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FRANK H. NETTER, MD

Atlas of

NETTER
Human
Anatomy

7
SEVENTH
EDITION

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1600 John F. Kennedy Blvd.
Ste. 1800
Philadelphia, PA 19103-2899

ATLAS OF HUMAN ANATOMY, SEVENTH EDITION Standard Edition: 978-0-323-39322-5


Professional Edition: 978-0-323-55428-2
International Edition: 978-0-323-39321-8

Copyright © 2019 by Elsevier Inc.


Previous editions copyrighted 2014, 2011, 2006, 2003, 1997, 1989

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by
any means, electronic or mechanical, including photocopying, recording, or any information storage
and retrieval system, without permission in writing from the publisher. Details on how to seek
permission, further information about the Publisher’s permissions policies and our arrangements
with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency can
be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).

Permission to use Netter Art figures may be sought through the website NetterImages.com or by
emailing Elsevier’s Licensing Department at H.Licensing@elsevier.com.

Notices

Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional practices, or
medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein.
In using such information or methods they should be mindful of their own safety and the safety
of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer of
each product to be administered, to verify the recommended dose or formula, the method and
duration of administration, and contraindications. It is the responsibility of practitioners, relying
on their own experience and knowledge of their patients, to make diagnoses, to determine
dosages and the best treatment for each individual patient, and to take all appropriate safety
precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or
editors, assume any liability for any injury and/or damage to persons or property as a matter of
products liability, negligence or otherwise, or from any use or operation of any methods,
products, instructions, or ideas contained in the material herein.

International Standard Book Number: 978-0-323-39322-5

Executive Content Strategist: Elyse O’Grady


Senior Content Development Specialist: Marybeth Thiel
Publishing Services Manager: Patricia Tannian
Senior Project Manager: John Casey
Book Design: Patrick Ferguson

Printed in China

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CONSULTING EDITORS
Carlos A. G. Machado, MD Jennifer Brueckner-Collins, PhD
Chief Contributing Medical Illustrator Professor and Vice Chair of Educational Programs
Department of Anatomical Sciences and Neurobiology
John T. Hansen, PhD University of Louisville School of Medicine
Lead Editor Louisville, Kentucky
Professor of Neuroscience
Former Chair of Neurobiology and Anatomy and Todd M. Hoagland, PhD
Associate Dean for Admissions Professor
University of Rochester Medical Center Department of Cell Biology, Neurobiology, and Anatomy
Rochester, New York Medical College of Wisconsin
Milwaukee, Wisconsin
Brion Benninger, MD, MSc
Professor of Medical Innovation, Technology, & R. Shane Tubbs, MS, PA-C, PhD
Research; Professor of Clinical Anatomy Chief Scientific Officer, and Vice President
Executive Director, Chair, Medical Anatomy Center Seattle Science Foundation
Department of Medical Anatomical Sciences Seattle, Washington;
Faculty College of Dentistry Professor of Anatomy
Western University of Health Sciences Department of Anatomical Sciences
Lebanon Oregon; St. George’s University
Faculty, Sports Medicine Fellows, Orthopaedic and Grenada, West Indies;
General Surgery Residencies Centre of Anatomy and Human Identification
Samaritan Health Services, Corvallis, Oregon; Dundee University
Faculty, Surgery, Orthopedics & Rehabilitation, and Oral United Kingdom
Maxillofacial Surgery
Oregon Health & Science University
Portland, Oregon

EDITORS OF PREVIOUS EDITIONS


First Edition Fifth Edition Sixth Edition
Sharon Colacino, PhD John T. Hansen, PhD John T. Hansen, PhD
Brion Benninger, MD, MS Brion Benninger, MD, MS
Second Edition Jennifer K. Brueckner, PhD Jennifer Brueckner-Collins, PhD
Arthur F. Dalley II, PhD Stephen W. Carmichael, PhD, DSc Todd M. Hoagland, PhD
Noelle A. Granger, PhD R. Shane Tubbs, MS, PA-C, PhD
Third Edition R. Shane Tubbs, MS, PA-C, PhD
John T. Hansen, PhD

Fourth Edition
John T. Hansen, PhD
Jennifer K. Brueckner, PhD
Stephen W. Carmichael, PhD, DSc
Thomas R. Gest, PhD
Noelle A. Granger, PhD
Anil H. Waljii, MD, PhD

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INTERNATIONAL ADVISORY BOARD
Hassan Amiralli, MBBS, MS (Surg) Virginia T. Lyons, PhD Mark E. Sturgill, DO
Professor and Chair Associate Professor of Medical Pediatric and Neuroradiologist
Department of Anatomy Education Radiology Partners
American University of Antigua Associate Dean of Preclinical Hopkinsville, Kentucky
College of Medicine Year 1
Antigua, West Indies Geisel School of Medicine at William J. Swartz, PhD
Dartmouth Professor of Cell Biology and
Nihal Apaydın, MD, PhD Hanover, New Hampshire Anatomy
Professor, Department of Anatomy Louisiana State University
Faculty of Medicine Thazhumpal Chacko Mathew, PhD Health Sciences Center
Vice Director, Brain Research Center Professor and Vice Dean for New Orleans, Louisiana
Ankara University Research, Training, and
Ankara, Turkey Consultation Kimberly Topp, PT, PhD
Faculty of Allied Health Sciences Professor and Chair
Keith E. Baynes, MD Health Sciences Centre Department of Physical Therapy and
Section Chief, MSK and General Kuwait University Rehabilitation Science
Radiology Kuwait City, Kuwait Department of Anatomy
Associate Professor of Radiology University of California, San
Medical College of Wisconsin Paul E. Neumann, MD Francisco
Milwaukee, Wisconsin Professor, Department of Anatomy San Francisco, California
and Neurobiology
Francisco J. Caycedo, MD Faculty of Medicine Ivan Varga, PhD
Specialist in Foot and Ankle Surgery Dalhousie University Professor of Anatomy, Histology,
Sports Medicine and Halifax, Nova Scotia, Canada and Embryology
Musculoskeletal Ultrasound Faculty of Medicine
OrthoSports Associates–St. Eduardo Cotecchia Ribeiro, PhD Comenius University
Vincent’s Birmingham Associate Professor of Descriptive Bratislava, Slovak Republic
Birmingham, Alabama and Topographic Anatomy
Department of Morphology and Peter J. Ward, PhD
William E. Cullinan, PhD Genetics Associate Professor of Anatomy
Professor, Department of School of Medicine West Virginia School of Osteopathic
Biomedical Sciences Federal University of São Paulo Medicine
Director, Integrative Neuroscience São Paulo, Brazil Lewisburg, West Virginia
Research Center
Dean, College of Health Sciences Danielle F. Royer, PhD Robert J. Ward, MD
Marquette University Associate Professor Chief, Musculoskeletal Imaging and
Milwaukee, Wisconsin Cell and Developmental Biology Intervention
University of Colorado, Anschutz Director, Bone Densitometry
Joe Iwanaga, DDS, PhD Medical Campus Department of Radiology
Assistant Professor Aurora, Colorado Tufts Medical Center
Division of Gross and Clinical Director, Undergraduate Radiology
Anatomy Jonathan Spratt, MB, BChir Education
Department of Anatomy Clinical Director of Radiology Assistant Professor of Radiology and
Kurume University School of Sunderland City Hospitals Orthopedics
Medicine Sunderland, United Kingdom Tufts University School of Medicine
Kurume, Japan Former Examiner in Anatomy Boston, Massachusetts
Royal College of Radiologists
Christopher R. Kelly, MD and Royal College of Surgeons of Kristy A. Weir, PhD
Clinical Fellow England School of Biomedical Sciences
Division of Cardiology Visiting Professor of Anatomy The University of Queensland
Columbia University Medical Center St. George’s University St Lucia, Queensland, Australia
New York, New York Grenada, West Indies

Robert Louis, MD Susan Standring, MBE, PhD, DSc


Director, Skull Base and Pituitary Professor Emeritus of Anatomy
Tumor Program Department of Anatomy
Minimally Invasive Brain and Spine King’s College London
Surgery London, United Kingdom
Hoag Neurosciences Institute
Newport Beach, California
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NEW TO THIS EDITION
With your copy of the Frank H. Netter, MD, Atlas of Human New Art Plates by Dr. Machado
Anatomy, you own a collection of some of the most well- For this edition alone, over 25 new illustrations have been
known depictions of human anatomy in medicine and painted by Dr. Machado. Suggestions for new plates of
healthcare. In addition to the famous work of Dr. Netter, additional anatomic views and concepts are submitted
with your copy of this 7th edition, you also have access to by students, faculty, anatomists, physicians, and others.
nearly 100 painted pieces by Carlos A. G. Machado, MD, Sometimes suggestions are solicited at major anatomy
one of the foremost medical illustrators working today. Dr. conferences with a “What Should Carlos Paint Next?” idea
Machado’s contributions to the Atlas highlight important box. Decisions around which new plates are prioritized
views of anatomy that have become more clinically relevant and given space in a new edition come from discussions
in recent years— anatomic views that have resulted from among consulting editors. The new plates for this edition are
improved dissection techniques and modern imaging. largely those that portray structures with clinical significance
In addition, you have access to more than 50 carefully (Fascial Columns of the Neck, Deep Veins of the Leg, Hip
selected radiologic images that help bridge the idealized Bursae, and Vasculature of the Prostate) or those that are
illustrated anatomy with living anatomy viewed in the difficult to visualize (Infratemporal Fossa)—and, of course,
clinic. the new additions created for the introductory section.
While numerous updates have been made to the
illustrated plates and tables to make them easier to learn Terminology Updates
from, the most significant changes to this edition include: The Atlas of Human Anatomy uses terminology accepted
(in Göttingen, Germany, on September 24, 2016) by the
Introductory Section Federative International Programme on Anatomical Termi-
To fulfill the requests from many students and fans of nologies and published as updates to the 1998 Terminologia
Netter’s Atlas, we have added a new opening section Anatomica. Numerous updates to terminology have been
containing several overview plates. These plates provide made, so in select cases, former terminology has been
the very first head-to-toe views in the Atlas of Human included within parentheses to assist with the transition.
Anatomy!
New Radiologic Images
Clinical Tables Over 50 radiologic images—some completely new views
The Atlas of Human Anatomy is the only anatomy atlas and others replacing existing views using newer imaging
illustrated by physicians. Dr. Netter was a surgeon and tools—are included in this edition. Images have been
Dr. Machado is a cardiologist. The views of anatomy selected based on their utility to students studying gross
in this atlas have always reflected a clinical perspec- anatomy.
tive. In line with this clinical focus, and in congruence Your Atlas of Human Anatomy content has been updated,
with integrated curricula in health and medicine, tables created, and overseen by a team of dedicated and pas-
at the end of each regional section highlight the most sionate consulting editors, with the help of a stellar
commonly injured structures, as well as other structures international advisory board, and guided by the feedback
with high clinical significance and commonly covered of many students, educators, anatomists, and clinicians
in anatomy courses. The tables provide students with that love Netter’s Atlas. Please feel free to comment on
quick summaries, organized by body system, and note the Netter Images Facebook page or Twitter feeds or email
where to best view these key structures in the illustrated us directly with your thoughts, suggestions, or questions
plates. at NetterAppFeedback@Elsevier.com.

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To my dear wife, Vera

PREFACE TO THE FIRST EDITION


I have often said that my career as a medical artist for revision of a number of them in order to make them more
almost 50 years has been a sort of “command performance” pertinent to today’s ever-expanding scope of medical and
in the sense that it has grown in response to the desires surgical practice. In addition, I found that there were gaps
and requests of the medical profession. Over these many in the portrayal of medical knowledge as pictorialized in
years, I have produced almost 4,000 illustrations, mostly the illustrations I had previously done, and this necessitated
for The CIBA (now Netter) Collection of Medical Illustrations my making a number of new pictures that are included in
but also for Clinical Symposia. These pictures have been this volume.
concerned with the varied subdivisions of medical knowl- In creating an atlas such as this, it is important to achieve a
edge such as gross anatomy, histology, embryology, happy medium between complexity and simplification. If the
physiology, pathology, diagnostic modalities, surgical and pictures are too complex, they may be difficult and confusing
therapeutic techniques, and clinical manifestations of a to read; if oversimplified, they may not be adequately defini-
multitude of diseases. As the years went by, however, tive or may even be misleading. I have therefore striven for
there were more and more requests from physicians and a middle course of realism without the clutter of confusing
students for me to produce an atlas purely of gross anatomy. minutiae. I hope that the students and members of the
Thus, this atlas has come about, not through any inspiration medical and allied professions will find the illustrations readily
on my part but rather, like most of my previous works, as understandable, yet instructive and useful.
a fulfillment of the desires of the medical profession. At one point, the publisher and I thought it might be
It involved going back over all the illustrations I had nice to include a foreword by a truly outstanding and
made over so many years, selecting those pertinent to renowned anatomist, but there are so many in that category
gross anatomy, classifying them and organizing them by that we could not make a choice. We did think of men
system and region, adapting them to page size and space, like Vesalius, Leonardo da Vinci, William Hunter, and Henry
and arranging them in logical sequence. Anatomy of course Gray, who of course are unfortunately unavailable, but I
does not change, but our understanding of anatomy and do wonder what their comments might have been about
its clinical significance does change, as do anatomical this atlas.
terminology and nomenclature. This therefore required Frank H. Netter, MD
much updating of many of the older pictures and even (1906–1991)

FRANK H. NETTER, MD
Frank H. Netter was born in New York City in 1906. He Dr. Netter’s works are among the finest examples of
studied art at the Art Students League and the National the use of illustration in the teaching of medical concepts.
Academy of Design before entering medical school at New The 13-book Netter Collection of Medical Illustrations, which
York University, where he received his Doctor of Medicine includes the greater part of the more than 20,000 paintings
degree in 1931. During his student years, Dr. Netter’s created by Dr. Netter, became and remains one of the
notebook sketches attracted the attention of the medical most famous medical works ever published. The Netter
faculty and other physicians, allowing him to augment his Atlas of Human Anatomy, first published in 1989, presents
income by illustrating articles and textbooks. He continued the anatomic paintings from the Netter Collection. Now
illustrating as a sideline after establishing a surgical practice translated into 16 languages, it is the anatomy atlas of
in 1933, but he ultimately opted to give up his practice in choice among medical and health professions students
favor of a full-time commitment to art. After service in the the world over.
United States Army during World War II, Dr. Netter began The Netter illustrations are appreciated not only for their
his long collaboration with the CIBA Pharmaceutical aesthetic qualities, but, more importantly, for their intel-
Company (now Novartis Pharmaceuticals). This 45-year lectual content. As Dr. Netter wrote in 1949 “clarification
partnership resulted in the production of the extraordinary of a subject is the aim and goal of illustration. No matter
collection of medical art so familiar to physicians and other how beautifully painted, how delicately and subtly rendered
medical professionals worldwide. a subject may be, it is of little value as a medical illustration
Icon Learning Systems acquired the Netter Collection if it does not serve to make clear some medical point.”
in July 2000 and continued to update Dr. Netter’s original Dr. Netter’s planning, conception, point of view, and
paintings and to add newly commissioned paintings by approach are what inform his paintings and what make
artists trained in the style of Dr. Netter. In 2005, Elsevier them so intellectually valuable.
Inc. purchased the Netter Collection and all publications
from Icon Learning Systems. There are now over 50 Frank H. Netter, MD, physician and artist, died in 1991.
publications featuring the art of Dr. Netter available through
Elsevier Inc.

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ACKNOWLEDGMENTS
Carlos A. G. Machado, MD colleagues at Rochester and to all my past and present
I struck luck when joining this golden team of consulting students who have provided generous and constructive
editors exceedingly knowledgeable in the fields of clini- feedback and have enriched my life. Finally, I am indebted
cal anatomy and medical education. It has been a great to my entire family for their continued support and especially
honor to work with and be under their guidance, as well to my wife, Paula. Their love and encouragement sustains
as under the highly competent coordination of Elyse me and is the source of all the happiness and joy I know.
O’Grady and Marybeth Thiel, Elsevier’s Executive Content
Strategist and Senior Content Development Specialist, Brion Benninger, MD, MSc
respectively. Every day I am thankful for my wife, Alison, and son,
This unique book would not exist without the genius Jack, for the laughs we have as a family, often from my
of its creator, Dr. Frank Netter, to whom I owe special follies, which is such a tonic. I thank Elsevier, especially
thanks, also in the name of generations of students and Marybeth Thiel, Elyse O’Grady, and Madelene Hyde for their
health professionals who, like myself, have learned so professionalism and guidance, enabling John Hansen, Carlos
much from his incommensurable body of work. Machado, and my fellow coeditors to work in a unique
I dedicate my work and express my most sincere thanks and dynamic environment. I thank those clinicians who
to my beloved parents, Carlos and Neide, who provided trained me, especially my early gifted surgeon/anatomist/
me with the foundation of my education; to my patient teacher mentors, Drs. Gerald Tressidor and Harold Ellis
wife, Adriana, and talented daughter, Beatriz, for their CBE (Cambridge & Guy’s Hospital); Dr. S. Standring, who
love and support; to the students, teachers, and health embodies professionalism and displays fortitude; Drs. P.
professionals who rely on my work to learn and teach; to Crone and J. Heatherington, and the University Board for
all the body donors and living friends that have respectively their stellar support; my past and future students and
been the subjects of my studies and models of most of the patients; and clinical colleagues from all corners of the
illustrations I have created for the Atlas; and to my teach- world who keep anatomy dynamic, fresh, and wanting
ers Eugênio Cavalcante, Mário Fortes, and Paulo Carneiro more. Special thanks to Jim Diegel and Erik Szeto, friends,
for taking my interest in human/clinical anatomy much mentors and fellow visionaries who also see “outside the
further. box,” challenging status quo. A heartfelt tribute to my late
mentors, friends, and sister, Jim McDaniel, Bill Bryan, and
John T. Hansen, PhD Gail Hendricks, all who represent what is good in teach-
At Elsevier I would like to thank Marybeth Thiel, Senior ing, caring, and healing. They made this world a wee bit
Content Development Specialist, Elyse O’Grady, Executive better. Lastly, I thank my mother for her love of education
Content Strategist, John Casey, Senior Project Manager, and equality and my father for his inquisitive and creative
Patricia Tannian, Publishing Services Manager, Julia mind.
Dummitt, Design Manager, Karen Giacomucci, Illustration
Buyer, and Madelene Hyde, Publishing Director, for their Jennifer Brueckner-Collins, PhD
continuous support and meticulous attention to detail during Many thanks to the Elsevier team, particularly Marybeth
the development of this seventh edition of the Atlas of Thiel and Elyse O’Grady, for their guidance and expertise
Human Anatomy. They, along with the entire editorial, during our preparation of the seventh edition. It is always
production, design, and marketing teams at Elsevier have an honor to work with Carlos Machado, whose passion
been a delight to work with and to know. I also wish to for and mastery of the art of clinical anatomy and medicine
thank my consulting editors for their insightful and construc- never cease to amaze me. I am forever indebted to Brian
tive suggestions as we strive to make every new edition MacPherson, who has served as a teacher, mentor, and
of the Atlas better. I am also indebted to Carlos Machado friend to me for more than 20 years….you showed me
for his superb artistic skill in producing and updating a what it means to be a true educator and I have been so
number of plates that appear in this latest edition of the fortunate to have the opportunity to build a career based
Atlas. His renderings of human anatomy are the perfect on those principles. To Kurt and Lincoln, you are my inspira-
complement to the Netter images. In addition to my fellow tion….my world…my life and I love you to the snow moon
editors, I wish to express my thanks to my faculty and back.

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Todd M. Hoagland, PhD helping me become a competent clinical anatomist, and
It is a privilege to teach clinical human anatomy and I am to Rob Bouchie for his camaraderie. I am most grateful to
eternally grateful to all the body donors and their families my brother, Bill, for his unwavering optimism and gregarious
for enabling healthcare professionals to train in the dis- nature. I thank my mother, Liz, for her dedication and love
section laboratory. It is my honor to work with outstanding and for instilling a strong work ethic. Finally, I am humbled
medical students and colleagues at the Medical College by my two awesome children, Ella and Caleb, for helping
of Wisconsin. I am grateful to John Hansen and the profes- me redefine love, wonder, and joy.
sionals of the Elsevier team for the opportunity to be a
steward of the incomparable Netter’s Atlas. Marybeth Thiel R. Shane Tubbs, MS, PA-C, PhD
and Elyse O’Grady were especially helpful and a pleasure Elsevier and the Netter team have once again been a joy
to work with. It was an honor to collaborate with the to work with. I thank Elyse O’Grady, Marybeth Thiel, and
brilliant Carlos Machado and all the consulting editors. I John Casey for their tremendous work on this edition. In
thank Bill Swartz and Mark Moss for being outstanding addition, Carlos Machado has again added his expertise
mentors, and I thank all of the graduate students I’ve to bringing his anatomical images to life. As always, my
worked with, especially Rebecca Lufler. I am deeply work is inspired by my beautiful wife, Susan, and son,
appreciative of Stan Hillman and Jack O’Malley for inspiring Isaiah. Lastly, I am indebted to my parents, Richard and
me with masterful teaching and rigorous expectations. I Karon Tubbs, who supported me in my career to better
am indebted to Gary Kolesari and Richard Hoyt Jr. for understand the human body.

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CONTENTS
SECTION 1 INTRODUCTION • Plates 1-7
Introduction • Plates 1-7
1 Body Planes and Terms of Relationship
2 Surface Anatomy: Regions (Anterior View of Female)
3 Surface Anatomy: Regions (Posterior View of Male)
4 Major Arteries and Pulse Points
5 Major Systemic Veins of the Cardiovascular System
6 General Organization of the Nervous System
7 Overview of the Lymphatic System

Electronic Bonus Plates • Plates BP1-BP16


BP 1 Cross Section of Skin
BP 2 Pilosebaceous Unit
BP 3 Major Body Cavities
BP 4 Skeletal System: Axial and Appendicular Skeletons
BP 5 Types of Synovial Joints
BP 6 Joints: Connective Tissues and Articular Cartilage
BP 7 Architecture of Bone
BP 8 Muscular System
BP 9 Overview of the Gastrointestinal System
BP 10 Overview of the Endocrine System
BP 11 Neurons and Synapses
BP 12 Features of a Typical Peripheral Nerve
BP 13 Sites of Visceral Referred Pain
BP 14 General Organization of the Cardiovascular System
BP 15 Cardiovascular System: Composition of Blood
BP 16 Arterial Wall

SECTION 2 HEAD AND NECK • Plates 8-160


Surface Anatomy • Plate 8
8 Head and Neck: Surface Anatomy

Superficial Head and Neck • Plates 9-10


9 Cutaneous Nerves of Head and Neck
10 Superficial Arteries and Veins of Face and Scalp

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Bones and Ligaments • Plates 11-30
11 Skull: Anterior View
12 Skull: Radiographs
13 Skull: Lateral View
14 Skull: Lateral Radiograph
15 Skull: Midsagittal Section
16 Calvaria
17 Cranial Base: Inferior View
18 Cranial Base: Superior View
19 Foramina and Canals of Cranial Base: Inferior View
20 Foramina and Canals of Cranial Base: Superior View
21 Skull of Newborn
22 Bony Framework of Head and Neck
23 Pterygoid Fossae
24 Mandible
25 Temporomandibular Joint
26 Cervical Vertebrae: Atlas and Axis
27 Cervical Vertebrae (continued)
28 Cervical Vertebrae: Uncovertebral Joints
29 External Craniocervical Ligaments
30 Internal Craniocervical Ligaments

Neck • Plates 31-41


31 Muscles of Facial Expression: Lateral View
32 Muscles of Neck: Anterior View
33 Fascial Layers of Neck
34 Cervical Fasciae
35 Infrahyoid and Suprahyoid Muscles
36 Muscles of Neck: Lateral View
37 Anterior and Lateral Cervical Muscles
38 Superficial Veins and Cutaneous Nerves of Neck
39 Nerves and Vessels of Neck
40 Nerves and Vessels of Neck (continued)
41 Carotid Arteries

Nasal Region • Plates 42-64


42 Nose
43 Lateral Wall of Nasal Cavity
44 Lateral Wall of Nasal Cavity (continued)
45 Medial Wall of Nasal Cavity (Nasal Septum)
46 Nerves of Nasal Cavity
47 Arteries of Nasal Cavity: Bony Nasal Septum Turned Up
48 Nerves of Nasal Cavity: Bony Nasal Septum Turned Up
49 Nose and Maxillary Sinus: Transverse Section
50 Paranasal Sinuses: Coronal and Transverse Sections
51 Paranasal Sinuses: Parasagittal Views
52 Paranasal Sinuses: Changes with Age

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53 Salivary Glands
54 Facial Nerve Branches and Parotid Gland
55 Muscles Involved in Mastication
56 Muscles Involved in Mastication (continued)
57 Maxillary Artery
58 Proximal Maxillary and Superficial Temporal Arteries
59 Mandibular Nerve (CN V3)
60 Superior View of Infratemporal Fossa
61 Ophthalmic (CN V1) and Maxillary (CN V2) Nerves
62 Autonomic Innervation of Nasal Cavity
63 Nerves and Arteries of the Deep Face
64 Orientation of Nerves and Vessels of the Cranial Base

Oral Region • Plates 65-74


65 Inspection of Oral Cavity
66 Afferent Innervation of Oral Cavity and Tongue
67 Roof of Oral Cavity
68 Tongue and Salivary Glands: Sections
69 Floor of Oral Cavity
70 Tongue
71 Tongue (continued)
72 Fauces
73 Teeth
74 Teeth (continued)

Pharynx • Plates 75-86


75 Muscles of Pharynx: Partially Opened Posterior View
76 Posterior View of Pharynx: Nerves and Vessels
77 Pharynx: Medial View
78 Muscles of Pharynx: Medial View
79 Pharynx: Opened Posterior View
80 Pharyngoesophageal Junction
81 Muscles of Pharynx: Lateral View
82 Nerves of Oral, Head, and Neck Regions
83 Arteries of Oral and Pharyngeal Regions
84 Veins of Face and Neck Regions
85 Lymph Vessels and Nodes of Head and Neck
86 Lymph Vessels and Nodes of Pharynx and Tongue

Thyroid Gland and Larynx • Plates 87-93


87 Thyroid Gland: Anterior View
88 Thyroid Gland and Pharynx: Posterior View
89 Parathyroid Glands
90 Cartilages of Larynx
91 Intrinsic Muscles of Larynx
92 Nerves and Coronal Section of Larynx
93 Action of Intrinsic Muscles of Larynx

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Orbit and Contents • Plates 94-104
94 Eyelids
95 Lacrimal Apparatus
96 Extrinsic Eye Muscles
97 Nerves of Orbit
98 Superior and Anterior Views of Orbit
99 Arteries and Veins of Orbit and Eyelids
100 Eyeball: Transverse Section
101 Anterior and Posterior Chambers of Eyeball
102 Lens and Supporting Structures
103 Intrinsic Arteries and Veins of Eye
104 Vascular Supply of Eye

Ear • Plates 105-110


105 Ear and Course of Sound in Cochlea
106 External Ear and Tympanic Cavity
107 Tympanic Cavity
108 Bony and Membranous Labyrinths
109 Bony and Membranous Labyrinths (continued)
110 Orientation of Labyrinths in Skull

Meninges and Brain • Plates 111-126


111 Meninges and Diploic Veins
112 Meningeal Arteries
113 Meninges and Superficial Cerebral Veins
114 Dural Venous Sinuses: Sagittal Section
115 Dural Venous Sinuses (continued)
116 Brain: Lateral Views
117 Brain: Medial Views
118 Brain: Inferior View
119 Ventricles of Brain
120 Circulation of Cerebrospinal Fluid
121 Basal Nuclei (Ganglia)
122 Thalamus and Related Structures
123 Hippocampus and Fornix
124 Brain Stem
125 Ventricles and Cerebellum
126 Cerebellum

Cranial and Cervical Nerves • Plates 127-146


127 Cranial Nerve Nuclei in Brain Stem: Schema
128 Cranial Nerve Nuclei in Brain Stem: Schema (continued)
129 Cranial Nerves (Motor and Sensory Distribution): Schema
130 Olfactory Nerve (CN I): Schema
131 Optic Nerve (CN II) (Visual Pathway): Schema

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132 Oculomotor (CN III), Trochlear (CN IV), and Abducens (CN VI)
Nerves: Schema
133 Trigeminal Nerve (CN V): Schema
134 Facial Nerve (CN VII): Schema
135 Vestibulocochlear Nerve (CN VIII): Schema
136 Glossopharyngeal Nerve (CN IX): Schema
137 Vagus Nerve (CN X): Schema
138 Accessory Nerve (CN XI): Schema
139 Hypoglossal Nerve (CN XII): Schema
140 Cervical Plexus: Schema
141 Autonomic Nerves in Neck
142 Autonomic Nerves in Head
143 Ciliary Ganglion: Schema
144 Pterygopalatine and Submandibular Ganglia: Schema
145 Otic Ganglion: Schema
146 Taste Pathways: Schema

Cerebral Vasculature • Plates 147-158


147 Arteries to Brain and Meninges
148 Internal Carotid Artery in Petrous Part of Temporal Bone
149 Arteries to Brain: Schema
150 Arteries of Brain: Inferior Views
151 Cerebral Arterial Circle (of Willis)
152 Arteries of Brain: Frontal View and Section
153 Arteries of Brain: Lateral and Medial Views
154 Arteries of Posterior Cranial Fossa
155 Veins of Posterior Cranial Fossa
156 Deep Veins of Brain
157 Subependymal Veins of Brain
158 Hypothalamus and Hypophysis

Regional Imaging • Plates 159-160


159 Cranial Imaging (MRA and MRV)
160 Cranial Imaging (MRI)

Structures with High Clinical Significance • Tables 2.1-2.3

Muscle Tables • Tables 2.4-2.9

Electronic Bonus Plates • Plates BP17-BP32


BP17 3D Skull Reconstruction CTs
BP18 Degenerative Changes in Cervical Vertebrae
BP19 Atlantooccipital Junction
BP20 Muscles of Facial Expression: Anterior View
BP21 Musculature of Face
BP22 Paranasal Sinuses

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BP23 Subclavian Artery
BP24 Opening of the Mandible
BP25 Afferent Innervation of Oral Cavity and Pharynx
BP26 Fasciae of Orbit and Eyeball
BP27 Tympanic Cavity
BP28 Anatomy of the Pediatric Ear
BP29 Auditory Tube (Eustachian)
BP30 Arteries and Veins of Hypothalamus and Hypophysis
BP31 Cranial Imaging (MRV and MRA)
BP32 Axial and Coronal MRIs of Brain

SECTION 3 BACK AND SPINAL CORD • Plates 161-186


Surface Anatomy • Plate 161
161 Back: Surface Anatomy

Bones and Ligaments • Plates 162-168


162 Vertebral Column
163 Thoracic Vertebrae
164 Lumbar Vertebrae
165 Vertebrae: Radiograph and MRI
166 Sacrum and Coccyx
167 Vertebral Ligaments: Lumbosacral Region
168 Vertebral Ligaments: Lumbar Region

Spinal Cord • Plates 169-179


169 Spinal Cord and Anterior Rami
170 Relation of Spinal Nerve Roots to Vertebrae
171 Dermatomes
172 Sympathetic Nervous System: Schema
173 Parasympathetic Nervous System: Schema
174 Spinal Meninges and Nerve Roots
175 Spinal Nerve Origin: Cross Sections
176 Arteries of Spinal Cord: Schema
177 Arteries of Spinal Cord: Intrinsic Distribution
178 Veins of Spinal Cord and Vertebral Column
179 Veins of Vertebral Column: Vertebral Veins

Muscles and Nerves • Plates 180-184


180 Muscles of Back: Superficial Layer
181 Muscles of Back: Intermediate Layer
182 Muscles of Back: Deep Layer
183 Nerves of Back
184 Suboccipital Triangle

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Cross-Sectional Anatomy • Plates 185-186
185 Lumbar Region of Back: Cross Section
186 Typical Thoracic Spinal Nerve: Cross Section

Structures with High Clinical Significance • Table 3.1

Muscle Tables • Tables 3.2-3.3

Electronic Bonus Plates • Plates BP33-BP43


BP33 Vertebral Ligaments
BP34 Cervical Spine: Radiographs
BP35 Cervical Spine: MRI and Radiograph
BP36 Thoracolumbar Spine: Lateral Radiograph
BP37 Lumbar Vertebrae: Radiographs
BP38 Lumbar Spine: MRIs
BP39 Sympathetic Nervous System: General Topography
BP40 Parasympathetic Nervous System: General Topography
BP41 Cholinergic and Adrenergic Synapses: Schema
BP42 Vertebral Veins: Detail Showing Venous Communications
BP43 Spinal Cord Cross Sections: Fiber Tracts

SECTION 4 THORAX • Plates 187-248


Surface Anatomy • Plate 187
187 Thorax: Surface Anatomy

Mammary Gland • Plates 188-191


188 Mammary Gland
189 Arteries of Mammary Gland
190 Lymph Vessels and Nodes of Mammary Gland
191 Lymphatic Drainage of Breast

Body Wall • Plates 192-201


192 Bony Framework of Thorax
193 Ribs and Associated Joints
194 Anterior Thoracic Wall
195 Anterior Thoracic Wall (continued)
196 Anterior Thoracic Wall: Internal View
197 Intercostal Nerves and Arteries
198 Veins of Internal Thoracic Wall
199 Phrenic Nerve
200 Respiratory Diaphragm: Thoracic Surface
201 Respiratory Diaphragm: Abdominal Surface

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Lungs • Plates 202-214
202 Topography of Lungs: Anterior View
203 Topography of Lungs: Posterior View
204 Lungs in Situ: Anterior View
205 Lungs: Medial Views
206 Bronchopulmonary Segments
207 Bronchopulmonary Segments (continued)
208 Trachea and Major Bronchi
209 Bronchi and Intrapulmonary Airways
210 Great Vessels of Superior Mediastinum
211 Bronchial Arteries and Veins
212 Lymph Vessels and Nodes of Lung
213 Autonomic Nerves of Thorax
214 Innervation of Tracheobronchial Tree: Schema

Heart • Plates 215-233


215 Heart in Situ
216 Heart: Anterior Exposure
217 Heart: Radiographs and CT Angiogram; Auscultation of Heart
218 Heart: Base and Diaphragmatic Surface
219 Pericardial Sac
220 Mediastinum: Cross Section
221 Thorax: Coronal Section of Heart and Ascending Aorta
222 Coronary Arteries and Cardiac Veins
223 Coronary Arteries: Imaging
224 Right Atrium and Ventricle
225 Left Atrium and Ventricle
226 Valves and Fibrous Skeleton of Heart
227 Valves and Fibrous Skeleton of Heart (continued)
228 Atria, Ventricles, and Interventricular Septum
229 Conducting System of Heart
230 Nerves of Thorax
231 Innervation of Heart: Schema
232 Innervation of Blood Vessels: Schema
233 Prenatal and Postnatal Circulation

Mediastinum • Plates 234-243


234 Mediastinum: Right Lateral View
235 Mediastinum: Left Lateral View
236 Esophagus in Situ
237 Topography and Constrictions of Esophagus
238 Musculature of Esophagus
239 Esophagogastric Junction
240 Arteries of Esophagus
241 Veins of Esophagus
242 Lymph Vessels and Nodes of Esophagus
243 Nerves of Esophagus

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Regional Scans • Plate 244
244 Chest Scans: Axial CT Images

Cross-Sectional Anatomy • Plates 245-248


245 Cross Section of Thorax at T3 Level
246 Cross Section of Thorax at T3-4 Disc Level
247 Cross Section of Thorax at T4-5 Disc Level
248 Cross Section of Thorax at T7 Level

Structures with High Clinical Significance • Tables 4.1-4.2

Muscle Table • Table 4.3

Electronic Bonus Plates • Plates BP44-BP57


BP44 Respiratory System
BP45 Cervical Ribs and Related Anomalies
BP46 Muscle Attachments of Ribs
BP47 Muscles of Respiration
BP48 Intrapulmonary Airways: Schema
BP49 Intrapulmonary Blood Circulation: Schema
BP50 Gas Exchange
BP51 Anterior Aspect of Heart
BP52 Coronary Arteries: Right Anterior Oblique Views with
Arteriograms
BP53 Coronary Arteries and Cardiac Veins: Variations
BP54 Intrinsic Nerves and Variations in Nerves of Esophagus
BP55 Arteries of Esophagus: Variations
BP56 Thorax: Coronal Section (Midaxillary Line, Tracheal
Bifurcation, Left Atrium)
BP57 Thorax: Coronal CTs

