H A N DBO O K O F A N A TO M Y

A RT S TU DEN TS

A RTH U R TH O M S O N , M A . .
,
M E . .

R
P O F E S S O R O P B U U A N A N A IO U Y I N TH E U

NI I
V E R S TY O F OX FOR D ; A N D L BC I U R BR O N
' '

A NA TOH Y IN TH E N R II
A TIO N A L A RT T A N NG SC H OO L, KE N IN N
S G TO

W I 7 1! N UM E R O US I LL U S TR A TI O N S

QDx f o r b

AT TH E C LA R E N DO N PR E S S

1 89 6
 O xf o r b
PR I N T E D A T T H E C LA R E N D O N PR E S S

BY H O R AC E HA R T

PR IN R
TE 10 TH E U NI R I
VE S TY
 PR E F A C E

TH E xpe rie nce wh ich I have h ad asa te ache r an d my

e

acq u ai ntan ce an d ympathy w ith th e requ ire m entso f

s
stu d e nts o f A rt h ave le d m e to th e c o n cl u s i o n that hithe rto
to o m u c h s tre s shasbee n laid o n th e n o mencl ature an d
te chnical detail s o f H um an An at o my an d to o l i ttl e e m p h as
, is
pl ace d o n th e re l ati o n o f the s e d et a il sto th e s u rface f o rm s
.

W h at th e s tude nt requ ire sisn o t a minute de s c ri pti o n o f

e ve ry bo n e m u s
, c l e an d j o int
, but o n l y s
, uch an acco u nt
as will e nabl e hi m to appre ci ate th e ir inue nce o n th e
m o d ell ing o f th e gure N ame sco nve y little to h is
.

mi nd f o rmsal o ne inte res

,
t him .

I n th e f o ll o w i ng page sw h i ch ar e bas
,
e d o n th e l e ctu re s

w hi ch I have h ad th e h o no u r o f giv ing at th e A r t S ch o o l ,

S o u th K e ns ingto n I have e nd e av o ure d to ca rry o ut as

,
far

as po s sibl e th es e pr i nc i pl e s W ith thi s

. inte nti o n e ve ry
e o r t h as
'

be e n m ade to avo id unne ce s sary d e ta il , an d to

ri d th e te xt asfar asp o s i bl e o f te chni cal i ti e s W h e re

s .

there are E ngl is h equ ival ents f o r th e sc i e nti c t e rm s m o re

viii Pr ez ce .

co mm o nly e mpl o ye d th ey h ave be e n m ad e us

, e o f ; b ut

u nf o rtunate ly th e ir num be r isl im ite d an d th e s ,

tud e nt is
l e ft with n o o the r alte rnat ive than to accept th e s e i en

tic no m e ncl at u re .

In pl ace o f ad o p ting as , is us ual th e me tho d o f furnis

,
h
in g a co m pl e te d es c ri p ti o n o f th e bo n e s s ucce e d e d by an
,

e qu ally d e ta il e d acco unt o f th e j o ints an d m u s cl es I h ave ,

inco rp o rate d th e m in th e d es cri p t i o n o f r e gi o ns A s . e ac h

re gi o n a limb fo r ins
tance i s co ns ide re d its bo ne sj o ints
, , ,

an d m us cl e s ar e d e s c ri b e d i n s o f ar as th e y have s pe cial
re fe r nce to th e m o ulding o f th e s
e

u rface f o rms I n th is .

w ay it is ho pe d that th e s tude nt may attain a be tt e r gras p

o f th e s ubj ect th an by th e s tudy o f is o l ate d d e scr i pt io ns of

th e var i o us s tructu res invo lve d.

I n o rd e r to carry o ut s uch an ide a it wasnece s sa ry that

th e de s c r ipti o ns give n s ho ul d b e s uppl e m ente d by f re que nt

refe re nce to th e m o de l o r by co pi o usillus trati o n In th e .

p r es e nt w o rk p ho to graphy h asbeen e mplo ye d f o r this

pu rpo s e
. I am w ell aware o f th e dr awbackso f s u ch
a m e th o d yet i t s
,
e e ms to m e th at th e s e ar e co u nte rbal ance d

by th e truth o f th e re s ul ting gur e s Th e pl ate slay n o

.

c l ai m to arti s ti c e xcell e nce ; th e ir value de pe ndso n the ir

d e lity to na tu re . A rti s ,tsI f e el s u re w ill s , y m p athi z e

w i th m e in regard to th e d efe cts of s o m e o f the f o rms

re pre s e nte d , kno wi ng asthey d o h o w dif cult i t isto

o b tain un i ve rs al e xce ll e nce in a m o d e l A pa rt f ro m th e
.

p r o f es sio nal m o del se m plo ye d I am l argely indebt d to

, e

s o m e o f th e be tte r kn o w n at hle tes o f th i s U nive rs ity fo r

 Pr ef a ce .

the facili ti esw hich have e n abled m e to take th e pho to

r aphs F o r o b vi o us r s n s i t i s s
s ry f m t
g . e a o u nn ec e a o r e o

n a m e th es e ge ntl e m e n b ut I w is
, h no ne the le s sto ex pres s
my in de bte dn es sto th e m .

In th e pro duct io n o f m o s t o f th e k eys whi ch acco m pan y

th e pl ate s I have recei ved much valuable as sis ta nce f ro m
my fr ie nd an d pup il M r Cecil W Pilch e r B A o f K e bl e
, . .
, . .
,

Co ll e ge w h o h as
, a lso dr awn a f e w o f th e i ll u s trat io nsin
th e te x t :to hi m my bes t than ksar e d ue F o r the re s . t
o f th e gu re s I am al o ne re s po ns i bl e Two o r th re e h ave
.

be e n bo rro we d f ro m o the r s o urc es an d i n co n s

,
truc ting th e

platesillus tra ti ve o f th e e ntire s ke l e to n I have availe d

mys e l f o f th e p ro p o rti o ns l ai d d o wn by th e l ate Pro fe s sor

Jo hn M a rs hall in h is wo rk e ntitle d A R ule of Pr o po r tio n

,

f o r the H uma n F igu re . In the cuts w i th whi ch th e te xt is

i ll us trate d I have e nd e avo u re d to lay particula r s tre sso n
th o s e p o in ts whi ch a r e o f im po rtan ce to th e arti s t an d , ,

in s pite o f the ir s ho rtco mingsasdrawingsI trus , t th at

they m ay appe al to th e r ad e r o n acco unt o f the ir dire ct
e

ap pli cati o n to th e s ubj e ct -m atte r .

A w o rd o r tw o as to h o w th e s u bj e ct s h o uld b e s t u d i e d Le t .

th e s tud e nt in the rs t pl ace famili arize h i m s e l f with th e

f o rm s o f th e bo ne s by rap i d s ke tche so f the m in d i ff e re nt ,

po s i t i o ns E s
. pe cially isthi s n e ce s sary wh e re th e lim bs ar e

f o re s ho rte ne d H aving acquire d thi skno wl e dge le t him

.
,

the n pro ce e d to th e s tudy o f the m o d e l I t isho pe d that

.

with the a i d o f th e pl ate s an d th e ir acco m panying k e ys he

will b e abl e to de te rmine f o r h im s e l f th e f o rm a n d po s i ti o n

x Pr ef a ce .

of t u t r s whi h th s
s
th e r c u e urf nt ursd p n d
on c e ac e co o e e .

Assis t th y wh r p s e s
i bl w ith th h nd d by r pi d
e e e e o e e a ,
an a

and s u dd n h g sf p s
e iti n s t i pr is
c an e ly tho o o a ce r a n ec e e

n tu r f th und rlyi g
a e o es e n ca u e .

In n l u s i n I h v t th k P f s
co c o sr R H wd f
a e o an ro e o . o en , o

th U ni v rs
e ity f D urh m f th tr ubl
e o d r whi h a , or e o e an ca e c

h h s
e bs
a t w d th r vi s
e o l f th pr f s
e on h tss w ll
e e a o e oo - ee , a e

asf th m ny v lu bl hintsh h sgiv n m

or e a a a e e a e e .

A . T .
 C O N T E N TS

CHAPT E R I .

IN L U N
TH E P STU F E O RM CE M OF O RE ON TH E F OF AN .

s
E ly tt m p tst w lki g C v sf b k b V t b l l m
n ou

ar a e a a n ur e o ac - on e er e ra co u n

E t s spi
re c o re L i m b g i d l s P l vi g i d l T h i g h b
n ae r e e c r e - o ne

S k l t f l w li mb L g d f t Sh ld gi d l F m
e e on o o er e an oo ou e r - r e or

f h s
o ct Sk l t f pp l i mb Sk ll
e e e on o u er u

CHA PT E R II .

G E N E RA L D E S C R I PT I O N O H E BO N S A N O IN S F T E D J T .

Cl s
a si ti ca f b on s Ch s o t w ll J i ts M v b l
one j i ts e - a o n o a e o n

I mm b l j i ts
o va e o n

CHAPT E R III .

V RT E BRA L C OL U M N
E S PIN OE E .

Ver te b ra l col um Th v t b n C sfe er e ra e urv e o c o um nl C vs ur e

of b
ac k G v sf musl s E t s
roo e pi
or c e r ec o r n ae M v m ts f
o e en o

l
co umn 27 -
45

CHAPT E R I V .

TH nom x m s
E R E G I O N S TH LA N A TH E
r ,
or E F K ND

NT RI O R B OM IN L W A L
,

A E A D A L .

Ri b s B
stb
- Th x A t i bd m i l w ll Lum b
re a one o ra n er o r a o na a ar

a p u s
on e is E x t l b li q
ro R t s bd mi is C t
e rn a s o ue ec u a o n o n o ur

o f b d m i l w ll
a o F ld f g i D iff
na a sb tw m l d o o ro n e re n c e e een a e an

f m l
e Th
a e k A ti ef bd mi l musl s E ff t f
an c on o a o na c e ec o

mo vem ts t u sf b d mi
en l w ll
o n co n o r 46 73 o a o na a -
 Co n ten ts .

CHA PT E R V .

TH E S H O U L R GIR L M U SC L S W H I C H
DE - D E AND TH E E

N L U C S MOV M N TS I E EN E IT E E .

PAG E S

S h ul d gi d l C ll -b
o
e r- r S h ld b l d Gi d l swh l
e o ar on e ou er - a e r e a a o e

Di t d i di t ti f m sl T p i s Rh mb id s
re c an s
n r ec ac on o u c e ra ez u o o
A ti cf t p i sS
on o t s m g s A ti
ra ez uf s t s e r ra u a nu c on o e r ra u

m g us R t ti
a n f sp l o a H m s Sh ld j i t
on o ca u a u e ru ou -
er o n

L ti s
asi m sd s i P t l i sm j
u or Th b s ts D l t id
e c o ra a or e rea e o

A tic f th d l t id
on o l f spi et s d t
e sm
o i T s n ra - na u an ere nor e re

m j a or S m m y f th musl sf th b k
u ar o 74 e c e o e ac -
121

CH APTE R VI .

TH E U PP R E A RM .

Th e i
an n p t b hi li s H um e us B o eso f f ea m
C o rac o - rac a r n or r

Ul Ra di us E l b w j i t
na - F si f upp m B hi lis
o o n a c a o e r ar rac a

an ti us Bi p scub i ti
c T i ps A
ce us E xte al i t r ce n co n e rn n er

m us ula s
c ep tum l te al i te m us
r ul sptum
1 22 149
n rn n r c ar e

CHA PT E R VII .

TH O R - M E F E AR .

Pro n ati d s up i
on ti
an W is tj i t B s f th w i s
na on t -
r o n one o e r

M v m ts f th w is
o e en tj i t P
o t s d se pi t s r - o n ro n a o r an u na o r

M sl s t f
u c e f h - o m Fl x s t w i S p i l
e f h
o re a r s
t e or o e r u er c a ex o r

of th g s e S pn i t l
er g

s R diu l x t s s U l
na o r o n x t u a a e en o r n ar e en

s U l f w C mm xt s f th g s D p s
or n ar urro o si on e en o r o e n er e re on

b h i d lb w E xt ssf th mb S mm y f m sl sf f
e n e o en o r o u u ar o u c e o o re

ar m S u f t s
r ace f f m H ll w i f t f l b w
co n o ur o -
o e ar
r o o n ro n o e o

I u
n f p s ii
e n ce ot f m ff o m C t s ud
on on or o -
o e ar
r o n o ur a ro n

el b w S p i l v i sf m F t f w i s
o u er c a t
e n A ti f
o ar ro n o r c on o

mus ls c e 5 1 0 187

CHAPTE R V III .

H H A ND T E .

Th s
e klt f th h d J i tsf th g s Th th mb

e e on o e an o n o e n er - e u

Sh t sl sf th th umb A bd t i d i is M sl sf th
m uor c e o e uc o r n c u c e o e

li tl g Th p lm Th g s B k f th h d
t
e n er e a e n er ac o e an

M v m ts th g m Sum m y
o e f en o 88
e- n e ar 1 2 10
 Co n ten ts .

CHA PTE R IX .

TH E G L U E A L R I ON T EG .

Sk el t f l w l i mb I mi te b Th ili um P ub i s

PA GES
e on o o er nno na one e

S um P l vi s F mu Ob liq uity f th thi gh -b es Th

acr e e r o e on e

h i p j i t I l i f m l lig m t M h is
- o n o-e m fo ra t p stu a en ec an o e r ec o re

Ob l i q uity f th p l vis I u
o o f p l vi
e e b li q i ty thi gh n e n ce e c o u on

M v m ts t th h ip j i t Gl t sm x im s
o e en a e Glut l f ld
-o n u eu a u ea o
Th e b tt k A ti s f glut sm xi m us T s f s
u oc c on io eu a en o r a c ae

f m is I l i -ti bi l b d
e or Gl t
uo u s m di us A t i s
a an up i e e n er o r er o r

ili sp i
ac S u f f mneso f b utt kr ace or oc 21 1-
245

CH APT E R X .

m sm r on .

Th e f mu B sf th l
e r one o p t ll e e g
Th e ti b i a Th e b la
u The a e a

K j i t M m tsf k j i t L ki g f th k
- n ee o n- o ve en o n ee o n oc n o e n ee

j i t M l f t th igh E xt s
o n s s h u c e m sl The v s
os
ti ed en o r u c e a an

re ctus S t i s Ad d u t m us s
l G
ar o r u i h
s A ti f d c or c e rac c on o a

d u t s Fl x
c or mus l es Th h ms
t i gs A ti
e or f th h m c e a r n c on o e a

st i gs F
r n m f m or w
f l thigh H i p idth C t u s
o o f th igh
e a e - on o r

St ight ssf li mb F m f k
ra ne o 46 or o n ee 2 284
-

CH APT E R XI .

'
TH E LE G A N D r o o r .

B sf l g l B sf th f t As Th e t g l s Os l i s
an k e
A kl j i t M sl sf l g Ti b i lis ti s L g xt s
o ne o e one o e oo ra a u ca c

n e o n u c e o e a an cu on e en or

of th t s P
el m sl s M sl s lf T d A hi llis
oe f
e ro n ea u c e u c e o ca en o c

A ti f m sl sf lf S f
c on o t
u c e s f l g
Th b
o k f ca ur ace co n o ur o e e ac o

th k
e F m f l g i f m l B s t f t A h sf
n ee or f h o e n e a e one o e oo rc e o

th f t D sm f th f t Sh t xt s f h t sM sl s
e oo or u o e oo or e en o r o t e oe u c e

o
f th f t Pl t e f s
oo

i S l f th f t Th t s F m l
an ar a c a o e o e oo e oe e a e

fo o t S upe rci al v i sf l g
e n o e 285 -
32 1

CH APTE R X II .

ms N CK E .

Th e at a ls an d a x i s M o v eme n ts
of k M sl sf th k
th e n ec u c e o e n ec

Liga m e tum uch ae n Dee ruc u en pst t

sf k Hy id b r o n ec o one

n
Lary x Thy o id b o dy Stern o - a o r m st id m sl Pit f th k u c e o e n ec

Ho ll o wsab o ve t e co llar o e
h - c b n A ti f st m s t id on o ern o - a o

Th e p l aty sma Co to u so f ec e n r n
k L gth f k M v m ts n o n ec o e en

o f n eck N eck an d sho ulders

 Co n ten ts .

CH APT E R X III .

TH E H E A D , FA C E , A N D E X P RE SSI ON .

s
n ou

kull B o ueso f
Th e s th e s
k ll F u ro n tal s
i s
C nu ran um i Si ze of

h ead Bo eso f f n l gl
a ce lw
Th e f i
ac a an e Th e o er j a w Th e

m s st F m f l w j w Th h i Th bi ts N s
a e er or o o er a e c n e or o e

E arM th Ey s Exp s
ou si e M sl sf x p s si reTh on u c e o e re on e

ey i
e x p
n e s
si M
re s l s f
on t h s M s l
u c esf th m th
o e no e u c e o e ou

Th me th i
ou xp s sin e L gh t R ti Sh y s
re on sR g
au er e ec on ne a e

S i g D is
n eer n d i F H
a nH bi t l x p s
earsi 345 385 o rro r a ua e re on -

CH APTE R X I V .

PR O PO RTI ON .

P p ti
ro or P p ti sf f m l F m l
on ro or on o e a e e a e g ur e Pro po ti s
r on

o f hild
c G wth Old g rod d y a e an eca 386
4 5
0

IND EX
 PLA TE S

PL A TE I
Ml s
klt
a e e e o n. F ro n t vi e w .

PL A TE II
F ema e l s
klt e e on. Fro n t vi e w .

PLA TE III
Ma l s
e kl e e to n . B ac k vi w e .

PL A TE IV

Ml s k l t S id
a e e e on . e vi e w .

PL V
A TE KEY PL AND A TE

Fig Vi w f m l
. 1 . e o a e b ac k with s
h l d sf w d ou er or ar

k with s
h ld s
.

Fi g Vi w f m l
. 2 . e o a e b ac d w b k ou er ra n ac .

PLA TE VI AND KEY PL TE A

B ack vi w e of ma l g i li
e ur e nc n ed to th e s
id e .

P L A TE VI I AND KEY PL A TE

Si d vi
e e w of ma l g
e ur e ro tated f
ro m s
p tt ec a o r .

PL A TE VIII AND KEY PL A TE

Fro n t i
v e w of ma l g i li
e u re nc n ed to th e s
id e .

P L A TE IX AND KEY PL A TE

S id vi
e ew of ma l g
e ure turn ed to w dss
p
ar ectato r .

P LA TE X KEY PL T AND A E

Fig Vi w f m l b k with igh

1 e o a e ac r t a rm ra is
e d t ight gl
o ar an e

i sd b v th h d
. . .

Fi g Vi w f m l b k wi th i ght
. 2 . e o a e ac r ar m ra e a o e e ea .

b
P L A TE XI AND KEY PL A TE

Fig 1 Vi e w of ma l e b k wi th s
ac h o uld s f er o r war d
h o uld e s
. . .

Fig . 2 . Vi e w o f ma l e b ac k wi th s d r ra w n b ac k .

P LA TE XII ANDKEY PLA T E

Fig 1 Sid i w f m l t
e v e o a e r un k with ar m ra isd t ight gl
e o a r an e

isd b v th h d
. .

Sid i w f m l t k with
.

Fig . 2 . e v e o a e r un a r m ra e a o e e ea .

P LA TE X III
Fig . w f f m l t k with m isd t ight
1. Sid vi e e o e a e run ar ra e o a r

gl an e.

Fig Sid vi w f f m l t k with m isd b v th h d

. 2 . e e o e a e r un ar ra e a o e e ea .

L A TE XI V
P AND KEY PL T A E

Th -
re e q uarte r sb k vi w ac e of ma l g wi th
e ure ar m u pl i fted .

LA
P TE XV A ND KEY P A L TE

Fi g . 1 . F ro n t vi w f m e o a e l tr un k wi th igh t r ar m ra i sde to a

r igh t an g e l
i sd b
.

Fi g . 2 . F ro n t vi e w of ma l
e trun k w ith ight r arm ra e a o ve

th e h ead .

LA T XVI
P E

Fi g F 1 ro n t vi e w ffm l o e a e bus
t
bus
. .

Fi g F w ffm l t wi th l e ft a p l i ft d
.

. 2 . ro n t vi e o e a e rm u e .

L TE
P A XVII
Fig 1 Vi e o h ld s
w f f m l b k with s
e f w d a e ac ou er or ar

w f th sm w ith mspl ift d

. . .

Fig . 2 . Vi e o e a e ar u e .

LA
P TE X VIII KEY PL T AND A E

F t i w f xt d d ms
ro n v e o e en e ar .

Fig P 1 ro n e

i ti s
.

sp i
. .

Fig . M id w y b tw th p
2 . a e ee n e r o n e an d u ne po s on .

Fig 3. . S up i n e.

LA T XIX
P E

Fig B . 1 . en t ar m . F iw
ro n t v e .

Fi g B . 2 . en t a rm . Bac k vi w e .
A N A TO M Y FO R A R T S TU D E N TS

C H A PTE R I .

TH E IN FLU E N CE or POS TU R E
'

UPON TE E s
c an or N AN .

MAN l ne s
a o ta nd s e r ect Th e l e as
.

t o bse rvan t am o ngs t
us can n o t h a ve f a i le d to re c o gn i z e th e f act t h at man o w e s

much o f h is d i gn i ty to th e e re ct po s t u re In thi sre s . p e ct

h e d i ff e rs fr o m all o th e r anim al s I f w e co m pare h i m wi th
.

th e m an -l i ke ape s h is n ear re l ati o nsth ey s ue r m uc h by

'

co ntras t Th e ga it o f the s e creature s s

.

is
,

. hufin g an d th e
bal ance o f the gure uns
,

tead y ; whi l e th e i r who le appe a r

an ce wh e n the y atte m p t to walk up ri ght s ugge s ts bu t a
f e e bl e i m itat i o n o f th e e as
, ,

e an d d i gni ty o f m an s ca rri ag e

.

Th e as sum pti o n by m an o f th e e re ct po s iti o n h asle d

to ve ry re m ark abl e changes i n th e fo rm o f h iss k e l e to n an d
th e arrange m e nt an d d e v e l o pm e nt o f hi s m us cl e s .

In h isgro wth fro m the o vum to th e adult h e pas ses

thro ugh many s tage s In s o m e o f th e s as

,

. e h is ce nt fr o m

l o we r f o r m s is c l ea rly d e m o n s t r at e d T h i s state me nt h o ld s
.

go o d n o t o nly in regard to s tructure but als o as , re ga rd s

f un ct io n .

To ta ke a cas e i n po i nt Th e chil d at b i rth i s

. f e e bl e an d
B
 E a r ly A tte mpts a t W a lkz ng
'

2 .

hel ple s s : th e l i mbsare asye t uns ui te d to pe rf o rm th e

f unct io ns they will b e call e d upo n to e xe rcis e wh e n fully

d e ve lo pe d Dr L R o bi ns
. . o n h as rece ntly pro ve d that th e
a re ma rkabl e gras
.

n e w -b o m ch i ld p o s s es s es ping po we r in
i ts hands H e f o und th at i nfantsi mme d i ate ly afte r birth
.
,

we re abl e to hang f ro m a s ti ck f o r a s
,

ho rt time by c l utching
i t with the hand s With th isexceptio n w e may re gard
.

th e m o ve m e nts o f th e l i mbs as i ll co ntro ll e d an d impe rf e ct .

A t r s t the l e gsare to o we ak to s uppo rt th e bo dy It i s .

o n ly afte r a co n s i d e rable ti m e h ase laps e d th at th e ch i l d

ma ke s e ff o rt s to us e th e m as m e an s o f p ro gre s s i o n Th e s
. e

rs t a tte mp ts ar e c o n n e d to cre ep ing an act i n whi ch th e

,

f o re limbs play asimpo rtant a part asthe hi nd W ith

a d van c ing a e h o we v e r th e l e gs
.

g be co m e l arge r an d th e

mus mo re po w e rfu l In co urs

,

cl e s e o f t im e th e y are s
,

. ui

ci e n tly s tro ng to s uppo rt th e bo dy -we ight I n th e e arli e r

.

s ta ge s o f th e as sum p ti o n o f th e e re c t po s ture th e child

as s istsits e l f by gras ping with i ts hands an
y o bj e ct whi ch

i t can co nve ni ently s e i ze ; as e t i ts e o rts a r e ungainly

'

y
an d u n s te ady but practi ce an d th e exe rcis
, , e o f a b e tt e r

co ntro l o ve r th e m us cle s o f th e l e gs , so o n e n abl e i t to s tand

up right an d walk w ith o u t th e ai d o f its hands an d arm s .

Th e re are thusthree s tage s in th e de ve lo pme nt o f th is

acti o n : rs tly th e us e of all f o u rs s e co ndly th e us e

as me ansto s teady an d as sis

, ,

o f th e up pe r lim bs t th e
i ns ufc i e ntly d e v e l o pe d l o we r l i mbsthi s m o de o f pro
g r e ss i o n i s c o m p a r a bl e t o th a t o f th e m a n -l i k e ap e san d
;
th ird ly th e pe rf ecte d act whe re in th e l egsare alo ne s
,

, um

c i e nt to s uppo rt an d carry the bo dy .

Th e gr o wth an d d e ve lo p m ent o f th e le gs are n o t th e

o nly c h ange s that ar e as so c i ate d with th e as sumpti o n o f th e

e re ct po s iti o n I f th e back -bo ne o f an inf ant at birth b e
.

e x amin e d an d co m p are d with th a t o f an ad ul t o th e r d i ffe r

o n ce s i z e an d o s s
,

than th o s e of s i cati o n w ill b e o bs e rve d

As w i ll b e afte rward sex pl ai n e d the adult back bo ne is

.

-
,
 f Ca r s
es o Ba ck b n
- o e 3 .

ch aracte riz e d by ce rtai n cu rve s s o m e o f wh i c h w e f ai l to

,

o bs e rve i n th e chil d The s e l a tte r th e re f o re ar e d e v e l o p e d

as
.
, ,

at a p e ri o d s ub s
e q ue nt to b i rth an d ar e d e s c ri be d
.

s e co n d ary curve swhil s t tho s

, e wh i ch e x is t at birth an d
ar e m ai nta ine d thro ugho ut li f e ar e call e d th e p ri mary
curv e s Th e p rim a ry cu r ve s
. are th o s e as so c i ate d w i th th e

f o rmati o n o f th e wa lls o f th e gre a t vis c e ral cavi t i e s whil s t ,

FI G 1 Di agra m to s
h w o s s vs
FI G z d i play th e cur e
si back b o b kb
. . .

th e cur e v
n th e - ne i n th e a c - o n e o f th e
o f an in fa n t d l T isg
a u t sb
h fi u re ha een
i s
s s
. .

d d
r e uc e to th e ame z e a
Fi g s s d
1 o a to r e n e r co m
p s s
.

i
a r i o n ea e r .

s nd ry
th e e co rve s
a are d e ve l o pe d wh e n th e e re ct p o s
cu i tio n
iss
sm d
a u e an d are co m pe n s a to r
y in th e ir n a t u re T h e

ar range m e nt i s
.

ad van tage o f th i s
,

that th e curve sar e n o t

a ll be nt in th e s a m e d i re cti o n bu t alte rn at e s o th at th e

co l umn i s mad e up o f a s ucces

,

s i o n o f bac kward an d fo rward

cur ve s I n thi s
. w ay th e ge ne ral di rect i o n o f th e b ac k
B 2
 4 Cur ves f
o Ba ck .

bo ne isve rti cal whi ch it co ul d n o t po s sibly b e if th e

cu r ve s
,

did n o t s o a lte rn ate f o r th e n th e c urve s wo u l d b e

directe d f o rward san d a ve rti cal lin e wo uld fall
,

all ,

e ith e r in f ro nt o f acro s so r be hin d th e be nt co lu mn in

place o f cutting it at s
, ,

e ve r a l p o in tsas h appe nsin th e

co l u mn w i th th e a lte rn ating curve sThis
,

beco m e s
. a m atte r

of m u ch i mpo rtance whe n th e ve rti ca l line co inc i d e s

with th e d irecti o n o f th e f o rce e xe rc i s e d by grav i ty a s in
s
,

ta nd i ng upright .

Th e s e f ac ts m ay b e pro v e d by lo o king at a baby Th e .

back pres e nt s a uni f o rm c u rve fro m th e s ho ul d e rsto

th e hip s ; as so o n a sthe child be gin sto walk h o weve r , ,

the d e ve l o pm e nt o f a f o rw ard c urve in th e re gi o n o f th e

l o ins is n o te d a cu r ve whi c h u ltim ate ly be co m e s pe rmane nt
s
,

a n d is as o ci at e d with th e grac e f u l o wing c o nt o u rs whi ch

are ch a rac te ri s tic o f th e back o f th e ad ult Th i sl um bar
c u rve i s o n e o f th e m o s t re m arkable f e atu re so f m an s

back -bo ne f o r alth o ugh th e cur v e is

, ,
e xhi b i te d to a s light
e xte nt in th e co l umn s o f th e ap e s in no ne d o es
,
it appro ach
anything lik e th e d e ve l o pm e nt m e t with i n m an On .

th e o th e r h a n d in f o u r fo o te d animal s
- wh e re th e co l umn
is iti o n the re ise ithe r n o s
,

h o ri zo ntal in po s u c h c u r ve
lightly de ve lo pe d Th e as s
,

p re s e nt o r it i s
,
o nly s u mpti o n
.

o f th e e re ct p o s ture ne ce s sa rily in v o l v e s th e gro wt h o f

po we rfu l m us cl e s a l o ng th e bac k to h o l d up a n d s uppo rt
th e b ac k -b o n e an d trunk in th e ve r ti ca l p o s itio n I n .

pro o f o f thisth e change swhi ch take place in o ld age

h ave o nly to b e no te d A t that ti m e o f li fe the mus
. cu l a r

s ys te m be co m e se nfe e bl e d an d is n o l o ng e r s tro ng e no ugh

to h o ld th e gu re e re ct ; th e re s u lt is th e b e nt bac k an d
to tte ring gait o f th e age d w ho in the ir e ff o rtsto avail
sis
, ,

them s e l ve s o f e v e ry adva nta ge s e e k th e as

,
tan ce w h i c h

th e us e of a staff aff o rds Thush is . to ry re pe atsi ts elf

within th e s pan o f o ur o wn e xis te nce It h asbe e s .

"

e en n

h o w th e yo u ng c hil d a vail s its e l f o f th e as s istance o f its

 Ver teb r a l Co lumn .
5

uppe r l i mbs in itsrs t atte m pts to wa lk ; an d i t is no te

wo rthy h o w in that s e co n d chil d h o o d th e we a k an d age d

s an d h a nd s
,

ee k ad d i t i o n al s upp o rt by th e us e o f th e i r a r m s
,

It isho we ve r to ne ithe r o f the s e t

yp e s t h at o ur atte nti o n

m us t b e es
, ,

pecially dire cte d but ra the r to the exam inatio n

,

of man i n th e f u ll ex e rci s e o f h is stre ngth afte r h e

h as o u tgro wn th e s
,

o f tn e s san d ro un dnes so f yo uth an d

be fo re h e h asacquire d an y o f th e we akn es
,

sdepe nd e nt
o n a dv an c ing y ea rs .

S tarting th e n with th e f un d am e nt al i d ea th at th e e rec t

po s ture is es s e nti ally a ch a ra c t e ri s tic o f m an it is n e ce s sa ry

to s t udy in s m o d i ca ti o nsin hi s
,

o m e d e t a il th e vari o us

bo ny fr am e wo rk an d m us cul ar s ys te m whi ch ar e as so ci a te d

with thi s po s ture .

A sa v e rt b ra te d
e a nim l m a a n p ss
o se ssa b a ck bo ne
e -

or s s
,

p i n a l co lu m n m a d e u p o f a se ri e s o f b o n e p l ace d o n e

abo v e th e o th e r . A ro und thi s ce n tral co l u mn a r e gro u p e d

th e b o n e s that pro tect an d s uppo rt th e trunk On th e upper .

en d o f th is c o l u mn i s po is e d th e h e ad an d co nn e cte d w i th

th e tr unk ar e th e tw o pa i rs o f limb sth e a rm s an d l e gs

,

F o r co nve ni e nce o f d e s c ri p ti o n it will b e n e c es sary to

co n s id e r th e bo dy in i ts s e v e ral pa rts

( )
I T h e tr u nk .

( )
2 T h e l o w e r lim bs .

( 3) T h e u pp e r lim bs .

T h e h e a d an d n e ck
( 4) .

In regard to th e tr unk ashasbe e n already s tat e d th e

o ca ll e d b ec a us e it i s c o mp o s
,

s
,

ve r te b ra l co lumn ,
ed o f a

numbe r o f s e p a ra te bo n e s o r ver te b r ae f o rm s ,
th e ce ntra l

ax i s a ro u nd wh i c h th e o th e r par ts ar e gro u p e d Co m pa ri ng
.

th e po s iti o n o f thi s ch ai n o f bo n e s in m an with what is

o bs e r ve d in a f o ur f o o t e d anim al it will b e n o t e d th a t i n
-
,

m an i ts ax i s is ve rtical whils
,
t in a quad rup e d it i s m o re
o r l es sho r izo ntal ; m o re o ve r th e co lu mn in man iscur ve d
,

i n a mo re co mp lex manne r than isth e cas e in a n i m a ls .

6 E r ecto r es s
p
'

zn ae .

I t i s th s u sth t th l mn ism inly d p nd nt

on e e c r ve a e co u a e e e

for i tsl s ti ity I t w uld h w v r b u n bl t s

e a c . ust i o ,
o e e ,
e a e o a n

th w ight f th t
e e k u nl s
ssm pr vis
o inhd b e r un e o e o o a ee n

m d wh r by i t ul d b h l d r t Thi siss
a e e e u pp l i d
co e e e ec e

by th p w rful gr upsf musl swhi h li i n th g v s

.

e o e o o c e c e e ro o e

on e ith r si d f d b hind th b kb n A ins

e e o p ti
an e e ac o e . n ec on

o f th b k f e m d l will n bl th s
ac o tud nt t
a gn oi e e a e e e o re co z e

th s s
e e hy m s ss ith r s
e id f th m i ddl l i
a e on e e e o e e n e,

p rti ul rly in th l w r p rt f th b k i th
a c a e o e a o e ac ,
n e

Fm 4 . .

Fi gs3 4 ( ft G a er i ) s
s
o od hw r o

t is si th
.
,

th e c harac e ti di ff
r c er e n ce n e

a r ra n gm e en t of th e p ts f th
ar o e

s
kl e eto n i n man an d a q uad r u ped .

of l o in sT he s
th e e gro u p s
. o f m us cl e s are call e d th e erecto res

sp i n ae a n am e whi c h su f c i e ntly e x p l ai ns th e ir ac t i o n .

o n th e ac ti o n o f th es e m us c l esisas
,

H o w m uc h d e pe nd s
h as
,

be e n s
'

a id d e m o ns trate d in th e cas
, e o f th e f e e bl e an d

age d in w ho m th e m us c le s ar e n o l o nge r ab l e p ro p e rly

ul t th at th e pe rs o ns
,

to pe rf o rm th e i r f u ncti o n with th e re s
o aff ec t e d ar e un ab l e to h o l d th e ms
,

s e l ve s e re ct f o r an
y tim e

wi tho ut f at igue
th e w e ight o f th e h e ad an d by i ts
.

Th e co l u mn s upp o r ts ,

co nne x i o n with th e ri b s e nte rs into th e fo rmatio n o f the

,
PLA T E I

MA LE SK ELE TO N FR O N T VI EW .

! An -
s
uT s1 uo u o
 FE M A LE SKE L E TO N .
-
FR O N T

W I b '
m y Fm a'p t
]
A R wR Tuo u
 L imb Gz r d le
'

s
.
7

c h es t -wall Th e uppe r limb s

. are co nn e cte d wi th th e ch e s t
wall in a w ay which will b e s u bs e qu e ntly d e s cri be d It .

is thuse vid e nt th at th is ce ntral ax is isa mo s t i m po rtant

f acto r in th e f o rm a ti o n o f th e s k e l e to n
o f th e tru nk Thro ugh it th e entire
.

we ight o f th e he ad uppe r limbsan d ,

trunk is trans mitte d to th e l o we r l i m bs

,

wh i ch o f n e ce s
,

sity h ave to s uppo r t th e

s up e rin cumbent we ight i n th e e rect
po s iti o n .

It isto th e s tructu re o f th e s e limbs

that o ur atte n tio n mus t next b e di re cte d .

I n co ns i d e ring th e m i t mus t b e bo rne

'

in mind that the legss e r ve tw o p u r

po s es : rs t they affo rd e fci e nt s

,
upp o rt ,

an d s e co ndly th e y are ad apte d f o r th e

o f p ro gre s s io n Th e l i mbs
, ,

purpo s es ar e

co nn e c te d with th e trunk by m e an s
.

of

bo nesarrange d i n a particu lar way

te rm ed th e l imb gi rdle s
.

Thes e are .

Th e re are tw o s uch gi rdlesth e s

ho uld e r
i r d le co nn e ct i ng th e upp e r l imbs w i t h
g ,

th e trun k an d th e p elvic gi r d le co n
n ecti n g th e l o w e r l imbs s
, ,

with t e trunk
h F o 5 Ar di mm

t s h w th
.
.

As th e l atte r 18 co nce rn e d i n tra n s m t f th m us

o o g e a rran e

en ls
o e c e

m i tti ng th e we ight o f th e trunk to wh i h s uppc t th or e

Th e " ms
th e l o we r limb s it i s well rs t to ex a l sWt hb k m ac f e' "
'

,
c e p are re ra

min e i t st d i sl i d b l k
,

.
en e n o ac

Fr o m i ts es s
f un cti o n it i s k
,

e nti al th at
re t b t h
88 9 i o e c

s
th e p e l vi c gi rdl e s
th in g f t h
e re i o n o e
ho uld b e rml y unite d l i s d o n k d an n ec an

to th e ve rte b ra l co l umn o r ce ntral axi s mp a tiv ly lm

,
"
co
} i
ra e n

by m e anso f an i mmo vable j o int In th m d d m l g

e l o a re ion
'

o rd e r to e ff e ct thi s un i o n th e s e gm e n ts o r ve rte b rae of

whi ch th e co lumn is
,

mad e up und ergo ce rta in m o d ica

tio nsi n
,

t h e r gi n wh r
e o e e th e gird l e b o nes
- o f th e l o w e r
8 Pelv ic G ir d le .

l i mb ar e a ttache d Thism di ti n ns
. is
otsi n th ca o co e

f s i n f num b r f th s
u o o a e o e e

v rt b r whi h sp r t e e ae , c ar e e a a e

i n th in f nt s st f rm e a , o a o o

l rg w dg s h p db n
on e a e e e- a e o e

ll d th s m Th isca bn e e acr u . o e,

f rm d by th uni n f
o e e o o ve

v rt br i sin m r m rk e e ae , an , e a

b l f i tswi dth d s
,

a t ut
e or an o

n s s It ts t ly s e . ac no on a a

s tr ng nn ting l i nk b o co ec e

tw n th v rt br l l umn ee e e e a co

d th b n sf th p l vi
an e o e o e e c

girdl wi th whi h it ti e c ar cu

l t sb ut ls pr vi d s
a e a o o e a

x d b s whi h th u pp r
,

e a e on c e e

d m v bl s gm ntsf th
an o a e e e o e

ntr l xi s pl d Th
ce a a are ace . e

ps t ri r s p t f th sru m
o e o a ec o e ac

l s f urnis h s a t s
o iv e an ex en e

srf f th tt hm nt u ace or e a ac e

f th r t r muso l sf th e e ec o c e o e

s p in wh i h s sist sm e, c a o a

t i lly in m i n t i n i ng th
er a a a e

lu mn in itsr t p s
co iti n e ec o o .

Th b n s f th p lvi e o e o e e c
kb d p lv i s
F0 bac girdl th gh s prt t
1 . 6. Th e - o n e an e .

e, ou e a a e a an
0 . I n c lud e sth e t wen ty-m
f o ur
rly p ri d f l if
o v ab le
ea in e o o e, are

b . In pl a c ed on th e s m
ac r u th p r
an d co ccyx
sf gr wth f usd
s , e o ce o o e

t g th r t f rm l rg s
ma d e up o f ve ver teb rae each ,

w h ic h are fu s ed to ge th e r ; th e o t ut
e e o o a a e o
sac r um s
a r ti cula te wi t h
i r gu l r b n ll d
e.Th e h aun ch -b o n e o nno ( si mi m)
n atu
re th a o e ca e e

s i
,

o n th e o ute r id e o f w h ch at ha u n ch bo n e
-
( 08 i n n o min a
ss p
c I th e o c k e t ( aceta b ul um f o r th e r ece
.

i
t o n o f th e h ead o f th e th igh - ho n e Th r tum) e e a re two s
uh c
sp s
.

sp s b n s
.

. p
d Th e ub ic arc h an d ym h y i ub i
f .

o e o ne or e ithe r limb
an d thes
e a re un i t d b h ind t
e h s
eid o e ac e of th e s acr u m
 Pelv ic G ir d le .
9

by m e anso f an i mmo vabl e j o int A d d i tio nal s . tre ngth

is g iv e n to th e girdl e b y th e un i o n o f th e tw o b o ne s w i th
eac h o the r in th e m i ddl e li n e i n f ro nt by m e ans o f an

immo vable j o int calle d th e s s

,

m
y p y h si sp u b i .

A bo ny bas in call e d th e p elvisisthusfo rm e d by th e

, ,

arti cu l at i o n o f th e s e tw o h a un c h b o n e s -
in f ro nt an d the ir ,

un i o n wi th th e s ac r um b e hin d The re isn o m o ve m e nt

.

b e t we e n th e s e ve ra l p arts o f thi s os se o us gird l e an d it is ,

rmly unite d with th e l o we r pa rt o f th e ve rt e b ra l co lu mn

It helpsto fo rm th e lo we r part o f th e trunk an d by its
.

ex pande d s tsm ate rially in s

,

urface sas s
,

is
s
,
uppo rting th e
ab d o m i na l co nt e nt .Th isf o rm
o f pe l vis is ve ry characte ri s ti c
of m an Asa re s u lt o f th e
as s
.

um p ti o n o f th e e re ct p o s t u re
th e abd o mina l vis ce ra ar e n o

l o nge r s uppo rte d e ntire ly by

th e abd o m in al wall s as in fo ur
,

f o o te d animal sbu t r e s t to a
,
F G 7 A d i g mm ti pw
V e ry co n s
1 a ra a c re

i d e rabl e e xte nt o n th e st ti f th p l vi gi d l
. .

cu a on o e e c r e

sm
.

ex pan de d w ings o f th e pe l v i c a ac r u

( s
.

b H i mi t m)
.

b o n es In add i ti o n th e o ute r s
h b a un c - one c nno na u

ym ph s isp b is
. .

.
c y u

s ur f ace sOf
,

the s
.

4 U pp f m
e expanded . d f h i gh b (
e r an ) o t - one e ur .

plateso f bo ne are utiliz e d to pro vide attachm e nt f o r th e

po we rful m us cle s wh ich pas sf ro m an d co nnect thispe lvic
a gro up o f m us cl e s
,

g i rdl e with, t h e thigh -bo n e

,
wh i ch

attain s in man a re markable d eve l o pme nt .

Th e fac t m u s t b e e mph as ize d th at n o m o ve m e nt is po s sibl e

be twee n th e pe l vi c girdle an d th e s ac rum a n d th at all th e ,

we ight tra ns mitte d d o wn th e ve rte b ral co lu mn thro ugh th e

s ac rum is e q ually di s tri bute d be tw e e n th e tw o haunch bo n e s - .

I f the o u te r s urf ace s o f e ach o f th e s e b o nes b e e xa m ine d .

a d ee p cup- s h ape d cav ity will b e no ti ce d in to whi ch th e ,

r o un d e d he ad o f th e th igh bo ne o r f emur ts thus

-
,

f o rm ing th e m o vabl e arti cu lati o n call e d th e hi p j o int

.
- .
10 Th !gi b o n et- .

Th e b n sf
o e o h igh an d leg are re m arkabl e f o r th e ir
th e t
l e ngth Co mbi n e d they equal in l e ngth th e me as
1
. ure m e nt

o f th e h ead an d trunk Thisre lative de ve lo pme nt isn o t

.

a tt a in e d by an
y o th e r a nim al I n a dd i t i o n th e th i gh -b o n e

es s
.

man po s s
,

o f es an e xtr m e ly l o ng a n d we ll marke d n e c k
e - .

