outlines of anatomy and lecture...

HI LLINO I SUNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN

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II 'I I I-sL~ab~ - I I I ~Irr~C~~ s

DR. C. B. JOHNt cKr4').CHAMPAIGN, ILLINOIS

THE UNIVERSITY

OF ILLINOIS

LIBRARY

From the library ofDr. Charles B. Johnson

ChampaignPresented by

Alice S. Johnson. '071933

Ec50

OUTLINES OF ANATOMYAND

ILECTURE SYLLABUS

BY -- , !.iiE

W. T. EC &EY, M. D.

Prof. of Anatomy in the American College of Dental Surgery,Chicago; Demonstrator of Anatomy in the College of

Physicians and Surgeons, Chicago; Prof. of Anat-omy, College of Physicians and Surgeons,

Chicago; Prof. of Anatomy in Harvard

Medical College, Chicago; Prof.of Anatomy in Columbus

Medical Laboratory,Chicago.

CH ICAGO, ILLINOIS,

Oct. 1st, 1894.

HENSON BROS. 350 DEARBORN

UN'P7Y L

INDEX.

Chapter IIIIIIIVV

VIVII

VIIIIXX

XIXII

XIIIXIVXVXVI

XVIIXVIII

Anatomical Axioms.Nomenclature.Anatomical Tissues.General Definition.Osteology.Articulation.Muscles and Fascie.Vascular System.Digestive Organs.

The Teeth.The Mouth.The Nasal Cavities.The Lungs.The Nervous System.The Cranial Nerves.The Spinal Nerves.Sympathetic.Dissection.

951277

PREFACE.

The present compend and lecture syllabus is in-tended to facilitate the work- of the student in hisanatomical study. First by placing under his observa-tion those anatomical things which most directlybear on the work before him, and secondly by callingattention to those anatomical descriptions given inGray's anatomy, which tis needful for the studentto peruse.

Much time has been given to the collation of ana-tomical axioms which ordinarily become the propertyof the student only after years of study. It is our firmconviction that those anatomical self-evident truthsshould form the ground-work for a liberal anatomicaleducation. These axioms are frequently referred to bynumber in the body of the book.

Much attention is given to the technical languageof anatomy under the caption of nomenclature. Toooften do students spend needless time in memorizingtechnical terms, the while ignorant of the very philos-ophy upon which our anatomical nomenclature rests,The laws of compounds, opposites and derivation cer-tainly deserve attention.

Special attention is given to the subjects respectivelyof anatomical tissues and anatomical structures; theformer being presented in the light of anatomicalelements, the latter as anatomical compounds. Thehighly specialized modifications of connective tissuesuch as all the anatomical envelopes, tendons, fascise,

PREFACE.

capsules and aponeuroses are treated in a separatechapter and the common source of these importantstructures lucidly pointed out.

The body of the compend is made up of questionand answer with references to chapters to be read inGray's anatomy.

In editing this work I desire to acknowledge theservices of my esteemed friend and pupil, Louis J.Smith, to whose assistance in its compilation I amvery considerably indebted.

Very truly,

W. T. ECKLEY.

813 W. Harrison St.,Chicago, Ill.

Outlines of AnatomyAND

Lecture Syllabus.

CHAPTER I.

ANATOMICAL AXIOMs.

i. Foramina for transmission of nerves are constant:they are primary and secondary.

2. Connective tissue is characterized by strength,ubiquity,minimum nerve and blood supply. The sameis true of all its derivatives.

3. Anatomical projectiles follow the line of greatesttraction, the point of least resistance or the resultantof the two.

4. Motion is rhythmical; force is persistant.

5. The sympathetic is the nerve of life organic.

6. Every anatomical structure has an envelope ofconnective tissue.

7: Anatomical conduits have three coats: internal,middle and external.

8. Abdominal organs have a fouth or adventitiouscoat.

9. Anatomical structures developing pass from thesimple, the unstable, the incoherent anl homogeneous

OUTLINES OF ANATOMY

to the complex, the stable, the coherent and the hetero-geneous, the while manifesting a tendency to bothgeneral and local specialization.

i o. Anatomical weak points are those where a suddenabrupt change in continuity takes place; also junc-tional areas.

Ir. Anatomical roots are places where vessels andnerves enter to carry on the functional and nutritiveactivity of the organ.

12. Unused organs, atrophy; over-used ones hyper-trophy.

13. The muscles of expression preside over facialpantomime. They are innervated by the 7 th.

14. Capsular ligament is the basis of every movablejoint; it is a continuation of periosteum over the inter-articular space and its inner surface is the so-calledsynovial membrane.

15. Articular branches of nerves and vessels supplyjoints, nutrient supply bone, cutaneous supply skinand muscular supply muscle.

16. The ultimate breaking up of vessels and nervesis called their final explosion.

17. Bicipital muscles have two, tricipital three andquadricipital four heads.

18. Macroscopic pertains to gross anatomy; micro-scopic to structures invisible to the unaided eye.

19. The muscles of matication are innervated by the

5 th cranial; those of expression by the 7th.

20. The maxillary sinus is called the Antrum ofHighmore.

AND LECTURE SYLLABUS.

21. The mandible is the lower jaw or inferiormaxilla.

22. Find out what is meant by the dental and sur-gical portions of the mandible.

23. Serous and synovial cavities are near akin.

24. Flexion, extention, pronation, supination, ab-duction and adduction summed up make circumduc-tion as seen at the hip and shoulder.

25. Dental solution of continuity: a broken tooth.

26. Highly specialized anatomical structures per-form, physiologically, maximal amounts in minimaltime.

27. A secreting or excreting membrane is the sim-plest form of glandular structures.

28. Secretions are retained and perform some usefuloffice in the economy; excretions are deleterious if notthrown off.

29. The spleen, thymus and thyrod have no excre-tory ducts.

30. The lining of all blood vessels is continuous withthe endocardium.

31. Muco-cutaneous line of junction is where skinand mucous membrane meet; hence are anatomicalweak points and prone to milignant growths and fis-sures.

32. Why are the sigmoid, the hepatic flexure, andthe colic region anatomical weak points ?

33. The large intestine becomes progressively smallerfrom coecum to rectum.

OUTLINES OF ANATOMY

34. Give the differential points between large andsmall intestines.

35. Anatomical tissues are elements; organs andstructures compounds.

36. Blood and lymph are congeners of connectivetissue.

37. The origin of a muscle is its more fixed pointand near the mesial axis of the body.

38. Give Hilton's law governing articular, fascialand cutaneous nerve-branches in the vicinity of joints.

39. Anatomical structure or substance implies anorgan in part or entire regardless of its anatomicalcomposition.

40. Dental formula: I: C B 2 M 3=32.41. The number of adult teeth is 32.

42. Define occluding and proximal surfaces of teeth.

43. Dissection is the art of dividing the connectivetissue in such a way as to do no violence to the organsor parts.

44. Gland formula: A layer of nucleated epethelialcells on a basement membrane, beneath which arevessels and nerves in a layer of connective tissues.

45. Nerve formula: (i) Axis cylinder. (2.) Whitesubstances of Schwam. (3) Perineurium.

46. Define the muscular formula.

47. Bony eminences and depressions are developedby muscular traction.

48. The appendix is an anatomical vestige, uselessnow except for abscesses.

IO

AND LECTURE SYLLABUS. II

49. Emissary foramina transmit emissary veins;these latter equalize the circulation between the sinusand extra-cranial veins.

50. No two anatomical structures are ever in directcontact, but they are always disjunctively connectedby a layer of connective tissue.

51. Superficial structures, arteries, veins, nerves,fat and lymphaties, are found between two layers ofsuperficial fascia.

52. Intracranial sinuses are associated with circula-tion; intramural with vocalization.

53. Structures are arbitrarily named from the ideaof the predominating osseous, muscular or nervouselement.

CHAPTER II.

NOMENCLATURE.

This is the technical language of anatomy. Theterms are chiefly Latin. The basis of description isgeometrical, for here you have such names as cuboids,trapezoids, etc. Our nomenclature is rich in oppositesand synonyms. Such is the role played by oppositesthat the student instinctively is on the look out foropposites. External condyle, lesser trochanter, su-perior curved line, all imply the necessary presence ofinternal condyle, greater trochanter, inferior curvedline. There are a few exceptions, as internal iliac.There being no external muscle, it should be callediliac only. Our nomenclature is rich in synonyms.The maxillary sinus, is called maxillary cavity, an-trum of highmore, antrum maxillaire, antrum high-moriansum. The upper jaw is called both super andsuperior maxillary bones, ossa maxillarea. The malarprocess: processus malaris, processus jugalis, processuszygomaticus, and processus zygomatico-orbitalis.

Inter implies location between two anatomical struc-tures. The word is often used and is often confoundedwith intra. The following will illustrate the use :

Inter osseous, between bones.Inter costal, between ribs.Inter maxillary, between jaws.Inter dental, between teeth.Inter ocular, between eyes.Inter scapular, between scapulae.Inter pubic, between pubes.Inter clavicular, between clavicles.Inter frontal, between the frontals.

13

OUTLINES OF ANATOMY

Location within, inside of a part is concisely ex-pressed by the word intra. This should not be con-founded with infer. Intra is the opposite of extra.

Intra abdominal, in the abdomen.Intra oral, in the mouth.Intra uterine, in the uterus.Intra thoracic, in the throax.Intra cranial, in the cranium.Intra mural, in the walls.

Extra means outside of.Extra abdominal, etc. The opposite of any of the

preceding may be formed by the use of this word.

Sub implies under, below, beneath. Location ismore frequently expressed by this than by any otherone word. The greatest latitude obtains, since thewords to which this is prefixed may be used substan-tively, adjectively and adverbially.

Sub maxillary, below the maxilla.Sub cutaneous, below the skin.Sub lingual, below the tongue.Sub mucous, below m. membrane.Sub serous, below s. membrane.Sub synovial, below syn. membrane.Sub pubic, below the pubes.Sub arachnoid, below the arachnoid.Sub dural, below the dura.Sub occipital, below the occipital.Sub muscular, muscle.Sub normal, normal.

Define anatomical opposites.These are words technically used in anatomical nomen-

clature to express primarially the ideas of antagonism.From the primative meaning digression has been madetill the idea now is little more than one of comparison.This much is true however, and may be dignified as

I4


law: Never make use of these extreme terms whenthe idea of antagonism is absent. If there is a musclelocated intra pelvically called iliacus do not name itinternal iliac since internal presupposes or implies anexternal iliacus, which there is not.

The following are in common use:Superior, the opposite of inferior.Internal, the opposite of external.Flexor, the opposite of extensor.Pronator, the opposite of supinator.Central, the opposite of peripheral.Longus, the opposite of brevis.Dorsal, the opposite of ventral.Cephalic, the opposite of podalic.Visceral, the opposite of parietal.Greater, the opposite of lesser.

The rule once learned then, the practical deductionis this: When in your reading you meet one of thewords combined thus: The grealer tuberosity of thehumerus, the exlernal oblique line of the lower jaw,the superior maxilla, the internal condyle of the fe-mur, the visceral layer of the pleura, theflexor tendon,or the dorsal surface of the scapula you intuitively rec-ognize the antagonism, and know that the opposites ofall the foregoing structures must exist. This willlessen your work, since by study you have learnedseven names and by implication seven more must existdiffering only in size, in location or function, etc. Byimplication then we know we must find: The lessertuberosity, the inztenal oblique line, the inferior max-illa, the exlernal condyle, the farielal layer, the ex-tensor tendons, the ventral surface, etc.

Define anatomical compound words:These are technicals for the purpose of expressing

the facts in relationship. The philosophy of thesecompounds far antedates written anatomy and finds its

I5

OUTLINES OF ANATOMY

origin in legal nomenclature. If you will pardon thedigression let us suppose a case of litigation betweenBrown and Drexel. The decision in this case is re-corded case of Brown vs. Drexel, in which Brown wasthe plaintive and Drexel the defendant and appears onthe docket as the Brown-Drexel decision. In thiscompound the activity is on Brown, the passivity onDrexel. The compound here expresses the facts inthe case since Brown and Drexel were the litigantsand the decision concerned them equally, hence therecould be but one proper name for the decision. Itcould not be called the Brown decision nor the Drexeldecision but the Brown-Drexel decision, written withthe hyphen. Legal compounds then are technicalsexpressing legal facts in relationship.

