesthat
obliquesectionshowingthe orifice of the left ejaculatoryduct the bladderis emptyand contracted.
 urogenttatorgans
193

Lig umbilicale medianum

Plica umbilicalis mediana

Vesicaurinaria\
A ; V epigastricainterior
\
A. iliaca externa -

V. iliaca externa --

Lig inguinale -
- Plicaumbilicalis
medialis

Ductusdeferens-- Ureter

Ureter - Os pubis,Ramussuperior

Ampullaductusdeferentis- --
Excavatio rectovesicalis

: Glandulavesiculosa
Glandulavesiculosa- -
-- Fundusvesicae
Ductusexcretorius- -

Ductusejaculatorius- - Proslala
-_Os pubis,Ramusinterior

Urethra,Parsintermedia-
Glandulabulbourethralis
Imembranacea]

Cruspenis - \ Bulbuspenis

- Corporacavernosapenis

- Corpusspongiosumpenis

/
Corona glandis / \ Glanspenis

Fig. 1061 Urinarybladder,Vesicaurinaria;deferentduct,

Ductusdeferens; seminalvesicles,
Glandulae vesiculosae;
prostate,Prostata; maleurethra,Urethramasculina;
partsof the pubishavebeenpreserved; the right seminalvesicle
hasbeenpulledapartby a hook;a wedge-shaped segmentof
the prostatehasbeenremovedto showthe left ejaculatory duct;
the distalpart of the corpusspongiosum 0f the penishasbeen
pulledposteriorly;
dorsalview.
 Petvicviscera
I94

Ducluslongitudinalis,
Epoophoron,
Ductulitransversi

rf +a - - - - Duclusparamesonephricus"
, i!
. 11
--
Ductusmesonephricus'
' i +---- Lig.ovariiproprium
Paroophoron\
Tubauterina[Salpinxl \ )
/ Uterus
Epoophoron \

Vesicaurinaria
/
lubae uterinae -
Infundibulum
,, Urachus

Appendixvesiculosa /
Ovarium ' /
/
Lig.ovariiproprium /
I
' / teresuteri //
Lig ./
Ductusmesonephicus' /
Urethrafeminina

Vagina
- -
Glansclitoridis
- -
Ostiumurethraeexternum
Crusclitoridis - -
Ostiumvaginae

Bulbusvestibuli \ Glandulaevestibulares
majores'*'

Fig. 1062 Femaleurogenitalorgans, Epoophoron= derivedfromthe cranialtubulesofthe

Organaurogenitalia feminina; mesonephros
diagramshowingtheir development; = derivedfromthe caudaltubulesofthe
Paroophoron
light pink: parts which degenerate; mesonePhros
brokenlines:locationofthe organsbeforedescending; * WoLFFianduct
the bladderhasbeenpulledto the left; *' MULLERianduct
*' ' BaRTHoLIN'S
ventralview. glands

Compareto Fig. 1052,which shows the developmentin the male.

 195
Fimbriaovarica Ovarium,Extremitas
tubaria
I
Ampulla tubae uterinae / Ampullatubaeuterinae
\ | Margomesovaricus
Ostium abdominale \
lubae uterinae; \ 1 Ovarium,
Margoliber
-
Infundibulumtubae A: Vv ovarica(e)
uterinae
/ Fundusuteri
Fimbriaetubae uterinae- -E
- Tuba
uterinalsalpinx]
Appendrxvesiculosa - -
Ovarium, Facles medialis - *
- Ovarium
ovatii-2
Lrg suspensorium
A ; Vv ovarica(e) /

\ ureter
Lig latumuteri /

\
Corpusuteri,
Faciesintestinalis
\ lsthmus
uteri
t, \
Portio suprauaginalisceruicis

\
Excavatio rectouterina,
Tunica serosa [Perimetrium]

Fig. 1063 Internalgenitalorgansof a female,

Organagenitaliafemininainterna;
dorsal view.
" clinical: (rardinalligamenr;see l'ig 1070
" c l i n i c a l :s a c r G U t e r i n lei s a m e n r

Lrg ovarii proprium

tubaeuterinae
I
arnou. u,"n'ftntus
rl / Amoullatubaeuterinae
/--
Tuba ulerina \ z Ductulitransversi
ISalprnxl ;

Lrg teres --
tubariae
ulerii'r
Lig ovarii - -- Infundibulum
propflum
tubae uterinae;
Tunicaserosa/ Fimbriaetubae
IPerimetrium] uterinae
Cavitasuteri;Tunica/ --
mucosaIEndometrium] - Appendix vesiculosa
- Fimbria ovarica
\
--
Corpusalbicans
Tunica muscularis /
\
\Vv ovaricae:A Lovarica
vv uvdlrude,A
lMyometriuml . Foilicuri \.
\. ' '
ovarici vesicul Appendix vesiculosa**
\ Corpusluteum
Canalis ceruicisuleri, / \- \ Lig latumuteri
Plicae palmatae \ \ P a r s u t e r i n a :) - .
\
\. diir;;i;;;r. ruba uterinalsalpinx]
Portio vaginaliscervicis / t corpusuteri I
\ lsthmusuteri
\
Po.tio arpr"u"ginalis cervrcis
lvagina

Fig. 1064 Internal genital organs,Organagenitalia feminina * r;linical:Gn,c.Arian follicle

interna, of a female of reproductiveage; *' stalkfll hydatid
* * * c l i n i c a l :I - i g r o t u n d u m
the lumen of vagina,uterus,and uterine tube can be seenon
the right side,frontal sectionthrough the ovary;the peritoneum
of the mesosalpinxhas beenremoved;
tlorsalview
 Petvtcviscera
196

/ Faciesintestinalis
lsthmusuteri

/ Canaliscervicisuleri
Fundusuteri
TunicamucosaIEndometrium] u Fornixvaginae,Parsposterior

-
Tunicamuscularis
lMyometrium] /, Peritoneumurogenilale
- Excavatiorectouterina
TunicaserosaIPerimetriuml Facies vesicalis v \ Labiumanterius
vesicouterina/
Peritoneumurogenitale,Excavatro \ ostiumuteri
Portiosupravaginalis
ceruicis 'Labiumposterius
\
Fornixvaginae,Parsanterior vagrna

Fig. 1065 Uterus, Uterus; vagina, Vagina,

of a femaleof reproductiveage;
mediansectionshowingthe lumen;
lateral view.

Fig. 1066 Uterus, Uterus; vagina,Vagina;

normal anglesbetweenthe vagina, the cervix and the
corpus of the uterus; schematicmedian section;
lateral view.
* longitudinal axis of the vagina
" longitudinal axis of the cervix of the uterus
*'* longitudinal axis of the corpus of the uterus

Angle betweenthe vagina and the cervix of the uterus = version

Angle betweenthe cervix and the corpus of the uterus = flexion
Normal situation of the uterus: anteversion,anteflexion
Position relative to the median plane = position
Compareto Fig. 1067where the uterus is in dextroposition.

- Ostiumuterinum
lubae
uterinae

- Tubauterina
ISalpinx]
- Cavitasuteri

- Ampullatubae
uterinae

- Canalisceruicis
uteri

Fig. 1067 Uterus,Uterus;uterine(fallopian) tube,Tubauterina; Thisclinicalmethodhasformerlybeenusedto checkfor luminal

AP-radiograph afterinjectionof a contrastmediumthroughthe obstructionin the uterinetube.
cervixof the uterus(hysterosalpingography); K = adapterof the injectiontubefor the contrastmedium
ventralview.
 Internal FemaleGenitalOrgans
rg7
Lig.ovariiproprium
I
A. uterina,R. tubarius,
Lig.teresuteri'\
A. ulerina,R. ovaricus\ Fundusut€ri
I
A. ovarica

A. ovarica

Lig.sus- /
p€nsonum
ovanl

- ']
APPerdix'
vesiculosa
i
- corpusuted
- Lig.l€res uteri'
I I
Ostiumabdominale / ovarium / Rr.helicini-
lubaeulerinae:
Infundibulumtubae
A ulerina- - A. ulerina

)--
/ Rr.vaginales
Cervix uteri /

A. vaginalis z -\
A. vaginalis

Fig. 1068 Arteriesofthe internalgenitalorgansofa female,

Organagenitaliafemininainterna;
the broadligament(Lig.latum)haswidelyandthe peritoneum
haspartiallybeenremoved;
on the left a part of the ovarianligamenthasbeenremoved;
dorsalview.
r clinical: round ligament

Tubaulerina\
I Lig.suspensorium
i ovanl

B lubarius\
Fundus \ A. ovarica
uteri
(R.fundi - Ovarium
uteri) \ R. oEricus
1
\ Lig ovariiproprium

-- Rr. helicini

Figs. 1069a-f Variationsof the arterial supplyof the

internalgenitalorgansof a female,Organagenitalia
femininainterna;
dorsalview.
a supplyofthe uterus('textbookcase")
b, c, d supplyof the ovary(b "textbookcase")
e, f supplyof the fundusof the uterus(e "textbookcase")
 Petvicvtscera
198

Reclum -

8\

__3

'_4
Vesicaurinaria-

6-'
- Lig Pubovesicale

clinical terms:
Fig.1070 Uterus,Uterus; 1 = rectal fascia 6 = Oaraveslcal SPaCe,
diagramof the supportingligamentsandconnectivetissue 2 = sacro-uterine ligament Paracystium
3 = cardinal ligament, Parametrium 7 = recto-uterinePouch
spacesin the smallpelvis;transverse through
section the cervix 4 = vesical fascia
(= ooucLAs'sspace)
5 = retrooubic space 8 = pararectalspace,
of the uterus; (= SPatiumPrevesicale Paraoroclium
= RETzrus's sPace) 9 = retrorectalspace
superiorview
Recentanatomicalstudies have questionedthe existenceof solid fibrous Iigaments
betweenthe uterus and the lateral wall of the pelvis, which have up to now been
termed the cardinal ligament.

Fornix vaginae, Pars anterior

Portio\
vaginalis
cerurcrs

Labium _
Labium- anterius
anterius
Ostium Labium -
uteri Labium- postenus
posterius

I Fornix vaginae, Pars Posteriot

Fornix vaginae, Pars Posteriorl

Figs.1071a, b Vaginalpart of the cervixof the uterus' To inspect the vaginal part of the cervix of the uterus, the
by two
Portiovaginaliscervicis. normally slit-like shapedvagina has been openedwide
-
a photograph of a youngfemale,who hasnot yetgivenbirth specula( );
inferior view.
lNullipara)
of a youngfemale,who hasborntwo children The cervix of the uterus clearly bulges into the vagina'
b photograph
 Irterus;Pregnancy
I99

Funiculusumbilicalis

Membruminferius

Fig. 1072 Uterus,Uterus,with embryo; Theembryoswimsin the amnioticfluid of the chorioniccavity;

ultrasoundimagethroughthe abdominalwall in the 10thweek lateralview (r.).
of pregnancy.

Caput,Frons
Nasus
Membruminferius-
Labiumsuperius
Begiomenlalis
Truncus-

Fig. 1073 Uterus,Uterus,with fetus; During sonographicexaminationthe movementof the limbs

ultrasoundimagein the 28thweekofpregnancy; andthe openingof the mouthcanbe assessed.
lateralview (1.).

PollexlDigitusll -
- Palmalvolal

-
Digili ll-V

Fig. 1074 Hand,Manus,of a fetus; detailssuchas the fingerscan be assessed;

ultrasoundimagein the 24thweekof pregnancy; lateralview.
 Pervicviscera
200

V umbilicalis Aa. umbilicales 1

Fundusuteri \
\
/ Colon sigmoideum

7 fornix vaginae,Parsposlerior

,/ Portio vaginalis cervicis,

/ Ostium uteri

/ Excavalio
reclouterina"

/ Plicatransversa
Placenta
recll

- Vagina

- - Os coccygis
-
Lig umbilicale
medianum
-.- Fascia
rectovaoinalis
-
Linea alba Iseptur; rectovaginalel

- Corpusano-
Excavatio
vesicouterina coccygeum[Lig.
anococcygeuml
/
Spatiumretropubicum***r
-
Symphysispubica,Discusinterpubicus
-
Vesicaurinaria

z
Clitoris,Corpuscavernosumclitoridis _-L. _,.*

z
Glansclitoridis
/
M transv€rsus perineiprofundus
/
Labiummaiuspudendi t
Urethrafeminina
I
Labium minus pudendi
M sphincterurethrae

*
Fig. 1075 Uterus,Uterus,with fetus; KRTSTELLER'S mucous plug in the cervical canal
clinical: Doucl^s's space
the pelvishasbeensectioned in the medianplane; *** clinical: vesicovaginalseptum
lateralview (1.). *'"* clinical: RETzlus'sspace
Thewall of the uterusis extremelythin at the endof
pregnancy.
 rrterus;
Pregnancy
20I

/ Femursinistrum

- - Femurdextrum

-- Inlestinum

- - Ulnasinistra

- - Radiussinister
\ - \ : o- o 'o o o '
\ \Oo-,12
- - Costae

- - Humerussinister

r ,,\ vt"i-. -- Scapula

Fig. 1076 Fetus; Formerlythis radiographwassometimesusedto

AP-radiographshortlybeforebirth; comparethe sizeof the pelvisto the sizeof the child's
ventralview. head.

-- Spinailiacaanteriorsuperior

Fig. lO77 Uterus,Uterus;

positionof the fundusof the uterusduringpregnancy;
monthof
the figuresindicatethe endof the respective
pregnancy(= 28 days);duringthe lastmonththe fundus
of the uterusdescends.
 Pe,icvtscera
202

Figs. 1078a, b Placenta,Placenta;

umbilicalcord,Funiculusumbilicalis.

a view of the fetal side

b view of the maternal side of a mature placentaat the
end ofterm

The fetal side has a smooth surface due to the amnion,

while the maternal side is structured by cotyledonsand of
red colour due to the blood.
 InternalFemaleGenitalOrgans
203
A. iliacacommunis\ VertebralumbalisV Cauda / M..erector
I equlna / splnae
Ureter \ !t
.r|eum
.\
\
\ t,,
l/
\ \ a M. gluteusmedius
\ ., -//' _z
3.tt -tt ,Mh@emrhr
Caecum\
M. iliacus
---- Os ilium
M. transversus\ --- Colon
abdominis \ sigmoideum

M obliquus\
internus \
abdominis

Fimbriaetubae --
uterinae
--
Ug. teresuteri

Fundusuteri --

Vesicaurinaria /

t
M rectus \ Lin€aatba
abdominis \
Plica umbilicalis mediana

Fig. 1079 Internalgenitalorgansofa female, laterallyby hooks;

Organagenitaliafemininainterna; the caecumand the sigmoidcolonhavebeenpulledsuperiorlyby
horizontalsectionthroughthe fifth lumbarvertebra; hooks;
the anteriorabdominalwall hasbeenlongitudinallysectioned ventrosuperiorview.
in the right rectusabdominismuscleand hasbeenretracted

Colon sigmoideum

------- Ovarium

Lig.ovariiproprium

Lig.teresut€ri

Fig. 1080 Internalgenitalorgansof a female, * The ovarieshavebeenpushedsuperomediallyby compresses.

** tampon
Organagenitaliafemininainterna;
operationsite of a youngfemale;
ventrosuperiorview.
 Pervicviscera
204

Fimbnaetubae
uterinae
A.;V.ovarica

Lig suspensorium
ovarii*

Infundibulum
tubaeuterinae
Ampullatubae
uterinae Ampullatubae
uterinae

Ovarium,-- Mesosalpinx
Faciesmedialis

lsthmustubae
uterinae
'-
Margomesovaricus

--
Lig ovariiproprium/ Lig latum uleri

/
Lig ieres uteri
-
Excavatio
medialis/
vesicoulerina
Plicaumbilicalis
\ \
/ \ Plica umbilicalismediana\ \ Vesica urinaria
Ulerus, Facies vesicalis

Fig. 1081 Internal genital organs of a female, The close topographicalrelationship betweenthe right
Organagenitalia feminina interna; adnexa(ovary and uterine tube) and the vermiform
the uterus has been lifted by hooks to show the vesico-uterine appendix can causeconsiderableproblems in the differential
pouch and the broad ligament (Lig. latum uteri); diagnosisof inflammation in these organs.
the left uterine (fallopian)tube has been pulled superiorly to ' clinical: Lig. intundibulopelvicum

demonstratethe mesosalpinx(suspensoryligament of the ovary);

ventral view.

- Lig latum
uterl

Meso- - Ovarium,
salpinx Corpus
albicans
Ampulla--
tubae --
Facies
uterinae inteslnalis

Appendix
vesiculosa

'
Fimbriaetubaeuterinae

Fig. 1082 Uterine(fallopian)tube,Tubauterina; Fig. 1083 Orificeof the uterine(fallopian)tube,

ovary,Ovarium;operationsite in a youngfemale; Ostiumabdominale tubaeuterinae;
dorsosuperior
view. operationsiteof a youngfemale;the pelviccavityhasbeen
' plastictray to supportthe ovaryand the uterinetube the fimbriae;
filledwith salinesolutionto demonstrate
" tampon dorsosuperior view.
* surgicalhook
" ' plastic tray to support the uterine tube
 Recrum
205

Tunicamuscularis,
Stratumlongiludinale

/ Plicatransversarecti*'

Periloneumurogenitale,
Excavatiorectovesicalis Tunica
muscularis,
Stratum
/ Noduli lymphoidei longitudinale
- solitarii
Ampullarecti

/ Junctioanorectalis - M. levator ani

Sinusanales-
- M. levator ani
Flexura-
anoreclalis -
lperinealisl M. sphincterani
externus
- Valvulae anales Telasubcutanea,
Panniculus
* M sphincterani adiposus
exlernus

-
Linea
anocutanea

Fig. 1084 Rectum,Rectum;anus,Anus; Fig. 1085 Rectum,Rectum;

frontalsectionshowingthe mucosaandthe mostof the surroundingtissuehasbeenremovedto
sphinctermuscles; demonstrate the musculature:
ventral view. lateralview(r.).
' Nodushaemorrhoidalis
'r KoHLRAUSCH'S
fold

I Plica lransversa recti

M. sphincter
ani externus

- M. sphincter
Columnaeanales;- ani inlernus
Vatvulaeanales
-
Pecten analis -

Linea anocutanea/

Fig. 1087 Rectum,Rectum;

mediansectionshowingthe arteriovenous anastomoses
in the analfolds;the mucosahasbeenpartiallyremoved;
lateralview(1.).
Themuscles(Mm.sphincterani internuset externus,
Fig. 1086 Rectum,Rectum; M. levatorani) andthe mucousfolds(analvalves)covering
viewthroughan endoscope the erectiletypearteriovenous makeit
anastomoses
whichhasbeenintroduced
via the analcanalinto the rectalampulla(rectoscopy) possiblefor the anusto close.
to * Glomerulus rectalis,numemusarteriovenous in the Corpus
anastomoses
assessthe mucosa; cavernosum recll
inferiorview. " clinical:Zonahaemorrhoidalis
 Petvicviscera
206

/ Parsabdominalisaortae

A. rectalissuperior*
/, A sacralis mediana

/, A. iliaca communis

A. iliaca intema - ---

Canalisobturatodus

/ //
/ ----
A. iliaca externa
So,n"ischiadica
/
A gluteainferior /
--
M. obturatorius
intemus
A. pudendaintema / \ Rectum

\
M. levatorani

'.. \
Tuberischiadicum
\
A r€ctalis inferiol M. sphinclerani externus

Fig. 1088 Arteriesof the rectum,Aa.rectales;

the iliac artery with its mostimportantbrancheson the left;
dorsalview.
" clinical:Suoscr'spoint (from this point on thereare no further anastomoses
with the sigmoidarteries)
 Rectum
207

V iliaca
communrs / V. cavainferior
V mesenterica--
inferior

Vv. sigmoideae

Colon
sigmoideum

V. gluleasuperior

V. iliaca intema -- -- Canalis

obturatorius

-
V. iliaca exlerna -

V. gluteainferior -- - Spina ischiadica

V. obluratoria /

V. pudendaintema /
M. obluratorius
intemus
V. rectalismedia /

\
M. levator ani
Reclum /
lPl"rua I
,"norua
W. reclales inleriores / roclalis
I
lTub", i."hi"di.ut
|u
Anu.// "pr,ino","n,

Fig. 1089 Veinsof,therectum,Vv. rectales;

diagramwith parts of the pelvisand the pelvicfloor;
dorsalview.
Manyof the smallveinsexistin pairsbut havebeendrawn
hereas onevesselfor clarity.Thevenousplexdsbelowthe
rectalmucosais not shown.Thereare numerousconnections
betweenthe vesselswhich drain into the portal vein (superior
rectalvein) and the vesselswhich drain into the inferior
venacava(medialand inferior rectalveins).Theseare called
portacavalanastomoses and are of considerable clinical
importance.
 Abdominatvisce
208
/ Costaxll superior
/ Ben,Extremitas

lumbalisl, Proc costalis

Vertebra

A. arcuata
I Ren,Margomedialis
A.renalis A.interlobaris
I
( A.segmentalis
- A renalis

Calyxrenalis-

- Pelvis renalis
Ren,Margolateralis-

- Ureter, Pars abdominalas

Ren,Extremitasinferior-

Cristailiaca -

Fig. 1090 Kidney,Ren; the ureter visible; simultaneousdemonstrationof the arteries

a contrastmediumhasbeeninjected
AP-radiograph; by a contrast medium which has been injected into the renal
intravenously
andis excretedby the kidneys(intra- artery via a catheter (') introduced through the aorta
venouspyelography)makingthe renalpelvisand (arteriography).

Pars abdominalis aortae \

A renalis \ \
(A

- (A renalispolarisinferior)

Figs. 1091a-d Variationsof the renalarterial supply.

a one renal artery with a branch to the upper renal pole

b two renal arteries to the renal hilum
c two renal arteries,one of which suppliesthe upper pole
d two renal arteries, one of which supplies the lower pole
 209
Peritoneum\ ,, Glandulasuprarenalis
parietale \\
-\ A;V.renalis
tOO
Truncuscoetiacuso
-- {
A mesenteflcao 7 O Mm intercostales
supeflor
Ren
A. suprarenalisinferi
V. suprarenalisdex -

(A- rena Ureter

accessorl

V cava inferioro -_
/ a a A;V testicularis

A ; V r e n a l i s oa - - / CostaXl

R e n ,- -
Capsulaadiposa N. subcostalis

Ureter--
-oaA;Vlumbatisl
exlernusa--
M obliquus
abdominrs N iliohypogastricus
M obliquusinternusa--
abdominis - O A mesenterica
interior
M transversuso--
abdominis
N ilioinguinalis
V i A l e s t i c u l a r i s aO - -
- o M quadratus
M psoasmajoro - lumborum
\\
Aa sigmoideaea - Lig.iliolumbale

\ o A colicasinistra
(M, psoas minor)O -

\ N. cutaneus
A a : V v i l i a c a e oa - - temorislateralis
communes
\ O M iliacus
R femoralis
N genilo-
lemoralis
\ a a A.; V. iliolumbalis,
R genitalis Br. iliaci
\ N femoralis

i.. B. femoratis)N. genito.

\ R. genitatisJ femoralis
\.,1L1. \- Ailiacainterna
\ ,/'
\ \\ -- .O A talissuperior
Vesicaurinaria/ ,//' O a A; V epigastricainferiol
/ \O
I A, V sacralismediana
M rectusabdominisa/
/ Colon sigmoideum
Plicaumbilicalis
mediana

Fig. 1092 Siteof the retroperitonealviscera,

Situsretroperitonealis, in the male;
Pars abdominalis aortae
V cava inleflor / V renalissinistra the intestine,liver,pancreasand spleenhavebeenremoved;
ventralview
Whereasthe left testicularvein drainsinto the left renal
vein,the right testicularvein drainsdirectlyinto the inferior
venacava.Thesameappliesfor the ovarianveins.

/ - SOY'
renalis
oertii ,' Figs. 1093a, b Variationsof the courseof the testicular
lesticularis/ arteries,Aa.testiculares.
dexlra
A testicularis/ a normal("textbook") case
sinistra
b both testiculararteriesbranchoffabovethe renalveins;
the A. testicularisthen runs behindthe inferior vena
cava.on the left it is in front of the left renalvein.
 Abdominatviscera
2I0

/ Nodilymphoideigastricisinistri
V cava inleriora

A. phrenicaa -
inferior

Nodi lymphoidei
phrenici inleriores

- aA renalis

Truncusintestinalis.-
-
OA. mesenterica
supenor
Cisterna chyli -

- a Pars abdominalis
Truncuslumbalis aortae
dexter

- Nodi lymphoidei
Nodilymphoidei lumbales intermedii
lumbalesdextri

V cavainferiorO -

_ oA itiaca
communrs
- Ureter
- OV iliaca
communts

- Nodi lymphoidei
iliaci inlerni

- Mesocolon
sigmoideum
- Colonsigmoideum

Nodilymphoidei
- inguinales
superficiales,
Nodi
-'---' superolaterales*
A i e m o r a l l sa

- ---
Fascia cribrosa
V lemoralis
\
Nodi lymphoideiinguinales
N femoralis a / superficiales, Nodi supero-
mediales et inferiores "
\
Nodi lymphoideiinguinales,(Nodi profundi) / ov saphenamagna
I rN
V saphenamagna a l itioinguinatis

Funiculus
spermaticus

Fig. 1094 Lymph nodes,Nodi lymphoidei; X and XII = Ribs

lymphatic vessels,Vasalymphatica,of the posterior abdominal * clinical: "horizontal chain", which drains the lower abdominal wall, the gluteal
region, the perineum and the external genitalia
wall and the inguinal area; * * clinical: 'vertical chain", which drains the lower limb
the abdominal viscera,the retroperitonealfat and the skin of the
thigh have been partially removed;
ventral view.
 RetroperitonealIymphatic
Drairlase
2I1

',ii
:il , j*r
tr*.

T r u n c u sl u m b a l i s
sinister

*
t
Vaslymphaticum
etferens

ft'
Vasa lymphatrca

Fig. 1095 Lymphaticvessels,\'asalymphatica;

l y m p h n o d e sN, o d il y m l l h o i r l e oi ,f t h e i n g u i n a l p
, e l v i ca n d
lumbar regions;
AP-radiograph after injectionof a contrastmedium into
the lymphaticvesselsof both feet (lymphography)
The segmentsbetweenthe valvesin the lymphaticvessels
can be clearlyseenas a string of pearls The storageof the
c o n t r a sm
t e d i u mb e g i n si n t h e i n g u i n a l y m p h n o d e s
 Abdominatviscera
2I2

N vagus [X], Plexus oesophageus

N splanchnicus
maior , Oesophagus

Plexus coeliacus

N thoracicus[T1'll,
N intercostalis / Cosla Xll

N subcoslalis
- aTruncuscoeliacus

a M quadratus
lumborum
N, iliohypogastricus

Truncussympathicus

N ilioinguinalis
Plexus mesentericus
inferior

N cutaneus
lemoris
lateralis Crista iliaca

N genitolemoralis N femoralis

- a M iliacus
N obturalorius

Truncuslumbosacralis
Plexussacralis

I Bectum

Fig. 1096 Nerves of the posterior abdominal wall,

Plexus lumbosacralis,Pars abdominalisautonomica;
'the
viscera, the vesselsand the psoasmuscle have
been removed;
ventral view.
 2r3
A phrenica interiorO Hiatusoesophageus
\ /
N splanchnicus
major I
\ \
V cavainferiora \ I
\
A;Vrenalis*Oa\ \

A ; V l e s t i c u l a r i s O a\

N subcostalis

a A..mesenlerica
/ / tmenot

, / O a A communrs
;Viliaca

lumbalislV
/ OA

Truncus
-t lumbosacralis

/ O A iliolumbalis,
Ft, iltacus

/ N. obturatorius

ta A iliolumbalis
--
M P s o a s m a i o r a- -
Rr musculares

N femorahs

N culaneus
temorislateralis
N genitolemoralis, -
R femoralis
-:
N genitofemoralis,
R genitalis

-OoA;Vcircumttexa
Ureter,Pars pelvrca' iliumprotunda

\ a a v;A itiaca
exlerna

Ductusdeterens/ I \
/
A ; V s a c r a l i sm e d i a n a l l Reclum

Fig. 1097 Vesselsand nerves of the posterior

abdominal wall in the male;
on the left the psoasmajor muscle and the iliac
arteries and veins have been largely removed to
demonstratethe lumbar plexus;
ventral view.
* In about l0% ofthe casesthe left renal vein runs Dosteriorto
the aorta
 Petvtcviscera
2I4
i -- M e d u l l as p i n a l i s Fig. 1098 Male genitalorgans,
Organagenitalia masculina;
diagram of the autonomic innervation on the left side;
ventral and lateral view.
green = sympatheticpart
purple = parasympatheticpart
* = Nn erigentes

During the surgical removal of the para-aortallymph nodesor

operationson the abdominal aorta and major pelvic arteries
'/ the sympatheticnervous system may be damaged,resulting in
/, Plexus hypogastricussuperior ejaculationimpotence(Impotentiagenerandi).During operations
,' /, Plexus leslicularis
on the prostatethe parasympatheticfibres to the penis may be
,' /A testicularis
/ Urelel sectioned,resultingin erectileimpotence(lmpotentiacoeundi).

/, Ductus deferens

7:------Ptoslala
Glandula bulbourethraiis
- - - Corpus spongiosumpenis

-
Corpus cavernosum penis
,/ Plexus I /
deferenliatis
// f .t,
/ Plexusprostaticus ' /
- Urethra masculina
'l . /
Ganglia pelvica, Radix
Pcr aryr rPd'r rvc
lNn. splanchnicipelvicilt
i - G l a n sp e n i s
/
Plexus testicularis Eproroymrs
leslrs
Plexus deferenlialis

lnnervation of the male genital organs

Origin Course Organ Function
Parasympathetic Sacralspinal Gangliapelvica,Radix Penis Vasodilatation
part cord(S2- 54) parasympathica Erectile
tissue Erection
[Nn.splanchnici pelvici]
Sympatheticpart Thoracic spinal Plexusmesenterici Testis Regulationof the blood
cord superioret inferior supply
( T h 1 0- T h 1 2 ) J
Truncussympathicus
J
Plexustesticularis
J
Lumbarspinal Plexushypogastricus
superior
c o r d( 1 1- L 2 ) J
N. hypogastricus
.' -J
Plexus
hypogastricus Glandulabulbo- of its fluid
Expulsion
inferior urethralis
Ductusdeferens transport
Contraction, of
thesemenintothe urethra
Glandulavesiculosa Expulsionof its contents
Prostata intothe urethra
Somatomotoric Sacralspinal N. pudendus (M.sphincter
vesicae) Closureof theurinary
Somatosensory cord(S2- 54) bladderstopstetrograde
ejaculation
of thesemenout
M. ischiocavernosus Expulsion
M. bulbospongiosus of theurethra
posteriores
Nn.scrotales Skinof thescrotum
N dorsalis
oenis Skinof the penis
 FemaleGenital Organs, Innervation
2I5
Medulla spinahs

LI
Fig. 1099 Femalegenital organs,
Organagenitaliafeminina;
L3 I
L4i diagram of the autonomicinnervation;
!s*"1 ventral view.
Rr communicantes
\ \
green = sympatheticpart
purple = parasympatheticpart
R interganglionaris\_ * clinical:FRANKENdiUSER'Splexus
** Nn erigentes
a
4
Plexusovaricus
\ Theautonomic plexusis interspersedwith ganglia
- -
Plexushypogasrricus (compare plexus
supenor
to Figs.50 and 51).Thehypogastric
Ganglia trunci .- .- andthe uterovaginalplexuscontainfibresof the
sympathici sympatheticaswell asthe parasympathetic part.
A ovarica -- .-

N hypogastricus .- --
Tuba uteflna lsalprnx]
/

Plexus hypogastflcusnlerior / r/
/
Plexusuterovaginalis* -- N s a c r a l i s[ S 1 ]

- - Ganglia pelvica,
Ganglia pelvica,- Radix parasympathica
Radix parasympathrca [Nn splanchnicipelvici]
INn splanchnicipelvicr]**
Clitoris--1
- - Plexus sacralis

Labiumminusoudendi-

(lntroitusvaginae) .-

lnnvervation of the female genital organs

Origin Course Organ Function
Parasympathedc Sacralspinalcord Gangliapelvica,Radix Tubauterina Vasodilatation
part (S2- 54) parasympathica Uterus Vasodilatation
[Nn.splanchnicipelvici]

Nn.caveriosiclitoridis Vagina Transudation

Clitoris Erection
Sympatheticpart Thoracicspinalcord Plexusmesentericus
( T h 1 0- T h 1 2 ) supenor \,-
Plexus
ovancus Ovary Vasoconstriction
Plexusrenalisy'
Truncuslympathicus
J
Lumbarspinalcord Plexushypogastricus
( 1 1- L 2 ) supenor,
J N. hypogastricus
Plexushypogastricus
inferior
v
Plexusuterovaginalis Tubauterina
(FnlxxrnHAusrn's Uterus Contraction
Plexus) Vagina
Somatonotoric Sacralspinalcord N. dorsalis Clitoris
Somatosensory (s2- s4) clitoridis
N. nudendus( Labiamajora
Nn. labiales M. ischiocavernosus Contraction
posteriores M. bulbospongiosus
 Petvicviscera
216

A. iliaca communis
/A iliolumbalis

A sacralislateralis

A iliacainterna -- /A gluteasuperior

-- M Piriformis

--A gluteainterior

A iliacaexlerna -- Lig sacrospinale

A obturatoria ---

-
A. umbilicalis - Lig.sacrotuberale
-
A vesicalissuperior - \A
rectalis media
\
\A
uterina

lOTo

Figs. 1100a-d Variationsof the branchingof the internal iliac artery,A. iliaca interna;
lateralview (r.).
a all brancheshavetheir origin in onetrunk
b the internal iliac artery hastwo main trunks (normal,"textbookcase')
c the internal iliac artery has three main trunts
d the internal iliac artery hasmorethan three main trunks
 Internallliac Artery,A.itiacainterna
2I7

Pars abdominalis aortae O \

\
A mesenterica
Inleriora \

Plexussacralis,
Truncus
lumbosacralis
iliaca communis sinistra O 1
.\
V iliaca communis O 1
\ / aA sacralislateralis

A sacralis mediana a \
\
A, iliacacommunis
dextraa \ / N sacralis [S1], R. anterior
\
A iliaca interna a \

A iliolumbalisa \\
\ -\ / aA gluteasuperio,
A iliaca externa o \\

A umbilicalis,Pars palens a --
_ ,
Truncussympathicus,
A obturatoriaa \ Gangliasacralia

N obturatorius \

N genilofemoralis, \-
R. genitalis \ N sacralis[S2],
R anlerior
Anulusinguinalis- - OA. gluteainferior
profundus J
N sacralis[S3],
R anterior
A cremasterica O --
Nn anales[rectales]
--dR.
o "o,gli:l,:?. interiores
-) Nn. sacrales[S4; S5l,
Rr anteriores
--
aM. ischiococcygeus
R pubicuso / lM coccygeusl

/
R obturalorius O

/
Symphysispubica

Fig. 1101 Internal iliac artery, A. iliaca interna;

sacral plexus, Plexussacralis;
demonstration0f its branchesin the pelvis, median section;
the viscera and fasciaehave been removed;the sacrospinal
ligament has been partially sectionedto show the courseof
the internal pudendalartery;
lateral view (r.).
Compareto Fig. 1100.
 Pe^icviscera
2I8

A ; V sacralis lateralis,Rr spinales a o I

I
N sacralis[S1],
R anterior f I Os sacrum

/ N sacralis{S21,B anlerior
N lumbalis [L5], B anterior \
V iliaca Inlerna a \ \
parietale
V iliaca externa o \
\ / Peritoneum

O \
A iliacacommunis
/ O M pirilormis
Mesocolon \\
sigmoideum
./ a M gluleusmaximus

Colonsigmoideum
\ / Rectum, Flexura sacralis

Appendices omentales lepiploicae] \

Ouctusdeferens\
/- Excavatio rectovesicalis
runicaserosa\\
Y,9"r99
[
unnarla
I Tunica
musculars
\- ta
'\
aa
a \\
M rectusabdominis

- Ureler
O s p u b i s- - _

--
Lig puboprostaticum

- Corpusanococcygeum
----
Funiculus
sDermatrcus [Lig anococcygeum]
--
a M levatorani
uuclus oelerens
--
-- corpusanococcygeum
M cremastera [Lig anococcygeum]
Tunicadartos,M. dartos "i-- \
Rectum, Flexura anorectalis
la--
- pe
urus
Iperinealis]
"tl ,\ --
)- \
- \ o M sphincterani externus
A protunda
penisO
/ \
M ischiocavernosuso
/ \
\
M transversusperineiprofunduso' r' \ \
a M tr"nau"r"usperineiprofundus
/ \
M sphincter o
urethrae \
\ o M butbospongiosus
Prostala

Fig. 1102 Pelvicvisceraof a male;

panamedian sectionon the left;the peritoneumhasbeen
partiallyremovedfrom the lateralsurfaceof the urinary
bladderto showthe courseofthe ureterandthe deferent
duct;
lateralview(r.).
* clinical: CowPER's
gland
 Internal lliac Artery, A. iliaca interna
2rg
/ aA sacralismediana
! , OA iliaca interna
i / O /promontorium
Pars abdominalisaortae O -
,/ aA umbilicalis,Pars patens
A mesentericainferior O -

A ihacacommunis a - - ,/ a aA: V vesicalissupeflor

V i l i a c a c o m m u n i sa - - _
,z Canalis sacralis

Urelerdexter\ / a aA: V rectafts

suoerior
A . t V . o b t u r a t o rai aO \
\
V iliacaexternaa \ \ -- aV iliaca interna
A rliacaexterna O \ \
\ - O aA :V vesicahsInferior
Ouctus delerens dexter \

A : V c i r c u m f l e x aO a - - OA ductusdeferentis
ilium protunda
- OM piriformis
Plica umbilicalislateralis;
A.; V. epigastrica O a
interior
-
OM ischiococcygeus
[M coccygeusl
Plica umbilicalismedialis -
-
Vesicaurinaria- O aA ;V rectalismedia

- Ductusdeterenssinister
Uretersinister

-
Glandula vesiculosa

-
O OA :V. rectalismedia
-' -)-
V dorsalis superficialis a
penrs \
aA vesicalisinferiot

/
/ // / \
oM levatorani
A dorsalis penis O
art
t
a o oA 'V rectalisinferior
/
Plexus venosus vesicalis O
/l
,'! t
o aA ,V oudenda interna
/A I
Funrculus
spermaticus profundapenib o
penrs
Corpuscavernosum O aA ; V oudenda interna, Rr scrotales poslenores

Fig. 1103 Arterial supply of the pelvic viscera of a male;

paramedian section on the left; most of the peritoneum has been
removed;
lateral view (r.).
 Petvicviscera
220

V iliaca communis * I
A iliaca communis a

A umbilicalis,Pars patens a \

A;VovaricaOs\ ,/ O A uletina

Ureter \
/ a a A:V r e c l a l i sm e d i a

Ovariumdextrum1
,/ Plica rectouterina

Intundibulumtubae

Tuba uterina / Uretersinister

Lig teres uleri \

A ; V i l i a c a e x t e r nO
a* : z OllA;V uterina

- -.-',
z O )A:V r e c t a l i sm e d i a

Vesica urinaria
-
OA vaginalis

Ovarium
sinistrum -
aA vesicalisinferior

-
tM levatorani
/
A uterina,O
Fl tubarius
\
a aA ;v reclalis Inferior

/
/ o Plexus venosus vagina[s
Bulbusvestibuli|
tooA,Voudendainterna
\
\
Lig teresuteri t vv vesicales

Fig. 1104 Arterialsupplyof the pelvicvisceraof a

female;
paramedian sectionon the left; the peritoneumhasbeen
partiallyandthe intestinecompletely removed;
the right ovaryhasbeenretractedsuperiorlyandthe left
ovaryventroinferiorly to showthe supplyingvessels;
lateralview (r.).
Thereis an extensive venousplexusaroundthe pelvic
viscera.
In the old femalethe ovarianarteryis frequentlyatrophied
anddifficultto dissect.
 andA.
obturatoria
22L
/ O Pars abdominalisaortae
,/ Nodi lymphoideirliacicommunes

z O O A ; V s a c r a l i sm e d i a n a
Nodus lymphoideusprecavatis
\
\ / O A iliolumbalis

Ureter\
A,Vovaricaoo\ z O o A.:V rectalissuoerior
Nodi lymphoideiiliaci interni \\
/ Bectum
Nodus lymphoideusitiacusexternus \
_
N genitofemoralis \ z O I A: V uterina

N obturatorius
/ Nodus lymphoideus
A;V rliacaexlernaoa - reclalis superior

A:Vobluraloriaoa -
-- O A. vaginalis

Nodi lymphoideiiliacrexterni \_
medtalesel lalerales , -- OA pudendainterna

umbilicalis,Pars occlusa O \ - It A. rectalis media

A;VepigastricaOa--
rnferior i - Lig sacrosprnale

- Nodi lymphoidei
Chorda arteriae
umbrlicalis pararectales

/ -
Excavatiorectouterina',
e s u t e r i ' */ Plica rectouterina

Anulustemoralis/ --
ooe;v rectalismedia

Nodi lymphoideiiliaciexterni obturatorii /

\
O A umbilicalis,Parspatens
Lig teres uteri / \
aM levatorani
Aa vesicalessupenoresO / Uterus,Faciesintestinalis
\. \
Vesicaurinaria/ i Ureter
\ a'n teresureri
\
u I lslhmustubae
a\ uterinae
Lig umbilicale
medranum
Fig. 1105 Lymphatic vessels,Vasalymphatica, Thelymph nodesshownhereare oftenmuch smallerbut always
lymph nodes,Nodi lymphoidei, of the pelvic wall in the female; present.Via the lymphaticvesselsin the roundligament
the pelvis has been sectionedin the median plane; (Lig.teresuteri) tumour cellsmay spreadfrom the uterusto
the uterus has been pulled sinistroventrally; the superficialinguinal lymph nodes.
most of the peritoneum has been removed; " clinical: DoucL.Ls'sspace
'* clinical: round ligament
lateral view (r.).

A rliaca
inlerna

A iliaca
exlerna
epigaslrica /
obturaloria - inferior

Foramen -
obluratum /
A obturatoria

Figs.1106a-c Variationsof the originof the obturatorartery; b originfromA. iliacainternadirectly

lateralview (r.). c originfromA. iliacaexterna
a originfromthe anteriorbranchof the A. iliacainterna Onlyin 75%of the casesthe A. obturatoriais a branchof the
(normal,"textbook"case) A. iliacainterna.
 Petvicviscera
222
Diaphragmapelvis and urogenitale(Figs.1107,1108,1115-1118,1126,1l2B)
Thefloorof the pelvisis constructed
of two partiallyoverlapping
musclelayers.TheDiaphragma petvisis formedby M. levatorani
andM. ischiococcygeus.
TheDiaphragma urogenitaleextendsas a t-riangular the two inferiorrami of 0s pubis.Its fibresareoriented
platebetvveen
transverselyandsupportthe urogenitalhiatus.Musclesbelongingto the urogenitaldiaphragmare:M. transversus perinei
profundus,M. sphincterurethrae(togetherreferredto as M. compressor urethrae),andM. ffansversus perineisuperficialis.
In the maleonly the urethrapassesthroughthe urogenitaldiaphragm, in the female,the urethraandvagina.
Muscle/ Innervation Origin Insertion Function
1. M. levator ani M. pubococcygeus: Os pubis Centrum tendineumperinei Slingsaroundthe rectum,
Branchesof N. sacralis (inner surfacecloseto the (prerectalfibres),in the its free medialborderforms
[53 and 54] symphysis),Arcus tendineus male:fasciaof the prostate the urogenitalhiatus through
musculi levatorisani, Spina (M. levatorl)rostatae), in the which, in the male,the urethra
Consists of the following
ischiadica female:wall of the vagina passes,in the female,urethra
parts:
(M. pubovaginalis), digitates and vagina.
M. pubococcygeus, M. iliococcygeus:Arcus
into M. sphincterani externus, It alsosupportsthe pelvic
M. levatorprostatae, t e n d i n e u sm u s c u l il e v a t o r i s
M. pubovaginalis, ani (posteriorthird) forms a sling with fibresof the diaphragm
M. puborectalis, oppositeside posteriorto the
M. iliococcygeus anus (M. puborectalis), Corpus
anococcygeum, Os coccygis
2. M. ischiococcygeus Spinaischiadica(inner 0s sacrum(lateralborderof Supportsthe pelvicfloor
BranchesofN.sacralis surface;adhesionwith the lower segments),
[54 and 55] Lig. sacrospinale) Os coccygis
3. M. sphincterani externus Pars subcutanea:Dermis Dermisand Subcutis Constrictormuscleof the
N. pudendus and SubcutissurroundinSthe surroundingthe anal orifice, anus
(Plexussacralis) anal orifice Lig. anococcygeum
Pars superficialis:Centrum
tendineumperinei
Pars profunda: muscularsling
to the M. levatorani
4. M. transversusperinei Ramusossisischii,connective Trapezoidalshapedmuscle Strengthensthe urogenital
profundus tissueof the Vasapudenda with openingsfor the urethra hiatus
N. pudendus interna (stretchesbetweenthe (male)or urethra and vagina
(Plexussacralis) Arcus pubis or Angulus (female).
subpubicus,supplementedby
Lig. pubicum inferius and
Lig. transversum perinei
protundum)
5. M. trangv.qrsusperinei ll Superficialpartof M. DigitationintoCentrum SupportsM transversus
superficialis transversusperineiprofundus tendineum perinei perineiprofundus
N. pudendus(Plexussaual.)
(variablemuscle)
6. M. sphincter urethrae Circularfibres Circularfibres Strengthens the urogenital
N. pudendus(Plarussacral.) hiatus,assistsin urinary
Surroundsthe Pars continence. Aisofunctions
membranacea urethrae duringejaculation to close
the urethra
7. M. ischiocavernosus Ramusossisischii Tunicaalbugineacorporum Fixesthecruraof thepenis
N. pudendus cavernosorum (male)or clitoris(female)to
(Plettussacralis) the Ramusinferiorossispubis
andRamusossisischiiand
to the urogenitaldiaphragm;
:111:..:11.:,' assists in ejaculationand
1,,:,, orgasm
8. M. bulbospongiosus Centrumtendineum. in the In the male:extends on the Fixesthe bulbof the penis
N. puden&ts malealsoinferiorpartof sideof Corpusspongiosum (male)or thevestibular bulb
(Plucussaualis) Corpusspongiosum penis penisto theFasciaurogenitalis (female)to the urogenital
penis (Raphepenis) inferiortothebackof thepenis; diaphragm; assistsin
Surroundsthe Bulbus
in the female:fibresextend eiaculation andorSasm
(male):or,:Bulbus
vestibuli,,::ll
(female) to the Corpuscavernosum
clitoridisandto the Fascia
diaphragmatis urogenitalis
inferior
 Tuberculumpubicum
/
Symphysis pubica
223
\ pubicum inlerius
! ,,tg
Urethra leminrna.Tuntca musculafls \
Lrg lransversumperinei

Fascia peflnei [Fascia \ Vagina - /, M transversusperinei profundus

investiensperinei superficralisl \1 \
/ Spina iliaca anleflor inferior
- Spina iliaca
anlenor supenor

Fossa acelabuli - Crista iliaca

Facies lunata - - Os ilium

- Fascia perinei
IFascia investiens
Lrg lransversum perinei supedicialisl
acetabuli - M lransversus
perinei superficialis
lvl obturatoriusinternus - - Fascia inferior
Tuber ischiadicum - diaphragmatispelvis
- Fascia
Fascia obluralofla - obturatoria
/\ Lig sacroluberale
Fascia inlerior /
-
draphragmatispelvis M levator anr, M puborectalis
\
Spina ischiadica
\ M levatorani,M iliococcygeus
\ M
Lig sacrotuberale / ischrococcygeus[M coccygeus]
\ M sphincler ani exlernus
Centrum periner / \ Lig sacrotuberale
\
Nl sphincterani exlernus / Sprna rliacaposteriorsupenor
\
Corprs anococcygeumILig anococcygeum]
os sacrum/ t
os coccygrs
Fig.1107 Muscles of theperineum, Mm.perinei; In the old womanthe transversus
perineisuperficialis
muscle
pelvicfloor,Diaphragma pelvis,of a female; oftenconsistsof only a fewmuscularfibres.
the sacrotuberal
ligamenthasbeenpartiallyremovedon the left ' probe in the pudendal canal (ALcocK's
canal)
to demonstratethe M. ischiococcygeus;
inferior view. l u b e r c u l u mp u b r c u m
\ / Symphysis pubica

Lrnea lerminalis \
\
Eminenlia iliopubica - _
/ Canalis obturalorius

Corpusossispubis -- M levalot aoi, M pubococcygeus

-- M. levator anr,
M. ihococcygeus

Fossa acetabuli _ - (Arcustendineus

musculi levatorisani)

--
Os sacrum- M rectococcygeus

--
Ligg sacroiliacaanteriora - M. ischiococcvoeus
[M coccygeus]-
\:
Pglsffion ischiadicum
Arliculatiosacroiliaca - maJus

\ Lig sacrotuberale
Ligg sacroiliacainterossea -

Proc arlicularissuoerior --

Fig. l10B Pelvic floor, Diaphragmapelvis, of a female; The ischiococcygealand the sacrococcygeal musclesoften consist
the superior part of the pelvic boneshas been sectionedin the of only a few muscular fibres, which cover the respective
transverseplane; ligaments.
superior view. * clinical: levator hiatus (Hiatus urogenitalis
et ani)
 Pervicviscera
224

/,aA iliacacommunis
/ a V iliacacommunis

7 Ol A;V iliacainterna

/ U(ele(

M pirilormis
a \ N obturatorius

/ e M transversus
/ abdominis
M levator ani * \ '
\; -- a M obliquus
rnternus
abdominis

-- o M obliquus
externus
abdominis
Lrg sacrococcygeum \ ---
anleflus ut M iliacus

--
oo A:v iliacaexterna
(M sacrococcygeus)
o :- --
\_ Pectenqssispubis
\ oo A:V
circumllexa
iliumprolunda
-
a o A ; V epigastricainferior

\ N obturatorius

- oo A iv obturatoria
Corpus anococcygeum
r] :1.+i'
ILig anococcygeum]
ijj*t- * rvrobturatorius
/ internus
/ \ \
M rectococcygeus
t (Arcustendineus
a'/
'/a musculilevatoris
ani)
z
- // --
M levator ani * o o A ; V pudendainterna
-=t --- --
t
/ \\ Corpusclitoridis
Clitoris,
M s p h i n c t e ra n i e x t e r n u s , --
/ \ \\ o vdorsalisprofunda
clitoridis
ani internusrl
M sphincter / \\
/ \\ \
a M pubovaginalis
/
Pecten analis *
m i n u sp u d e n d i
Labium Ostrum urethrae externum
/
M sphincteranr exlernus O Vagina
Cenlrum perinei
Labium majus pudendi

o M sohincterurethrae

Fig. 1109 Muscles of the pelvic floor,

Diaphragmapelvis, of a female;
median section through the pelvis; the viscera have
been completelyremoved,the vesselsand nerves
have been partially removedto show the musculature;
lateral view (1.).
 Rectum
225
I Femur,Caputfemorrs

lleum ----- Os sacrum

Colonsigmoideum
F e m u rC, o r o u sf e m o r i s- - - - -

Os oubis. Ramus infenor - - - - - Ampulla recti

-- Os coccygis

-- M gluteusmaximus

- - Canalisanalis

Fig. 1110 Rectum,Rectum; the rectum has been filled with a contrast medium. The angle
lateralradiographtaken during voluntaryclosureof the anus betweenthe longitudinalaxis of the anus and the rectum is 90".
(defaecography ). This angulationis causedby the loop of the levatorani muscle
The transitionfrom the anus to the rectum (arrow)is locatedat (puborectalmuscle).The scaleis rn cm.
the levelof the tip of the coccygis(white triangle);

Femur, Capul femoris

- - Os sacrum

F e m u r .C o r o u sf e m o r i s - - - - .
- - Colonsigmoideum

Os pubis, Flamusinterior ---.-*--

- - Os coccygis

- - Ampulla recti

-- M gluteusmaximus

Canalis analis

Fig.11ll R e c t u mR
, ectum; In contrastto Fig. 1110the transitionalregionbetweenthe
lateralradiographtaken during defaecation(defaecography), rectum and the anus is lower.The angle has increasedto 137o,
the rectum has beenfilled with a contrastmedium. becausethe loop of the levatorani muscle is relaxed.The original
angulation,which servesas a valve,has now diminishedso
that the faecalcolumn to be excretedpressesdirectly upon the
anal canal.
 Pelvicviscera
226

Plexuscoeliacus;
Gangtia

- Truncuscoeliacus

/ Pars abdominalis aortae

Gangliatruncisympathici- - //
\

Ganglionmesentericum
inferius
/ A mesenterica
inferior
Nn.splanchnici
lumbales

Plexushypogastricus
superior -

A iliaca communis - -

/, Radicos anteriores (S 2-S 5)

dexter --
N hypogastricus

/ Plexushypogastricus
inferior

Plexusrectalissuperior - -
- Ganglia pelvica,
Plexusrectalismedius - - Badix parasympalhica
INn splanchnicipelvici]

Plexusrectalisinterior--
- Plexussacralis

- N pudendus
- -
Nn anales
--
M sohincter
ani externus

Fig. 1112 Rectum,Rectum; Thefibres of the parasympathetic part run throughthe hypo
diagramof its innervation; gastricplexusto the pelvicvisceraandwithin the hypogastric
ventralview. nervefurther superiorly.The inferior hypogastricplexus
green:sympatheticsystem accommodates fibres of both the sympatheticand the
purple:parasympathetic system parasympathetic partsandtheir respective ganglia(Ganglia
pelvica).
 GlutealRegion,Regioglutealis
227

- Raphesdoti

TestislOrc{rbl<bxter
I
Penisl

Flg. 1ll3 Glutealregion, Regioglutealis;

perineal rc$on, Regioperinealls,of a male;
dorsalview.
When it is cold the crcmastermuscle
conhactsand pulls the scmtum towards
tlte perineum.

