Simon Menno Yutzy.

A manual and atlas of dissection online

. (page 3 of 11)
Online LibrarySimon Menno YutzyA manual and atlas of dissection → online text (page 3 of 11)
Font size
QR-code for this ebook


PAROTID GLAND



Masseter muscle




SOOIA HAROTIDIS



DUCT OF PAROTID



Bristle inserted
into duct



Fraenum linguae

DUCT OF R1VINUS



SUBLINGUAL GLAND



DUCT OF SUBMAXILLARY

GLAND
Mylo-hyoid muscle



Sterno-mastoid

muscle

Posterior belly of
digastric muscle



SUBMAXILLARY GLAND,
DRAWN BACKWARDS



Loop of fascia



HYOID BONE'



Anterior belly of
digastric muscle

DEEP PORTION OF SUBMAXILLARY GLAND



FIG. 45. SCHEME OF THE RIGHT LINGUAL ARTERY. (Walsham.) (Morris.)



Descending palatine artery
Falato-pharyngeus

TONSIL

Ascending palatine branch

of facial
Tonsillar branch of dorsalis

linguce

Tonsillar branch of facial

Stylo-glossus

Dorsalis linguce artery

le constrictor
?AL NERVE

Facial artery

Posterior belly of digastric
and stylo-hyoid
Supra-hyo'id branch

SUP. LARYNGEALN.

Infra-hyoid branch
Internal carotid artery



Middle constrictor
HYPOGLOSSAL NERVE



Falato-glossus



Ranine artery




r thyroid artery



External carotid artery
Common carotid artery



Muscles (Figs. 45 and 46) :
Mylo-hyoid.
Hyo-glossus.
Genio-hyoid.
Stylo-glossus.

Genio-hyo-glossus (m. genioglossus}.
Chondro-glossus .



SUBM AXILLARY



39



FIG. 46. MUSCLES, VESSELS, AXD NERVES OF THE TONGUE. (Holden.)



Styloid
process.



Glosso-
pharyngeal n.

Hypoglossal n.
Occipital a

Submandibular
ganglion.
Duct of sub-
mandibular
gland.
Middle con-
strictor m.

Lingual a.

Descendens
hypoglossi n.



. Chorda tympani c .
. Gustatory n.




Sablin-
guala.



40 DEEP NECK



DEMONSTRATION VIII.
DEEP DISSECTION OF THE NECK. (Figs. 28 and 47.)

Expose the ascending pharyngeal artery.

Trace to the base of the cranium the :
Internal carotid artery.
Internal jugular vein.
Vagus nerve.
Hypoglossal nerve.
Gangliated cord.

Note the cervical ganglia of the sympathetic.

Clean and study the stylo-pharyngeus muscle. Use care so as not to
cut the glosso-pharyngeal nerve, which winds around the posterior and
external surface of the stylo-pharyngeus muscle.
Trace and study the glosso-pharyngeal nerve.
Branches of seventh nerve at its exit through stylo-mastoid foramen.

Digastric.

Stylo-hyoid.

Posterior auricular.

Note the position of the internal carotid artery in relation to the follow-
ing structures:
Muscles :

Middle constrictor of the pharynx.

Superior constrictor of the pharynx.

Stylo-pharyngeus.

Stylo-glossus.

Ascending pharyngeal artery.
Glosso-pharyngeal nerve.



DEEP NECK



FIG. 47. SCHEME OF RIGHT ASCENDING PHARYNGEAL ARTERY. (Walsham.) (Morris.}

The internal carotid artery is hooked aside.

Also see Figs. 30 and 50.



