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A manual and atlas of dissection online

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dura mater through the sphenoidal fissure.

Study the fascia of the orbit.

Next expose the following structures:

Lachrymal gland. (Figs. 6 and 8.)

FIG. 17. VIEW OF ORBIT FROM ABOVE. (Holden.)



IN FRA-TROCHLEAR



SUPRA-ORBITAL



SUPRA-
TROCHLE AR




NASAL



LAC HRYM AL
FRONTAL



Nerves :

Ophthalmic.

Frontal.

Lachrymal.

Nasal.
Ciliary ganglion. (This lies between the external rectus muscle

and optic nerve in posterior third of orbit.} (Fig. 18.)
Motor oculi.
Trochlear.
Abducens.

Orbital branch of superior maxillary.
Optic.



THE ORBIT
FIG. iS. NERVES OF THE ORBIT, FROM THE OUTER SIDE. (Morris.)

I. FXTICULA R GA NGLION
SUPERIOR DIVISION OF THE THIRD NERVE



SUPRAORBITAL

SERVE



SHORT f'JLlARY.
SERVES



SPA NCH OF THIRD TO
INFERIOR OBLiqUE




NASAL BRANCH OF OPHTHALMIC

LONG ROO T OF LENTICU-
LAR GANGLION

OPTIC NERVE



THIRD NERVE
SIXTH NERVE
GASSERIAN GANGLION



OPHTHALMIC DIVISION
OF FIFTH NERVE



SHORT ROOT OF SYMPA THETIC ROOT OP LENTICULAR

LENTICULAR GANGLION GANGLION



Arteries (see Fig. 19):

Ophthalmic and branches.
Veins :

Ophthalmic and tributaries.
Muscles (see Fig. 20):

Levator palpebrae.

Rectus superior.

Rectus inferior.

Rectus externus.



Rectus internus.
Superior oblique.
Inferior oblique.



FIG. 19. THE LEFT OPHTHALMIC ARTERY AND VEIN. (Morris.)



Svpraorbital artery

LACHRYMAL GLAND

Superior rectus, cut

EYEBALL



External rectus
Lachrymal artery

Superior rectus, cut
Jnferitjr ophthalmic rein
Superior ophthalmic rein



OPTIC NERVE
Common ophthalmic vein




Commencement of tuperior
ophthalmic rein

Reflected tendon of superior

oblique
Ophthalmic artery



Anterior ethmoidal artery

Posterior ethmoidal artery

Ciliary arteriet

*

Levator palpebrae, cut
Ligament of Zinn
Ophthalmic artery

OPTIC COMMISSURE



Internal carotid artery



i8



THE EYE



FIG. 20 (see also Fig. 18). VIEW OF LEFT ORBIT FROM ABOVE, SHOWING THE OCULAR
MUSCLES. (Morris.)



Internal rectus muscle



Superior oblique muscle



Trochlea




Levator palpebrae superioris
muscle, cut



External rectua muscle

Inferior oblique muscle
Superior rectus muscle



Levator palpebrae superioris
muscle, cut



THE EYE

Dissect the eye of an ox or sheep. Remove the muscles and fat about
the eyeball.

Study the aqueous humor, sclerotic coat, and cornea. Then cut
through the sclerotic coat just behind the cornea, nearly encircling the
eye, and turn forwards the anterior part. Note the iris and pupil.

Float out the crystalline lens and vitreous in water. Study the lens
and its capsule and vitreous. Then note and study choroid, ciliary pro-
cesses, retina, anterior and posterior chambers.



FIG. 21. SURFACE OF CHOROID AND IRIS EXPOSED BY REMOVAL OF SCLEROTIC AND COR-
NEA, SHOWING DISTRIBUTION OF BLOOD-VESSELS AND NERVES. (Twice natural size.)
(Morris.)



A CILIARY NERVE




SURFACE OF CHOROID IN
CILIARY REGION



A CILIARY XERVE



Long posterior ciliary
artery



FLAP OF SCLEROTIC,
REFLECTED



THE EYE



FIG. 22. SEMI-DIAGRAMMATIC HORIZONTAL SECTION THROUGH EYEBALL AND OPTIC NERVE.

(Morris.')

