Sinelnikov Vol 1 - Ebook download as PDF File .pdf), Text File .txt) or read book R.D.. SINELNIKOV. ATLAS OF HUMAN ANATOMY IN TREE VOLUMES. Sinelnikov Vol I(1) - Free ebook download as PDF File .pdf), Text File .txt) or read This edition of Professor R.D. Sinclnikov's Atlas of Human Anatomy is a. Sinelnikov Vol II(1) - Free ebook download as PDF File .pdf), Text File .txt) or ATLAS OF HUMAN ANATOMY T h e teeth of a human erupt in two periods.
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osakeya.infoIKOV. ATLAS. OF. HUMAN. ANATOMY. IN THREE VOLUMES. Volume III. The Science of the Nervous System,. Sense Organs, and Endocrine. Sinelnikov - Atlas of Human Anatomy - Volume 3. Document Cover . DESCRIPTION. atlas anatomie sinelnikov. Transcript. Created with. R sinelnikov atlasanatomii pdf F. Grants Atlas pthw pdf of Anatomy PDF. Atlas of human.R. R.D. Sinelnikov, Atlas anatomii.
Margo linguae Glandula ingualis anterior N. Cavity of mouth cavum oris ; anterior aspect Vi. The tongue is raised; areas of the mucous membrane are removed on the left; the sublingual gland glandula sublingualis and the anterior lingual gland glandula lingualis anterior can be seen.
The superior, dorsal surface is called the dorsum of the tongue dorsum linguae and is convex longitudinally and transversely. A longitudinal median sulcus of the tongue sulcus medianus linguae divides the body of the tongue into a right and a left part.
Corre sponding to this sulcus there is a connective-tissue plate, the sep tum of the tongue septum linguae , within the tongue. The body of the tongue is bounded on each side by the margin of the tongue margo linguae.
The inferior surface of the tongue fades inferior linguae is free only in the anterior part. Its mucous membrane is smooth and has two fimbriated folds plicae jimbriatae which converge anteriorly. O n either side of it, on the floor of the cavity of the mouth, is a small round elevation called the sublingual papilla caruncula sublingualis Fig. Posteriorly and laterally of the sublingual papilla the mucous membrane covers the sublingual gland and forms a longitudinal sublingual fold plica sublingualis Fig.
Tunica mucosa linguae M. Foramen caecum linguae Uvula palatina Ductus lingualis remnant of ductus thyroglossus Pharynx. T h e styloglossus muscle muscutus styloglossus Figs , , arises from the slyloid process and the stylohyoid ligament, passes obliquely downwards, anteriorly, and medially between the slylohyoid muscle and the pharynx, and adjoins the lateral surface of the root of the tongue and the lateral surface of the hyoglossus muscle.
Its thicker upper bundle runs along the lateral. Muscles of tongue musculi linguae , right side; lateral aspect Vi. T h e hyoglossus muscle musculus hyoglossus Figs , is flat and quadrangular and is situated laterally of the gemoglossus muscle. It arises from the superior border of the body and the greater horn of the hyoid bone. Its fibres pass upwards and anteri orly towards the lateral margins of the root and body of the tongue where they run between the styloglossus and inferior longitudinal muscles and reach the lip of the tongue.
T h e genioglossus muscle musculus genioglossus Figs lies t o both sides of the septum of the tongue. O n arising from the spina mentalis genial tubercle of the mandible ils fibres radiate tnwaids the mUCOUS m n n b n u i c ol the Unique.
T h e chondroglossus muscle musculus ckondroglossus arises by a small muscular slip from the lesser horn of the hyoid bone and is interlaced into the dorsum of the tongue. Apex linguae M. T h e inferior longitudinal muscle of the tongue musculus lon gitudinalis inferior Figs , is long and narrow and lies in the tongue lateral of the genioglossus muscle.
It arises from the mucous membrane of the root of the tongue and passes directly to the front to the tip of the tongue on whose inferior surface it termi nates. It lies first between the hyoglossus and genioglossus muscles and then between the styloglossus and genioglossus muscles. T h e superior longitudinal muscle of the tongue musculus longitudinalis superior Fig. T h e three slips converge and pass immediately under the mucous membrane along the whole dorsum of the tongue to its tip, interlacing with one another.
T h e transverse muscle of the tongue musculus transversus linguae Figs , lies along the whole length of the tongue. It consists of separate transversely directed muscle fibres arising.
T h e vertical muscle of the tongue musculus verticalis linguae. Its short muscle fibres lie in the free part of the tongue between its dorsum and inferior surface. The roughness is produced by the large number of small elevations called the lingual papillae papillae linguales Fig. The filiform papillae papillae filiformes occur on the whole body of the tongue and lend its mucous membrane a velvety ap pearance.
These are structures composed of a conical bod on whose apex are brush-shaped appendages of epithelium Fig.
T h e filiform papillae are most pronounced in the middle of the dorsum of the tongue and in the vicinity of the vallate papillae papillae vallatae. The fungiform papillae papillae fungiformes , to in number, are scattered mainly on the dorsum of the tongue nearer to its margins but are rarer in its median parts.
They are cone-like projections larger than the filiform papillae and are therefore well detectable among them. O n the margins of the tongue they are very flattened. The vallate papillae papillae vallatae are the largest but are hardly elevated above the surface.
There are from 7 to 11 of them arranged at the junction of the body with the root, to the front of and parallel to the sulcus terminalis. T h e central papilla is sur rounded by a ridge and is immediately in front of the foramen cae cum.