Meningtal branch pasting through
middle lacerated foramen

Tympanic branch

Men ingtal branch patting through

jugular foramen

Men ingeal branch pasting through
anterior candy loid foramen



Stylo-pharyngeus



GLOSSO-PfTA R YXGEA L
*E YE

Occipital artery
Rectua capitis anticus

major
Ascending pharyngeal

artery

Middle constrictor of
pharynx

SY.VPA THE TIC .\ERTE
Internal carotid artery
External carotid artery




Intracranial part of internal
carotid



Intraosseous part of internal
carotid

Leva tor palati
Palatine branch



Buccinator muscle



Superior constrictor
of pharynx

Pterygo-maxillary
ligament

Stylo-glossus



Ascending palatine branch
of facial artery

Tonrillar branch of facial artery

Hyo-glossus
Facial artery



Lingual artery
Superior thyroid artery



Common carotid artery



42 ANTERIOR VERTEBRAL AND PHARYNX

DEMONSTRATION IX.

Remove the anterior part of the skull with pharynx attached by dividing
the trachea and oesophagus about one inch below the larynx. Draw the trachea
and (esophagus forward and separate them from their arterial and vertebral
attachments. With a saw cut inward along the posterior border of petrous por-
tion of temporal bone, passing behind the jugular foramen. Divide the basilar
part of occipital bone with a chisel.

Wrap the part thus severed in a wet cloth and lay it aside while the anterior
vertebral region is being dissected.



ANTERIOR VERTEBRAL REGION.

Expose and study the following structures:
Muscles (Fig. 48) :

Longus colli.

Rectus capitis anticus major.

Rectus capitis anticus minor.

Rectus capitis lateralis.

Scaleni.

Arteries (Fig. 49) :

Vertebral and branches.
Deep cervical.

Veins :

Vertebral and tributaries.

Nerves :

Trunks of cervical plexus. (Fig. 50.)
Trunks of brachial plexus.

Study articulations of head.
Atlas with occiput.
Atlas and axis.
Axis and occiput.

PHARYNX. (Figs. 51 and 52.)

Moderately distend the walls of the pharynx with tow.

Study a description of the pharynx. Then clean and study the in-
ferior, middle, and superior constrictor muscles.

Study the pharyngeal aponeurosis.

Now open the pharynx by a posterior median incision. (Fig. 53.)

Study the interior of the pharynx. Examine, posterior nares, open-
ing of Eustachian tube, opening into larynx, pharyngeal recess or fossa
of Rosenmuller, pharyngeal tonsil, pharyngeal bursa, base of tongue and
beginning of oesophagus.



AXTERIOR VERTEBRAL REGIOX



FIG. 48. THE MUSCLES OF THE FRONT OF THE NECK. (Morris.)



Rectus capitis anticua
minor

Rectus capitis lateralis



Rectus capitis anticus
major



Origin of rectus capitis
anticus major



Scalenus medius



Scalenus antious



Scalenus posticus




Rectus capitis later-
alis

Rectus capitis anti-
cus minor



Intertransyersalis
anterior



Intertransversalis
posterior



Longus colli



Insertion of scalenus
anticus



Sealenus medius



Scalenus posticus



44



DEEP NECK



FIG. 49. SCHEME OF THE LEFT VERTEBRAL ARTERY. (Walsham.) (Morris.}
The internal jugular and vertebral veins are hooked aside to expose the artery.



Right posterior cerebral artery

Left posterior cerebral artery

Basilar artery

BASILAR PROCESS, OCCIPITAL BONE



Inlracranial portion of vertebral artery
Rectus capitis lateralia muscle

FIRST CER VIC A L NER VE

Commencement of vertebral vein

SECOND CERVICAL NERVE

Vertebral plexus of reins

THIRD CERVICAL NERVE

Vertebral portion of vertebral artery
FOURTH CERVICAL NERVE

Vertebral plexus of veins
FIFTH CERVICAL NERVE

SIXTH CERVICAL NERVE

Inferior thyroid artery

Longus colli muscle

Cervical portion of vertebral artery

Internal jugular vein, hooked a little
aside

Vertebral re hi, cut
Subclavian artery




Right and left supe-
i i</r cerebellar
arteries

OCCIPITAL BONE



Rectus capitis pos-
ticus minor mus-
cle



Occipital portion of vertebral artery



Arleria princeps cervicis



Semispinalis colli muscle

Deep cervical artery

Scalenus anticus muscle, cut
Thyroid axis, hooked a little aside
Siibclavian vein



DEEP NECK



45



FIG. 50. DIAGRAM OF THE CERVICAL PLEXUS. (Morris.)