Corneal epithelium

CORNEA

; ^/ ^NX

CANAL OF SCHLEUU
Ciliary muscle



CANAL OF PETIT




cowimci -A



MOM :

BETIXA



Central retinal vessel*

OPTIC XERVE-

Sl'BXTAXCE

PIAL XERVE-



SCLEROTIC

(covered exter-
nally by Tenon't
capsule and

loose tissue)



DURAL XERVE-SHEATH



20



THE NECK



DEMONSTRATION V.
THE NECK

Place the body upon its back with a block under the upper part of the
thorax; turn the face to one side. You will see that the side of the neck pre-
sents a quadrilateral figure, the boundaries of which are: Anterior, middle
line; posterior, anterior margin of trapezius muscle; superior, mandible;
inferior, clavicle and manubrium.

FIG. 23. ANTERIOR AND LATERAL CERVICAL MUSCLES. (Morris.}



Stylo-glossus

Hyo-glossus

Mylo-hyoid

Anterior belly
of digastric

Raphe of raylo-
hyoid

Thyro-hyoid
Inferior constrictor

Anterior belly of
omo-hyoid

Sterno-hyoid
Sterno-thyroid




Stylo-hyoid

Posterior belly of digastric

Splenius capitis

Sterno-mastoid

Levator anguli scapulae

Scalenus medius
Trapezius

Scalenus posticus



Posterior belly of
omo-hyoid



Surface anatomy:

Outline sterno-mastoid muscle. This muscle divides the neck into an
anterior or carotid and a posterior triangle. The omo-hyoid muscle divides
the anterior triangle into a superior and inferior carotid triangle; and
the posterior triangle into the subclavian and occipital. The submaxil-
lary or digastric triangle is between the mandible and stylo-hyoid and
digastric muscles.

Locate the hyoid bone, thyroid and cricoid cartilages, and trachea.
As the trachea passes down from the cricoid cartilage it recedes so that
there is a deep fossa fonticulus gutturis above the sternum.

Dissection: Make a vertical incision through the skin down the middle
of the neck from the symphysis of the mandible to the sternum, a second in-
cision along the clavicle to the acromion process. Reflect the skin outwards
to the anterior boundary of the trapezius muscle.



THE NECK



21



This will expose the superficial fascia and platysma myoides muscle.
Study the superficial cervical fascia.

FIG. 24. THE SUPERFICIAL VEINS AND LYMPHATICS OF THE SCALP, FACE, AND NECK.

(Morris.)



Frontal i tin



SiipraorbUal vein
Communication with

ophthalmic vein
Transrtrse natal r



Angular rtin
Lateral natal reins

Transverse facial

vein
Superior labial or

coronary rein

Anterior p'terygoid

or deep facial rein

Inferior coronary

vein

Facial rein -

Inferior labial vein

Submental rein

Lingual vein

Superior thyroid

Middle thyroid
vein

Sterno-maatoid

A nterior jou lor

rein

Communication
between anterior
jugular veins

Platysma




Anterior temporal vein
Posterior temporal vein

Deep temporal vein
Parotid lymphatic gland*
Common temporal rein
Internal maxillary vein
-77- \~r Occipital vein
^ff Temporo^mazillary rein
Posterior auricular vein

Occipital lymphatic gland*
Sterno-mastoid lymphatic

glands

Communication beltceen
facial and external
jugular rein*
Svbmarillary lymphatic

glands

Internal jugular rein
Posterior external jugular

vein
External jugular rein



Superficial cervical chain
of gland*



Trapeziua



Transrerte
cervical rein

Supratcapular
rein



Jugulo-cephalic
vein



Superficial branches of cervical plexus. (See Fig. 25.)

Transverse cervical.

Supra-sternal.

Supra -clavicular.

Supra-acromial.

Great auricular.

Small occipital.
Spinal accessory.

Study the platysma myoides.

Carefully remove the platysma myoides and expose :-

Superficial veins (Fig. 24) :

External jugular.

Anterior jugular.

Posterior jugular.



22



THE NECK



Lymphatics of the neck. (Fig. 24.)
Superficial cervical.
External jugular.
Anterior cervical.
Submaxillary.
Submental.