SECTION 5 ABDOMEN • Plates 249-332


Surface Anatomy • Plate 249
249 Abdomen: Surface Anatomy

Body Wall • Plates 250-269


250 Bony Framework of Abdomen
251 Regions and Planes of Abdomen
252 Anterior Abdominal Wall: Superficial Dissection
253 Anterior Abdominal Wall: Intermediate Dissection
254 Anterior Abdominal Wall: Deep Dissection
255 Rectus Sheath: Cross Section
256 Anterior Abdominal Wall: Internal View

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257 Posterolateral Abdominal Wall
258 Arteries of Anterior Abdominal Wall
259 Veins of Anterior Abdominal Wall
260 Nerves of Anterior Abdominal Wall
261 Thoracoabdominal Nerves
262 Inguinal Region: Dissections
263 Inguinal Canal and Spermatic Cord
264 Femoral Sheath and Inguinal Canal
265 Posterior Abdominal Wall: Internal View
266 Arteries of Posterior Abdominal Wall
267 Veins of Posterior Abdominal Wall
268 Lymph Vessels and Nodes of Posterior Abdominal Wall
269 Nerves of Posterior Abdominal Wall

Peritoneal Cavity • Plates 270-275


270 Greater Omentum and Abdominal Viscera
271 Mesenteric Relations of Intestines
272 Mesenteric Relations of Intestines (continued)
273 Omental Bursa: Stomach Reflected
274 Omental Bursa: Cross Section
275 Peritoneum of Posterior Abdominal Wall

Viscera (Gut) • Plates 276-283


276 Stomach in Situ
277 Mucosa of Stomach
278 Duodenum in Situ
279 Mucosa and Musculature of Small Intestine
280 Ileocecal Region
281 Ileocecal Region (continued)
282 (Vermiform) Appendix
283 Mucosa and Musculature of Large Intestine

Viscera (Accessory Organs) • Plates 284-289


284 Surfaces and Bed of Liver
285 Liver in Situ: Vascular and Duct Systems
286 Liver Structure: Schema
287 Gallbladder, Extrahepatic Bile Ducts, and Pancreatic Duct
288 Pancreas in Situ
289 Spleen

Visceral Vasculature • Plates 290-299


290 Arteries of Stomach, Liver, and Spleen
291 Arteries of Liver, Pancreas, Duodenum, and Spleen
292 Celiac Arteriogram and CT Angiogram
293 Arteries of Duodenum and Head of Pancreas
294 Arteries of Small Intestine
295 Arteries of Large Intestine

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296 Veins of Stomach, Duodenum, Pancreas, and Spleen
297 Veins of Small Intestine
298 Veins of Large Intestine
299 Hepatic Portal Vein Tributaries: Portacaval Anastomoses

Innervation • Plates 300-310


300 Autonomic Nerves and Ganglia
301 Autonomic Innervation of Stomach and Duodenum
302 Autonomic Innervation of Stomach and Duodenum
(continued)
303 Autonomic Innervation of Esophagus, Stomach, and
Duodenum: Schema
304 Autonomic Innervation of Small Intestine
305 Autonomic Innervation of Large Intestine
306 Autonomic Innervation of Intestines: Schema
307 Autonomic Reflex Pathways: Schema
308 Enteric Plexuses of Intestine
309 Autonomic Innervation of Liver: Schema
310 Autonomic Innervation of Pancreas: Schema

Kidneys and Suprarenal Glands • Plates 311-324


311 Kidneys in Situ: Anterior Views
312 Kidneys in Situ: Posterior Views
313 Renal Artery and Vein in Situ
314 Gross Structure of Kidney
315 Intrarenal Arteries and Renal Segments
316 Ureters in Abdomen and Pelvis
317 Arteries of Ureters and Urinary Bladder
318 Renal Fasciae
319 Lymph Vessels and Nodes of Kidneys and Urinary Bladder
320 Autonomic Nerves of Kidneys, Ureters, and Urinary Bladder
321 Autonomic Innervation of Kidneys and Upper Ureters:
Schema
322 Autonomic Nerves of Suprarenal Glands: Dissection and
Schema
323 Arteries and Veins of Suprarenal Glands in Situ
324 Abdominal Wall and Viscera: Paramedian (Parasagittal)
Section

Lymphatics • Plate 325


325 Abdominal and Pelvic Lymphatics: Schema

Regional Scans • Plates 326-327


326 Abdominal Scans: Axial CT Images
327 Abdominal Scans: Axial CT Images (continued)

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Cross-Sectional Anatomy • Plates 328-332
328 Cross Section at T10, Esophagogastric Junction
329 Cross Section at T12, Inferior to Xiphoid
330 Cross Section at T12–L1, Intervertebral Disc
331 Cross Section at L1–2, Intervertebral Disc
332 Cross Section at L3–4

Structures with High Clinical Significance • Tables 5.1-5.2

Muscle Table • Table 5.3

Electronic Bonus Plates • Plates BP58-BP87


BP58 Inguinal and Femoral Regions
BP59 Indirect Inguinal Hernia
BP60 Variations in Position and Contour of Stomach in Relation to
Body Habitus
BP61 Layers of Duodenal Wall
BP62 CT and MRCP Showing Appendix, Gallbladder, and Ducts;
Nerve Branches of Hepatic Artery
BP63 Topography of Liver
BP64 Variations in Form of Liver
BP65 Sigmoid Colon: Variations in Position
BP66 Variations in Arterial Supply to Cecum and Posterior
Peritoneal Attachment of Cecum
BP67 Variations in Pancreatic Duct
BP68 Variations in Cystic, Hepatic, and Pancreatic Ducts
BP69 Variations in Cystic Arteries
BP70 Variations in Hepatic Arteries
BP71 Variations and Anomalies of Hepatic Portal Vein
BP72 Variations in Celiac Trunk
BP73 Variations in Colic Arteries
BP74 Variations in Colic Arteries (continued)
BP75 Variations in Renal Artery and Vein
BP76 Histology of Renal Corpuscle
BP77 Nephron and Collecting Tubule: Schema
BP78 Blood Vessels in Parenchyma of Kidney: Schema
BP79 Lymph Vessels and Nodes of Stomach
BP80 Lymph Vessels and Nodes of Pancreas
BP81 Lymph Vessels and Nodes of Small Intestine
BP82 Lymph Vessels and Nodes of Large Intestine
BP83 Lymph Vessels and Nodes of Liver
BP84 Schematic Cross Section of Abdomen at Middle T12
BP85 Transverse Section of Abdomen: Level of L5, Near
Transtubercular Plane
BP86 Transverse Section of Abdomen: Level of S1, Anterior
Superior Iliac Spine
BP87 Axial CT Image of Upper Abdomen

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SECTION 6 PELVIS AND PERINEUM • Plates 333-401
Surface Anatomy • Plate 333
333 Pelvis and Perineum: Surface Anatomy

Bones and Ligaments • Plates 334-338


334 Bony Framework of Pelvis
335 Male and Female Pelvis: Radiographs
336 Sex Differences of Pelvis: Measurements
337 Bones and Ligaments of Pelvis
338 Bones and Ligaments of Pelvis (continued)

Pelvic Floor and Contents • Plates 339-349


339 Pelvic Diaphragm: Female
340 Pelvic Diaphragm: Female (continued)
341 Pelvic Diaphragm: Female (continued)
342 Pelvic Diaphragm: Male
343 Pelvic Diaphragm: Male (continued)
344 Pelvic Contents: Female
345 Pelvic Viscera and Perineum: Female
346 Pelvic Viscera: Female
347 Endopelvic Fascia and Potential Spaces
348 Pelvic Contents: Male
349 Pelvic Viscera and Perineum: Male

Urinary Bladder • Plates 350-352


350 Urinary Bladder: Orientation and Supports
351 Female Sphincters
352 Urinary Bladder: Female and Male

Uterus, Vagina, and Supporting Structures • Plates 353-357


353 Uterus, Vagina, and Supporting Structures
354 Uterus: Fascial Ligaments
355 Uterus and Adnexa
356 Female Pelvic Relationships
357 Pelvic Ligaments

Perineum and External Genitalia: Female • Plates 358-361


358 Female Perineum and External Genitalia (Pudendum or Vulva)
359 Female Perineum (Superficial Dissection)
360 Female Perineum and Deep Perineum
361 Female Perineal Spaces

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Perineum and External Genitalia: Male • Plates 362-369
362 Male Perineum and External Genitalia (Superficial Dissection)
363 Male Perineum and External Genitalia (Deeper Dissection)
364 Penis
365 Male Perineal Spaces
366 Prostate Gland and Seminal Vesicles
367 Urethra
368 Descent of Testis
369 Scrotum and Contents

Homologues of Genitalia • Plates 370-371


370 Homologues of External Genitalia
371 Homologues of Internal Genitalia

Testis, Epididymis, and Ductus Deferens • Plate 372


372 Testis, Epididymis, and Ductus Deferens

Rectum • Plates 373-378


373 Rectum in Situ: Female and Male
374 Ischioanal Fossae
375 Rectum and Anal Canal
376 Anorectal Musculature
377 External Anal Sphincter Muscle: Perineal Views
378 Actual and Potential Perineopelvic Spaces

Regional Scan • Plate 379


379 Pelvic Scans: Sagittal T2-Weighted MRIs

Vasculature • Plates 380-390


380 Arteries of Rectum and Anal Canal: Male Posterior View
381 Veins of Rectum and Anal Canal: Female Anterior View
382 Arteries and Veins of Pelvic Organs: Female Anterior View
383 Arteries and Veins of Testis: Anterior View
384 Arteries of Pelvis: Female
385 Arteries and Veins of Pelvis: Male
386 Arteries and Veins of Perineum and Uterus
387 Arteries and Veins of Perineum: Male
388 Lymph Vessels and Nodes of Pelvis and Genitalia: Female
389 Lymph Vessels and Nodes of Perineum: Female
390 Lymph Vessels and Nodes of Pelvis and Genitalia: Male

Innervation • Plates 391-399


391 Nerves of External Genitalia: Male
392 Nerves of Pelvic Viscera: Male
393 Nerves of Perineum: Male

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394 Nerves of Pelvic Viscera: Female
395 Nerves of Perineum and External Genitalia: Female
396 Neuropathways in Parturition
397 Innervation of Female Reproductive Organs: Schema
398 Innervation of Male Reproductive Organs: Schema
399 Innervation of Urinary Bladder and Lower Ureter: Schema

Cross-Sectional Anatomy • Plates 400-401


400 Male Pelvis: Cross Section of Bladder–Prostate Gland
Junction
401 Female Pelvis: Cross Section of Vagina and Urethra

Structures with High Clinical Significance • Tables 6.1-6.2

Muscle Tables • Tables 6.3-6.4

Electronic Bonus Plates • Plates BP88-BP98


BP88 Fasciae of Male and Female Pelvis and Perineum
BP89 Male and Female Cystourethrograms
BP90 Female Urethra
BP91 Genetics of Reproduction
BP92 Menstrual Cycle
BP93 Testes
BP94 Uterine Development
BP95 Ovary, Ova, and Follicles
BP96 Variations in Hymen
BP97 Cross Section Through Prostate
BP98 Arteries and Veins of Pelvis: Male

SECTION 7 UPPER LIMB • Plates 402-470


Surface Anatomy • Plate 402
402 Upper Limb: Surface Anatomy

Cutaneous Anatomy • Plates 403-407


403 Dermatomes of Upper Limb and Segmental Nerve Function
404 Cutaneous Innervation of Upper Limb
405 Cutaneous Nerves and Superficial Veins of Proximal Upper
Limb
406 Cutaneous Nerves and Superficial Veins of Forearm and Hand
407 Lymph Vessels and Nodes of Upper Limb

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Shoulder and Axilla • Plate 408-420
408 Clavicle and Sternoclavicular Joint
409 Humerus and Scapula: Anterior Views
410 Humerus and Scapula: Posterior Views
411 Shoulder: Anteroposterior Radiograph
412 Shoulder with Details of Glenohumeral Joint
413 Muscles of Shoulder
414 Axilla: Posterior Wall
415 Muscles of Rotator (Compressor) Cuff
416 Pectoral, Clavipectoral, and Axillary Fasciae
417 Scapulothoracic and Shoulder Dissection
418 Axillary Artery and Anastomoses Around Scapula
419 Axilla: Anterior View
420 Brachial Plexus: Schema

Arm • Plates 421-425


421 Muscles of Arm: Anterior Views
422 Muscles of Arm: Posterior Views
423 Brachial Artery in Situ
424 Arteries of Arm and Proximal Forearm
425 Arm: Serial Cross Sections

Elbow and Forearm • Plates 426-441


426 Bones of Elbow
427 Elbow: Radiographs
428 Ligaments of Elbow
429 Bones of Forearm
430 Individual Muscles of Forearm: Rotators of Radius
431 Individual Muscles of Forearm: Extensors of Wrist and Digits
432 Individual Muscles of Forearm: Flexors of Wrist
433 Individual Muscles of Forearm: Flexors of Digits
434 Muscles of Forearm (Superficial Layer): Posterior View
435 Muscles of Forearm (Deeper Layer): Posterior View
436 Muscles of Forearm (Superficial Layer): Anterior View
437 Muscles of Forearm (Intermediate Layer): Anterior View
438 Muscles of Forearm (Deep Layer): Anterior View
439 Attachments of Muscles of Forearm: Anterior View
440 Attachments of Muscles of Forearm: Posterior View
441 Forearm: Serial Cross Sections, Anterior View

Wrist and Hand • Plates 442-461


442 Carpal Bones
443 Movements of Wrist
444 Ligaments of Wrist
445 Ligaments of Wrist (continued)
446 Bones of Wrist and Hand

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447 Wrist and Hand: Radiographs
448 Metacarpophalangeal and Interphalangeal Ligaments
449 Wrist and Hand: Superficial Palmar Dissections
450 Wrist and Hand: Deeper Palmar Dissections
451 Lumbrical Muscles and Bursae, Spaces, and Sheaths:
Schema
452 Flexor Tendons, Arteries, and Nerves at Wrist
453 Bursae, Spaces, and Tendon Sheaths of Hand
454 Flexor and Extensor Tendons in Fingers
455 Intrinsic Muscles of Hand
456 Arteries and Nerves of Hand: Palmar Views
457 Wrist and Hand: Superficial Dissection
458 Wrist and Hand: Superficial Dorsal Dissection
459 Nerves and Arteries of Dorsal Hand and Wrist
460 Extensor Tendons at Wrist
461 Fingers

Neurovasculature • Plates 462-469


462 Cutaneous Innervation of Wrist and Hand
463 Arteries and Nerves of Upper Limb: Anterior View
464 Nerves of Upper Limb
465 Musculocutaneous Nerve: Anterior View
466 Median Nerve
467 Ulnar Nerve
468 Radial Nerve in Arm and Nerves of Posterior Shoulder:
Posterior View
469 Radial Nerve in Forearm and Hand

Regional Imaging • Plate 470


470 Shoulder MRI and CT Scan

Structures with High Clinical Significance • Tables 7.1-7.2

Muscle Tables • Tables 7.3-7.6

Electronic Bonus Plates • Plates BP99-BP106


BP99 Veins of Upper Limb
BP100 Arteries of Arm and Proximal Forearm
BP101 Arteries of Forearm and Hand
BP102 Ligaments of Wrist
BP103 Flexor and Extensor Zones of Hand
BP104 Section Through Metacarpal and Distal Carpal Bones
BP105 Cross Section of Hand: Axial View
BP106 Cross Section of Hand: Axial View (continued)

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SECTION 8 LOWER LIMB • Plates 471-535
Surface Anatomy • Plate 471
471 Lower Limb: Surface Anatomy

Cutaneous Anatomy • Plates 472-475


472 Dermatomes of Lower Limb and Segmental Nerve Function
473 Superficial Nerves and Veins of Lower Limb: Anterior View
474 Superficial Nerves and Veins of Lower Limb: Posterior View
475 Lymph Vessels and Nodes of Lower Limb

Hip and Thigh • Plates 476-496


476 Coxal Bone
477 Hip Joint
478 Hip Joint: Anteroposterior Radiograph
479 Femur
480 Bony Attachments of Muscles of Hip and Thigh: Anterior
View
481 Bony Attachments of Muscles of Hip and Thigh: Posterior
View
482 Muscles of Thigh: Anterior Views
483 Muscles of Thigh: Anterior Views (continued)
484 Muscles of Hip and Thigh: Lateral View
485 Muscles of Hip and Thigh: Posterior Views
486 Psoas and Iliacus Muscles
487 Lumbosacral and Coccygeal Plexuses
488 Lumbar Plexus
489 Sacral and Coccygeal Plexuses
490 Arteries and Nerves of Thigh: Anterior Views
491 Arteries and Nerves of Thigh: Anterior Views (continued)
492 Arteries and Nerves of Thigh: Posterior View
493 Nerves of Hip and Buttock
494 Hip Bursae: Posterior and Anterolateral Views
495 Arteries of Femoral Head and Neck
496 Thigh: Serial Cross Sections

Knee • Plates 497-503


497 Knee: Medial and Lateral Views
498 Knee: Anterior Views
499 Knee: Interior Views
500 Knee: Cruciate and Collateral Ligaments
501 Knee: Anteroposterior Radiograph and Posterior View
502 Knee: Posterior and Sagittal Views
503 Arteries of Lower Limb: Schema

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Leg • Plates 504-514
504 Tibia and Fibula
505 Tibia and Fibula (continued)
506 Attachments of Muscles of Leg
507 Muscles of Leg (Superficial Dissection): Posterior View
508 Muscles of Leg (Intermediate Dissection): Posterior View
509 Muscles of Leg (Deep Dissection): Posterior View
510 Muscles of Leg: Lateral View
511 Muscles of Leg (Superficial Dissection): Anterior View
512 Muscles of Leg (Deep Dissection): Anterior View
513 Venous Drainage of Leg
514 Leg: Cross Sections and Fascial Compartments

Ankle and Foot • Plates 515-528


515 Bones of Foot
516 Bones of Foot (continued)
517 Calcaneus
518 Ligaments and Tendons of Ankle
519 Ligaments and Tendons of Foot: Plantar View
520 Tendon Sheaths of Ankle
521 Muscles of Dorsum of Foot: Superficial Dissection
522 Dorsum of Foot: Deep Dissection
523 Plantar Region of Foot: Superficial Dissection
524 Muscles of Plantar Region of Foot: First Layer
525 Muscles of Plantar Region of Foot: Second Layer
526 Muscles of Plantar Region of Foot: Third Layer
527 Interosseous Muscles and Deep Arteries of Foot
528 Interosseous Muscles of Foot

Neurovasculature • Plates 529-533


529 Femoral Nerve and Lateral Femoral Cutaneous Nerve
530 Obturator Nerve
531 Sciatic Nerve and Posterior Femoral Cutaneous Nerve
532 Tibial Nerve
533 Common Fibular Nerve

Regional Imaging • Plates 534-535


534 Hip MRI and 3D CT
535 Ankle: Radiographs

Structures with High Clinical Significance • Tables 8.1-8.2

Muscle Tables • Tables 8.3-8.6

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Electronic Bonus Plates • Plates BP107-BP117
BP107 Veins of Lower Limb
BP108 Arteries of Thigh and Knee
BP109 Cross-Sectional Anatomy of Hip: Axial View
BP110 Arteries of Knee and Foot
BP111 Leg: Serial Cross Sections
BP112 Osteology of Knee
BP113 Knee Radiograph: Lateral View
BP114 Anatomy of Foot: Nerves and Arteries
BP115 Cross-Sectional Anatomy of Ankle and Foot
BP116 Cross-Sectional Anatomy of Ankle and Foot (continued)
BP117 Anatomy of Toenail

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INTRODUCTION 1

Introduction 1-7

ELEC TR ON I C B O N U S PL A T E S

BP 1 Cross Section of Skin BP 2 Pilosebaceous Unit BP 3 Major Body Cavities BP 4 Skeletal System:
Axial and Appendicular
Skeletons

BP 5 Types of BP 6 Joints: Connective BP 7 Architecture of Bone BP 8 Muscular System


Synovial Joints Tissues and Articular
Cartilage

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1 Introduction

ELEC TR O N I C B O N U S P LA T E S — c ont’ d

BP 9 Overview of the BP 10 Overview of the BP 11 Neurons and BP 12 Features of a


Gastrointestinal System Endocrine System Synapses Typical Peripheral Nerve

BP 13 Sites of Visceral BP 14 General BP 15 Cardiovascular BP 16 Arterial Wall


Referred Pain Organization of the System: Composition of
Cardiovascular System Blood

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Body Planes and Terms of Relationship 1
Coronal plane

Superior
Transverse
plane Right Left

Cranial

Medial Lateral
Proximal

Proximal
Posterior
or dorsal

Sagittal
plane
Caudal Distal

Anterior or ventral

Distal
Inferior

Introduction Plate 1

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Surface Anatomy: Regions (Anterior View of Female)

Temporal
Frontal
Orbital
Nasal
Oral
Anterior cervical
Mental
Lateral cervical
Sternocleidomastoid
Infraclavicular
Deltoid

Pectoral Axillary

Mammary Presternal

Anterior brachial Posterior brachial


Lateral thoracic
Inframammary

Cubital Anterior elbow

Hypochondriac
Epigastric
Anterior antebrachial
Umbilical
Lumbar
Palmar

Inguinal

Hip

Posterior
antebrachial
Hypogastric

Femoral triangle
Anterior femoral

Perineal
Anterior knee

Anterior leg Posterior leg

Dorsum of
Heel the foot

Plate 2 Introduction

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Surface Anatomy: Regions (Posterior View of Male) 1
Parietal

Occipital
Temporal

Posterior cervical Sternocleidomastoid

Suprascapular Interscapular

Deltoid
Infrascapular
Scapular

Lateral pectoral

Posterior brachial
Hypochondriac

Lumbar
Posterior
of elbow

Vertebral
Posterior
antebrachial

Dorsum of
the hand

Gluteal Sacral

Anal
Posterior femoral

Posterior knee Popliteal fossa

Posterior leg

Calcaneal
Dorsum of
the foot

Introduction Plate 3

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Major Arteries and Pulse Points

Facial artery pulse

Carotid artery pulse Right and left


common carotid arteries
Aortic arch
Subclavian artery
Axillary artery

Descending thoracic aorta


Brachial artery pulse
Celiac trunk
Brachial artery
Renal artery

Superior mesenteric artery

Inferior mesenteric artery


Radial artery
Common iliac artery
Ulnar artery
Ulnar artery pulse
Internal iliac artery

Radial artery pulse

Palmar arches

External
iliac artery

Femoral artery pulse Deep femoral artery

Femoral artery

Popliteal artery Popliteal artery pulse

Locations for palpating arterial pulses Anterior tibial artery


(in bold)
Fibular artery

Posterior tibial artery

Posterior tibial artery pulse

Dorsalis pedis artery


Dorsalis pedis artery pulse

Plantar arch

Plate 4 Introduction

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Major Systemic Veins of the Cardiovascular System 1

Major veins
Superficial vv.
Deep vv.

External jugular vein


Internal jugular vein
Brachiocephalic vein
Subclavian vein Superior vena cava

Axillary vein Azygos vein

Intercostal veins
Cephalic vein
Inferior vena cava
Brachial vein

Basilic vein
Renal vein

Common iliac vein

Radial vein
Internal iliac vein

External iliac vein

Superficial
venous Deep
palmar femoral vein
arch Ulnar vein

Femoral vein
Palmar digital veins
Great saphenous vein

Popliteal vein

Posterior tibial vein

Anterior tibial vein

Dorsal venous arch

Introduction Plate 5

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General Organization of the Nervous System

Central nervous
system

Brain

Receptors
Spinal cord

Somatic sensory Visceral sensory


receptors: (monitor the receptors: (monitor
outside world and body internal conditions and
Peripheral position) organ systems)
nervous
system

Sensory signals within


afferent division

CNS processing

Motor commands within


efferent division

Somatic nervous Autonomic nervous


system system

Parasympathetic Sympathetic Enteric nervous


division division system

Smooth muscle
Cardiac muscle Gastrointestinal
Skeletal muscle
Glands smooth muscle

Effectors

Plate 6 Introduction

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Overview of the Lymphatic System

Lymphatics
of upper limb

Tonsils

Thoracic duct Cervical


lymph nodes
Right lymphatic duct

Thymus gland

Mediastinal lymph nodes


Axillary lymph
Thoracic duct nodes

Lymph vessels of
mammary gland
Cisterna
chyli Spleen

Lumbar lymph
Lymphoid nodes
nodules of
intestine
Iliac lymph
nodes

Inguinal lymph nodes

Bone marrow

Drainage Drainage of
of right thoracic
lymphatic duct
duct

Lymphatics
of lower limb

Plate 7

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Cross Section of Skin

Meissner’s corpuscle
Free nerve endings Pore of sweat gland
Hair shaft Stratum corneum
Melanocyte Stratum lucidum
Arrector pili muscle

Epidermis
Sebaceous gland Stratum granulosum

Stratum spinosum
Cuticle
Internal sheath Stratum basale
Hair follicle

External sheath
Glassy
membrane
Connective Dermal papilla
tissue layer (of papillary
layer)

Dermis
Reticular layer
Hair cuticle

Sweat gland

Superficial fascia (hypodermis)


Hair matrix

Papilla of hair follicle

Pacinian corpuscle
Artery

Vein

Sensory nerves
Subcutaneous artery and vein
Elastic fibers

Skin ligaments (retinacula cutis)

Somatic nerve

Electronic Bonus Plates Plate BP 1

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Pilosebaceous Unit

Epidermis

Hair shaft

Sebaceous gland and its duct

Arrector pili muscle

Hair cortex

Hair medulla
Hair cuticle

Huxley layer
Internal root sheath
Henle layer

External root sheath

Dermal papilla
Hair bulb

Plate BP 2 Electronic Bonus Plates

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Major Body Cavities

Cranial
Cranial cavity
cavity

Vertebral cavity

Superior
mediastinum
Dorsal
body Thoracic Pleural
cavity cavity cavity
Pericardial
cavity within
the mediastinum
Thoracic and
abdominopelvic
Respiratory diaphragm cavities
Abdominal cavity Abdomino-
Vertebral pelvic
cavity cavity

Pelvic cavity

Electronic Bonus Plates Plate BP 3

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Skeletal System: Axial and Appendicular Skeletons

Appendicular skeleton (134) Axial skeleton (80)

Skull (22)
Cranium (8)
Skull and
Face (14)
associated
Associated bones (29)
bones (7)
Auditory
Pectoral Clavicle (2) ossicles (6)
girdle Hyoid (1)
(4) Scapula (2)

Sternum (1) Thoracic


cage (25)
Ribs (24)

Humerus (2)
Vertebrae (24)
Radius (2)
Vertebral
Sacrum (1) column
Ulna (2) (26)
Coccyx (1)
Upper Carpal
limbs bones (16)
(64)
Metacarpal
bones (10)

Phalanges
(proximal,
middle,
distal) (28)

Sesamoid bones (4)

Pelvic
girdle Coxal bone (2)
(2)
Femur (2)

Patella (2)

Tibia (2)
Lower
limbs Fibula (2)
(64)
Tarsal bones (14)

Metatarsal bones (10)

Phalanges (28)

Sesamoid bones (4)

Plate BP 4 Electronic Bonus Plates

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Types of Synovial Joints

Structure of synovial joints


Metaphyseal bone
Subchondral
bone
Articular
cartilage
Synovium
Meniscus
Fibrous capsule
Articular cartilage

Dens
Humerus

Atlas

Axis of the
Ulna of
atlantoaxial
the elbow’s
pivot joint
hinge joint

A. Hinge B. Pivot
Metacarpal of the
thumb’s saddle joint Femur

Tibia of
the knee’s
Trapezium condyloid
bone joint
C. Saddle D. Condyloid
Acromioclavicular plane joint at the
shoulder: plane joint between the
Acetabulum acromion of the scapula and clavicle

Acromion Clavicle

Femur of the hip’s


ball-and-socket joint:
acetabulum of the
coxal bone forms the
“socket” of this joint
E. Ball-and-socket F. Plane

Electronic Bonus Plates Plate BP 5

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Joints: Connective Tissues and Articular Cartilage

Amorphous matrix

Fibroblast Collagen fibers

Macrophage
Elastic fibers
Reticular fibers
Lymphocyte
Monocyte Capillary

Red blood
cell
Mast cell Endothelial
Fat cells cell
Pericyte
Macrophage

Section of loose
connective tissue Eosinophil
Plasma cell
Articular cartilage
Longitudinal bundles
Subchondral of collagen and/or
bone elastic fibers

Tendon sectioned
longitudinally and transversely
Dense connective tissue Fibroblast nuclei Transverse fibers of
loose connective tissue

Articular cartilage

Synovial membrane
Joint capsule

Joint with cartilage-covered


Architecture of articular cartilage articular surfaces
and subchondral bone
Hip joint and articular surface

Plate BP 6 Electronic Bonus Plates

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Architecture of Bone

Active osteoblasts
produce osteoid
Osteoid

Osteocytes
Marrow spaces
Trabecular Trabeculae contain
bone hematopoietic
cells and fat
Trabecular (cancellous) bone

Cortical
(compact)
bone
Subperiosteal
circumferential
lamellae Endosteal
surface

Periosteum

Capillaries
in haversian
canals

Periosteal
vessels

Cortical (compact) bone

Electronic Bonus Plates Plate BP 7

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Muscular System

Muscle
Nuclei (ghosted through endomysium)

Satellite cell
Basement membrane
Sarcolemma

Sarcoplasm
Tendon Muscle fiber

Muscle fascicles
I
Perimysium
Epimysium I
Z Myofibril
H
M

Myofilaments

Sarcomere

Z line Z line

Sarcomere

Z line Z line

I band A band I band


H band

A band A band A band


I band I band Muscle relaxed
H band H band H band

Muscle contracted

Plate BP 8 Electronic Bonus Plates

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Overview of the Gastrointestinal System

Pharynx
Pharyngeal muscles propel food into esophagus Oral cavity, teeth, tongue
Mechanical breakdown,
mixing with saliva

Liver
Secretion of bile (important for lipid digestion), Salivary glands (lingual,
storage of nutrients, production of cellular fuels, submandibular, parotid)
plasma proteins, clotting factors, Secretion of lubricating fluid
and detoxification and phagocytosis containing enzymes that
initiate digestion

Pancreas
Secretion of buffers Esophagus
and digestive Transport of food
enzymes by exocrine into the stomach
cells; secretion of
hormones by
endocrine cells
to regulate digestion

Stomach
Gallbladder Chemical breakdown of
Concentration and storage of bile food by acid and enzymes;
mechanical breakdown
via muscular contractions;
absorption of water, alcohol,
Large intestine and some minerals
Dehydration and compaction
of indigestible materials for Small intestine
elimination; resorption of water Enzymatic digestion and
and electrolytes; host defense absorption of water,
organic substrates, vitamins,
and ions; host defense

Electronic Bonus Plates Plate BP 9

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Overview of the Endocrine System

Hypothalamus
Production of ADH, oxytocin,
TRH, CRH, GHRH, GnRH,
and somatostatin
Pineal gland
Melatonin
Pituitary gland
Anterior pituitary:
ACTH, TSH, GH, PRL,
FSH, LH, and MSH

Posterior pituitary: Thyroid gland


Release of oxytocin and ADH Thyroxine (T4),
triiodothyronine (T3),
Parathyroid glands calcitonin
(on posterior surface
of thyroid gland)
Parathyroid hormone (PTH) Thymus
(undergoes atrophy
during adulthood)
Thymopoietin
Heart
Atrial natriuretic
peptide (ANP)
Digestive tract
Numerous hormones:
Suprarenal gastrin, secretin, CCK,
(adrenal) glands GIP, motilin
Each adrenal gland
is divided into:
Adrenal medulla:
epinephrine, Pancreatic islets
norepinephrine Insulin, glucagon,
(adrenaline, somatostatin
noradrenaline)

Adrenal cortex:
aldosterone,
cortisol, Ovaries
androgens Estrogens, progestins, inhibin,
relaxin

Kidney
Erythropoietin
(EPO), calcitriol,
renin

Fat
Leptin

Testes
Androgens (especially
testosterone), inhibin

Plate BP 10 Electronic Bonus Plates

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Neurons and Synapses

Endings of preganglionic autonomic


neuron synapsing onto cell bodies Axons ending on gland or
of postganglionic neurons smooth (involuntary) muscle
or cardiac muscle cells

Satellite cells

Neurilemma surrounding
unmyelinated axons of two neurons

Two postganglionic autonomic neurons


of a sympathetic or parasympathetic ganglion

Dendrite

Axon hillock
Initial segment

Node Axon

Myelin sheath

Dendrite

Neurofilaments
Schematic of synaptic endings
Neurotubules
Numerous boutons (synaptic knobs)
of presynaptic neurons terminating on Axon (axoplasm)
a motor neuron and its dendrites Axolemma
Mitochondria
Glial process
Synaptic vesicles
Synaptic cleft

Presynaptic membrane
(densely staining)
Postsynaptic membrane
(densely staining)
Postsynaptic cell

Enlarged section of bouton

Electronic Bonus Plates Plate BP 11

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Features of a Typical Peripheral Nerve

Longitudinal vessels

Outer epineurium Cell body of an oligodendrocyte


(neurilemmal cells play similar
role in peripheral nervous system)
Inner epineurium
Cell membrane of
Fascicle myelinated axon

Mitochondrion
Nerve fiber in cytoplasm of
bundles neuronal axon

Fascicle
Perineurium
Nerve fibers Fused layers of cell membrane of
Node of Ranvier
oligodendrocyte wrapped around
Minute masses of cytoplasm axon of a myelinated neuron of central
Endoneurium trapped between fused nervous system (the lipid of lipoprotein
layers of cell membrane constituting fused cell membrane is
of oligodendrocyte myelin, which gives myelinated axon
a white, glistening appearance)

Plate BP 12 Electronic Bonus Plates

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Sites of Visceral Referred Pain

Liver, gallbladder, and


duodenum (irritation of
respiratory diaphragm)

Duodenum,
head of Stomach
pancreas

Gallbladder Spleen

Liver
Gallbladder
Small
intestine
Liver

Kidney and
ureter

Cecum and Sigmoid colon


ascending colon

Electronic Bonus Plates Plate BP 13

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General Organization of the Cardiovascular System

Volume distribution Distribution of vascular resistance

Small arteries
Brain: and arterioles (47%)
Q = 13%
VO2 = 21%
Lungs (9%)

Veins (64%) Veins (7%)


Small arteries
and arterioles (8%) Capillaries (5%) Lungs Capillaries (27%) Large arteries (19%)
Heart in diastole (7%) Aortic pressure: 120/80 mm Hg
Large arteries (7%) (mean pressure 95 mm Hg)
LA
Pulmonary arterial pressure: 25/10 mm Hg RA
(mean pressure 15 mm Hg) Coronary
LV circulation:
RV Q = 4%
VO2 = 11%
Liver and gastro-
intestinal tract:
Q = 24%
VO2 = 23%

Low-pressure system Skeletal High-pressure system


(reservoir function) muscle: (supply function)
Q = 21%
VO2 = 27%

Kidney:
Q = 20%
VO2 = 7%

Skin and other


organs:
Q = 18%
VO2 = 11%

Q = blood flow per minute


VO2= oxygen used per minute

Plate BP 14 Electronic Bonus Plates

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Cardiovascular System: Composition of Blood

Plasma composition Plasma proteins


Water 92% Albumins 60%
Transports organic and Transport lipids, steroid hormones;
Centrifuged inorganic molecules, major contributors to osmotic
blood sample cells, platelets, and heat concentration of plasma

Plasma proteins 7% Globulins 35%


Transport ions, hormones, lipids;
Other solutes 1% immune function

Fibrinogen 4%
Plasma Essential component of clotting system
~55%
Regulatory proteins <1%
Enzymes, hormones, clotting proteins

Platelets Other solutes


Electrolytes
Buffy coat
<1% Normal extracellular fluid ion compo-
Blood clot formation sition essential for vital cellular
and tissue repair activities (e.g., Na+, K+, Cl )

Organic nutrients
White blood cells Used for ATP production, growth, and
maintenance of cells (e.g., fatty acids,
glucose, amino acids)

Red blood Organic wastes


cells Carried to sites of breakdown or
~45% excretion (e.g., urea, bilirubin)
Neutrophils (50-70%)

Red blood cells

Eosinophils Lymphocytes Basophils


Monocytes (2-8%) (2-4%) (20-30%) (<1%)

Electronic Bonus Plates Plate BP 15

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Arterial Wall

Avascular
zone

Endothelium
Desmosome
Basement membrane

Smooth muscle Tunica


Vascular cell (atherophil) intima
zone
Fibroblast Lamina
propria
Collagen
Matrix
Internal elastic
membrane
Smooth muscle
and elastic tissue Tunica
Reticular fibers media
External elastic
membrane