Now let us assume two anatomical structures broughtinto relationship. For an instance the stomach andliver, the stomach and colon, the stomach and spleen,the radius and ulna, the radius and carpus or theparietal and occipital bones.

Here we find a relationship existing just as in thelegal case, the only difference being in length of timeof tenure. The question is how shall we name therelationship and at the same time express the ana-tomical facts in the case. A junction between radiusand ulna is neither a radial nor an ulnar junction, buta compound formed by the union of the bones. Callit then the radius-ulnar, just as our legal friends saythe Brown-Drexel. Also say the gastro-hepatic, gastro-splenic, gastro-colic. For euphony we retain theablative o. The rule then for writing these compoundsis this. Place the smaller word first, the larger onenext, connect by hyphen and terminate the first in theablative o. To express direction the order may bereversed. If you wish to express the direction of aprojectile passing through the arm from ulna to radiusthen say ulno-radially, etc. There is practically no

16


limit to the possible compounds. In this manner wedesignate not only the region, the joint, the relation,but the very ligaments binding the antagonistic partiestogether in a life tenure! Given then the compound,by analysis we can find the names of the individualbones, or given the names of the bones we can namebeyond the peradventure of error the relation, thejoint, the ligament. We can use the compound ad-verbially to express direction. We can make eitherthe basis or either the adjlnct, according as we desirethe activity or passivity to pose on this or that, andlastly, while the rule requires the smaller word first,still for euphony, the larger may occupy this position.This one law thoroughly understood, no student needever complain of anatomical nomenclature. The fol-lowing are common anatomical compounds. Analyzethese and make adverbs therefrom. Then reversebasis and adjunct and do the same:

Temporo-maxillary.Occipito-parietal.Fronto-parietal.Squamo-parietal.Atlo-axoidean.Temporo-sphenoidal.Fronto-sphenoidal.Gastro-pulmonary.Gastro-hepatic.Gastro-splenic.Tibio-fibular.Sacro-coccygial.Lumbo-sacral.Sterno-clavicular.Costo-chondral.Costo-vertebral.Genio-hyo-glossus.Sterno-cleido-mastoid.

17

i8 OUTLINES OF ANATOMY

Define Peri Structures.The word peri occurs frequently and implies around

or surrounding in the borrowed sense of investing,enveloping, ensheathing. It gains its chief anatomicalimportance as a technical term from the fact that everyvisible anatomical structure has a covering, tunic,sheath, envelope or capsule. The universality of thislaw is even more interesting when we remember thatthis investing sheath in each instance is made so tospeak of the same material. In the great majority ofinstances, if indeed not in all, this covering is techni-cally designated by prefixing the preposition peri tothe substantive ensheathed, thus:

Peri cardium, covering for heart.Peri osteum, covering for bone.Peri chondrium, covering for cartilage.Peri tendinum, covering for tendinum.Peri mysium, covering for muscle.Peri neurium, covering for nerve.Peri pulmonium, covering for lung.Peri dontium, covering for tooth.

CHAPTER III.

ANATOMICAL TISSUES.

Define anatomical tissues.

A tissue is an anatomical element. In chemestry anelement is a substance which admits of no further dis-sociation. In anatomical analysis, i. e., dissection, wedissociate until we have certain elementals which wecan not further sub-divide and classify. These we callprimitive tissues, or elements, since from them everypart and organ of the body was constructed. Thetissues are more imperfectly understood by the studentof anatomy than any other department of this science.This is probably due to the fact that no definite classi-fication has been rigidly adhered to by authors. Thefollowing classifications of tissues must be memorized,since you will be examined weekly on the cadaver onthis subject :

i. Corpuscular tissue.2. Epithelial tissue.3. Connective tissue.4. Adipose tissue.5. Muscular tissue.6. Nervous tissue.7. Cartilaginous tissue.8. Osseous tissue.

The tissues have very apparent physical differencesas bone, gristle, fat, nerves, etc., still it must be re-membered that these are more apparent differences thanreal ones, since they are all transformations from a

19

OUTLINES OF ANATOMY

common structural element called an organic cell. Inother words each organic cell is made up of structuralelements, each one element of which is capable of form-ing one tissue. Each cell then is composed of eightstructural elements.

These tissues are in various combinations known asorgans and parts, as heart, arteries, muscles, brain,glands, etc. These are called anatomical structures.From this composite make-up they may be called com-pounds in contra distinction to elemental tissues. Thefollowing scheme will make this plain.

I 2 3

(i) Tissue Corpuscular.-(2) Tissue Epithelial.

S--(3) Tissue Connective.Cell --(4) Tissue Adipose.

--(5) Tissue Muscular.-(6) Tissue Nervous.-(7) Tissue Cartilaginous.

(8) Tissue Osseous.

I represents the organic cell.2 represents the eight structural elements of which

each organic cell is composed.3 represents the elemental tissues formed from the

structural elements.

Define modified forms of tissues.Remembering now the eight elemental tissues, and

their transformations from an organic cell, I wouldhave you note that each tissue has several varieties.Thus there are red and white blood corpuscles; epitheliaof the skin and different membranes; white and yellowconnective tissues; different kinds of fat or adiposetissue; striped and unstriped muscular fibre; hyalinand fibro-cartilage; compact and cancellous bone tissue.Remember that each organ or part, while composed

20


of several tissues, is in the main made up of one.Thus muscle mostly of muscular, bone mostly ofosseous and brain mostly of nervous tissue.

Define the tissues seriatim, with reference to theirvarious forms.

I. CORPUSCULAR TISSUE constitutes the active ele-ment in the blood and lymph. This is microscopic.[See Gray p. 34 to 38.]

2. EPITHELIAL. The surface of the body, thegastro-pulmonary, and the genito-urinary tracts, allblood vessels, glandular structures and body cavitiesare covered by one or more layers of cells called epi-thelial. There are several varieties of this founded onthe idea of shape and function. [See Gray p. 42 to 45.]

3. CONNECTIVE TISSUE. The varieties of this tissueare : i. White fibrous. 2. Yellow elastic. 3. Areolar.This tissue is characterized by its great strength, itsgeneral distribution and its small amount of nerve andblood supply. It is the tissue upon and within whichall the tissues and organs of the body are housed,poised, bound and constructed. It enters into the for-mation of every anatomical structure. Blood andlymph are its congeners. Under modified forms itoccurs as tendon, ligament, fascia, aponeurosis andall the peri-structures. [See Nomenclature] It wasby the ancients designated areolar tissue, areolar mem-brane. When strength is needed as in ligament andtendon, the white is found; where elasticity is the des-ideratum, the yellow is found. [See Gray p. 45 to 68.]

4. ADIPOSE. This is popularl'y known as fat. Com-mercially lard and tallow are adipose freed from itsconnective habitat. This is done by heat. Thistissue is found under the skin forming the panniculusadiposus. [See Gray p. 49.]

21

OUTLINES OF ANATOMY

5. MUSCULAR. This is the predominant tissue inthe makeup of the muscular system. The term mus-culature is applied to the muscles of one part. Thusof the arm or back. Muscles are made up of fibres.Some muscles are under the control of the will and arecalled voluntary. Still others are under the control ofthe sympathetic nerve and are called involuntary.The envelope of muscle is called peri mysium. Thisis one of the most fascinating subjects in anatomy..[See Gray p. 64 et. Seq.]

6. NERVOUs. This tissue is found in brain andnerves. Two systems are comprised: (i) The cerebro-spinal. (2) The sympathetic. There are two kindsof this tissue matter, grey and white. [See Gray p.69 et. Seq.]

7. CARTILAGINOUS. The sheath of this tissue iscalled peri chondrium. Its use is found in movablejoints, in the thoracic construction, etc. It being aderivative of connective tissue has minimum blood andnerve supply. [See Gray p. 51 et. Seq.]

8. OssEous. This is a very important tissue. Itis hard, tough, elastic. It is composed of compact andcancellous structure. The envelope is periosteum. Itwill receive attention later on. [See Gray p. 54 et.Seq.]

Thus far we have seen the organic cell broken upinto eight structural elements, and from these lattereight primary anatomical elemental tissues get theirbeing. It now remains to see these arranged in vary-ing proportions that organs, structures, and anatomi-cal substances may arise. It is to these latter expres-sions I wish to call your attention, since such termsare often used and poorly understood by students ofanatomy. The terms belong to catch-basin or police

22


court coroner's nomenclature more properly than tothe class-room. Let a suspicious find in a catch-basinbe the subject of a coroner's jury. One piece afteranother is scanned. This is pronounced liver sub-stance, that lung substance and a third spleen substanceor structure. This then is a general term, definiteonly in so far as it points to the find as belonging toan animal. The term is equivalent to a piece of liver,lung or spleen and has no regard to the anatomy.

FIRST QUIZ.

I. What is anatomical nomenclature ?

2. What is an anatomical synonym ?

3. Define anatomical opposites.

4. Define inter and give example.

5. Define infra and give example.

6. Define sub and give example.

7. What are compound words?

8. Give rule for writing them.

9. Give rule for reversion of them.

So. Define peri and give examples.

Ir. Define a tissue.

12. Name the anatomical tissues.

I3. Define an organ and structures.

14. How do tissues differ inter se ?

15. Tissues are transformed from what ?

I6. Define an organic cell.

I7. How is it made up?

23

24 OUTLINES OF ANATOMY

18. Define structural elements.

19. Define corpuscular tissue, where found ?

20. Define epithelial tissue, where found ?

21. Define connective tissue, where found ?

22. Define adipose tissue, where found?

23. Define muscular tissue, where found?

24. Define nervous tissue, where found ?

25. Define cartilaginous tissue, where found ?

26. Define osseous tissue, where found ?

27. Name the three great groups of connectivetissues.

28. Name the three varieties of fibrous connectivetissues.

3~~p~~zj ~-f~s-- 3

CHAPTER IV.

GENERAL DEFINITION.

i. Define anatomy.

The study of the physical structure of organizedbodies.

2. Define dissection.The art of dividing the connective tissue in such

manner as to do no violence to the parts.

3. Define anatomical tissues.Simple anatomical elements.

4. How many tissues are there?There are eight, out of which all the parts and

organs are made.

5. Is the converse true ?Yes, since by dissection we can regain all the

elements from the composite mass.

6. What determines tissue variety ?The special function each has to discharge under

forced environment.

7. Define an anatomical organ.A compound of two or more tissues for the dis-

charge of rhythmical and persistent physiological func-tion.

25

OUTLINES OF ANATOMY

8. Why say rhythmical and persistent ?Because all motion is rhythmical; all force is

persistent.

9. Define an anatomical system.Organs working in harmony to discharge some

special function, as the digestive, excretory, muscularand reproductive systems.

io. Define anatomical coverings.Fibrous envelopes surrounding every visible

anatomical structure.

Si1. Are they otherwise designated?Yes; togas, tunics, sheaths, capsules. The

greater number are designated by placing the preposi-tion peri before the substantive, thus: peri-osteum.

12. What are these coverings tissually ?

Each is a specialized modification of connectivetissue.

13. Do these coverings adhere closely?Not in all cases; those of the brain, heart,

tendon and kidneys are very loose.

14. Function of the coverings ?They are largely protective.

15. Define anatomical conduits.Channels for passage of fluids or solids, having

three coats and being air-communicating or non-air-communicating; the former are called mucous thelatter serous.

16. Name some mucous conduits.Gastro-pulmonary; genito-urinary.

26


17. Name some serous conduits.All arteries, veins and lymph-spaces.

18. How many coats have conduits?All visible ones have three, called inner, middle

and outer.

19. Define adventitious coat.The extra covering by the peritoneum to struc-

tures in the abdominal cavity.

20. Define anatomical root.The part of an organ, uncovered by serous

membrane, where vessels, nerves and lymphatics enterto carry on the functional and nutritive activity ofthe organ.