FIG. 25. SUPERFICIAL BRANCHES OF THE CERVICAL PLEXUS. (Morns.}



POSTERIOR

A URICULAR
NER VE



FACIAL NERVE



INFRAMAXUIB ULAR



SUPERFICIAL CERVICAL
BRANCHES OF SUPER-
FICIAL CERVICAL
NERVE



SUPRASTERNAL




BRANCHES OF
}- GREA T
) AURICULAR

GREAT OCCIPITAL



LESSER OCCIPITAL



GREA T A URICI'LA R
.V AS TO ID BR. OR 2nd

SMALL OCCIPITAL
SPINAL ACCESSORY



BR. TO LEV ATI IR

\si;ri.i sr.\i>rr..E

SUPRA- A CROMIAL
SUPRACLAVICCLAR



BRANCHES TO

TRAPEZIUS



SU PR AC LA VIC ULAR



Study deep cervical fascia.
Triangles of the neck :

Anterior triangles.

Digastric or submaxillary.
Carotid superior or carotid.
Carotid inferior or muscular.
Posterior triangles.
Occipital.
Subclavian.

Complete the dissection of the posterior triangle before doing any
further dissection on the anterior triangles.



THE NECK



In posterior triangle expose and study:
Arteries :

Supra-scapular (A. transversa scapula).

Transverse cervical.

Expose third portion of subclavian artery by pushing aside
scalenus anticus and medius muscles.



FIG. 26. REGION OF THE THIRD PART OF THE SUBCLAVIAN ARTERY.

(Morris.) Also see Fig. 28.
(The shoulder represented depressed.)



(Bellamy.)



\




Splenius

Lerator anguli scapulae
Scalenus posticus

f'ERFlCIAL DE-
.S' /: \DIXG BRA -V 'H
1 1 r THE CER I '1C A L
PLKXU8

ft RA fill A L PL EX f 'I
Transrtrtali* colli artery

(deep)

First serration of serratus
magnus



PHRESIC XER VE

Scalenus anticus



First serration of serratus magnus
v -~ Siibclarian vei

Suprascapular artery
Svbclarian artery

Stiprascapuiar rein
Costo-coracoid membrane and cephalic et

Xerves (see Figs. 25 and 28):
Cervical plexus.

Superficial branches have been studied.
Deep branches:
External.
Muscular.
Communicating.
Internal.
Muscular.
Communicating.

Phrenic lies on anterior surface of scalenus anticus.
Spinal accessor}-.
Muscles:

Sterno-cleido-mastoid. Scalenus medius.

Omo-hyoid. Scalenus posticus.

Trapezius. Splenius.

Scalenus anticus. Levator anguli scapulae.



24 THE NECK

DEMONSTRATION VI.

In anterior triangles of the neck.

Note that the carotid artery lies just beneath the anterior border of
the sterno-mastoid muscle.

Cut the clavicle at its inner third, disarticulate sternal end, turn it up with
the sterno-mastoid muscle, taking care not to remove any of the structures
beneath the muscle.

Study the cervical fascia.

Lying on or in the sheath of the carotid artery, internal jugular vein,
and vagus nerve you will find the descendens hypoglossi nerve. Trace it
up to the hypoglossal nerve and down to the communication with the com-
municantes hypoglossi, forming the anas. (Fig. 27.)



FIG. 27. CENTRAL LINE OF NECK. COURSE AND RELATIONS OF COMMON CAROTID

' ARTERY. (Holden.}



Occipital a.

Hypoglossal

n.

Descendens
hypoglossi n .

2d cervical n.

Superior thy- _
roid a.

3d cervical n.

Communicans
hypoglossi n.
Crico-thyroid

m.

Internal jugu-
lar v.

Common car-
otid a.



Digastricus.




THE XECK



FIG. 28. THE COMMON CAROTID, THE EXTERNAL AND INTERNAL CAROTID AND THE SUB-

CLAVIAN ARTERIES OF THE RIGHT SIDE AND THEIR BRANCHES. (Morris.)
(From a dissection by Dr. Alder Smith in the Museum of St. Bartholomew's Hospital.)