STERNO-MASTOID
SMALL OCCIPITAL



on E.I T

A URICL'LAR



SCA LEX US
MEDIUM



SPINA L
ACCESSORY



TRANSVERSE

CERVICAL



S^A LE.VT'S

MED 1 1 \

LEVA TOR
SCA PULJE

SYMPATHETIC




RECTUS CA PITTS ANTICUS

MAJOR
RECTUS CAPITIS ANTICUS

MINOR
RECTUS CAPITIS LATER ALIS



HYPOGLOSSAL NERVE

SUPERIOR CERVICAL
SYMPATHETIC GANGLION

LONG US COLLI
RECTUS CAPITIS ANTICUS
MAJOR



GENIO-HYOID
THYRO-HYOID

LONG US COLLI
RECTUS CAPITIS
ANTICUS MAJOR
DESCEND ENS

CERVICIS-
O3IO-HYOID

COMXUNICANS

CERVICIS
LONG US COLLI

STERNO-HYOID
RECTUS CAPITIS
ANTICUS MAJOR
SCA LENUS
A NTICUS
STKR NO-
THYROID
OMO-HYOID



SCA L EN US MED I US
LEVATOR SCAPULM



TRAI'EZIUS



SUPRA- SUPRA-

A CROMIA L CLA J 'ICULA R



SUPRASTERNAL



46 THE PHARYNX

FIG. 51. SIDE VIEW OF THE MUSCLES OF THE PHARYNX. (Holden.)



Obicularis oris

Pterygo-mandibular
ligament.



- Glosso-pharyngeal n.

- Stylo-pliaryngeus.



Mylo-hyoideus.

Os hyoides.

Thyro-hyoid ligament.

Pomum Adami.



Cricoid cartilage.

Trachea.




Superior laryngeal
n. and a.



External laryngeal n.
- Crico-thyroideus.

Inferior laryngeal n.
(Esophagus.



FIG. 52. VIEW OF THE CONSTRICTOR MUSCLES FROM BEHIND. (Holden.)




THE PHARYNX



47



p 1G ro VIEW OF MUSCLES OF SOFT PALATE, AS SEEN FROM WITHIN THE PHARYNX.



(Modified from Bourgery.) (Morris.)



Levator palati



Azygos uvulae
Hamular process



Palato-
pharyngeus




EUSTACHIAN TUBE



Levator palati



Palato-pharyngeus



Superior constrictor



Crico-arytenoideus
posticus



Thyroid cartilage



Cricoid cartilage



(ESOPHAGUS



48 PALATE, MOUTH, TONGUE, ETC.

PALATE.

Study description of hard and soft palate.
Soft palate:

Anterior palatine arch or pillar.

Posterior palatine arch or pillar.

Tonsillar recess.

Isthmus of fauces.

Uvula.
Dissect out and study the following muscles (Fig. 53) :

Palato-pharyngeus.

Palato-glossus.

Levator palati (M. levator veli palatini}.

Tensor palati (M. tensor veli palatini}.

Azygos uvulae (M. wuulaz).

Salpingo-phary ngeus .
Tonsils, faucial.

Their location and description.

Describe the arteries, veins, and nerves of the pharynx, palate, and
tonsils.

MOUTH.

Study a description of mouth.

TEETH.

General description.
Temporary or milk teeth:

How many?

At what ages do their eruptions occur?
Permanent teeth.

How many?

At what ages do their eruptions occur?
What is the arterial and nerve supply of the teeth?

TONGUE.

General description.
Muscles of tongue:

Extrinsic. (See Fig. 60.)