Each papilla is composed of a small cylindrical elevation sur rounded by a circular groove around which is a ridge of the mucous membrane. T h e folia linguae papillae foliatae are arranged on the la teral parts margins of the tongue. They consist of 5 to 8 folds which are separated by grooves; the folds run almost vertically in front of the palatoglossal arch. T h e folia linguae differ in size and are pronounced best in the posterior parts of the tongue. Very many lymphatic lingual follicles folliculi linguales of var ious size are arranged under the epithelium in the region of the root of the tongue to the epiglottis.
The aggregation of these folli cles is called the lingual tonsil tonsilla lingualis Fig.
The lingual glands glandulae linguales Figs , , A, B are grouped into mucous, serous, and mixed glands. T h e serous glands are in the region of the vallate papillae and the folia linguae.
T h e following glands are distinguished in the mucous and mixed groups. Its duct opens on the inferior surface of the tongue along the fimbriated fold. Besides, these glands may be arranged in small groups in the posterior part of the margin of the tongue in the styloglossus and palatoglossus muscles. Their ducts open in the folds of the folia linguae. They oc cupy the region of the lingual tonsil to the epiglottis.
Their ducts open in the grooves surrounding the follicles and even in the pit in the middle of the follicle. Three folds form where the mucous membrane passes over from the root of the tongue to the epiglottis. One of them is un paired and lies centrally; this is the glosso-epiglottic fold plica glossoepiglottiea mediana Fig. T h e paired fold stretches to the la teral border of the epiglottis and is called the pharyngo-epiglottic fold plica glossotpiglottica lateralis. Between these folds on each side is a depression called the vallecula epiglottica.
In the submucosa of the tongue are embedded a large amount of loose connective tissue and tendinous bands of the intrinsic muscles of the tongue, which form the aponeurosis of the tongue aponeurosis linguae in the aggregate. Vessels and nerves pass through the tongue.
Three of them are quite large paired organs: Glands of tongue specimens prepared by Ya.
Area of totally stained mucous membrane of the root of the tongue. Glands of tongue. Isolated glands of the region of the root from a totally stained mucous membrane of the tongue. Inferiorly it may come in con tact with the submandibular gland. Its deeply situated part is in re lation with the styloid process, the stylohyoid and styloglossus muscles as well as with the internal carotid artery and the internal jugular vein.
The gland is enclosed in the parotid fascia fascia parotidea which gives off processes penetrating between the lobules of the gland. The parotid duct ductus parotideus emerges from the upper part of the anterior border of the gland and runs almost horizonlally, parallel to the zygomatic arch, on the lateral surface of the masseter muscle; on reaching the anterior border of the muscle the duct passes through the buccal pad of fat corpus adiposum buccae.
An accessory parotid gland glandula parotis accessona varying in shape is situated along the length of the parotid duct Fig. T h e parotid gland is penetrated by the branches of the external ca rotid artery, the posterior facial vein, and small branches of the fa cial nerve. The superior surface of the gland comes into relation with ihe mylohyoid muscle, then the gland curves round the posterior bor der of the muscle to lie on its anterior surface and touches the posterolateral border of the sublingual gland.
Posteriorly the gland reaches the parotid gland and the medial pterygoid muscle. T h e submandibular duct ductus submandibularis passes on the medial surface of the sublingual gland forward and upward to open on the sublingual papilla caruncula sublingualis Fig.
T h e anterior end of the gland is in relation with the medial surface of the body of the mandible, the posterior end with the submandibular gland. Numerous short smaller sublingual ducts ductus sublinguales minores open along the sublingual fold plica sublingualis. Besides these small ducts, there is sometimes a principal sublingual duct ductus sublin gualis major ; it stretches on the medial surface of the gland and opens on the sublingual papilla either independently or alongside the submandibular duct.
T h e type of articulation between the tooth and the socket is called a peg-and-socket suture gomphosis which is related to fibrous joints junctura fibrosa. Glandulac palalinae Palatum durum Velum palatinum palatum mollc Arcus palatoglossus Tonsilla palatina. T h e teeth of a human erupt in two periods. T h e deciduous, or milk, teeth denies decidui erupt in the first period, the permanent teeth denies permanentes , in the second period.
Some teeth have only one root, others have more.
T h e bulk of the tooth is composed of dentine dentinum. The dentine of the crown is coated with enamel cnamelum , that of the neck and root, with cement cementum. T h e root of the tooth is surrounded by the alveolar periosteum periodontium holding the root securely in the socket.
Besides, the. T h e crown of the tooth contains the cavity of the tooth cavum dentis which is continuous with a narrow root canal of the tooth canalis radicis dentis. O n the root apex apex radicis dentis there is a small root foramen foramen apias radicis dentis transmitting vessels and nerves into the cavity of the tooth which contains the pulp of the tooth pulpa dentis. T h e pulp of the crown pulpa coronale and the pulp of the root pulpa radicularis are distinguished.
According to the shape of the crown, the teeth are grouped into incisor teeth denies incisivi , canine teeth denies canini , premo-.
Maxillary and mandibular teeth, permanent dentes permanentes Qlx. The following surfaces are distinguished in the crown of the tooth: They are smaller than the respective permanent teeth; their crowns are relatively wider and shorter while the roots are. Permanent single-root tooth represented semischematically. Vertical section. Permanent double-root tooth represented semischematically.
Deciduous teeth denies decidui of right side. Amaxillary teeth; B mandibular teeth 1medial incisor, veslibular facial surface 2 medial incisor, culling edge 3 lateral incisor, veslibular facial surface 4lateral incisor, cutting edge 5canine tooth, vestibular facial surface 6canine tooth, culling edge 7 6rst molar, veslibular facial surface 8 first molar, occlusal surface 9second molar, veslibular facial surface 10second molar, occlusal surface.