Stylo-gloss ua



INFERIOR DESTAL SERVE
CHORDA TYMPASI
FACIAL SERVE
Internal maxillary artery
Stylo-hyoid, turned up
Digastricus, turned up
Temporal artery



Submental artery
facial artery

MYLO-HYOID SERVE
LOWER JAW. TURNED UP



Posterior auricular artery
Internal jugular rein



SECOS'n CERVICAL

SERVE
$PI\A I. A CCESSOR Y N

SERVE

Bectus capitis anticus major

Stylo-pharyngeus muscle

OF SYMPATHETIC

"it-PHAR. SERVE

Sterno-mastoid, reflected

Occipital artery

Internal carotid

Lerator anguli scapulae

THIRD CERVH: SERVE

L>E -ESl>f-:S.< HYPIJ-

SSI SERVE

External carotid

Inferior constrictor



l\\'. HYPOGLOSSI
FO UR TH f 'ER I '. SER f 'E
Atcending cerrfcal artery
ZPISA L A C>. "ESSOR Y
PHRESIC SER VE
Scalenus anticus
Levator anguli scapulae

FIFTH CERV. SERVE
Scalenus medius
r'F.RVIi-AL PLEXUS

\7>/;.V.S - BRASfff
PSEl'UOGASTRIC

SERVE ^^

DRAfHlAL PLEXl ~



Internal jugular rein
Superficial cerrical artery

Suprateapular artery

Serratus magnus

Coraco-brachialis



Suprateapular artery giren of from third
part of tubclarian

Posterior scapular artery
Sl'PRASCAPl'LAR SERVE

Humeral thoracic artery
Posterior belly of orno-hyoid, drawn do




SL'B.V AXIL LAKY GANGLION
G US TA TORY SER I ~E
SUBMAXIUART DUCT
SUBUAX1LURY 6UND
TONGUE

1IYPOGLOS. SERVE
Ranine artery

Genio-hyo-glossus
Sublingual artery

Lingual artery
Artery offraenvm
LOWER JAW

Genio-hyoid

Hyo-glosaus
Lingual artery
Hyoid branch
Mylo-hyoid muscle
Thyro-hyoid membrane

SUPERIOR LARYS-
GEAL SERVE

Superior iaryngtal artery

Thyro-hyoid

Superior thyroid artery

Omo-hyoid

EX TERSA L L A R YA'-

GEAL SERVE
THYROID GLAND

Sterno-hyoid
Common carotid
Sterno-thyroid

Vertebral artery
Inferior thyroid artery
Anterior jugular rein
Common carotid
CLAVICLE

Vertebral rein

BRACIHAL PLEXUS
(SEVESTH CERVIC.)

Subclarian artery

Fectoralis major,
reflected



\ Transverse cerrical artery
Subclavius, reflected

BRACHIAL PLEXUS (EIGHTH CERVICAL)
Pectoral branch of acromial thoracic artery
Subclarian rein
Pectoralis minor



Expose the carotid artery, internal jugular vein, and vagus nerve, and
note their relative position to each other and to surrounding structures.

Expose the sympathetic gangliated cord behind the carotid sheath.
(See Figs. 28 and 29.)

Trace the superior laryngeal nerve to the superior border of thyroid
cartilage; note its division into internal and external branches.

Xote the division of the common carotid into the external and internal
carotid.



26



THE NECK



Now expose and study the branches of the external carotid . (See Fig. 28.)
Expose the subclavian artery and its branches. (See Figs. 26 and 28.)
What position does this artery have in relation to the subclavian vein,
vagus nerve, and scaleni muscles?

Expose the inferior or recurrent laryngeal nerve lying behind the com-
mon carotid artery and in the groove between the trachea and oesophagus.



FIG. 29. DISTRIBUTION OF THE PNEUMOGASTRIC NERVE,

(Krause.) (Morris.}



VIEWED FROM BEHIND.



Stylo-hyoid



Ligamentum pharyngeum
XI



Posterior belly of
digastric



Sterno-mastoid

Rectus capitis
anticus major

Stylo-pharyngeus

Stylo-glossus

Internal pterygoid

XIT'ERIOR
CERVICAL
GANGLION

Middle constrictor

Common carotid
artery

Inferior constrictor

GANGLION

THYROIDEUM
(VARIETY)

THYROID GLAND



Infa-io? thyroid
artery

Subc/arittii iirli'rii



RECURRENT
LARYNGEAL
NER VE



Thoracic aorta



Cru3 of diaphragm




Internal carotid

in /;//

'



SYMPATHETIC
Occipital urti'ry

Posterior belly of
digastric



DESCENDEN8
HYPdGLOSSI

<'<iiiiiii<n< carotid
artery

- Sterno-raastoid



TWIG or
RECURRENT

LARYNGEAL TO

I'llARYSGEAL

PLEXUS



Thyroid <u'M



INFERIOR
CERVICAL
GANGLION

RECURRENT
LARYXGEAL

['LEXL'S GULJE



RIGHT
PNEUMOGA8TRIG



THE NECK



27



Search carefully for the thoracic duct on the left side as it enters the
subclavian vein near the junction with internal jugular. (Fig. 30.)



