Ebook Textbook of anatomy (5/E): Part 2

(BQ) Part 2 book “Textbook of anatomy” has contents: Bones and joints of the abdomen, introduction to the abdomen and the anterior abdomen, the perineum and related genital organs, surface and radiological anatomy of the abdomen, pelvic viscera and peritoneum,… and other contents.

Part Abdomen and Pelvis 24 Bones and Joints of the Abdomen CHAPTER bones of the abdomen The bones that belong exclusively to the abdomen are: Lumbar vertebrae Sacrum Coccyx Other Bones Related to Structures in the Abdomen The inner surfaces of the hip-bones are closely related to structures in the abdomen and pelvis They have been described in Chapter This chapter also describes the pelvis as a whole The lower ribs and costal cartilages give attachment to, and are related to, many structures in the abdomen They have been described in Chapter 16 LUMBAR VERTEBRAE Distinguishing Features of Typical Cervical, Thoracic and Lumbar Vertebrae The structure of a typical vertebra has been described in Chapter 16 The cervical, thoracic and lumbar vertebrae can be easily distinguished from one another because of the following characteristics: The transverse process of a cervical vertebra is pierced by a foramen called the foramen transversarium The thoracic vertebrae bear costal facets for articulation with ribs These are present on the sides of the vertebral bodies and on the transverse processes A lumbar vertebra (24.1) can be distinguished from thoracic and cervical vertebrae by the fact that it neither has foramina transversaria nor does it bear facets for ribs It is also recognised by the large size of its body Some Features of Typical Lumbar Vertebrae The vertebral bodies progressively increase in size from above downwards They are, therefore, largest in the lumbar vertebrae The body of a lumbar vertebra is oval in shape The vertebral foramen is triangular (24.1) The pedicles are thick and short in the lumbar region and are directed backwards and somewhat laterally (24.1) The laminae of lumbar vertebrae are short and broad, but not overlap each other The spinous processes of lumbar vertebrae are large and quadrangular They are more or less horizontal and have a thick posterior edge (24.2) The articular facets of lumbar vertebrae are vertical They are curved from side-to-side a The superior facets are slightly concave (24.1) and are directed equally backwards and medially b The inferior facets are slightly convex, and are directed equally forwards and laterally (24.2) c Each superior articular process of a lumbar vertebra bears a rough projection called the mamillary process, on its posterior border 474 Part ♦ Abdomen and Pelvis 24.1: Typical lumbar vertebra seen from above 24.2: Typical lumbar vertebra seen from the lateral side The first to fourth lumbar vertebrae are typical and show the features described above The fifth lumbar vertebra is atypical Fifth Lumbar Vertebra The fifth lumbar vertebra is the largest of lumbar vertebrae In contrast to the small and tapering transverse processes of typical lumbar vertebrae the transverse processes of the fifth lumbar vertebra are very large They form a distinguishing characteristic of this vertebra (24.3) 24.3: Fifth lumbar vertebra seen from above Chapter 24 ♦ Bones and Joints of the Abdomen 475 Clinical Correlation Congenital Malformations Vertebrae have a complex developmental history, and abnormalities resulting from maldevelopment are frequently seen The two halves of the neural arch may fail to fuse in the midline This condition is called spina bifida a If the gap between the neural arches is small, no obvious deformity may be apparent on the surface (spina bifida occulta: occult = hidden) b When the gap is large, meninges and nerves may bulge out through the gap forming a visible swelling c When the swelling contains only meninges and CSF it is called a meningocoele d When neural elements are also present in the swelling the condition is called meningomyelocoele Two or more vertebrae that are normally separate may be fused to one another The fifth lumbar vertebra may be partially, or completely fused to the sacrum (sacralisation of 5th lumbar vertebra) Alternatively, the first piece of the sacrum may form a separate vertebra (lumbarisation of first sacral vertebra) Abnormality in ossification of a vertebra may result in a condition in which the spine, laminae and inferior articular processes are not fused to the rest of the vertebra a Normally, vertebral bodies not slip forwards over one another because of the restraining influence of the inferior articular processes b However, when the abnormality described above is present, body weight can cause the body of the 5th lumbar vertebra to slip forward over the sacrum c This condition is called spondylolisthesis Sometimes, a similar condition may affect the 4th lumbar vertebra that may then slip forwards over the 5th lumbar vertebra Spondylolisthesis can be a cause of persistent low back pain Fractures of Lumbar Vertebrae Like other vertebrae those in the lumbar region can be fractured by direct injury a Such injury usually results in fracture of the spinous process, transverse process or lamina b If the lumbar spine is forcibly flexed (as in a fall from a height) the body of a vertebra can be compressed c In a compression injury, the vertebral arch and the ligaments around the body can remain intact and can prevent the spinal cord from being injured In more severe injuries, compression of the body of a lumbar vertebra may be combined with fracture of the articular processes (fracture dislocation) The vertebrae involved become unstable and injury to structures within the spinal canal can result Such injury in the lumbar region leads to the cauda equina syndrome a The patient has a flaccid paraplegia b Sensations are lost over the perineum and upper medial area of thighs (the area corresponding to that which comes in contact with a saddle) c There is incontinence of urine and of faeces Lumbar Puncture The term lumbar puncture is applied to a procedure in which a long needle is passed into the subarachnoid space through the interval between the 3rd and 4th lumbar vertebrae, or sometimes through the interval between the 4th and 5th vertebrae a In this connection, it is important to note that the lower end of the spinal cord lies at the level of the lower border of the first lumbar vertebra b The subarachnoid space (containing cerebrospinal fluid) extends down to the level of the lower border of the second sacral vertebra c Hence, a needle passed into the lower lumbar part of the vertebral canal does not injure the spinal cord 476 Part ♦ Abdomen and Pelvis a Remember, however, that