Adventitia

Vasa vasorum

Sympathetic nerve
Wall of an artery: (vasomotor)
cutaway view

Valve

Healthy artery Healthy vein

Plate BP 16 Electronic Bonus Plates

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HEAD AND NECK 2

Surface Anatomy 8 Ear 105-110


sect outl 1 Superficial Head and Neck 9-10 Meninges and Brain 111-126
Bones and Ligaments 11-30 Cranial and Cervical Nerves 127-146
Neck 31-41 Cerebral Vasculature 147-158
Nasal Region 42-64 Regional Imaging 159-160
Oral Region 65-74 Structures with High Clinical
Pharynx 75-86 Significance Tables 2.1-2.3
Thyroid Gland and Larynx 87-93 Muscle Tables Tables 2.4-2.9
Orbit and Contents 94-104 Electronic Bonus Plates BP17-BP32

ELEC TR ON I C B O N U S PL A T E S

BP17 3D Skull BP18 Degenerative BP19 Atlantooccipital BP20 Muscles of Facial


Reconstruction CTs Changes in Cervical Junction Expression: Anterior View
Vertebrae

BP21 Musculature of Face BP22 Paranasal Sinuses BP23 Subclavian Artery BP24 Opening of the
Mandible

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2 Head and Neck

ELEC TR O N I C B O N U S P LA T E S — c ont’ d

BP25 Afferent Innervation BP26 Fasciae of Orbit and BP27 Tympanic Cavity BP28 Anatomy of
of Oral Cavity and Pharynx Eyeball the Pediatric Ear

BP29 Auditory Tube BP30 Arteries and Veins of BP31 Cranial Imaging (MRV BP32 Axial and
(Eustachian) Hypothalamus and and MRA) Coronal MRIs
Hypophysis of Brain

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Head and Neck: Surface Anatomy 2
See also Plate 171

Frontal
bone Infraorbital margin

Supraorbital Zygomatic bone


notch

Superciliary
arch
Helix
Glabella Tragus

Antihelix
Nasal
bone
Antitragus
Ala of nose
Anterior nares
(nostril) Lobule

Commissure of lips
Philtrum
Angle of mandible
Nasolabial
sulcus Submandibular gland
Tubercle of
upper lip External jugular vein

Inferior belly of omohyoid muscle

Brachial plexus
Mental
protuberance Trapezius muscle

Thyroid cartilage
Clavicle

Jugular notch Clavicular head of


sternocleidomastoid muscle

Sternal head of
sternocleidomastoid muscle

Surface Anatomy Plate 8

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Cutaneous Nerves of Head and Neck
See also Plates 39, 42, 61

From ophthalmic division Auricular branch


of trigeminal nerve (CN V1) of vagus nerve (CN X)

Supraorbital nerve
Supratrochlear nerve
Medial branches
Palpebral branch of of posterior rami
lacrimal nerve of cervical spinal
nerves
Infratrochlear nerve
Greater occipital
External nasal branch of
nerve (C2)
anterior ethmoidal nerve
3rd occipital
nerve (C3)

From maxillary division From 4th, 5th,


of trigeminal nerve (CN V2) 6th, and 7th

Infraorbital nerve

Zygomaticofacial nerve

Zygomaticotemporal nerve
Branches from
cervical plexus
Lesser occipital
From mandibular division of nerve (C2)
trigeminal nerve (CN V3) Great auricular
Mental nerve nerve (C2, 3)
Transverse cervical
Buccal nerve nerve (C2, 3)

Auriculotemporal nerve Supraclavicular


nerves (C3, 4)

Posterior rami of
Ophthalmic nerve (CN V1) cervical spinal
nerves

Note: Auricular branch


of vagus nerve to
Trigeminal external acoustic
nerve (CN V) Maxillary nerve (CN V2) meatus and small
area on posteromedial
surface of auricle and
concha via facial nerve

Branches from
Mandibular nerve (CN V3) cervical plexus

Plate 9 Superficial Head and Neck

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Superficial Arteries and Veins of Face and Scalp 2
See also Plates 57, 83, 84

Skin and
superficial fascia
Scalp Parietal emissary vein
Epicranial aponeurosis
(cut to reveal skull) Frontal Branches of
superficial temporal
Parietal artery and vein
Middle temporal artery and vein

Zygomaticoorbital artery

Transverse facial
artery and vein Anterior
auricular
Supraorbital arteries
artery and vein

Supratrochlear
artery and vein

Nasofrontal vein

External nasal
artery and vein

Zygomaticotemporal
artery and vein

Angular
artery
and vein

Zygomatico-
facial artery Mastoid emissary
and vein vein and meningeal
branch of occipital
Infraorbital artery
artery and vein
Occipital artery
and vein (cut)
Deep facial vein
Posterior auricular
artery and vein
Facial artery and vein
External jugular vein (cut)

Retromandibular vein
Common facial vein
Internal jugular vein

Internal carotid artery

External carotid artery

Common carotid artery

Lingual artery and vein

Sources of arterial supply of face


Black: from internal carotid artery (via ophthalmic artery)
Red: from external carotid artery

Superficial Head and Neck Plate 10

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Skull: Anterior View
See also Plate 13

Frontal bone Coronal suture

Glabella
Parietal bone
Supraorbital Nasion
notch (foramen)
Sphenoid bone
Orbital surface Lesser wing

Nasal bone Greater wing

Temporal bone
Lacrimal bone
Ethmoid bone

Zygomatic bone Orbital plate

Perpendicular plate
Frontal process

Orbital surface Middle nasal concha

Temporal process Inferior nasal concha


Zygomaticofacial
foramen Vomer

Maxillary bone Mandible

Zygomatic process Ramus

Orbital surface Body


Infraorbital foramen Mental foramen
Frontal process Mental tubercle
Alveolar process Mental protuberance

Anterior nasal spine

Right orbit: frontal view


Orbital surface of frontal bone Supraorbital notch

Orbital surface of lesser Posterior and


wing of sphenoid bone Anterior
ethmoidal foramina
Superior orbital fissure Orbital plate of
Optic canal (foramen) ethmoid bone
Orbital surface of greater Lacrimal bone
wing of sphenoid bone
Fossa for lacrimal sac
Orbital surface of
Orbital process of
zygomatic bone
palatine bone
Zygomaticofacial foramen Orbital surface
of maxillary bone
Inferior orbital fissure
Infraorbital foramen
Infraorbital groove

Plate 11 Bones and Ligaments

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Skull: Radiographs 2
See also Plate 11

Posterior anterior view

Sagittal suture Coronal suture

Lambdoid suture

Lesser wing of sphenoid bone


Frontal sinus
Petrous part of temporal bone Superior orbital fissure

Foramen rotundum
Mastoid cells
Maxillary sinus

Nasal septum Inferior nasal concha


Lateral mass of atlas
Dens (C2)

Body of axis Ramus


Angle Mandible
Body

Waters’ view

Frontal sinus

Supraorbital margin
Ethmoidal sinus
Zygomaticofrontal suture Nasal bone
Nasal septum
Zygomatic bone

Infraorbital foramen Zygomatic arch


Mandibular
Maxillary sinus condyle

Mastoid cells

Lateral mass of atlas Angle of mandible

Dens

Bones and Ligaments Plate 12

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Skull: Lateral View
See also Plates 14, 15, 22

Sphenoid bone Parietal bone Temporal fossa Temporal bone


Greater wing Superior temporal line Squamous part

Frontal bone Inferior temporal line Zygomatic process


Coronal suture
Supraorbital Articular tubercle
notch (foramen) Pterion
Groove for posterior
Glabella deep temporal artery

Ethmoid bone Supramastoid crest


Orbital plate External acoustic
meatus
Lacrimal bone Mastoid process

Fossa for Lambdoid suture


lacrimal sac
Occipital bone
Nasal bone Sutural (wormian)
bone
Maxillary bone
External
Frontal process occipital
Infraorbital protuberance
foramen (inion)
Anterior Asterion
nasal spine
Alveolar process Mandible
Head of condylar process
Zygomatic bone Mandibular notch
Zygomaticofacial Coronoid process
foramen Ramus
Temporal process Oblique line
Body
Mental foramen
Zygomatic arch

Sphenoid bone

Infratemporal fossa exposed by Greater wing


removal of zygomatic arch and mandible* Infratemporal crest
Lateral plate of
Pterygomaxillary fissure pterygoid process
Pterygoid hamulus
Inferior orbital fissure (of medial plate of
pterygoid process)
Infratemporal surface of maxillary bone
Temporal bone
Posterior superior
alveolar foramina Foramen External acoustic
ovale meatus
Tuberosity of maxillary bone
Mandibular fossa
Articular tubercle
Pterygopalatine fossa
Styloid process
Sphenopalatine foramen

*Superficially, mastoid process forms posterior boundary.

Plate 13 Bones and Ligaments

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Skull: Lateral Radiograph 2
See also Plate 15

Parietal bone
Lambdoid
Auricle suture

Coronal suture

Frontal bone

Frontal sinus

Greater wing of
sphenoid bone

Anterior clinoid
process

Sella turcica

Sphenoidal sinus

Maxillary sinus

Palatine process
of maxilla

Coronoid process
of mandible

Mandibular
condyle

Anterior arch C1

Dens of Mastoid cells Occipital bone External


axis occipital
protuberance

Bones and Ligaments Plate 14

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Skull: Midsagittal Section
See also Plates 44, 46

Sphenoid bone Temporal bone


Parietal bone
Greater wing Squamous part
Coronal Grooves for
Lesser wing suture branches of middle Petrous part
Anterior clinoid meningeal vessels Internal acoustic meatus
process
Groove for superior
Optic canal petrosal sinus
Sella turcica Opening of
Sphenoidal sinus vestibular aqueduct
Body Groove for
Medial and lateral sigmoid sinus
plates of
pterygoid
process

Lambdoid suture
Frontal bone
Frontal sinus
Ethmoid bone Occipital bone
Crista galli Groove for
Cribriform plate transverse sinus
Perpendicular
plate External occipital
protuberance (inion)

Jugular foramen
Nasal bone
Groove for inferior
Inferior nasal petrosal sinus
concha
Hypoglossal canal
Maxillary bone
Foramen magnum
Anterior
nasal spine Occipital condyle
Palatine bone
Nasal surface
Vomer Basilar part
Incisive canal
Palatine process
Alveolar process

Frontal bone
Opening of sphenoidal sinus
Nasal bone

Ethmoid bone Sphenopalatine foramen


Cribriform plate
Superior nasal concha
Middle nasal concha

Sphenoid bone
Lacrimal bone
Body
Inferior nasal concha Medial
Plates of pterygoid process
Lateral
Maxillary bone Pterygoid hamulus
Nasal surface
Palatine process Palatine bone
Alveolar process Perpendicular plate
Horizontal plate

View of lateral nasal wall with nasal septum removed

Plate 15 Bones and Ligaments

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Calvaria 2
See also Plates 111, 112

Superior view

Frontal bone

Coronal suture

Bregma

Parietal bone

Sagittal suture

Parietal foramen (for emissary vein)

Lambda

Lambdoid suture
Sutural (wormian)
bone
Occipital bone

Inferior view
Frontal bone

Frontal crest

Groove for superior sagittal sinus

Coronal suture

Parietal bone

Granular foveolae
(for arachnoid granulations)

Diploë

Grooves for branches of


middle meningeal vessels

Groove for superior sagittal sinus

Sagittal suture

Lambdoid suture

Occipital bone

Bones and Ligaments Plate 16

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Cranial Base: Inferior View
See also Plate 19

Maxillary bone
Incisive fossa
Palatine process
Intermaxillary suture
Zygomatic process

Zygomatic bone

Frontal bone
Palatomaxillary suture
Sphenoid bone
Pterygoid process
Hamulus Palatine bone
Medial plate Horizontal plate
Pterygoid fossa Greater palatine foramen
Lateral plate Pyramidal process
Scaphoid fossa Lesser palatine foramina
Greater wing Posterior nasal spine
Foramen ovale
Foramen spinosum
Spine
Choanae
Temporal bone
Zygomatic process Vomer
Articular tubercle Ala
Mandibular fossa
Styloid process
Groove for auditory
Petrotympanic fissure tube (eustachian)
Carotid canal (external opening)
Inferior tympanic canaliculus
External acoustic meatus Foramen lacerum
Mastoid canaliculus
Mastoid process
Stylomastoid foramen
Petrous part
Mastoid notch
Groove for occipital artery
Jugular fossa
(jugular foramen in its depth)
Mastoid foramen

Parietal bone

Occipital bone
Hypoglossal canal
Occipital condyle
Condylar canal and fossa
Basilar part
Pharyngeal tubercle
Foramen magnum
Inferior nuchal line
External occipital crest
Superior nuchal line
External occipital protuberance

Plate 17 Bones and Ligaments

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Cranial Base: Superior View 2
See also Plates 20, 115

Frontal bone
Groove for superior sagittal sinus
Frontal crest
Groove for anterior meningeal vessels
Foramen cecum
Superior surface of orbital part

Ethmoid bone
Crista galli
Cribriform plate
Anterior
Sphenoid bone cranial
Lesser wing fossa
Anterior clinoid process
Greater wing
Groove for middle meningeal
vessels (frontal branches)
Body
Yoke
Prechiasmatic groove
Middle
Tuberculum sellae cranial
Sella Hypophyseal fossa fossa
turcica Dorsum sellae
Posterior clinoid process
Carotid groove (for int. carotid a.)
Clivus

Temporal bone
Squamous part
Petrous part
Groove for lesser petrosal nerve
Groove for greater petrosal nerve
Arcuate eminence
Trigeminal impression
Groove for superior petrosal sinus Posterior
cranial
Groove for sigmoid sinus fossa

Parietal bone
Groove for middle meningeal
vessels (parietal branches)
Mastoid angle

Occipital bone
Clivus
Groove for inferior petrosal sinus
Basilar part
Groove for posterior meningeal vessels
Condyle
Groove for transverse sinus
Groove for occipital sinus
Internal occipital crest
Internal occipital protuberance
Groove for superior sagittal sinus

Bones and Ligaments Plate 18

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Foramina and Canals of Cranial Base: Inferior View
See also Plate 17

Nasopalatine nerve
Anastomosis of posterior septal branches of Incisive fossa
sphenopalatine artery and greater palatine artery

Greater palatine nerve and vessels Greater palatine foramen


Lesser palatine nerve and vessels Lesser palatine foramen
Greater petrosal nerve (passes over foramen) Foramen lacerum
Lesser petrosal nerve
Mandibular nerve (CN V3) Foramen ovale
Accessory meningeal artery

Middle meningeal vessels


Meningeal branch of mandibular nerve (CN V3) Foramen spinosum

Internal carotid artery


Internal carotid plexus Carotid canal

Chorda tympani of intermediate nerve (CN VII) Petrotympanic fissure


Tympanic branch of glossopharyngeal nerve (CN IX) Inferior tympanic
canaliculus
Auricular branch of vagus nerve (CN X) Mastoid canaliculus

Facial nerve (CN VII) Stylomastoid foramen

Glossopharyngeal nerve (CN IX)


Vagus nerve (CN X)
Jugular fossa
Accessory nerve (CN XI)
Superior bulb and internal jugular vein

Mastoid emissary vein


Posterior meningeal artery Mastoid foramen

Hypoglossal nerve (CN XII) Hypoglossal canal

Medulla oblongata
Vertebral arteries and venous plexus Foramen magnum
Spinal roots of accessory nerves (CN XI)

Plate 19 Bones and Ligaments

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Foramina and Canals of Cranial Base: Superior View 2
See also Plates 18, 115

Foramen cecum Emissary vein to superior sagittal sinus

Nasal slit Anterior ethmoidal artery, vein,


Anterior ethmoidal foramen and nerve
Foramina of cribriform plate Olfactory nerves (CN I)
Posterior ethmoidal foramen Posterior ethmoidal artery, vein,
and nerve

Optic nerve (CN II)


Optic canal Ophthalmic artery

Oculomotor nerve (CN III)


Trochlear nerve (CN IV)
Superior orbital fissure Lacrimal, frontal, and nasociliary
branches of ophthalmic nerve (CN V1)
Abducens nerve (CN VI)
Superior ophthalmic vein

Foramen rotundum Maxillary nerve (CN V2)

Mandibular nerve (CN V3)


Foramen ovale Accessory meningeal artery
Lesser petrosal nerve

Foramen spinosum Middle meningeal artery and vein


Meningeal branch of mandibular nerve

Sphenoidal emissary foramen (of Vesalius) (inconstant)


Foramen lacerum Greater petrosal nerve (passes over foramen)
Carotid canal Internal carotid artery
Internal carotid nerve plexus
Hiatus for Lesser petrosal nerve

Hiatus for Greater petrosal nerve

Facial nerve (CN VII)


Internal acoustic meatus Vestibulocochlear nerve (CN VIII)
Labyrinthine artery
Opening of
vestibular aqueduct Endolymphatic duct

Mastoid foramen (inconstant) Emissary vein (and occasional


branch of occipital artery)

Inferior petrosal sinus


Glossopharyngeal nerve (CN IX)
Jugular foramen Vagus nerve (CN X)
Accessory nerve (CN XI)
Sigmoid sinus
Posterior meningeal artery

Condylar canal (inconstant) Emissary vein and meningeal branch


of ascending pharyngeal artery

Hypoglossal canal Hypoglossal nerve (CN XII)

Medulla oblongata
Meninges
Vertebral arteries and venous plexus
Foramen magnum
Meningeal branches of vertebral
arteries
Spinal roots of accessory nerves

Bones and Ligaments Plate 20

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Skull of Newborn
See also Plates 13, 16

Lateral view Anterior fontanelle Parietal bone


Coronal suture Parietal eminence
Sphenoidal fontanelle
Frontal bone Squamous suture
Squamous part
Supraorbital notch (foramen) Posterior fontanelle

Ethmoid bone Lambdoid suture


Anterior ethmoidal
foramen Occipital bone
Orbital plate
Mastoid fontanelle
Lacrimal bone

Nasal bone

Temporal bone
Maxillary bone
Infraorbital foramen Squamous part

Petrosquamous fissure
Zygomatic bone
Sphenoid Petrous part
Zygomaticofacial foramen bone (mastoid process absent)
Greater wing
Palatine bone Lateral plate of Tympanic part (bony external
Pyramidal process pterygoid process acoustic meatus absent)
Hamulus of medial
plate of pterygoid Vestibular (oval) window
process
Cochlear (round) window

Styloid process
Superior view
Mandibular fossa
Metopic suture
Zygomatic process

Frontal bone

Anterior fontanelle

Coronal suture

Parietal bone
Sagittal suture

Posterior fontanelle

Occipital bone Lambdoid suture

Plate 21 Bones and Ligaments

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Bony Framework of Head and Neck 2
See also Plates 13, 26

Temporal bone
Sphenoid bone
Temporal fossa
Zygomatic arch
Condylar process of mandible

Mandibular notch

Coronoid process of mandible

Lateral pterygoid plate (broken line)

Hamulus of medial pterygoid plate (broken line)


Mastoid
process
Pterygomandibular raphe (broken line)
External
acoustic meatus
Ramus
Mandible Angle Atlas (C1)
Body
Styloid process

Stylohyoid ligament Axis (C2)

Stylomandibular
Body ligament
Hyoid bone Lesser horn
Greater horn C3 vertebra
Epiglottis
C7 vertebra
Thyroid cartilage
Cricoid cartilage

Trachea T1 vertebra

1st rib

Bones and Ligaments Plate 22

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Pterygoid Fossae
See also Plates 46, 47, 48

Posterior view

External occipital protuberance (inion) Superior nuchal line


External occipital crest
Nasal septum
Inferior nuchal line Choana
Foramen magnum
Inferior orbital fissure Mastoid foramen
Occipitomastoid
suture
Occipital condyle
Mastoid process
Styloid process Lateral pterygoid plate
Medial pterygoid plate
Pterygoid fossa
Zygomatic arch
Horizontal plate of palatine bone Pyramidal process of
palatine bone
Inferior concha
Pterygoid hamulus
Tuberosity of maxillary bone
Palatine process of maxillary bone Alveolar process of maxillary
bone
Incisive fossa

Inferolateral view

Foramen ovale
Foramen spinosum
Infratemporal fossa Spine of sphenoid bone

Tuberosity of maxillary bone


Sphenopalatine foramen
Alveolar process of maxillary bone Pterygopalatine fossa
Choanae
Lateral plate
of pterygoid
Medial plate process
Pterygoid hamulus

Pyramidal process of palatine bone

Plate 23 Bones and Ligaments

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Mandible 2
See also Plates 55, 56

Head
Pterygoid fovea
Condylar process
Neck
Coronoid process
Mandibular notch
Mylohyoid groove
Lingula
Retromolar fossa
Mandibular
Oblique line foramen
Submandibular fossa

Mylohyoid line
Sublingual fossa
Interalveolar
septa
Ramus

Alveolar part (crest)


Mental foramen
Mental protuberance
Angle
Mental tubercle
Base of mandible
Body

Coronoid process
Head Condylar process
Neck Lingula
Mandibular foramen
Mandibular notch
Mylohyoid groove
Pterygoid fovea

Mylohyoid line Ramus

Angle

y
Bod
Submandibular fossa
Sublingual fossa
Digastric fossa
Superior and inferior mental spines (genial tubercles)

Mandible of aged
person (edentulous)

Bones and Ligaments Plate 24

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Temporomandibular Joint
See also Plate 56

Lateral view

Joint capsule
Lateral ligament of temporomandibular joint
Sphenomandibular ligament
Sphenomandibular ligament (phantom)
Styloid process
Stylomandibular ligament

Mandibular nerve
and otic ganglion

Joint capsule
Middle meningeal
artery
Auriculotemporal nerve
Maxillary artery
Inferior alveolar nerve
Lingual nerve
Sphenomandibular ligament
Stylomandibular ligament
Mandibular fossa
Articular disc
Articular tubercle
Mylohyoid branch of
inferior alveolar artery Medial view
Joint capsule
and mylohyoid nerve

Jaws closed

Jaws slightly Jaws widely


opened opened
(hinge action (hinge and gliding
predominates) actions combined)

Plate 25 Bones and Ligaments

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Cervical Vertebrae: Atlas and Axis 2
See also Plates 28, 30

Anterior tubercle
Anterior articular
Articular facet Dens facet (for anterior
Anterior arch for dens arch of atlas)
Transverse Lateral Pedicle
process mass
Superior articular
facet for atlas Interarticular
part
Tubercle for
transverse
ligament of
Transverse atlas
foramen Vertebral
foramen
Posterior arch
Superior articular surface
of lateral mass for Posterior tubercle Transverse
Inferior articular Body process
occipital condyle facet for C3
Groove for vertebral artery

Atlas (C1): superior view Axis (C2): anterior view

Posterior arch Dens


Posterior tubercle Posterior articular
facet (for transverse
Vertebral Superior articular ligament of atlas)
Transverse foramen facet for atlas
process
Interarticular Transverse
part process

Transverse
foramen Articular facet
for dens Inferior
Inferior articular articular Spinous process
surface of lateral Anterior arch Anterior tubercle process
mass for axis
Atlas (C1): inferior view Axis (C2): posterosuperior view

Dens

Atlas (C1)
Superior articular
surface for occipital condyle

Axis (C2)

Posterior articular facet (for


transverse ligament of atlas)
C3

C4

Upper cervical vertebrae, assembled: posterosuperior view

Bones and Ligaments Plate 26

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Cervical Vertebrae (continued)
See also Plates 28, 29

Inferior aspect of C3 and superior aspect of C4 showing the sites of the facet and uncovertebral articulations

C3 Bifid spinous process


Inferior aspect Lamina

Inferior articular process and facet Vertebral foramen


Pedicle
Transverse foramen
Posterior tubercle
Costal lamella Transverse process
Anterior tubercle

Area for articulation of left uncinate process of C4

Vertebral body

Left uncinate process Articular surface of right uncinate process

Superior articular process and facet


Groove for spinal nerve (C4)
C4 Inferior articular process
Superior aspect

4th cervical vertebra: anterior view 7th cervical vertebra: anterior view
Superior articular process Superior articular process
Spinous process Septated transverse foramen
Lamina
Uncinate process Uncinate process
Costal lamella
Articular surface Articular surface
Inferior Bony spicule
articular dividing
facet transverse
foramen
Posterior
Body tubercle
Anterior Transverse process Posterior tubercle
Transverse foramen tubercle Inferior articular facet for T1 Body Transverse
Anterior tubercle process
(inconspicuous)

7th cervical vertebra (vertebra prominens): superior view


Body Articular surface of uncinate process
Uncinate process
Costal lamella Transverse foramen (septated)

Transverse foramen*
Groove for C7 spinal nerve
Inconspicuous anterior tubercle
(transverse process)
Transverse process (posterior tubercle)
Superior articular process and facet
Pedicle
Inferior articular process
Lamina
Vertebral foramen

Spinous process

*The foramina transversaria of C7 transmit vertebral veins, but usually not the vertebral artery, and are asymmetrical in this specimen.

Plate 27 Bones and Ligaments

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Cervical Vertebrae: Uncovertebral Joints 2
See also Plate 29

Cervical vertebrae: anterior view


Dens of axis
Anterior tubercle of atlas
Anterior arch of atlas

Atlas (C1) Transverse foramen


Intervertebral foramen (for C3 spinal nerve)
Intervertebral disc
Axis (C2) Vertebral body
Inferior articular process (C3)
Superior articular process (C4)

C3 Groove for spinal nerve


Uncus
C4
Anterior tubercle
Transverse process
Posterior tubercle
Articular cartilage on dens for median
Carotid tubercle (of atlantoaxial joint
C5
Chassaignac)
Lateral atlantoaxial joint
Uncinate processes Facet (zygapophysial)
C6 joint between C2 and C3
1st rib

C7 Atlas (C1)

T1

Axis (C2)

Transverse foramen
Uncinate processes

Anulus fibrosus

Uncovertebral joints (clefts of Luschka)

Nucleus pulposus

Transverse process

Intervertebral foramen (for C7 spinal nerve)


Vertebral body (C7)
The uncovertebral joints of the cervical spine: anterior view
(C3 to C7 have been sectioned coronally to expose the joints)

T1

Bones and Ligaments Plate 28

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External Craniocervical Ligaments

Anterior view

Basilar part of occipital bone


Pharyngeal tubercle
Anterior atlantooccipital membrane
Capsule of atlantooccipital joint

Atlas (C1) Posterior atlantooccipital membrane


Lateral atlantoaxial joint (exposed)
Capsule of lateral Anterior longitudinal ligament
atlantoaxial joint

Posterior atlantooccipital membrane


Posterior view
Axis (C2)

Occipital
Capsule of bone
zygapophysial
joint (C3–4)
Capsule of
atlantooccipital
joint
Anterior atlantooccipital membrane Transverse
process
of atlas (C1)
Capsule of Capsule of lateral
atlantooccipital atlantoaxial joint
joint
Axis (C2)

Posterior Ligamenta flava


Atlas (C1)
atlantooccipital Vertebral
artery Suboccipital nerve (posterior
membrane ramus of C1 spinal nerve)

Ligamenta flava
Body of axis (C2)
Nuchal ligament
Intervertebral discs (C2–3 and C3–4)

Zygapophysial joints (C4–5 and C5–6)

Anterior tubercle of C6 vertebra (carotid tubercle of Chassaignac)


Spinous process
of C7 vertebra Vertebral artery
(vertebra prominens)
T1 vertebra

Supraspinous
ligament

Right lateral view

Plate 29 Bones and Ligaments

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Internal Craniocervical Ligaments 2
See also Plate 26

Clivus Upper part of vertebral canal with spinous processes


and parts of vertebral arches removed to expose ligaments
on posterior vertebral bodies: posterior view

Tectorial membrane
Capsule of
atlantooccipital Deeper (accessory) part of tectorial membrane (atlantoaxial ligament)
joint
Atlas (C1) Posterior longitudinal ligament
Capsule of lateral
atlantoaxial joint
Axis (C2) Alar ligaments

Capsule of
zygapophysial
joint
(C2–3)

Atlas (C1)

Superior longitudinal band


Cruciate
ligament Transverse ligament of atlas
Inferior longitudinal band Axis (C2)
Deeper (accessory) part of tectorial membrane (atlantoaxial ligament)

Principal part of tectorial membrane removed


to expose deeper ligaments: posterior view
Apical ligament of dens

Anterior atlantooccipital ligament


Alar ligament
Atlas (C1) Posterior articular facet of dens (for transverse
ligament of atlas)
Anterior tubercle of atlas
Alar ligament Synovial cavities
Axis (C2)

Dens
Cruciate ligament removed to show
deeper ligaments: posterior view
Transverse ligament
of atlas

Median atlantoaxial joint: superior view

Bones and Ligaments Plate 30

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Muscles of Facial Expression: Lateral View
See also Plates 34, 55, 56

Skin
Epicranial aponeurosis Auricularis anterior muscle
Temporal fascia Auricularis superior muscle
Orbital part
Orbicularis oculi muscle Palpebral part Auricularis posterior muscle
Occipital belly
Frontal belly of occipitofrontalis muscle of occipitofrontalis
muscle

Corrugator supercilii muscle (frontalis


and orbicularis oculi, partially cut away)

Procerus muscle

Levator labii superioris muscle

Levator labii superioris


alaeque nasi muscle
(partially cut away)

Nasalis Transverse part


muscle Alar part Parotid
fascia

Depressor septi
nasi muscle Masseteric fascia

Orbicularis oris muscle

Zygomaticus minor muscle Superficial layer of


deep cervical fascia
Zygomaticus major muscle

Orbicularis oris muscle

Mentalis muscle
Modiolus (circled region)
Depressor labii inferioris muscle

Depressor anguli oris muscle

Buccinator muscle

Risorius muscle

Platysma muscle

Sternum

Clavicle

Plate 31 Neck

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Muscles of Neck: Anterior View 2
See also Plates 33, 35, 38

Digastric muscle (anterior belly)

Mylohyoid muscle
Parotid gland
Submandibular gland

Platysma muscle Fibrous loop for


(cut away) intermediate
digastric tendon

Mastoid process Stylohyoid muscle

Digastric muscle
Hyoid bone (posterior belly)

External carotid artery


Carotid sheath
Internal jugular vein
Fascia of infrahyoid
muscles (pretracheal Thyrohyoid muscle
layer) and cut edge
Omohyoid muscle
Thyroid cartilage (superior belly)

Sternohyoid muscle
Superficial layer of deep
cervical fascia and cut edge Sternothyroid muscle
Scalenus medius
Cricoid and scalenus
cartilage posterior muscles

Trapezius muscle
Deltoid muscle

Clavicle

Omohyoid muscle
(inferior belly)

Pretracheal layer of Pectoralis major muscle


deep cervical fascia over
thyroid gland and trachea
Clavicular head Sternocleidomastoid
Sternal head muscle
Suprasternal space (of Burns)

Manubrium of sternum Jugular notch

Neck Plate 32

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Fascial Layers of Neck
See also Plate 32

Cross section
Superficial layer of deep cervical fascia Platysma muscle
Skin Sternohyoid muscle
Infrahyoid fascia Trachea
Sternothyroid muscle
Pretracheal (visceral) fascia Thyroid gland
(thyroid capsule)
Esophagus
Buccopharyngeal Omohyoid muscle
fascia Sternocleidomastoid
muscle
Carotid sheath Recurrent laryngeal
nerve
Superficial fascia
Common carotid artery
Internal jugular vein
Superficial layer of deep Vagus nerve (CN X)
cervical fascia Phrenic nerve
Scalenus anterior muscle
Sympathetic trunk
Spinal nerve
Scalenus medius and
scalenus posterior muscles
Longus colli muscle
Prevertebral fascia
Levator scapulae muscle
Trapezius muscle
Alar fascia Deep cervical muscles
Retropharyngeal Cervical vertebra (C7)
space

Midsagittal section

Mandible
Oropharynx
Geniohyoid muscle
Buccopharyngeal
fascia
Superficial layer of
Retropharyngeal deep cervical fascia
space
Fascia of infrahyoid muscles
Alar fascia
Pretracheal fascia
Prevertebral fascia
Thyroid gland
Trachea
Superficial fascia
Esophagus
Suprasternal space (of Burns)
Skin
Manubrium of sternum
Aortic arch
Pericardium

Plate 33 Neck

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Cervical Fasciae 2
See also Plates 32, 33, 38

Superficial layer of deep cervical fascia (SLDCF)


Pretracheal fascia over intrahyoid muscles Coronoid process with mandible,
masseter, and temporalis muscles
Pretracheal fascia (all cut to show splitting of SLDCF)
Buccopharyngeal fascia
Carotid sheath
Prevertebral fascia

Temporalis muscle fascia and tendon


temporalis
Superior and inferior heads of lateral
pterygoid muscle (cut to show
buccopharyngeal fascia)

Buccopharyngeal fascia
on superior pharyngeal
constrictor muscle Inferior head of
lateral pterygoid
Parotid gland and ramus of muscle
mandible (both cut to show Medial pterygoid
buccopharyngeal fascia) muscle and SLDCF
Sternocleidomastoid Buccinator muscle
muscle (cut) and (deep to bucco-
SLDCF pharyngeal fascia)
Submandibular
Trapezius muscle gland (cut)
Hyoglossus muscle Anterior belly of
digastric muscle

Alar fascia Mylohyoid muscle


SLDCF (cut and
Retropharyngeal space reflected)
Posterior and lateral right Right sternohyoid, omohyoid, and
cricoarytenoid muscles thyrohyoid muscles (cut to expose
Cricopharyngeal pretracheal fascia)
part of inferior pharyngeal Left thyrohyoid, omohyoid,
constrictor muscle sternohyoid , and
sternocleidomastoid muscles
Straight and (pretracheal fascia between
oblique parts of muscles and the viewer)
right cricothy-
roid muscle SLDCF (cut and
reflected)
Esophagus
and trachea Thyroid gland and
pretracheal fascia
Right recurrent (both cut)
laryngeal nerve
Sternothyroid and sternohyoid
muscles (cut) and pretracheal
Carotid sheath fascia
enveloping internal
jugular vein, common
carotid artery, and Manubrium
vagus nerve SLDCF (cut)
Second rib
Suprasternal
space (of Burns)
Clavicle (cut)
Esophagus

SLDCF: Superficial layer of deep cervical fascia

Neck Plate 34

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Infrahyoid and Suprahyoid Muscles
See also Plates 32, 36, 69

Hyoid bone
Digastric muscle (anterior belly)
Mylohyoid muscle
Thyrohyoid membrane
Hyoglossus muscle
External carotid artery
Stylohyoid muscle

Internal jugular vein Digastric muscle


(posterior belly)
Thyrohyoid muscle
Fibrous loop for
Thyroid cartilage intermediate
digastric tendon
Omohyoid muscle
(superior belly) Sternohyoid
and omohyoid
muscles (cut)
Sternohyoid muscle
Thyrohyoid muscle
Median cricothyroid
ligament
Oblique line of
Cricoid cartilage thyroid cartilage

Scalenus Cricothyroid muscle


muscle
Sternothyroid muscle

Omohyoid
muscle
(superior
belly) (cut)
Trapezius
muscle
Thyroid gland
Omohyoid muscle
(inferior belly) Sternohyoid muscle (cut)
Trachea Clavicle

Plate 35 Neck

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Muscles of Neck: Lateral View 2
See also Plates 32, 35, 38

Parotid gland (cut) Masseter muscle

Ramus of mandible Submandibular gland

Hyoglossus muscle

Mylohyoid muscle

Mastoid process

Styloid process

Stylohyoid muscle

Digastric muscle Body of


(posterior belly) mandible

Middle pharyngeal
constrictor muscle
Digastric
muscle
Longus capitis muscle (anterior
belly)
Splenius capitis muscle

Sternocleidomastoid muscle Hyoid bone

Levator scapulae muscle Thyrohyoid muscle

Posterior
Omohyoid muscle
Scalenus muscles Medius (superior belly)
Anterior
Sternohyoid muscle
Brachial plexus
Inferior pharyngeal
Trapezius muscle constrictor muscle

Acromion Sternothyroid
muscle
Deltoid muscle

Omohyoid muscle (inferior belly) Manubrium of sternum

Clavicle Sternal head


Sternocleidomastoid muscle
Clavicular head
Pectoralis major muscle

Neck Plate 36

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Anterior and Lateral Cervical Muscles

Basilar part of
Longus capitis muscle (cut)
occipital bone

Occipital condyle
Jugular process of Rectus capitis
occipital bone anterior muscle

Rectus capitis
Mastoid process lateralis muscle

Styloid process
Transverse process of atlas (C1)

Longus capitis muscle


Anterior Tubercles of transverse
Posterior process of C3 vertebra
Posterior tubercle of
transverse process of axis (C2)