- Regiosrcralis

f negioanati - Resioghrbalb
I
Rogio pednealis
I - AnuS
\ Regio urcgenitalis
Cornmissuralabiorumpo€terio.-
Labiummajus pudendi-
Rimapud€ndi-

Fig. lf14 Glutealrcgion,Re$o glutealis;

perineal regon, Regioperinealis,of a female;
dorSalview.
' cllnical Rima anl
 Petvicviscera
228

1Corpusspongiosumpenis

/ M. bulbospongiosus
Tunicadartos,M. dartos \
t I / M ischiocav€rnosus
Glandula
bulbourethralis' Rapheperinei a

M. transversusperinei M gracilis
.t
prolundus

M. transversus\ / Fascia perinei

perineisuperficialis\
-./ [Fascia investiens
p€rineisuperficialisl

Tuber :
ischiadicum

Tela -
subcutanea,
Panniculus
aorposus

-
/
Lig sacrotuberale /
- -
Fo"sa
ischioanalis

Fasciaobturatoria/ \
M. sohincterani externus
/
M. gluleusmaximus
I
/
M. levatorani

Fig. 1115 Perineum, Perineum;pelvicfloor,

Diaphragmapelvis,of a male;
the fat hasbeenremovedfrom the ischio-analfossa;
on the right the lowerfasciaof the urogenitaldiaphragm
hasbeendissectedto demonstratethe bulbo-urethral
gland;
inferior view.
" also: CowPER'sgland
 PelvicFloor,Diaphragmapelvi.s
229
Preputiumctitoridis
\
Ostiumurethraeexternum\ \
./ Bugae vaginales
M gracilis 1 Labium minus pudendi\

M ischiocavernosus \ / Glandulavestibularis
' maior,(Ostium)*

-z M.bulbo-
_/ spongosus

/ Fascia oerinei
-t fFascia'investiens
.t ferinei superficialisl

M. transversus
pennel
superticialis

Lig
sacrotuberale

/ //
//
/
Fossa ischioanalis/ \
I M. sphincier
l) anaextemus
/l
M gluteus maximus / |

i
l\4m transversiperinei superficialiset protundusl

Os coccygis

Fig. 1116 Perineum,Perineum;pelvicfloor, Topographically the vaginalorificeand the anuslie closetogether.

Diaphragmapelvis;externalgenitalorgansof a female, During birth there may be tearingof the skin and musculature
Organagenitaliafemininaexterna; of the perineumreachingthesphinctermusclesof the anus
the fat hasbeenremovedfuomthe ischioanalfossa: (first- to thirddegreelacerationof the perineum).Extensive
inferior view. tearingcanbe avoidedby a lateralor medianincision(lateralor
* also:BAnrHotrx'ssland
medialepisiotomy).
 Petvicviscera
230
-- Lig inguinale

- Symphysispubica

// OV dorsalisprofundapenis
A . ; N d o r s a l i s p e na
is
-/ Lig pubicuminferius
/ Lig.transversumperinei
Urethramasculina

Glandulabulbourethralis'
\ / OM. sohincterurethrae
M lransversusperineiprolundusll \\ / Ductusglandulaebulbourethralis
A . ; V b u l b pi e n i sO a \ \ / protundus
aM transversusperinei
A;VperinealisOo:- - FasciaperineilFasciainvestiensp€rineisuperlicialisl
N perinealis \- -- Ramusossisischii
A: V oudenda inlerna il a \

N pudendus

'
aM. transversus
pennel
superficialis

Fig. 1117 Anterior part of the pelvicfloor,

Diaphragmaurogenitale,of a male;
mostof the lowerfasciahasbeenremoved;on the
right the bulbo-urethralglandhasbeendissected;
inferior view.
Compareto Fig. 1118.
' also: CowPER'sgland

Tuberculum
oubicum\ Lig pubicumsuperiusI // Lig inguinale
I

Os pubis,Ramussuperior\\
/ Symphysispubica

- o V dorsalisprotundaclitoridis

A;N d o r s a l i s c l i t o r i d iO
s \ -- Lig pubicum inlerius

Vagina \ -- perinei
Lig.transversum
Os pubis,Ramusinferior\\ -
Urethra feminina

A bulbivestibulia \ - OM transversusperineiprolundus
Ramusossisischii \
---;--- F a s c i ap e r i n e i
IFascia investiens perinei
superlicialisl

Tuber ischiadrcum -

Fig. 1118 Anteriorpart of the pelvicfloor,

Diaphragma of a female;
urogenitale,
mostof the lowerfasciahasbeenremoved;
inferiorview.
Compare to Fig.1117.
 A dorsalis penisO 1 Lig fundilormepenisI Lrg suspensoflum penrs ,/ a V. dorsalisprotundapenis
\ I
I

\\- -' Anulusinguinalis

Funiculus
spermaticus superlicialis

N. ilioinguinalis
V testicularisa---

genitofemoralis,
B genitalis

N dorsalis penis
---
o a A . ; V o u d e n deax t e r n a

Plexus pamf;iniformis a

Ductusdeferens---

--
A testicularisO O Rr.scrotalesanleriores

o V. dorsalisprofundapenis

a V dorsalissuperticialis
penis
-
Fasciapenis(protunda\'

i\>.

Fig. 1119 Externalgenitalorgansofa male,

Organagenitaliamasculinaexterna;
mostof the skin and the superficialfasciaof the penis
hasbeenremovedto demonstrate the vesselsandnerves:
on the right the fasciaeof the spermaticcordhave
beensectioned;
ventralview.
Thevenousplexusaroundthe testicularartery (Plexus
pampiniformis)is alwaysvery prominent.
 Petvicviscera
232

Anulusinouinalis
- suoerlicialis,
\'\ Aponeurosis
CrJs mediale 7 | M obliquusexternusabdominis,
Telasubcutanea,
\
Panniculus
adiposus\ internusabdominis
7 | M obliquus
\

N. ilioinguinalis

Lig suspensorium
penrs

o V dorsalisprofunda
externaa --
Fasciasoermatica 0enls;
A.; N. dorsalispenis

O --t
Fasciacremasterica:
M cremaster \. - OA Prolundapenrs

o -
Plexuspampiniformis

Ductusdeferens

a---f-
A testicularis
- Corpusspongiosum
penis
f caput
Epididymis
I ----
--
[(APPendrxl

--
Appendix teslis -
O Fascia cremasteflca,
M cremaster
testis,--
Tunicavaginalis
Lamtnavrscerails
- a Fascia sPermalicaexterna
/
/
Tunicavaginalis
testis,
Laminaparietalis
/
/ -
Fasciaspermaticainterna O Tunica dartos, M dartos

Mcremaster./ T i
/
externaa
Fasciaspermatica
I
' Raphe scrota
Seotumscrotr

Fig. f 120 Male genital organs,

Organagenitalia masculina;
the abdominal skin and parts of the scrotal skin have
been removed;
the body of the penis has been sectioned;on the right
the fasciae of the spermatic cord and the testicles have
been dissected;
ventral view.
Compare to Figs. 824 to 827,on the oriSin of M. cremaster
and of the fasciaeof the abdominal wall.
 teGenitatorgans
233

(Plicae mucosae) \

Trigonumvesicae--

- Ostiumureteris
U v u l a v e s i c a- e
*_

Pars Osliumurethraeinternum
iniramuralis
Colliculusseminalis;Utriculusprostaticus
Pars Ductusejaculatorii- Ductuliprostatici
prostatica

Cristaurethralis
Pars
intermedia
- - Bulbuspenis
Imembranaceal
- - Cruspenis

- Ductusglandulaebulbourethralis

- - Tunicaalbugineacorporumcavernosorum
Urethra
masculina Corpusspongiosumpenis- -
- Trabeculaecorporumcavernosorum
A profundapenis -
Pars
sPongiosa Aa helicinae- - Cavernaecorporumcavernosorum

- Lacunaeurethrales

Coronaglandis-
* (Valvulafossaenavicularis)
Glanspenis-
- Fossanavicularisurethrae
penis-
Preputium
- Osiiumurethraeexternum

Fig. 1121 Urinarybladder,Vesicaurinaria;

prostate,Prostata;maleurethra,Urethramasculina;
the urinary bladderand the urethrahavebeenexposed
to showtheir lumen;mostof the skin of the penishas
beenremoved;
ventralview.
Physiologicallythe urethra is curved.Compareto
Fig.1l45.
 Petvicviscera
234

Corona glandis \

-- Osliumurethrae
externum

-
Fascia penis (supedicialis)
- penis
Preputium

\
preputii
Frenulum

Fig. ll22 Penis,Penis,with glans,Glans,and foreskin, * level ofthe section in Fig 1123a
Preputium; level ofthe section in Fig. 1123b
*** level ofthe section in Fig. 1123c
the skin andthe superficialfasciaof the penishavebeen * * * * level of the section in Fig. 1123d
removedin layers;
lateralview.
V dorsalis prolunda penis \
\\ / A protunda penis
-. V-dorsalis
supenrcrails penrs /a> / Fascia penis / Glanspenis,
p"ni" -,fi
A dorsalis (profunda)
Corona glandis

- Tunica
albuginea
corpons
spon9rosl
Tunicaalbuginea-
corporum
cavernosorum

-- -
Septum penis Tunica
albuginea
- corporum
Urelhra cavernosorum
Fascia penis Pars
masculina,
(profunda) spon9rosa
/ -n urethralis
Corpusspongiosum Septum penis Urethra masculina
penrs
a

Glanspenis;\ penis
/ Preputium
Corpus
spongrosum
penis, Cavernae
corpofls spongrosr
-
- A. dorsalis
i penls

-
Corpus
cavernosum
penis,Cavernae
corpons
cavernosl
- Seplum glandis

penis
Corpusspongiosum
\ preputii
Frenulum
d

Figs.1123a-d Penis,Penis; sectionthrough the proximal circumferenceof the Glans

crosssections;the levelsof sectionareshowninFig. 1122; penis
ventralview. c sectionthrough the middle of the Glans penis
a Sectionthroughthe middleof the bodyof the penis. d section through the distal end of the Glans penis
Notethat the two cavernousbodiesare incompletely
separatedby the septumof the penis.
 IeGenitalorgans
235

deferentialis
A. ductusdeferentisa \ / *Plexus
\
Ductusdelerens -_
_

--- oN. genitofemotalis,

R. genitalis
penis -__
Corpuscavernosum

Tunicaalbuginea---
cofporum
cavernosorum

A testicularis
a---

Fasciapenis(profunda)-
--- M. cremaster
OFasciacremasterica;

Vv Dudendae extemae O --- ---

OFasciaspermatktaexlema

- --
Corpusspongiosumpenis / OTunicadarlos

Fig. 1124 Spermaticcord,Funiculusspermaticus;

frontal section:
ventralview (1.,250%).
Thedevelopmentof the cremastermuscle,the pampini-
form plexusand the positionof the deferentduct within
the spermaticcordare extremelyvariable.

Soinailiacaanteriorsuoerior-

Penrs,Corpus--_

Scrolum--_

Fig. 1125 Externalgenitalorgansofa male,

Organagenitaliamasculina
externa.
236 Pelvicviscera

Fossa supravesicalis Plica umbilicalismedialis

\ | (Chorda arteriae umbilicalis)
Plica umbilicalismediana. \
(Lig. umbilicalemedianum, \1'r \
Chorda urachii \

Vesicaurinaria\ / Fossainguinalis
lateralis
\ \.
N femoralis
M psoasmajora -__
N genitolemoralis
A : V i l i a c ae x t e r n a aa - - -

Ductus deferens---- - - Fossainguinalismedialis

Nodi lymphoidei---- - - Nodilymphoideiiliaciexterni

iliaci externi
- a A umbilicalis,Pars occlusa
N obturatorius
-- Lineaterminalis
A ; V o b t u r a t o r i aOo - -
- -
- Lig, capitis femoris
- -- Ureter
Ductusdelerens-
- Duclusdeferens
M obturatoriusinlenusa /' - Glandulavesiculosa
- -
Amoullaductusdeterentis
M obturatorius
--
Excavatio lis-' a Plexusvenosusvesicalis;Plexusvenosusproslaticus
Membrana obturaloria -' -- Fossa ischioanalis
M levatorania/

Os ischii/-
\ Prostata

A;Vpudendainterna,N pudendusOo /
\ Cruspenis
I \ Glandula
bulbourethralis
M transversusperineiprofundusl / f
/Butbuspenis

Fig. 1126 Pelvic floor, Diaphragmapelvis; pelvic

viscera and abdominal wall,
Organaabdominis et pelvis, in the male;
on the left the specimen has been sectioned in the
frontal plane through the head of the femur and
the urinary bladder; on the right the urinary bladder
and the prostate have been preserved;
dorsal view.
 Vessels
and Nervesof thePerinealRegion,Regropertnealis
237
Nn scrotalesposteriores \
7 OA. perinealis, posteriores
Rr scrotales

A dorsalispenisO \
a M bulbospongiosus
/,/

A bulbi penis O \
\
/ o M. ischiocavernosus

N dorsalispenis \
/ OM sphincterani
externus

Br. perineales \ // O A perinealis

(N.cutaneus \
femons \
posterior)

/ O M. transversus
/' Derinei
.t 3uperficialis

Nn clunium \
inferiores \. -:
(N cutaneus
femoris -,
posteflor) N perinealis
..

N dorsalis
pents

N dorsalis
penrs

\ tooA;Vpudenda
interna

\ a A. rectalisinterior

^ **-"':::::" ',o.,^,.
Nn cluniuminferiores
;' (N. culaneusfemorisposterior)
/ \
M gluteusmaximus
"' | \ aM levatorani
Corpus anococcygeum [Lig anococcygeum; / Nn anococcygei

Fig. ll27 Vesselsand nerves of the perineal region,

Regioperinealis,and the external genital organs of a
male, Organagenitalia masculinaexterna;
the fat in the ischio-analfossahas been removed:
on the right the gluteus maximus muscle has been
sectionedto demonstratethe courseof the pudendal
nerve and the internal pudendalartery;
inferior view.
 Pervicviscera
238
Symphysispubica clitoridis
/, Lig suspensorium
pubicum--
Tuberculum
- Lig. inguinale

Corouscavernosumclitoridis
- Preputiumclitoridis
Glans cliloridis -
- Frenulum
clitoridis
Crusclitoridis
Labiumminusoud€ndi- Ostiumurethraeexternum
Ostiumvaginae;Columnarugarumanterior- - hymenales
Carunculae
Bulbusvestibuli-
-- M ischiocavemosus
maior*. -
Glandulavestibularis -
(Ostlum) - M bulbospongiosus
- Fascia perinei [Fascia investiens
M lransversusperineiprolundus- \ perineisuperficialisl
\ Vestibulum
vagrnae - Tuberischiadicum
\ Frenulumlabiorum
M. transversus/ pudendi
perineisuperficialis

M. sphincter /
aniexlernus,Parssubcutanea
\ Anus

Corpusanococcygeum
lLig anococcygeuml

Fig. 1128 Externalgenitalorgansof a female, musclehasbeendissected;

on the left the ischiocavernosus
Organagenitaliafemininaexterna; musclehasbeehremovedto
on the right the bulbospongiosus
parts of the pelvicfloor,Diaphragmaurogenitale; showthe erectiletissueof the vestibularbulb:
mostof the lowerfasciaof the urogenitaldiaphragmhasbeen ventroinferior view.
removed; * clinicat BARrHoux's gland

Commissuralabiorum
anleflor
Preputium\
clitoridis -_
' z Commissura
labiorum
anleflor Preputiumcliloridis
Frenulum1
clitoridis --
- Glans Labiummajuspudendi
clitoridis
(Ducluspara--
urethralis) -: -- Labiummajus
pudendi Rimapudendi
Ostium--
urethrae - Labiumminus
enernum pudendi Labiumminuspudendi

--, -- Oslium
Glandula
vestibularis va9rnae
malor, --
(Ostium) Hymen
--
Fossa - Frenulum
vestibuli labiorum
vagrnae Pudendi
/ \ Perineum,
Commissura/ Raphe
labiorum pennel
posterior
-l
Anusl

Fig. U29 Externalgenitalorgansof a female, Fig. 1130 Externalgenitalorgansof a female,

Organagenitaliafemininaexterna; Organagenitaliafemininaexterna;
inferior view inferior view.
This view into the vestibuleof the vaginais only possiblewhen Evenwith the legsspreadapart the labiaminoracoverthe
the labiamajoraand minoraare held apart,for exampleby entry of the vagina,as in this 26-yearoldfemale.
a speculumor by the fingersof the physician(not shownhere).
 Vessels
and Nervesof thePerinealRegion,Regioperinealis
239
M butbospongiosus
a
Ostiumurethrae
externum
\
Labiumminuspudendi\
V.bulbro \
vestibuli \ Bulbusvestibuli a)
\,

A dorsalisa \
clitoridis \

A perinealis
a \
\ Nn labiales
oosteriores
N dorsalis \
clitoridis \

A pudenda a \
tnlerna \

_// O (Diaphragma
--' urogenitale)

Br perineales \
(N cutaneus -- :1
lemofls . O M lransversus
posterior) r'.. __--
peflnel
-....- superficialis

N dorsalis
cillonors

tt \ oM gruteus
\ maXlmUS
\ ooA;vpudenda
Interna
OA rectalisinferior
'
Nn. anales [rectales] inferiores
Nn ctunium inferiores
(N culaneus femoris poslerior)

Fig. 1131 Vessels andnervesofthe perinealregion,

Regioperinealis, andofthe externalgenitalorgansofa female,
Organagenitaliafemininaexterna;
the subcutaneous fat andthat of the ischio.anal
fossahave
beenremovedto demonstratethe vesselsand nerves;on the
right the gluteusmaximusandthe transversus perinei
profundusmuscleshavebeensectionedto demonstratethe
courseofthe vesselsandnerves;the right bulbospongiosus
musclehasbeenremovedto showthe erectilebodyof the
vestibularbulb;
inferiorview.
 Pe^icviscera
240

Oesophagus Hepar,Area nuda

Plexus venosus '$ \ Aorta,O \ -a Diaphragma,Centrum tendineum
Pars ,
vertebralisinternus .
anterior,
\\abdominalis
I'l I HePar'Lobussinister
\
V basivertebralis ,/ t' cor
- - S t e r n u mC, o r p u s

--- Sternum, Proc xiphoideus

-- Gaster,Cardra
Pancreas,Ductus pancreaticus -- --
- - Fornixgastricus

A gaslroduodenalisO -*

A mesentencasuperior a --
-- Colontransversum
P a r s l u m b a l i s& - -
diaphragmatis -- L i n e aa l b a
V r e n a l i s d e x t r ae - - -

A r e n a l i s d e x t r aa - -

Filum terminale
- - Omentummaius
Aa Jelunales --- Peritoneumviscerale
V m e s e n t e r i c a s u p e r i o' -r e f. - - Peritoneumparietale

A i l i a c ac o m m u n i sa - -
dextra
V iliaca communis s - -
dextra
Cauda equina

--- OA leiunalis

Plica transversa -.-

-- aM reclusabdominis
recti

Ossacrum .-- --- V e s i c au r i n a r i a

Glandula vesiculosa - - --- 6 M Pyramidalis

Ampulla recti - - --- Oc nrrhi<

-
Os coccygis -
penis
Lig lundiforme
.-
Prostata -

M sphincterani t ---
- - - Corpus spongiosumPenrs
externus
lvl sphincterani & - - - Corous cavernosum Dents
internus
a
Columnae anales / - - -
Tunica albuginoacorporum cavernosorum
/
/
M levator ani, *
M DUbococcygeus -*-
/
/ Septum scroti
lvl transversus perrnei *
prolundus -.---
/
/ Prepulium penis
M ischiocavernosusrl
a
/
M bulbospongiosusC
\
4* M cremaster
* Tunica dartos

Fig. 1132 Abdomen,Abdomen,and pelvis,Pelvis,

of a male:mediansection:
lateral view.
The external genital organs and the anterior parts of the
pelvis have been sectionedto the left of the median plane.
 V hepaticadextra *
\
Atrium cordrsdextrum \
\
\ Pulmo dexler, Lobus infeflor
V hepaticasinislra * -

Lig falciforme - V/
l]epar, Lobus sinister -_ - Recessus
phrenrcomediastinalis
M rectus abdominis I \ _
- O Pars lumbalisdiaphragmatis
P a r s s t e r n a l i sO - _
diaphragmatis
- aVcavainferior
Gaster --

A hepaticapropria a ** -- Nodi lymphoideiretrocavales

Caput pancreatis; --
Duclus pancreaticus -- lV r e n a l i sd e x t r a

Ductus choledochus - - -- 1A renalis dextra

Ibiharis]
V portae hepatis * --
Omenlum majus, - -
Lig gastrocolicum
-- Duodenum
Colon transversum -

O m e n t u mm a j u s - - _- tV lumbalis

Caput pancreatis, - -
Proc uncinatus
V mesenterica * ..-
supeflor _- lM ereclorspinae

A mesenterica a -
supenor - - OA iliaca communis

-- lY r l i a c ac o m m u n i s

- - Os sacrum
Nodi lymphoiderileocotrci --

N sacralis[S1]

- Rectum
- aM piriformis
l, reclus abdominis a --
- - Excavatio rectovesicalis

- - Ouctusdeterens
- - Glandula
vesiculosa
- - Rectum
-- O(M sacrococcygeus)
Corpusossispubis - - - aM gluteusmaximus

Lig fundilormepenis - - - Proslata

- aM levator ani, M iliococcygeus

(Mm adduclores) - -

- tM levatorani,M pubococcygeus

S e p t u mp e n i s ' -
- urogenitale)
a(Diaphragma
Corpus cavernosum penis -

Glans penis -
\_ .-:W-- aM cremaster
P r e p u t i u mp e n i s z - \ Epididymis
A testicularisO / lTestis \ 6r"Plexus pampiniformis

Fig. 1133 Abdomen,Abdomen,and pelvis, pelvis, of a male; Because of its lateralcurvature(skoliosis)the lumbarspinehas'
sagittal section to the right of the median plane; beensectioned morelaterallythanthe thoracicspine.In contrast
medial view (r.). to the subcutaneous adiposetissuea lot of adiposetissueis
deposited in the mesentery andthe greateromentum.
242 Abdominal'and PelvicViscera

................
V cava inferior
Hepar,Lobuscaudatus Atrium cordis dextrum
\
I
V hepaticasinistra * \ I Ventriculuscordis dexter
\ 1
\ .lI
Lig. triangularesinistrum
V Dortae heoatis 6 .
\, \ ,t
.t/-/
/ /

V. portaehepatis,* \
R .d e x l e r --
Gasler,Ostium
- _- cardracum
A hepalicapropriaO :__
--- a * A ; V g a s t r i csai n i s t r a

Duodenum, -
Parssuperior Coiontransversum
_-.-

Hepar,Lobusdexter- _ Par rLrvaLr-

---
O A gastroduodenalis

----
# V splenica

---
D u o d e n u m ,F l e x u r a
duodenojelunalis
Colon ascendens - -
---
OA mesenterica
superlor

A;Vmesentericaa* -.-
---
supeflor
l Aa jelunates

- Jejunum

- -
Cavitas peritonealis

- Colon descendens

M sartorius M --'

M tensor fasciae lalae w ---

M rliacus* --

N temoralis -/ --
Colon sigmoideum

|F'
\- - Ospubis

Symphysis PUbica
./,/i! \ \--: \ penis
M pectineus*/ ,' 1 I Lrg fundiforme
M.adductorbtevis*/ --
I i \ o A dorsalispenis
M adductorlongus# ' \ Urethramasculina
!
I
Penis,Tunicaalbuginea I OA profundapenis

Fig. 1134 Abdomen,Abdomen;

frontal section through the most ventral part of the
peritoneal cavity;
ventral view.
The names of the muscles,vesselsand nerves are
shown in Fig. 837.
 Abdomen
243

Ostiumcardiacum\ Oesophagus,Parsthoracica
\
V pulmonalisa\
sinistrainferior \

/ Pulmodexter,
Lobusmedius
Lobushepatis\
srntster Pleuraoarielalis.
Parsdiaphragmatica
Lig triangulare\
sinistrum / a Diaphragma
- Lobushepatis
Diaphragmaa - dexter
Lig _ - Duclusthoracicus
gastrosplenicum
Corpusdastricum* - Noduslymphoideus
mediastinalis
posterior
SplenlLien]-
- a A subcostalis
Glandula -
suprarenalis
Lrg splenorenale - - a Parsabdominalis
Nodi lymphoidei- aortae
splenici
- a Nn.splanchnici
A;V splenicaj j - maioret minor

Pancreas - Glandula
suprarenalis
Omentummaius
Pyramisrenalis-
aOA;Vlumbalisl
Colondescendens -
Papillarenalis-
CostaXl / a Truncus
sympathicus
Ben -
A ;V renalisl a z-
\ \ Pelvisrenalis, Ben,
Capsulaadiposa
\ Calyxrenalismaior

a V hemiazygos , OaA;V lumbalisll

Parslumbalis;l
diaphragmatis

Fig. 1135 Abdomen, Abdomen;

frontal sectionshowingthe diaphragm,the
visceraof the upperabdomenandthe kidneys;
dorsalview.
Because of the lumbarlordosisthe first and
secondlumbarvertebraehavebeensectioned.
244 Abdominaland PelvicViscera

^ Draphragma,a
uentrum tendrneum
'/ Pulmodexter,
Lobusinferior
Hepar, r
Lobus dexter '\
/, CostaV

- - Pleura visceralis[pulmonalis]

--- P l e u r ap a r i e t a l i s ,
Pars costalis

--- | P a r sc o s l a l i s
draphragmatis

--* sV hepaticadextra

-- * V porlae
C o l u m n ar e n a f t s - - - nepaus,
R dexler,
R anlerior
V renalis,& ---

A r e n a l i sa - -

Pelvis renalis - --

M e d u l l ar e n a l i s - - -

Calyxrenalis -"
mrnor

M quadralu5 I -/
lumborum

Cortex renalis /
L
I
/ <k
Ren, Capsula /
adrposa /l
Ren, Capsula librosa M psoas maiors /
|
Fasciarenalis'

Fig. 1136 Abdomen,Abdomen;

sagittal section through the upper abdomen
at the level of the right kidney;
viewed from the right.
 Abdomen
245

Gaster.Cardia, Ostium cardiacum

Gaster.Fornixgastricus

Omentum minus, Lig hepatogastricum Lig phrenicosplenicum

I I
Pericardium ,r,ro
| | | Lobus inferior
, ",n,.,"r,

C o s t aV l \ \
Pleura visceralisIpuhonalisl

Pleura parietalis,
.Parscoslalsa \\ Pars costalis
oraphragmalts

Hepar, Lobus sinister - -

A gastrica sinistraa --

B intercoslalisanlerior:a -- - Bursaomentalis
V inlercoslalisanlerior;O
N Inlercostalis
- Recessus
costodiaphragmaticus
-- O M erectorsoinae

- CostaXll

Omentum m a j u s-,-
Lig gastrocolicum

M rectus abdominisl --
\ I M p"o""r"1o,
\
Omenlum malus -
- \ Cavitas peritonealis
\ Jelunum

Fig. 1137 Abdomen, Abdomen;

sagittalsectionthroughthe upperabdomen at the
levelof the spleen;
viewedfrom the left.
Thethickenedcapsuleof the liver is pathological.
246 Abdominat

Lig falcilorme \ Ltg teres heoatis; Lobus hepatis sinlster

I
M rectus abdominis,Vagina musculi recli abdominis t \ OA hepaticacommunls
/
abdominisi :
M transversus f
He0ar, Lobus quadratus
z Omentum minus. Lig hepatogastrlcum
Ductus\
Ductuscyslrcust
choledochuslbiliaris]: z O OA.. V. gastflca sinistra:
Lio heoaloduodenaie \ Ganokon coeliacum:Nodi
I lymploidei gastroomentales
A hepaticapropria,a --
R dexter; - Bursa omentalis
V porlae hepatis o
Lobus caudatus. Proc -- - Omentummajus
papillaris;
Recessus
superiorbursaeomentalis
' Recessus splenicus
V portaehepatis,w --
R dexter
-
Parscostalis; - Hilum splenicum;
Diaphragma Parslumbalis, Nodi lymphoidel
Crusdextrum splenici
- -
Lobus heoatis dexter Splen ILien]
.---
V cavainferiors
-
-- Cauda pancreatis
Ductusthoracrcus
--
V azygos* -
Peritoneumviscerale
- -
Cavrtaspleuralis Cavrtasperitoneafts
/ \
Pleura parielalis, \ Peritoneumparietale
Pars diaphragmatica / t
/ z \ -\ a oA ,v splenica
Pleura parietalis,Pars costalis
/
Mm intercostalesexterni et tnlernt | Ren; Glandula suprarenalis
t
Ren, capsula adiposa
/ \ '
dorsi|
M latissimus a V hemiazygos:Nsplanchnicusmaior
i
/ o t Aorta; DiaphragmaiN splanchnicusminor
inferior!*
M serratusposterior \
N tnoracicus
[T12]
thoracisa
M iliocostalis Medullaspinalis
N splanchnrcusminor VertebrathoracicaXll, Proc spinosus
I/ longissimusthoracis * ItrMm multitidl

Fig. 1138 Abdomen,Abdomen; the peritoneumhas beencolouredblue,exceptfor the omental

transversesection through the intervertebral disc betweenthe bursawhere it is green;
twelfth thoracic vertebra and the first lumbar vertebra; inferior view.
In this specimenthere is little adiposetissue

Hepar,Lobussinister M rectus abdominis Gasler

I ,z
z Colon lransversum
Lig falcrforme

/ Jelunum
Lig teres hepatis ----.

/ Pancreas

Hepar, Lobus caudatus *--*

- Colon descendens
----
H e p a r ,L o b u sd e x t e r

V portae hepatis ---- Aotla

V cava inferior
Vertebralumbalis.
Pars lumbalisdiaphragmatis Corpus vertebrae

C o s t aX - - - - - Splen ILien]

M l a l i s s i m udso r s i- - - - - Ren sinister

Costa Xl
M erector spinae
Ren dexter

C o s t aX l l

Fig. 1139 Abdomen,Abdomen;

cross-sectionalimage through the first lumbar vertebra
obtained with computedtomography(CT);
inferior view.
The intestine has been partially filled with a contrast
medium.
 Abdomen
241

M reclus abdominis
Lig lalcrforme
V cava inferior
I Lrnea alba
I
C o s t av l t l
\ Hepar,
Lobus
sinister
Pleura parietalis,l C o s l a v l I j
Pars costalis \ \ \ i
\ i\\ / a Pars descendensaortae
P l e u r ap a r i e t a l i s , . \ \\\
Pars diaphragmatica\\ \

/ Gaster

Peritoneumviscerale \ / Cavitas pleuralis,

/ HeceSSUS
C o s t aV l \ coslodiaphragmaticus

d, M. obliquus
'/ externus
abdominis
C o s t aV l l l

Fig. 1140 Abdomen,Abdomen;

transversesection through the upper
abdomenat the level of the eleventh
thoracic vertebra;
inferior view.
 Abdominatvisce
248

I -e
:-

Hepar Lobus sanrster

Vesica biliarisl portae hepatis V splenica
CostalXt Lrg. teres I Colon transversum
hepatis I
C o s t av l l l l i i M reclusabdominis
! tu
Peritoneumparietale\ I
i,/ /aAmesenleflcasupeflor
Cavitasperitonealis\ ibj-4- / _
\
\| 7 Pancreas
Pars 'costalis
--..'.- diaphragmatis
-'.r' ''.J''.."- 4,
'
\\
Recessus. \ 7 N o d u sl y m p h o i d e u s
\
costodiaphragmaticus\, / ^^^.to)t;.tt<
\
Pleura parietalis,\
'\ \
Pars draphragmatica \ / Je)unum
Pleura parietalis,\
Pars costalis \

C o s t aV l l l -
/ Costa lX

- Colon
descen-
dens
CostaX -
-aA
renaIs

V cava inferior /

Pars lumbalisdiaphragmatrs t' -,

t t\
C o s t aX l l ,' / \ M"dr,," ,"n"ri,
Truncussympathicus / \
/ c a t y x r e n a l i sm r n o r
Ren
/ S i n u sr e n a l i s
M ereclor sprnae Vertebralumbalis
\
Cortex renalis
Cauda equina
V renalis
I
A mesenlenca rnlerrora O Aorta, Pars abdominalis

Fig. 1141 Abdomen,Abdomen;

transversesection through the upper abdomenat the
level of the first lumbar vertebra;
inferior view.
In this casethe spinal cord is no longer present.Instead
cauda equina can be seen.The stomachis contracted
which makes the mucosaappearvery thick.
 Abdomen
249

Lineaalba;
I
I a M rectusabdominis
A : V mesenterica superior, Aa ; Vv ileales O O 1,
I
I
I / lleum
I
A mesentericarnferiorO 1
l,Cavitasperitonealis
h- / o-,1^^-,,-
Peritoneum-i.,
viscerale
/
I
Nodus lvmohoideus
'prbaorticus \ parietale
\ / Peritoneum

/ | M. transversus
/ aDdomtnts

Colon sigmoideum - -
7 | M obliquus
/ Internusabdominis

/ a M obliquus
exernus
abdominis

-- OoA:V
mesenlenca
Aorta, Parsa -- supenor
abdominalis Aa:W
ileales
- Colon
descendens
-
Colon -
ascendens

\ lleum

M latissimusdorsi a /
\ Ureter

Ureler / \ a M quadratus
,// t\ lumborum
Truncus sympalhicus '
,' \t
/ r M psoasmajor
Vertebralumbalis lll
\oaA,vtesticutaris
/
cauda equina
a M erector spinae
I N spinalis
Vertebra
lumbalislV Proc spinosus'

Fig. 1142 Abdomen,Abdomen;

transversesection through the lower abdomenat the
levelof the third lumbar vertebra;
inferior view.
In this casethe sigmoidloop risesso far superiorlythat
the ascendingand descendingparts can be seen.
 Petvicviscera
250
Ductus thoracicusI
N rlioinguinalis \ '
Cauda equina ,uI pars abdominarrs
Ureter\ / aorlae
l\,4quadratus lumborum O 1

,/ a V lumbalisascendensi
Rr urelericia \ / O Aa lumbales,
(A renahs) Truncus sympathicus

N iliohypogastricus \\
jM
zt Psoasmajor

V cava inferiorO \

-'Uteler

-- aV mesenterica
Inlerior
Plexus hypogastricus
supenor
--
Nodi lymphoidei
M iliacus a --. aonici lalerales

--
N genitofemoralis Nodi lymphoidei
preaonrcl
N cutaneus
femoflslateraIs
-- aA iliacacommunis
A ; V t e s t i c u l a r i s O- a
- -
Peritoneumparietale
(M psoas minor), Tendo t -- -- Nodus lymphoideus
i l i a c u sc o m m u n i s ,
Nodus medialis

- -
N genito- C o l o ns r g m o t d e u m
femoralis
?
--
-- Ductus deterens
A iliaca externa O
- -
s ---
A a v e s i c a l e s s u p e r i o r eO Vesica urinaria

Noduslymphoideus externus--
rhacus --
Nodus lymphordeus
obturatorius

-
L i g i n g u i n a l e- - Fossa inguinalis
laleralis

prolundus-
Anulusinguinalis rossa paravesrcats

: rOSSa,lngulnalls
meotaIs

Lrg Interfoveolare -
\ FOSSa
Supravesrcalrs

/ rllca umoiltcatrs
M transversusabdominis a lateralis

--
Pli"uumbi|calis
o rO /
A ; V e p i g a s t f l c a i n t e nO
medrahs
--
P e r i t o n e u mp a r i e t a l e

/ \
M rectus abdominis | Plrcaumbilicahsmediana
't \
OA. umbrlrcahs \, ,^^_ ^.^
Lrnea arcuala Pars occlusa Llnea arcuala
IChorda arteriae
umbilicalisl

Fig. 1143 Abdominal wall and pelvic viscera of a male;

the posterior abdominal wall has been sectionedin the
transverseplane; the anterior wall has been pulled ventrally;
on the right the peritoneum has been removedto show the
vesselsand nerves;
supenor vtew.
 Petvis
25I
lumbalis
Vertebra V

Os sacrum

recti
Plicatransversa
Vesica urinaria - -

L i n e aa l b a - - Ampullarecli

Symphysis pubica --
Prostala

Anus

Bulbuspenis,
penis
Corpusspongiosum

- Os sacrum

--
Cervix ulert

--
Vagina

Figs. 1144a, b Pelvis,Pelvis;

sectionalimage in the paramedianplane obtained
with magneticresonancetomography(MRT);
viewed from the left.
a in a male
b in an female
Compareto Figs. 1145and 1146.
 petuicviscera
252

I Spatiumsubarachnoideum
Filum terminale / 7 nr""nnoioeamaterspinalis
I
N s a c r a l i s[ S 1 ] ,R a d i x i ...iS, \l 7 Spatiumepidurate
' /

Ostium urethrae internuml

I ,t o Plexus venosus vertebralis
/ externus anterioret poslerior
Mesenterium
I

7 Colon sigmordeum
\
/ Filum terminale
Intestinumtenue \

Apex vestcae\
/ Ostium ureleris

Omentummajus

/ Plica transversarecti'
Plica umbihcalismediana
(Lig umbilicalemedianum)
Spatrum: / Lrg sacrococcygeum
retropubicum** \-' posteriussuperficiale

Linea alba \ Excavatioreclovesicalis

- Articulatio
sacrococcygea
Symphysis pubica \
- Ampulla recti
Lig fundilorme penrs \
- Fasciarectoprostatica

V dorsalis profunda penrs a \ - Prostata

\{.r - Fascia pelvis visceralis
V dorsalis supedicrahspenis s \
- Corpus anococcygeum
ILig. anococcygeum]
Urethra, Pars spongiosa \
- { M sphincterani
externus
Ductus deferens
- * M sphincteranl
Capul epididymidis- inlernus
Tunica albuginea -
corporum cavernosorum C o l u m n a ea n a l e s tS i n u sa n a l e s
\
Corpus cavernosum penis - lPecten analis)
Corpus spongiosum penis - irtrM sphincler ani externus

Septula testis - 4t M transversusperinei profundus

\
Corona glandis - Membrana periner
- \ ta \
Glans penis Ductulietferenlestestls
tt Urelhra, Pars intermediaImembranacea]
\
Fossa navicularisurethrae/ \\ t..
- ta \ Mediastinum \
testis Lig puboproslaticum
Preputiumpenis/ i \
/
Ostiumurelhraeexternum Ductusdelerens,
Caudaepididymidis
, \ Bulbus penis, Corpus spongiosum penis
\
M cremaster; Fascia cremaslericarl / i I Scrotum,
Tunicadartos,M dartos
- o b u l it e s t i s l

Fig. 1145 Pelvis,Pelvis,of a male;

mediansection;
lateralview (r.).
' clinical: Koslnluscn's fold
** clinical: RETzrus's
space
 Fimbriaelubae uterinae
lnfundibulumtubae uterinae
I
A sacralismediana O
| |
l1
t/
Ureter
\

Lrg suspensorrumovarii;A ; V ovarica ar O \

A:V iliacaexternaOa Colonsigmoideum

Ampullatubaeuterinae
Ovarium, Folliculusovaflcus vesiculosus
/ OA sacralismediana
lsthmuslubaeulerinae\
Fundusuteri\ -
Lrg teres uteri \
\ / Plica rectouterina"
A ; V epigastricainferior OO \
Plica umbilicalismedialis (Chorda a umbilicahs)\
Peritoneumparietale \ - Ampulla rectii
Plicae transversaerecti
Linea alba -
- Excavatiorectouterina'**
Plica umbilicalismediana -
(Lig umbilicalemedranum)
- Fornix vaginae, Pars
Fascia pelvis parietalis - posterior
lsthmus uleri - - - -
Portio uag,nalisceruicis
Uterus, Facies vesicalis - -
Ostiumuteri

Excavatiovesicoulerna -'
-
Glomus coccygeum

\ Fascia rectovaoinalis
Ostiumurethraeinlernum-' lseptum rectoviginalel

',1
I
I \
I ll \
Corpusclilondis, clitoridrsI
Corpuscavernosum tl \
tl \
Frenulumcliloridis ll \
,l \ \ Ostiumureteris
LabiumminuspudenoiI
I \
Ostium urethrae exlernum
LabiummaluspudendrI

Fig. 1146 Pelvis,Pelvis,of a female;

mediansection;the intestinehasbeenremoved,
exceptfor parts of the sigmoidcolonand rectum;
lateralview (r.).
* clinical: vesico-vaginal septum
** clinical:sacro-uterineligament
*** clinical: Douglas's
space
 Petuicviscera
254

I/ rectus abdominisl M transversus, M obliquus inlernus abdominis

Colon sigmordeuml abdominisl M obliquus externus abdomrnrs
ileuml cotondescendenl I
i I Crista iliaca
r

M psoas maiort' 1/ v itiacainternal I I Anicutatio lMsluleusmedius

\
A i l i a c ac o m m u n i s / V rliacaexternal sacrorlraca I \ M iliacus
I M gtuteusmaximus

Fig. ll47 Pelvis, Pelvis; In the sigmoid and the descendingcolon the contrast medium
cross-sectionalimage through the first sacral segmentobtained has mixed with the contentsof the intestine,whereasthe
with computedtomography (CT);a contrast medium has been caecum is almost completelyfilled with the contrast medium.
introduced into the colon with the patient lying on his back; The thickness of the subcutaneousfat in the gluteal region is
inferior view quite marked in this patient. This is of importance during
* calcificationin the wall of the common iliac artery intramuscular injections,becausemany medicinesshould only
be injected into the musculature,but not into the adiposetissue.
Compareto Figs. 1342and 1343.
 Omentum malus
I
L r n e aa l b a l reclalrssupeflor
loA
Colon srgmoideum sigmoideae
I \ I raAa
A iliaca communrsO tl
\ t\ I i .rrt'""'':"0:"-Tlll:
V i l i a c ac o m m u n i sa / / OA ePrgaslrrcarnferror
\
Ureler\
/ |eum

- a M . o b l i q u u si n l e r n u s
z' aDOOmlnlS

/ O l\'4lransversus
/ aooomtnts

_- j M..obliquus
EXIETNUS
abdominis

- - Colon
oescenoens

-- a M itiacus
-- A l a o s s i si l i u m

- a M .g l u t e u s
meorus

-- Os sacrum,
Pars lateralis

\ Os sacrum,
AiVgluleasupenoroa/ Proc arlicularissuperior
/ I
Lrgg sacroiliacarnterossea/ I \a M gluteusmaximus
Catdaeguna I
,/ I \ Spina iliaca posteriorsuperior
V e ( e b r a l u m b a l i sV / flavuml \
I VertebralumbalisV, Proc articularisinferior

Fig. 1148 Pelvis,Pelvis;

transversesectionthroughthe fifth lumbarvertebra;
inferior view.
This sectionwasobtainedfrom a differentindividual
thanthe sectionsin Figs.1140to 1142.Thesigmoidcolon
reachesfar superiorly,the top of its loophastherefore
beensectioned. Thethicknessofthe subcutaneous fat in
the glutealregionmustbe takeninto accountduring
intramuscular iniections.
 Pett,icviscera
256
/, Funiculusspermalicus
/, ry,M Pectineus
/
, Nodus lymphoideus
7' inguinalrssuperticialis,
,/ Nodussuperomedialis
// 7.v femoralis

B u r s as u b t e n d i n e ai l i a c a\
M s a r t o r i u s* \ \ t,
M r | o p s o a ss - - - )
M rectus femoris * :
tF---
A:VobturatoriaO+- a A profunda lemoris
Lig capilis ----
lemofls 'l'opsoas
\-- #M
Femur -
Capul femoris
-
Zona - - Bursa
ororculans subtendinea
l\4 tensor& - iliaca
lasctae
talae

F e m u r ,-
Trochanter
malor
vesicalis

M g l u t e u s*
I
meorus
i
/ i los iscnit
A c i r c u mlfe x a O I Bursasubtendinea
f e m o r i sm e d i a l i s interni
musculiobluratorii
la A;Vpudendarnterna
V circumllexafemoris medialrs Os coccygis' I
Fectuml G l a n d u l av e s i c u l o s a

F i g . 1 1 4 9 P e l v i sP , e l v i so, f a m a l e ;
t h r o u g ht h e l e s s e rp e l v i sa t t h e l e v e lo f t h e
t r a n s v e r s se e c t i ( ) n
s 1m J r hsl i s ;
i n f e r i o rr i e u
B e c a u so e f t h e s l i g h ta s y m m e t r yo f t h i s l l e l v i st h e h i l l i o i n t h a s
l ) e e ns e c t i o n e a( lt r l i f f e r e nIte v e l so n t h e l e f t a n d o n t h e r i g h t .

M reclus abdominrs O sp u b i s ,
\ I
S y m p h y s i sp u b i c a I / M iliopsoas
\ --. I
M p e c t i n e u s\ \
I
/ M sartonus
I
/ lvl reclus lemoris
M obluraloflus Internus \

_- l M l e n s o r f a s c i a el a l a e
F o s s a a c e t a b u l i- -

- - Vesrcauflnaria

N i l mg l u l e rm e d r u se l m r n r m u s- -
- * Glandula vesiculosa

F e m u r T r o c h a n l e r m a l o r_ _
-.. M obturatoriusexternus

--
M g l u t e u sm a x i m u s - - N ischiadicus

Spinaischiadical
I i \ Fossa rschioanalis
lV1.
levatorani' I
/
Rectum l\,4ischrococcygeusIM coccygeusl

Fig. 1150 Pelvis,Pelvis,of a male;

cross-sectionalimage through the lesserpelvis obtained
with computedtomography (CT);the patient is lying on
his back;sectionsimilar to Fig. 1149;
inferior view.
* calcification in the medial
Dart of the femoral artery
 N,4itiacus
t L r g .p u b i c u ms u p e n u q pubrca
I 1S y m p h y s r s la V. femoralis
Spatiumrelropubicuml | | V e s r c au r i n a r i a V , A o b l u r a t o r i aN
: obluratorius
M .s a rustI i i la O
I M peclineus*l tl | | lOspubis I I
l\y'rectusfemorls /OAfemoralis
I I I I p r o fu n d a l e m o r i s
I ./ y O A.
N femoralis

M lensora -

/
M vastust
lateralrs
A r t r c u l a t t/o
coxae /
Femur/
C o l l u ml e m o i l s
/
M psoas malor | /
Tendo / \ N rschradicus
N I o b t u r a l o n u se x t e r n u s a/
\
N cutaneus
B u r s as u b t e n d t n e am u s c u l t / lemofls poslerior
o b t u r a l o fr lr n t e r n:rT u b e rt s c h t a d t c u n r tt a"rru^l \
1 A . o l u t e ai n f e r i o r
M g l u t e u sm a x i m u s a / / Corpus anococcygeum
F o s s ar s c h r o a n a l i s \-
a lM levalor ani N g eus Interior
l \ 4 o b t u f a l o n u sI n l e r n u s { */ [L S anococcygeum]
Vagrna I I V : A p u d e n d ai n t e r n a .
E x c a v a t r or e c t o u l e r r n a l N pudendus

Fig. 1151 Pelvis,Pelvis,of a female;

transversesectionthrough the lesser pelvis at the level of the symphysis;
inferior view.

V s a p h e n am a g n a \ M pecttneus
A. femoralts\ \ Os pubrs
'\ ,
A prolunda lemorrs1 t,,
| , S y m p h y s r sp u b r c a

N l s a r l o n u s\ \

[,4 rectus femoris- _

V femoralis
l\,4rliopsoas .-. _
Vesrcaurinaria
M l e n s o rf a s c t a el a t a e- -
-- Vagrna
-
M vastus lateralrs-

- - Reclum Ampulla recti

Femlrr _
Collum femors

M o b t u r a t o n u se x l e r n u s- - - -- Fossa ischioanalis

R a m u so s s i st s c h | ; -
T u b e rr s c h i a d r c u m

/
N rschradrcus/

Fig. 1152 Pelvis,Pelvis,of a female;

cross-sectionalimagethroughthe lesserpelvisobtained
with computedtomography(CT);the patientis lying on
her back;sectionsimilar io Fig. 1151;
inferior view.
t remainins contrast
medium in the inkrstine
 Petuicviscera
258

,, OAa sigmoideae
Pefltoneumparietale ,/ v i l i a c ai n t e r n a
\
\
(t
tl

,; g) N
il, ,)t J o
Ee i

Appendicesomenlales - - - -Colon sigmoideum

Iepiploicae]

,'il- . \ ' '

0
\.
;'r--
ir)
Ductus delerens - - -E-=i

\ ..:ft
- - . * M o b t u r a t o r iiunst e r n u s

Ampulla recti - -
- - - levalor anl
1M

Fossa ischroanalis - -
OVtA pudendainterna'

\
Columnae anales -- - -Tuber rschiadrcum

- - g M b i c e p sl e m o f l s ;
M semilendinosus;
M semimembranosus

Qr

151(

C u t i s/
lv1 sphincterani internus s N4

Fig. 1153 Pelvis,Pelvis,of a male;

frontal section through the lesser pelvis;
ventral view.
* clinical: AlcocK's canal
 - - Discusintervertebralis
Vesica urinaria\

-- M gluteusmaximus

Corpusossisilium-

Caputfemoris-

Prostata-

- externus
M obturalorius
--
Urethramasculina

-- M vastuslateralis
penis-/
Corpuscavernosum

penis-'
Corpusspongiosum - (Mm adductores)

Fig. 1154 Pelvis,Pelvis,of a male;

sectionalimagein the frontal planethroughboth hip joints
obtainedwith magneticresonancetomography(MRT);
ventral view.

M psoasmalor

M iliacus
Cavrtas uteri \

Corpus uteri \
M gluteusmaximus

- M gluteusmedius
Corpus ossis ilium -

Caput temoris -

- M obluratoriusinternus
Collum femoris -

Tuba ulerina / - M obluratoriusexternus

Vesica urinaria /
- (Mm adductores)

Fig. 1155 Pelvis,Pelvis,of a female; Whenthe bladderis empty,the uteruslies on its roof due to the
sectionalimage in the frontal plane through both hip joints, anteflexion.
obtainedwith magneticresonancetomography(MRT);
venftal view.
 Petvicviscera
260

lProstata
i l\il levator ani
Ostium urethrae inlernum

Ostium uretefls \
--\
\
A vesicalissuperior O 1

Fossa acelabuli ..
\ t. tt '\

-- Capul
femoris

Cruspenis - _
o
o.