21. Give some example.

The root of the heart, lung, kidney.

22. Define functional activity.The exertion of an organ or viscus in the dis-

charge of its intended work in the economy.

23. Define nutritive activity.The appropriation of nutritous material for self-

sustenance.

24. Define anatomical quartette.A coinage to impress conjunction of and co-viage

of artery, vein, nerve and lymphatic.

25. Define anatomical continuity.Continuousness of structure throughout; normal

entirety; applicable to functionating parts. We speakof osseous, muscular, tendinous, intestinal continuity.

27

OUTLINES OF ANATOMY

26. Define solution of continuity.Interrupted continuousness. Such results are

known as fracture, laceration, rupture, incision, etc.

27. Define anatomical contiguity.Adjoining only. Structural sameness not im-

perative. Bone may be contignous to nerve, and thisto artery.

28. Are structures contignous in contact ?No; they are disjunctively connected by a layer

of connective tissue.

29. Explain invasion by continuity.A necrotic process extending from apex to

crown of tooth.

30. Explain invasion by contiguity.A necrotic process extending from alveolus or

gum to tooth.

31. Define a sinus.

An irregular cavity, air-communicating or non-air-communicating.

32. Define intra-mural sinuses.They are partially enclosed between the bony

walls about the skull. They are the antrum of High-more or the maxillary sinus, the frontal sinus, theethmoidal and sphenoidal cells and the mastoid cells.They communicate with the external air.

33. Define intra-cranial sinuses.They are blood channels in clefts of dura matre.

They collect blood from the brain and feed the internaljugular veins. They number fifteen and are non-air-communicating.

28


34. Define viscus.This means any organ; the plural is viscera.

Collectively we speak by stereotype of abdominal,thoracic, cephalic and pelvic viscera, meaning respec-tively all the organs in these cavities.

35. Define resiliency.The property possessed by some organs of re-

turning to their normal size after physiological orpathological engorgement. This property is enjoyedby the lung, liver, spleen, kidney, ovary, testicle,thyroid and thymus, and is due to musculo-tendinoustrabeculae extending through the parenchy matousstructure of the viscus and connecting the two sidesof the capsule.

36. Define anatomical vestiges.These are parts or organs in vestigal remnant

which now takes no active part in the economy.Through non-use they have undergone atrophy orcomplete obliteration. Some of the prominent onesare: the hypogastric arteries, the umbilical vein, theappendix, the thymus, the foramen ovale and certainvestigial remains of the foetus.

SECOND QuiZ.

i. Define anatomy.

2. Define dissection..

3. Anatoncal tissues ?

4. Number of tissues?

5. Can we regain tissues ? How?

6. How is tissue variety determined ?

7. What is an organ or viscus ?

8. Define the qualities of motion and force.

29

OUTLINES OF ANATOMY

9. What is an anatomical system ?

io. What are anatomical coverings ?i 1. How are they otherwise designated?12. Coverings composed of what ?13. How do coverings adhere?

14. Function of these coverings?15. Define an anatomical conduit.

16. Define mucous conduit.

17. Define serous conduit.

18. How many coats have conduits?

19. Define adventitious coat.

20. What is an anatomical root ?21. Give some examples.

22. Functional activity ?

23. Nutritive activity ?

24. Anatomical quartette?

25. Continuity ?

26. Solution of continuity ?

27. Contiguity ?

28. Contact in contiguity ?

29. Invasion by continuity ?

30. Invasion by contiguity ?

31. Define a sinus.

32. Intra mural?

33. Intra cranial?34. Viscus and viscera ?35. Resiliency ?

30

CHAPTER V.

OSTEOLOGY.

i. Define osteology.A subdivision of general anatomy describing the

number, form, size, structure and use of bones.

2. Why do we use osseous tissue synonymously withbone ?

Because this tissue predominates; this is a basicprinciple of the nomenclature.

3. Chemical composition of bones.About one-third animal or organic matter and

two-thirds mineral or inorganic matter.

4. Is a bone homogeneous?No; for we find outside compact structure, inside

cancellous structure and in the interior sinuses andand medullary canals.

5. What is a haversian system ?This is microscopic, consists of haversian canal,

lacunae, canaliculi and aids nutrient circulation.

6. Define periosteum.The anatomical envelope of bone, a modification

of connective tissue specialized for protection, nutri-tion and for tendinous origin and insertion of muscle.

7. Define the osteoblastic property of periosteum.The layer in contact with the bone contains

osteoblasts or bone-forming cells which make the bonegrow in thickness.

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OUTLINES OF ANATOMY

8. Define endosteum.A delicate membrane lining medullary canals and

cancellous tissue. It contains osteoblasts.

9. Define marrow or medulla.A fatty substance found in all medullary canals

and in all cancellous bone tissue.

So. How many kinds of medulla ?There are two varieties. First the yellow or

adult found in medullary canals. Second the red orfoetal found in cancellous tissue.

I1. How distinguish between the two?Adult marrow is yellow and contains 96% of fat.

Foetal marrow is red and contains i% of fat.

12. Why is this kind called foetal ?Because it resembles microscopically the marrow

normally found in all foetal bones.

13. Describe the blood-supply of bone ?Bones have a double supply of blood. First the

periosteum supplies blood. Second the nutrient artery.

14. Where does the blood leave the bone?

Through veins which emerge through forminaat the ends of the bones.

15. Define ossification.Bone-formation. There are two modes, the

intra membranous and the intra cartilaginous. Theefficient factors are the osteoblasts. [See Gray.]

I6. Define the skeleton.

The bony framework of the body.

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17. Define a natural skeleton.One bound together by natural ligaments.

18. Define an artificial skeleton.One bound together by wire or other artificial

ligaments.

19. The number of bones in the skeleton ?Vertebral column, - - - - 26Cranium, - - - 8Face, - - - - - 14Os hyosdes sternum and ribs, - 26Upper extremeties, - - - 64Lower extremities, - - - 62

200

20. Classification ?

Long, short, flat, irregular.. This you willobserve is on a geometric basis. Bones that are un-geometrical are called irregular. The short bones arefound in the carpus and tarsus. Flat bones have twotables, inner and outer, separated by cancellous tissuecalled diploe. Long bones have shaft and two ex-tremeties.

21. Define wormian bones.They are developed from a separate centre and

associated with the cranial bones in the neighborhoodof the intra-cranial sinuses.

22. Define sesamoid bones.These are developed in tendon to increase mus-

cular leverage. Example the patella.

23. Define the chief physical characters of bonysurfaces.

These are geometrical planes, geometrical em-inences and geometrical depressions.

33

OUTLINES OF ANATOMY

24. Define bony eminences.Projections above the plane-level.

25. How are eminences named?They are called processes and described as artic-

ular and non-articular.

26. As to shape, how named?Tuber, a large process.Tubercle, a very small process.Tuberosity, a broad, rough process.Head, a process having a neck.Trochanter, a process situated favorably for

rotation.Spine, a very sharp process.Line or ridge, a succession of little spines

attached.Coronoid, process like a crow's beak.Coracoid, process like a crow's beak.Mastoid, process like a nipple.Rostrum, process like a beak.Styloid, process like a pen.Squamous, process like a scale.Vaginal, process like scabbard.Azygos, without a fellow.

27. Name the depressions.Cotyloid, like a deep cup.Glenoid, like a shallow cup.Trochlear, like a pulley.Sigmoid, curved in two directions.Facet, smooth like a cut gem.Fossa, a shallow depression.Sinus, a deep cavity.Groove, a long, narrow depression.Fissure, a crack.Notch, a deficient edge.Foramen, a hole.

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28. Define epiphysis.A supplementary centre, separated from the

shaft (diaphysis) by the epiphyseo-diaphysial line.Here is where long bones grow in length.

29. Remember that the majority of descriptive termsin anatomy are at best but arbitrary appellations.They were named by the ancient anatomist in harmonywith some fancied resemblance to something withwhich he was familiar. These words must all becomehousehold words to the class.

30. Remember also that bony eminences and depres-sions are developed directly or indirectly by musculartraction.

THE SPINE.

I. How many vertebrae in vertebral column ?Thirty-three.

2. How many in each region?Cervical, 7; dorsal, 12; lumbar, 5; sacral, 5;

coccygeal, 4.

3. What are false vertebrae ?Those forming the sacrum and coccyx; the others

are called true.

4. Define flexuous and flexible.Flexuous means permanently tortuous. Flex-

ible means capable of being bent.

5. A vertebra has how many parts?

Two; a body and an arch.

6. How is the arch formed ?

Of two pedicles and two laminae.

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OUTLINES OF ANATOMY

7. How many processes has the arch?Four articular and three non-articular.

8. Define laminae, spinous processes, transverse pro-cesses, articular processes, spinal canal, venae basisvertebrae. [See Gray p. 146. ]

9. CHARACTER OF CERVICAL VERTEBRA.

Distinguished by foramen in tr. process.They are smaller than those in any other region.Describe the body.Describe the pedicles.Describe the laminae.Describe the spinous process.Describe the articular process.Each tr. pr. has two roots; the outer one is

called the costal process.Ant. and post. tubercles of tr. process.The peculiar vertebrae.

Io. ATLAS.

Has neither body nor sp. pr.The pedicles lost in ant. arch.Anterior arch.Porterior arch.Two lateral masses.Tubercle of the posterior arch.Superior grooves for vertebral arteries.Articular processes above and below.Tubercle for transverse ligament.Spinal canal for cord.Transverse processes.

i i. Axis.Why called axis?The most distinctive character ?Function and history of odontoid ?Articular surfaces of odontoid ?

36


Ligamentum suspensorium ?Odontoid or check ligaments.The pedicles and laminae.The tr. pr. and art. pr.The intervertebral notches sup. and inf.

12. VERTEBRA PROMINENS ?

The distinctive character of?Describe the sp. process.Describe the tr. process.Peculiarity of vertebral foramen ?What passes through this foramen?

13. CHARACTERS OF DORSAL VERTEBRA .

Comparative size of?How are they recognized?Define facets and demifacets.Describe the bodies.The intervertebral notches?Describe the pedicles and laminae.Describe the spinous processes.Describe the articular processes.Name the peculiar vertebrae.

14. CHARACTERS OF LUMBAR VERTEBRE.

Comparative size ?How distinguished from other regions ?Describe the body, pedicles, laminae.Art. and non-art. processes.Give the structure of vertebrae.

15. SACRUM AND COCCYX.

How many pieces in these bones in early life?Shape of the sacrum ?Define promontory of sacrum.Describe the anterior surface.Describe the posterior surface.Describe the base.

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OUTLINES OF ANATOMY

Describe number and use of ant. sac. foramina.What are the lateral masses?Name the vestigial parts.Name the articulations.Explain the sacral canal.Give peculiarities of the sacrum.Define the word coccyx.Formed of how many bones ?Shape of coccyx ?Describe base, apex, surfaces, borders.Describe coccygeal groove, sacral groove.Muscles attached to coccyx ?Vestigial remains of coccyx ?Articulation of coccyx ?

16. SPINE IN GENERAL.

Length of spinal column ?Length of female spinal column ?How many pyramids, viewed in front?How many small pyramids in upper one?How many curvatures viewed laterally?Cervical, dorsal, lumbar and pelvic.Explain anterior and posterior surfaces.The two lateral surfaces.The base summit and spinal canal.Ligaments of vertebral column.May the ligaments become ossified?Describe formation of spina bifida.

17. THE SKULL, TWENTY-TWO BONES.

Define the term.Cranium; skull bones that encase the brain.Face; skull bones that do not encase the brain.Are flat or irregular bones.They comprehend all the sinuses.Name and define the kinds of sinuses.The flat bones have outer and inner tables.The inner covering is called dura matre.

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Ant. and post. fontanelles are where?Condition of these bones in hydrocephalus?Cranial bones fed by the meningeal arteries.

i8. MEMORIZE THIS TAB]

( Cranium 8

Skull 22

Face 14

( Occipital.Two Parietal.Frontal.Two Temporal.Sphenoid.