There are no premolars among the deciduous teeth. T h e deciduous teeth formula. O n each half of the maxilla are 2 incisors, 1 canine, 0 premolars, 2 molars: Each half of the mandible has 2 incisors, 1 canine, 0 premolars, 2 molars; 10 leeth on ihe whole jaw. Some of them erupt in addition to the 20 deciduous teeth, others replace the lost deciduous teeth. T h e permanent teeth formula.
Each half of the maxilla has 2 incisors, 1 canine, 2 premolars, 3 molars; 16 teeth on the whole jaw. Each half of the mandible bears 2 incisors, 1 canine, 2 premolars, 3 molars; 16 teeth on the whole jaw. Dens incisivus superior lateralis Dens incisivus superior mcdialis Facies vestibularis facialis Dens incisivus inferior medialis Canalis mandibulae Dens incisivus inferior lateralis Dens caninus inferior Dentes pre molares.
Permanent maxillary and mandibular teeth of right side; lateral aspect! Canalis mandibulae opened Denies molares Dens incisivus inferior lateralis Dentes premolares Dens caninus inferior. T h e crowns of the teeth are shaped like a chisel with a sharp cul ling edge. T h e vestibular surface of the crown is slightly convex. O n the lingual surface, at the neck, is the tubercle of the tooth tuberculum coronae dentis.
T h e contiguous surface is triangular be cause the crown is narrow at the cutting edge but becomes thicker towards the neck. The upper maxillary incisors are larger than ihe lower mandibular ones.
T h e upper medial incisors are the largest. The root is conical and compressed from the sides. Its sides bear poorly pronounced longitudinal grooves. T h e following three signs are used to distinguish the teeth of the right side from those of the left side: In the incisors these signs are manifested as follows: T h e root sign is clearly pronounced in the upper incisors but is inconstant in the lower ones. T h e canine teeth dentes canini Figs , 4 in number, are arranged one on each side immediately distal of the incisors on each jaw.
They are distinguished by a long root and a conical crown. Like in the incisors, the crown has four surfaces. T h e ves tibular facial surface is convex, pentagonal, and is widest be-. Dens incisivus medialis Margo jncisivus Dens incisivus lateralis Dens caninus Dens premolaris 1 Dens premolaris 11 Densmolaris 1 F-ides occlusalis.
The lingual surface bears at the neck a well pronounced tubercle which is continuous with a longi tudinal elevation passing to the mesial angle of the cutting edge. The tubercle is not pronounced on the lower canine tooth.
T h e cutting edge is formed of two segments meeting at an angle; the contiguous surface is triangular. A canine tooth has a single root, which is compressed on the sides and has longitudinal grooves on the distal surface.
T h e root apex is slightly inclined distally laterally. The upper canine teeth are distinguished from the lower ca nines by a larger size, a wider crown, and a longer root. The deciduous canine teeth greatly resemble the permanent canines; their roots are curved and directed towards the first mo lar.
The premolar teeth denies prcmolares Figs , 8 in number, are set 2 on each side distally to the canine tooth on each jaw. The occlusal surface is almost quadrangular in shape and is divided by a groove into two eminences, or cusps. T h e buccal cusp is developed stronger than the lingual cusp. These masticating cusps are more massive on the upper teeth and are separated one from the other more distinctly. T h e premolars usually have a. T h e root of the lower teeth is conical, the root of the upper teeth is slightly compressed anteroposteriorly and has longitudinal grooves on the anterior and posterior surfaces.
T h e upper first premolar contains two canals in its root, one buccal and the other lingual. T h e molar teeth denies molares Figs , 12 in num ber, are set distal of the premolars, 3 on each side of each jaw. The last molar is called the dens serotinus wisdom tooth.
T h e crown is cubic. T h e occlusal surface of the upper molars is divided into four cusps by grooves which form the letter H two buccal and two lin gual cusps. Each upper molar tooth has three roots: T h e size of the upper molars diminishes from the first to the third tooth.
T h e third molar tooth, dens serotinus, is the smallest and va ries both in the shape of the crown and the number of roots, which may be more, or less, than three. T h e cavity of the tooth is large and continues into each cusp. Each root has a separate canal. The lower molars are larger than the upper molars and two grooves divide their occlusal surface into four cusps. Two cusps. Only the first molar has five cusps, three of which are at the buccal edge.
T h e lower third molar, just like the upper third molar, is extremely var iable. Each lower molar has two roots, anterior and posterior, which arc compressed anteroposteriorly. T h e anterior root is almost verti cal while the posterior root is directed to the back. T h e cavity of the tooth follows the outlines of the crown and continues into each cusp. Two canals are present in the anterior root and one canal in ihe posterior root. T h e size of the lower molars, like that of the upper molars, re duces from the first to the third tooth.
T h e deciduous molars, 8 in number, are shaped like the per manent molars. In nervation: Amaxillary teeth; B mandibular teeth 1medial incisor, mesial surface 2 lateral incisor, mesial surface 3 canine, mesial surface 4 first premolar, mesial surface 5 - s e c o n d premolar, mesial surface 6 first molar, mesial surface 7second molar, mesial surface 8 third molar, mesial surface.
Amaxillary teeth; B mandibular teeth Section of each tooth is made in the direction from the vestibule of the mouth to the tongue. Tin- term bite indicates the relationship between the superior dental arch farcus dentalis superior and the inferior dental arch orcus dentalis inferior when the teeth are brought together into occlu sion Figs , 4 2 1 , 4 2 2.
In occlusion the teeth of one jaw come in contact with their fel lows of the other jaw; each maxillary tooth also comes in contact with the tooth set laterally of the fellow mandibular tooth; each mandibular tooth, in contrast, comes in contact with a maxillarv.