Th e n e ck i s th at part o f th e bo ne whi ch s uppo rtsth e

ro unded arti cul ar h ead an d co nnectsit with th e uppe r
,

e n d o f th e s h af t i n an o b lique d irecti o n Th e le ngth .

o f th e ne c k o f th e f e mu r is peculiar to man an d pe rmits ,

a ra nge o f m o ve m e nt o f th e l i mb n o t a tta in abl e by an y

o th e r an i m a l th e m o v e m e nts
, in th e lo w er a nim al sb ei ng
m o re o r l es sl imite d to a bac kward an d fo rward d irectio n .

By m e an s o f t h e n ec k o f th e th i gh -bo ne we have i n man

an arrange m e nt wh i ch f ul l s a ll th e co nditi o ns neces sa ry

to e n s ure s tab il i ty an d pe rmits

, o f a m o re e xte nd e d range

o f m o ve m e nt n o t o nl y f ro m b e f o re ba c kward s an d f ro m

id e to s ide but als

,

s o i n an inwa rd an d o utwa rd di re cti o n .

Th islatte r isth e mo vem e nt o f ro tatio n whe reby we are

,

o r o utwar d s
,

e n ab l e d to tur n th e fro nt o f th e lim b inwar d s

as de s i re d .

Th e mus cl es to wh ic h re f e re nce h as bee n alre ady made in

co nn e x i o n w i th th e o ute r s urf ac es o f th e ha un ch -bo n e s ar e

i ns e rt e d int o th e u pp e r p a rt o f th e t h i gh - bo ne A s t he y
are i m m
.

e d i a te ly co nce rn e d in th e co ntro l o f ce rtai n im po r

tant m o ve m e nts o f the h ip j o ints

- thro ugh wh ich th e e ntire
we ight o f the trunk is m itte d to the lo we r l i mbsthe y
,

trans ,

neces sa ri ly acq u ire a ve ry gre at d e ve l o p me nt a d e ve l o p m e nt

d epe nd e nt the p ro m i ne nce o f th e butto cks

,

o n wh i ch i s

to tle as
.

Thisappearance wasj us tly re garded by A ris em in

ently ch arac te r i s tic o f man

bo ness
.

T e
h thigh - e p arate d abo ve by th e wi dt h o f th e

pel visare p lace d o blique ly s o th at th e y li e s i de by s

,

id e
in th e re gi o n o f th e knee s
,

Th t msth igh
e er d leg an

pp li ed s

p
are a ti v l y
re t ecth e p ts
e f o ar o

th l im b b v
e a o e an d b l o w th k ee
e e n .
12 Leg and F oot .

b n sf th
Th e o e o e le g in num b e r The y ar e
ar e tw o .

imm v bly unit d

o a e to e ach o th e r s ince an y m o ve me nt
,

b etwee n th e m wo ul d inte rf e re with th e ir s tab ility an d

thuswe ak e n th e l imb asa m eanso f s uppo rt On e o nly .

of th e se bo nesth e s h in b o ne o r tib ia e nt e rsinto th e

,
-
,

f o rm ati o n o f th e kn e e j o int ; by its

- e x pa n d e d upp e r e x

tr e m i ty i t aff o rds a b ro a d s urf ac e n o t o n ly f o r th e s uppo rt

b ut a l s o f o r th e m o v e m e nts o f th e co n d yles o r a rt i cul a r

s u rfac eso f th e thigh -bo n e Th e s l e nde r o ute r b o n e

.
,

th e b ula furni s ,
h e se xte n s i ve attachme ntsf o r num e ro us
mus cl e s .

Th e e s hy m as s es which m o ve th e le g o n th e thigh at
th e kn e e j o in t cl o th e b o th th e f ro nt an d b ac k o f th e th i gh
-

bo n e ; in m an th e e xte ns o r gro u p o f m us c l e sv iz that ,

.

pl ace d o n th e f ro nt o f th e thigh wh ich exte ndso r

s tra ighte nsth e leg attainsa re l ati v e ly gre ate r d e velo p
,

m e nt than th e ex o r gro up whi ch iss ituate d o n th e b ack

Thisisj us t th e reve rs
,

o f th e l i m b . e o f wh a t i s fo un d
in an im al san d i s as s o c i ate d i n m a n w i th th e po w e r h e

s
,

po s ses es o f bri n gi ng h i s le g i nto a d ire ct l i n e wi th h is

thigh th at isto s a h e can s tra ight e n o r e xt e nd h i s lim b
, y
at th e kn e e j o i nt i n a w ay whi c h n o o th e r anim al ca n
-

eff ec t.

M an s

fo o t is a ve ry c h arac te ri s tic me mbe r I t po s s ess es.

th e qual i ti e s ess e nti a l to s tre ngth an d s o lid ity co m b ine d

wi th e l as ticity an d m o ve m ent W he n s tan d ing up right

.

th e axi s o f th e f o o t i s p lac e d at right angle sto th e axis

of th e le g .

Th e bo ne swh ich e nte r i nto th e fo rmati o n o f th e f o o t

ar e a rrange d s o asto f o rm a s e rie s o f a rc h e sTh e a dv a ntage .

o f thi s is th at th e s o f t p a rt so n th e s o l e ar e p ro te c te d f ro m

pre s sure whil e at th e s a m e tim e c o ns i d e rabl e e l as

ti i ty i s c

impa rte d to th e f o o t The s li ght p lay o f th e bo ne s

. whi h c

f o rm th e a rch e s a ll o ws th e l at t r to act l ik e a s ee rie s of

cu rv e d sp r i ngs .
 MA LE SKE LE T O N BA C K V IE W .

I
0 I, m y Fl o wp t /
T
:

[A R TH U R H O M SO N pd .
 F oot . 13

Th e f o rm o f th e h l b ne o r as
ee - o ca lcis is re markabl e : to
i ts po s
,

cl e s
,

te ri o r par t isattache d th at gro up o f m us which

d ete rmine s th e f o rm o f th e ca l f Th e d e v e l o pm e nt o f th es
. e

m us cle s is ve ry gre at ; an d it isno tewo rthy that th ey are

qu ite typical o f man asn o animal e qualshim in this
re s pect Thi sfact isexpl ained whe n it isbo rn e in mind
,

th at n o t u nf re q ue ntly th ey ar e ca ll e d upo n to s uppo r t

th e e nt i re w e ight o f th e b o dy as ,
in th e actso f s tanding o r
dancing o n tipto e whi l e at o th e r time sthey ar e require d
,

to p roj e ct th e bo dy f o rw a rd as ,
in s p ringin g o r l eaping .

Th e b o ne so f th e to e sare s ho rt e r than tho s e o f th e

ng e rs Th e gre at to e is
. u nite d to th e o th e rs an d li e s s ide
by s id e with th e m it has no s u ch p o w e r o f s ep a rati o n an d

cl o s ing o n th e o th e r to e sasispo s sess e d by th e th umb .

Thusth e s tabil ity o f th e f o o t isn o t inte rf e re d with by

an e xce s so f mo bility s uc h a s we s e e in th e ape s whe re th is
po we r o f mo veme nt isneces In th em th e f o o t i s
,

s a ry .

e m p l o y e d as a gras ping o rgan a mo d i catio n which greatly

a rb o re al h ab i ts
,

as s ists th e anim a l in i ts .

F ro m wh at h as be e n s tate d it will b e appa re nt that th e

l o w e r limb o f m an d is playsin itss tr uctu re tho s e m o d ica

t i o ns which are e s se nti al to th e co m bi n ati o n o f s u pp o rt an d

mo bi lity
am e inu e n ce s
.

In th e uppe r limb th e s l e ad to m o d ica

tructu re which e n h ance i tsus s As
e f u ln e s
,

ti o nsin itss .

alread y s tate d th e ch ild dis pe n s es with th e us e o f h is a rm s

io n ass o o n as hi s l e gsb eco m e s

,

as ai ds to p ro gre s s tro ng
e n o ugh to s uppo rt him Thisre li eve s
. th e upp e r l i m b o f

o n e f u n cti o n an d p e rmits
,
a d e v e l o p m e nt o f th at m e m b e r

rathe r in th e d ire ct io n o f f re e do m o f m o ti o n Th e range o f .

m o ve m ent o f th is l im b iss o e xte ns i ve th at man can to uch

an p a rt o f h i s b o d y wi th o n e o r o th e r h an d
y .

A n e xam in ati o n o f th e bo ne s o f th e s
ho ul d e r gird l e th e
- o

bo n esby wh ich th e uppe r limbsa r e co nne cte d with th e

trunk at o nce d e mo ns tr ate s a re ma rka b l e d i ff e re nce be tw e e n
I4 S ho uld er g i r a le
.

the ir mo d e o f articul atio n with the s ke l et o n o f th e tru nk

an d th at wh i ch h as be en alre ady d es
c ri b e d i n co nn e xi o n

with th e p elvic gird l e .

FI G . 10 . B o ne sf th ight pp l imb f
o e r u er , ro n t vi e w .

Co lla r- i
b o n e ( c lav c le )
s m
a

s
. .

b Bre a t-ho n e ( te rn u )
sp W risb o n es ps
. .

S h o u l d e r-
b lad e ( ca ula ) t- (car u)
m s
c . .
g . .

d H u er u

s s
. .

i . F i
n ge r-
bo n e p( h ala n ge
) .

Th e s
h uld o er -
g i r d le co ith r s
id ns
is
tsof tw o bo ne son e e e.

th e co lla r - o n e b d th s
o r cla vicle ,
h uld bl d sp l an e o er - a e or ca u a .

T h stw
e e o b n s uni t d by s
o e m ll j int wh i h p mits
a re e a a o c er
 S ho uld e gir d ler - . 15

of i mit d m v m nt in rt in dir ti nsbut th gi dl

l e o e e ce a ec o e r e

isnly
,

o nn t d with th s
co k l t n f th tru nk by
ec e e e e o o e on e

j int
o ith r s
on id viz th t b tw n th upp r d f th
e e e, . a e ee e e en o e

Fm . 11 . B one sf th igh t p p li mb b k vi w
o e r u er , ac e .

a. Co lla r-ho n e ( cla vi c l e ) f U ln a

sp s s ps
. . .

c. S h o ul d e r -b lad e ( ca ula ) W i t-b o n e ( ca r u )

m g r

s ps
.

H
. .

d u er u h M e taca r u
sp s
. . . .

i Fin ge r -b o n e ( h ala n ge )
. .

b r ea s
t bo n e o r
- s
in n e r e xtr e mi ty o f th e co ll ar
t er n um an d th e

bo ne The range o f mo ve me nt o f this j o int is n o t e xt e n s

i ve
Th e s
. .

ho ulde r-bl ad e o n th e o the r hand isn o t d ire ctly

, ,
16 F or m f
o Chest .

co nnecte d wi th th e s ke l e to n o f th e trunk but o nly ind i rectly

thro ugh its
,

a rt icul ati o n with th e co ll ar b o n e A t th e s ame - .

tim e th e bl ad e bo n e isattac h e d by nu mero usmus

- cl es to
th e f r am e wo rk o f th e ch e s t wall By t hi s m e a ns th o ugh th e
- .

range o f mo ve me nt in th e tw o j o ints t n am e d i s
,

j us limi te d
e ne sso f
,

th e co m bin ati o n o f th e s e m o v e m e nt s an d th e l o o s

th e co nn exi o n o f th e s ho ul d e r bl ad e wi th th e ch e s t-wall -

impartsa ve r y e xte ns ive range o f mo ve me nt to th e entire

girdl e W h e n it isre m e mbe re d th at thi sgirdl e isarti
.

cul ate d wi th th e bo n e o f th e u pp e r a r m th e s tud ent wi ll

re co gni ze h o w i mpo rta nt a pa rt it pl aysin incre as
,

ing th e
f re e d o m o f mo ve me nt o f th e upp e r lim bs .

As h asbe e n s ho wn t e sh h o ul de r girdl e in m an is
-
,
mo die d
in o rde r to increas e th e range o f m o ve m e nt o f a lim b us ed

Fm 12 Di agra m mat c r e i p es
r e tati o
n n of th e
s
h ld l
. .

ou r- i
e g rd e .

a. s sl t b
r t do r a ve r e ra d S h o ul d e r -b lad e ( ca ula )sp
s
. . .

b Fi r t r i b e Co lla r -b o n e ( c la v i cl e )
s (s s
. .

pp
.

H
.

c . Br ea t-
b t
one e r n um ) .
j : um er u (b o n e o f u e r ar m ) .

fo r il pu p ss
p r h ns e e e r o e hisisco rrel ate d with an
an d t
I n animalsin
,

lt
a e r at i o n in t h e f o rm o f th e c h e st -wa ll .

which th e f o re -l imb is us e d as a m e an s of s uppo rt th e f o rm

s
,

o f th e c h e s t w a ll - i s l a te ra lly c o m p re s s e d th a t i s t o a y th e
,

d e pth o f th e ch e s t ca v i ty i s gr e ate r than its wi d th In man .

,

o n t h e o t h e r h a nd in wh o m,
t h e lim b i s n o t h a b it u a lly m ad e

u s e o f t o su pp o r t th e tr u n k th e c h e s t w a ll re l i e v e d f ro m
-

s
, ,

p re s su r e e x p a n d s l a t e r a lly ; h e n c e t h e t h o r a c i c o r c h e t c a v i ty
i de th an f ro m be fo re bac kward s
,

is w i d e r f ro m s i d e to s .

Th e j o in t be twe e n th e s h o u l d e r gird l e an d th e uppe r

-
18 S kull .

m o ve me nt p w r f pp s iti n f th th umb th m s
an d t o e o o o o o e e o

us sit isth m s t imp t nt in r g rd t s

,

f ul
e a iz d e o or a e a o e an

str ngth f ll th d i gi ts
,

e ,
o a e .

Th s k ll m u s
e t wb nsid r d this ns
u istsf tw no e co e e : co o o

p rts whi h n l ss
a on e th br in th th r whi h s upp rts
c e c o e e a e o e c o

d p r t ts ft p tsf th f
,

th s
,

an o ec I f th h u m n skul l
e o ar o e ace . e a

b mp r d with th t f th h igh s
e co a e t f th p sit will b a o e e o e a e e

bsrv d th t th d v l pm nt f th t p rti n whi h

,

o e e a e e e o e o a o o c

co nt i sth b r in isf in x s
a n sf nyt h ing sn in
e a ar e ce o a ee

FI G 13 u Sk
a n d ce rv ca l ver ll i FI G vi l
14 Skull an d ce r ca

s
g i ll g s
h wi sh wi g
. . . .

te b ra o f a or a o n p r o v tber e f m ra e o an , o n

l s ll b i s sm ll f b sl g b i
,

j ec ti n g m uz z e m a ra n -ca e a ac e - one ar e ra n

l g vi l spi s s ds h t vi l s
pi s
, . ,

a n d e o n a ted c e r ca ne . c a e , an or ce r ca ne .

an i m l s I n th l tt r th b n sf th f
a . lw ys
e a e e o e o e ac e a re a a

m r p min nt f rmi ng th pr j ti n whi h is

o e ro e f m ili ly
,
o e o ec o c a ar

kn wn sth m uzzl whil s

o at in m th fe und r e, an e ac e e

li sth xp nd d b r in s d pr j tsb ut s
e e e a l ightly in
e a -ca e an o ec

Thi sd iff r n giv srist m d i ti nsin th

,

f r nt
o . e e ce e e o o ca o e

m nn in whi h th h d is
a er d th v t br l
c lumn e ea xe on e er e a co .

I n d g th sa kull iss
o l u ng t th nt ri r xtr mity f
e a e a e o e e o

a m r l s
o sh riz nt l s
e or p in l l umn ; i n m th h d
e o o a a co an e ea

is p isd o th upp r e d f v rti l lumn ; whils

on e t in e en o a e ca co
 MA LE SK ELE T O N S ID E V IE W .

m 4" t r FI W DE J
[A R TH U R T uo u s 1)
'
oa
 I9

the m an -l ike ape s an intermedi ate condition i s noted the

col um n here being more or le s s
,

oblique in direction Owing

to the f act th at in quadruped s an d ape sthe muz z le is very
l arge s pecial provi s ion in the form o f an elas ti c ligament
isnece s
,

sa ry to as sist in s upporting the he ad . In m an ,

however the partsar e s

, o di s
tributed owing to the ah
s
,

ence o f muz z le an d the greate r development o f the back

an d upper pa rt o f the s k ull that the s kull when plac ed
upon its
,

a rti cul a r sur f ac e s

,

on the upper end o f the verte

bral column nea rly balances its
elf The importa nce o f thi s
.

ar ran gement is
,

evident be caus e it enablesusto keep

light mus
,

the hea d erect with comparatively s c u l ar eff ort

a condition whi ch wo u ld h ave been otherwis

,

e h ad it been
requi s ite to s upport a l arge an d heavy m uz z le . The el as tic
ligament pres ent in other anim alsisthusrendered n u
neces s a ry A t the s ame time there i s proof th at s ome
cul ar eff ort is
.

little m us needed to keep the head upright

y pers
,

f o r i f a d ro ws on b e watched the f orward nodding o f

the he ad is an indi cation o f the r el axation o f the m us c le s
, ,

which s uppo rt it It may b e noted that the pos ition o f

kull exertsan inuence on the pl ane o f vis
.

the s ion in
m an in the erec t po s ition the vi s ual ax i s i sdirected
to wardsthe horiz on H e look sthe whole world in the
an d the occas ional rem ark th at one h asa hang
,

f ac e
dog expre s s ion h asmore s ignicance in it th an at rs t
app ea rs .

S o f ar we h ave de alt generally with the phys ical attributes

o f m an . It is u nnece s sa ry here to dwell upon tho s e higher
mental an d moral developmentswhich dis tinguis h hi m
f rom the brute s .
 CH A PTE R II .

GE NE R A L D E SC R I PTI ON OF TH E BO E S N AN D JOI NTS .

IN the previousch apter great s tres swasl aid on th e

'

i n uence exerted by pos ture on the bodily f ramework o f

m an . The reader mus t now cons ider s ome pointsco n
n ec te d with the s keleton asa whole bef ore proceedin g to
s tu dy it in detail Fortunately fo r the art s
,

'

tudent a
a ry as
,

m inute de s
.

c ription o f all the bones is u nn ec e s

s many
o f them h ave little or no in u enc e on the s u rf ac e f orms
,

The term s keleton isapplied to the s

olid f ramework
o f the body This .cons is ts largely o f bone b ut als o incl ud es
,

ca rtil age or gri s tle an d ligaments A n examination o f .

keleton as
,

a s ordinaril y prepared is somewh at mis leading

In the proc es sof maceration to which fo r the purpos
.

es
preparation it iss
,

of ubjec ted the ca rtilaginousan d

ligamentouselementso f this
,

f ramework h ave di s appe a red

being more eas inte grated than the os s eousparts

.

ily dis
The res ult is that the dried bonesconvey b ut a poor
impres s
ion o f the delicacy an d preci s ion with which the
s e veral portionso f thiss keleta l f ramework are jointed
together
ight almo s
.

It would app ear at rs t s t hopeles sto attempt

to cl as if y the bones
s o f the body b ut a clos .er exami nation
11prove th at there a r e m any points o f resemblance between
'

them not only in regard to s

,
tructure b ut als o in regard
,
 Cla s
s
f
'

g B
ca tzo n
o n e s'

o 21 .

to f unction . There ar e b ones which ar e characteriz ed by

their length ; thes e we nd in the limbsf o r example the
s
, ,

b ne o the upper arm f ore arm thigh an d leg S uch ar e

o f -

clea rly as s
, .

ociated with movement f o r their extremi ties

,

ar e moulded into s mooth s ur f ace s ca ll ed a rticul ar s

,

ur f aces

which t mor e or l es saccu rately on the corres

,

ponding
su rf ace s o f adj ac ent b ones Of the joints so f ormed e ach

is
.

speciall y adapted f o r pa rticul ar movements To thes e .

long bo nesare attached the mus c les which caus e their

movementsan d conve rt them in to a s
,

erieso f leve rsthe

var io us f orms
,

o f whi ch wi ll b e e as ily recogniz ed by the

student o f mech an i cs This lever principle isnot co n
ned to the long bones I f one o f the irr egul arly s
.

.
- h ap e d
b o nes which make up the ve r tebral column be examined
it will be s een to pos sessa number o f prominent proces ses

S ome o f thes e a o r d attachment to mus an d act as

.

cles
'

le versen abling thes e m us cles to operate with greater

mechan ical advantage In addition to the us e o f the long

as leversit mus
.

b on es t al so be borne in mind that they

act as upportsH av ing re f ere nc e to wh at h as
s
,

. been already
state d in the previous ch apter we s e e th at the bon es of

th e l o wer limb are s toute r an d s

,

tronger th an thos e o f the

upper ; moreover their a rticul ar s urf ace s a re more expa nded

if the range o f movement o f the joints

, ,

an d which unite
them b e les sextens ive they have this
,

, advan tage th at they ,

ar e s tronger an d better tte d to be ar the s train o f the

weight o f the body which is pl aced upon them .

A nother group o f bone s ar e thos e which ar e more or

les sattened an d expanded pl ate like bones
- they are ca lled .

G enerally s peaking thes e bones

,
serve as protective coverings
f o r the more delica te s tructures which are lod ged beneath
them On examining that part o f the s kull which contains
th e bra in it i s
.

seen that the oval cas e which envelops

it is made up o f a number o f s uc h exp and e d bone s rmly
united together S o al s
. o in the pelvic region the b ones
, ,
22 C[ s
z e t wa ll
- .

which cons titute the gird le o f the lower limb afford

protection to the vi s c era whi ch ar e lodged in the cav ity

within But nature takesadvantage o f thes

. e expanded
s u rf ace s in other ways ; be s
ide s prote c ting the org a n s whi ch
they overlie they aff ord extens ive s u rf ac es f o r the att ach
ment o f mus on their oute r or expos u rf ac e s Th us
,

cle s ed s .
,

in the head the region o f th e te mple which in the s , keleton

f ormed o f expanded portions
,

is o f the te mp o r a l p a r ieta l , ,

f r o n ta l a n d s p h e n o id bone s aff ord s a ttac hm ent to one o f the

sthe temporal mus
,

powerf ul mus esthe

,

c le c le which rai s ,

lower jaw an d is ,
thus one o f the mus c le so f mas tication It .

h as been already noted how the outer s ur f ace o f the pel v ic

gird le f u rn is hes wide areas f o r the origin o f mus cle s which

pas sto the thigh bone an d control the movementso f the
-

hip-joint .

In the examplesabove cited the protec tive bonesare

rml y unite d to each other allowing o f no perceptible ,

movementsbetween them In the animal ec onomy it is .

ometimesneces s
.

however s ,
a ry to provide an a rra ngement

which while being prote ctive will at the s a me tim e allow

o f c erta in movements
,

: s
,

uch f o r in s tance is the ches t wall -

tso f an os s eous
.
,

c on s
,

This is f ramework compos ed on either

s ide o f the cur ved ribsunited in f ront with the breas
,
t
bone an d conn ected behind with the ve r te bral colum n by
,

means of a s eries o f movable joints Thi s

.

bony f ramework
.
,

c ombined with ca rt i l age membrane an d mus cle f orm s a

highly elas
, ,

tic movable yet rel atively s

,

, tro n g protecting cas e

f o r the he art a n d l u ngs
,

which ar e pl aced within i ts cavity .

M ovement in this in stance is required in order to provide

s
f o r the bellow like action which is
- neces sa ry to draw in a n d

expel the air f rom the lungs H ere again advantage is .

t ken
a o f t s
the ex en ive o ter sr ac e o f the ches
u u f t wa ll to
-

provide attac hment f o r the numerousmus c le s which p

f rom the trunk to the upper limb another example o f the ,

economy o f s pace an d materi al practis ed by nature .

24 Mo va ble j o in ts .

to keep them in contact by the i nuence o f the atmos pheric

pr e s s ure alone .

But s ome a rrangement isrequis ite whe r eby the o p

p o se d s u rf ac es m a
y be held t ogether Thi s is pr o vided .

f o r by s tructurescalled ligamen ts Thes e ligamentsare .

b a ndso f broustis s ue whi ch completely s u rround the

joint f ormi n g itscaps ule The thi cknes so f thi scaps ule

on d iff ere nt as
.

va ries pectso f the joint ; an d in s ome s itua

tionsthe thicken i n g o f the caps ul e

f orms specializ e d band s whi ch are de

s c ribe d a n d n a med as separate liga
ments A t other points . the caps ul e is

s o t h i n as merely to cons ist o f the layer

to be next des c ribed T h is is a d e li cate .

membrane which lines the interior o f

the caps ul e ca ll ed the s y n o vi a l m m
It s ecrete s
,

br a n e an oily u id call ed
.

mg gw i zgg
l
i
p
h
m
s y
a
n o via whi c h l ubri ca te s the a rti cul ar

s o f the joint an d s o r ed uces

,

ur f ace s
c on o

a m bl j i t
o va e o n .

Th thi k b l k li s f ri ction to a m in i m um S uch i s the

m m
a. e c ac ne .

m3
h
i s tr

u c t ure o f a mov a ble joint i ts
h
i3
tim s
5 my
r e .

s tren g th depen d s on the f orm o f 1ta

surf ac esan d the s toutnes s

b Th - e 1, .

arti cul ar
.

n
;
c

s
.

th ie i f
n ter o r owh i l; o f i ts lig aoment ; b u t whil s t the s e
aments
,

lig ar e us e ul in bi ndi n g together

23112 5
;x it f
s the joint they als o in many ins tances
9 1 e

ed b y d tt d li o e ne .

movement es
,

limit or check its pec ially

when s
,

uc h a n eff e ct i snot pro d uced b the lo king

y c

o f the bones thems elve s .

The accompa nyi n g gure may as s is t in expl ain i n g the

details above des cribed .

Bu t there ar e other varieti eso f movable joints the :

t ype mentioned a bove po s s ess esa joint ca vity an d a wi d e ,

ra n ge o f movement The next clas . sincl udesthos e joints

in which there isno joint cavity an d in which the move ,
 I mmo va ble j o in t s . 25

m ent i slimit d in its tent I f f res e h vertebr l olumn ex . a a c

be ex mined the bodies

a or s olid p rtsf the vertebr e a o a ar e

s een to be unit d by me sf p d sf l mi n ted br s

,

e an o a o a a ou

ti sse d p l p m tter whi h bind them together d permit

u an u a c an

limi t d movement between y two s egments

,

o f o ly n a e an .

The movement b tween the indi idu l bones e issm ll b t v a a u

egments
,

i f the n mber f sh su be t ken into o nt the

o uc a ac c u

a mo nt f movement pos
u o sible in the ol mn s whole c u a a

is very ons ider ble The rr ngement m y be better

c a . a a a

u nder s i
tood f we omp re the b k -bone to c n mber a ac a u

o f w oden di s
o k semented together by c

p d sf indi r bb r ; the movement

a o - a u e

between y two dis an kswill be s light ;

b t s
u ,
ppos ing we h ve h in f sh
u a a c a o uc

dis kss imil rly united the ol mna c u

sf ormed will q ire em rk ble

,

o ac u a r a a

exibility As will be s en here f t r e a e

ks s
.
,

thes e inte e tebr l dis

F 6 S ti ro 1 ec on
rv r they th ga
h j i t p ,
a are
ro u a o n 03

lled not o l y llow f movement ss s

,

ca n ai g j i t i ty o e n no o n cav .

o s e the us
,

ef l purpos
,

b t ls
u a erv e f m m u o a a, Th e ho e, of ,

ac ti g s
n b ff ers
a to red e the s
u ho ks uc c
by
f rom time to time tr n s
1 g m
whi h c ar e a b . in t w e rte

mi tt d long the h in f bone s

(1 k t
e a whi h c m 233
a o c p o f ,

the ite 3 a

y
un .

$ 3; a
t:
Fl g I 6 repre s
. ents the general appear i mf c rc u er en ce

an ce o f such a joint .

There are other kinds o f jointsin whi ch there is no move

ment Thes . e may be compared to the dove tailed joints -

employed in carpentry ; they are o f little importance

f rom o ur s tandpoint aswe are o nl y conce rned with the
f orms produced by their f us ion A word or two ishow
,

ever neces sa ry in regard to thes e particul ar f ormso f

jointsbecaus ,
e w i thout a knowledge o f their s tructure it
woul d be impos sible to ac count f o r the gro wth o f certain
partso f the body The mos t typi cal examplesare met
.
26 I mmo va b le j s
o in t .

with in the s kull The s everal bones

. which cover in an d
protect the brain are s een to be united at their borders
by a s erieso f interlocking teeth I f we exam ine a f res .h
spe cimen or bette r s
, till the s
, kull o f an i n f ant it will be ,

obs erved th at there isa l ayer o f me mbrane be tween the

,

oppos ed borderso f the bones ; so long as thi s membr a ne

pe rsistsgrowth may take place b ut on itsdi s appe aran ce

between the contiguous bones In thi s

,

oss eous union occurs .

FI G 17 s
Sh o w th e arr a n ge m en tb y wh ich th e b o n e sf th t p
o e o
s s j s sutu s
. .

o f th e k
ull a r e un i te d b y e rr a ted o in t called re .

w ay it is pos s ible to unders tand how increas e in siz e takes

plac e an d how the bony wall s
, o f the c ra ni al box exp and to

a llow o f the
g rowth o f the bra in When grow th i s
c omplete
the neces s
.

ity fo r thi sexpans ion no longer exi s ts; an d i f

the s kulls o f old people be ex ami ned it will not un f requ ently

be f ound th at all trace o f the s e joints or s utur es as they

h as dis appe a re d the bone s
,

ar e called h aving be come i n

s
, ,

ep arably uni te d .
 C HA PTE R III .

VE R TE BR A L COLU M N OR S PI NE .

Ir
'
will now be neces sa ry to ta ke up in detail the co n

s ideration o f the various parts o f the bo d y .

For des c riptive pu rpos esit isno doubt convenient to

f urnis has eparate ac count o f th e bones jointsan d mus c les , ,

s sesgreat advantagesin the

,

an d u ch a method po s ses
study o f s c ienti c a natomy ; b ut a knowledge o f m uch

o f the deta il whi ch it is nec es sary the medi cal s tudent

s hou ld pos s es sisaltogether us e le s
sto the s tudent o f art .

The b onesjointsan d mus c le s all f o rm p a rt o f one gre at

sys tem an d it will it ishoped s e rve o ur purpo s

, ,

e better
to c ons ider them together asthe variousregionso f the
, , ,

body are s tudied .

Althou gh the div is ions o f the body s ugges te d in Ch apte r I

are not s t ri ctly s
,
pe aking s c ienti c yet they ar e c onvenient
, , ,

an d f o r the purpo s e in view may be ad opte d with advantage .

Commen cing with the de s cription o f the trunk it will

examine the central ax i sor vertem
,

be neces s ary to

co l umn the c he s t-wall an d the pe lvi s ; though as we have

s ee n the pelvis is
, ,

properly s
,

peaking the girdle o f the lower

limbs The trunk corres
,

ponds
, ,

. pretty clos ely with wh at in

ar tis ti c language isca lled the tors o wi th thisdi fference
,

that the latter in cludespo rtionso f the upper an d lower

, ,

limbs .

A n examination o f the b ack o f the trunk involve s a more

d etailed de s cription o f the vertebral c ol umn than h as

28 Ver teb ra l Co lumn .

hitherto been given . The back bone , r epres

ente d in

Verteb ral Co lumn .

FI G 18 Fro n t view FI G 19 Back vi ew FI G 20 S id e vi ew,

s s
. . . . . . .
.

h wi o n g curve .

a Ce r vi c al v e rte b rae . s ev e n in m b er
nu 4 S acr um , fb rm e d s
b y f u io n of ve
sl sgm ts
. .

b Do r a or th o raci c ve rte b rae , t w e l ve e en

sg
. .

in nu m b er a Co cc
y m d
x a e up o f fo ur or ve e

m ts
.
,

c. Lum b ar ve r te b rae , ve in n um b e r . en .

th e acc omp nying gure sis

a s
een to cons
is
t o f th irty o r ,
-f u
 The Ver teb r a e . 29

b o nespl ed one on the top o f th e other Th is

ac statement
however requi res
.

s
,

o me qual i catio n f o r if th e s keleton b e

e s egments
, , ,

more care fu lly ex ami ned the lower te n o f thes

are s
,

een to have be come fus ed together in the pro ces so f

g row t h to f orm two sep a rate bone s o nl y ve s e gment s to
eac h b one ; thes e two b onesare not unf requently more
,

o r les suni ted They are the s

. a cr um to whi ch re f erence

has bee n alr ead y made an d the co ccyx which isf ormed
,

, ,

o f the dwar f ed ta il vertebrae o f m an .

The remaining twenty four vertebrae ar e s

- eparate an d
dis tinct s ,
o th at we have an e as y meanso f s ubdividing

the co lumn into ( a ) the region in which the vertebrae ,

twenty-f our in number are movable an d ( b) the pa rt co m

ing the s ac ral an d c occyge al po rtion s
,

pris
,

o f the col umn

ion o f ten s egmentsin whi ch the

,

f ormed by the f us ,

v e r te b ra e are immovable .

Proceeding with the examination o f one o f the movable

v e rtebrae it is seen to cons ist of a s olid p a rt in front more
o r les sdis h aped which variesin s iz e an d th icknes sac
, ,

ks -
,

cording to th e pa rt o f the c ol umn f rom whi c h the s pe cimen

has bee n taken Fus .ed on to the pos te rior as p e c t o f th i s

s o lid portion or bod y there i s an os s eousarch which thus

includes
,

between it an d the body a more or les scircular

ho le Connected wi th thi sarch ar e a number o f pro
ces s ess
.

, ome o f which ar e articul ar an d as sis t in the

j un ction o f the var ious vertebrae to gether ; others ar e long

an d o uts ta nd ing an d f o r m levers

,
to which mus cle s ar e

attac h ed . Of the l atter one s pringsf rom either s

,
ide
o f th e arch a n d f o 1 ma the tr a n s ve r se p r o ces sthe third
o r r ema i n ing o n e j uts
, ,

o ut f ro m the c entre o f the arc h

b ehin d an d i s known asthe s p i n o us p r o cess The length .

an d d ir ection o f thes e s pinesvary in di ff erent re gions

o f th e verteb ral c olumn an d as will be pres
, , ently s hown
hav e an important inuen ce on the s
,

u rf ac e conto u rs of

the b ack I f two or t h ree o f thes

. e vertebrae be taken
32 Cur vesof the Co lumn .

There ar e rvesin th e
f our cu col umn a f orwar d
curve

in th e cervica l region a backward in the dors

,
al r egio n ,

a forward in th e l u mb ar region an d a backw a rd in th e

s Of thes e f our curvesash asbee n alread y

,

ac ral region .

t at birth vi z thos
,

stated two only exi s e as s

.ociated with
the f orm ation o f the thorac i c an d pelvi c cavities ; thes
, ,

ar e the p rim ary cu rves an d ar e both direc te d b ackwa rd .

The s
,

e c ond ary cu rve s ar e thos e in the cervical an d lumbar

regions ; they ar e f orw a rd cu rve s an d as ,
h as b e en, expl a ined
in Chapter I they on ly attain their f ull development af ter
the as s umption o f the ere ct pos ture A s wi ll be s
,

. een by
a ref erenc e to Fi g 20 the s . e cu rvespas simperceptibly into
one another w ith the exception o f the lumba r an d s
,

,
ac ral

cu rves ; here the tr a ns ition f r om the f orw ar d to the b a ck

ward curve is sudden an d abrupt an d f orms the projection
tssthe s
,

known to anato is m a ac ro vertebr l

- a a e
ngl the
bony promontory which overhangs the cavity o f the pe lvis .

The cur ves f ormed by the bodies o f the vertebra e ar e to

a ce r tain extent repeated by the line connecting the tips

,

o f th e s pinous proces ses The latter h ave a very important

.

relation to the s u r f ac e c ontour s o f the b ac k f o r if the ngers

, ,

be rml y ca rr ied down the middl e line o f the back from

the lower part o f the neck to the inf erior ext remity o f the
c ol umn the tips o f th e s e proces sescan be dis tinctly f elt
It is
.

well to examin e them ca ref ully in the s

,

keleton to s ee

how far they accurately repeat the cur ves o f the anterior

outline o f the column A shasbeen s . aid the length o f

pinousproc es s
,

thes e s esvariesin diff erent s ituations : n ot

on ly s o b ut their dire ction alters co n s iderably ; in s ome

cas
,

esthey are directed almos t hor iz ontally backwardsin

other ins tan c es they ar e very obliq uely pl aced (s
,

e e Fig

Thes
.

e f ac tsh ave a very important inuence in modifyi n g

the contour line whi ch isf ormed by the line con ne cting
their tipsan d we n d that whils
, ,
t they repe at generally

the cu rveso f the s olid part o f the colum n th ey ar e ,

34 Gr o o ve s
f or Mus
cles .

ons iderable modi cation sparti c ,

cul arly in th e d irection o f ex

hi b iti n g thes e curvesto a les s

marked extent Thes e detailsare .

evident in Fig 23 . .

The grooves which lie on either

s ide o f the central ridge o f s pines
requi re fu rther noti c e par ticularly
if a s keleton is
,

examined in whi ch
the ribs an d pelvi c bones are a rti

cul ated with the vertebral col umn .

The two haunch bonesare s een -

to be united to either s ide o f the

s ac rum an d their upper an d back

partsproject co ns
,

iderably behi nd
the s urf ac es o f their atta chm ent to

the s ac rum the res ult i sthat they

bound externally thes e lateral
grooves asthey run down the back
o f th at bone In thisw ay the .

groove in thi s region on each s ide

is much deepened an d an exten ,

s ive s u rf ac e f o r the attac hment

o f m us c le sth us f or med .

On trac ing the groove upwards ,

into the mid dors a l region it is -

,

P ro3 Di g m sh wa th t f
rao u nd totobe come very
o sh a llow a f rom
sf m d b y th li
2

ac t th at the s s
. .

th e c ur v e
ti g th ti ps f th s
or

pi s the e
f
e
pine
n ou
ne
ar e not
sssd s
n e o e
s
co n n e c

o prominent ; owing to the a rti

p ro ce e op d t
not co rre on o
t h sp d d b y th
s
e c ur ve ro uc e e eu

cul ation the rib with the

t i li f th l m
of
er o r o u t ne o e co u n.
Th st g b l k li
s ds h
e ro n ac ne co rr e

p on to t f th b k vert
e co n to ur o
e bra e however the groove
e ac
,

ugh s allow is
,
i th mi d d l li h d tt d t e
p sts
n e e ne ; o e
li n e re h p l
re en tl i tho
t e h
ro e ou m uch wi der
ne

f o r the s haftso f the ribsasf ar

,
o f th b k w hi h M
e ac ,
f m c o re ro

th f i w i g h th i k to t e
ssf h s
e o re o n
g g o n c
hy m s l s
,
,

astheir angles( the pointsat

ne o t e e d u c e aro un
th s h ld - bl d b d h t
m s l sf
e ou er a e a o v e , an e

whi ch they bend f or ward) as sis

d l pm
ev e o t f h en o t e u c e o

th b e t k b l w
ut o c e o . t ,
 Erecto r s
pi n ae .
35

i n f ormi ng it soor . A bove the mi d -dor sl

a

deepens .

Lying in this groove on ,

e ither s ide o f the median

spinesisthe great es hy
col umn o f the er ecto r s
,

p i n ae

mus cle whi ch ta kesorigin

terior s
.

fr om the pos u rf ac e

an d s p ine s o f the sa c ru m
th e s pi neso f the lumbar
,

an d s
,

ome o f the lower dors al

verte brae an d in addition

receives
,

bres o f ori gin f rom

th e pos terior border o f the

haunch bone an d f rom the
-

s
,

p o te r i o r su p e r i o r ilia c ( or
h aunch ) s p i ne a s well 1
as
,

f ro m the upper border o f

that bone in i tspo s t erior
f ourth Thismus c le whi ch

is
.
,

very complicated in the

s
Th e po te ri o r upe rio r iliac s
sp i n e i th es n am e g i ve n to th e

pro m i n en t p o te r i o r e s
x t r e m ity o f
th e uppe r b o rd e r of th e h aun ch
bon e .

a Pla ced s o v er te n di n o u pa r t o f e r e c to r

s
pi n ae.

b P s
ot i sp i ili s
er or pi u er o r ac n e.

( s
.

c. H h-
b
an n a i mi t one 0 nno n a um ) .

4 S o cke t ( ace ta b ul um ) f o r h ead o f th igh

.

bone
s s
.

0 Tub ero it y o f th e i ch i um
s
.

s
.

j ! Pla ced o v e r e h y part o f e r ecto r FI G S ho w th e gr eat er ecto r

24

s s
s ss
.

ss
.

s s p i n ae m a o f m u cle The m u cle

S l i m l
s s
.

g p en u u c e

s s
s
. .

h M a to i d p r o ce o f te m po r al b o n e
a re h o wn o n ly o n o n e id e , th e
ss s s
. .

t Co m plex u m u cl e an d upe rio r c ur ved r o o ve i n wh i ch th e e lo d ged i

g y a r

s s
.

lin e o f o ccip i tal b o n e . e e n o n th e righ t id e o f th e u

g er
.
 36 Er ecto r s p in a e .

r ngement f itsbr sbre ksup into

a ra number f
o e a a o

sbs idi ry m sleswhi h h ve been s

,

u a ep r tely desribed
u c c a a a c

tsf rom u point f view h owever

,

and n med by n tomi s a a a : o r o

it m y be reg rded s one mus

, ,

le h vi ng a a a c a

m ny tt hmentsbeing r inf o ed by a a ac e rc

ddition l s lipssit send s t the

,

a a a a c a

sme time th t it f ur is hestendons

,

a a n

f insertion to the ribs d tr s ve se o an an r

pro es ses A s the g oove in whi h it c . r c

liesbe omess h llower in the do s l c a r a

region the mus le sp ds t d , c rea ou an

thi nsto be ome g in mor es hy d c a a e an

more powerfully developed s it is

,

a co n

tin ed into the upper do s l region d n r a an

the b k f the ne k s f sthe b s e ac o c a ar a a

f the s kul l to whi h it i s ul tim t ly o c a e

tt hed The es hy m s st the b k

,

a ac a a ac

f the ne k is fu ther in re s
.

ed by o c r c a

the addition o f mus c les which need n o t

here be particul ariz ed ; thes e are im
mediately concerned wi th th e move
ments o f the he ad an d neck .

A gl a nce at the accompanying d i a

FI G 25 A d i g m
gram will enable the reader to rec ogn iz e
a ra
t s
. .

h w th
o
m t f th mus
en
o g
les
o
th a t
e
the e
arran
lower p ar
c
t o
e
f thi s m u sc ul a r
wh i h s upp t
c the column i s particul arly concerned with
or

Th m us
control o f the movements
b k b -
ac

lswh i h
the
one . e
o f the

st d i slid b l k lo w er tw o thirds o f the b ack b o n e w h il s

e e, c are re
p e r

en e n o
-
ac
- t
s t b th i k the upper part ismore immediately
, ,

a re ee n o e c

sf the
i th
n

l i s d
gi
k
e re

d asso c i a
on
ted with
o
the movement s o f the
thos
o n

head on the column as

an

well as
n ec , an
co mp ti ly thi i
ara ve n n e of
th mid -d s
,

e l egi
the upper pa rt o f the col umn its
or a r on .

el f .

Whils t the er ecto r s p i n ae h as a f ree adm ixture of

tend inousbresthroughout itsentire length thes e fo

pect o f the mus
,

a dens e layer on the s uper ci al as c le at i ts

38 Er ecto r s
pi na e .

body The depth o f the median f ur row o f the bac k wil l

.

there f ore depend l argely on the development o f thes e

mus c le s their s
,
tate o f contraction an d the pos
, ture o f the
body We have only to ex ami ne the bac k o f a weakly
.

pe rs on an d co mpare it w ith that o f the athl e te to s ee

at on ce the extent to whi c h thes e mus cles inuence the

surf ac e c ontou rs .

On tracing the median groove downward we nd th at ,

it not unfr equently end s in a depres sion or dimple whi ch

po nd sto the pos ition o f the s econd s
,

us ually co r res ac

spine ; below thispoint the f urrow fadesins ens ibly into

the cleft between th e buttocks The gro ove its . elf isbes t
marked in the region o f the loinsin which s ituation
there are ofte n indicationso f the pres
,

ence o f the lu mbar

s pinesasdemons trated by the unevennes so f the bottom
s
,

o f the groove ; it become s hallower again above where it ,

is inte rrupted by the outline o f s ome o f the more s u pe r ci al

mus c le s The lower attachm ent o f the er ecto r s

.
p i n ae is
as s ociated with two dis tinct depres sions on either s ide ; one
co r re spondsto the oute r border o f the attachm ent o f its
es hy bres to the pos terior f ourth or s o o f th e ili ac cre s t .