1 Ethmoid.Two Nasal.Two Sup. Maxillary.Two Lachrymal.Two Maler.Two Palate.Two Inf. Turbinated.Vomer.Inf. Maxillary.

19. THE OCCIPITAL BONE.

Derivation of term, locate the bone.Define the bone geometrically.External surface.External occipital protuberance ?External occipital crest ?Superior curved line?Inferior curved line ?The foramen magnum and Condyles ?The transverse or jugular processes ?The paramastoid processes ?Anterior condyloid foramen ?Posterior condyloid foramen ?Basilar process and pharyngeal spine?

20. INTERNAL OR CEREBRAL SURFACE,Define geometrically,Crucial ridge and fossae.

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OUTLINES OF ANATOMY

Internal occipital protuberance.Internal occipital crest.Torcular Herophili.Basilar groove.Name angles and articulations.Jugular foramen and bone structure.

21. PARIETAL BONES.

Location and geometry of.Define the word,External surface and parietal eminence.Temporal ridge and function.Emissary parietal foramen.Internal surface and depressions.Articulations of, and grooves.

22. FRONTAL BONE.

Define the terms,The vertical or frontal portion.The horizontal or orbito-nasal portion.External surface.Median ridge or inter-frontal suture.The frontal eminence.Are they usually unsymmetrical?The superciliary ridge.The glabella or nasal eminence.The supra-orbital arch.The supra-orbital notch or foramen.This transmits what structures ?The internal angular process.The external angular process.Temporal ridge; nasal notch.Nasal process; nasal spine.Internal surface.Frontal crest; foramen ccecum.Depressions and lachrymal fossa.Ant. and post. ethmoid cells.Superciliary ridges.

40


Eth moidal notch.Give borders and articulations.Locate frontal sinus.Locate the infundibulum.

23. THE TEMPORAL BONE.

Locate and classify.Has how many portions?Define each portion.The zygoma or zygomatic process.The number of zygomatic roots.The eminentia articularis.The Glaserian fissure.Post-glenoid process and tympanic plate.Vaginal and mastoid processes.The emissary mastoid foramen.The mastoid cells, classify.Digastric fossa; occipital groove.The sigmoid fossa.Geometry of petrous portion.The meatus auditorius externus.The auditory process.The meatus auditorius internus.Styloid process and stylo-mastoid for.For minute description see Gray.

24. THE SPHENOID BONE.

Define and describe geometrically.In form resembles what ?Give the divisions of.Describe body geometrically.Ethmoid spine and optic groove.Optic foramen and olivary process.Pituitary fossa or sella turcica.Clinoid processes.Dorsum sellae, D. Ephippii.Carotid or cavernous groove.

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OUTLINES OF ANATOMY

Ethnloid crest and sphenoidal cells.Sphenoidal turbinated bones.Rostrum and vaginal processes.The ptergo-palatine canal.Greater wing.Spinous process and cerebral surface.Foramen rotundum; foramen ovale.Foramen Vesalii; foramen slinosum.The pteryoid ridge.The ant. or orbital surface.The external orbital foramina.The lesser wings. P. Ingrassias.The sphenoidal fissure.Pterygoid processes.Pterygoid fossa.Internal pterygoid plate.External pterygoid plate.Hamular process; scaphoid fossa.Vidian canal; pterygoid tubercle.Sphenoidal spongy bones.Articulations of.

25. THE ETHMOID BONE.

Define and classify.Horizontal or cribriform plate.Crista galli; perpendicular plate.The lateral masses.The ethmoidal cells.Ant. and post. ethmoid foramina.Os planum; middle turbinated.The unciform process.The superior turbinated.Ant. and post. ethmoid cells.The infundibulum.Articulations of.

26. THE NASAL BONES.

Define the bone.

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Define bridge of the nose.Describe the bone geometrically.Describe the articulations.Muscle attached.

27. THE SUPERIOR MAXILLA.

Define and locate the bone.Surgical importance of the bone.Largest bone of face, except what ?Articulates with what ?Helps from how many cavities?Helps from how many fissures?Shape of the body? Antrum?Surfaces of the body ?Canine fassa and eminence.The infra-orbital foramen.The zygomatic surface.The posterior dental canals and anterior.The maxillary tuberosity.Lachrymal notch; infra-orbital groove.Palate process; post. palatine canals.Malar process; alveolar process.Nasal process; palatal process.Orbital process; the nasal crest.

28. THE LACHRYMAL BONES.

Derivation of the term.Location of the bone.Articulations technically.Geometry and description of.Why called ossa unguis ?External or orbital surface.Lachrymal crest and function.Lachrymal groove how formed.Lachrymal sac; nasal duct.Hamular process; lesser lach. bone.Internal or nasal surface.

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OUTLINES OF ANATOMY

Name the four borders.Muscular attachment.

29. THE MALAR BONES.

Location and articulation.External and internal surfaces.Frontal, orbital, maxillary and zygom. pr.The malar foramina.Name the four borders.

30. THE PALATE BONES.

Derivation and location.Resembles what letter?Horizontal plate and surfaces.The posterior palatine canal.Accessory post. palatine canals.The perpendicular plate.The internal surface.The inferior turbinated crest.The superior turbinated crest.The external surface.Anterior border; maxillary process.Post. border; ptery goid process.The orbital process; sphenoidal pr.

31. THE INFERIOR TURBINATED.

Derivation of the word.Articulation of the bone.Location; outer wall nasal fossa.The middle and superior turbinated bones belong

to the ethmoid. They are separated from each otherby the superior meatus.

They mark the final explosion of the olfactorynerves.

32. THE VOMER.

Derivation and location.Classification; articulations.

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Nasa-palatine groove.Superior border and ale.Anterior and inferior borders.The posterior border.

33. THE INFERIOR MAXILLA.

Called also lower jaw, mandible.Function and articulation.The body and rami.Symphysis and mental process.The mental tubercles and foramen.The external oblique line.The genial tubercles.The internal oblique line.The sub maxillary fossa.The alveolar border.The surgical portion of body?The dental portion of body?Coronoid and condyloid processes.The sigmoid notch.Muscles attached.Muscles of mastication.

The lower jaw was called mandible because it aidsprehensibly in obtaining food. From this idea ofpseudo-manipulation its name mandible. It is thelargest and strongest bone of the facial group. Itgives individuality to the human face, protection tothe vocal organs, and attachment to all the muscles ofmastication. It presents the greatest variety of spec-ialized bony tissue of any osseous structure in theskeleton. Its spongy alveolar process is excavated forthe reception of the teeth; and these latter by their com-plex anatomy have given rise to dentistry, one of theleading medical specialties; its exterior is compact,having a configuration comprehending strength, utilityand beauty. The bone is so poised that when actedupon by the muscles of mastication, a variety of mas-

45

OUTLINES OF ANATOMY

ticatory motions is produced. At birth the body ofthe lower jaw is a mere shell containing the temporaryteeth. After birth the bone grows pari passu with theskeleton. In the adult the alveolar and basilar por-tions of the body are the same depth; the former iscalled the dental portion, the latter the surgical. Inold age the chief part of the body is below the externaloblique line, since the teeth have gone and the alveo-lar process has become absorbed. History here repeatsitself, for the mandible now in the actogenarian bearsa strong resemblance to that of the child prior to thefirst dentition.

34. Now review anatomical compounds, Chap. II,and study the following compounds which representthe points in relation between the various bones of theskull called joints, articulations, sutures:

Interparietal, (Sagittal.)Fronto-parietal, (Coronal.)Occipito-parietal, (Lambdoid.)Spheno-parietal.Squamo-parietal.Masto-parietal.Masto-occipital.Petro-occipital.Petro sphenoidal.One more suture or joint remains to be considered.

This is the point in relation or junction between thefrontal or facial bones. Its common name is transversesuture since it extends from one external angular pro-cess to the other. Its technical name however, wouldbe: the malo-naso-fronto-ethmo-spheno-lachrymo-max-illary articulation.

Define bregma, lambda, obelion.

35. BASE OF SKULL INTERNAL.

This part represents many interesting points.Of special importance are the foramina, since through

46


these the cranial nerves make their escape; throughthem the vertebral and internal carotid arteries pass tosupply the brain with blood; through them the intra-cranial sinuses discharge blood from the brain; throughthem the miningeal arteries pass to supply with bloodthe dura matre and cranial bones; through them theemissary veins in childhood pass to equalize the pres-sure between the internal and the external circulation.In this region we find all the special senses, so-called,located; hence the gravity of fracture here. The pri-mary divisions of this region are the anterior, middleand posterior fossae.

Study now:Foramen caccum.Crista galli.Olfactory groove.Ant. ethmoidal foramina.Post. ethmoidal foramina.The ethmoidal spine.Optic groove and foramen.Olivary body and clinoid process.The dorsum ephipii.Sella turcica.Cavernous groove.Sphenoidal fissure.Foramen lacerum anterium.Foramen rotundum.Foramen vesalii.Foramin ovale and magnum.Foramen spinosum.Foramen lacerum medium.Foramen lacerum posterium.Condyloid for. ant. and post:

36. BASE OF SKULL EXTERNAL.This is very irregular. Study these.Anterior palatine fossa.

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OUTLINES OF ANATOMY

Foramina of Stenson and Scarpa.The incisive foramina.The posterior palatine formina.Tuberosity of the palate bone.The posterior nasal spine.The pterygo-palatine canals.Pterygoid or Vidian canal.The scaphoid fossa.The hamular process.Pharyngeal spine.Foramen ovale and spinosum.Glenoid fossa; styloid process.Stylo-mastoid foramen.Auricular fissure.Digastric fossa.Occipital groove.Foramen lacerum medium.Petro-sphenoidal suture.Jugular fossa and for. magnum.Jugular process.Ant. condyloid fossa and foramen.Post. condyloid fossa and foramen.External occipital crest.Is there an internal? Why ?External occipital protuberance.Sup. and inf. curved lines.

37. LATERAL REGION OF SKULL.

Give the boundary lines.Study: temporal fossa; mastoid portions.The zygomatic fossa.The spheno-maxillary fissure.Pterygo-maxillary fissure.The spheno-maxillary fossa.

38. THE ANTERIOR REGION OF THE SKULL.

Give boundaries of the face.Study superciliary ridges; glabella.

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Nasion and nasal arch.The anterior nares.The anterior nasal spine.The intermaxillary suture.Symphysis of chin; mental process.Mental tubercles; incisive fossa.Supraorbital ridge and foramen.Infraorbital foramen; canine fossa.The mental foramen; external obl. line.This region is excavated for the reception of the

eye and nose; that for the former is called the orbit,for the latter the nasal fossa. These excavations con-tain much interesting anatomy and should be studiedfrom specimens only.

39. THE ORBIT.

Name the bones forming the orbit.Which three help form both orbits?Study the roof, floor, apex.Inner and outer wall of each.Also angles and circumference.

40. THE NASAL FOSSAE.Define a fossa.Study: boundary lines of.Anterior and posterior nares.Largest measurements, where?Communicate with what four cavities ?And through what channels?Formed by what fourteen bones?Upper; floor; septum.The outer wall; sutures in.The three meatuses; the turbinals.Orifice of antrum; nasal duct.Study:Supraorbital arch.Internal angular process.External angular process.

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OUTLINES OF ANATOMY

Zygomatic arch.Mastoid process.External occipital protuberance.Superior curved line.Parietal eminence.Temporal ridge.Frontal eminence.Superciliary ridge.Nasal bones.Lower margin of orbit.Lower jaw.

41. THE HYOID BONE.

Derivation of the word ?Also called the lingual bone.Study body and four cornua.Borders and surfaces.

42. THE THORAX.

Why an osseo-cartilaginous cage?Normally contains what?Give its boundaries, size, shape.Name bones forming same.Name cartilages of.Name technically these points:Between sternum and rib.Between sternum and cartilage.Between rib and vertebra.Between sternum and clavicle.Name the openings.Name spaces between ribs.How many intercostal spaces?Define the subcostal angle.Define floor of thorax.Differences between male and female thorax-

43. THE STERNUM.Define the term.Locate and classify the bone.

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Name its articulations.Name its ligaments.Name its three portions.Derivation of each.Study: manubrium (pre-sternum).Gladiolus (meso-sternum).Ensiform, xiphoid (meta-sternum).