FIG. 30. THE SUPERIOR AND INFERIOR VEN.E CAVJB, THE INNOMINATE VEINS, AND THE

AZYGOS VEINS. (Morris.)



Right common carotid

artery

Right internal jugular
rein



RIGHT LYMPHATIC DUCT

Innominate artery

RIGHT PffBUMO-

GASTRIC XERl'E

Right innominate vein

Internal mammary vein

Trunk of the perifardiac
and thymic veins
Vena cata superior



Vena azygos major



Vena azygos minor, cross-
ing spine tfj enter vena
major



Hepatic reins



Vena cata inferior

Right phrenic artery
Cailiac axis

Right middle suprarenal
artery



Right spermatic artery
Right spermatic rein




Left common carotid

artery

LEFT PNMUMOGA&
TRIG SERVE

THORACIC DUCT

Left innominate vein

Left subclavian artery



Left superior intercostal
rein

RECURRENT
LARYSGEAL
XER YE



Vena azygos tertius

(ESOPHAGUS

Left upper azygos vein

CEsophageal branches
from aorta

Vena azygos minor



THORAC C DUCT



Left phrenic artery

Left middle suprarenal
artery

RECEPTACULUM CHYLI

Superior mesenteric
artery

Left ascending lumbar
rein

Left spermatic vessel*



Inferior mesenteric
artery



In the anterior triangle you have the following structures, some of
which have been exposed and studied. Clean and study each carefully
and note the position each bears to the surrounding structures: -
Xerves :

Descendens hypoglossi.
Hypoglossal.

Communicantes hypoglossi.



28 THE NECK

Ansa hypoglossi.
Vagus or pneumogastric.

Pharyngeal.

Superior laryngeal.

Inferior laryngeal.
Phrenic.
Sympathetic.

Arteries :

Common carotid.
External carotid.

Superior thyroid.

Lingual.

Facial.

Ascending pharyngeal.

Occipital.

Posterior auricular.
Internal carotid.

Veins :

Internal jugular.

Tributaries to internal jugular.

Review veins of head and neck.
Thoracic duct, its termination.
Right lymphatic duct.
Review lymphatics of head and neck.

Subclavian artery.

Thyroid axis (A . truncus thyreo-cervicalis) and branches.

Vertebral.

Internal mammary.

Superior intercostal (A. truncus costocervicalis] .

Subclavian vein.

Tributaries to internal jugular.

Muscles (see Fig. 27 and 34):
Omo-hyoid.
Sterno-hyoid.
Sterno-thyroid.
Thyro-hyoid.
Scaleni.



THE XECK



29



FJG. 31. DIAGRAM OF THE SUPERFICIAL LYMPHATIC VESSELS AND GLANDS OF THE HEAD
AND NECK. (After Drawing by Dr. Francis R. Sherwood.) (Morris.)



Ext. part of eyel
Outer part of cheek
Part of face



Occipital region



Face and Lips superficial
Nose and floor of mcut

Ant. part of tongue

Sublingual

Submaxillary

Part of parotid



Submaxillary glands 8 to



Deep cervical glands

Superficial cervical glands



Suboccipital gland*



Post. Auric, or
Sterno-mastoid glands




Efferent vessels to deep cervical



FIG. 32.- DIAGRAM OF THE DEEP LYMPHATIC VESSELS AND GLANDS OF THE HEAD AND
XECK. (After Drawing by Dr. Francis R. Sherwood.) (Morris.')



Spheno-maxfflary Fossa

Temporal Fossa

Orbit
Nose



Upper part of pharynx and pal

Internal maxillary glands 3 to



Efferent vessels from
submaxJIlary glands



Middle of pharynx
Lower part of Larynx




Upper and post, part of Tongue



Interior of Cranium

Inner and posterior part of Nose



Trachea ) u
Esophagus)



CEs

Lower part of Thyroid body

Efferent vessels



Upper part of pharynx

Deep muscles of neck
(prevertebral)

Posterior pharyngeal glandr



Deep cervical glands



Deep muscje*



nd L. Lymphatic ducts



Thyroid body or gland.