here the subarachnoid space contains nerve roots forming the cauda equina b They are not injured as they are mobile Lumbar puncture has several uses as follows: a Samples of cerebrospinal fluid (CSF) can be obtained for examination Important points to note about CSF are its colour, its cellular content, and its chemical composition (specially the protein and sugar content) b The pressure of CSF can be estimated c Air or radio-opaque dyes can be introduced into the subarachnoid space for certain investigative procedures A skiagram taken after injecting iodinized oil into the subarachnoid space outlines the space d Anaesthetic agents injected into the subarachnoid space act on the lower spinal nerve roots and render the lower part of the body insensitive to pain This procedure, called spinal anaesthesia, is frequently used for operations on the lower abdomen and on the lower extremities Prolapse of Intervertebral Disc a The intervertebral discs are very strong in the young b With advancing age, however, the annulus fibrosus becomes weak and it then becomes possible for the nucleus pulposus to burst through it c This is called prolapse of the intervertebral disc (though it is really prolapse of the nucleus pulposus) A prolapsed nucleus pulposus usually passes backwards and laterally and may press upon nerve roots attached to the spinal cord at that level Prolapse results in local pain in the back a When nerves are pressed upon there is shooting pain along the course of the nerve involved b Disc prolapse occurs most frequently in the lumbosacral region and results in pain shooting down the back of the leg and thigh This is called sciata Psoas Abscess Tubercular infection of thoracic or lumbar vertebrae (commonly seen a few decades ago) can lead to formation of pus As the bodies of lumbar vertebrae are closely related to the psoas major this pus passes into the potential space deep to the fascia enclosing the muscle It then descends along the fascia to reach the femoral triangle where it forms a swelling Such a swelling may sometimes be confused with a femoral hernia A tubercular abscess is referred to as a cold abscess because the usual signs of inflammation are missing THE SACRUM AND COCCYX The Sacrum The sacrum lies below the fifth lumbar vertebra It is made up of five sacral vertebrae that are fused together (24.4 and 24.5) It is wedged between the two hip-bones and takes part in forming the pelvis As a whole the bone is triangular a It has an upper end or base which articulates with the fifth lumbar vertebra b A lower end or apex which articulates with the coccyx c A concave anterior (or pelvic) surface d A convex posterior or (dorsal) surface (24.5) e Right and left lateral surfaces that articulate with the ilium of the corresponding side When viewed from the front (24.4) the pelvic surface of the sacrum shows the presence of four pairs of anterior sacral foramina The first foramen is the largest and the fourth the smallest Chapter 24 ♦ Bones and Joints of the Abdomen 24.4: Sacrum seen from the front 24.5: Sacrum seen from behind 477 478 Part ♦ Abdomen and Pelvis The foramina separate the medial part of the bone from the lateral part a The medial part is formed by the fused bodies of the sacral vertebrae b The lateral part represents the fused transverse processes, including the costal elements The anterior sacral foramina, seen on the pelvic surface, are continued into the substance of the bone and become continuous posteriorly with the posterior sacral foramina that open onto the dorsal surface The canals connecting the anterior and posterior foramina open medially into the sacral canal that is a downward continuation of the vertebral canal When viewed from above, we see the base of the sacrum It is seen formed by the first sacral vertebra a It has a large oval body that articulates with the body of the fifth lumbar vertebra b The body has a projecting anterior margin called the sacral promontory 10 Behind the body of the sacrum, there is a triangular vertebral (or sacral) canal bounded by thick pedicles and laminae Where the laminae meet there is a small tubercle representing the spine 11 Arising from the junction of the pedicles and laminae there are the superior articular facets that articulate with the inferior articular facets of the fifth lumbar vertebra 12 Lateral to the body, we see the superior surface of the lateral part, which is also called the ala 13 When the sacrum is viewed from behind (24.5) we see the dorsal surface a We can again distinguish medial and lateral parts separated by four pairs of posterior sacral foramina b These foramina give passage to the dorsal rami of sacral nerves c The medial part of the dorsum of the sacrum is formed by the fused laminae of sacral vertebrae 14 The laminae of the fifth sacral vertebra (sometimes also of the fourth) are deficient leaving an inverted Ushaped or V-shaped gap called the sacral hiatus 15 The midline is marked by a ridge called the median sacral crest on which four spinous tubercles (representing the spines) can be recognised 16 Just medial to the dorsal sacral foramina, we see four small tubercles that represent fused articular processes They collectively form the intermediate crest 17 Lateral to the foramina, we see a prominent lateral sacral crest formed by the fused transverse processes The crest is marked by tubercles that represent the tips of transverse processes 18 The lower end of the bone (apex) bears an oval facet for articulation with the coccyx 19 At the sides of the sacral hiatus, we see two small downward projections called the sacral cornua They represent the inferior articular processes of the fifth sacral vertebra They are connected to the coccyx by ligaments 20 When the sacrum is viewed from the side, we see that the pelvic aspect of the bone is concave forwards, while the dorsal aspect is convex backwards 21 The lateral surface bears a large L-shaped auricular area (or facet) for articulation with the ilium (It is so called because its shape resembles that of the auricle or pinna) a It consists of a cranial limb present on the first sacral vertebra b A caudal limb that lies on the second and third sacral vertebrae 22 The area behind the auricular surface is rough and gives attachment to strong ligaments that connect the sacrum to the ilium want to know more? Sex Differences in the Sacrum The female sacrum is wider and shorter than in the male This is to be correlated with the fact that the female pelvis is also shorter and broader than the male pelvis The forward concavity is more pronounced in the female The auricular surface is shorter in the female However, for practical purposes the sex