Contacting corresponding teeth are called principal antagon ists, teeth coming partly in contact with noncorresponding teeth are known as accessory antagonists. The lower medial incisors and the maxillary third molars have no accessory antagonists. When the teeth are in occlusion the maxillary incisors partly overlap the mandibular incisors and j u t out over them as a rule.
Al the same time the pharynx is the pathway for air from the cavity of the mouth into the larynx and in the opposite direction.
T h e pharynx is situated in front of the cervical segment of the vertebral column, its posterior wall adjoining the prevertebral fas cia, and stretches from the base of the skull to the level of the sixth cervical vertebra where it narrows and is continuous with the oeso phagus.
T h e pharynx communicates widely with the cavities of the nose, mouth, and larynx which are in front of it. T h e pharynx is cm long. Its upper wall, called the pharyngeal fornix fornix pharyngis , is attached to the external surface of the base of the skull from the pharyngeal tubercle and then, lateral of it for the distance to the carotid canals, and then anteriorly to the base of the medial pterygoid plate.
A maxillary teeth; B mandibular teeth 1medial incisor, vestibular facial surface 2medial incisor, cutting edge 3lateral incisor, vestibular facial surface 4lateral incisor, cutting edge 5canine, vestibular facial surface 6canine, cutting edge 7 first premolar, vestibular facial surface 8 first premolar, occlusal surface 9second premolar. The lateral walls of the pharynx come into relation with the common and internal carotid arteries, internal jugular vein, nerves, the greater horns of the hyoid bone, and the lamina of the thyroid cartilage.
The upper part of the pharynx is poorly mobile because it is fused with some of the bony structures of the skull; the lower part is very mobile due to the well developed loose areolar tissue sur rounding it and filling the peripharyngeal space spatium peripharyngeum. This space is bounded medially by the levator veli palatini and tensor veli palatini muscles, the superior constrictor.
T h e peripharyngeal space is limited by the base of the skull su periorly and by the fascial sheath of the salivary submandibular gland inferiorly. T h e peripharyngeal space is divided in turn into the retrophar-. Palatum durum Sinus frontalis Concha nasalis media Concha nasalis inferior Velum palatinum Concha nasalis superior Concha nasalis suprema Apcrtura sinus sphenoidalis Sinus sphenoidalis Sulcus nasalis posterior Plica salpingopalaiina Oslium pharyngeum ubac Tonsillapharyngea Cavum oris Recessus pharyngeus Torus tubarius Arcus atlantis Vestibulum oris Pars nasalis pharyngis Plica salpingopharyngea Uvula palatina Arcus palatoglossus Tonsilla palatina M, genioglossus Arcus palatopharyngeus Pars oralis pharyngis Epiglottis M.
Cavity of pharynx cavum pharyngis , right side; medial aspect 2A Sagittal section to the right of the septum of the nose.
The retropharyngeal space spatium retropkaryngeum is a slit si tuated posteriorly of the pharynx and filled with areolar tissue. It is limited anteriorly by the buccopharyngeal fascia fascia buccopkaryngea covering the pharynx and posteriorly by the prevertebral fascia lamina prevertebralis fasciae cervicalis.
T h e lateral peripharyngeal space spatium lateropharyngeum is found on each side; it is filled with areolar tissue. It is situated la terally and a little to the back of the lateral wall of the pharynx, which is covered by the buccopharyngeal fascia, and medially of the ramus of the mandible, the medial pterygoid muscle, the proxi mal parts of muscles arising from the styloid process, and the pa-.
Each lateral peripharyngeal space contains the internal jugular vein and the internal carotid artery which are embedded in areolar tissue. Three parts are distinguished in the cavity of the pharynx: The upper part of the pharynx is situated between the pharyngcal fornix fornix pharyngis and the soft palate. T h e two posterior apertures of the nose choanae communicating with the cavity of the nose open into the front of the nasal part.
O n the lateral wall of each nasal part is a funnel-shaped pharyngeal opening of the pharyngotympanic tube ostium pharyngeum tubae auditivae through which it communicates with the cavity of the middle ear.
These openings are on a level with the attachment of the posterior end of the inferior nasal concha. The middle part of the pharynx extends from the soft palate to the inlet of the larynx. The posterior wall of this part corresponds to the third cervical vertebra.
During swallowing it is separated from the upper part by the soft palate which takes a horizontal po sition. On the anterior wall of this part is the oropharyngeal isth mus isthmus faucium by means of which it communicates with the cavity of the mouth.
T h e lower part of the pharynx stretches behind the larynx from the level of its inlet to the inferior border of the cricoid cartilage at whose level it is continuous with the oesophagus. T h e posterior wall of the lower part corresponds to the fourth, fifth, and sixth.
O n the anterior wall is the inlet of the larynx aditus laryngis through which the laryngeal part of the pharynx communicates with the cavity of the larynx cavum laryngis. T h e wall of the pharynx consists of three coats: Between the muscular and mucous coats is the submucous coat tela submucosa which is characterized by the presence of fibrous tissue.
T h e adventitious connective-tissue coat of the pharynx tunica adventitia pharyngis is a continuation of the buccopharyn geal fascia fascia buccopharyngea covering the buccinator muscle and is in turn continuous with the adventitious coat of the oeso phagus. Between the adventitious coat of the pharynx and the ad joining organs is a layer of loose connective tissue which is espe cially developed between the posterior wall of the pharynx and the prevertebral fascia.