44. THE RIBS.Number and classification.True, false and floating.Intercostal spaces and structures.Articulations: common characters.Study: Surface and borders.Head, neck, tubercle, angle.Subcostal groove.Costo-sternal ligaments.Name the peculiar ribs.Define costal cartilages.

45. THE UPPER EXTREMITIES.

Define the shoulder girdle.Name the bones of up. extr.Clavicle, define and classify.Articulations of: borders: surfaces.Conoid tubercle: deltoid tubercle.Subclavian border.Sternal extremity: acromial ex.

46. THE SCAPULA.

Define and locate the bone.Give its articulations.Anterior and ventral surface.Subscapular fossa.Subscapular angle.Posterior surface; spine.Supraspinous and infraspinous.Describe the acromion.

5I

OUTLINES OF ANATOMY

Costae or scapular borders.Suprascapular notch and foramen.Borders of scapula.Infraglenoid tubercle ?Angles of the scapula?Coracoid process.Muscular attachments.

47. THE HUMERUS.Describe and classify the bone.Study: the scapulo-humeral joint.Anatomical and surgical necks.Greater and lesser tuberosities.Bicipital groove and lips..Coraco-brachial impression.The nutrient canal.The deltoid impression.The musculo-spiral groove.Internal and external condyle.The condyloid ridges.The trochlear surface; capitellum.Olecranon and coronoid fossae.

48. THE ULNA.

Study: olecranon and coronoid.The greater sigmoid cavity.The lesser sigmoid cavity.The rough imp. ant.Eminence and tereal ridge.The shaft; nutrient foramen.External sharp. border.Head; styloid process.Groove for tendon of ulno-carp. ext.

49. THE RADIUS.

Study: head, neck, tuberosity.Shaft, interosseous border.The nutrient foramen.Carpal extreme; artic. surface.

52


Sigmoid cavity; styloid pr.Grooves for extensor tendons.

50. THE HAND.

Carpus 8; metacarpus 5; phalanges 14.

Arrangement of carpal bones.Scaphoid, semilunar, cuneiform, pisiform.Trapezium, trapezoid, os magnum, unciform.Give articulations of each.Describe the phalanges.

51. THE LOWER EXTREMITY.

Composition of this extremity.The hip-os innominatum.Study: ilium, ischium, pubes.Acetabulum, cotyloid cavity.Cotyloid notch; obturator foramen.Ilium: ant. sup. spine and crest.Poupart's ligament.Ant. inf. spinous process.Superior and inf. post. spines.The inter-spinous notch.Greater sacro-sciatic notch.Lesser sacro-sciatic notch.The three curved lines.How are these developed ?Dorsum, venter and groove.Ilio-pectineal line.The auricular surface.Ischium: body spine groove.The lesser sacro-sciatic notch.The tuberosity; asc. ramus.Pubes: ramus, horizontal and descending.Ilio-pectineal eminence.Symphysis; ilio-pectineal line.Crest, spine and obturator groove.Angle and descending ramus.Iliac fossa; true and false pelvis.

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OUTLINES OF ANATOMY

52. THE FEMUR.

Location and articulations.Ligaments and classification.Head, neck and tereal depression.Greater and lesser trochanter.The diagonal line.Intertrochanteric lines.Linea aspera and nutrient foramen.Spiral line and popliteal space.Condyles and their ridges.Gastrochnemial depressions.Intercondyloid notch.Int. tuberosity; adductor tubercle.Describe and locate the patella.

53. FIBULA.

Locate and name articulations.Lateral tuberosities.Spine and ovoidal facets.Tubercle for lig. patellae.The popliteal notch.Fibular facet; oblique for pop. fascia.The nutrient foramen.Comparative sizes of this.Interosseous ridge; int. mal.Fibula.-The peroneal bone.Define term and locate the bone.Articulation of; styloid process.Shaft and interosseous ridge.Nutrient foramen. Ext. mal.

54. THE FOOT.

Tarsus, metatarsus, phalanges.Name the tarsal bones.Give their articulations.Describe metatarsals and phalanges.

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CHAPTER VI.

THE ARTICULATIONS.

55. THE ARTICULATIONS.A joint is any place in the body where two or

more bones or cartilages are brought together to ac-complish either firm union for protection or firm unionto ficilitate and make motion possible. The sciencethat technically treats of these joints or points in bonyunion, is called arthrology. Confusion often arises inthe mind of the student as to the true import of a joint,forgetting as he seems to do, that a joint may be ajoint and still possess no motion. Again the greatarray of adjectives, descriptive of different kinds ofjoints, often tends to confuse rather than instruct. Theobject of this chapter is to so analyze the subject ofarticulations, and the philosophy of joint-nomenclature,that no careful and thoughtful student need have otherthan a clear conception of this much-abused and trulyinteresting department of descriptive anatomy.

As in mechanics it is necessary to know that someengines are portable while others are stationary, so inarthrology it is necessary to know that some joints aremovable while others are immovable. This principleonce understood, 'tis an easy secondary considerationto follow out departures from the typical ones thatmove, or the typical ones that do not move. In thiscase let us follow our common practice of teaching, byconsidering first, either that which we already know,or that which we may most easily acquire: i. e., let usturn our attention to immovable joints known synony-mously as immovable articulations.

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OUTLINES OF ANATOMY

56. THE IMMOVABLE JOINTS.As the name implies, these are joints which have

no motion, as the joint between the parietal bones,between the frontal and parietal, etc. This kind ofunion is called joint by syn-arthrosis. This is a com-pound word composed of the preposition syn (with)and arthrosis (framing, uniting); varieties arise in thismanner, viz.: in the manner, mode, form, wuay in whichone edge is framed to or united with another. Thus ifthe union presents the appearance of two cog-wheelsharmoniously working together, the borders being reg-ularly indentated, thus the union, junction, joint orarticulation, from its striking resemblance to a seam,is called the sutural or seamed variety of immovablejoints or synarthrosis. If, however, as occurs, some ofthe surfaces are true indented border, while others arelocked or articulate simply by rough surfaces the for-mer are called true sutures [sutura vera], while thelatter are called false sutures [sutura not/za]. Nowagain if these true sutures resemble tooth-like processesthey are called dentate; if they resemble saw edgesthey are called serrate; if they have beveled marginsand indentated processes, they are called limbose. Againif the false sutures [or rough surfaces] have thin,overlapping edges, they are called the scaly or squa-mous kind; while if the contiguous surfaces are joinedby harmonious apposition, then they are called har-monia. If the immovable joint has the appearance ofa process of bone in a socket it is called gomphosis.While the appearance is as a plate of bone fitting in afissure then the term schindylesis is used. Summingup then this tedious argument we see this: i. Thedentate, the serrate and the limbose varieties of truesatural immovable joints. 2. The squamous and har-moneous varieties of false sutural immovable joints.3. The gomphosal [or nail driving] variety of immov-able joint. 4. The variety, by schindylesis, of im-movable joint.

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57. THE MOVABLE JOINT.

The dominating idea is laxity of union, permit-ting of motion, and we shall find that the classificationis founded on the degree of this motion. The simplestkind of motion is gliding on one plane. This is calledarthrodia. The next kind is gliding on two planes,called di-arthrodia; while a more complicated varietyis a combination of all the planes of a planal circle oren-arthrodia. To name the class properly, the anat-omist selected neither the simplest nor the most com-plex, but one truly representative of all the varieties,which is the one moving on two planes, hence all themovable joints belong to the di-arthrodial variety.The sub varieties named after fancied resemblancesare ginglymus, trochoids, condyle, reciporal reception.

58. THE MIXED JOINT.

A variety of union possessing neither the freemobility of the one nor the extreme fixidness of theother, but being a compromise mixture of the charactersof both is called a mixed joint or amphi-arthrosis. Wesee the dual idea in our words amphi-bians, amphi-theatre, etc. These joints possess no synovial mem-brane for lubricant purposes, since this would makemotion free, nor do they possess sutures, since thiswould make motion impossible. One variety is unitedby fibro-cartilage and called symphysis, the other isunited by interosseous ligament and called syndos-mosis.

SDentata.Sutura vera Serrata.

Sutura Limbosa.

Synarthrosis Schindylesis. Suturanotha rmonia.

LGomphosis.

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OUTLINES OF ANATOMY

Amphi- arthrosis Sym physis.Endosmosis.

Ginglymus.Trochoides or pivot joint.

Diarthrosis Condyloid.Reciprocal Reception.Enarthrosis.Arthrodia.

59. Articulating surfaces are held together by liga-ments. This is true of all articulations regardless ofclassification. The ligaments are all derived from thesame source, i. e., from the periosteum. Let us under-stand this well. Take for example any movable jointas the shoulder. This is an articulation between thehumerus and scapula, technically called humero-scapu-lar. It will be remembered that each bone is coveredby an anatomical envelope of connective tissue, calledperiostium; now in the instance above cited, this peri-osteum bridges over the space between humerus andscapula, enclosing or encapsulating the articular endsof the bone. For this reason capsular ligament iscalled the basis of every movable join. The exteriorof the capsule is strong and protective; the interior ofthe capsule secretes synovia for lubricating the joint.Hence synovial membrane is the inner specialized partof capsular ligament, and does not exist as a separatemembrane or sac, as students sometimes think it does.

The parts forming an immovable joint are boundtogether in the same manner by periosteum, but fromthe fact that typical immovable joints are called sutural,the ligament, or binding periosteum, here is calledsutural ligament. Capsular ligament then is the basisof movable joints, while sulitral ligament is the basisof all immovable joints. Every ligament is a modifi-cation of connective tissues specialized for binding, anda derivation of periosteum. [See Gray p. 315.]

58


6o. The individual ligaments will be thoroughlydemonstrated on the cadaver and from our preparations.A few words, however, must here be said pertainingto the naming of ligaments. Luckily this is easy if yourecall anatomical bony compounds, [see Ch. ii.] Herewe see a host of compound words, as tibio-fibular,radio-alnar, etc., simply designating anatomical bonyrelationship. Now the ligaments binding these bonestogether are known by the same names; hence wespeak of tibio-fibular, radio-ulnar ligaments. If, how-ever, we wish to designate the bond of union aboveor below between tibia and fibula then we would saysuperior or inferior tibio-fibular ligaments. If againwe wish to be specific in our designation then we cansay internal, external, anterior or posterior part of acertain union above or below. If you will apply thismethod of analysis, bone and ligament in hand, youwill soon see why they are so called, and be able toname ligaments with ease and precision. [See Gray.]

61. Capsular ligament is the basis of every mov-able joint. Sutural ligament is the basis of immovablejoints. The. inner layer of capsular ligament isspecialized synovially. Mixed joints have littlemotion, but no synovial membrane. The structuresentering into the formation of a movable joint are:bone, articular lamella, articular cartilage, ligament,synovial membrane, articular arteries and nerves, andinter-articular fat. The structures forming immovablejoints are: the articular surfaces of the bone, separatedby connective tissue [see A 50o] and bound together bysutural ligament. The main factor holding movablejoints together is atmospheric pressure. Muscles pas-sing over a joint are said to act in a ligamentouscapacity to the joint.

59

CHAPTER VII.

MUSCLES AND FASCIA.

i. Define a muscle.

The lean meat of an animal.

2. Define muscular contraction.

Shortening, i. e.: bringing the origin and insertionof the muscle closer together.

3. Define origin and insertion.

These are arbitrary terms; the former means themore fixed point, while the latter applies to the moredistal end.

4. Define a voluntary muscle.One under the will-control. The majority of

muscles are voluntary.

5. Define an involuntary muscle.Ones under sympathetic control. The heart, di-

gestive organs. etc.

6. Origin and insertion apply to what?To voluntary muscles.

7. How are muscles inserted and how do they taketheir origin?

They do this by tendon, fascia and aponeurosis.

8. Upon what does contraction depend?

Upon fibres composed of sarcous elements.61

OUTLINES OF ANATOMY

9. Name the envelope of muscle.

Perimysium.