of a given sacrum is most easily found out by examining the base a In the female, the transverse diameter of the body is approximately equal to the width of the ala b But in the male, the diameter of the body is distinctly larger than that of the ala Chapter 24 ♦ Bones and Joints of the Abdomen 479 The attachments on the sacrum, and its ossification, are described below along with those of the coccyx THE COCCYX The coccyx consists of four rudimentary vertebrae fused together (24.6) It has pelvic and dorsal surfaces The base or upper end has an oval facet for articulation with the apex of the sacrum Lateral to the facet, there are two cornua that project upwards and are connected to the cornua of the sacrum by ligaments The first coccygeal vertebra has rudimentary transverse processes The remaining vertebrae are represented by nodules of bone 24.6: Coccyx seen from the front want to know more? Attachments on the Sacrum and Coccyx The following muscles are attached (24.7 and 24.8): The iliacus arises from the anterolateral part of the upper surface of the ala (or lateral part) The piriformis arises from the pelvic surface The medial part of the origin is in the form of three digitations that arise from the areas between the sacral foramina The coccygeus is inserted into the lateral side of the pelvic aspect of the last piece of the sacrum and to the coccyx The levator ani is inserted into the sides of the lower two segments of the coccyx The gluteus maximus arises from the lateral margin of the lowest part of the sacrum, and that of the coccyx The erector spinae has a linear U-shaped origin from the dorsal aspect of the sacrum The medial limb of the ‘U’ is attached to the spinous tubercles, and the lateral limb to the transverse tubercles The multifidus arises from a large area within the U-shaped origin of the erector spinae The following ligaments are attached: Ligaments of the joints between the fifth lumbar vertebra and the sacrum correspond to those of other intervertebral joints The area around the auricular surface gives attachment to the ventral, dorsal and interosseus ligaments of the sacroiliac joint The iliolumbar ligament is attached to the lateral part of the ala The sacrotuberous ligament is attached to the lower lateral part of the dorsal surface of the sacrum The sacrospinous ligament is attached to the lower part of the lateral margin of the sacrum and to the adjoining lateral margin of the coccyx Important Relations of the Sacrum The rectum is in contact with the ventral surface of the 3rd, 4th and 5th pieces of the sacrum The ventral surfaces of the first three pieces of the sacrum are covered by peritoneum and give attachment to the sigmoid mesocolon Deep to the peritoneum and rectum, the ventral surface is crossed by the right and left sympathetic trunks, the median sacral vessels, the right and left lateral sacral vessels, and the superior rectal vessels The ala is covered by the psoas major muscle and is crossed by the lumbosacral trunk The sacral canal contains the cauda equina, the spinal meninges and the filum terminale The subarachnoid and subdural spaces end at the level of the middle of the sacrum The ventral and dorsal sacral foramina give passage to the corresponding rami of sacral nerves 480 Part ♦ Abdomen and Pelvis 24.7: Attachments on the pelvic aspect of the sacrum and coccyx Some related structures are also shown JOINTS OF THE AbDOMEN Intervertebral Joints The joints between the lumbar vertebrae are similar to typical intervertebral joints These have been described in Chapter 17 Lumbosacral Joint This joint is similar to an intervertebral joint Because of the large size of the vertebral bodies the intervertebral disc is thick and large It is deepest anteriorly The fifth lumbar vertebra and the pelvis are connected by two additional ligaments a The iliolumbar ligament connects the tip of the transverse process of the fifth lumbar vertebra to the posterior part of the iliac crest b The lumbosacral ligament is attached above to the inferior margin and anterior aspect of the transverse process Below it is attached to the sacrum near the anterior sacroiliac ligament Pubic Symphysis The two pubic bones are united in front at the pubic symphysis This is a secondary cartilaginous joint Such cartilaginous joints are permanent structures that not disappear with age They are also called symphyses The bone ends forming the joint are covered by a thin layer of hyaline cartilage The two layers of hyaline cartilage are united by an intervening layer of fibrocartilage Sacroiliac Joints The sacrum articulates on each side with the corresponding ilium forming the right and left sacroiliac joints These are synovial joints Chapter 56 ♦ Blood Supply of the Brain and Some Investigative Procedures for Neurological 1151 56.13: Arteries of the brain visualised in a living person by the technique of carotid angiography Lateral view:(1) Anterior cerebral artery; (2) Middle cerebral artery; (3) Posterior communicating artery In this patient this artery appears to continue into the posterior cerebral artery; (4) This is unusual; (5) Internal carotid artery in the cavernous sinus; (6) Branches of ophthalmic artery; (7) Internal carotid artery in the neck Courtesy: Dr RK Yadav 1152 Part ♦ Central Nervous System 56.14: Sectional view of cerebral hemisphere obtained in a living person by the technique of magnetic resonance imaging (MRI) Frontal lobe; Median longitudinal fissure; Genu of corpus callosum; Anterior horn of lateral ventricle; Septum pellucidum (double layered); Caudate nucleus; Lentiform nucleus; Thalamus; Third ventricle; 10 Insula; 11 Splenium of corpus callosum; 12 Posterior horn of lateral ventricle; 13 Occipital lobe; 14 Superior sagittal sinus Index Page numbers followed by f refer to figures, and those followed by t refer to tables Abducent nerve 804, 891, 942 nucleus 879 Accessory meningeal branch 845 nerve 854t, 927 olivary nuclei 1088 phrenic nerve 874 Acoustic radiation 1117, 1125 Actions of muscles of pharynx 994 of palatine muscle 979 of pterygoid muscles 774 Acute retropharyngeal abscess 829 Adenoidectomy 760, 997 Adenoids 992, 997 Afferent fibres entering   cerebellum 1078 Alae nasi 751 Alar ligaments 746 Alpha neurons 1038 Alterations in shape of rima   glottides 1003 Amygdaloid complex 1108 nuclear complex 1112 Anencephaly 742, 805 Angles of mouth 751 Angular artery 842 gyrus 1055 Ankyloglossia 794 Ansa cervicalis 873 subclavia 933 Anterior and middle cerebral   arteries 836 and posterior ethmoidal branches 837 fontanelles 720 malleolar 960 spinal arteries 717, 1139 transverse temporal   gyri 1056 arch 716 atlanto-occipital membrane 745 auricular