Slips of origin of scalenus


Longus colli muscle
anterior muscle (cut)

Slips of origin of scalenus


posterior muscle
Anterior
Scalenus Medius Scalenus
muscles Medius
Posterior muscles
Posterior

Scalenus anterior
muscle (cut)
Phrenic nerve

Trunks of
brachial plexus

1st rib
Subclavian artery
Common carotid artery
Subclavian vein Posterior tubercle of transverse
process of C7 vertebra
Internal jugular vein

Plate 37 Neck

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Superficial Veins and Cutaneous Nerves of Neck 2
For deep veins of neck see Plate 84

Submental vein
Platysma muscle (cut)
Facial artery and vein
Digastric muscle
(anterior belly)
Marginal mandibular
branch of facial nerve Submandibular gland
Mylohyoid muscle
Hyoid bone
Parotid gland
Retromandibular vein
Omohyoid muscle (cut)
Internal jugular vein External carotid artery
Thyrohyoid muscle
External jugular vein
Sternocleidomastoid muscle (cut)
Anterior jugular vein
Superior thyroid artery and vein
Communicating vein Internal jugular vein
Common carotid artery
Great auricular nerve
Sternohyoid muscle
Thyroid cartilage Sternothyroid muscle
Ansa cervicalis
Transverse cervical nerves Middle thyroid vein
Omohyoid muscle
Thyroid gland
(superior belly) (cut)
Phrenic nerve

Brachial plexus

Trapezius muscle Scalenus anterior


muscle
Platysma muscle (cut)
Pectoralis major muscle
Supraclavicular nerves
Clavicle
Sternocleidomastoid muscle
Sternocleidomastoid muscle (cut)
Inferior thyroid vein
Sternothyroid muscle

Neck Plate 38

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Nerves and Vessels of Neck
See also Plates 138, 139, 140

Anterior branch retromandibular vein Retromandibular vein


Posterior branch retromandibular vein

Posterior auricular vein

Lesser occipital nerve

Greater occipital nerve

Great auricular nerve


Facial vein
Common facial vein External jugular vein
Transverse cervical nerve

Accessory nerve (CN XI)

Supraclavicular nerves

Great auricular nerve

Lesser occipital nerve


Sternocleidomastoid muscle
(cut, reflected superiorly)
Nerve to C2 anterior ramus
mylohyoid
muscle Accessory nerve (CN XI)
C3 anterior ramus
Hypoglossal nerve (CN XII)
Levator scapulae muscle

Scalenus medius muscle

Scalenus anterior muscle


Ansa cervicalis Superior root
Inferior root C5 anterior ramus

Transverse cervical artery


Vagus nerve (CN X)
Phrenic nerve
Omohyoid muscle
Vertebral artery (inferior belly) (cut)

Thyrocervical trunk
Brachial plexus

Dorsal scapular artery


Subclavian artery and vein Suprascapular artery

Plate 39 Neck

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Nerves and Vessels of Neck (continued) 2
See also Plate 140

Accessory nerve (CN XI)


S
Hypoglossal nerve (CN XII) Great auricular nerve
Cervical plexus: schema
C1
(S = gray ramus communicans Lesser occipital nerve
from superior cervical ganglion)
To rectus capitis lateralis,
S longus capitis, and rectus
To geniohyoid muscle C2 capitis anterior muscles
To thyrohyoid muscle

S
C3
Transverse cervical nerve
To omohyoid muscle (superior belly)
S To longus capitis and
C4 longus colli muscles
Superior root
Ansa cervicalis
Inferior root

To sternothyroid muscle
To sternohyoid muscle
To omohyoid muscle (inferior belly)
To scalenus and levator
Supraclavicular nerves scapulae muscles
Phrenic nerve

Right anterior view


Thyroid gland (retracted)
Internal jugular vein

Common carotid artery


Middle cervical ganglion
Ascending cervical artery

Phrenic nerve Vagus nerve (CN X)


Scalenus anterior
muscle Vertebral artery
Inferior thyroid artery
Transverse cervical artery Common carotid artery
Brachial plexus
Suprascapular artery Recurrent laryngeal nerve

Dorsal scapular artery


Brachiocephalic trunk
Costocervical trunk

Thyrocervical trunk Internal jugular vein (cut)

Subclavian artery and vein

Neck Plate 40

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Carotid Arteries
See also Plates 147, 149

Parotid space Superficial temporal artery


(bed): right lateral
view Transverse facial artery

Maxillary artery

External carotid artery


Styloid process Posterior auricular artery
Facial nerve (CN VII) (cut) Glossopharyngeal nerve (CN IX)
Sternocleidomastoid muscle (cut) Stylohyoid muscle
Digastric muscle (posterior belly) (cut) Hypoglossal nerve (CN XII)
Occipital artery and Facial artery
sternocleidomastoid branch
Lingual artery
Accessory nerve (CN XI)
Superior root Mylohyoid muscle
Ansa cervicalis
Inferior root Hyoglossus muscle
Vagus nerve (CN X) Digastric muscle
(anterior belly)
Ascending pharyngeal artery
Hyoid bone
Carotid sinus nerve [from glossopharyngeal
nerve (CN IX)] and carotid body
Branch to thyrohyoid
Internal carotid artery muscle

Internal jugular vein


Superior laryngeal artery

Superior thyroid artery

External carotid artery


Superficial temporal artery
Transverse facial artery Common carotid artery
Digastric muscle Maxillary artery
(phantom)
Posterior auricular artery
Occipital artery Facial artery
Descending branch
Sternocleidomastoid branch Lingual artery
Ascending pharyngeal artery
Internal carotid artery
Superior thyroid artery and
External carotid artery superior laryngeal branch
Omohyoid muscle (phantom)
Common carotid artery

Inferior thyroid artery


Right external carotid artery branches: schema

Thyrocervical trunk
Vertebral artery

Plate 41 Neck

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Nose 2
See also Plate 45

Anterolateral view Inferior view

Frontal bone Major alar cartilage


Nasal bones
Lateral Medial
Frontal process of maxillary bone crus crus

Lateral process of
septal nasal cartilages
Septal nasal cartilage
Minor alar cartilage
Accessory nasal cartilage

Lateral crus
Major alar cartilage
Medial crus
Alar Anterior
Septal nasal cartilage fibrofatty nasal spine
tissue of maxillary
Anterior nasal spine of maxillary bone bone
Septal nasal
Alar fibrofatty tissue cartilage Intermaxillary
suture
Infraorbital foramen
Superficial temporal artery

Frontal belly of occipitofrontalis muscle


Supraorbital artery and nerve
Supratrochlear artery and nerve

Procerus muscle

Corrugator supercilii muscle


External nasal artery

Infratrochlear nerve

Angular artery
External nasal artery and nerve
Nasalis muscle (transverse part)

Infraorbital artery and nerve


Lateral nasal artery
Transverse facial artery
Nasalis muscle (alar part)

Depressor septi nasi muscle


Orbicularis oris muscle
Facial artery

Superior and inferior labial arteries

Nasal Region Plate 42

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Lateral Wall of Nasal Cavity

Frontal sinus Sphenoethmoidal recess


Opening of
Superior nasal concha sphenoidal sinus
Superior nasal meatus Hypophysis
(pituitary gland)
Middle nasal concha in sella turcica
Agger nasi Sphenoidal sinus
Atrium of middle nasal meatus Pharyngeal tonsil
Middle nasal meatus (adenoid if enlarged)
Inferior nasal concha Basilar part of
(turbinate) occipital bone
Pharyngeal raphe
Vomeronasal organ
Choana
Limen nasi
Torus tubarius
Nasal vestibule
Opening of
Inferior nasal meatus auditory tube
(eustachian)
Palatine process of
maxillary bone
Incisive canal Pharyngeal recess
Horizontal plate of
palatine bone
Soft palate
Middle nasal concha
Middle nasal meatus
Bulging septum
To nasopharynx
Inferior nasal concha
Inferior nasal meatus

Inferior view with speculum in place


Frontal sinus Cribriform plate of ethmoid bone
Probe passing from semilunar Probe in opening of sphenoidal sinus
hiatus into frontal sinus via
frontonasal duct Sphenoidal sinus
Superior nasal meatus
Middle nasal concha (cut surface) with opening of posterior
ethmoidal cells
Ethmoidal bulla
Openings of middle ethmoidal cells Basilar part
of occipital bone
Semilunar hiatus (osteomeatal unit)
with opening of anterior Torus tubarius
ethmoidal cells Opening of
Uncinate process auditory tube
(eustachian)
Vomeronasal organ
Inferior nasal concha
(cut surface)
Opening of nasolacrimal duct Opening of
Inferior nasal meatus maxillary sinus

Plate 43 Nasal Region

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Lateral Wall of Nasal Cavity (continued) 2
See also Plates 43, 45

Lacrimal bone
Frontal bone Ethmoid bone
Squamous part Cribriform plate
Frontal sinus
Middle nasal concha
Nasal spine
Uncinate process
Superior nasal concha
Nasal bone Highest nasal concha

Sphenoethmoidal recess
Agger nasi
Sphenopalatine foramen
Basilar part of
Lateral process of occipital bone
nasal septal cartilage

Major alar cartilage

Alar fibrofatty tissue


Sphenoid bone
Maxillary bone Sphenoidal sinus
Frontal process Medial and
Lateral plates of
Anterior nasal spine pterygoid process
Pterygoid hamulus
Incisive canal Palatine bone

Palatine process Sphenoidal process


Inferior Orbital process
Alveolar process nasal concha
Posterior nasal spine
Perpendicular plate
Horizontal plate

Ethmoidal bulla

Frontal sinus Opening of middle ethmoidal cells

Superior nasal concha (cut away)


Opening of frontonasal canal
Openings of posterior ethmoidal cells
Middle nasal concha (cut away)
Opening of sphenoidal sinus
Infundibulum leading to
frontonasal recess Openings into maxillary sinus

Semilunar hiatus (osteomeatal unit) Sphenopalatine foramen


with opening of anterior
ethmoidal cells

Uncinate process

Ethmoidal process of
Inferior nasal concha (cut away) inferior nasal concha
Lesser palatine foramen
Opening of nasolacrimal canal
Greater palatine foramen

Nasal Region Plate 44

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Medial Wall of Nasal Cavity (Nasal Septum)
See also Plate 15

Frontal crest Falx cerebri


Frontal sinus Cribriform plate of ethmoid bone
Dura mater
Sphenoidal sinus
Sella turcica
Nasal septum

Choanae

Lateral process of nasal septal cartilage


Pharyngeal
Major tonsil
alar cartilage
Torus tubarius

Nasal vestibule
Anterior nasal spine Soft palate
Incisive canal

Oral cavity

Tongue

Genioglossus

Frontal bone
Squamous part
Frontal sinus Ethmoid bone
Nasal spine
Crista galli
Cribriform plate Sphenoid bone
Nasal bone
Perpendicular plate Crest
Vomer Body
Sphenoidal sinus
Groove for Medial,
nasopalatine Lateral plates of
nerve and vessels pterygoid process
Septal cartilage
Basilar part of
Major alar occipital bone
cartilage (medial crus)
Pharyngeal
tubercle
Maxillary bone Palatine bone

Anterior nasal spine Perpendicular plate


Nasal crest
Nasal crest Posterior nasal spine
Horizontal plate
Incisive canal Lesser palatine foramen
Palatine process Greater palatine foramen

Plate 45 Nasal Region

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Nerves of Nasal Cavity 2
See also Plates 63, 73, 130

Distribution of olfactory
mucosa (shaded blue)
Nasal
septum
Lateral wall
of nasal cavity

External nasal branch of anterior ethmoidal nerve (CN V1)


Lateral internal nasal branch of anterior ethmoidal nerve (CN V1)
Olfactory bulb
Cribriform plate
Olfactory tract
Posterior superior lateral nasal branches
from pterygopalatine ganglion
Maxillary nerve (CN V2) (sphenopalatine
foramen dissected away)
Pterygopalatine ganglion
Greater petrosal nerve
Deep petrosal nerve
Nerve (vidian) of pterygoid canal
Pharyngeal branch of pterygopalatine ganglion
Nasopalatine nerve (CN V2) passing to nasal septum (cut)
Posterior inferior lateral nasal branch
from greater palatine nerve (CN V2)
Lateral
wall of
nasal Olfactory bulb
cavity Cribriform plate
Olfactory tract

Olfactory nerves (CN I)

Greater
Palatine nerves (CN V2)
Lesser

Medial internal nasal branch


of anterior ethmoidal nerve (CN V1)

Olfactory nerves (CN I)


Nasopalatine nerve (CN V2)
Incisive canal

Nasal septum

Nasal Region Plate 46

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Arteries of Nasal Cavity: Bony Nasal Septum Turned Up
See also Plates 57, 63

Nasal septal branch of superior labial branch


(from facial artery)

Nasal septum (turned up)


Anastomosis between posterior
septal branch of sphenopalatine
artery and greater palatine artery
in incisive canal
Schematic hinge

Septal and lateral nasal


branches of posterior
ethmoidal artery
Anterior septal branch,
Anterior lateral nasal branch,
External nasal branch Posterior septal
of anterior branch of
ethmoidal sphenopalatine
artery artery

Sphenopalatine
artery

Sphenopalatine
foramen
Alar branches of
lateral nasal
branch
(of facial artery)

Posterior
lateral nasal
branches of
sphenopalatine
artery
Maxillary
artery
Inferior
Anastomosis between alveolar artery
posterior septal branch of External carotid
sphenopalatine artery artery
and greater palatine
artery in incisive canal
Lesser palatine foramen and artery
Greater palatine artery
Greater palatine foramen and artery

Lateral wall of nasal cavity

Plate 47 Nasal Region

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Nerves of Nasal Cavity: Bony Nasal Septum Turned Up 2
See also Plate 62

Olfactory nerves (CN I)


Nasal septum (turned up)

Incisive canal
Schematic hinge

Medial internal nasal, Nasopalatine nerve (CN V2)


Lateral internal nasal,
External nasal
branches of
anterior
ethmoidal
nerve (CN V1)

Sphenopalatine foramen
(dissected away)

Internal nasal Pterygopalatine


branches of ganglion
infraorbital
nerve (CN V2) Nerve (vidian)
of pterygoid canal

Posterior superior lateral


nasal branch of maxillary
nerve (CN V2)

Nasal branch of Greater and lesser


anterior superior palatine nerves (CN V2)
alveolar branch of
maxillary nerve (CN V2) Posterior inferior lateral nasal
branch of greater palatine
nerve (CN V2)
Lesser palatine nerves (CN V2)

Communication between
greater palatine and nasopalatine Greater palatine nerve (CN V2)
nerves at incisive canal

Lateral wall of nasal cavity

Nasal Region Plate 48

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Nose and Maxillary Sinus: Transverse Section

Major alar
cartilage
Nasal vestibule
Vomer
Nasal septal cartilage Inferior nasal concha
Facial artery
Facial vein
Maxillary bone
Maxillary sinus
Sphenoid bone
Masseter muscle
Coronoid
process of Medial pterygoid
mandible muscle

Lateral Lateral pterygoid


pterygoid plate
muscle
Levator veli
Cartilage of palatini muscle
auditory tube
(eustachian) Pharyngeal recess

Neck of Longus capitis


mandible muscle

Parotid
gland Rectus capitis
anterior
muscle
Retroman-
dibular
vein Superficial
temporal
artery
Glosso-
pharyngeal
nerve Sympathetic
(CN IX) trunk

Styloid
process Styloglossus
muscle
Stylohyoid
muscle

Auricular
cartilage
Medulla oblongata
Internal carotid
Mastoid cells artery

Internal Vagus nerve (CN X)


jugular vein
Facial nerve (CN VII)
Hypoglossal nerve (CN XII)

Accessory
nerve (CN XI)

Plate 49 Nasal Region

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Paranasal Sinuses: Coronal and Transverse Sections 2
Coronal section

Falx cerebri
Olfactory bulbs
Brain
Frontal sinus

Nasal septum

Middle nasal Ethmoidal cells


concha
Lacrimal gland
Middle nasal
meatus
Opening of
maxillary sinus
Maxillary sinus
Infraorbital
Inferior nasal Recesses of
concha Zygomatic maxillary
Alveolar and sinus
Inferior nasal membrane
meatus
Alveolar process of maxillary bone
Palatine process of Buccinator muscle
maxillary bone
Body of tongue
Oral cavity Sublingual gland
Mandible (body)
Genioglossus muscle
Anterior belly of digastric muscle
Mylohyoid muscle

Geniohyoid muscle
Nasal bone
Nasal septum
Lacrimal bone
Ethmoidal cells
Transverse section Eyeball
Medial wall of orbit

Zygomatic Medial rectus


bone muscle
Lateral
Retrobulbar fat
rectus
muscle
Sphenoidal sinuses
Optic nerve
Optic chiasm (CN II)
Temporal lobe Temporalis
muscle
Infundibular recess of
3rd ventricle
Optic tract
Mammillary bodies

Cerebral peduncle

Cerebral aqueduct Interpeduncular fossa


Vermis

Nasal Region Plate 50

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Paranasal Sinuses: Parasagittal Views
See also Plate 43

Ethmoidal cells
(sinuses)

Frontal sinus
Opening of
sphenoidal sinus
Opening of frontonasal duct

Sphenoidal sinus

Semilunar hiatus

Uncinate process Middle nasal


concha (cut away)

Opening of
maxillary sinus

Inferior nasal
concha

Frontal sinus

Opening into middle nasal meatus

Orbit Pterygopalatine fossa

Maxillary sinus

Roots of teeth

Plate 51 Nasal Region

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Paranasal Sinuses: Changes with Age 2

Bones of nasal cavity Sinus represents one or more anterior ethmoidal cells
and paranasal sinuses opening into semilunar hiatus of middle nasal meatus
at birth

Sinus represents one or more middle ethmoidal cells


opening into middle nasal meatus

Part of nasolacrimal duct Sinuses represent two or more posterior ethmoidal cells
that formed in depths of opening into superior nasal meatus
nasooptic furrow
Sphenoidal sinus within bony shell (sphenoidal concha)
located anterior and lateral to body of sphenoid bone
Nasal bone (broken line indicates sinus lateral to sphenoid body)
Body of sphenoid bone
Lacrimal bone
Hypophyseal fossa

Vestigial remnant
of Rathke’s pouch

Medial plate of
Part of nasolacrimal pterygoid process
duct within nasal
cavity with slit-like Lower border of highest nasal concha
opening in inferior
nasal meatus Lower border of superior nasal concha

Palatine Superior nasal meatus


Maxillary bone
bone
Middle nasal concha (cut edge) (inferior
Uncinate process of ethmoid bone nasal concha completely removed)
Pterygoid hamulus

Semilunar hiatus Maxillary sinus with opening into semilunar hiatus (striped
area represents membrane forming most of medial wall of sinus)

Growth of frontal and maxillary


sinuses throughout life

Frontal sinus
within frontal bone
Birth Left orbit
Middle nasal concha
1 year

4 years Nasal septum


Maxillary sinus
7 years within maxillary
Nasal cavity
bone
12 years

Adult Inferior nasal concha


Molar tooth
Old age
Palate

Nasal Region Plate 52

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Salivary Glands
See also Plates 54, 144, 145

Superficial temporal artery and vein


and auriculotemporal nerve
Temporalis tendon
Branches of facial nerve (CN VII)
Transverse facial artery

Accessory parotid gland

Parotid duct

Buccinator muscle (cut)

Masseter muscle

Lingual nerve

Submandibular ganglion

Tongue

Frenulum of tongue
Sublingual fold with openings
of sublingual ducts (of Rivinus)
Parotid gland
Sublingual caruncle with opening Retromandibular
of submandibular duct vein (anterior and
posterior divisions)
Sublingual gland
Digastric muscle
Submandibular duct (posterior belly)
Stylohyoid muscle
Sublingual artery and vein External jugular vein
Mylohyoid muscle (cut) Sternocleidomastoid muscle
Common facial vein
Digastric muscle (anterior belly)
Submandibular gland Hyoid bone
(deep and superficial lobes)
Internal jugular vein
Facial artery and vein
External carotid artery

Plate 53 Nasal Region

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Facial Nerve Branches and Parotid Gland 2
See also Plates 53, 134

Temporal
branches

Parotid
gland
Zygomatic
branches

Posterior
auricular
nerve

Facial nerve
emerging from Parotid
stylomastoid duct (of
foramen Stensen)

Buccal
branches

Digastric and
stylohyoid Marginal
branches mandibular
branch

Cervical branch

Temporofacial division Temporal branch

Posterior auricular nerve


Zygomatic branches
Facial nerve proper

Digastric and stylohyoid Buccal branches


branches

Cervicofacial division
Marginal mandibular branch

Cervical branch

Nasal Region Plate 54

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Muscles Involved in Mastication
For facial muscles see Plate 31

Temporalis muscle

Temporal fascia
Superficial layer
Deep layer
Levator labii
superioris
alaeque nasi Zygomatic arch
muscle

Levator labii Articular disc of


superioris temporomandibular joint
muscle

Zygomaticus Deep part Masseter


minor muscle Superficial part muscle

Zygomaticus Parotid duct (of Stensen)


major muscle

Levator Buccinator muscle


anguli
oris
muscle

Orbicularis
oris muscle

Mentalis
muscle

Depressor labii
inferioris muscle Depressor anguli
oris muscle

Temporalis muscle
Insertion of temporalis muscle
to coronoid process and
ramus of mandible

Parotid duct (of Stensen)

Buccinator muscle

Orbicularis oris muscle Lateral pterygoid


muscle
Masseteric nerve
and artery
Maxillary artery
Insertion of
masseter muscle

Plate 55 Nasal Region

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Muscles Involved in Mastication (continued) 2
See also Plates 55, 59

Lateral view
Articular disc of
temporomandibular joint

Articular tubercle

Lateral pterygoid muscle


(superior and inferior heads)
Sphenomandibular ligament

Medial pterygoid muscle

Parotid duct (of Stensen)

Buccinator muscle

Pterygomandibular raphe

Superior pharyngeal constrictor muscle

Posterior view
Choanae
Otic ganglion
Sphenomandibular ligament Cartilaginous part of auditory tube (eustachian)
Internal carotid artery
Masseteric nerve Foramen ovale
Lateral pterygoid plate
Middle meningeal artery

Auriculotemporal nerve Temporomandibular joint

Masseteric artery Lateral pterygoid muscle


(superior and inferior heads)

Medial pterygoid nerve


Medial pterygoid muscle
Maxillary artery

Inferior alveolar nerve

Lingual nerve

Medial pterygoid muscle

Medial pterygoid plate Tensor veli palatini muscle (cut)

Pterygoid hamulus Levator veli palatini muscle (cut)

Nerve to mylohyoid muscle


Pterygoid hamulus

Nasal Region Plate 56

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Maxillary Artery
See also Plates 63, 83

Anterior Deep temporal arteries and nerves


Lateral pterygoid artery and muscle Posterior
Masseteric artery and nerve
Supraorbital artery
Supratrochlear artery Middle meningeal artery
Ophthalmic artery Auriculotemporal nerve
External nasal artery Maxillary artery
Angular artery Superficial temporal artery
Infraorbital artery
Posterior auricular artery
Superior Posterior
alveolar Facial nerve (CN VII)
Middle
arteries Inferior alveolar
Anterior
artery and nerve
Buccal artery and nerve Sphenomandibular ligament
Medial pterygoid Mylohyoid nerve and artery
artery and muscle
Digastric muscle (posterior belly)
Pterygomandibular raphe
Stylohyoid muscle
Lingual nerve
Facial artery External carotid artery

Mental branch of Facial artery


inferior alveolar artery
Lingual artery
Submental artery
Mylohyoid artery and nerve

Anterior Deep temporal


Sphenopalatine artery Artery of pterygoid canal
Posterior arteries and nerves
Pharyngeal artery Accessory meningeal artery
Posterior lateral nasal branch
Sphenopalatine foramen Middle meningeal artery
Infraorbital artery Anterior tympanic artery
Deep auricular artery
Posterior superior
alveolar artery Auriculo-
temporal
Sphenopalatine artery nerve

Posterior septal branches

Greater (descending)
palatine artery

Buccal artery

Anastomosis in Superficial
incisive canal temporal artery
Ascending pharyngeal
Left and right artery
greater palatine arteries Ascending palatine artery
Left and right Tonsillar branches
lesser palatine arteries Tonsillar artery
Pterygoid arteries External carotid artery
Facial artery
Masseteric artery
Superior pharyngeal constrictor muscle
Inferior alveolar artery
Styloglossus muscle

Plate 57 Nasal Region

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Proximal Maxillary and Superficial Temporal Arteries 2
See also Plates 57, 59, 63

Lateral view
Zygomatic process Deep temporal arteries
of temporal bone

Joint capsule

Temporomandibular Lateral ligament


joint capsule

Superficial temporal
artery

Transverse facial
artery
Left and right external
carotid arteries
Maxillary artery
Facial artery

Lingual artery
Masseteric artery

Medial view Middle meningeal artery


Joint capsule

Zygomatic process of temporal bone

Deep temporal artery

Transverse facial artery Anterior tympanic


artery

Maxillary artery

Masseteric artery

Lateral pterygoid
muscle (cut)

Sphenomandibular
ligament
Superficial temporal
artery
Deep auricular
artery
Facial artery
Maxillary artery

Lingual artery Inferior alveolar artery

Right external carotid

Nasal Region Plate 58

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Mandibular Nerve (CN V3)
See also Plates 82, 133

Anterior division Temporal fascia


and temporalis muscle Posterior
Lateral view Posterior division Deep temporal nerves
Anterior
Foramen ovale
Masseteric nerve
Meningeal branch
Lateral pterygoid
Foramen spinosum muscle and nerve
to lateral ptyergoid
Middle muscle
meningeal artery

Auriculotemporal
nerve

Posterior
auricular nerve

Facial nerve (CN VII)


Buccal nerve
Chorda tympani and buccinator
muscle (cut)
Lingual nerve

Inferior alveolar nerve (cut) Submandibular


ganglion
Nerve to mylohyoid muscle
Sublingual
Medial pterygoid muscle (cut) gland

Digastric muscle (posterior belly) Mylohyoid


muscle (cut)
Stylohyoid muscle

Hypoglossal nerve (CN XII) Mental nerve

Submandibular gland
Inferior alveolar nerve (cut)

Medial view Digastric muscle (anterior belly)


Motor root
Trigeminal (semilunar) Sensory root
ganglion
Geniculate ganglion
Ophthalmic nerve (CN V1) Tympanic membrane
Maxillary nerve (CN V2)
Chorda tympani
Mandibular nerve (CN V3)
Facial nerve (CN VII)
Posterior division
Anterior division Tensor tympani muscle
Tensor veli palatini muscle and nerve to tensor
and nerve to tensor veli tympani muscle
palatini muscle
Lesser petrosal nerve
Otic ganglion Auriculotemporal nerve
Chorda tympani Middle meningeal artery
Medial pterygoid muscle
(cut) and nerve to medial Maxillary artery
pterygoid muscle
Nerve to mylohyoid muscle
Pterygoid hamulus
Inferior alveolar nerve entering
Lingual nerve mandibular foramen

Plate 59 Nasal Region

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Superior View of Infratemporal Fossa 2
See also Plates 57-59, 63, 64, 115

Infraorbital and posterior superior alveolar arteries and nerves

Mandibular nerve (CN V3) (cut and reflected anterolaterally) Inferior head of the lateral pterygoid muscle
Pterygoid (venous) plexus Buccal nerve
Maxillary artery
Otic ganglion and lesser petrosal nerve
Roots of auriculotemporal nerve
Nerves to tensor veli palatini
and medial pterygoid muscles Anterior deep temporal nerve and artery

Ophthalmic nerve (CN V1) Coronoid process

Maxillary nerve Superior head of lateral


(CN V2) pterygoid muscle (cut)

Posterior deep temporal


nerve and artery
Foramen ovale
Masseteric artery
and nerve

Internal Masseter muscle


carotid
artery Temporomandibular
joint capsule

Temporalis
Oculomotor muscle
nerve (CN III)
Articular disc
Abducens
nerve (CN VI)
Superficial
Trochlear temporal
nerve (CN IV) artery and vein

Parotid gland
Trigeminal
nerve (CN V)
External
carotid artery

Accessory meningeal artery

Middle meningeal artery


and meningeal branch of
mandibular nerve (CN V3) Posterior auricular artery
Facial nerve (CN VII) and Facial nerve (CN VII)
vestibulocochlear nerve (CN VIII) Auriculotemporal nerve

Inferior alveolar nerve Maxillary artery


Malleus (head) and incus
Sphenomandibular ligament
Chorda tympani (reflected medially) and
Lesser petrosal nerve and superior tympanic artery anterior tympanic artery

Geniculate ganglion
Greater petrosal nerve
Stylomandibular ligament

Nasal Region Plate 60

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Ophthalmic (CN V1) and Maxillary (CN V2) Nerves
See also Plates 63, 66

Anterior ethmoidal nerve


Communicating branch
Supraorbital nerve
Posterior ethmoidal nerve
Supratrochlear nerve
Long and short ciliary nerves
Infratrochlear nerve
Ciliary ganglion (from nasociliary nerve)

Palpebral branch of
Lacrimal nerve lacrimal nerve

Nasociliary nerve Zygomaticotemporal


nerve
Frontal nerve
Zygomaticofacial
nerve
Ophthalmic nerve (CN V1)
External
Trigeminal nasal
(semilunar) ganglion branch of
anterior
ethmoidal
Trigeminal nerve
nerve
(CN V)

Foramen
rotundum Infraorbital
nerve
Anterior superior
alveolar branch
Middle superior
alveolar branch

Maxillary nerve (CN V2)

Zygomatic nerve

Infraorbital nerve entering


Nerve (vidian) of pterygoid canal infraorbital canal

Pterygopalatine ganglion
Posterior superior alveolar branches

Branches to pterygopalatine ganglion

Plate 61 Nasal Region

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Autonomic Innervation of Nasal Cavity 2
See also Plates 133, 142, 144

Superior salivatory nucleus (parasympathetic)


Facial nerve (CN VII)
Geniculate ganglion
Greater petrosal nerve (parasympathetic)
Deep petrosal nerve (sympathetic)
Nerve (vidian) of pterygoid canal
Maxillary nerve (CN V2) entering foramen rotundum

Pterygopalatine ganglion
Lateral and medial posterior
superior nasal branches
Infraorbital nerve

Tympanic cavity

Internal carotid
nerve
Medulla
oblongata
Greater
Internal and lesser
carotid palatine Posterior Nasopalatine
Spinal artery nerves superior Maxillary nerve
cord alveolar sinus
Superior branches
cervical ganglion
Sympathetic
trunk Postsynaptic fibers to
vessels (sympathetic) and
T1 glands (parasympathetic) of
nasal cavity, maxillary sinus,
and palate
T2
Preganglionic parasympathetic fibers
T3
Postganglionic parasympathetic fibers
Preganglionic sympathetic fibers

Preganglionic sympathetic cell Postganglionic sympathetic fibers


bodies in intermediolateral nucleus
(lateral horn) (T1--5)

Nasal Region Plate 62

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Nerves and Arteries of the Deep Face
See also Plates 46, 48, 61

Nerve of pterygoid canal Posterior superior Nasopalatine nerve Posterior lateral nasal branches of
and inferior lateral sphenopalatine artery
nasal branches
Maxillary nerve (CN V2) Pharyngeal artery

Pterygopalatine ganglion
Artery of pterygoid canal
Lacrimal nerve
Sphenopalatine artery
Zygomatic
nerve

Zygomatico-
temporal Infraorbital
nerve artery

Posterior
Zygomatico- superior
facial alveolar
nerve artery
Descending
Infraorbital palatine
nerve artery
Middle Maxillary
superior artery
alveolar
branch
Superficial
Posterior temporal
wall of right artery
maxillary
sinus (cut)
Posterior External
superior carotid artery
alveolar
branch
Anterior and middle
Greater superior alveolar
and lesser arteries
palatine
nerves Dental branches
of superior
Dental and gingival branches alveolar artery
(of superior alveolar nerves)
Lesser and greater palatine arteries
Communication between greater palatine and
nasopalatine nerves, and anastomosis between
posterior septal branch of sphenopalatine artery
and greater palatine artery in incisive canal

Anterior perspective of pterygopalatine fossa and


nasal cavity with lower facial skeleton removed

Plate 63 Nasal Region

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Orientation of Nerves and Vessels of the Cranial Base 2
See also Plates 115, 142, 147

Internal carotid artery (cerebral part)


Internal carotid artery (cavernous part) Abducens nerve (CN VI)
Trochlear nerve (CN IV) Artery and nerve of pterygoid canal
Oculomotor nerve (CN III)
Superior petrosal sinus
Sphenoidal sinus
Trigeminal nerve (CN V) Maxillary nerve (CN V2)
Greater petrosal nerve Pterygopalatine ganglion
Internal carotid artery Ciliary ganglion
(petrosal part) and venous plexus
Ophthalmic artery
Cochlea
Infraorbital nerve
Anterior semicircular canal Optic nerve (CN II)
Opening of maxillary sinus
Inferior tympanic artery
and tympanic nerve

Facial nerve (CN VII)

Sigmoid
sinus

C1
Mastoid cells

Internal carotid plexus

Inferior ganglion of Maxillary sinus


glossopharyngeal nerve
Right medial
Accessory nerve (CN XI) pterygoid plate
Descending
palatine artery
Inferior ganglion
of vagus nerve
Greater and lesser palatine arteries and nerves
Hypoglossal nerve (CN XII)
Ascending pharyngeal artery

Internal jugular vein Superior cervical ganglion


Vagus nerve (CN X)
External carotid artery
Glossopharyngeal nerve (CN IX)
Common carotid artery Internal carotid artery

Nasal Region Plate 64

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Inspection of Oral Cavity

Philtrum
Soft palate
Palatopharyngeal arch
Uvula of the palate
Palatoglossal arch
Palatine tonsil
Posterior wall of oral pharynx

Frenulum of upper lip


Lingual minor salivary gland
Deep lingual artery and veins
and lingual nerve
Fimbriated fold
Submandibular duct
Sublingual gland
Frenulum of tongue
Sublingual fold with openings
of sublingual ducts
Sublingual caruncle with opening of
submandibular duct (of Wharton)
Frenulum of lower lip

Tubercle of upper lip

Papilla of parotid
duct (of Stensen)

Plate 65 Oral Region

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Afferent Innervation of Oral Cavity and Tongue 2
See also Plates 144, 146

Midde superior
alveolar branch

Ophthalmic nerve (CN V1) Anterior superior


alveolar branch
Trigeminal nerve (CN V)

Trigeminal (semilunar) ganglion


Infraorbital
Maxillary nerve (CN V2) nerve
Mandibular nerve (CN V3)
Buccal nerve

Posterior superior alveolar branch

Lingual nerve

Inferior alveolar nerve


Anterior superior
alveolar branch
Nasopalatine nerve
Mental
Infraorbital nerve nerve
Middle superior
alveolar nerve Middle superior
alveolar branch
Posterior superior Inferior alveolar nerve Incisive branch
alveolar branch and
buccal nerves

Greater palatine Posterior superior


nerve alveolar branch
Lesser palatine Buccal nerve
nerve

Inferior
Lingual nerve and alveolar
nerve to mylohyoid nerve
muscle
Mental nerve Incisive branch
(branch of inferior
alveolar nerve)

Glossopharyngeal nerve (CN IX)

Lingual nerve

Vagus nerve (CN X)


Taste and general sensation
via superior laryngeal nerve Glossopharyngeal nerve (CN IX)
Taste plus general sensation
via lingual branches

Facial nerve (CN VII)


Intermediate nerve of (Wrisberg) Trigeminal nerve (CN V)
via chorda tympani (taste) (mandibular nerve V3)
via lingual nerve
(general sensation)

Oral Region Plate 66

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Roof of Oral Cavity
See also Plate 48

Incisive papilla
Incisive fossa
Transverse palatine
folds Greater palatine artery and nerve

Palatine raphe Greater palatine foramen

Palatine process Lesser palatine foramen


of maxillary bone
Lesser palatine artery and nerves
Palatine glands
Tendon of tensor veli
Horizontal plate palatini muscle
of palatine bone
Pterygoid hamulus
Palatine
aponeurosis Interdigitating fibers of
(from tensor levator veli palatini muscle
veli palatini
muscle) Buccinator muscle

Musculus uvulae Pterygomandibular raphe

Molar minor Superior pharyngeal


salivary glands constrictor muscle

Palatopharyngeus Palatoglossus muscle


muscle

Palatine tonsil

Basilar part of
Anterior view occipital bone

Cartilaginous part
of auditory tube
(eustachian)