It is called here the retropharyngeal areolar tis sue and fills the retrovisceral space spatium retrovisceraU. T h e muscular coat of the pharynx tunica muscularis pharyngis , or the muscular layer, is formed of five layers of striated muscles. T h e three pairs of constrictors of the pharynx meet posteriorly on the midline and partly pass over to the contralateral side and interlace with a longitudinal connective-tissue band arising from the phar yngeal tubercle tuberculum pharyngeum and called the raphe of the pharynx raphe pharyngis.
The superior constrictor muscle of the pharynx musculus constrictor pharyngis superior Figs is a quadrangular sheet. It arises from several areas according to which the following four parts or muscles are distinguished in it: The muscle fibres pass horizontally on the lateral wall of the pharynx to the posterior wall to meet with the fibres of the contralateral muscle in the raphe of the pharynx. T h e upper border of the muscle does not reach the base of the skull and the area of the pharyngeal wall devoid of the muscular coat consists of a thick ened submucous framework of the pharynx called the pharyngobasilar fascia fascia pharyngobasilaris.
The middle constrictor muscle of the pharynx musculus con strictor pharyngis medius Figs consists of the following two parts or muscles: T h e muscle is a triangular sheet whose base is on the raphe of the pharynx while the apex faces the hyoid bone.
Its upper fibres partly cover the superior constrictor muscle of the pharynx. T h e inferior constrictor muscle of the pharynx musculus con strictor pharyngis inferior Figs is flat and covers partly the middle constrictor muscle of the pharynx.
It consists of two parts or muscles: Tuber maxillae Ductus parotideus Lamina lateralis processus pterygoidei Hamulus pterygoidcus M. Pars pterygopharyngea m. Tuber maxillae M. Pars thyropharyngea m.
The stylopharyngeus muscle musculus stylopharyngeus Figs is narrow and long and arises from the styloid pro cess, runs downwards on the wall of the pharynx, penetrates it be tween the superior and the middle constrictor muscles of the pha rynx, and separates into fibres some of which blend with the wall of the pharynx and the others reach the cartilages of the larynx.
T h e palatopharyngeus muscle musculus palatopharyngeus Fig. The posterior pharyngeal wall is opened by midsagittal incision, the mucous membrane is removed.
Its upper, thickest part is called the pharyngobasilar fascia fascia pharyngobasilaris and is attached to the external surface of the base of the skull. Lymph glands embedded under the mucous coat form accumulations of lymphoid tissue on the posterior wall of the upper pharynx and at the openings of the pharyngotympanic tubes the nasopharyngeal tonsil tonsilla pkaryngea Fig.
T h e lingual, palatine, tube, and nasopharyngeal tonsils form a lympho-epilhelial ring Waldcyer's tonsillar ring. T h e mucous coat membrane of the pharynx tunica mucosa.
Posterior pharyngeal wall is opened by midsagillal incision. T h e mucous coat is covered by stratified ciliated epithelium in the upper part of the pharynx and with stratified squamous ep ithelium in the other parts. It is closely fused with the mucous coat. In the upper part of the pharynx, in the region of the pharyn geal opening of the pharyngotympanic tube ostium pkaryngeum tu bae auditivae Figs , the mucous membrane forms two folds which meet at the opening.
T h e cartilage of the pharyngo tympanic tube, which forms the tubal elevation torus tubarius , is embedded in one of them. This fold is continuous downwards with a gradually thinned out mucous salpingopharyngeal fold plica sal-. Pharyngeal glands specimen prepared by V. Group of glands from totally stained wall of whole pharynx. A short salpingopalatine fold plica salpingopalatinaj stretches from the second fold to the soft palate. Posteriorly of the lubal elevation is a small cavity called the re Pharynx pars laryngea cess of the pharynx recessus pharyngeus.
In an adult the junction between the pharynx and the oesophagus corresponds to the level of the sixth cervical vertebra or the inferior border of the cricoid cartilage. The junction with the stomach is projected on a level with the eleventh thoracic vertebra. In the newborn the be ginning of the oesophagus is on a level with the fourth or fifth cer vical vertebra while the end is on a level with the eleventh thoracic vertebra.
These boundaries may alter in a living human when he flings back his head or takes a deep breath, and in a person with gastroptosis. The oesophagus is 10 to 16 cm in length in the newborn, 20 cm by the age of 2 years, and up to 25 cm in an adult. A small part of the oesophagus is situated in the region of the neck, after which it descends through the inlet of the thorax apertura thoracis superior into the thoracic cavity, passes in it, and then leaves il through the oesophageal opening of the diaphragm hiatus esophageus diaphragmatis to enter the cavity of the abdomen and to be continuous with the cardiac portion of the stomach.
In view of this, the following three parts are distinguished: The cervical part of the oesophagus stretches from the level of the sixth cervical vertebra to that of the first or second thoracic vertebra. Its length ranges from 5 to 8 cm. The thoracic part is the longest, measuring 15 to 18 cm, and ends on a level with the tenth or eleventh vertebra, i. The abdominal part of the oesophagus is the shortest and its length varies from 1 to 3 cm.
At the junction with the stomach the oesophagus is slightly dilated. T h e oesophagus stretches in front of the vertebral column and forms four curves: The beginning of the oesophagus is almost strictly on the midline but at the level of the second thoracic vertebra it deviates to Middle aortic constriction of oesophagus Pars ihoracica.
Oesophagus; right side radiograph. At the level of the fifth vertebra it again stretches on the midline but distally deviates to the right, be ing pushed aside by the aorta. T h e curve to the right extends to the level of the eighth thoracic vertebra. Running downwards the oeso phagus again deviates to the left at the level of the eighth to ninth vertebrae, where it passes through the diaphragm.