branch 847 belly of digastric 741 canaliculus 960 cerebral and middle cerebral   arteries 1137 artery 1137 cervical nodes 766, 830, 832 choroidal artery 1138 ciliary arteries 838, 940 clinoid process 733 commissure 1057, 1112 communicating artery 1137 corticospinal tract 1066 cranial fossa 732 ethmoidal and infratrochlear nerves 897 nerve 897 external arcuate fibres 1042 fontanelle 738 funiculus 807 horn 1128 inferior cerebellar artery 1140 jugular vein 863 limb 1063 lobe 1048 longitudinal ligament 745 median fissure 807, 1042 nasal aperture 735 nucleus 1101 perforated substance 1058 spinal artery 810 superior alveolar nerve 900 thalamic radiation 1116 tubercle 717 tympanic branch 844 vertebral muscles 819t wall of middle ear 961 Anterolateral funiculus 807 sulcus 1042 Apertures in nasal cavity 738 in orbit 723 Apical foramen 982 ligament 746 Arachnoid mater 795, 799 villi 800 Arcuate nuclei 1086, 1088 Arcus parieto-occipitalis 1055 temporo-occipitalis 1055 Arrangement of fascia in orbit 938 Arteria radicularis magna 811 Arterial supply of brainstem 1144 cerebral cortex 1141 vasocorona 810 Arteries 749, 765, 833, 864 supplying cerebellum 1146 interior of cerebral hemisphere 1143 Artery of cerebral haemorrhage 1143 of Heubner 1138 of pterygoid canal 846 ii Articular area for mandible 731 disc 776 facets 716 tubercle 731 Aryepiglottic folds 1000 Arytenoid cartilage 1000 Ascending fibres 1116 palatine artery 842 pharyngeal artery 825, 839, 840 tracts 1072 Association fibres 1037, 1063 Asthenia 1083 Asynergia 1083 Athetosis 1108 Atlanto-axial joints 744 Atlanto-occipital and atlanto-axial joints 746 joint 716, 731, 744, 745 membrane 745 Atlas vertebra 716 Atrium 987 Attachments of infrahyoid muscles 817f of masseter muscle 775f of orbicularis oculi muscle 762f of semispinalis capitis   muscle 821f of splenius capitis muscle 821f of suboccipital muscles 822f Atypical cervical vertebrae 716 Auditory tube 730, 954, 958, 967 Auricular branch 843, 871, 909, 923 muscles 955 Auriculotemporal nerve 764, 768, 771, 903 Autonomic ganglia 1035 Basal ganglia 1060, 1096, 1106 lamina 945 veins 1147 Basic structure of cerebral hemisphere 1060 Basilar artery 850, 1139 plexus of veins 858 Textbook of Anatomy Basivertebral vein 811 Bipolar cells 948 Bitemporal heteronymous hemianopia 887, 1124 Biventral lobule 1050 Blepharitis 952 Blind spot 948 Blood supply and nerve supply of cerebral dura mater 799 and nerve supply of teeth 983 of brain 1137 of nasal cavity 987 of spinal cord 810 vessels 795 and nerves of eyeball 949 and nerves of scalp 749 and nerves of tympanic   membrane 961 of eyelids 754 of head and neck 833, 864 of internal ear 974 Bones and joints of head and neck 715 of skull 743 Bony cochlea 969, 971 labyrinth 954, 969 palate 727 Boundaries of fourth ventricle 1132 Brachium 1043 Branch in middle cranial fossa 898 Branches carrying fibres of cervical   nerves 930 of auriculotemporal nerve 903 of basilar artery 1140 of cervicothoracic ganglion 933 of costocervical trunk 853f of external carotid artery 839 of facial nerve 909, 910f of first part of maxillary artery in infratemporal region 770f of glossopharyngeal nerve   919, 920f of hypoglossal nerve 930 of inferior thyroid artery 853f of infraorbital nerve in face 901 of mandibular nerve 771f, 901f of maxillary artery 845f of middle cervical ganglion 932 sympathetic and   cervicothoracic ganglia 934f of ophthalmic artery 837, 838f, 940 of pterygopalatine ganglion 899f of subclavian artery 850 of superior cervical ganglion 932 sympathetic ganglion 934f of vagus nerve in neck 923 Bregma 720 Buccal branches 909 nodes 766, 830 Buccinator 741, 757, 761t Buccopharyngeal fascia 993 Bulb of posterior horn 1064, 1128 Bulla ethmoidalis 987 Calamus scriptorius 1133 Calcarine sulcus 1057 Canal of Schlemm 945 Canthus 753 Capsule of temporomandibular joint 741 Cardiac branches 925 Caroticotympanic nerves 932, 962 Carotid branch 919 canal 731, 735 groove 734 sheath 828, 833 triangle 822, 824 Cartilages of epiglottis 1000 of larynx 998 Cataract 952 Cauda equina 801 Caudate nucleus 1060, 1107, 1144 Cavernous sinus 799 Cell body 1033 Central artery of retina 837, 940 canal 807, 1127 nervous system 1033 vein of retina 859, 949 Centromedian nucleus 1098 Cerebellar cortex 1051 notches 1048 nuclei 1051, 1052f peduncles 1051, 1078 Cerebello-cortical pathways 1082 Cerebello-reticular fibres 1079 Cerebello-rubral connections 1081 fibres 1079 Cerebello-spinal pathways 1082 Cerebello-thalamic connections 1081 fibres 1079 Cerebellum 1148 and cerebral cortex 1082 Cerebral angiography 1149 aqueduct 1056, 1127 concussion 806, 1065 contusion 806, 1065 cortex 1061 dura mater 796 laceration 806, 1065 Cerebrospinal fluid 795, 800, 1134 Cerumen 957 Ceruminous glands 957 Cervical branch 766 enlargement of cord 809 nerves 868 part of sympathetic trunk 931 plexus 870, 871f spondylolisthesis 719 spondylosis 718 vertebrae 744 Cervicothoracic ganglion 931 Chalazion 952 Charcot’s artery of cerebral haemorrhage 1072 Chorda tympani 771, 903, 909, 911 Choroid fissure 1114f plexuses 800, 1131 of fourth ventricle 1134 Index Chronic retropharyngeal abscess 829 Ciliary arteries 949 body 943, 946 ganglion 880, 942 glands 753 muscle 946 processes 946 ring 946 Cingulate sulcus 1057 Circadian rhythms 1104 Circular fibres 946 sulcus 1055 Circulus arteriosus 1140 Circumolivary bundle 1089 Cisternal puncture 1135 Claustrum 1108 Cleft palate 980 Cleidocranial dysostosis 742, 805 Cochlear nerve 917 nuclei 881 Collar stud abscess 829 Collateral eminence 1129 sulcus 1058 Commissural fibres 1037, 1063 Commissure of brain 1119 of fornix 1115 Common carotid arteries 833 facial vein 765, 860 Conchae 985 Concomitant squint 893 Condylar fossa 731 process 739 Cone of light 961 Confluence of sinuses 856 Congenital anomalies 864 hydrocephalus 742, 805 malformations 718, 742, 794 of skull 805 Conjunctiva 752 Conjunctival fornix 754 sac 752 iii Conjunctivitis 952 Connections of cerebellar nuclei 1081 of cerebellum 1078 of ciliary ganglion 890f of hypothalamus 1101 of inferior colliculus 1094 olivary nucleus 1088 of otic ganglion 922f of red nucleus 1094 of substantia nigra 1094 of superior colliculus 1094 of thalamus 1098 Constriction of pupil 933 Constrictors of pharynx 994 Contents of cranial cavity and   vertebral canal 795 of orbit 935 Control of autonomic activity 1104 of endocrine activity 1104 Conus medullaris 807 Cornea 752, 945, 952 Corneal opacities 952 reflex 752 Corona radiata 1060 Coronal suture 720 Corpus callosum 1061, 1064, 1119 cerebelli 1048 striatum 1060, 1106, 1144 and internal capsule 1148 Corrugator supercillii 758t Corticofugal fibres 1063 Corticonuclear fibres 1118 tracts 1071 Corticopetal