Hyo-glossus.

Genio-hyo-glossus.

Stylo-glossus.

Palato-glossus.

Part of sup. constrictor.
Intrinsic. (See Fig. 60).

Lingualis superior.

Lingualis inferior.

Transverse fibres.

Vertical fibres.
What is the arterial and nerve supply of the tongue?



THE TOXGUE



49



fFic. 54. DORSUM OF THE TONGUE. (Morris.)

EXTREMITY OF CORNU OF False vocal cord LOWER END OF PHARYNX

HYOIO BONE

SUPERIOR CORNU OF THYROID\
CARTILAGE



LATERAL GLOSSO-
EPIGLOTTIDEAN FOLD



ANTERIOR WALL OF THE
PHARYNX

CORNICULUM LARYNGIS
CUNEIFORM CARTILAGE
SINUS PYRIFORMIS

True vocal cord
EPIGLOTTIS



MEDIAN GLOSSO-
EPIGLOTTIDEAN FOLD




POSTERIOR PILLAR OF FAUCES



CIRCUMVALLATE PAPILL/E



FUN6IFORM PAPILLC



THE TONGUE



FIG. 55. UNDER SURFACE OF THE TONGUE WITH MUSCLES. (Morris.)



FR/ENUM LINGU/E



LingualiB inferior



Hyo-glosBus



Qenio-hyoid



Mylo-hyoid, reflected



Sterno-hyoid




Lingualis inferior



Genio-hyo-elossu



Stylo-glossus

Hyo-glosaua
BODY OF HYOID BONE
Oenio-hyoid



THYROID CARTILAGE



THE LARYNX



LARYNX.



General description.

Note its position, and its relation to the pharynx.



FIG. 56. FRONT VIEW OF THE CARTILAGES OF THE LARYNX. (Modified from Bourgery

and Jacob.) (Morris.)



BODY OF HYOID BONE
Thyro-hyoid ligament

Cartilage triticea
Foramen for superior

laryngeal nerve
Median portion ol thyro-

hyoid membrane

SUPERIOR CORNU OF THYROID

CARTILAGE

MEDIAN NOTCH OF THYROID
CARTILAGE

Fomum Adami



OBLIQUE LINE OF THYROID
CARTILAGE



Crico-thyroid membrane



THIRD RING OF TRACHEA




Note the following:

Connection with the tongue. (Fig. 54.)

Median glosso-epiglottic fold.

Lateral glosso-epiglottic fold.

Epiglottic vallecula.
Superior aperture of larynx. (Fig. 54.)

Epiglottis.

Aryteno-epiglottic fold.

Cuneiform cartilage.

Carniculum laryngeus.

Inter-arytenoid fold.

Sinus pyriformis.

Lower end of pharynx.
Inside of larynx.

Cushion or tubercle of the epiglottis.

Vocal process of arytenoid cartilage.



THE LARYNX



FIG. 57. SIDE VIEW OF THE CARTILAGES- OF THE LARYNX. (Modified from Bourgery and

Jacob.) (Morris.)



Thyro-hyoid membrane



SUPERIOR BORDER OF THYROID



Crieo-thyroid muscle
Crico-thyroid membrane
(median portion)

Crico-thyroid muscle



THIRD RING OF TRACHEA




Thyro-hyoid ligament

CARTILAGO TRITICEA



-SUPERIOR CORNU



Superior tubercle
Stylo-pharyngeus and
palato-pharyngeus

Thyro-hyoid muscle



Sterno-thyroid muscle and
inferior tubercle



Inferior constrictor



FIG. 58. POSTERIOR VIEW OF THE LARYNX, WITH THE MUSCLES REMOVED. (Holden.)
E., Epiglottis cushion (W.); L. ar.-ep., Aryteno-epiglottic fold or ligament; M.m., Mem-
brana mucosa; C. W., Cartilage of Wrisberg or cuneiform; C. S., Cartilage of Santorini
or cornicula laryngis; C. aryt., Arytenoid cartilage; C. c., Cricoid cartilage; P. m.,
Muscular process or external angle; L.cr.-ar., Cricoarytenoid ligament; C. s., Superior
cornu; C. i., Inferior cornu of the thyroid cartilage; L. ce.-cr. p. i., Posterior inferior
cerato-cricoid ligament; C. tr., Tracheal cartilage; P. m. tr., Membranous portion of
the trachea.