As R icher h as
,

pointed o ut thi sisonl y s

,

e en in men ; in

women the more abundant depos

,

ition o f fat in this region

ob literates this little hollow The oth er depres sion co rre
n ds s
.

s po to the po ition o f the po sterior su perior il i ac s pine

f rom whi ch the tendino us o f the m us
,

bres c le spring an d th is ,

little dimple iscommon alike to ma le an d f emale Thes .e

tw o l atter depres sions c ombined with the f urrows on either
s ide corres
, ponding to the pos terior border o f the h aun ch
bonesan d the outer converging marginso f the s a cr um

mark o ff a s
,

omewh at depres s ed tri angular are a overlyi ng

terior s urf ace o f the s
,

in part the pos a crum It is

. thi s a re a

which isasit were wedged in between the prominences

, ,

f orm e d at either s ide an d below by the projection o f the

buttocksIt s hould be noted that the an gles
. o f thi s triangle
 Er ecto r s
p in a e .
39

are ll xed poin ts d wh tever h

a an a e the relation o f the
tssin en ed by h ange o f pos
, ,

sur unding p
ro ar a u c c ture the
s
,

limitsf thisr rem in lw ysthe ame Pl atesV VI

o a ea a a a ( , ,

x , XVII pp ,
. 6
3 ,

FI G . 26 . FI G . 27
.

In the lumbar region in the m ale the outer margin

o f the erecto r m as sisindicated by a s
,

hallow depres s ion

which s e par ates
,

it f rom the ank

The movements
.

o f the c ol umn ar e exceedingly compli ca ted .

40 Mo vemen tsof Co lumn .

In attempting to analyz e them th e s tudent s hould bear in

a lready s ts
is
,

mind the facts tated viz th at the column cons .

egmentsan d a part in whi ch

,

o f a p a rt m ade up o f separate s ,

the originally s eparate s egments have become f us e d together

in the proces s o f growth The l atter compri s

. es the s ac rum

a n d co ccyx the f ormer incl udes

,
the parts o f the col umn whi ch

FI G . 28.

lie in the neck thorax an d loinsM ovement can alone take

, .

e parts
,

place in thos o f th e col umn in whi c h the vertebra e

ar e s eparate Further it i s
. well to note fo r reasons already

explained that the s ac rum is

, ,

rmly an d immovably co n
to form the pelvis In this
,

n ecte d with the h aun ch -bones .

w ay a xed b as e isprovided f o r the uppe r an d movable

,

p ar t o f the bac k bone an d an y movement o f the pelvis

-

as joints
,

a whole e i ther at th e hi p-
, or by ro tation on the
 Mo vemen tsof Co lumn .
4 1

thi ghsneces s
arily in volves an al te ration in the pos ition
o f th e bas e on whi ch the movable part o f the column res
,

ts
h as
.

As been s hown the upper or movable pa rt o f the

pl ayscertain cur vesa f o r war d curve in
,

v e r te b m l ax i sdis :

the lum bar re gion a bac kw ar d in the thorac ic region an d

, ,

a f or war d in the cervi cal region .

FI G . 29.

The s
e curves s
ar e nec es a ri ly much modied not
to the extent we might im agi ne when the bac k is
,

bent
f o r war dsan d backw ard s
,

; the se movement s a r e termed

ex io n an d ext en s ion respectively an d are f rees t in the
lumba r an d cervical regions They ar e n o t s
. o f ree in
th e thoracic region f o r here the cage e
,
- structure o f
th e tho rac i c w all limits the range o f the movement in
eith er di rection The power o f b ending f or ward in thi s
.
42 Mo vemen tsof Co lumn .

part o f the column ischecked by the compres s ion o f th e

ches t wall whils
- t the extent o f the backward movemen t
in th isregion islimited by the res ta nce o f the che s
,

is t
wall to f urther expan s ion ; again the overlapping o f the
s pines o f the dors exten s
,

a l ver tebra e mech a ni ca lly checks ion

o f the col u mn in thi s s ituation
Flexion is ion in the neck As
.

fr eest in the loinsextens

h as
.
,

been already pointed o ut the s pineso f the cervical

vertebrae ar e s
,

hort hence they do not interfere with the

ion asisthe cas e with the s pineso f
,

movement o f exten s
the dors
,

a l verte brae .

In throwing back the head an d trunk the curve d es cr ibed

is
,

not a uni f orm one on account o f the limited power o f

extens ion pos s region ass
,

essed in the dors al hown in

F igs
,

. 26 2 7 .

It is
,

to be noted th at when the body i s bent f orward the

hollow in the lumbar region dis

a ppear s an d f o r it i s sub

s
,

tituted a curve which blends above with th at o f the thorax ,

th us
,

lead ing to a more owing an d uni form outline .

It will be obs erved h o wever ( Fig . that the outline

o f the gure in ex act prol e doe s not corres
,

pond to the
cur ve o f the medi an line o f the bac k f rom th e f a ct th at
,

the mus cul ar proje ctio n s on either s ide o f the column ,

particul arly in the regi on o f the s houl der bladesconceal

-
,

f rom view the middle line o f the gure .

Latera l movements o f the col um n are al s o pos sible the

ide Thismovement
,

trunk being bent to one or other s .

is f ree st in the ne c k extremely

,
limi te d in the l umb a r
region an d not great in the thoracic region f o r here it ,

is a ril y as sociated with a compres s ion o f the ches

,

nec es s t
wall on the s ide toward swhich the body isbent an d an
tr ucture on the oppos
,

exte n s ion or s tretching o f the s a me s ite

side The range o f this side to s
- - ide movement isgreatly
ition o f the pelvi s Th
.

incre as ed by altering the pos . e

alteration in the po s ition o f the pelviss hi ftsthe plane

44 Mo vemen tsof Co lumn .

dors a l region an d h as its convex ity d irected towar d s th e

probably d ue to the greater us
,

right s ide It is
. e o f the right

ar m as compar ed with the lef t an d is

, ass oci ated with
a more pronoun ced development o f the

mus cles o f the right l i mb

of ten a s
.

Below this cur ve there is light

compens a to ry curve in the oppo s i te dir ec
tion whi ch impar ts a s inuousas pect to
the bac k an d relieves
,

it o f its appea rance

of s tiff nes s .

M ovements o f rotation m ay ta ke pl ace

in the cer vical an d als o s lightly in the

dors al region A s .w e have s een thes e move

ments
,

ar e combined with the l atera l ex i o n

in the s ide to s
- - ide movementsThe po wer .

which we pos ses so f turni ng the head

round s o as ,
to direct the eyes in a dirce
tion Oppos ite to that in which the toe s
point ismainly d ue to the exi s tence o f
a s
,

pecial joint between the top o f the

col umn an d the bas e o f the s kull f urther
as sis ted by the rotation o f the pelvis
,

which
suppo r ts
,

the bas e o f the col umn on the

upper extremities o f the thigh bones This
,

- .

ca n be demons trated in the f ollowing w ay .

S tand in g erec t x the pelvis

, by plac ing
the hands on the h aunchestur n the he ad ,

to one or other s ide without caus,

ing an y
pe rceptible movement o f the column then
s
,

rot a te the c ol umn s til l keeping the pelvi

FI G 32
xed if thes e directionsbe f ollowed it
.
,
.

will be found that the eyescan be directed ac ro s sthe

,

point o f the s houlder If now the p elvi sb e rele as

. ed ,

the f urther movement in a bac kward direction will b e

seen to b e eff ected by the rotation o f the pelvi son the
 Mo vemen tsof Co lumn .
45

thigh bonesthe one hip being advanced whil s

- t the other
is d irecte d back ward s This uf ciently proves
, ,

. s how limited
the movement o f rotation is when s trictly conned to the
column an d demons trates how much the range o f this
upon the rotation o f the pelvi s
,

movement depends on th e
th ighsf o r the head isnow turned s o that the eye s m ay
be d irected s traight beh ind the gure ins te ad o f acro s
sthe
,

shoulder ashappened when the movement wasconned

,

to the tr un k alone .
 C HA PTE R IV .

TH E TH ORAX , TH E NS
RE G I O OF TH E F LA NK , A ND

TH E A NTE R I OR A BD OM I NA L WALL .

A LTH OU G H the ches t -wall comesinto immediate relation

with the s u rf ace o f the body at comp aratively f ew points

it isan extremely importa nt f acto r in determining the

,

general outline o f the upper part o f the trunk becaus e it

the boneso f the
,

f orms the f ramework whi ch s uppor ts

s houlder girdle The s

- . e bonesimpart a var ying width to
the s houl der according as they ar e pl aced upon a narrow
or a broad ches
,

t a diff erence which is ch aracteris tic o f th e

exesthe comparatively nar row ches
,

two s ,
t o f the f emale
c ontras ting with the broad expa nded ches t o f the male .

In examining the s t ructur es which enter into its f ormation ,

it is neces sa ry to con s ider what are the requirements o f the

c he s
t -wall In the rs
. t pl ac e it mus t be capable o f move
ment This depends on its association with the res pirato ry
wall expand san d contrac tswith
.

n
fu c tion .The c he st -

a bellows -like action an d thisiseff ected by meanso f

o f jointe d bone s which ar e acted on by mus c le s
,

a s eries .

neces s
,

But in addition it i s
, ,
a ry th at the c he st -wa ll s hould
f orm a protective covering f o r the vita l orga n s whi ch ar e
lodged within itscavity ; f o r thisreas on bes idesbeing
movable it mus t combine s ti city I ts
,

trength with el as .

s
,

tructure i sadmirably adapted to meet thes e require

 R ib s .
47

ments ; bone c a rt i l a ge ligament mus c le an d membrane all

enter into its

, , , ,

f orm ation .

Th e os seous am ew o rk cons
'
is
tso f twelve pairso f ri bs
whi ch vary in length an d in degr ee o f curvature acc ording
to the pos ition they occupy A typical s
,

pecimen exhibits .

a sh aft which ismore or les scurved an d twis ted ; the

poste ri or extr emity or head articul ateswi th the dors al

FI G 34 S h o w h o w th e rib arti culate s s

s
s
. .

wi th a verteb ra a een f ro m ab o ve .

Fro 33 Th e r t an d s a.H ea d o f r i b ar ti cula ti n g wi th b o d y o f ve rte b r a

N
.

s s
. .

b ec k o f r i b
i x th rib
ss
. .

c Tub e rcl e o f r ib ar ti culatin g wi th tr an v er e

b N
.

0. H ead . . ec k.

11 Bo dy o f v e rte b r a .

sss
.

0. S h a ft A r t i cul a r p ro ce e o f ver te b r a
e.
s s
.

J E x t r em i ty o f h a ft w h i ch N
j : eural r in g f o r l o d gem en t o f p in al co rd
s ss s ss
. .

ar ti c ul a te wi th th e r i b Tra n v e r e p ro ce e o f ve rte b r a
0
s s
sf t b
. .

It
. S pi p n ou ro ce o ve r e ra .

ver tebrae ; an d the ant e rior an d is connecte d in f ront with

the breas t-bone by means o f a b ar o f ca rtil age .

I f an articulated s kele to n b e exami ned it will be noti ced

im ila rly connected with the breas
,

that all the ribs a r e not s t

bo ne The rs . t s even p airsar e connected with it directly
by means o f their ca rtil age s ; the next t h ree p a irsn a mely ,

the eighth ninth an d tenth ar e only indirectly connected ,

with it by pieces
, ,

o f cartil age whi ch ar e joined together , ,

48 R ib s.

b ut which un ite above with the cartil ageso f the s eventh

pa ir o f ribs ; while the two lowes t viz the eleventh an d .

twel th pa i sa e not connected with the breas

,

f r r t bo ne at all
-

The ribs
.

ar e th us cl as
,

s
i ed according to their relation to
the s tern um into the tr ue r ibswhich include the rs ts
,

e ven

pairs an d the f a ls e the lower ve pai rs

,

e r ib s
,

,
which compri s
,

FI G 35 Fro n t vi ew of s
kl e e to n o f th o rax Th e co s
t l
a carti lage s
s
. . .

are h d a ed .

The l atte r gro up th usincludesthe two las t pairswhi ch

ar e ge nerally known as the o a ting r i bs
,

A r ranged one ab ove the other thes e arched bones f orm

a cage like s tructure by their uni on with the breas
,

- t bone in
-

fro nt an d the col umn be hi nd The s hape o f the f ramework

s c ri b ed as
.

o f ormed h as bee n des a trunca te d cone or it m ay ,

50 Br ea sb t o ne
- .

isf ormed not o l y be tween th rv sthems n elvesb t e cu e u

between the pl nes f the rves this ngle h sbeen

a o cu ; a a

alre dy re f erred to in onnexion with the s

a t dy f the c u o

v ertebr l ol mn ; the p rt f the s

a c h f t f the rib b hind
u a o a o e

it h sb en s
a een to s
esis
t in the f orm tion f the g oove in
a a o r

whi h the er t r m slesf the b k

c pl d the p t
ec o u c o ac ar e ace ar

of the sh ft f the rib in f ront f the ngle f orms

a o the rve o a cu

s s
Brea t-b o n e ( ter n um ) .

FI G 37 Fr o n t vi e w
. . . FI G 38 S id e . . vi ew .

a s
U ppe r p a r t o f b rea t-b o n e ( ma n u d sf
S ur f ac e ti l ti o r ar cu a on w ith c o l la r

s s
. .

b ri u m te rn i ) b one

s sf
. .

6 M id d l e pa rt o f b rea t-b o n e ( b o d y , o r e S f
ur ac e ti l ti or ar cu a on wi t h ca r t i
s f s
. .

g la d i o l u ) I g t ib
s
n e o r r

s sf
. .

c Lo w er pa r t o f b r ea t -b o n e ( e n ifo r m S f
u r ac e ti l ti or ar cu a on wi th c a r ti
s
s g s f s d t s th s s
.

p r o ce ) . la e o e co n o e ve n r ib i n cl u i ve .

of the side an d f ront o f the ches t -w all The ad aptation o f

the ribsto the barrel s
.

hape o f the che s t -wa ll n eces sa rily

involvesa s light twis ting o f their s haftss o that the

atte ned s
.

urf ac e s o f thes e bones ar e bro ught in to h a rmony

with the genera l outline o f the thorax

Th e b r eas
.

t-b o n e or s te r n um in th e ad ul t c on s is tso f three

piec esthe middle one o f which h asbeen f ormed by the

, ,

,
 Br ea sb t o ne
-
.
5 1

fu sion f s ever l elements Th s

o e three p rts f the
a . e a o

bre s at b one m y be ins

- ep bly nited b t it iss l to
a a ra u ,
u u ua

nd the highe s t one det hed f om the othersin the ac r

m er ted s
ac keleton A s
a the joints whi h ite thes e p ts
. c un ar

in lif e s m th t there i spr ti lly no movement in

ar e o r a ac ca

them we m y f pres
,
ent p rpos esreg rd the s
a tern m s
or u a u a

one bone ons isti g f three p ts pper middle d

c n o ar ,
an u ,
a ,
an

a lower Viewed from the f ront the pper p rt ppe s

. u a a ar

the l rg s t d mos
a t exp nded the mid d le portion dis
e an pl ys a a

mu h v riety f s
c h pe in diff erent individ l s it v ries
a o a ua : a

in width d is often ons,

ide bly w ider belo w th n bove
an c ra a a .

The j oint between the pper d m iddl p rtsf the b one u an e a o ,

i f f usion h s t ken pl e i s m rk d b y tr n s
a a vers e ridge ac ,
a e a a .

Th lowes
e t p rt ons istsin e rly lif e f
a til ge whi h
c a o ca r a c

be omess i d l ter it ls
,

c s o o v riesm h in s
e h pe d i ts
a a a uc a ,
an

a nterior su f e does not ome sf f orw rd sthe lev l

r ac c a ar a a e

of the front o f the middle p art .

I f we exa mine the bone f rom the s ide w e note tha t it is ,

s lightly cu rved a curve whi ch corres ,

pond s to tha t o f th e

f ront o f the ches t -wa ll in the middle line ; above this

cu rve i s
,

inte rrupted at the point o f j unction o f the upper

an d middle portion s by a s light angle f ormed by the
a rticul a tion between the two Thisi sknown to an a
te as
.

to mis the s te m a l a ngle ( S e e Fig

h as
. .

As been already s een the breas t bone iso f grea t -

s
,

ervi ce in f orming a s uppo r t f o r the rib s in f ont being r ,

uni te d to them by the r i b ca rtil a ges a lre a dy re f e r red to .

The rs t pa ir o f ribsarticul a teswith thisbone at the

upper angle s o f the highe s t portion ; the s ec o n d p a ir o f

r ibs by means o f their ca rtil a ges unite with th e bone on ,

either s
,

ide at a level w ith the li n e o f a rti culation or it

, ,

m ay be o f fus ion o f the highes ts e g m e nt w ith the mi d d l e

ixth pai rso f ri b s

,

por tion The thi rd f ourth f th an d s

.
, , ,

ar e u nite d to the middle pa rt o f th e bon e a lo n g i ts o ut e r

b o r d e r an d the s
,
eventh p air o f ribsi e the l as t pair direc tly ,
. .

E 2
52 B sb
r ea t o n e
- .

c onnecte d with the s ternum iswedged in between the

t portio n s
,

middle a n d lowe s o f the bone .

In addition to itsconnexion with the ribsthe breas ,

t
bone ls a o rticul teswi th the co ll a r bones
a a -
; the s u rf ac es

f o r thes e m ay be s een at the upper angleso f the rs t

portion j us , t above the point w here the rs t ribsar e
a ttached . The upper border o f the rs t pa rt o f the breas t
bo ne between the s e tw o articul ar s urf ace s f o r the coll a r
bone sisthick an d rounded an d s lightly hollowed ; it
f orms the lower limit o f that depres sion familiarly known
as the pit o f the neck From this . point downward s a long

the middle line the bone isquite s uperc i a l a n d c orre

s p o n ds to a groove ,
noti c e a ble on the model the s ide,s
of which are f ormed by the bulging o f the powerf ul
mus c le s which ari s e f rom the la tera l s ur f ac e s o f thi s bone .

I f the nger be run down thi s groove the s terna l a ngle

f ormed as h as been s
, ,

a id by the a rti cul a tion o f the hi ghe s t

middle portionso f the breas t bone can a lwaysbe
, ,

an d -
,

recogniz ed by touch an d in the male not unf requ ently

ight In f eriorly the groove end sin a more or les s
,

by s .

well marked depres

- ion over the s
s ituation o f the lowes t
s egment o f the bone or en s if o r m c a rtil a ge a s it h as been
named This ion i scalled the pit o f the s
,

. depres s tomach
ides
,

an d i ts s a r e f ormed by the s light projection o f the ca rti

lages o f the s eventh pair o f ribs asthey pas s upw a rd s to the
breas t bone ( Plates
- VIII IX XV X VI pp 62 72 108
, ,
.

e detailsa re obs
, , , , ,

In the f emale thes cu red by the l arge

depos ition o f fat in thisregion d ue to the pres , ence o f the

bre as ts The extent to whi ch thes
. e points can be ob s erved
in pers ons o f either s e x will l a rgely d e pend on the degree

o f m us cu l a r develop m ent a n d the a mo u nt o f f a t In an .

emaciate d pers on not only ca n the outline o f the w hole

bre s a t bone be s
- een b ut the ribsan d rib cartilagesm ay
,

with cas e be c o unted .

From the fact that the ribs a r e a rti cul a ted with the bac k
 Th o r a x .
53

bone in s uch a w ay that their po s terior extremities a lw a ys

li e on a higher level tha n their anterior end sthe s ha f t ,

o f e ac h bone lie s in a plane obliqu e to an d not horiz onta l

with the verti cal pl an e In cons . eq uence o f thi sthe upper
the bre s t bone doesnot lie on a level with the
,

end o f a -

r s t thoracic vertebra b ut at a point cons iderably below

corres
, ,

po nding it may be to the lower border o f the s econd ,

or the upper bo rder o f the thi rd thoraci c vertebra ; the level

varies lightly according asthe breas
,

s t-bone i srais ed or
lowered dur in g the re s piratory movements F
( gi It i s .

d ue to thi s obliquity o f the rs t rib

that the nec k appears longer in f ront
than behind In like manner the
.

lower end o f the middl e s egment

o f the s ternum corres pondsus ua lly

to the level o f the ninth or te nth

th oracic vertebra Of cours e this w ill
vary according to th e len gth o f the
bo ne which diff erscons
,
iderably in
diff erent indi vidual s Th e angle
.

whi ch the bone f orms with a hori

z o n tal li ne drawn through i ts
m
inf erior 11152 3 32fz gzzl
( er '

31

extremity ranges
3

f rom abo ut 70 to
f ll f tha h s
ot- w ll i e c e a n

m ts f s
approache s
th m i
75
0
The bone more ti
e

o n.
o ve
p en o re ra

nea rly the ver tical in the f em ale

o it isrelatively broader in proportion to its
,

in whom a l s
length an d als o a b su s
ol tely hor t er th a n in the m a le Thi s .

s s s
,

ir
c cu m t n
a c e imp a rt a more ro u nded f orm to the c he t -w a ll
of wom an .In re g a rd to the proportion a te length o f the
s u Du
tern m v a l h a s pointed o u t th a t in c l u ding the u pper
pond spretty clos
,

an d mi ddle portions only it corres

,

,
ely to
the length o f the coll ar-bone or to the length o f the hand
,

les s the third joint o f the middle nger .

Taken as a whole the thorax i n the f em a le i s of s lighte r

build an d relatively s
,

horte r an d more rounded than in the ,

 54 Th o r a x .

ma le ; in the fe mal e too the upper ribs

, ,
a r e more movable

th an in the male an a rrangement w hich a llow so f great er

,

e x pan s ion o f thispart o f the f emale ches t during v iolent

in s piratory movementss uch as
. ar e very f req uently e m ploy d e

on the s tage to indi cate s uppre s s

e d emotion The lo w er .

ma rgin o f th e thorax pl aysan important pa rt in the

moulding o f the s u rf ace contou rs The eleventh an d
.

tw elfth ribsm ay b e di s re ga rded fo r their s haf tsan d ex

tre m iti e s c les
,

a r e deeply i m bedded in th e e s hy mus o f th e

ank b ut the ca rtil ageso f the tenth ninth an d eighth ,

they cu rve forward a n d upw ard to join the cartil ages

.

ribsas
,

o f the s eventh ribsan d thus . beco m e indir ctly unite d w ith e

the breas t-bon e are very cle arly indicated on the s

,
u rf ace

o f the body . though their outline m ay be concea led to

a grea ter or le s sexte nt by the development a n d s tate o f
contrac tion o f s o m e o f the mus c les w hi c h f orm the wa ll o f
the abdomen in f ro n t ( Plate s VIII IX XV pp 62 72 , .

o de s
,

Th e f orm o f the o utline s

, , ,

c ribed s w eeps downward

an d outwa rd f rom the pit o f the s tomac h in a dire ction
toward s
,

the highes t point o f the cres t o f the haunch bone -

the convexity o f the cur ve being direct ed inw ardsan d

downwa rds A s . w ill be s hown hereaf ter the ac utenes , so f
the angle between the tw o converging borderso f the
thorac ic w a ll is to a great exte nt concealed by the pres ence
o f tw o o f the mus cle s w hi ch f orm the wa ll o f the abdomen
in fr ont Thes. e ar e ca lled the r ecti a bd o mi n ismus c les an d

are pl ac e d one on either s

,

ide o f the middle line

As
.

a lr ead y s ta ted the expanded oute r s

, urf ac e o f the

thorac ic wa ll aff ord sextens ive attachment not o n ly to

the mus c le s
,

o f th e a bdomen b ut a l s ,
o to the mus c le s o f th e

upper limb . In thisw ay the outer s u rf ac e o f th e rib s is

c lothed with es hy l ayerswhich conceal the f orm o f thes e
boneswhil s
.

, t the s houlder girdle above w ith its

- as s o c i a ted

mus c le s entirely modies the s

,

, h ape o f the upper pa rt o f the

9
trunk .
 A n ter io r A bdo m i n a l Wa ll .
55

The region o f the abdomen which we have next to ,

co n s ider lies , between the lower thoracic margin above an d

the pelvis below It extend s . round the s ides o f the trunk

where it orms the nks d there i ts u rf ac e f orm blend s

.

f a an , s -

behind with th at produced on either s ide by the erectores

spinae mus c les A . longitudina l fu rrow along the o uter
border o f that es hy mas sin the lumbar regio n s erves
to dene the b i n d e r limit o f the
ank .

The ca vi ty o f the abdomen how ,

ever isnot s
,
o limited b ut extend s ,

up wa rd s beneath the thoracic wall

fo r a con s iderable dis tance itsroof ,

bei n g f ormed by a dome s - h aped par

tition the d iap hr agm which s
,
eparates
,

it from the thoracic cavity .

Th e anterior as p e c t of the ab

d o min al wall is limi ted above in the

mid dle lin e by the pit o f the s tomac h .

a depres sion which corres pond sto F G -4 133 8 h w I 0 13 111 S o

i g th b u d i sf th
the e n s 1fo r m car ti l age Fr om th rs b d mi l i
.
n e o n ar e o e

poin t itsmargin isdened by the

g a o na re on .

A t i sp i mm u er o r

car til ages the s

a n e r or

s i s
.

of e venth eighth b S m h s p ne

y p y is p b is
.

, ,

n m th an d tenth ri bs
u

P p ts
. .

1n the m a nner li g m

t c . ou ar a en .

a lrea dy d e s
,
d W
c ribed ; the eleventh an d

twelf th r ibs th ough not dis

an d as
,

a rule with d i culty f elt

c erni ble
E
dg gl i it
,

,
0; '

m
ca rry thi s cur ve toward s the back .

Th e lower bound ary o f the abdomin al w all is f ormed by

th e h n
au c h - b on e Th i s .bone w ill be more fully des c ribe d

when th e anatomy o f the thigh an d buttock is cons idered ,

b ut it is neces sary here to mention s ome points connec ted

with its struc tur e As w as. s tate d in an earlier ch apter it

f o r med by the f us
,

is i on o f three s maller bonesthe ilium

th e p ub isan d the is
, ,

,
chium With the rs . t two only ar e
56 Ha un ch b - o ne .

we at pres ent concerned The ili um f ormsthe upper ex

an d by i ts
.

p a n d e d wing - lik e p o rtion o f the h a u n c h -bone

uppo rt f o r the conte nts
,

inner hollow s ur f ac e f urnis hes a s

o f the abdomin a l cav ity while the outer s urf ac e aff ord s

a ttac hment to the mus the buttock Th es

,

cles of e two
.

s urf ac es meet above an d f or m the upper curved margin

o f the bone whi c h is te r med the cr es Thisili ac cres
,

t . t

end sin f ront an d behi nd in two well -marked projections

,

or s pinescalled res pectively the a n ter io r an d p o s

,

ter i o r
up e r io r i lia c s s
,

s p i n e. T h e rel a tion o f the l a tter we h a ve

already s tudied in connexion with the s urf ac e f orm s of

the lower part o f the back ( vide Ch apter III ) Th e an terior .

s u perior ili ac s pine w ill be f ound to have a like importance in

rel ation to the anterior region ( Plates VIII IX pp 62
The p ub isis
.
, , ,

th at portion o f the h aunch bone whi ch lies -

in f ront an d be low The pubi s

. o f the one s ide is united to

its f ellow o f the oppo s ite s ide by an immovable joint called

the s m
y p y h sis p u b i
,
s whi c h corre spond s in p o sition to the
lower pa rt o f the abdomen in the middle l ine An inch , .

or s o fr om the m iddle line ( s omewh at more in the f em ale )

the upper border o f thi sbon e f ormsa projection called
,

the s s
,

p i ne of th e p u b i .S tret c hi ng between the a nterior

superior s pine o f the ilium which liesat a cons i derably
pine there is a b and o f brous
,

higher level an d the pubic s

liga me n t This
,

tis su e ca lled Po up a r t s band which i sin

'

reality for med by the lower bres o f the s

, ,

heet like tendon

-

o f one o f the abdomin al mus cles is curved be tween i ts

,

pointso f attachment The convexity o f the cur ve i s

.

directed dow nward an d cor res ,

pond sto the f urrow which
separatesthe lower abdomi nal region f rom the f ront o f
the thigh ; the f urrow i scomm only known by the name
o f the f old o f the groin .

S uch ar e the bo und ar i es o f the abdomi na l w all N ow .

this wall ismade up o f a number o f extended s heet like

-

mus cle s attached by their ed ge s to thes e boundari esan d ,

58 L umba r A po n eur o i s
s .

other two l ayersar e f rom without inward sthe in tern a l

,
a lis The e s
o b liq ue a n d tr a n ver s hy breso f thes
e three .

mus c le sdo not reac h far f orw a rd son th e abdominal w all

b u t a r e again repl ac ed by tendino us
,

sheetsor apone uroses ;

as we approach the middl e line in f ront the apone uros is ,

F I G 42 S id e
. . vi ew o f mu slesf the t u k
c o r n .

11 s
Pec to ra li maj o r m u sl i g i f t f t us b d m i is o n

q
c e. n n ro n o re c a

sl f b d m m s
.

b E x te r n a l o bli ue m u l u c e
l b li q
c e o a o en

si sf s A t i sp i ili s
. . .

c Ap o n e ur o o ex ter n a ue , co r e. n pi P
er o r u er o r ac n e, o u
f p b is
o

s ssm il is p ts d s
.

rep di g t
on li n e un a r l ig m t pi

a en an ne o u
l b li q
n o e ar

u sis ss s s s
.
. ,

d Ap o ne f
ro o ex t er n a o p ue ,
9 S at u m n u m l
e r ra e u c e.
h L tis s im sd si m s
. .

. a l u or u c e.

of intermedia te mus
th e cle splitsthe s plit l ayersbeing
united in f ront an d behind w ith the aponeur o s
,

es o f the

oute r an d inner mus c le respectively The l ayers s

o f ormed

enclos c lb which is
.

e a m us e nted in s
here repres ection the .
,
 A bd o min a l Wa ll .
59

breso f which directed longitudin ally Thisisthe

are .

str a ight o r r ectusmus cle o f the abdomina l wall A t the s

ide .

o f this mus t the middle line the layers

cle nea re s ,
which ,

o verlie it back an d f ront aga in unite a n d bec ome blended ,

FI G 43 Fro n t vi ew
. . of mu sl sf th
c e o e ab d o mi n al wa ll .

a. th e rem o va l of th e fr o n t of it s
s q
6 E x ter n al o b li ue m u cle o f ab d o m en s
h th
ea s
h w i g i ts
an dt di o n en no u s
s
s i t sti s
.
,

c A po u euro i o f ex te rn a l o b li q ue, co r n e r ec on

s s s g t s m g s m s
. .

re po n d i n g to li n ea e m il un ar i S l nu u c e
q s
er ra u e

s
s s 1 L tis s im s d si m s
. . .

d A po n eu r o i o f ex ter n al o b li u e , pa 0 a u l or u c e

s s i Li sl b f m d b y th f s
. . .

in g i n f r o n t o f rectu a b d o m i n i ne e e, i f
or e e u on o

s sp ssf th
.

mu cl e th e t di
en n ou a o n e u ro e o e

s s m s l sf th
.

a c A n te r i o r upe r i o r ili ac pin e, Po u u c e k i th m id d l

o e an n e e

s s s
.

pa r t ligam en t , an d pi n e o f pu b i li

ne

s ss s U m b ili s
.

f Rect u ab d o mi n i m u cle , ex po ed b y
. I t . cu l o r na ve .

with a sim il ar l ayer fr om the oppos ite side o f the body As .

both sideso f the tr unk ar e s ymm etrical there isf ormed ,

in thisw ay a brous cord whi c h li esin th middle line in

,
60 Exter n a l Oblique .

f ront , exte nding f rom the ca rtil age o f the breas t -bone above
to the s ymphys is pubis below ; this is ca lled the li nea a lb a .

On either s ide o f thisare the longi tudinal recti mus c le s ,

whi ch als o s tretc h from the thoracic margin above to the

pubis be low Thes e mus c le s ar e ens hea thed in the manner
j us
.

t des cribed We are only concerned with the mos t

s
.

uper c ial o f the m us cles o f the ank an d abdomin al wall .

Th isi sthe ex tern a l o b lique ; as i tsn ame impliesi ts

bresha ve an oblique direction The mus
,

. cle c on s istso f
a bro ad s heet o f e s hy bres which takes origin f rom the
outer s ur f ace s o f the eight lower ribs by a s erie s of s lips or
digita tionsThe hi nder bresalmos
,

t ve r tical in direction
sdown to be attac hed to the anterior hal f o f the cres
.

pas
, ,

t
o f the ili um or haunch bone - In f ront o f thisattachment
.

the es hy bresare ins erted into the mos t s uperc i al o f

the aponeurotic l ayers j us t des c ribed Thes

. e anterior bres
ar e di rected f or ward s with varying degrees o f obliquity .

Through the medium o f its a poneuro s is th e mus cle b ecome s

attac hed to Poupart s ligament ( which hasbeen already

des cribed as pas s ing be tween the anterior s upe rior iliac
'

s pine an d the s pine o f the pubis ) to the whole length

o f the lin es extending from the s ispubis
,

a lba
. ymphys
below to the rtil ge o the breas
,

ca a f t bo ne above an d to
-

the fas
,

c i a coveri n g the l arge m us cle whi ch ari s es f rom th e

f ront o f the c he st- wall on either s ide o f the middl e li ne
the mus
,

v iz. c le ca lled the gr ea t p ecto ra l A line let fall

.

vertica lly fr om the middle o f the coll ar bone to meet -

a tr ans vers e line carried acros sbetween the two anterior

superior s pineso f the il i a with the an gle between the
,

two rounded o ff will f a irly acc urately dene the anterior

hy p ortion o f the mus
,

limit o f the es cle ( Figs 4 2

cles
.
,

The r ecti mus o f the abdomen lie on either s ide o f the

middle line ; they are attac hed above to th e cartil ages of

the f th s ixth an d s eventh ribsas well as to the cartilage

t-bone ; below th ey are connected with the pubes
, , ,

o f the breas
 R ectu sb d a o mz m
'

s
'

. 61

an d pubi c s ymphys is ; their lower a ttachments ar e very

much narrower than their upper Thes e m us

. c les do not lie
immedi ately be nea th the s kin an d s uperc i a l f a tty l ayer ,

b ut a r e en s heathed in the man ner a lready s tated by the

es o f the mus c le s
, ,

aponeu ro s o f the ank When the anterior .

layer o f th es es heathsisremoved the mus c le s ar e expo s ed .

is
,

The arrangement o f their es hy bres peculiar In pl ace .

o f extending the whole length o f the m u s c le they ar e

ections wh ich us
,

interrupted by tendinous inters ua lly occupy

ce rta in de nite po s itions In thisw ay the mus

. c le i s not
co mpo s e d o f one e s hy belly b ut o f f our or ve s
, egments
rml y united to each other by s hort tendinous bresThes e
tendinous
.

inters ectionsor lin eae tr a n s

, ver s a e as they ar e ,

called ar e us ,
ua lly three in n umber an d ar e s ,
ituated the
lowes
,

t a little above the level o f the navel ; the hi ghes t

a s
,

hort dis tance below the pit o f the s

,

tomach ; the inter

mediate one midway between the other two The l atter
,
.

is us ua lly contin u ous towards the ou ter s ide with the broad
s
,

h allow f u rrows which s

,

urro und the s ides o f the trunk a n d

ition o f the wai s

,

which mark the pos t ( Fig .

The inner bo rde rso f the two mus c le s lie s ide by s ide
being s
,

eparated merely by their s heathsan d the linea

alb a whi ch i swider above th e navel than below The .

outer border i sgently cur ved f rom the upper broad

,

attachm ent to the m ore pointed lower origin f rom the

pubis .

We mus t now examine the in u nce thes e s etructures

have upon the s u rf ac e con to u rs A medi a n fu r row i s
. seen
r unn i ng f rom the pit o f the s tomach downwa rdstow ards
the s ymphys ispubis ; thi s c orre spond s to the po sition of

the li nea alba The prominence o f the rectusmus

. c le on

either s ide as sists in deepening the groove A bout midway .

betwee n the rtil ge o the br sbone an d the s

ca a f e a t- ymphys is
pubisisplaced the n a vel Below thi spoint the median
.

f ur r ow become s le ssdis ti n ct an d nally dis

,
appea rs owing
62 Co n to ursof A bdo m i n a l Wa ll .

to the c lo s er approx imation o f the rec ti mus cles an d th e

more abund an t q uantity o f f at in thi s region .

The ou ter borde rs o f the re c ti mu s c les a r e m a rked by t h e

exis tence o f f u rows so m eti m es

r ca lled the Ii n eae s em i lun a n s

e p a ra te the a n te rior a bdomin a l region f r o m tho s

.
,

Thes e s e

o f the ank s C ommen c i n g a bove a t the C o s

. ta] margin
to the rib s
,

j us t wide o f the attachment o f the recti mus c l es ,

thes e furrowsar e narro w ashere the es hy p a rts o f th e

li e clos
,

recti an d x ternal obli q u e mus

e c les e together A t .

the level o f the navel th e f urrowsbegin to widen an d ,

u ltim a tely s pread o ut to f orm s mooth areaso f trian gular

s h ape Thes
. e areascorres pon d to the s ur f ac e o f the ab

d o m in a l wa ll i mm edi a tely above th e f old s o f the gr o in .

H ere the e s hy pa rtso f the s uperc i a l mu s cles o f the

abd omin a l w all ar e s e p a ra te d by a wide interva l co m

pos ed o f te ndinousbre s The ou ter border o f the rectus

.

as it cu rvesin to be attac hed to the pubi slimitsthis

region on the in ner s ide I tslow er bound ary i smarked
.

by Poup art sligament A bove an d to the outer s

'

. ide ,

th e bre s o f the extern al obliqu e f orm i ts oute r limit .

Thes e deta ilsm ay not in eve ry ca s e be clearly recogniz ed ,

as their s harpnes sd epen d son the quantity o f fat be neath

the s kin ( P late s VIII IX pp 62 , .
,

A gl anc e at Fig 4 3 will enable one to re aliz e that

.

thistriangul ar area corres pondsto the low er p a rt o f the

a poneuro s iso f the exter al ob lique m us nc le which here ,

h as a f orm s omew hat res embling the s hape o f an a rrow

hea d the point being directe d toward sthe s pine o f the
s
,

pubis ; the ide s to the,

o u ter bor d er o f t h r t u s a n d e ec

Po upa rt sliga ment res

'

pe tive ly ; the tang or p art where

c ,

the arrow-hea d isco n ne c te d w ith the s haft co r re s ponding ,

to the ins ertion o f th e bres o f th e extern a l obliqu e .

The prominence sf o r me d by the recti mus c le s as they lie

between the m e d i n an d late ra l furrow s
a ar i n te rr upte d bye

tran s vers e gr ooves A bove the level o f the navel thes

. e
64 Fo ld of the Gr ain .

The f old o f the groin ashas be en se en co rre s

, pondsto
the pos
,

ition o f Poupart s ligament Owing to the fact that

.

thi sband isvery intim ately connected with the fas ci a or

inve sting brous sheath o f the thigh it i sf ound to undergo ,

con siderab le modication according to the pos ition o f the

limb Thuswhen th e thigh i sextended or s
.
,
traightened

FI G 44 s
Diagra m matic r epre en tatio n o f th e var io u f urro ws sd
an

s
ss s
. .

d epre i o n o n th e an te ri o r urf ace o f th e trun k .

on the trunk the f as ,

tsit will nece s
cia whi ch inve s sari ly

be draw n down an d asone o f the attachmentso f this

c i a isPoup art s
,

fa s ligament the res ult i sth at the ligam nt

e

is rend e re d more tens e at the same time th a t i ts

downward
curve i s increas ed If however the thigh be bent upon
.
,

the trunk the ligament isrelaxed an d tend sto become

,

,
 Fo ld of the Gr o in . 65

s
t i ght
ra er ; th esf tse t on
e ac r ac Wh enth e sf
ur ace f o rm
.

th e li mb is extended the f old o f th e groin wil l b e s een

to bes t ad vantage an d will di s play a more o r l es scurved
outl ine a f orm which is a lways accentuated in the antique .

Th e outer end o f th is to th e p os
,

f u rrow corres p onds ition

o f the anterior s u perior ili ac s pine at which point it
f orms an open angle with the tran s vers
,

e furrow o f the
an k ; the in n er extremitieso f th e f oldso f th e groin
ar e n o t unf requ ently los t in the f at in thi s region though
in many cas esthey become blended with a s
,

h allow
dep res sion which cur vesdownwards acro ssthe lower part
o f the abdomin al wa ll an d the p rominen c e whi ch over

lies the s y mphy si sp u bi s J u st above thi s in the f em a le

h allow curved depres s
.

there isf requent ly a s

, ,

econd s ion
as s
,

een in the Townley Venusan d i n the accompanying ,

gur e ( Fig 45) .

D is tinct f rom the above an d d ue to the ex i o n o f the

e or s
,

thi gh at the hip joint there i s

- a creas uper ci al f oldi ng

o f the s kin This lies below the fold o f the groin an d is

,

b es ts een in the plump thi gh o f a youn g child Thi s

,

line
whi ch ismos t dis
.
,

tinct internally by the s ide o f th e

geni talscurves u pwards acro s
sthe uppe r
,

, an d o u tward s

an d anterior part o f the thi gh to be los t in the general

r ou ndne s s o f the limb In the adul t it isbes t seen in the
not concealed as
.

f ema le in whom its

, inner extremity is ,

in the m ale Brucke h aspointed o ut th at in the f emal e

tinct f orms In the one as
.

thislin e appearsin two dis .

s
,

hown in Fi g 46 the hollow o f the curve i sdirected

.

up wardsthe outer extremity o f the fu rrow i s

,

turned
towar ds the anterior s
,

uperior i li ac s pine an d it us ua l ly

blends with th e f old o f the groin about i tsmiddle In

,

outward s
.

th e other type ( Fi g 45 ) the line cur v es . acro s s

th e thi gh th e holl ow o f the cu rve be ing direc te d down
wards E xternally the line i sb ut f aintly s
,

een on th e
ral rounded s
.

g e ne u r f ac e o f the f ront o f the thigh b ut ,

r
66

the t
s
gh be exed
er en ce

the f old i s
Fsbetween M a le
e m a le

rendered more
a nd .

if hi
di stin t c

s s
.

Th bdomen
e a in the m l e hou ld be m ll ; th t
a f the a a o

of thi ker f tty l yer ; in the

a c a s s
l o the r e
a f f e male a u ac

conto rsdependent on m s
u les obsred d dis
pl y u c ar e cu an a

s
,

a s
moother d more ro nded
an ppe r n e For the me
u a a a c . a

re son the n vel in women isslly more depres

a a sed owing u ua ,

to the presen e f the srro nding f t One need not here

c o u u a .

FI G 45
. . Fro .
46
.

dil ate on the banef ul inuence o f the pres su re exerted by

the us e o f co r s
etson the s hape o f the abdomen it is
s
,

uf cient merely to note the fac t an d put the s tudent on

h is guard agains t the articial f orms so prod uced .

Tam ing next to th at portion o f the abdominal wall w hi c h

liesbetw een the lateral abdominal depres s ion in f ron t
( i .e the
. f urrow c orre s
ponding to the inte r va l bet w een the
rectus an d ex tern al obliqu e an d the l a teral dors l depre ss
ion
) a

behi nd this isf ound to incl ude the region known as

,
the ank .

A bo ve the thorac ic margin limits

, thisregion ; be low the ,
 68 Fla n k The .

prominent where it f orms ngle with the f rrow f an a u o

the groin s h s been lre dy s

,

a a t ted a a a .

The pper limit f the nk orr s pond sto the w i s

,

u o t a c e a ,

the n r owes
a r vers
t tr n s e di meter f the trunk A bove
a a o .

thi slevel the gure in re se sin bre dth owing to the

c a a

enlargement o f the thorac ic f rame

work an d the mus c les connec ted,

with the upper limb Below the .