The lumen of the oesophagus varies along its length and three constrictions and two dilations are distinguished in it. T h e first constriction is where the pharynx is continuous with the oesopha gus, the second is where the oesophagus is related to the aorta, and the third constriction is at the site of its passage through the oesophagcal opening of the diaphragm.
Between these constrictions are two dilations. The oesophagus comes into relation with a series of organs. T h e posterior surface of the cervical part of the oesophagus lies on the prcvertebral fascia to which it is joined by areolar tissue; the anterior surface is related to the membranous wall of the trachea.
O n both sides the oesophagus is approached by the common ca rotid arteries and the reccurrent laryngeal nerves. T h e posterior surface of the thoracic part of the oesophagus also stretches along the vertebral column while the upper third of the anterior surface is related to the membranous wall of the tra chea. O n the level of the fourth-fifth vertebra the oesophagus crosses the arch of the aorta below which it is related to the poste rior surface of the left bronchus to which it is connected by a poorly developed broncho-oesophagcal muscle musculus bronchoesopkageus.
Oesophageal glands specimen prepared by F. Group of glands from totally stained wall of whole oesophagus. Oesophageal gland specimen prepared by F. Gland isolated from totally stained wall of whole oesophagus. The lower third of the oesophagus comes in contact with an area of the pericardium corresponding to the left atrium and left ventricle, then runs downwards, curving spirally about the aorta, and continues as the abdominal part which is covered in front by an area of the left lobe of the liver.
T h e wall of the oesophagus consists of three coats: The mucous coat of the oesophagus tunica mucosa esophagi is covered by stratified squamous epithelium. It is formed of areolar tissue and a well developed lamina muscularis mucosae of smooth fibres whose role consists in contracting the mucous coat during constriction of the oesophagus. O n a transverse section the oesophageal lumen is seen as a stel late slit due to the compressed walls and the well-pronounced lon gitudinal folds.
T h e size of the folds is linked with the strongly de veloped areolar tissue forming the submucous coat of the oesophagus tela submucosa esophagi situated between the mucous and muscular coats.
T h e submucous coat contains many vessels. The muscular coat of the oesophagus tunica muscularis esophagi consists of two layers: Vascular and nerve networks are lodged in the loose connec tive tissue between the layers. T h e muscular layers are represented in the upper third of the oesophagus by striated musculature, in the middle third by stri ated and smooth musculature, and finally, in the lower third by smooth musculature alone. The layers of muscles are developed irregularly.
T h e longitudi nal muscles for instance, are composed of longitudinal fibres form ing two bands in the upper part of the oesophagus which are in serted into the cricoid cartilage of the larynx. An area devoid of the longitudinal layer remains therefore in the initial part of the oesophagus. T h e circular layer of the oesophageal wall is con nected with the muscles of the pharynx in the upper p a n s and is continuous with the circular and oblique fibres of the muscular.
A poorly-developed longitudinal layer lying innerly of the circular layer can be seen at places along the length of the oesophagus. The muscular coat of the oesophagus gives off processes which as slips connect it to the adjoining organs.
Where the oesophagus passes through the diaphragm its muscle fibres are closely joined to those of the diaphragm as a result of which a circular muscle re sembling a sphincter forms around the oesophagus. The adventitious coat of the oesophagus tunica adoentitia eso phagi is formed of loose connective tissue containing a few elastic fibres.
By means of this coat the oesophagus is attached to the. The main vessels supplying blood to the oesophagus, lymph vessels draining the oesophageal walls, as well as nerves forming plexuses pass within the adventitious coat.
Its long axis passes downwards from left to right and from back to front, almost in the frontal plane. The shape and size of the sto mach are quite variable and are determined by the degree of its filling, the functional condition of the musculature of its walls contraction, relaxation , distention of the large and small intes tine, and other factors.
The shape of the stomach also changes with age. It is usually compared to a retort placed upside down with the wide left part si tuated under the diaphragm and the narrow part, under the liver. The length of the stomach along its long axis measures 2 1 - 2 5 cm on the average. Its capacity reaches 3 litres. The stomach has several parts: The cardiac portion of the stomach, or cardia pars cardiaca ventriculi begins by an opening through which the oesophagus com municates with the stomach; this is the cardiac orifice ostium cardiacum.
The part of the stomach in close vicinity to the orifice is the cardiac portion. Jornix ventriculi. T h e largest and widest part is the body of the stomach corpus ventriculi which is continuous upwards with the fundus without any appar ent boundaries; as it stretches to the right it gradually becomes narrower to be continuous with the pyloric portion.
The pyloric portion of the stomach pars pylarica ventriculi is the distal part of the stomach immediately adjacent to the pyloric orifice ostium pyioricum by means of which the stomach communi cates with the duodenum. The pyloric portion consists of the pyloric antrum antrum py ioricum , which is the widest and contiguous with the body part, and a narrow part called the pyloric canal canalis pyloricus whose diameter is the same as that of the adjacent part of the small intes tine the duodenum.
The cardiac portion, fundus, and body make up that part of the stomach which stretches downwards and to the right; the py loric portion is the part which is directed upwards and to the right at an angle to the body of the stomach. At the junction with the pyloric antrum the body forms the lowest part of the cavity of the stomach. T h e described shape of the stomach is encountered more fre quently during X-ray examination and is compared to the shape of a fish-hook; another shape that can be seen on X-ray examination is that of a horn, in which case the body of the stomach lies almost transversely while the pyloric part is its continuation without angulation.
T h e surface of the stomach facing the front is the anterior wall of the stomach paries anterior ventriculi , that facing the back is the posterior wall of the stomach paries posterior ventriculi.