Levator veli palatini muscle (cut) Pharyngobasilar


fascia
Tensor veli palatini muscle and tendon
Levator veli palatini muscle
Medial pterygoid muscle (cut)
Choanae
Medial pterygoid plate
Pterygoid hamulus
Pterygoid hamulus

Tendon of tensor veli palatini muscle Superior pharyngeal


constrictor muscle (cut)
Levator veli palatini muscle (cut)
Palatopharyngeus muscle
Palatopharyngeus muscle (cut)

Musculus uvulae

Posterior view

Plate 67 Oral Region

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Tongue and Salivary Glands: Sections 2

Horizontal section Orbicularis oris muscle


below lingula of Buccinator muscle
mandible (superior view)
demonstrating bed Buccopharyngeal fascia
of parotid gland Facial artery and vein
Palatoglossus muscle in palatoglossal arch
Palatine tonsil
Pterygomandibular raphe
Lingual nerve and superior pharyngeal constrictor muscle
Buccal nerve and branches
Masseter muscle
Palatopharyngeus muscle in palatopharyngeal arch
Ramus of mandible
Inferior alveolar artery, vein, and nerve to mylohyoid muscle
Medial pterygoid muscle
Styloglossus muscle
Facial nerve (CN VII)
Retromandibular vein
External carotid artery
Parotid gland
Stylopharyngeus muscle
Stylohyoid muscle
Axis (C2)
Sternocleidomastoid muscle
Digastric muscle (posterior belly)
Internal jugular vein, internal carotid artery, Longus capitis muscle
and nerves CN IX, CN X, and CN XII in carotid sheath
Prevertebral fascia
Superior cervical sympathetic ganglion Buccopharyngeal fascia
and retropharyngeal space

Superior longitudinal lingual muscle


Verticalis and transversus linguae muscles of tongue
Inferior longitudinal lingual muscle
Styloglossus muscle
Buccinator muscle

Hyoglossus muscle
Genioglossus muscle
Sublingual salivary gland
Submandibular duct
Submandibular salivary gland
Mandibular canal, inferior alveolar artery, vein, and nerve
Lingual nerve
Nerve to mylohyoid muscle
Vena comitans of hypoglossal nerve (to lingual vein)
Lingual artery
Facial artery Coronal section
Hypoglossal nerve (CN XII) posterior to 1st
Submandibular salivary gland molar tooth
Submandibular lymph node (anterior view)
Mylohyoid muscle demonstrating
Facial vein sublingual and
Intermediate digastric tendon submandibular
Hyoid bone glands

Oral Region Plate 68

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Floor of Oral Cavity
See also Plate 35

Lateral, slightly inferior view

Hyoglossus muscle
Mylohyoid muscle
Fibrous loop for intermediate digastric tendon
Digastric muscle (anterior belly)
Median raphe between mylohyoid muscles Mastoid
process
Styloid process
Digastric muscle
Anteroinferior (posterior belly)
view
Stylohyoid muscle
Greater horn
Lesser horn Hyoid bone
Body
Thyrohyoid muscle
Omohyoid muscle
Sternohyoid muscle

Median raphe between mylohyoid muscles


Digastric muscle (anterior belly)
Mylohyoid muscle
Stylohyoid muscle
Hyoglossus Digastric muscle (posterior belly)
muscle
Fibrous loop for intermediate digastric tendon

Sublingual fold with openings Sublingual gland and submandibular duct open to show the
Mandibular nerve (CN V3) of sublingual ducts sublingual ducts of the sublingual gland draining into it

Inferior alveolar nerve


Sublingual caruncles with Sublingual artery
opening of submandibular and lingual nerve Chorda tympani
duct (of Wharton)
Maxillary and inferior
Frenulum of tongue alveolar arteries
(cut)
Genioglossus muscles Superficial temporal
artery
Inferior alveolar
nerve and artery Mylohyoid branch of
inferior alveolar artery and
nerve to mylohyoid muscle
Facial artery
Facial artery
Angle of mandible Submandibular
ganglion
Mylohyoid muscle Submandibular gland
Deep lingual artery (cut) External carotid
Lingual artery artery
Geniohyoid muscles Lingual artery

Body Dorsal lingual artery (cut)


Hyoid bone Lesser horn
Greater horn Hyoglossus muscle

Plate 69 Oral Region

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Tongue 2
See also Plates 69, 139

Palatopharyngeus muscle
Palatoglossus muscle
Inferior longitudinal lingual muscle

Mastoid process
Digastric muscle (posterior
belly) (cut)
Styloid process
Pharyngobasilar fascia
Superior pharyngeal constrictor muscle
Stylohyoid ligament
Styloglossus muscle
Glossopharyngeal part of superior
pharyngeal constrictor muscle
Stylopharyngeus muscle
Stylohyoid muscle
Middle pharyngeal constrictor muscle
Digastric muscle (posterior belly) (cut)
Hyoglossus muscle
Genioglossus muscle Intermediate tendon of digastric muscle (cut)
Mylohyoid muscle (cut) Fibrous loop for intermediate digastric tendon
Hyoid bone
Geniohyoid muscle

Lateral view (left side of mandible removed)


Lingual nerve Superior pharyngeal
constrictor muscle
Submandibular ganglion Styloglossus muscle
Palatoglossus muscle (cut)
Deep lingual artery
and vein Stylohyoid ligament
Stylopharyngeus muscle
Hyoglossus muscle (cut)
Lingual artery
External carotid artery
Internal jugular vein
Submandibular duct Retromandibular vein
(of Wharton) Facial vein
Common trunk for facial,
retromandibular, and
lingual veins (common
facial vein)
Genioglossus muscle Lingual vein
Suprahyoid artery
Sublingual artery and vein
Geniohyoid muscle Hyoid bone Dorsal lingual artery and vein

Hypoglossal nerve (CN XII) Vena comitans of hypoglossal nerve

Oral Region Plate 70

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Tongue (continued)

Epiglottis
Median glossoepiglottic fold
Lateral glossoepiglottic fold
Vallecula
Palatopharyngeal arch and muscle (cut)
Palatine tonsil (cut)
Lingual tonsil
Root
Palatoglossal arch and muscle (cut)
Foramen cecum
Terminal sulcus
Vallate papillae

Foliate papillae

Filiform papillae

Body

Fungiform papilla
Midline groove

Dorsum of tongue

Apex
Lingual tonsil

Filiform papillae

Fungiform papilla
Keratinized tip
of papilla

Intrinsic muscle

Duct of gland
Crypt
Schematic stereogram: window area Lymph follicles
indicated above
Mucous glands
Vallate papilla
Taste buds
Furrow
Lingual glands (serous glands of von Ebner)

Plate 71 Oral Region

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Fauces 2

Medial view
sagittal section
Sphenoidal sinus
Pharyngeal tonsil
Torus tubarius
Pharyngeal raphe
Pharyngeal tubercle (basilar part of occipital bone)
Pharyngeal opening of auditory tube
(eustachian)
Hard palate
Pharyngeal recess
Salpingopharyngeal fold
Soft palate
Palatine glands
Musculus uvulae
Semilunar fold
Supratonsillar fossa
Palatine tonsil
Palatopharyngeal arch
Palatoglossal arch
Oropharynx
Triangular fold
Tongue (drawn anteriorly and inferiorly)
Lingual tonsil
Epiglottis
Vallecula

Pharyngeal mucosa removed


Pharyngeal tonsil
Cartilaginous part of auditory tube (eustachian)
Medial pterygoid plate
Tensor veli palatini muscle and tendon
Levator veli palatini muscle
Ascending palatine artery
Pharyngeal branch of ascending pharyngeal artery
Lesser palatine artery
Salpingopharyngeus muscle
Pterygoid hamulus
Pterygomandibular raphe
Tonsillar branch of lesser palatine artery
Superior pharyngeal constrictor muscle
Tonsillar branch of ascending pharyngeal artery
Palatoglossus muscle
Palatopharyngeus muscle
Tonsillar branch of ascending palatine artery
Tonsillar branch of facial artery
Tonsillar branch of dorsal lingual artery
Glossopharyngeal nerve (CN IX) and tonsillar branch
Stylohyoid ligament
Hyoglossus muscle
Middle pharyngeal constrictor muscle
Stylopharyngeus muscle

Oral Region Plate 72

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Teeth
See also Plate 67

Deciduous Permanent
(primary) (colored blue)
Usual age of Usual age of
eruption eruption

Central incisor (7th year)


Central incisor
(8–10 months) Lateral incisor (8th year)
Lateral incisor Canine (cuspid) (11th–12th year)
(8–10 months)
1st premolar (9th year)
Canine (cuspid)
(16–20 months) 2nd premolar (10th year)
1st molar 1st molar (6th year)
(15–21 months) 2nd molar (12th–13th year)
2nd molar
(20–24 months)
3rd molars (17th–25th year)

2nd molar
(20–24 months)
2nd molar (12th–13th year)
1st molar
(15–21 months) 1st molar (6th year)
Canine (cuspid) 2nd premolar (10th year)
(16–20 months)
1st premolar (9th year)
Lateral incisor
(15–21 months) Canine (cuspid) (11th–12th year)

Central incisor Lateral incisor (8th year)


(6–9 months) Central incisor (7th year)

Central incisors
Incisive fossa Lateral incisors

Canines
Palatine process
of maxillary bone
1st premolars

Horizontal 2nd premolars


plate of
palatine 1st molars
bone
2nd molars

3rd molars

Greater and lesser


palatine foramina
Upper permanent teeth Lower permanent teeth

Plate 73 Oral Region

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Teeth (continued) 2

Enamel

Dentine and dentinal tubules

Crown Interglobular spaces


Odontoblast layer
Interproximal spaces
Dental pulp containing vessels
and nerves
Neck Gingival epithelium (stratified)
Gingival groove
Lamina propria of gingiva
(mandibular or maxillary periosteum)
Periodontium

Interdental papilla
Cement
Root
Root canals containing vessels
and nerves
Bone
Apical foramina

Left upper
permanent
teeth:
labiobuccal
view

Left lower
permanent
teeth:
labiobuccal
view
Central Lateral 1 2 1 2 3

Incisors Canines Premolars Molars

Oral Region Plate 74

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Muscles of Pharynx: Partially Opened Posterior View
See also Plates 76, 81

Basilar part of occipital bone Pharyngeal tubercle

Pharyngeal
tonsil
Cartilaginous part
Styloid of auditory tube
process (eustachian)
Digastric
muscle Pharyngobasilar
(posterior fascia
belly)
Choana
Stylohyoid
muscle Levator veli
palatini muscle
Stylopharyngeus
muscle Superior pharyngeal
constrictor muscle
Accessory muscle
bundle from Salpingopharyngeus
petrous part of muscle
temporal bone Musculus uvulae
(petropharyngeus
muscle) Palatopharyngeus muscle

Medial Middle pharyngeal


pterygoid muscle constrictor muscle
Pharyngobasilar fascia Root of tongue
Stylopharyngeus muscle
Pharyngeal raphe
Superior pharyngeal Pharyngoepiglottic fold
constrictor muscle
Aryepiglottic fold
Hyoid bone (tip of greater horn)
Inferior pharyngeal
Middle pharyngeal constrictor muscle constrictor muscle (cut edge)
Longitudinal pharyngeal muscles
Epiglottis
Superior horn of
Inferior pharyngeal constrictor muscle thyroid cartilage
Cuneiform tubercle Thyrohyoid membrane

Corniculate tubercle Internal branch of


superior laryngeal nerve
(Transverse and oblique)
arytenoid muscles

Posterior cricoarytenoid muscle Cricopharyngeal part of


inferior pharyngeal constrictor muscle
Cricopharyngeus muscle (part of Posterior border of thyroid cartilage lamina
inferior pharyngeal constrictor muscle)
Cricoid attachment of longitudinal
Longitudinal esophageal muscle esophageal muscle
Circular esophageal muscle

Plate 75 Pharynx

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Posterior View of Pharynx: Nerves and Vessels 2
See also Plates 75, 79, 82, 83

Facial and vestibulocochlear nerves (CN VII, CN VIII) Superior and inferior ganglia of vagus nerve (CN X)

Glossopharyngeal nerve (CN IX) Facial nerve (CN VII) and stylomastoid artery

Sigmoid
Hypoglossal sinus
nerve (CN XII)
Occipital
Accessory
artery
nerve (CN XI)

Stylopharyngeus
muscle Ascending pharyngeal
artery
Glossopharyngeal
nerve (CN IX) Superficial temporal
artery
Vagus nerve (CN X) (cut)
Internal carotid artery
Superior cervical ganglion
External carotid artery

Superior laryngeal nerve Facial artery

Superior thyroid
Angle of the mandible artery

Pharyngeal
Pharyngeal
venous plexus
branch of vagus nerve

Internal carotid artery Internal jugular vein

Pharyngeal nervous plexus Common carotid artery

Superior cervical cardiac nerve Inferior thyroid artery

Sympathetic trunk Thyrocervical trunk


Thyroid and parathyroid glands
Vertebral artery
Middle cervical ganglion
Subclavian artery
Common carotid artery
Recurrent laryngeal nerve
Esophagus

Superior view of the skull base


showing line of cut and the
removed part

Pharynx Plate 76

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Pharynx: Medial View

Sella turcica Pharyngeal opening of auditory tube


Frontal sinus
(eustachian)
Sphenoidal sinus Sphenooccipital synchondrosis
Nasal septum Pharyngeal tonsil
Nasopharynx Pharyngeal tubercle of occipital bone
Soft palate Pharyngeal raphe
Anterior longitudinal ligament
Palatine glands
Anterior atlantooccipital membrane
Hard palate
Apical ligament of dens
Oral cavity
Incisive canal Anterior
arch of
Palatine tonsil atlas (C1
vertebra)
Body of tongue
Dens of
Oropharynx axis (C2
vertebra)
Foramen cecum C1 C1
Pharyngeal
Lingual tonsil constrictor
Genioglossus muscles
muscle C2
Bucco-
Root of tongue pharyngeal
fascia
Epiglottis C3 Retro-
Geniohyoid muscle pharyngeal
space
Mandible
Prevertebral
Mylohyoid muscle C4 fascia and
Hyoid bone anterior
longitudinal
Hyoepiglottic ligament ligament
C5
Thyrohyoid membrane
Laryngopharynx
C6
Thyroid cartilage
Vocal fold
Transverse arytenoid muscle
C7

Cricoid cartilage
Trachea T1
Esophagus
Esophageal muscles
Thyroid gland
Superficial layer of deep cervical fascia
Pretracheal fascia
Suprasternal space (of Burns)
Manubrium of sternum

Plate 77 Pharynx

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Muscles of Pharynx: Medial View 2
See also Plate 72

Medial pterygoid plate


Cartilaginous part of auditory tube (eustachian)
Tensor veli palatini muscle
Pharyngobasilar fascia
Levator veli palatini muscle
Palatine aponeurosis and tendon of
tensor veli palatini muscle
Pharyngeal tubercle (basilar part of occipital bone)
Pharyngeal raphe
Anterior longitudinal ligament
Anterior atlantooccipital membrane
Apical ligament of dens
C1 Salpingopharyngeus muscle
Muscles of soft palate
Palatopharyngeal ridge (Passavant’s ridge)
C2 Pterygoid hamulus
Superior pharyngeal constrictor muscle
Pterygomandibular raphe
Palatopharyngeus muscle
Buccinator muscle
Glossopharyngeal part of
C3 superior pharyngeal constrictor muscle
Stylopharyngeus muscle
Stylohyoid ligament
Styloglossus muscle
Middle pharyngeal constrictor muscle
C4 Fibers to pharyngoepiglottic fold
Buccopharyngeal fascia and
retropharyngeal space
Hyoglossus Prevertebral fascia and anterior
muscle longitudinal ligament
Geniohyoid Internal branch of superior laryngeal nerve
muscle
C5 Longitudinal pharyngeal muscles
Mylohyoid
muscle Inferior pharyngeal constrictor muscle
Hyoid bone
Thyrohyoid C6 Cricopharyngeal muscle
membrane (part of inferior pharyngeal constrictor muscle)
Thyroid cartilage
Median
cricothyroid ligament
Circular esophageal muscle
Corniculate and
arytenoid cartilages C7 Longitudinal esophageal muscle
Cricoid cartilage
Trachea

Pharynx Plate 78

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Pharynx: Opened Posterior View

Choanae Basilar part of occipital bone


Pharyngeal tonsil

Styloid process
Nasal septum
Torus tubarius
Pharyngeal opening
of auditory tube
(eustachian)
Nasopharynx
Pharyngeal recess
Parotid gland
Torus levatorius (fold
caused by levator
veli palatini muscle)
Inferior nasal concha
Salpingopharyngeal fold
Soft palate
Angle of mandible
Submandibular gland
Oropharynx Uvula of the palate
Palatine tonsil
Root of tongue
Palatopharyngeal arch
Prominence caused by greater horn
of hyoid bone
Epiglottis
Laryngeal inlet
Prominence caused by superior horn
Laryngopharynx of thyroid cartilage
Aryepiglottic fold
Piriform recess
Cuneiform tubercle
Fold over internal branch
of superior laryngeal nerve
Corniculate tubercle
Interarytenoid notch
Prominence over lamina
Esophagus of cricoid cartilage

Trachea

Plate 79 Pharynx

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Pharyngoesophageal Junction 2

Superior pharyngeal constrictor muscle


Root of tongue
Epiglottis
Middle pharyngeal constrictor muscle
Palatopharyngeus muscle Longitudinal
pharyngeal
Stylopharyngeus muscle muscles
Pharyngoepiglottic fold
Laryngeal inlet
Thyroid cartilage (superior horn)
Thyrohyoid membrane
Internal branch of superior laryngeal
nerve and superior laryngeal artery
and vein
Oblique arytenoid muscle
Transverse arytenoid muscle
Thyroid cartilage
Posterior cricoarytenoid muscle
Inferior pharyngeal constrictor muscle
(thyropharyngeus muscle)
Pharyngeal aponeurosis (cut away)
Zone of sparse muscle fibers
Cricopharyngeal part of inferior
pharyngeal constrictor muscle
Cricoid cartilage (lamina)
Cricoesophageal tendon

Posterior view with


pharynx opened and
mucosa removed Esophageal mucosa and submucosa
Circular muscle in V-shaped area (of Laimer)
Right recurrent laryngeal nerve

Longitudinal esophageal muscle

Window cut in longitudinal muscle


exposes circular muscle layer

Pharynx Plate 80

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Muscles of Pharynx: Lateral View
See also Plate 75

Pharyngobasilar fascia

Tensor veli palatini muscle

Levator veli palatini muscle

Lateral pterygoid plate

Pterygoid hamulus

Buccinator muscle (cut)

Pterygomandibular raphe
Digastric muscle
(posterior belly) (cut)
Styloid process
Superior pharyngeal constrictor muscle
Styloglossus muscle
Oblique line
of mandible Stylohyoid ligament
Stylopharyngeus muscle
Middle pharyngeal constrictor muscle
Hyoglossus muscle
Greater horn of hyoid bone
Digastric muscle (anterior belly) Superior horn of thyroid cartilage
Mylohyoid muscle Thyrohyoid membrane
Hyoid bone Inferior pharyngeal constrictor muscle
Tendinous arch
Stylohyoid muscle (cut)

Thyroid cartilage
Cricopharyngeal part of
Median cricothyroid ligament inferior pharyngeal
constrictor muscle
Cricothyroid muscle
Cricoid cartilage Esophagus
Trachea
Tracheoesophageal groove

Plate 81 Pharynx

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Nerves of Oral, Head, and Neck Regions 2
See also Plates 59, 133, 136

Zygomaticotemporal branch
of zygomatic nerve (CN V2)
Deep temporal nerves (CN V3)
Masseteric nerve (CN V3)
Mandibular nerve (CN V3)
Nerve to medial pterygoid
muscle and tensor veli
palatini muscles (CN V3) (cut)
Zygomaticofacial branch of
zygomatic nerve (CN V2)
Maxillary nerve (CN V2)
Infraorbital nerve (CN V2)
Pterygopalatine ganglion
Greater and lesser
palatine nerves (CN V2)
Auriculotemporal
Anterior, middle, and nerve (CN V3)
posterior superior
alveolar branches (CN V2) Middle meningeal artery
Nerve to lateral pterygoid Superficial temporal
muscle (CN V3) (cut) artery (cut)
Buccal nerve (CN V3) Facial nerve (CN VII) (cut)
Chorda tympani (CN VII) Maxillary artery
Lingual nerve (CN V3) Accessory nerve (CN XI) (cut)
Medial pterygoid muscle C1 spinal nerve
(cut) (lateral pterygoid (anterior ramus) (cut)
removed) C2 spinal nerve
Mental nerve (CN V3) (anterior ramus) (cut)
Inferior alveolar Pharyngeal plexus composed of
nerve (CN V3) branches from glossopharyngeal
(CN IX), vagus (CN X), and
Nerve to mylohyoid muscle (CN V3) sympathetic trunk and superior
Submandibular ganglion cervical ganglion
Internal carotid artery
Glossopharyngeal nerve (CN IX) and tonsillar branch
External carotid artery
Hypoglossal nerve (CN XII)
Vagus nerve (CN X) and
Carotid sinus nerve (of Hering) (CN IX) and carotid body superior cervical cardiac branch
Nerve to thyrohyoid muscle (C1, 2 via CN XII) C4 spinal nerve
Internal and external branches (anterior ramus) (cut)
of superior laryngeal nerve (CN X) Phrenic nerve
(anterior rami C3, 4, 5)
Superior root
Ansa cervicalis (C1, 2, 3) Ascending cervical artery
Inferior root
Scalenus medius muscle
Muscular branches of ansa cervicalis Scalenus anterior muscle
Recurrent laryngeal nerve (CN X) Brachial plexus (cut)
(superior, middle,
Sympathetic trunk and middle cervical ganglion inferior trunks)
Common carotid artery
Vertebral artery Thyrocervical trunk

Subclavian artery

Pharynx Plate 82

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Arteries of Oral and Pharyngeal Regions
See also Plates 41, 57

From Supraorbital artery


ophthalmic
artery Supratrochlear artery

Middle meningeal artery


Deep temporal arteries
External nasal artery
Masseteric artery
Angular artery
Occipital
Infraorbital artery artery
Sphenopalatine artery Auriculo-
Descending palatine artery temporal
nerve
Posterior superior Transverse facial
alveolar artery artery (cut)
Superior labial artery Superficial
Buccal artery temporal artery

Buccinator muscle Deep auricular and


and parotid duct (cut) anterior tympanic arteries
Maxillary artery
Inferior labial artery
Posterior auricular artery
Superior pharyngeal
constrictor muscle Ascending pharyngeal artery
Mental branch of Occipital artery and
inferior alveolar artery sternocleidomastoid branch
Inferior alveolar artery Glossopharyngeal nerve (CN IX)
and lingual branch Ascending palatine artery
Facial artery Tonsillar artery
Submental artery Facial artery
Mylohyoid branch of Lingual artery
inferior alveolar artery Ascending pharyngeal artery
Submandibular gland Internal carotid artery
Hypoglossal nerve (CN XII) Vagus nerve (CN X)

Suprahyoid artery Superior cervical


cardiac nerve
External carotid artery Sympathetic trunk
Superior laryngeal artery Scalenus anterior muscle
Superior thyroid artery Phrenic nerve
Scalenus medius muscle
Cricothyroid artery
Ascending cervical artery
Common carotid artery
Subclavian artery
Thyrocervical trunk

Plate 83 Pharynx

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Veins of Face and Neck Regions 2
See also Plate 85

Supratrochlear vein
Supraorbital vein
Nasofrontal vein
Superior ophthalmic vein
Angular vein
External nasal vein
Emissary vein (of Vesalius)
communicating with
cavernous sinus
Infraorbital vein
Occipital vein
Posterior superior and artery
alveolar veins
Superficial temporal
Palatine vein vein and artery
Pterygoid plexus Transverse facial vein (cut)
Superior labial vein
Posterior auricular vein
Deep facial vein
Retromandibular vein
Maxillary veins (anterior and
posterior branches)
Inferior labial vein
External jugular vein (cut)
Mental vein
Facial vein and artery Inferior alveolar vein and artery

External palatine vein Occipital vein and artery

Submental vein Hypoglossal nerve (CN XII)


Submandibular gland Common facial vein
Vena comitans of
hypoglossal nerve
Dorsal lingual vein coursing External carotid artery
medial to hyoglossus muscle
Internal jugular vein
Lingual vein
Communication to anterior jugular vein (cut) Common carotid artery

Superior laryngeal vein Vagus nerve (CN X) and


sympathetic trunk
Superior thyroid vein
Middle scalene muscle
Thyroid gland
Anterior scalene muscle
Middle thyroid vein
External jugular vein (cut)
Inferior thyroid veins
Termination of anterior jugular vein (cut) Subclavian artery

Left brachiocephalic vein Subclavian vein

Pharynx Plate 84

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Lymph Vessels and Nodes of Head and Neck
See also Plate 242

Superficial parotid nodes


(deep parotid nodes
deep to and within
parotid gland)

Facial nodes
Nasolabial
Buccinator Occipital nodes
Mastoid nodes
Mandibular
nodes

Superficial lateral
Submandibular cervical node
nodes

Accessory nerve
(CN XI)
Submental Jugulodigastric node
nodes
Accessory nodes

Superior deep lateral


cervical nodes

Thyroid nodes Inferior deep


lateral cervical
node
Juguloomohyoid node
Thoracic duct

Pretracheal and thyroid nodes


(deep to infrahyoid muscles)

Anterior cervical nodes

Jugular trunk

Supraclavicular nodes*

*The supraclavicular group of nodes,


especially on the left, are also sometimes
referred to as the signal or sentinel lymph
nodes of Virchow or Troisier, especially when
sufficiently enlarged and palpable. These
nodes (or a single node) are so termed because
they may be the first recognized presumptive
evidence of malignant disease in the viscera.

Plate 85 Pharynx

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Lymph Vessels and Nodes of Pharynx and Tongue 2
Accessory nerve (CN XI)
Hypoglossal nerve (CN XII)
Rectus capitis anterior muscle (cut)
Pharyngobasilar fascia

Retropharyngeal nodes

Internal jugular vein

Digastric muscle (posterior belly)

Sternocleidomastoid muscle

Jugulodigastric node

Superior deep lateral


cervical nodes

Juguloomohyoid node

Lymphatic drainage of pharynx:


posterior view

Submental node

Submandibular node

Jugulodigastric node

Superior deep lateral


cervical nodes

Juguloomohyoid node

Lymphatic drainage of tongue

Pharynx Plate 86

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Thyroid Gland: Anterior View

External carotid artery Hyoid bone


Internal carotid artery Superior laryngeal nerve
Infrahyoid artery Internal branch
External branch
Superior thyroid artery and vein
Thyroid cartilage (lamina)
Superior laryngeal artery
Thyrohyoid membrane Median cricothyroid
ligament
Ansa Superior root
cervicalis
Inferior root Cricothyroid muscles
Common carotid artery Cricoid cartilage
Cricothyroid artery
Pyramidal lobe
Internal jugular vein (often absent
or small) Thyroid
Phrenic nerve
Right lobe gland
Middle thyroid vein Left lobe
Inferior thyroid veins Isthmus
Ascending cervical artery
Pretracheal lymph nodes
Inferior thyroid artery
Phrenic nerve
Superficial branch
Anterior scalene muscle
Suprascapular artery
Vagus nerve (CN X)
Thyrocervical trunk
External jugular vein
Subclavian
artery and vein Anterior jugular vein

Vagus nerve (CN X) 1st rib (cut)

Right recurrent Left recurrent laryngeal nerve


laryngeal nerve

Brachiocephalic trunk

Brachiocephalic veins

Superior vena cava

Aortic arch

Thyroid cartilage
Median cricothyroid ligament
Common carotid artery

Cricothyroid muscle
Cricoid cartilage
Thyroid gland
Cervical pleura
Trachea

Plate 87 Thyroid Gland and Larynx

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Thyroid Gland and Pharynx: Posterior View 2
See also Plate 89

Superior pharyngeal
External carotid artery
constrictor muscle

Middle pharyngeal Internal carotid artery


constrictor muscle
Facial artery
Tip of greater horn
of hyoid bone Lingual artery

Inferior pharyngeal Superior laryngeal nerve


constrictor muscle Internal branch
External branch
Pharyngeal raphe
Superior thyroid artery
Zone of sparse
muscle fibers Superior laryngeal artery

Cricopharyngeus Common carotid artery


muscle (part of inferior
pharyngeal constrictor Vagus nerve (CN X)
muscle)
Circular esophageal Internal jugular vein
muscle in V-shaped
area of sparse
longitudinal muscle Thyroid gland
fibers (right lobe)

Longitudinal Superior parathyroid gland


esophageal muscle
Ascending cervical artery
Inferior thyroid vein
Inferior parathyroid gland
Trachea
Inferior thyroid artery
Inferior bulb of
internal jugular vein Right recurrent laryngeal nerve

Vertebral artery Superficial branch

Left subclavian Suprascapular artery


artery and vein
Thyrocervical trunk

Internal thoracic Right subclavian


artery and vein artery and vein

Left brachiocephalic vein Right brachiocephalic vein

Left recurrent laryngeal nerve Brachiocephalic trunk

Arch of aorta Right vagus nerve (CN X)

Left vagus nerve (CN X) Superior vena cava

Thyroid Gland and Larynx Plate 88

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Parathyroid Glands
See also Plates 80, 88, 92

Thyrohyoid membrane External carotid artery


Posterior view
Hyoid bone Internal carotid artery
Superior laryngeal nerve
Internal branch Superior thyroid artery
External branch
Superior laryngeal artery
Vagus nerve (CN X)
Inferior pharyngeal
constrictor muscle (cut)
Epiglottis
Common carotid artery
Superior thyroid artery
Fibrous capsule of
thyroid gland (cut)
Common carotid artery
Cricopharyngeus muscle (part of
inferior pharyngeal constrictor
Fibrous capsule of muscle)
thyroid gland (cut)
Superior parathyroid gland
Superior parathyroid gland
Right lobe of thyroid gland
Left lobe of thyroid gland
Inferior parathyroid gland
(may be more caudally located,
Ascending cervical artery even within mediastinum)
Inferior thyroid artery
Inferior parathyroid gland
Right recurrent laryngeal nerve

Left recurrent laryngeal nerve Transverse cervical artery

Suprascapular artery
Esophagus
Thyrocervical trunk
Subclavian artery Vertebral artery

Subclavian artery
Trachea
Brachiocephalic trunk

Right lateral view Internal branch of


superior laryngeal nerve
External carotid artery
Superior thyroid vein External branch of
superior laryngeal nerve
Superior laryngeal artery
Superior thyroid artery (cut) Superior parathyroid gland

Inferior pharyngeal constrictor muscle Thyroid gland (right lobe)


(retracted anteriorly)
Common carotid artery
Internal jugular vein
Middle thyroid vein
Inferior thyroid artery Inferior parathyroid gland

Right recurrent laryngeal nerve


Esophagus Inferior thyroid vein

Plate 89 Thyroid Gland and Larynx

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Cartilages of Larynx 2
See also Plates 91, 92, 93

Epiglottis
Hyoid bone
Thyrohyoid membrane
Superior horn of thyroid cartilage
Corniculate cartilage
Arytenoid cartilage
Superior thyroid notch
Thyroid cartilage lamina
Vocal ligament
Median cricothyroid ligament
Inferior horn of thyroid cartilage
Cricoid cartilage
Trachea

Anterior view Posterior view

Arytenoid Corniculate cartilage


articular surface
Cricoid Muscular process Arytenoid
cartilage Lamina Vocal process cartilage
Arch

Anterosuperior view

Epiglottis
Hyoepiglottic ligament
Hyoid bone
Triticeal cartilage
Thyrohyoid membrane
Thyroid cartilage lamina
Oblique line
Laryngeal prominence
Corniculate cartilage
Arytenoid cartilage
Muscular process
Median
Lateral Vocal process
Vocal ligament
Thyroepiglottic ligament
Cricothyroid ligament
Cricoid cartilage
Cricothyroid joint
Right lateral view Medial view, median
Trachea (sagittal) section

Thyroid Gland and Larynx Plate 90

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Intrinsic Muscles of Larynx
See also Plates 90, 92, 93

Epiglottis Foramen for superior


laryngeal vessels and
Aryepiglottic fold internal branch of
superior laryngeal nerve
Cuneiform tubercle

Corniculate tubercle Oblique and transverse


arytenoid muscles
Aryepiglottic part of
oblique arytenoid muscle Posterior cricoarytenoid
muscle
Oblique
arytenoid muscle
Transverse Straight
arytenoid muscle part Cricothyroid
Posterior Oblique muscle
cricoarytenoid part
muscle
Cricoid cartilage

Posterior Right lateral view


view
Epiglottis
Aryepiglottic part of
oblique arytenoid muscle
Thyroepiglottic part of
thyroarytenoid muscle
Oblique and transverse
arytenoid muscles Arytenoid Muscular process
Thyroarytenoid muscle cartilage Vocal process
Lateral cricoarytenoid
muscle Lamina of
cricoid cartilage
Posterior cricoarytenoid
muscle Posterior cricoarytenoid muscle

Conus elasticus Lateral cricoarytenoid muscle

Thyroid articular surface


Cricothyroid
muscle (cut away) Transverse and oblique
Lateral view arytenoid muscles
Conus elasticus
Root of tongue (lingual tonsil)
Median Cricothyroid muscle
glossoepiglottic Epiglottis
ligament Thyroarytenoid muscle

Ventricular folds Lamina of


Vocal fold Vocalis muscle thyroid
(false cords)
(true cords) Vocal ligament cartilage

Trachea
Superior view
Aryepiglottic fold

Piriform recess
Cuneiform tubercle

Corniculate tubercle

Esophagus
Normal larynx: inspiration

Plate 91 Thyroid Gland and Larynx

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Nerves and Coronal Section of Larynx 2
See also Plates 90, 91, 93

Internal branch of
superior laryngeal nerve
Middle pharyngeal constrictor muscle
Superior laryngeal nerve Aryepiglottic part of oblique
Internal branch arytenoid muscle
External branch Thyroepiglottic part of
thyroarytenoid muscle
Thyrohyoid membrane
Transverse and oblique
arytenoid muscles
Inferior pharyngeal
constrictor muscle Thyroarytenoid muscle
Vocalis muscle
Cricothyroid muscle Lateral cricoarytenoid muscle
Posterior cricoarytenoid muscle
Cricopharyngeal
part of inferior Thyroid articular surface
pharyngeal constrictor
muscle
Right recurrent
laryngeal nerve Right recurrent laryngeal nerve

Right lateral view:


thyroid cartilage lamina removed

Coronal section through larynx


Epiglottis

Superior thyroid veins Hyoid bone


Internal laryngeal nerve
Superior laryngeal artery Vestibule

Thyrohyoid muscle
Aryepiglottic part of oblique
arytenoid muscle
Vestibular fold
Thyroid cartilage
Vocal fold
Lateral cricoarytenoid muscle
Cricothyroid muscle
Vocalis muscle
Inferior pharyngeal
constrictor muscle
Sternothyroid muscle Superior thyroid veins
Cricoid cartilage
Conus elasticus

Thyroid gland Infraglottic cavity

Recurrent laryngeal nerve


Inferior laryngeal artery

Thyroid Gland and Larynx Plate 92

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Action of Intrinsic Muscles of Larynx
See also Plates 90, 91, 92

Action of cricothyroid muscles


Cricothyroid joint
(pivot point) Lengthening (increasing tension)
of vocal ligaments

Action of posterior cricoarytenoid muscles Action of lateral cricoarytenoid muscles


Abduction of vocal ligaments Adduction of vocal ligaments

Action of transverse and oblique arytenoid muscles Action of vocalis and thyroarytenoid muscles
Adduction of vocal ligaments Shortening (relaxation) of vocal ligaments

Plate 93 Thyroid Gland and Larynx

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Eyelids 2
Superior palpebral conjunctiva:
tarsal (meibomian) glands Superior lacrimal papilla and punctum
shining through
Plica semilunaris
Seen through Pupil
cornea Iris
Lacrimal caruncle in
lacrimal lake (lacus lacrimalis)
Corneoscleral junction
(corneal limbus)
Inferior lacrimal papilla and punctum
Bulbar conjunctiva
over sclera

Inferior conjunctival fornix

Inferior palpebral conjunctiva:


tarsal glands shining through

Levator palpebrae superioris muscle


Orbital septum
Superior tarsal (Müller’s) muscle (smooth) Sclera
Superior conjunctival fornix Bulbar conjunctiva
Orbicularis oculi muscle (palpebral part) Palpebral conjunctiva
Superior tarsus Cornea
Tarsal (meibomian) glands
Lens
Sebaceous glands
Anterior chamber
Eyelashes (cilia)
Iris
Openings of tarsal glands
Inferior tarsus Posterior chamber