,

outline iscarried down by a

gentle curve whi ch in creas es th e
breadth o f the trunk until the
iliac crest isreached at this point ,

ow ing to the overl apping o f the

iliac cres t by the es hy bres of

the external oblique the curve

i smuch accentuated asit dip s
,

down into the ili ac furrow In .

the f em ale the outline iss of ter

an d more owing an d th e ili ac

furrow not s
,

o we ll m arked Th e .

wai s t therefore corres pond sto

hallow f urrow whi ch lies
, ,

a broa d s

between the wider p artso f the

trunk above an d below ; in f ront
thi ss hallow depres s ion becomes
blended with the lateral abdomin al
furrow or linea s emil un ari sat a ,

point corre s ponding to the j unc

FI G 4 7 ( f ta Ri h ) ti o n o f the tenth rib cartil age
er c er

W i th the n i nth at s ome d i s

th 1t

f
tance ,

above the level o f the n avel an d

a trie below the level o f the middle trans vers e inters

,

ection
o f the rec tus A t thi s
. point where there i s a slight genera l
hollowing o f the s
,

ur f ac e th e thorac i c ma rgin f ormed by the

ca rtil ages o f the fa l se ribscan be dis tinctly fe lt A si s

,

.
 A ctio n
f o A bdo mi n a l Mus
cles . 69

s een in many o f the antique sthi sfurrow o f the wais , t is

ca rried round the front o f the gure in corr e s ponden ce
with the furrows prod uced by the middle tendinous inter
s ection s o f the recti

above des
.

The abdominal mus cle s c ribed ar e o f re a t u s

g e

in s upporting the content s o f the abdomina l cavity an d

al s o as sis t in the movementso f res

,

piration When an y .

violent mus cu la r eff ort i s abou t to be m a de the s e mus cle s

ar e th rown in to a s
,

tate o f contraction to brace up the

abdomin al w all s an d s o re s is t the s train to which they
e be s
,

would otherwi s ubj ec t ed I f the vertebra l colum n be

.

not xed thes e mus cle s will as s is t in bending the trunk

f or wa rds i f the mus c le s o f both s idesact at the s
,

am e

time I f on ly thos
. e o f one s ide ar e brought into play they
will eff ect a lateral movement o f the trun k towardsth e
s ide on which they ar e contracted It may happen that .

th e upper p a rt o f the trunk is xed asin climbing or

hanging by the hand s s s s s
,

; in thi ca e the m u c le wil l a s si st

in drawing upwards an d f or ward s or to one or oth er s ide
th e pelvis an d lower limbs
, ,

The s e movements give ri s e to very con s iderable mo d ica

tions in the s urfac e f orm sWhen the tru nk i s
. bent f orward
the tis su es o f the anterior abdomin a l wa ll become in f olded

( F i g s 4
.8 The d e epe s t o f the s e tr an s ver se f old s p a ss e s
s
,

a c r o s the belly a l i ttle above or j u s t on a level with the

n ave l Latera lly thi s f old corres pond s to the in f erior thoraci c
s
.

margin an d the compres ion o f the abdomi nal contents le ads

to a greater di s tens ion o f the abdominal wall below this
,

line
o f ex i o n tha n i s the cas e in the erect pos ition S econdary .

fo lds may appear either above or below the one alrea dy

menti oned an d in extreme ex i o n the furrow us ually very

s hallow whi ch connects the two furrows

, ,

o f the groin above

th e pubis
,

becomesemphas i ed an d converte d into a deep

z

line A t the s
. a me time the furrow o f the groin i s deepened
an d th e f ore p a rt o f the ili ac f u rrow rendered more di s tinct .
70 Co n to ursof .
A b d o m in a l Wa ll .

The pos ition o f the se f olds isofte n indi cated on the surf ace

o f the abdomen in the ordin ary erec t po s ition by delicate ,

which merely aff ect the s

,

lines kin an d do not in an y way

in uence the s ur face c onto urs C on s equent on the altera .

tion in the f orm o f the abdominal wall in the exed pos ition
there i sa di s appe ara nc e o f some o f the mos t character

FI G 48
. .

s smos
i ti c f urrow t not bly the l t r l bdomin l f rro ws
'

a a e a a a u

whi h orr s pond to the o ter border f the re ti ; thes

, ,

c c e e u o c

di s ppe r d the ro nded f orm f the nk be omes

a a ,
an u o a c co n

ti
n uo u swith the gener l ro ndnes sf the f ront f the b lly
a u o o e

whi h lies
c below the bes t m rked line f i The mos t a o ex on .

noti e ble eff e tsf extens

c a ion f the tr nk on the srf e
c o o u u ac

f orm sf the bdomin l w ll

o a di s
tin t ttening d
a a ar e a c a an

s tret hi g f th t region d m rked proje tion f the

c n o a , an a a c o
72 Ej f
ect o Mo vemen ts .

body isbent isnaturally stretched an d the furrows whi ch

dene it above an d below ar e obliterated their place s
,

being taken by reliefs whi ch corres

,

pond to the thoracic

m rgin an d th e re t o f the haun ch bone res
a c s - pectively ,

Fm .
s
o.

On th e s id e towardswhich the movement takesplace

thes e f urrows are deepened an d owing to the compres sion
o f th e ti s
sues o f the s
, ,

ide o f the body th e ank forms

the s
,

a p ro min en t pad o r e levation , ur face o f whi c h is

 Ej ect o f M o vemen t s
.
73

travers ed by numerous s kin foldswhi ch are us ually more

distinct behind than in f ro nt ( Pl ates VI VIII pp 42 .

Th e s urf ace f orm s

, ,

o f the abdomen an d ank ar e like

wi se aecte d by the movements

'

o f rotation o f whi ch menti on

has
,

been already made ( p 44 ) in connexi on with the move

.

ments o f the verte bra l col umn . Their principal in uence

is to caus e an obliquity o f the longitudinal f urrowsan d
vers
,

to intens ify the trans e f urrowsn a mely thos e o f the

wais t an d cres t o f the haun ch bone on the s
,

- ide towar d
which th e body is turned whils
,

t leading to their eacemen t

'

ide f rom which the body is

,

on th e s turn ed ( Plate IX p .

Combi nati ons thes e movementswi ll neces s

,

of a rily be

associated with modicationsin the s urf ace f ormsb ut ,

bearin g in mi nd the main poin ts as they have been des

,

c ribed

in the s imples t f orms o f movement the s tudent will be

enabled to analyz e more correctly the complex outlines
,

associated with combinationso f thes e movements .

 CH A PTE R V .

TH E S H OU LD E R -G IR DLE A N D TH E M U S CLE S W H I CH
I N F LUE N CE I TS M OVE M E N TS .

W E have next to s
t dy the
u manner in which the upper
limb i so
c n necte d the trunk This iseff ected in the
.

FI G 51 A
. . Bo n e sf th
o e right upper li mb , f ro n t vi ew .

a Co lla r -b o n e ( c la v icle ) d H um e r u s g W risb o n es

t- ( ca r p u )s
s s sR s s
. . . . . .

b Bre a t -b o n e ( te rn um ) ad iu h M etao a r pu
s s s
. . . .

c . S h o ul d e r -b lad e ( capul a) .
f . U ln a . i . Fi n ger -b o n e ( ph ala uge )
.
76 Co ll -b
a r o n e.

keep clearly in view the f act th at the s houlder gird le is -

pa rticularly modied in ord er to permit o f great f reedom

,

o f movement between the upper limb an d trunk .

The co lla r b o ne ( Figs53 54) may be compared to a rod

-

esses
.

bent into the f o r m o f the italic letter f It pos s

,

two .

extremitiesthe inner o f which isenl arged an d articul ate s

with the upper end o f the breas t bone j us
,

- t above the
t rib ca rtil age to which it isals
,

j unction o f the rs o rmly ,

a ttac hed by liga ment The outer extremi ty is attened

.

f rom above down ward s an d s lightly expanded ; it i s ca lled

the acr o mia l en d o f the bone b ecaus e it articul ateswith

,

FI G 52 Diagramma tic r epre en tatio n s of the

s
. .

h o uld e r-gi rd le .

a. s sl t b
F ir t d o r a ver e ra . d S h o u ld er- s
b lad e ( ca pula )
Fi s
. .

b rt ib r a Co lla r -b o n e ( cla vi c le )
s (s s
. . .

c B t-b
re a t one er n um ) .
f . H um e r u ( b o n e o f upper ar m ) .

the acromion proces s o f the shoulder-blade This end o f the

pond sto the s
.

bone corre s ummit o f the s houlder an d in

the male liesat a s
,

lightly hi gher level than the inner

or etern a l en d The cur veso f the bone ar e s
. o a rra nged

th t the p rt
a a o f the s h ft near the breas
a t bone isbulged
-

f orward whil s, t the oute r half o f the bone des cribes a curve ,

the convexity o f which is direc te d backward s Thes e curves .

impart a certain amount o f s pring to the bone s o tha t

the s
,

hock o f blows f a lling on the s houlder is reduced by the

s light yi elding o f the cur vesa condition whi ch would
not hold good h ad the bone been s
,

tra igh t .

The urveso f the collar bone vary cons

c - iderably in
diff erent individuals The vari ations . ar e d ue in gre at part
 Co ll - b
ar o ne .
77

to the exercis e or us e th at h as been made o f the limb

In pers
.

ons who have to live by har d manual labour the

c urves ar e more pronoun ced th an in tho s e whos e occupation
is se denta ry a diff eren ce whi ch is to a greater or l ess extent
a lso charac teris exes The curvatures
tic o f the s
,

o f the bone
,

may there f ore be regarded asaff ording s ome indication

o f th e m us cul ar development o f the pers on to whom the
bo ne belonged As men ar e us uall y more m us cul ar th a n

wo men the in f erence will be th at a bone which dis plays

.

well marked cur vesisthat o f a male D iff erenc esin

,

- .

le n gth m ay al s o b e noted as havin g an impo rtant relation

to the width o f the s houlders Asthe inner enl arged .

extre mities o f the coll ar bones res t upon the upper extremity
-

o f the bre as t -bone t hey are s eparated by a notch the

, ,

Ri gh t co llar-b o n e ( cla vi cle )

s
s s
s
.

FI G 53 A
. . ee n fro m th e fro n t. FI G 54 A . . e en fr o m ab o ve .

a. S h a c. A cr o mia l e n d , w ith a r ti cular u r f aces

ss
.

0 S te rn al
. en d . f o r ac r o m io n p ro cw o f ca pula .

lower boundary o f which isf ormed by th e upper margin

o f the b re ast bone Pas
- i ng acros
s sfr om one clavicle to the
.

o ther there isa s trong band called the i n ter cla vz cula r '

liga men t ; thisliga ment s moothso ff the angleso f the

,

notch which is thus converted into a round e d well -m arked

es
s
, ,

d epr i on between the extremitie so f the c oll a r-boneson

e ith er s ide n d the breas
a t bone below ( Fig
- I t is .

th is which caus es the s urfac e depre s

s ion known asthe pit
o f th e nec k the di s tinctnes so f which isfurther increas ed
b y the attachment o f one o f the neck m us cle s
,

to whi ch ,

ref eren c e wi ll be made in a f ut ure ch apte r .

Fr om what h asbeen s tated regarding the coll ar bone-

an d i ts arti cul ation s it will be eas y to unders ta nd how it

 Sho uld er bla de
- .

actsasa prop or fulc c rum on whi h the s

ahoulder bl de -

moves Thisaction o f the bone may be readily demon

.

strate d i f we comp are its pos ition when the limb is thrown
forward an d when it i s d rawn b ack In the former ca s e .

the coll ar bone is - pulled f orward f rom the ches t wall whil s
- t ,

in the latte r action the bone is bro ught into clos er rel ation
with the ches t wall The acc ompanying gure ( Fig 56 )
-

e actions
. .

repres entsin a diagrammatic way thes .

The s ho uld er b lad e o r scap u la ( Fi gs s

, ,

a thin
57 5 59)
8 i
- .
, ,

plate like bone o f trian gular f orm with certain outs

- tanding
proce ss terior as
,

e s It is. placed on the upper an d pos pect o f

FI G 55 S h o win g arti culatio n o f th e co lla r-b o n e ( clavi cle ) wi th s s

s s
. .

the b rea t-b o n e ( te r n um ) .

a.Co lla r - s
b o n e ( cla vicl e ) s g Place d o ve r th e b o dy of th e td s
s l r or a

s s s
. .

b Ete rn a l en d o f co ll ar -bone ve r te b r a ,li e i n th e in te r val b e t w een

s s s s s
. .

c Place d o n th e r t an d e co n d r i b th e ete r n al en d o f th e co llar - b on e ,

s s s ds
. .

d Th e upper p iece o f th e b rea t- bon e ap w hi h ace p t th c co r r e on o e

s sf d p s s
.

( man u b r i um te rni ) ur ace i t th t f th

e re on a e ro o o e
s
.

f Ri b ca r ti lage
. . n ec k , call ed th e p it o f th e n eck .

the ches t-wall overlying the s

, econd to the s eventh ribs
i ncl us ive In the upright pos
. ition with the arm s by the s ide
usuall y cor res
,

the int v l between the two blade bones

e r a - ponds
to the width o f the neck As a tri angle the bone po s
. ses ses
three s ides a n d three a ngles The borde rs ar e de s
. c ribed as

inner outer an d s
, ,uperior It m ay be well here to ad d s
. ome
expl anation o f the us e o f thes e te rm s in anato my Th e body .

being s ymmetrical on the two s ideswe can divide it by

i al plane A s
,

an im agin ary pl ane whi ch we te rm the me s

this
.

ectsthe trunk in f ront an d behind it corre

,

pl ane bis
s s s s s
,

po n d t o the middle line o f the e re gion In comp a ri n g .

80 Sh o uld er - bl de
a .

sperior
u inf erior ar e eas
an d ily distinguis hable particul arly
the l atte r which can b e obs erved to advance acros s the ches
,

t
wall when we ra is
,

e the arm over the head The external .

angle whi ch f urni s hes the s hallow s ocket f o r the lodgement

is obscured by the s tructure s
,

o f the hea d o f the h umerus

houl der joint I t will be des

,

around the s - c ribed a t greate r

con s
.

length when the anatomy o f that joint i s idered .

s
Th e righ t h o uld er-b lad e s
f ca u a ) .
p l
FI G 57 Back vi ew
. . . Fm 58 E x te rn al
. . view . FI G 59 Fro n t view
. . .

a G le n o i d f ac e , fo r h ead o f h ume ru
. s .

b S p in e It E x tc r n al i lla ry b o rd e r
o r ax

ss
. . .

c A c r o mi o n p r o ce
. . i I n te r nal o r ver te b ral b o r d er
. .

d Face t f o r o uter e n d o f co lla r- bon e k S upe r i o r b o r d er

s
s s ss
s
. . . .

3 Co raco i d p ro ce 1 S upra-p in o u f o a
s ss
s
. . . .

f S uper i o r a n gle m I n f r a -pi n o u f o a

s
. . . .

n. V e n tr a l or a n te r i o r ur fac e .

si g f rom the pos

A ri n t erior s rf e f the s ho lder bl de u ac o u - a

we s the pro es
ee s ll ed the s p i cThi s pro e s
s i s
cas
ome ne c

wh t tri ng l r i f orm It i s tt hed by one f its

.

a a u a n a ac o

bordersto the bl de bone the pos

.

terior srf e f whi h

a - u ac o c

it th sdivides se lled res

,

u int two neq l f os o pe tively u ua a ca c

the s s s s
s s
,

p d i f
u ra p i f
an ordingn ra - they nou o ae , acc a

lie b ove or below the s

a pine whi h s ep r t sthem The c a a e

idesf the s
.

rem ining two s

a pine f orm free b ordersth t o ,
a
 Sho uld er -bla de . 81

i sto sya they ar e not attached by os

, seousun ion to an y
other pa rtso f the bone ; one the longes t or pos terior
border iss
,

, uper c i a l throughout its entire extent an d

form san importa nt facto r in the modelling o f the
,

s urf ace conto ur s over it The externa l b order i ss

. hort
an d curved con n e cting the externa l extremi t ie s
,
o f the

attac hed an d the po s terior borders The plane o f thi s .

tria ngular s pinous proc e s s is

oblique to the plane o f the bl ade
bone in an upward direction ,

a f act whi c h i s bes t di s played

on m aking a s ection o f the bone .

I ts upper s u rf ace f orm s part o f

the oor o f the s upra s pinous -

f oss a i ts
,
under s urf ac e part o f the

inf ra s
- pinous f ossa .

Th e inner angle o f thi s spine ,

f ormed by the convergenc e o f the

pos terior an d attac hed borders
c orr e s
,

pond sto the point o f j unc

tion o f the upper with the middle th E

ld iE hzjil
t
Zhbg
l
bl h zfs
l
- e a
third o f th e i n te r nal border o f the 91mm f f
a, h d f 9 o g , or ea o

bl ad e -bone There ar e two ex b

.

tern al a nglesone anterior which A mi p s

as c ro on ro ce

ss
.
, ,

corres pond sto the outer end o f a I i gl

C id p 6. o r ac o ro c e .

. n fe r o r an e.

the attached border the other l S p si sf s ,

E l in
s
b d x t e rn a
ra - p n o u
0? ? or er .

s
u o a

s f ss
. .

r l o r w h 1ch 18 f ormed by the

4

p o t e m I fm pi n nou o a.

v l
.
,
m m
fu s
t in e n tr a o r an e r o r
ion o f the exter nal with the '

pos terior b order A t this point the spine b ecome s continuous

sca lled the a cr o mio n p r o ces swhich iscarried

.

with a proc es ,

upwa rd s an d o utwa rd s fo r some di sta nce in a line with the ,

pos terior border o f the s pine It then t urnss

. ome what
sudden l y f orwa rd s an d becomes compre s sed an d attened
s
,

o th at i ts surfac es
,

a r e dire c ted upwa r ds a n d do wn ward s

It archeso v er the s houl der j oint an d i s

.

- f urnis
, hed on i ts
G
82 Sho uld er - bla de .

inner border near itsextremity with a s mall facet by ,

meanso f which it a rticulate swith the oute r end o f the

c oll r bone
a - Thi s proces
. siso f great importance in r ela
tion to the s urf ac e c ontoursas it f orm sthe s um mit o f

the s houl der an d i ss Thes

,

uperc i al throu ghout e details .

though s
, ,

omewhat tediousare neces sa ry aswithout a know ,

ledge o f the s
,

hape o f thi s bone it will be d i cult to under

stand itsrelation to the s u rro un di ng m usc le san d to the

proces
A nother so f hook like form called the co r a co id
-

sss s
,

p r o ce pring f rom the u pper border o f the bl a de bone -

e to the externa l angle Thisisimporta nt o nl y as

,

c los
,

FI G 6 1 s
On th e lef t id e o f th e gure th e girdle i h o wn pulled s
s
s
. .

b ac k
o n th e r igh t i d e d rawn f o rwa rd
, .

a Co ll ar -b o n e ( cla vi c le ) c s
Br ea t-b o n e 6. s ib
F ir t r

s s
t d s
. . . . .

b . S h o ul d er -
b lad e ( ca pu la ) . d . Fir l
or a ve r teb ra .

aff ording attachment to mus c le s an d ligaments an d is not

a de te rmin ant o f s
,

u rf ac e f orm

the bl ad e bone oppos

.

The s u rf ace o f - ite th at to which the

s pine is a tta c h ed is o as
,

hollowed o ut s to f orm a s ha llow

a in whi c h es Thiss u rf a ce i s
,

f oss hy m us c les ar e lodged .

dire cted to w ardsthe che s t wall an d liesin relation to

-
,

th e outer s u rface s o f the ribs being s ep arated f rom them

heetso f intervening m us cle s Ash asbeen s
.

by s a id .
,

the c ollar -bone articulate s with the acromion proces so f the

su bl ade The joint its
ho ld r - e . el f iss m a ll an d weak b ut is ,

very much s trength ened by powerful ligaments which pas s

b etween the c oll a r -bone an d the corac oid proces s .
84 Sh o uld er -
gi r dle .

various ly combined Ash as been s een certa in movements

ta ke place at the acromio -clavicul ar joint s
.
,

o that the ,

movementso f the blade bone ar e further compli cate d by

-

the addition o f thos e which ar e e ff ected at the s te rno

cl avi cul a r arti cul a tion

houlder-blade isonly thus s

.

But whils t the s lightly co n

eousf ramework o f the ches t it is
,

n ec te d with the os s very ,

ef ciently s upporte d an d held in po s ition by the many

m us c le swith w hich it is conn ec ted an d the s e react on the
ur fac e f orm ac c ording as they ar e s
,

s
.

tron gly developed

or not .

In m an we us ua lly n d the ou te r end o f the coll ar b one -

lying at a s omewhat higher level than th e inner end In .

woman the outer end o f the bone lies eith e r about the s a me

level as the inner end or s o mewh a t lower In other words

.
,

in the m ale the col lar bonestend to s

- lope o utward s an d

upwa rd sin the f em a le o utwa rd s ,

an d do w n w a rd s Thi s is .

owing to the diffe rent form o f the ches t wall in the two -

sexes The s . maller an d narrow er ches t o f the f emale aff ord s

the girdle le s ss upport th an in m an in whom the larger
a wi d e r s
,

thorax fu m i s hes urf ac e on whi ch the girdle m a

y
res t But independently o f the f orm o f the framework o f
.
,

the ches t there a r e other fa c tors

, which mus t be taken
into account ; thes e ar e the m us c l es It o f te n h appen s
. th at
a pers on w ith s loping s hou ld e rsis recom m e nd e d to indu lge
in s ome f orm o f gymnas tic exe rci s e to e x pa nd h isch e s t .

Af ter the age o f twenty v e when all the bo n e s

-
a r e f ul ly

os s
,

i e d a n d th e gure s e t an
y f orm
, o f exer c is e w ill h a ve
b ut little in uen ce on the f o rm o f the thorax ex cept th a t
~

it s timu latesa more hea lthy res

,

piration Y e t we can n ot .

b ut a dmit the eff ec t which the exerci s e h as h a d on the m a n

f o r he a pp a rsn o w w ith braced -up gure a n d s
,

e qu e ar

s ho ulders The in creas

. e i n bread th o f the ch es t isn o t d ue
to an y marked increas e in the cap ac ity or f orm o f the ch e s t
wall b u t isd ue almos
, t entire ly to the incre as e in s i e of z
 Sho uld er -
gi r dle . 85

the mus cles brought about by exercis e As h as been s

. hown ,

s ome o thes cles

,

f e mus lie between the bl de bone an d the

a -

ches t wall an d o n e can readily un ders

-
, tand how an y i n
c reas e in the thi cknes so f thes e l a yers will tend to pus h

u pw a rd s a n d u o tw a rd s the bl a de -bone f rom the c he swall

t -

an d s
,

o imp a rt to the s houlders th a t s quarenes swhich is so

des irable in the mal e gure In regard to the relative .

proporti ons o f the se bo nes to others we nd that the col lar

the os
,

b one i s us ua lly a bo ut the s a me length as s eouspar t

o f the breas t b one or abou t h a l f the length o f the bone
-
,

o f the upper ar m The length o f the inte rnal border o f

.

th e s houlder blade ver y nea rly appro xim ate s

- to that o f the
coll r b one
a - .Thes e meas uremen ts ar e ver y li able to va ry

an d m us t not be ta ken as
,

aff ec ting a n
y s c ienti c ac c u r ac y ;
they ar e merely put f orw a rd as a id s to as sist the draughts
m an to apportion approx i ma tely the lengthsto thes e
diff erent bone s .

Bef ore pas s ing to the cons ideration o f the mus c les which
move the upper li mb on the tru nk it will be nec es s a ry

to ente r into a s
,

hort explanation o f the m o d e in which

mus c l es act .Taking the s imple cas e where two long bones
ar e u nited by a joint whi ch permits o f a hin ge like move
-

ment it wi ll be apparent that an y mus c le attac hed to the

upper bone an d p as s
,

ing down over the joint either in ,

f ront o f or behind it to be ins , erted into the lower bone ,

will when it contractseff ec t a movement o f the lower

, ,

bone on the upper If t he mus . c le p as s es in front o f the

joint the limb will b e b ent or exed ; if it pas
,
s esbehind
the joint the limb will h s traigh te ned or exte nded S uch .

mus c les or ex te n s
,

ar e ca lled d i r ect e x o rs o rs .

But it not unf requ ently h appen sth at a m us c le whi ch

takesori gin f rom the upper bone isnot ins erte d into the
bone imm edia te ly below b ut p as s es over that bone to be
e the mus c le p a s s es
,

ins erted into one b eyond In thi scas

over more than one arti culation A ll the inte r ven i n g joi n ts
.

.
86 A ctio n f
o M n sc le s .

may be in uenced by the contraction o f s uch a mus c le

b ut as
,

the action o f thismus c le i s not brought to bea r

directly on the intermediate bo n e it has been des cribed as

pos ses s ing an ind i rect action .

To ta ke the cas e with whi ch we a re immedi ate ly co n

c erned A number o f mus
. c les p as sf rom the trunk to the
bones o f the s houlder girdle Thes
- . e have a direc t inuence
on the movements o f the bones o f the girdle b ut there a r e
,

othe rswhi ch ari s ing f rom the trunk ar e no t attac hed to

sto be ins
,

o f the girdle b ut p a s
,

the bones erted into the bone

c onn ec ted with the s
,

o f the upper arm whi ch is houlder

e mus c le s
,

girdle by the s houlder-joint Thes . act prim a rily

u pon the bone o f the upper a r m movi ng it a t the s , houlder

joint b ut t h ey als
,
os econd arily aff ect the movements o f the

g irdle thro u gh i ts c onnexio n with th e bone o f the upper

ar m . This is the indirect action o f thes e mus c le s a n d they

,

ar e there f ore de s c ribed as ac ting indire ctly on the move

mentso f the girdle in contrad is tinction to thos e which

act dir ec tly upon it .

A rr anging the m us cle s acc ording to their ac tion it will ,

be mos t convenient to take up the cons ideration o f that

group which actsdirectly on the girdle n amely thos e
which aris
, ,

e from the trunk an d are ins e rte d into the bones

o f the girdle It will not be nec es
. s a ry to des c ribe them

all f o r s ome have no in uence on the s u rf ac e f orm an d

may fo r pres
,

ent p urpos
,

esbe dis regarded

The mus
.

c les with whi ch we ar e p articularly con cern ed

a r e the tr ap ez ius the r ho mb o id sthe le va to r a n gu li s cap ula e

the s e r r a tus
, , ,

ma gn us an d the p ecto r a lis mi n o r Be it u nder

.

s e mus c les ides

,

tood that thes ar e s ymm etrical on the two s

o f the body .There is a p a ir o f e ach one o f eac h p air being

as s igned to oppo s
,

ite s ides o f the trunk .

Unf ortunately there isno E ngl is h equivalent f o r thes e

tec hni cal namess o tha t the s tudent hasno al tern a tive
b ut to acquire a knowled ge o f thes e anatomica l term s
,

.
88 Tr apez ius .

inte rmedi ate attac hments o f the musc le p assoutward s with

a va rying degree o f obliqu ity whil s t thos e which s prin g
pines
,

f rom the upper two dors al s ar e ne arly horiz onta l in

direction when the limb i sat res t by the s ide o f the

trunk
u rfac es
.

The mus cle is attac hed to the s e points an d s by

means o f tendinous breswhich ar e us ua lly s hort ; b ut in
they are longer an d give ris
,

some s ituations e to alterations

dependent on thi smus
,

in the s u rf ac e f orm s c le f o r where ,

the tendinous bresar e long they ar e repres ente d on the

surf ace by a ttened depres sion sin contras t wi th the pro

mi n e n ce s produced by the co ntrac tion o f the es hy bres .

The tendinous bresar e long at the origin o f the mus c le

in the lower regi on o f the neck an d upper p a rt o f the

thorax ; they reach their maximum length ab out the level
o f the s pine o f the vertebr a prominens( s eventh neck
ver te bra) ; a loz enge s - haped gure isthusf ormed by the
mus c le s of oppos ite s idesthe inf erior angle o f whi c h
reachesaslow asthe third thoraci c s pine whils
,

t above
it grad ually taperstoward sthe occiput On a level with
,

the externa l angleso f thi sarea isthe projection formed

by the s pine o f the s eventh c ervi cal vertebra in the middle
line During the powerfu l contrac tion o f the mus
. c le sthi s
area corres pond sto a s u rf ac e depress ion in the centre o f ,

whi ch the projec tion caus ed by the s pine o f the s eventh

c ervi ca l ve r tebra i s re adily recogni z ed ( Plate sv x x i , , ,

pa 3 6 86 9 )
2 ,

A t the lowe s t point f origin f the m s le f rom the l s

o t o u c a

two or three dorsl s pines the tendino sabres f orm sm ll u a a

tri ngul r poneuros

a i s Thi s ombin d with th t f the
a a . c e a o

h p d srf e whi h when

,

oppo sit s ide f orm s di mond s

e ,
a a - a e u ac c ,

the m sles powe fully ontr ted orres

u c ar e pond sto
r c ac c a

depres sion on the srf e f the b k f s

,

omewh t s
u acim i l r
o ac o a a

sh pe tho gh les
a , s pp rent th n the bove A third
u a a a a .

tendino sre i s unoti e ble over the point where the s

a a c a pine
 R h o m bo i d s . 89

of the s houlder-bla de becomesblended with the inte rna l

border o f that bone A sthe p a rtso f the mus
. c le a round

thisar e thrown into relief d uri n g contraction there is

a s u rfac e depre s
,

s ion in co r res pondence with it b ut the

ion va ri eswith the movementso f
,

po s ition o f the depre s s

th e bl de bones
a -
( Pl a te XI Fig 1 p .

Th e entire mus c le i s
.
, ,

s
uper ci al that is to s a
y it i s merely
,

covere d by the s kin an d the s uper c i a l f a tty l ayer w hi c h

lies benea th the s kin A ccordin g to the thicknes

. so f this
fa tty l ayer the h ar pn e s so f the s u rf ac e f orm s dependen t
on the mus c le will va ry be i ng obs cu red in thos e in whom
there i smuch f at benea th the s
,

ki n Th e s u rf ac e f orm s
.

a ls o depend on the development o f the mus cle s thems elv es .

Thes e m us c les overli e deeper l ayerso f m us c le s an d so

tructures
,

they thems elves a r e in u enc ed by the f orm o f the s

on which they res . t On either s ide o f the middle line

the ro un ded form o f the back i snot d ue to the trape ii z ,

which here con s titute a comp aratively thin layer b ut

depend s on the fullnes so f the erectore ss
,

pinae group upon

which they res .t
Beneath the trape iusthere ar e three mus
z cle s attac hed

to the in terna l border o f the bl ade bone Thes - e ar e the

.

two r ho mb o id s an d the ele va to r of the a n gle of the s cap ula .

For o ur p urpos e we may con s ider the two r ho m b o id sas

f ormi n g one m us cu l a r s heet Thi si satta ched along th e
.

middle line extending ashigh a sthe lower p art o f the

,

medi an ligament o f the n eck an d p as s ing dow n w ard sto

be conn ected with the s pin e o f the s ev enth neck vertebra
an d the s pine so f the rs t ve thoraci c vertebra e The .

mus c le lie s high er at itsori gin tha n at i tsin s ertion s o ,

that i ts bres a r e d i rec t e d do w nw a rd s a n d o utwa rd s toward s

th eir ins e rtio n into the inn e r bord er o f the s houlder bl ade -
,

where th eir atta chm e nt extend sf rom the ro ot o f the s p ine

down to the in f erior angle ( F ig .

Thes e m us c le s
,
although c ov ered by the trap ez i us w ith ,
9 0 R h o mbo id s .

the exception o f a s mall portion below clos e to the i n f eri or ,

angle o f the bl ade bone exerc i s e a cons iderable inuence

-
,

on the s
ur f ac e contou rsas d ur ing their contraction they f orm
a somewhat broad an d oblique elevation which accentuates
,

the relief o f the trapez iusmus c leswhi ch overlie them

FI G 62 Vi ew o f th e m u sl stt
c e a ac h ed to th e sh uld -b l d
o er a e Th e
ss ft s
. .

tra pez iu ha b een cut away o n th e le id f th g

e o e ur e .

a. s s
Tra pez i u m u c le j S te rn o - s s
ma to id m u c le
ss
s sp
. . .

b R h o m b o id I u f r a-e p i n o u f o a o n b a k o f ca ula
sp
g c

ss
s
. . . .

c. E le va to r o f th e an gle o f th e ca ula h A c ro m i o n p ro ce o f ca p ula

s s
. .

( le v a to r an guli ca pulae ) i S p i n e o f capul a

s s
. .

d S ple n i u m u c le j Co ll ar -b o n e ( c lavi c le )
s s s
. . . .

. Co m pl ex u m u cle .

Pl a te s
X XI pp The ele va to r of the upp er a ngle of
( , ,
. 86
,

the s c ap ul a e aris
cap ula ( le v ato r angul i s es f rom the tr an s
ver se
)
proces ses o f the higher n ec k v ertebra e an d i s ins erted in to
th e inner border o f the bl a de bone above the level o f the
-
92 Ser r a tusmagn us .

f rom the side o f the ches t wall Pas s ing bac kward sit i s - .

c lo s
ely applied to the ches t wall an d liesbetween it an d -

the deep s u rf ac e o f the bl a de bone to the inner bord e r -

ition o f thismus c le i s
,

o f whi ch it i s attac hed The pos .

d i cult to unders ta nd a diagram m ay help to expla in it

: .

H g 63 repre s
. entsa s ection acros sthe che s t cavity ; -

the s houlder bl adesar e s een on either s ide an d behind ,

an d th e m us c le i s repre sented in s ection ari sing from .

the s ide o f the ches t wall rather tow ardsthe f ro n t an d

-
,

pas sing back betwe en the ches t wall an d s

- houlder blad e
-

to be attac hed to the inn er border o f that bone Only .

s
FI G 63 Diagram matic ectio n ac r o th e ch e t to s
s s s
h w th o e relati o n s
s s s
. .

o f th e gr eat e rra tu mu cle .

a. H ead o f h umer u s d Brea t-b o n e s

sl t
. . .

b A do r a v e r e b r a. e. S h o uld e r -
b lad e
i sti
Bib s s m s
s
. .

c. n ec o n. I . S e r ra t u m agn u l u c e .

a s
m ll porti on
a the mus cle is
of superc i al a s it isin great
p a rt covered by other mus
,

c le s a n d by the bl ad e -bone ; b ut

the p art which i s su per ci a l h a s a mo st important in uen ce

on the s u rf ac e f orm s an d c o r re spon d sto th at row o f n ge r
,

like elevations on the s ide o f the che s t wall with whi ch the -

s tudent isfamili ar in the m o del when the ar m isra is ed

( Pl a te s VIII IX XII ,
XIV ,pp 62 7 2 1,02 ,
they .
, .
,

ar e well s hown on the gure o f the G l ad i ator Thes e .

eleva tionsco rres pond to the pointso f origin o f the

m us c le an d it will be neces sa ry to de s c ribe them ( s ee

Figs64
.

. The m us c le a ri s es by eight or ni n e e s hy
s urf ace o f the eight upper ribs The
,

lips from t h e oute r s .

border o f the blade -bone f orming a well -marked es hy
pro minen c e which though i t is not s
uper c i a l yet inu en c es
,

to a m ark ed degree the s

,

u rf a ce conto ur The mus c le whic h

covers
.

it an d which will be pres

, ently de s c ribed f orm s a ,

rel atively thin layer over it The lower an d anterior p art .

FI G s 64
h w th Vi e w to o FI G 6 5 Th e s
ame, with th e
s t sm g sm sl with
e

s
. . . .

erra u a nu u c e h o uld e r b la d e turn ed away f r o m

-

th s
e h ld bl d iouits e r - a e n na s -
th e ch e t w all in o rd e r to h o w th e s
t
uralp s
iti o on s s
i n e rtio n o f th e m u cle in to th e e u
s
.

te ri o r a pect o f th e i n n er o r ve rte
b ral b o rd e r o f th e b o n e .

a.S h o uld e r -b la d e c Co r ac o id pro ce s

s
s
s s ss
. . .

6 G len o id f o a f o r h ead
. of h um e r u . d . A c ro m io n p r o c e .

of the s e rratusmus cle i s however s uperci al an d it 13 here

that itsinuence on the s is mos

,

u r fac e contou rs t re adily

recogni z ed Thi s p art o f the m us
. c le compri s esthe lowe s t
f our sli ps e f rom the s
whi ch ari s o f the fth s
u r f ac e s ixth
s e s
, ,

eventh an d eighth ribs The s

, lip scons is
t o f poi nted
.
,

n ger like es
- hy pro ce s
s escalled d igita tio n san d ow ing to
, , , ,
94 Ser r a tusmagn us .

the that they ar e pl aced between corre s

f ac t pondin g s lip s
o f origin o f the extern al obliqu e mus c le o f the abdomen ,

th ey ar e s a id to inte rdigit ate with the s e attac hmentso f

the l atter mus cle j u s t as we can thrus t the ngerso f one
h and between the ngers
,

o f the other .

It i sthi sarrangement
whi ch give sri s e to the
z igz ag f u rrow whi ch i s so

ch arac teri s tic a f eature o f

the lower an d lateral p art
o f the che s t-wall in violent
ac tion o f thes e mus cle s .

The gen eral direction o f

the f urrow s o produced
corre s pond sto a gently
cu rved line with the ,

conv exity di r e c ted down

F G 66 A i w t s h w th s
ard sdrawn
t u
I

swh i h u d li th d lt id d
. . v e o
w o
f rom the
e r e
,

above towa rd s
tur e c n er e e e o an

gr ea t p t l m u s
e c o ra l s th tli c es f nipple e ou the
ne o

s s pos terior end o f the cre s

,

wh i hc p are r e t d i d t
re e n e t d l i n o e
tne

Th s s
.

e p t ie f
ara t h on o l i u l be c av c ar re

l b sf th g f the h h bone below

o au n c -
f m th
ro t e e e rn a t
re o e r ea
.

p t
e c o ra l i s l s sh aw b y o d ott d The furrow isobliterated
n a o e

fo r a s s
line .

hort di tan c e below

C ll - ( l i l )
s
a. b o ar one c av c e

s s the n pple by the e hy

.

b B t-b (
r ea t onem ) er n u i
s s sp l as s
. .

A mi f
c

d C
.

id p
p
c ro

s
on

sf sp l
ro c e
_ _

m o
o f the gre at pecto ra l
ca u a.

us
o r a co r o ce o ca u a
lis m s
. .

P t
e mi
ec o r a l nor
m cle ; behind an d b elow
u c e
hi lis m s
. .

s
j C -b o rao o r ac l a u c e
s s it de w y where it
. .

9 S h t h d f
orb i eap m l
o ce f a a a
u c e.

g h d f b i ps m s
,

s s
.

h L l
k H m
.

s
on ea o ce
join the bro
u c e
ad
.

h allow

f u rr ow o f the w a i s
. u er u .

t an d
where the lower bres d o rs
,

o f the la tis s im us i overl a p The .

two mus c l es whi ch h ave j us t been mentioned the l atis s im us

dors i an d the pectora lismajor will be d e s
,

c rib e d in the

next group It h asbeen nece s

,

. s
a ry to anti c ip a te here in

referrin g to the m The higher bres . o f the S erra tus m agnus

ar e not as a ru le expo s ed except when we rai s e the arm ,
98 Hn mer n s
.

by whi ch the movementsm ay be eff ected A sthe b ones

o f the uppe r li mb ar e not c on cer ned in s
.

upporting th e

trunk they ar e s m aller an d not s o s tout asthe bones

o f the lower limb whi c h h ave to s us
,

tai n the body weight

The long boneshave many charac tersin common ; they
.

a r e us ua lly des cri bed as con s is ting o f a s haf t an d two

e x tremities Of the latter the upper isus ually ca lled the

head To thisrule there i san exception in the cas

.
,

. e of
the ulna the inner bone o f the f ore arm the lower end
,
-
,

o f whi ch i s so n a med .

The term hea d though us , u a lly appli e d to the upper

extremity o f a long bone i snot s o employed unl e s sth at

playsa round d appe arance thus
,

end o f the bone dis e we

s pe ak o f the head o f the hum erusthe head o f the f em ur ,

the head o f the rad iusb ut we do not s

,

,
o de s cri be th e

upper end o f the tibi a Both end so f a long bone are

.

provided wi th articul ar s urf ac es whils t the s haft ao r d s '

which caus
,

a tt ac hm ent f o r the m us c le s e the movem e nts .

Th e upper end o f the humerus is enlarged an d is provided ,

with a hemi s pherica l s u r f ac e Thi si sth e head which

.
,

in the recent condition iscovered with ca rtilage and ,

arti cul a te s with the s h allow s ocket on the outer angle o f

the blade -bone To the outer s . ide in f ront an d b elow , ,

thi shead th e bone i srough an d prominent f orming two

, ,

well marked tuberos

- iti e sfo r the attac hment o f mus c le s;
the s e a r e ca l le d the grea te r an d les s
e r tub e r o sitie s There .

is a groove betwe en the tw o tubero s itiesto the outer s

s
ide
tubero s
,

o f whi c h the gre a ter ity lie whils t the les ser

ide From both thes

,

tubero s ity i splaced on the inner s . e

tubero s iti esprominent ridge so f bone des c end on either

side o f the groove forming well marked lips The groove

,
- .

is call e d the b ic ip i ta l
gr o o ve f rom the f ac t th a t
,
in it
liesone o f th e tendonso f origin o f the bicepsmus c le o f

the a rm ( Fig 66 p
cylindri ca l above bec omes
.
,
.

The s ha f t o f th e bone w hich is , ,

 Humem s
.
99
attened below s o th at i ts
, surf ace s may be de s c ribed as

an terior an d po s te ri or Th es e s urf ac esar e s

. eparated by
inner an d outer m argin swhi ch end inf eriorly in tw o
escalled the co n d yleso f the hum erus
,

prominent proce s s .

Th e condyles ar e pl ac ed one on e ither s

,

ide o f the lower

a rti cu l a r end o f the bone whi ch i smuch broader from
side to s
,

ide than f rom before backward s On the outer .

side o f the s h aft about i tsmiddle an d f ormed by the

, ,

recurved margin o f the outer lip o f the bi cipital groove

th e re i sa rough V s s
,

- h aped im pres ion ca lled the delto id

imp r es s ertion to the mus
,

i o n whi ch aff ord s in s c le o f th at

name Th e f uller con s

,

. ideration o f the lower end o f th e

FI G 72 Diagram m atic ectio n acro th e ch e t to s s

s s s
h o w th e r elati o n s
s s s
. .

o f th e gr ea t e rratu m u cle .

a. H ead of h u m e ru s d Brea t -
bon e s (s t m) ern u

sl t b
. . .

b A dor Shou ld -
bl d
m us
e. a e.
m g s
a ve r e r a. er

R ib s
i sti t s
.

c. n ec on. 12 S er r a u al nu c e.

bone will be delay ed until the elbo w -joint i sdes cribed

( s
ee p .

Th e upper end an d s h af t o f the humerusdo not i m

medi ately come in relation to the s u r f ac e being enveloped

hy m as houl d er an d upper arm Thi s

,

in the es so f the s .

p art o f the bone however determ inesto a l arge extent

uppo r ting the m us cle s
, ,

the general form o f the limb by s

which s u r round i t Particularly i sthi sthe cas
. e in the
region o f the s houlder f o r here the l arge rounded head
o f the s houlder impartsto them
,

u nderlying the mus c le s

that roundnes swhi ch iss o ch a racteri s tic Thi si sat .

11 2
100 Hn mer n s .

once apparent fo r if f rom an y caus e the h ead o f the

bon e isdis
,

so f the s
,

pl aced th e roun dnes hould e r d i s

appears
,

connexion there i s
.

In this one other point to be noted .

If we examine th e hum e rusin an articulated s

keleton when ,

FI G 73 View o f th e b o es
whi n ch e n te r i n to th e f o rmatio n of th e
s j s
s
. .

h o uld e r - o in t a ee n f ro m th e f ro n t .

a.Co llar -b o n e ( cla vi cle ) i sj s

t b
u elo w an d to th e o ute r s
id e

s s
.

b Br ea t-b o n e ( ter n u m ) of th e lette r fl

sss s
. .

c A c ro mi o n pro ce of ca pul a g Placed on th e an te r io r ur f ac e o f

sss s s s
. . .

d Co r aco id pro c e o f ca pula th e h o uld e r -b l ad e ( cap ula ) Th i

s s s
. . .