---olfA v
Iil iliopsoas, f -- circumllexa
Tendo lemoris
I medialis
t\
M q u a d r a l u sa - - - I

femoris I I
I I
I I H a m u sr n r e n o r
M a d d u c t o ri -- I I o s s r sp u b i s
mtntmus I I
I
I
M a d d u c t o&r ' - - U
magnus

Mm * -'-
ischiocrurales
N pennealrs

masculrna
P e n i s .C o r p u ss p o n g r o s u m

Fig. 1156 Pelvis,Pelvis,of a male;

angular section through the urinary bladder;
ventral view.
' clinical:paracystium
'* clinical: venous plexus of the prostate
 Petvis26I

/ U r e t h r al e m i n i n a

Vesrcauflnarial
lV1obturaloriusinternuse
N . o b l u r a l o n u s .a a - I
A . V. obturalofla

-- Acelabulum

M e m b r a n a- _ - - Caput lemoris
oDluralofla

M o b t u r a l o f l u s s- - t /- aa V.tA.
puoenoa
externus interna:
N pudendus
N perinealrs
-- f (Diaphragma
M iliopsoass \\\ urogenrtale)

- - Flamusossis
[/ adductor* \ rschii
brevrs - -
- - Crusclitoridrs
A Drolundaa
'lemoris. -
-r
Aa circumflexae S iil ischio-
cavernosus
f e m o r i sm e d i a l i s
et laleralis
I
V prolundao --
lemoris,
'fl, - -
Bulbus
vestrbuli

Vv circumllexae --
f e m o r i sm e d i a l i s * N4 brlbo-
el lateralis spon9rosus

M adductor* --
l o n gu s .tK

\ L"bi" majus
pudendi
" BlillffiJ:f;ilffbr,",n,,

Fig. 1157 Pelvis,Pelvis,of a female;

angular section through the urinary bladder;
ventral view.
* paracystium
withvenous
plexus
 Lowerltmb
262

----Os sacrum
Spinailiacaanteriorsuperior---
--- (Sulcusanalis)
M. lensor fasciae latae ---
--- R€gioglutealis,
Regioinguinalis,-- M. oluteusmaximus
Lig. inguinale
- - Trochantermaior(Femur)
Trochanter-!- -- - Sulcusglutealis
major(Femuo
Regiofemoris---
anlerior

M. sartoiius---

M. quadriceps
lemoris
---.i

Begiog€nusanierior,- -

Caputfibulae ---
libiae --
Tuberositas

>---M. gastrocnemius

---B€gio crurisposterio(
R€giocruris
anterior

Margo ante.ior (Tibia) - - -

/ Malleolusmedialis(Tibia)

Malleolusm€dialis(Tibia)\
\ / Malleoluslaleralis(Fibula)
Malleoluslateralis(Fibula)\
---Dorsum pedis
Do6um p€dis \\\
Digitusminimus\
i;;ii:it:'i---
Digilusquarlus ---
DioiluglErl;uE//
itr'r"|"".", i
"
Hallux[Digitusprimusl I

Fig. 1158 Lowerlimb, Extremitasinferior; Fig. 1159 Lowerlimb, Extremitasinferior;

surfaceanatomy; surfaceanatomy;
ventralview (r.). dorsalview (r.).
 Pelvic Girdle, Cingulum membri inferioris

Promontorium
\
Tuberositasiliaca
\
Os sacrum, Pars lateralis
\
-\
Artrculatiosacrotliaca\ \\
'!.i' / Ala ossis ilium

,w F o s s ai l i a c a

-)l I .t
lr,
Linea termrnalis\ ,-'
+--
\
I
l
I

-- Tuberculum
iliacum
--
Lrneaarcuata

O s i l i u m/
- -
-f Spina iliaca anterior
7- supeflor
-
Spina iliaca anterior inferior
-
Spina ischiadica
O s i s c h i i/ --
/ --
Eminentiailiopubica
Articulatiosacrococcygea/ t " . , " n o s s i sp u b i s
1\
Ramussuperiorossispubis
t\ Tuberculumpubicum
I
I S y m p h y s i sp u b r c a

Fig. 1160 Sacralbone, Os sacrum, and pelvic girdle,

Cingulum pelvicum;
ventrosuperiorview (407o).
The spaceabovethe Linea terminalis is called the greater
pelvis, Pelvis major, the spacebelow it the lesser pelvis,
Pelvis minor.

connections of the bones of the pelvic girdle, Iuncturae cinguli pelvici

: ':. ,.1 ''
Name Possiblemovements
,. lDe
,,,,,, .',',;:',,"
Pubicsymphysis, Cartilaginous
Symphysispubica synchondrosiswith
Discusinterpubicus
Sacroiliacjoint, Rigidjoint,
Articulatiosacroiliaca amphiarthrosis Displacement and rotationof a few
Ligg.sacroiliacaanteriora Syndesmoses, millimeters,associated with the deformity
Ligg.sacroiliacaposteriora fibrousjoints of the pelvisas a unit undervarious
Ligg.sacroiliacainterossea weight-bearingstresses
Lig. sacrotuberale
Lig. sacrospinale
Lig. pubicumsuperius
Lig. pubicuminferius
264 LowerLimb

:- - - Articulatiosacroiliaca
Cingulum I
pelvrcum Os coxae -

-J-f =--- A r t i c u t a tci o x a e

Femur

Patella -
(Articulatiolemoropatellaris)
f
- - Artrculatiogenus {Arlrculaliomeniscofemorahs)
1
(Articulatiomeniscotrbialis)
L
Pars libera
membri inferioris
\ Articulatiotibiolibularis

Crus

/ Svndesmosistibiofibularis

/ Articulatiotalocruralis

/ Articulatiocalcaneocubordea
- - Articulalrosubtalaris )
(A'1'"'l"l'o lalotarsalls)
Tarsus,Ossa tarsi --Articuralro larocarcaneonavrcrr"riaJ
F- - Articulahocuneonavrculafls

Melalarsus, ]-- lerticulatiocuneocuboidea)

Ossa melatarsi \\ \ Articulationesintercuneiformes
Pes -
Articulationestarsometatarsales

Digiti pedis,
Ossa digitorum: ---
- Phalanx proximalis
- Phalanx media Arliculationesmetatarsophalangeae
----
- P h a l a n xd i s t a l i s Articulalionesinterphalangeaepedis

Fig. 1161 Lowerlimb, Membruminferius;

demonstrationof the skeletonand the articular regions;
ventralview (r.).
 Ioints of theLowerLimb

Ioints of the lower limb, Articulationesmembri inferioris liberi (Fig.1161)

"265
Ioint Type ofloint

Hip joint j oint,

Ball-and-socket Flexion(anteversion),
Articulatiocoxae Articulatiospheroidea extension(retroversion),
abduction,
adduction,
medialand lateralrotation,
circumduction

Knee ioint Pivot-hingejoint, compound: Flexion,extension;

Articulatiogenus 2 condyloidand 1 sellar, medialand lateralrotation
Articulatiotrochoidey'Ginglymus (only possiblein flexedposition)

Proximal tibiofibular joint Rigidjoint, Limitedmovementin transverse

Articulatiotibiofibularis(superior) Amphiarthrosis and verticaldirection,limited
rotation

Distal tibiofibular joint Fibrous, Bonesslightly separatein

Articulatiotibiofibularis(inferior) Articulatiofibrosa dorsalfl exionof Articulatio
talocruralis

Ankle ioint Hingejoint, Plantarflexion

Articulatio talocruralis Ginglymus Dorsalflexion

Intertarsal joints Spheroidjoints,compound, Lift the medialborderof the foot

(Articulatiotalotarsalis) multiaxial,synovial (supination)
a) Articulatiotalocalcaneonavicularis Lift the lateralborderof the foot
(anteriorpart) (pronation)
b) Articulatiosubtalaris
(posteriorpart)

Articulatio tarsi transversa Rigidjoints, Minimal gliding and rotation,

(CHormr'sjoint line) Amphiarthroses hold the longitudinalarchof the
a) Articulatiotalonavicularis foot (fladoot)
b) Articulatiocalcaneocuboidea

Tarsaljoints Rigidjoints, Minimal gliding and rotation,

a) Articulatiocuneonavicularis Amphiarthroses assistin inversionandeversion,
b) Articulatiointercunei
formes assistin gripping the ground
c) Articulatiocuneocuboidea while walking

Tarsometatarsalj oints Rigidjoints, Minimal gliding,supination

Articulationestarsometatarsales Amphiarthroses and pronationof the forepart
joint Iine)
(Ltsrnn'trc's of the foot

Interrnetatarsalj oints Rigidjoints, Assistin rotaungthe forepart

Articulationesintermetatarsales Amphiarthroses of the foot

Metatarsophalangealj oints joints

Limitedball-and-socket
Articulationesmetatarsophalangeae
Flexionand extension
of the toes
Interphalangealjoints Hingejoints,
Articulationesinterphalangeae
pedis Ginglymi
266 Lowerlimb

Os ischii -

Fig. 1162 Hip bone,Oscoxae; Fig. 1163 Hip bone,Oscoxae;

extentof its thlee osseousparts in the neonate; extensibnof its three osseousparts at differentages;
lateralview (r., 110%). lateralview (r.).
' here about 6 yearsofage

Crista iliaca (cartilaginea)

Alaossisilium----

---- Corpusossisilium

--- Eminentia
iliooubica

Corpusossispubis

---- ossispubis
Ramussuperior
Corpusossisischii ----

Tuberischiadicum(cartilagineum)
--- Ramusinferiorossispubis

Bamusossisischii-----

Fig. 1164 Hip bone,Oscoxae; The threeparts of the hip bonejoin in the acetabulumto form
stage0f developmentin a 6-yearoldchild; a Y-shapedcartilaginousjunction.Theyfusebetweenthe ageof
lateralview (r., 90%). 13and 18.
 ,*3* d- ff
HipBone,
oscoxae
,*,. ffi ft
C r i s t ai l i a c a- - -

Linea intermedra- -

/ Ala ossis ilium

Labium inlernum - _ -

-- Faciessacropelvica

-- Tuberosiiasiliaca

-- Faciesauricularis

- - Spinailiacaposteriorsuperior
Soina iliaca ----.,L
anterior inlerior t - - - Spinailiacaposteriorinferior
Linea arcuala - -

- Incisura
ischiadica
major
E m i n e n t i lai o p u b i c-a- - i

Sulcusobturatoriur- - -
$; Corpusossisischii
ossispubis Spinaischiadica
Pectenossispubis
Incisura
ischiadica
minor
Foramen-
obturatum (Tuberculum posterius)
obturatorium

Facies symphysialis- -
Fig. 1165 Hip bone,Oscoxae;
Bamusossisischii- - -
/ medialview (r.,50%).
Bamusinleriorossispubis/
Thethin areain the centreof the ala of the ilium, Ala ossis
Tuber rschiadicum/ ilium, is a characteristicstructuralfeatureof the pelvis.

Labium ---
internum
L i n e ai n t e r m e d i-a- - 1 ,
_-- Tuberositasiliaca
- - - Alaossisilium
Labium ---+
externum

- - Faciessacropelvica
rossaitiaca----!-
Spina iliaca anlerior superior ---\
-- Faciesauricularis

-- Corpus ossis ilium

,, Eminentia iliopubica

/, Corpusossispubis
/ Ramrs superiorossispubis
,
\ / /cristaobturatoria
I ossispubis
,Peclen
; I ,Tuberculumpubicum
*\ /' ,cristaoubica

Corousossisischii -- Facies
symphysialis
(Tuberculum posterius)//
obturatorium
/ (Angulusossispubis)
Foramenobturatum/ --
BamusinferiorossisDubis
Fig. 1166 Hip bone,Oscoxae; ---
Tuber ischiadicum z/ Ramusossisischii
ventralview (r., 50%).
268 Lowerlimb

:--- L a b i u mi n l e r n u m
--- Linea intermedia
Alaossisiliurn- - -

- - A l a o s s i si l i u m

- - - - - Spina rliacaanteriorsuperior
(Tuberositas
musculi
gluteimaximi)

superior----
Spinailiacaposterior
- - - Corousossisilium

Spina iliaca ooslerior inferior- - - - - Spina iliaca anteriorintenor

--- Sulcussuoraacetabularis
Incisuraischiadicamajor /

Limbus acetabu[ [Margo acetabuli]- _ --- Facies lunata

_--- F o s s aa c e t a b u l i
Incisuraacetabuli -
- - - Pectenossispubis

Spina rschiadica- - _-- Cristaobturatoria

Incisuraischradrcaminor - -' --- pubicum
Tuberculum

- -
(Tuberculum - -
postenus)
obturatorium Ramus inferiorossis oubis

-
Corpusossisischii-
\ Tuberculumobturatorium
anreflus
\ Foramen
Tuber rschiadicum'- obturatum

\ Ramus ossis ischii

Fig. 1167 Hip bone,Os coxae;

dorsolateralview (r.,5070)

/, Promontorium
Articulatio \ /, Promontorium
sacroiliaca \ / Otamelel
,z lransversa

Diameter - -
\ Linea terminalis obliqua ll
Eminentia iliopubica \
I Conjugata vera
/
Eminentra iliopubica
\ Symphys,s
puoica pubica
Symphysis

Fig. 1l6B Pelvis,Pelvis; Fig. 1169 Pelvis,Pelvis;

form of the pelvic inlet in the male; form and measurementsof the pelvicinlet in the female;
supenorvlew. supenorvlew.

Differencesbetweenthe male and femalepelvis

In the:male the inlet of the pelvis is clearly narrowedby the Arcus pubicus.The lateral parts of tbe pelvis aXeJlatter s,nd
promontoriumof the 0s sacrum.The femalepelvis has a more broaderin the female.The maximumdiameterofthe Foramen
oval-shapedinlet. The rami of the Ospubis form a right angle obfuratum is found in the transverseplane in the female,but in
in the male, Angulus subpubicus,but an arch in the female, the vertical plane in the male.
 Petvis
;169

a-a = Crestal dislance, Diametertransversaof

Distantiaintercristalis the pelvic brim
29-29 cm' (= interacetabularline)
Anteriorspinal distance, 12-12,5 cm
Distantraintersprnosa e€= Diameler lransversaof
anterior25-26 cm' the pelvrcconslriction
Posleriorspinal drstance, (= interspinalline)
DislantiaInterspinosa 1 0 , 5c m
posterior(widlh of the Fig.1170 P e l v i sP
, elvis; Diametertransversaof
s a c r u m )| 0 c m variousmeasurements of the pelvisin the female; the inleriorpelvicaperture
Due to perspective (= tuberal diameter)
reasons the crestal dorsalview. 1 1 - 1 2c m
distance appears shorter
lhan lhe spinal distance

K_K = Pelvic axis, Axis pelvis h-d = Clinical:Diameler

Clinical:Conjugata sagittalisof the pelvic
anatomrca b r r m 1 2 - 1 2 , 5c m
Clinical:ConJUgata e-€ = Clinical:Drameter
d i a g o n a l i s1, 2 , 5 - 1 3c m sagitlalisol the pelvic
Clinical:ConJugata constriction11-1 1,5 cm
v e r a , 1 0 , 4 - 1 1c m e-f = Diameler sagittalisol
the inferiorpelvic
aperture (= Distantia
puoococcy9ea)
9-10 cm

Spina iliaca anterior

- - Foramen ischiadicummaius

pelvissuperior*
Apertura
-- Lig sacrospinale

-- Lig sacroluberale

- minus
F o r a m e ni s c h i a d i c u m

Foramen obturatum -

\ Tuber ischradicum

Fig. 1171 Pelvis,Pelvis; * The Linea terminalis forms the upper margin of the pelvic inlet - also called
pelvic brim (Apertura pelvis superior).Line a-c shows the plane of this inlet
various measurementsof the pelvis in the female; median section;
The pelvic outlet (Apertura pelvis inferior) is bounded by the tip of the coccygis,
medial view (r.). the ischial tuberosities, the rami of the ischium and the inferior pubic rami.
 LowerLimb
270
VerlebralumbalislV Lig longiludinaleanterius
/,/

Ligg sacroiliacaanteriora\

Spina iliaca anterior superior \

Lig inguinale

Lig pubicumsuperius--

Lig iliofemorale

- Arliculatio coxae,
Trochanler major Caosula articularis

- Membranaobturatoria

I
l' A
. -n g u l u s
subpubicus

Fig. ll72 Ioints ofthe pelvis,Iuncturaecinguli

pelvici,and of the lumbosacralregion,Articulatio
lumbosacralis,in the male;
ventroinferiorview (30%).

/ VertebralumbalislV

Ariiculatio sacroiliaca

Canalis obluratoriua --_

iliofemorale

Trochantermajor --

I
I
I
Tuber Arcuspubicus
ischiadicum

Fig.ll73 Jointsof the pelvis,functuraecinguli

pelvici,andof the lumbosacralregion,Articulatio
lumbosacralis, in thefemale;
ventroinferiorview(30%).
 Petvis
2? I
Vertebra lumbatislV, Corpus 1
ta
VertebralumbalisV, Proc costalis ..

Cnsta iliaca \

/ - Fotamen ischiadicummajus

Spina iliaca anteriorsuoerior

-- Lig sacrotuberale
Lig inguinale
--- Lig sacrospinale

Lacunamusculorum - - - i,ll rectusfemoris,Tendo

Arcusiliopectineus -- Foramenischiadicum
minus

-
Trochantermajor --
-
Artrculatiocoxae,
Lig iliofemorale

\rz'W
I I
lAngutus I
I
subpubicus For"a"n
obluralum

Fig. 1174 Jointsof the pelvis,Iuncturaecinguli

pelvici,and of the lumbosacralregion,Articulatio
lumbosacralis, in the male;
ventrosuperior view (30%).

Vertebralumbalis lV, Corpus

Vertebralumbalis V Proc costalis \

Crista iliaca

-- Foramenischiadicum
maius

-- Lig sacrospinale
Sprna iliaca anteriorsuperior ---

L i g i n g u i n a l e- - - -

- - - Foramen ischiadicumminus
L a c u n am u s c u l o r u m - - - -
-- M rectusfemoris,
Tendo
- --
Arcusiliopectineus
/
Trochanler malor z/ |
Lacuna /
vasorum
I
I I
' Arcus I Foramen
pubicus obluratum

Fig. 1175 Ioints of the pelvis,Iuncturaecinguli

pelvici,and of the lumbosacralregion,Articulatio
lumbosacralis, in the female;
ventrosuperior view(30%).
 2 LowerLimb
21

/ Lig iliolumbale
Lig supraspinale\
/ Ligg sacroiliacaPosteriora
Ligg sacroiliacaposteriora \

Lig sacrotuberale \\
- Articulatiocoxae,
--- Capsula arliculafls

\ Trochantermajor

\ Lig sacrospinale
ri. I
Lig sacrococcygeuml
posteriussuperliciale L i g p u b i c u mi n f e r i u s

Fig. 1176 Jointsof the pelvis, Iuncturae cinguli

pelvici, and of the lumbosacral region, Articulatio
lumbosacralis, in the female;
posteriorview (30%).

mediana
Lr9. SaCrOcoCCygeUm /, Crista sacralis
\ Soina iliaca PosteriorsuPerror
oosleflus supenlclale \

/, Lig sacrotuberale
Foramen ischiadicummaius

/ Lrg sacrospinale

Foramen ischiadicummrnus \
| / Ptoc
falciformis

/, Trochantermajor

Articulatiocoxae, -
Capsula articularis

I
Tuber ischiadicum Lig pubicum interrus

Fig. ll77 Jointsof the pelvis,Iuncturaecinguli

pelvici,in the female;
inferiorview (307o).
 Petvis
273
I Canalissacralis
Ligg sacroiliacaposteriora Li99 sacroiliacainterossea
\ i t
lt
Articulatio sacroiliaca
/
Lrgg sacroiliacaanleriora
\
/, Lig sacrospinale

/ Fo'amen ischiadicum
Lig capitisfemoris majus

Caputfemoris / Lig.sacrotuberale
\
\ Foramen ischiadicum
/
Cavilas articularis \ mrnus
\
Zonaorbicularis- .j

\-:,

obturatoria/
Membrana
I
Symphysis /
pubica,Discusinterpubicus Lig capitis femoris

Fig. 1178 Jointsofthe pelvis,Juncturae cinguli

pelvici,in the female;
frontal sectionthroughthe centreof the acetabulum.
ventralview (30%).

Vertebra
lumbafts
V,Corous _ - Foramen inlervertebrale

Articulatiolumbosacralis, ---
Discus intervertebralis
os sacrum
---

Spina rhacaanteriorsuperior _ _

Sprna iliaca anteriorinferior _ _

- - Foramenischiadicummajus
Lineaarcuata
f
Lineaterminalis,l -- - Lig sacrospinale

Pectenossispubis
I r--Oscoccygis

-\
Foramenischiadicum
minus

\ Lig sacrotuberale

--
Foramen
obturatum

Fig. 1179 Ioints of the pelvis,.Articulationescinguli pelvici, Usuallythe anteriormarginof the lowestintervertebraldisc is
and of the lumbosacralregion, Articulatio lumbosacralis,in the the mostprominentpoint of the posteriorboundaryof the pelvic
female; inlet. Themostventralpoint of the sacralbone,which is also
median section; visibleon radiographs,is calledthe promontory.
medial view (35%).
 LowerLimb
21 1
ArtrculatiozygaPoPhYsialis
I
I

Ligg sacroiliacainterossea--

\ os sacrr.

anteriora
Ligg sacroiliaca

F i g . 1 1 8 0 S a c r o i l i aico i n t ,A r t i c u l a t i os a c r o i l i a c a ;
frontal section;
v e n t r a lv i e w ( 1 . 4, 5 % ) .

librosa
Cartilago
Discusinterpubicus,
Ramussuperiorossispubis\ (CavitassymPhYsialis)'
r superius\
Lig Pubicum /,
, Cartilagohyalina
,

Fig. 1181 Pubicsymphysis, Symphysis pubica;

obliquesectionalongthe longitudinalaxis of the pubic
symphysis,slightly inclinedto the frontal plane;
ventroinferiorview (60%).
Theinterpubicdisc consistsof fibrouscartilagewith exception
of the surfaceadjacentto the symphysialsidesof both pubic
boneswhich are hyalinecartilaginous.
' Fromthe 10thyearof life this longitudinalflat cleft occurs'
 ')'7 tr
Petvis
^LIJ

Proc spinosus
/
/ Ptoc articularis
superior
Basis ossis sacri / Vertebra
lumbalislV
\ z Pediculusarcus verlebrae
,/
C?T
Cflsta rhaca t Proc coslalis
\ t' /

Spina iliaca\
^^clari^r
supeflor Os sacrum,
Pars lateralis
Spina iliaca \
posterior
interior
Arliculatio
sacroiliaca
Ala ossis ilium\

Spina iliaca- Foramina

anleflor sacraIa
supeflor anteriora
Ltnea-
arcuata

S p i n ai l i a c a -
anterior - Os sacrum
inferior

Articulatio
coxae, Cavrtas
articulafls
Spina - Fossa
ischiadica acelabuli

Fovea capitis
Capul -
femoris
femoris

Eminenlra
Trochanter- iliopubrca
malor
Collum-
temoris

Crista inter--
trochanterica Tuber
ischiadicum

Trochanter- Foramen
mrnor obturatum

t Tuberculum
Pubicum
\
\ os coccygis

pubica
Symphysrs

Fig. 1182 Pelvis,Pelvis,of a male;

AP-radiograph;the patientis standingupright;
the centralbeamis focusedon the third sacralsegment.
21 6 Lowerlimb

Collumfemoris
I Caputfemoris\
/ Fovea capitistemoris Fovea capitis \ /, Trochantermaior
lr' femoris \ -l
- Caputfemoris
- Tuberculum
quadratum
\ collumremoris
\ t crista
Lineainlertrochanterica
intertrochanlerica
\ Trochanterminor Trochanlerminor/'

Lineapectinea-- \ (Trochanter
tertius)
\ Tuberosilas
glutea

Linea.supracondylaris
z _- |ateralrs
-- Linea supracondylaris
meotails

_- Facies poplitea
Tuberculumadductorium
/
- Epicondylus
lateralis

Epicondyluslateralis/ \ Epicondylusmedialis

Faciesoatellaris Condylusmedialis/ t condyluslateralis

,/ \
/
Lineaintercondylaris \ Fossaintercondylaris

Fig. 1183 Femur,Femur; Fig. 1184 Femur,Femur;

ventralview (r., 30%). dorsalview (r., 30%).
 Fossatrochanterical
Caputr
femoris

Fovea
capitis
femoris

Collumlemoris-

-
Cristaintertrochanterica

Trochanterminor-

Lineapectinea-

Linea asoera. -
Labium mediale

Fig. 1186 Femur,Femur;

variationof the angleof the femoralneck;
Fig.ll85 Femur,Femur; dorsalview(r.).
proximalend; Thisangleis alsocalledthe collodiaphysealangle.
dorsalview(r.,60%). It measures1500in the neonateandabout126"in
theadult.

Fig. 1187 Femur,Femur; Fig. 1188 Femur,Femur;

strucrur€ of the trabecularbonein the Coxavalga (grear structure of the trabecularbonein the Coxavara (small
collodiaphyseal angle);the bonehas beensectionedin collodiaphyseal angle);the bonehasbeensectionedin the
the planeof antetorsionof the femoralneck(60%). planeof antetorsionof the femoralneck (60%).
Thelateralplates(') of trabecularbone("tensilesystem") Thelateralplates(.) of trabecularbone("tensilesystem")are
are hardly developed, the medialplates(**) oftrabecular well developed,the medial plates (* * ) of trabecularbone
bone("compressive system")are well developedto transmit ("compressivesystem")are hardly developed.The cordcal bone
forcesfrom the femoralheadto the neckand shaft. on the interior sideof the femoralneckis particularlythick
reflectinghigh bendingstress.
278 LowerLimb

Caputfemoris / Fovea capilis lemons

/Trochanter maior

Collum femoris l==----i-

- - -Trochanler minor

Fig. 1190 Femur,Femur;

variationof the angleof antetorsion;the proximalend
of the femur hasbeenprojectedoverthe distal end;
proximalview (r.,70%).
In infantsthe angleof antetorsionmeasures
approximately30", in adultsabout 14".

---Facies poplitea

- Tuberculum
adductorium
_-
- Fossa intercondylaris
- - \
Epicondylusmedrahs Cavilas medullaris
---Condylus lateralis

t! lL"o'u. mediale) . .
I i
lCondylus r
'Labium l Lineaaspera
medialis laterale )

Fig. 1189 Femur,Femur; Fig. 1191 Femur,Femur;

medialview (r.,30%). crosssectionthroughthe middleof the diaphysis;
distalview (r.)
 PetvisandFemur
ng

O s i l i u m-

- Symphysis pubica
Os pubis -

minor* -
Trochanter

Os ischii -

Fig. 1192 Pelvis,Pelvis,andfemur,Femur; * osseousroofof the acetabulum(acetabular roo0

* * Y-shaped
AP-radiographof a femalefetusborn prematurelyin the eighth iunctionin the baseof the acetabularfossa
'* * Theossificationcentrein the headof the femur appearsbetweenthe third
month of pregnancy. and fifth monthsof life.
. At this agebothgreatertrochantersareonly seenas smallprotuberances of
the boneof the diaphysis

Os ilium

Vertebrae sacrales -

Cartilago
malort -
Trochanter epiphysialis

pubica-
Symphysis

Os pubrs-

obturalum-
Foramen

Os ischii -

Trochanler mtno(* --

Femur, Diaphysts - -

Fig. 1193 Pelvis,Pelvis,andfemur,Femur; * osseous roof of the acetabulum (acetabular roofl

** Y-formed junction in the base of the acetabular fossa
AP-radiograph
of a 12-month-oldmale. *t * ossification centre of the epiphysis of the head of the femur
+ At this age both greater trochanters become apparent only as small
protuberances of the bone of the diaphysis.
 LowerLimb
fS{}
/ caputrectum

/, Lig iliofemorale
Labrumacetabuli
/
/, Lig. capitis
Iemons
M rectus / -
femoris,
Tendo Canalisobturatorius

Caputretlexum/
- - Os pubis,
Faciessymphysialis

- Lig pubolemorale

-. Lig capitis femoris

- Membrana
obturatoria

/Trochanter
minor
- Caout \
recium I M reclus
r--
7
caputll?T31"'
(eltexum )
Fig. 1194 Hip joint,Articulatiocoxae; -- Lig,iiiofemorale;
thejoint capsulehasbeenexposed andthe head Capsula articularis
- -
of the femur hasbeenpartially disarticulated; Labrum acetabuli

Iaterodistalview (r., 70%). -- Faciesiunata

-- Fossa acetabuli

--
Fig. 1195 Hip joint,Articulatiocoxae; Lig capitistemoris
acetabularfossaof the hip joint; the joint capsule - - Canalisobturatorius
hasbeensectionedand the headof the femur has --
Lig transversumacetabuli
beenexarticulated: \ Lig ischiofemorale;
laterodistalview (r., 50%). Capsula articularis

-- Facies lunata
M tensorfasciae latae --
_-- Cavitasarticularis
M gluteus medius -- --- Caputfemoris
--- Fossa acetabuli
M gluteusminimus- - -
- - - Lig capitistemoris
- - - Fovea capitis temoris
M. obturatorius
\ internus

Tendo*---
M gluteusmaximus,
Labrum
musculi- - -
Bursatrochanterica acetabuli
gluteimaximi
musculi- --
Bursatrochanterica M obluratoriusexternus
glutei medii

Tractus iliotibialis--- --- M ilioosoas.Tendo

:---- Trochanterminor
M vastus lateralis - -

Fig. 1196 Hip joint,Articulatiocoxae;

verticalsectionin a planecorrespondingto the angleof antetorsion;
ventralview (r., 65%).
* radiatinginto the iliotibial tract,Tractusiliotibialis
 t,Articutatto
coxae
28I

M. reclusfemoris.Tendo----

- Membranaobturatoria

- Trochanterminor

Fig. 1197 Hip joint, Ardculatiocoxae;

venhodistalview (r., 50%).

Lig. sacrospinale

-- Lig.iliofemorale

-- Collumlemoris

- TrochantermaFl

/
Trochanlerminor /

- Tuberositasglutoa

Fig. 1198 Hip joint, Articulatiocoxae;

posteriorview (r., 50%).
 LowerLimb

Corousossisilium -

- Fossa acelabuli

- Fovea capitis femoris

- Foramen obturatum

Fig. 1199 Hip joint,Articulatiocoxae; * clinical:acetabularroof,the tangentialprojectionof the lunatesurface

* * clinical:mostprominentlateralpart of the acetabulum
in a standingposition.
AP-radiograph *** clinical:KtiHlrn's tear-likefigure,projectionofthe acetabularfossa

- Os ilium

- lncisura ischiadica
maJor

- Cavitas arlicularis'

Caputfemoris -

major -
Trochanter

Trochanterminor -

Fig. 1200 Hip joint, Articulatiocoxae; radiological articular space. This space appears wide because the cartilage
absorbs hardly any X-rays
AP-radiograph; abductionandflexionof the thigh in a patient
who is lying on his back(socalledLluExsretNprojection).
 Femur
283

/ Epicondyluslateralis

Condyluslateralis

Sulcuspopliteus

Fig. 1201 Femur,Femur;

distalend;
lateralview (r.,80%).

Fig. 1202 Femur,Femur;

distal end;
distal view (r., 50%).

Cavitasmedullaris \

Substantiaspongiosd:_

Linea€piphysialis --

--
Epicondyluslateralis

Sulcuspoplileus - -

Condyluslateralis - -
(Cartilagoartiorlaris) /

Fig. 1203 Femur,Femur;

frontal sectionthroughthe distal end;
ventralview (r., 50%).
 LowerLimb

Area inlercondylarisanterior Tuberculum

Facies \ I 1 7 Tuberculum
arlicularis \ medialel
intercondylare / Intercondylare
laterale
- Facies articularis
supeflor
supeflor Facies / Condylus
articularis Condylus\
Condylus/ - Condylus / fibutaris mediaIs lalerahs
laleralis medialis
Eminentia \ Emrnentia/
antercondylaris intercondylaris
Area' I Facies
intercondylaris articularis
Tuberositas/ libularis
tibiae Posterior

Corpus--
tibiae
- Margo medialis Foramen--
nutricium

Facies - -
posterior
- - Facies posterior
Facies mediahs

-- Margointerosseus
- Facies lateralis

- Corpus tibiae

Incisura- Sulcus \
fibularis malleolaris

Facies articularis inferior / Incisura--

fibularis \
Malleolus/ Facies arlicularis
Facies arlicularismalleoli / inferior
medialis \
medialis
Facies articularis/ \ Faciesarlicularis \ Facies arlicularismalleoli
interior malleolimedialis medialis

Fig. 1204 Tibia,Tibia; Fig. 1205 Tibia,Tibia; F i g . 1 2 0 6 T i b i a ,T i b i a ;

ventral view (r., 35%). lateralview (r., 35%). dorsalview (r., 357o).

Tuberositaslibrae
/
Tuberculumintercondylarelaterale

Condylus medialis' \ , Condylus lateralis*

Tuberculum intercondvlare mediale / Area inlercondylarisposterior

Fig. l2O7 Tibia,Tibia,and fibula,Fibula;

proximalview (r., 70%).
* Thearticularsurfacesof the condylestakenas a whole
are calledFaciesarticularissuperior.
 ribiaandFrbuta
285
Apex capitis \ / Faciesarticularis
libulae -- capitisfibulae Capulfibulae

- - Ca9utfibulae

-- Collumfibulae

-- Cristamedialis

- Margoanterior
Margo --
Inlefosseus
-- Foramennutricium
Facies -- -- Faciesposterior
medialis
- - Corousfibulae
Margo
anterior

- Malleolus
-- Fossamalleoli laleralis
laleralis

Fig.1208 Fibula,Fibula; Fig.1209 Fibula,Fibula; Fig. 1210 Tibia,Tibia,and

medialview(r.,35%). lateralview(r.,35%). fibula,Fibula;
dorsalview(r.,35%).

Facieslateralis

- Margoanterior

Membranainterosseacruris - Faciesmedialis
-

Corpustibiae

Margoanterior -_
Facieslateralis - - Margomedialis

Facies medialis - -
Corpusfibulae t Faciesposterior
\
\ Margointerosseus

Crista medialis I

Fig. 12ll Tibia,Tibia,andfibula,Fibula;

crosssection;with the interosseousmembraneof the crus;
distalview (r.,60%).
* openlngfor the anterior tibial artery
 LowerLimb
286

Basispatellae /, Basispatellae

Faciesarticularis
Facies anterior

Fig. l2l2 Patella,Patella; Fig. 1213 Patella,Patella;

ventral view (r., 80%). dorsal view (r., 80%).

Bursasubcutaneaprepatellaris\
Faciesanterior
Patella \ Faciesarticularis,Carlilagoarticularis

Articulatiogenus(Articulatio\ _- Betinaculum patellae mediale

femoropatellaris)
- - (Plica synovialis mediopatellaris)
Retinaculum patellae laterale -

- - Faciespatellaris,Cartilagoarticularis

medialis
Epicondylus

Lig.collateraletibiale

M. biceos femoris --
- M sartorius,Tendo
M gastrocnemius,--
Capullaterale
\ V saphena magna
A poplitea --

V poplitea-' \ M. gracilis,Tendo

\ M. semimembranosus,
Tendo
\ M semiiendinosus.
Tendo
I M. gastrocnemius,
Caputmediale

Fig. l2l4 Patella,Patella,and femur,Femur;

crosssectionthroughthe kneejoint at the levelof
the middleof the femoropatellarjoint; kneejoint
in extension;
didtalview (r.,70%1.
* medial border facet
 Kneeloint, Articulatiogenus
?87
Femur
Femur I
I I

/ M articularisgenus / Faciespatellaris

Condylus\
lateralis \

- Plicae
atares
Retinaculum- -
patellae
laterale

Corpus--
adiposum
intrapatellare

Lig '-
collaterale
fibulare

Caput fibulae /

\ Lig paterrae
\ Bursa
suprapatellaris
\ Tuberositas
tibiae

Fig. 1215 Kneejoint,Articulatiogenus; Fig. f216 Kneejoint,Articulatiogenus;

the joint capsuleis intact; the ventralpart of thejoint capsulehasbeen
ventralview (r.,65%). retracteddistally,the quadricepsmuscle
sectionedand the suprapatellar
bursaexposed;
ventralview (r., 65%).
 LowerLimb
2S$
palellans
/ Facies
*"
posterius
/ Lig cruciatum

/ Condylusmedialis

Condylus lateralis \

-- Meniscus medialis
Meniscus laterahs \ \

Lig capitis fibulae anteflus --- \ Lig cruciatum

anterius'

' Lig transversum

genus
I
Caputfibulae/

\
Tuberositas
tibiae

Fig. l2l7 Kneejoint,Articulatiogenus; * clinical:ACL(- anteriorcruciateligament)

* * clinical:PCL(- posteriorcruciateligament)
90' flexion;the joint capsuleand the collateralligaments
havebeenremoved;
ventralview (r.,65%).

M adductormagnus,Tendo
/ M plantaris

M gastrocnemius,
Caputmediale - / M. gastrocnemius,
/ Caoutlaterale

- - Lig collaterale fibulare

Lig popliteum
obliquum

- - Lrg pophteum
arcuatum
Li9 collateraletibiale

--M brcepsfemoris,
M semimembranosus,
Tendo Tendo
- -
M poplrteus

i/ popliteus /
- -
Fibrra

Tibia -'

Fig. 1218 Kneejoint,Articulatiogenus;

thejoint capsuleis intactandthe muscularoriginscanbe seen; -Membrana
dorsalview (r., 65%). interossea
cruris
 Articutatiosenus
289

t
M. gastrocnemius
Caputmediale.Tendo M. gastrocnemius,
Caoullaterale.Tendo
Femur,Condylusmedialis----
Lig.cruciatumanterius
Lig meniscof
emoraleposterius
Femu( Condyluslateralis

Lig. collaterale tibiale - - - -

M. s€mimembranosus,Tendo.- - - - M. poplileus,Tendo

Meniscuslateralis

obliquum./'
Lig.popfiteum Lig collateralefibulare
'libia,
- Condyluslateralis
Lig cruciatumposterius-
Lig.capitisfibulaeposterius

Caputfibulae
- -
M poplileus,Aponeurosis'-
M. popliteus--
Fig. 1219 Kneejoint,Articulatiogenus; r In additionto the insertionbelowthe medialcondyleof the tibia,the tendonof
the cruciateligamentsandthe meniscihavebeenexposed; the semimembranosus muscleradiatesinto the obliquepoplitealligamentand
dorsalview (r.,65%). into an aponeurosis which coversthe areaof the origin of the popliteusmuscle.

Patella - - -

Epicondylus - - -
medialis

Lig. patellae -.

Meniscus medialis -

Lig. collaterale tibial€

tibiae- ---
Tuberositas

F i b u l a- - - -

Fig. l22O Kneejoint, Articulatiogenus; Fig, l22l Kneejoint, Articulatiogenus;

organisation of fibresof the tibialcollateralligamentwith the organisati0n of fibresof the tibialcollateralligamentwith the
kneein an extended position; kneein a flexedposition;
medialview(r.,60%). medialview(r.,60%).
Only the posteriorfibres of the tibial collateralligamentare During flexion the posteriorand proximalfibres of the tibial
fixed to the medialmeniscus. collateralligamentbecometwisted,therebystabilizingthe
medialmeniscus.
290 Lowerltmb

,/ Bursa suprapatellaris

M. quadricepsl€moris,Tendo
/,/

- - - Bursasubtascialis
prepatellaris

Lig.collaterale ---
Lig. patellae
tibulare

- - Meniscus lateralis
M popliteus,Tendo
- - - Bursainfrapatellaris
protunda
Lig.popliteumarcuatum

M. bicepsfemoris,Tendo --

Fig.1222 Kneejoint,Articulatiogenus;
a plasticmaterialhasbeeninjectedwhich completelyfills the
joint cavity;
lateralview(r.,65%|
Thesubpopliteal recessusis not shownhere.Compare to
Fig.1223.

M. adduclormagnus,Tendo -- / Lig.cruciatumposterius

posterius
/ Lig. meniscofemorale

/ M. oaslrocnemius.
/ Caduttaterale
- / Lig collaterale fibulare"
Lig. collaterale libiale' - -
- - Meniscuslateralis
M. semimembranosus, Tendo --
-- M, poplileus,Tendo
medialis--
Meniscus biceosfemoris.Tendo
--
Lig poplileumobliquum / Lig popliteumarcualum

Fig, 1223 Kneejoint, Articulatiogenus;

a plasticmaterialhasbeeninjectedwhich
completelyfills the joint cavity;
dorsalview (r., 65%).
* clinical LCM (- Llg. collaterale medlale)
* . clinicah I-CL Lig. collaterale lateritle)
1-
 Kneeloint, Articulatiogenus
29r
Ug. pateilae\
\
Bursa infrapatellarisprcfunda\\
Lb. cnrtatm anbrirl8
Lig. transw'sum \-
genus -:

Meniscussr
m€orat|s
- A. m€dh gcnus,
(R. po3fiodoo

Lb. crucialum - M. popllteu3,

anterius T6ndo
- 'lft
Lig. cruciatumposterius/ iI
A. irrt"ri" b genus

Fig. 1224 Kneejoint, Articulatiogenus; Flg. 1225 Kneejoint, Articulatiogenus;

the joint capsule,the cruciateand the collateralligamentshave arterial supplyof the menisci;the joint capsule,the cruciate
beensectionedin the transverseplaneto showthe menisci; and the collateralligamentshavebeensectionedin the
proximalview (r.,65%). transverseplane;
proximalview (r., 65%).

Figs. 1226a,b Kneejoint, Articulatiogenus; a extension

displacementof the menisciduring flexion; b flexion
lateralview (r.).

Fig. 1227 Kneejoint, Articulatiogenus;

displacementof the menisciduring flexion;
proximalview (r.).
During flexion both menisci are forcedposteriorly wer
the edgeof the tibial condyles.Thercis lessrisk of
damageto the lateral meniscus,which can be explained
by its greater mobility.

Parts of the knee joint

 Lowerlimb
292
Bursasuprapatellaris

M. quadricepslemoris,Tendo\-

Corpusadiposumintrapatellare Femur,Condyluslateralis
- CaPsulaarticularis,
Meniscus (Cornuant€rius)-----
lateralis, Lig. popliteumarcuatum
-- - - Meniscuslateralis,(Cornuposlerius)

M. popliteus,Tendo
FlecessussubPoPliteus

Tlbia,Condyluslat eralis-" Lig.capitisfibulaePoslerius

Articulatiotibiofibularis

- M. soleus
M tibialisanterior/

Fig. 1228 Kneejoint,Articulatiogenus;

sagittalsectionthroughthe lateralpart of the joint;
lateralview (r.,65%1.

\
M. vastuslateralis

medialis
Epicondylus

Epicondyluslateralis-- - - - Lig collateraletibiale

Lig cruciatum Poslerius

anterius-----
Lig.crucialum
Femur,Condylusmedialis
M popliteus,
Tendo-----
Femur,Condyluslaleralis----- Meniscusmedialis
----
Capsulaarticularis Tibia,Condylusmedialis

lateralis
MeniSCuS
/
Tibia,Condyluslaleralis-' .'
/
Emin€ntiaintercondylarisz

. ---- M .s o l e u s
M. tibialisanterior//

Fig. 1229 Kneejoint,Articulatiogenus;

frontalsectionthroughthe middleof the ioint;
ventralview(r.,65%).
 Kneelotnt, Articulatiogenus

Corpusfemoris -

- Basisoatellae

Epicondyluslateralis - - Epicondylus
medialis
Fossainlercondylaris --

Sulcus popliteus - - Apexpatellae

Femur, Condylus lateralis r

- Femur,Condylusmedialis

Tibia, Condylus lateralis - * f ibia,Condylusmedialis

\ Tuberculum
Apex capitis fibulae - )
intercondvlare
mediale
---- | -
i Eminentia
\ Tuberculum intercondvlaris
Articulatiotibiofibularis - I
inlercondylare
laterale,/

Caput fibulae - \ Lineaepiphysialis

Corpusfibulae-
\ Corpustibiae

Fig.1230 Kneejoint,Articulatio genus;

AP-radiograph;
the patientis lying andthe central
beamis focusedon the middleof the knee.

Corpus femoris -

Patella,Facies anterior -

- Facies poplilea

Apexpatellae-
- Fossaintercondvlaris

Femur,Condylusmedialis-

Femur,Condyluslateralis-
- Eminentia intercondylaris

-
Lineaepiphysialis
- Apex capitis libulae

tibiae /
Tuberositas - Articulatiotibiofibularis

- Caput fibulae

Corpustibiae /
- Corpus fibulae

Fig.1231 Kneejoint,Articulatio genus;

lateralradiograph;
the patientis lying andthe central
beamis focusedon the middleof the knee.
 LowerLimb
2*-€
/ Patella,Facies
/' articularis'

'
Bursa
suprapatellaris" t
'| Arthroscooe i
2 Inletor outletfor the rinsingsolution iI
3 Coldlightsource Femur.Faciesoatellaris
4 Ocularor connectorto the videosvstem
5 Anterolateralapproach
6 Anteromedial approach
7 Additionalinstrument Figs.1233a-c Kneejoint,Articulatiogenus;
arthroscopy;
joint (r.).
a inferiorviewinto the femoropatellar
* ridge between the medial and lateral articular surfaces
* * clinical: suprapatellarrecess
Fig.1232 Arthroscopicapproaches.

Kneejoint,Articulatiogenus;arthroscopy;medialviewof Kneejoint,ArticulatioSenus;arthroscopy; anterolateral

the freeinneredgeof the lateralmeniscus(r.). viewof the distalpart of the anterior ligament(r.).
cruciate
Theventralpart of the meniscushasbeensomewhat Theligamentis coveredby a vascularsynovialmembrane,
depressed by a probinghook(-). it hasbeenslightlyretractedmediallyby a probinghook(-).
 Kneelotnt, Articulati.ogenus
295
M vastuslateralis
I
I Sulcuspopliteus
,
I
I femur, Condytustareratis Femur Lineaepiphysialis
| , / /

'/ Condylus
lateralis
Fossa Capsula
intercondylaris /
articularis;
M. gastrocnemius,
Tendo
- Femur, / Meniscus
Condylus lateralis,(Comu
medialis poslerius)
- Ltg.
collalerale - M. popliteus,
tibiale Tendo
- Meniscus
medialis - Caput
fibulae
\ Tibia, - Articulatio
Condylus tibiofibulads
medialis - Tibia
'Tibia,
| | | Condytuslateralis I Faciesarticularissuperior,
| | Meniscuslateralis
I Caoutlibulae Condyluslateralis
Lig collateraletibulare Meniscuslateralis,(Cornuant€rius)
Corpusadiposuminfrapatellare
Li9. oatellae

Fig. 1234 Kneejoint,Articulatiogenus; Fig. 1235 Kneejoint,Articulatiogenus;

frontalsectionalimagethroughthe middleof the sagittalsectionalimagethroughthe lateralpart of the
intercondylareminenceobtainedwith magnetic kneeobtainedwith magneticresonance tomography (MRT);
resonance tomography (MRT); kneeioint in extension.
kneein the extendedposition.
Compact boneappearsblackusingthis imaging
technique.

z Fossa
Capsula intercondylaris
articularis,
Lig.popliteum - Capsula
obliquum articularis,
Lig.popliteum
Lig cruciatum obliquum
anterius
- Lig.cruciatum
Lig cruciatum posterius'
posterius
Area - Area
intercondylaris intefcondylaris
anterior poslerior

| | | Tibia
I I Coryusadiposuminfrapateilare
I Retinaculum
oatellaemediale Corpusadiposuminfrapatellare

Figs.1236a,b Kneejoint,Articulatio genus;

sagittalsectionalimagesobtainedwith magneticresonance
tomography (MRT);kneejoint in extension.
a anteriorcruciateligament,Lig.cruciatumanterius
b posteriorcruciateligament,Lig.cruciatumposterius
* The inhomogeneous
appearanceis due to the oblique sectioningofthe fibre
bundles
 LowerLimb
296

Caput fibulae \

- - - Membranainterosseacruris

\ Malleolusmedialis
/
Malleoluslateralis / Synd€smosistibiofibularis,Lig. libiotibulareantedus

Flg. 1237 Connectingfibres of the bonesof the crus;

ventralview (r., 30%).

/ Faciesarticularisinterior

/ Faciesarlicularismall€olim€dialis

Malleoluslat€ralis \

' \ Malleolusm€dialis
Faci€sarticularismalleoli latgralis

Fig. 1238 Tibia,Tibia,and fibula,Fibula;

distalview (r.,55%).
 Bonesof theFoot,Ossapedis
297
Fig. 1239 Bonesof the foot, Ossapedis;
proximal view (r., 507o).

-- Caputphalangis
- - Corpusphalangis
Capuiossismstatarsi - Basisphalangis

Corousossismelatarsi--

Basisossismetatarsi - -

- - Os cuneiforme
laterale
Os cuneitormem€diale
- Tuberositas
ossis
Os cuneiforme metalarsiquinti
intermedium \ Os cuboideum
/
Os naviculare/
Caputtali /
- Calcaneus

I Tuberositasphalangisdistalis \ Proc.lateralistali

Caput phalangis l-lll \ \ Trochleatali

\ calcaneus
Phalanx distalis \
Phalanx media \
Phalanx proximalis \

Tuberositas
/ / m€tatarsiorimi
ossis

Ossamelatarsil-V

- Os cuneitormelaterale
Basisossis *--
metatarsi lll-V
- - Os cunoitormgm€diale
ossis -
Tuberositas
metaiarsiouinti - Os cuneiformeintermedium
Sulcustendinismusculi
tibularislongi
Tuberositasossis \ Tuberositasossisnavicularis
cuboidei

Calcaneus / \ caputtati

\ Talus

'Sustentaculum
Proc lateralis/ tali
tuberiscalcanei
Fig. 1240 Bonesofthe foot,Ossapedis;
plantarview (r.,50%).
/*b
IF
L',g
H
L.F
LowerLimb

Os naviculare I -- Collum tali

\
Os cuneiformeintermedium - - Facies malleolaris
\
tt medialis
Os cuneiformemediale. _-
\
\\ t"
Ossametatarsi - - Proc.posterior
\ ..\
tali,Tuberculum
mediale
proximalesl
Phalanges I
Phalanges mediael
i
Phalangesdistales
I j

I t\
Tuberositas
ossisl I Sutcustendinismuscutittexoris
metatarsi
V nallucislongi
I
lOs cuboideum,
Tuberosilasossiscuboidei

Fig. 1241 Bonesof the foot,Ossapedis;

medialview(r.,45%).

Ossatarsi

tarsitransversa'
/Articulatio

t! f
io tarsl/ /'
Articuta I I
transversa' ; 7 rTuberositas I
Sinustarsi / ossis
lCaputossismetatarsi
Os cuboioeum/ metatarsiV V
,/
Articulationes/
tarsometatarsales'*

Fig.1242 Bonesofthe foot,Ossapedis;

lateralview (r.,45%).
* also CHoPART'Sjoint line
" also LsFRANc's ioint line
 sandcatcaneus
299
/ Faciesarlicularisnavicularis /, Caput tali

Facies--
malleolaris
medialis Sulcustali
-- Facies
malleolaris --- Corpustali
Corpuslali - - lateralis
Proc. laleralis /
tali
---
Trochlea tali,
Proc.posteriortali, --- Facies superior
Tuberculummediale Faciesarticularis/
I calcaneaposterior
SulcuslendinismusculiflexorisI \ Proc.posteriortali, \
hallucislongi Tub€rculumlaterale \ Proc.posteriortali

Fig.1243 Talus,Talus; Fig.1244 Talus,Talus;

proximalview (r., 85%). plantarview (r., 85%).

Suslentaculum
lali
Faciesarlicularislalarism€dia\ _ - - Faciesarticularistalarisposlerior

Faciesarticularistalarisanterior- - - Sulcustendinismusculi
llexorishallucislongi

Faciesarticulariscuboidea---

Proc medialistuberiscalcanei
--
Tubercalcanei

Fig. 1245 Calcaneus, Calcaneus;

medialview (r.,90%).

Faciesarticularistalaris m€dia

Faciesarticularistalarisposterior- - -
- Faciesarticularistalaris anteriol

- Sulcuscalcenei

---
Faciosarticulariscuboidea

---
Subust€ndinismusdlli
fibularislongi

laleralistuhls calcanei

Fig.1246 Calcaneus,Calcaneus;
lateralview(r.,90%).
 LowerLimb
300

-- Os metalarsill

l.-4-- os metatarsi
lll

Os metatarsiI
- - Os metatarsilV

Tuberositasossis--
melatarsiprimi

- - Os
mediale----
Os cuneiforme Corpusossis metalarsi
V
metatarsi

Os cuneiformeinlermedium-- / Basisossis
metatarsi

/ Tub€rosilas
Os cuneiformelaterale - ossismetalarsi
quinti

Os navicular€

Tuberositasossisnavicularis- -
Faciosarticularisnavicularis
Caputtali * -
Collumtali --

Faciesmalleolarismedialis
- - Faciesarticulariscuboidea

Trochleatati - - Faciesarticularistalaris
anlerior
Faciesmalleolarislateralis - - Faciesarticularistalarismedia
Proc lateralistali -- Sulcuscalcanei

Tuberculummeoiateli I
Proc l.
posterior Sulcustendinismusculi i
tali flexorishallucislonoi I
Tub€rculumt"'t r"t" I Calcaneus

tali /
Suslentaculum

Sulcustendinismusculiflexorishallucislongi

il - - - - ----ft?,5::,;x;"ilr,u'
--- P r o cm e d i a l i s I c a l c a n e i
tuberiscalcanei,,

Fig.1247 Tarsalbones,Ossatarsi, and metatarsal

bones,Ossametatarsi;
the distancebetweenthe boneshasbeenenlarged;
proximalview (r., 80%).
' Thecuboidboneis shownfrom medial.
 Bonesof theFoot,Ossapedis
30I

--
Ossacunertormia -1

Os naviculare
Os cuboideum

Calcaneus

Figs. 1248a,b The bonesofthe foot,Ossapedis; The headsof all metatarsalboneslie in the plantar plane. The
structural diagram. cuneiform bones,the navicular bone and the talus rest upon
a proximal view (r.) the lateral parts of the skeleton,especiallyin the posterior part
b plantarview (r.) of the foot.The talus is thereforesituated abovethe calcaneus
and the longitudinal vault is formed on the medial aspectof the
foot.The wedge-shapedcross sectionof the cuneiforln bones and
the basesof the metatarsalbonescontributesto the formation of
the transversevault.

Os naviculare
\
Ossacuneiformia
\
Os melatarsr
lt \
\
\
O s m e t a t a r ls\ i \
\

' Lig.calcaneonaviculare
plantare
|'
AponeurosisplantarisI Lig plantarelongum

Fig.1249 Bracingof the longitudinalvaultof the foot; Theligamentousstructureswhich are shownin this figure are
medialview(r.). orientatedin the longitudinalaxisofthe footandpassively
' medial intermuscular
septum bracethe longitudinalvault.Theyaremainlysupported by the
shortmusclesof the foot.
 LowerLimb
302

M. tibialisposterior,Tendo\

M. libialisanterior,Tendo - - -
-- posterius
Lig.tibiofibulare

-- Sustenlaculum
tali

'--
Lig calcaneonaviculare

Ligg tarsometatarsalia I
plantaria I
Sulcustendinis
musculi
fibularis
longi

pedis;
Fig. 1250 Iointsof the foot,Articulationes
ligamentsand tendonsof the footand ankle
joint;
(talocrural)
medialview (r.,70o/o\.

Fibula:

Lig.tibiofibulare
anterius\

/ Lig.talocalcaneum
laterale
Lig.talofibulareanterius
/ Lig lalocalcaneum
interosseum
Malleoluslateralis\ '
/ Lig.cuboideonaviculare
dorsale
Ligg.cuneonavicularia
dorsalia

- z Ligg.metatarsalia
dorsalia
Lig. calcaneofibulare \

Tendo.
calcaneus'-

tl --
I t | |
/ tll
calcanEus I I I
1' Lig.calcaneo- Lig.calcaneo- I t-,ss tarsometatarsalia
dorsalia
Lig. plantarelongum' naviculare cuboideum '
M fibularis[peroneuslbrevis,Tendo
Lig.bifurcatum

Fig. 1251 Ioints ofthe foot,Articulationespedis;

ligamentsand tendonsof the tarsusand the metatarsus;
lateralview (r., 70%).
* also Achilles tendon
 Iointsof thefoot,Articulationespedis
303

Lig libiotibulareposlerius
//

Malleolus medialis \ ./ Lig talofibulareposterius

Lig. collaterale mediale, Pars tibiotalaris posterior -

- Malleoluslateralis

Lig. collalerale mediale, Pars tibiocalcanea - -

- posterius
Lig.talocalcaneum
Talus/
\
Lig. calcaneolibulare
Lig.talocalcaneum
mediale

Calcanous

/
Tuber calcanei

Fig.1252 Iointsof the foot,Articulationes

pedis;
ligamentsandtendonsofthe tarsus:
dorsalview (r.,70%).
' also Achilles
tendon

Membranainterosseacruris -

/ Faciesarticularisinlerior
anterius- -
Lig.tibiofibulare

/ Faci€sarticularismalloolimedialis

Faciesarlicularismalleolilateralis-
- Malleolusmedialis

-- Sulcusmalleolaris

' Lig.tibiofibulare
poslerius

Fig. 1253 Anklejoint,Articulatiotalocruralis;

proximalelements;
distalview(r., 120%).
 Lowerlimb
3il4
pedis;
Fig. 1254 lointsof the foot,Articulationes
plantarview (r.,55%).
* The long plantar ligament enclosesthe grooveof a canal for the
tendon of M fibularis [peroneus]longus.