fibres 1063 Corticopontine fibres 1118 Cortico-ponto-cerebellar pathway 1071 Corticoreticular fibres 1118 Corticorubral fibres 1118 Corticospinal fibres 1044 tract 1066 Corticothalamic fibres 1118 iv Costocervical trunk 850, 853 Course of central artery of retina 839f of greater occipital nerve 869f of maxillary artery 770f Cranial cavity 719, 795 fossae 732 nerves 795, 803, 874 part of accessory nerve 926, 927 internal carotid arteries 835 Cranium 719 Cribriform plate 803 of ethmoid bone 732 Cricoid cartilage 1000 Crista galli 803 Cristae ampullae 974 Crura 1043 Crus cerebri 1091 Cuneate tubercles 1042 Cyclitis 952 Dangerous area of face 760, 866 of scalp 750, 867 Decussating fibres 1037 Decussation of pyramids 1042, 1044 Deep cervical artery 854 fascia and lymph nodes 813 lymph nodes 766, 831f nodes 830, 832 vein 863 lingual vein 787 muscles of back 815, 820t petrosal nerve 911, 932 temporal branches 846 nerves 769, 771 Deeper structures in temporal region 769 Dental caries 984 Dentate nucleus 1051 Dentine 982 Depressor anguli oris 758t labii inferioris 758t septi 758t supercillii 758t Textbook of Anatomy Dermatome 1077 Dermoid cysts 751 Descending branch 843, 930 fibres 1118 tracts ending in brainstem 1071 spinal cord 1066 Detachment of retina 948 Diaphragma sellae 798 Diencephalon 1096 Digastric fossa 739 triangle 824 Dilator tubae 968 Diploic veins 859 Diplopia 892 Disorders of equilibrium 1083 of motor function 1071 Distribution of internal carotid nerve 934f of oculomotor nerve 890f of posterior auricular artery 843f Dorsal lingual veins 787 longitudinal fasciculus 1102 nasal branch 941 nerve root ganglion 808 nucleus 1038 rami of cervical nerves 868 ramus of first cervical nerve 868, 869f second cervical nerve 868 third cervical nerve 870 typical spinal nerve 869f scapular artery 850, 854 spinocerebellar tract 1075 supraoptic commissure 1119 tegmental decussation 1069, 1093 vagal nucleus 1088 Dorsimedial nucleus 1101 Dorsum nasi 751 sellae 733 Duct of cochlea 970, 972 Ductus reunions 971 Dura mater 795 Early development of brain 1059 Edinger-Westphal nucleus 880, 887, 1093 Emboliform nucleus 1051 Eminentia conchae 955 Emissary veins 860 Enamel 982 Endocranium 795 Endolymph 969 Endolymphatic sac 973 Enlarged lymph nodes 831 Enophthalmos 759, 933 Entorhinal area 884, 1109 Ependyma 800, 1127 Epicranial aponeurosis 748 Episcleritis 952 Epistaxis 988 Epithalamus 1105 Epitympanic recess 958 Erector spinae 820t Ethmoid bone 721 Ethmoidal air sinuses 990 infundibulum 737, 987 Eustachian tube 967 Exterior of cerebral hemispheres 1051 External acoustic meatus 725, 954, 956 carotid arteries 838 ear 954 jugular vein 863 laryngeal nerve 924 medullary lamina 1097 nares 751 nasal nerves 766, 897 nose 751 occipital crest 721 protuberance 720 strabismus 893 Extradural haemorrhage 807, 1065 Extraocular muscles 935, 936t Extrapyramidal tracts 1070 Extrinsic muscles 787, 1002 of tongue 788t Eyelids 752 Eyes and related structures 952 Facial artery 825, 839, 841 colliculus 891, 908, 1091, 1133 nerve 764, 767, 908 nucleus 908 vein 765 Falx cerebelli 798 cerebri 796, 797f Fascial sheath of eyeball 939 Fasciculus cuneatus 1042 gracilis and fasciculus   cuneatus 1074 Fastigial nucleus 1051 Fenestra cochleae 964, 965 vestibuli 964, 965 Fibres entering cerebellum 1079, 1080 leaving cerebellum 1079, 1080f of optic nerve 948 of subthalamic fasciculus 1118 Filiform papillae 786 Filum terminale 801 Fimbria 1113 First cervical vertebra 716f Flail joints 1083 Flexion of head 746 Flocculonodular lobe 1048 Floor of middle and posterior cranial fossae 733f of middle ear 959 of nasal cavity 987 Fontanelles 738 Foramen caecum 732, 786 lacerum 731, 734 magnum 727, 731, 734, 735 ovale 730, 734, 735 rotundum 735 spinosum 730, 734 Foramina of skull 735 Fornix 1115 Fossa incudis 962 Fovea centralis 948 Fractures of anterior cranial fossa 743 Index of hyoid bone 742 of middle cranial fossa 743 of posterior cranial fossa 743 of skull 742, 806 Frenulum linguae 786, 977 Frontal bone 720 branch 844, 847 crest 732 eminence 721 lobe 1055 nerve 895, 942 notch 721 operculum 1056 process of maxilla 721 of zygomatic bone 721 sinuses 737, 988 thalamic peduncle 1116 Frontonasal duct 987 Frontoparietal operculum 1056 Functional components of facial nerve 912 of glossopharyngeal nerve 920 of vagus nerve 925 Functions of cerebellum 1082 of hypothalamus 1104 of reticular formation 1095 Fungiform 786 Gamma neurons 1038 Ganglion cells 948 General somatic afferent fibres 876, 913 nuclei 881 visceral efferent fibres 876, 912 nuclei 880 Genicular ganglion 908 Geniculocalcarine tract and visual cortex 1123 Geniohyoid muscle 741 Gingivitis 984 Globose nucleus 1051 Globus pallidus 1144 Glossopharyngeal nerve 788, 791, 792f, 804, 918 Gracile lobule 1050 v Great cerebral vein 856, 1147 Greater arterial circle 949 auricle nerve 871 cornua 741 occipital nerve 868 palatine artery 846 nerve 898 petrosal nerve 909, 911 Grey commissure 807 matter of cerebellum 1051 Gross anatomy of brain 1040 of brainstem 1040 of cerebellum 1048 of cerebral hemispheres 1051 of medulla 1042 of midbrain 1043 of pons 1042 Gustatory nucleus 881 Gyrus cinguli 1057 descendens 1055 faciolaris 1113 rectus 1058 Hair cells 974 Hard palate 978 Harelip 760, 980 Helicotrema 972 Hemianopia 887 Hemiballism 1108 Hemiplegia 1071, 1072 Herpes zoster 913 Hiatus semilunaris 737, 987 Highest nuchal lines 721 Hippocampal commissure 1115 fissure 1113, 1114f formation 1113 Homonymous 887 Horizontal fissure 1050 plate 728 Horner’s syndrome 759, 933 Human osteology 719 Hutchinson’s teeth 983 Hyaloid fossa 949 Hydrocephalus 1135 vi Hyoglossus muscle 741, 789 Hyoid bone 741 Hyperacusis 965 Hypermetropia 953 Hypoglossal canal 734, 735 nerve 789, 792, 793f, 929, 931f nucleus 880, 1088 triangle 1133 Hypophyseal fossa 733 Hypophysis cerebri 1057 Hypothalamic nuclei 1100 sulcus 1096, 1129 Hypothalamo-hypophyseal portal system 1103 Hypotonia 1083 Incisivus labii inferioris 758t superioris 758t Incus 958 Indusium griseum 1113 Infections of scalp 750 Inferior alveolar artery 845 nerve 771, 905 anastomotic vein 1146 articular surface 776 brachium 1093 cerebellar peduncle 1045, 1051, 1080 cerebral veins 1146 colliculus 1093 cornu 998 fovea 1133 frontal gyri 1055 sulci 1055 ganglion 919, 923 horn 1128 labial artery 765 medullary velum 1131 nuchal line 721 olivary nucleus 1042, 1045, 1086 ophthalmic vein 859 orbital fissure 724, 728 parietal lobule 1055 petrosal sinus 858 rectus 936t Textbook of Anatomy sagittal sinus 796, 856 semilunar lobule 1050 striate veins 1147, 1148 surface of cerebrum 1057 temporal sulci 1055 thalamic radiation 1117 thyroid artery 851, 852 veins 861 Infrahyoid muscles 813, 816t