0 C o r a co -
ac ro m ia l l iga m en t i th e ur face o f th e b o n e w hi ch i
s s
s s
. .

f S h af t o f h um e r u ; th e im pre io n fo r d i r ecte d to war d th e ch a t-

wall
s
. .

th e a tta ch men t o f th e d e lto id m u cl e

the boneso f the limb a re in a pos ition corresponding to

th at which they occupy in the living when the ar m is
hanging loos e ly by the s ide it wi ll be noticed that the
arti cula r h e ad o f the humer us is
,

not turned directly inwards

b u t inwa rd san d backward s Owing to thisthe great
,

tuberos ity o f the b one is directe d s

omewhat f orward s The .

im portance o f thi s wi ll be at once apparent if the s houlders

i n the living b e ex amin e d In them the mos t prominent
.
 100 Hn mer u s .

once apparent fo r if f rom an y caus e the h ead o f the

bon e isdis
, ,

pl aced the roundnes so f the s houlder d i s

appea rs
,

connexion there is
.

In thi s one other point to be noted

If we ex amin e th e humerus
.

in an articulated s
keleton when ,

FI G 73 View o f th e b o es
whi n ch en te r in to th e f o rmatio n of th e
s j s
s
. .

h ul d
o e r- o in t a een f ro m th e f ro n t .

a.Co llar -b o n e ( cla vi cle ) i sj s

t b
u el o w an d to th e o ute r s
id e

s s
.

6 Br ea t- b o n e ( tern um ) of th e lette r f:
sss sf
. .

c A cr o mi o n p ro ce of ca pula g Placed on th e an ter io r ur ace of

sss s sp s
. . .

d Co r ac o i d pro ce o f ca p ula th e h o ul d er -
b lad e ( ca ula ) Th i
s s s
. . .

0 Co r aco - a cro m ia l liga m en t i th e ur face o f th e b o n e w h i ch i

s s
s s
. .

f S h af t o f h um e r u ; th e im pre io n fo r d i r ec te d to war d th e ch a t- wa ll
s
. .

th e attach m en t o f th e d el to id m u cl e

the boneso f the limb ar e in a pos ition corresponding to

th at which they occupy in the living when the ar m is
han ging loo s ely by the s ide it wi ll be noticed that the
isnot turned directly inwards
,

arti cul ar he ad o f the h umer us

an d bac kward s Owing to thi s

,

b ut inwards th e great
.

tuberos ity o f th e bone is directe d somewhat f orwards The .

importan ce o f thi s will b e at once appare nt if the shoulders

i n the livi n g b e ex amined In them the mos t prominent
.

I
l
A i ' sd
O
-v o

!r
I

part o f th e s i -
ct .
"
v iz
-
i s sis p
a re re

sente d in th e d ia : g
e
"

2 . hr ; "
wa rd sh side
t e

as
,

one might natural

: t o:

s
it move ment . The e x t e rn al a: blade-bone i s

s
FI G 74 S h o w th e ch an ge i n po i ti o n o f the M u s s! th a
e n
s s
. .
.

i d l w h n th c a r m i ra i ed ; i e e le vatio n of the e d i t-
g r e e hon
s and
. .

ad van ce a n d ro ta ti o n o f th e h o uld e b lad e

r - .

Co lla r -
b o n e ( cla v i c le )
s
a. .

c. H umer u .

provided with a s h allow hollow called the i !an d

s s
,

( s
e e Fig s 57 5 8 . Thi i o
, ll, r

an d slightly d e epened by a l igament 7 5 6 da 1t s

ro z S ko uld er j o znt .

sf
u iently deep to have embraced a greater portion o f the
c

arti cul a r h ead .

Th e ligaments urround this

which s joint an d form its
cap sul e are ve r y loo s
e The joint is protected above by
s
.

an ar ch f ormed by the ac romion an d coracoid pro ces es

o f the bl ade bone whi ch a r e united by a s
,

-
, trong ligament
( g 73, )
Fi 8

M o vemen t in every direction may take place at the

s ho u l der-joint Thes. e movements will be better unders tood
i f we res olve them into their s imples t f orms
There ar e the movements
.

o f a b d uctio n a n d add uctio n by

which the arm i s rai s

,

ed from or drawn down to the s ide .

F lex io n an d ex tens io n ar e movements in a f orward an d .

backwar d direction the l atter is more limited in i ts range

than an y o f the others There is . the combin ation o f th es e
f ou r movements termed cir cumd uctio n an d an additional ,

move ment tha t o f r o ta tio n by which the s haft o f the

turned on itslong ax is I f the elbow be bent
,

hume r us is
,

n d the f ore ar m cro s

.

at a right angle a - s ed over the front o f

the trunk we can by this rotatory movement o f the humerus
,

car ry th e f ore arm away f rom the f ront o f the che s

- t at the
s ame time th at we keep the el b ow clo s e to the s
,

ide The
r a n ge o f t hi s rotatory movement iss
.

lightly more than

a quarte r o f a cir cle .

A nother interes ting obs ervation may be m ade regarding

th e movements o f abd uction an d e x i o n I f we ra i s e the
.

arm fr om the s ide or bend it f orwardswe can do s o to

id erable ex te nt without caus

, ,

a co n s ing an y very extens ive

movement o f the s houlder blad e as
- may be as ce rta ined by

p laci ng th e Oppos
,

ite hand over that bone ; b ut when we

have rais ed th e limb fr om th e s ide s o as to m ake a right
,

a ngle with the trun k we nd i f we continue to rais e

th e arm higher tha t the movement is
, ,

not now ta king

place at th e s houlder joint b ut isb eing e ecte d through
,

th e ro tatio n o f th e s
,

capula the lower angle o f whi c h ca n

,
104 Latzl s
sm s
z d s
i
'

u or .

sper
u i l wall o f which is
c a f ormed by the apon euros is of

th e l atis simus dors i

The line o f attachment o f the es hy bres o f th e mus
.

c le

to the apon euro s isisindicate d by a cur ved line drawn

f rom the highe s t point o f attachm en t o f the mus cle nea r

th e middle line to its inf erior attac hment to the iliac cres
,

t .

The convex ity o f the curve is inward sTh is

,

ar rangement o f

is
.

th e es hy an d te ndinousbres important becaus e it is

readily re cogniz ed on the s urf ac e o f the back o f a mus
,

cul ar

mod e l Fr om thisexten s ive attach ment the es hy bre s

s
.

converge to th e pos teri or f old o f the armpit ; here

they becom e thick an d he lp to form the roundnes s o f th a t

f old ; they then pas sforward to be ins

,

er ted into the front

o f the upper p art o f th e s haf t o f the humerusto a line ,

cor re sponding to the bottom o f the bicipital groove .

The upper breso f the mus cle are almo s t hori z ontal in
direction an d as
, they pas soutwardsacros sthe back they
overlie the inferior angle o f the blade-bone to which they
ar e n o t un fr equently attach e d ; here th e y s erve a us
,

. ef ul
purpos e in pre venting the low e r angle o f the bl ade bon e -

fr om being s ep ated from e ches

ar th t wall in certain move
-

ments o f the limb . It s o metime s happens that as a re sul t

o f violent m us cu l ar e ff ort the lower angl e o f the s

,

houl der
b l ade s lipsf rom under cover o f the mus
,

cl e Under s uch

tan ces
.

circum s it i s not readily repl aced beneath the latis s i

mus dors i an d a de formity res ul tsin the s hape o f an
und u e projec tion o f the lower p a rt o f th e s
,

capul a thereby ,

demon s trating the action o f the mus c le in keeping the

blade bone clos

- ely applied to the ches t wall
- The upper
.

border o f the mus cle can us ually be eas ily s een on the
o u s as
m del j t it overl ps a the lower angle o f the blade bone -

The lower bres

.

an d tho s e whi ch s pr ing f rom the las t

thre e ribspas salmos t vertically upwardscorres ponding
very clos
,

ely abo ve to the outline o f the fr on t o f the upper

ar m when the limb is hanging by the s ide .
106 Pecto r a lz sm j
'

a or .

If the arm be rais ed the lati s simus wi ll as sist in drawing

it down to the s ide With the limb by the s ide the
mus c le draws es
.

it downwards an d backwa rd s an d s o caus

houl der blade to move s lightly downwards

,

the s - an d n ea rer

the middle line The mus cle als

. o as sistsin rotating the
upper ar m inwa rd s anta goniz ing the movement o f external

rota tion Under certain conditions the actio n o f the mus

,

. c le

m ay be revers ed i e the xed point being the attac hment o f

. .

c le to the hu mer us the movable part corres

,

the mus ponding

,

to i ts attac h ment to the trunk ; thi s happe n s when we pu ll up

the trunk as in the act o f climbing ( Pla tes
VII X X II XIV pp 44 86 102 , .

The p ecto r a lismaj o r mus

, , , , , ,

cle or great
c le o f the brea s
,

mus t h asbeen included

in the group o f mus which s
,

c le s pring
f rom the trun k an d pas sto the limb This .

is not s trictly correct as will pre s ently be

cle al s es
,

F 76 Di g m
IG . s een f o r the mus
a ra o ari s f rom one
o f the s
.

o f the bone s
32
1
2 251 2 212 1
122 2 ho ulder girdle it -

o f th pe t li s i s however
ec o ra more conv e nient f o r o ur

s
,
.

m im s gr it with the l a ti s sim

ax 11110 30 9
u
ar e
t u u
P Po e o o P
i st d i t
r
n er e

t
o u er li p
th
f th
n o
dor o
si ( Pla
e
te
e
s VIII IX XV pp 62 7 2 ,
.
, ,

The mus
, ,

b i iPit l g
C r o o ve .
cle a ri s esby e s hy bre s f rom
the anterior border o f the inner two
thirdsor half o f the collar-bone i e f rom that end . .

with the breas

,

o f the coll ar bone whi ch a rti cul a te s

- t bone -
,

f rom the a nterior s u rf ace o f the bre as t bone on either -

side o f the middle line f rom the cartilageso f th e upper

ix ribsan d f rom the upper part o f the apone uros
,

s i so f
the exte rnal oblique o f the abdominal wall The bres
,

o f the m us cle converge as th ey pas soutwardsto the limb

the highes t bres pas
,

sing d ownwards an d o utward s in f ront

o f the lowes t breswhich p as supwardsan d outwards
Between the two extremes
,
.

they have diff e rent degree so f

o bliq uity Tho se . springing f rom the bre ast -bone at the
 Pecto r a li smajo r
'

. 10 7

j n
u ct ion o f i ts lower an d m i ddle th i r d ( not in c l u ding
the ca rtilaginousportion) lie in a hor iz onta l direction
when the l imb ishanging by the s ide Th e tucking .

in o f the lower bres behin d the upper asthey p as sfrom

the ches t-wall to the arm leadsto an increas e in the
th i ckne s so f the es hy f old which boundsthe hollow o f
the armpit in front By th isconvergence an d inf olding
o f the bre s
.

o f the m us cle it be c ome s much narrowed an d

is inserted by mean so f a at te ndon about 2 }inches
,

in breadth into the outer lip o f the bi cipita l gr oove o f the

humerus( Fi g The mus cle i s supe r cial thro ughou t

tendinousins w here it is
.

ex c ept at i ts
,

e rtion overlapped
by the d elto id or great mus cle o f the s
,

houlder The grea t

the les
.

pectoral mus c le overlie s s er pectoral When the arm

is rais
.

ed above the head ho wever the lower border o f

the l es s er pectora l isfo r a s hort dis
, ,

tance uncovered an d
.

imp artsa roundne s sto the lower part o f the anterior

ax illa r y}f old

The bre so f the gr eat pectoral which s

.

p ri n g f rom the
c oll ar bone ar e us
- ua lly s eparated fr om the breswhich
ar is e f r om the br e as t-bone by a s hallow fu rrow p as sing
obliquely downwardsan d outward sfr om the inner end o f
the coll ar-bone The dis tinctnes so f thisf urrow on the
s on the development o f the mus
.

urface depend s cle a n d

the po s ition o f the l imb Th e es . hy bres which s pring

f rom the bre as t -bone an d ribsf orm a tria ngular m as s ,

th e apex o f whi ch overlies the f ront o f the upper ar m

pond sto t h e s u r f ac e on either s
,

while the bas e corres ide o f

the mi ddl e line o f the breas
by thes e bre sformsthe s
bottom o f which corres
t bone The prominence cau s
- . ed
ideso f the medi an furrow the
pond sto the bre t bone The s
,

a - .

angles f ormed by the bas e an d s ides o f the tr i an gle above

an d below ar e ro u nded o ff The upper s

. ide o f the tri an gle
The term
ax i lla

i susd
e by an ato mi s
tsf or the h o llo w of th e
W pit.
108 Pecto r a lz sm j

a or .

liescont iguousto the lower border o f the portion o f the

mus c le whi ch ari s es fr om the coll ar-bone The lower s ide
o f the tri angle i s almos
.

t horiz onta l in i ts inn er half where

it overliesthe ch es t-wall b ut cur ving s lightly upwardsas
,

es f rom the ches

,

it pas s
,

t to the limb corres ponds

, to the lower
border o f the anterior f old o f the armpit Fr om the round
ing o f the an gles o f the bas e o f thi s es hy mas sit f ollows
.

that the median f urrow which on the s

, u r f ace corres pond s to
the interval between the two mus cles is opened o ut above an d
below in f ront o f the upper an d lower ends o f the o s s eous
,

a s
part o f the bre t bone The latter is
- . at s ome little dis tance
a bove the pit o f the s to mach whi ch it may be remembered
,

c orres pondsto the pos ition o f the car tilaginousportion o f

the breas t bone ( Plates
- VIII IX XV pp 62 72
ionally happensin pers
.
, ,

It occas
, , ,

o ns o f grea t m us cul ar

development that bundle s o f tendino us bres pas s f r om th e

origin o f one mus cle ac ros sthe middle line o f the breas t
bone to the oppos ite s ide an d when the mus cle is powerf ully
c ontrac te d thes tan d o ut as
,

e may s more o r les sprominent

cord s cro s sing an d s li ghtly interrupting the s moothnes so f
the central breas t furrow Oftentimesto o the lower an d
in ternal attachment o f the mus
.

cle ca n be recogni z ed as
, ,

s eries of s light elevations corre s ponding to the lower es hy

s lips o f origi n
. The lower border o f the m us c le c orres p ond s
us ually to the ca rtil age o f the f th rib or to a line dra wn

outward s an d slightly upward s f rom the pit o f the s

,

tomach .

When well developed the mus cl e completely con ce a l s the

f ramework o f the thorac ic wall whi ch it overlie sb ut in
w here the m us cle i s thin the ribsan d rib ca rtilages
,

es
,

cas

may be recogn iz ed benea th it Pas s ing asit does

. f rom the
brea s t to the upper arm the mus c le c on c ea ls the rounded
t except in front where it i s s
,

f orm o f the ch es , upported on

the c onvex s ur fac e o f thi s part o f the trunk the ful ln e s s of

which it carri estowardsthe upper part o f the limb thus

,

im pa rti n g an appearance o f width to the ches t an d cau s ing

1 10 The Br eas
ts .

th e pos ition o f the n ipple on a level with the inters pace

between the fourth an d f th ribs .

In the f emale the breas tsa r e gl and ul ar an d their develop

men t depends largely on age an d other conditionsA s

,

they
cle s
.

lie on th e s u rf ac e o f the pectora l m us the brea s tsshould

be widely s ep arated from o n e another ; this wi ll va ry ac
cording to the wi dth o f the ches t wall In cas
-
es
. where that
is narrow the gl and s ar e nece s sa rily brought clo s er together .

The nipples s hould b e directed f o r ward an d s

,

lightly outwa rd
so as to point away f rom each oth er The bre as . tsshould
not be unduly large an d their cons
, iste nce s hould be s uch

as to counteract the in uence o f gr avity ; there s hould be

no f old or creas e o f the s kin below them b ut they s hould
ri s As s
,

e gently from the general s urf ace Profe s o r Br ii cke

h as
.

pointed o ut the angle f ormed by the apex o f the cone

s
,

hould n early appro ach a right angle the lower p art o f the
organ bei n g s
,

lightly more convex an d rounded .

In regard to the level at which the f emale breas tsare

placed th i s will vary s omewh at in d iff erent modelsb ut
the eff ect produced isalwaysm
,

ore pleas ing when they

ar e s e t high an d combined with the genera l rou ndne s so f
the neck an d s houl dersthan when they ar e s ituated on
a s omewhat lower level ( Plate X VI p .

urro und s
,

In s ome model s the areola or tinte d a rea whi ch s

,

the nipple iss lightly elevated f rom the s urrounding s ur

f ac e o f the breas t a f ea ture which i s sometimes repre s ented

in modern s The brea s ts thems e lve s
,

culptu re . ar e mov able ,

a cir cu m s tance which accounts f o r the f act th at in the erec t

pos ture they lie at a s omewhat lower level than in the
recumbent pos ition when they ar e no longer in uenced by
,

their own weigh t

aid regarding the f orm o f the bre as ts
.

What hasbee n s
wi ll require modica tion if it be the arti s t sintention to

repres ent a matronly fo rm ; in thi s case the change s in the

gla nd dependent on the mate rnal f unction wi ll h ave given
the more s uper cial mus cles w hi ch overlie the m It will .

b e nec es sary however to ref er to two o f them the i n r a

f
s s s s
, , ,

p i n a tu a n d the te r e m a j o r be c au e they ar e in p ar t
s The co a co b r achia lismus c le a ls o aris es
,

up er cia l . r f rom
th e bl ade bone (c oracoid proces
- s) a n d i s in s erted into the
humerusb ut i ts con s ideration had bes t be delayed until
the s urf ac e f orms
,

o f the upper arm ar e di s cus sed

upe rcia l thro ughout f orms

.

The delto id mus c le whi ch i s s

the cap o f the s ho ulder A s i ts name impliesit i s
, ,

trian
s ape an d i s s
.

s
,

u l a r in h o ca lled f rom i ts re emb la n e to

g c

Th e b as e o f the tri angle i s

,

th e G r eek letter A . directed

up ward sn d i sa attached to the girdle bones - the ap ex or
point ed extremi ty o f the mus cle p as s down to wards
,

es the
middle o f the outer s ide o f the up p er arm
s
.

Th e m us c le ri
a s e f rom both bones o f the ho s u l der girdle
-

fr om the ante r ior s

,

urface o f the externa l third o f the coll ar

'

bone in f ront ab ove th e s houl der fr om the point an d outer

m rgin o the acro on p roce o the s s s
,

a f m i f houl der blade an d

-

behind from the lower border o f the s p ine o f the s

,

ame bone

in its whole length Th e origin o f thi s

. mus c le i s th us s een
to corres p ond to the in s ertion o f the trapez iusindeed we
may regard it as a prolonga tion o f th at m us
,

. c le down ward to

the limb the bones

,
o f the gi rdle f orming an interruption

to the dire c t continuity o f the m us cular bre s

o f the m us cle whi c h ari s

.

The bres e f rom the bony origin

t des cribed ar e arr anged in es hy bundl es

,

j us whi c h co n
verge inf eriorly to f orm a s
,

trong thi ck tendon w hich

i sins erted into that rough V s - h aped s u rf ace alrea dy

on the outer s
,

des cribed ( p ide o f the s haf t o f the

middle Thi s r ai s haped s
.

h umerus abo ut i ts ed V s
.
- u rf ac e i s

hence called the delto id emin en ce The thi ckes

,

. t p art o f
the m us cle corres pond s to its c entra l bres ; in f ront th e
anterior border o f the mus c le lies alongs
,

ide the outer margin

o f the cl avi cul a r bre s o f the great pectoral f rom whi ch it

is s eparated by a lin ear depres s

,

ion which i swider above ,

 D elto id . 1 13

a s the two m s les s lightly s

u c ep r ted f
ar e om one another a a r

a t their origin sf rom the oll r bone c In

a - c orre spondence .

with thi son the s. urf ac e o f the s houl der in f ront there is
a s
,

light hollow below the collar bone overlying the interval

-

between the mus cle sFrom thi s . there pas ses down a line ar
f urrow whi ch f ollows
,
the line o f s ep arati on between the
two mus c les toward s the ex terna l limit o f the ante rior f old
o f the a rmpit w here the tendon o f the in s erti on o f the
grea t pectoral s ink sunder cover o f the d eltoid Thes e .

s u rf ac e depre s sions ar e bes ts een in a mus cula r model with

little or no s uper c i a l f a t an d ar e o f cou rs e intens

, ied
w hen the m us cle s a r e power f ully contracted They ar e .

ab s ent in the f emale or i f pres ent ar e very much s

, of te ned ,

o n ac co un t o f the q ua ntity o f f at an d the f eebler mus

,

cul a r

development ( Plates VII I XV pp 62 , , .

,

The po s te rior border o f the deltoid i s much thinner .

Owi ng to the f act that it isintimately connected with

a s trong aponeuros is whi ch s tretc he sacros sthe lower part
o f the bla de bone it h as
-
much les
, sinuence on the s ur f ace

c ontoursthough i f the arm be ra i s e d over the hea d th e

border may be traced upon the s

,

o utline o f thi s ur f ace

Pl ates VII X XII X I V pp 86

( 44 1 02

c ula r m as so f the deltoid is

, , .

The roundnes so f the mus

, , , , ,
.

d u e as h as been already s tated to the fact that it overlie s

the head o f the h umerusan d receivess
, ,

upport fr om th at

ortion o f the bone Thi s al so expl a ins why the mo st

p .

prominent point o f its ge neral roundnes s is directed f or ward s

.

an d o utw a rd s the ante r ior part o f the mus cle appea rin g

e nts
,

m uch f uller than the po s te rior whi ch pres a s omewhat

,

a ttened appea ranc e .

The gr eate s t w idth o f the s houldershowever doesnot

pond to the points
,

at w hi c h the deltoid mus cle s

,

c orre s over
lap the hea d o f the humerus b ut i ssituate d at a s , omewhat
l ower leve l where the various bundles o f bre s ar e gathere d

to gether to p as sto their ins ertion Thi s poin t i sus

,

ua ll y .

1
1 14 D elto id .

f oun d to corres pond to the level o f a line drawn outwards

acro s s the limb in continuation with the lower border o f the
anterior f old o f the ar mpit ( Plate IX p

urf ac e f orm doe s n o t c onvey a c orre ct impre s s

, .

The s ion
o f the ex tent to whi c h the m us c le de s cend s to be attached
to the s haf t o f the h umerusf o r the ins ertion o f the mus c le

is hy mus cle s
,

obs cured bo th in f ront an d behind by the e s of

the upper arm between whi ch its tendinous bres des c end to

ts
,

a m uc h lower level th an migh t at rs

. eem likely A ccord .

ing to the amount o f f at pres ent a depre s s ion on the s ur f ac e

w hi ch overlie s the point o f j un ction o f the es hy bres with

the tendon o f ins ertion is more or les sclearly s een It is
mos
.

t pronounced w hen the arm is rais ed an d s lightly dr awn

bac k an d the mus cle
p ower f u lly c ontr a c ted L e ading u p .

f rom thi s hollow on either s ide ar e the linear furrows whi ch

mark the po s ition o f the ante rior an d pos terior borders of

the mus c le res pectively ( Plates XVIII XX pp 144 , ,

.
,

Th e origin o f the deltoid is rendered much more apparent

when the limb is rai sed I t then corres
. pond sto a f urrow
w hic h overlie s the outer third o f the collar bone an d which
-
,

ca n be traced bac kward a long the upper s ur fac e o f the

ac romion on to the s pine o f the sc ap ul a over the middle

into the general f ullnes

,

o f whi c h i t gra d ua lly f ade s so f the

trapez i us The depth o f the f urrow w hi ch i sgreates
.
,
t in ,

this pos ition o f the limb over the acromion depend s

,
on the
,

development an d s tate o f contraction o f the d eltoid an d

trapez ius mus c le swhi ch lie on either s ide o f it Thi s f u rrow .
,

which i s s een in the f emale w ith the limb upli fte d ismuch
s
,

of ter in i ts c ontours,
owing to the grea ter thi cknes so f the
s up e r c i a l f atty layer ( Pl ate s X X I I pp 86
, , .
,

The ac tion o f the deltoid varie saccording to the pa rt o f

the mus c le brought into pl ay .It as s is ts in ra is ing the ar m .

That par t o f the mus c le whi c h a ri s esfrom the acromion

draws the ar m upwards a n d aw ay f rom the s i d e the anterior
bresrais e the limb an d bend it f orward s the pos terior
 I n ra -
f s
p
'

z n a tu sand Teresmi n o r .

the trapez i uswithin the deltoid above an d the upper

imus
,

border o f the latiss

,

dorsi below The s urf ac e o f the s

e .

m uscle s so expo sed f ormsa s light relie f bo unded by the

outlin esabove des c ribed Thes e po intsmay be s een bes t
hou ldersare drawn bac k When the limb is
.

when the s
rais
.

ed above the head the s u rf ac e f orm i smodied by ,

the rotation o f the blade bone the inf e r ior an gle o f which
-
,

FI G 77 Diagra m h o win g th e s Diagram h o wi n g th e

FI G 78 s
s s s s sj
. . . .

atta ch m e n t o f th e i n f ra pi n atu
- attac hm e n t o f th e te r e ma o r
s ss
.

a n d te re m i n o r The t wo m u cle
s s s
s s ss s
s
.

a. Th e in f ra -pin o u f o o f th e b lad e
are tr eated a o n e e hy ma
. .

s
b o n e ( ca p ul a ) , f ro m w h ic h th e in tra
6. s ss
S upra-p in o u f o s a. spi sm sl d t smi
n a tu u c e an e re n or

b s
A c ro m i o n pro m o h b
a ve m d ee n r e o ve

s ss
. . .

c. R o o t o f p in e 6 A cromi p on r o ce

s R t f s
. . .

d H um er u c. oo pio n e.

s s
. .

e U p pe r a n gl e of h o uld e r -b lad e d H mu er u

( sp l )
. . .

ca u a e U ppe r a n gle o f b lad e-b o n e

s
. .
.

12 L w o l fer h l d -bl d o ou f Lo w e r an gle of b lad e-b o n e Th e

s p st
g an e er a
s
e

( sp l )
. .

u a d o t te d li n e re re e n th e o utl in e

tis
ca

s t s d t sm i
.

I f - pi
n ra Th o f th e d e lto id a b o ve an d th e la
im s
na u
s
g an e re nor e

p sts d s
. .

d tt d li o e th tli ne re re en e ou ne i b u or e lo w .

of t h e d e lto id .

i s ied f o
c arr rds an d slightly upward s In this
r wa po sition .

the inner border o f that bone isrendered more apparent ,

a n d the lower pa rt o f the rhomboideu s major i smore fully

e xpo s ed ( Plates X XII XIV pp 86 102 , , ,

c le o f thi s
.

t mus
, ,

The las gro up which we have to cons ider

i sthe te res maj o r It ta kesorigin f rom the po s terior
.

s u rf ac e o f the lower a ngle o f the bl d e bone ; i ts

a - bres r un
 Ter esmajo r .

u pwar dsan d outwar ds parallel to thos e o f the tere s minor

b ut in pl ace o f being attac hed to the bac k o f the humerus
,

the teresmajor runsf orward to the fr ont o f the s h af t o f

tha t bone a n d is ins erted into the inner lip o f the bi cipita l
g roove . The m u sc le when well developed f orm s a th i c k
e s hy mas s I tsrelationsto the latis
, ,

simusdors i an d th e
pos
.

te rior f old o f the armpit ar e importa nt A sh asbeen .

alrea dy s tated the l atis s im usdors i f old sround the outer

border o f thi s
,

m us c le s o as to enclos e it like a s ling A s .

the breso f the latis simuss weep round the thick te res
m ajor mus cle the l atter impa r ts a f ullnes sto them which
accou nts f o r th e thicknes so f the pos te rior f old o f the
ar mpit . The te resm ajor actsasa rotator in w ard so f
the arm thus , a nt agoniz i n g th e ac tion o f the tere s minor .

A cting in conj un ction with the minor it draws down the

uplifted limb ( Fig

The mus
.

cle imp art s a f ullnes sto the s u rf ac e whi c h overlie s

the outer border o f the bl ade bon e With the limb by the
- .

side an d f orcibly rotate d inward sthe mus ,

c le f orm s a well

marked elevation between th e upper border o f the latis si

m us dors i an d the te re s minor Thi s . relief exte rn ally s
,
ink s ,

under c over o f the deltoid an d the long he ad o f the gre at

exten s or mus c le on the bac k o f the upper arm ca lled the ,

triceps It i sowi ng to the pres

. ence o f thism us c le th at

the ext ern al or axill ary bo rder o f the bl ade bone exercis - es
so li ttle dire ct in uenc e on the s ur f ac e f orm sPlate s
( XII ,

XIV pp 102
idered in detail the variouss
.
,

H av i n g now c on s
,

upe r c i a l

m us c le s which lie on the bac k o f the tr unk it m ay be w ell ,

to review briey the m ain f eatures o f the s uper c i al an atomy

o f thi s region .

A ri sing from the middle line o f the back throughout the ,

en tire ex tent o f the dor s a l region an d ext e n d i n g u pw a rd s

the tr ap ez i us The bres

,

as high as the bac k o f the s ku ll i s .

to the boneso f the

,

o f ins e rtion ar e to be tr ac ed o u tw ard s

1 18 Summa ry of the Mus cles of the Ba ch .

shoulder girdle The higher breswhi ch pas

- . sf orward to
,

be attached to the outer third o f the f ront o f the collar bone

-
,

have a downward direction The lower whi ch ar e ins

. ert ed
into a tendon overlying the root o f the s
,

pine o f the
shoulder blade have an upward direction The inter
- .

med iate bresrun with varying degreeso f o bliqu i ty to

,

be ins erted into the upper m argin o f the s

,

pine an d the
acromion proc esso f the bl a de -bone ( Plate sV X I X I V , , ,

pp
The origin o f the delto id corres pond spreci s ely to the
ins ertion o f the trap ez iusthe coll ar-bone an d the bony
,

proces s eso f the bl ade-bone alone s eparating the attac h

mentso f thes e m us c le s The br es
. o f th e deltoid are

gathered together to form a pointed tendinousin s ertion

ide o f the s
,

which i sattached to the outer s haf t o f the

bone o f the upper arm about itsmiddle The mus c le

th uscoversthe s
.
,

houlder-joint behind in front above an d

ide ( Plates
, , ,

to the outer s VIII IX XII pp 62 72

, , , .
, ,

A ri sing from the middle line o f the back throughout

the entire region o f the loinsan d al s
,

o from the lower

h alf o f the thoracic region i sthe la tis s
,

imus do rs i The .

l atter part o f i ts
,

origin isoverlapped by the pointed lower

breso f attac hment o f the trapez ius In a ddition the .

l ati ssimusdors i ari s

esf rom the l as t three ribsaswell
as f rom the hinder end o f the ili ac c res t f o r a vari able
di s tanc e ash asbeen already des cribed The brespas . s
with varying degree so f obliquity
,

upwa rd s an d outw a rd s

towa rd sthe hinder f old o f the armpit the contour line o f

c le i s
,

whi ch they f o rm here the m us

: twi sted on its el f to
reac h the f ront o f the upper pa rt o f the s haf t o f the
h umerusinto which it i sins
,
erted ( PlatesXII X I V , ,

pp 102
A tri angul ar interva l between the s
.
,

e m us c l e sin the
s c ap ul ar region s is to be noted the ap ex o f whi ch co r
,

res pond sto the root o f the s pine o f the bl ad e bone Of

- .
1 20 Summa ry of the Mus cles of the Ba ch .

neck R ota tory movement in an oppos

. ite direction is
pro d uced when the ar m i sca rri ed acros sthe back o f the
tn m k towa rd sthe oppo s ite s ide o f the body In this .

po sition the lower angle o f the blade bone is - drawn nearer

the middle line o f the back whils t the upper angle pas
,
ses
to li e wide o f the middle line .

As will be obviousthere may be many combination s

e movements Tw o exampleswill be s
,

o f the s . ui c i e n t to

render this cle ar We m ay have th e upli fted arm wi th the

.

shoul der throw n f orward sor on the other han d th e upli fte d
.
, ,

limb with the s

hou lder d rawn back the a rrangeme n t o f
the conte ntsan d outlines o f thi s sca pul ar tri angle di s play
ing very characteris ti c diff eren ce sin the two po s itions .

Thes e d iff erencesthe s tudent will bes t appre ciate fo r ;

hims el f by a s tudy o f Pl ates V X X I XII XIV pp 36 86 , , , , ,

.
, ,

92 1 02

n e c es
,

upe r c i a l m uscle whi c h it i s

,

The only remaining s

s a ry to s tudy here i s a portion o f the ex ter n a l o b lique as it
f orm s the ank thi sis vi sible in a view o f the s upe r ci a l

m us cle s o f th e b ack s ince it lies wide o f the lower attach

i to the ribsan d ili ac cres
,

men t o f the latis sim usdors t .

Us ually ho w ever the s uper c i a l l ayer o f f at in thi s region

u rf ac e conto urs
, ,

is so abund ant th at the s a re not m uch in .

ue n ce d by the develop ment or contraction o f thi s p ar t o f

the exte rnal oblique
titute the s
.

Whils t the mus cles above mentioned con s uper

c ial l ayer o f the back the s tuden t mus

,

t not overlook
cle s exercis
,

the f act that many o f the d ee per mus e a very

powerf ul inue nce on the s urface f or m s M os t important .

o f the s e ar e the e recto res sp i n ae The s e c ontrol to .a l arge

extent the movementso f the vertebral colum n or back

bone an d though their action h as been already fully d i s
cus
, ,

sed it m ay be well here to remind the s tud e nt th at

when the gure i srepres es

,

e nte d in po s in wh ich the bac k

is b ent either f orwards or back wardsto the s ide or twis ted
, , ,
 C HA PTE R V I .

TH E U PPE R ARM.

BE FORE pas sing to the cons ideration o f the s ur face forms

o f the upper arm it m ay be well to gl anc e f o r a moment

,

at the m anner in whi ch the ar m s pringsf rom the trunk .

When the arm ishanging by the s ide there i sa hollow ,

ca lled the a r mp i t between the uppe r part o f the limb a n d

.

the ches t wall I f the ngers

- . be thr us t into this space the
anterior an d po s terior walls o f the hollow w ill be f ound to

be thick an d es hy Thes
. e have been already f requently
ref erred to asthe an te rior an d pos terior f olds o f the arm

pit an d have been s

, een to be f ormed by the m us c les pas s ing
f rom the tr unk to the l imb .

G reat altera tions take place in the f orm o f thishollow

when the arm isra is ed from the s ide I ts . bound aries ar e

now bet ter s een fo r the borderso f the an terior an d

pos terior f olds ar e stretched an d more cle arly dened
t noticeable f ea ture in connex ion with them is
.

The mos
,

that the pos te rior f old exte nds f arther down the limb th an
the anterior ; the res ult o f thi s is th at if the gure i s looked
at f rom the f ront when the ar m is rai sed we can s e e into

the hollow o f the armpit In thisview the anterior

s urf ac e o f the pos
.

terior wa ll isin part expos ed an d we

h ave to acc ount fo r the s tructu res which determine i ts
,

f orm .

I f on the other h and the gure i s

, ,
sketched f rom behind
 The A r mpit .
3
12

when the arm i s upli f ted the pos terior f old o f the armpit
c onc e a l s f rom vi ew the hollow an d the lower m argin o f
thi s f old f orm s
.

the o utline o f the gure in thi spos ition .

Viewed f rom the s ide we can o f cours e recogniz e both

bo unda riesan d get a better idea o f the in ner wall o f
,

th e s
,

pac e .

For clearnes so f des c ription the b ou nd a ries o f th e s

.

pac e
h ad now bette r be de s c ribed In f o rm the hollow res
. embles
a f o ur s -ided pyramid the s ides o f whi c h a r e u neq u a l The
bas
.

pond s
,

e o f the pyramid c orres to the s kin which overlies

the hollow The inner wall o f the s
. pace i sf ormed by the
c he s t wall overl ain by the s
- erra tus m agn us Th e anterior .

wall ash asbeen already des

, c ribed is f ormed by the
,

pec to rali s m ajor an d minor The pos . te rior wall i s in part

m ad e up o f the anterior s u rf ac e an d exte r nal border o f

the bl ade bone both o f which ar e clothed b y mus

-
,
c le s On .

th e ante r ior s u rf ac e there i s a m us c le ca lled the s ub

scapula ri s an d r u nni n g along the ex tern al border o f the

bone are s
,

een the thick e s hy breso f the teresm aj or

,

so f thi sm us cle i s s uf c ient to m as

,

The thicknes k the

ou tline o f the extern al border o f the bone b ut the s tudent
a ti s e lf o f i ts pres
,

can e as ily s f y him s ence by gras ping rmly

the pos terior f old o f the armpit when the limb i srai s ed .

S weeping ro und the ou ter border o f the te re s m ajor the

bre s o f the l ati s sim us dors i can readily be s e en in a d i s

s ec tion o f this region an d in certain pos ition so f the limb

es u rf ac e f o rm s
,

their pre s e n ce c au s dis tinct al terations o f the s .

The anterior an d pos terior w all s o f the a r mpit a r e wide

apa rt as they pas sf rom the trunk b u t asthe mus , cle s

whi ch f orm them with one exception the pec torali s

,
minor
ar e all in s erted into the bone o f the upper arm th e
f old s a re nec e s s a rily bro ught m uch clo s er together at their
at tac hmen ts to the limb .

The ou te r wall o f the s pac e i s nece s sari ly m u ch n arrower

than the othe rsan d con s ,

is tso f the uppe r portion o f the
124 Co r a co b ra ch zalz
- s
.

s
h ft a the hu merus
of an d ce r tain m us cle s which ar e pas sing
down along i tsinner s id e Thes e ar e the bicep smus c le

o f the a rm a n d the co r a co b r a ch ia lis

.

whi ch will pres ently ,

be des c ribed The hollow its . elf is lled with fat in whi ch
the large ves s el san d nerveso f thi sregion ar e embedded
,

It is owing to the pres ence

o f the s e contentsan d al s o
to th e s
,

tretching o f the .

s kin an d brousl aye rs

which f orm the bas e of
the s pac e that the hol low
is not s o deep as
,

one would
expect f rom a mere s tudy
o f the m us c le s alone .

Pl ate sX X I I XV re , , ,

pres ent the gure with the

l imb in diff erent pos itions
FI G 79 A i w t s h w th s
,

th e s
t o r uc

tu s
re whi h
. .

d li th d lt i d
c un
v e

er ed
an d
o

e
te
udent W 111 be
e

o an

g rea t p t l m u s l
ec o ra s t h u tli s f
c e a ble to f o r m
e o a bett e
ner ide
o a .

s s Of the arrangemen t Of the

,

wh i hc p t
a r e red b y d tt
re en d li e o e ne

Th s s
.

s
e p ti
e f th
a ra l i
on o l b e c a v cu a r re

f m th
ro t l b sf th g
e e ern a t m
re u SC le o b y a S
e
tu dyr ea
O f '

p t
ec o ra l i s l s s
h w ab y o d tt do the s
n e pla te sthan by an y
a o e

al de s
line .

verb c ri Pti on .

Thi s18 a co n v e m en t
a C l l -b ( l i l )
o ar one c av c e

s (s
. .
0

b B t b rea m)
- one te r n u
ssf s l
. .

A mi u a
d C
c .

i d pr s
cro

sf sp iil
on r o ce
po o
i nt a t
ea
W h I C h
.

to S tu dy

co r aco b r a ch ia lis s
. o ra co o ce o ca a.

w m m mm the - Thi
h mh s m s
.

s s s
j C m -b a eo l
rac u c e
s s m le r e
.

a S h h d f b i
o rt p m
ea l o ce u c a i u c e i n c o n j u n c
d f bi p m s
,
.

h b
I H m
t
gh
.

s
e

u
ea

er u
l o ce
t i on
'
W i th the
u c e .

s hort he ad

o f the bi c eps m us
. .

cle o f

the arm f rom the tip o f the coracoid proce s so f th e blade

ide o f the humerus
,

bone an d i sins , erte d into the inner s ,

where i tsattac hmen t c orre s pond sto the middle third o f

the leng th o f the s h af t .

The uppe r part o f the m us c le i sc on c e aled by the anterior

f old o f the armpit an d as i t run s down along the inner

,
1 26 Humer u s
.

It becom esattened an d di s pl aysashasbeen alread y ,

ur fac e s
terior s
m arked anterior an d pos
,

sa
t ted well -
,
which ,

Right Hum eru s .

FI G . 80 Fro n t view
. . FI G 8 1 Oute r
. . s
id e . FI G 82 Bac
. . k vi ew.

a. H ead Ca pi te llu m f o r ar ti c ula tio n wi th h ead

h
s s
. .

b G r eate r tu b e ro ity o f rad iu

s
s s s
. . .

c Le. e r tu b e ro it y . i Tro ch l ear

. ur face f o r arti c ula ti o n

d . Bi c ipita l gr oo v e wi th uln a
s
s
. .

e De lto i d i m p re io n w h ere d el to id j E x te rn al co n d ylo id r id ge

s ss
. . .

m u c l e i in e r ted k I n te rn al co n d ylo id r i d ge
s s
. . .

f I n tern al co n d y le Th e e r i dge a ff o r d a ttac h m en t to th e

s
. .

9 E x te r n a l co n d yle ex te rn a l a n d in te r n al i n ter mu c ul a r

spt s
. .

e a re p tiec vely .

s
ar eep r ted on the inner d o ter s
a a ide sby di s
tin t an u c

m rgins If tr ed downw rd sthes

a . e m rginswill be ac a a
 Humer u s . 127

f ound to terminate in pointed pro ces ses called res pectively

the i n ne r an d o uter con d yles Of the s e condylesthe
inner i sthe more prominent whil s
.

,
t o f the ridgesleading
to them ( c a lled s up r a -co nd ylo id ridge sthe outer i s
) the
bette r m arked Thes . e ridgesan d pro ces sesar e o f great
importance in aff ording attac hment to numerousm us c le s

an d proc es seso f fas c i a in thi s region The part o f the

.

humeruswhi ch liesbetween the two condyloid proces ses

is much thi ckened an d iscu rved s lightly f or ward It i s
.

on thi sportion o f the bone that the articular s urf ac e s

ar e p l aced by mean s o f whi c h it i s c onnected with the

ra dius an d uln a .

Jus t below the extern al condyle an d to i tsinner s ide

a s mooth rounded s urf ac e called the cap itel lum or little

notic ed Thi s
,

h e ad is
,
. s u rface whi c h lies
,
more on the f ront
o f the lower extremity o f the humerus th an on its inf erior
as pect is , ad apte d to arti cul ate with the s h allow hollow on
the upper end o the outer bone o the ore arm ( radius
f f f -
)
ide o f thi slittle arti cul ar head it will be
.

To the in ner s
obs e rved th at the lower end o f the humerusisgro oved
by a pul ley like s- u rf ac e whi ch pas sesround it in a s lightly
s pira l m anner f rom back to f ront Thi s
'

. surf ace i s cal led

the tr o chlea an d isf o r articul ation wi th the inner bone o f

,

th e f ore -arm ( uln a ) . The trochl ea i ss eparated from the

ca pitell um by a s light s
. mooth ridge whil s t i ts inner border
is
,

dened by a well - m arked an d prominent edge The .

latter i ss eparated by a con s iderable interval from the

inter nal condyle o f the humeruswhich lie s above it an d to

i ts ide It is to this
,

inner s . f act th at the in tern al condyle

owes i ts prominence .

As h as been already s tated there are two bone sin the

f ore arm the r a d i us
,

- an d the uln a . N o w it mus t be borne

in mind th at the s e two bone s ar e not im mov ably united a s

e with the corres ponding bone s

,

is the cas o f the leg b ut ar e

f r ee ly movable on one ano ther in certa in direc tion s Thi s

,

.
 B o ne sf
o Fo re a r m
- .

m ay be be s t unders to od if we compare f o r a moment their

rel ations to each other in diff erent pos ition s o f the limb If .

the arm be held with the palm o f the h and directed upwards
the bon es ide an d more or les s
,

will be f ound to lie s ide by s

parallel to e ach other where asif the hand b e now turn ed
it will be obs
,

s o that the p alm i s directe d downward s erved

th at the ou ter bone o the ore arm pas
f f - s esto li e obliquely
acros sthe inner bo ne .