THE LARYXX



53



True vocal cords.

False vocal cords.

Ventricle of larynx.

Rima glottidis.

Study the cartilages of the larynx. (Fig. 58.)

Note the articulations of the thyroid, cricoid, and arytenoid cartilages.
Clean and study the muscles:
Crico-thvroid.



FIG. 59. POSTERIOR VIEW OF THE LARYNX, WITH ITS MUSCLES. (Holden.)
E., Epiglottis, with the cushion (W.); C.W., Cartilage of Wrisberg; C.S., Cartilage of San-
torini; Cart, eric., Cricoid cartilage; Cornu sup., Superior cornu of the thyroid carti-
lage; A/, ar. tr., Transverse portion of the arytenoideus ; Mtn.ar. obi., Oblique portion
of the arytenoideus; M. cr. aryt. post., Crico-arytenoideus muscle; Pars can., Car-
tilaginous rings of the trachea; Pars memb., Tracheal membrane.




Crico-arytenoides posticus.

Arytenoides.

Now cut the thyroid cartilage a little to one side of the anterior median line,
disarticulate the inferior cornu from cricoid cartilage and remove this part of
thyroid cartilage. Then expose the muscles:
Crico-arytenoides lateralis.
Thyro-arytenoides.
Aryteno-epiglottideus .
Thyro-epiglottideus .

Study closely the action of the laryngeal muscles.



54



THE LARYNX
FIG. 60. SIDE VIEW OF THE MUSCLES AND LIGAMENTS OF THE LARYNX. (Morris.}

Epiglottis



Cut edge of hyo-epiglottidean
ligament

SECTION THROUGH BODY OF HYOID
BONE

Periglottis

Cut edge of thyro-hyoid
membrane

Thyro-epiglottideus muscle



SECTION OF THYROID CARTILAGE
Thyro-arytenoideus muscle



Crico - arytenoideus lateralis
muscle (the pointer crosses
crico-thyroid membrane.)

CRICOID CARTILAGE




Aryteno-epiglottidean fold
Aryteno-epiglottideus muscle



Arytenoideus muscle



Crico-arytenoideus posticus



Recurrent laryngeal nerve



FIG. 61. NERVES OF THE LARYNX (POSTERIOR VIEW.) (Morris.}

FORAMEN C/ECUM
BASE OF TONGUE



GREATER CORNU OF

HYOID BONE
CARTILAGO TRITICEA



SUPERIOR CORNU OF
THYROID CARTILAGE



BRANCH TO LATERAL
CRICO ARYTENOID
AND THYRO-ARYTE-
JfOID MUSCLES
BRANCH JOINING THE
SUPERIOR LARYN-
GEAL NERVE
Crico-arytenoideus
posticus muscle
INFERIOR CORNU OF
THYROID CARTILAGE




EXTERNAL LARYN-
GEAL NERVE

IN TERN A LLAR YN-
GEAL NERVE

Cut edge of thyro-
hyoid membrane



Arytenoideus muscle



RECURRENT

I,M:YNGEAL

NER VE



THE LARYXX



55



Study the thyro-hyoid membrane, crico-thyroid membrane, infenor
thyro-arytenoid ligament, superior thyro-arytenoid ligament, true vocal
cords, rima glottidis, ventricle, false vocal cords, laryngeal pouch or sac-
culus laryngis, and the mucous membrane.