Ligg collateralia\ / Li99. plantaria

- - BasisossismetatarsiI

-- Li99 tarsometatarsaliaplantaria

- - Os cuneiforme mediale
Tuberositas\ \
ossrs
metatarsi --
quinti Ligg cuneonaviculariaplanlaria
--
Sulcustendinismusculi Lig cuboideonaviculare plantare
fibularis *
lperoneillongi
\
Lig. plantare/ Tuberositas ossis navicularis
longum
/
Lig calcaneo- / \
cuboideumplantare Lig. calcaneonaviculareplantare

Lig.-
calcaneofibulare
a \
Lig. plantare / Sustentaculumlali
rongum
\ Lig. collateralemediale,
Pars tibiocalcanea
' Articulationes
metatarsophalangeae
Sulcustendinismusculi I
flexorishallucislonoi
Proc medialis /
tuberis calcanei
/ Os sesamoideum
Tuber calcanei

Lig metatarsale-
transversumprofundum

/ M. fibularis
longus,
ffroneusl

Ligg metatarsalia - -- Ligg.tarsometa-

plantaria tarsaliaolantaria
- M. tibialis anterior,
Tendo

-- Ligg tarsi
-- plantaria
M fibularis[peroneusl
brevis,Tendo
- Lig cuboideo-
/ naviculareplantare
Tuberositasossis /
cuboidei
\ M tibialisposterior,
Tendo
'
Lio. calcaneonaviculare
plantare

pedis;
Fig. 1255 Iointsof the foot,Articulationes Lig. calcaneocuboideum /
olaniare
ligamentSandtendonsof the tarsusandthe
metatarsus;
plantarview (r.,55%).
 Iointsof thefoot, Articulationespedis
30s
Ligg.tarsometatarsalia
dorsalia
I

/ Os metatarsilV

Os meiatarsiV

ossismetatarsiquinti
/ Tuberositas
dorsalia/-
Ligg.intercuneiformia
- Lig cuneocuboideumdorsale
dorsalia/
Ligg.cuneonavicularia

Os cuboideum
Lio.calcan€onavicutare)
.. ...
.. I L|q.Olrurcalum
Os naviculare-- Lrg.calcaneocuDodeum,
\ M fibularis[peroneuslbrevis,Tendo

Lig. calcaneonaviculare plantare /

\ Faciesarticularistalarisanteriol

/
/
Faciesarticularistalarismedia
interosseum/
Lig talocalcaneum

Faciesarticularistalarisposterior/

\ Calcaneus

\ Tuber calcanei

Fig. 1256 Iointsof the foot,Articulationes

pedis;
joint hasbeenexarticulated;
the talocalcaneonavicular
proximalview(r.,70%).
' seeFig 1257

Os naviculare(Faciesarticularistalaris)
I
Lig. cuboideonaviculare dorsale
r""i",".rc,r",il1lff[:ffi:*
il

I Lio.calcaneonaviculare
)
I Lio.bifurcatum
calcaneocubordaum I

Fig. 1257 Therighttalocalcaneonavicularjoint, Articulatio tight fibroustissuesheetbetweenthe plantarcalcaneonavicular llgamentand

talocalcaneonavicularis; the tibionavicularpart of the deltoidllgament.This sfucture enclosesthe medially
directedheadof the talus. If it weakens,flaftening of the longitudinal vault
the talusand the lateralligamentshavebeenremoved; occurs(flat foot).
lateralview (r., 70%).
Thetwo arrowsindicatethe corkscrewtwist of the interosseous
talocalcanealligament.
3flr,* LowerLimb

/ Melaphysis, Linea epiphysialis

Syndesmosis-- - Articulatio
lalocruralis
tibiofibularis

/'llbia, Malleolusmedialis

- - Lio.collateralemediale.
Pirs tibiocalcanea

- - M libialisposterior,Tendo
- - Vaginatendinismusculitibialis
posterioris
--M
flexordigitorum
longus,Tendo
- -Vagina
tendinismusculiflexoris
Lig calcaneofibulare -\ digitorumlongi
- -
Articulatiosubtalaris - - Retinaculummusculorumllexorum
- -
Retinaculummusculorum -- Articulatiosubtalaris
fibularium superius
[peroneorum] --
Lig talocalcaneum
interosseum
M fibularis brevis,Tendo ---
[peroneus]
Vaginacommunis lendinum- - - --N
musculorum fibularium
lperoneorum] olantarismedialis
- -
M fibularis
lperoneus]longus,Tendo --- (V plantaris
medialis)
/ \ A plantarismedialis
musculorum|bularium /
Retinaculum
inferius
Iperoneoruml \ M abductor hallucis
Calcaneus /
\ M quadratusplantae
M abductor digiti minimi // 'A ; N plantaris (V plantaris
lateralis; lateralis)
..
Aponeurosisplantaris /
\ M flexordigitorumbrevis

Fig. 1258 Ankleandintertarsalioints,Articulationes

talocruraliset talocalcaneonavicularis;
frontalsectionthroughthe malleoli;
distalview (r.,90o/ol.
M. tlexorhallucislongus

M. tricepssurae,,
TendocalcaneusI

/ M 6xtensorhallucislongus

/ Articulatiotalocruralis
')
Articulatiosubtalaris
// (Articulatio
talotarsalis)
/ Articuhti i
\ -/ Ialocalcaneonavlcularls
J
/ Os naviculare
/ Os cuneiformeintermedium
ta_
Articulaliolarsometalarsalis
r,
/ M fibularislperoneusllongus,Tendo
o" metatarsill
L .-
/ M interosseusdorsatispedisI

Apnneurosisplantaris I i i l r" ptantare

tonsum rM. adductor hallucis,
metalarsophalangea
M llexordigitorumbrevis I lM quadratus
plantae Caput obliquum (Digitusll)

Fig. 1259 Ankleandintertarsaljoints,Articulationes sagittal sectionthrough the middle of the trochleaof the talus;
talocruraliset talocalcaneonavicularis: lateral view (r., 50%).
' fat pad of the heel
(
Talocrural.Subtalarand Talocalcaneonavicular
Joints

Lrnea eprphysialis

Syndesmosistibiolibularis
Trochlea tali

Arliculatiotalocruralis Malleolusmedialis

Malleoluslateralis Talus

Fig. 1260 Ankle and intertarsaljoints,Articulationes The posterior margin of the fibular notch is clinically termed Malleolus tertius
talocruraliset talocalcaneonavicularis;
AP-radiograph; the patientis lying; the centralbeamhas been
tangentiallyfocusedon the trochleaof the talus.

-- Fibula
Tlbia

-- Lrneaepiphysialis"

-- Articulatiotalocruralis
Trochleatali

Malleolusmedialis
-- Proc posteriortall

Malleoluslateralis

-- Articulatiosubtalaris'

C o l l u mt a l l
-- Sinus tarsi
Caput tali

Articulatio
talocalcaneonavicularis' -- Sustentaculumtali
Os naviculare

-- Tuber calcanei

Fig. 1261 Ankle and intertarsal joints, Articulationes * The joint spaces are not orthoSradely aligned with the film because oftheir
talocruralis et talocalcaneonavicularis; screwlike form
" overlapping of the epiphyseal lines of the tibia and the fibula
lateral radiograph;the patient is lying; the central beam has been
focusedon the top of the trochlea of the talus.
 LowerLimb
308
Spina iliaca
anteraorsuperior

// Lig inguinale
Hiatussaohenus.\ \
Fasciabribrosa

M tensorfasciae -

M. tensor
fasciaelatae
V saphena -
magna

Tractus -
iliotibialis

Fascia lata

- Traclus iliotibialis

-- Fascia lata

Patella -_

Bursasubcutanea ---
prepatellaris

Caputfibulae- --

Bursasubcutanea ---
infrapatellaris

-- V saphenaparva'

Fig.1262 Fasciaof the thigh,Fascialata; Fig. 1263 Fasciaof the thigh,Fascialata;

ventralview (r.). dorsalview (r.).
Thetransitionalareabetweenthe aponeurosis ' subfascial and intrafascial course of the saphena parya vein
of the obliquus
externusabdominismuscleand the fascialata is calledthe
inguinal ligament,Lig. inguinale.It insertslaterallyto the
anteriorsuperioriliac spineandmediallyto the pubictubercle.
* gapsfor the peforating veins(Dono'sveins)
 Hiatus saphenusand Lacunae

4 M psoasmajor

(M psoasminor),Tendo

_- Atcus iliopectineus
Lrg inguinale
/a AiVlemoralas

/ (Nodus lymphoideuslacunarismedialis)*

-- Lig lacunare**

V circumflexailium suoerficrahs
-
-- =: - - - Lig pubicumsuperius
superius V epigaslricasuperficralis
fcornu U
Margofatcrformis
t F---- Fascia lata
I
I Cornuinlerius

V saphena magna Vv pudendae exlernae

Fig.1264 Saphenoushiatus,Hiatussaphenus,and vascular * a l s o R o s E N M i J l L n al y' sm p h n o d e

' * a l s oG T M B E R N AITi g' sa m e n t
lacuna,Lacunavasorum;
the anteriorabdominalwall, the abdominalviscera,the iliac
fasciaand the femoralseptum(Cr_oourr)havebeenremoved;
ventralview (r )

/ Vagina musguli recti

. - - - +$!!,\S\F,$&$l-
M obriquus€xrernu" abdomrnis,Lamina anterior

/ B M obliquusexternus
abdomrnis,Aponeurosrs

N cutaneus femoris lateralis - _ _ l

------7
Spina rhacaanlerior supeflor - - - / \ - a A;Vfemoralis
/z
/. t' -)--- - e ' t u m ffemorale
sSePtum emorate
' -.ni --
')-

":s -.(- - (Nodilymphoidei

(Nodi tymphoidelacunares)
- -

Funiculus
spermaticus
.-_-.-
-----l- Lig inguinale

-l
- ruberculum
pubicum
Eet;- ' --
, pubica
Symphysis
jf;-- ---- -
- f Jl-
I Membrana
M e m b r a nobturato
aobturarona
l-
- -j - - canalis
q: obturatorius

Fig. 1265 Muscularand vascularlacunae,

Lacunaemusculorumet vasorum;
obliquesectionthroughthe inguinal ligament;
distal view (r.)

Lacunae below the inguinal ligament

The arcusiliopectineusdividesthe spacebelowthe inguinal vasorum.Thespaceborderedby the V. femoralis0n the lateral
l i g a m e n ti n t o a l a t e r a la n d a m e d i a ll a c u n a ,t h e l a c u n a side,the Lig.Iacunare(medial),the Lig.inguinale(ventral)and
musculorumandthe lacunavasorum,respectively. the Lig. pectineum(dorsal)is filled with looseconnectivetissue,
The M. iliopsoas,the N. cutaneusfemorislateralisand the N. the Septumfemorale(Cloourr), and is calledthe Anulus
femoralispassthroughthe lacunamusculorumto the thigh. femoralisor Canalisfemoralis.
TheA. andV. femoralis,the R.femoralisof the N. genitofemoralis, Femoralherniascan developin this region,with the Anulus
t h e n o d i l y m p h o i d e il a c u n a r e s( l a t e r a l i s ,m e d i a l i sa n d femoralisbecomingthe internal openingand the Hiatus
intermedius)aswell aslymphaticvesselsarefoundin the lacuna saphenus the externalopeningof the hernia.
 LowerLimb
310

-- (M psoasminoo

Lig.inguinale

Arcusiliop€c'tineus

M. iliopsoas

M. tensor fasciae latae

M. rectustemoris
M. adductorlongus

M. adductormagnus

M. gracilis

M. vastuslaleralis

- - - M. vaslusmedialis
Fascia lata. Traclus iliotibialis

Bu6a subtendineaprepatellaris- - --- Femur,Condylusmedialis

Bursasubcutaneainlrapatellaris

Fig. 1266 Musclesof the thigh and hip;

the Fascialata hasbeenremoved,exceptfor the iliotibial tract;
ventralview (r.).
* commoninsertion of the sartorius, gracllls and semitendinosusmusclesbelow
the medialtibial condyle(formerlycalledPesanserinussuperficialis)
 sclesof
therhish
31 1

M. iliacus 1

M. sarlorius \

--- M. pirilormis
M. tensor fasciae latae - - -

--- Lig.sacrospinale
s e d i u -s- - - -
M .g l u t e u m
- -- PectenossisDubis

--- Lig.pubicumsuperius

M. iliopsoas -- M. pectineus

--- M adduclorlongus

--- M. gracilis

A.: V temoralis
Canalisadductoriust

S€ptumint€rmusculare
vastoadductorium
M. quadricepsfemoris

Fascia lata ---

M. reclusfemoris,Tendo--

Femur,Condylusmedialis

Fig. 1267 Musclesof the thigh andhip;

the Fascialata,the tensorfasciaelataemuscleandthe sartorius
musclehavebeenremoved;
ventralview(r.).
3TZLowerLtmb

Spinailiacaanteriorsuperior - r

M. pirilormis
M sartorius\\\
I Bursasubtendineailiaca
reclum - - - -
M. rectustemoris.. { lanut
l\u a p u r e f l e x u m- - -

_-- Pectenossispubis

M gluteusmedius--
adductorlongus
--
Lig iliofemorale

M iliopsoas pectineus

M adductor brevis

M vastuslateralis M gracilis

M adductor longus

M adduclor magnus

Fascia lata

-- M vastusmedialis

M vastusintermedius

M. rectusfemoris,Tendo

Lig patellae

Fig. 1268 Musclesof the thigh andhip; the poplitealfossa,Hiatusadductorius,is visible;

deeplayer;the sartorius,the rectusfemorisand the adductor ventralview (r.).
longusmuscleshavebeencompletelyremoved;the M. iliopsoas * commoninsertionofthe sartorius,gracilisand semitendinosus
musclesbelow
the medialtibial condyle
hasbeenpartiauyremovedat the levelof the joint; the ventral * * Theorisin of M. rectusfemorishasbeenmovedaside.
and lateralwalls ofthe adductorcanal,Septumintermusculare
vastoadductorium, havebeenremovedso that the openinginto
 scresoftherhigh
3I3
M. iliopsoas\

M sarlodus\
M. pirilormis
M. reclus lemoris 1
\ Canalisobturatorius

Bursasubt€ndin€a
iliaca -- M. p€clineus

M. gluleusmedius / M. adductorlonous

_-- M obturaloriusexternus
M. iliopsoas--_
--- M. adductorbrevis

M. pectineus--_ - -- Trochanterminor

M. adductorbrevis - _ _
- - - M. adductorminimus

M. adductormagnus
M. vastus lateralis

M. vastusmedialis---

M. vastusinlerm€dius

M adductormagnus,T€ndo

- -
M. gracitis,Tendo

M. sartorius.Tendo ' - Bursasubtendineamusculisarlorii

-
M. gracilis, Tendo -

Tendo -'
M. semitendinosus, --
Burcaanserina

Fig. 1269 Musclesof the thighandhip;

mostof the superficialmusclesand sombof the deeper
muscleshavebeenremoved;the ventralandlateralwalls
of the adductorcanalhavebeenremoved;
ventralview (r.).
 LowerLimb

/ Axis
/ sagiltalis

Anteversio
(Flexio)
Adductrol

Fig. 1270 Hip joint; Fig. l27l Hip joint; Fig. 1272 Hip joint;
movementin the sagittalplane. movementin the frontal plane. movementin the transverseplane.

Ventralmusclesof the hip (Figs.1266-1268,1ZB5)

To this groupbelongsthe M. ilitpsoas,that consistsof M. iliacusand M. psoasmajor.This is the only musclethat drawsfrontally
olgltne nin o1|{,,,AXother,mUlqlesaSqi$g* overthe,kneeand are:therefore p-altof the thigtr
.,..:
Muscle Origin Insertion Function
Innervation
1. M. iliacus ::, r,:, Fossailiaca,Spinailiaca Trochanter minorandadjacent
the,;,:,;;1;;;;:
,':,&6,muscutaf&if.ron anteriorinferibrof Oscoxae, regionof the Labiummediale
lumhiatii'
"'P.lrxus anteriorcapsuleof the of the Lineaaspera
Articulatiocoxae
Lumbar vertebral column:
2. M. psoasmaior Superficiallayer:bodyof the Trochanter
minor Lateralflexion,extension
::Ri musculares:
fu m the 12ththoracicto 4th lumbar (hyperlordosis)
":P[exus
lumbril6:' vertebrae(lateralsurface),
Disciintervertebrales Hip joint:
Deeplayer:Procc.costales of Flexionand medialrotation
the lst to 4th lumbar (whenthe Mm.gluteicontract
vertebrae simultaneously alsolateral
. rotation)
3. M. psoasmiiibr Bodyof the 12ththoracic Fasciaof M. iliopsoas, Arcus
Rr.mruculareshom the vertebraandthe lst lumbar iliopectineus (oftena long,
Plerus lumbalis vertebra(lateralsurface) flat tendon)
,,{yariable),::::::::

Ventral muscles of the thigh (Figs. 1266, 1267, IZBS)

!rylq,proximal:biera,obriqdq:Oyer
tnetlhlgb]M.
sartoriusdrawsmedialdistal.Themostlateralventrafe!&tgtgof the,Uiigtis
M:r'iensor
fasbiCii:iatae,
thatendsin theTractusiliotibialis.ThemaiiiiventralmuiCleis M. qtiailriceps
rei{i6iii. ,..t:r.,
Muscle Origin Insertion Function
Innervation
1;r:M.:quadrioJili.i.fonoriBttt:i:t:rt
: M. rectusfemoris,Caput Commontendonof the most Hip joint: M. rectusfemoris
N. femoralis rectum:Spinailiacaanterior powerfulmuscleof the human assistsin flexionof the
(Ple,ruslumbalis) inferior body,attaches to the baseand Articulatiocoxae
M. rectusfemoris: lateralmarginsof the patella
M. rectusfemoris,Caput Kneeioint:
operatestwo joints; andblendswith the Lig.
'r::Mn reflexum:cranialmarginof Extension
vastimigdiblls,
laterdllSr
:l the acetabulum patellaeandthe Retinacula
and intermedius:operate patellaeto inserton the
onejoint M. vastusmedialis:Labium Tuberositas tibae
medialeof Lineaaspera
(lowertwo thirds)
 Musclesof the Thigh

M. vastus lateralis:
Trochantermajor (distal
circumference). Labium
lateraleof Lineaaspera
M. vastus intermedius:
Anterior surfaceof the femur
(uppertwo thirds)
M. articularis genus:
Anterior surfaceof the femur
/l :- .^l - ..^- .^- \
tutSrdl qudr rtrl,

2. M. sartorius S p i n ai l i a c aa n t e r i o rs u p e r i o r Medialsurfaceof the Hip joint: Flexes,laterallY

N.femoralis Tuberositastibiae rotatesand abductsthe thigh
(Plexuslumbalis) Knee ioint: Flexesand rotates
m e d i a l l yw h e n t h e k n e ei s
flexed

3. M. tensorfasciaelatae Spinailiacaanteriorsuperior Lateral end of tibia (above Hip joint: Flexes,mediallY

N. gluteussuperior Tractus iliotibialis, below rotatesand abductsthe thigh
(Plexuslumbalis) Condyluslateralis) Knee joint: Stabilizesthe
knee when extended

Medial femoral muscles of the thigh (Figs.1266, 1268,1269,1285,1286l

The groupof medialfemoralmusclesof the thigh is, accordingto its main functionadductors.In the ventralvieW M. gracilisis
the mostmedial,from proximalto distal onefinds: M. pectineus,M. adductorbrevis,M. adductorlongusand M- adductormagnus.
M. obturatoriusexternusis hiddenbehindM. pectineus.
Muscle Origin Insertion Function
Innervation
l. M. gracilis Ramusinferiorossispubis Proximalend of the tibia Hip ioint:
N. obturatorius (medialborder,
alongthe (medialof the Tuberositas Adduction, flexion,
(Plexuslumbalis) symphysis) tibiae) lateralrotation
Kneejoint:
Flexion,medialrotation
2. M. pectineus Pectenossispubis Lineapectineaof the femur Hip joint:
N.femoralisandN. obtura- Adduction, flexion,
torius(Plexuslumba lis) lateralrotation
3. M. adductor brevis Ramusinferiorossispubis Proximalthird of the Linea Hip joint:
N. obturatorius (closerto the Foramenob- aspera,Labium mediale Adduction, flexion,
(Plexuslumbalis) turatumthanthe M. adductor lateralrotation
longus)
4. M. adductor longus Ospubis(belowCristapubica Middlethird of the Linea Hip joint:
N. obturatorius to the symphysis) aspera,Labium mediale Adduction, flexion,lateral
(Plaatslumbalis) rotation(mostanteriorfibres:
medialrotation)
5. M. adductormagnus Ramusinferiorossispubis, Labium medialeof Linea Hip ioint:
N. obturatoriru(Plezru RamusandTuberossisischii aspera(proximal two thirds), Adduction,lateralrotation,
Iumbalis)and N. ischiadicus (medialborder) Tuberositas,Tuberculum flexion(anteriorpart),
(tibial part- P latus sacralts) adductorium(Hiatus extension (posterior
Part)
adductoriusbetweenthe
M. adductorminimus is
two insertions)
a proximalpart of
M. adductormagnus
6. M. obturatorius externus Circumferenceof Foramen Tendinousat the Fossa Hip joint:
N. obturatoriw obturatum(lateralsurface), trochantericaof the femur Rotates the thigh laterallY,
(Pla<uslumbalis) Membranaobfuratoria adduction, flexionof the
Articulatiocoxae
- t g tru Lower
Limb

M obliquus
externus
abdominis

-- Cristailiaca,Labiumexternum

- Spinailiacaanteriorsuperior

M. gluteusmaximus-

--
M tensorlasciae latae

-- M rectusfemoris

- - M. vastuslateralis
M bicepsfemoris,Caputlongum-

M biceps femoris, Caput breve --

Caputlaterale--<
M gastrocnemius,

Caoutlibulae-

Fig. 1273 Muscles of the thigh and hip;

the Fascialata has been removed,exceptfor the iliotibial tract;
lateral view (r.).
 dorsi------
M latissimus
Crisla iliaca

M. eEc{orspinae,
Fasciathoracolumbalis

M. gluleusmaximus

Trochanlermaior

Sulcusglutealis

----Tractus iliotibialis

Fascia lata
M. glulousmaximus,Tendo

Fig. 1274 Musclesof the thigh and hip;

superficialhip muscles;the fasciaof the gluteusmaximus
musclehasbeenremoved;
dorsalview (r.).

M. latissimusdorsi,Aponeurosis -- Crista iliaca

M. erec{orspinae, Fascia
thoracolumbalis
_-- Fascialata, (Fasciaglutea)

M. gluteusmaximus--

- - - M. glui€usm€dius

-- M. pirito'rmis
Spina ischiadica ---
-- M. gem€llussup€rbr
Foramen ischiadicum ---
mtnus - M. obturaloriusintemus'
--
Lig.sacrotuberale - M. gem€llusinf€.ior
Ramusinferiorossispubis -

Tuberischiadicum
--- -- Bursatrochanterica
musculigluleima(imi
Ramusossisischii - - -
M. quadralusfemoris
M. gracilis----
--- M. gluteusmaximus
M . a d d u c t o r m a g n-u-s- -

M semitendinosus --- M.adductormagnus

M bicepsfemoris,- - - Tub€rGit$ glutea

Caputlongum -- - Fascialata,Tractusiliotibialis

Fig. 1275 Musclesof the thigh and hip; * The part of the internal obtumtor muscleftom wher€ it turns around the lesser
superficialhip muscles;the gluteusmaximusmusclehasbeen scladc notchand lts inserdon ln the trochanterlcfossais frequently tendinous.
sectioned;
dorsalview (r.).
-'5t
r h'; LowerLimb

Vertebralumbalis V \

Crista iliaca \ / Canalis verlebralis

\
M iliacus \

M psoasmajor- / Peclenossispubis

(M psoas minor), \ z Os sacrum

Tendo
Spina iliaca .- .- / Articulatiosacroiliaca,
anteriorsuperior Ligg sacroiliacaanteriora

. N . c u t a n e u s- r _ _ - Canalis sacrafts
lemofls laleralrs

L i g i n g u i n a l e- - - *
- - (Fo'amensuprapiriforme)

N genitolemoralis, _--- Foramina sacralia

R femoralis - -- anteflora

N lemoralis*--_ M piriformis
_--
Arcusiliopectineus
-- _
.' - (Foramen infrapiriforme)
A ; V iliacaexterna--
Ramussuperior- - _-- M ischiococcygeus
ossispubis Icoccygeus]
N obluratorius;-- -- Fascia obturatoria
A ; V obturatoria
Lig lacunare -' - - Foramenischiadicum
Canafts //
obturatorius mrnus
-- Lig sacrotuberale
-
M. sartorius- *-
- M obturatoriusinternus
pubica-
Symphysis
(Arcus lendrneug -- --- Tuberischiadicum
musculi levatorisani)
-
A femoralis / t--
R a m u so s s i si s c h i i

Ramus inferior - /
ossrs pubis -.--
M gluteusmaximus
M adductor longus -'
----
- M bicepsfemoris,Caputlongum
M gracilis /

- M semitendinosus
M rectus femoris z

M adductor magnus -

Fig. 1276 Musclesof the thigh and hip;

the hip musculature,the pelvisand the lumbar spine
havebeensectionedin the medianplane;
medialview (r.).

The Foramenischiadicum [sciaticum] majus is borderedby The smaller Foramen ischiadlcum [sclaticum] minus is
the Incisuraischiadicamaior of the Osischil, thc lowerEargin borderedby the lncisura i€chiadicaof the Os:,ischiiand the
of the sacro-iliacjoint, the lateral margin of the 0s sacrum Ligg.sacrospinaleand sacrotuberale.
and the Lig. sacrospinale.It is divided into the Foramen The Canalis obturatorius is a gap in the Membranaobturatoria
suprapiriforme and the Fgramen infrapirlforme by the M. near to the Sulcusobturatorius(compareto Figs. 1171and
pirifonnls extendingto the ftmur. 1175).
 rhighandHip
319

-- M gluteusmedius

,- M. gluteusminimus

M gluteusmaximus - - - (Foramensuprapiritorme)
--- M Piriformis

(Forameninfrapirilorme) M. gemellus
superior
_--
M. tensortasciaelatae
M obluratoriusinternus ----

M gemellus
inferior
Lig sacrotuberale _---

M quadratus
femoris
M obturatoriusinternus _---
--- M gluteusmedius
Tuberischiadicum
l--- Trochanter
major
---
Bursatrochanterica
musculiglutoimaximi

M adductormagnus
- - M. gluteusmaximus
---
M adduclorminimus

- M adductormagnus

M gracilis ---

M. semitendinosus ---
----
M bicepsfemoris,Caputlongum - - - M vastushreralis

'--
M bicepsfemoris,Caputbreve

- -
- M. bicepsfemoris,Caputrongum
M semimembranosus
--'-

-- A poplitea
M semitendinosus,fendo
--'

M semimembranosus,
Tendo---
- - M gastrocnemius,
Caputlaterale
M. gastrocnemius,
Caputmediale---

Fig. 1277 Muscles0f the thigh andhip;

thegluteusmaximusandmediusmuscleshavebeen
partiallyremoved;
dorsalview(r.).
 Lowerlimb
320

/ M. gluteusmedius

/ M. gluteusminimus

M. gluteusmaximus-_ /, M. g€mellusinf€rior
/
/, M. ob'..ualoriusinlemus,Tendo
M. piriformis-__
/ musculigluteimgdii
2 Bursalrochanterica
(Forameninfrapiriform€)-
/-
/ Trcchanle.mEor
M. g€mellussuperbr --
M. obturatoriusinlemus--- _- M. obturatorius
€xl€mus

Bursaischiadicamusd.lliobturatoriiintemi- - - M. qudratus femoris

- - -

Lig. sacrotub€rale - - Bursatrochantericamusculi

gluieimaximi
M. bicepsf€moris,Caputlongum---- --- M. ilioosoas,
Tendo
---
M. semitendinosus
--- Taochanterminor
Foram€nischiadicumminus /-

M. semimembranosus-- ---
M. gluteusmaximus

-:
M. adductorminimus
M.gracilis-"

M. adduclormagnus .t'

--
M. Yastuslateralis

/
--
M. semimembranosus
-- M. bicepslemoris, Caput longum

--
M. bicepsfemoris,Caputbreve

Iendo -'
M. semitendinosus, \ Fossapoplitea

Tendo/
M. s€mimembranosus,

M. gastroc'lemius,Caput medialez/ -:
M. gaslrocnemiw, Caput laterale

Fig. 1278 Musclesof the thigh and hip;

deeplayer;mostof the superficialglutealand ischiocrural
muscleshavebeenremoved:
dorsalview (r.).
 *- '*
F €
Musclesof theHip s€
s
S*rs R

Dorsalmusclesof the hip (Figs.1274,127S, 7277,IZBS,lZB6l

pmellus inftdor ed ld. quadrs"tEfi

Origin Insertion

FaciesgluteaofAla ossis Upper fibres: Tibia,below Hip joint:

ilium (dorsalofLineaglutea Condyluslateralis(above Upperfibres:tension,lateral
posterior),
Faciesposterior Tractusiliotibialis).Between rotation,abduction
of 0s sacrum,Fascia Trochanter majorandTractus Lowerfibres:extension,lateral
thoracolumbalis,Lig. iliotibialisis the Bursa
rotation,adduction
sacrotuberale trochanterica musculiglutei
maximi. Knee joint:
(via Tractusiliotibialis)
Lower fibres: Tuberositas extension
glutea,Septumintermusculare
femorislaterale
2. M. gluteus medius Faciesgluteaof Ala ossis Trochantermajor(oblique IIip joint:
N. glutetusuperior ilium (betweenLineaegluteae ridgeon the lateralsurface) Ven8alpart: abduction,
(Plaus saualis) anteriorandposterior) flexion,medialrotation
Dorsalpart: abduction,
extension,lateralrotation
3. M. gluteus minimus Faciesgluteaof Ala ossis Trochantermajor (oblique Hip joint:
N. gluteussuperior ilium (betweenLineeegluteae ridge on the lateralsurface) Venhalpart: abduction,
(Plaus socmlis) anteriorandinferior) flexion,medialrotation
Dorsalpart: abduction,
extension,lateralrotation
4. M. pirifornis Faciespelvicaof 0s sacrum Trochantermajor(medial Hip joint:
N. ischiadicnsand/or (lateralandbetween3rd and surface,superiorborder) Lateralrotation,extension,
N. murculipiriformis 4th ForaminasacraliapeMca), adduction
(Plerus sauulis) Incisuraischiadicamajor
(closeto Ossacrum)
5. M. obturatorius internus Inner surfaceof Foramen Fossatrochanterica
N. mtsatl obLraturii inhmi obturatum
andRxrurcularcs
(Plautssaaulb)
Spinaischiadica Fossatrochanterica

Hip jolnt:
Lateralrotation,extension,
Tuberischiadicum Fossatrochanterica adduction

Lateralborderof Tuber Cristainterhochanterica

ischiadicum
Dorsal muscles of the thigh (Figs.1277,1286)
To the dorsalmusclesof the thigh belong:M. bicepsfemoris, M. semitendinosuqand M. semimembranosus(orderfioiri:$tii&ce to
bone)
Muscle Origin Insertion Function
Innervation
Caput longum: Tuber Caputfibulae(aroundLig. Hip joint:
longum:N. ischiadi- ischiadicum(commontendon collateralefibulare),radiates extension,adduction,
with M. semitendinosus) into Fasciacruris lateralrotation
:r Caput breve: Knee joint:
Labiumlateraleof Unea flexion,lateralrotation
aspera(medialthird)

Caputbreve:operates
l joint
Tuberischiadicum(common Tuberositastibiae Hip joint:
tendonwith Caputlongum (medialsurface) extension,adduction,
musculibicipitisfemoris) medialrotation
Knee joint:
flexion,medialrotation
Tuberischiadicum Proximalend of tibia (below Hip joint:
Condylusmedialis),posterior extension,adduction,
capsuleof the kneejoint, medialrotation
Lig. popliteumobliquum, Knee joint:
fasciaof M. popliteus.The flexion.medialrotation
three insertionsof M. semi
membranosus wereearlier
referredto as Pesanserinus
nrofundus.

Rotalio externa

Fig.1279 Kneejoint; Fig. 1280 Kneejoint;

movementin the sagittalplane. movementin the transverseplane.
' Thisaxisin particularchanges
its positionduringthe course
of the movementcorrespondingto the differentcurvatures
of
the femoralcondyles.
 andKneeloints
323

J. gravityol 4/6 ot lhe body weight

Fs forceof the partot the bodyweighton the hip joint
Rz resultingforcesthal havean effecton the hipioints
whenstandingon both legs
s5 gravityof 5/6 of the bodyweight
F., forceof lhe partof the bodyweighton the hip joint
RE resultingforcesthat havean €tfecton the hip joints
whenstandingon one leg
Fe torcesof the abductingmuscles
leverarmof F*
l2 lever arm of Fe
carryingline
angleof lemoralneck(approx.125')

Fig. 1281 Forceson the hip joint,when

standingon bothlegs.

Fig. 1282 Unilateralforceon the hip joint

in the standingphasewhenwalking.

\
I

td

E part of the force that eft€ctsthe lateral Fo force ot M. quadric€psfemoris lr l€verarmcausedby about56 oflhe body
comoanment force ot Lig. pat€llae weighton the kn6oioint in this po€ition
F- partof the forc€that eft€ctsthe medial RF resultingforcesin th€ f€moropatellar joint 12 leverarmofthe Lig. patellae
@moartment * body'simpulse
joint
Rfi resultingtorcesIn the femorotibial
F$ force on the kneeioint caus€d by about 5/6 of
th€ bodyweight

Fig. 1283 Forceson the kneejoint; Figs. 1284a,b Forceson the kneejoint; sagittalplane.
frontal plane. a femorotibialjoint joint
b femoropatellar
324 Lowerlimb

/ M obliquusextgrnus
M. quadratus
lumborum\ / abdominis
M. obliquusinternusaMominis 1 -- M gluteusmedius
M. transversusabdominis- -
- M. gluteus
mrnrmus
M. iliacus -

4l M. piriformis - --M lensor

tasciaelatae
M gluteus- /, M. rectustemoris
/M.
maxrmus
obturatorius
internus
- M pirilormis
M. rectustemoris - - /. M. gluteus
// Lig sacro- medtus
----
(Bursailiopectinea) i spinale;M obluratorius - M. gluteus
anococcygeus internus mtntmus
\ Bursalrochan-
;- M pectineus M levator-
M. gluleus-- anl tericamusculi
mtnrmus /M. obturalorius gluteimedii
externus \ M. quadratus
M-_
M vastus - - M. adduclor transversus femoris
lateralis longus pennel
- M adductor Bursa
prolundus
M. iliopsoas- brevis i ! suDcutanea
trochanterica
\ M.gemellus /
superior / M gluteusmaximus
M. vastus / M. gracilis
iniermedius \, t t.adductor magnus o,..--,-^*,-rr^- /
\
' M. quadratusfemoris M pectineus
M. vastus -
medialis M. bicepsfemoris M. adductormagnus
semimembranosus \ M. adductorbrevis

M. iliopsoas/ \ M. vastusmedialis

M. vastusintermedius

\ M. adductorlongus

M bicepsfemoris

\ M. vastuslateralis
M adduclor,
magnus
\

Bursasubtendin6a / M gastrocnemius
M. articularisgenus \ \
musculigastrocn-emii'\
meorafis
-- M plantaris
M. quadricepsfemoris:_ / M vastusmedialis
M. semi--
-- M. adductor membranosus
magnus _- Lig. collateraletibulare
M. sartorius-
M. bicepsfemoris\ M gracilis - M. biceps femoris
Lig collaterale fibulare -
M semi-- - M. popliteus
patellae--
Retinaculum - M sartorius lendinosus
M. semi- /
- M soleus
membranosus
M. gracilis
Arcustendineus
\ M. semitendinosus musculisolei
Foramen-
nutricium
Lig patellae M. soleusz-
I
M. fibularis--
Iperoneusllongus
f M.llexot /
digitorum longus
- M libialisposterior
- M. soleus

Fig. 1285 Muscularorigins and insertionson the lower Fig. 1286 Muscularoriginsandinsertionson the pelvicbones,
lumbarspine,the pelvicbones,the femur and the proximal the femur and the proximalendsof the crural bones;
endsof the crural bones; dorsalview (r.).
ventralview (r.).
 Fasciaeof theKneeand Crus
325

-- M. quadric€psfemoris,
Tendo

- M. bicepsiemoris,
- Basis patellae Tendo

Retinaculum--- - Bursasubcutanea
patellaelateral€ piEpalellaris

-- Lig. paiellae
- - Bursasubcutanea
intraoatellaris
Fossapoplit€a -
- (Fasciapoplitea)

--- Tibia, Facies m€dialis

- - M. tibialisanterior.
Tendo

- M.n%asrocnemius,
/ Rolinaculummusculorum
., exlensorumsuperius

-- Retinaculummusculorum
extensoruminlerius
M. exlensordioitorum - Tgndocalcaneus
tongus,tdndines \
-- Malleolusmedialis -
M. exlensorhallucisbrevis

- - M.€xlensorhallucislongus,

-- Fasciadorsalisoedis

Flg. 1287 Fasciaeof the kneeandcrus; Fig. 1288 Fasciaeof the kneeandcrus;
ventralview (r.). dorsalview (r.).
 Lowerlimb
326
Patella Fig.1289 Muscles of thecrusandfoot;
Tractus iliotibialis the fasciaehavebeenremoved:
--- Trbia,
Condylus
ventralview(r.).
Lig patellae medialis
--- Tuberositas
tibiae

M fibularis--
lperoneus] longus
--
M tibialisanterior

M extensor-
digitorumlongus

M extensor --- tibialisanterior.Tendo

digitorumlongus
M extensor - --
hallucislongus
Retinaculum
musculorum\
exlensorum
infeflus
Malleoluslateralis - -

M. fibularis.[peroneusl M biceps
-_ lemoris
tenrus.tenoo --
M extensor hallucis
M, extensordigitorum-- longus, Tendo
longus,Tendines
\
M. exlensor / ,l M ertensot Tractus
digitorum brevis i hallucis brevis iliotibialis

Caput -- --- Lig patellae

fibulae
---- Tuberositas
tibrae

--- M fibularis longus

[peroneusl

--- M tibialisantenor

l\4 soleus -
- - Seolumintermusculare
crdrisanterius
- M tibulansloeroneuslbrevrs

M extensor digitorum longus

//
Tendo calcaneus
\ M libialis anterior,Tendo
\ --
\ M extensor hallucislongus
Malleoluslaleralis \ \.
\ \\ ----
musculorum
musculorum \ / Betinaculum
Retrnaculum .-:. / extensorumInrenus
fibularium superrus
lperoneorum] /M. extensor drgitorum
M fibularis longus,Tendo\\ \
lperoneusl /,' longus, Tendines
Retinaculummusculorum \ / M. extensor
- '
fibularium inferius
lperoneoruml hallucisbrevis

brevis,Tendo--
M libularislperoneus]

Fig. 1290 Musclesof the crusand foot; rM, libularis tertius,Tendo

[peroneus]
the fasciaehavebeenremoved; extensordigitorumbrevis
lateralview(r.).
 "'''$ l*Y
Musctes
of theCrus """'%
*-3 ** I

F i g . 1 2 9 1 A n k l ej o i n t o r t a l o c r u r ailo i n t ; Fig.1292 Intertarsaljoints;

movementin the sagittalplane.Flextonand extensiontaxe turning movementsof the foot.ln extremeplantar flexion,
p l a c ea l m o s te x c l u s i v e liyn t h e a n k l ej o i n t .F o r c l a r i t y pronationin the intertarsaljoints may alsobe calledlateral
t h e F l e x i o -* m a y a l s ob e c a l l e d" p l a n t a rf l e x i o n "a n d t h e abduction,supinationmay be calledmedialabduction.
E x t e n s i o *" d o r s o f l e x i o n " . ' T h i s a x j s r u n n i n g f r o m t h e i n t e r n a la s p e c to f t h e t a l a r n e c k p o s t e r o i n f e r i o r l y
to the lateral processof the Tuber calcaneihas been exaggeratedhere in its
o b l i q u ec o u r s e( s e eF i g 1 3 1 0 )

Ventral muscles of the lower leg (Figs. 1289, 1300, 1308, 1310)

M. tibialisanterior,beingthemostsuperticialanduledial,bulgestheFasciacruris&rtryard.Thenextdeeperuustte:istrfl.erteasor
digitorumlongus,fromwhoselateralborderM.fibularistertiusoftenarises.Thodoepest ls M. ocensqfu*l,U**$t,:,,: ::,,:,,
Muscle Origin Insertion Function
Innervation
1. M. dbialis anterior Proximalpart of the tibia Baseof l st metatarsal
bone Ankle joint:
N. fibularis profundus (belowthe Condyluslateralis), (medialborder),0s cuneiforme dorsoflexion
(N. ischiadicus) Facieslateralisof the tibia mediale(plantarsurface) Intertarsal joints:
(upper2/3),Membrana
supinatesthe foot
rnrerossea,
-rascracrurrs
2. M. extensor hallucis Faciesmedialisof the fibula Baseof the distalphalanxof Ankle joint:
longus (distal2/3),Membrana thegreattoe,baseofphalanx dorsoflexion
N. fibularis profintlw interossea,Fasciacruris
(N. tschiadtcus) Intertarsal joints:
supinatesthe foot
Great toe joints:
extendsthe toe
3. M. extensor digitorum Proximalpart of the tibia , Dorsalaponeuroses
of the
longus (belowCondyluslateralis), 4 lateraltoes
N. fibularisprofwdus Margoanteriorof fibula, Ankle joint:
(N. ischtadla$) Membranainterosseacruris, dorsoflexion
Septumintermusculare cruris
Intertarsal joints:
anterius,Fasciacruris
pronatethe foot
4. M. ftbularls [peronans] Part of M. extensordigitorum Basisof 0s metatarsiV
terdus Toejoints:
,,,, : longus
N. fibularissqti@iatts extendthe toes
(ischtadtcrts): i i: :ri:::
(variable)
32ffi LowerLimb
---- M semitendinosus

- M semimembranosus

----
M sartorius
M gracifts, Tendo

M semimembranosus, Tendo

M semitendinosus,Tendo
/
patellaemediale/
Retinaculum

Corpusadiposuminlrapatellare/

Lig patellae

M gastrocnemrus,Caput mediale

Fig.1293 Muscles in the area of the knee joint; ' common insertion below the medial condyle of the tibia (formerly called

the fasciaehavebeenremoved: Pes anserinus superficialis)

medialview (r.).

--- M vasluslateralis

M adductor magnus
-- M brcepsfemoris,Caput breve

M gracilis
- - - Femur,Lineaaspera

--- M bicepstemoris,Capullongum

M adductormagnus,Tendo--

- - - Femur,Faciespoplitea

- - - Arliculatio
genus,Capsulaarlicularis

---- M biceosfemoris.
Tendo
Tendo---
M semimembranosus,

M gracilis,Tendo ---

Tendo- - -
M. semitendinosus. --- M gastrocnemius,
Caputmediale

---M gastrocnemius,
Caputlaterale

Fig. 1294 Musclesin the areaof the kneejoint;

the fasciaeandthe ischiocruralmuscleshavebeenremoved;
dorsalview (r.).
 Musclesofthecrus
329

1 Compartimentum cruds 3 Compodrn nt n mri!

anterius pGtarfut, Par! profunde
A. and V. tibialisanterior A. and V tibialisposterior
N, fibularisprotundus A. and V.fibularis
M. tibialisanterior N. tibialis
M. extensordigitorumlongus M. tlexordioilorumlonous
-
M. extensorhallucislonous M. tibialisp66terior
M. fibularis[peron€uslt6rtius M. flexorhallucislongus

Fasciacruds \\\ 2 Comparlimenfumcrurla 4 Comp.|trncntum 6urir

lalerab posb|t||+ Paltt|f.|fidalb
N. libularissup€rficialis M. tric€ps surae
Septum-
M. fibularis[peroneus]longus M. plantaris
intermuscirlare M. fibularis[peroneuslbrevis
crurisanlerius

Septum--
intermusculare
crurisposterius -- Membrana
interossea
cruns
--
v. saphena
magna
\
\ N saphenus Fig. 1295 Osteofibroustubesofthe crus;
Fasciacruris-
crosssectionabovethe middleof the crus;
distalview (r.).
Clinically theseosteofibroustubestogetherwith thelr contentsarc
calledcompartments.
N. culaneus/- * deeppart of the crural fascia
suraemedialis
V saphenaparva /

Lateral musclesof the lower leg (Fig. llg0)

Mwdg
Iut*ffit

tendon
33tl LowerLimb

--- --- M biceosfemoris

M semitendanosus

---
M semimembranosus
--- M plantaris

- -
Femur, Facies poplitea

M semitendinosus.Tendo --

Tendo---
M semimembranosus.
M gastrocnemius,Caput mediale ---
--- CaPutlaterale
M gastrocnemius,

- M soleus

Tendo--
M gastrocnemius,

M, olantaris.Tendo ---

--- Malleoluslateralis
1i

tl
t

Fig. 1296 Musclesof the crus;

the cruralfasciahasbeenremoved;
dorsalview(r.).
* also: Achilles tendon
 sctesofthecrus
33I

M gastrocnemius,Caput mediale --
--
M bicepsfemoris
-
M semrmembranosus-

--
Bursasubtendinea
musculi - M gastrocnemius,
gastrocnemii
medialis Caputlaterale
--
Bursamusculisemrmembranosi

Lrg popliteum -- --
obliquum Lig popliteum
arcualum
--
lrbia, Condylus medialis
/
M planlaris

A ; V poplitea;Arcus tendineusmusculi solei

M Dlantaris.Tendo --

M gastrocnemius

M libularislperoneus]
longus

M gastrocnemius,Tendo --

- M flexor hallucislongus
M tlexor digitorumlongus --

\
Septum intermuscularecruris posterius
M tibialisoosterior.Tendo -

Malleolusmedialis /

/
Tendo calcaneus' /

- Retinaculummusculorum
Retinaculummusculorumf lexorum frbularium superius
Iperoneorum]

Tuber calcanei

Fig. 1297 Musclesof the crus;

the gastrocnemiusmusclehasbeenpartiallyremoved;
dorsalview (r.).
* also: Achilles tendon
 Lowerlimb
332

M gaslrocnemius,
Caputmediale \\ -- Femur, Facies poplilea

i,\
\. / / M. bicepstemoris
Bursasubtendineamusculi \ --* \
gastrocnemiimedialis -- M. gastrocnemius,
Caputlaterale
!

Bursamusculisemimembranosi-- i
- M planlaris
Tendo --
M semimembranosus,

Lig.popliteumobliquum - -

M tibialisoosterior--
- M soleus

Fibula,Margointerosseus

M. llexordigitorumlongus --

--
M tibialisoosl€rior

M. fibularislperoneusllongus

- - M. flexorhallucislongus

longus,Tendo--
M flexordigitorum

Malleolusmedialis - -

M tibialisoosterior.Tendo /

Betinaculummusculorumtlexorum /

\ Retinaculum
musculorumfibularium
lperoneorumlsuperius

Tendocalcaneus'
\ Tub€r calcanei

Fig. 1298 Musclesof the crus;

mostof the superficialmuscleshavebeenremoved;
dorsalview (r.).
' also: Achilles tendon
 sctesofthecrus
333
M gastrocnemius,
Caputmediale
---'

_-- M. plantaris
---
Bursamusculisemimembranosi
--- M popliteus

---
Tibia,Condytusmedialis- - - M. bicepsfemoris,
Tendo

-
Recessussubpopliteus

-- Fibula,Margoinlerosseus
Iibia ----

M. tlexordigitorumlongus- - - -

M tibialisposterior

M flexor hallucis longus

M tibialisoosierior.Tendo

- - - M. llexorhallucislongus,Tendo

M flexordigitorum longus, Tendo

M. tibularislperoneuslbrevis

Flelinaculum tlexorum---
musculorum

- - Retinaculum
musculorum fibularium
lperoneorumlsuperius

Tendo calcaneus /

Fig. 1299 Musclesof the crus;

mostof the superficialmuscleshavebeenremoved; the
poplitealmusclehasbeensectioned; the tendonof the flexor
digitorumlongusmusclehasbeenremovedwhereit crosses
the tendonof M. tibialisposterior(so-calledcruralchiasma);
dorsalview(r.).
 LowerLimb

Dorsal muscles of the lower leg, superficial group (Figs.1296,1297,1301)

The surfaceanatomyof the calf is formedby the two headsof M. gasFocnemius,:lqfies
uponM. soleus.Togetherthey form
M. tricepssurae.The small M. plantariscan be seenasl& 4th muscb.,ofthis gioq, ,::':r:r,,
MuscIe Origin Insertion Function*
Innervation
M. eiceps surae.:,r, :.,:r:M. gastrocnemius, Caput aboveTendo
Tubercalcanei, Kneejoint: (M.gastrocnemius
N. tibialis (N. ischiadicns) "l:r mediale:Faciespoplitea (Achillestendon)
calcaneus and M. plantarisonly)
of the femur(proximalof Flexion
Condylusmedialis) Ankle joint:
r;::,M. gastrocnemius,Caput Plantarflexion
'::i' laterale:Faciespopliteaof the
Intertarsal joints:
femur (proximalof Condylus Supination
Iateralis)
.r:::::M. soleus:Caputfibulae,
:l:llllFaciesposteriorandMargo
posteriorof the fibula
(proximalthird),Facies
posteriorof the tibia (at and
lrll:lunderLineamusculisolei),
' ,:1,At'custendineusmusculisolei
M. plantaris:Faciespoplitea
femoris(proximalof Condylus
r,l lateralis)
* Regarding the foot, plantar flexion
is also called flexion, dorsal flexion is ca_lledfitension

Dorsalmusclesof the lowerleg,deepgroup(Figs.1298,1301,1313,1314,1318)

.4,:l 'tttt:t:,. ,,:,,1
I ,.:ll . ..i::i:. ,
tl::,,,. :i:1.,
Themost proximal muscle,M. popliteus,coursesobliquely lateral to the knee joint. 0f all theimusclesrunning into the feet,
M. tibialis posterioris the most superficial. Belowit are, medially,M. flexor digitorum longus and laterally, M. flexor hallucis
Iongus.
::i::1, :l::::rl :::i:::::,

Muscle Origin Insertion Function*

Innervation
1. M. popliteus Epicondyluslateralisof the Faciesposteriorof the tibia, Knee joint:
N. tibialis(N. ischiadicus) femur aboveLineamusculisolei Medialrotation,fl exion

2. M. tibialis posterior Membranainterossea, Fascies Tuberositasossisnavicularis. Ankle joint:

N. tibialis (N. ischiadicus) posteriorof tibia and fibula Ossacuneiformia I-III Plantarflexion
(proximalhalf adjacentto (plantarsurface),
basesof Intertarsal joints:
Membranainterossea) OssametatarsiII-lV Supination
3. M. flexor digitorum Faciesposteriorof tibia Phalangesdistalesof the 2nd Ankle ioint:
longus (distalof Lineamusculisolei), to 5th toes Plantarflexion
tendinousarchbetween Intertarsal joints:
fibula and tibia (proximalof Supination
Chiasmacrurale)
Toejoints:
Flexion
Faciesposteriorof tibia Phalanxdistalisof greattoe Ankle joint:
(distal2/3),Membrana Plantarflexion
interossea,Septum Intertarsal joints:
intermuscularecruris Supination
posterius
Great toe joints:
Flexion
r Regarding the foot, plantar flexion is also called flexion, dorsal flexion is
called extension
 Tractusrliotibialis
Musclesof theFoot;Originsand Insertions;Forces
33s
-- M sartorius
M extensor
digrtorum -- - -
M semimembranosus
longus M gracilis
--
M quadricepstemoris
M biceps femoris - - M popliteus--
M semitendinosus

M fibularis[peroneus] --
longus M tibratisanterior
-- M tibialisposterior
M extensor digitorum
longus

- M fibularis
{peroneusl
M flexor drgitorumlongus - - longus

M fibularis[peroneus] -- M flexorhallucislongus
orevts

-- M tibularis
[peroneusl
M extensor hallucis -- orevrs
tongus

- M flexordigitorum
longus
M flexor hallucislongus, -
Tendo
./ M. fibularis
[peroneus]
lil tibialisposlerior, --- Drevrs,tenoo
Tendo
/ '-
M flexor digitorumlongus, / M, libularislperoneus]
Tendo longus,Tendo

Fig. 1300 Muscularoriginsand insertionson the Fig.1301 Muscular

originsandinsertions
on the
crural bones; cruralbones;
ventralview (r.). dorsalview(r.).

Fr" Force of the body weight (6/6) Forceof lhe Archillestendon lr lever arm
BosG Resultingforce in the superiorankle joint Forceof the extensormuscles 12 lever arm
E
Stresson the plantaraponeurosis

Fig. 1302 Forceson the footwhenthe Fig. 1303 Forceson the footwhen Fig. 1304 Forceson the footwhen
heeltouchesthe ground. there is a staticstress. pushingfrom the ball of the toe.
 LowerLimb
336

M extensor digrtorumlongus ..
-- M tibialisanterior,Tendo

-- M extensor hallucislongus
Lig tibiofibulareanterius \.

Retinaculum
musculorum: - Malleolusmedialis
inferius \
extensorum

Malleoluslaleralis \ -- Vagina tendinis musculi tibralisanlerioris

-- Vagina tendinis musculi extensoflshallucislongi

Retinaculummusculorumfibularium --
Iperoneorum]inferius

Vaginacommunis
tendinum -
musculorum
libularium
[peroneorum]

M fibularis[peroneus]brevis,Tendo .-

M extensor digitorumbrevrs
-- M tibialisanterior.Tendo
Tuberositasossis metatarsiquinti
- - M extensor hailucisbrevis
M abductor digiti minimi
-- Li99 tarsometatarsaliadorsalia

M fibularis tertius,Tendo-
{peroneusl

(M opponens digiti minimi) /

--
Corpus ossis metatarsi I

M extensor longus,Tendines-
digitorum
--
M extensor hallucisbrevis.Tendo

Mm interosseidorsales pedis -

Fig. 1305 Synovial sheathsofthe tendons,Vaginaetendinum, ofthe foot;

dorsal view (r.).
(
SynovialSheathsof the Tendons
of theFoot

- Vaginatendinismusculi
tibialisposterioris

' Vagina tendinis musculi

flexoris digitorum longi

Retinaculum
muscuforum
extensorum
r^r"rr"", ---'Lf - Vaginatendinis musculi
tlexoris hallucis longi
i.:
Vaginatendinis musculi extensorishallucislongi\\
-- Tendocalcaneus
4
-
Vagina tendrnismuscuh flexorishallucislongi\ ii -----
Relinaculummusculorum
llexorum

-
M abductor hallucis,\ Vaginatendinismusculi
Tendo tibialisoosterioris

- -
M. abductor hallucis

Vagina lendinis musculi tlexorisdigitorumlongi/ M flexor digitorum brevis

Fig. 1306 Synovial sheathsof the tendons,Vaginaetendinum, of the foot;

medialview (r.).