Orbicularis oculi muscle (palpebral part)


Inferior conjunctival fornix
Orbital septum

Frontal bone

Insertion of levator palpebrae


superioris muscle

Orbital septum
Supraorbital artery and nerve
Superior tarsus Supratrochlear artery and nerve
External nasal artery
Lateral palpebral ligament and infratrochlear nerve

Inferior tarsus Lacrimal sac


Medial palpebral ligament
Orbital septum
Maxillary bone (frontal process)
Zygomatic bone
Infraorbital artery and nerve

Orbit and Contents Plate 94

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Lacrimal Apparatus
See also Plate 144

Superior lacrimal papilla and punctum

Orbital part of
lacrimal gland
Lacrimal canaliculi

Palpebral part of
lacrimal gland Lacrimal sac

Excretory ducts of
lacrimal gland Nasolacrimal duct

Plica semilunaris
Opening of
nasolacrimal duct
Lacrimal caruncle

Inferior lacrimal papilla and punctum

Superior lacrimal papilla and punctum


Frontal bone (cut away)

Lacrimal canaliculi
Orbital part of
lacrimal gland

Lacrimal sac
Palpebral part of
lacrimal gland
Nasolacrimal duct
Excretory ducts of
lacrimal gland
Middle nasal
concha
Plica semilunaris
and lacrimal lake

Nasal cavity
Lacrimal caruncle

Inferior nasal
Inferior lacrimal papilla and punctum concha (cut)

Opening of nasolacrimal duct Inferior nasal meatus

Plate 95 Orbit and Contents

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Extrinsic Eye Muscles 2
See also Plate 97

Right lateral view Superior oblique muscle

Levator palpebrae superioris muscle


Trochlea (pulley)
Superior rectus muscle
Optic nerve (CN II)
Medial rectus muscle (within meningeal sheath)

Common tendinous Lateral rectus muscle (cut)


ring (of Zinn)

Lateral rectus muscle (cut)


Inferior oblique muscle
Inferior rectus muscle

Maxillary sinus

Superior tarsus
Superior view
Levator palpebrae
Trochlea superioris muscle (cut)

Superior oblique muscle


Superior rectus muscle (cut)

Medial rectus muscle


Lateral rectus muscle

Inferior rectus muscle


Optic nerve (CN II) (within
meningeal sheath)
Common tendinous
ring (of Zinn) Superior rectus muscle (cut)

Levator palpebrae superioris muscle (cut)

Innervation of extrinsic eye muscles: Trochlear


anterior view Superior oblique muscle
Trochlea nerve (CN IV)

Levator palpebrae
superioris muscle

Superior rectus muscle Abducens


Oculomotor Lateral rectus muscle
nerve (CN VI)
nerve (CN III) Medial rectus muscle

Inferior rectus muscle

Inferior oblique muscle

Orbit and Contents Plate 96

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Nerves of Orbit
See also Plates 61, 132, 133

Superior view Medial branch Supraorbital nerve


Lateral branch

Supratrochlear nerve Levator palpebrae superioris muscle

Medial rectus muscle Superior rectus muscle


Lacrimal gland
Superior oblique muscle
Lacrimal nerve
Infratrochlear nerve
Lateral rectus muscle
Nasociliary nerve
Frontal nerve
Trochlear nerve (CN IV)
Maxillary nerve (CN V2)
Common tendinous ring (of Zinn) Meningeal branch
of maxillary nerve
Ophthalmic nerve (CN V1)
Mandibular nerve (CN V3)
Optic nerve (CN II)
Lesser petrosal nerve
Internal carotid artery
and nerve plexus Meningeal branch
of mandibular nerve
Oculomotor nerve (CN III)
Greater petrosal nerve
Trochlear nerve (CN IV)
Trigeminal (semilunar) ganglion
Abducens nerve (CN VI) Tentorial (recurrent meningeal)
branch of ophthalmic nerve
Tentorium cerebelli

Long ciliary nerves


Superior view:
levator palpebrae superioris, Short ciliary nerves
superior rectus, and superior Lacrimal nerve
oblique muscles partially
cut away Ciliary ganglion
Parasympathetic root of ciliary
Supratrochlear nerve (cut) ganglion (from inferior branch
of oculomotor nerve)
Supraorbital nerve branches (cut)
Sympathetic root of ciliary
Infratrochlear nerve ganglion (from internal
carotid plexus)
Anterior ethmoidal nerve
Sensory root of ciliary ganglion
Meningeal sheath of (from nasociliary nerve)
optic nerve (CN II)
Branches to inferior
Posterior ethmoidal nerve and medial rectus muscles
Superior branch of Abducens nerve (CN VI)
oculomotor nerve (CN III) (cut)
Inferior branch of
Nasociliary nerve oculomotor nerve (CN III)
Internal carotid plexus Lacrimal nerve
Trochlear nerve (CN IV) (cut) Meningeal branch (CN V2)
Frontal nerve (cut)
Oculomotor nerve (CN III)
Ophthalmic nerve CN V1)
Abducens nerve (CN VI) Meningeal branch (CN V3)

Plate 97 Orbit and Contents

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Superior and Anterior Views of Orbit 2
See also Plates 96, 97

Posterior
Superior view of right orbit Abducens nerve (CN VI) Oculomotor nerve (CN III)
Trigeminal ganglion Trochlear nerve (CN IV)
Ophthalmic nerve (CN V1) Optic nerve (CN II)
Maxillary nerve (CN V2) Sphenoidal sinus
Mandibular nerve (CN V3)
Anterior clinoid process
Frontal nerve
Posterior ethmoidal nerve
Abducens nerve and lateral rectus muscle
Long ciliary nerve
Ciliary ganglion Inferior rectus muscle
Nasociliary nerve
Short ciliary nerves
Infraorbital nerve Skin
Right and
Medial rectus muscle left anterior ethmoidal nerves

Superior rectus muscle Frontal belly of


occiptofrontalis
Lacrimal gland muscle
Supratrochlear nerve Left supraorbital nerve
(lateral and medial
Levator palpebrae superioris muscle branches)
Supraorbital nerve: Supratrochlear nerve
Medial branch
Lateral branch Right and left infratrochlear nerves
Superior oblique muscle
and tendon Right and
Tendon of inferior oblique muscle left external nasal branches of anterior
Anterior ethmoidal cells ethmoidal nerves of respective sides
Medial and lateral internal nasal branches Medial internal nasal branch of anterior
(of anterior ethmoidal nerve) ethmoidal nerve
Anterior view of right orbit Anterior
(eyeball transparent) Lateral and medial branches
Posterior and anterior ethmoidal nerves of supraorbital nerve Superior oblique
muscle and trochlea
Levator palpebrae superioris muscle
Supratrochlear nerve
Superior rectus muscle

Nasociliary nerve

Zygomaticotemporal nerve Trochlear nerve

Lacrimal nerve
Communicating branch Infratrochlear nerve
to the lacrimal gland
Lateral rectus muscle Optic nerve (CN III)
and abducens nerve
Ciliary ganglion Long ciliary nerve
and short ciliary nerves

Zygomaticotemporal nerve Oculomotor nerve (CN II)

Zygomaticofacial nerve Medial rectus muscle (cut)


Zygomatic nerve
Inferior rectus muscle and
inferior branch of oculomotor
Infraorbital nerve
nerve (CN III)

Inferior oblique
Lateral muscle
Medial

Orbit and Contents Plate 98

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Arteries and Veins of Orbit and Eyelids
See also Plates 10, 84

Superior view Medial palpebral artery

Lateral palpebral artery


Supratrochlear artery
Lacrimal gland
External (dorsal) nasal artery
Supraorbital artery
Anterior meningeal artery
Zygomatic branches
Anterior ethmoidal artery
Posterior ciliary arteries
Posterior ethmoidal artery
Muscular branch

Lacrimal artery

Muscular branch Central retinal artery

Ophthalmic artery

Internal carotid artery


Supraorbital artery

X Supratrochlear artery

External nasal artery


Anterior view X
Superior medial
Frontal branch of palpebral artery
superficial temporal artery
Angular artery
Superior lateral palpebral artery X
Inferior medial
Zygomaticoorbital artery palpebral artery
Inferior lateral palpebral artery X
Superior and inferior
Zygomaticofacial artery palpebral arterial arches

Facial artery
Transverse facial artery

Infraorbital artery (X = anastomosis of vessels from


external and internal carotid arteries)

Supratrochlear vein
Lateral view Supraorbital vein Nasofrontal vein

Superior ophthalmic vein Angular vein

Cavernous sinus Vorticose veins

Facial vein

Inferior ophthalmic vein


Pterygoid plexus
Maxillary vein

Retromandibular vein Deep facial vein

Plate 99 Orbit and Contents

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Eyeball: Transverse Section 2

Cornea
Zonular fibers Capsule of lens Anterior chamber
(suspensory ligament of lens)
Lens Posterior chamber
Scleral venous sinus
(canal of Schlemm) Iris Iridocorneal angle
Scleral spur
Ciliary processes
Ciliary body and ciliary muscle
Bulbar conjunctiva
Ciliary part of retina
Ora serrata
Tendon of
lateral rectus
muscle Tendon of
medial rectus
muscle

Optic (visual)
part of retina
Vitreous body
Choroid

Perichoroidal space Hyaloid canal

Sclera
Lamina cribrosa of sclera
Bulbar sheath
(Tenon’s capsule) Optic nerve (CN II)
Episcleral space
Central retinal
Fovea centralis in macula artery and vein

Meningeal sheath of optic nerve (CN II)

Subarachnoid space

Orbit and Contents Plate 100

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Anterior and Posterior Chambers of Eyeball

Linea translucens (Schwalbe’s line) Posterior limiting lamina


(Descemet’s membrane)
Trabecular meshwork and spaces
of iridocorneal angle (of Fontana) Posterior epithelium
Scleral venous sinus (canal of Schlemm) Cornea
Scleral spur
Iridocorneal angle
Pectinate ligament
Major arterial
circle of iris
Anterior ciliary vein
Bulbar
conjunctiva Anterior chamber
Folds of iris
Sclera
Minor arterial
circle of iris

Lens

Posterior chamber

Ciliary
process
Ciliary Meridional Circular
part of fibers fibers Dilator pupillae
retina muscle
Ciliary muscle
Pigment Nucleus of lens
Zonular fibers epithelium
Ciliary body (suspensory (iridial part of Capsule of lens
ligament retina)
of lens)
Perichoroidal space Sphincter pupillae muscle

Note: For clarity, only single plane of zonular fibers shown;


actually, fibers surround entire circumference of lens.

Plate 101 Orbit and Contents

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Lens and Supporting Structures 2

Sclera

Choroid

Optic part of retina

Ora serrata
Axis
Orbiculus ciliaris of Lens
ciliary body covered Nucleus
by ciliary part of retina Capsule

Ciliary processes Cortex


Equator
Zonular fibers
Anterior chamber
Lens
Iris

Posterior chamber

Ciliary body
Eyeball sectioned in coronal plane:
anterior segment viewed from behind Ciliary process

Preequatorial
Zonular fibers Equatoria l
Postequatorial

Orbiculus ciliaris of ciliary body


Horizontal section
Ora serrata

Optic part of retina


Ora serrata
Orbiculus ciliaris of
Optic part ciliary body covered Zonular fibers fanning out
of retina by ciliary part of retina and blending into lens capsule
Ciliary processes Zonular fibers
Iris Lens

Enlargement of segment outlined in top illustration (semischematic)

Orbit and Contents Plate 102

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Intrinsic Arteries and Veins of Eye
See also Plate 104

Cornea Minor arterial circle of iris


Anterior chamber
Major arterial circle of iris
Scleral venous sinus
(canal of Schlemm)
Blood vessels of ciliary body

Bulbar conjunctiva and


conjunctival vessels
Anterior ciliary artery and vein

Ciliary
body
Iridocorneal Iris Lens
angle
Ora serrata
Posterior chamber Muscular artery and vein
Zonular fibers
Extrinsic eye muscle
Retina
Vitreous chamber
Long posterior ciliary artery

Choroid

Sclera
Vorticose (choroid) vein

Episcleral artery and vein

Retinal artery and vein

Long posterior ciliary artery

Short posterior ciliary arteries


Superior macular
Central retinal artery and vein arteriole and venule

Superior nasal
Superior temporal retinal arteriole
retinal arteriole and venule
and venule
Optic nerve (CN II)

Macula Optic disc


Fovea centralis

Inferior temporal Inferior nasal


retinal arteriole retinal arteriole
and venule and venule

Inferior macular
Right retinal vessels: funduscopic view arteriole and venule

Plate 103 Orbit and Contents

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Vascular Supply of Eye 2

Vascular arrangements within the choroid (vascular tunic) of the eyeball

Anterior tributaries of vorticose vein


Anterior ciliary arteries
Episcleral vein*
Tendon of superior rectus muscle
Junctions of suprachoroidal
Sclera tributaries forming vorticose vein

Posterior conjunctival Superior ophthalmic vein


artery and vein
Bulb of vorticose vein

Anterior ciliary veins Vorticose vein

Long posterior ciliary artery


Major arterial circle of iris
Short posterior
Minor arterial ciliary arteries
circle of iris

Meningeal sheath of
optic nerve
Conjunctiva
and cornea

Short posterior
ciliary arteries

Central retinal
Arteries and artery and vein
veins of iris

Scleral venous sinus


(canal of Schlemm) Vessels of internal
sheath of optic nerve
Veins draining scleral venous
sinus (into anterior ciliary veins)
Short posterior ciliary arteries
Anterior ciliary veins
Nonpigmented and pigmented Segment of episcleral vein*
regions of the retina Muscular artery Inferior ophthalmic vein
Recurrent branch of anterior ciliary artery Posterior tributaries of a vorticose vein

*The episcleral veins are shown here anastomosing with the vorticose veins,
which they do; however, they also drain into the anterior ciliary veins.

Orbit and Contents Plate 104

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Ear and Course of Sound in Cochlea

Frontal section Facial nerve (CN VII) (cut)

Base of stapes in vestibular (oval) window


Vestibule
Limbs of stapes
Semicircular ducts, ampullae, utricle, and saccule
Prominence of lateral semicircular canal
Arcuate Facial nerve (CN VII) (cut)
Tegmen tympani Incus eminence Vestibular nerve
Malleus (head) Cochlear nerve

Epitympanic recess Internal acoustic


meatus

Vestibulocochlear
Auricle nerve (CN VIII)

External Nasopharynx
acoustic meatus

Tympanic membrane
Parotid gland Helicotrema
Tympanic cavity Scala vestibuli
Promontory Auditory tube (eustachian) Cochlear duct
Cochlea
Cochlear (round) window containing
spiral organ
Internal jugular vein (of Corti)
Scala tympani

Adult

Child

Auditory tube
Auditory tube (eustachian) is shorter
(eustachian) and more horizontal

Plate 105 Ear

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External Ear and Tympanic Cavity 2
See also Plate 107

Right auricle (pinna) Otoscopic view of right tympanic membrane


Triangular fossa Crux of helix
Helix External acoustic meatus
Pars flaccida
Lateral process of malleus
Scaphoid fossa Posterior mallear fold

Crura of antihelix Anterior mallear


fold
Auricular tubercle (of Darwin) Long limb of incus

Antihelix Tragus Handle of malleus

Concha of auricle Intertragic notch Umbo


Antitragus
Lobule of auricle Cone of light

Pars tensa

Coronal oblique section of external acoustic meatus and middle ear (tympanic cavity)
Tegmen tympani
Epitympanic recess
Dura mater
Superior ligament of malleus Head of malleus

Short limb of incus Long limb of incus

Footplate of stapes

Handle of malleus
Chorda tympani (cut)
Tympanic plexus on promontory
Anterior ligment of malleus (cut) Tensor tympani muscle

Tympanic membrane

External acoustic meatus Tensor veli palatini muscle


Tympanic cavity
Auditory tube (eustachian)

Right tympanic cavity after removal of tympanic membrane (lateral view)


Chorda tympani Lateral process of malleus
Tendon of tensor tympani muscle
Long limb of incus

Prominence of facial canal Ossicles articulated: medial view


Malleus Incus
Pyramidal eminence and tendon
of stapedius muscle Handle of malleus
Lenticular process
of incus
Stapes
Fossa of cochlear window Stapes
Lesser petrosal nerve
Tympanic nerve
Tympanic plexus on promontory

Ear Plate 106

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Tympanic Cavity
See also Plates 59, 146
Pyramidal eminence (cut) Mastoid antrum Medial view
Chorda tympani

Anterior tympanic artery

Tensor tympani muscle


and tendon (cut) Stapedial branch
of stylomastoid artery
Arteries of mallear stria

Handle of malleus

Tubal artery
Mastoid cells

Auditory tube
(eustachian)

Marginal arterial rete


Facial nerve (CN VII)
Tympanic membrane

Inferior tympanic artery

Deep auricular artery Lateral view

Posterior tympanic
branch of stylomastoid artery Stylomastoid artery
Styloid process

Tensor tympani Geniculate Lesser petrosal nerve Labyrinthine artery


muscle ganglion and superior tympanic
artery Superficial petrosal
artery and greater
petrosal nerve
Stapes
Facial nerve and
intermediate nerve

Stapedius
muscle
Artery and
Stapedial nerve of
branch of pterygoid
stylomastoid canal
artery
Otic ganglion
Chorda tympani

Posterior tympanic Lesser petrosal nerve


artery and superior tympanic
artery
Facial nerve (CN VII) Accessory branch of
middle meningeal artery
Deep auricular
artery
Middle meningeal
Anterior tympanic artery
artery
Tympanic plexus
Stylomastoid artery Maxillary artery
Superficial Caroticotympanic
temporal artery artery and nerve
Maxillary
Posterior artery (cut)
auricular artery Internal carotid artery
Ascending and carotid plexus
Internal jugular External carotid pharyngeal
vein artery artery Inferior tympanic artery and nerve

Plate 107 Ear

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Bony and Membranous Labyrinths 2
See also Plate 135

Right bony labyrinth (otic capsule), anterolateral view: Dissected right bony labyrinth (otic capsule):
surrounding cancellous bone removed membranous labyrinth removed

Posterior Posterior
Lateral Semicircular canals Lateral Semicircular canals
Anterior Anterior

Common bony limb Elliptical recess


Cochlear recess Vestibule
Ampullae Spherical recess (note
Vestibule perforations
for nerve
Cochlea fibers)

Helicotrema

Hamulus
of spiral
lamina
Internal opening of Scala vestibuli
Oval (vestibular) Cochlear vestibular aqueduct
window cupula (for endolymphatic Osseous spiral
duct) lamina
Cochlear (round) window
Cochlear (round) window Scala tympani

Right membranous labyrinth with nerves: medial view


Anterior semicircular duct
Superior part of vestibular nerve
(from utricle and anterior and Anterior ampulla
lateral ampullae) Utricle Lateral ampulla
Common
membranous limb
Cochlear duct (basal turn)

Cochlear nerve Lateral


semicircular
duct

Vestibulocochlear nerve (CN VIII) Posterior


semicircular
duct
Vestibular nerve
Saccule Posterior ampulla
Vestibular ganglion
(of Scarpa)
Endolymphatic duct
Inferior part of vestibular nerve (from
saccule and posterior ampulla)

Ear Plate 108

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Bony and Membranous Labyrinths (continued)

Bony and membranous labyrinths: schema


Ampullae
Anterior semicircular canal and duct
Dura mater
Posterior semicircular
canal and duct
Endolymphatic sac
Common bony and
membranous limbs Endolymphatic duct
in vestibular aqueduct
Lateral semicircular
canal and duct Utricle

Otic capsule Saccule

Stapes in oval Helicotrema of cochlea


(vestibular) window
Ductus reuniens
Incus
Scala vestibuli
Malleus
Cochlear duct
Tympanic cavity
Scala tympani
External acoustic meatus
Umbo
Tympanic membrane
Cochlear aqueduct
Cochlear (round) window Otic capsule
(closed by secondary Vestibule
tympanic membrane)
Auditory tube (eustachian)

Section through turn of cochlea


Scala vestibuli
Osseous
spiral lamina Vestibular (Reissner’s)
membrane

Cochlear duct
Nerve fibers
Spiral ligament

Modiolus of cochlea Tectorial membrane

Spiral organ (of Corti)


Spiral ganglion
(of Corti)
Basilar membrane

Osseous cochlea
Scala tympani
Outer hair cells

Cochlear nerve Pillar (rod) cells

Inner hair cell

Plate 109 Ear

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Orientation of Labyrinths in Skull 2

Superior projection of
right bony labyrinth Groove for greater petrosal nerve
on floor of skull
Geniculate ganglion
Cochlea
Plane of anterior
semicircular canal
Cochlear nerve

Facial nerve (CN VII)

Internal acoustic
opening

Vestibulocochlear
nerve (CN VIII) Lateral semicircular
canal
Vestibular nerve

Petrous part
of temporal bone

Opening of
vestibular aqueduct Plane of posterior
(for endolymphatic duct) semicircular canal

Lateral projection of right membranous labyrinth

Geniculate ganglion Auricle (retracted Cochlear duct


anteriorly)
Cochlear nerve

Trigeminal nerve (CN V)


Superior part of
vestibular nerve

Vestibulocochlear
nerve (CN VIII) Internal jugular vein

Inferior part of
Anterior vestibular nerve
semicircular duct

Lateral semicircular duct


Cerebellum
Posterior semicircular duct
Superior
petrosal sinus

Straight sinus
Sigmoid sinus
Confluence
of sinuses
Transverse sinus

Ear Plate 110

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Meninges and Diploic Veins
See also Plate 10

Coronal Diploic veins Arachnoid granulation


view Cerebral vein (bridging vein) penetrates subdural space to enter sinus
Superior sagittal sinus
Dura mater (periosteal and meningeal layers)
Emissary vein

Arachnoid mater
Superficial temporal vein
Subarachnoid space

Superficial temporal artery Pia mater


Middle meningeal
Granular foveola artery and vein
(indentation of skull by
arachnoid granulation) Deep,
middle, and
Lateral lacuna superficial
(of Trolard) temporal
Superior cerebral vein arteries
and veins
Inferior
sagittal
Temporalis
sinus
muscle
Cavum
septum
pellucidum

Superior thalamostriate and


choroidal veins, internal cerebral
veins, and choroid plexus of
lateral ventricle Deep and superficial middle
cerebral veins

Diploic and emissary


veins of skull
Parietal emissary vein

Posterior temporal
Frontal diploic vein diploic vein

Anterior temporal Occipital emissary vein


diploic vein
Occipital diploic vein

Mastoid emissary vein

Plate 111 Meninges and Brain

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Meningeal Arteries 2
See also Plate 147

Frontal (anterior) and parietal Arachnoid granulations


(posterior) branches of
middle meningeal artery Opening of superior cerebral vein

Middle Lateral (venous) lacuna


meningeal artery (of Trolard)

Superior sagittal sinus


Anterior
meningeal
branch of Dura mater
anterior
ethmoidal
artery

Mastoid branch of
occipital artery

Internal carotid artery


(cavernous segment) Meningeal branches of
ascending pharyngeal artery

Mastoid branch of
occipital artery
Middle meningeal artery
Recurrent meningeal branch of
lacrimal artery
Accessory meningeal artery
Anterior meningeal branch of
anterior ethmoidal artery
Posterior ethmoidal artery
Internal carotid artery and its
meningohypophyseal trunk (phantom)
Middle meningeal artery
Accessory meningeal artery
Superficial
temporal artery
Maxillary artery
Anterior and posterior
Posterior auricular artery meningeal branches of
Occipital artery vertebral artery
Tentorial, inferior, cavernous, and dorsal
External carotid artery meningeal branches of meningohypophyseal
trunk

Meninges and Brain Plate 112

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Meninges and Superficial Cerebral Veins
For deep veins of brain see Plate 156

Skin
Connective tissue

Epicranial aponeurosis
Granular foveola
Loose areolar tissue Superior sagittal sinus
Emissary vein
Pericranium Arachnoid granulation
Tributary of superficial temporal vein
Calvaria Diploic vein

Dura mater
Subdural space
Superior
cerebral Arachnoid mater
vein Subarachnoid space
Pia mater
Cerebral artery
Superior cerebral vein
Falx cerebri
Cerebral hemisphere

Branches of middle meningeal artery


Superior cerebral veins
Superior sagittal sinus (bridging veins) (penetrating
arachnoid and dura mater to
enter superior sagittal sinus)

Dura mater
(meningeal layer)

Superior cerebral veins


(beneath arachnoid)

Superior anastomotic
vein (of Trolard)

Inferior anastomotic
vein (of Labbé)

Superficial middle
cerebral vein

Middle meningeal
artery and veins
Inferior cerebral veins
Dura mater (beneath arachnoid)
Temporalis muscle (endostial layer)

Plate 113 Meninges and Brain

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Dural Venous Sinuses: Sagittal Section 2
See also Plates 111, 117

Great cerebral vein (of Galen)


Tentorium cerebelli
Superior cerebral veins

Superior sagittal sinus

Falx cerebri Superior sagittal sinus

Inferior sagittal sinus

Sphenoparietal sinus

Straight sinus
Anterior and posterior
intercavernous sinuses

Superior
petrosal sinus

Basilar
venous plexus

Confluence of sinuses
Inferior
petrosal sinus

To jugular Falx cerebelli


foramen

Occipital sinus

Vertebral venous plexus (of Batson) Transverse sinus


Sigmoid sinus

Meninges and Brain Plate 114

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Dural Venous Sinuses (continued)
See also Plates 64, 97

Skull sectioned horizontally:


superior view Hypophysis (pituitary gland)

Superior sagittal sinus (cut) Optic nerve (CN II)


Falx cerebri (cut) Internal carotid artery (cavernous segment)
Superior ophthalmic vein Oculomotor nerve (CN III)
Anterior and posterior Sphenoparietal sinus
intercavernous
sinuses Trochlear nerve (CN IV)
Superficial middle Ophthalmic nerve (CN V1)
cerebral vein (cut)
Maxillary nerve (CN V2)
Cavernous sinus
Trigeminal ganglion
Basilar (semilunar)
venous plexus
Mandibular nerve (CN V3)
Superior Middle meningeal artery
petrosal sinus
Abducens nerve (CN VI)
Inferior
petrosal sinus Petrosal vein
Tentorial Facial nerve (CN VII),
artery intermediate nerve (of
Tentorium Wrisberg), and
cerebelli vestibulocochlear
nerve (CN VIII)
Inferior Glossopharyngeal (CN IX)
cerebral vein and vagus (CN X) nerves
(cut)
Jugular foramen
Transverse sinus
Sigmoid sinus (continuation
Inferior sagittal of transverse sinus)
sinus (cut)
Transverse sinus
Straight sinus
Accessory nerve (CN XI)
Falx cerebri (cut)
Confluence of sinuses Hypoglossal nerve (CN XII)
Great cerebral vein (of Galen)
Superior sagittal sinus (cut)

Cavernous sinus Optic chiasm

Oculomotor nerve (CN III) Posterior


communicating artery
Trochlear nerve (CN IV)
Internal carotid
Abducens nerve (CN VI) artery (cavernous
segment)
Ophthalmic nerve (CN V1) Hypophysis
(pituitary gland)
Maxillary nerve (CN V2)
Sphenoidal sinus

Coronal section Nasopharynx


through cavernous sinus:
posterior view

Plate 115 Meninges and Brain

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Brain: Lateral Views 2

Central sulcus (of Rolando) Postcentral gyrus

Precentral gyrus Postcentral sulcus


Precentral sulcus
Superior parietal lobule
Superior frontal gyrus
Intraparietal sulcus
Superior frontal sulcus
Inferior parietal lobule
Middle frontal gyrus
Supramarginal gyrus
Inferior frontal sulcus Angular gyrus

Inferior frontal gyrus Parieto-


Opercular part occipital
Triangular part sulcus
Orbital part

Frontal
pole Occipital
pole
Calcarine
sulcus
Lunate sulcus
Lateral sulcus Anterior ramus (inconstant)
(of Sylvius) Ascending ramus
Posterior ramus Transverse
occipital sulcus
Superior temporal gyrus Preoccipital notch
Temporal pole
Superior temporal sulcus Inferior temporal gyrus
Middle temporal gyrus
Inferior temporal sulcus
Frontal lobe

Parietal lobe

Temporal lobe

Occipital lobe Parietal operculum


Frontal operculum

Short gyri
Insula Central sulcus
(island Limen
of Reil) Long gyrus
Circular sulcus
Temporal operculum

Meninges and Brain Plate 116

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Brain: Medial Views
See also Plate 158

Sagittal section of Cingulate gyrus Paracentral sulcus


brain in situ Cingulate sulcus Central sulcus (of Rolando)
Paracentral lobule
Medial frontal gyrus
Marginal sulcus
Sulcus of corpus callosum
Corpus callosum
Fornix
Precuneus
Septum pellucidum Superior sagittal sinus
Interventricular Choroid plexus
foramen (of Monro) of 3rd ventricle
Interthalamic Stria medullaris
adhesion of thalamus
Thalamus and Parietooccipital
3rd ventricle sulcus
Cuneus
Subcallosal
area Habenular
commissure
Anterior
commissure Pineal gland
Subcallosal Calcarine
gyrus sulcus
Hypothalamic Straight sinus
sulcus
Great cerebral
Lamina vein (of Galen)
terminalis
Posterior
Supra- commissure
optic
recess Superior colliculus
Optic chiasm Inferior colliculus
Tectal plate
Tuber cinereum
Cerebellum
Hypophysis (pituitary gland)
Superior medullary velum
Mammillary body
4th ventricle and choroid plexus
Cerebral peduncle Inferior medullary velum
Pons Cerebral aqueduct Medulla oblongata
(of Sylvius)

Medial surface of cerebral Genu


hemisphere: brain stem excised Rostrum of
Trunk corpus callosum
Splenium
Cingulate gyrus
Isthmus of cingulate gyrus
Mammillothalamic
fasciculus Parietooccipital sulcus
Mammillary body
Cuneus
Uncus
Calcarine sulcus
Optic nerve (CN II)
Lingual gyrus
Olfactory tract
Collateral sulcus Crus
Body of fornix
Rhinal sulcus Column
Medial occipitotemporal gyrus Fimbria of hippocampus
Occipitotemporal sulcus Dentate gyrus
Lateral occipitotemporal gyrus Parahippocampal gyrus

Plate 117 Meninges and Brain

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Brain: Inferior View 2
See also Plate 117

Sectioned brain stem Frontal pole of cerebrum Longitudinal cerebral fissure

Straight gyrus Genu of corpus callosum

Olfactory sulcus Lamina terminalis

Orbital sulci Olfactory bulb

Orbital gyri Olfactory tract

Temporal pole of cerebrum Optic chiasm

Optic nerve (CN II) (cut)


Lateral sulcus (of Sylvius)
Hypophysis
Inferior temporal sulcus (pituitary gland)
Inferior temporal gyrus Anterior
perforated substance

Optic tract

Tuber cinereum

Inferior (infero- Mammillary body


lateral) margin
of cerebrum Posterior perforated
substance (in
interpeduncular
Rhinal sulcus fossa)

Cerebral crus
Uncus
Lateral geniculate
body
Inferior
temporal gyrus Substantia nigra

Medial geniculate
Occipitotemporal body
sulcus
Red nucleus
Lateral occipito-
temporal gyrus Pulvinar

Superior colliculus
Collateral sulcus
Cerebral aqueduct
Parahippocampal gyrus
Splenium of corpus callosum
Medial occipitotemporal gyrus Cuneus

Calcarine sulcus Occipital pole of cerebrum

Longitudinal cerebral fissure


Isthmus of cingulate gyrus

Meninges and Brain Plate 118

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Ventricles of Brain

Left lateral phantom view Frontal (anterior) horn


Central part Left
Right lateral ventricle lateral
Temporal (inferior) horn ventricle
Occipital (posterior) horn

Cerebral aqueduct (of Sylvius)

4th ventricle

Left lateral aperture


(foramen of Luschka)

Left interventricular Left lateral recess


foramen (of Monro)
3rd ventricle Median aperture
(foramen of Magendie)
Supraoptic recess
Interthalamic adhesion
Infundibular recess
Pineal recess
Suprapineal recess
Corpus callosum
Septum pellucidum
Lateral ventricle
Body of caudate nucleus
Choroid plexus of lateral ventricle
Stria terminalis
Superior thalamostriate vein
Body of fornix
Internal cerebral vein
Tela choroidea of 3rd ventricle
Choroid plexus of 3rd ventricle
Thalamus
Putamen
Lentiform nucleus
Globus pallidus
Internal capsule
3rd ventricle and interthalamic adhesion
Hypothalamus
Tail of caudate nucleus
Optic tract
Choroid plexus of lateral ventricle
Temporal (inferior) horn of lateral ventricle
White arrow in left Fimbria of hippocampus
interventricular
foramen (of Monro) Hippocampus
Ependyma Dentate gyrus
Pia mater Mammillary body
Parahippocampal gyrus

Coronal section of brain: posterior view

Plate 119 Meninges and Brain

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Circulation of Cerebrospinal Fluid 2
See also Plates 119, 157

Choroid plexus of lateral ventricle (phantom)

Superior cerebral veins Superior sagittal sinus

Subarachnoid space

Dura mater Arachnoid granulations

Arachnoid mater

Occipital
(posterior)
horn

Interventricular
foramen (of Monro) Straight sinus

Chiasmatic cistern

Choroid plexus of 3rd ventricle

Interpeduncular cistern

Prepontine cistern
Quadrigeminal cistern
Cerebral aqueduct (of Sylvius) (with great cerebral vein)
(of Galen)
Posterior
Lateral aperture (foramen of Luschka) cerebellomedullary cistern

Choroid plexus of 4th ventricle Median aperture


(foramen of Magendie)
Dura mater

Arachnoid mater

Subarachnoid space

Central canal of spinal cord

Meninges and Brain Plate 120

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Basal Nuclei (Ganglia)

Horizontal sections
through cerebrum A B

Genu of corpus callosum


Head of caudate nucleus

Lateral ventricle Anterior limb


of internal
Genu capsule
Septum pellucidum
Posterior limb
Column of fornix Extreme capsule
Putamen Lentiform
Insula nucleus
(island of Reil) Globus pallidus

3rd ventricle
Interthalamic
adhesion External capsule

Thalamus Claustrum

Crus of fornix Retrolenticular part


of internal capsule
Choroid plexus
of lateral ventricle Tail of caudate nucleus

Splenium of Fimbria of hippocampus


corpus callosum
Occipital (posterior) horn
of lateral ventricle

Habenula
Organization of
basal nuclei (ganglia) A Pineal gland
B

Caudate Putamen Globus


nucleus pallidus
Cleft for internal capsule

Lentiform
Striatum nucleus
Caudate Body
nucleus Head Thalamus
Corpus
striatum Levels of A A
sections
above B B
Basal nuclei
(ganglia)
Pulvinar
Lentiform nucleus Medial geniculate body
(globus pallidus medial
to putamen) Lateral geniculate body
Amygdaloid body Tail of caudate nucleus

Interrelationship of thalamus, lentiform nucleus, caudate


nucleus, and amygdaloid body (schema): left lateral view

Plate 121 Meninges and Brain

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Thalamus and Related Structures 2

Corpus callosum (cut)


Interventricular foramen (of Monro)
Tela choroidea (cut edge) Head of caudate nucleus
of 3rd ventricle
Septum pellucidum
3rd ventricle
Columns of fornix
Choroid plexus
Anterior tubercle
Superior thalamostriate vein
Stria terminalis
Pes of hippocampus
Temporal (inferior) horn Interthalamic adhesion
of lateral ventricle
Lamina affixa
Internal cerebral vein Stria medullaris of thalamus
Dentate gyrus
Habenular trigone
Collateral eminence
Pulvinar (retracted)
Hippocampus
Lateral geniculate body
Fimbria of hippocampus
Posterior commissure Medial geniculate body

Habenular commissure Brachium of superior colliculus


Pineal gland Brachium of inferior colliculus
Collateral trigone Superior colliculus
Calcar avis Inferior colliculus
Occipital (posterior) horn
Cerebellum
of lateral ventricle
Calcarine sulcus

Internal 3rd ventricle


medullary Interthalamic
lamina adhesion
Pulvinar ior
n ter
e dia An
M ia l
d ina
MD Intralaminar Me lary lam
u l VA
LP nuclei
l m
ed LD
rna
In t e L P VL
M 3rd ventricle
VPL
VP VI
CM Reticular nuclei M
VP
M