T h e upper border of the stomach at the junction of the anterior and posterior walls is concave, shorter, and forms the lesser curvaiure of the sto mach curvatura ventriculi minor. The lower border forming the lower junction of the walls of the stomach is convex and longer and is the greater curvature of the stomach curvatura ventriculi ma jor. At the junction of the body of the stomach with the pyloric portion the lesser curvature forms the angular notch incisura angulans while the greater curvature bears no noticeable marking here.
Only during the digestion of food the body is separated from the pyloric portion antrum by a deep fold, which can be seen on Xray. This constriction is usually seen on a cadaver also. T h e greater curvature bears the cardiac notch incisura cardiaca separating the cardiac portion from the fundus.
T h e wall of the stomach consists of three coats: T h e serous coat of the stomach tunica serosa ventriculi Fig. Only narrow bands on the lesser and greater curvatures remain uncovered where the. Stomach radiograph. Along the curvatures between the sheets of peritoneum pass blood and lymph vessels, the nerves of the stomach, and regional lymph nodes are invested.
A small area of the posterior wall of the stomach to the left of the cardiac portion, where the wall is in contact with the dia phragm, is not covered by the peritoneum. A peritoneal fold aris ing from the extreme left part of the lesser curvature passes to the diaphragm; this is the gastrophrenic ligament ligamentum gastrophrenicum.
Its right segment runs to the inferior surface of the. These three ligaments make up the lesser omentum amentum minus. The peritoneal fold arising from the greater curvature on the left side connects the fundus of the stomach with the spleen and is known as the gastrosplenic ligament ligamentum gastrolienale see Fig.
From the grea ter curvature of the body of the stomach and the pyloric portion. Below the level of the transverse colon this liga ment descends in front of the intestinal loops to the true pelvis and thus forms the anterior two layers of the greater omentum omfKtum majus see Fig.
The muscular coat of he stomach tunica muscularis ventriculi; consists of three layers: Muscular coat of stomach and duodenum tunica muscularis ventriculi et duodeni V 2. Serous coat is removed. Where the body of the stomach is continuous with the pyloric portion the fibres of the Iongitudinal layer spread out fanwise on the anterior and posterior walls of the stomach and interlace with the fibres of the next, circular layer. In the region of the greater curvature and fundus the. It is an uninterrupted layer enclosing the stomach completely and is less developed in the re-.
Mucous and submucous coats are removed. The inner layer is formed of oblique fibres fibrae obliquae Fig. T h e muscular bundles embrace the cardiac portion of the stomach like a loop and pass over to the anterior and posterior.
Contraction of this muscular loop is just what is responsible for the presence of the cardiac notch incisura cardiaca. In the vicinity of the lesser curvature the oblique fibres change to longitudinal. The mucous coat, or membrane, of the stomach tunica mucosu ventriculi is a continuation of the mucous coat of the oesophagus.
An easily detectable serrated line is the boundary between the epi-. Mucous coat membrane of stomach tunica mucosa ventriculi ; inner surface of posterior wall 'A. A fold of mucous membrane is always present at the level of the pylorus corresponding to the position of the sphincter.
The mucous coat of the stomach is 1. It forms very many gastric folds plicae gastricat , mainly on the posterior wall. T h e folds differ in length and direction: The folds on the other areas of the wall vary greatly in direction, and longer folds connected to one another by shorter folds are distinguished. T h e direction and number of longitudinal folds are more or less constant and in a living person are easily detected on X-ray exami nation with contrast media.
When the stomach is distended the folds are smoothed out. Glands of mucous coat of stomach specimens prepared by V. Aregion of lesser curvature, middle parts year-old boy. B region of lesser curvature, nearer to pylorus year-old boy. Photograph, x Area of totally stained mucous coat of stomach. The mucous coal of the stomach has its own lamina muscularis mucosae and is separated from ihe muscular coal by a well de veloped loose submucous coat tela submucosa ; these two coats are responsible for the formation of ihe folds.
The mucous coat of ihe stomach is divided into small, I to 6 mm in diameter, gastric areas areae gastricae Fig. The foveolae are surrounded by villous folds plicae villosae which are most pronouced in the region of the pylorus. One or two ducts of the gastric glands open in each foveola. Gastric glands proper glandulae gastricae propriae occurring in the region of the fundus and body and consisting of chief and parietal cells, and pyloric glands glandulae pyloricae , consisting of chief cells alone, are distinguished.
Gastric lymphatic nodules folliculi lymphatici gastrid are embedded in the mucous coat predominantly in the pyloric portion. Topography of ihe stomach. The greater p a n of the stomach is situated to the left of the midplane of the body, occupying the left hypochondric and epigastric regions. Skeletopically, the entry into the stomach is lo the left of the vertebral column on a level with the tenlh or eleventh thoracic ver tebra; the exit is to the right of the vertebral column on a level with the twelfth thoracic or first lumbar vertebra.
The upper vertical in a horn-shaped stomach part of the lesser curvature stretches along the lefl border of the vertebral co lumn, the lower part crosses the vertebral column from left to right. The posterior wall of the stomach in the region of the fundus is in relation with the spleen; the other parts of ihe posterior wall ad join organs situated at the back of the abdomen: The stomach is displaced during respiration and when the ad jacent hollow organs the transverse colon are filled.
The cardiac and pyloric portions of the slomach are less mobile, ihe other por tions are distinguished by considerable ability to displace. T h e fundus of the stomach is below the dome of the left half of the diaphragm. The lesser curvature and upper portion of the an terior wall are in relation with the inferior surface of the left lobe of the liver.
T h e anteroinferior surface of the body and pyloric portion adjoin the costal part of the diaphragm and the anterior abdominal wall corresponding to the epigastrium. T h e left part of the greater curvature is related to the visceral surface of the spleen; the other parts, stretching to the right, are in relation with the transverse colon.