M extensor hallucislongus,Tendo\

M exlensor digitorum longus .--

M frbularis.---- / Vaginatendinum
musculiexlensoris
digitorum
longi
[peroneus]brevrs
/ Retinaculum
musculorum inlerius
extensorum
Fibula - -1 .-j
\ / Vagina tendinis musculi extensorishallucislongi

\-i \.= ,
I \r,'1 / M extensor hallucis brevis
M fibularis-
longus
lperoneus] \ '.\ )t '/)
Tendo calcaneus-

Retinaculummusculorum-
f ibulariumlperoneorum]superius M extensordigitorum
longus,Tendines
Relinaculummusculorum-
f ibularaumIperoneorum]inferius

\ M extensordigitorumbrevis
Vagina communis tendrnummusculoruml
fibularium \ M libularis tertius,Tendo
[peroneorum] lperoneus]
M fibularislperoneus]brevis,Tendo

Fig. 1307 Synovial sheathsof the tendons,Vaginaetendinum, of the foot;

lateral view (r.).

Synovial sheaths of the tendons of the foot

Dorsaltarsal vaginaetendinum: on the dorsumofthe footand superius and inferius, in most cases a common vagina
coveredby the Retinaculamusculorumextensorumsuperius tendinumfor the tendonsof the M. fibularis [peroneus]longus
and inferius, for the tendons of the M. tibialis anterior, and M. fibularis [peroneus] brevis. The synovial sheath
M. extensorhallucislongusandM. extensordigitorumIongus. continuesalongthe tendonof the M. fibularis [peroneus]longus
Medial tarsal vaginaetendinum:dorsalto the medialmalleolus below the Lig. plantare longum as far as the insertion at the
and coveredby the Retinaculamusculorumflexorum,for the plantar base of the first 0s metatarsiand 0s cuneiforme
tendonsof the M. tibialisposterior,M. flexordigitorumlongus mediale.
andM. flexorhallucislongus. Digital plantar vaginae tendinum: at the plantar side of the
Lateral tarsal vaginae tendinum: dorsal to the lateral toes, for the tendonsof the M. flexor digitorum longus and
malleolusandcoveredby the Retinaculamusculorumfibularium M. flexordigitorumbrevis.
33lq LowerLimb

---- M tibialisanlerior,Tendo

- -
M extensor hallucislongus

M extensor longus - -
digitorum

Retinaculum
musculorum inferius- - -
extensorum

brevis,Tendo ----
M fibularis[peroneus]

Retinaculum
musculorumfibularium- - -
Iperoneorum]interius

M. exlensordigilorumbrevis - -

M fibularis tertius,Tendo ----

[peroneus]

M extensor longus,Tendines---
digitorum

- - - - M. extensor
hallucisbrevis
M. abductordigiti minimi - - -

- - - Articulatiometatarsophalangea
hallucis,Capsulaarticularis

Fig. 1308 Musclesof the foot;

the synovial sheathsof the tendons have been removed;
dorsal view (r.).
 sctesoftheFoot
33g

M libularislperoneus] --
tertius
M libialis anterior, Tendo

M extensor digitorumlongus ---

' M
extensor hallucislongus

M fibularis brevis,Tendo-*--
lperoneus]

M extensordigitorum brevis - - - ---- M extensor hallucisbrevis

M fibularis terlius,Tendo--
lperoneus]

M. abductordigrtiminimi - - - -

Fig. 1309 Musclesof the foot;

the inferior extensorretinaculumhas beensectioned;
most of the extensordigitorum longus muscle has been removed;
dorsalview (r.).
 LowerLimb \

- - M triceos surae. Tendo calcaneus

Articulatio Axistransversalis
talocruralis,

M extensor digilorum brevis; M exlensor hallucisbrevis --

Axis obliqua
Articulalrolalocalcaneonavicularis,

M fibularis[peroneus]
brevis
M fibularislp€roneus]tertius

/ Mm. interosseidorsales pedis

minimi--
M abductordigiti

Mm interosseiplantares - - -- M abductorhallucis

)-- hatlucis
trlm extensores longuset brevis
Mm extensoresdigitorumlonguset brevis

Fig. 1310 Muscularoriginsandinsertionson the bonesof the foot;

dorsalview (r.).
Theaxesof the ankleioint andof the intertarsaliointsareshown.

Musclesof the dorsumof the foot (Fig.1308)

Muscle OriC,ln Inserdori Function*

Innervation
Toejoints:
Extension

Metatarsophalangealjoint
of the great toe:
Extension
 MusctesoftheFoot
34I

-- Lig. metata.salelrans\roEum
sup€rficiale

(Emin€ntiaplantarislateralis) --

Aponeurosisplantaris /

Malleoluslateralis /'

-- BurBasubcutan€acalcanea

Fig. 1311 Musclesof the foot;

the plantaraponeurosisis shown;
plantarview (r.).
 LowerLimb

Vaginaetendinum digitorumpedis
\

N
t \ l-
t\
I
I
I

- - - M tlexor hallucislongus,Tendo

M m l u m b r i c a l e sp e d r sl v - l - - -

--- M llexor hallucisbrevis

M adductor hallucis.Caput ---
transversum

planlanslll
M interosseus

M abduclor digiti minimr - - -

---- M a b d u c t o rh a l l u c i s
M flexor digiti minimr brevis --

Nl tlexor digitorum brevis -

plantaris/
Aponeurosis

Fig. 1312 Musclesof the foot;

most of the plantar aponeurosishas been removed;
plantar view (r ).
 sctesoftheFoot
343

M flexorhallucislongus,Tendo
Vaginaetendinum digitorum pedis \

M. llexordigitorumlongus,
tenotnes

M flexor digitorumbrevis,/ ---- M adductor hallucis,

Tendines Caput lransversum

--- M flexor hallucisbrevis

M flexordigitorumlongus,Tendo
Vaginaplantaristendinis
musculifibularis[peroneillongi

M flexorhallucislongus,Tendo
M interosseus
plantaris
llll

M interosseusdorsalispedislVl

M tibularis longus,Tendo/
lperoneus]
---- M abduclor hallucis

plantaez
M quadratus

- M. tlexordigitorum
brevis

Tubercalcanei

Fig. 1313 Musclesof the foot;

middlelayer;mostof the plantaraponeurosishasbeen
removedtogetherwith the flexordigitorumbrevismuscle;
plantarview(r.).
 LowerLimb
34€

M flexordigitorumlongus,Tendines

- - - M. llexorhallucislongus,Tendo

- - - M. flexordigitorumbrevis,Tendines

Mm lumbricalespedislV-l - -

M. int€rosseusdorsalisoedislll - - -

plantares
Mm.interossei lll et ll ---
dorsalispedislV ---
M interosseus M flexor hallucis brevis

digitiminimD--
(M opponens -

M. fl€xordigitiminimibrevis - - - --- M aHuclorhallucis

M abductor digiti minimi - - - -- M. flexorhallucislongus,Tendo

longus,Tendo ---
M fibularis[peroneus]

M. quadratusplanlae -' - - - M. flexordigitorumlongus,Tendo'

--- M tibialisposterior,Tendo

-- - - Relinaculummusculorumfloxorum

Lig.plantarelongum -- - -
- t. llexorhallucistongus,Tendo*

M abductordigitiminimi -:
"'
M abduclor hallucis

Aponeurosisplaniaris /' \:
M. flexordigitorumbrevis

Fig. 1314 Musclesof the foot; The place where the tendon of the flexor diSitorum longus muscle crosses the
tendon of the flexor hallucis longus muscle is called Chiasma plantare.
deeplayer;mostof the superficialmuscles,the flexordigitorum
and the flexor hallucislongusmuscleshavebeenremoved;
plantarview (r.).
 sctesoftheFoot
345

/ Mm. extensoreshallucislonguset brevis,Tondines

Mm.extensoresdigitorumlonguset br€vis,Tendines \

Fasciadorsalispedis \
-- M. inleross€usdorsalispedisll

M. inteosseusdorselisp€dislll -- -- M. inlerossousdorsalisp€dis I

M interosseusdorsalisp€dislV -- -- M. int€rosseusplantarisI

(M. opponensdigitiminimi) -- j - - M. adductorhallucis,Caputobliquum

M. abduclordigitiminimi - - - - M. abductorhallucis

M. flexor digiti minimi brevis -- - -

M. flexorhallucislongus,Tendo
TI
(Emin€ntiaplantaristateratis)I !
M. inteross€usplantarislll '
M. inleross€usplantarisll
Aponeurosisplantaris

Fig. 1315 Osteofibrous tubesof the foot;

frontal sectionthroughthe metatarsus;
distalview(r.).

Mm. inteross€i
dorsalesD€disl-lv

Flg. 1316 Musclesof the foot: Fig. 1317 Musclesof the foot;
dorsalinterosseous
muscles; plantarinterosseous
muscles;
dorsalview(r.). plantarview (r.).
 LowerLimb

Muscles of the medial plantar group (Figs.1312,1318)

Thecontourof the medialrim of the f00t,the Eminentiaplantarismedialis,is formedprimarilyby M. abductorhallucis
followedby M. flexorhallucisbrevisandlaterallyM. adductorhallucisfollow.
Muscle Origin Insertion Function*
Innervation
1. M. abductorhallucis Proc.medialisof Tuber Medial sesamoidbone of the Metatarsophalangeal joint of
N. plantarismedtalis calcanei,Aponeurosis c a p s u l eo f t h e g r e a tt o ej o i n t , the great toe:
(N. tibialis) plantaris,Retinaculum medialside of the Phalanx abduction,flexion
musculorumflexorum proximalisof the great toe
2. M. flexor hallucis brevis Ossacuneiformia (plantar Medial part: Medial sesamoid Metatarsophalangeal joint of
Medialpart:N. pLantaris surface), boneof the capsuleof the meta- the great toe:
medialis(N. tibialis) Lig. calcaneocuboideum tarsophalangeal joint of the flexion
Lateralpart: N. plantaris plantare, great toe;baseof the Phalanx
Iateralis(N. tibialis) Lig. plantare longum, proximalis of the great toe
tendon of M tibialis posterior
Lateral part: Lateral sesamoid
boneof the capsuleof the meta-
tarsophalangealjoint of the
great toe; baseof the Phalanx
proximalis of the great toe
3. M. adductor hallucis Caput obliquum: 0s Lateralsesamoidboneof the Metatarsophalangeal joint of
N. plantarislateralis cuboideum,Os cuneiforme capsuleof the metatarso- the great toe:
(N. tibialis) laterale,Lig. plantare longum, phalangealjoint of the great adduction to the 2nd toe,
Lig. calcaneocuboideum toe;baseof the Phalanx flexion
plantare proximalis of the great toe
Caput transversum: Capsules
of the metatarsophalangeal
joints of 3rd to 5th toes,Lig
metatarsaletransversum
orohlndum
* R e g a r d i n gt h e f o o t ,p l a n t a rf l e x i o n
i s a i s oc a l l e df l c x i o n ,d o r s a lf l e - r i o ni s c a l l c ( ie x t o n s i o n

Musclesof the middle of the sole of the foot (Figs.1312,1318)

In the middleof the footarea numberof smallmuscles.M. flexordigitorumbrevisarisesfromthe plantaraponeurosis. Below
it M. quadratusplantaeand M. flexor digitorumlongusform onetendon.Fromits 4 small tendonsarisethe Mm. lumbricales
pedisI-IV. TheMm.interossei plantaresI-III andtheMm.interossei
dorsalespedisI-IV fill the spaces
betweenthe Ossametata.rsi.
Mttscle/lnnervation Origin Insertion Function*
1, M. flexor digitorum brevis Tuber calcanei(plantar Medial phalangesof the 2nd to Proximal phalangeal j oints:
N. plantarismedialis surface),Aponeurosis 4th toes (penetratedby the flexion
(N. tibialis) plantaris tendons of M. flexor digitorum Toe joints:
l0ngusl flexion
2. M. guadratus plantae Calcaneus(plantarsurface), Lateral margin of tendon of Correctsthe oblique
N. plantaris lateralis Lig. plantare longum M. fleror digitorum longus orientation of M flexor
(N. tibialis) (beforeit divides) digitorum longus
(alsocalledM. flexor
accessorius)
3. Mm. lumbricales M. lumbricalis pedis I: Medial side of the proximal Proximal phalangeal joints:
pedis I-fV tendonofM flexor digitorum phalangesof the 2nd to 5th flexion
Nn.plantaretmedialis(l) Iongusto the 2nd toe (medial toes,sometimesinserting into
and lateralis(II-N) side) the dorsalaponeurosis
(N. tibialis)
Mm. lumbricales pedis II-[V:
tendonsof M. fiexor digitorum
longus to the 3rd to 5th toes
4; Mm, interossei Ossametatarsi III-V Medial sideof the basesof the Proximal phalangeal joints:
plantares I-Itr (plantarsurface),Lig. proximal phalangesof the 3rd flexion,adductionto the 2nd
N. plantarislateralts plantarelongum to 5th toes t0e
(N. tibialis) :
5. Mm. interossei By two heads from the M. interosseus dorsalis l: Proximal phalangeal joints:
dorsalespedis I-IV adjacentsidesof the Medial side of the baseof the flexion, abduction of the 3rd
N. plantarislateralis metatarsalbones,Lig. plantare Phaianx proximalis of the 2nd and 4th toesto the lateral.
(N. tibiatts) longum toe adductionof the 2nd toe to the
medial side
Mm. interossei dorsales
II-IV: Lateral side of the bases Toe joints:
of the proximal phalangesof extensl0n
the 3rd and 4th toes,inserting
into the dorsal aponeuroses
. R e g a r d i n gt h e f o o t ,p l a n t a rf l e x i o ni s a l s or ; a l l e df l e x r o n ,d o r s a lf l e x i o n
i s c a l l e dc x t e n s i o n
( Musclesof theFoot,Originsand Insertions

M adductor hallucis,Caput obliquum

I
I
M tlexor digitorumbrevis
\

M flexor digitorum longus \

- - - M flexor hallucislongus,Tendo '

M adductor hallucis,Caput transversum \

Mm interosseiplantares \.
abductor hallucis
i/ flexor digiti minimi brevis \
\
M abductordigiti minimr --

- - M abductor hallucis,Tendo
I
- -].--- M l l e x o rh a l l u c i sb r e v r s
I
--+--- M fibularis longus
[peroneus]
t'
Mm interosseidorsalespedis
"'i it
v\
lx
flexor digiti minimi brevis --
\-
x
t
-'- J
M abductordigiti minimi-' T -- M abductorhallucis

{f *
lx
xI

M fibularis[peroneus]longus, fendo -' -- M libialisposlerior

)il

M abductor digiti minimi -/

M abductordigitrminrmi -

Fig. 1318 Muscularoriginsand insertionson the

bonesof the foot;
plantarview (r.).

Muscle/Innervation Insertion
:1;: Base of Phalanx proxinalis of
the Sthtoe.Tuberositas
ossis
metatarsiV

Phalanxproximalisof the 5th Metatarsophalangeal joint

toe of the 5th toe:
Abducts,flexes,and opposes

0s metatarsiV Metatarsophalangealjoint
(lateralmargin) of the Sth toe:
Abducts,flexes,and opposes

' Regarding the foot, plantar

flexion is also called flexion, dorsal flexion is called extension
348 Lowerlimb

s2
s3
s4

s5

sl \\\

Fig. 1319 Segmentalinnervation(dermatomes)

of the lower Figs. 1320a,b Segmentalinnervation(dermatomesl
of the
limb; lowerlimb.
ventralview (r.). a dorsalview (r.)
b plantarview(r.)
 Cutaneous
Nervesof theLowerLimb

--
N. iliohypogastricus,
R. cutaneuslateralis
-- N. iliohypogastricus,
R. cutaneuslateralis
Nn.lumbales.
Nn.clunium t\-
N culaneus -- supenores \
femoris lateralis

-- N. iliohypogastricus,
H.Cutaneus anlenor

N cutaneus-
lemoris
posterior,
Nn clunium
inleriores

N cutaneus
lemorisposterior

N. obturatorius,
R. cutaneus

- -
obturatorius,
R cutaneus

>--- N .f i b u l a r i s
z communts,
N. cutaneus
N saphenus,-- suraelateralis
(N ischiadicus)
Rr.cutaneicruris
mediales
(N.lemoralis)
N .f i b u l a r -i s- - ( '
communrs, \
N cutaneus
suraelateralis N saphenus,
(N.ischiadicus) Rr. cutanei
cruns mediales
(N femoralis)

- - N. fibularisprotundus,
Nn.digitalesdorsalespedis
(N ischiadicus)

I Nn lumbales
I N. iliohypo-
gaslricus
N genito-
lemoralis I N. obturalorius
I
N.fiburaris

I Nn sacrales
I N cutaneus
lemorislateralis N. lemoralis
I N. cuianeus
femorispost€rior SN\
N.suraris

Fig. 1321 Cutaneous

nervesof the lowerlimb; Fig. 1322 Cutaneous
nervesof the lowerlimb;
ventralview(r.). dorsalview (r.).
 LowerLimb
350

I
I

lI
,, tn
- -
N genitofemoralis X
''*
N femoralis- - c
4'
c -- N gluteussuperior
-- N. gluteusinterior
-- N. pudendus
-- N cutaneus
femorisposterior
--
N. ischiadicus

- - - N. fibulariscommunis

communis- - -
N. fibularis

profundus---
N fibularis N.cutaneus
surae
+---
/ medialis

N tibularis ---
superfrcialis
--- N cutaneussuraelaleralis

--- R communicans
fibularis

N. cutaneus dorsalis---
intermedius
/
N cutaneusdorsalismedialis / - - N. culanousdorsalislateralis

- N. plantarislateralis
\\\:-

;--- N . P l a n t a r i sm e d i a l i s
Nn. digitalesdorsalespedis /

Fig. 1323 Nerves of the lower limb; Fig. 1324 Nervesof the lowerlirnb;
ventral view (r.). dorsalview (r.).
 Arteriesof theLowerLimb
351
A. gluteainferior
i------A.femoralis
A circumflexa - --t--A
femorislateralis circumflexa
femorismedialis

R ascendens - - - A. profundafemoris

-
R descendens

Aa perforantes--
-z!- -- Aa. p€rforanles ( l ;l l ; l l l )
( l ;l l ; l l l )

--
A descendens
9enus

-t-- R saphenus A poplitea -

--T--
R .a r t i c u l a r i s

/ A. superiorlateralis
A superior genus
A. superior - -- medialisgenus
lateralisgenus A superior
genus
medialis - - A. suralis
- - Retearticularegenus - A. mediagenus
A inferior- A suralis
lateralisgenus - A. intoriorlaleralis
- A. inferior
genus A. inferior-- 9enus
- - (A.
medialis medialisgenus r€curr€nstibialis
posterior)
A. recurrens-
tibialisanterior --
A tibialisoosterior - A. tibialisanterior

A tibialisanterior -
\ A. fibularis

- R communicans
A libularis.R oerforans
/ A malleolaris
/ anteriormedialis
A malleolarisanteriorlateralis - Rr. malleolareslaterales
A. tarsalislateralis -/ A. tarsalismedialis

-- A. dorsalisD€dis -- A planlarislateralis

-- - - Arcusplantarisprofundus
Aa. metatarsales
(A. arcuata)/ dorsales

Fig. 1325 Arteriesof the lowerlimb; Fig. 1326 Arteriesof the lowerlimb;
ventralview (r.). dorsalview(r.).
Thepart of the femoralarterybetweenthe pointwherethe
A. profundafemorisbranchesoff and the point
whereit entersintothe adductor canal,Canalisadductorius,
is clinicallycalledthe superficialfemoralartery.
 ,s .*=.
&s -,-' LowerLimb

A femoralisO \ R. culaneusanterior(N. iliohypogastricus)

A.; V.epigastrica s --
superlicialisa

/ N ilioinguinalis

/ o V. lemoralis
N. culaneuslemorislateralis

- O * Aa.:Vv.pudendaeexternae

R. femoralis(N genitofemoralis) -

- & V saphenaa@essoria(lateralis)
A.;V circumflexa s /
iliumsuperficialisO

- s V. saphenamagna

Rr cutaneianteriores(N femoralis)

Rr.cutanei(N. obturatorius)

O A desc€ndensgenus

(N. saphenus)
R. infrapatellaris

Rete oatellareo /

Fig.1327 Epifascial vessels andnervesofthe inguinal

region,Regioinguinalis,the anteriorfemoralregion,
Regiofemorisanterior,andthe anteriorkneeregion,
Regiogenusanterior;
ventralview (r.).
 Regtoinguinatis
353

Lig. inguinale :_

-/ v epigastricasup€rticialis

/ Nodi lymphoid€iinguinales
/ / superficiales

-- Funiculusspermaticus
V s a p h e n a m a g n-a-
-- W pud€ndaeexternae

-- V saphenaacc€ssoaia
(medialis)

-- V.saphenamagna

--
M. adductorlongus

Fig. 1328 Superficiallymphaticvessels, lymphnodes

and main veinsof the inguinalregion,Regioinguinalis;
ventralview(r.).

M psoas maior - Nodilymphoideiiliaci

intemi

Nodi lymphoidei iliaci externi, - A.; V. iliacainterna

Nodi taterales

Nodi lymphoidei iliaci externi, - Rectum

Nodi mediales

A.; V. iliaca externa

- Ovarium

- Ul€rus

Nodi lymphoidei inguinales

super{iciales, Nodi superolaterales - Vesicaurinaria
Lig inguinate
Nodi lymphoidei inguinates
superficiales, Nodi superomediales

- Nodilymphoideiinguinales,
(Nodiprofundi)

- Nodilymphoideiinguinal€s
superficiales,
Nodiinlerior€s

Fig. 1329 Drainingareasof the lyrnphnodesof the

inguinal region,Regioinguinalis,in the female;
ventralview (r.).
Thearrowsshowthe directionof the lymph flow.
* Lymph fluid can drain from the medial part of the uterlne tube and the
uterinefundusvia the mund ligament(Lig.tercsuteri) to the superficial
lynph nodesof the inguinalregion.
 LowerLimb
354
/ OA iliaca externa
N temoralis
- OV iliaca externa
N culaneus femoris laleralis

- aA iliaca interna
Lig inguinate

A circumflexailium prolunda O

M iliacusO -- -- aM pectineus
N temoralis
-- OV saphena magna

A profundafemoris O --
- -
+R muscularis(N femoralis)
A temoralis* a --

-
M tensor fasciae latae a -- aV lemoralis

- OM adductor longus

M rectus femoris O -

M vastuslateralis| --

--
OM vastus medialis

R articularisa -
(A descendens
genus)

ro92 Rete patellare O --

ro94
tYttt
827/l
Lig patellae --

Fig. 1330 Vesselsand neryesof the anteriorfemoral * Clinicallythe femoralartery is oftencalledsuperficialfemoralartery to

region,Regiofemorisanterior; differentiateit from the A. prcfundafemoris(deepfemoralartery).
the Fascialata hasbeenremoved,exceptfor the iliotibial tract;
ventralview (r.).
J Vessels
and Nervesof the Thigh
355
e N obturatorius
N cutaneus femoris lateralisa -
/ O A femoralis

N lemoralisa -_ I O M Pectineus

M i l i a c u s O- _ _ / a R acetabularis(A. obturatoria)

/ O R. anterior(A obturatoria)

.- t N obluratorius
A circumflexafemoris lateralisO
-- O A circumllexa
femorismedialis

A prolundafemorisa-
a R superlicialis
(A circumflexafemorismedialis)
M sartoriusa--

R d e s c e n d e n s O- - -
(A, crrcumflexatemoris lateralis) '-- O V femoralis

-- OA femoralis

'-- a R cutaneus(N obturalorius)

-- o N saphenus
M r e c t u s f e m o r i s -O- -
R muscularis
(N femoralis)
r --

Septumintermusculare
vastoadductorium'

O M gracilis

- a N saphenus

M v a s t u s m e d i a h s-a- D M, sarlorius

(A descendens
B articularis genus)O--

lo92
1094

tggoll
Y""
Fig. 1331 Vesselsand nervesof the anteriorfemoral * Theentranceinto the adductorcanalis formedby the M. vastusmedialis,the
region,Regiofemorisanterior; M. adductorlongusand the fibrousmembranebetweenthesetwo muscles
(Septumintermusculare vastoadductorium).
the sartoriusmusclehasbeenpartially removedand the
pectineusmusclehasbeensectioned;
ventralview (r.).
356 Lowerlimb
s N. obturatorius
-
V. iliaca extema O
z o V. saphenamagna
A. iliacaexternaO -- z OA. circumflexatemorismedialis

N. femoralis 'n'N.obturatorius
/
-
M. iliacusa
/ aA. obturatoria

A. profundafemoris O -- OV. femoralis

--

IJ:::
OV orofundalemoris
A. circumflexa
femorislaleralis -- aM. adductorbrevis
- OM.adductorlongus

- aA. perforans
Rr.musculares(N. femo.alis)

--
M rectusfemorisO - # R. cutaneus(N. obluratorius)

-- O M. adductorlongus

--
A. perforanso -- O V femoralis

-- OM. gracilis
-
M. vastuslateralisO - OM.adductormagnus
R. muscularis(N. femoralis) -
OA. femoralis

M. rectusfemoris O - --- Hialusadductorius

M. vastusmedialisa a M. sartorius

--
N. saphenus an. des@ndensg6nus,
R. saphenus

descendensgenus,O
Br. articulares

tog2
t094 . superiormedialisgenus)
ro97 I A. poplitea
inleriorm€dialisgenus ,

Bst# Retearticulareg€nusO -

Flg. 1332 Vesselsand nervesofthe anteriorfemoralregion.

Regiofemorisanterior;
deeplayer; the sartorius and the rectus femoris muscleshavebeen
partially removed;the pectineusand the adductorlongus muscles
havebeensectioned;the Septumintermuscularevastoadductorium
has beencut longitudinally, extensivelyexposingthe adductorcanal;
venhal view (r.).
E Arteriesof theHip and Thigh
35?
A iliacacommunis- __
_

A iliaca externa -.-_

_

A circumflexailium profunda

A. epigastrica superficialis
A circumflexa ilium superticialis

A lemoralis.-__

R ascendensetRtransversus --__
R ascendens___
A. protunda femoris____
A. circumtlexafemorislateralis
R. transversus
A circumllexa temoris medialis
R descendens

Aa.perforantes
---

Fig. 1333 Arteriesof the hip andthigh;

ventralview(r.).
Thisvariationof originof the A. profundafemoris
is foundin about58%of cases.

48% b 40% c l0%

Figs. 1334a-c Variationsof the origin of the A. profunda femoris:
a lateral or laterodorsalof the A. femoralis
b dorsal of the A. femoralis
c medial of the A. femoralis

a 18% 15%
Figs.1335a, b Variationsof the branchesof the Aa.circumflexae femoris:
a independent branchof the A. circumflexafemorismedialisof the A. femoralis
b independent branchof the A. circumflexafemorislateralisof the A. femoralis
 LowerLimb
358
-- N n c l u n i u ms u p e r i o r e s( L 1 - L 3 )

--
R cutaneus lateralis(N iliohypogastricus)

N n c l u n i u mm e d i i( S 1 - S 3 )

Sulcus glutealis -

- N cutaneus femoris laleralis

Nn clunium inleriores(N cutaneuslemoris postenor) -

)- Fascia lata

-
R cutaneus(N obturatorius)
- N cutaneus femoris oosterior

794

#
1346
V saphena magna

- V saphena oarua

Fig.1336 Sulrerfir:ia vel i n sa n d n e r v e st t f t h e p o s t t ' r i o r

femoralregion,Regiotemorisposterior,the glutealrr:girtn,
, o s s ap o p l i t e a ;
R e g i og l u t e a l i sa, n d t h e p o l l l i t e aflo s s aF
d o r s a lv i e u ( r . ) .

Crisla iliaca -

Spina iliaca anterior superior

Spina iliaca postenor superior

bf Crista sacralis mediana
N gluteus superior
(Foramen supraprriforme;'\ Foramen
Spina iliaca posteriorinferior l rschtadrcum
(Foramen infrapiritorme) | majus
Foramen ischiadicummajus )
N ischiadicus --

N gluteus inlerior - - - M pirilormis

N p u d e n d u s- -
j
a,n a""roa',n"," - --- Trochantermajor
Foramenrschradicumminus - --
--- T u b e ri s c h i a d i c u m
N c u t a n e u s f e m o r i s o o s t e r i o-r-

Lig sacrotuberale --

T u b e ri s c h i a d i c u m- -

Fig. 1337 Projection0f the skeletalelementsand

the sciatic nerve onto the surface of the gluteal region,
Regio glutealis;
dorsal view.
 Vessels
and Nervesof theGlutealRegton
359
z-- a M gluteusmedius,Fascia

N n c l u n i u mm e d i r( S 1 - S 3 ) O :

M gluteusmaximuso\\
\

/ / f ( aclus iliotibialis

---- O Nn cluniuminferioras
(N cutaneusfemorisposterior)

culaneusfemorisposlerior

--- O M vastuslateralis

---
M semimembranosusa

-- a M bicepslemoris

V popliteaa ---
I N tibialis

---
M, semimembranosusa) O N fibulariscommunis

A popliteaa

---
a N cutaneussuraelateralis
(N fibularis
communis)
--*
M gastrocnemiusO O V saphenaparua

N culaneussuraemedialisG ---
a M. bicepsfemoris,Tendo

rcs6#6
Fig. 1338 Vesselsand nervesofthe glutealregion,
Regioglutealis,the posteriorfemoralregion,Regiofemoris
posterior,and the poplitealfossa,Fossapoplitea;
the Fascialata has beenremoved,exceptfor the iliotibial bact;
dorsalview (r.).
.J
%
F'
fu{g LowerLtmb

N n c l u n i u m s u p e r i o r e s ( L 1 - L 3\)

Nn clunium medii (S 1-S 3)

--- aM gluteusmaximus

Rr cluniuminferiores
(N. cutaneustemorisposterior)

N cutaneusfemorisoosterior

OA perforans

O M bicepsfemoris,Caputlongum

N tibialis

semitendinosus
a
O Aa perforantes
Hiatusadductoris

N tibulariscommunis

M g r a c i l ias - - - -

O ---
M. semimembranosus

A poplileaO ---

M sarloriusa ---

V popliteat ---
genusO - - -
A. superiormedialis

Rr. musculares(N tibialis)

N suralis
M g€strocnemius,
a ---
uaput meotate

O M gastrocnemius,
Caputlaterale
,rrrx"oo
1356

Fig. 1339 Vesselsand nervesofthe glutealregion,Regio

glutealis,the posteriorfemoralregion,Regiofemorisposterior,
and the poplitealfossa,Fossapoplitea;
the Fascialata hasbeencompletelyremoved;the long headof the
bicepsfemorismusclehasbeenretractedlaterally;
dorsalview (r.).
In this specimenthe medialand lateralcutaneousnervesbranch
off quite far proximally.
 ,theGtuteatRegion
36I
A gluteasuperior,R superficialis
a \
/ I M. gluteus medius

M gluteusmaximus
e \ ,t
\ / -z aM.Pirilormis

N gluteusinterior

A gluteainferiorO circumflexa
aF. ascendens{A.
_--
lemonsmeorails)

- - - - a F. superticialis.(4.
circumfl€xa
remonsmeotals]
11 -''
A ; V pudendainterna
O M quadratusfemoris

/
N. cutaneusfemorisooslerior+ z
I- R. profundus
(A circumflsxatemorismedialis)

N ischiadicusi& --- OA perforans

a M adduclormagnus
(N tibialis)
Rr musculares

bicepsfemoris,CaputlongumO -----
OAa. perlorantes

M s e m i t e n d i n o sOu s- - - - - - O M bicepsfemoris,Capullongum

- I M bicepsfemoris,Caputbreve
M s e m i m e m b r a n o sOu-s- - - - -

V popliteaO * N. fibulariscommunis

A popliteaa

N t i b i a l i s& z z z z - z

N cutaneussurae medialis* --'- * N. cutaneus

suraelateralis

V saphenaparvaO /-
ffis#6
Fig. 1340 Vesselsand nervesofthe glutealreSion,
Regioglutealis,the posteriorfemoralregion,Regio
femorisposteriot and the poplitealfossa,Fossapoplitea;
the M. gluteusmaximusand the longheadof the biceps
femorismusclehavebeensectioned;
dorsalview (r.).
 .-: it
'tq"
)X
f \
i
LowerLimb

---- T r i g o n u ml u m b a l e
R culaneus lateralis(N iliohypogastricus)
Rr profundiO#.. --- O M obliquusexternusabdominis
(A , V glutea superio0 \
Crista iliaca
N g l u t e us u p e r i o r - -
--- O M oluteusmedius

--- a M oluteusminimus
N gluteusinferior
- O M gluteusmedius
A ; V g l u t e a i n l e r i o r o a-
-- a M gluteusmaximus
a - '
M gluteusmaximus -- O M prritormis
femorisposterior
cutaneus
--
O M gemellussuperior
N ischiadicus
--
a M obturatoriusinternus
--
I u gemellus inferior
A : V p u d e n d ai n t e r n a o t
--
/ o M obturalonusexternus
Lig sacrotuberale
-
a M quadratusfemoris
--
Trochanterminor
--
o ttil adductor magnus
Rr orofundr(A circumtlexalemoris medialis)O -

Fig. 1341 Vesselsand nervesof the glutealregion,Regioglutealis;

the gluteusmaximusand mediusmuscleshavebeensectionedand partiallyremoved;
the sciaticnerve has beensectionedafter leavingthe infrapiriformforamen;
dorsalview (r.).

Tbe Foramen ischiadicum [sciaticum] majus is divided into posterio4 A. and V. glutea inferior and A- and V. pudenda
two parts by the M. piriformis: the Foramen suprapiriforme, interna.
containing the N. gluteus superio4 A. and V. glutea supe' The tendonsof the M. obturatorius internus, N' pudendusand
rior, and the Foramen infrapiriforme, containing the Nn. A. and V. pudenda interna run through the Foramen
ischiadicus, gluteus inferior, pudendus, cutaneus femoris ischiadicum [sciaticum] trinus.

-- Crisla iliaca.Tuberculumihacum

N gluteus superior -- M gluteusmedius

- - Soina iliaca anlerior suPerior

Spina iliaca posteriorinlerior - -

Fig. 1342 Projectionof the skeletalelementsusedto

injectionsintothe M. gluteusmedius;
directintramuscular
lateralview (r.).
 I ntramuscular I njections
363

Spinailiacaanteriorsuperior

-- M gluteusmedius
N g l u t e u s s u p e r i-o-r-

N ischiadicus

Trochantermajor

Fig. 1343 Intragluteal injection (after A. v. HocHsrrrrEn). the handon the Trochanter major.Forthe injectionto enterthe
To minimize the risk of damagingthe superior gluteal nerve gluteusmediusmuscleandbe as far awayfromthe vesselsas
and artery, the injection should be given in the triangular area possible,
the linesof the triangleshouldnot be crossedby the
defined by the two spread fingers and the iliac crest.The needle.A certainrisk remainsfor the branchthat runs fromthe
middle finger - or when using the left hand, the secondfinger - superiorglutealnerveto the tensorfasciaelataemuscle.
is placedon the anterior superior iliac spine and the palm of

---
N ischiadicus

---
Trochanter
ma;or

Fig. 1344 Intramuscularinjectioninto the vastuslateralis externalaspectof the thigh. After ascertainingthe positionof
muscle(afterA. v. HocHsrrrrnn). the femur,the needleis insertedtransverselyinto the belly of
Apart from somesmallbranchesof the lateralcutaneousfemoral the vastuslateralismuscle.
nerveno greatvesselsor nervesare foundin the middleof the
364 Lowerlimb

-' V saphena parua

\ R infrapatellaris
(N saphenus)

\ N saphenus - N cutaneus
surae laleralis
(N fibularis
communts)

V perforans -

Br cutanei--
Rr cutanei cruris mediales - crurismedrales - N culaneus
(N saphenus) (N saphenus) surae medralis
(N tibialis)
V saphena--
--
(V arcuatacrurisposterior) parua - R communicans
f ibularis

- N surahs

Fasciacruris -

Rr cutanei cruris mediales

(N saphenus) V marginalislateralis
I

i rllgy:,,Y":^",.,Y"
pedis
N fibularissuperlicialis i ; dorsalis

N culaneus-
dorsalis medialis
N cutaneusdorsalis-
intermedius

'(' lR"t" u"norut

i dorsalepedrs
' N culaneusdorsalis
I V marginalismedialis
(N sulalis)
lateralis
'
V saphena parua

1336
.v
1327
#

Fig. 1345 Superficialveins and nervesofthe crus Fig. 1346 Superficialveinsand nervesof the crus
and foot,Regionescruris et pedis; and foot,Regionescruris et Pedis;
medialview (r.). the crural fasciahasbeenopenedproximally;
dorsalview (r.).
' clinical: M,lv's vein
 ortheLowerLimb
365

V saphena magna

- V saphena parva
1 DoDD'sveins
2 HUNTEB'S veins
3 BoYo'sveins
4 SHERMAN'S veins
5 CocKETr's veins
6 HacH'sprofunda
oerforatino veins
7 Poolitea o-erforatinoveins
,#F.*-,\**r"!
I Mrv's veins
9 Lateral perforating veins

Fig. 1347 Connections betweenthe superficialandthe Fig. 1348 Connectionsbetweenthe superficial and the deep
deepveinsin the drainingareaof the greatsaphenousvein, veins in the draining area of the small saphenousvein,
Vv.perforantes; Vv. perforantes;
(afterHncH,1986); (afterHncH, 1986);
medialview(r.). dorsal view (r.).

V superlicialis

Valvula

V. pertorans

V protunda

Fig. 1349 Veinsof the lowerlimb; especiallyvaricosis,are common.If oneof the venoussystems
schematicrepresentationof the venoussystem. is completelyclosed,the perforatingveinsplay a critical role in
Disturbancesin the drainageof the veinsof the lowerlimb, maintainingthe drainageof the lowerlimb.
 LowerLimb
366

Caputtibulae \

- Tuberositastibiae

M fibularis[peroneus]
longusO \

-- OM tibialisanlerior
(Nodus lymphoideustibialisanterio0 \

Vasa lymphatica profunda -

- Tibia. Facies medialis

Vv tibialesanterioresO -

- O M tibialisanterior,Tendo

A. tibialisanteriorO -

M extensorhallucislongusO

M exlensordigitorum
longusO -
-- Retinaculum
musculorum interius
extensorum

Malleoluslateralis--

-v
1330

Fig. 1350 Vesselsof the anteriorcrural region, The superficiallymphaticvesselsfollow the majorsuperficial
Regiocruris anterior; veinsconvergingalongthe greatsaphenousvein to the medial
the fasciaof the crus hasbeenremovedand the extensor sideof the crus.Thedeeplymphaticvesselsrun in the fibrous
muscleshavebeenspreadout; sheathsof the deepcrural arteriesand veins.
ventralview (r.).
 367
n u\ \s_ \
A s u p e r i o r l a t e r a l i s g eO
// a A superiotmedialisgenus

-- O Betearticulare
genus
A interiorlateralisgenus O \\

N fibulariscommunis

M fibularislperoneusl tongus a -

longusO --
extensordigitorum

tibialisanteriorO -
A recutrens

N fibularisprolundus --
OA tibialisanterior

N fibularissupedicialis

M tibularis lperoneusl longus O

M extensor digitorum longus O /

libialisanterior

N fibulanssuoerficialis N tibularis
orofundus

M fibularis brevisO --
lperoneus]

-- OM exlensor hallucislonous
M extensor digitorumlongus O -

A fibularis,R perforans O --

- Retinaculum
musculorum
exlensorum
interius
Bete malleolarelaterale O --

A malleolaris a -
anieriortateralis \ . N fibularisorofundus

-
\ OA.dorsalis pedis
M extensordigitorumbrevis| -'

fibularis tertius,TendoO --
lperoneusl
- 1 Nn digitalesdorsales pedis

dorsalesa //
Aa metatarsales

ts50x
Fig. 135t Arteriesand veinsof the anteriorcrural region,
Regiocruris anterior,and of the backof the foot,Dorsumpedis;
the fasciaof the crus hasbeenremoved;the extensordigitorum
longusandthe longperoneusmuscleshavebeensectioned;
ventralview (r.).
 LowerLimb

a (V femoropoplitea)

V saphena magna o -

Nodus lymphoideus PoPliteus

V saphenaparuao -- - - superficialis

A PoPlitea O

N tibialis

Nodi lymphoidei poplitei profundi

O V poplitea

'--
Vasa fymphatica s upedicialia

I
M gastrocnemius

V s a p h e n am a g n a O
--

Fig. 1352
Fossapoplitea;
ffi
Vesselsand nerves of the popliteal fossa,
--- o V.saphenaparua

the crural fascia has been openedand the small

saphenousvein partiallY removed;
dorsal view (r.).

- - tD M bicepsfemoris
M gracilis o *-

a --
M semitendinosus

M semimembranosusi--
N tibialis

communls
N fibularis
V popliteaa --

A p o p l i t e a o- - -- genus
lateralis
O A suPerior

A superior medialisgenus O - -
-- r N. cutaneussuraelateralis
V saphenaparvao
- O Aa. surales

Rr musculares(N. tibialis)

N. cutaneussuraemedialis

CaputmedialeO - -
M gastrocnemius,
- - . N. fibularis
communrs

- o M. bicepslemoris,Tendo

"l)ttun -- Caputlaterale
I M gastrocnemius,
:r,46[6.

Fig. 1353 Vessels andnervesof the PoPlitealfossa,

Fossapoplitea;
the crural fasciaand the Fascialata havebeenremoved;
dorsalview (r.).
 Arteriesof thePopliteal.Fossa
369
-- A. perforans

-
M semimembranosus

M gracilis - -- M. bicepsfemoris

-- Femur,Faciespoplitea
A descendensgenus -

A superiormedialis
genus -
- - A. superiorlateralisgenus
-
M semimembranosus
- M biceosfemoris

A m e d i a g e n u -si - --
A poptitea

Caputmediate-
M gastrocnemius, --
M plantaris
--
Aa surales - M gastrocnemius,
Caputlatefale

\ A. inleriorlateralisgenus
A inlerior medialis genus / --
M popliteus

\ M soleus
M soleus /

\\
(A recurrenstibialisposterior)
A libialis anterior /

(Truncus tibiofibularis) / \ M. soleus

A tibialisoosterior/

Fig. 1354 Arteries of the popliteal fossa,Fossapoplitea;

the musclescovering the fossahave been partially
removedto show the arterial supply;
dorsal view (r.).
This pattern of branchesis found in about 90%.

404 3% o/o
L

Figs. 1355a-d Variationsof the branchesof the poplitealartery.

a common origin of Aa. tibiales anterior and posteriorand A. fibularis
b branching of A. poplitea proximal of the upper margin of M. popliteus
c proximal truncus of A. tibialis posterior and A. fibularis
d A. tibialisanteriorrunning ventrallyof M. popliteus
 LowerLimb
37il
M semilendinosus
a - / OM bicepsfemoris

N tibialis

M semimembrano"rsa-il -- O V poplitea
l
-- OV saphenaparua

- O M gastrocnemius,Caput laterale
-OOA:Vsuralis
A;V suralisaO
-
(N tibialis)
Rr musculares

CaputmedialeO --
M gastrocnemius, N tibularis
communis

A inlerior medralisgenus O -

--
a /
Vv tibialesposteriores a M soleus
musculisolei/
Arcustendineus

Tendoa -
M plantaris,

- O M gastrocnemius

/ a M fibularis[peroneus]
longus

N trbialis
- a M fibularislperoneus]
brevis
posterior
A ;V, trbralis aa
M tibialisposterior,Tendo I -
!-*- Malleoluslateralis

Retinaculum flexorum/
musculorum
\ musculorum
Retinaculum fibularium
superius
lperoneorum]
Tendo calcaneus* /

Fig. 1356 Vesselsand nervesof the poplitealfossa,Fossa

poplitea,and the posteriorcrural region,Regiocruris posterior;
the crural fasciahas beenremovedand the eastrocnemius
musclesectioned;
dorsalview (r.).
' a l s o : A c h i l l e st e n d o n

Tbe Reti.Raculummusculorum .{tgxonql forms a canal in the ofthe canalextgndingbelowthe!{. abQqqtorfiallucisis

''',," ':::: taat' 9,1lled ,,
':r:r:r' :r
medial retromalleolar space, which corinects the deep the "tarsaltuilief (seeFig.r:1364),"
regions of the calf ry.ith the planla. From anterior to posterior, The latepl retromalleolar.lpace,is cov,eredby the Retinacula .
this canal containsthe tetrdonsof the Mm:'tibialis posterior muscutorumtiuirtarini lpeioneorinnl siilieriuiiand liiferii$:6ird,'ii
an! flerylr digitorum longus, th9 Vasg tibialia, the tendon of contains the tendons of the Mp. fibulares , Bero4gl brevis
the M. flixor halluciSlongus and the N. tibialis. The distal part :111.';::11;:1:r.1
lanterior'iegion)ano:ionsui(postOiiori6gioal;::
 Vesselsand Nervesof the Popliteal Fossa
371
N fibularis
communrs

A p o p l i t e a o- _
- N libialis

V p o p l i t e a a- - _

A inlerior medialisgenuso - - O M plantaris

- O M soleus
A popliteao z

-- O A tibularis
M soleuso /

A tibialisposterioro /

N tibialis '

M tibialisposleriora /

M flexor digitorumlongusO /

A tibialisposterioro /

-- 1 M f l e x o r h a l l u c i sl o n g u s

N libialis /

M libialisposterior,TendoO
\
Malleoluslateralis
Malleolusmedialis-

Retinaculum llexoru(/
musculorum - Retinaculummusculorumfibularium
Iperoneorum] superius

\ Tendo calcaneus

Fig. 1357 Vesselsandnervesof the poplitealfossa,Fossa

poplitea,and the posteriorcrural region,Regiocruris posterior;
deeplayer;mostof the gastrocnemius musclehasbeenremoved;
the soleusmusclehasbeensectioned andretracted:
dorsalview (r.).
 "}i 'ffi
=\
=.j LowerLimb
&*-r"
FS S

A poplitea O \ / N tibialis

A infenor medialisgenus O 1
- OM plantaris

M popliteusa \

A tibialisanterior O - -

(Truncuslibiofibularis)O --
- aM soleus
M soleusa --

M tibialisposteriora --

- OA fibularis
A tibialisposteriorO - -

N tibialis

\
M flexordigitorum longus o --
-- aM fibularis longus
lperoneus]

- O M flexor hallucislongus

A tibialisposteriorO --

- 1M fibularis brevis
lperoneus]

TendoO --
M tibialisposterior,

Br malleolaresmediales O--

M flexor hallucislongus,Tendo a --

Br calcanei 1 -

1340 O Rete calcaneum

ts57*
1363

Fig. 1358 Arteriesandnervesof the poplitealfossa,

Fossapoplitea,andthe posteriolcruralregion,Regiocruris
posterior;
mostof the tricepssuraeandthe extensorhallucislongus
muscleshavebeenremoved:
dorsalview (r.).
 N saphenus

N cutaneus surae medralis(N tibiatis)

N fibularissuperficralis -- iVsaphenamagna

m u s c u t o r u m- - - -
Retrnaculum Malleolusmedialis
extenSorUmInferiUS

s t e r a t r s- - -
[ , 4 a l l e o l ul a

-- iVsaphenamagna
N c u l a n e u sd o r s a l i sm e d i a l t s

N saphenus
N c u t a n e u sd o r s a l s i n t e r m e d r u s /

V saphena parvaa '

O V m a r g i n a l i sm e d i a l i s

N c u t a n e u sd o r s a [ s
lateralis

V m a r g i n a [ sl a t e r a l t s) / -- o V perlorans

N. fibularisprofundus,Nn digitales
uvrJdreJ pEurr

Arcus venosus dorsairspedrs o /

(,

'I2"uo
V v d r g r t a l eds o r s a t e sp e d r s I /

N n d i g i l a l e sd o r s a l e sp e d r s

Fig. 1359 Superficialveins and nerves of the

back of the foot, Dorsum pedis;
dorsal view (r.).
3?4 Lowerlimb

M exlensor digitorumlongus O --
- oM tibialisantenor,Tendo
---
M e x l e n s o r h a l l u c i s l o n g uO
s

-- Tibia

- OA malleolarisanterior medialis
perforans O --
(A fibularis)

A tibialisanteriorO -- - profundus
N fibularis

A malleolarisanteriorlateralis a -- -- ORetemalleolare
mediale

- -
Rele malleolarelaterale a aA malleolaris
anteflormedialis

-.-
oM extensor longus,Tendo
digrtorum

(N fibularis
Rr musculares profundus)

Mm exlensores digitorumet hallucisbrevis O - -

- OAa tarsalesmediales

A tarsalis lateralis O -

- aA dorsalis oedis

(A arcuata) O --

- OA plantaris
profunda

Aa metatarsalesdorsales O - - OM extensor hallucisbrevis.Tendo

- OM extensor
hallucislongus,Tendo

- dorsalespedis
Nn digitales

dorsalesO -
Aa digitales

1351
J:
1359''

Fig. 1360 Arteries and nerves ofthe back of the foot,

Dorsum pedis;
the fasciaofthe back of the foot has been removed,the
extensor digitorum longus and extensor hallucis longus
muscles have been partially removed;
dorsal view (r.).
 rteriesoftheFoot
375

Aa. digitalesplantarespropriae\

Aa. digilalesplantarescommunes

- Aa. metatarsales
olantares

- - A. plantarisprofunda(4. dorsalispedis)

Arcusplantarisprofundus-

-- A. olantaris
medialis

A. Dlantaris lateralis -

- A. tibialis posleriof
Fig. 1361 Arteriesof the soleof the foot,
Planta;
plantarview(r.).