L
VP
VP

Thalamic nuclei Pulvinar


External Lateral geniculate body
medullary CM Centromedian
lamina Medial geniculate body
LD Lateral dorsal
LP Lateral posterior
Median nuclei Schematic representation of thalamus
M Medial group
MD Medial dorsal (external medullary lamina and
Schematic section VA Ventral anterior reticular nuclei removed)
through thalamus VI Ventral intermedial
(at level of broken VL Ventral lateral
line shown in figure Lateral cell mass
at right) VP Ventral posterior (ventrodorsal)
Medial and median cell mass
VPL Ventral posterolateral
VPM Ventral posteromedial Anterior cell mass

Meninges and Brain Plate 122

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Hippocampus and Fornix

Superior view Genu of corpus callosum (cut)

Septum pellucidum with cavum

Head of caudate nucleus

Columns of fornix

Stria terminalis

Body of fornix

Pes of hippocampus

Thalami

Crura of fornix

Dentate gyrus

Fimbria of hippocampus

Hippocampus

Commissure of fornix

Splenium of corpus callosum (cut)

Lateral ventricle

Calcar avis

Occipital (posterior) horn


of lateral ventricle

Tail of caudate nucleus


Choroid plexus
Body of fornix Fimbria of hippocampus
Columns Optic tract
of fornix Commissure
of fornix

Crura of fornix
Hippocampal
sulcus

Dentate
gyrus

Hippocampus

Alveus of
Mammillary bodies hippocampus
Fimbria of hippocampus
Temporal (inferior) horn
Amygdaloid bodies Hippocampus of lateral ventricle

Fornix: schema Coronal section: posterior view

Plate 123 Meninges and Brain

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Brain Stem 2

Posterolateral view Thalamus (cut surface)


Lateral geniculate body

Pulvinars Optic tract


Pineal gland Medial geniculate body
Superior colliculi Brachia of superior and inferior colliculi
Inferior colliculi Cerebral crus
Trochlear nerve (CN IV) Pons
Superior medullary velum
Trigeminal nerve (CN V)
Superior cerebellar peduncle
Middle cerebellar peduncle
Rhomboid fossa of
4th ventricle Vestibulocochlear nerve (CN VIII)

Glossopharyngeal (CN IX) and Facial nerve (CN VII)


vagus (CN X) nerves
Inferior cerebellar peduncle
Cuneate tubercle
Hypoglossal nerve (CN XII)
Gracile tubercle
Accessory nerve (CN XI)
Posterior rootlets of
1st spinal nerve (C1)
Cuneate fasciculus
Gracile fasciculus

Olfactory tract

Anterior view Anterior perforated substance


Infundibulum
Optic chiasm Mammillary bodies
Temporal lobe (cut surface)
Optic tract
Oculomotor nerve (CN III)
Tuber cinereum Trochlear nerve (CN IV)
Trigeminal nerve (CN V)
Cerebral crus (sensory and motor roots)

Lateral geniculate body Abducens nerve (CN VI)


Facial nerve (CN VII) and
Posterior perforated substance intermediate nerve
(of Wrisberg)
Pons Vestibulocochlear nerve (CN VIII)
Flocculus of cerebellum
Middle cerebellar peduncle
Choroid plexus of 4th
ventricle extending out
Olive of lateral aperture
Glossopharyngeal nerve (CN IX)
Pyramids Vagus nerve (CN X)

Anterior rootlets of 1st spinal nerve (C1) Hypoglossal nerve (CN XII)
Accessory nerve (CN XI)
Decussation of pyramids

Meninges and Brain Plate 124

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Ventricles and Cerebellum

Posterior view Habenular trigone


Medial Geniculate bodies
3rd ventricle Lateral
Pulvinar Posterior median sulcus
Pineal gland Superior cerebellar peduncle
Superior colliculus Locus coeruleus
Inferior colliculus Medial eminence
Trochlear nerve (CN IV) Facial colliculus

Superior medullary velum Vestibular area

Superior Dentate nucleus


Cerebellar peduncles Middle
Inferior Striae medullares
Lateral recess Taenia of 4th ventricle
Superior fovea Cuneate tubercle
Sulcus limitans Gracile tubercle
Inferior fovea Posterior median sulcus
Trigeminal tubercle Lateral funiculus
Hypoglossal trigone Cuneate fasciculus
Vagal trigone Gracile fasciculus
Obex

Choroid plexus
Median sagittal section Interthalamic adhesion

Body of fornix Posterior commissure

Thalamus (in Habenular commissure


3rd ventricle)
Pineal gland
Interventricular
foramen (of Monro) Splenium of corpus callosum
Anterior commissure Great cerebral vein (of Galen)
Lamina terminalis
Lingula (I)
Hypothalamic sulcus Central lobule (II and III)
Vermis of
Cerebral peduncle Culmen (IV and V) cerebellum
Cerebral aqueduct (of Sylvius) Declive (VI)
Superior colliculus Folium (VIIA)
Tectal plate
Superior medullary velum
Inferior colliculus
Pons Inferior medullary velum
Medial longitudinal fasciculus
Tuber (VIIB)
4th ventricle
Pyramid (VIII) Vermis of
Choroid plexus of 4th ventricle cerebellum
Uvula (IX)
Medulla oblongata
Nodulus (X)
Median aperture (foramen of Magendie)
Decussation of pyramids Choroid plexus of 4th ventricle
Central canal of spinal cord Tonsil

Plate 125 Meninges and Brain

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Cerebellum 2
See also Plate 125

Superior surface
Anterior cerebellar notch Anterior lobe
Quadrangular lobule (H IV and V)
Central lobule (II and III) Primary fissure
Horizontal fissure
Culmen (IV and V) Simple lobule (H VI)
Superior
vermis
Declive (VI) Posterior lobe
Postlunate fissure
Folium (VIIA) Superior semilunar
(anseriform) lobule (H VIIA)
Horizontal fissure
Inferior semilunar
Posterior cerebellar notch (caudal) lobule (H VIIB)

Central lobule Anterior lobe


Inferior surface
Superior vermis Wing of central lobule
Lingula (I)
Superior
Superior medullary velum Middle Cerebellar peduncles
Inferior
Flocculus (H X)
Flocculonodular lobe
4th ventricle
Posterolateral (dorsolateral)
Inferior medullary velum fissure
Nodule (X) Retrotonsillar fissure

Uvula (IX) Posterior lobe


Inferior
vermis Tonsil
Pyramid (VIII)
Biventer lobule (H VIII)
Tuber (VIIB) Secondary (postpyramidal)
fissure
Posterior cerebellar notch
Horizontal fissure
Inferior semilunar
(caudal) lobule (H VIIB)

Cerebral crus
Decussation of
superior cerebellar peduncles
Medial longitudinal fasciculus
4th ventricle

Superior medullary velum Superior cerebellar


peduncle
Fastigial

Globose Lingula (I)


Cerebellar
nuclei
Dentate
Vermis
Emboliform

Section in plane of superior cerebellar peduncle

Meninges and Brain Plate 126

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Cranial Nerve Nuclei in Brain Stem: Schema

Oculomotor nerve (CN III)

Red nucleus
Superior colliculus

Oculomotor nucleus

Accessory oculomotor
Lateral geniculate body (Edinger-Westphal) nucleus

Mesencephalic nucleus Trochlear nucleus


of trigeminal nerve
Trochlear nerve (CN IV)
Principal
sensory nucleus of Motor nucleus of
trigeminal nerve trigeminal nerve
Trigeminal nerve
(CN V) and ganglion Trigeminal
(semilunar) nerve (CN V)
and ganglion
Facial nerve (CN VII)
and geniculate
ganglion Abducens nucleus
Vestibulocochlear
Facial nucleus
nerve (CN VIII)

Geniculate ganglion
of facial nerve

Superior
Anterior and inferior
Cochlear salivatory
nuclei Posterior nuclei

Vestibular
nuclei Glosso-
pharyngeal
nerve (CN IX)
Glossopharyngeal
nerve (CN IX)
Vagus nerve (CN X)

Vagus nerve (CN X)


Accessory nerve (CN XI)

Spinal tract and spinal Nucleus ambiguus


nucleus of trigeminal nerve
Dorsal nucleus
Nuclei of solitary tract of vagus nerve (CN X)

Nucleus of hypoglossal nerve

Accessory nucleus
Efferent fibers
Afferent fibers
Mixed fibers

Plate 127 Cranial and Cervical Nerves

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Cranial Nerve Nuclei in Brain Stem: Schema (continued) 2

Accessory oculomotor
Substantia nigra (Edinger-Westphal) nucleus

Red nucleus Oculomotor nucleus

Trochlear nucleus
Oculomotor nerve (CN III)
Cerebral aqueduct

Mesencephalic nucleus Trochlear nerve (CN IV)


of trigeminal nerve

Trigeminal Abducens nucleus


nerve (CN V)
and ganglion
(gasserian) Genu of facial nerve

Principal
sensory nucleus of Facial nucleus
trigeminal nerve

Vestibular nuclei
Motor nucleus of
trigeminal nerve
Anterior and posterior
cochlear nuclei
Facial nerve (CN VII)
Superior and
Vestibulocochlear nerve (CN VIII) inferior salivatory
nuclei

Abducens nerve (CN VI) Nuclei of solitary tract

Glossopharyngeal nerve (CN IX)


Posterior (dorsal) nucleus
of vagus nerve (CN X)
Hypoglossal nerve (CN XII) Median aperture (foramen
of Magendie)

Vagus nerve (CN X) Nucleus of hypoglossal nerve


Nucleus ambiguus
Accessory nerve (CN XI) Accessory nucleus

Inferior olivary complex Central canal

Efferent fibers
Spinal tract and spinal
nucleus of trigeminal nerve Afferent fibers
Mixed fibers

Cranial and Cervical Nerves Plate 128

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Cranial Nerves (Motor and Sensory Distribution): Schema

Spinal nerve fibers


Efferent (motor) fibers
Afferent (sensory) fibers

CN III
Oculomotor
Ciliary muscle, sphincter
CN I CN II pupillae, and all external eye lm
ic
a
Olfactory Optic muscles except those below hth
Eye Op
Nasal cavity
CN IV ry
Trochlear illa
ax
Superior oblique muscle M
CN V lar Motor—muscles of
ibu
Trigeminal Ma
nd mastication: tensor
CN VI Sensory—face, tympani, tensor
Abducens sinuses, teeth, orbit veli palatini,
Lateral rectus and oral cavities, mylohyoid,
muscle dura mater anterior belly
of digastric

CN VII Intermediate nerve


Facial Motor—submandibular,
Muscles of face, sublingual, lacrimal glands
stapedius, posterior Taste—anterior 2⁄3 of
belly of digastric, tongue, sensory soft palate
stylohyoid, occipitalis,
auricularis muscles

CN VIII
Vestibulocochlear
Cochlear Vestibular

CN IX
Glossopharyngeal
Taste—posterior 1⁄3 of tongue
Sensory—tonsil, pharynx, middle ear
Motor—stylopharyngeus,
parotid gland

CN X
Vagus
Motor—heart, lungs, palate, pharynx,
larynx, trachea, bronchi, GI tract
CN XI Sensory—heart, lungs, trachea,
CN XII Accessory bronchi, larynx, pharynx,
Hypoglossal Sternocleidomastoid, GI tract, external ear
Tongue trapezius muscles
muscles

Infrahyoid
muscles
(C1, 2, 3
fibers)

Plate 129 Cranial and Cervical Nerves

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Olfactory Nerve (CN I): Schema 2
See also Plate 46

Subcallosal area

Septal area and nuclei


Olfactory bulb cells: schema
Fibers from Contralateral
Efferent fibers to Fibers to olfactory bulb
olfactory bulb
Afferent fibers from bulb Anterior commissure
to central connections
and contralateral bulb Medial
olfactory stria
Granule cell (excited by
and inhibiting to mitral
and tufted cells)
Mitral cell
Recurrent process
Tufted cell
Periglomerular
cell
Glomerulus
Olfactory
nerve fibers

Dura
mater

Olfactory cells Olfactory tract

Olfactory mucosa Olfactory trigone


and olfactory tubercle
Olfactory nerves (CN I)
Lateral olfactory stria Uncus
Olfactory bulb
Lateral olfactory tract nucleus
Fimbria of
Cribriform plate of ethmoid bone hippocampus
Anterior perforated substance
Anterior olfactory nucleus
Amygdaloid body (phantom) Dentate gyrus

Piriform cortex Parahippocampal gyrus

Cranial and Cervical Nerves Plate 130

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Optic Nerve (CN II) (Visual Pathway): Schema

G Central darker
G circle represents
macular zone
Overlapping Lighter shades
A visual fields represent
A
monocular fields
B B
Each quadrant
H H a different color

Projection on
R RC C Projection on
right retina
left retina

P P Optic nerves
Choroid Choroid (CN II)
Optic chiasm
Periphery Macula

Structure of retina: schema Projection on right


Projection on left
A Amacrine cells dorsal lateral dorsal lateral
B Bipolar cells geniculate nucleus geniculate nucleus
C Cones Optic tracts
G Ganglion cells
H Horizontal cells
P Pigment cells Lateral
R Rods geniculate
bodies

Optic radiation Optic radiation

Calcarine
sulcus

Calcarine
sulcus

Projection on left
Projection on right
occipital lobe
occipital lobe

Plate 131 Cranial and Cervical Nerves

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Oculomotor (CN III), Trochlear (CN IV), and Abducens (CN VI) Nerves: Schema 2
See also Plates 97, 143

Long ciliary nerve Ciliary ganglion

Short ciliary nerves Posterior ethmoidal nerve Abducens nucleus


Anterior ethmoidal nerve Branch to ciliary ganglion
Trochlear nucleus
Superior oblique muscle
Sympathetic root of ciliary ganglion
Levator palpebrae Oculomotor nucleus
superioris muscle Superior division of
oculomotor nerve
Superior Accessory oculomotor
rectus muscle Frontal nerve (cut) (Edinger-Westphal)
nucleus (parasympathetic)
Lacrimal nerve (cut)

Nasociliary nerve Trochlear nerve (CN IV)

Oculomotor nerve (CN III)

Ophthalmic nerve
(CN V1)

Infraorbital nerve Abducens


Maxillary nerve (CN VI)
Zygomatic nerve (cut) nerve (CN V2)
Pterygopalatine Mandibular nerve (CN V3)
Inferior oblique muscle ganglion
Internal carotid artery
Ciliary muscle Inferior division of and internal carotid plexus
oculomotor nerve
Dilator pupillae muscle Maxillary nerve (CN V2)
Sphincter pupillae muscle Medial rectus muscle
Lateral rectus muscle and
Inferior rectus muscle abducens nerve (turned back)
Efferent fibers
Afferent fibers Cavernous plexus
Parasympathetic root
Sympathetic fibers of ciliary ganglion
Common tendinous ring (of Zinn)
Parasympathetic fibers

Cranial and Cervical Nerves Plate 132

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Trigeminal Nerve (CN V): Schema
See also Plates 9, 59, 61

Trigeminal nerve (CN V) ganglion


Ophthalmic nerve (CN V1) Motor nucleus
Efferent fibers Mesencephalic nucleus
Afferent fibers Tentorial branch Principal sensory nucleus
Proprioceptive fibers Nasociliary nerve Spinal tract and nucleus
Parasympathetic fibers Lacrimal nerve
Sympathetic fibers Branch to
ciliary ganglion
Frontal nerve
Ciliary ganglion
Posterior ethmoidal nerve
Long ciliary nerve
Short ciliary nerves
Anterior ethmoidal nerve
Supraorbital nerve
Supratrochlear nerve
Infratrochlear nerve
Internal nasal branches
and
External nasal branches
of anterior ethmoidal nerve
Maxillary nerve (CN V2)
Meningeal branch
Zygomaticotemporal
branch
Zygomaticofacial
branch
Zygomatic nerve
Infraorbital nerve
Pterygopalatine
ganglion
Superior
alveolar
branches of
infraorbital nerve
Nasal branches
(posterior superior Facial nerve
lateral, nasopalatine, (CN VII)
and posterior
superior medial) Chorda
Nerve (vidian) of tympani
pterygoid canal
(from facial nerve [CN VII]
and carotid plexus)
Pharyngeal branch
Greater and lesser
palatine nerves

Deep temporal nerves


Superficial
Nerve to lateral pterygoid temporal branches
muscle and masseteric nerve
Articular and anterior
Nerves to tensor veli auricular branches
palatini and medial
pterygoid muscles Submandibular Auriculotemporal nerve
Buccal nerve ganglion Inferior Parotid branches
Nerve to mylohyoid muscle alveolar nerve
Mental nerve Meningeal branch
Inferior dental plexus Mandibular nerve (CN V3) Otic ganglion
Lesser petrosal nerve (from
Lingual nerve Nerve to tensor tympani muscle glossopharyngeal nerve [CN IX])

Plate 133 Cranial and Cervical Nerves

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Facial Nerve (CN VII): Schema 2
See also Plate 54

Greater petrosal nerve from intermediate nerve Facial nerve (CN VII) Internal acoustic meatus
Deep petrosal nerve (from internal carotid plexus) Geniculate ganglion Intermediate nerve
Lesser petrosal nerve Internal carotid plexus Motor nucleus of facial nerve
(on internal carotid artery)
Nerve (vidian) of pterygoid canal Superior salivatory nucleus
Otic ganglion Nuclei of solitary tract
Pterygopalatine ganglion

Facial muscles
Frontal belly
of occipitofrontalis
Orbicularis oculi
Corrugator supercilii
Zygomaticus major
Zygomaticus minor
Temporal bran

Procerus
Levator labii
superioris
Levator labii
superioris
che

alaeque nasi
s

Levator
anguli oris
Nasalis

Zygomatic bra
nc hes
Depressor
anterior ⁄3
2 Occipital
septi nasi Taste: belly of
of tongue Buccal
Orbicularis branches occipitofrontalis
oris muscle
Occipital
Depressor branch of
h
anc

anguli oris posterior


auricular
al br

Depressor labii nerve


Cer vic

inferioris
Auricular branch of posterior
Mentalis auricular nerve
(Risorius) Posterior auricular nerve
al
(not shown) Margin ular Nerve to stapedius muscle
man d ib
Buccinator branch Stylomastoid foramen
Platysma Tympanic plexus
Tympanic nerve (of Jacobson)
Sublingual gland (from glossopharyngeal nerve)
Submandibular gland Glossopharyngeal nerve (CN IX)
Efferent fibers
Submandibular ganglion Digastric muscle (posterior belly)
Afferent fibers
Parasympathetic fibers Lingual nerve (from trigeminal nerve) Stylohyoid muscle
Sympathetic fibers Chorda tympani Caroticotympanic nerve (from internal carotid plexus)
from intermediate nerve

Cranial and Cervical Nerves Plate 134

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Vestibulocochlear Nerve (CN VIII): Schema

Afferent fibers Facial canal


Tympanic cavity
Geniculate
ganglion (CN VII) Chorda tympani

Head of malleus
Greater petrosal nerve
Cochlear (spiral) ganglion Incus

Vestibular nerve

Cochlear nerve*

Motor root of facial nerve


and intermediate nerve

Vestibulocochlear
nerve (CN VIII)

Medulla oblongata
(cross section)

Ampulla of lateral
semicircular duct
Internal
Medial acoustic Ampulla of superior
meatus semicircular duct
Vestibular Superior
nuclei Anterior Utricle
Cochlear
(diagrammatic) Inferior nuclei
Posterior
Ampulla of posterior
Lateral semicircular duct
Inferior cerebellar
peduncle Saccule

Superior division
Vestibular ganglion of vestibular nerve
Inferior division

*Note: The cochlear nerve also contains efferent fibers to the sensory epithelium.
These fibers are derived from the vestibular nerve while in the internal acoustic meatus.

Plate 135 Cranial and Cervical Nerves

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Glossopharyngeal Nerve (CN IX): Schema 2

Efferent fibers Spinal tract and spinal nucleus of trigeminal nerve


Afferent fibers Nuclei of solitary tract
Parasympathetic fibers Tympanic nerve (of Jacobson) Nucleus ambiguus
Tympanic cavity and plexus Inferior salivatory nucleus
Stylomastoid foramen Geniculate
ganglion
Caroticotympanic nerves (from internal carotid plexus)
Greater petrosal nerve
Deep petrosal nerve
Nerve (vidian) of pterygoid canal
Lesser petrosal nerve
Pterygopalatine ganglion
Mandibular nerve (CN V3)
Otic ganglion
Auriculotemporal nerve
Parotid gland
Tubal branch of tympanic plexus
Auditory tube (eustachian)
and pharyngeal opening
Stylopharyngeus muscle Glossopharyngeal
and stylopharyngeal branch nerve (CN IX)
Jugular foramen

Communicating branch with


auricular branch of vagus nerve

Superior and
Inferior ganglia

Communication to facial
nerve (CN VII)
Taste and
somatic Vagus nerve (CN X)
sensation:
posterior Superior cervical
1⁄3 of tongue
ganglion

Sympathetic trunk

Carotid sinus nerve


(of Hering)

Pharyngeal plexus* Internal carotid artery

Carotid sinus
Pharyngeal, tonsillar, and lingual branches
Carotid body
*Pharyngeal plexus
is composed of Pharyngeal branch of vagus nerve
afferent fibers (CN IX), Common carotid artery
efferent fibers (CN X),
and sympathetic fibers External carotid artery

Cranial and Cervical Nerves Plate 136

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Vagus Nerve (CN X): Schema

Dorsal nucleus of vagus


nerve (parasympathetic
Glossopharyngeal nerve (CN IX) and visceral afferent)

Meningeal branch of vagus nerve Nuclei of solitary tract (visceral


afferents including taste)
Auricular branch of vagus nerve
Spinal tract and spinal
Auditory tube (eustachian) nucleus of trigeminal nerve
(somatic afferent)
Levator veli
palatini muscle Nucleus ambiguus
(motor to pharyngeal
Salpingopharyngeus and laryngeal muscles)
muscle

Palatoglossus muscle Cranial root (CN XI)

Palatopharyngeus Vagus nerve (CN X)


muscle
Jugular foramen
Superior pharyngeal
constrictor muscle Superior ganglion of vagus nerve

Stylopharyngeus muscle Inferior ganglion of vagus nerve

Middle pharyngeal constrictor muscle Pharyngeal branch of vagus nerve (motor to muscles of
palate and pharynx; sensory to lower pharynx)
Inferior pharyngeal constrictor muscle
Communicating branch of vagus nerve to
Cricothyroid muscle carotid sinus nerve (CN IX)

Trachea Pharyngeal plexus

Esophagus Superior laryngeal nerve:


Internal branch (sensory and parasympathetic)
Right subclavian artery External branch (motor to cricothyroid muscle and
inferior pharyngeal constrictor muscle)
Right recurrent laryngeal nerve Superior cervical cardiac branch of vagus nerve
Heart Inferior cervical cardiac branch of vagus nerve

Hepatic branch of anterior Thoracic cardiac branch of vagus nerve


vagal trunk (in lesser omentum)
Left recurrent laryngeal nerve (motor to muscles of larynx
Celiac branches from anterior except cricothyroid; sensory and parasympathetic to
and posterior vagal trunks larynx below vocal folds; parasympathetic and
to celiac plexus afferent to upper esophagus and trachea)
Celiac and superior mesenteric Pulmonary plexus
ganglia and celiac plexus
Cardiac plexus
Hepatic plexus
Esophageal plexus
Gallbladder
and bile ducts Anterior vagal trunk
Liver Gastric branches of anterior vagal trunk
(branches from posterior trunk behind stomach)
Pyloric branch
from hepatic plexus Vagal fibers (parasympathetic and afferent
fibers) accompany superior mesenteric artery
Pancreas and its branches usually as far as left colic
(splenic) flexure
Duodenum
Small intestine
Ascending colon
Efferent fibers
Cecum
Afferent fibers
Appendix Parasympathetic fibers

Plate 137 Cranial and Cervical Nerves

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Accessory Nerve (CN XI): Schema 2
See also Plate 39

Nucleus ambiguus

Vagus nerve (CN X) Cranial root of accessory nerve (CN XI)

Spinal root of
accessory nerve (CN XI) Jugular foramen
Foramen
magnum Superior ganglion of
vagus nerve (CN X)

Accessory nerve (CN XI)

Inferior ganglion of
vagus nerve (CN X)

C1 spinal nerve

C2 spinal nerve

Accessory nerve
(to sternocleidomastoid
and trapezius muscles)

Sternocleidomastoid muscle (cut)

C3 spinal nerve

C4 spinal nerve

Trapezius muscle

Efferent fibers
Sensory fibers

Cranial and Cervical Nerves Plate 138

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Hypoglossal Nerve (CN XII): Schema
See also Plate 39

Hypoglossal nerve (CN XII) Meningeal branch


(in hypoglossal canal)

Nucleus of hypoglossal nerve


Superior
longitudinal
Intrinsic
muscles Transverse
of tongue and vertical
Styloglossus
Inferior muscle
longitudinal

Occipital condyle

Spinal ganglion

Inferior ganglion of
vagus nerve

Anterior rami of
C1, 2, 3 form
ansa cervicalis
of cervical plexus

Superior cervical
ganglion

Superior root of
Genioglossus ansa cervicalis
muscle

Internal carotid artery


Geniohyoid muscle
(C1) Inferior root of ansa cervicalis
Hyoglossus muscle
Ansa cervicalis

Thyrohyoid muscle
(C1) Middle cervical ganglion

Omohyoid muscle
(superior belly) Internal jugular vein

Sternohyoid muscle Common carotid artery

Sternothyroid muscle

Omohyoid muscle (inferior belly) Efferent fibers


Afferent fibers

Plate 139 Cranial and Cervical Nerves

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Cervical Plexus: Schema 2
See also Plates 39, 40

Sternocleidomastoid muscle (cut) Great auricular nerve

Accessory nerve (CN XI)


Lesser occipital nerve
Hypoglossal nerve (CN XII)
Greater occipital nerve
Geniohyoid muscle (from posterior ramus of C2)

C1

C2 Nerves to anterior and lateral


rectus capitis and longus
capitis and colli muscles

Nerve to Nerves to longus capitis and


thyrohyoid muscle colli and levator scapulae muscles
C3
Thyrohyoid muscle Trapezius muscle
Superior root Nerves to longus capitis and
of ansa cervicalis colli, levator scapulae, and
C4 middle scalene muscles
Inferior root
of ansa cervicalis Contribution to
brachial plexus
C5 (i.e., pre-fixed plexus)
Transverse cervical nerve
Phrenic nerve
Omohyoid muscle
(superior belly)

Sternothyroid muscle

Sternohyoid muscle Supraclavicular nerves (medial,


intermediate, and lateral)
Ansa cervicalis

Sternocleidomastoid muscle (cut)


Omohyoid muscle (inferior belly) Efferent fibers
Afferent fibers

Cranial and Cervical Nerves Plate 140

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Autonomic Nerves in Neck
See also Plate 136

Internal
carotid nerve

Glossopharyngeal
nerve (CN IX)

Jugular nerve

Laryngopharyngeal
branch of vagus nerve C1

Vagus nerve
(CN X) (cut)

Superior cervical
ganglion

C2

C3
Pharyngeal
plexus
Pharyngeal branch
C4 of vagus nerve
External carotid artery and external
carotid plexus
Gray rami
communicantes Superior laryngeal nerve
Internal carotid artery and carotid
sinus nerve (of Hering) (CN IX)
Carotid body
C5 Carotid sinus
Superior cervical cardiac branch
C6 of vagus nerve
Superior cervical
cardiac nerve
Phrenic nerve (cut)
C7 Middle cervical ganglion
Common carotid artery and plexus
Middle cervical cardiac nerve
C8 Vertebral ganglion
T1 Vertebral artery and vertebral plexus
Recurrent laryngeal nerve
Cervicothoracic (stellate) ganglion
Ansa subclavia
Vagus nerve (CN X) (cut)
Inferior cervical
cardiac nerve
Thoracic cardiac branches
(sympathetic and vagus nerves)
Subclavian artery Gray and white rami communicantes

Plate 141 Cranial and Cervical Nerves

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Autonomic Nerves in Head 2
See also Plates 62, 133, 144

Greater petrosal nerve Deep petrosal nerve Nasociliary nerve


Nerve (vidian) of pterygoid canal
Sensory root Sensory Roots of
Trigeminal nerve (CN V) Motor root Oculomotor nerve (CN III) Sympathetic ciliary
Parasympathetic ganglion
Ganglion Maxillary nerve (CN V2)
Ophthalmic nerve
Internal carotid artery and plexus (CN V1)
Ciliary ganglion
Frontal and
Geniculate ganglion of facial nerve
lacrimal
nerves (cut) Long ciliary nerves
Facial nerve (CN VII)
Short ciliary nerves
Intermediate nerve
(of Wrisberg)
Posterior and superior
Vestibulocochlear lateral nasal branches
nerve (CN VIII) of pterygopalatine
ganglion
Glossopharyngeal
nerve (CN IX)

Vagus nerve (CN X)

Mandibular
nerve (CN V3)
Otic
ganglion

Internal
carotid nerve Posterior inferior
nasal branch of greater
Chorda tympani palatine nerve
Pterygopalatine
Pharyngeal branch
ganglion
of vagus nerve (CN X)
Superior laryngeal Greater
nerve (cut) and lesser
palatine nerves
Superior cervical
ganglion
Lingual nerve
Internal carotid
artery and internal
carotid plexus Inferior
alveolar nerve
Carotid sinus
nerve (CN IX) Submandibular
Pharyngeal
plexus ganglion

Maxillary artery Middle meningeal artery


Sympathetic trunk
External carotid Facial artery
artery and external
carotid plexus
Superior cervical
cardiac branch of Common carotid artery and plexus
vagus nerve (CN X)
Superior cervical sympathetic cardiac nerve

Cranial and Cervical Nerves Plate 142

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Ciliary Ganglion: Schema
See also Plate 62

Sphincter pupillae muscle Oculomotor Accessory oculomotor


Short ciliary nerves (parasympathetic) (Edinger-Westphal)
Dilator pupillae muscle root of ciliary ganglion nucleus (parasympathetic)
Ciliary
Ciliary muscle ganglion

Superior colliculus

Lateral
geniculate body

Optic nerve (CN II)


Ophthalmic Tympanic
Nasociliary nerve nerve (CN V1) plexus

Long ciliary nerve


Trigeminal
ganglion Tectospinal tract
Branch to ciliary ganglion
Internal
Sympathetic root of ciliary ganglion carotid plexus Thoracic part
of spinal cord
Ophthalmic artery
Internal
carotid artery

Superior cervical ganglion

1st thoracic ganglion of sympathetic trunk


Preganglionic
sympathetic
Gray ramus communicans cell bodies
in inter-
mediolateral
Afferent fibers White ramus communicans nucleus
(lateral
Visual pathway horn)
T1 spinal nerve
Descending pathway
Spinal ganglion
Preganglionic parasympathetic fibers
Postganglionic parasympathetic fibers
Preganglionic sympathetic fibers
Postganglionic sympathetic fibers

Plate 143 Cranial and Cervical Nerves

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Pterygopalatine and Submandibular Ganglia: Schema 2
See also Plate 95

Trigeminal ganglion
Ophthalmic nerve (CN V1)
Deep petrosal nerve
Mandibular nerve (CN V3)
Greater petrosal nerve
Otic ganglion
Chorda tympani
Lingual nerve
Trigeminal nerve (CN V)
Maxillary nerve (CN V2)
Facial nerve (CN VII)
Nerve (vidian) of pterygoid canal intermediate nerve
Pterygopalatine ganglion Superior salivatory
nucleus
Lacrimal gland

Descending palatine nerves Pharyngeal nerve


Posterior nasal nerves
Maxillary
artery

Internal
carotid
nerve
Glossopharyngeal nerve
(CN IX)
Palatine nerves Greater Superior cervical ganglion
Lesser Sympathetic trunk
T1 and T2 spinal nerves
Submandibular ganglion Thoracic
spinal
cord

Posterior
root
Sublingual gland

Submandibular gland White Gray


Anterior Sympathetic
Facial artery Rami communicantes root preganglionic cell
bodies in
Lingual artery intermediolateral
Internal carotid artery
nucleus (lateral
External carotid artery and plexus horn)
Common carotid artery

Preganglionic sympathetic fibers


Postganglionic sympathetic fibers
Preganglionic parasympathetic fibers
Postganglionic parasympathetic fibers

Cranial and Cervical Nerves Plate 144

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Otic Ganglion: Schema

Mandibular nerve (CN V3) Trigeminal ganglion

Lesser petrosal nerve


Otic ganglion
Chorda tympani
Ophthalmic nerve (CN V1)
Trigeminal nerve (CN V)

Maxillary nerve (CN V2) Facial nerve (CN VII)

Glossopharyngeal nerve (CN IX)


Auriculotemporal nerve
Inferior salivatory nucleus
Superficial temporal artery
Pons
Parotid gland

Maxillary
artery

Medulla
oblongata

Tympanic
plexus

Inferior Tympanic
alveolar nerve nerve
(of Jacobson)

Inferior ganglion (CN IX)


Lingual nerve
Superior cervical ganglion
Sympathetic trunk
T1 and T2 spinal nerves Thoracic
spinal cord
External carotid artery

Posterior root
Internal carotid artery

Common carotid artery


White Gray Anterior root Sympathetic
preganglionic
Rami communicantes cell bodies in
intermediolateral
nucleus (lateral
Preganglionic sympathetic fibers horn)
Postganglionic sympathetic fibers
Preganglionic parasympathetic fibers
Postganglionic parasympathetic fibers

Plate 145 Cranial and Cervical Nerves

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Taste Pathways: Schema 2
See also Plates 134, 136

Usual pathway
Accessory pathway

Ventral posteromedial (VPM)


nucleus of thalamus

Sensory cortex (just inferior to face area)

Lateral hypothalamic area

Amygdaloid body

Parabrachial nucleus

Trigeminal nerve (CN V)

Trigeminal (semilunar) ganglion


Mesencephalic nucleus
and
Motor nucleus Ophthalmic nerve (CN V1)
of trigeminal nerve
Maxillary nerve (CN V2)

Mandibular nerve (CN V3)

Pons

Pterygopalatine
ganglion
Greater petrosal nerve
from intermediate nerve

Geniculate ganglion Nerve (vidian)


of pterygoid canal
Otic
Facial nerve (CN VII) ganglion
and
intermediate nerve (of Wrisberg) Lingual nerve

Nuclei of solitary tract


(rostral part) Chorda Fungiform
tympani papillae
from
Glossopharyngeal nerve (CN IX) intermediate
nerve

Foliate
papillae
Medulla oblongata
(lower part)
Vallate
papillae

Inferior (petrosal) ganglion Lingual branch of Epiglottis


of glossopharyngeal nerve glossopharyngeal
nerve (CN IX)
Inferior (nodose) ganglion of vagus nerve Larynx
Superior laryngeal nerve Internal branch of
Vagus nerve (CN X) superior laryngeal nerve

Cranial and Cervical Nerves Plate 146

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Arteries to Brain and Meninges
See also Plates 41, 64, 148

Left middle meningeal artery Middle cerebral artery

Posterior cerebral artery Anterior cerebral artery

Superior cerebellar artery Anterior communicating artery

Basilar artery Ophthalmic artery


Left labyrinthine
(internal acoustic) artery Posterior
communicating
Mastoid branch of artery
left occipital artery
Cavernous sinus
Anterior inferior
cerebellar artery Middle
meningeal
Posterior meningeal artery
branch of left ascending
pharyngeal artery

Posterior inferior
cerebellar artery

Left and right Maxillary


vertebral arteries artery
(intracranial part)
Superficial
Posterior meningeal temporal
branch of vertebral artery
artery
External
Anterior meningeal carotid
branch of vertebral artery artery

Posterior auricular artery Facial artery

Occipital artery Lingual artery

Internal carotid artery Ascending pharyngeal artery

Carotid sinus
Superior laryngeal artery
Carotid body
Superior thyroid artery
Vertebral artery
(cervical part)
Common carotid artery
Transverse process of C6
Inferior thyroid artery
Deep cervical artery

Supreme intercostal Thyrocervical trunk


artery

Costocervical trunk Brachiocephalic trunk

Subclavian artery

Plate 147 Cerebral Vasculature

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Internal Carotid Artery in Petrous Part of Temporal Bone 2
See also Plates 147, 150

Inferior hypophyseal artery Superior hypophyseal arteries

Posterior communicating artery Right optic nerve (CN II)


Optic chiasm
Cerebral part of internal carotid artery
Anterior cerebral arteries (A2 segments)
Anterior choroidal artery
Anterior communicating artery
Anterolateral central
(lenticulostriate) arteries Medial frontobasal (medial
Middle cerebral artery orbitofrontal) artery
and branches
Long medial striate artery
(recurrent artery of Heubner)

Anterior cerebral
artery (A1 segment)

Posterior Ophthalmic
cerebral artery
artery
(P2
segment)
Left
optic
Tentorial nerve
branch (of (CN II)
meningo-
hypophyseal
trunk)