Thi smovement i stermed the moveme nt o f p r o na tion

an d s up i n a tio n ; it will req uire to be s tudied in de tail
late r b ut it isneces sary th at it s hould be ref err e d to
here in order th at the s tuden t m ay unders tand the f orms
,

o f the a rti cul ar s u rf ac e s o f the two b one s

,

s
In comparing the two bone o f the ore arm it will b e f -

noticed th at the upper extremity o f the ulna i s large wh il s t ,

i ts lower end i s c omp a ratively s m all On the other hand

.
,

the uppe r end o f the rad iu si ss m all whil s t itsinf erior

tu dent s
,

extremity islarge an d expanded The s . houl d

as so ci ate with the s e detail s the facts th at the ulna or inner ,

bone o f the f ore -arm enters mos t l a rgely into the f orm ation
t the ou ter bone or radiuspl ays
,

o f the elbow joint whil s

-
, ,

the mos
,

t im portant part in s u pporting the s keleto n o f the

ha nd a t th e wri s
t-join t .

s s
A it i with the mu s c le s which move the f ore arm on -

the upper arm th at we ar e at pres e nt c on c erned it will

ider rs
,

be ad vi s able to c on s t the f orm o f the bone o f the

f ore -arm whi ch i s
, mos t intim ately as socia ted with thes e

movements .

The upper extremity o f the uln a i s l arge an d pre s e n ts ,

a very c h arac te ri s tic appe arance The mos . t noticeable

f e a ture i s a deep an d well -m a rked notc h c a lled th e
gr ea ter

s es
,

igmo id n o tch which lie s

, between tw o prominent proce s s
pl ac ed one above the other below i t The higher o f thes . e
ss
, ,

called the o le c r a n o n
p r o c e lie s in line with the u ppe r end
o f the s haft The pos proces s
,

. terior prominent angle o f thi s

1 30 U lua .

easily verify fo r himself by running h is

nger rmly along
the bac k o f the fore-arm co mmencing above at the tip o f ,

Bo n e sf
o r igh t fo re-arm .

FI G 83 Fro n t FI G 84 Bac k FI G 85 Outer FI G 86 I n n er

s s
. . . . . . . .

vi ew . vi ew . id e . id e .

a U ln a 11 Lo w er en d o r h ead o f ul n a .

ss s
. . .

a Ol cc ra n o n pro ce o f ul n a r Ra d iu
s
s s
. . . .

b C o ro n o i d pr o ce o f ul n a i H ea d o f r adi u

s s s
. . . .

c G r e a te r igm o id n o tch j Bi c i p i ta l t u b e ro ity to w h ic h i at

s s s
. . .

4 A tta c h m en t o f b r ac h ial i a n ticu tec h ed th e te n d o n o f th e b i ce p

s ss s
. . .

e Tr i a n gula r ub c u ta n eo u ur f ace o n k Plac e d n ea r th e i n e r t io n o f th e

ss s
. .

b ack o f o lec ran o n pr o ce p ro n a to r rad ii ter e

s
s s
. .

f S tylo id p ro ce o f ul n a l E x pa n d ed lo w er e n d o f r ad i u , w hi c h
s s s s s
. . .

g P o te r i o r ub cu ta n e o u b o r d e r o f uln a arti c u la te wi t h th e car pu

s
s s
. . .

m S tylo i d pr o ce
. o f rad i u .

the elbow an d ending below at the prominence on the back

,

an d inner s ide o f the wris

t whi ch liesin a line with the
little nger .
 R a diu s
. 1 31

The lower end o f the ulna curious ly enough called the

head cons istso f a rounded thi c k button like proces
,

,
- sfus ed
on the extremity o f th e s
,

haft Fr om the back an d inner

.

side o f thishead there proje ctsdownwardsa promine nt

proces s o f bone ca lled the s tylo id p r o ces so f the ulna The .

fu rther deta ils o f thi s portion o f the bone will be s tudied

in connexion with the de s c ri ption o f the wri s t
The r ad iusor o uter bone o f the f ore arm diff ers
.

,
-
,
f rom th e
uln a or inner bone in being s mall above an d thi ck an d
expanded below M oreover thisbone isnot aslong as
_

the ulna which exceed sit by the length o f the olecranon

proces s
,

Th e upper end o f the radi us is ca lled the he ad It too .

may be c ompared to a thi ck dis k -s haped piece o f bone

xed on the end o f the s haft Th e upper s
. ur f ac e o f th i s

dis k or head i ss lightly hollowed o ut s o as to t on to th e

smooth rounded s urf ac e o f the ca pitell u m or little he ad o f

the humerus The circum f erence o f the dis

. k is thi ck an d
rounded an d on itsinner s
, ide isa dapte d f o r arti cul ation
with the les s
er s igmoid ca vity o f the uln a whi ch we hav e
so f
,

al rea dy s een on the outer s ide o f the coronoid proce s

that bone The head o f the radiusca n be dis
. ti ctly f elt n

beneath the s kin in the dimple or depre s s ion which appears

behind a n d to ward sthe outer s ide o f the elbow when ,

the f ore -arm is straighte ned on the upper ar m .

Below the head the s haft o f the bone iscons tr i cte d b ut

s
,

rad ua l ly expa nd s a it p as se sdownw ard s be c oming m uc h

g ,

thicker towa rds i ts lower extremity .

A bout three -quarters o f a n i n ch below the he a d there

is an o ut s tanding os se ous tu bercl e o n the in n er s ide o f the

s haft Thi s
. isca lled the b icip i ta l tu b e r cle b ec aus,
e the te ndon
o f the bi c ep s mus c le i s a ttac hed to it .

The s haft o f the bone iss o overl ain by m us c le s that

it h asno direct in ue nce on the s u r f ac e conto urs o f the

f ore arm though indire ctly it re ac ts

-
,
on the s urf ac e f orm s

11 2
1 32 E lbozvj o iut .

by s upporting the s e mu s cles an d thus

, g i v e s ri s
e to g reat

modications in the general outline o f the limb acc ording ,

as i ts pos i tion ischanged in the movementso f pronation

an d s up in ation alrea dy re f erred to .

The lower end o f the bone isbroad an d expanded It .

enters largely into the f orm ation o f the wr is t-joint f urni s h

in ferior ar ticul ar s
,

in g by i ts u rf ac e a bro a d s
. upport f o r the

bones o f the wri s t The external border o f thi sexpanded

.

in ferior extre mity i sprolonged do wnward s in the f orm o f

a bl unt pointe d pro c e s
- scalled the s tylo id p r o ces so f the
radiusThis proces sas well as
,

.
,
the bone immediately around ,

is s ub cu ta neous an d f o rm s the prominence on the o ute r s ide

o f the wris t whi ch liesin line with the thumb A n oval .

hollow s een on the in ner s ide o f the expanded lower end

receivesthe thi ck m argin o f the rounded
,

o f the bone ,

head o f the ulna when the two bones ar e arti cul ated

Thes e points
.

will require fu rther cons ideration when the

movementso f pronation an d s upin ation are di s cus sed an d
when the anatomy o f the wri s t is c ons idered .

There ar e few s u bje cts whi ch require more care f ul s tu dy

th n
a t h e elbow joint A knowledge o f the s
- . hape an d
re lation so f the boneswhich en ter into itsf o rm ation is
es sential to enable the s tudent to unders ta nd the a l teratio ns
in f orm which depend on the movements o f t hi s joint .

Th e elb o w j o i n t i s
- a typi ca l ex ample o f a hinge - joint .

That is to s a
y movement ta ke s pl a c e in one or other o f two
or backwardswhich movements
,

dire tion either orw rds

c s f a
ar e te rmed ex io n a n d ex ten s
,

io n In the f ormer the f ore

.

arm i s bent f orward so u the upper arm in the l atte r the

tra ightened s
,

li m b ssi o that the ore arm isbrought

f -

nearly into line with the upper arm Th e caps . ule whi c h

inves ts the joint isloos e in front an d behind s o as to

a llow f reely o f movements e direction s A t the s ides
,

in thos .

o f the joint however the cap s

, u le i s strengthened by the
addition o f s
,

trong ligament s which prevent an y lateral play .

1 34 Elb j o w o in t
- .

the o le cr a n o n f o s s a When the limb isextended the

a nterior an d upper border o f the olecranon pro ce s slies
.

in the olecranon f os s a whils t in the bent pos ition the

p rominent lower border o f the great s
,

igmoid notch f ormed ,

by the coronoid pro ces soccupies the coronoid fos s a .

The movements o f e x i o n an d extens

,

ion o f the f ore arm

-

ar e eff e c ted by the s igmoid notch being d rawn over the

trochlea o f the h umerusb u t asthe ra diusisunite d to
the u lna by meanso f certain jointsit f ollowsthat asthe
,

uln a moves it carries with it the radius It h as been alre ady

.

s tated th at the upper s ur fac e o f the he ad o f the radi us is

hollowed o ut to ad apt it to t the capitell um or s mal l head
o f the h umerus b ut as this l atter articular s urface i s placed
more on the f ront th an on the lower as
,

pect o f the i nf er ior

extre mi ty o f the humerusit res
s lightly in contac t with this
the limb is fu lly extended
ever the he ad o f the radiusismore clos
ul ts that the radius is b ut
u rf ac e o f the humerus
s when
When the elbow is
. bent how
,

ely applied to the

The s u rf ace s j us t des c ribe d ar e s
,

capite ll um . o arranged

as to permit not onl y o f movem en tsin a backward an d

f orw ar d di re ction b u t al s o o f movements o f ro ta tion o f the

he ad o f the radius on the capite ll um This

,

movement o f
itionso f the limb b ut is
.

the rad i usi spos sible in all pos ,

be st controlled an d mos t efciently employed when the

elbow is be n t fo r in thi spos
,
ition the head o f the radi us
ts more accurately on the capitell um an d is theref ore better
supported .

Thes e f actsare born e o u t by expe rience It isin the .

movemen ts o f prona tion an d s up i na tion a lre a dy in cide n ta lly

takes
,

re ferr ed to tha t the rota tion o f the head o f the radi us

,

plac e When we make us

. e o f the s e movemen tsan d des ire ,

to employ a cons iderable amount o f f orce we ar e accus to med

in the actso f i n s
,

to do s o w ith the arm b e nt as ertin g

c rew or us
,

a c ork s ing a s c rew driver f o r in thi s

-
,
pos ition
o f the limb the he ad o f the ra di us is well s upporte d by th e
 E [b o w o in t
j
- . 1 35

ca pitellum But whils

.
, t this is the cas e the s tudent mus t
not overlook the fact that the s
,

ame movements m ay be
perf ormed with the lim b extended as in the act o f fencing
or when we lift an d twis
, ,

t anything about ; in the latter

ac t however it will be obvi o us
, , that the joint i s subje cted

to a te a ring rather than a crus hing s tra in

It is neces s
.

ary to c ons ider the movementso f ex i o n an d

extens ion o f the elbow more ca ref ully Were the move
men ts s
.

as imple as have been des cr ibed one would n aturally

,

e xpec t th at when the f ore -arm is bent on the upper arm

the ante rior s ur f ace s o f the two p a rts o f the limb would be

brought into contact ; that this is not the cas e the s tudent
can eas ily demons elf I f the arms
,

trate fo r hims . b e extended

by th e s ideso f the tm n k with the palmso f the hand s
d ir e cte d f orwa rd s an d the f ore - ar m s then bent upwards
wi thou t an y c on s c ious traint the elbows being s
,

res till kept

in contact with the s ides o f the c he s
,

t it wil l be f ound th at
the handswill fall natur ally in a cros s ed pos
,

ition on the
f ront o f the bre as t an d not as one might reas onably expect
over the s ponding limbs This
, , ,

houl derso f the corres wi ll

.

be obviousi f the a tte m pt ism ad e to touch the s houlder

wi th the hand o f the s ame s ide while the upper arm is
s till c los
,

ely applied to the s ide o f the body an experim ent :

which wi ll prove that the action is a very c ons trained one .

If the arms be aga in exte nded by the s ide in the manner,

abo ve de s cribed another point will be noti c ed The f ore .

appear s s
,

arm s played on the upper arm s ; in other word ,

the axi s o f the f ore arm when vi ewed f rom the f ront is
- not
in line with the axis o f the upper arm b ut f orms with it
an obtus
,

e angle Wh y thi si snot asa r ul e apparent i s

.

d ue to the f ac t tha t when we carry o ur limbs by the s ides

o f o ur body we us u ally have the pa lms o f the h and s dire cte d
inwards towardsthe s ides o f the thigh s as in the milita ry
a ttitude the bones
,

attitude o f attention ; in thi s o f the

f ore -arm are in a p os i tion midway between s upina tion an d

I 36 Elbo w-jo in t .

pronation a pos ition which s o modi esth e direction o f th e

axi s o f the f ore arm as
,

- to bring it directly in li ne with

th e axi s o f the upper arm an d th us cause the dis appea ran c e

o f th e obtus e angle alluded to To repres ent thi s an gle h as .

been regarded by many asoffens ive an d inar ti s

tic ; at th e
same time it m us t be borne in mind that the co nd ition is
a perf ec tly n a tural one an d the ac tion in whi ch it i

pronounced i sby no me ansunfr equently employed by

, mos t s
m any asa ges ture wh i ch is us
ually as sociate d with an
obs e q uious manner .

FI G 88 s
Di agram to illu t rate th e m an n er in wh ich ez io n of th e
s
. .

elb o w aff e ct th e li mb .

a a. Th e sf
ax i o r o tati o n of th e j o in t

ispl d a ce o b li q ue ly to th e lo n g at b b Wh en sb d d i
t en upo n
isf th s pi s p s
.

ax o e h um er u cc it o ccu th
e i tie o on ne

st sf s ss
.

c c an d d d . R e pr e en two piece o pr e en ted b y th e d o tte d lin e a .

The expla nation o f the above f acts is to be f ound in the

urf ac es
f orm o f th e arti cu lar s by which the h umerus an d

ulna are united The s tudent will be s

. t unders tand this by
a ref erenc e to the acc omp anying di agram s Fig The s
( e

do not account f o r all the movemen ts

.

which take place at

the elbow b ut they at leas t render clear the caus e o f the
obtus e angle when the limb isextended an d the cros s
,

ing
inw rd when the o e arm isbe nt As
a s f r - will b e seen this .
,
I
38 E lb o wj o in t .

lim b in whi ch the fore is exed on the upper am at

-arm

a right angle the ti p o f the olecranon lie s in dire ct line with

o f the humerus
,

the axis an d f ro m an in ch to an in ch an d

a h a l f ac c ording to the siz e o f the bonesbe low the level o f

,

, ,

the internal condyle Thes e pointsi f viewed fr om behind

.

po s will be s
,

with the arm in th is ition ( Fi g een to f orm .

a tri angle o f whi ch the bas e corre spond s to an imagin ary

lin e connec ting the two condyloid proces o f the h umerus
,

ses ,

th e ape x being f ormed by the tip o f the olecranon .

Bo n e sf th
o e le ft elb o w .

Fm 89 A . . ee n ss Pro 90 . A . e en ss FI G 9 1 A . . ee n ss
f ro m th e f ro n t wh e n f ro m b ehi n d wh e n th e f r o m b eh in d wh en th e
j s
th e o i n t i e x te n d ed . j s
o i n t i ex ten d ed . j s
o in t i b e n t to a r igh t

a n gle .

0. E x te r n al co n d yle . 1 I n te r n al
. co n d yle .

If ex i o n the f ore -arm b e ca rried f urther the tip o f the

of

o advance an d the outline o f this proc es s

,

ole cranon will als ,

will be rendered more di s tinct The bac k o f the olecranon

sf ormsa tri angular s ur fac e which i s
.

proc es bou nded on

either side by bony ridges ; these gr a d u a lly c o ale s
c e in f eriorly
to form the po s terior border o f the s h aft o f the u lna The .

triangular s ur face o f bone in c luded between the two lines

is unc ov e red by m us cle an d imm e di ately underlies the s kin

FI G 92
. . View o f s
th e b o n e o f th e ri ght elb o w f ro m th e o ute r s
id
e
j
with th e o in t e x te n d ed .

FI G 93 View o f s
th e b o n e o f th e r ight elb o w f ro m th e o uter s
id e
j s
. .

wi th th e o in t ligh tly b en t .

FI G 94 Vi e w o f th e b o n e sf o th e right elb o w f ro m th e o ute r s

id e
j s
. .

wi th th e o in t till f ur the r b en t .

h H um er u s u U ln a
s s
s
. . . .

c
. Ce pi te llum of h um er u . o. Olec ran o n pr o ce o f ul n a .
1 40 Fa sacz f
o Upper A r m .

it can be eas ily f elt an d is

,
limited above by th e pointed
extremity o f the olec ranon whil s t below it becomesco n
pondson the
,

ti n u o u s with the ulnar f urrow whi ch corres ,

s u rf ac e to the pos terior border o f the ulna .

The movemen ts o f whi ch the elbow j oint i s

,

- cap able a r e

thos e o f ex io n an d extens ion The f ormer iseff ec ted by

.

the contraction o f the m us c le so f the f ront o f the upper arm ,

an d i s c h ec ked by the oppo s ition o f the s of t parts which

clothe the anterior as pect o f the limb E xtens . ion isd ue
to the contraction o f the tri cepsm us c le whi c h lie s on the
bac k o f the upper arm an d i sli m ited by the tightening
,

o f c ertain ligamen ts
,

an d the m ech ani ca l loc king o f the

boneses pecially when the action isa vi olent one The .

extent to whi ch thi smovement may take place variesin

,

diff erent individual s ; in s ome owing to a greater l axity o f

the ligamen ts an d to m o di cation s in the f orm o f the bones
,

ible Thi s gives

,

a certain amo u nt o f hyper extens - ion is pos s

ant appe ranc e f o r the f ore arm appe a rs
.

ri se to an unpleas a -

as
,

if bent back on the upper arm .

The m us c les whi ch co ntrol the movemen ts o f the elbow

joint mus t now be des c ri b ed ; they f o rm the es hy m as ses

on the f ront an d bac k o f the uppe r arm Beneath the .

s ki n an d s ubc utaneou s fat o f the arm a s hea th o f fas ci a

inves tsthe entire lim b Thi s .

f asci a l s hea t h m a y be co m
pared to a tigh t ttin g s- leeve A bove it isc on tinuous
.

with the fas ci a covering the s

,

houlder an d the layer which

f orm s the oor o f the armpit ; at s everal pointscorre
s d i to the a tt achm ent o f the m us le s whi c h f o rm
p o n n
g c

the an te rior an d pos terior f oldso f the armpit it receives

iderable addition s by meanso f brous
,

cons s trands derived

fr om the tendonso f in s ertion o f thes e m us c les Thes e .

bro usband sm as k to s ome ex te nt the borderso f the

tendonso f in s ertion o f thes e m us c les an d render more
,

owing the ou tline o f the axill ary f oldswhere they become

blended with the s urfac e conto urs
,

of the upper arm .

1 42 Bicepscub iti .

The brac hi ali santicusisoverlain by the biceps mu s cl e ,

b ut as the l atter i snarrower than the f ormer the bres of

the brachialisar e expos ed both o n the inner an d oute r

as Al ong the ou ter s
,

pec ts o f the f ront o f the limb . ide o f

the uppe r arm the breso f the brachi a li sare s een lying
in th e interva l between the bicepsin front the exte rn al
eptum an d the outer head o f the triceps
,

inter mus
- c u l ar s

b ehind the in s ,
ertion o f the del toid above an d the origin o f ,

a mus c le ca lled the s upin ator longus below ( PlatesXX ,

XXI pp 1 70 .
,

pect o f the upper arm the bres

,

A long the inner as ar e

vi s ible between th e bic ep sin f ront the intern al in ter

m us
,

c ul ar s eptum an d inner head o f the tri cepsbehind ,

an d the origin o f the pron a tor r a dii tere s m us c le below

( Pl a te s XVIII XXI pp 1 44 .

c le i s
,

In both thes
, ,

e s ituation sthe m us super c i al an d , ,

du ring powerf ul contraction m ay directly in uence the

s
,

u rf ac e f orm s .

In ac tion it will als o pu s h f orward the lower part o f th e

bi ceps which lies u pon it an d s o indirectly exert an in u ence

on the s
, ,

uper ci al c ontours .

The m us c le ac ts as a e x o r o f the f ore -arm ; by i ts in

s ertion into the coronoid proces so f the ulna it draws
th e s igmoid arti cular area over the trochl ear s u rf ac e o f the

humerus .

The bicep s ex o r cub iti or bi c ep s o f th e arm belongs to ,

c ribed as
,

that group o f m us c le s w hi ch h as been des indirec t

in their ac tion Under norm al conditions
. it h as no attach
ment to the hume rus wh atever b u t aris es f rom the s hould er
blade Thi sit does by two tendon sone o f which called
,

.
,

pringsf rom the blade -bone j us

,

the lo ng hea d s ,
t above the
a rti cu l ar s ur f ac e ( glenoid f os sa f o r the he ad o f the h umerus
) ;
the other or s ho r t head aris esalong with the c orac o
,

s
,

brachialis s h been lre ady de s c ribed a t the beginning o f

( a a a

this ch apter f rom the c orac oid proc e s

) s o f the s ho u lder bl a de - .
 Bicepscub iti . 1 43

s
e tendons
The lie nder over f the m s les whi h f orm
u c o u c c

ca ho lder d it i s
the p f the s o j st be fore they ppe r
u ,
an u a a

beneath the an te rior f old o f th e armpit that they become

e s hy E ach tendon isprovided with a belly hence the
.
,

n ame o f the m us c le b u t the s e belliesare s o c los ely applied

regard their s
,

the one to the other tha t we m ay dis eparate

exi s te nce an d c on s ider only the es hy m as sf orm ed by their
u ni on ( Fig 79 p. .

A t the upper p art o f the limb thi s appears as it es cape s

,

below the margin o f the pectorali s m ajor whi ch here f orms ,

the anterior f old o f the armpit ; gradually increas ing in

bulk the mus
,
c le atta ins its maxim um thi cknes sabout the
middle o f th e uppe r arm Below thi spoint the bres
. are

gathered to gether to end in a powerf ul tendon part o f

s es
,

whi ch pas by a ribbon like expans - ion to be in s erte d into

an d blended with the f as ci a o f the f ore arm where it
-

overlies the mus c le swhich s pring fr om the inner condyle

o f the h umerusTh e rem ainder by f a r the s
. tronger portion
as a thi ck ro unded te n d o n w hi ch i s
, ,

is c ontinued downward s ,

ins e rted into the bi cipita l tubercle o f the outer bone o f the
f ore -ar m ( radius In f orm the m us c le m ay va ry c on s ider
) .

ably in diff ere nt individ ua ls a di ff eren c e not dependent

on itsdevelopment from exerci s

,

e or otherwi s e b ut d ue
c omponent p arts Th us
,

to the arrangement o f i ts in s ome

.

the mus cu l ar bre s are long an d the tendinou s portions

ar e rel atively s hort whil s t in others the es hy belly o f the
hort an d the tendonsare long The inuence
,

mus cle is s .

o f thes e varietieso f th e mus c le on th e s urfa ce f orm m ay

be be tte r unde rs tood by a re ference to the condition met

with in the calf o f the leg It isa m atter o f common .

knowledge that the f orm o f the leg diff ers much in diff erent
pers ons ; in m a n y the prominen c e o f the c a l f i s sit u a ted

high up on the back o f the leg where asin othersthe ,

swelling o f the calf reaches lower dow n a n d impa rts a mu c h

more clums y app earance to the ankle Thi s is entirely d ue

.
1 44 Bicepscub iti
.

to diff erencesin the length o f the es hy bellieso f the

m us cle s which are plac e d on the back o f the leg
In cons
.

idering the relation so f the biceps to the s urf ac e

th e s tudent mu s t bear i n mind that the mus -

c le i s in
g re at p art s u per cial It i s o nl y at its
. u pper an d lower
attachments that it isconcealed f rom vi ew A bove the
anterior f old o f the a rmpit c overs
.

the tendonso f origin

,

o f the m us c le Be low the te ndon o f in s

. ertion s ink s deepl y
between the mu leso the f ore arm ( Plates
,

sc f - XVIII XXI , ,

pp 144
.
,

The gre at r part o f the e s

e hy belly o f the mus cle i s

there fore s uper ci al an d it is ,to thi sthat the ro unded

f orm o f the f ront o f the upper ar m i s d ue The form o f
thickne s sisgreater
.

the belly o f the mus c le i ssu c h th at its

than its width ; henc e the di ameter o f the upper arm is

g re a ter f rom be f ore bac kw ar d s th an f rom s ide to side A s
been already s aid the width o f the belly o f the bic eps
.

h as ,

is not s uf c ient to c on ce a l entirely the brach i ali s anti cus on

which it res tss o th at a portion o f the l a tter m us
, . c le i s

expos ed on either s ide o f it ( Plate sXVIII XX XXI , , ,

pp 144 1 70
The oute r an d inner borderso f the biceps
.
, ,

ar e dened

by two s h allow f urrows which run down one on either s ide

o f the f ront o f the u pper a rm The outer furrow corre
.

s p o n d s su periorly to the in t erv a l between t h e deltoid an d

bicepswhil s t be low where it i sus , u a lly well m ark ed it ,

overlies
,

the inte rval be tw een the bicepsabove an d to the

inner s ide an d the s upin a tor longu s below an d to the outer
ide The middle part o f thisf urrow which isles swell
,

s .
,

m arked overliesthe extern al intermus cu l ar s eptum an d it ,

here th at bres o f the brac hi a li s anti cus

,

is ar e bro ught into

direct relation with the s u rf ace ( s The s e f ac ts will

e e a n te
) .

be cle arly demons trated by a reference to Pla te sXVIII ,

XIX XX X X I .

ur f ac e fu rrow along the inner s

, ,

The s ide o f the upper arm

 146 Tr iceps .

be The bice ps
. will be contracted when the limb is in the
su pine po si tion an d rel axed when in th e prone pos ition .

hy m as s
,

The es which is pl aced on the back o f the upper

ar m ac ts as an extens or mus c le o f the f ore arm : it is
-

called the tr i cep s an d a s i ts name impliesari s es by three

,

tinguis
, ,

h e ad s which are dis hed asthe i n ner the o uter an d , ,

the midd le or lo n g head The two f ormer a ri s

,

. e fr om the
h um erus ; the l a tter spring s f rom the ou ter m argin o f th e

blade bone j us
- t below the s
,
h allow s oc ket which receives
the head o f the humerus Pl ate s XVIII XX XXI pp
( ,
144
, ,
.
,

1 70 ,

The s e three e s hy m as s e sare a ttache d inferiorly to an

aponeuroti c tendon f rom an inc h to an in ch an d a half

as
,

wide which re aches high as the middle o f th e u ppe r am

c le i s ins
,

By meanso f thi ste ndon the m us erted in to

th e hi n der p art an d o u ter border o f the olec ranon p ro ce s s
hy breso f the inner head o f the mus
,

a fe w o f the es cle

being directly connected with the olecranon without the

intervention o f tendino us bre s A s the es
. hy m as s o f th e

mus c le overlie s th e b ac k o f the s h aft o f the humerusi t

is
,

brought into relation with the interm us cu l a r s

epta which
have been already des cribe d From the po s terior s u r face o f

o f the m us
.

thes es epta the ou ter an d i n ner he ad s cle derive

breso f origin It will thu sbe s. een that thes e s epta

lie between the brachiali s anti c usmus c le in f ront an d the

tricepsm u s cle on the b ack o f the u pper arm one alon g

,

the inner the other along the outer s ide o f the limb .

c le i s
,

The m us su per c i a l exc ept at the upper part o f th e

limb where the deltoid coversa part o f the long head as

,

well as the highes t at tachm ent o f the outer head .

The s u rf ac e c onto u rs o f the b ac k o f the u ppe r arm depend

on the arrangement o f the breso f the tri cepsan d the ,

dis tinction between its s everal pa r ts is mos t apparent when

the mus c le i s in a s ta te o f powerfu l contrac tion In th is
hy an d te ndinous
.

co ndition the contras t be tween the es

 A n co n eu s
. 14
7

parts o f the m us c le i s at on ce apparent Th e are a overlying

the te ndinou sp art f ormsan elongated attened s
.

u rf ac e

pas s
,

ing up the centre o f the bac k o f the li mb f rom the tip

o f the elbow below to a point above c orres ponding pretty
c lo s ely to the middle o f the length o f the upper arm On
either s
.

ide o f an d above thisattened area the bul ging

,

is
,

produced by the contraction o f the es h y bres s ee n .

Th e mos t noticeable co ntour is th at prod uced by the attach

ment o f the ou ter head o f the mus c le to the ten d inous part ;
thi pro d ucesa well m arked obliqu e fu rrow whi ch repe ats
s -

at a lower level th at caus

,

ed by the hinder border o f the

deltoid asit pas sesacros sth e upper part o f the limb
Pl ate s X XX XXI pp
( , 86 1 70 .

On the inner s
, , , ,

ide o f the limb the s eparation o f the long

f rom the inner head is indica ted by a f urrow which pas ses

obliquely downwards an d b ac kw ard s acro s sthe hi nder an d

inner as pect o f the upper arm f rom a point abou t i ts middle
toward s the inner border o f the tendi nous part o f the m us c le

( P l a te s XIX XXI pp 1 48 .

as
, ,

c le acts
,

Th e m us a powerfu l exten s or o f th e f ore arm

-

o n the uppe r ar m Owing to the at tachment o f the long

is
.

h e ad to the blade -bone th i s part o f the mus

,
cle als o as s ts
in drawing down the elevated limb
c l e called the a n co n eus
.

M ention m ay now be mad e o f a m us

c les
,

which whil s t it might well be des c ribed with th e m u s

idered here as it is
,

o f th e bac k o f the f ore ar m i s

- better cons ,

intim ately as ociate d with the triceps

,

s
The a n co neus h as
.

a tri a ngul ar outline an d ll s up the in ,

te rv al be tween the bac k o f the extern a l condyle the ou te r ,

bo rder o f the olecran on proces san d the uppe r part o f the

s h af t o f th e ulna It thusoverliesto a s
,

back o f the h e ad o f the radiu The mus s

light extent the
c le ari s
. esf rom
th e po s te rior s urf ac e o f the extern al condyle o f the h umerus

by a pointed te ndinous a ttac hm ent The bre s spread o ut

t hor iz on tal pas s
.

in a fan s - haped manner ; the upper alm os , ,

1. 2
148 Exter n a l I n ter mu sl
cu a r Septum .

inward s to b e attach e d to the ou ter m argin o f th e olec ranon ,

whils t the lower pas swith varying degrees o f obli quity to

be ins terior border o f the ulna along i ts

, ,

erted into the pos

o uter m argin The exte nt o f thisattac hment varies
. some
what b ut generally s
, ,
peaking m ay be s aid to corres
,
pond to
the upper fourth or third o f the len gth o f the bone .

The m us c le i s held down by an expans ion derived f ro m

the o uter s ide o f the tendinous ins ertion o f the triceps A t .

i ts origin the anconeusisdirectly r el ated to the mus cl es

which ari s e fr om the front an d outer s ide o f the external

condyle an d the interva l between it a n d the s e m us c l es

ion to which attention has

,

c orre s pond sto the depres s

alre ady be en direc ted in c on s idering the s u rf ac e re la tio n s

o f the pa r ts abo ut the elbow

The general lie o f the m us c le m ay be s t be unders

.

tood by
a re f erence to Pl ates XX X X I It actsalong with the .

tri cepsin extending the f ore arm

, ,

on the s
, .

The in uence o f the f oregoing m us c le s u r f ac e

f orm o f the limb h as been alread y cons idered b ut reference ,

m ay now be made to the interm u s c ul ar s epta which have

be en al re ady des c ribed Of thes . e the more important as ,

a d e te rmin ant o f s urf ac e f orm i s the external When the,

.

m us c le s ar e powerf u lly c ontrac ted an d the li mb i s exed ,

the m argin o f the extern al s eptum f ormsa well d en e d -

ridge which pas ses u p f rom the extern a l condyloid proce s s .

which will be des

,

A n important group o f mu s c le s c ribed

eptum as
,

in the n e t chap ter a ri s

x es ,
f rom the f ront o f thi s s
well as f rom the front o f the extern al c ondyle Wh en the .

limb iss traight th es e m us c le s overlie the condyle an d s o

partia lly m as k i tsform b ut wi th the el b ow bent an d the

,

m us cl e s powerf ully cont racted the con d yle i suncovered

an d the at tac hment o f th e e x te rn a l inte r m us c ul ar s e ptum

to it i s more pl ai n ly s ee n as is s h o w n in Pl a te X X I Fi g 2
, ,
.
,

p 180
. .

In thi spo s itio n th e s u r fac e r idge c or r e s ponding to the ,

 I n em a l I n ter mu

sl
cu a r Septum
. 149

s
h rp edge
a of the s eptum lies between the extern al head
o f the tri c ep s cles o f the f ore arm whi ch ari s
,

an d the m us - e

f rom i ts anterior s u r fac e.

The intern al interm us c ul a r s eptum does not prod uce s o

pronounced a s u r fac e eleva tion b u t i ts

,
position may be
readily recogniz ed on the inner s ide o f the upper arm when
the elbow i s bent an d the mus c les a re powerf ully contrac te d
.

Under thes e conditionsit m ay be trac ed upward s f rom th e

prominent internal condyle asa rou nded elevation which
s eparatesthe triceps behind from the brachi alis anti cus in
f ront ( Pl ate X X I Fig 1 p
,
.
, .
 C H A PTE R V I I .

TH E -
F OR E A BM .

A sh sbeen already pointed o ut the two boneswhich

a ,

f orm the s
keleton o f the f ore -arm are join t ed together in

a m a nner di ff erent f rom that o f the corre s

. ponding bone s of

the lower limb In the leg the bones

. are bo und together in

s uch a w ay th at they cannot po s sibly move on one another ,

whil s t in the f ore arm they are united s

- o th at o n e o f

them may rotate round the other Th e importance o f this

.

arr angement ca nnot be overlooked when we con s id er h o w

m uch thi smovement enh ancesthe utility o f the hand .

By i ts meanswe are en abled to perf orm s uch ac ts as in

s erting a corks c rew or turning a s c rew -driver ; it permi ts

us with eas e to m ake us e o f an y s c rewing ac tion o f the

hand We employ i t every time we turn the handle o f

.

a door .

Thes e movements ar e termed p r o n a tio n an d s up i n a tio n .

Le t us endeavo ur to an alyz e them in their s imples t f orm .

With the elbow by the s ide an d the f ore arm bent on the
,
-

upper arm a t a right angle we can c ontrol the movement

o f the hand s o th at the p a lm i s

,

directed upward s In
thiscondition the limb i ss
.

aid to be s up i n e A caref ul
.

examination o f the lim b in thi spos ition wi ll revea l the

f act th at the tw o bones o f the f ore a rm ar e lying s
- ide by
s ide the rad i us
, ex ternally the ulna inte rn ally The f orm
,
.
 Pr o n a tio n and S upz na tio n
'

152 .

grea te s t thicknes so f the limb i snow from f ro nt to bac k .

Thi salteration in f orm i sprim arily d ue to the change

in the relative pos ition o f the bone sb ut as the rad ius ,
is
covered by the powerf ul m u s c le s which form the es hy
m as salong the o uter s ide o f the f ore arm it re s u lts that -

when thi sbone changesitspos ition it ca rrie sthem with

it an d thusbringsabout a f u rther modica tion o f the
s u rfac e f orm s
,

When the limb is

.

i n the prone pos ition i e with the palm . .

directed downward s
,

we can revers e the action an d bring th e

the movement o f s
,

palm upward s again This is up i n a ti o n

therefore are movements

. .

Pr onation an d s u pin ation

whereby we may rota te the ax i so f the hand through an

, ,

ar c o f or abou t half a circle .

But if the s tudent will repe a t the movement already

des c ribed an d in addition will now exte nd the elbow
the palm o f the h and which wasin the rs
, , , ,

t ins tance
directed downwa rd swi ll now the lim b iss
,

traighte ned by
ide o f the body be directed bac kw ards In the rs
, ,

the s t .

po s
,

iti on we h ad no fu rther power o f rotating the hand

b ut when the axis
,

o f the f ore arm i s bro ught into line

-

with the axi so f the upper arm the hand can be tu rn ed

f urther round s o tha t the palm isdirected outward s .

There i sthus
,

a con s iderable gain f o r whils t we were onl y

, ,

a b le to rota te the h and thro ugh 180 with the elbow bent

now that the limb i ss traightened we ca n rotate the hand

to the extent o f i e thro ugh three q uar ters
. . o f a c ircle - .

The expl anation o f this diff erence iss im ple S uperadded .

to the movemen ts of pronation an d s upina tion move

mentswhich are conned to the f ore a rm there isthe
,

-
,

f u rther advantage o f bringing into pl ay the power o f

ro ta tion at the s ho ulder joint ; thi senablesusto turn
-

the h ume rusa n d the boneso f the f ore arm along with it
,
-
,

an d s o lead sto a rotation o f the en tire limb

Thes
.

e two movementsm us t be kept q uite dis tin ct in

 Pr o n a tio n an d S upz n a tzo n
' '

. 153

th e mind o f the s tudent an d al s o the fac t that they

can only be as
,

sociated when the limb is s traight i o wi th ,

. .

the elbow extended The

bes
.

t example o f thi sco m

b i n a tion o f the two action s
is s ee n in c ertain o f the pa rry
in g movements in f encing .

Co n n i n g o ur attention
s tri ctly to the movemen ts of

pronation an d s upin a tion it

i snec es
,

s a ry to s tudy the
m echan i s m by which they
are eff ected .

A swill be remembered
fr o m the des c ri p tion given

in the previous ch apter the

head o f the radi us

,

is li ke a
thi ck di s k o f bone unite d to
th e upper extremi ty o f the
S haf t .The margi n Of thi s F I G 95 A i ew f th e b . . s f v o on e o

dis k is
th ight lb w wi th th h d f th
e r e o e ea o e
c oa te d with ar ti c ul a r m u wi thd w f m th les s ra n ro e er

ca rtil age an d s
n,

,
t in to the g s i m i d t h o d th no cb i ul an e or c ar

o val hollow on the outer s

.

hg m t
id e a en

o f the co ronoid proce s s Of th e

T hl
a.
c ll m
s
ro f f h m
ea r s ur ace o u an .

ul n a called the les s er s

b C p l te u
di s
. a .

igmoid H d f c ea o ra u
ssf l
. .
,
d C id p r o ce o u n a.
notch; W here I t 18 h eld l n sI t l d yl f h m s . o ro n o
u er u

s
n er n a co n e o

ss s
. .

p o i t n
0

b y a 0 0B a r or b a nd f C
E t
i.d
l
fo ro n o

d l
f h
f
m
h m s
o

co n
a o

e o
u er u

u er u
.

9 y
x e rn a .

call e d the o r b icula r liga me n t

.

a E . l l tx l l ig m
te r n a t f lb w a er a a en o e o .

( g 95)
Fi . Thi s lig ament
i O bi l
j L ,ss s
.

i m
l ig m
r

id
cu ar

t h
a e n t.

whils t it does hi l s
.
g e er o no c .

not interf ere k S f . f tt h

ur ac e o
t
m
.
t f b a ac en o rac a l

with the rotation o f the head 1 Biaia nm l f di s

m
n e o ra u

o f the rad i us within it s er ves3

, .

,
.

to reta in the hea d o f the bone

in contac t with the articula r s urfac e o f the le s s er sigmoid
n ot c h A .not h er im port ant p oi n t to remember i s th a t t h e
 Pr o n a tio n and S npz n a tzo n
' '

154 .

exte rnal l ateral ligament o f the elbow joint ins - tead o f being
is
,

connec ted with the he ad o f the radi us a ttac hed to the

o th a t the rota tion o f the radi us

,

orbi cula r ligament s at

thi sjoin t isin no w ay inte rfered with Thes e points

,

ar e better s hown in the accomp anying guresthe rs t of ,

which ( Fig 95) s . howsthe boneso f the elbow joint with -

,

the head o f the radiuswithdrawn from the orbicular

ligam ent an d les s er s i gmoid notc h Fig 96 ( I ) repres . e nts .

o f the bones
.

a s
. ection thr ough th e upper end s o f the f ore

arm an d s
,
howshow the head o f the rad iusis s
u rrounded

by the orbicul ar ligament

we note rs
.

Turni ng to the lower end s o f the bone s t the

is
,

fac t th at the lower extremity o f the radius much larger

than the lower end ( or h ead ) o f the ulna On tha t s ide .

o f the enl arged extremity o f the radi us whi ch i sdirected

toward s the head o f the ulna we obs erve a hollow arti cu lar
sur face called the s
,
igmo id ca vi ty of the r ad i us in which the ,

head o f the ulna res t s In thisres

. pect therefore there , ,

is a s triking s imi larity between thi s joint an d the articul a

tion between the upper extremitieso f the b ones In the .

one cas e the head o f the radius ts into the les ser sigmoid
hollow o f the ulna in the other the head o f the ulna ts
,
into
the s igmoid hollow o f the lower end o f the rad i usb ut the ,

m anner in which the li gaments unite the end s o f the bone s

is quite diff erent The lower end o f the ulna is

. not bound
to the radi u s by an orbicular ligament b ut by a triangular,

b r o cartil age the a pe x o f whi ch i s

-
,
atta ched to the bas e of
the proc es s o f bone whi c h s prings f rom the inner an d hinder
as pec t o f the head o f the uln a a proces swhich h asbeen
alre a dy re f erred to under the n am e o f the s tylo id p r o ces s
,

By i tsbas e the b ro -ca r tilage i sunite d to the ridge o n

the lower end o f the radi uswhi ch s eparatesthe articular
s u rf ac e f o r the uln a from tha t f o r the bone s o f the wri s t .

Thi sarrangement pe rmitso f an entirely diff erent kind

o f movement f rom that de s c rib ed i n co n nexion with the
 Pro n a tio n a nd S upz n a tio n
'

156 .

h ardly nece s s a ry here to enter into a d e tail e d account o f

the complex nature o f thi s latter movem en t ; the pointsto

be emphas iz ed are thes e v iz th at ,
.

the upper end o f the radius whils t

it undergoes
,

a r o tatory movement ,

s till re tainsitsrel ative pos ition

to the ulna an d humeruswhereas ,

the movement o f the lower end

o f the r adi us e ff ec ts a change in

its pos ition f rom the oute r to the

inner s ide o f the ulna It follows .

ince the s
,

therefore s haft o f the

radius
,

c onnects the two ex tremi

ties that when thes e two ex ,

trem i tiesar e both lying to th e

oute r s ide o f the u lna the s haft
o f the radi us will als o lie to the
ou ter s ide o f the ulnar s haft .

As we have s ee n the head o f the

radiusalwaysli esto the oute r
,

s ide o f the s u perior extremity o f

the ul na whi ls t the lower end

FI G 97 Di g m to ill s
o f the s
,
a ra u

s
. .

t t ra e th it i f th ame bon e m ay b e mov e d e

p e o on o

b one sf th e igh t f
o m s
r
o as to lie to the inn er s
o re ar
ide o f
an d th p s iti
e of th h d on o e an

i p ti ds upi ti
the lower end o f the ul na ; under

s c ircums a n ces com es

n ro n a o n an na on.

Th s i m pl t li s p st the e t it b e
s d neces sary tha t the s
e e ou ne re re en

th p s
e i io ft h
on b o t e on e
h af t o f th e
an
d i s
rad ius shoul d pas s obliquely acros s
h an pin i u nat o n

d s
.

Th d e d tli
o t te h d d
ou n e an a e

p ts p s p s
o f the s
th i i f
an d lie in ront h
ar re re en t e o t on o
f aft o f
h b s d h d i p
ul n a an d it is s
t e one an an n ro n a

ti Th di s w l i sh u
the thi di ff erence
li q l
on. e ra no e o

s sh f t f h ,

in the relative pos

ue y a c ro t e ro n o t e

l
u n a , an d h h m b li s
t e t h
t u e oition o f th e
t e

i
n n er si d wi h h b k f th
e t t
bone e
s whi
ac
ch chiey expl ain s
o e
h
d d i m d f w ds
h te
t e

a l te ra tion s
an r or ar .

in f orm an d outline
whic h we rec ogni e when the limb isin the prone an d z

s upine po s i tions res pecti vely ( s e e Fig .

 Wms
tj o znt

. 1 57

In addition to the ligamentswhich bind together the

bones o f the f o r e arm at the points
- above des crib ed there

is a s trong brouss heet called the i n ter o s s

eo us
,

, mem b r a n e
whi ch unitesthe s haf tso f the bonesthro ugho ut almos
,

t
their entire length We are not much concerned with this
.

layer except to point o ut

that it aff ord sexte ns
,

ive
attac hmentsto the deep
mus c les on both the f ront
an d b ac k o f the f ore ar m - .

I ts po s ition variesacc ord

in g to the rel ation o f the
bonesin prona tion an d
supin ation an d it i s n ece s

s
,

a rily as sociated wi th al
te rati o n sin the f o rm s of

the mus c le s
which are co n
n ecte d with it altera tions ,

which re act to a greater or

les sextent on the s u rf ace

co ntours .