Figs. 1362a-d Variationsof the arteriesof the soleof the foot, Thearteriesthat supplythe 5th andthe lateralpart of the 4th
Planta. toebranchoff A. tibialisposterior,
the moremedialtoesare
a The Arcus plantaris profundus is mainly supplied by the suppliedby A. dorsqlispedis.
A. dorsalis pedis. Thearteriesthat supplythe 5th,4th andthe lateralpartof the
b The Arcus plantaris profundus is mainly supplied by the 3rd toebranchoff A. tibialisposterior,
the moremedialtoes
A. tibialis posterior. aresuppliedby A. dorsalispedis.
31 6 Lowerlimb
Aa digitates plantares propriae O ,

Nn digilales plantares proprii

Nn.digitalesir: ----
plantarescommunes

O -----
plantares
Aa metatarsales

N. plantarislateralis, : N digitalisplantarisproprius
R. superlicialis

llexorum
musculorum
Retinaculum

'r.
N. olantarismedialis
\

\ ' a A. libialisposterior
1356
v \ N plantarislateralis

Fig. 1363 Arteriesand nervesof the soleof the foot,Planta;

the retinaculumof the flexor muscleshas beensectioned;
plantarview (r.).
 NervesoftheFoot
3?Jp

M flexor digitorumbrevrs,Tendinesa \

Ns
i\l O Aa digitalesplantarespropriae

O Aa digilalesplantarescommunes
_---

, Nn. digitates a M flexor hallucislonous. Tendo

pranlarescommunes

O M flexor hallucisbrevis

il M flexor digitorum longus,Tendines

R superficialis

profundus
a M abductorhallucis

a M quadratus plantae

A planlaris lateralisa (R cutaneus)

N Dlantarismedialis
M a b d u c t o rd i g r l im i n r m a
i -----

Aponeurosisolantaris-- .- - Betinaculum
musculorumllexorum

M llexor digilorum brevis* (B muscutaris)

-
OA tibialisposterior

N plantans lateralis

\ abductorhallucis'
Bete calcaneumO aM

'j),'0,
lg6gll

Fig. 1364 Arteries and nerves of the sole of the foot, planta; The distal extension of the medial retromalleolar space below the abductor
most of the plantar aponeurosisand the flexor digitorum brevis hallucis muscle is also called the tarsal tunnel (see also page 370).
muscle have been removed;the abductorhallucis muscle has
been sectioned;
piantar view (r.).
 LowerLimb
3, T i=

Nn digitalesplanlaresproprii O M tlexor hallucislongus.Tendo

Nn digilales plantares
communes

--
a Capul lransversum)
I
N'l adductor hallucis
I
Aa melalarsalesolanlares O - - I
-- aCaputobliquum )
-- a l\4 llexor hallucisbrevis

Arcus olantarisorofundus O -- --
OFI perforans'
--
OA planlans medialis,R superficialis

---
t M flexor hallucislongus,Tendo

-- ---
M adductor hallucis,Caput obliquum tl longus Tendo
a M flexordigitorum

--
A plantarls lateralisO

-
'- OM quadralusplantae
M abductordlglti minimti

--
OM abductorhallucis

N plantarismedialis
M llexor digitorum brevis a --
-- - -
Retinaculummusculorum
flexorum
Aponeurosisplantaris /
--
o A t i b i a l ipso s t e r i o r

N planlaris laleralis
1358 \ on,t abductor hallucis
):
lg64/' R e t e c a l c a n e u ma
--'

Fig. 1365 Arteries and nerves of the sole of the foot,

Planta; most of the flexor digitorum brevis and longus and
the flexor hallucis longus muscles have been removed;
the M. abductor hallucis and the oblique head of the adductor
hallucis muscle have been sectioned:
plantar view (r.).
* Anastomosis
toA.dorsalispedis
 Compartments
of theFoot
379
,t,vflt''

N fibularissuperficiatis \

Fascia dorsalis pedrs \

M extensor digitorum longus, Tendines -__

!.-- prolundus
N fibularis
M extensordigitorumbrevis --
-- A dorsalis oedis

- - M. extensorhallucislonous.
Tendo

(Septa longitudinalia) --- Lig plantare longum

Mm flexoresdrgitorum
Tendines

\ M flexorhallucislongus,Tendo

Fig. 1366 Compartments of the foot,

sectionedin layers;
dorsofrontalview (r., 30%)
* spacesfor Mm. interossei
lateralcompartment
medialcompartment
**"* centralcompartment
380 Lowerlimb

/ O M tensor fasciae latae

/ aM gluteusminimus

/ O M sarlorius
M gluteus medrusO - -

/ O M rectus femoris, Tendo

A ; V g l u t e a s u p e r i o r O- -t l l
,, a M ilioPsoas

,, N femoralis

/ O A femoralis

/ Bursa sublendineailiaca

--
M oiriformis.Tendoo
-- a V femoralis

M. gemellus a - -
superior -- O M pectineus

M obturaloriusinternus.TendoO -- -- O A profundafemoris

M oluteusmaximustl-- -- t N obturatorius

lvl gemeflus inleriorO / -- O M adductorlongus

A t V g l u t e a i n f e r i o r O O/

a --
N gluteusinferrors/ O M adductorbrevis
/
externusO/
M obturatorius
\ O M adductormagnus
/
N ischiadicus* /
\; M quadratusfemoris
N culaneus femoris oosleriors /
\ a M semitendinosus
Tendoa'
M semimembranosus, l1 M bicepsfemoris,
Caput longum, Tendo

Fig. 1367 Thigh,Femur;

obliquesectionthroughthe hip joint;
distalview (r.).
 CrossSectionsthrough the Thigh

M vaslus intermedius l} \
/, Fascia lata

[/ vastus laterals a \
/ aM vastus medialis

tlY sapnena magna

F e m u r- -
O OA ;V lemoralis

Tractus iliolibialis - - -- ai/ sarlorius

M biceps femoris,Caput breve I --

- N femorahs

M brcepslemoris, Caput longum | --

--
aM gracrlis

N ischiadicus \ lM adductormagnus

'i:i:ft-= \ a lvl adductorlongus

M semitendinosusO /
aM seriimembranosus

Fig. 1368 Thigh,Femur;

c r o s ss e c t i o nt h r o u g ht h e m i d d l eo f t h e t h i g h ;
distal vieu' (r )

/ l\,1vastus medialis

- M sartorius

.-A;Vlemorals
M vaslus laleralis
- V saphena magna
Femur
- M gracilis

M adductor magnus - -- M adduclor longus

N ischiadicus -
- [,4 adductor magnus
b r c e p sf e m o n s .C a p u l l o n g u m -
- [,4 semimembranosus

lvl semilendinosus -

F i g . 1 3 6 9 T h i g h ,F e m u r ,
cross-sectional imageslightll' abOvethe middleof the
thigh obtainedwith magneticresonancetomography
(MRr);
(listalvi()u'(r )
LowerLimb

B u r s as u p r a P a t e l l a r i s
p a l e l l a el a l e r a l e\
Relrnaculum

/ FielrnaculumPatellaemedrale

Femur \
/' M vastusmedtalls

/ s M a d d u c t o rm a g n u s T e n d o

R Infrapatellans
M gastrocnemius :' - - (N saphenus)
C a p u t l a t e r a l eT, e n d o

- ;r M. qastrocnemius,
.-
tv1biceps femoris ' - Cadut medrale Tendo

.--
l' M sarloflus
ArVpopliteaos--

/
/ - V s a p h e n am a g n a
N f i b u l a r i sc o m m u n i s
/ \aMgracilisTendo
N lrbralrs /

M semitendinosus Tendo r, I # M semimembranosus

Fig. 1370 T h i g h ,F e m u r ;
c r o s ss e c t i o nt h r o u g ht h e d i s t a le n d o f t h e t h i g h
t h r o u g ht h e b a s i so f t h e p a t e l l a ;
d i s t a lr i e t t ( r )

- V s a p h e n am a g n a

- M v a s t u sm e d l a l l s
Femur ..-

- A poplitea

- V poplitea

- N,1sartortus

- M gracrlrs

N ischiadicus -

M semtmembranosus

M semitendinosus

Fig.1371 T h i g h ,F e m u r ;
cross-sectional imagethroughthe lower third of
the thigh slightly abovethe patellaobtainedwith
magneticresonancetomography(MRT);
d i s t a lv i e w ( r . ) .
 " F{ ' } " T
CrossSectionsthroughthe Crus
*3i3*-3
M libialisanlerior a Fascia cruris
I /
M exlensor hallucislongus *
\
\ /OA tibialisanterior
M e x l e n s o rd i g i t o r u ml o n g u sa

N l i b u l a r i ss u p e r l i c i a t i s
\

Seplum intermusculare- - N libularisprolundus

cruls anteflus

M fibularis[peroneus]brevrs1 - .-
-- O M flexor digilorum longus

-* aV saphenamagna
M fibularisIperoneusl longus a --

--
Membrana interossea

\ | M libialsposterior
Fibula /

\ OA tibialisposlerior
M l l e x o rh a l l u c i sl o n g u s1 /

\ a M gastrocnemius,
M soleus 1 / Caput mediale
\ N lrbratis
ll
I
A frbutariso la V saphena
parva

F i g . 1 3 7 2 C r u s ,C r u s ;
crosssectionthrough the middleof the crus;
d i s t a lv i e w ( r ) .
C o m p a r et o F i g . 1 2 9 5

- Tibia, l/argo anlerior

M extensor digitorumlongus
_

Membrana Inlerossea \ - M libialis anterior

Seplum rntermuscularecruris anlerius _

- M flexor drgilorumlongus
M exlensor hallucislongus _ _

M f i b u l a r i sl p e r o n e u s l]o n g u s - -

M fibularrs[peroneus]brevis -- -. M tibialisposterior

Fibuta-

Septum intermuscularecruris posterius /

- - M f l e x o rh a l l u c i sl o n g u s

M soleus -

- M gastrocnemrus

F i g . 1 3 7 3 C r u s ,C r u s ;
cross-sectional imagethroughthe middleof the crus
obtainedwith magneticresonancetomography(MRT);
d i s t a lv i e w ( r . ) .
 LowerLimb
384

N fibularisprofundus
/, a M extensor hallucislongus,Tendo
A dorsalis pedis O
\
'
N libutarissuperfrcialis -
\l -- a M tibialisanterior,Tendo
M extensor
digitorum
longus,Tendot \_
Tibia
Syndesmosistibiofibularis

-- oV saphenamagna
Fibula \\
N saphenus

M fibulans [peroneus] O -_
longus. Tendo

-- oM tibialisposlerior,Tendo
M libularis brevisO --
[peroneus]

-- O M tlexor digitorumlongus,Tendo
A frbulaflsO z

- + N tibialis
M flexor hallucislongus t /

V saphena pawa a /
\ aA tibialisposterior
/
N s u r a l i s, /
/ \
aM plantaris,Tendo
Fasciacruris /
I
lTendocalcaneus

Fig.1374 Crus,Crus;
crosssectionjustabovetheanklejoint;
distalview(r.).

, OM exlensor hallucislongus, Tendo

M extensor
digitorum
brevis,Tendoa \\ tibialisanterior,Tendo
/, oM

M exlensordigitorum longus,Tendo a \ / N saphenus

/ oV saphena magna
M fibularis tertius,TendoO --
[peroneus]
/ Lig collalerale mediale
Caputtali - -
/ Sustentaculumtali
Fascia pedis --

-- 1M tibialisposterior,
Tendo
Proc lateralis tali - -
-- 1M llexor digitorum longus,Tendo

- aM, flexor hallucislongus, Tendo

M fibularis brevis,Tendoa --
[peroneusl
- OA plantarismedialis
longus,Tendo3 --
M fibularis[peroneus]
N plantarismedialis
N planlaris lateralis

\
OA plantarislateralis

\
OM quadratus plantae

Fig. 1375 Foot,Pes;

andheadof the talus;
obliquesectionthroughthe calcaneus
distalview (r.).
 Frontal Sectionthrough the Foot
385

/ Mm exlensores hallucis
/ lonous et brevis.Tendines
Mm extensoresdigitorumlongus et brevis,Tendines \

- - M interosseusdorsalis oedis ll
Fascia dorsahsDedis \

-- M interosseusdorsalis oedis I
M interosseusdorsalis oedis lll -.-

.. M interosseusolantarisI
Ll interosseusdorsalis pedis lV -- -

(M opponens digrli minimi) -- -- M abductor hallucis

i,4 abduclor digiti --

minimi pedis i,4 adductor hallucis,
C a p u to b l i q u u m

M flexor digiti minimi -

brevis pedis --
trl flexor hallucislongus,Tendo

I
'
(Eminentiaplantarislateralis)i | leminentraplantansmedialis)
|
M interosseusplantarislll I 'lvl flexorhallucisbrevrs
M Interosseuspt"nt"ri. tt | ' t. flexoresdigitorumtongus et brevis,Tendines
| |
Aponeurosisplantarrsl llEminentiaplantarisintermedra)

Fig. 1376 Foot,Pes;

frontalsectionthrough the metatarsus;
tlistal vieu (r.)

/ M exlensor hallucislongus, Tendo

/ Os melatarsi hallucis

Mm extensoresdrgilorum.Tendrnes_

/ M adductor hallucis.Capul obliquum

Mm interosseidorsales pedis _ - M abductor hallucis

- M flexor hallucisbrevis
Os metatarsi lV -
- M flexor hallucislongus,Tendo

Mm interosseiplantares _

- [.4 llexor digitorum longus,Tendines

M a b d u c t o rd i g i t im i n i m ip e d i s _

\ Aponeurosisplantaris
M flexor digiti minimi brevrspedis -

\ M flexor digitorum brevis,Tendines

Fig.1377 Foot,Pes;
ct'oss-sectional imagethroughthe metatarsus olltainerl
$ i t h m a g n e t i cr e s o n a n cteo m o g r a p h (l N I R T ) ;
d i s t a lv i e u ( r )
 LowerLimb
3$ft

Articulatiotalocrurahs

CaPUtah

Os naviculare \
'
Os cuneiformeintermedium t
Os cuboideum \ t,

l\.4fibularis[peroneus]longus,Tendo . t,
--- Articulatio
subtalaris
Os metatarsill \

s o r s a l i sp e d i s | \
M interosseud

l\4 exlensor drgilorumlongus. Tendo \

P h a l a n xp r o x i m a l i s\

Phalanx media \
\
Phalanxdistalis .
.--
M quadratus plantae

// \ Aponeurosisplantaris
f l e x o rd i g i t o r u ml o n g u s , / M adductor / M flexor / plantarelongum
Tendo hallucis, d i g i t o r u mb r e v i s
Caput obliquum

F i g . 1 3 7 8 F o o t ,P e s ;
sagittalsectionthroughthe secondtoe;
m e d i a lv i e n .

M tibialis
anterior,Tendo - M flexor hallucislongus
Tibia

- Linea epiphysialis

Articulaliotalocruralis - - M triceps surae,

Tendo calcaneus

- Articulatiosubtalaris

- Lig talocalcaneum
interosseum
Os naviculare -

- Calcaneus
Lig plantarelongum -

Fig. 1379 Foot,Pes;

imageslightly medialof the longitudinalaxis of
longitudinal-sectional
the Collumtali obtainedwith magneticresonancetomography(MRT);
medialview (r.).
W: ustumbosacratis
__3
ffiT
Distribution of the nerves of the Plexus lumbosacralis (T 12)L 1- S 4 (S 5)
Motor Sensory
Plexus lumbalis
(r 12)Ll-13 (L 4)
N. iliohypogastricus Mm.rectusabdominis, obliquus
T 1 2 , LI externusabdominis,
obliquus
R.cutaneuslateralis transversus
internusabdominis, Skinof thehip
R. cutaneusanterior abdominis Skincranialof the inguinalregionandthe Monspubis
N. ilioinguinalis Mm.rectusabdominis, obliquus
(T12)11(12) externusabdominis,
obliquus
Nn. scrotales anteriores/ internusabdominis,
transversus Skinof the inguinalregion,rootof penisandscrotum
Nn. Iabialesanteriores abdominis Skinof the inguinalregionandLabiamajora
N. genitofemoralisL l, L 2
R.genitalis M. cremaster Fasciaof testis(includingTunicadartos)
R.femoralis SkinoverHiatussaphenus
N. cutaneusfemoris Skinof the lateralandanteriorsideof the thigh to the
l a t e r a l i sL 2 , L 3 knee
N. obturatoriusL 2-L 4 M. obturatorius
externus,Mm. Capsule of the hipjoint
R. anterior pectineus,
adductorbrevis,
adductorlongus,gracilis
R.cutaneus Skinof the medialsideof the thigh,proximalto the knee
R.posterior Capsuleof the hip joint,periosteumof the dorsalsurface
Rr.musculares M, adductor magnus, (M.adductor of the femur
brevis),M. adductorminimus
N. obturatoriusaccessorius M. pectineus Capsuleof the hip joint
L3,L4
N. femoralisL2-L4 pectineus,
Mm.iliopsoas, of the hipjoint
Capsule
Rr.musculares quadriceps
sartorius, femoris
Rr.cutaneianteriores Skinof the anteriorandmedialsideof the thigh to the
knee,periosteum of the anteriorsideofthe femur
N. saphenus Skinof the medialandanteriorsideof the knee,medial
R. infrapatellaris sideof the crusandthe foot
Rr.cutaneicrurismediales
Plexus sacralis
( 1 4 )1 5 - S 3 ( S4 )
N. m. obturatorii interni M. obturatorius
internus
L5_S2
N. m. piriformis S 1,S 2 M. piriformis
N. m. quadrati femoris M. quadratusfemoris
L5-S1(S2)
N. gluteussuperiorL 4-S 1 Mm.gluteimediusund minimus,
tensorfasciaelatae
N. gluteusinferior L 5-S 2 M. gluteusmaximus
N. cutaneusfemoris Skinof the posteriorthighandthe proximalcrus
posteriorS 1-S 3
Nn.cluniuminferiores Skinoverthe M. gluteusmaximus
Nn.perineales Perineum,skin of the scrotumor the Labiamajora
N. ischiadicusL 4-S 3 Flexorsof the thigh,all
muscles of thecrusand
the foot
N. fibularis cornmunisL 4-S 2 M. bicepsfemoris,Caputbreve Capsule of the kneejoint
N. cutaneussuraelateralis Skinof the calfto the lateralmalleolus
R. communicans fibularis Connecting branchto N. suralis
N. fibularis superficialis Mm.fibulares[peronei]longus
Rr.musculares andbrevis
N. cutaneusdorsalismedialis Skinof the crusandthe dorsumof the footto
lst to 3rd toes
N. cutaneusdorsalisintermedius Skinof the lateralsideof the foot
Nn.digitalesdorsalespedis Skinof the dorsumof the toeswith the exception of the
1st interdigitalspaceandthe lateralsideof the sth toe
C o n t i n u a t i o n+ P 3 8 8
 LowerLimb

Motor Sensory
N. fibularis profundus Mm. tibialisanterior,extensor Periosteumof the bonesof the crus and capsuleof the
Rr.musculares digitorumlongus,extensorhallucis ankle joint
longus,extensordigitorumbrevis
andextensor hallucisbrevis
Nn. digitalesdorsalespedis Skin ofthe 1st interdigital space
N. tibialis L 4-S 3 Mm. tricepssurae,plantaris,popli- Capsuleof the knee joint
Rr.musculares teus,tibialis posterior,flexor digi-
torum longus,flexorhallucislongus
N. interosseus
cruris Periosteumof the bones of the crus and capsuleof
the ankle joint
N. cutaneussuraemedialis Unites with N. cutaneussurae lateralis to N. suralis
N. suralis
N. cutaneusdorsalislateralis Skin of lateral foot and lateral side of little toe
Rr.calcaneilaterales Skin of the lateral side of the heel
Rr.calcaneimediales Skin of the medial side of the heel
N. plantarismedialis Mm. abductorhallucisandflexor Skin of the medial sole of foot
digitorumbrevis,flexorhallucis
brevis(Caputmediale),lum-
bricalespedisI, II
Nn. digitalesplantares Skin of the plantar side of medial 3 % toes and their
communes nail region
Nn. digitalesplantares
propnl
N. plantarislateralis Mm. abductordigiti minimi,
R.superficialis quadratusplantae
Nn. digitalesplantares Mm. flexordigiti minimi brevis,
communes opponens digiti minimi,inter-
Nn.digitalesproprii osseiof the 4th intermetatarsal Skinof the plantarsideof the lateralI % toesand
space their nail region
R.profundus Mm. lumbricalespedisII-N,
adductorhallucis(Caputtrans-
versum),interosseiof the
4th intermetatarsal space
N. pudendus(S 1)S 2-S 4
Nn. rectales[anales]inferiores Skinof analandperinealregion
s3,s4
Nn.perineales
Nn. scrotalesposteriores/ Skinof scrotum,/Labia
majoraandminora,mucosaof
Nn. labialesposteriores the urethra,Vestibulum
vaginae
Rr.musculares Mm. transversiperineisuper-
ficialisandprofundus,bulbo-
spongiosus andischiocavernosus,
sphincterani externus
N. dorsalispenis/ M. transversusperineiprofundus Skinof penis,glans/clitoris,
prepuce
N. dorsalisclitoris
N. coccygeusS 4, S 5 (Co1) M. ischiococcygeus
[coccygeus], Skin overthe qqgcyxan!;benreeg,ggcqyx
a4{lqnus
Plexuscoccygeus S 4, S 5 (Co1) M. levatorani
N. anococcygeus

Muscles used in clinical diagnosis of segmental innervation of the lower limb

Spinalcord segmentor AJfectedmuscle(s)or tendonreflex(es)
segmentalspinal nerve
L3 M. quadricepsfemoris(paralysis
andlossof patellartendonreflex)
L4 M. quadricepsfemorisandM. tibialisanterior(weakeningof patellartendonreflex)
L5 M. extensorhallucislongus,sometimesalsobrevis(paralysisandatrophy)
S1 Mm.fibulares(peronei),sometimes alsoM. tricepssuraeandMm.glutei(lossof the Achilles
tendonreflex)
 Index

Index
The numbersin bold type indicatepageswhere
the terms appearin the legendsof figuresor tablesas well.

A Ansasubclavia119-120 Arcus Arteria(ae) colica

Anteflexio(Uterus)196 - aortae76-77,83,85, 88,91, - - sinistra165,173-175,175,
Abdomen Anteversio 100-101,103,106-102 177,209
- cross section 246-248,249 - (Articulatiocoxae)314 - coronariadextra76-77,80-82,
109-110,116,116,1r7,
- cT 246 - (Uterus)196 722-124,126,128-129 84-86,86,8Z 87,88,100.
- frontal section 242,243 Anthracoticlymph node 97 - - branches116 123-124,r3l
- median section 240 Anthracotic pigment96 - - radiograph (ap) 116 coronaryangiography87
- sagittal section 241, 244,245 Antrumpyloricum132,134-136, - - variations116 - - sinistra76-77,81-82,
Abdominal aorta + 139,245 - cartilaginis cricoideae92 84-86,86,87,87,88,100,
Pars abdominalisaortae Anulus - costalis3, 48,62,69, 201 123-124,131
Abdominal muscles 58, 62-66, - femoralis221,309 - iliopectineus271,309-310, coronaryangiography87
74,75 - fibrosus24-25,30 318 - coronariae85-86
-cT75 - - dexter79,85 - musculipsoatis70 - cremasterica190,217,231
Abdominal viscera156,160,164, - - sinister79,81,85 - - quadrati 70 - cystica142,168-169
169 - inguinalisprofundus67,69, - plantaris profundus351,375, - descendens genus351-352,
- neonate157 217,250 J/6 354,356,369
- upperabdomen158,159 - - superficialis63-65,67,67, - posterioratlantis6, 12,18-19, - digitalesdorsales (Pes)374
Abdominal wall 56, 58,67,72,73 73,231-232 38,40,45-46 - - plantares communes375,
- anterior69 - umbilicalis48,56,58,62-63, - pubicus268,271 377
- male 250 69,73-75,t57,167,179,235, - tendineus musculilevatorisani propriae375-377
- posterior69,212,213 240 - dorsalisclitoridis230
223-224,318
- sensoryinnervation, Anus 205,205,206-207,223, - - pedis 351,367,374-375,
solei324,331,370
segmental57 226-229,238,251 - venaeazygos 118 379,384
- surfaceanatomy48 - closure205 - venosus - - penis 219,230-232,234,
dorsalispedis 364,
Abductio(Articulatiocoxae)314 Aorta 30, 41,71,78, 90, tlg, 373 237,242
Acetabular fossa279 rtg, t26, 130,t72, 240,246, - - jugularis113 - ductusdeferentisl9O,219,235
Acetabular roof 279,282 248-249,357 - vertebrae6-8, 15,17,20,22, - epigastrica inferior 56,72,74,
- lateralprotuberance 279,282 Apertura 30,37 156-157, 171,173, 177,193,
Acetabulum 256,261,267 - pelvisinferior 263,269,269 Area(-ae) 203,209,213,2t7,219,221,
AcHTLLES tendon+ Tendo - - superior263,263,269, - gastricae132 224,236,250,253,255,357
calcaneus 269 - intercondylaris anterior284, - - superficialis56,352,357
AoHTLLES tendonreflex 388 Apex 295 - - superior56,71,72-74
Acromion1,26-27,53, 126 - capitisfibulae285,293 - - posterior284 - femoralis68,75, 210,242,
Adductio(Articulatiocoxae)314 - cordis 76-77,79-82,85,88, - nuda 123,142-143,240 256-257,309, 309,311,318,
Adductorcanal 313,355,356 90,100-101,103 Areolamammae54,54 351-352,354-357, 380-381
Adminiculumlineaealbae69 - dentis 6 Arteria(-ae) - - superficialis351,354
Ala - ossissacri10-ll - appendicularis 172 - fibularis 329,351,367,369,
- ossisilium 74,255,263, - patellae286,292-293 - arcuata209,351,374 377-372,383-384
266-268,273,27s - pulmonis96-92 100-101,113, - ascendens 174 - gastricadextra 134,168-170
- - sacri 10 127 - auricularisposterior44-45 - - posteriorl7O,l70
ALcocK's canal223,258 - vesicae787-788,252 - axillaris59,90,115,124,126, - - sinistra108,134,151,158,
Ampulla Aponeurosis 128 168,168,169-170,170,171,
- ductusdeferentis67,187, - musculilatissimusdorsi 32 - bulbipenis230,237 t76-177, 210,242,245-246
192-193,236 - plantaris301,306, 341-342, - - vestibuli230 - gastricae breves134,164,
- (Duodenum)132,134-135, 344-345,376-37 - caecalis
9, 385-386 posterior172 170-771
139,177 Appendixfces) - carotis communis76-77,91, - gastroduodenalis 151,168-171,
- hepatopancreatica 139,150, - epididymidis190,232 100-101,106-109,112-113, 240,242
t52 - epiploicae + Appendix(-ces) 115-116,119-120,122, - gastroomentalis dextra 134,
- recti 205,225,240,252-253, omentales 124-128 165,168,168,169- 170, r70,
257-258 - fibrosahepatis 142-143, 158 - cervicalisprofunda45, 117 171
- tubaeuterinae165-166, - omentales 140,160,163,177, - - superficialis56 - - sinistra134,158,168,168,
195-196,203-204,253 218,258 - circumflexa femorislateralis 169-170,170,245
Angle - t e s t i s1 8 9 - 1 9 0 , 2 3 2 261,351,355-3s7 - gluteainferior 206,216-217,
- ofantetorsion278 - vermiformis140,140,141, medialis260-261,351, 256-257,351,361-362, 362,
- of the femoralneck 277 161-164,167,173,204 355-352361-362 380
Angulus - - projection167 - - humeriposterior43,126 - - superior206,216-217,255,
- costae49-50,103 - - sitevariations166,167 - - ilium protunda177,213, 361,362,380
- i n f e r i o r1 , 2 7 , 2 9 - vesiculosae 194-195, 197,204 - helicinae233
219,224,354,357
- infrasternalis48 Arachnoidea - hepatica165
superficialis56,352,357
- mandibulae 12 - matercranialis46 - - scapulae - - communis134,151,168,
43, 126
- ossispubis 267 - - spinalis46-47,252 - colicadextra151,172,172,173 168,169- 171, t76- 177,210,
- sterni48,51 Arcus - - media151,161-162, 246
- subpubicus 268,270-271 - anterioratlantis 6, 12,19 172-175.175 radiograph (ap) 168
 Inrlex

irtena(4e)nepotrc0 Arteria(ae) Arteria(ae) lruculatio(nes)

p r o p r i al 3 - l 1 + 2l,l 8 , 1 5 1 , pancreaticoduodenalis inferior splenica i51 i53, 159,165, femoropatellaris 264, 256, 291
i 6 5 ,1 6 9 1 - 7 0 1, 7r - , 2 1 1 - 2 4 2 , 171,175 l 6 t J -1 7 0 ,7 7 0 , 1 7 1 ,1 7 6 1 7 7 , - g e n u s 2 6 1 , 2 6 5 , 2 8 6 , ? 8 7- 2 9 7 ,
2+6 superior anterior168,171 2 1 0 ,2 4 3 . 2 + 6 - ? _ 1 7 294,328
- - variations168 posterior168,170,176 s u b c l a v i a7 6 7 7 . 9 1 , 1 0 0 1 0 1 , - a r t h r o s c o p y2 9 4
ilealesi51,172-173, 219 perforantes 351,356-357, 1 0 6 -1 0 9 ,1 1 2 ,1 , 1 4 - 1 7 51,1 7 ,1 1 9 , - - axes 322
- ileocolica 172,172,173 3 6 0 3 6 13, 6 9 , 3 8 1 127 r ; r o s ss e c t i o n 2 8 6
- i l i a c ac o m m u n i 1 s 6 51, 7 7 , - pericardiacophrenica 72, - dextra 116,724 - - forces323
203,206,209-210,213, 9 0 - 9 11, 1 4 - 1 1 1
52, 21, 22 - - s i n i s t r a 1 1 6 ,1 2 4 , 1 2 8 - - f r o n t a ls e c t i o n 2 9 2
216 221,224,226,240-241, - perinealis230,237 - subcostalis 717-11.8,243 - - MRT 295
2 5 0 , 2 5 42 5 5 , 2 5 9 , 3 5 7 - phrenica inferior106,169,171, s u b s c a p u l a r i s1 2 8 - radiograph(ap) 293
- - e x t e r n a6 7 , 7 2 , 1 7 7 , 1 9 3 , 209-210,213 - superior lateralis genus 351, - - radiograph,lateral 293
206, 213,216- 217,219- 221, - plantaris lateralis306,351, 367 369 - - s a g i t t a ls e o t i o n 2 9 2
221,236,250,253,318. 3 7 5 , 3 7-73 7 8 , 3 8 4 - - m e d i a l i sg e n u s 3 5 1 ,3 5 t , , i n t e r t u n e i f o r m e s2 6 1 , 2 6 5
353-35'1, 356-357 - - medialis306,351,375,378, 360,367 369 - i n t e r m e t a t a r s a l e2 s65
- interna 206,209,216-277, 384 - suprarenalisinlerior 1B0,209 - i n t e r p h a l a n g e apee d i s 2 6 4 ,
217, 219-22r,224,353-354, - - protunda374-375 m e d i a 1 8 0 ,2 0 9 265
357 - poplitea286,291,319, 331. - - superior 180 - ! u m b o s a c r a l i s2 7 0 , 2 7 0 - 2 7 2 ,
variations216 3 5 13, 5 6 ,3 5 9 - 3 6 13,6 8 3 6 9 , s u p r a s c a p u l a r i s1 2 4 273,273
iliolumbalis 209,213,216-217, 371-372,382 - s u r a l e s 3 5 1 ,3 6 8 - 3 7 0 m e m b r i i n f e r i o r i sl i b e r i 2 6 5
221 - - variations369 tarsalesmediales 351, 374 - meniscofemoralis261, 291
- inferiorlateralis genus291, - profundabrachii 43 - tarsalis lateralis 351, 374 meniscotibialis 264, 291
351,367,369 - femoris256-257, 261,351, t e s t i c u l a r i s6 7 , 7 3 , 1 5 1 ,1 7 7 , - m e t a t a r s o p h a l a n g e a ( - a2e6)4 ,
- - medialis genus291,351, 3 5 4 - 3 5 23 8 0 190-191,209,213-214, 265,304,306
356,369-372 - variations357 231-232, 235, 747,249-250, - - h a l l u c i s3 0 6 , 3 3 8
- intercostales 124,131 - - penis218 219,232-234, 255-256 pedis265,302-305
- - p o s t e r i o r e3s4 , 3 6 , 5 9 , 7 3 , 141
v a r i a t i o n s2 0 9 - s a c r o c o c c y g e2a1 8 , 2 5 2 , 2 6 3
75, 77,106-t07,114-115, - propria168,168 - t h o r a c i c ai n t e r n a 5 6 , 7 2 , 9 0 , - s a c r o i l i a c a1 , 1 6 ,1 7 4 , 2 2 3 , 2 5 4 ,
117-118 - pudendainterna 206,216-217, 113- 114,116-117,122, 124, 2 6 3 , 2 6 3 , 2 6 4 , 2 6 5 ,2 7 0 - 2 7 7 ,
intercostalis suprema117 219-221,224,230,236-237, 128,130 2 7 3 - 2 7 4 , 2 7 4 , 257, 2 8 2 ,3 7 8
- interlobares182,208 239,256-258,260-261, l a t e r a l i s5 6 - s t e r n o c l a v i c u l a r i4 s8, 52,52,
- jejunales151,172-173,175, 361 362,362 - thoracoacromialis 124 123
240,242 - pudendae externae56,231, - t h o r a c o d o r s a l i s1 2 8 - sternocostales52
- lienalis + Arteria(-ae) splenica 352,357 - thyroidea inferior 108 - s u b t a l a r i s2 6 4 , 2 6 5 , 3 0 6 3 0 7 ,
- lobares inferiores100-101,130 - pulmonalisfes) 114 superior 113 3 8 5- 3 8 6
- - superiores 100,103,129 - d e x t r a7 6 - 7 8 , 8 5 , 8 8 , 9 0 - 9 1 , - tibialis anterior 285, 329, 351, - t a l o c a l c a n e o n a v i c u l a r2i s6 4 ,
lobarismedia100 97,100-101, 102,103,107, 3 6 6 - 3 6 7 ,3 6 9 , 3 72 , 3 7 4 ,3 8 3 265, 305, 307, 340
- lobicaudati142 109,123,129 - - p o s t e r i o r3 2 9 , 3 5 1 , 3 6 9 3 7 2 , - - axis 327
- lumbales177,209,213,243, sinistra76-7285,BB, 375 378,383 384 - - frontal section 306
250 9 0 - 9 11, 0 0 - 1 0 1 ,0 71, 0 9 , - t r a n s v e r s ao o l l i 4 4 4 5 - - radiograph (ap) 307
- malleolaris anteriorlateralis 115,128 u m b i l i c a l i s 6 7 , 7 3 , 1 5 7 ,1 8 3 , - - radiograph,lateral 307
351,367,374 - rectalis inferior206,219-22O, 1 9 3 ,2 0 0 , 2 1 6- 2 1 7 ,2 1 9- 2 2 1 , - - sagittal section 306
medialis351,374 237,239 236 - talocruralis 264, 265, 3O3.
- mammaria interna72 - - media206,216-217, - urethralis 234 3 0 6 - 3 0 2 3 4 0 ,3 8 5 - 3 8 6
- marginaliscoli 172-174,175 219-221 - u t e r i n a 1 9 7 ,2 1 6 ,2 2 0 - 2 2 1 - - axis 327
- mediagenus291,351,369 - - superior165,174-175,177, - - variations 197 - - frontal section 306
mesenterica inferiorl5l, 165, 206,209,219-221,255 - vaginalis 197,220-221 - - radiograph(ap) 307
172.174- t75, t75. 177,206, - recurrens tibialisanterior351, - vertebralis 24, 40, 43, 45-46, - - radiograph,lateral 307
209,213,217,219,226, 367 46,108, 116,124 - sagittal section 306
248 249 posterior351,369 - v e s i c a l e s u p e r i o r e s7 3 , 2 1 6 , - t a l o n a v i c u l a r i s3 8 6
radiograph (ap) 174 - r e n a l i s1 5 11, 8 0 1, 8 2 , 1 8 4 , 1 8 5 , 2 1 9 , 2 2 1 , 2 5 0 , 2 6 0 - talotarsalis 264
variations174 208-210,213,210-241, - vesicalisinferior 217,219-22O - tarsi transversa 265,298
- - superior70,117,151-152, 243-244,248,250 Arteriography 208 - tarsometatarsales264, 265,
165,168,168,17t-172,172, - - accessoria 209 Arthroscopy,Articulatio genus 2 9 8 ,3 0 6
173-177, 184,209-210,213, - - arteriography208 294 - tibiofibularis 264, 265, 284,
240-242,248-249 - - polarisinferior 208 Articu latio(-nes) 292-293,295-296
radiograph (apl 172 superior208 - a c r o m i o c l a v i c u l a r i s1 2 6 - z y g a p o p h y s i a l e1 s 2,l5-16,23,
variations172 - - variations208 - a t l a n t o a x i a l i lsa t e r a l i s 1 7 - 1 9 23, 25,30, 40-41,274
- metatarsales dorsales351,367, - sacrafis lateralis216-218 - a t l a n t o o c c i p i t a l i sl 7 - 1 9 Ascuorr-TlwanA node 84
374 - - mediana175,177,206,209, - cafcaneocuboidea264, 265 Atlas 2, 5, 6, 7, 12, 77-19, 34, 38,
- - plantares375-376,378,385 213,217,279-227,253 - capitiscosta4 e, 14,20,22 40,45-46
- musculophrenica 72 - segmentalis (A.renalis)208 - costotransversaria4, 14, 20 Atrioventricular node 84
- obturatoria 206,216-217, 219, - anterior128 - costovertebrales 20-22 Atrium cordis
221,224,236,250,256-257, - - basalisanterior 100 - coxae 257,264, 265, 270-273, - dextrum 76-78,80,80, 83-84,
? 6 1 , 3 0 9 , 3 1385, 6 - 3 5 7 lateralis101 275,280-281 8 4 , 8 s , 8 8 , 9 1 l, 0 l , 1 0 3 ,1 1 6 ,
- - variations221 medialis101 - - axes 314 123-125, 131,24r-242
- occipitalis43-45 posterior101 - - frlrces 323 - sinistrum 77-78, 81,81, 82,
- ovarica151,165,195,197,2O4, - segmentianterioris168 - - LnurNsrrtN projection 282 8 5 , 8 8 , 9 1 ,1 0 1 ,1 0 3 ,1 1 6 , r 2 3 ,
215,220-221,253 - - posterioris168 - - radiograph (ap) 282 1 3 0 -l 3 l
- pancreatica dorsalis168 - sigmoideae165,174-775,177, - cuneocuboidea264, 265 Auricula
- - inferior 168 206,209,255,258 - cuneonavicularis 264, 265 - dextra 76,80-82,85, 100
 Index

Auricula Bronchus(i)Lobaris(es) inferior Bursa Caput

- s i n i s t r a7 6 - 7 8 , 8 1 , 8 5 8, 8 , 1 0 0 , s i n i s t e9r 2 - 9 3 9, 5 ,1 0 0 , - suprapatellaris - laterale(M.gastrocnemius)
287,287,290,
116.130 104 292,294,382 286,288-289, 316,319-320,
Autonomic nervous system - m e d i u s9 2 - 9 3 , 9 7 , 1 0 4 , 1 2 1 , - trochanterica musculiglutei 3 2 8 ,3 3 0 - 3 3 23,3 4 ,3 6 0 ,
parasympatheticpart 214-215, 130 maximi 280,317,319-320 368-370,382
226 - superiordexter92-93,97, medii 256,280,320, - - (M.tricepsbrachii)62
- sympatheticpart 214-215,226 101,104,106,129 - longum(M.bicepsbrachii)
324
Axilla 126 sinister92-93,95, 126
A x i s 2 , 6 , 7 , 1 2 , 1 7- 1 9 , 3 8 1001 - 0 11, 0 4 - - (M.bicepsfemoris)
- longitudinalis (Articulatio - principalis dexter90,92-93, C 316-320,322,328,361,
coxae) 314 97,101,103-104,106-107,109, 380-381
- (Articulatio genus) 322 114,117, 119-120,123,129 - - (M.tricepsbrachii)43,62
Caecum140,140,141,156,
- obliqua (Articulatio talocalca- - - s i n i s t e 9r 2 - 9 3 , 9 5 , 1 0 1 , 1 0 4 , 160-164, - mediale(M.gastrocnemius)
166-167, 173,
neonavicularis) 327, 340 106-107, t15, 117,119,123, 203-204,254 286,288-290,319-320,328,
- pelvis 269 129 - mobile 166 330-333,334,360,368-370,
- sagittalis (Articulatio coxae) - projection104 - projection167 3 8 2- 3 8 3
374 - segmentalis(-es) 92-94, 101 Calcaneus 297-298,299, - obliquum(M.adductor
- transversalis(Articulatio coxae) - - anterior[BIII] 92,95,126, 300-303,305-306,385-386 hallucis)306,341,344-345,
314 128-129 Calices 346,347,378, 385-386
- - (Articulatio genus) 322 - - apicalis[B I] 92 - renalesmajores - ossismetatarsi297,300
181,183,243
- - (Articulatio talocruralis) - - apicoposterior I + II] 92, - - m i n o r e s1 8 1 - 1 8 3 , 2 0 8 , 2 4 4 ,
[B quinti 298
327,340 95 248 - pancreatis 149-151, 165-166,
- - basalisanterior[B VIII] 92, Calx 262 171,177,241-242
95 Canalis - phalangis(Pesl297
B cardiacus [B VII] + - adductorius 311,351 - rectum 280-281,312,314
Bronchus(-i) segmentalis - analis225 - reflexum 280-281,312,314
B a c k1 , 4 3 basalismediatis[B VII] - cervicis uteri 195-196,253 - tali 297-300,302 384,386
- cutaneous nerves42 lateralis [BlX] 92,95,131 - femoralis309 - transversum(M. adductor
- dermatomes 42 medialis - inguinalis232
[BVII] 92 hallucis)342-344,346,347,
- innervation, segmental42 posterior[B X] 92,95, - nervihypoglossi18 378,388
- orienteering lines 1 130 - obturatorius206-207,223, Cardia132,158,245
- surfaceanatomy1, I - - lateralis[B IVI 92 270, 280-281, 309,313,318, Cardiacaxis 82
Backmuscles28 - - medialis[B V] 92 318 Cardiacsilhouette103
- autochthonous 3,31-34,36, - - posteriorlBlll 92, 129 - pudendalis223 - aorticbutton 103
- - superior[B VI] 92,95 - pyloricus132,139,150 - left atrium 103
- - lateraltract 30,33,39 BnuuNpn's glands 138 - sacralis4, 10-11,24,219,273, - pulmonaryarch103
- - long fibers 32 Bulbus - radiograph103
318
- - medialtract 30, 35 - aortae81 - vertebralis3,24,318 - right atrium 103
- - superficial31 - duodeni132,132 - ventricularcontour103
Capsula
- deeplayer 29 - penis 193,233,236,251-252 - adiposa180,209, 243-246 Carinatracheae104,123
- superficiallayer 27 - vestibuli194,220,238-239, - articularis(Articulatio Cartilago(-ines)
BrnruorrN'sgland 194,229,238 261 atlantoaxialis lateralis)17-18 - articularis286
Basis Bursa - - (Articulatioatlantooccipitalis- arytenoidea 93
- ossismetatarsi297,300,304 - anserina313 - bronchiales
18 92,106
hallucis298 - iliopectinea309,324 - - (Articulatiocostovertebralis)- corniculata93
- - sacri 10-11,275 - infrapatellaris profunda287, - costalis52,52, 61,64-65,70,
21-22
- patellae286,292-293,325 290-291 - - (Articulatiocoxael270, 73,117,129,131
- phalangis(Pes\297 - ischiadica musculiobturatorii - cricoidea12,123
272-273
- prostatae192 interni 320,324 - - (Articulatiogenusl287,292, - thyroidea41,65, 92-93,106,
- pulmonis97 - musculisemimembranosi 328 113,120,123
- pyramidis181 3 3 1- 3 3 3 - - (Articulatiometatarsopha- - tracheales92-93,104,
Bluurn'svalve 140 - omentalis154-155, 159, langeahallucis)338 106-107,123
Bifurcatio 164-165,245-247 - - (Articulatiosternoclavi- Carunculae hymenales229,238
- aortae175,177,357 - subcutanea calcanea341 cularis)52 Cauda
- tracheae92-93,1Ol,104, - - coccygea43 - - (Articulatiozygapophysialis) - epididymidis189-191, 252
106-107,109,123,129 - - infrapatellaris 308,310, 23,25,40 - equina24,30,203,240,
- truncipulmonalis77-78, 88, 325 - fibrosa(Ren)180,182,244-245 248-250,255
9l - - prepatellaris 286,308,325 Caput - pancreatis149-152,159,
Boorolur's triangle69, 70 - - sacralis43 - breve(M.bicepsbrachii)59 164-165, 177,242,246
Boyn'svein 365 - - spinaeiliacaeposterioris - - (M.bicepsfemoris)316, Cavea
Bronchography95 superioris43 319-320, 322,328,361,381, - thoracis26,53,61
Bronchoscopy104 - - trochanterica324 387 - - radiograph (ap) 103
Bronchus(-i) 92-94 - subfascialis prepatellaris290 - c o s t a e4 , 1 4 , 2 2 , 4 9 Cavernae corporum
- bronchography95 - subtendinea iliaca 256, - epididymidis 189-191,232, cavernosorum 233
- intrasegmentalis124,128 3 1 2 - 3 1 3 ,8 0 252 Cavitas
- lingularisinferior(B Vl 92,95 - - musculigastrocnemii - femoris225,256,259-261, - articularis(Articulatiocoxae)
- - superior(B IV) 92,95 medialis324,331-333 273,275-278,280,282 2 7 3 , 257, 2 8 0
- lobaris(+s)94, 109 obturatoriiinterni - fibulae262,284-285, - glenoidalis 53,126
- - inferior 130 256-257 287-289, 293,295-296,308, - infraglottica123
dexter92-93,97,104, sartorii 313 3 1 0 , 3 1 63 ,2 5 , 3 6 6 - medullaris278,283
120-121 - - prepatellaris310 - humeri 126-127 - nasi 12
 index

Cuvitas Colon Cor Costa(ae)

- p e r i c a r d i a c a1 2 3 , l ? 9 - sigmoideum141,154-156,160, ventricle,left 81-83,84 - fluctuantes [XI; XII] 53
- p e r i t o n e a l i s1 5 4 - 1 5 5 ,1 5 5 . 162 166,173,t7 5, 177,200, - - right80,82-83,84 - spuriae IVIII-XII] 53
165,240-242,245 249 203,206-207,209 210,218, Cornu - verae
[I-VII] 53
- - d e v e l o p m e n t1 5 4 , 1 5 5 , 225,240,242,249-255,258 - anterius(Meniscus lateralis) Cotyledons 202
155 transversum140,141,148. 292 Cowprn's gland 218, 228,230
- p l e u r a l i s 1 1 4 - 1 1 5 ,1 1 9 ,1 2 2 , 154-156,158-160,162-164, 166, - coccygeum11 Coxa
1 2 5 ,1 3 0 , 2 4 6 - 2 4 7 173,240-242,244-246,248 - inferius(Margofalciformis) - valga 277
- symphysialis 274 - - variations141 308-309 vara 277
- thoracis 122-123,129 - wall, layers 140 - posterius(Meniscus lateralis) Crista
- cT 129 Coloscopy141 292 - capitis costae 49
- - frontal seclion 124,126 Columna(-ae) - sacrale10-11 - colli costae 49
MRT 124,125 anales205,240,252,258 - superius(Margofalciformis) - iliaca 1, 15, 27, 29, 43, 68,75,
- - median sagittal section - renales181,244 308-309 , 08,272,223,
1 0 5 ,1 7 4 , 1 8 6 2
123 - rugarumanterior238 Coronaglandis193,233-234,252 2 5 4 - 2 5 5 ,2 5 9 ,2 6 3 ,2 6 6 - 2 6 8 ,
- MRT 125 - vertebralis2-3 Coronaryangiograplry 87 2 7t , 2 75 , 3 0 8 , 3 1 6 - 3 1 9 3
, 58,
- - transversesection 127-128, Commissura Coronaryarteries85, 86 362-363
129-130 labiorumanterior238 Corpus(-ora) - intertrochanterica 275-277
- uteri 195-196,253 - - posterior227,238 - adiposuminfrapatellare287, - medialis 285
Cavum serosumscroti 191 Compartimentum cruris 292,295,328 - obturatoria 268
Centrum - anterius329 - - pararenale185 - occipitalisexterna 6
- perinei 223-224 - laterale329 - albicans195,204 - sacralislateralis 4, 10
- t e n d i n e u m 6 1 ,6 8 - 7 O , 7 1 , 7 5 , - posterius329 - anococcygeum 200,218, - - medialis 10
1 0 6 -1 0 8 ,1 1 4 - 1 1 52, 4 0 ,2 4 4 Compartment 2 2 3 - 2 2 42,2 8 - ? 2 92,3 7- 2 3 9 , - m e d i a n a4 , 1 0 - 1 1 , 1 5 , 2 7 2 ,
Cervical vertebral column - anterior329,329 252,257 Jf,d

CT 41 - lateral 329 - cavernosum clitoridis200 - urethralis188,233

- radiograph (ap) 13 - posterior, deep329 238,253 Crus 264
- radiograph,lateral l2 - - superficial329 - - penis 189,193,214,219, - clitoridis 194,238,261
Cervix Compartment syndrome329 232,234,234,235,240-241, - compartments 329
- uteri 196-198,251 Computed tomography (CT) 252 - crosssection383,384
- vesicae 192 - abdomen246 - (Clavicula)48 - - MRT 383
Chiasma cervicalvertebralcolumn41 - clitoridis224,253 - dextrum(Diaphragma) 68-69,
crurale 333 - lumbarvertebralcolumn4l - costae49,103 70, 71,71,106,108,1.18, 246
- plantare 344 - Mm.abdominis75 - epididymidis191 - - (Fasciculus atrioventri-
CHop.q.nt's joint line 265,298 - Mm.dorsi 30 femoris276,278,293 cularis)84
C h o r d a (a e ) - pelvis 254 - fibulae 285,293 - fascia325
- arteriae umbilicalis 56, 56,74, - - temarc zJl gastricum125,132,134-136, - laterale(Anulusinguinalis
1 5 6 ,1 9 3 ,2 2 1 ,2 3 6 , 2 5 0 , 2 5 3 - - male 256 156,158-159,243 superficialis)63,65,67,232
- t e n d i n e a e8 1 - 8 3 thoracic caviay 129 - luteum195 - mediale(Anulusinguinalis
- nrachi 74,236 Conductionsystem 84 - mammae62 superficialis)58,63, 65,67,
Cingulum Condylus - ossisilium 259,266,268 232
- p e c t o r a l e3 , 2 6 , 5 3 - lateralis (Femtrl 276,278, - - ischii 266-268 - muscles326,330-332,333
- pelvicum 3,263,264 2 8 3- 2 5 4 , 2 8 7- 2 8 9 , 2 92 - 2 9 5 - - metatarsi297,300,336 - - lateral 329
Cisterna - - (Tibia) 284,289,292-295 - pubis 223,241,266 - - originsandinsertions335
- cerebellomedullaris46 - mediafis (Femtr\ 276,278, - pancreatis149-152,159,164, - - superficial,deep 334
- chyli 118,210 283 - 284, 287- 289, 29 2 -29 3, 171 dorsal334
C l a v i c u l a3 , 2 6 , 4 8 , 5 2 - 5 3 , 6 2 , 295,310-311 - penis235 - - ventral 327
103 104, 110,113-115,122, - - (Tibia) 284,292-293,295, - phalangis(Pesl297 - osteofibrous tubes 329
124,726-727,757 3 2 6 ,3 3 1 ,3 3 3 - spongiosum penis 189,193, - penis 193,218,233,236,260
Clitoris 200, 215,215, 224 - occipitalis 6 193,214,228,232-235,240, - sinistrum(Diaphragma)
Clivus 18 Conjugata 2 5 1- 2 5 2 , 2 6 0 69-70, 70-71, 106,108,118,
Cloouer's septum 309, 328 - anatomica 269 - sterni3, 51,61,1O4,123, 247
Cocrrrr's veins 365 - diagonalis 269 128-130,240 - - (Fasciculus atrioventricu-
C o l l i c u l u ss e m i n a l i s 1 8 8 ,2 3 3 - vera 268-269 - tali 298-299,306 laris) 84
Collodiaphysealangle 277 Conus arteriosus 76, 85, 100 - tibiae284-285,?93 Cryptaeintestinales + Glandulae
Lollum z)/ Cor 57,76-77, 100, 116,116, 240 - uteri 195,192251 intestinales
- costae 4, 49 - arterial supply 86, 103 - vertebrae 4-9, 12-17,19-25, Cupulapleurae105,126
- femoris 275-278, 280-282 - balancedtype 86 30,74,129,246 Curvatura
- fibulae 285 - - left dominance 86 - vesicae187 - major 132-135, 156-159
- frontal section 126 atrium, left 81 - - biliaris 146 - minor 132-L35,139, 158
- tali 298 300,307 - - right 80,84 Cortex Cuspis
- v e s i c a e b i l i a r i s1 4 6 - 1 4 7 - coronary arteries 85, 86-87 - (Glandula suprarenalis)187 - anterior(Valvaatrioventricu-
Colon140,161-163 - - coronary angiography 87 - renalis181-182, 185,244-245, larisdextra)79-80,83-84
- a s c e n d e n s1 4 0 ,1 4 0 - 1 4 1 ,1 5 6 , - p o s i t i o nd u r i n g e x p i r a t i o r y ' 248 - - (Valvaatrioventricularis
1 s 9 -1 6 0 ,1 6 3 - 1 6 4 ,1 6 6 - 1 6 7 , inspiration 104 Costa(-ae) 3-5, 14,14,15-16, sinistra)79,81-82,84,130
1 7 8 ,1 8 6 ,2 4 2 , 2 4 9 , 2 5 5 - projection 103 20-22,26,29-30,34,37,39, - commissuralis dextra 79
- descendens 141,157,163-164, - right dominance 86 49,49,50,50,53,59,65, - - sinistra79
1 6 6 ,1 75 , 1 78 , 1 8 6 ,2 4 2 - 2 4 3 , - site 90 6 9 - 7 0 , 7 2 , 7151, 31, 1 5 , - posterior(Valvaatrioventricu-
2 4 6 , 2 4 8 - 2 4 9 ,2 5 4 - 2 5 5 - sonographicimage 130 I l7- 118,122-124, 126, farisdextra)79-80,82-83
- projection 141 - valves 85 128-130,136,208-209,212, - - (Valvaatrioventricularis
- radiograph (ap) 141 - - projection 90 213-248 sinistra)79,81-83,130
 Index