Position and general description.

Lobes.

Isthmus.



M. levator glandulse thyroidae.
Accessory thyroids.
Arteries and veins.



FIG. 33. VIEW OF THYROID BODY. (Morris.)

SMALLER CORNU OF HYOID BONE

BODY OF HVOID BONE



Thyro-hyoid ligament



THYROID CARTILAGE



THYROID ISTHMUS




Thyro-hyoid membrane



Thyro-hyoid muscle



Inferior constrictor



Sterno-thyroid muscle



Median portion of crieo-
thyroid membrane



- Crico -thyroid muscle



LATERAL LOBE OF THYROID BODY




SECTION THROUGH CARTILAGES



FIG. 34- THYROID BODY, WITH MIDDLE LOBE AND LEVATOR MUSCLE. (Morris.)



Stylo-hyoid ligament




TRACHEA



EPIGLOTTIS



BODY OF HYOID BONE
Thyro-hyoid ligament



Thyro-hyoid membrane



Levator glandulae thyroidea
THYROID CARTILAGE



PYRAMIDAL PROCESS OF THYROID BODY



I LEFT LATERAL LOBE



THE NECK

FIG. 35. THVMUS GLAND IN A CHILD AT BIRTH. (Morris.)



3'



HYOID BONE

Thyro-hyoid membrane
THYROID CARTILAGE



Sterno-thyroid muscle
Crico-thyroid
membrane

Crico-thyroid muscle
THYROID BUND

Right common carotid

artery
RIGHT pyEl'MO-

i:i<- yERVK

lernal jugular
MSN

Level of sternum

SECTION OF CLAYICLE
SECTION OF FIRST RIB



SECTION OF STERNUM




Thyro-hyoid muscle

Lateral portion crico-
thyroid membrane

Omo-hyoid muscle
Sterno-mastoid muscle

CRICOID CARTIUGE
FIRST RIN6 OF TRACHEA

TRACHEA

Left suspensory

ligament
LEFT RECTRREXT

XER VE

(Esophagus

Lift innominate rein
LEFT LOBE OF TIIYHUS



Left inltrnaj mammary
artery



Pericardium



SECTION OF RFTH RIB
CARTILAGE



ENSIFORM CARTIUGE



Submaxillary or Digastric Triangle (Fig. 36).

Expose the following superficial structures only:-
Submaxillary gland.

Do not remove this gland now.
Facial artery.
Hypoglossal nerve.



THE NECK



Muscles :

Digastric.

Stylo-hyoid.

Mylo-hyoid.



FIG. 36. DIGASTRIC TRIANGLE AND CONTENTS. (Holden.)



Occipita



Hypoglossal



Descendens
glossi n.

Ling



hypo-



lala.



Internal jugu
Superior thyr-



oid a



Common carotid a. __



ala.



hyoid n.



bmental ;




TEMPORAL AND PTERYGOID MUSCLES



33



DEMONSTRATION VII.

TEMPORO- AND PTERYGO-MAXILLARY REGION.

Study the temporal fascia and remove it.

Study the masseter fascia and remove it.

Study the masseter muscle. (Fig. 7.)

Then cut the zygomatic arch on each side of the masseter muscle. The
posterior cut should be made immediately in front of the glenoid fossa; the
anterior cut should extend obliquely through the malar bone. Now turn the
bony arch thus cut with the masseter muscle down; observe the nerve
and artery which pass to the muscle through the sigmoid notch between
the neck of the jaw and posterior margin of the temporal muscle. When
the nerve and artery are found and studied, cut them and remove them
with the muscle.

Clean and study the temporal muscle.

Then cut the coronoid process of mandible and turn it up with the tem-
poral muscle attached.

Now note the external pterygoid muscle.



FIG. 37. (Holder.)




Clean and study the external pterygoid muscle with care so as not
to destroy the internal maxillary artery. (Figs. 38 and 39.)



34



PTERYGOID REGION

FIG. 38. THE PTERYGOID MUSCLES. (Morris.)