If the stomach is horn-shaped and its position is more horizon tal, the greater curvature lies on a level with a line connecting the ends of the tenth ribs or on a level with the umbilicus.
T h e age features of the shape and position of the stomach are as follows: The stomach of infants is pear-shaped and situated at a higher level because it is usually displaced by the inflated intesti nal loops. Later ihe slomach gradually takes a more horizontal po sition. T h e stomach of infants is almost completely covered by the liver. T h e lymph is drained from the walls of the slomach into the regional lymph nodes situated on the lesser and greater curvatures.
The small intestine is made up of three parts: T h e two last-named constitute its mesenteric part mescnterial inlestine. T h e small intestine is the longest up to 5 m portion of the di gestive tract; its mesenteric part occupies almost the whole lower storey of the abdominal cavity and partly the cavity of the true pel vis. Its diameter is irregular, measuring 4 - 6 cm in the proximal and 2.
T h e duodenum is characteristically almost entirely retroperitoncal while the mesenterial intestine is intraperitoneal and has a mesentery mesenterium. It stretches from the pylorus of the stomach from left to right and to the back, then curves downwards and descends in front of the right kidney to the level of the second or upper part of the third lumbar vertebra; here. Small intestine intestinum tenue V2. Loop of mesentcric part of. Thus, the duodenum forms as if a horseshoe or an incomplete ring embracing the head and partly the body of the pancreas superi orly, on the right side, and inferiorly.
T h e superior flexure of the du odenum flexura duodeni superior forms at the junction of the first and second parts; the inferior flexure of the duodenum flexura du.
The duodenum is cm long. Its diameter is biggest in the second part where it measures 4. T h e first part adjoining the pylorus is dilated and because of the shape of its X-ray image is known as the duodenal bulb. T h e duodenum is slightly constricted in the middle of the second part, where the right colic artery crosses it, and at the junction of the third and fourth parts, where it is crossed by the descending superior mesenteric vessels.
T h e wall of the duodenum consists of three coats: Only the initial portion of the first part for a length of 2. Duodenal glands specimen prepared by L. Group of glands from totally stained duodenal wall. Duodenal gland. Gland isolated from totally stained duodenal wall. Segment of the jejunum, opened for a greater p a n of its length; the serou: Mucous coat of small intestine V,. Segment of the ileum partly opened along the mesenteric border. Villi of ileum represented schematically. Arterial vessels are coloured red, venousblue; lymph vessels are yellow.
The muscular coat of the duodenum tunica muscularis duodent is 0. It is made up of two layers of smooth muscles: T h e mucous coat, or membrane, of the duodenum tunica mucosa duodenij is composed of an epithelial layer with an underlying connective-tissue lamina muscularis mucosae and a layer of submucous areolar tissue separating the mucous coat from the muscu lar.
T h e mucous membrane forms longitudinal folds plicae longit udinals in the first part of the duodenum and circular folds plicae circulares in the second and third parts. T h e circular folds are al ways present and occupy one half or two thirds of the duodenal. In the lower half of the second part of the duode num less frequently in the upper half on the medial area of the posterior wall stretches the longitudinal fold of the duodenum plica longitudinalis duodeni ; it is up to 11 mm long and ends distally by an elevation called the greater duodenal papilla papilla du odeni major on whose apex are the orifice of the common bile duel and the pancreatic duct see Fig.
A little above it on the apex of the lesser duodenal papilla papilla duodeni minor opens an in constant accessory pancreatic duct. The mucous membrane of the duodenum, just like that of the other parts of the small intestine, forms on its surface finger-like projections called intestinal villi villi intestinales Fig. There are up to 40 of them per 1 m m , which lends the mucous mem brane a velvety appearance.
The duodenal villi are foliate, their height ranges from 0. The villi in the jejunum are cylindrical; those in the ileum are club-like. In the central part of each villus is a lymphatic lacteal vessel. Blood vessels stretch through the entire thickness of the mucous membrane to the base of the villus, penetrate it, branch out to form capillary networks, and reach the apex of the villus Fig.
T h e mucous membrane forms pits around the base of the villi; these are called crypts and the orifices of the intestinal glands glandulae intestinales open on them. T h e glands have the shape of straight tubules whose floor reaches the lamina musculai is inucosae. T h e mucous membrane of the duodenum, the villi, and of the crypts is lined with simple prismatic or cylindrical bor dered epithelium with an admixture of goblet cells; cells of glandu lar epithelium are present in the deepest part of a crypt.
In preparing every new edition extensive research was carried out to supplement and improve the matenal of the book and to update it on the basis of the achievements of modem anatomical science.
Up till work on the Atlas was conducted by R. Sinelnikov with the collaboration of Ya. Sinelnikov and in recent years only by Ya.
Several new drawings have been added to this edition and new sections introduced pertaining to age features, particularly to those of children.
To bring the fundamental theoretical discipline, which is what human anatomy is, closer to clinical practice, much space among the illustrations has been allotted to radiographs. Many drawings have been redrawn to show the anatomicai structures included in the new nomenclature, the text has been supplemented accordingly, and the subject index has been updated. The material is presented in line with the dialectical principles of studying the body as an organic whole with consideration of all the links binding its systems.
Special attention is focused on the data of macro-microscopic anatomy. The material in this edition is arranged in the following manner. The first volume consists of sections on osteology, arthroiogy and myology, The second volume is devoted to splanchnology and angiology.
The third volume provides descriptions of the nervous system, the sense organs and the endocrine glands. The sections on the science of the muscles and viscera point out the connection of every skeletal muscle and each internal organ with its nerves and vessels.