Cuspis Dorsum E Faciesarticularis

septalis(Valvaatrioventricu- pedis262,367,373-374 - - capitiscostae49
larisdextra) 79 80,82 - penis235 Eminentia fibulae285
Cutaneousnerves - surfaceanatomy1 i l i o p u b i c a 2 2 3 ,2 6 3 , 2 6 6 - 2 6 7 , - - cuboidea299-300
- back 42 Doucr-A,s's - - fibularis 284
space155,165,198, 275
lower limb 349 200,221,253 - intercondylaris 284, 292-293 - - inferior (Atlas) 6
Cutis 73 Ductulus(-i) - plantaris intermedia 345 (Tibia)284,296,303
Cystoscopy 188 - aberransinferior189,l9t - - fateralis 341,345 (Vertebralumbalis) 9
- efferentes
testis 191,252 medialis 341,345 - - malleolilateralis285,296,
- prostatici188,233 E n d o c a r d i u m8 2 303
D - transversi194-195 Endometrium+ Tunica mucosa medialis284,296,303
Ductusfus) (Uterus) - - navicularis299-300
Defaecography225 _ ARANTII 143
Epicardium 76, 76, 80-82, 124 - - (Patella) 286-287,292,294
D e n sa x i s 6 - 7 , 1 2 , 1 8 1 9 - arteriosuslBorALLol76-77, Epicondylus - - posterior(Axis) 6, 19
Dermatomes 90 - lateralis (Femur) 276, 283, - - superior(Atlas)6, 19
- back 42 - biliaris+ Ductus 286,292-293 (Tibia)284,295
- lower limb 348 choledochus - medialis (Fem',s,rl276,278, - - talarisanterior299-300,
Diameter - choledochus 142,146-148, 283, 286, 289, 292-293, 312 305
- conjugata 269 150-152,168-169,177,241, E p i d i d y m i s 1 8 3 ,1 8 9 ,1 8 9 - 1 9 1 , media299-300,305
- obliqua I 268 246 2 1 4 ,2 3 2 , 2 4 0 - 2 4 1 posterior299-300,305
- obliqua II 268 - - radiograph (apl 147,152 - - tuberculicostae49
Epiglottis 12
sagittalis 269 - - variations146,150 Epiorchium l9l - auricularis10-11,267
- transversa 268-269 - cysticus134,147,151-152, - colica 153
E p i p h y s i sa n u l a r i s 4 - 5 , 7 - 9 ,
- tuberalis 269 1 6 51, 68,777,246 - contacta hepatis209
Diaphragma 57, 59, 61, 68, 68, - deferens73, 164,177,187,187, Episiotomy 229 - costalis(Pulmo)96-97
6 9 , 6 9 - 7 1 , 7 2 , 7 5 , 8 7 ,1 0 3 , 188-191,l9r, 192,r92, 193, Epithelium 108, 732, 137,140 - diaphragmatica (Hepar)
106- 110,112-114,117- 119, r93, 213- 274,2r4, 218- 219, Epoophoron 194,194 142-143,158- 159
127-125, 142, 145, 148, 151, 23t-232,235-236,241,250, ERCP( (endoscopicretrograde - - (Pulmo)97
1 5 5 ,1 5 7 -1 5 8 252,256,258 cholangiopancreaticography) - - (Splen)153
p e l v i s 1 8 5 ,2 2 2 , 2 4 0 - 2 4 1 , - - radiograph (ap) 192 152,152 - dorsalis(Ossacrum)27
243-248 - ejaculatorius188-189,192, Erection 214 - gastrica(Splen)153,164-165
- f e r n a l e2 2 3 - 2 2 4 , 2 2 9 192,193,193,233 - glutea 268
Excavatio
- - male 228,236 - epoophorontis - rectouterina 155, 165, 195-196, - intervertebralis4, 7 -9, 72,
longitudinalis
+
- urogenitale 222, 239, 241, Ductus(-us) longitudinalis 198,200,221, 253,257 t4-16,25
261 excretorius193 - rectovesicalis 164, 193, 205, - intestinalis195-196,203-204,
- - female 230,238 - glandulae bulbourethralis189, 2 0 9 , 2 1 8 ,2 3 6 , 2 4 1 , 2 5 2 221,253
- male 230 233 - v e s i c o u t e r i n a1 5 5 ,1 6 5 ,1 9 6 , - lateralis(Fibula)285
D i a p h y s i s( F e m u r ) 2 7 9 - hepaticus communis134,146, 200,204,253 - - (Testis)190
Digitus(-i) 146,147,151-152,16s,168, Extensio - - (Tibia) 284-285
minimus (Pes)262,297 t77 - (Articulatio coxae) 314 - lunata 223,267-268, 280
- pedis 264 - - dexter 146-148 - (Articulatio genus) 322 - malleolaris lateralis298-300
- primus (Pes)+ Hallux - - sinister 146-148 - (Articulatio talocruralis) 327 - - medialis298-300
- q u a r t u s( P e s l 2 6 2 , 2 9 7 - lactiferi54 - medialis(Fibula)285
Extremitas
- quintus (Pes)+ Digitus - Iongitudinalis194-195 - a c r o m i a l i s2 6 , 1 2 6 - - (Ovarium)195,204
mlnlmus - mesonephricus 189,194 - a n t e r i o r( S p l e n ) 1 5 3 ,1 5 7 - - (Tibia)284-285,325-326,
- s e c u n d u s( P e s l 2 6 2 , 2 9 7 - omphaloentericus - i n f e r i o r( R e n ) 1 6 2 ,1 6 5 ,
137 366
- t e r t i u s( P e s l 2 6 2 , 2 9 7 - pancreaticus - patellaris 276,283,286-288,
146,150-152, 1 8 5 -1 8 6 ,2 0 8
Discus 240-241 - - ( T e s t i s )1 9 0 292,294
- articularis 273 - - accessorius - posterior (Splen) 153 - pelvica11
150
- (Articulatio sternoclavicu- - - radiograph (ap) 152 - sternalis3, 110 - poplitea276,278,293,328,
laris) 52 - - variations150 - s u p e r i o r( R e n ) 1 5 8 ,1 6 4 ,1 8 5 , 330,332,369
- interpubicus 20O,270, - paramesonephricus - posterior(Fibula)285
189,189, 208
273-274,274 194 - - ( T e s t i s )1 9 0 - - (Prostata)187
- intervertebralis 12, 17,19, - paraurethralis - tubaria 195 - - (Ren)185
238
2 1- 2 4 , 2 4 , 2 5 , 3 0 , 4 1 ,1 76 , 2 70 - thoracicus71, 115,117- 118, - uterina 195 - - (Tibia) 284-285
Distantia ttB, 121,128-131,243, - renalis(Splen)152-153
- i n t e r c r i s t a l i s2 6 9 246-247,250 - sacropelvica267
interspinosa nterior 269 venosus143 F - superior(Talus)299
- p o s t e r i o r2 6 9 Duodenum119,132,132, - symphysialis3, 267,273,280
pubococcygea269 133-134,134,139,139, Facies - vesicalis196,203-204,253
D i v e r t i c u l um ( - a ) 146-147, 149-150,150,151, - anterior (Glandulasupra- - visceralis(Hepar)143,158
- ampullae 187 r5l, 152,154-155,158-159, - - (Splen)153
renalis) 187
- ilei 137 161,163-166, t68,177-178, - - (Patella) 286-287,292-293 Falxinguinalis69
Divisio 241 242 - - (Ren)185 Fascia
l a t e r a l i sd e x t r a 1 4 4 - endoscopy 139 - a n t e r o i n f e r i o r1 6 2 - axillaris 58
- sinistra 144 - projection149 - a n t e r o s u p e r i o r1 5 9 - brachii 58
m e r l i a l i sd e x t r a 1 4 4 - radiograph (ap) 135,139 - a r t i c u l a r i sa n t e r i o r( A x i s ) 6 , l 9 - cervicalis113,123
- sinistra 144 - wall,layers138 - - c a l c a n e a3 0 0 - clavipectoralis 58
I ) o n u ' sv e i n s 3 0 8 , 3 6 5 Duramater - anterior 299 - cremasterica 191,232,235,
D r l r s r r mI c r a n i a l i sl 9 media 299 252
- o r i e n t o e r i n lgi t ) e s I slrinalis19,16-47,123 - - cribrosa210,308
l x ) s t e r i o r2 9 9
 Inriex

Fasan Fibrae foramen(-ina) Canglion(ia)

- stellatum+ cervicothoraclcum
- r , e r t e b r a l 4e , 4 , 6 9 , 2 0 , 4 1 , 1 2 9
cruris 308,325,325,329,329, intercrurales58,63,6/-
- obliquae133 WTNSLOW 1 5I 8 t h o r a c i c 1a 1 4 - 1 1 1
51, 9-121
330,364,368,383 - truncisympathici
- deltoidea27,29,31,44 Fibula 264,284 285,287-289, Fornix 214 215,226
296,302-303,306-307,329, - gastricus 132, 134, 136,24O, G a s t e 5r 7 , 7 01, 0 6 1 , 0 81 , 1 01, 1 9 '
dorsalis pedis325,345.379,
332-333,332 383-384 L+a ttg, 125,132-134,136,139,
385
- g l u t e a6 2 , 3 0 8 , 3 6 0 Filumfa) - vaginae196,198,20O,253 1s.l-155,158-1s9,164.166,
- iliaca 177 radiculariaposteriora 46 Fossa 168-169,177,209,240-242,
- inferiordiaphragmatis pelvis - terminale240,252 - acetabuli223,260,261-268, 244-248
275.280,282 - arteries,variations170
223,238 Fimbriafae)
- infraspinata27,29,31,44 - ovarica 195 - condylaris6 - forms 136
- projection136
- investiens perineisuperficialis - tubaeuterinae195,203-204, tliaca263,267
infraspinata26 - radiograph (aP) 135,170
+ Fasciaperinei 253
- lata 308,308,309-311, 311, Fissura - inguinalislateralis67,736,25O - wall,layers 132
- horizontalis pulmonisdextri - rnedialis67,236,25O Gastroscopy 136
312,317,358, 381
- nuchae45 96-97,124 - intercondylaris278, 283,293, Genitalorgans
- obturatoria223, 228-229,318 - ligamentiteretis 142 295 - female215
- pedis 384 - obliqua 96-97,101,125, - ischioanalis 228,228,229, - - development 194
- pelvisparietalis 253 229,236,239,257 -258 - - external229,238,239
1 2 8 -1 3 1
- - visceralis252 - portalisdextra 144 - malleolilateralis 285 - - innervation215
- penisprotunda 231,234-235 - - principalis 144 - navicularisurethrae 233-234, - - internal 195,197,2O3,204
- - superficialis234 - umbilicalis 144 252 - male 214,232
- perinei 223, 228-230,260 - ovalis80 - - development 189
Flatfoot 305,305
- rectalis198 - paravesicalis250,260-261 - - external231,235,237
Flexio
- rectoprostatica252 - (Articulatiocoxae)314 - poplitea262,308,320,325, - - innervation214
- rectovaginalis2OO,253 - (Articulatiogenus)322 358-361,368-372 Genu264
- renalis 244-245 - (Articulatiotalocruralis)327 - supravesicalis67,236,250 - fascia325
- spermatica - (Uterus) 196 - trochanterica 277-278, 280 - muscles328
externa73, 190,
Flexura - vestibulivaginae238 GrMssRNlrI's liSament309
232,235
- - interna73,190-191,232,235 - anorectalis205,218 Fovea Glandulafae)
- thoracolumbalis24-25,27, - coli dextra 141,152,158-160, - capitisfemoris275-278,280, - areolares54
282 - bulbourethralis789,193,214,
29-30,30, 31,31,32,32, 34, 163-164,173
36-37,41,62,74,317 - - sinistra124-125,135,141, costalisinferior 4,8, 20 214,218,228,228, 230, 233,
- transversalis34, 65,68,72, 160,162-164,173 - - processus transversi4, 8-9, 236
- duodeniinferior 134,151,173 2l - duodenales138
74-75
- vesicalis198 - - superior151 - - superior4,8-9,20-21 - gastricae132
- vesicovaginalis200 - duodenojejunalis139, - dentis6,19 - intestinales137,14O
Foveolae gastricae132 - mammaria 129-131
Fasciculus(-i) 149-150,164-165,175, 242
- atrioventricularis84-85 - perinealis+ Flexura FRANKENHAUSER's plexus 215 - oesophageae 108
- lateralis126 Frenulum - suprarenalis151,159,165,177,
anorectalis
- longitudinales(Lig.cruciforme - sacralis205,218 - clitoridis238,253 180,180,183,183,187,209,
Folliculiovaricivesiculosi 195, - labiorumpudendi238 243,246
atlantis)18-19 - thyroidea106-102109,
- posterior126 253 - ostiiilealis 140
- transversi(Aponeurosis Foramen(-ina) - preputii 234 112-113,122-123
- costotransvefsarium Fundus - tracheales93
plantaris) 341 4, 21
- epiploicum+ Foramenfina) - gastricus 124,132-135,758 - vesiculosa187,187,189,192,
Fat,parathymic 111
omentale - uteri 165,195-197,200, 192,193,r93,214,214,
Femoralhernia 309
- infrapiriforme317-318,318, 203-204,253 218- 219,236,240- 241,256,
Femur(thigh) 3, 225,256-257,
264,275-276, 276-278, 279, 319-320,358,362 - vesicae165,192-793,233 258
- intervertebrale2, 72,74-15, - - biliaris 146,148,156, l6i, - - radiograph(aPl 192
282,283, 286,286, 287-289, - vestibularisnaior 794,229,
292-295,310-313, 328,330, 21,22,25,30,41,273 164
381-382 - ischiadicummajus 223, 269, Funiculus 238
332,354,369,
- angleof antetorsion278 277-273,317, 318,358,362 - spermaticus58, 63-65,67,67, Glans
- arteries 357 - - minus 269,271-273, 71,190,190,210,218-219,231, - clitoridis 194,20O,229,238
- collodlaphyseal 235,256,308-309, 3s3 - penis 189,193,214,233-234,
angle 277 317-318, 318,320,358,362
- crosssection380-381,382 - magnum 6 - umbilicalis73,2O2 234, 235,235, 240-241,252
- - MRT 382 - nutricium 284-285,324 Glomerulusrectalis 205
- fascia 308 - obturatum 221,,267-268, 268, Glomuscoccygeum253
- head,epiphysis279 269,271,273,275,282 G Glutealregion
- omentale158,164,165 - female 227
- MRT 381
- ovale(Cor) 80,80 Ganglionfia) - male 227
- muscles310-313,316-320
- - dorsal322 - sacraliaanteriora 10,16,275, - cardiacum120 Gnrlrian follicle 195
- - medial 315 318 - cervicalemediumll9-l20 Gubernaculum testis 73, 189
- - origin and insertion 324 - - posteriora10-ll - cervicothoracicum 119-120
- - ventral 314-315 - suprapiriforme317-318,318, - coeliaca226,246
- neck-shaftangle 277 319,358,362 - impar 71 H
- radiograph lapJ 279 - transversarium4, 6-7, 4l - mesentericum inferius 226
- trabecularbone277 - venaebasivertebralis9, 23, 25 - pefvica 214,214,215,226 Hncu'sdeepfemoralvein 365
- - cavae61,68-69,71,106, - sacralia217 HlLLrn'sarch 70
Fetus
- radiograph(ap) 201 108 - sensorium nervorumsPinalium Haflux262,297,3O1
- sonographicimage 199 - venarumminimarum 80 24,46-47 Haustracoli140-141,161
 in.dex

ilead ioints 17-18, i9 !ncisura Lalrrum acetabuli 280 Ligamentum(t)

r a r l i o g r a p h( a p ) 1 9 - c a r d i a c ap u l m o n i ss i n i s t r i i.a(juna(-ae) - collaterale fibulare287-29i,
H F . A D z' So n e s 5 7 e 6 - 9 7 ,1 0 5 , 1 1 3 rnusculorum 7i, 271, 3O9 295,324
Heart c a r O i a l i s1 3 2 ,1 3 r t - u r e t h r a l e s2 3 3 laterale290
- m u s c u l a t u r e7 8 , 7 9 - c l a v i c u l a r i s5 1 - v a s o r u m 6 8 , 7 1 ,2 7 7 , 3 O 9 - - mediale(Articulatiogenus)
v e i n s8 5 , 8 8 , 8 9 c 0 s t a l i s5 1 I-amina 290
Hrrsrln's valve 146 - fibularis 284 - anterior (Vaginamusculi recti (Articulatiotalocrura lisl
Hepar 57, 59, 123-125, 134, ischiadicamajor 267- 268, 282 a b d o m i n i s )5 8 , 6 2 - 6 5 , 7 3 - 7 4 , 302,304.306.384
1 4 2 - 1 4 3 , t 4 6 , 1 4 8 ,1 4 8 , 1 4 9 , - - minor 267-268.282 309 - tibiale 286-292,295
1 5 2 ,i 5 4 - 1 5 5 ,1 5 9 ,1 5 9 ,1 7 8 , - j u g u l a r i s( S t e r n u m )4 8 , 5 1 a r c u sv e r t e b r a e4 , 7 - 9 , 2 1- 2 3 , - collateralia (Arriculariones
1 8 5 ,2 4 0 - 2 4 2 , 2 4 4 - 2 4 8 ligamenti teretis 142 '25,30,41,47
interphalangeae pedis)304
- c r t e r i e s ,v a r i a t i o n s 1 6 8 - p a n c r e a t i s1 5 0 - t;artilaginiscricoideae 12, 93, - coronarium142-143,158, 165
hilum 142 v e r t e b r a l i si n f e r i o r r l , 8 , 1 2 , 1 5 123 - costoclaviculare 52
- projection 149 - - s u p e r i o r4 , 1 2 , 1 5 - cribrosa 71 - costotransversarium
- s e g m e n t s1 4 4
20-21.37
lnfundibulum - (lextra (Cartilagothyroidea) - - laterale20-22.34.36
- v e i n s ,p r o j e c t i o n 1 4 8 - ductus paramesonephrici 189 - - s u p e r i u2
92 93, tO6 s1-22,34
s o n o g r a p h i ci m a g e 1 4 5 - tubaeuterinae194 195,197, - muscularis mucosae 1O8,132, costoxiphoidea 58,63
H e r n i a f e m o r a l i s3 0 9 204,220,253 137,140 - cricothyroideum medianum
Hiatus Inguinal canal 67,73 - parietalis (Pericardium 92
- a d d u c t o r i u s3 1 2 . 3 1 3 ,3 Z B ,3 5 6 , Injection, intragluteal 362, 363 - cruciatumanterius288-289,
serosum) 76, 76, 77, 85, 91,
360 Interacetabularline 269 123 124,240 291 292,295
- a o r t i c u s6 8 - 7 O , 7 7 , 1 0 6i,5 l , lnterarticular portion B, 15 - - (Tunica vaginalis testis) 73, - - posterius288-292,295
t77 l n t e r s e c t i ot e n d i n e a 4 8 , 6 3 - 6 5 , t90-197,232 - cruciformeatlantis 18-19
o e s o p h a g e u s6 8 - 6 9 , 7 1 , 1 0 6 , 69 posterior(Vaginamusculi recti - cuboideonaviculare dorsale
106, lryt, 109, 177,209, 213 Interspinaline 269 a b d o m i n i s )6 5 , 6 9 , 7 2 - 7 3 302
sacralis i0 11 lntestinum - profunda (Fasciathoraco- - - plantare304
s a p h e n u s3 0 8 , 3 0 9 , 3 5 3 - crassum 57, 761, 162, 162-163 lumbalis) 30,37 - cuneocuboideum dorsale305
- urogenitalis etani 223 - tenue 57, 137, 138, 138, 157, - propria mucosae 108,132,137, - cuneonavicularia dorsalia302,
Hilum t6t, 162, 162,252 140 305
( G l a n d u l as u p r a r e n a l i s )1 8 0 - - wall, layers 137 - superficialis(Fasciacervicalis) - - plantaria304
- lymph nodes 90, 101 Introitus vaginae 215 - deltoideum
123 + Ligamentum(-a)
- renale lB0, 180-181 Isthmus 8, 15 - - (Fasciathoracolumbalis) 30 collaterale mediale(Articulatio
- s p l e n i c u m 1 5 3 ,1 5 9 , 2 4 6 - glandulaethyroideae 106 - visceralis(Pericardium talocruralis)
Hip - t u b a eu t e r i n a e 1 9 5 , 2 0 3 - 2 0 4 , serosum) 76,76, 77, 80-82, - denticulatum46
- arteries357 221,253 - epididymidisinferius 190
123,240
- m u s c l e s3 1 0 - 3 1 3 , 3 1 6 - 3 1 9 , - - (Tunicavaginalis testis) 191, - - superius190
uteri 195-196,253
320 232,240 - falciforme 67,74, 142-143,
- - dorsal 321
LaNNeLoNcur'scr)?ts 89 146,156-1s8,164-165,241,
- - ventral 314
I v. LANz'spoint 167 246-247
HIs's bundle 84 Laparoscopy 148 - flavum 20-23,25, 30,37,41,
Horseshoekidney 182 lejunum135,138,138,139, LARREY'S fissure 71 47.255
H u m e r u s3 , 1 2 8 151-152,154 155,160-161, l-arynx 41,92-93 - fundiformepenis 58, 67,231,
Hurtrn's vein 365 163,173,777,240,242, Lluensrprr's projection 282 240-242,252
Hydatid, pedunculated 195 245-246,248 Levatorhiatus 223 - gastrocolicum 155-156,
Hymen 238 Junctioanorectalis205 Lien + Splen ts8-159,164,t7l, 241,245
Hysterosalpingography196 Juncturaecingulipelvici 263, Ligamentumfa) - gastrophrenicum165
270,270-273 - alare 18, 18 - gastrosplenicum 153,158-159,
- anococcygeum+ Corpus(ora) 164-165,243,245
I anococcySeum - hepatoduodenale 134,146,
K - anularia 92-93 158-159,164-165,246
Ileocaecalvalve 14O - apicisdentis 18-19 - hepatogastricum 134,154-155,
Ileum 137-138, 138,140, Krnn-Fr.lcx node 84 - arcuatum laterale 68-71 158-159,164,245-246
154-156,160-161,164, KdHr-En's
tear-likefigure 282 - - mediale 68-70 - iliofemorale270-271,
166-167,r73,203,225, KosLnruscu'sfold 2O5,252 - - medianum 69 280-281,312,380
240-242,249,254-255 KRtsrnnnn'smucousplug - arteriosum 76-77, 85, 90, 1O1, - iliolumbale 34,47,209,
Impotentia 200 106-102115 270-272.274
- coeundi214 - atlantooccipitale laterale 17 - infundibulopelvicum204
- generandi214 - biturcatum 302,305 - inguinale 64,67-69, 193,230,
Impressio L - calcaneocuboideurn 302, 305 235,238,250,262,270- 272,
- cardiaca97 - - plantare 302,304 308,308,309,309,310,318,
- colica 142 Iabium - calcaneofibulare302-304,306 353-354,357
- duodenalis142 - anterius196.198 - calcaneonaviculare 302, 305 - interclaviculare52
- gastrica142 - externum 263,267-268, 316 - - plantare301-302,304-305 - intercuneiformiadorsalia 305
- oesophagea142 - internum 263,267-268 - capitis costae intraarticulare - interfoveolare69. 250
- renalis 142 - laterale276,278 - interspinalia 24-25, 34, 41,
22
- suprarenalis142 - majuspudendi 200,224,227, radiatum 20-21 123
Incisura 238,253,259, 261 - - femoris 236,256,260, - intertransversarium21-22.
- acetabuli267-268 - mediale276-278 272-273,280 34,36-37,47
- angularis132,134-135, 139, - minuspudendi200,215,224, - - fibulaeanterius 288,296 - ischiofemorale280-281
158 229,238-239,253,261 posterius 289,292 - lacunare68,309,309,318
- apiciscordis 85,88, 101 - posterius196,198 - cardinale 195, 198, 198 - latumuteri 195,204
 Indet

Ligomentum(-a) Ligamentum(fl) Lobulus(i) Mamma 54-55

- longitudrnale anterius17, - t a l o f i b u i a r ea n t e r i u s 3 0 2 - r e s t i s1 9 0 - 1 9 1 , 2 5 2 - lymphatic drainage 55
20 22,24 25,30.61,74,118, - p o s t e r i u s3 0 3 , 3 0 6 - thymi111 - radiograph 55
128,270-27i.273 t a r s ip l a n t a r i a 3 0 4 LobusCi) Mammographv 55
- - posterius24,23-25 - tarsometatarsalia302 - caudatus142-144,144,152, M a n u h r i u ms t e r n i 3 , 5 1 - 5 2 , 6 1 ,
- Iumbocostale 70 - - d o r s a l i a3 0 2 ,3 0 5 ,3 3 6 159, 164,\69, 242,246 72,110,123,128
- meniscofemorale posterius - p l a n t a r i a 3 0 2 ,3 0 4 glandulae mammariae 62 Margo
289-290 - t e r e sh e p a t i s 6 7 , 7 4 , 1 4 2 , 7 4 4 , - hepatisdexter 134,142-143, - acetabuli+ Limbus acetabuli
- metatarsale transversum 1 5 2 ,1 5 6 ,1 5 8 ,1 6 4 ,1 6 8 - 1 6 9 , 148-149,156-159,161,16+, a n t e r i o r( F i b u l a ) 2 8 5
protundum302,304 246,248 166,169,242-244, 246,248 - - (Pulmo) 96-97,112 113
superficiale341 - - uteri 165,194-195,197, - - sinrster121,134,142-143, - - (Tesris) 190
- metatarsalia dorsalia302 203-204, 220-221, 253 146,149,152,156- 159,164, - (Tibia) 262,284-285,325,
- - plantaria304 - thyrohyoideumlaterale 106 168-169,240-241,243, 383
- nuchae25,31-32,39 - - medianum 106 245-248 - falciformis 308-309
- ovariiproprium 194-195,197, - tibiofibulare anterius 296, inferior96 98,100-101, 105, - inferior(Hepar)142-143, 161
203-204 3 0 2 - 3 0 3 ,3 3 6 113,122, 125,128-129,145, - - (Pulmo)96-97,113
- patellae287,289-292,295, - - p o s t e r i u s3 0 2 - 3 0 3 157,241,243-245 -- (SPlen)153
310-312, 316,324-326,328, - transversum acetabuli 223 medius pulmonis dextri 96-98, - interosseus (Fibula)285,
354,367 - - atlantis 18-19 100,105,113,122,130-131, 332-333
- pectineum271,3O9,309, 310 - - genus 288,291 157,243 - - (Tibia) 284-285
- phrenicocolicum 158,164 - - p e r i n e i 223,230 - prostatae dexter 192 - l a t e r a l i s( R e n ) 1 8 0 , 2 0 8
- phrenicosplenicum 245 - triangulare dextrum 142 - - medius 192 - liber (Ovarium) 195
- plantare(-ia) 304 - - sinistrum 142,144, - - sinister 192 - medialis (Glandulasupra-
- - l o n g u m3 0 1 - 3 0 2 , 3 0 4 , 3 0 4 , 164-165,242-243 - pyramidalis 113 r e n a l i s ) 1 8 0 ,1 8 7
3 0 6 ,3 4 4 ,3 7 9 3, 85-386 - umbilicale mediale 56 - quadratus 142, 158-159, 169, - - ( R e n )1 8 0 , 2 0 8
- popliteumarcuatum 288,290, - - m e d i a n u m 7 4 , 1 5 6 , 1 8 7 - 1 8 8 , 246 - - (Scapula) 26
292,331 193,200, 221, 236,252-253 - superior 96-98,98, 100-101, - - (Tibia) 284-285
- - obliquum288-290, - venae cavae 142,142,143 1 0 5 ,1 1 2 -1 1 3 ,1 2 2 ,1 2 8 - 1 3 r , - mesovaricus 195,204
331 - 3 3 2 - venosum 142 157,243 - p o s t e r i o r( F i b u l a ) 2 8 5
- pubicuminferius230,263, - vocale 123 Lower abdomen,vessels 173, - - (Testis) 190
270,272-274 Limbus 175 - superior (Glandulasupra-
- - superius230,256-257,263, - a c e t a b u l i 2 5 6 , 2 6 7 - 2 6 8 Lower limb 264 r e n a l i s )1 8 0 , 1 8 7
270-271, 274,309,311 - fossaeovalis 80 - arteries351 - - ( S p l e n )1 5 3 ,1 5 9 , 1 6 4 - 1 6 5
- pubofemorale 280-281 Linea - cutaneousnerves 349 M a s s al a t e r a l i sa t l a n t i s 6 , 1 7 ,1 9
- puboprostaticum 218,252 - a l b a t l 8 , 5 8 , 6 3 ,6 7 ,6 9 , 7 4 - 7 5 , - dermatomes 348 Mrv's vein 364,365
- pulmonale97,114,114 200, 203, 240-241, 246-247, - joints 265 McBunNrv's point 167
- reflexum58,63,67 249,252-253,255 - m u s c l e s o, r i g i n sa n d i n s e r t i o n s Mrcrrl's diverticulum 137
- rotundum165,195,197,221 - a n o c u t a n e a2 0 5 324,335 Mediastinum 114-115, ll7 -118,
- sacrococcygeum anterius - arcuata273,275 - n e r v e s ,N e r v e n 3 5 0 122-123,129
223-224,271 - - (0s ilium) 263,267 - sceleton 264 - posterius125
- - laterale 271 - - (Vaginamusculi recti - - venous system 365 - superius 129,129
- - posterius profundum272 a b d o m i n i s ) 6 5 ,6 7 ,6 9 ,7 3 , - segmentalinnervation 348 - r e s r i s1 9 0 - 1 9 1 , 2 5 2
superficiale 252,272 156,250 - surface anatomy 262 Medulla 248
- sacroiliaca anteriora223,263, - aspera276-278,328 Lumbar vertebral column - ( G l a n d u l as u p r a r e n a l i s )1 8 7
270-271,273-274, 318 - a x i l l a r i sp o s t e r i o r I _CT41 - o s s i u mf l a v a 3 8 1
- - interossea 223,255,263, - e p i p h y s i a l i s2 8 3 , 2 9 3 , 2 9 5 , - I i g a m e n t s2 3 - r e n a l i s 1 8 1 - 1 8 2 , 1 8 5 , 2 4 42 4 5
272-274 306-307,386 - MRT 24 - spinalis 46, 123, 127,214-215,
- - posteriora 263,272-?73 - g l u t e a a n t e r i o r 2 6 8 radiograph (ap) 16 246-247
- sacrospinale 216-217, 221,237, - - i n f e r i o r 2 6 8 - r a d i o g r a p hI,a t e r a l 1 5 Membrana
2 6 3 ,2 6 9 ,2 71- 2 73 , 2 8 13, 1 1 , - - p o s t e r i o r2 6 8 - s t r e s sb y u p r i g h t p o s i t i o n - a t l a n t o o c c i p i t a la i sn t e r i o r 1 7 ,
3243 , 58 - i n t e r c o n d y l a r i s2 7 6 4 0 19
- sacrotuberale 34,216,223, - i n t e r m e d i a 2 6 3 , 2 6 7- 2 6 8 - z y g a p o p h y s i aj ol i n t s 2 3 - - p o s t e r i o r 1 7 ,1 9 ,4 0
228 229,237,263,269, - i n t e r t r o c h a n t e r i c a2 7 6 L u n u l av a l v u l a es e m i l u n a r i s i n t e r c o s t a l i isn t e r n a 3 4 , 3 6 , 6 l
271-273, 281,317-320,358, - mediana posterior I 8l - interossea cruris 285, 28B,
362 - m u s c u l is o l e i 2 8 4 - 2 8 5 L y m p h n o d e s ,a n t h r a c o t i c9 7 2 9 6 ,2 9 6 , 3 0 3 ,3 2 8 , 3 2 9 ,3 2 9 ,
- sacrouterinum195,198,253 - paravertebralis 1 L y m p h a t i cv e s s e l sr,a d i o g r a p h 383
- splenorenale 153,243 - p e c t i n e a2 7 6 2 7 7 (ap) 2il - o b t u r a k ) r i a2 3 6 , 2 6 0 - 2 6 1 ,2 7 0 ,
- sternoclaviculare anterius52 - scapularisI L y m p h o g r a p h y2 1 1 280-281,309
sternocostale intraarticulare 52 - s e m i l u n a r i s6 5 - perinei 252
- - radiatum52 - s u J r r a c o n d y l a rliastj e r a l i s 2 7 6 tectoria 1ti-19
- s u p r a s p i n a l2i a
2,25,34,38, medialis 276 M t h y r o h y o i ( l e a1 0 6
272 - t e r m i n a l i s1 6 5 , 2 2 3 , 2 3 6 , 2 6 3 , Membrum
- suspensorium clitoridis238 2 6 8 - 2 6 9 , 2 6 9 , 2 7 1 ,2 7 3 , 2 8 2 Malleolus - i n f e r i u s2 6 4
- ovarii 165,195,197, - t r a n s v e r s al 0 f a t e r a l i s2 6 2 , 2 9 6 , 3 0 2 3 0 3 , - surface anatomy 262
203-204,253 Lingua 12 306 307,326,330,336, Meniscus
- - penis 58,231-232 L i n g u l ap u l m o n i ss i n i s t r i 9 6 9 7 , 3 3 8 - 3 3 9 ,3 4 1 ,3 6 6 ,3 70 - 3 71 , - l a t e r a f i s2 t l 8 - 2 9 2 , 2 9 12 9 5
- talocalcaneum interosseum l l 3 373 m e r l i a l i s 2 t l t l- 2 9 2 , 2 95
302,305-306,385-386 L r s rH n N c ' sj o i n t l i n e 2 6 5 , 2 9 8 m e r l i a l i s2 6 2 ,2 U 1 ,2 9 6 ,3 0 3 , i l l c s e n t e r i u m 1 3 7 ,1 6 2 -1 6 3 ,1 6 3 ,
- - laterale302-303 L o b a rb r o n c h i 9 4 3 0 6 , 3 0 7 ,i 2 5 3 2 6 , 3 3 0 3 3 2 , 164,252
- mediale303 L o b u Iu s ( -)i 3 3 6 ,3 3 1 t3 , 4 1 ,3 7t , 3 73 r l i v e r t i r ; u lIi 3 7
- - posterius303 - g l a n d u l a em a m m a r i a t 5 :J l r : r t i u s3 0 7 M t ' s o a p p e n t l i xl t l l l t ' r 5
 Index

Mesocolon Musculus(i)dorsi Musculus(i) Musculus(i)

- sigmoideum162,164-165,177, - - deeplayer 29 - gracilis 228-229,261,286, - longissimuscapitis 31-32,33,
209-270,218 - - lateraltract 39 310--313, 3r5, 317-320, 324, 34,38-40,43-45
- transversum 140,155,158-159, - - medialtract 35 3 2 8 ,3 3 0 3
, 3 5 ,3 5 4 - 3 5 6 , - - cervicis31-32,33,38-40
1 6 11, 6 3 1
- 6 5 1, 71 ,1 73 , 1 75 - - superficiallayer 27 359-360,368-369,381-382, - - thoracis3l-32,33,36,43,
Mesosalpinx 195,2O4 - epicranius 44-45 387 74,246
Metaphysis306 - erectorspinae l, 29-32,33, - iliacus 67-68, 70,74,203, - longuscolli 61
Metatarsus 264,3OO 36-37,75, 126,129,203,241, 209,2t2,224,242,250, - lumbricales (Pes)342,342,
Moderator band 80,80 244-249,254,317 254-255,257,259,309-311, 343-344,345, 385,388
Monspubis238 - extensor digitorumbrevis 326, 3 1 4 , 3 1 83,2 4 , 3 5 4 - 3 5 6 - multifidi34,35,36-38,40,43,
Miillrnian duct 189,194 336-340,340,345,367,374, - iliococcygeus 222,223,241 45,246
Muscles oftheneck 39 3 7 93, 8 3 - 3 8 53,8 8 - iliocostalis cervicis31-32, 33, - obliquuscapitisinferior 34,
Muscularoriginsandinsertions longus324-326,327, 38-40 3 8 ,3 9 , 4 0 , 4 5 - 4 6
- Crus 335 329,335-339,345, - - fumborum31-32,33,74 superior34,38,39,40,
- Femur324 366-367,374,379, - - thoracis3l-32,33,36,43, 45-46
- Pelvis324 383-386,388 - - externusabdominis27,29,
246
Pes340,347 - - hallucisbrevis 325-326, - iliopsoas75,256,259-261, 3l-32,34,43,48,56,58-59,
Musculus(-i) 336-340,340,345,374,385, 280,309,309,310-313, 320, 62- 65,66,67,69-7 t, 73-7 5,
- abdominis58, 62-66, 68, 388 324,380,387 113,156,203,209,224,
74-75 longus306,325-326, - infraspinatus27,29,31, 231-232,247,249,254-255,
- - Ll /f, 329,335-340,345,367, 43-44,62,127 -129 309,316,324,362,387
- abductordigiti minimi 306, 3 7 4 , 3 7 9 , 3 8 3 , 3 8 5 , 3 8 8 - intercostales - - internus
61,74,129,209, abdominis 29-32,
336,338-340,342-345,347, - fibularisbrevis302,304-306, 247 34,36, 63-65,66,67,69,
347,377-378,385,388 326,329,333,335 340,367, - - e x t e r n 3i 2 , 3 4 , 3 6 , 5 9 , 6 0 , 71,73-75,156,203,209,
- hallucis306,332340-345, 370,370,372, 383-384,387 61,64-65,108,117,128, 224,232,249,254-255,324,
346,347,377-378, 385,388 - - longus304,306,324,326, 130-131,246 387
- adductor(-es) 241,259 329,331-332,335, - - interni 34,36,59,60,61, - obturatorius
332 externus236,
- - b r e v i s2 4 2 , 2 6 1 , 3 1 2 - 3 1 3 , 343-344,347,366-367,370, 63-656 , 9 ,1 0 8 1, 1 71- 1 8 , 257,260-26t,280,313,315,
315,324,3s6,380,387 370,372, 383-384,386,387 124,126,246 320,324, 362,380,387
- - hallucis306,342-345,346, - - t e r t i u s3 2 6 , 3 2 7 , 3 2 9 , - - intimi 36 - - internus206-207,217,
347,378,385-386, 388 3 3 6 - 3 4 03,6 7 , 3 8 4 - interossei 346,388 223- 224,236,?56- 261,280,
- - longus242,261,310-313, - flexoraccessorius - - compartments
+ 379 317-320,321,324,361-362,
315,318,324,353-3s4,355, Musculus(-i) quadratus plantae - dorsales (Pes)306,336, 362,380,387
356,380-381, 387 - - digiti minimibrevis(Pes) 338-340,343-345,345,347, - occipitofrontalis 44-45
- - magnus260,288-290,292, 342-345,347,347,385,388 - omohyoideus173,727
385-386
3 1 03, 1 2 - 3 1 3 ,1 5 3
, 17-320, - - digitorumbrevis 306,337, . - plantares340,342-345, - opponens digitiminimi 336,
324,328,356,361-362, 342-345,346,347,377-378, 345,347,385,388 344-345,347, 38s,388
3 8 0 - 3 8 23,8 7 385-386,388 - interspinales cervicis34,35, - papillarisanterior80-84
- - m i n i m u s2 6 0 , 3 1 3 , 3 1 5 , longus306,324,329, - - posterior8l-83
38,46
319-320, 387 331-333,334,335, - - lumborum34,35 - - septalis80
- articularis genus287,314-315, 343-345,347,370, - thoracis35,123 - pectinati80
324 371-372, 377-378, - intertransversarii anteriores - pectineus 242,256-257,
- arytenoideus transversus123 383-386,388 cervicis33 309-3r3,3r5,324,354-355,
- bicepsbrachii59,62,126,288, - - hallucisbrevis - - laterales
342-345, lumborum33,34, 380,387
380 346,347,377 -378,385, 36-37,47 - pectoralis major48,54,58-59,
- - femoris258,286,290, 388 - - mediales lumborum33, 34, 60,62-65,7r3,122-123,127,
316 320,322,324-326,328, longus329,331-333, 36 37,47 129-r3r
3 3 0 - 3 3 33,3 5 ,3 5 9 - 3 6 1 , 334,335,342-345,347, - - posteriores cervicis33, 34, - - minor 59,60,122,124,
3 6 8 - 3 7 03,8 0 - 3 8 23,8 7 3 7 0 , 3 7 13 7 2 , 3 7 7 _ 3 7 9 , 40 128
- brachialis 62 3 8 3 ,3 8 5 - 3 8 63,8 8 - - thoracis33,34 - perinei 223
- bronchooesophageus 101 - flexoresdigitorum379 - ischiocavernosus - peroneus
214-215, brevis+ Musculus(-i)
- bulbospongiosus 214-215, - gastrocnemius 262,286, 218,222,228-229,237- 240, fibularisbrevis
218,222,228 229,237 -240, 288-290,29s,316,319 320, 260-261,388 - - longus+Musculus(-i)
260-261,388 324-326,328,330-333,334, - ischiococcygeus 217,219, fibularislongus
- coccygeus + Musculus(-i) 359-360,368-370, 382-383 - - tertius+Musculus(-i)
222,223 224,256,318,324,
ischiococcygeus - gemellusinferior 317,319-320, 388 fibularistertius
- colli 39 321,324,361 -362,380 - ischiocrurales - piriformis 216,218-219,
260 224,
- constrictor pharyngisinferior - superior317,379-320,321, - latissimus dorsi7,27,28, 2 4 13, 1 1- 3 1 33, t 7- 3 2 0 , 3 2 r ,
106,120 324,361-362,380 29-32, 43-44,58-59, 62, 324,358,361-362,362,380,
- coracobrachialis 59, 126 - gluteusmaximus1,32,34,43, 64-65,70,74,t30-131, 387
- cremaster58,63-64,67,73, 62,218,225,228-229,237, - plantaris288,324,328,329,
246-249,317
190-t91,218,232,235,235, 239,241,254-257,259,262, - levatorani 205-207,218-221, 330-333,334,369-372,384,
240-241,252,387 280,316-320,321, 324, 222,223-224,226,228-229, 388
- cricothyroideus 106,113,120 359-362,380,387 - popliteus288-292,295,324,
236-237, 239-241, 252,
- dartos73,218,228,232,252 - - medius74,203,254-256, 256-258,260-261, 324,388 332-333,334,335,369,372,
- deltoideus 1,43,48, 58-59,62, 259,280,311-313, - - prostatae222
317, 388
126-127 319-320, 321,324,3s9, - - scapulae 28,29,31-32,39, - psoasmajor30,41,47,68-70,
- digastricus 34,38,40 361-363,380,387 43-44 74,151,183,185-186,203,209,
- dorsi 26-27, 28, 28-32, 34, injection362-363 - levatores costarum32,33 273,236,243- 245,249- 250,
36-39,41 - - minimus280,319-320,321, breves33,34,36 2s4-255,257,259,309-311,
-- cT30 324,362,380,387 l o n g i3 3 , 3 4 , 3 6 314,318, 324,353
 Index

,llusculus(i)psoas ,\'lusculus(i) Xlusculus(i ) transversus Nervus(i)

- - m i n o r 6 8 , 7 0 - 7 1 , 7 4 , 1 7 7 , - serratus anterior28,29,31, - perineiprofundus200,218, digitales dorsales pedis
203,209,250,309-310, 314, 4 8 ,5 4 ,5 8 - 5 9 6
, 2 - 6 5 7
, 0 ,7 3 , 222, 223, 228-230, 236, 3 4 9 - 3 5 03, 6 7 , 3 7 3-374,
318 124,126-131 238,240,252,260,324, 388 387-388
- pubococcygeus posterior inferior28,29, superficialis 222,223, - J)lantares communes
222,223,
240-241 31-32,36,43,246 228-230, 237 -239 , 260, 376-378, 388
- p u b o r e c r a 2f i2s 2 ,2 2 3 2 , 56. superior28,29,31 32, 388 proprii376,378,388
thoracis61,72, 113,I31 - dorsalisclitoridis215,230,
258 43
- pubovaginalis 222,224 s o l e u s2 9 2 ,3 2 1 , 3 2 6 , 3 3303 3 , trapezius1,26,27,29,31, 2 3 9 ,3 8 8
- pyramidalis56,63,63, 64-65, 38-39,44-45,62,126-130 - l)enis 214,230-232,237,
334,335,369-372,383
66,73-71,240 - sphincter ampullae hepato tricepsbrachii43,62 388
- quadratus femoris260,317, pancreaticae 150 - - s u r a e3 0 6 , 3 2 9 , 3 3 4 , 3 4 0 , - - scapulae 28,44-45
319-320,321,324,36l-362, - aniexternus200,205207, 3 8 6 ,3 8 8 erigentes - Nervus(-i)
3 8 0 ,3 8 7 2 1 8 , 2 2 2 , 2 2232 4 , 2 2 6 , vastusintermedius 312-313, splanchnici pelvici
- - l u m b o r u m3 0 , 3 4 , 6 6 , 2 2 8 - 2 2 92,3 7- 2 4 0 ,2 5 2 ,2 5 8 , 314-315,324,381-382 femoralis50,71,75. 177,20).
68-70, 74 75, 1.21, 151,209, 388 - l a t e r a l i2s 5 7 , 2 5 9 , 2 8 0 , 2 9 2 , 209-210,212-213, 236,242,
212 213,244-245, 249 -250, internus20O,205,224, 2 9 5 3
, 1 0 - 3 1 3 1
, 4 - 3 1 3
5 ,1 6 , 250-251, 256 257, 309,309,
324 240,252,258 319-320, 324,326,328,354, 3 1 4 - 3 1 53,1 83, 4 9 - 3 5 03,5 2 ,
- - plantae306,343-344,346, - - pyloricus139,150 3 5 6 , 3 5 9 , 3 6338, 1 - 3 8 2 3 5 4 - 3 5 63,8 0 - 3 8 13,8 7
3 4 7 , 3 7- 7
3 7 8 , 3 8 43,8 6 , - - urethrae200,218,222,224, - - m e d i a l i 2 s 9 2 , 3 1 03 1 3 , 3 1 4 , - fibulariscommunis286,34O,
388 230 324,328,354-356,381-382 3 4 9 - 3 5 03,5 9 - 3 6 13,6 4 ,
- quadriceps femoris262,287, - - vesicae 214 Myocardium 7 8-7 9, 80 -82, 123 367-368,370-371,382,387
- + Tunica - lrrofundus327,329,329,
289-290,292,311,314, spinalis33 Myometrium
3 2 4 - 3 2 6 , 3 3358, 7 - - c a p i t i s3 2 , 3 4 , 3 5 muscularis (Uterus) 340,349-350,367,373-371,
- rectococcygeus 223-224 - cervicis 3 2 , 3 5 3 7 9 , 3 8 33 8 4 , 3 8 8
- rectouterinus195 - - thoracis31 32,33,36 - - superficialis 329,349-350,
- rectusabdominis - splenius capitis27,29,31-32, N 364,367, 373,379,383- 384,
48,56,63,
6 3 ,6 4 - 6 56, 6 ,6 7 - 6 8 , 7 0 , 33,34,38-40,44-45,126 387
- - cervicis29,31-32,33, Nephros+ Ren - genitofemoralis 56,66,71,177,
72 75, 113,123,156,203,209,
3 8 - 4 0 Nervous system, autonomic 209, 212 213, 217, 221,231,
218,240-241,244-251,
254 256,387 - sternalis59,60 119-720,121 235-236,250,256,309,309,
- - capitislateralis39, 40 - sternocleidomastoideus 27, Nervus(-i) 31U,349-350,352,387
- accessorius - gluteusinferior257,321,350,
posteriormajor 34,38, 2 9 ,3 1 ,4 1 4, 4 ,s 8 - 5 9 ,1 1 31, 2 3 , [XI] 26,44-45
39,40,45-46 127 anales226 3 5 8 ,3 6 1- 3 6 2 ,3 6 2 ,3 8 0 3, 87
m i n o r3 4 , 3 8 , 3 9 , 4 0 , - sternohyoideus 713,127 - - inferiores217,237,239,388 - superior315,321,350, 358,
46 - sternothyroideus 61, 113, 123, anococcygei 217, 237, 239, 388 3 6 2 , 3 6 2 , 3 6 3 , 3 8 0 , 3 87
- - f e m o r i s2 4 2 , 2 5 6 - 2 5 7 , 2 7 1 , 728 - auricularis magnus42-44 - hypogastricus 214,214,215,
314,316, - subclavius 59,60, 113-115, - axillaris42-43,126 215,226, 226
280-281, 310-313,
- cardiacus cervicalismedius - iliohypogastricus 42-43.56,
318,324,354-356, 380 381 122,124,126-127
- rhomboideus maior27,28,29, - subcostales 60 t20 66,71,75, 117,119,177,209,
- suboccipitales 34,37-38,40, - cavernosi clitoridis215 212-213, 250,349-350,352,
3 1 ,4 3 - 4 5
- - m i n o r2 8 , 2 9 , 4 4 - 4 5 46 cervicales19,28, 33,33, 42, 362,387
- rotatores - subscapularis 46,120 - ilioinguinalis 56,66,71,75, 177,
35,36 60, 126,128
- - cervicis35 - superficial layer 27 - cluniuminferiores42, 237, 209-21O,212 213,231-232,
- - lumborum35 - deeplayer 29 239,349,358-360,387 2 5 0 , 3 1 93 5 0 ,3 5 2 , 3 8 7
- supraspinatus - - medii 42,349,358360 - intercostales 34,36,42,44,56,
- - thoracis34,35,37 126-127
- sacrococcygeus - suspensorius duodenii39, - superiores 42-43,349,358, 59 , 66,7 5, 114, 117,rr7,
223-224,241
- sartorius62,242,256'257, 1 5 01 - 51 360 1 1 8 - 1 1 l9r,9 , 1 2 0 1 , 2 81, 31,
- tensor fasciae latae 62, 75, - coccygeus 71,217,388 212, 245,247
, 1 0 - 3 1 3 ,1 5 3
2 6 2 ,2 8 6 3 , 16,
- intercostobrachialis
242,256-257, 262,280,308, - cutaneus brachiilateralis 43
318,324,328,335,354-356,
310-31 1, 315-316, 319, 324, inferior 42-43 interosseus cruris 388
360, 380-382, 387 . ischiadicus
- scalenus 354,380,387 superior42 256-257,286,
anterior61,113-114,
- teresmajor 1,27,29,31, posterior 42-43 315,321-322,327,329,334,
119,122,127
- - medius39-40,46,61,124, 43-44,62,126,128-129 - - dorsalisintermedius 350,358,360-362,362,363,
- - m i n o r4 3 , 6 2 349-350, 364,373,387 380-382,387
126 - - projection358
- - posterior31-32,34,39,61 - thoracis59-60,62 lateralis349-350,364,
- thyrohyoideus 373,388 - labiales215
- semimembranosus 258,286, 113
- - medialis 349-350,364' - - anteriores387
288- 290, 316,318 320,322, tibialisanterior292,3O2,304,
- - posteriores215,239,388
324,328,330-332, 335, 324-326,327,329,335-336, 387
-367, - femoris lateralis 42,71,75' - laryngeusrecurrens90-91,
3 5 9 - 3 6 13,6 8 - 3 7 03,8 0 - 3 8 2 338-339, 347, 366 374,
- semispinalis32 383-384,386,388 177, 209, 212-213, 250, 309, 112,114- 175,117,119- 120,122
- - p o s t e r i o3r0 2 , 3 0 4 , 3 0 6 , 309,318,349-350,352, - - superior106
- - capitis31-32,34,35,
3 5 4 - 3 5 53, 5 8 3
, 8 7 - lumbales28, 33, 66,218,349
38-40,44-46 324,329,331-333,334,
posterior42,237,239, - musculiobturatoriiinterni
- - cervicis31-32,34,35,38, 335,344,347,370,370,
3 7 1 - 3 7 2 , 3 8 3 - 3 8 4 , 3 8 8 257,349-350,358-362, 321,387
45 - - piriformis321,387
- - thoracis32,34,35,36, - trachealis93 362,380,387
- transversospinales - - suraelateralis329, - - quadratifemoris321,387
38-39 30
- 349-350, 359-361, 364, 368, - obturatorius71, 212'273,217,
- semitendinosus 258,286,313, transversus abdominis 34, 36,
387 221,224,236,256- 257,261,
317-320, 322,324,328,330, 65,66,68-71,73-7 5, 156,203,
209,213,224,246, 249-250, m e d i a l i3 s50,359-36i, 3 093 , 153 , 1 83, 4 9 - 3 5 03,5 2 ,
3 3 5 ,3 5 9 - 3 6 13,6 8 - 3 7 0 ,
364,368,373, 388 355-356, 380,387
380-382 254-255,324,387
 Index

Nervus( i) obturotori us Nodus(-i) Nodus(-i) Os(sa)

- - accessorius 387 - atrioventricularis B4 - s a c r u m2 3 , 4 , 5 , 1 0 - 1 1 , 1 5 ,
s i n u a t r i a l i s8 4
occipitalis major43-46 - haemorrhoidalis 205 - t i b i a l i sa n t e r i o r 3 6 6 23,27,47,2r8,223,225,
- - minor 42-44 - lymphoideus(-i) aorticilaterales N u c l e u sp u l p o s u s 2 4 - 2 5 , 3 0 240-241,251,255,262-263,
- t e r t i u s4 3 , 4 6 221,250 263,273-275,318
- pectoralis lateralis60 - - axillares55,126,128 - - genderdifferences 11
- medialis60
- perineales230,237,239,
- axillarisapicalis128
- - brachiales
o - sesamoidea (Pes\297-298,
55 301,304,347
260-261,388 - bronchopulmonales 129-131 Oesophageal constriction110 - tarsi 264,297,298,298,300
- phrenicus70-71,90-91, - - cervicales anteriores55 - temporale46
Oesophageal varices108
112-715, 117,120-122,122, profundi 55 0esophagoscopy 110 Ostium
128-131 laterales124 Oesophagus 57,68,70, 71, 106, - abdominaletubaeuterinae
plantarislateralis306, profundiinferiores124 106,107,107,108-110, 195,197,204,204
346-347, 350,376-378, 384, - - deltopectorales 55 114-115,117-119,trg, 720, - appendicis vermiformis140
386,388 - - gastrici 134,210 1 2 0 ,1 2 1t,2 3 - 1 2 5 , 1 2- 7135, - atrioventriculare dextrum 80
- medialis306,346-347,350, - gastroomentales - - sinistrum81,130
134,246 155,178,212,240,243
376-375,384,388 - - hepatici134 - radiograph110 - cardiacumll0, 125,132,
- pudendus214,215,215,217, - - ileocolici241 - veins108 t64-165,242-243,245
222-223,226,230,236-237, - - iliacicommunes210,221, 0listhesis9 - ileale 140
239,257,267,350,358,362, 250 Omentum - pyloricum139
388 mediales250 - majus 125,134,14O,148, - sinuscoronarii80,84-85
- radialis42-43 externi210,221,236, - ureteris188,192,233,
1 5 4 - 1 5 61,5 6 ,1 5 7 - 1 5 81 ,5 8 ,
rectalesinferiores+ Nervus(-i) 250,353 159 164,166,169,240-241, 252-253,260
analesinferiores - laterales221,353 243-246,252,255 - urethraeexternum(female)
- sacrales215,217-218,241, mediales221,353 - m i n u s1 3 4 , 1 5 8 - 1 5196, 4 , 194,224,229,238-239,
252,349 interni 210,221,353 245-246 261
sacralis222 - infraclaviculares 55 Orchis+ Testis (malel 233-234,252
- saphenus329,349-350,352, - - inguinales profundi210, - - internum(female)253
Organa
3 5 5 - 3 5 63, 6 4 3, 73 , 3 8 1- 3 8 2 , 353 - genitaliafemininaexterna215, (male)188,192,233,252,
384,387 superficiales 210,353 229,238-239 260
- scrotales anteriores387 inferiores210,353 - uteri 195-196,
interna195,197, 198,200,253
- posteriores214,237,388 superolaterales - uterinumtubaeuterinae
210, 203-204
- spinales24,30,33, 35,41-42, 353 - masculina214,232 195-196
46-47,203,249 superomediales 210, externa231,235,237 - vaginae194,229,238
- splanchnici lumbales226 256,353 - urogenitalia - venaecavaeinferioris 84
feminina,
- pelvici214,214,215,215, - - juxtaoesophageales
109 development 194 superioris80,84
226 - - lacunaris(-es) 309 - - masculina, development Outlinesilhouetteof the heart,
- splanchnicus major 71, intermedius309 189 radiograph103
114-115,lt7 - 121,212-213, lateralis309 Orificiumductuspancreatici Ovarium165-166,194-195,195,
243,246 medialis309 146 197,203-204,204,215,215,
- - m i n o r7 1 , 1 1 7 , 1 1 9 , 1 2 1 , 2 4 3-, - ligamenti
arteriosi90 0s(-sa) 220,253,353
246 - - lumbales dextri 210 - coccygis2-3, 11,ll, 2O0,223, Ovary+ Ovarium
- subcostalis71,75, 117,719, - - mediastinales anteriores90, 225,228-229,240,256-257,
209,212-213 112,115 273,275
- suboccipitalis 39, 43,45-46, posteriores109,243 - costalia4 P
390 - - obturatorii221,251 - coxae47,264,267-268
- subscapularis 43 - - pancreaticus - - development
248 266 Palatumosseum12
- supraclaviculares 56 - - paramammarii55 - cuboideum297-298,300,300, Pancreas125,134,149-150,150,
- laterales42-43 - - pararectales 726,221 3 0 13, 0 5 ,3 8 6 1 5 11, 5 1 1
, 5 4 - 1 5 s1,5 9 , 1 5 9 ,
- suprascapularis 127 - - parasternales - cuneiforme
55 intermedium 167- 162,169,175, 240- 241,
- suralis349-350,360,364, - - paratracheales 90, 124,128 2 9 7- 2 9 8 ,3 0 0 - 3 0 13,0 6 3, 86 243,246,248
373,384,388 - - parietales210 - - laterale292 300-301 - projection149
- t h o r a c i c2i 8 ,3 3 , 3 3 , 3 4 , 3 6 , - - phrenicisuperiores90, 123 - - mediale297-298,300-301, Panniculus adiposus58,74,205
42,43,56,60,66,73, 114-115, - - popliteusprofundus368 304 Papillafae)
177 -721,212,246 superficialis368 - digitorum - bipartita 150
(Pes)264,297,297,
- thoracicus longus 126, - - postcavales - duodenimajor 139,146,150
241 298,298
-
128130 - - preaortici221,249-250 - hyoideum - - minor 150
12,106
- thoracodorsalis 28, 126 - - precavales - ilium 3, 15,47,67,75,203, - ilealis 140
221
- tibialis 286,329,334,346, - - promontorii210 - mammaria54,62,131
223,242,258,263,266,274,
350,359-361, 364,368,370, * - pylorici 134 279,282 - renales181-182, 186,243
370,371-373,376,382-384, - - rectalissuperior221 - i s c h i i2 3 6 ,2 5 6 , 2 6 3 , 2 6 6 , 2 7 9 Paracystium198,260-261
388 - - retroaortici221 - metatarsi264,297-298, 300, Paradidymis
- vaginalis215 189,189
- - splenici243,246 300,305-306,379,385-386
- vaguslxl 71,90-91,112, Parametrium198
- - submammarii55 - naviculare 297-298,300-301, Paraproctium 198
114-115,117,1r9- 120,120, - - supraclaviculares 55 3 0 5 - 3 0 23 8 6 Paries
127-722,124,t27 -131,212 - - thoracis109,124 - occipitale 6,12,17-19 - anterior(Gaster)136,
Nodulus(-i) - tracheobronchiales 100-101, - pedis297-298,301
- lymphoideus(-i) 1 5 81
- 59
aggregati138 115,126 - - structuraldiagram301 - membranaceus (Trachea)93,
- - solitarii132,137,140,146, inferiores90,97,109, - pubis 69, 193,218,225,230, 101,104,109,123
205 123,131 240,242,256-257, 259,263, - posterior(Gaster)136
- valvulaesemilunaris81 superiores 90,109,123 266,279-280 Paroophoron 194,194
 Index