Io. Tendon, fascia, aponeurosis, perimysium, in-ternal and external, can be more fully and profitablydemonstrated on the cadaver.

i 1. Do muscles have more than one head or origin ?

Yes, at times: bicipital, tricipital and quadricip-ital designate respectively one, two and three heads.

12. What are muscles of mastication.

Those that move the lower jaw and triturate thefood. They are supplied by the fifth cranial nerve.

13. Define muscles of expression.

Those surrounding the orbits, mouth and nose.They preside over facial pantomime. They are sup-plied by the seventh cranial nerve.

14. Name the muscles of mastication.

The temporal, masseter, buccinator and ptery-goids. Give the origin and insertion of these and theirnerve supply.

15. Study the following muscles on the cadaver.Origin, insertion, nerve-supply.

Occipito-frontalis.Attolens aurem.Retrahens aurem.Atrahens aurem.Orbicularis palpebrarum.Corrugator supercilii.Tensor tarsi.Levator palpebrae superioris.Pyramidalis nasi.Levator labii superioris alaeque nasi.Dilator naris anterior.

62


Dilator naris posterior.Compressor nasi.Compressor narium minor.Depressor alae nasi.Levator labii superioris.Levator anguli oris.Zygomaticus major.Zygomaticus minor.Levator labii inferioris, (levator menti).Depressor labii inferioris, (quadratus menti).Depressor anguli oris.Orbicularis oris.Risorius.

16. MUSCLES OF THE NECK.

Give the origin, insertion and nerve-supply ofthe following muscles:

Platysma-myoides.Sterno-cleido- mastoid.Sterno-hyoid.Sterno-thyroid.Thyro-hyoid.Omo-hyoid.Digastric.Stylo-hyoid.Mylo-hyoid.Genio-hyoid.Genio-hyo-glossus.Hyo-glossus.Stylo-glossus.Lingualis.

17. PALATAL REGION.

Levator-palati.Tensor palati.Azygos uvulae.Palato-glossus.Palato-pharyngeus.

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OUTLINES OF ANATOMY

i8. VERTEBRAL REGION.

Rectus capitis anticus major.Rectus capitis anticus minor.Rectus lateralis.Longus colli.Scalenus anticus.Scalenus medicus.Scalenus posticus.

19. MUSCLES OF THE BACK.

Trapegius.Ligamentum nuchae.Latissimus dorsi.Levator anguli scapulae.Rhomboideus minor.Rhomboideus major.Serratus posticus superior.Serratus posticus inferior.Splenius capitis et colli.Erector spine and divisions.

20. MUSCLES OF ABDOMEN.

External oblique.Internal oblique.Transversalis.Lumbar fascia.Rectus Abdominis.Pyramidalis.Sheath of the rectus.Deep epigastric artery in.

21. MUSCLES OF THORAX.

External intercostals.Internal intercostals.Infracostals.Triangularis sterni.Levatores costarum.

64


Diaphragm and nerve-supply.Openings of the diaphragm.

22. MUSCLES OF ARM AND SHOULDER.

Pectoralis major and minor.Subclavius and serratus mugnus.Deltoid and subscapularis.Supraspinatus and infraspinatus.Teres major and minor.Coraco-brachialis.Biceps flexor cubiti.Brachialis anticus.Triceps extensor cubiti.Subanconeus.

23. MUSCLES OF THE FOREARM.Pronator radii teres.Flexor carpi radialis.Palmaris longus.Flexor carpi ulnaris.Flexor sublimus digitorum.Flexor profundus digitorum.Flexor longus pollicis.Pronator quadratus.Supinator longus.Extensor carpi radialis longior.Extensor carpi radialis brevior.Extensor communis digitorum.Extensor minimi digiti.Extensor carpi ulnaris.Anconeus and spinator brevis.Extensor ossis metacarpi pollicis.Extensor primi internodii pollicis.Extensor indicis.Anterior annular ligament.Posterior annular ligament.Palmar fascia.

OUTLINES OF ANATOMY

24. MUSCLES OF THE HAND.Abductor policis.Opponens pollicis.Flexor brevis pollicis.Adductor Pollicis.Palmaris brevis.Adductor minimi digiti.Flexor brevis minimi digiti.Opponens minimi digiti.Lumbricales and dorsal interossei.Palmar interossei.

25. MUSCLES OF THE LOWER EXTREMITY.

Psoas magnus and parvus.Iliacus and fascia lata.Poupart's ligament and saphenous opening.Tensor vaginae femoris.Sartorius and rectus femoris.Vastus externus.Vastus internus.Crureus and subcrureus.Gracilis and pectineus.Adductor longus and brevis.Adductor magnus.Gluteus maximus.Gluteus medius.Gluteus minimus.Pyraformis and biceps.Obturator internus.Obturator externus.Gemellus superior and inferior.Quadratus femoris.Semi-tendinosus.Semi-membranosus.

26. MUSCLEs oF THE LEG.

Tibialis anticus.

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Extensor proprius pollicis.Extensor longus digitorum.Peroneus tertius.Gastrochnemius.Soleus and plantaris.Popliteus and flexor longus pollicis.Flexor longus digitorum.Tibialis posticus.Peroneus longus.Peroneus brevis.

27. FOOT.

Anterior annular ligament.Internal annular ligament.External annular ligament.Plantar fascia.Relation of to deep fascia?Extensor brevis digitorum.Abductor pollicis.Flexor brevis digitorum.Abductor minimi digiti.Flexor accessorius.Lumbricales.Flexor brevis pollicis.Adductor pollicis.Flexor brevis minimi digiti.Transversus pedis.Dorsal interossei.Plantar interossei.

67

CHAPTER VIII.

THE VASCULAR SYSTEM.

I. THE VASCULAR SYSTEM.

The heart, arteries, veins and lymphatics com-prise this system, although the lymphatic system oftenreceives separate description. The heart is called aninvoluntary muscle; arteries and veins are anatomicalconduits. How many coats? The capillaries consti-tute the indefinite borderland between the arteries andveins. Veins are superficial and deep. The latteraccompany arteries and are called the venae coniites ofthese. Deep veins have more valves than superficialones. The superficial veins are found between twolayers of connective tissue or superficial fascia. [SeeAx 51.] By stereotype we say arteries convey pureblood and veins impure. Exceptions to the rule: pul-monary veins, umbilical vein.

2. Study: The mediastinal spaces.The pericardium, endocardium.Base and apex of heart.Root and nerve supply of heart.Relation of pericardium to diaphragm.The auricles and ventricles,Auriculo-ventricular openings and valves.Interior of ventricles and auricles.Systemic circulation.Pulmonic circulation.Foetal circulation.

69

OUTLINES OF ANATOMY

3. ARTERIES.

How many coats? Describe each.

Why are they called arteries?

How are arteries nourished?By little vessels called vasa vasorum.

How are they innervated?By nerves called nervi vasorum.

What is their function?To increase or lessen the calibre.

Where is the capillary system?Between the arterial and venous trees.

Study: Aorta and its arch.Define thoracic aorta.Define abdominal aorta.Study these branches:The coronary arteries.The innominate arteries.The left common carotid.The left subclavian.The pericardiac.The bronchial.The cesophageal.The posterior mediastinal.The intercostals.The phrenics and spermatics.The cceliac axis.The gastric and hepatic.The splenic and lumbar.The superior and inferior mesenterics.The renal and suprarenals.The sacra media.Describe internal and external carotids.Branches of internal maxillary.Describe circle of Willis.

70


Give its formation.Describe the subclavian and branches.The vertebral and thyroid axis.The internal mammary.

4. Study the axillary and branches:Superior thoracic.Acromio-thoracic.Long thoracic.Subscapular and alar thoracic.Ant. and post. circumflex.Study the bronchial and branches:Sup. and inf. profunda.Nutrient and muscular.Anastomotica magna.The radial and branches.The ulnar and branches.The arches in the palm.

5. THE THORACIC AORTA.Name and describe its branches.Give extent of thoracic aorta.Describe the abdominal aorta.Study branches of ccelise axis.Describe common iliac.Give branches of internal iliac.Give branches external iliac.Define femoral artery.Common femoral and deep.Hunter's canal and sup. femoral.Describe Scarpa's triangle.Describe the popliteal space.Give boundaries and contents.Describe popliteal artery.Locate anterior tibial and branches.Locate posterior tibial and branches.Describe pulmonary artery.Describe the portal circulation.

71

OUTLINES OF ANATOMY

Describe circulation in bone.Name the extra-vascular structures.Define vascular structures.Derivation of the term ?

6. THE VEINS.

Describe the structure of a vein.Describe the venae cavae.Describe the azygos veins.Describe the brachio-cephalics.Name thoracic branches of vena cava.Name abdominal branches of vena cava.Give formation of portal vein.Describe the hepatic vein.Describe iliac and femoral veins.Law. Veins above the diaphragm, when not on

the same plane, are situated in front of the arterieswhich they accompany; below the diaphragm they arebehind the same. Exception: the renal.

Name the cerebral sinuses.Where do they discharge ?

72

CHAPTER IX.

DIGESTIVE ORGANS.

i. In what cavities are the viscera found ?In the thoracic, abdominal, pelvic and cranial.

2. Of what does the digestive apparatus consist ?Of the alimentary canal and certain accessory

organs. This is an anatomical conduit.

3. What are the subdivisions of?Mouth, pharynx, ocsophagus, stomach, small and

large intestine.

4. Name the accessory organs?Teeth, salivary glands, liver, pancreas and spleen.

5. Subdivisions of the large intestine ?An abdominal portion and a pelvic portion; the

former is called colon, the latter rectum.

6. Subdivisions of the colon ?Ascending colon from right iliac fossa to hepatic

flexure, transverse colon, from hepatic flexure tosplenic flexure, descending colon from splenic flexureto pelvic. Sigmoid and rectum are subdivisions ofpelvic portion of colon.

7. Subdivisions of small intestine ?Duodenum, jejunum, ilium.

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OUTLINES OF ANATOMY

8. Distinguish between small and large intestine.The large intestine has longitudinal bands, fatty

masses and sacculations. The bands are muscular,equidistant and terminate in the appendix. The largeintestine becomes progressively smaller. The point injunction between ileum and colon is called ileo-colic,guarded by a valve of the same name.

Study: the liver and its ligaments;Its lobes and fissures;Portal vein and Glissons capsule.Study: the stomach;Its surfaces and curvatures;Its orifices and extremities;Its blood and nerve-supply.

What kind of cavity is the abdominal?A serous cavity, having a parietal layer that lines

the walls, and a visceral layer that covers the viscera.

9. Define the function of the peritoneum.It secrets a fluid for lubrication, is an adventi-

tious coat for the viscera, and forms ligaments for theorgans.

io. Define omenta.These are three ligamentous structures connect-

ing the stomach to the liver, spleen and colon, calledgastro-hepatic, gastro-splenic, gastro-colic.

I1. Define mesentery.There are two mesenteries. The mesentery of

the small intestine and the mesentery of the colon, theformer is called the mesentery proper, the latter meso-colon.

12. What is the cavity of the peritoneum ?

The space between the visceral 'and parietallayers of the peritoneum.

74

AND LECTURE SYLLABUS. 75

13. Are the viscera in the peritoneal cavity ?No; all blood-vessels and all the viscera are be-

hind both layers of peritoneum.

14. Define true and false pelvis.The true pelvis is below the brine, the false

pelvis above this line.

15. Describe the pharynx, its openings, muscles.coats.

16. Study the mouth and hard palate.The pillars of the fauces.The isthmus of the fauces.The tonsils and soft palate.Opening of Steno's duct.Opening of Wharton's duct.The sub-maxillary gland.The sublingual gland.The parotid gland.Study and describe the tongue;Its nerve and blood supply.

CHAPTER X.

THE TEETH.

i. Number of temporary or milk teeth ?

Ten in each jaw; four incisors, two canines,four molars.

2. Number of permanent teeth ?

Sixteen in each jaw; four incisors, two canines,four bicuspids or premolars, six molars.