Infraorbital artery 846 foramen 721, 724 groove 724 and canal 900 nerve 766 Infratemporal crest 728 fossa 725, 769 Infratrochlear nerve 897 Infundibular nucleus 1101 Insertion of constrictors of   pharynx 994 Insula 1055 Intention tremor 1108 Interior of larynx 1000 Intermediolateral and intermediomedial nuclei 1038 Internal acoustic meatus 734, 735 arcuate fibres 1074 capsule 1060, 1063, 1116, 1143 commissures 1116 carotid artery 834, 1137 nerve 932 cerebral veins 1147 ear 969 jugular veins 854 laryngeal nerve 924 medullary lamina 1097 nasal branches 897 occipital crest 735 protuberance 735 strabismus 893 structure of brainstem 1043, 1084 medulla 1043 midbrain 1047 pons 1045 spinal cord 1033, 1037 thalamus 1097 vertebral venous plexus 801, 811 Internuncial neuron 1035 Interpeduncular fossa 1057 Intersegmental tracts 1039 Interthalamic connexus 1056, 1096, 1129 Interventricular foramen 1056, 1127 Intervertebral foramina 808 vein 812 Intorsion 937 Intracranial sinuses and veins 858 venous sinuses 803, 855, 867 Intralaminar nuclei 1098 Intraocular lens transplantation 953 Intraparietal sulcus 1055 Intrinsic muscles 787, 1002 Iridocyclitis 952 Iris 943, 946 Isthmus 1057 Joints 744 of head and neck 743 Jugular arch 863 foramen 731, 735 fossa 731 tubercle 734 Jugulodigastric nodes 830 Jugulo-omohyoid node 830 Jugum sphenoidale 732 Keratitis 952 Killian’s dehiscence 995 Klippel-Feil syndrome 718 Labyrinth 969 Labyrinthine artery 1140 Labyrinthitis 975 Laceration of tongue 794 Lacrimal apparatus 754 artery 837, 940 canaliculi 754, 756 caruncle 753 gland 754, 939 groove 723 nerve 895, 942 papilla 753 punctum 753 sac 754, 756 Lacus lacrimalis 753 Lambdoid suture 720 Lamina cribrosa 886, 944 fusca 945 terminalis 1057 Laminae 716 Large muscles of face 761t paired sinuses 857 Laryngeal part of pharynx 993 prominence 998 Laryngitis 1004 Laryngopharyngeal branches 932 Laryngoscopy 1005 Larynx 998, 1004 Lateral and medial palpebral ligaments 753 atlanto-axial joints 745 corticospinal tract 1066 dorsal nucleus 1098 flexion of head at atlantooccipital joint 746 funiculus 807 geniculate body 886, 1105, 1123 glossoepiglottic folds 786 grey column 807 lemniscus 1124 longitudinal striae 1113 masses 716 medullary syndrome 1145 nasal artery 765 branch 842 occipital sulcus 1055 occipitotemporal gyrus 1059 orbital gyri 1058 posterior nucleus 1098 pterygoid muscle 769 reticular nucleus 1086 reticulospinal tract 1069 striate arteries 1143 temporomandibular   ligament 776 ventricles 1127 vertebral muscles 814, 818t Index wall of middle ear 959 nasal cavity 736f, 985 Layers of scalp 748, 749f Left homonymous hemianopia 887, 1124 recurrent laryngeal nerve 924 Lentiform nucleus 1060, 1107 Lesser occipital nerve 871 palatine foramina 728 palatine nerves 899 petrosal nerve 919 Levator anguli oris 758t labii superioris 758t alaeque nasi 758t palati 978, 979 palpebrae superioris 936t Ligamentum denticulatum 802 flavum 745 Limbic system 1111 Limbus 945 Limen insulae 1058 nasi 987 Linea splendens 802 Lingual artery 787, 825, 839, 840 branch 845 nerve 771, 790, 791f, 903 tonsil 786 vein 787, 860 Lingula 739 Lips and cheeks 751 Lobes 1052 Lobule 955 Long and short ciliary nerves 949 ciliary arteries 949 nerves 897 Longus capitis 815, 819t colli 815 Loose areolar tissue 748 Lower motor neuron paralysis 1071 Ludwig’s angina 829 vii Lumbar puncture 801, 1149 Lunate sulcus 1055 Lymph nodes of head and neck 829 vessels 995 Lymphatic drainage 750, 955, 987, 1003 drainage of neck 831 drainage of tongue 792, 793f of face 766 Macroglossia 794 Maculae 974 Main sensory nucleus 881 Mammillary bodies 1057 nuclei 1100 peduncle 1102 Mandibular foramen 739 fossa 725, 731 nerve 770, 804, 901 notch 739 Mandibulofacial dysostosis 742, 760, 805 Marginal mandibular branch 766, 911 Mastoid air cells 958, 966 antrum 958, 966 fontanelle 738 notch 731 Maxillary artery 770, 839, 843 nerve 804, 898 sinuses 990 tuberosity 727 vein and pterygoid plexus 861 Medial accessory olivary nucleus 1086 and lateral geniculate bodies 1057, 1098 olfactory striae 1109 forebrain bundle 1102 frontal gyrus 1057 geniculate body 1105 lemniscus 1044, 1074 medullary syndrome 1145 occipitotemporal gyrus 1059 viii palpebral branches 838, 940 pterygoid muscle 770 plate 728 reticulospinal tract 1069 striate arteries 1143 surface of cerebral   hemisphere 1056 wall of middle ear 963 nasal cavity 984 Median atlanto-axial joint 745 atlanto-occipital joint 717 dorsal recess 1132 glossoepiglottic fold 786 Medicolegal importance of teeth 984 Meibomian glands 753 Melanoma 953 Membrana tectoria 746 Membranous labyrinth 969, 972 Meningeal branch 843, 923, 930 veins 859 Meninges 717, 795 and cerebrospinal fluid 801 in vertebral canal 801 Mental branch 845 foramen 739 protuberance 740 tubercles 738, 740 Meriodonal fibres 946 Mesencephalic nucleus 881 nucleus of trigeminal nerve 1093 Mesencephalon 1059 Metathalamus 1105 Microglossia 794 Middle and inferior nasal conchae 721 cerebellar peduncle 1042, 1045, 1051, 1080 cerebral artery 1138, 1141 cranial fossa 733 ear 957 ganglion 931 lobe 1048 meningeal Textbook of Anatomy artery 844 sinus 858 superior alveolar nerve 900 temporal artery 847 vein 861 thyroid vein 861 Midline nuclei 1098 Millard-Gubler syndrome 1072 Monoplegia 1071, 1072 Motor nucleus of trigeminal nerve 880 Movements of eyeball 935 Muscles of face 757, 758t of larynx 1002 of mastication 772, 773t of middle ear 965 of neck 813 of orbit 935 of pharynx 994 of soft palate 978 of tongue 787 Muscular branches 838 triangle 822, 825 Musculus uvulae 978, 979 Myelin sheath 1034 Myelinated axons 1034 Mylohyoid 741 branch 845 groove 739 line 739 muscle 741, 784 nerve 771 Myoclonus 1108 Myopia 953 Nasal cavity 735, 988 hemianopia 887, 1124 part of pharynx 991 process of frontal bone 721 septum 721, 735 Nasociliary nerve 897 Nasolacrimal canal 723, 738 duct 754, 757, 990 Nasopalatine nerve 899 Nasopharyngeal tonsil 759 Nerves and arteries in cranial cavity 803 of scalp 749f and vessels of orbit 940 of face 766, 767 of head and neck 868 of ordinary sensation 788 of taste 788 supplying eyelids 754 muscles 789 tongue 787 Neuroglia 1033 Neurons 1033 of dorsal grey column 1038 of intermediolateral group 1039 supplying smooth muscle and   glands 878 typical skeletal muscle 877 Nuclei in anterior part 1097 in intermediate zone 1101 in lateral part 1097 zone 1101 in periventricular zone 1101 of lateral group 1098 pontis 1089 Nucleus ambiguus 880 cuneatus 1043, 1084 gracilis 1043, 1084 of facial nerve 880 of lateral lemniscus 1124 of solitary tract 880 of trapezoid body 1124 of vagus 880 Occipital artery 825, 839, 842 bone 720 branches 843 condyles 731 nodes 766, 832 pole 1051 triangle 823 vein 863 