Pars Pars Pectoralmuscles 58-59, 60, 62 Peritoneum

- urogenitale 196,2O5,260-261
abdominalis aortae41,68,106, - media(M.serratusanterior) Pediculusarcus vertebrae 4, 7-9,
1 2 , 1 4 - 1 6 ,2 0 - 2 1 , 2 3 - 2 5 , 3 0 , - viscerale 59, 73, 124, 137,240,'
117,117, 119,145,152, 28
154-155,169,772, 175-176, - mediastinalis91,97,112, 41,275 244,246-247,249
1 7 6 , 1 7 7 , 1 8 3 - 128046, , 1 1 4 - 1 17 52, 9,157 Pelvic constriction 269 Pes 264
208-210,213,217,219,22r, - membranacea (Septum inter Pelvic floor anserinus superficialis 310,
2 2 6 , ? 4 0 , 2 4 3 , 2 4285 0 ventriculare)81,81,82 - female 223 224,229-230, 328
- - - compartments 379
sonographic image 176 (Urethra masculina) 238
- - male 228,230,236 - cross section 384, 385
(M.pectoralis major)58-59, Parsintermedia(Urethra
Pelvic inlet 268 - forceson the foot 335
60,62-63 masculina)
- - muscularis Pelvic measurements,female - frontal section 345, 385
(Oesophagus) 68,70,106, 80-82
- occlusa193,221,236,250 269 - joints 302-304,305
108,110,119,132,134
- - (Ureter)161,208 - patens217,219-221 Pelvicviscera - ligaments 304
- anterior(Fornixvaginae)196, - pelvica(Ureter)67,164-165, female 201,220 - longitudinal section,MRT 386
- male 218-219,250 - longitudinal vault 301
198 273
- - (Hepar)143 - posterior(Fornixvaginae)196, P e l v i s 2 6 8 , 2 7 0 - MRT 385
- anularisvaginaefibrosae342 1 9 82, 0 0 ,2 s 3 - cr 254 - m u s c l e s3 2 6 , 3 3 8 - 3 3 9 ,
- ascendens aorlae77,80,82, - hepatis144 female 269 3 4 1- 3 4 4 , 3 4 5
- profunda(Compartimentum - - cross section 257 - dorsumofthefoot 340
84-85,109,116-117,119,
- cT 257 - - middle of the sole 346
123-125,129-130 crurisposterius)329
- - (Duodenum - - - - female 269 - - origins and insertions 340,
13) 9,149-150, (M. sphincter ani externus)
222 - measurements 270 347
163,165-166
- (M trapezius)26 - - median section 253 - - plantar group, lateral 346
prostatica188,192,233
- atlantica40,46 . p y l o r i c1 a 1 91, 3 2 , 1 3 4 - 1 3 5 , - - M R T 2 5 r , 2 5 9 medial 347
- oblique section 261 - osteofibroustubes 345
- basalis(Aa.Iobares inferiores 135,136,139,156,164,245
- - gender differences 268, - sagittal section 386
dextrae) 100 spongiosa 233-234,252
- (Aa.lobaresinferiores - sternalisdiaphragmatis 68 70, 270-272,273 t e n d o ns h e a t h 3 3 6 , 3 3 7
joints 270-272,273 - - digital 337
sinistrae)100 101 7 0-71, 112-113, 123,241
- sternocostalis - lumbosacralregion 270-271, - - plantar 337
- b a s i l a r i 6s , 1 7 - 1 9 58 59,60,
- - tarsal, dorsal 337
- cardiaca70, 125,132,734, 62-63 273
- subcutanea (M.sphincter ani - major 263 lateral 337
t36, 177,209,240
- cervicalis(Oesophagus) externus)222,238 - male, cross section 255, 256 medial 337
106,
- valgus 305
108-110,123 - superficialis (ComPartimentum - - c r 2 5 6
- clavicularis 59,60 crurisposterius)329 - frontalsection258 PEYER'S patches 138
- costalis124 - - (M.sphincterani externus) - - mediansection240,252 Phalanxfges)
- MRT 251,259 - d i s t a l i s( P e s ) 2 6 4 , 2 9 7- 2 9 8 ,
- - diaphragmatis 59,68-69, 222
- superior(Duodenum) 132,134, - obliquesection260 386
70-71,75,177,244-248 - m e d i a( P e s ) 2 6 4 , 2 9 7 - 2 9 8 , 3 8 6
- (Pleura parietalis) 59, 138,139,149,151,158-159, - - sagittalsection241
- proximalis (Pes) 264, 297-298,
113-115,124-725,128-129, 164-165, 177,242 minor 165,263
- (Hepar)142 - muscles, originsandinsertions 3 0 1 ,3 0 6 , 3 8 6
157,244-248
- cruciformisvaginaefibrosae - - (M.serratusanterior)28 324 Pia mater spinalis 47
- supraclavicularis 28 - radiograph (aPl 275,279 Pigment,anthracotic 96
342
- descendens - terminalis(lleum) 138,161 - renalis170,180-181, 183,183, Placenta 200,2O2
aoftae77,116,
- thoracica 185,185,186,186,189,794, Planta pedis 262, 37 5-377, 37I
129-131,247 aortae70, 106,106,
- arteries 375
- - (Duodenum 1 )3 2 , 1 3 4 - i 3 5 , lo7,1o7,108, 115,717,ll7,119, 208,243-244,248
- - radiograPh (aP) 186 - - variations 375
139,149- 152,165-166,177 121,125,128-129,151,176
- muscles,lateral 347
- - (Lig.iliofemorale) 281 - - autonomicall9-l2l Penis214,227,234,235,242,
- - (Ductus - - medial 346
- - (M.trapezius)26 thoracicus) 115, 260
vein,lateral365 - - median 346
- diaphragmatica 59,70,91, 117-118 Perforating
- (Oesophagus) 70, 106-110, Pericardium 70, 76,77,88,91, Plantar aponeurosis+
1 1 2 1- 1 51, 2 2 , 1 5 7 , 2 4 3 ,
246 248 115, 117- 119, 123, 125, 129, 100-101, 107,113,lr3, 122, AponeurosisPlantaris
243 122,245 Planum occipitale 6
hepatisdextra 144
- - sinistra 144 - tibiocalcanea 302-304,306 - fibrosum76,91,109,112, Platysrna 58
- horizontalis - tibionavicularis 302 714-115,127,757 Pleura 129
(Duodenum)139, - extent,projection 105
1 7 7 - tibiotalaris anterior 302 - serosum 76,76,77,88 02,85,
149-15 , 1 6 11, 6 3 1
, 6 5 , - parietalis 59, 70, 97, 112-115,
- inferior(M.serratusanterior) - - posterior302-303 91,123-124,240
- transversa (Lig.iliofemorale) Perimetrium + Tunicaserosa 122, 724- 725, 127- 129, 157,
28
- infraclavicularis 287 (Uterus) 243-248
59,114-115 - pulmonalis + Pleura visceralis
- intermedia(Urethramasculina) - - (M.trapezius) 26 Perineum(Perineal region)238
- female223,227,229,229, - visceralis 59, 724-129,
192-193,233,252 - transversaria (A.vertebralis)
- intramuralis(Urethra 239 244-245
46
- uterina(Tubauterina) 195 - laceration229 Plexus
masculina) 233 - aorticus thoracicus 91, 115,
- intrasegmentalis Patella262,264,286 287,289, - male227,228,228,237
124,726
308, 311 -31 2, 316, Periorchium 191 119,121
lateralis(0s occiPitale)17 292-295, - brachialis 28, 59, 60, 90, ll2'
- - (Ossacrum)4,10-11,47, 326,328,364,382 Peristalsis135
- ridge 294 Peritoneal cavitY, develoPment 1 1 4 -1 1 5 ,1 2 0 , r 2 4 , 1 2 6 - 1 2 8
255,263,275 - cardiacus ll5, 779, 722
- liberamembriinferioris264 Patellartendonreflex 388 154,155
- caroticuscommunis 113
lumbalisdiaPhragmatis 68-70' Pecten Peritoneum143
parietale59,68,75, 124,156, - cervicalis 42,43, 46,70
7 0 - 7 1 ,1 0 6 , 1 0 81,1 7 1 1 8 , - a n a l i s2 0 5 , 2 2 4 , 2 5 2
- coccygeus 217,388
123,125,169,240-241, 243, - o s s i sp u b i s6 8 , 2 2 4 , 2 6 3 , 165,177,193,209,218,240,
- coeliacus 212,226
246-248 267- 265,273, 311- 312,318 246-250,253,258
(
Index

PLexus Popliteal perforating vein 365 Pulmo Ramus(i)

d e f e r e n t i a l i s2 1 4 , 2 3 5 Portahepatis142 d e x t e r 9 1 ,9 7 , 9 8 , 9 8 , 1 0 0 , - communicans(A. fibularis)
- hypogastricus 226 Portalhypertension108 112-113,120 122, 124-125, 351
- - inferior 214,214,215,215 Portio 127,129,131, 145, 157,241, fibularis 364,387
- superior 214,214,215,215, supravaginalis cervicis195 196 243 244 coniarteriosi 85,85, 86-87
226,250 - vaginalis cervicis195,198, - s i n i s t e r9 1 , 9 7 , 9 8 , 1 0 0 l 0 l , - cutaneus(-i)anterior(-es)
- lumbalis 30, 42,66,71,213, 198,200,253 112,113,122, 124-125, 126, abdominales 56
2 5 5 , 3 1 4 - 3 1 5 ,3 8 7 Nullipara198 l 2 8 , 1 3 0 -1 3 1 ,1 5 7 ,2 4 3 ,2 4 5 - (N. femoralis) 71
- l u m b o s a c r a l i s7 1 , 2 1 2 , 3 8 7 Portocaval - veins 102
anastomosis 108,179, ( N . i l i o h y p o g a s t r i c u s5) 6 ,
- mesentericusinferior 212,214 207 Pulmonary angiography 102 349,352,387
- superior 274-215 Positio(Uterus)196 Pulmonary boundaries,projection pectorales 56
- oesophageus714,119,121,212 Preputium 105 anteriores(N. femoralis)
- ovaricus215 clitoridis229,238 P u l p as p l e n i c a 1 5 3 349,352,387
pampiniformis 7 3, 190- 191, - penis233-234,234,240-241, Pyelography,intravenous 208 - - cruris mediales 349,364,
231,231,232,235,241 252 P y l o r u s 1 3 2 ,1 3 2 , 1 3 3 - 1 3 4 ,1 3 9 , 387
p r o s t a t i c u s2 1 4 Processus( us) 1 5 8 -1 5 9 - - lateralis(-es)(N. iliohypo-
- p u l m o n a l i s 1 1 4 - 1 1 5 , 1 2 01 2 1 - a c c e s s o r i 4u ,s4 , 5 , 8 - 9 P y r a m i d e sr e n a l e s 1 8 1 - 1 8 2 ,1 8 5 , gastricus) 42, 349, 358, 362,
rectalis inferior 226 - articularis inferior4,4, 6, 243 387
- - medius 226 8 - 9 ,1 2 ,1 5 - 1 62, 2 - 2 32, 5 , 3 0 , (N. spinalis) 42
- - superior 226 41,255 pectorales(N. thoracicus)
renalis 215
- sacralis 71, 212, 215,217,217,
- - superior275 o 44,56
(Ossacrum) 10 11,47, - - medialis(-es)(N. spinalis) 42
2 2 2 ,2 2 6 , 3 1 5 3 , 2 1 ,3 2 1 ,3 2 2 , 223,255 Ouadrangularspace 43 - - (N.obturatorius) 349,352,
322,387 - (Vertebrael 4,4,5-9,12, Ouadratusarch 70 3 5 5 - 3 5 6 ,3 5 8 ,3 8 7
- testicularis 274,214, 235 75-t6, 20-27,23,25,30, (N. plantaris medialis) 377
uterovaginalis 215, 215 41,47,247 - - posterior(€s) (Nn. cervicales)
- venosusareolaris 56 - caudatus142 R 44
- - prostaticus 236,260 - coracoideus 53, 126 (Nn. thoracici) 44
r e c t a l i s 1 7 9 ,2 0 7 - costales4, 5, 9, 16,23,26,30, Radix(-ces) - descendens(A circumflexa
- - suboccipitalis 45 36-37,41,47,53,69 70, 208, - anteriores(Nn. spinales)4l 226 femoris lateralis) 351, 355-357
- vaginalis220 271,274-275 - - (A. circumflexa femoris
mesenterii 161,164-166, 175
- - \'ertebralisexternus anterior - falciformis272 - parasympathica 214, 214, 215, medialis) 357
252 - lateralisrali 297,299-300,384 215,22o - dexter (A. hepaticapropria)
posterior 123,252 - - tuberis calcanei297, posterior (N spinalis) 47 148, 168,246
internus 127 299-300 Ramus(-i) - - (V. portae hepatis) 148,242,
aoterior 47,240 - mamillaris4,8-9,41 - acetabularis(A circumflexa 244,246-247
posterior 47 mastoideus12,38,46 femoris medialis) 357 - dorsalis (A. lumbalis) 47
- - v e s i c a l i s2 1 9 , 2 3 6 , 2 5 6 - medialistuberiscalcanei - - ( A . o b t u r a t o r i a )3 5 5 , 3 5 7 - - (V. lumbalis) 47
Plica( ae) 297-300,304 - anterior (A media genus) 291 - femoralis 56,71, 209, 213,
- adiposae 91 - papillaris142,164,246 - ( A . o b t u r a t o r i a )3 5 5 , 3 5 7 250,309,309, 318, 349, 352,
alares 287 posterior tali 298-300,307 - (A. renalis) 180 387
- c i r c u l a r e s 1 3 2 ,1 3 5 ,1 3 8 - 1 3 9 , - spinosus1,4, 4,5-9, 12-16, - - (N. cervicalis) 120 fundi uteri (A. uterina) 197
1 4 6 ,1 5 0 19 20,22-25,27,30,31, - - (N. lumbalisl 47,218 - gastrici anteriores (Truncus
duodenalisinferior 163, 165 38-39,41,123,128,246, 249, (N. obturatoriusl 71, 387 vagalis anterior) 119
- gastricae 132,136 275 - - ( N . s a c r a l i s )2 1 8 - - (V. gastroomentalis dextra)
gastropancreatica159, - styloideus (Ostemporale)38, - - (N. spinalis) 33, 46 158
764-765 40 - (V. portae hepatis) 244 - genitalis 71, 2O9,213, 277,231,
- i l e o c a e c a l i s1 6 0 - 1 6 1 1 , 65 - transversus4, 4, 6-8, 13-14, - articulares (A. descendens 235,250,256,349,387
- interureterica 188,233,260 78,20,22,34,36, 40-47,129 genus) 351,354-356 - helicini 197
- l o n g i t u d i n a l i sd u o d e n i 1 4 6 , uncinatus(Pancreas) 150-151, - ascendens(A. circumflexa - iliacus 209,213
150 1 7 7t,7 t , 1 7 7 , 2 4 1 femoris lateralis) 351, 356-357 - inferior ossispubis 193, 225,
- m u c o s a e 1 4 6 ,1 8 8 , 2 3 3 - uncinatus(Vertebra)+ Uncus - - (A. circumflexa femoris 2 3 0 , 2 6 0 , 2 6 6 - 2 6 8 , 2 7 4 - 2 75 ,
- palmatae 195,253 corpons medialis) 361 317-318
- rectouterina 195, 220-227, 253 - xiphoideus51,61,69,73, 90, - atriales (A. coronariadextra) - infrapatellaris 349, 352, 364,
- semilunarescoli 140-141,161 t23, 131,136,201,240 85-86 382,387
- spiralis 146-147 Promontorium (Ossacrum)2-3, - - (A. coronariasinistra) 86 - intercostales anteriores 72
- synovialis 303 10-11,15,68,175, 183,209, - atrioventriculares 86-87 a i F

- - infrapatellaris 287 279,240,263,268,268,273, - bronchiales(Aorta) 107-108, - interganglionares 121

- - mediopatellaris 286 273,371 114,117,121 - internus(N.laryngeus
- transversarecti 200, 240, Pronatio(Articulatiotalocalcaneo- - - (N. vagus) 117,119-12l superior)106
251-253 navicularis)327 - calcanei(A. tibialis posterior) - interventricularis(+s)
tubariae 195 Prostata67,187,788,188,192, 372 anterior76,81-82,85-82 100,
- umbilicalis lateralis 67,74. r92, 193,193,274,214, - - laterales(N. tibialis) 388 131
156 157,203, 219, 236, 250 278-279,233, 236,236, - - mediales(N. tibialis) 376, - - posterior 77,82, 85-87, 124
medialis 56, 67,74, 156-157, 240 241,251-252, 259-260 388 - - septales(A. coronaria
193, 204, 209, 2r9, 236, 250, Protuberantia occipitalis externa - cardiaci cervicalesinferiores dextra) 86
253 27,45 120,122 (A. coronariasinistra)
- - mediana67,74,156-157, Psoasarch 70 - - thoracici (N. vagus) 86-87
793, 203-204, 209,236, 250, Pubes227,235 114-715,122 - labialesposteriores239
252-253 Pulmo94,96-102,173 - circumflexus (A. coronaria - lateralis(A. coronariasinistra)
- vesicalistransversa 67, 236 - arteries102 sinistra)76-77,85-88 86
 Index

Ramus(i) Ramus(i) Regio(-nes) R E r z r u s ' s p a c e 1 9 8 ,2 O O 2

, 52
- malleolareslaterales 351, 372 - pubicus (A epigastricainferior) - analis 227 Rima
- - m e d i a l e s3 5 1 , 3 7 2 217, 357 c e r v i c a l i sp o s t e r i o r 1 , 4 4 - 4 6 ani 227
- mandibulae12 - - (A. obturatoria\ 217 - cruris 364 - glottidis 116
- m a r g i n a l i sd e x t e r 8 2 , 8 5 8 7 - s a p h e n u s( A . d e s c e n d e n s - anterior 262,366-367 - pudendi 227,238
- - sinister 82,85-87 g e n i c u l a r i s )3 5 1 - posterior262,371-372 Rim(s) (ofvertebra body) 4
- m a s t o i d e u s( A o c c i p i t a l i s ) - - ( A d e s c e n d e ngs e n u s ) 3 5 6 - deltoidea 1 RosrNuUrrrn's lymph node 309
44-45 - scrotalesanteriores 231 - f e m o r i sa n t e r i o r 2 6 2 , 3 5 2 , Rotatio
- m u s c u l a r i s ( - e s( )N . f e m o r a l i s ) ( N i l i o i n g u i n a l i s )3 4 9 354-356 - externa (Articulatio coxae) 314
- - p o s t e r i o r e s2 1 9 , 2 3 7 - - posterior262,358-361 - - (Articulatio genus) 322
354 356,387
- - (N fibularis profundus) 374, - sinister (A. hepaticapropria) g e n u sa n t e r i o r 2 6 2 , 3 5 2 interna (Articulatio coxae) 314
148 - - p o s t e r i o r2 6 2 - - (Articulatio genus) 322
388
- - (N. fibularis superficialis) - - (V portae hepatis) 748,152 - g l u t e a l i s1 , 2 2 7 , 2 6 2 , Rugaevaginales 195, 198,229
387 - spinales(A. sacralislateralis) 358-362
- - (N. obturatorius) 387 218 - - female 227
- - ( N p l a n t a r i sm e d i a l i s ) 3 7 7 - splenici 171 - male 227 S
- - ( N t i b i a l i s )3 6 0 - 3 6 1 , 3 6 8 , - superficialis (A. circumflexa - infrascapularis 1
3 7 0 ,3 8 8 femoris medialis) 355, 357, 361 inguinalis 262, 352-353 width269
Sacrum,
- - ( N n p e r i n e a l e s )3 8 8 - - (A. glutea superior) 361 - lumbalis 1,47 Salpinx + Tuba uterina
- nodi atrioventricularis 86 - - ( A . p l a n t a r i sm e d i a l i s ) 3 7 5 , - - r a d i o g r a p h( a p ) 2 1 1 SANTORINI'S duct 150
- - sinuatrialis 86 378 - o c c i p i t a l i s4 4 - 4 5 S c a p u l a 1 ,3 , 2 6 - 2 7 ,2 9 , 5 3 , 1 0 3 ,
- obturatorius (A epigastrica - - (A. transversacolli) 45 - pedis 364 110,126-129
inferior) 217,357 - - (N. plantaris lateralis) perinealis,female 227, 239 Scrotum 191,235,252
- occipitalis(-es)(A. auricularis 3 7 6 - 3 7 8 ,3 8 8 - - male 227,237 Segmentalbronchi 92-93, 94
posterior) 44 - s u p e r i o r o s s i s p u b i s6 9 , 1 9 3 , sacralis 7,227 Segmentalinnervation
- - (A. occipitalis) 44-45 2 3 0 , 2 6 3 , 2 6 6 - 2 6 7 ,2 7 4 - 2 75 , - u r o g e n i t a l i s2 2 7 - back 42
- oesophageales (A. gastrica 318 - vertebralis 1 lower limb 348-349
s i n i s t r a ) 1 0 8 ,1 3 4 tracheales(N. laryngeus R e n 3 0 , 4 1 ,5 7 , 1 5 1- 1 5 2 , 1 5 8 ,1 6 2 , Segmentum(-a)
- (A thyroidea inferior) 108 recurrens)120 1 6 4 - 1 6 5 ,1 7 5 , 1 7 7 , 1 8 0 , - anterius inferius (Ren) 184
- - (Aorta) 108 - transversus 357 1 8 0 - 1 8 2 ,1 8 3 ,1 8 3 ,1 8 5 - 1 8 6 , - - lateraledextrum [VI] (HePar)
- ( G a n g l i o nt h o r a c i c u m ) 1 2 0 - tubarius (A. uterina) 197,220 1 8 6 , 1 8 9 ,1 9 4 , 2 0 8 - 2 0 9 , r44,144
- - (N. laryngeus recurrens) - ureterici (A. renalis) 250 243 246,248,250 sinistrumIII] (Hepar)
177,121 vaginales(A. uterina) 197 - development 183 144,144
- omentales(Aa. gastro- Raphe - projection 186 - - medialedextrum[V] (HePar)
omentales) 134,169 - perinei 228-229,238 - r a d i o g r a p h( a p ) 1 8 6 , 2 0 8 144,144
- - ( V v . g a s t r o o m e n t a l e s1)3 4 , - scrori191,227,232 - sonographicimage 185 - - [SIll] (Pulmo)98
158 Recessus Rete - superius(Ren)184
- o s s i si s c h i i 2 3 O ,2 6 1 ,2 6 6 - 2 6 8 , - axillaris 126 - a r t i c u l a r eg e n u s 3 5 1 ,3 5 6 , - apicale[SI] 98
2 75 , 3 1 7- 3 t 8 - costodiaphragmaticus59, 103, 367 - apicoposterius [SI-ll] (Pulmo)
- ovaricus 197 1 0 5 , 1 1 3 ,1 2 2 , 1 2 4 - 1 2 5 ,r 5 8 , - c a l c a n e u m3 7 2 , 3 7 7- 3 7 8 98
- perforans(tes) (A fibularis) 244-245,247 -248 - malleolarelaterale 367,374 basaleanterius[SVII! (Pulmo)
3 5 7 ,3 6 7 , 3 7 4 c o s t o m e d i a s t i n a l i 1s 1 3 ,1 1 5 , - mediale 374 98
- - (A. thoracicainterna) 72 128,131 - patellare 352,354 [cardiacum] - Segmen-
- - (Arcus plantaris profundus) - duodenalisinferior 162, - venosum dorsalepedis 364 tumfa) basalemediale
378 164-165 Retinaculum [SVII] (Pulmo)
- pericardiacus(N. phrenicus) - - superior 162,164-165 - musculorum extensorum - laterale[SIX] (Pulmo)98
722 - i l e o c a e c a l iisn f e r i o r 1 6 1 - 1 6 5 i n f e r i u s 3 2 5 - 3 2 6 ,3 3 6 - 3 3 9 , - mediale [SVII] (Pulmo)98
- perineales 237, 239, 387 - - s u p e r i o r1 6 1 , 1 6 3 - 1 6 5 339,366-367,373 - posterius[SX] (Pulmo)98
- p h r e n i c o a b d o m i n a l e7s1 , 1 2 2 i n f e r i o rb u r s a eo m e n t a l i s 1 5 9 superius325 - bronchopulmonalia 98-99
- posterior (A. media genus) 291 - intersigmoideus 162, 165 - - fibularium inferius 306, - [] (Hepar)144
- - (A. obturatoria) 357 - p h r e n i c o m e d i a s t i n a l i 1s 2 5 , 3 2 6 ,3 3 6 - 3 3 8 - inferius 184
- (A. renalis) 180 241 superius 306,326, - laterale[SIV] (Pulmo)98
- - (N. auricularis magnus) 42 - piriformis 110 331-3333 , 37,370-377 lingulareinferius[SV] (Pulmo)
- - ( N . c e r v i c a l i s )4 3 - 4 6 - retrocaecalis 164 - - flexorum (Pes) 306, 98
- - (N. obturatorius) 387 - s p l e n i c u s 1 5 9 ,1 6 5 , 2 4 6 3 3 1- 3 3 3 , 3 3 7 ,3 4 4 , 3 70 - 3 71 , - superius[SIV] (Pulmo)98
- ( N s a c r a l i s )4 3 subpopliteus 29O,292, 333 376-378 - mediale[SV] (Pulmo)98
- - (N.spinalis) 33,35,42-43, - superior bursaeomentalis 159, - peroneoruminferius/ - sinistrum[V] 144,144
47 165,246 superius+ Retinaculum - posterius lateraledextrum[VII]
- - ( N t h o r a c i c u s )4 3 - 4 4 - suprapatellaris 294 musculorum fibularium (Hepar)144,144
- - (V. portae hepatis) 247 - v e r t e b r o m e d i a s t i n a l i1s 2 8 , 1 3 0 inferius/superius sinistrum[II] (Hepar)
- - ventriculi sinistri 86 Rectoscopy205 - patellae laterale 286 287, 144,144
- posterolateralisdexter 86-87 Rectum 68, 141,163- 165, 175, 324-325,382 - - medialedextrum[VIII]
- profundus 388 1 7 8 , 1 8 3 ,2 0 4 , 2 0 5 , 2 0 6 - 2 0 7 , m e d i a l e 2 8 6 - 2 8 7 ,3 2 8 , 3 8 2 (Hepar)144,144
- - (A. circumflexa femoris 212 213, 278, 220-221, 224, RetromalleolarsPace - - (Ren)184
medialis)357,361-362 226, 247,251, 256-257,353 lateral 370 - [SIl] (Pulmo)98
- - (A. glutea superior) 362 - arteries 206 -' medial 370 - renalia184
- - (A. plantaris medialis) 375 - innervation226 Retroperitonealspace 177 - superius (Ren)184
- - (A. transversacolli) 44-45 radiograph (ap) f41 Retroperitonealviscera 151 - [SVI] (Pulmo)98
- - (N plantaris lateralis) - radiograph,iateral 225 - site 209, 210 septulatestis 190-191,252
3 7 7- 3 7 8 - veins 207 Retroversio(Articulatio coxae) Septum(-a)
- - (V. glutea superior) 362 R e c t u ss h e a t h 6 3 - 6 5 , 7 4 , 7 5 314 - atrioventriculare 84
 Index "'

Septun(a) Spinailiaco Si,mpfutrs Trigonum fibrosum

f e m o r a l e( C L o o L E r )3 0 9 , 3 0 9 , - l)osteriorinferhr 267 268. - p u b i c a 7 5 , 2 0 0 , 7 1 7 ,2 2 3 , 2 3 0 , - - s i n i s t r u m7 9 , 8 5
328 2 75 , 3 5 8 , 3 6 2 2 3 8 ,2 4 2 , 2 s 1 2 5 2 , 2 5 6 2 5 7 , lumbale27,29,43,62,362
- glandis 234 - s u p e r i o r3 1 , 6 2 , 1 8 6 , 2 2 3 , 2 6 3 , 2 6 3 , 2 6 8 , 2 7 0 , 2 73 , 2 7 4 , lumbocostale 70
- i n t e r a t r i a l e8 0 - 8 1 ,1 2 3
2 5 5 , 2 6 3 , 2 6 72 6 8 , 275,279,309,318 - vesicae188,192,233
i n t e r m u s c u l a r ec l u r i s a n t e r l u s 271 272,275,35n - r i p h o s t e r n a l i s5 1 Trochanter
326,329,329, 353 - i s c h i a d i c a3 , 2 0 6 - 2 0 7 ,2 2 3 , S y n c h o n d r o s icso s t a e 5 2 - m a j o r2 5 6 , 2 6 2 , 2 7 2 07 2 ,
posterius 328, 329, 329, 2 6 3 , 2 6 7- 2 6 8 , 2 75 , 2 8 2 , 3 1 7 S y n d e s n r o s itsi b i o f i b u l a r i s2 6 4 , 275 282,317,379 320,358,
331,383 - s c a l r u l a le, 2 n 2 7 ,o 2 . 1 0 5 , 2 6 5 , 2 9 6 . 3 0 6 ,3 8 4
-
362 363
v a s t o a d d u c t o r i u m3 1 1 ,3 5 5 , 127 - m i n o r2 7 5 2 8 2 , 3 1 3 , 3 2 0 , 3 6 2
356 S p i n o c o s t am l u s c l e s2 B - tertius276
- i n t e r v e n t r i c u l a r ef l 0 - 8 2 , 1 3 0 S p l e n 1 5 3 , 1 5 7- 1 5 9 , 1 5 9 , T Trochlea
l o n g i t u d i n a l i s3 7 9 1 6 1 1 6 6 ,1 6 8 - 1 6 9 ,1 7 8 ,2 4 3 , - fibularis 298-299
- penis234,234,241 245-247 - tali 297,299-300,307
Taenia
- rectovaginale 200, 253
hilum 153 l i b e r a 1 4 0 ,1 5 6 ,1 5 9 - 1 6 3 Truncu s
- scroti 191,232,240 - r a d i o g r a p h( a p ) 1 7 0 - m e s o c o l i c a1 4 0 ,1 5 9 - brachiocephalicls
- r'esicovaginale
76 77,91,
+ Fascia S p o n d y l o l i s t h e s i 9s - o m e n t a l i s1 4 0 ,1 5 6 ,1 5 8 - 1 5 9 , 100-101,106-707,109,112,
rectovaginaI i s S p o n d y l o l y s i s9 161,164 116 117,120,122-725,128
Srlrnlr,llr's vein 365 S q u a m ao c c i p i t a l i s 1 9 Talus 297 298,299,300 301, coeliacus 68, 106,108,117,
Sinus S t e r n u m 5 , 5 1 ,5 f , 5 2 , 5 2 , 5 3 , 3 0 3 ,3 8 6 151,768 171,176,176,177,
- anales 205,252
112,123, 129, 131,136, 201, T a r s a lt u n n e l 3 7 0 , 3 7 7 184,209-210,272 213,226
- aortae 8l-82,84 240 Tarsus264 costocervicalis 117
- c o r o n a r i u s7 7- 7 8 , 8 5 , 8 8 , B B , Stratum - gastrosplenicus
Tela 176
89,101 - c i r c u l a r e 1 0 8 ,1 3 2 1 3 3 , subcutanea 58, 74, 205, 381 - hepatomesentericus 176
- epididymidis190 191 - hepatosplenicus
1 3 7 -1 3 8 ,1 4 0 s u b m u c o s a1 0 8 , 1 3 2 1, 3 7 1 3 8 , 176
- l a c t i f e r u s5 4 - l o n g i t u d i n a l e1 0 8 , 1 3 2 1 3 4 , 1,+0 intestinalis 210
m a x i l l a r i sl 2 1 3 7 -1 3 8 ,1 4 0 , 2 0 5 , 2 2 0 - subserosa
132,137,140 - lumbalis210-211
- o b l i q u u sp e r i c a r d i i 7 7 , 9 1
Stromaovarii 195 T e n d oc a l c a n e u s3 0 2 - 3 0 3 , 3 0 6 , lumbosacralis 77,212- 213,217
p r o s t a t i c u s1 8 8 S u b o c c i p i t aml uscles 34,37-4O, 3 2 5 3 2 6 , 3 3 0 - 3 3 3 , 3 3 7 ,3 4 0 , p u l m o n a l i7s6 7 8 , 8 1 , 8 48 5 ,
- r e n a l i s 1 8 1 ,1 8 1 , 1 9 2 , 2 4 9
46 370,371-372,384,386 100,103,116,124- 125,129- 130
sagittalissuperior 46 - d e e pa u t o c h t h o n o u s3 9 T e s t i s 5 7 , 1 8 3 , 1 8 9 ,7 9 O - 1 9 1 , 2 1 4 , - sympathicus 71,71, 114-715,
t a r s i 2 9 8 ,3 0 7 Substantia 214,227,240-241 117,tl7, 118,118,119,119,
- transversus 46 c o m p a c t a2 7 8 T h i g h+ F e m u r 120-121,128-129,131,203,
- p e r i c a r d i i7 7 , 8 5 , 9 1 ,1 2 3 , - s p o n g i o s a2 7 8 , 2 8 3 'Ihoracic
vertebrae,lateral parts 212-214,214-215,217,243,
130 Suntcx's point 174,206 4,5 247 250
- trunci pulmonalis78, 84, Sulcus(-i) - tibiofibularis
Thoracicvertebral column 369,372
100 - analis 262 radiograph (ap) 14 - vagalis anterior119
v e n a r u mc a v a r u m 7 7 , 8 8 a r t e r i a es p l e n i c a e1 5 1 radiograph,lateral 14 - - posterior120-121
S i n u sn o d e 8 4 - - subclaviae 49 T h o r a c i cw a l l 5 6 , 5 8 , 7 2 Tubauterina 165,794-195,195,
Situs - - v e r t e b r a l i s6 , 1 7 - segmentalinnervation 57 1e6,196,1q7,203.204,215,
cordis 90 - c a l c a n e i3 0 0 - surface anatomy 48 275,220,259
- retroperitonealis 177, - c o r o n a r i u s7 7 7 8 , 8 8 Thorax Tuber
209-2lO costae 49 - c r o s ss e c t i o n 1 2 9 - calcanei297-300,302-307,
viscerum 156, 156-157, 760, - g l u r e a l i s2 6 2 , 3 0 8 , 3 1 73, 5 8 frontal section 122, 125 330-332,342-343
1 6 4 , 7 6 9 ,t 7 t , 1 7 3 - i n t e r v e n t r i c u l a r i sa n t e r i o r - m e d i a ns e c t i o n 1 2 3 - ischiadicum3, 206-207,223,
Soleof the foot - P1s113pg6it 7 S - 7 9 ,8 2 Thymus ll1, 172,ll2, 713,ll3, 225,228-230,238,257 -258,
Space - - p o s t e r i o r7 8 - 7 9 , 8 2 - 8 3 , 5 8 114-715,123,157 2 6 6 - 2 6 92,7 1 - 2 7 22,75 , 2 8 2 ,
- quadrangular 43 - malleolaris 284-285 T i b i a 2 6 4 , 2 8 4 - 2 8 5 , 2 8 7- 2 8 9 , 317-379,358,362
triangular 43 nervi spinalis 4,7 292-295, 296, 302-303, - omentale142,159
Spatiumfa) - obturatorius 267 306-307,325-326,329, Tuberculumfa)
- epidurale 24, 47, 247,252 - paracolici 160-162,164 - adductorium
3 3 1- 3 3 3 , 3 6 6 , 3 7 4 , 3 8 3 - 3 8 4 , 276,278
- intercostalia 50 - popliteus 283, 293, 295 - anterius(Vertebrae
386 cervicales)
- pararectale 198 - sinus sigmoidei l8 Trabecula(-ae) 4,6-7,41,67
- paravesicale 198 - supraacetabularis267 -268 - c a r n e a e8 1 - 8 2 - caroticum + Tuberculum(-a)
- perineiprofundum 223,227 - tali 299 - corporum cavernosorum 233 anterius
prevesicale 198 - tendinis musculi fibularis longi - septomarginalis 80, 82-83 c o s t a e4 , 2 0 , 2 2 , 4 9
- retropubicum 73, 198, 200, 297,299-300,302,304 - splenicae 153 - i l i a c u m2 6 3 , 2 6 8 , 3 6 2
252,257 flexoris hallucis longi T r a c h e a 9 1 ,9 2 - 9 3 , 1 0 0 - 1 0 1 , - intercondylare laterale284,
- retrorectale 198 (Calcaneus2 ) 98-300, 1 0 3 - 1 0 4 , 1 0 41, 0 6 , 1 0 6 , 293
- subarachnoideum47, 123,127, 304 - - mediale284,293
108- 109, 112,716-719,
252 longi (Talus) 122-125, 727-128 - intervenosum80
- subdurale 47 - bifurcation 104 - laterale(Talus)298-300
299-300
Spina - terminalis cordis 77, 88 - projection 104 - mediale(Talus)298-300
- iliaca anterior inferior 223 - venae subclaviae 49 - musculiscalenianterioris49
Tractus iliotibialis 280, 308, 310,
2 6 3 , 2 6 7- 2 6 9 , 2 7 3 , 2 75 Supinatio (Articulatio talocalca- 3 1 0 ,3 1 6 ,3 1 6 , 3 1 7 , 3 2 6 3
, 35, - obturatorium anterius268
superior 3, 48, 58, neonavicularis) 327 3 5 9 ,3 8 1 - - posterius267-268
62-64, 67, 136, 167,201, Sura 262 TREtrz'smuscle 139, 150 - posterius(Vertebraecervicales)
2 2 3 , 2 3 5 ,2 6 2 - 2 6 3 , Sustentaculumtali 297- 300, 302, Triangular space 43 4, 6-7, 72,17,34,38,41
2 6 7- 2 7 1, 2 73 , 2 75 , 3 0 4 ,3 0 2 3 8 4 Trigonum - pubicum223,230,238,263,
3 0 8 - 3 0 9 ,3 1 2 ,3 1 6 ,3 1 8 , Symphysis - clavipectorale 58 2 6 7- 2 6 8 , 2 7 1 , 2 7 5 , 3 0 9
3 5 8 , 3 6 23 6 3 - m a n u b r i o s t e r n a l i s5 1 - 5 2 - fibrosum dextrum 79, 85 - quadratum276-277
 Index

Tuberositas v Vena(ae) Vena(ae)epiSastricd

apicalis100 - - s u p e r i o5r 6 , 7 1 , 7 2 - 7 4
glutea276 277,281,317
- lliaca 263,267 - apicoposterior 100 - femoralis68,75, 210,242,
Vaginafae) 194- 195, 195, 196,
- musculigluteimaximi 268 196, 197- 198,200, 215, 220, - appendicularis 778-179 256-257, 309,309,317,352,
- serratianterioris49 2 2 3 - 2 2 4 , 2 3 0 , 2 5 7 ,2 5 7 - arcuatacrurisposterior364 3 5 4 - 3 5 63,8 0 - 3 8 1
- ossiscuboidei297-298,300, - communis tendinum - atrialesdextrae89 - femoropoplitea 368
- - sinistrae77,89 - fibularis 329
304 musculorum fibularium 306,
- - metatarsiprimi 297,300 336-337 - auricularisposterior44-45 gastricadextra 134,178-179
- musculi recti abdominis 58, axillaris 90, 115,724,726,728 - - s i n i s t r a1 0 8 , 1 3 4 , 1 5 1 , 1 5 8 ,
quinti 297-298,300,
304-305,336 6 2 , 6 5 , 6 9 ,7 2 - 7 4 , 2 4 6 ,3 0 9 - azygos71,77,101,107-109, 7 6 91, 7 7- 1 7 9 , 2 4 2 , 2 4 6
- - navicularis - plantaris tendinis musculi 114,117 -118,118, 121, - gastricae breves134,164,
300,304
- sacri l0 11 fibularis longi 343 1 2 8 -1 3 11, 7 9 , 2 4 6 178-179
- phalangis - tendinis musculi extensoris basalisinferior 11 - gastroduodenalis l5l
distalis(Pes)297
- tibiae 262,284,287-289,293, - basivertebralis 123,240 - gastroomentalis dextra 134,
hallucis longi 336-337
296,326,366 flexoris hallucis longi - brachiocephalica 100,113,115, 165,169,169,77r, 17I -179
722 - - sinistra 108,134,158,169,
Tunica 337,342
- adventitia108 tibialis anterioris - - dextra77,97,1O7,112,114, 169,171,778-179
- albuginea190,242 118 - gluteainferior 207,256,362,
336-337
- - corporisspongiosi234 p o s t e r i o r i s3 0 6 , 3 3 7 - sinistra77,91,107-108,112, 362,380
- - corporumcavernosorum - tendinum digitorum pedis 332 t18,122-123 - - superior207,255,362,
233-235,240,752 337,342 343 - bronchialis114 380
- dartos73, 190-191, - - musculi extensoris - bulbipenis230 - hemiazygos 71,108,118,123,
218,228,
232,235,240,252 digitorum longi 336-337 - - vestibuli239 179,243,246
- fibrosa 153 - cardiacamagna76-77,81,85, - - accessoria 108,115,118,179
flexoris digitorum longi
- mucosa108,125,132,137, 88-891 , 31 - hepaticae70, 91,124-125,143,
3 0 6 ,3 3 7
140,146,188,195-196 - - (Pes) 336-337 - - m e d i a7 6 , 8 5 , 8 8 - 8 91,0 1 , 145,165,177-179,209-210
- muscularis107-108, 123 - - dextrae145,148,241,244,
123, Valvafae)
-140,167, - aortae 79, 82, 84-85, 90, 116, - cavainferior41,70,71,77 -78, 247
132-134,137
8 0 , 8 8 , 9 11, 0 11, 0 7 - 1 0 91,1 6 , - - intermediae145,148
187-188,195-196,205, 278, 123-124,130-131
- atrioventricularis dextra 118,121,125,r42-r45, 148, - - projection148
220,223,261
- sinistrae145,148,241-242
- serosa132,137-138,143, 146, 79 -80, 82-84, 90, 123-724, 131 1 s l - 1 5 21, 6 5 , 7 6 9 , 1 7 1 ,
- - sinistra 79,81-84,90, -
177 179, 9, 17 183 - 184, 207, - sonographic image 145
1 5 31
, 95-196,218
- vaginalis 209-21O,213, 247-242, - ileales178-179,249
testis73, 190-191, 130 131
- cordis 79,85 246-250 - ileocolica178-179
232,240
- mitralis - Valva(-ae)atrio- - - superior76-78,80,84-85, - iliacacommunis165,177,203,
ventricularis sinistra 8 8 ,9 0 - 9 11, 0 0 - 1 0 1 ,0 3 , 207,209,213,217,219-220,
- tricuspidalis + Valva(-ae) 107-109,1r2,174,116, 118, 224,240-241, 255
r24,128-130 - - externa67,177,179,193,
U atrioventricularis dextra 120,122,
- trunci pulmonalis 79, 84-85, - centralis187 207,213,218-221,224,236,
Umbilicalcord 202 90 - cephalica 56,58,726 253-254,318,353-354,3s6
cervicalisprofunda 45 - - interna179,207,209,
Umbilicalknot,false 73 Vahulafae)
Umbilicus74 - anales 205 - - superficialis56 218-220,224,254,258,353
- Eusmcslt 80 - circumflexa femorislateralis - iliolumbalis209
Uncovertebralcleft 24
- foraminis ovalis 81 261 - intercostales 73, 130-131
Uncuscorporis4, 7, 13,24-25,
- fossaenavicularis 233 medialis256,260-261 - anteriores245
4l
- semilunaris anterior 79, 85 - - humeriposterior43 - - posteriores 34,36,59,75,
Upperabdomen
vessels169,171 - - dextra (Valvaaortae) 79, 81, - ilium profunda177,213, 108,114-115,117-118
- viscera158 219,224 - interventricularis anterior76,
8 4 - 8 5 , 1 2 3 ,1 3 0
Urachus73, 157,183,189,194 (Valvatrunci pulmonalis) superficialis 56,309, 8 2 ,8 5 ,8 9
352-353 - - posterior77,82,85,88-89,
Ureter67,151,167-162, 164-765, 79,85
170,177,180-184,186,186, - - posterior (Valvaaortae) 79, - - scapulae43 101
187,189,193-195,203-204, 8 1 - 8 2 , 8 4 - 8 s1, 2 3 ,1 3 0 - colicadextra 151,173,178-179 - jejunales151,173,175,
208- 210,213- 214,218-221, - - sinistra (Valvaaortae) 79, - - media 151,167-762,173, 178 179
175,178-179 - jugularis anterior123
?24,236,243,249-250,253, B1-82,84-85,123,130
(Valvatrunci Pulmonalis) - sinistra165,173,175, - - externa44
255,258
- radiograph 178-179 - interna91,107-108, 113,
(ap) f86 79,84-85
Urethra 188,193,193,233,233, - sinus coronarii 80, 84 85, 89 - cordis85,88-89 t22,125-126
252 - venae cavaeinferioris 80, 84 cremasterica 231 lobi medii 100
- feminina 194,200,223,23O, - cystica169,178-179 - lumbalisfes)177,209,247,243
Vasfa)
- digitalesdorsales - - ascendens117-118,213,
261 - lymphatica profunda 366 Pedis373
, 9 2 - 1 9 3 , 1 9 3 , - - superficialia 368
- m a s c u l i n1a8 8 1 - dorsalisprofundaclitoridis 250
- l y m p h a t i c u m ( - a \2 1 1 , 2 3 5 224,230 - marginalis lateralis364,373
214,230,232-233,233,234,
242,259-260 - - afferentia 211 p e n i s2 3 0 - 2 3 2 , 2 3 4 , 2 5 2 - medialis364,373
- - superficialis - - sinistra89
Uterus 166,194,195-196,198, - - centrale 137 Penis219,231,
- mesenterica inferior 151,165,
200,203- 204,215,220- 227, - - efferentia 211 234,252
253, 3 5 3 - - radiograph (ap) 211 epigastricainferior 56,72, 74, 1 75 , 1 7 5 ,1 7 7- 1 7 9 , 2 0 7 , 2 5 0
- tibialia 370 156- 157,17l, 173, 177, 179, - - s u p e r i o1r 5 1 , 1 6 5 , 1 7 1 , 1 7 3 ,
in pregnancy 199-200,2Ol
- sonographic image 199 VrrEn's papilla 139, 146, 150 193, 209, 2r3, 219, 221, 224, 173, 175, 177- 179, 240-242,
Utriculusprostaticus188-189, Venafae) 236,250,253 249
- anterior (V. pulmonalis dextra - - superficialis 56,179,309, - musculophrenica 72
233,252
352-353 - obliquaatriisinistri88-89
Uvulavesicae188,233 superior) 1O0,724,126
 d'-\ /"
Index il l'\
\JJ
Vena(ae) Vena(te)pulmonalis(cs)sinistru(te) Vena(te) Vertebm(te)thomcicde
- obturatoria2O7,219,221,224, inferior81,97,100, - transversacolli 44 - - radiograph,lateral 14
236,256-257, 261,309,318 1301 - 31 - umbilicalis67,73,143,157, Vertebralbody
- occipitalis43-45 superior81,9Z 100-101, 200 - development 5,24
- oesophageae 108,108, 129 - uterina 220-221 - epiphyses 5,24,25
178-179 - rectalis(+s) inferiores179, - ventriculidextri anteriores85, - lowersurface4
- ovarica151,165,179-180, 184, 207,219-220 89 - uppersurface4
195,204,220-221, 253 - - mediae207,219-221 - - sinistri posteriores77, Vertebralcolumn 3
- pancreaticoduodenales - - superior175,178-179,207, 88-89 - ligaments20
178-t79 2t9-221 - vertebralis45,77,108 Vertebralmotorsegment
- paraumbilicales 56,74,179 - renalis151-152, 179-180, - vesicalis(-es) 73,220 - cervical 25
- perforantes308,364,365, 182-184,185,209,213, - - inferior 219 - lumbal 25
373 240-24t.243-244. 248 - - superior219 Vesica
- pericardiacophrenica 90-91, - sacralislateralis218 Venouscross9l - biliaris 57,142,144,146,146,
112,114-115,122 - - mediana177,209,213,221 Venter 147-148, 148,149,152,
- perinealis230 - saphenaaccessoria lateralis - occipitalis44-45 158-1s9,166,168-169,17I,
- phrenicainferior 108,179, 352 - posterior34,38,40 248
209 medialis353 - superior113 - - radiograph(apl 147,152
- plantarislateralis306 - - magna56,71,210,257,286, Ventriculuscordis - fellea+ Vesicabiliaris
- - medialis306 308-309,329,352-354, - dexter76-78,80,80,82,82, - urinaria 57,68,73, 157,
- poplitea286,331, 359-361, 356,358,364-365,365, 83,83,84,84,88,100-101, 163-166,177,183,187-188,
368,370-371,382 368,373,379,381-384 1t6, 124- 125,130- 131,242 189,193,193,194,200,
- portaehepatis134,142,145, - - parva 286,308,329, - sinister76-78,81,81,82, 203- 204,209,2r4, 218- 221,
148,15r-152,165,168-169, 3s8-359,361,364-36s,368, 82-83,84,84,88,100,103, 233,236,236,240-241,
r77,777-178, 178, 179, 179, 370,373,383 107,116,124-125,130-131 250-251,256-257,259- 261,
241-242,244,246-248 - sigmoideae175,177-179,207 Versio(Uterus)196 353
projection 148 - spinalisposterior47 Vertebra(-ae) Vestibulum
sonographicimage 145 - splenica151-153, 159,165, - cervicales2-3, 4, 5,7, 12,12, - bursaeomentalis159,164
- posterior(V.pulmonalisdextra 171,175,177-179,242-243, t3, 17-19,26, 41,46,53,123 - vaginae 238
superior) 100 246-248 - - radiograph(ap) 13 Villi intestinales137
- prepylorica169 - subclavia91,107-108, 112, - - radiograph,lateral 12 Vortexcordis 79
- profundabrachii 43 114,118,122,125,127 - coccygeaell
- - femoris261,356 - subcostalis117-118 - development5
- pudendainterna 179,207,
2r9-220, 224,230,236- 237,
- subcutaneae abdominis56
- suprarenalis180,184,209
- l u m b a l e ls- 3 , 4 , 5 , 8 - 9 ,1 5 - 1 6 , w
23-24,26-27,31,36-37,47,53,
239,256-258,260-26r, - suralis 370 68-70,74,152,176,203,208, Width of pelvis 269
36r-362,362 - testicularis67,151,177, 246, 248-249, 251, 255, Wtxstow'sforamen 158
- pudendaeexternae56, 231, 179- 180,184,190,209,209, 270-271,274-275,318 WrRsuNG's duct 150
235,309,3s2-353 2t3,231,249-250 - - radiograph(ap) 16 Worrrianduct 189,194
- pulmonalis(+s)114,120 - thoracica interna 56,72, - - radiograph,lateral 15
- - dextrafae)77-78,80-87, 90-91,100, |2-113,128 - ossificationcentres 5
88,91,97,100,102,107,109, - - lateralis 56
- thoracoepigastrica
- prominensl-3,7, 27,39,105, z
114,121,243 56 123
inferior 130-131 - thymica 91 - regionalcharactenstics5 Zona
superior1O1,124,128, - thyroideainferior g0-91,108, - structuralcharacteristics4,4 - haemorrhoidalis205
130 112-113,118 - thoracicae2-3, 4, 5, 8-9, 20, - orbicularis 256,273
- - sinistrafael77-78,88, - - superior113 26-27,36,53,125-130, Zygapophysis + Processus
90- 91,107,109,115,123, - tibialesanteriores329,366 ?46-247 articularissuperior/inferior
243 - - posteriores329,370 - - radiograph(ap) 14 (Vertebra)