3. Every tooth has what parts?

Crown or body, neck, fang or root, and pulpcavity.

4. Define the gum and its function.

It is composed of dense connective tissue coveredby mucous membrane, and by it the teeth are steadiedin the gum.

5. What holds the fang in the alveolus ?

The periosteum, here technically called peri-dontium.

6. Locate the neck of the tooth.

It is between the crown or body and fang. It isa constriction and closely invested by the gum.

77

OUTLINES OF ANATOMY

7. Define the pulp-cavity.A natural cavity filled with tooth pulp in which

are found blood and nerves.

8. How gains the blood access here?The blood and nerves reach the pulp by a canal

at the apex of the root.

9. What is the pulp?A vascular connective tissue.

io. Give function and derivation of incisor, canine,bicuspid, molar.

i I. What helps retain the food between the occlud-ing surfaces of the molars, and at the same time antag-onizes the action of the tongue ?

12. Define deciduous teeth.Deciduous teeth, milk teeth, dents lactei, dents

caduci, and dentes temporarii are terms synonomouswith temporary teeth. [See i above.]

13. Define triturating surface.The part of the occluding surface specialized for

grinding.

14. Give dental formula for milk teeth.It is I I, C , M 2=20.

15. Give formula for permanent teeth.

It is I 2, C }, prm. 2, M 3=32.

16. Define wisdom teeth, where found and whyso called.

17. Define lingual, labial, median and distal sur-faces of teeth.

78

AND LECTURE SYLLABUS. 79

i8. Define cuspidati, bicuspidati and multicuspidati.

These are synonyms respectively for cuspids,bicuspids and molars.

19. Give the nerve supply of the teeth.

From the anterior and posterior dental branchesof the superior maxillary division of the fifth cranialnerve, and from the inferior maxillary division of fifth.

20. Give the blood supply.

From the alveolar and infra orbital branches ofthe internal maxillary and from the inferior dentalartery.

21. Define the dental arch geometrically.

22. Define dentes incisives, incisores and primores;dens sapientiae, dens serotinus: dentes molares, dentesmulti-cuspidati, dentes maxillares; dents cuspidati,dents canini, dentes angulares, dentes laniarii, dentes.oculares, dentes mordentes, eye teeth and stomachteeth.

CHAPTER XI.

THE MOUTH.

i. What does the mouth contain.The organs of taste, mastication and the greater

part of those of speech.

2. Define buccal orifice and fauces.The former is the opening into the external

world; the latter the one into the pharynx.

3. Define the vestibule of the mouth.The space outside the teeth and enclosed by the

lips and cheeks.

4. How is the mouth bounded?Anteriorly by the teeth and alveolar arches, above

by the hard palate, below by the tongue; behind itopens into the pharynx.

5. Where are the angles of the buccal orifice?They are opposite the first bicuspid tooth.

6. Of what do the cheeks consist ?Of the buccinator muscle, fat, dermal muscles

and mucous membrane.

7. Define the labial fraenum.A fold of mucous membrane connecting the lip

with the gum.


8. The roof of the mouth consists of what ?The hard and soft palate.

9. Where is the tonsil ?Between the pillars of the palate.

io. How are these pillars formed?The anterior one by the palato-glossus muscle,

covered by mucous membrane, the posterior one by thepalato-pharyngeus.

I i. Define the fauces.A passage from the mouth to the pharynx be-

tween the niches for the tonsils. Its floor is formed bythe posterior third of the tongue.

12. Describe the isthmus of the fauces.This is sometimes called the anterior palatine

arch; it is formed by the anterior pillars of the palate.

CHAPTER XII.

NASAL CAVITIES.

I. Define the nasal cavities.

Two air cavities occupying the middle part ofthe skull between the orbits.

2. Define anterior and posterior nares.

The openings whereby these cavities communi-cate with the external world in front and with thepharynx behind.

3. How are they separated ?

By the nasal partition.

4. The outer wall presents what?

Three turbinals separated from one another andthe floor by three meatuses called superior, middle andinferior.

5. How are the nasal cavities separated from the-oral and cranial cavities ?

By the roof and floor respectively.

6. By what other names are the nasal cavities known ?

They are called nasal fosse, nasal sinuses, cavinarium, caverna narium and fossa nasales.

83

OUTLINES OF ANATOMY

7. Where is the superior meatus ?Above the superior and middle turbinal. Into it

the post. ethmoidal cells, the spheno-palatine foramenand sphenoidal sinus open.

8. Where is the middle meatus ?Between the middle and inferior turbinal. With

it the antrum and infundibulum communicate.

9. Where is the inferior meatus ?Between the inferior turbinal and floor of the

fossa. Into it the nasal duct opens.

io. Locate the maxillary sinus.This, also called antrum of Highmore, is the

hollow body of the superior maxilla. It is triangular.

11. What do you find on the posterior wall of theantrum ?

The posterior dental canals; on its floor areprominences produced by the first and second molarteeth.

12. Do the nasal fossae have important communica-tions ?

Yes, with all the more important fossa andsinuses of the skull; with the. cranial cavity throughforamina in the roof; with the fronlal and anterioretlzmoidal cells, through the infundibulum; with thepost. ethmoidal and sphenoidal cells; with the spleno-maxillary fossa, through the spheno-palatine foramina;with the antra; with the orbits, through the nasalducts; with the buccal cavitiy, through the anteriorpalatine canals; and indirectly with the middle ear andmastoid cells, through the eustachian tube. It willthus be seen that the nasal fossae communicate withall the intramural sinuses, hence these latter are asso-ciated with vocalization.

84

CHAPTER XIII.

THE LUNGS.

i. Define the lungs.They are the adult organs of respiration.

2. What is the foetal organ of respiration ?The placenta.

3. Where are the lungs found ?In the thoracic cavity, separated from each other

by the heart and other contents of the mediastinum.

4. Define mediastinum.Thoracic space not occupied by lung, divided

into anterior, middle and posterior.

5. Define pleura.A serous membrane having two layers, one of

which invests the lung and is called visceral fleura,another of which invest the inner surface of the thor-acic cavity called parietal pleura.

6. Define root of lung.The place where structures enter to carry on the

functional and nutritive activity of the lung. [SeeAx. ii.] These structures are: bronchial tube, pul-monary and bronchial arteries and veins, their lym-phatics and nerves.

7. What important relations in front of and behindthe lung-root ?

The phrenic nerve in front, the pneumogastricbehind.

8. Study from the cadaver the contents and relationof all structures in the mediastinum.

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CHAPTER XIV.

THE NERVOUS SYSTEM.

i. Define the nervous system.

The brain, spinal cord and sympathetic, withtheir nerves and ganglia.

2. Give the two divisions of the nervous system.The cerebro-sinal or that presiding over volun-

tary animal life, and the sympahzelic or that whichregulates organic life.

3. Principally what kind of tissue do we find in thenervous system.

The predominating tissue is called nervous, ofwhich there are two varieties, viz.: the gray or vesicular,and the white or fibrous.

4. Define the function of each.The gray originates ideas, and receives impres-

sions, the fibrous (nerves) does the conducting. Thismay be rendered more comprehensible by comparingthe one to the chemicals of a battery, the other to thewires; this originates an electrical impulse, while thatconducts it. If you will keep this constantly in mindyou have but little trouble in mastering the nervoussystem. Remember you will see the gray and whitein many different relations, but the physiological lawreferred to is immutable.

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OUTLINES OF ANATOMY

5. How are nerves constructed?After the nerve formula. [See Ax. 45.1

6. How is the gray constructed ?As nucleated cells having processes called poles.

7. Define unipolar, bipolar, multipolar cells.Cells having one, tivo or more processes.

8. How do sensory nerves terminate ?In a final explosion variously designated plexuses,

end-bulbs, tactile corpuscles, tastes, goblests, etc., the-principle being to expose a larger surface to the specialexternal disturbing influence.

9. Define peripheral organs.Organs connected to nerve-centres by nerves.

io. Define commissure.

These are nerves connecting one nerve-centre-with another.

i i. Define cerebro-spinal nerves.The larger and more conspicuous nerves that

proceed from the brain and cord.

12. The brain and cord together are called what?The cerebro-spinal axis.

13. To what are cerebro-spinal nerves distributed ?With one exception, to skin, special sense organs

and voluntary muscles.14. Name the exception.

The pneumo-gastric, which is distributed tointernal viscera; aside from this the sympathetic is thenerve of sensation and motion to the internal organs.

15. How do motor nerves end?In motorial end-plates.

88


16. Are the arterial terminations well understood ?No.

17. Define centripetal, centrifugal, centro-parietal,parieto-central, afferent and efferent.

These terms are founded on the idea of directionto or from the brain to peripheral organs.

18. The cerebro-spinal system comprehends whatorgans?

The brain, spinal cord, spinal nerves and cranialnerves.

19. Name the meninges or membranes of the brain.The dura mater, arachnoid and pia mater.

20. Distinguish between the dura of the brain andthat of the cord.

The dura of the brain has processes, sinuses andattachment; that of the cord none of these.

21. Read up Pacchionian bodies piamater and arach-noid, neurilemma, medullated and non-medullatednerve-fibres.

22. Give weight of the brain.49 oz. in males and 44 oz. in females.

23. What arteries supply the brain with blood?The internal carotid and vertebral. These unite

to form the anastomotic wheel known as the circleof Willis from which the brain receives its blood.

24. What are the miningeal arteries?They are vessels that supply the dura mater and

the calvarium, principally the latter.

25. Define neurology.That branch of anatomy which treats of the

nervous system.

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OUTLINES OF ANATOMY

26. Define cephalic, encephalon, anen-cephalic andcalvarium.

27. Define cerebro-spinal axis.The brain and spinal cord also called the central

nervous system.

28. How is the sympathetic related to this?Properly it is an appendage, consisting of less

perceptible nerves, which are distributed in greatnumbers to the viscera and blood vessels; in fact thevarious divisions of the sympathetic take their namesfrom the arteries which they accompany. This arterialdistribution is called plexus, hence the terms hepatic,hypogastric, and renal plexuses.

29. Name the divisions of the brain.Cerebrum, cerebellum, pons Varolii and medulla

oblongata.

30. From the specimen brains study :Fissure of Sylvius.Fissure of Rolando.Fissure parieto-occipital.Fissure great longitudinal.Fissure great transverse.Lobes: parietal, temporo-sphenoidal.Lobes: occipital, central.On base of brain study:Longitudinal fissure.Corpus callosum.Lamina cinerea.Fissure of Sylvius.Anterior perforated space.Optic commissure.Tuber cirerium.In fundibulum.Pituitary body.

90


Corpora albicantia.Posterior perforated space.Crura cerebri (peduncles of cerebum.)Pons Varolii.Study the following ganglia:Olfactory bulbs.Corpora striata.Optic thalami.Pons Varolii.Tubercula quadrigemina.Also study the membranes and fissures of the

cord and the ventricles of the brain.

31. Define deep and superficial nerve origin. Arethese terms synonymous with apparent and real origin ?

Sensory nerves preside over sensation. As theremay be an infinite variety of sensations, whose ex-tremes are pleasurable and painful, so there may be aninfinite number of nerves of this special kind. Thecommon acceptation of sensory nerve is one that reportsfrom the periphery sensations painful. Motor nervesproduce motion or contraction in muscle. Now itoccurs that these two functions are inherent in oneterve trunk, when the term mixed is used. Specialnerves are those that preside over one sensation only,as the sensation of light, smell, sound and facial pant-omime. Cranial nerves as a technical expression isfounded on no such rational basis, but simply has ref-erence to all those nerve trunks, [twelve pairs] whichhave a deep origin in the brain and a superficial originon the surface of the base of the brain and make theirescape through foramina. There are twelve pairs ofthese. In this region you will find a strong tendencyto one special function only. In studying these nerveslearn: i. Deep origin. 2. Superficial origin. 3. For-amen of exit. 4. Function of. 5. Distribution.

91

CHAPTER XV.

THE CRANIAL NERVES.

Study the cranial nerves :I. Olfactory.2. Optic.3. Motor oculi.4. Pathetic.5. Trifacial.6. Abducent.