Sphenoidal
sinus
Meningo-
hypophyseal Dorsal
trunk meningeal
artery
Caroticotympanic
artery

Recurrent artery of
foramen lacerum

Meningeal branch
Middle meningeal artery

Petrous part of internal carotid artery


Artery to inferior cavernous
sinus (inferolateral trunk) and
Cervical part of internal carotid artery branch to superior orbital fissure

Branch to foramen ovale Artery of pterygoid canal

Branch to foramen spinosum Cavernous part of internal carotid artery

Internal to external
carotid artery anastomosis Branch to foramen rotundum

Cerebral Vasculature Plate 148

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Arteries to Brain: Schema

Anterior cerebral artery Anterior communicating artery


1
Middle cerebral artery Ophthalmic artery

Supraorbital artery
Posterior communicating artery
Supratrochlear artery
Caroticotympanic artery 2
3 3 Lacrimal artery
from internal carotid artery 3
1
External nasal artery
Posterior cerebral artery
Middle meningeal artery
Superior cerebellar artery 3
Angular artery
Anterior tympanic artery
1 Superficial temporal artery
Middle meningeal artery 1
Posterior auricular artery
4
Maxillary artery Facial artery
5 5 Occipital artery
Basilar artery 4
Lingual artery
Anterior inferior
cerebellar artery 5 5 Ascending pharyngeal artery

Posterior inferior 5 Anterior spinal artery


cerebellar artery
Segmental
medullary arteries
External carotid artery 5
Vertebral artery
Internal carotid artery 5
Common carotid artery
Superior thyroid artery Deep cervical artery
5
Common carotid artery Transverse cervical artery
Suprascapular artery
Vertebral artery
Supreme intercostal artery
Ascending cervical artery
Costocervical trunk
Inferior thyroid artery

Thyrocervical trunk
Subclavian artery
Subclavian artery Internal thoracic artery

Brachiocephalic trunk

Anastomoses
Arch
1 Right–Left
Aorta Descending 2 Carotid–Vertebral
Ascending 3 Internal carotid–External carotid
4 Subclavian–Carotid
5 Subclavian–Vertebral

Plate 149 Cerebral Vasculature

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Arteries of Brain: Inferior Views 2
See also Plate 148

Medial frontobasal (orbitofrontal) artery


Anterior communicating artery
Anterior cerebral artery
Long medial striate artery
(recurrent artery of Heubner)
Internal carotid artery
Anterolateral central (lenticulostriate) arteries
Middle cerebral artery
Lateral frontobasal (orbitofrontal) artery
Prefrontal artery
Anterior choroidal artery
Posterior communicating artery
Posterior cerebral artery
Superior cerebellar artery
Basilar artery
Pontine arteries

Labyrinthine artery

Anterior inferior cerebellar artery


Vertebral artery
Anterior spinal artery
Posterior inferior cerebellar artery (cut)
Posterior spinal artery

Cerebral arterial
circle (of Willis)
Long medial striate artery (broken line)
(recurrent artery of Heubner)
Anterior communicating artery
Anterior cerebral artery
Middle cerebral artery
Posterior communicating artery
Anterior choroidal artery
Optic tract
Posterior cerebral artery
Cerebral crus
Lateral geniculate body
Posterior medial choroidal artery
Posterior lateral choroidal artery
Choroid plexus of lateral ventricle
Medial geniculate body
Pulvinar of thalamus
Lateral ventricle

Cerebral Vasculature Plate 150

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Cerebral Arterial Circle (of Willis)

Long medial striate artery


Vessels dissected out: inferior view (recurrent artery of Heubner)
Anterior cerebral artery Anteromedial central (perforating)
(A2 segment) arteries
Anterior communicating artery
Anterior cerebral artery
(A1 segment)
Anterolateral central
Ophthalmic artery (lenticulostriate) arteries

Internal carotid artery

Middle cerebral artery


Superior hypophyseal artery
Posterior communicating artery Inferior hypophyseal artery

Anterior choroidal artery


Posterior cerebral artery
(P2 segment) Thalamotuberal artery
(P1 segment)

Posteromedial central
Superior cerebellar artery (perforating) arteries

Basilar artery Thalamoperforating artery

Pontine arteries Posteromedial central


(paramedian) arteries

Anterior inferior cerebellar artery Labyrinthine artery

Vertebral artery

Vessels in situ: inferior view

Anterior cerebral artery Anterior communicating artery

Optic chiasm
Hypothalamic artery
Cavernous sinus
Internal carotid artery
Infundibulum and portal
veins of hypophysis

Anterior lobe (adenohypophysis)


Middle cerebral artery of pituitary gland

Inferior hypophyseal artery Posterior lobe (neurohypophysis)


of pituitary gland
Posterior communicating artery Posteromedial central
(perforating) arteries
Efferent hypophyseal veins
Superior cerebellar artery
Posterior cerebral artery
Basilar artery

Plate 151 Cerebral Vasculature

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Arteries of Brain: Frontal View and Section 2

Corpus callosum Paracentral artery


Medial frontal branches
Anterolateral central
(lenticulostriate) arteries Pericallosal artery
Lateral frontobasal Callosomarginal artery
(orbitofrontal) artery
Frontopolar artery
Prefrontal artery
Anterior cerebral
arteries
Arteries of precentral
and central sulcus Medial frontobasal
(orbitofrontal) artery
Artery of postcentral
sulcus (anterior parietal Long medial striate
artery) artery (recurrent
artery of Heubner)
Posterior parietal Internal carotid
artery artery
Artery to Anterior choroidal
angular gyrus artery
Temporal branches Posterior cerebral
(anterior, middle, artery
and posterior)
Superior cerebellar artery
Middle cerebral artery
and branches Basilar and pontine arteries
(deep in lateral cerebral
[sylvian] sulcus) Labyrinthine artery

Anterior communicating artery


Vertebral artery
Posterior communicating artery
Posterior inferior cerebellar artery
Anterior inferior cerebellar artery (AICA) Anterior spinal artery
Posterior spinal artery
Falx cerebri

Callosomarginal arteries
Corpus striatum and
(caudate and lentiform nuclei) Pericallosal arteries
(branches of anterior
Anterolateral central cerebral arteries)
(lenticulostriate) arteries
Trunk of corpus callosum
Insula (island of Reil)
Internal capsule
Arteries of precentral
and central sulcus Septum pellucidum
and parietal arteries
Rostrum of corpus callosum
Lateral (sylvian) sulcus
Anterior cerebral arteries
Temporal branches of
middle cerebral artery Long medial striate artery
(recurrent artery of Heubner)
Temporal lobe
Anterior communicating artery
Middle cerebral artery
Optic chiasm
Internal carotid artery

Cerebral Vasculature Plate 152

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Arteries of Brain: Lateral and Medial Views

Artery of postcentral sulcus (anterior parietal artery) Posterior parietal artery

Artery of central sulcus Artery to angular gyrus

Artery of precentral sulcus


Cortical branches
of posterior cerebral
Prefrontal artery
artery

Terminal branches of
anterior cerebral
artery

Lateral frontobasal
(orbitofrontal) artery

Left middle
cerebral artery

Left anterior
cerebral artery
Occipitotemporal
Anterior communicating artery branches

Right anterior cerebral artery Posterior temporal artery


Middle temporal artery
Left internal carotid artery
Superior and inferior cortical parts
Polar temporal artery Anterior temporal artery

Paracentral artery
Posterior Pericallosal artery
Medial
frontal Cingular branches
Intermediate
branches Right posterior cerebral artery
Anterior
Precuneal artery
Callosomarginal
Dorsal branch
artery
to corpus callosum
Parietooccipital branch
Frontopolar artery
Calcarine branch
Right anterior
cerebral artery

Medial fronto-
basal (orbito-
frontal) artery

Anterior
communicating artery (cut)
Medial occipital artery
Long medial striate artery Posterior temporal artery
(recurrent artery of Heubner)
Anterior temporal artery
Right internal carotid artery Posterior communicating artery

Plate 153 Cerebral Vasculature

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Arteries of Posterior Cranial Fossa 2

Thalamogeniculate arteries Lateral and medial geniculate bodies of left thalamus


Anterior choroidal artery Choroid plexuses of lateral ventricles

Columns of fornix Left and right pulvinar


Splenium of corpus callosum
Anterolateral central
(lenticulostriate) arteries Occipital (posterior) horn of right lateral ventricle
Heads of caudate nuclei Right dorsal branch to corpus callosum
(posterior pericallosal artery)
Septum pellucidum
Parietooccipital Branches of
Corpus callosum right posterior
Calcarine cerebral artery
Anterior
cerebral arteries
Longitudinal
cerebral
fissure

Superior
colliculi

Superior
vermian
Optic nerve (CN II) branch
IV
Ophthalmic artery III Posterior medial
V choroidal artery
Anterior
cerebral artery to choroid plexus
of 3rd ventricle
Middle VIII
cerebral artery Posterior lateral
choroidal artery
Posterior VII
communicating artery VI Lateral (marginal) branch
IX
Thalamoperforating arteries
X Inferior vermian artery
Left internal carotid artery (phantom)
XI
Basilar artery Choroidal branch to 4th ventricle
(phantom) and
Pontine arteries Cerebellar tonsillar branch
Labyrinthine artery of posterior inferior cerebellar artery

Posterior cerebral artery Outline of 4th ventricle (broken line)


Superior cerebellar artery Posterior meningeal branch of vertebral artery
Anterior inferior cerebellar artery (AICA) Posterior inferior cerebellar artery (PICA)
Anterior meningeal branch of vertebral artery
Left posterior spinal artery
Temporal branches of posterior cerebral artery
Left vertebral artery
Anterior spinal artery

Cerebral Vasculature Plate 154

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Veins of Posterior Cranial Fossa

Left superior and inferior colliculi Left pulvinar


Basal vein (of Rosenthal) Right pulvinar
Posterior mesencephalic vein Internal cerebral veins
Medial geniculate body Splenium of corpus callosum
Lateral Great cerebral vein (of Galen)
mesencephalic vein Dorsal vein of corpus callosum
Lateral geniculate body Inferior sagittal sinus
Left thalamus Straight sinus
(cut surface)
Falx cerebri
Optic tract Confluence of sinuses
Tentorium
Inferior thalamo- cerebelli (cut) Left transverse
striate veins sinus (cut)
Deep middle
cerebral Superior
vein (cut) sagittal
sinus
Anterior
cerebral
vein
Optic
nerve (CN II)

Oculo-
motor
nerve C
(CN III) C
CL D
Trochlear F
nerve L
(CN IV)
TU
Superior
vermian
N P vein
U Inferior
vermian vein
Anterior ponto- Falx cerebelli (cut)
mesencephalic vein T and occipital sinus
Inferior cerebellar
Trigeminal nerve (CN V) hemispheric veins
Transverse pontine vein Intraculminate vein
Petrosal vein (draining Superior cerebellar vein (inconstant)
to superior petrosal sinus)
Preculminate vein
Lateral pontine vein Precentral cerebellar vein
Anteromedian medullary vein Superior retrotonsillar vein
(Inferior retrotonsillar) Parts of cerebellum
Vein of lateral recess of 4th ventricle
vein of cerebellomedullary
C Culmen N Nodule
Superior, middle, and cistern
CL Central lobule P Pyramid
inferior cerebellar peduncles Posterior spinal vein D Declive T Tonsil
4th ventricle with F Folium TU Tuber
Anterior spinal vein L Lingula U Uvula
choroid plexus

Plate 155 Cerebral Vasculature

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Deep Veins of Brain 2
For superficial veins of brain see Plate 122

Longitudinal cerebral fissure


Anterior cerebral veins and arteries
Rostrum of corpus callosum
Septum pellucidum
Vein of septum pellucidum
Head of caudate nucleus
Anterior vein of caudate nucleus
Transverse veins of caudate nucleus
Interventricular foramen (of Monro)
Columns of fornix
Superior thalamostriate vein
Superior choroid vein and
choroid plexus of lateral ventricle
Thalamus
Tela choroidea of 3rd ventricle
Lateral direct vein
Posterior vein of caudate nucleus
Internal cerebral veins
Basal vein (of Rosenthal)
Great cerebral vein (of Galen)
Inferior sagittal sinus
Straight sinus
Tentorium cerebelli
Transverse sinus
Confluence of sinuses
Superior sagittal sinus

Superior view

Uncal vein

Anterior cerebral vein


Superficial middle cerebral vein
(draining to sphenoparietal sinus) Optic chiasm
Deep middle cerebral vein

Cerebral crus

Basal vein (of Rosenthal)


Lateral geniculate body Inferior
cerebral
Medial geniculate body veins

Pulvinar of thalamus
Splenium of corpus callosum

Great cerebral vein (of Galen) Inferior


anastomotic
vein (of Labbé)

Inferior view

Cerebral Vasculature Plate 156

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Subependymal Veins of Brain

Posterior veins of septum pellucidum Lateral direct vein


Superior thalamic veins Posterior terminal vein of caudate nucleus
(posterior part of thalamostriate vein)
Superior choroid vein
Internal cerebral veins (right and left)
Transverse veins of caudate nucleus
Medial vein of lateral ventricle
Superior thalamostriate vein
Lateral vein of lateral ventricle
Lateral ventricle
Splenium of corpus callosum
Anterior vein of
caudate nucleus Great cerebral vein
(of Galen)
Vein of
septum pellucidum Dorsal vein of corpus
callosum
Genu of
corpus Inferior sagittal
callosum sinus
Internal
occipital vein
Straight sinus
Occipital
(posterior)
horn of
lateral
ventricle

Interventricular
foramen (of Monro)

Anterior commissure

Interthalamic adhesion

Anterior cerebral vein

Optic chiasm
Cerebellum
3rd ventricle

Deep middle cerebral vein

Inferior thalamostriate veins

Basal vein (of Rosenthal)


Temporal (inferior) horn of lateral ventricle

Posterior mesencephalic vein Superior vermian vein


Hippocampal and inferior ventricular veins

Cerebral aqueduct
Veins on lateral wall of ventricle
4th ventricle
Veins on medial wall and floor of ventricle
Lateral and median apertures of 4th ventricle All other veins

Plate 157 Cerebral Vasculature

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Hypothalamus and Hypophysis 2
See also Plate 117

Septum pellucidum

Thalamus

Fornix

Interthalamic adhesion
Hypothalamic sulcus
Anterior commissure

Paraventricular
Posterior

Principal Dorsomedial
nuclei of Supraoptic
hypothalamus
Ventromedial
Arcuate
(infundibular)
Mammillary body
Mammillothalamic tract
(of Vicq d’Azyr)
Optic chiasm Cerebral aqueduct
Dorsal longitudinal
Infundibulum fasciculus and other
descending pathways
Hypophysis (pituitary gland)

Lamina terminalis Hypothalamic


sulcus
Paraventricular hypothalamic nucleus

Supraoptic hypothalamic nucleus

Supraopticohypophyseal tract

Tuberohypophyseal tract
Mammillary
Hypothalamohypophyseal tract body

Infundibulum
Arcuate (infundibular) nucleus

Pars tuberalis
Median eminence
of tuber cinereum
Anterior lobe Fibrous trabecula
(adenohypophysis) Posterior lobe
Pars intermedia Infundibular
of pituitary gland stem (neurohypophysis)
of pituitary gland
Pars distalis
Infundibular
process
Cleft

Cerebral Vasculature Plate 158

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Cranial Imaging (MRA and MRV)

Magnetic resonance
angiography (MRA)
at level of circle of Anterior cerebral artery
Willis (3D time-of- (A1 segment)
flight image without
contrast)
Anterior cerebral artery
(A2 segment)
Middle cerebral artery
Middle cerebral artery (M1 segment)
(M2 segments)

Anterior
communicating artery
Posterior
Internal carotid artery communicating
artery
Superior cerebellar
artery Posterior cerebral
artery
Anterior inferior
Basilar artery cerebellar artery

Magnetic resonance
venography (MRV) (2D
time-of-flight image
without contrast)
Superior cerebral vein
Superior sagittal sinus

Internal cerebral vein


Great cerebral vein
(of Galen)
Straight sinus

Confluence of sinuses
Transverse sinus

Sigmoid sinus

Internal jugular vein

Plate 159 Regional Imaging

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Cranial Imaging (MRI) 2
T1-weighted MRI, sagittal view

Body of corpus callosum


Genu and rostrum
of corpus callosum
Splenium of corpus callosum
Mammillary body 3rd ventricle
Optic chiasm
Cerebral aqueduct
Infundibulum Tectum
Crista galli Midbrain
Pituitary gland Cerebellum
Sphenoidal sinus 4th ventricle
Clivus Pons
Nasopharyngeal adenoid Medulla oblongata
Hard palate Anterior arch of atlas (C1)
Soft palate Axis (C2) vertebral body
Tongue Cervical spinal cord

T2-weighted, MRI axial views


without contrast

Eyeball
Ethmoidal cells

Sphenoidal sinus
Internal carotid artery Temporal lobe
Trigeminal cave
Basilar artery
Trigeminal nerve (CN V)
Pons
Middle cerebellar peduncle
4th ventricle
Cerebellum

Gray matter (cortex)


White matter Longitudinal cerebral fissure
Head of caudate nucleus
Anterior limb of internal capsule Genu of corpus callosum
External capsule Frontal horn of lateral ventricle

Putamen of lentiform nucleus Interventricular foramen (of Monro)


3rd ventricle
Genu of internal capsule
Posterior limb of internal capsule
Occipital horn of lateral ventricle

Thalamus Splenium of corpus callosum

Regional Imaging Plate 160

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Structures With High* Clinical Significance

PLATE
ANATOMIC STRUCTURES CLINICAL IMPORTANCE NUMBERS

SKELETAL SYSTEM
Orbit Direct trauma to eye may result in “blowout” fracture; margin remains intact, but medial 11, 50
and/or inferior walls of orbit have fractured
Pterion Weak area of skull that is common site of fracture 13
Temporomandibular joint Temporomandibular disorders are common source of pain and joint dysfunction 25
Cervical vertebrae Degenerative changes cause narrowing of intervertebral foramina that may cause cervical 26–28
radiculopathy
Cervical vertebrae Bilateral fracture of pars interarticularis of C2 (spondylolysis) results from hyperextension 26
of head on neck and results in spondylolisthesis of C2 (hangman’s fracture); fractures
(common) are due to motor vehicle, snowmobile, and all-terrain vehicle accidents
Thyroid cartilage, cricoid Palpable landmarks used for cricothyrotomy and tracheostomy 87, 90
cartilage
Ear ossicles Pathologic conditions involving ossicles (e.g., otosclerosis) can cause conductive hearing 105, 106
loss

MUSCULAR SYSTEM
Muscles of facial expression Used to assess function of CN VII during cranial nerve examination; may become weak or 31, 134
paralyzed with CN VII dysfunction (e.g., Bell’s palsy)
Sternocleidomastoid muscle Palpated to identify “nerve point of neck” for administration of anesthesia to cervical 39
plexus
Sternocleidomastoid, Used to assess function of CN XI during cranial nerve examination 39, 138
trapezius muscles
Muscles of mastication Used to assess function of CN V (V3) during cranial nerve examination 55, 56
Levator veli palatini, Used to assess function of CN X during cranial nerve examination; contralateral deviation 67
musculus uvulae of uvula during elevation indicates CN X dysfunction
Genioglossus muscle Used to assess CN XII function during cranial nerve examination; deviates to side of lesion 70, 139
when protruded following CN XII injury
Levator palpebrae superioris, Muscles responsible for elevating eyelid; ptosis indicates pathologic change in CN III or 94, 96
superior tarsal muscles sympathetics (superior tarsal muscle)
Eye muscles Used to assess function of CN III, CN IV, and CN VI during cranial nerve examination 96, 98
Dilator pupillae muscle Important in assessment of sympathetic function in head; lack of dilation indicates 101, 132
interruption in sympathetic outflow (e.g., Horner’s syndrome)
Sphincter pupillae muscle Involved in pupillary light reflex and accommodation reflex 101, 132

RESPIRATORY SYSTEM
Paranasal sinuses Cavities in skull; prone to mucosal inflammation due to bacterial or viral infection 49, 50

DIGESTIVE SYSTEM
Parotid gland Swelling of gland due to infection (e.g., mumps) may compress branches of facial nerve, 53, 54
producing facial muscle weakness

Table 2.1 Clinical Tables

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Structures With High* Clinical Significance 2

PLATE
ANATOMIC STRUCTURES CLINICAL IMPORTANCE NUMBERS

ENDOCRINE SYSTEM
Thyroid gland Common site of cancer; removed with thyroidectomy 87

NERVOUS SYSTEM
Accessory nerve (CN XI) Lymph node biopsy in posterior cervical triangle can cause iatrogenic injury of CN XI 39
Cervical plexus Cervical plexus blocks are performed for neck procedures 39, 40
Trigeminal nerve (CN V) Branches of CN V are anesthetized for procedures on face or anterior scalp 42, 133
Olfactory nerve (CN I) One of most commonly injured cranial nerves; can be avulsed at cribriform plate following 46, 130
falls
Facial nerve (CN VII) Idiopathic unilateral facial nerve palsy (Bell’s palsy) can result in inability to fully close eye 54
and result in desiccated cornea ipsilaterally
Recurrent laryngeal nerve May be compressed or damaged by procedures in neck (e.g., thyroidectomy), aortic arch 88, 89
aneurysm, or lung cancer, producing hoarseness of voice
Oculomotor nerve (CN III), Cavernous sinus thrombosis can result in dysfunction of extraocular muscles caused by 115
trochlear nerve (CN IV), compression of one, two, or all three nerves
and abducens nerve (CN
VI)
Superior colliculus and Tumor of midbrain can result in compression of cerebral aqueduct, with resultant 120
cerebral aqueduct hydrocephalus
Optic nerve (CN II) One early sign of growing pituitary gland mass is bitemporal hemianopsia 131, 151
Optic nerve (CN II) One of first signs of ophthalmic artery aneurysm is visual loss due to compression of 148
overlying optic nerve

CARDIOVASCULAR SYSTEM
Right internal and external Examined to assess jugular venous pulse; internal jugular vein is preferred because it is in 38
jugular veins line with superior vena cava; external jugular vein may be used instead as the internal
jugular vein is very difficult to visualize
Internal jugular vein, Used to obtain venous access via insertion of central venous catheter 38, 84
subclavian vein
Inferior thyroid artery At risk during thyroidectomy; must be preserved to maintain blood supply to parathyroid 40, 88
glands
Common carotid artery Palpated in neck to assess carotid pulse; prone to atherosclerotic thickening of vessel wall 41
Anterior ethmoidal, Anastomosis site of these vessels in nasal vestibule is common site of nosebleed 47
sphenopalatine, and facial (epistaxis)
arteries
Pterygoid venous plexus Common route for spread of infection due to connections between face, orbit, and venous 84, 99
sinuses
Ophthalmic artery Primary source of blood to retina; blindness may occur if artery is occluded 99, 103
Arteries of scalp Lacerations bleed profusely owing to rich blood supply; vessels do not retract in dense 111
connective tissue layer of scalp
Superior cerebral veins May be torn from their junction with superior sagittal sinus, producing subdural hematoma 112, 113,
114, 120

Clinical Tables Table 2.2

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Structures With High* Clinical Significance

PLATE
ANATOMIC STRUCTURES CLINICAL IMPORTANCE NUMBERS

CARDIOVASCULAR SYSTEM—Continued
Middle meningeal artery Trauma to skull can tear middle meningeal artery, causing epidural hematoma 112
Dural venous sinuses Infections in head may spread to sinuses, causing dural sinus thrombosis; cavernous sinus 114, 115
is most common site
Cavernous sinus Fistula (anastomosis) between internal carotid artery and cavernous sinus may form, 115, 151
especially following trauma
Carotid sinus Compressed during carotid sinus massage 141
Cerebral arterial circle of Common site of aneurysms; rupture produces subarachnoid hemorrhage 150
Willis

LYMPHATIC SYSTEM
Thoracic duct May be injured in neck at junction of internal jugular and subclavian veins 85
Superior and inferior deep Palpated during neck examination to assess size 85, 86
nodes

*Selections were based largely on clinical data and commonly discussed clinical correlations in gross anatomy courses.

Table 2.3 Clinical Tables

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Muscle Tables 2
PROXIMAL DISTAL
MUSCLE ATTACHMENT ATTACHMENT
MUSCLE GROUP (ORIGIN) (INSERTION) INNERVATION BLOOD SUPPLY MAIN ACTIONS
Auricularis anterior External ear Temporal fascia, Anterior part of medial Posterior auricular Auricular branch of Elevates and draws
epicranial surface of helix of and temporal posterior auricular auricle forward
aponeurosis ear branches of artery, parietal branch
facial nerve of superficial temporal
artery
Auricularis posterior External ear Base of mastoid Lower part of cranial Posterior auricular Auricular branch of Retracts and
process surface of and temporal posterior auricular elevates auricle
auricle branches of artery, parietal branch
facial nerve of superficial temporal
artery
Auricularis superior External ear Temporal fascia, Upper part of medial Posterior auricular Auricular branch of Retracts and
epicranial surface of auricle and temporal posterior auricular elevates auricle
aponeurosis branches of artery, parietal branch
facial nerve of superficial temporal
artery
Buccinator Facial Posterior portion of Angle of mouth Buccal branches of Muscular branches of Compresses cheeks,
expression alveolar process of facial nerve facial artery, buccal expels air
maxillary bone and branch of maxillary between lips, aids
mandible opposite artery in mastication
sockets of molar
teeth, anterior
border of
pterygomandibular
raphe
Ciliary Intrinsic eye Corneoscleral junction Ciliary body Parasympathetic Ophthalmic artery Constricts ciliary
fibers via short body and lens
ciliary nerves rounds up
(CN III) (accommodation)
Corrugator supercilii Facial Medial part of Skin of medial half of Zygomatic and Zygomatic and anterior Draws eyebrows
expression supraorbital margin eyebrow temporal branches of superficial downward and
branches of temporal artery medially, produces
facial nerve vertical wrinkles
of skin between
eyebrows
Cricothyroid Laryngeal Anterior cricoid Inferior border of External branch of Superior and inferior Lengthens and
cartilage thyroid cartilage superior thyroid arteries tenses vocal
and its inferior horn laryngeal nerve ligaments
Depressor anguli oris Facial Continuous with Angle of mouth into Mandibular and Inferior labial artery of Depresses angle of
expression platysma muscle orbicularis oris buccal branches facial artery mouth
on oblique line of muscle and skin of facial nerve
mandible
Depressor labii Facial Lateral surface of Skin to lower lip, Mandibular and Inferior labial artery of Depresses lower lip
inferioris expression mandible between mingling with buccal branches facial artery and draws it
symphysis and orbicularis oris of facial nerve lateralward
mental foramen muscle, medial
deep to depressor fibers joining those
anguli oris of opposite side
Depressor septi nasi Facial Incisive fossa of Septum and posterior Zygomatic and Superior labial artery of Narrows nostril,
expression maxillary bone part of ala of nose buccal branches facial artery draws septum
of facial nerve downward
Digastric Suprahyoid Anterior belly: Intermediate tendon Anterior belly: Anterior belly: branches Raises hyoid bone
digastric fossa of attached to body of nerve to of submental artery and base of
mandible hyoid mylohyoid tongue, steadies
muscle hyoid bone,
Posterior belly: Posterior belly: Posterior belly: muscular opens mouth by
mastoid notch of facial nerve branches of posterior lowering mandible
temporal bone auricular artery,
muscular branches of
occipital artery
Dilator pupillae Intrinsic eye Radial fibers in iris Blends with sphincter Sympathetic fibers Ophthalmic artery Dilates pupil
pupillae fibers from superior
cervical ganglion
Frontal belly of Facial Epicranial aponeurosis Skin of frontal region, Temporal branches Frontal branch of Horizontally wrinkles
occipitofrontalis expression at level of coronal epicranial of facial nerve superficial temporal skin of forehead,
suture aponeurosis artery raises eyebrows
Genioglossus Extrinsic Mental spine of Dorsum of tongue, Hypoglossal nerve Sublingual and Depresses and
tongue mandible hyoid bone (CN XII) submental arteries protrudes tongue

Variations in spinal nerve contributions to the innervation of muscles, their arterial supply, their attachments, and their actions are common
themes in human anatomy. Therefore, expect differences between texts and realize that anatomical variation is normal.

Muscle Tables Table 2.4

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Muscle Tables

PROXIMAL DISTAL
MUSCLE ATTACHMENT ATTACHMENT
MUSCLE GROUP (ORIGIN) (INSERTION) INNERVATION BLOOD SUPPLY MAIN ACTIONS
Geniohyoid Suprahyoid Inferior genial tubercle Anterior surface of Branch of C1 Sublingual branch of Elevates hyoid bone
on back of body of hyoid bone through lingual artery and depresses
symphysis of hypoglossal mandible
mandible nerve (CN XII)
Hyoglossus Extrinsic Body and greater horn Lateral and inferior Hypoglossal nerve Sublingual and Depresses and
tongue of hyoid bone aspect of tongue (CN XII) submental arteries retracts tongue
Inferior longitudinal Intrinsic Under surface of Apex of tongue Hypoglossal nerve Deep lingual branch of Shortens tongue,
lingual muscle tongue tongue between blending with (CN XII) lingual artery, turns tip and
genioglossus and styloglossus branches from facial sides downward
hyoglossus artery
Inferior oblique Extraocular; Anterior floor of orbit Lateral sclera deep to Oculomotor nerve Ophthalmic artery Abducts, elevates,
eyelid lateral to lateral rectus (CN III), inferior and laterally
nasolacrimal canal muscle division rotates eyeball
Inferior pharyngeal Circular Oblique line of thyroid Median raphe of Vagus nerve via Ascending pharyngeal Constricts wall of
constrictor pharyngeal cartilage and cricoid pharynx pharyngeal artery, branches of pharynx during
cartilage plexus superior thyroid artery swallowing
Inferior rectus Extraocular; Common tendinous Inferior aspect of Oculomotor nerve Ophthalmic artery Depresses, adducts,
eyelid ring eyeball, posterior to (CN III), inferior and laterally
corneoscleral division rotates eyeball
junction
Lateral cricoarytenoid Laryngeal Arch of cricoid Muscular process of Recurrent laryngeal Superior and inferior Adducts vocal folds
cartilage arytenoid cartilage nerve thyroid arteries
Lateral pterygoid Mastication Superior head: Pterygoid fovea, Mandibular nerve Muscular branches of Bilaterally: protrudes
infratemporal capsule of (CN V3) maxillary artery mandible
surface of greater temporomandibular
wing of sphenoid joint, articular disc
bone
Inferior head: lateral Unilaterally and
pterygoid plate alternately:
produces
side-to-side
grinding
Lateral rectus Extraocular; Common tendinous Lateral aspect of Abducens nerve Ophthalmic artery Abducts eyeball
eyelid ring eyeball, posterior to (CN VI)
corneoscleral
junction
Levator anguli oris Facial Canine fossa of Angle of mouth; fibers Zygomatic and Superior labial artery of Elevates angle of
expression maxillary bone intermingle with buccal branches facial artery mouth
immediately below orbicularis oris, of facial nerve
infra-orbital depressor anguli
foramen and under oris, zygomaticus
cover of zygomatic
head of levator labii
superioris
Levator labii Facial Upper part of frontal Into major alar Zygomatic and Superior labial artery and Elevates upper lip
superioris alaeque expression process of cartilage, skin of buccal branches angular branches of and dilates nostril
nasi maxillary bone nose, lateral upper of facial nerve facial artery
lip

Levator labii Facial Maxillary bone above Skin of upper lip Zygomatic and Superior labial artery and Elevates upper lip,
superioris expression infraorbital foramen buccal branches angular branches of dilates nares
of facial nerve facial artery
Levator palpebrae Extraocular; Lesser wing of Superior tarsal plate Oculomotor nerve Ophthalmic artery Raises upper eyelid
superioris eyelid sphenoid bone, (CN III), superior
anterior to optic division
canal
Levator veli palatini Palatal Temporal bone Palatine aponeurosis Vagus nerve via Ascending palatine artery Elevates soft palate
(petrous portion) pharyngeal branch of facial artery, during swallowing
and auditory tube plexus descending palatine
artery branch of
maxillary artery

Table 2.5 Muscle Tables

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Muscle Tables 2
PROXIMAL DISTAL
MUSCLE ATTACHMENT ATTACHMENT
MUSCLE GROUP (ORIGIN) (INSERTION) INNERVATION BLOOD SUPPLY MAIN ACTIONS
Longus capitis Anterior Anterior tubercles of Inferior surface of Anterior rami of Ascending cervical Flexes head
vertebral transverse basilar part of cervical nerves branch of inferior
processes of occipital bone (C1–C3) thyroid artery,
C3–C6 ascending pharyngeal
artery, muscular
branches of vertebral
artery
Longus colli Anterior Vertical portion: C5–T3 Vertical portion: into Anterior primary Prevertebral branches of Bilaterally: flex and
vertebral vertebrae C2–C4 vertebrae rami of cervical ascending pharyngeal assist in rotating
nerves (C2–C8) artery, muscular cervical vertebrae
branches of ascending and head
Inferior oblique Inferior oblique portion: cervical and vertebral Unilaterally: flexes
portion: T1–T3 on anterior arteries vertebral column
vertebrae tubercles of laterally
transverse
processes of
C3–C6 vertebrae
Superior oblique Superior oblique
portion: anterior portion: tubercle of
tubercles of anterior arch of
transverse atlas
processes of
C3–C5 vertebrae
Masseter Mastication Zygomatic arch Ramus of mandible, Mandibular nerve Transverse facial artery; Elevates and
coronoid process (CN V3), via masseteric branch of protrudes
masseteric maxillary and facial mandible; deep
nerve arteries fibers retract it
Medial pterygoid Mastication Medial surface of Medial surface of Mandibular nerve Facial and maxillary Bilaterally: protrudes
lateral plate of ramus and angle of (V3), nerve to arteries and elevates
pterygoid, mandible inferior to medial pterygoid mandible
pyramidal process mandibular foramen muscle Unilaterally and
of palatine bone, alternately:
maxillary tuberosity produces
side-to-side
movements
Medial rectus Extraocular; Common tendinous Medial aspect of Oculomotor nerve Ophthalmic artery Adducts eyeball
eyelid ring eyeball, posterior to (CN III), inferior
corneoscleral division
junction
Mentalis Facial Incisive fossa of Skin of chin Marginal mandibular Inferior labial artery of Raises and protrudes
expression mandible branch of facial facial artery lower lip
nerve

Middle pharyngeal Circular Stylohyoid ligament Median raphe of Vagus nerve via Ascending pharyngeal Constricts wall of
constrictor pharyngeal and horns of hyoid pharynx pharyngeal artery, ascending pharynx during
bone plexus palatine and tonsillar swallowing
branches of facial
artery, dorsal lingual
branches of lingual
artery
Musculus uvulae Palatal Nasal spine, palatine Mucosa of uvula of Vagus nerve via Ascending palatine artery Shortens, elevates,
aponeurosis the palate pharyngeal branch of facial artery, and retracts uvula
plexus descending palatine of the palate
artery branch of
maxillary artery
Mylohyoid Suprahyoid Mylohyoid line of Median raphe and Nerve to Sublingual branch of Elevates hyoid bone,
mandible body of hyoid bone mylohyoid lingual artery, base of tongue,
muscle submental branch of floor of mouth;
facial artery depresses
mandible
Nasalis Facial Canine eminence Aponeurosis on nasal Zygomatic and Superior labial, septal, Draws ala of nose
expression above and lateral to cartilages buccal branches and lateral nasal toward nasal
incisive fossa of of facial nerve branches of facial septum,
maxillary bone artery compresses
nostrils; alar part
opens nostrils
Occipital belly Facial Lateral 2/3 of superior Skin of occipital Posterior auricular Occipital branch of Moves scalp
(occipitofrontalis) expression nuchal line and region, epicranial nerve of posterior auricular backward
muscle mastoid process aponeurosis facial nerve artery, descending
branch of occipital
artery

Muscle Tables Table 2.6

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Muscle Tables

PROXIMAL DISTAL
MUSCLE ATTACHMENT ATTACHMENT
MUSCLE GROUP (ORIGIN) (INSERTION) INNERVATION BLOOD SUPPLY MAIN ACTIONS
Omohyoid Infrahyoid Inferior belly: from Inferior belly: to Ansa cervicalis Hyoid branch of lingual Steadies hyoid bone
upper border of intermediate artery, and depresses
scapula and superior tendon sternocleidomastoid hyoid
transverse scapular branch of superior
ligament, ending in thyroid artery
intermediate tendon
Superior belly: from Superior belly: to body
this tendon of hyoid bone

Orbicularis oculi Facial Medial orbital margin, Skin around orbit, Facial nerve (CN Facial and superficial Closes eyelids
expression palpebral ligament,