External pterygoid



Internal pterygoid



flbro-cartilage




FIG. 39. SCHEME OF LEFT INTERNAL MAXILLARY ARTERY. (Walsham.) (Morris.)



Infraorbital artery and nerve



Orbital branch



Palpebral
ch



lpebr
bran



Nasal branch

Anterior .
dental branch I

Labial branch

Posterior dental

branch



Alveolar branch



Incisive branch
Menial branch

Submenlal branch



Spheno-palatine branch

Posterior or descending palatine branch
Inline branch




'emporal artery

Small meningeal
artery

Middle meningeal

artery



Temporal artery
Ti/in/iiinic branch

Deep auricular
branch

A I'HICULO-TEM-
I'OHAL XKRVK

Manseteric brunch



External carotid
artery



Internal lateral or
spheno-mandibu-
lar ligament

Mtinillbiiltir or
htfi'rinr dental
artery and nerve



Buccal branch with. Internal pterygoid branch
portion of buccal nerve
Mylo-hyoidean branch



PTERYGOID REGIOX



35



Cut the condyle of the mandible, disarticulate, and remove it, unthjhe ex-
ternal pterygoid muscle.

Study the temporo-mandibular articulation.



FIG. 40. VERTICAL SECTION THROUGH THE COXDYLE OF JAW TO SHOW THE TWO]SYXOVIAL

SACS AXD THE IXTERARTICULAR FlBRO-CARTILAGE. (Morris.)




Stylo-mandibular ligament



Xext expose the deep pterygoid region by removing the upper part of
the ramus of the mandible. Cut the ramus with saw and bone-pliers im-
mediately above the inferior dental foramen. To find the inferior dental
foramen thrust a knife handle down between the ramus and soft parts until
its progress is arrested by the entrance of the inferior dental nerve and vessels
into the foramen.

Expose the inferior dental vessels and nerve as far as possible by cutting

\y part of the mandible with chisel and bone-pliers.

Cut the mandible at the mental foramen and turn the piece cut off up, care-
fully cutting the insertions of the internal pterygoid and mylo-hyoid muscles
and other structures beneath from the bone.

Study the internal pterygoid muscle. Xote its relation to the ex-
ternal pterygoid. Also note the structures lying between these two mus-
cles. .

Expose and study the following structures : -

Arteries :

Internal maxillary and branches. (See Figs. 39 and 41.)

Veins :

Internal maxillary and its tributaries.



MAXILLARY REGION



Nerves (Figs. 42 and 43) :

Mandibular division of fifth.
Recurrent.
Internal pterygoid.
Anterior portion.
Temporal.
Masseteric.
External pterygoid.
Long buccal.



Posterior portion.

Lingual.

Inferior dental.

Auriculo-temporal.
Submaxillary ganglion .
Otic ganglion.
Chorda tympani.



FIG. 41. INTERNAL MAXILLARY ARTERY. (Holden.}




INCISOR



Submaxillary or digastric triangle.

The superficial structures have been worked out.
Deep structures:
Submaxillary gland.
Submaxillary ganglion. (See Fig. 43.)
Sublingual gland. (Fig. 44.)
Nerves in this triangle :

Lingual.

Inferior dental.

Hypoglossal.

Chorda tympani.
Arteries (see Figs. 45 and 28):

Lingual and branches.

Facial (a. maxillaris externa).

Inferior dental. (Fig. 41.)



Veins :
Lingual.
Facial.



FIG. 42. DISTRIBUTION OF THE MAXDIBULAR DIVISION OF THE TRIGEMINAL NERVE.

(Henle.) (Morris.)




SUB-

MAXDIBCLAR
GAXGLIOy

MENTAL

BRANCH



ANTERIOR TEM-
PORAL NER VE

AL'RICULO-TEM-
PORAL SERVE

POSTERIOR TEM-
PORAL SERVE



NERVE TO MAS-
SETER



CHORDA TYM-
PANI

MYLO-HYOID

XERVE
LiyGUAL
XER VE

INFERIOR
DEXTAL SERVE



FIG. 43. SHOWING FIFTH XERVE. (Holden.)






SSKSCftY ROOT
MOTOR HOOT




AHHICULO TtMPOHM. H.



37



SUBMA XILLA R Y REGION

FIG. 44. THE SALIVARY GLANDS. (Morris.)


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