Occipitalisation of atlas 718 Occipitotectal fibres 1118 Occipitotemporal sulcus 1058 Ocular conjunctiva 752, 753 Oculomotor nerve 803, 887, 941 nucleus 879, 1093 Odontoid process 717 Oesophagus in neck 1006 Olfactory bulb 803, 883, 1109 mucosa 984, 1109 nerve 874, 1109 receptor cells 1110 region and limbic system 1109 tract 803, 1109 trigone 1109 tubercle 1109 Oligodendrocyte 1033 Olivocerebellar connections 1080f, 1081 Olivospinal tract 1069 Opercula 1056 Ophthalmic artery 836, 940 nerve 804, 895, 942 Ophthalmoscope 953 Optic canal 723, 735 chiasma 941 and optic tract 1121 disc 948 nerve 803, 884, 941, 1121 neuritis 952 stalk 947 tract 886 vesicle 947 Ora serrata 946 Oral cavity 976 diaphragm 783 Orbicularis oculi 757, 761t oris 757, 761t Orbit 722, 935 Orbital branches 899 fascia 938 septum 753, 939 sulcus 1058 surface 1058 Origin of buccinator muscle 762f Oropharyngeal isthmus 976, 991 Ossicles of middle ear 958 Index Osteophytes 718 Otic ganglion 921 Otitis media 974 Palate 978 Palatine aponeurosis 978 bones 726, 728 crest 728 tonsils 996 Palatoglossal fold 786, 978 Palatoglossus 978, 979 Palatopharyngeal folds 978, 993 sphincter 979, 991, 995 Palpebral conjunctiva 753 fissure 752 Pannulus carnosus 813 Papillomacular bundle 886, 1121 Paracentral lobule 1057 Parahippocampal gyrus 884, 1059, 1109 Paralysis of abducent nerve 893 of facial nerve 767, 915 of oculomotor nerve 893 of trochlear nerve 893 Paralytic squint 893 Paranasal sinuses 737, 990 Paraplegia 1072 Parasympathetic ganglia 1035 Paraterminal gyrus 1112 Paraventricular nucleus 1101 Parieto-occipital sulcus 1053 Parolfactory gyrus 1112 sulci 1112 Parotid duct 763 fascia 764 gland 760, 764, 854t, 909 nodes 832 Pars flaccida 960 opercularis 1055 orbitalis 1055 triangularis 1055 Parts of bony labyrinth 969 membranous labyrinth 970 ix Pedicles 716 Pelvic splanchnic nerves 1039 Pericranium 748 Perimetry 1123 Periodontal ligament 982 Peripheral nervous system 1033 Peritonsillar abscess 997 Perivascular spaces 800 Perpendicular plate 728 Petrotympanic fissure 960 Petrous temporal bone 908 Pharyngeal branches 919 isthmus 991 nerve 899 part of tongue 786 plexus 924, 995 recess 992 tonsil 997 Pharyngotympanic tube 967 Pharynx 991, 995 Philtrum 760, 980 Phrenic nerve 873 Pia mater 795, 800 Pigment cell layer 947 Pineal gland 1057 Platysma 813 muscle 815f Plica semilunaris 753 Poliomyelitis 1072 Pontine branches 1140 nuclei 1045, 1089 Pontobulbar body 1089 Postcentral gyrus 1055 Posterior atlanto-occipital membrane 745 auricular artery 839, 843 branch of facial nerve 769 nerve 909 vein 862 canaliculus 960 cerebral artery 1139 choroidal artery 1140 ciliary arteries 837, 940 clinoid processes 734 column tracts 1074 communicating artery 1138 condylar canal 731, 734 x cranial fossa 734 ethmoidal branch 897 external jugular vein 863 fontanelle 738 funiculus 807 horn 1128 inferior cerebellar artery 1139 nasal branches 899 limb 1063 lobe 1048 median septum 807 sulcus 1042 nasal apertures 728, 735 nucleus 1101 perforated substance 1058 ramus of lateral sulcus 1052 septal branches 847 spinal arteries 810 superior alveolar artery 846 nerve 900 superior nasal nerves 899 thalamic radiation 1116 thyroid branches 840 triangle 823 tubercle 717 wall of middle ear 962 Posterolateral fissure 1048 nasal branches 847 sulcus 1042 Precentral gyrus 1055 sulcus 1055 Preganglionic neuron 878 Premammillary nuclei 1101 Preoptic nucleus 1100 Presbyopia 953 Pretectal nucleus 1093 Pretracheal fascia 828 Prevertebral fascia 828 muscles 815 Primary olfactory cortex 1111 Processus trochleariformis 961 Pterion 725 Pterygoid canal 911 Textbook of Anatomy fossa 728 fovea 739 muscles 769 plates 725 plexus 861 Pterygomaxillary fissure 728 Pterygopalatine fossa 898 ganglion 880, 899, 913 Ptosis 893 Pulp canal 982 Pulsating exophthalmos 867 Pyorrhea 984 Pyramid 962, 1044 Pyramidal tracts 1070 Quadrangular lobule 1050 Quadriplegia 1072 Radicular arteries 810 Raymond’s syndrome 1072 Rectus capitis anterior 815 lateralis 815 posterior minor 822t Recurrent laryngeal nerve 924 meningeal branch 837 Referred pain 1077 Reflex arc 1035 Refracting media 944 Region of atlanto-occipital and atlanto-axial joints 747f Regulation of sexual activity and reproduction 1104 Renshaw cell 1038 Reticular formation 1044, 1047 of brainstem 1094 nucleus 1098 Reticulocerebellar connections 1081 Reticulospinal tracts 1069 Retina 944, 947 Retinitis 952 Retinoblastoma 953 Retinoscopy 953 Retroauricular nodes 766 Retromandibular vein 861, 764, 765 Rhinal sulcus 1059 Rhinencephalon 1111 Rhinitis 988 Rhombencephalon 1059 Rhomboid fossa 1132 Right recurrent laryngeal nerve 924 Rima glottidis 998, 1001 vestibuli 1001 Romberg’s sign 1083 Roof of middle ear 959 of nasal cavity 987 Roots and divisions of trigeminal nerve 894f Rostral spinocerebellar tract 1079 Rubrospinal tract 1068 Saccus endolymphaticus 971 Salivary glands 782 Salpingopalatine fold 992 Salpingopharyngeal fold 992 Salpingopharyngeus 994 Scala tympani 964, 969 vestibuli 964, 969 Scalenus anterior 814 medius 814 minimus 814 posterior 814 Scalp 748 Schwann cells 1033 Sclera 944 Scleral spur 945 Scleritis 952 Sclerocorneal junction 945 Sebaceous cysts 750 Second cervical vertebra 717f Secondary olfactory cortex 1111 tympanic membrane 965, 972 Secretomotor fibres 790, 905 nerve supply 781, 782 Sella turcica 733 Semicircular canals 954, 970 duct 970, 972 Sensory decussation 1074 disorders 1077 ganglia 1034 root of ciliary ganglion 897 Septum lucidum 1057 pellucidum 1057 Seventh cervical vertebra 718, 719f Sigmoid sinuses 857 sulcus 735 Sinus tympani 965 venosus sclerae 945 Soft palate 978 Solitary tract 1088 Somatic efferent fibres 876 nuclei 879 Spastic paralysis 1071 Sphenoethmoidal recess 738, 986, 989 Sphenoid bone 725 Sphenoidal fontanelle 738 sinuses 737, 989 Sphenomandibular ligament 771, 776 Sphenopalatine artery 847 foramen 738 Sphenoparietal sinus 858 Spina bifida 718 occulta 718 Spinal branches 851 cord 717, 807 ganglion 808 lemniscus 1075 nerve roots 877 nerves and spinal segments 808 nucleus 881 of trigeminal nerve 1042, 1043 part of accessory nerve 717, 804, 927 root of accessory nerve 809 segment 808 tract 1044 of trigeminal nerve 1042 Spine of sphenoid 730 Spino-olivary tract 1075 Spinotectal tract 1075 Index Spinothalamic pathway 1075 Spinous processes 716 Spiral ganglion 972 lamina 972 organ of corti 973 Splenial gyrus 1113 Splenium 1056 Splenius capitis 820t cervicis 820t Squamotympanic fissure 731 Squint 892 Stellate ganglion 931 Stereoscopic vision 1121 Sternocleidomastoid muscle 816t Sternohyoid muscle 741 Strabismus 892 Straight sinus 796, 856 Stratum zonale 1097 Stria medullaris thalami 1096 terminalis 1096, 1112 Striate