Describe the nerve supply of the larynx (See Fig. 61):
Superior laryngeal.
Inferior or recurrent laryngeal.
Describe the arteries of the larynx (See Fig. 62) :
Branches of superior thyroid.
Branches of inferior thyroid.
Dorsalis lingual.



FIG. 62. SCHEME OF LEFT SUPERIOR THYROID ARTERY. (Walsham.) (Morris.)

Facial artery



Lingual artery



Supra-hyoid branch
Infra-hyoid branch

Superior laryngeal bratictt



Crico-thyroid branch




External carotid artery
Ascending pharyngeal artery

Internal carotid artery



Sterno-mastoid branch



Superior thyroid artery



Common carotid artery




Inferior thyroid artery



SUPRAM AXILLARY NERVE AXD XOSE



DEMONSTRATION X.

SUPRA-MAXILLARY REGION.

With a saw cut through the squamous portion of the temporal bone to within
one-fourth of an inch of the foramen rotundum. With a hammer break out
the portion of bone in front of the incision. Then begin at the Gassenan gan-
glion and trace out the superior tnaxillary division of the fifth nerve across the
spheno -maxillary fossa to the infra-orbital canal.

Deep in the spheno-maxillary fossa and just below the superior maxil-
lary nerve find Meckel's ga'nglion. (Figs. 63 and 66.)

FIG. 63. THE MAXILLARY NERVE SEEN FROM WITHOUT. (Beaunis.) (Morris.)

AJXTERWR DENTAL MAXILLARY KERVE ORBITAL BRAN< II

I \ .MAXILLARY NERVE




MECKEL'S GANGLION



POSTERIOR DENTAL



LOOP FORMED BY MIDDLE AND ANTERIOR DENTAL NERVES



Trace and study the branches of superior maxillary nerve:

Recurrent meningeal.

Spheno-palatine .

Orbital or temporo-malar.

Posterior superior dental.

Middle superior dental.

Anterior superior dental.

Review the third division of the internal' maxillary artery.

NOSE.

Study general description of the nose.

Open the nasal cavity by a vertical incision to one side of median line
so as to escape the septum. (Figs. 64 and 65.)
Study the septum.

Study the turbinate bones and meatuses and the openings into each.
What is the nerve and arterial supply of the nose?



THE XOSE



57



FIG. 64. SECTION SHOWING BONY AND CARTILAGINOUS SEPTUM. (Morris.)
The dotted lines indicate the course of the anterior palatine canal.



NASAL BONE



Frontal sinus



Sphenoidal sinus



UPPER LATERAL CARTILAGE

Groove between septal
and upper lateral
cartilage



LZ.'.i- LATERAL




N-P- -V

THICKENED BORDER OF CARTILAGE RESTING \ Pouch at r

UPOa AUTERiOR NASAL SPINE Incisive papilla \ extremity of Sten-



SEPTAL CARTILAGE 8on>8 canal



ORIFICE OF EUSTACHIAH

TUBE
SOFT PALATE



FIG. 65. SECTION OF THE XOSE. SHOWING THE TURBINAL BONES AND MEATUSES. WITH
THE OPENINGS IN DOTTED OUTLINE. (Morris.)



Frontal sinus



Orifice of middle ethmoidal cells

SUPERIOR TURBINAL BONE

Orifice of the posterior ethmoidal cells
Orifice of the sphenoidal sinus
Sphenoidal sinus




Orifice of frontal sintu



UPPER ORIRCE OF
NASAL DUCT



OWFICE OF EUSTACHIAN

/ 17 \

MIDDLE TURBINAL BONE / \ \

INFERlOfi TURBINAL BONE ORIFICE OF THE ANTRUM ORIFICE OF INFUNOIBULUU



LOWER ORIFICE OF NASAL DUCT



THE NOSE



FIG. 66. NERVES OF THE NASAL CAVITY. (Morris.)