As m any o f the m us c le s

in t he f ore ar m ar e as
- so FI G 98 Th b sf th ight w is t
ci sted with the movemen ts
e one o e r r

d h d s f m th f
.

an t an ee n ro e ro n .

R di s
of the ha nd it will be r. a u .

s
Ul
n eces
,

s
u na

s
. .

ary next to c on ider S t l i d p m f a d i y o r o co o ra u

ssf l
. .

the ana tomy o f the wr is

S l id p c. ty o ro ce o u na
s
.

t Th p l b c c. e ca r a one

o i n t.
m m Th e m etaca r pa l b o n e s
j s ph s
.

Th e n ge r -b o n e a la n ge

s
pp . or

Th e kelet n
the palm
o of

of the hand cons ists of ve bone scall e d metaca rp a l

ar e des
c ribed as ac h pos
,

( Fig The se long bone s e se s

sing
a s
.
,

haft an d two extremities By one end they a rti cul ate

. .

with an d s u pport the p ha la nges or bo n esof the n ger s ;

by the other they are uni te d by a s
,

erieso f complex
join tswith a num be r o f s mall bonescalled the wr is t or ,
 Bo n esof the Wr zs
'

1 58 t .

carp a l swhi h int rvene between them d the

bo ne , c e an

bonesf the f ore m Thes e rp l bones eight in

o -
ar . ca a ar e

number an d exceedingly irregular in their outline b ut

,

united together they f o rm a compac t m as

,

s( Fig 99) which

pres ents
.

f o r exami nation certain very ch a rac teri s tic f ea tures .

It wi ll be well here to recall to mind ce rtain pointsin

regard to the s tructure o f the lower end s o f the uln a an d

rad i usto whic h reference has ,

been already m ade The lower end .

o f the r a d ius is much expanded

enting on i tsinf erior as
,

pres pect
a s omewhat tri an gu lar s - haped ar
ticu lar s u rf ac e whi ch i s hollowed ,

o ut f rom s ide to s ide an d from

before bac kwards The apex o f .

thi striangle corr es pondsexter

F o 99 I th i s gu e th n a lly to the Pointe d proje ction

ss s
l n r e
s s s
. .

c alled th e S t whil
ca r p l ba one h w a re o n l e id p r o ce t
s i tsbas i sth at edge which is
,

P m
a t d ef m th ro d i u d e ra
e an

i gh t s
i rec ted toward s
ul f th
na o id e r e
d the uln a
.

.
Th t b l f th m ph id
Thi ss tyloid proces s
e u er c e o e o

d
Gi l can be
di s tl n ctly f elt at the outer s
a th i on m n
mi g?
n

film i g th n a n e n i de

3m o f the wri s s
f a 1 f a
t
where it lie in lin e

p Th p ies
i f m d or an with the ou ts tretc hed thumb I ts
ssf th
.

s
n Th h e k lik poo - e r o ce o e
to ome exten
.

if m f mi g th
un c or p or p r onm l n en c e e 18ro t
mi s th
n on e t f th
at
m
e ro o
aS ke d b
o
the e
tend W h Jh
b ll f th li l g
0118 -
a o e tt e n y
er .

overl i e i t .

The lower end o f the uln a i s s m all an d doe snot reach

low in th e limb asthe radi us s
,

s o ; f o r we h ave een
that the tri angul ar b r o ca rtil age already d es
- cribed in

c onnexion wi th the lower a rti cu l ation between the radius

,

an d u ln a pas sesac ros si tslower as pect being attac h ed ,

san d
,

inte rn ally to the bas e o f the ulnar s tyloid proces ,

exte rn ally to the ridge whi ch s epara tes the carpal from th e
uln a r a rti c ul a r s u rf ac e on the lower end o f the radi us (s ee
 Bo n esof the Wr is
t .

e iesf joints
s r between the f ore
o -arm a nd the s
keleton of th e
p alm are arran ged in two tran s ve rs e rowso f four each
The outer three bone so f the rs
.
,

t row provide a s urf ac e

c onvex f rom s ide to s ide aswell asfrom bef ore back

ward swhi ch articulates
,
with the lower end o f the rad ius
externa lly an d the under s ur f ace o f the tri angul ar b r o

The boneso f the s

,

ca rtil age inte r n ally . econd row ar ti

cu l a te by means of an irregular joint with the bones
o f the rs t row an d them s elvesprovide arti cular s
, ur

f ace s fo r the bone so f the p alm But the s e eight bones .

which con s titute th e two

rowso f the carp usare n o t
unite d in s uc h a w ay that .

the s u rfac es f ormed by their

anterior an d pos terior as
po o ts ar e at Their a rr ange .

ment can bes t be unders tood

by a di agram which repro
F o 1 l A di g m t
00 p s ta
s ra
ent s o re r e en
a view o f the ca r pal
sl th pp
. .

l g
s s s
on a ar er ca e e a earan ce

o f th us
e ca r
p w h u t s
s t bone
en ao een ac roon m a king
a a .

th d tt d li
e o sh w i Fig 98
e ne
s e o
tion n
ro s s
n
the wri st joint
-
s
.

c ac
.

Th h ll w i f t f th u
s
e o ro n e ca r
o n p o

is t d i t
co n ve r e l by n (
o Fig a From
can a thi it a
will .

lig m t wh i h s
a en t t h s b twc be obs
re c erved that the bones
e e e en

a r e gro u ped in s
th e p m i rot i d
n en u t n n er an o er
uc h a m an
b d s
ner as
or er .

to fo rm a deep groove
anteriorly whil s t their pos
,
terior s u rf ac e s f orm a broad
a re a ro u nded f rom s ide to s id e It isthi ss u r fac e whi ch

t where it is
.

we can feel on the bac k o f the wri s

overl ain by the tendon so f the variousmus c les pas s
,

ing
dow n to the bac k o f the h and .

In regard to the anterior as pect o f the wri s t bones

- they
f o r m as h as j us t been s ta ted a deep groove the borders
tanding an d prominent Thisgr oove
, , ,

o f whi c h ar e o u ts .

is c onverted into a tu nnel by a s trong band called the ,

a n te r i o r a n n u la r liga me n t o f the wri s t p as s ing ac ros sit ,

 Bo n esof the Wr is
t . 1 61

from one prominent border to the other In this cana l ar e

l o dged the tendons o f m us

.

c le s the es hy bellies
, o f whic h

are pl ace d in the fore a rm - It isthes e mus c les which

inuence the movemen tso f the thumb an d ngersby
.

bending them f or ward s .

Thisarrangement iso f
advan tage in reta ining the

ex o r tendonsin po ition
when the wri s t is bent for
s
ward sotherwis
,
e they wo uld
b e liable to be pu lled o u t o f
place by the contraction o f
the m us c les .

I f th e s tudent will b ut look

at hi s own f ore arm with-
,

the m us c le s st ra ined an d the

wr i s t exed he will obs erve
that all the tendons
,

which
he can both feel an d s ee ar e
FI G 1 1 Outli e f th h d
rmly bo und down asthey s
. 0 . n o e an ,

h wi g th e o g m n t f t h arra n e en o e

cro s s the f ront o f the joint sk i f l d s i f n t f tho w i st n ro n o e r

d g s Th
.

d th p lman on e a an n er e
R etu rning now to th e sh d d p ts i d i t th p s i ti s
.

a e ar n ca e e o on

con s ideration o f th e promi f th b s

o whi h f m th p
e o ne c or e ro

b d sf
nent borderso f thisgroove th mi t i
s T h
d ut
n en

s t th b
n n er an

ll f
o er or er o

sbones th th mb p e e ca r u o a e a o

s
.

f ormed by the wri t - e p d fu m b l w

co rr e on ro e o
s
,

the s tu dent will have no d if s h id d th id

p w d t u t h tu bar

o
l
f
f
an
ot
t
h
h
e

e r
e rc e

e o
o e

e
p ca g
cu lty in recogn iz ing the f o l t p i m ; th s ra th
ez u b ll f o e on e a o

lowing pointsI f the nger th li t tl fi g e t th i

p fs
e m n er o e l or

d h k lik p s sf th
.

an oo - i e r o ce o e un c
be placed on the ball o f the
thumb clos e to the wri s t an d ,

in l ine with the clef t between the index an d middle nger

he will recogniz e a bony prominence ; thi sisd ue to
,

two o f the boneso f the wris t called s cap ho id

,
an d

tr ap ez i um whi ch lie to the o uter s

,
ide o f the groove .

If the b all o f the little nger be examined a corre ,

11
1 62 Mo vemen tsof the Wr zls
tyb in t .

s
p o n d in geminence will be noti ced clos e to the level o f the
wri s t an d in line wi th the clef t between the little an d
ri n g ngers Thi sprojection i scaus
. ed by the pres ence
o f a s mall rounded pea like bone ca lled the p is
-
, ifo r m bone .

Thi sbone doe snot enter into the f ormation o f the joint
bet ween the radiusan d the rs t row o f the wr i s t bones -

b ut arti cul ate s

,

with the innermos t bone o f that row on i ts

anterior s u rf ac e. It thushelpsto deepen the groove by
caus ing a projection along the inner border o f the wris t;
i n f ront o f thi sb ut les
, sdi s tin ctly f elt isthe hook like -
,

proce s so f the u n cifo rm bone the inn ermos t o f the bone s

o f the s econd row o f th e carpus It i s e prominences
,

. to thes
that the anterior annula r ligament isattached whi ch
converts the groove into a canal ash asbeen already
,

de s c ribed ( s
,

ee Fig .

The movementso f the wri s t-joint ar e neces sarily co m

plicate d by the large number o f jointsinvolved b ut fo r

ent purpo s e si t isnot neces
,

pres s
ary to c on sider thes e
movementsin detail .

The wri s t m ay be bent f orward i e ex ed or bent back

,
. .
, ,

i e ex tend ed The f ormer movement isf reer than the

. . .

l atter The wris

. t m ay als o be moved f rom s ide to s ide ,

either to the inner or ulnar s ide or to the o ute r or radial

ide The fo rmer movement i s
,

s . f requ ently ca lled a dd uctio n ,

the latter ab d uctio n The range o f movement to wards

.

the inner isgreater than that to wardsthe outer s ide .

Furthe r thes ,
e movementso f e x io n extens ion abd uction
, , ,

an d add uction m ay be combined co n s , tituting the movement

o f ci r cumd uctio n . The ro ta tory or twi s ting movement o f
t h e h a nd i s e ff ec ted not a t the w ri st joint b u t by the
-

c ro s ing o f the boneso f the f ore arm already alluded to

, ,

s -
,

u nder the term s pronation an d s u pin a tion .

In s tudying the mus cles o f the f ore ar m we have to de al

-

with an exceedingly complex mas swhich not only controls

the movements
,

o f p ron a tion an d s upin ation an d the move

1 64 cles
Mus of the F -
o re a r m .

along the co rre sponding s ide s the S uperiorly of f ore -a rm

o f e ac h gro up ar e attached to the co ndyles
.

th e muscle s

Pro Diagram to i llu tra te

102 s FI G Di agra m to illu tra te
10 3 s
s
. . . .

th e arra n ge m e n t o f th e pro n ato r th e arran geme n t o f th e upe r c ial

an d s
u pe r c i a l ax o r m u cle ss ss
mu cle ( e x t n o r an d e
ss s
up in a
s
wh ich a ri e fro m th e i n te r na l co n s s
to r ) wh ich a ri e f ro m th e ex ter n al
d yle a n d pa s
s
d o w n th e f ro n t o f co n d yle an d th e r id ge ab o ve i t, an d

th e fo r e -a r m whi ch pa s
s
d o w n th e b ack an d
s
.

o ute r id e o f th e f o r e -a rm .

a. Pr ona to r r ad ii tere s sS up ina to r lo n gu s

s s pi d i lisl gi (l g
. . .

b Fle x o r ca r p i ra d ia li ( rad ia l ex o r o f f E x te n o r ca r ra a on or on

s s f th w is
. .

t h e w ri t ) di l
ra t a ex en t)
or o e r

s s s E t s d i lis (s
. .

c. F le x o r ub li m i d igito r ui n ( upe r g x pi
e n o r ca r b i
ra h t
a r ev o r or
s s f t h w is
.

c ia l aax o r o f th e n ge r ) di l
ra t a ex e n o r o t) e r

s E t s mm is
. .

d Fle x o r car pi ul n ar i ( ul n ar aax o r o f h x e n o r co d i gi t un m( m o ru co

s s f th g s
. .

th e wr i t ) m t
o n ex c n or o ) e n er

E t s is
. .

t x en o r pi l ca r ( l u nar u n ar ex

s f th w is
.

t en o r o t) e r

s
.

j . An co n e u .

of the h umerusthos e o f the o ute r gr oup aris

, ing f rom
the ex te rn al condyle thos e o f the inner f rom th e in te rnal
,
 Mus
clesof the F o r e a r m
- . 1 65

c ondyle A n ins
. pection o f the limb will enable the s tudent
to rec ogn i z e th at the es hy bellies o f the m us c les are not

c onn e d to the s ides o the ore ar m b ut s

.

f f - pread o ut on the
Thusthe mus c les
,

fr ont an d bac k o f the limb which

s
.
,

pri n g fr om the inner co ndyle o f the humerus not only pas s

down along the inner s ide o f the f ore-arm b ut a ls o clothe
the an te rior s urf ace o f the boneswhil s
,

t thos e which
ari s e f rom the exte rnal condyle pas sdown the oute r s
,

ide
o f th e limb an d s pread bac kwa rd s over i ts posterior as pect
Th e f ormer group compri s esthe ex o r m us
.

cleswhi c h

lie on th e front ; the l atter the ex te ns orswhi ch lie on

,

the back o f the limb Ashasbeen pointed o ut by S ir

, ,

Charles
.

Bell the inner condyle isthe longer one an d gives

,

g r ea te r lever a ge more power being req u ired f o r gr asping

with the ngers
,

th an f o r exte n di n g them ; there f ore all the

m us c les which be nd the ngersan d turn the palm down
come f ro m thi s condyle . The ex te rnal condyle i sthe
s horte r ; it givesles spower being required merely to
h attac hment fo r the mus c le s which open the ngers
,

f ur n i s .

The greate r bulk o f the f ore arm above an d its

-
,
tapering
f orm below ar e d ue to the f ac t that in the lower p art o f the
hy bellies o f the mus
,

li mb the e s c les ar e rep lac ed by their

te ndonswhi ch obvious
,
ly take up les sroom .

Lo oking at the inner s u perc i al group rs t it will be ,

f o und to take origin f rom the inte rnal condyle o f the

humerus by a common tendon o f attachment ; thi sgroup
compri s es the ex o r mus cle s a n d one o f the pron a tors v iz

the pronator radii teresFrom thi s

.

poin ted s
,

. uperior attach

ment the es hy mas ss pread s o ut belo w an d i s arranged in

th e f ollowing m anner . The oute r an d mos ts uper ci a l pa rt

c ro s ss
e the f ore ar m obliq u ely f rom above downw ard s
- an d

outward san d i sins erted in to the outer s ide o f the s haf t

o f the radi us abo u t i ts middle ; this is
,

known by the name

o f the p r o n a to r r ad i i ter es
,

( Pl a te XVIII m p . .

s
,

As ociated with the above at i ts origin there isa well

 F lex o r sf the W r zs
'

166 o t .

marked es hy belly the mus cul ar bre s o f whi ch ar e r e

plac ed by tendon bo t the middle o the ore arm Thi s

,

a u f f - .

tendon m ay eas ily be recogniz ed on the s u rf ac e o f the limb

when the mus cle s ar e c ontrac ted ; it will be f ound to pas s

down towardsthe radi al or oute r s ide o f the wri s t to the ,

prominence whi ch has been already des c ribed in connexion

with the bas e o f the ball o f the th umb H ere it s inks

. deeply
into the palm o f the hand into the s eco nd bone o f which it
t joint an d as
,

is ins erted The mus . cle i s a ex o r o f the wri s -

i ts tendon pas s es
,

to the radi al or oute r s ide o f that articula

tion it i scalled the a vo r ca rp i r ad ia lis ( Pl a te s XVIII p , ,

XXI pp 144 .

I f we re turn again to the inte rna l condyle o f the humerus

, ,

an d trac e the a rra ngement o f the mos t inte rnal bres

whi ch s pring f rom that proce s so f bone we nd they
f o r m a es swhich liesalong the inner s
,

hy mas ide o f
the s haf t o f the ulna an d which i s al so attached by a s trong
a poneur o s i sco nnected with the pos terior or s
,

ubcuta neous

margin o f that bone From thi sexte ns . ive attachment the

bres p as sdown ward s an d f o r ward s to end in the tendon o f
ertion which lies
,

in s a long the ante rior border o f the e s hy

belly in its lower half This tendon may be trac e d along the
f ront an d inner s ide o f the fore arm to itsins
- ertion into
the pi s i f orm bone which f orm sashasbe en alr ead y
tated the prominen c e to the inner s
,

ide o f the wris

,

s t in .

l ine with the clef t between the little an d ring ngers

,

This m us c le like the l as t i sals o a ex o r o f the wris t or

b u t as
, ,

ca rpu s i t lies to the inner or ulnar s ide o f the joint it

ca lled the a vo r ca rp i uln a r is I ts tendon isnot nearly
,

is .

s o prominent on the s urf ac e as th at o f the ex o r carpi

radi al i s b ut i ts es hy belly is o f gre at importa n c e in de ter

urf ac e f orm as
,

mining the s to i ts pres e nc e i s d ue the owing

outline o f the inner s
,

ide o f the fore arm f rom internal co n

-

dyle above to wr i s t below ( Pl ates XVIII y XX, l X X I , , , ,

pp 144 1 70
.
, ,
1 68 Superf icia l Flex o r of Fingers .

diff e rent individ ualsthe proportion between the length s

o f the e s hy an d tendinous pa rts o f the mus c le s vari e san d
thi s es s o individ ual di ff e r enc es
,

g iv ri e t in the f o r m o f the

l i mb In a pers
. on in whom the e s hy p art o f the m us cle

is proportion ately long the thick es n so f the fore arm will be

-

car r ied to a lower level an d vi c e vers a .

Underlying thes e s u pe rc ial mus cle s

,

we have others
which are placed in f ront o f the bone s o f the f ore arm- The s
. e
are the s u pe r c ial an d deep ex o r s o f the nge rs an d the

long ex o r o f the thumb together with a mus c le ca lled

the p ron a to r q uad ratus the bre s o f whi ch cro s sover from
,

the l ower e n d o f the ulna to the lower end o f the radius

A de ta iled des
.

cri p tion o f the s e m us c le s is however un n ece s

s a ry as th ey do not directly inu enc e the s urface f orms the
on ly exceptionsbeing the tendonso f the s
, ,

up ercia l ewo r

of the n ger s which when powerf ully cont rac te d ap pea r in

,

the interval s between th e tendons

, ,

alre ady en umerated in the

region o f the wris t Ind i rectly however th es

. e deep mus c le s

do exert an inuence on the co ntours

, ,

o f the limb f o r they

help to imp art to it i ts san d pad up

,

ch arac teri s tic round nes

as it were the s uper cia l m us
,

c les
,

which overlie them Th e .

s tuden t may bes t obs erve this f o r him s

,

elf by Opening an d
clos ing the s t rapidly when the s l ight changesin form
d ue to the contrac tion o f thes e mus
,

c le s wi ll be readily s een ,

pa rti cularly in the lower part o f the fore-arm wh ere the

re tr ac tion o f the f as c i a covering the mus c les renders
,

more
di s tinct the tendonso f the s u pe r c ia l m us c les alread y

all uded to ( Pl ate XV III z p , ,

.

Turning now to the con s ide ration o f the m us cle s which

s pring f rom the exte rna l condyle the s tudent will do well
to remember two facts
,

in this co nnexion rs tly that the ex

ternal condyle o f the hume r usi snot s
,

o pro mi ne n t as the
internal ; an d s econdly th at the origin o f the mus cle swhi ch
lie a long the oute r s
,

ide o f the f ore arm is

,

-
not conned to
it b ut exte nd s
, fo r s ome very cons iderable di s tance above it ,
 S upma to r lo ngu s . 169

a r ising f rom the exte rnal condyloi d ridge an d f ro m the ex

terna l inte r mus cu la r septum attached to it A knowledge o f
th es
.

e fac ts will do m uch to enable the s tudent to apprec i ate the

diff erence s betwee n the outer an d inner outlines o f the limb

The mus c le s
.

which a ri s e f rom thi sa ttachment con s is t

o f the s upina to rs two n n um ber an d s ome the exten sor
( i ) o f
mus c le s o f the wri s t an d ngers Of the s upin a tors we a r e
con ce rn ed with one only the s up i n a to r lo n gus Thi s f orm s
.

th e highes t o f the es s
.

hy bres o f the outer m us c ul a r m as

,

an d ari s esf rom th e uppe r two third so f the exte rnal

condyloid ridge pas sing up to within an inch o f the level
o f the lowe s
,

t point o f attachment o f the delto id f rom ,

which however it iss e pa rate d by the bre s o f origin o f

as may be s
,

the brac hi a li s
,

a nticus ee n in Pl ate XX p 1 70 .

Th e be lly o f the mus

.

c le cu rve s
,

fo rward f rom thi s

,

a ttach

ment to lie in f ront o f the s haf t o f the radi usthus co n

ce ali n g the ins e rtion o f the pron ato r radii te r es

,

an d parti ally

overlappi ng the belly o f the ex o r carpi radialis It res ts

,

upon s
.

ome o f the other mus c les to be p r e s ently des cr i bed an d

ends abo ut the middle o f the f ore arm in a s

,

- trong tendon
whi ch pas s with a s
,

es downward s light outward inclination

toward s the lower end o f the rad iusto the outer s ide o f the
bas e o f the s so f which it i sattached The
,

tyloid proces .

mus c le i s super ci al throughou t exc ept at i ts lower part

where its tendon o f in s
,

ertion i s obliq uely cros

,

s ed by certain
tendon sto be mentioned l ater Asthe name o f the .

mus c le implie s it acts as a s u pin ator i e it draw s . back the

.

sthe f ront
, ,

radi us when that bone h asbeen carr ied ac ros

o f the uln a in pron ation ; b ut f rom i ts relatively high
attac hment to the h umerus it als o actsas a e x o r o f the

elbow an ac tion which i seas ily demons tra ted when o n e

li ftsa heavy weight with the limb in a bent pos
,

ition .

I ts inuence on the s urf ace f orm i s at on c e appa rent an d ,

is well s een in Plates XIX XXI Fig 2 pp 148 180

,
. .
, .

Beneath the f oregoing mus

,

cle an d p arti ally overl a in

,
1 70 Ex tens o rs R a dia l .

by it in f ront there two m sleswhi h lie long th ar e u c c a

s
,

ide f the s
,

o t rs
u e h f t f the r di s
o ; the t ndon s
a f the o a u e o e

musleshowever p s
c , sto their ins ertion into the bones
, a

o f the h nd over the b k f the wri s

a t tow rd s the o ter ac o a u

or r di l s a ide they a there fore extens

: ors f the wri s t
a re o

an d n med
, t s s pi
a di t s
ex di s
en o r e t ng i s hed ca r ra a e ar e i u

lled long d s
,

f om one nother by bei ng

r a hort ca an .

The t s p i d i lis
ex en o r l gi is the more sper i l
ca r ra a on or u c a

o f th two e it t kesorigin bove f rom the lower third

: a a

o f th ext rn l ondyloid ridge th t i s

e e a to sy the p t f
c a a ar o

the ridge b low the tt hment f the spin tor long sI ts

, ,

e a ac o u a u .

es hy belly isdire t d obliq ely f orw rd s d dow w rds c e u a an n a

ss
,

o a t lie rossthe o ter s

o acide d f ront f the pp r p rt u an o u e a

o f the s h f t f the r di s
a ; in othi spo sition the m asle i suin u c

p rt overed by the belly f the spin tor long sonly its

a c o u a u

t ri or border d p rt f i tso ter srf e being sper

,

pos e an a o u u ac u

i l A t level orre s
c a . ponding t the j n tion f the mid dle
a c o u c o

with the pp r third f the for m the bellyjoins

u e itstendon
o -
e ar ,

whi h p s
c sesdown in ve y los
a e rel tion wi th th t f the r c a a o

s hort d i l ext n s
ra or ( Pl tes
a X X q X X I Fig e pp 7 a 2, 1 0,

s
. .

The t s
,

s s
, ,

p
exi d i l
en o r i b i ri e
ca r f rom the ex
ra a r ev ar a

t n l ondyle f the h mer sin onj n tion with the

er a c o u u c u c

rem ining membe sf the sp i l extens

a or gro p A t
r o u er c a u .

i ts pper tt hment the m s

u a le isovered by the es
ac hy u c c

bresf the ext ns o or rpi r di li slongior b t sits e ca a a u a

hy bres dire t d dow w rd slong the o ter s

, ,

es ar e ide
c e n a a u

o f the s h f t f the r di usthey pp r spe i l lying

a o a ,
a ea u r c a ,

ext rn l d pos
e aterior to the belly f the pre eding m sle
an o c u c .

The es hy belly f the s hort d i l ext ns or re hes

o ra a e ac

a lower level th n th t f the long d i l exten s a or ina o ra a

the f ore m It join si ts -ar tendon bo t the level f th

. a u o e

j unction o f the middle with the lower third o f the f ore m -a r .

As sta te d above the tendons e two mus

o f the s c les a r e ve ry

c los sdown to reac h

,

ely related to one another ; they pas

a gr oove on th e back o f the radi us t behind the s
j us tyloid ,
PLA TE XX

F IG . 2
1 72 U ln a r Fur r o w .

sentire xtent
it e Commenc ing bove at the triangul ar
a

sb t neo sre
.

u cu a u a a whi ch co r res pond s to the b ack o f the ole

margin o f the s
,

cran o n proce s sor tip o f the elbow thi s ,

h af t
m ay be traced along the whole o f the back o f the f ore
ar m to the wri s t below where it endson th e enlarge
,

ment prod uced by the lower end o f the bone The line
s traight b ut takesthe f orm o f a s inuous
.

o trace d i s not s
The two ulnar mus cles
,

cu rve lie one on the inner an d

ide o f thisborder ; th at to the
.
,

th e other on th e oute r s
inner s ide is th e ex o r ca rpi ul na ri s while that which is
pl ac ed along the oute r or radi al s ide is the exte ns
,

or carpi
uln ari s j ust des c ribed The bulging o f th es e es hy mus c les

ridge o f bone reactson the s

.

i de o f thi s
,

on either s ur f ace

f orm s o as to prod uce a fu rrow betwee n th em This s ur f ace

depres
.

s
ion is ca lled the uln a r f ur r o w an d the bot tom o f it

corres ponds
,

to the po s terior border o f the bone When the

c les
.

nger isrun alon g it one f ee l s

, the uln a with the mus
above mentioned on either s ide The fu rrow iso f cours
. e
bes ts een when th e mus c les ar e powerfu lly contracte d an d

tudent not to confus

,

it may b e well to warn the s e it with

the f u rro w whi ch l i es behind the back o f the ex te rnal
condyle o f the humerus an d the upper end o f the radi us ;

an d f urther th e read er s hould be ca reful to note th at the

two ulnar mus are not in clo s
,

cles
,

e rela tion throughout their

e ntire extent b ut are s eparate d above by the inte rpos ition
o f the bre s o f the an c oneus mus
,

cle in addi tion to th e

expanded upper extremi ty o f the ulna Thes e pointsmay

be re ndered clearer by a ref ere nce to Plate XX Figs1 2 p
.

. .

ideration o f th e s
, , ,

R eturn i ng onc e more to th e cons uper

c ial mus cl es which s pring from the exte rn al condyle ,

an d noting the f act that we have al ready traced th e

attac hment an d a rra ngem en t o f th e ex tens or carpi radi al is
brevie r an d the extens or carpi ulnariswe h ave now to
acco unt f o r the in terval be tw ee n the s
,

e m us c le sas they pa s s
dow n along the rad ial an d ulnar s ides o f th e limb This .
 Co mmo n Extenso r of th e Fi nger s . 1 73

i n ter val iso upi d by the es

cc e hy belly f the o ex te n o r s
s
co mmuuid igit o r um , i
. ommon exte ns
e the o r m us
c c le o f the

g s Th ere ar e real ly two mus cles

.

n er here the common

t nsrm s an d a s pec ial exte ns or mus
.
,

ex e o l u c e o f the nge rs cle

o f th e little n ger b ut f o r o ur pur po s e we may di s regard

th e latte r alto geth e r an d cons ider th e two asone The
,

es hy mas so f thi s mus c le is

.

wedged in between the origins

o f the s hort radial ex te ns o r on th e outer s ide an d the
ex ten s ide an d pas s
,

on the inner s
,

ul n ar or esdown ,

th e mid d le o f the back o f the f ore ar m occupying the

-

inte rval betwee n the f oregoing mus cle s

,

whi ch are widely

s The common exte ns
,

eparate d below . or o f th e ngers

h owever doe s not completely ll up thisinte rval b u t i s
,

s hort radi al extens

,

e parate d fr om the tendon o f the s

,

or
by s ome o f the deeper mus c l es whi ch here crop up s o

as to become s hort radial extens

,

u per c i al betwe e n the s or

on th e oute r s ide an d the common exte ns o r o f the ngers

n s
on the i ner ide In the lower third o he ore ar m the
. f t f -

es hy bres o f the common exte n s or are replaced by a broad

te ndon an d thi s subs eq uently bre ak s up into a n umber

of s lips which af ter cros s

,

ing the c entre o f the back o f the

wris t s pread o ut on the bac k o f the hand to pas
,

sto
pective ngers Thro ughout i tsentire length the
,

their res .

inner bo rder o f the mus cle i e that portion o f it whi c h

pecia l extens
. .

f orms
,

the s or o f the little nger isin contact

or an d this
,

with the oute r margin o f the ulnar extens as will

equently noticed is
.
,

be s ubs repres ented by an intermus

, cul ar

f urrow on the s u rf ac e o f the limb The common extens or o f

.

the ngers acts primarily on the ngers straigh tening them ,

af ter they h ave been bent ; b u t it a l s o actss econdarily as

an extens or o f the wri s t as sisting in p ulling back the hand
,

at th at arti cul a tion ( Pl ates XX n XXI Fig 2 pp 1 70

o f thes e mus
.
, .

As
, , , .

the tendons cle s together wi th the te ndon s

ed pas s
,

o f others whi ch s till remain to be di s cus s acro s sth e

region o f the wri s
,

t they ar e bound down by a ligament ,

1 74 D epre s
si on beh in d Elbo w .

ca lled the p o s teri o r a n n ula r liga men t Thi sar rangement

.

is c omparable to th at alread y des c ribed on the f ront o f the

wri s t an d preventsthe di s placement o f th e te ndonsin

powerf ul exte n s
,

ion or bending bac k o f the wri s t

A ttention s
.

hould next be directed to the arrangement

o f the f oregoing m us c les as they ar e grouped behind the
external condyle o f the h umerus A n examination o f Plate
1 2 3 will s
.

X X Figs
,
.
, , , how that there isa A s - hape d area
overlying th e back an d o uter s ide o f the elbow The apex
o f the A corr e s pond s
.

to the b acko f the exte rn al condyle ;

i ts oute r limb is f ormed by the b i n d er border o f the long
radi a l ex te n s or wh ils
, t i tsinner s ide corres pondsto the
o uter bord er o f the anconeus The oor o f thi ss . p ace i s
made up o f the tendinousoriginso f the ulna r extens or
o f th e wri s t an d the co m i no n extens or o f the ngers It
fr om thi s
.

res u lts ar ran ge ment th at when the limb is ex

te nded the borde rs o f the mus cle s j ust enumerated become
more prominent an d prod uce on the s urf ace a well -marked

cu l ar depre s s
,

inte rmus ion the botto m o f which cor res pond s

to the ori gins
,

o f the ulnar extens or an d the common ex

te ns or o f th e ngers In thi s . pos ition thes e m us c les overlie
the back o f the head o f the radiusan d as they ar e tendinous
that we can eas
,

rather than e s hy it f ollows ily recogniz e

the head o f the radi usbe neath them when we plac e o ur
ngers in the hollow the more s o i f at the s ame time we

upin ate the f ore ar m s o as

, , ,

pronate a d s n - to caus e rotation o f

the he ad o f the radius Th e s harpnes so f the s u rf ac e

f urrow whi ch corres

.

pond s to thes es tructures will o f cours e , ,

largely depend on the abs ence o f f at in the s ubcuta neo us

tiss ue an d the development o f the mus c les A s h as been

.

previ ous ly s tated in th e f ema le an d child there i s a l a rger

amount o f s
,

ubcutaneo us f at an d the s urf ace f orm no longer

plays th e characteris tic appearance above des

,

di s c ribed b ut

only a s h allow depres s

,

exhibits ion or dimple

in the cas e o f the f ront o f the f ore arm s
.

As - o in the b ac k
, ,
 Summa ry of Mus
clesof F o re ar m
- . 1 77

d rawn away f rom the pa lm a p rominent ridge caus ed by

thi s
,

tendon wi ll be obs erved cro s sing the back o f the wri s t

an d h and obliqu ely f rom a point ab ove in line w ith the

c lef t between the index an d middl e ngers to ward s

,
the rs t
knuckle o f the thumb below over whi ch it may be traced
onward to reach the s
,

econd or termin al phalanx o f that digit

As o f thi s mus
.

the tendons cle an d tho s e j ust des cribe d pas s

over the b ack an d outer s ide o f the lower end o f the radius
they ar e s ep arate d by an inte rval o f abo ut an inch I f the .

th umb be f orcibly drawn away f rom the palm they are ren
dered tens e an d s kin over them s o as
,

tretc h the s to prod uc e

a little hollow cor re s ponding to the interv al between them .

hollow h as
,

This been ca lled by the Fr ench la tabati ere an a

to m i q u e f rom the circum s

tan ce that it w as f requently m ade
us
,

e o f to meas ure the amo unt o f s n u nec es sa ry f o r a do s e

'

H aving des c ribed the a rrangement o f the m u s c le s o f the

f ore -ar m s o f ar as is neces sa r y f o r o ur p urpo s e the s tudent

is now in a pos ition to s u mm ariz e m any o f the re s u lts

obtained Taking rs . t the ex o r san d extens orso f the

wri s t thes e mus c le sar e se en to be a rranged in the f ollowing

There is a gro up o f uln ar e x o rs an d extens o rs

,

w ay an d ,

an d ex t ens
.

a grou p o f radi a l ex o r s o rs The f ormer lie

.

along the uln ar or i n n er s ide o f the f ore ar m the latter

-

ide o f the limb b ut whereas

,

along the ra di al or ou ter s , , ea c h

ro u p i s f u rther u bdivided into a ex o r an d an exten s
s or
g
mas sit iss een that along the inner s ide o f th e limb there
is a e wo r ca rp i uln a r is
,

running down the f ront o f the

uln a an d an ex ten s o r ca rp i uln a r is pa s sing along th e bac k
In like manner the outer s
,

o f the s a me bone ide o f the

provided with a ewo r ca rp i r ad ia lis
.

limb i s m us c le w hi ch ,

lie smore or les sin f ront o f the radiusan d an extens or

o r es ca rp i r a d ia les
,

m us c le made up o f the ex ten s ( g

lo n io r

an d b r evi o r ) whi c h runs down along the pos

,

te rior an d outer
s an d s
,

ide o f the s a me bone .Of the pronato rs upin ators we

ar e concern ed o n ly with two v iz ,
. the p r o n a to r r a d ii ter es ,

N
 1 78 Surf ace Co n to ur sof F o re a r m
- .

which cros sesthe fr ont o f the limb obliquely f rom the

internal condyle toward sthe middle o f the s h af t o f the
rad iusan d the s up i n a to r lo n gus which overli esthe es hy
orsas s
,

o f the lo n g an d s hort radial extens

,

b ellies they p as
down the outer s ide o f the limb Th e pos . ition o f the
remaining mus cle s h as been s u ci e n t ly de s c ribed ; they
occupy the in te rvalsbetween the radi al an d uln ar ex o rs
in f ront an d the radi al an d ulnar exte n s orsbehind an d
,

s s s s
,

ar e
e mo r or ex ten o r in their ac tion acco rding a they
lie on the front or back o f the f ore arm - .

H ither to the mus cle s o f the f ore ar m h ave bee n s

- tudied
with the limb in the s u pine po s ition i e wi th the radius
,
. .

lying pa rallel to an d along the oute r s ide o f the ulna .

Under thes e conditionsthe outline o f the limb as viewed

pondson the inner s
,

f rom f ro nt or back corr es ide with the

owi n g curve produced by the es
,

hy belly o f the ex o r
ca rpi u ln ari s On the o uter s
. ide the outli ne is made up
o f three c urve s the pro minence o f which variesaccord
i n g to the development o f the mus cles
,

on which they
depend The highes t o f th es e curves comm ence s above

i n the lower thi rd o f the upper ar m an d s

.

w eeps
,
over the
region o f the exte rnal condyle or outer elbow to end below ,

at the j un c tion o f the u pper wi th the middle third o f the

f ore -ar m Thi s

. curve depend s on the origin an d attach
ment o f the long s upinator an d the lo n g r adi a l exten s or
o f the wri s t The s . ec ond cur ve Oppos , ite the mi ddle third
o f the f ore ar m corre s
- pond s to the es hy belly o f th e s h o rt
'

radial extens
,

or o f the wr i s t The third curve generally

.

spronounced than the othersoccupies

,

le s the low er third

Thi slas t iscaus
,

o f the limb ed by the lower portion o f

haf t o f the radius
.

the s an d the te ndon s an d m us c le s which

o verlie it p arti cula rly the two f ollowing exten s or mus c le s

o f the th u mb v iz the exte ns

,

.or o f the metacarpal b one an d

th e exte n s or o f th e rs
,

t phalanx ( Pl ate XX Fig 2 pp

Whe n the limb is in the s upin e pos
. .
, ,

ition the f ro nt o f th e
 Fr o n t of Elbo w
H allo w i n 79 . 1

f ore - m i s somewh t ttened

ar d thi s tt ned srf a a an a e u ac e

i sontinuousbove with wh t i s lled the hollow in f ront

,

c a a ca

o f the elbow Thi s hollow i s d . t the V s h ped interv l ue o - a a

s ep r ti g th m s
a a le s
n whi h s pring re s
e pe tively f rom the
u c c c

outer d inner s ide sf th lower end f the h mer s

an o e o u u .

Th uson th o ter s ide we nd the interv l bo nded by

e u a u

th einner border f the lo g s upin t r whil s t inte n lly

o n a o r a

outer or pper border f th p on tor r dii t re s f orm s

,

th e u o e r a a e

i tsbound ry In the int rv l s f orm ed the bi eps

a . e a o c

p s esdownw rd sto be in s erted by me sf i tst ndon

,

s
a a an o e

into the t ber le f the r di s Thi s s

u ce s proj tion o a u . ca u a ec

in the middle f the V s h ped intermusl r i terv l

o - a cu a n a

j ust des ribed sth t the s

c u rf e hollow pre s
, entsr ther
o a ac a

the ppe r n e f Y s
a h ped f rrow on either s
a a c o ide f thea - a u o

lower p rt f the bi epsm s

a o le sit lie sin f ront f c u c a o

the elbow The two pper limbsf the Y

. ontinuous u o ar e c

b ve with the srf e f rrows

a o whi h lie long the inner
u ac u c a

an d o t r s idesf the belly f th bi epsin the pper

u e o o e c u

ar m A slre dy s
. t t d the inner f the two upper furrows
a a a e o

not s l rly s een sthe o ter the re s

,

is o c ea on being th t a u a a

ertion f the bi epsinto the f si

,

th e pone uroti i s
a c n o c a c a

c overing the mus leswhi h s pring f om the intern l c c r a

c ondyle bridge sover the int rv l th sinterr pting the e a u u

ider bly the srf e f orm ( s

,

groove d modi f ying ons an c a u ac ee

a nt p e, The lower limb or s

. t lk f the Y orre s pond s a o c

t the interv l whi h s

o ep tes the long spin t r f rom the
a c ar a u a o

r di l
a a f the w i s t Thi sf rrow i snot noti e ble
ex o r o r . u c a

to y extent when the f ore m i s

an in th spine pos ition -ar e u

m is
,

b t when the f ore

u pron ted it be ome s q ite di s
-artin t a c u c

( Pl ate XV I II p , .

The f ro nt o f the elbow iscro s sed by a number o f n e

cu ta neous cre ases
; the s
e a r e d ue to the f olding o f the
s ki n when the elbow isexed Th e mos t marked runs
sthe hollow o f the f ront o f the elbow
.

trans ely acros

vers
f rom one condyle o f the h umerus to the other .

N 2
 Elbo w
Co n to ur s a ro un d .

we usu lly rry u for m sin

a ca pos iti o mi dw y
o r -
e ar a n a

betwee extreme pron tion d spi tion ; in oth r words

n a an u na e ,

in walking we ca rry the li mb with the palm o f th e hand

directed to war d s the thigh an d not with th e palm s ,
turn ed
f orward sas in extreme s
,
upination or bac kward s as in , ,

extreme pronation .

The modica tion in th e arrangement an d grouping o f

the mus c le s o f the limb ca n be s t be s tudied by an exami na
tion o f Plate s XVIII XX pp 144 1 70 in whi ch they ar e
itions
.
, ,

repre s
, ,

ente d with the limb in diff erent pos

When the elbow-joint was
.

des c ribed the rel ation o f i ts

cus s
,

bony parts to the s ur f ace f orm w as then di s ed S ome .

thing yet rem ainsto b e s aid regarding the change s

in f orm d ue to the mus c le s o f the f ore arm whi c h ar e
-

grouped around it In the extended po s

. ition o f the joint
i swhen the whole limb is
,

. . s trai ght th e o uter condyle

o f the hu merus is c le s
,

con c ealed by th e m us whi ch overlie

it an d s pring f rom it v iz the s upin ators an d ex te ns
. o rs .

In thi sconnexion it isimportant to remember that tw o

,

o f the s e m us c le s v iz,
the long s. upin ator an d the long radi a l

extens or o f the wri s t do not take origin f rom the external

,

c ondyle b ut f rom the extern a l condy loid ridge above

,

it On the other hand if we examine the in ner s

. ide
the elbow there i sno d if culty in re cogn iz ing the
,

of

s urf ac e prominence whi ch corres pondsto the internal

condyle o f the h umerus fo r th e prona to r an d e x o r m us cle s ,

which s pring f rom th i sdo not extend upwardsto an y

,

extent to be conne cted with the ridge abo ve it ( the internal

condyloid ridge a r e conned in their a ttachment to the
) b u t
el f a circums tance which explains
,

condyle it s the character

is proce s s As
,

tic prominenc e on the s urf ace o f thi s o f bone .

a re s ult o f the s e arrangements w e can readily explain th e

m arked diff erence s whi ch the limb pre s ents when the e lbow
is bent according aswe V iew it f rom th e oute r or inner
,

as pe ct (Plates XIX XXI pp 148 , , .

,
182 Fo r m of Ben t Elbo w .

The angle f ormed by the outline o f the f ore m an d -ar

the upper arm ispl ac ed much higher on the oute r s ide

o f the elbow tha n on the inner ; thi s is d ue to the f act th at
the long s upinator take s origin f rom the exte rnal condyloid
ri d ge o f the humerusashigh as the j unction o f the lower
with the middle third o f the length o f th at bone Thi s
,

may .

be be s ts een when a heavy weight is ra i s

ed with the elbow
bent ; the lon g s upina tor i s then powerfu lly contracte d
ante rior margin i s re ndered very te ns
,

an d i ts e a condition ,

s
Fm 10 5 Diagram to h o w th e o utli n e o f th e o ute r id e o f th e arm s
s s
. .

h
w e n th e e lb o w i b e n t The o utli n e o f th e fo re arm at th e e lb o w i
-

s s s s
.

d eterm in ed b y th e upi n a to r lo n gu an d ex te n o r carpi radiali lo n gio r,

s
w h ich ari e ab o ve th e e x te rn al co n d yle o f th e h umeru s
.

shown in the di g m ( Fig aN t o ly i s

ra the belly . o n

of the s pin t r longusb v the level f the joint b t

u a o a o e o u

th long r di l extens t islso sn po w e f lly

,

e or f the w i s
a a o r a ee r u

contr ted s ac es
it ri s f om the ridge on the h mer sbove
a a r u u a

the exter l ondyle the s

na urfc e point orres ponding to ac c

whi h is
,

cpl ed m h b lo w the level f the gle f ormed

ac uc e o an

by the outline o f the limb When viewed f rom the inner

side the limb di s
.