7. Facial.8. Auditory.9. Glosso-pharyngeal.

10. Pneumo-gastric.I I. Spinal accessory.12. Hypoglossal.

i. Define the olfactory.It is the nerve of the special sense of smell.

2. Where does it leave the cranium?Through foramina in the cribriform plate of the

ethmoid bone, from the under surface of the olfactorybulb.

3. How many nerve filaments are there?About twenty arranged in three rows, internal,

middle and external.

4. Where are they distributed ?The inner to the septum, the middle to the roof,

and the outer to the upper and middle turbinated bone.

5. What is the optic nerve ?The nerve of the special sense of sight. It passes

out through the optic foramen, accompanied by theophthalmic artery.

93

OUTLINES OF ANATOMY

6. What is the third nerve ?

Called the motor oculi, because it supplies withmotion the iris and all the muscles except the externalrectus and superior oblique. Escapes through sphen-oidal fissure.

7. Explain the fourth nerve.

This is called patheticus. It supplies with motionthe superior oblique, and escapes through the sphen-oidal fissure.

8. Explain the fifth nerve.

This is also called trifacial and trigeminus onaccount of its three divisions mostly distributed to theface.

9. What are the three divisions of the fifth andwhere do they escape?

They are the ophthalmic division which passesthrough the spnenoidal fissure; the superior maxillarydivision, which passes through the foramen rotundum;and the inferior maxillary division, which leavesthrough the foramen ovale.

Io. Describe the ophthalmic branch of the fifth nerve.

It is purely sensory, supplying the mucous-membranes of the eye and nose, the eye-ball, thelachrymal gland, the ciliary ganglion, and the skinand muscles of the eye-brow, forehead and nose. Itdoes this through its frontal, nasal and lachrymalbranches.

i1. Describe the superior maxillary division of thefifth nerve.

This nerve is sensory. It supplies the temple,cheek, lower lid, nose, upper lip and teeth of upper jaw.

94


12. Name its branches.Orbital, anterior and posterior dental, infra

orbital and spheno-palatine.

13. Describe the inferior maxillary division of thefifth.

This is a nerve of sensation, motion and taste.It sends muscular branches to all the muscles of mas-tication, dental branches to the teeth of the lower jawand a gustatory or a lingual branch to the tongue.The branches are the masseteric, temporal, buccal,.pterygoid, auriculo-temporal, inferior dental.

14. Of how many roots does the fifth consist ?

Of two; I. A large or sensory root. 2. Of asmall or motor root.

15. What is peculiar about the large root?The presence of a large ganglion called the

Gasserian.

16. Is the small or motor root connected with theGasserian ganglion ?

No, it is entirely unconnected therewith and liesbelow the same.

17. Describe the sixth nerve.This is called the abducens. It escapes through

the sphenoidal fissure and supplies the external rectuswith motion.

18. Describe the seventh nerve.This is the facial. It is the motor nerve of all

the muscles of expression. It may be called the nerveof facial pantomime. It escapes through the internalauditory meatus and aquaeductus Fallopii and finallypasses through the stylo-mastoid foramen. Aside fromsupplying the muscles of expression it also supplies theplatysma, the buccinator, two muscles of the external

95

OUTLINES OF ANATOMY

ear, the stylo-hyoid, stapedius, posterior belly of thedigastric, through the chorda tympani, the lingualis,through the otic ganglion the tensor tympani, throughthe Vidian the levator palati and azygos uvulae.

Study its branches :Tympanic.Chorda tympani.Posterior auricular.Digastric.Stylo-hyoid.

Temporal.Temporo-facial Malar.

Infraorbital.{ Buccal.

Cervico-facial Supra maxillary.Infra maxillary.

19. Describe the eighth nerve.The nerve of hearing. It escapes through the

internal auditory meatus and is distributed to the in-ternal ear. It gives a vestibular branch to the vesti-bule and a cochlear branch to the cochlea.

50. Describe the ninth nerve.

This is a nerve of general sensation and taste.It escapes through the central part of the jugular for-amen. It is distributed to the pharynx, tonsil, faucesand middle ear.

21. Describe the pneumo-gastric.It is a mixed nerve. It supplies the organs of

voice and respiration with motion and sensation, thoseof circulation and digestion with motion only. Itsbranches are:

Auricular.Pharyngeal.Superior laryngeal.

96


Inferior laryngeal.Cervical cardiac.Thoracic cardiac.Anterior pulmonary.Posterior pulmonary.Oesophageal.Gastric.Hepatic.The technical name then would be the auriculo-

pharyngeo-laryngeo-card.io-pulmono-antero et postero-oesophageo-gastro-hepatico pneumogastric nerve. Itescapes through the jugular foramen.

22. Describe the eleventh nerve.The spinal accessory is motor. It escapes

through jugular foramen. Distributed to sterno-mast-oid and trapezius.

23. Describe the twelfth nerve.The hypoglossal is the motor nerve of the tongue.

It escapes through the anterior condyloid foramen.

44;-.

97

CHAPTER XVI.

SPINAL NERVES.

i. Define spinal nerves.

Those nerves belonging to the cerebro-spinalsystem which arise from the spinal cord. They passout through the intervertebral foramina.

2. Give their number and classification.

They number thirty-one in all, and are thusclassified according to the region in which found:cervical; 8, dorsal 12, lumbar 5, sacral 5, coccygeal I;total, 31.

3. By how many roots does each spinal nerve arise?

By two; an anterior motor root and by a posteriorsensory root.

4. What is peculiar about the sensory or posteriorroot ?

It has a- ganglion, similar to the sensory branchof the fifth nerve or trifacial.

5. Does each spinal nerve pass out through an in-tervertebral foramen ?

No, the first passes out between the atlas andoccipital bone.

6. When and where do the two roots unite, if at all,and what do they then ?

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OUTLINES OF ANATOMY

Immediately inside the foramen they unite into-one cord and pass out, dividing at once into anteriorand posterior primary divisions.

7. Which division is the larger, the anterior or theposterior, and why?

Since the posterior has a much smaller territoryto innervate it is much smaller.

8. What territories do the anterior and posteriorprimary divisions supply, and with what?

The posterior supplies with motion and sensationthe spine, dorsal muscles and integument, the anteriorsupplies the trunk and limbs.

9. Define a nerve plexus.Where several nerves are united by connecting

or communicating branches.

io. How many plexuses are there?Cervical, brachial, lumbar, sacral; four in all.

ii. What divisions are concerned in these ?Only the anterior primary; the posterior primary

do not plexify.

12. Define the dorsal nerves.They are twelve in number. They do not

plexify. They have anterior and posterior divisions.The posterior supply the spine, muscle' and integu-ment of the back. The anterior are called intercostalnerves, from their location between the ribs. Thefirst helps from the brachial plexus. Its intercostalbranch is small and gives off no lateral cutaneousbranch. The lateral cutaneous branch of the secondis called intercosto-humeral; all the remaining nervesgive off lateral cutaneous branches, which supply theskin of the front of thorax and abdomen, and muscu-

I00


lar branches which supply the intercostal and abdomi-nal muscles. The six lower are sometimes called theabdominal intercostal nerves.

13. Describe the cervical plexus.This plexus lies upon the levator anguli scapulae

and scalenus medius muscles. It is formed by the unionof the anterior branches of the four upper cervicalnerves. Its branches are:

Superficialis colli.Auricularis nmagnus.Occipitalis minor.Sternal and clavicular.Acromial and muscular.Communicating and phrenic.Communicans noni.

I4. Describe the phrenic.The motor nerve of the diaphragm; is is also

distributed to the pericardium, pleura and phrenicplexus. It passes through the thorax in front of rootof lung.

15. Describe the brachial plexus.It is in the axillary space, formed by the union

of the anterior branches of the fifth, sixth, seventhand eighth cervical and first dorsal nerves. Itsbranches are,

Communicating and muscular.Suprascapular and three scapular.Circumflex and musculo-cutaneous.Internal and lesser internal cu'taneous.Median and thoracic branches.Ulnar and musculo-spiral.Interosseous and cutaneous branches.

16. Describe the lumbar plexus.It is in the psoas magnus. It is formed by the

IOI


union of the anterior branches of the four upperlumbar nerves. Its branches are,

Ilio-hypogastric.Ilio-inguinal.External cutaneous.Genito-crural.Obturator.Accessory obturator.Anterior crural.Communicatin g.Muscular.

17. Describe the sacral plexus.It is found on anterior surface of the pyraformis

muscle. It is formed by the union of the lumbo-sacral cord and anterior branches of three upper sacralnerves and part of the fourth. Its branches are,

Muscular and pudic.Inferior glutral and articular.Large and small sciatic.

CHAPTER XVII.

THE SYMPATHETIC NERVE.

i. Define the trunk of the sympathetic system.The successive ganglia of the same side connected

by intermediate nerves.

2. Is this trunk connected with the spinal nerves?Yes, with them all.

3. Name the ganglionic extremes of this trunk.The ganglion of Ribes on the anterior cerebral

colmunicating artery, and the ganglion impar on theanterior part of the coccyx.

4. What are communicating branches?Nerves that connect the ganglia with each other

and also with the spinal nerves.

5. What are distributing branches?Branches given off from the sympathetic that

supply all the internal viscera, and the coats of theblood-vessels.

6. How are the ganglia arranged?They are arranged in four portions, correspond-

ing to the regions of the vertebral col.Cervical portion, three pairs of ganglia.Dorsal portion, twelve pairs of ganglia.Lumbar portion, four pairs of ganglia.Sacral portion, four or five pairs of ganglia.

103

OUTLINES OF ANATOMY

7. Describe sympathetic connections with the cranialand facial ganglia.

The carotid ganglion on carotid artery.The Gasserian ganglion on the fifth nerve.Ciliary or ophthalmic ganglion in the orbit.Meckel's [sph-pal] in sph-max fossa.Otic [Arnold's] on inf. max. nerve.Sub-maxillary-above sub-maxillary gland.Bochdalek on nasal branch of Meckel's.

8. How many gangliated plexuses are there?

There are :The cardiac.The solar or epigastric.The hypogastric.

9. Of what does a gangliated plexus consist?

Of ganglia, and of nerves derived from the sym-pathetic and cerebro-spinal.

io. To what are the branches of distribution dis-tributed ?

They are destined for the blood vessels, thoracic,abdominal and pelvic viscera, they supply also the in-voluntary muscular fibres in the hollow viscera, secret-ing cells and glandular viscera.

SI1. Physiologically they increase or diminish vasalcalibre, thus increasing or lessening blood-supply toparts. From this function they are named vaso-inhib-itors and vasor dilators. It is probable that the ulti-mate actions of drugs is on this part of the nervoussystem.

IO4

SEP 2 5 1934

UNIVERSTY OF ILLIN1OI

CHAPTER XVIII.

DISSECTION OF HEAD AND NECK.

The region of the body known in dissecting-roomparlance, as head and neck, is at one and the sametime the most complex and instructive of any part inthe cadaver-field; hence the most difficult of dissec-tion. Here we find a variety of structures differing indelicacy and minuteness from any we have thus farconsidered. Here for example we find the rudimentarymusculature represented in the external muscles of theear and the platysma the only human extant represent-ative of the great panniculus carnosus of the herbivora.Here we find the brain, its miningeal coverings, itssinuses, to say nothing of the skull-cap. Here we findthe triangles of the neck, and their contents; the sal-ivary glands and their excretory ducts; the cranialnerves-motor, as the third; sensory as the first divisionof the fifth; mixed as the pneumo-gastric, and specialsense as the first, second and eighth pairs. Here,too,wefind inconstant emissary canals, vestiges of childhood,and constant foramina for nerve-transmission. Herewe find the muscles of mastication supplied by the fifthnerve and the muscles of the expression supplied bythe seventh. In short we have an array of importantstructures. If we carelessly cut this, destroy the otherand never see the third, we are slaughtering material;but if we carefully remove one part from another bysimply dividing the connective tissue, then we are dis-secting, for dissection is the art of dividing the con-nective tissue without doing any violence to organs orparts.

[THE END.

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