NA SA L OLFA CTOR Y
FRONTAL SINUS NERVE NERVE




OF, FA CTOR Y NEK VK
TO SUPERIOR TUR-
BINA TE BONE

SPHENOIDAL SINUS



VIDIAN SERVE

MECKEL'S
GANGLION

DESCENDING
PA LA TINE

ORIFICE OF EUSTACHIAN
TUBE



NASAL BRANCHES



POSTERIOR

PALATINE
. ANTERIOR

PA LA TINE
MIDDLE PALATINE



FIG. 67. SECTION OF THE MIDDLE AND EXTERNAL EAR. (Morris.)



SEMI-
CIRCULAR
CANALS
Membrana
tympani



CAVITY OF
TYMPANUM




CARTILAGE

PINNA

CARTILAGINOUS MEATUS



OSSEOUS MEATUS



CARTILAGE OF EXTERNAL
MEATUS



PAROTID GLAND



STYLOID PROCESS



Internal carotid
artery



CARTILAGINOUS EUSTACHIAN
TUBE



OSSEOUS EUSTACHIAN TUBE



THE EAR



59



EAR.

External ear. (Fig. 67.)
Pinna or auricle.
Integument.
Cartilage.
Ligaments.
Muscles.

External auditory meat us.
Cartilaginous portion.
Osseous portion.
Skin.

Middle ear or tympanum.

Tympanic Cavity. This is best opened for inspection by removing its
roof or tegmen tympani. Make an opening through the tegmen tympani
external to the elevation formed by the superior semicircular canal. Re-
move the whole roof of the tympanic cavity, and study its ossicles, walls,
mastoid antrum, attic, and Eustachian tube.
Internal ear or labyrinth.
Osseous labyrinth.
Vestibule.

Semicircular canals.
Cochlea.



FIG. 68. SECTION OF THE TYMPANUM, ETC. Enlarged. (Morris.)



HEAD OF MALLEUS

LONG CRUS OF INCUS
BASE OF STAPES
HEAD OF STAPES

ORBICULAR BONE, OR

LENTICULAR PROCESS

EUSTACHIAN TUBE



Fibrous layer of
membrana tympani



CAVITY OF TYMPANUM







Suspensory ligament
ATTIC OF THE TYMPANUM
External ligament
SHORT CRUS OF MALLEUS

HANDLE OF MALLEUS
EXTERNAL AUDITORY CANAL



60 THE BACK

DEMONSTRATION XL
BACK.

Place the cadaver in a prone position. Note the vertebral spines. Sup-
port the chest with a block so as to make the muscles tense.

Dissection: Make an incision along the middle line of the back from
the occiput down. Turn the skin outward with care so as not to destroy
all of the posterior primary divisions of nerves. (Fig. 69.)

Posterior primary nerves:
Cervical.

Internal branches.

External branches.
First cervical.
Second cervical.

Internal branch or Great Occipital.
Third cervical.

Small occipital.

Fourth, fifth, sixth, seventh and eighth cervical.
Dorsal.

Internal branches.

External branches.

Lumbar branches.

Study superficial and deep fascia of the back.
Expose and study the following:

Muscles :

First layer. (Fig. 70.)
Trapezius.
Latissimus dorsi.

' Second layer. (Fig. 71.)

Levator anguli scapulas.
Rhomboideus minor.
Rhomboideus major.

Third layer. (Fig. 72.)

Serratus posticus superior.
Serratus posticus inferior.
Splenius capitis colli.



THE BACK



61



FIG. 69. DISTRIBUTION OF THE POSTERIOR PRIMARY DIVISIONS OF THE SPINAL NERVES.

(Henle.) (Morris.}



Scmi-spinalis



Multifldua spinae



LongissimuB
dorsi



Ilio-costalia



Trap ezi ns




Gluteus
maiimua



62 THE BACK

FIG. 70. FIRST LAYER OF MUSCLES OF THE BACK. (Morris.}



Triceps '-



Teres minor
Infraapinatus

Teres major

Rhomboideus major

Pectoralis major




Obliquus externus



Glutens medius



Glutens maximus



THE BACK



FIG. 71. THE LEVATOR ANGULI SCAPULAE AND RHOMBOIDEI. (Morris.')