arteries 1143 Structures crossing external carotid artery 840t internal carotid artery 835t superficial and deep to internal jugular vein 854t Stylohyoid muscle 742 Styloid process 725, 731 Stylomandibular ligament 764, 776, 828 Stylomastoid branch 842 foramen 731, 735 Stylopharyngeus 994 Subarachnoid haemorrhage 807, 1065 Subclavian arteries 847 veins 855 Subdivisions of anterior triangle 824 cerebellum 1048 grey matter 1037 hypothalamus 1100 xi Subdural haemorrhage 807, 1065 space 800 Sublingual fold 786 fossa 739 gland 781 papilla 786, 977 Submandibular duct 780 fossa 739 ganglion 791, 880, 913 gland 779 nodes 766 region and tongue 779 Submental nodes 766, 832 triangle 824 Suboccipital muscles 821, 822t triangle 823, 826 Substantia gelatinosa 1038 nigra 1047, 1091 Subthalamic nucleus 1106 region 1106 Sulcus basilaris 1043 chiasmaticus 733 limitans 1133 sclerae 945 terminalis 786 Superficial and deep parotid nodes 766 cervical nodes 766, 830 contents of infratemporal fossa 769 fascia 748 lymph nodes 829 middle cerebral vein 1146 structures 768 temporal artery 765, 768, 839, 847 vein 768, 861 Superior anastomotic vein 1146 and inferior labial branches 842 occipital gyri 1055 tubercles 998 xii belly of omohyoid muscle 741 cerebellar artery 1140 peduncle 1051, 1079 cerebral veins 1146 colliculus 1093 cornu 998 dental plexus 901 fovea 1133 ganglion 923, 931 intercostal artery 854 labial artery 765 laryngeal branch of vagus nerve 789 nerve 924 medullary velum 1043, 1131 nuchal line 720 ophthalmic vein 858 orbital fissure 723, 734, 735 parietal lobule 1055 petrosal sinus 798, 858 sagittal sinus 796 salivatory nucleus 912 semilunar lobule 1050 striate veins 1148 thalamic radiation 1116 thyroid artery 825, 839, 840 vein 861 Suprachiasmatic nucleus 1101 Suprachoroid lamina 945 Supraclavicular nerves 872 triangle 823 Suprahyoid muscles 782t, 783 Supramarginal gyrus 1055 Suprameatal triangle 966 Supranuclear paralysis 915 Supraoptic nucleus 1101 Supraorbital branch 837, 940 nerve 895, 942 notch 721 Suprascapular artery 851 veins 863 Suprasternal nodes 832 space 828 Textbook of Anatomy Supratentorial compartment 797 Supratrochlear 766 artery 838, 940 nerve 896, 942 Suspensory ligament 949 Swellings 832 Sympathetic ganglia 1035 innervation of upper limb 933 root 942 trunk 825 Symphysis menti 739 Synchondroses 743 Syringomyelia 1077 Taenia thalami 1096 Tail of dentate gyrus 1113 Tarsal glands 753 Tectospinal tract 1069 Tegmen tympani 731, 734, 959 Tela choroidea 800, 1096 of fourth ventricle 1134 of third and lateral   ventricles 1130 Telencephalic vesicles 1059 Temporal and infratemporal regions 768 branch 766, 909 of facial nerve 769 fascia 768, 773 fossa 725, 768 lines 724 operculum 1056 pole 1051 region 768 surface 730 Temporomandibular joint 725, 744, 776 Tensor palati 978 tympani 965 Tentorial notch 797 surface 1058 Tentorium cerebelli 796, 797, 1048 Terminal ventricle 807 Testing facial nerve 915 glossopharyngeal nerve 923 of trigeminal nerve 906 optic nerve 886, 1123 vestibulocochlear nerve 918, 1125 Thalamic peduncles 1099 radiations 1099 Thalamocortical fibres 1116 Thalamostriate vein 1147 Thalamus 1096, 1144 and hypothalamus 1060 Thrombosis in cavernous sinus 867 sigmoid sinus 867 superior sagittal sinus 867 Thyrocervical trunk 850, 851 Thyroepiglottic muscles 1002 Thyrohyoid muscle 742 Thyroid cartilage 998 Tongue 784 Tonsil 1050 Tonsilar branches 919 crypts 996 sinus 993 branch 842 Tonsillectomy 996, 997 Tonsillitis 997 Trachea 1005 Tracheostomy 1004 Tracts of spinal cord and brainstem 1066 Transverse cervical vein 863 cutaneous nerve of neck 871 facial artery 765 branch 847 fissure 1131 ligament of atlas 746 occipital sulcus 1055 sinuses 857 sulcus 735 Trapezoid nucleus 1124 Triangles of neck 813, 821, 825f Tributaries of internal jugular vein 855, 860 of subclavian vein 856f Trigeminal cave 798, 804, 895 ganglion 804, 895 impression 734, 895 nerve 766, 767, 804, 893 neuralgia 907 Trochlear nerve 803, 891, 942 nucleus 879 Tubal elevation 992 tonsil 992 Tuberculum cinereum 1042 sellae 733 Tuberomammillary nucleus 1101 Tympanic branch 919 cavity or tympanum 957 membrane 954, 959, 961 plexus 919 sulcus 956, 960 Tympanum 954 Typical cervical vertebrae 715 Unmyelinated axons 1034 Unpaired sinuses lying in midline 856 Upper and lower buccal branches 766 articular surface 776 motor neuron paralysis 1071 Utriculosaccular duct 971 Uvula 978 Vagal triangle 1133 Vagus nerve 804, 923, 926 Vallate papillae 786 Vallecula 786 Vascular coat 943 layer 945 Veins 749, 765, 854, 866 draining eyeball and orbit 858 xiii Index in head 859 of cerebellum and   brainstem 1148 of cerebral hemisphere 1146 of orbit 941 Venae vorticosae 945, 949 Venous drainage of brain 1146 pressure 866 vasocorona 811 Ventral anterior nucleus 1097 aspect of brainstem 1040f column neurons 1038 intermediate nucleus 1097 posterior nucleus 1097, 1099 posterolateral nucleus 1097 posteromedial nucleus 1097 rami of cervical nerves 870 spinocerebellar tract 1075, 1079 supraoptic commissure 1119 tegmental decussation 1069, 1093 thalamic peduncle 1117 thalamus 1106 white commissure 807 Ventricles of brain and cerebrospinal fluid 1127 Ventriculography 1136, 1149 Ventromedial nucleus 1101 Vertebra prominens 718 Vertebral arteries 1138 bodies 715 canal 795 column 715 vein 863 venous plexus 795, 811, 812f Vessels and nerves of larynx 1003 of face and parotid region 765 Vestibular area 1133 ligament 1000 membrane 972 nerve 916 nuclei 881, 1088 Vestibule 969, 987 Vestibulocerebellar connections 1080 Vestibulocochlear nerves 804 Vestibulospinal tract 1069 Visual field and retinal quadrants 1120 Vocal folds 998 Vocalis 1003 Waldeyer’s ring of lymphoid tissue 997f Walls of orbit 722 pharynx 993 Weber’s syndrome 1072 White matter of cerebellum 1051 of cerebral hemispheres 1063 of spinal cord 1039 Wounds of scalp 750 Zona incerta 1106 Zonule 949 Zygomatic arch 725 branches 837, 909, 940 nerve 900 process of frontal bone 721 of maxilla 721 Zygomaticofacial foramen 721 nerve 769, 900 Zygomatico-orbital branch 847 Zygomaticotemporal nerve 769, 900 ... pyramidalis (25 .25 ) Nerves of Anterior Abdominal Wall The various nerves to be seen in relation to each half of the anterior abdominal wall are (25 .23 ): anterior parts of the lower five pairs of intercostal... anterior wall of the sheath c The posterior part of the sheath has a lower free margin, called the arcuate line (25 .20 ) lying on the transversalis fascia 25 .20 : Diagram showing contents of the rectus... iliac spines b The lower part of the posterior surface of the sacrum (transverse tubercles) c The lateral margin of the lower part of the sacrum and the upper part of the coccyx Its lower end