Supraspinatu




Obliquus internus



Complexus
Splenius capitis



Levator anguli scapulae



Serratus posticua
superior



Rhomboideua minor



Splenius colli
Rhomboideus major



THE BACK



FIG. 72. THE THIRD AND FOURTH LAYERS OF THE MUSCLES OF THE BACK. (Morris.)



Spleniu;



Sple



Serratus posticua



Vertebral aponeurcwis



Serratus postious
inferior



Obliquus interims



Origin of latissimus
dorsi




SEVENTH CERV CAL VERTEBRA



TWELFTH THORACIC VERTEBRA



FIFTH LUMBAR VERTEBRA



THE BACK



FIG. 73. SCHEME OF INTERCOSTAL ARTERY. (Walsham.) (Morris.)



. Internal division of muscular branch
Semispinalis dorsi and multifidus spinae



Posterior spinal arteries



Rftroneural branch

Medullary branch

Preneural branch

> /'/.V.I /, ffjRD

Anterior spinal artery



Intercostal artery

Vena azygos minor
Vena azygns major _
THORACIC DUCT



External division of mitscular branch

Ilio-costalis



Spinal branch



Donal branch



Anterior intercostal



Internal mammary artery



Anterior perforating branch if
" Inti-miil mammary artery



SYMPATHETIC



Lower branch of
aortic intercostal

Upper or main
branch of aortic
intercostal




Lower branch of
anterior intercostal

Mammary glandular

branch

l'/>per or main
branch of anterior

intercostal



FIG. 74. SCHEME OF ANASTOMOSES OF THE RIGHT SCAPULAR ARTERIES. (Walsham.)

(Morris. )

Snhscapular branch of suprascapular artery
Supratpinons branch of siiprascapular artery



Posterior scapular artery



Suitraspinott* branch

of posterior scapular

artery
Snbscapular branch

of posterior scapular

artery



Branch of intercostal
artery



Branch of intercostal

artery

Continuation of posterior
scapular artery




Siiproicapular artery



Acromial branch
ofacromio-
thoracic

Acromial rete



Subscapular branch

of svprascapiilar

artery
Infraspinovs branch

of suprascapular

artery
Sttbscajmlfir branch

of axillary artery



Dorsal scapular branch of
subscapnlar artery



Continuation of sub-
scapular artery



66



THE BACK



FIG. 75. THE FIFTH LAYER OF THE MUSCLES OF THE BACK. (Morris.)



Com pi



Traehelo-m



Transversalis colli



Cervicalis ascendens



Longissimus dorsi



Aceessorius ad ilio-

costalera



Spinalis dorsi



Ilio-eostalis



Obliquus internus



Erector spinae




SEVENTH CERVICAL VERTEBRA



TWELFTH THORACIC VERTEBRA



FIFTH LUMBAR VERTEBRA



SUBOCCIPITAL TRIANGLE



67



Arteries (Figs. 73 and 74) :
Intercostals.
Posterior scapular.

Expose and study the erector spinae muscle. (Fig. 75.)
Study the vertebral aponeurosis.

The remaining muscles of the back, except the muscles of the sub-
occipital triangle, need not be dissected out. The names of the muscles
should, however, be remembered.



FIG. 76. DRAWING FROM NATURE, OF THE SUBOCCIPITAL TRIANGLE. (Holden.~)
and 7. Complexus. 2. Rectus cap. posticus minor. 3. Rectus cap. posticus major.
4. Obliquus inferior. 5. Sternomastoid. 6. Semispinalis colli. 8. Obliquus superior.
10. Splenius. n. Trachelo-mastoid. 12. Great occipital nerve. 13. Occipital artery


1 3 5 6 7 8 9 10 11

Online LibrarySimon Menno YutzyA manual and atlas of dissection → online text (page 3 of 11)