, plays a marked cont rast to the form j ust

descri b ed ; a deep f old c ros
se sthe front an d in ner s ide
 Fo r m of Ben t Elbo w . 183

pas se sin toward sthe s urf ace prominen ce corre s ponding

to the pos ition o f the internal condyle o f the humerus
The depth o f this f old w ill o f c ours
.

e depend on th e degre e
o f e x i o n o f th e joint being mos t marked when the jo in t
is
,

f orcibly bent ( Plate s X I X X X I pp 148

In les s
,

er degree s
,

o f e x io n s
.
,

ay about a right an gle th e

-s
, ,

Y hape d hollow o f the f ront o f the becomes more

Fro 106 s
Outli n e o f the i n n er id e o f th e arm wi th th e elb o w b e n t
s
. . .

Th e f ro n t o f th e f o re ar m i in co n tact with th e f ro n t o f th e u ppe r arm ,

an d f o r m as d ee p f o ld at th e b o tto m o f which th e i n te rn al co n dyle i s
s
,

itua te d .

pronounced parti cularly if a powe rful s

, train be put o n
the mus cle s as in li f ting a weight ; the outer s ide o f the
hollow i s ion o f i ts
,

rendered more prominent by the te n s

outer bo unda ry the long s upin ator Th e ins ertion so f th e
bice psmus
.
,

cle both te ndino us an d apone uroti c a r e now

een as they pas sinto the s

, ,

we ll s pac e S uch a view o f the .

limb is shown in Plate XXI Fig I p 180 ,

.
,
. .

In con sidering the s e detailsthe s tudent will do well

to contrast the in ue n c e o f powerf ul m us cul ar c ontraction
 Supercia l Ve in sf
o A rm . 18
5

an d the veins ar e no longer re c ogniz able by their in u en c e

on the s u rf ac e contou rs Th is . diff erence in th e di s tens ion

o f th e veins in th e s e two pos ition so f the limb i sd u e to
the fact that in the rs t the blood whi ch iscirculating
in th e veinsispas
, ,

s ing up toward sthe s houlder an d

h as th usto counte rac t the inu ence o f gravity whereas ,

when th e arm i srais ed above the s houlder the blood

owing in th at direction i sas sis ted by the in uence o f
gravity an d th ere fore does not s o re adily accum ul a te in the

veins F rom this

. it f ollows th at i f the arti s t wi s
he sto b e
s trictly accurate in h i srepre s entation o f the f orm s o f the

lim b in ac tion he s hould not emphas iz e the pre s ence o f

th e s e s uper c i a l veins on the s u rf ac e o f the upli f ted ar m ,

un le s so f co u rs e he merely wi s hes to repre s ent a m omentary

rai s ing o f the limb On the other hand their pre s
.
,
enc e
may be cle arly dened if the limb be repre s ente d on
a lower level th an the s hou lder .

The prominen ce o f th e s e s upe r ci al v ein snot only

depend son their di s tens ion b ut als , o on the thickne s s

o f the s ubc utaneou s f atty l ayer in w hi ch they ar e imbedded .

They ar e be s t marked ass urf ac e elevation s when th at

layer i sthi n asin a lean m us cul ar model ; b u t their
is m as
,

in u ence on the s u rf ac e f o rm s ked w hen the fatty

s u bc u ta neou sl ayer i sth i ck con s equ ently it wo uld be
tic idea sto indi cate them by
,

a ltogether contrary to arti s

s urf ac e elevations in an y repre s entation o f a fu ll an d

he althy f emale type Under the s . e circum s tan ce stheir

pres ence iss ufc iently s ugge s ted by c olour an d this ,

es peci ally asthe ner an d whiter s kin o f the f emale

enhance sthe contras t Particularly isthi sthe cas
. e in
c ertain region s v iz . the front o f the elbow an d the f ront
kin i s thin ner th an el s
,

o f the wri s t where the s

,
ewhere ; here
a s ugge s tion o f thi sdeli cacy m ay be obtained by r epr e
s enting the colour whi ch th e s m aller v ei n simpart to
the s u rf ac e
.
186

The s u rf ace re lations o f the vario us s tructure s met with

in the region o f th e wri s t have been alre ady de s cribed ;

b ut in addition the exis tence o f certa in line sor creas es

kin in f ront o f thisregion m us
, ,

in the s t be noted Of
e th e re ar e tw o whi ch ar e us
.

the s ua lly well dened Th e .

lowe s t is a line with a double

c urve whi ch s weep sacros s

th e wri s t an d corres ponds
to the bas es o f the elevation s
,

f ami li ar to the re ader as

the ball o f the th umb an d the
'

ball o f th e little nger A t .

s ome little dis ta nc e above

thi son a level with the ti p
o f th e s tyloid proce s
,

so f the
radiusis a s econd delica te

f old ; thi s bec om e sat once

,

ap p arent as a line o f ex ur e

w hen we be nd th e wri s t fo r
Fm 1 7 Outli e f the
ard sOth e r s s
0 n o
s
. .

h wi g th e
o n g m t f
arran t h e w e en light
o f old are
s t f th e w is
.

ki n f lds io f n t
ro n
rendered e vident lying m ore
o r

d g s The
s s
,
an d th e palm
on an n er

s h d d p ts i d i t th p s i ti s or le p rall el to an d above
.

thisby further bendi n g th e

a e ar n ca e e o on

o f th e b es whi h f m th p
on c or e ro
ute b o d e s
,

a nd f orwa rd s
mi ti a d f
n en

s
n n er

s
n o
h r r r o

action o f the vario us

th Th h b l
.

p
e ca r u o t t l f
e a e a o

s
.

th th m b
e u
p d f m
co r re b l won T h e ro e o
up w d s
us cle s s
th e tub l o f th
t
ar o
m e rc e
de c ribed in th e f ore
e
sph id d th e idg f th
ca
t p
r a ez i
o

m ; th s
u e
an

th ob ll f a
on rm
r
i s s u
e

e c i e
o
n tly indi
a ca tedo
e

the littl g e to th n is
p i f
er m by their n ame s
e Tho s e whi
or ch
ssf th u i ex an d e xtend th e wri s
.

a d h oo k like p o
n - r ce o e nc
t
ar e as sis te d in their ac tion
by the mus cl e s which be nd an d s traighten th e ngers .

A bd uction or the action o f d rawing the ha nd toward s the

radi a l or oute r s
,

ide iseffec te d by the mus c le s wh ich lie

along the o ute r or rad i al s
,

ide o f the limb v iz the radial

o rs
.

ex o r an d the radial exten s o f the wri s

,

t .
 cles
A ctio n of Mus . 187

A dd uction , or the movement o f the h and towardsthe

ulna r or inner s ide o f the limb i s caus ed by the combined
action o f the uln ar ex o r an d exte n s or o f the wris
,

, t which
li e a long the inner s ide o f the fore -ar m
Th e movement o f circumd uction o f cours itates
.

e nece ss
a combin ation o f the ac tion o f e x o r s abd uctors extens ors
or vice vers
, ,

a accordi n g as
,

an d add uc to rs the movement

tak es place f rom within outwards or f rom wi thout inwards
, ,

.
 Skeleto n of Ha n d 1 89
.

that the h ands an d nger s o f tho s e employed in the mos t

delicate manipulationsar e of ten cl ums y an d u nco uth
As s
.

a rule however we as
, , oci ate delicacy o f hand with
renement an d with mental rather th an m an ual labour
whils t a powerful mus
,

c ul ar h and i s regarded as an a ttrib ute

of s trength an d o f a powerfu l
phys ique A man shand s
'

a r e often as c ha rac teri s tic as

h is fac e an d in portraiture
,

the arti s t f requently avail s

him s elf o f this f eat ure With .

women however thi s

, ,
is s
le s
m arked ashere we expect
,

to s e e elegan ce an d be auty

rather th an c h a rac ter a c i r

cum s tan ce whi ch h as

,

of ten
led paintersin the pas t to
s upply the ha nd s f rom other
an d be tter model s .

The s keleton o f the h and

compri s esthe bone so f the
palm an d ngersTh e f o rm e r
s
.

co us in sOf the ve meta w is

FI G 1 8 Th b f th
0 g h t e one o e ri

d h d s s f m th
. .

t
ca i p a l bone s
r an an a een ro e

alrea dy men f t ro n .

ti o n e d The s
. e ar e long bone s ,
R di sr . a u .

long I n the s e ns
Ul u n a.
e th at they ssf d i s
.

S l id p
a ty o r o ce o ra u

co n s is t of a s
.
.

haf t an d two S ylmd P

a
s
f I
t M O n

s
Thcc p l b e ca r a one

the pper end s

.

ex tre m 1t 1e ; u m m T h m t p l b e e aca r a one

m
.

or bas e isdirected towards am m ( L

p p T h i e n on or

th e wri s t the lower end whi ch isrounded to form a

the boneso f the digits Of thes
,

he ad s u pports
,

e ve .

metacarpal bonesf our ar e connected with the ngers

,

s s s s
,

s
,

whil s t one the o u termo t o f the erie u pp o rt the

e ve bonesarticulate with
,

thumb The bas eso f thes

,

econd row o f the wri s t or carp al bone s The b ead s

.

the s .
1 90 Skeleto n of Ha n d .

or lower endsare arranged in the following way The

f o ur inner bonesv i z thos e which s
. upport the nger s

are u nite d together by ligamen ts s

, ,

o that they cannot

be s eparate d f rom each other They m ay be rega rded as .

almo s t immovable f o r we pos ses slittle or no control

over their movements i f we except the innermos
,

t member
o f the s erie sv iz that connecte d with the l i ttle nger the
.

s light movementso f which will b e af te rwar d sdes

, ,

c ribed .

Whils t we can not by th e contraction o f o ur mus c le s caus e

an y a lte ration in the relative po s ition o f thes e bonesto
each othe r they may by the exerci s e o f pres sur e he moved

to a s
,

light exte nt Th us by gras

, ,

. ping the hand o f another

they may b e crus hed clos er to gether or by pres sing the
,

palm rmly agains t a at s urf ac e they m ay b e s eparate d

s lightly fr o m each other In marked contras . t to thi s
a rra n ement it m us
g t be ob s er v ed th a t th e lower e n d or

head o the me ca rp bone o the th mb sree that is

f ta al f u i f
to s ay it is not con nec te d with the he ad so f the other
metaca rpalsby mea nso f l igaments It i sthi scondition
,

o f th e pa rts
.

which enable susto draw th e th umb away

fr om the palm an d ngers The s tudent wi ll thus
. obs erve
that it is only over th e inner an d oute r memberso f this
s e rie s o f bones tha t we have an y m us cu lar control the
inner only to a s l ight degree the ou te r or metacarpal o f
,

the th umb to a very grea t extent .

Th e genera l f orm o f the p alm depends on the bones

f o rming its os s eo usf ramework b ut it is only on the back
,

o f the h and th at there i s a n y di s tinct evidence o f th e ir

arrangement an d f or m f o r on the fr ont o f the pa lm their

outline i s mus c le s
,

con c ea led by the nu mero us an d tendon s

which overlie them On the back o f the hand there ar e

.

n o e s hy mus cle s to mas k their outl ine ashere they

ar e cros ed merely by the tendonso f the mu s c le soin
,

s g g to
the back o f th e ngers Th e reader may s . a ti s
f y hims elf as
to thisby feeli n g the back o f h isown hand when th e ,
 Skeleto n of Ha n d . 19 1

m etac arpa l bones o f the n gers an d th umb wi ll be re adily

recogniz ed in line with the s everal digitsIf the s

. t be now
c lo s
e d the head s o f th e se bonesbe come at once apparent
as a s erie so f well marked rounded prominencesfamiliar to
-

t row o f knuckles A cc ording

,

all under the n a me o f the rs .

to the dis po s ition o f the fatty layer on the bac k o f the han d
th e se knuckl e swil l pre s
,

ent a diff erent appe arance when

th e hand i s ag ai n opened an d the n gers ar e s traightened
I f the f at be abs ent or s
.

m a ll in a mount th e heads o f th e

metac a rpalsan d th e joints

,

which th ey f orm with th e rs t

row o f the bone s o f th e n gers eries
,

will be s een to form a s

of s light elevationscovered with wrin kled s
,

kin towards
which the ridge sf orm e d by the s everal extens or tendon s
,

o f the ngers m a y be tr aced ; b ut if as i n the idea l f emal e

hand an d als
,

o in th at o f the child the f a t i s pre s

e nt in

iderable quan tity th e s

,

u rf ac e cor re s
,

c ons pondin g to th e
po s ition o f the knuckle sisdepre s se d an d f orms a s erie s
o f hollow s or dimple swi th b ut s light if an y indication
,

or tendonso f
, ,

o f the dire ction an d po s ition o f th e ex te ns

,

th e ngers .

In regard to the jointsbetween the bas es o f the me ta

ca r pa l bone s an d the bone s o f the wri s t little need be s

, a id .

The articulation s
,

o f ormed i s curved f rom s ide to s ide ,

corres ponding to the curve already des c ribed in c onnexion

with the arrangement o f the wri s t bones Thi scurve

- .
,

it will be remembered f ormed the s ide san d bo ttom

o f the e x o r s
,

o f the tunnel thro ugh whi ch the tendon s

of the th um b an d ngersp as se d whils t itspos terior

son the back
,

c onv e xity cau sed the s

ide - to s
- ide roundne s
o f th e w ri s t Thisarched arrangement ismainta ined
.

throughou t by the f our inner me taca rpal bone sa fact

which can be e as ily demons
,

trated I f we lay the bac k

.

o f th e h and on a a t s u rf ac e it will be f ound th a t it i s

ible to bri ng all four i n ner kn uckle s o f the rs

,

impos s t row
into contact with the s urf ac e at the s a me time un le s ,
swe
 j o in t F i ng er ssf o . 193

th ird ro w horte s
the s t thos
t whils ,
e f the s
e ond row o c ar e

interm e d i ate in length Both the back an d the f ront o f

th e s o f the ngers
.

e bone s ar e overl ain by the tendo n s in

such a w ay a s to conc eal their outline When we bend the
nge rs the lower ends o f the rs
.

o f the bone s t an d s econd

r ows o f ph a la nges are s een to f orm the proj ection s o f the

second an d third r ows o f the kn uckle s .

If the reader will now compare the f or m o f the s e

knuckles with th at o f the rs t row previous ly de s cribed
, ,

h e w ill note a diff erence Whereasth e s

. u rf ace proje ction

o f th e rs t row o f knuckleswass een to be rounded the ,

o utlin e o f the s econd an d third rowsisattened f rom

s ide to s ide Th i sdi ff erenc e depends
. on the s hape o f the
lower ends o f the ph a l ange s as compa red with the he ad s of

th e metacarp al bone s As . previous ly stated the l atter ar e ,

ro und e d an d t into the s hallo w hollowson the upper

e nd s o f the rs t row o f ph alange s Thes es u rf ace s.p ermit
o f movements in a bac kward an d f orward dire ction i e . .

; in thi s re s
,

bendin g or extendin g the ngers pect the

joints ar e hinge joints A t th e s ame time another move

ible : the phalangesmay move f rom

.

s
.
,

ment i shere po s
s ide to s ide on the rounded end o f the metacarpal bone .

Thi s is demon s trated when we s pread o ut the nge rsor

draw them together a movement which we eff ect at th e
rs t knuckle joint o f the f our ngers Thi slateral play
,

- .

o f the ph al a nx on the metac ar pa l bone i s ab s ent in the

thumb the corre s ponding joint o f which perm itsonly
ion S uch movement here i sun
,

o f e x io n an d exten s .

n ece s sary f o r we po s s es sth e power o f pulling the me ta

ca rpa l bone o f tha t digit aw ay f rom or towards
,

th e p alm ,

a movement whi ch in the other d i gitsisrendered i m

s o f their metacarp al bone s
,

po s
,

ible by the f act that the he ads

ar e bo und together by ligaments When we s eparate th e
the movement istermed a bd uctio n o f th e ngers
.

ngers ;
when we bring them clos e toge ther we a dd uct them .

0
194 The Th umb .

Th e line o f the midd le nger is regarded as the axis o f th e

hand f rom an d towards which the s e movemen ts take pl ace .

A n examination o f the articu l ar s u rf ac e s of the o ther

kn uckle sexplainsat once their diff erence in f orm as
comp ar ed with thos e o f the rs t row Th e lower end s
. of

the bones o f the rs t an d s econd row s o f phal an ge s a r e pro

v i d e d wi th two s mall rounded articular areas separated by

a groove ; the s e t into corre s ponding hollows on th e upper
endso f the bone swith which th ey articu late the two ,

shallow hollowsbein g s eparated by a s light ridge which

ts into the groove above mentioned S uch a joint permi ts
.

o f movement only in one dire c tion v iz e x i o n an d exte n .

s
,

ion ; an y late ral play is rendered impos sible by the arrange

ment o f itsarticular s u rf ac e s Thi s
. i sthe expl anation
why the s u rf ac e f or m o f the s eco nd an d th ird rowso f
knuckle si ss o much more s q uare in outline th an that
o f the rs t row fo r the outline depend s on the f orm o f the
lower ends t an d s
,

o f the ph a l ange s o f the rs econd rows

re s pectively ; indeed a clos e ins pe ction o f the s e joints will
s s
,

how not onl y the s q u arene s s o f the kn u ckle b u t a l o a

s
,

li ght hollowing in the centre whi ch corre s pondsto the

u rf ace s
,

groove which s ep aratesthe tw o s m all articular s .

This m ay be s t be s een i n th e s econd knuckle o f the th umb .

As wi ll be gathered fr om the f ore going de s c ription

e sa f ar f reer range o f movem ent than

,

the thumb pos ses s

an y o f the other digits an d a moment s co nsideration wi ll
'

enable the reader to realiz e its gre at importa nce as

,

a p art

o f the h and . The th umb can be brought i nto oppo s ition

wi th eac h o f the ngers : in thi s way we can employ it
an d the nger w i th w hi ch it i s brought into contac t as
a p a ir o f f orc eps en abl ing usto pick up the mos t delicate
objects Perh aps
. the s tudent will have thi s brought home
more forcibly to h i m if he cons idersfo r a moment wh at
the los so f the thumb en ta ils Th e n gersmay by the
. ,

po wer o f add uction which we po s sessb e brought to gether

,
 cles
Sh o r t Mus of Th umb . 1 95

s sto l s
o a p nything between them b t we h ve no
c a a u a

ing the m si s
,

longer th power f ppos e the s e with the

o O a ca

be e s
,

th mb ; thi s
u f t ily demons
actr t d if the re d er
can a a e a

will ende vo r to hold pen il between y two ngers d

a u a c an ,
an

then try t m ke s f it N do bt pr ti e will s

o a u e o sist . o u ac c a

u sin q iring gre ter f ility in holding nyth ing in th i s

ac u a ac a

w y b t it will be t on e pp rent th t there i s v s

a ,
u t a c a a a a a

diff eren e betw een the s f the in s

c t ment sheld d u e o ru o an

the ontrol whi h we

c exer i s
e over it w hen held by
c can c

the thumb an d nger .

A ccordingly we nd th at th e th umb i s
,
f ur ni s hed with
a la rge n umber o f m us cle s mus cle s which not only move
it in diff erent directionsb ut whi ch ar e s
,

uf ciently powerf ul
,

to enable usto employ very cons iderable force S ome .

o f the s e m us c le s h ave already been s tudied ; they ar e the

lon g mus c le s Of the th umb an d their e s hy bellie s ar e pl ac ed

in the f ore -arm But there i sa gro up o f s hort m us c le s

,

.
,

the e s hy parts o f whi ch ar e in the h and i ts elf .

It is thi s l atte r group whi ch form s th e ro unded eleva tion

along the o uter s ide o f the pa lm an d overlying the meta
ca rp a l bo ne o f th e thu mb whi ch i s f amili arly known a s ,

the ba ll of the thum b .

Thi s es hy mas s con s ists o f the f ollowing m u s c le sa s ho r t :

n d an ns f the th m b We
e w o r an a
,
bd u c to r a opp o n e
,
o u .

n eed not here enter into deta il s regarding the preci s e

attac hm ent an d po s ition o f the s e mus c le s; their n a m e s
have been mentioned in order that the re ad er m ay hav e
s o me ide a o f their ac tion G e n erally s pe ak in g the afore
.
,

s aid m us c le s a ri se f rom the w r i s t b o n es w hi ch f orm the

external ridge Of th e groov e in wh ich the e x o r tendon s
o f the ngers ar e lod ge d ; th i sridge h asbeen alre ad y
re f e r red to (ante p an d w as
,
s een to con s
. is t o f parts
o f the s ca phoid a n d trape i u m w hi ch f orm the elev ation z

at the b as e o f the ball o f th e th um b on a line w ith the

c le f t between the index a n d middle nger B u t a s th i s .

0 2
 Mus
clesof Th umb . 197

s
h fta of the me taca rpal bone an d form s the opp o n eus p o ll i c is
a m us
, ,

cle by whi ch we a r e en abled to c a rry the thumb

acro s sthe palm an d s o oppos e it to the other ngersTh e
remaining breswhich cons t o f th e ewo r b r evis
.

is p o ll i c is
pas
,

an d the a bd uc to r p o llicz s sdo wn to be ins erted into th e

bas
,

e o f the rs t ph alanx o f the th umb in the f ollowing way

Th e bres o f the s
.

hort ex o r ar e connected with a little

b one ca lled a s esa mo id bone wh i ch lie s to the o uter s ide
o f the f ront o f the joint between the rs
, ,

t phalanx o f th e
thumb an d itsmetaca rp al bone Thi slittle nod ule o f .

bo ne i s provided with a ca rtilage covered articula r s

- urf ac e

wh ich glide son the ro unded s

,

u rf ac e o f the o u ter pa rt

o f the he ad o f th e metac a rp al bone From thi ss esa moid

.

bone which thusactsasa pulley tendinousbrespas s

to conne ct it with the outer s
, ,

ide o f the bas e o f the rs t

phala nx S upercial to an d to th e ou ter s
. id e o f thi s
s es am oid bone tho ugh not connected with it the abd uc to r

s
,

s s
,

p o ll ic i s i sf o
o

und a it p s
a e to i ts in se r tion into the ou te r

s ide o f the bas e o f the rs t ph alanx along with the f ore

goi n g Th e abd ucto r action o f thismus
. c le move s the
th umb as a whole an d not the ph a la nx on the metaca rp a l

bone as isthe cas e with the other ngers

,

( Fig s 10 9 .

m all portion o f th e e x o r brevi si sins

, ,

A s erte d into
a corre s ponding s esa moid bone on th e inner s ide o f the
joint by meanso f whi ch it i sconnected with the inner
,

s ide o f the bas e o f the rs t ph al anx o f the th umb Th e .

thumb i sals o provided with add uctor m u s c l e sw h ich , ,

like the opponen sdraw th e th umb inward sto ward sthe

,

palm o f thes
: e there ar e tw o the o b lique an d the tr a n s
s
,

s
ve r e ad d ucto r .

Th e f ormer h a c ribed as
shithert
been de s the deep o

hort ex o r b u t the des

part o f the s cription here
given i s
th at now generall y adopted Th i smus
,

cle lie sdeeply in .

the palm an d alth ough cov ered by thos e already de

it as
s tsin impa rtin g to the ball o f the th umb
,

sc ribed is,
 8 cles
Mus of Th umb
1
9 .

it s h r t ris
c ti f llne s
a ac es The obliq e dd t r isin
c u . u a uc o

gre ter p rt i s
a erted into the inner s
a n esmoid bone b t a u

ome bresto the o ter s e smoid swell

,

i t ls
o sen d ss
a u a a

whi h i te with thos

,

c un e f the brevi s M h mor o ex o r . uc e

imp rt nt f rom
o a t ndpoint i sthe t s s dd t
s o ur a r a n ver e a uc o r .

This m s le doe snot s

u c sist in forming the s welling f the
a o

b ll f the th mb b t lie s
a o intern l to it ; it help s
u u t f orm a o

hy m s swhi h o piesthe inte v l between the

,

the e s a c cc u r a

metaca rpal bone o f the th umb an d that o f the index nger .

The mus c le i s f an -shaped ; by itspoin te d extremity it i s

united to th e inner s es a moid bo n e a long with the ad ductor

obliquusby its bas

,
e it is attached to the f ront o f the s haf t
o f the me tac a r pa l bo ne o f the middle n ger Wh en the .

th umb isouts tretc hed the lower bo rder o f the m us cle

ca n be di s tinctly f elt ab out half an inch above the f old

of s kin which f orm sthe web be tween the th u mb an d
f orenger By their connexion with the inner s
. esa moid

bone both th e s e m us c le s ar e attac hed to the bas e o f the

rs t phalanx on itsinner s ide Ashowever the joint o f .

the rs
, ,

t knuckle o f the thumb allowso f no lateral play ,

b ut o n ly o f e x i o n an d extens ion thes e mu s c le s do not ,

move the phalanx b ut ac t on th e metaca rpal bo ne with

,

which the phalanx iscon nected The pre s e nc e of . th e

s mall s es a moid bone s impartsa f ullne s sto the f ront o f
the joint w hi ch it would not otherwi s e possess( Fig
Th e ad d ucto r trans vers
.

usa s above des c ribed, i snot ,

the on ly m us c le w hich o ccupie s the interval b etween the

metacarpal bone so f the th umb an d forenger .

I f the reader will examine the b ack o f h is own ha nd

with the th umb outs tretc hed an d the f oren ger p u lle d
as f a r ap a rt f rom the middle nger as po s sible he will ,

s
o b e ve ro nded elevation occupyi n g the V s
r a u - hape d inte rv al
be t w een the metac arp al bone s o f the th umb a n d f ore n er
g
d ue to the e s
.

Th is is hy part o f th e a bd ucto r in d ic ts It is
one o f a s erie so f m us c le s
.

which lie between the meta

 A bd uclar in dicis . I
99
ca rp l bonesf the digits lled the
a o ca i n ter o su
s
e an d

i shen e s
,

ometimes lled
,

c ca

the s t d s
r l i t ssus
or a n ero eo

m s le Th fo mer n me
u c e r a

isthe better f
.

present or

purpos es s it ind i te sthe

a ca

es
,

action f the m s
o le It is u c . ar

by es hy bre swhi h c ar e

a ttached to the metaca rp al

boneso f the thumb an d
index nger res pectively as
they lie on either s
,

ide o f the
V -sh a ped inte r val T h e se .

bres unite to f o r m a e s hy
belly which ispl ac ed along
the radi al s ide o f the meta
ca rpal bone o f the index
nger an d terminate near
, ,
FI G 1 1 1 V i ew of th e te n d o n s
itslower extremity in a ss
. .

, an d m u cle on the k
b ac o f th e

tendon which runs down the right h an d .

radi al s ide o f the rs t knuckle a. s

Te n d o n o f ecun d i in te r n o d ii po l
li c i s
s
.

o f the f orenger to beco me b Te n d o n o f pr i mi i n te rn o d ii po l l ic i

s s
. .

attached to the bas

,
c Te n d o n o f e x ten o r car pi ra d ia li
e o f th e
.

lo n gio r

rs s s
.

d Te n d o n o f ex ten o r carp i rad ia li

t ph al an x o f that digit
.

along with the extens

b r e vi o r
s
.

or ten e e Po t e r i o r an n ula r l iga m en t o f

s
.

don sThis m us cle lie s

w ri t
behind s s s
.

.
j : Te n d o n o f e x te n o r c o mm un i

the tran s ve rs e adducto o f r

T
d igi to r um
e d o n o t e x t e n

o
.

r m i s
n i m i d ig i ti
s
g n

s
. .

the th umb an d when we h Ten d o n o f e x te n o r ca r p i u ln ar i

.

s
.

hy l ayersb e
,

gras p the e s
i Te n d o n o f e x o r ca r p i uln a r i
ss s
. .

j . M u c l e o f b a ll o f li tt l e n ge r een
f ro m b e h in d
tween the th umb an d fore s s s
k A b d uc to r i n d ic i o r
.

r t d o r al

nger we compres s the s ss s

s
.

e tw o i n te r o eo u m u c le
s
.

mus c le sbetween o ur ngers

I l l S ec o n d th i r d , a n d f o ur th d o r a l
s ss
s
.
,

i n te ro e i m u c le
s s
ss s
. .

J us t as the ou ter digit or m E x ten o r o i m etac a r p i po lli c i

.

u A d d uc to r po lli c i ss
ee n f ro m b e
.

th umb i s provided with s s s s

.

hort h in d . Th i m u c le d ete r m i n e

m us cle s s
t h e o u t l i n e o f t h e w e b b e tw ee n
o the inner digi t or
, th e t h um b an d th e in d ex n ger .
 The Pa lm .

the palm is hollowed o ut fr om s ide to s i de an d slightly als o

f rom above downwards I f th e ngers . be p re s s ed i nto

thi shollow the s kin isf elt to be rm an d re s is
tant
Thi si sd ue t o the f ac t th at there i sa dens
.

e l ayer o f
brous ti ss ue ca lle d the p a lma r f a s cia immedi ately bene a th
/

an d intim ately connected with the s

, ,

kin in thi ss i tuation .

Th isf as c i a is s omewhat tri angular in s hape ; itsna rrow

or pointed end is united to the ante r ior annul ar ligament

which bridgesac ros sth e groove f ormed by the wris t

boneswhil s t i tsbroad end or bas e i sdirected to wards
th e roots o f the ngers heathso f which
,

with the tendon s

it i sconnected On either s ide thi sfas ci a thin s
,

. o ut

f ur n i s
,

hi ng brousexpans ion swhich cover the mus cles

o f the ball s o f the th umb an d little nger re s pectively ;

the middle por tion i showever by f ar the s tronges t .

A ll the ex o r te ndons
, ,

of the ngersto gether with a

n umbe r o f bloo d -ve s se ls an d deli ca te ne r ve spas sunder
,

neath thisfas cia s o that ample protection i s

,

aff orded to

the s e partsa mos

,

t important detail when we remember

how f req uently we gras p the ha ndle o f a tool an d th us
,

s ubj ect the s t ructure s in the palm o f the hand to th e

i n uence o f direct pres s ure

kin o f the palm varie sin thicknes sin diff erent

.

The s
plac e s ; it i st hi c k in the c entre an d a long the inner side
where it covers the ball o f the little nger thinner where
e sover the mus s
,

it pas s cles o f th e th u mb The thicknes.

o f the s kin o f cours e depend son the occupation o f the

individual the horny-handed s

o n o f toil in thi sre s p

e ct
pre s enting a marked contras t to the appe arance di s
,

played
by the ha nd o f one wh os e lo t h as never required him to
engage in h ard manual labo ur The palm pres en ts a series
'

t before the ngers

.

of s mall rounded elevation s or pads j us

s pring fr om it Thes . e prominenceso f whi ch there ar e ,

three lie ra ther in the in tervalsbet w een than over the

rootso f the ngers Viewed f rom the f ront the webs
,

.
,
 The Pa lm
.

b etween the ngersan d the s kin creas eswhich cros s

s the n gersf orm a well d en e d line with a
,

the r ot o o f -
,

owing cur ve f rom w ithout in wards which limi ts inf er iorly

the region o f the palm
esor fold sare s
.

A n mber
u o f well marked creas
- een
cro s s ing the palm in diff erent
directions Of th es e f our .
,

ar e us ually well m ark ed two

havin g a s omewhat trans

,

vers e direction whils t the

smore or
,

other two p as
les slongitudinally their
a rrangement h as been de
s c ribed as res emblin g the
writte n capital M plac ed
obliquely acros sthe palm .

Th e lo w er o f thes e trans
vers e lines m ay be traced
fr om the inner border o f th e
FI G 1 Outli e f th h d
12 n o e an

s h nd bo t in h bove
. .
,

h wi g th
o m t f th
a rra n a a u
en an c a
n g e e o e
s
,

ki n f ld si o f t f th e w is
n ro nt the level o f th e web between
o r

d g s Th e
e little an d ring ngers
an d onth p lm e a an n er

s h d d p ts i di te th p s iti s
h
.

t
acros
,

s th e palm curving
a e ar n ca e o on

o f th b e swh i h f m th p
one c or e ro

b d sf
ard to w ards
mi ti d ut
th
n en

s T h
n n e r an

u s t t h b l l f
downw
o er o r er
the cleft
o
e car p o e a e a o
s
.

th th mb
e u p d f m b
c o rre l w between
on the romid d le a n d f o re
e o
upw d s
s s cond tran s
th t b l f th
ar t o e
nger
u erc e
The e o e

sp h id d th idg f th
.

ca

t p i m ; th s
ra ez
o

u
an

th b ll o e
e
f ve
on rs
r
e line c
e
o memen c
o
e s a bo
a ut o
e

th e littl g e t th n i
p is fer m an 1u ch above the web o f
o e or

an d h k li k p
oo - ssf th e i
r o ce
the o
index an d middle ngers
e u nc

f m
es
,

an d curving up w ard c ro s s
or .

, ,

the palm to be gradually los t on the s u rf ac e o f the ball

o f the l i ttle nger I f the s tudent will exam ine thes e

l i neswith the ngers
.

straight an d the pa lm s tretched an d

then proc eed to bend the ngerson the palm he will at
,

once recogni z e tha t they ar e lineso f ex io n an d corre

 Fingers The 3 . 20

sp d
on to th in f olding
e f the s
kin over the
o joints between
the met p l bonesf the ngers d the s
acar a o t row f an r o

ph l nges
a a .

In lik e m nner the two longit din l linesone s

a weeping u a ,

r ound the ball o f the thumb the other running down the
een to be as s
,

centr e o f the p alm a r e at onc e s

, oc iate d with
the movements by whi ch the hollo w o f the p alm i s deepened
b y the approxi m ation o f its inner an d outer borders through
the action o f the Oppos ing m us cles o f the th umb an d little

nger .

To apply an y other s ign i cance to thes e line s is at once

an impos ition an d a f raud .

M any pers o ns poss essthe power o f wrinkli ng the s kin

a long the inner bord er o f the pa lm overlyi n g the ball

o f the little nger ; this isd ue to the action o f a s m all

s uper c i al m us c le ca lled the p a lmaris b r evis the s cattered

bres vers sthe upper

,

o f whi ch h ave a trans e direction acros

,

an d inner s ide of th e palm f rom the den s e fasc ia o f whi ch

th ey ta ke origin whil s t by their inner endsthey ar e

,

attach ed to the s
,

kin .

The four ngers as they s pring f rom the palm ar e unite d

by s kin f oldswhich f or m the webs o f the n gers Thes e
f old suni te the ngers
.
,

at a level corre s ponding to the

middle o f the rs t row o f phal anges or n ge r boness o th at
-
,

a con s iderable portion o f the palm isf orm ed by the bas es

o f thes e bone s an d their a rti cu la tion with the metac a r p al s .

The part o f th e palm which lies below the level o f the two
trans vers e f oldsaforementioned corr es pond sto the roots
o f the n gers A s . we s hall s e e thi s is one o f the reas
,
ons
why th e ngers appear s horte r wh e n viewed f rom the f ront
than f rom the back .

The ngerss hould taper regularly from bas e to tip ,

an d s hould not di s play an y thi ckening at the joints The .

rounded f orm o f the anterior s u rf ac e i s d ue to the tendons

which pas sdown the f ront o f the phalange s Thes e .
 Ba ck of Ha n d . 20 5

p a ren t en abling u s to re cogni z e e as ily the po sition o f the

s upe rci al veins
,

either b y their colour or prominence ;

th e latte r woul d be j us tiable in a repres entation o f a m ale
h an d b ut would be entirely o ut o f place if indicated in the
,

f emal e unl es sit be th e han d o f an old woman in whom

the was
,

ting o f th e fat h asled to an undue prominence

o f th e ves sels In m an thes
. es upe r ci a l veins ar e s een to
f or m an irregular arch acros sthe back o f the hand fr om
which th e bloo d pas ses up by the s upe r cial vein s o f the

f ore ar m already noti ced ( ante p

- .

Th e appea ranc e o f the rs t row o f knuckles h as

,

been
already all uded to In handsin which the tendon sar e
eas
.

ily s een thes e wil l b e noticed wh e n in a s ta te o f ten s ion

f or ming a s pa ss
,

eries o f ridge s
,

ing down f rom the m iddle

o f th e b ack o f the wri s t to the rs t row o f knuckles
o ver wh ich they ar e carried on to the b ack s o f the ngers
,

Th e te ndons which f or m the mos t pronounced ridges on the

s ur fac e ar e th os e as so ci ated with th e thumb . Th es e we
have already des c ribed in connexion wi th the wri s t j oint
an d the m us c le s o f the f ore ar m
- . They ar e the extens ors
o f the metaca r p al bone an d phal a nges o f the th um b . That
pas s ing to the s econd phalanx f orm s the s a lient ridge whi ch

is pla in l y vis ible wh e n we s trongly extend the th umb ;

th isridge i ss e en to p as sf rom a point on the back o f
th e wri s t in line with the clef t between the index an d
middl e ngersdownwards toward s the rs t kn uckle o f the
thumb afte r whi ch it is carried along the b ac k o f the rs
,

t
phalanx to reach the bas e o f the s
,

econd to which the

te ndon i s
,

attac h e d

Th e manner in which the nge rs

.

spring from the bac k

o f the h and is very diff erent f rom what we have s een in
f ront . I f the ngers be s pread o ut the web sbetween
ideso f the
,

them wi ll be noticed to be attach ed to the s

ngers m uch lower down in f ront where they f orm a s harp
tretchesacros sthe inter val between
,

abrupt f old whi ch s

 Ba ck of Ha n d .

the ngers on a level with the middle o f the rs t phalan ges .

A bove an d behi nd thi s the s kin between th e ngers f orm s

a broad groo ve when the ngersar e o uts pread which
grad ually fadesaway on the back o f th e hand in the
,

interval sbetween the knuckleso f the rs t row When

.

th e ngers ar e again brought toge ther thes e f urrows ar e

repres ented by a s er i eso f fold swhich carry upwardsth e

outline o f the ngers on to the bac k o f the hand It is fo r
o n th at the ngers
.

thi s reas o f the h and appear m uch lon er

g
when viewed f rom the back than f rom the f ront fo r on
o f the rs
,

the bac k the whole length o f the phalanges t row

is seen to enter into the compos i tion o f the ngerswhereas
on the palmar s urf ac e nea rly ha l f the leng th o f thes e bones
,

is co nc ealed in th e f ore -pa rt o f the p alm . Th e reader may

at onc e s ati sfy him s el f as to the correctn es so f thi s explanation
i f he ex amine s h is two hands placed s ide by s ide the o n e
,

pa lm upward sthe other palm downwar d s ( Fig .

The ow o f the lines which s eparate the ngers

,

behind
when clos
,

ely approximated is pecul iar The lines

. on either
s
,

ide o f the middle nger take di ff erent direc tionsthat

between the middle an d index ngerspas i n g outward s
,

s
towards the thumb the other between the middl e an d ri ng
,

nge rs being directed towards the inner border o f the hand ,

a direc tion which i s als o f ollowed by the line between the

ring an d little nge rs The direction o f thes e linesis
ition an d direction o f the te ndons
.

determined by the pos

o f certa in s m all mus c les lod ged between the s hafts o f the

metaca rp al bonesan d called the d o r s a l i n ter o s sei Th e

c les
.

middle nger i sprovided wi th two o f thes e mus

,

c les
,

one on either s ide an d it is the tendons o f the s e mus

ide to the rs
,

sdown to be attac hed on either s

,

as they pas t
phalanx which accoun t fo r the ow o f the lines in oppo s ite
directions Th e corres ponding m us
,

. cle o f the ring n ger

is attac hed to the ulnar s ide o f the rs t ph al anx o f that

digit ( Fig .
 Fingers Back of
7 ,
. 20

In th ext nded pos

e ition f the ngersthe s
e kin isseen o

to be mu h wrinkl d over the s

c e ond row f kn klesles
e s c o uc

sover the third beyond whi h we nd the n ils

,

o c a

h ped n ilss
.
,

Well s - ahould be long d t t bro d ;

a an no oo a

str ight or b t s
a ligh tly urved in their long dire tion ;
u c c

r h d f rom s
a c e ide to side The n il f the f orenger is the . a o

l s
ea t rv d f rom s
cu ide to s
e ide th t f the little nger a o

the mos t curved S hort broad an d at nails

,

. ar e an n u

pleas
, ,

ant f eatu re i n the h and

Th e length o f the ngers

.

varies in d iff erent individ uals

b ut as a rul e in a well f ormed h a nd the rel a tive len t h s
,

-
, g o f
th e digits ar e approxim ately as
,

f ollows The m iddle nger

is
.

th e longe s t ; th e tip o f the index nger corres pon ds

pretty clos ely to the level o f the root o f the nail o f the
middle nger Th e rin g nger reac hes
. as low as the level
o f th e middle o f the nail o f the middl e nger an d i s thus
s
,

lightly longer than the index nger ; the little nger

reac hesto the level o f the third joint o f the ring nger ;
whils t the thumb when clos ely applied to the outer s
, ide o f
th e f orenger s hould reac h the level o f the s econd joint
o f th a t digit though it i s f requ ently s
,

omewhat s horte r
S een f rom the f ront the middle nger appea rs
.
,

shorter than
the palm viewed f rom the back it appears
,
longer than the
bac k o f the h and
When the ngersare bent the length o f their dors
.

al

sur fac e is increas ed this isat onc e app a rent i f we ex a mine

th e condition o f the s ki n When the ngersar e s . traight

the s kin over the knucklesi spuckered an d wrinkled ;
when bent the s kin becomestens e an d s tretched over the
jointsthusindicating that there h asbeen an increas
,

e in
dors pect Th is
,

the lengt h o f the n ger on i ts a l as increas e .

is d ue to the fac t th at the thi ckne s s o f the lower arti cul a r

endso f the metacarpal bonesan d rs t two row s o f ph a

langes h as n o w to be taken into ac co unt The accompanying .

diagr ams will at once m ake thi s c lear ( Fi gs 1 13 .

,
 Summa ry . 209

of a bout one hundred an d tw enty or one h undred an d

thi rty degrees .

In su mmi n g up the f acts in regard to the hand the s tudent

will now realiz e the advantageso f i tscomplex s
,

tructure .

Th e number o f bone s an d m u s cle s whi ch en te r i nto its

f ormation impa rt to it a wide ra nge o f mobility an d
adaptability f o r the mos t delicate manipulations Th e .

varying length o f the ngersan d the manner o f their

s
,

arti cu l ation enable usto gras

, p with ea s e an d rmne s
obj ectso f a s pherical form S imil arly their arrange
.
,

ment isconducive to the ea s e with which we can pois e

on o u ge tipsan d th umb an y at s
r n r - u rf ac e such

as
,

a pl a te .

The numerousbonesan d join tsin the h and are al s o

o f m uch s ervice in red ucing the violence o f a s hock In
s
.

triking a blo w w ith the s t the f orc e is m uch broken

up an d dimini s h e d in inten s ity before it reachesthe bone s
of the fore arm s - o th at we ar e en abled to s
,
trike power
f ully witho ut doi n g inj u ry to ours elves In concl us
. ion
it m ay be well to remind the reader that the for m o f the
upper limb di ff ers in the tw o s exes A s an a rti s
. t o f rep ute
once s a id A wom an s hould have no anato m y thisreally
is
,

the gi s t o f the whole matter In the f em ale the bon e s

.

ar e s maller a n d o f more delica te form ; the mus cle s ar e

les sdeveloped an d in additio n they ar e covered by a thicker

,

layer o f s ubcuta neo us f a t whi ch m as k san d s o fte nsthe

outlineso f the underlying s tructuresimpa rting a ro und
,

nes san d f ullnes sto the lim b which are charac te ri s tic o f
the s ex in both m ale an d f em ale the f orm o f the li m b i s
:

tapering itsgreate s
,
t thickne s sbein g in the regio n o f the
s houlder where the deltoid m us
,
cle ov e rlie sthe s houlde r
joint .

A nother m atter req u iring con s iderat ion i sth e length

o f the li m b Thi s .w ill be mo r e f u lly d i scu ssed w hen the
ques tion o f propo rti o n is con s idered b ut it m ay b e w ell to
r
 Pr opo r tio n of Upper L imb .

s
t tea here that a s hort arm ism uch more pleas i n g th an
a long one the l atter bei n g regarded as r ather an a e -lik e
, p
ch aracte ri s
tic an d one which is m ore f requently obs er ve d in
the lower raceso f m an A sBrii cke h as tly obs
,

j us er ved
A model i s
.
,

not eas y to nd in whom the arm sar e to o

short asco mpare d with the legsb ut there isno lac k o f
pec imens
,

s in w hom they ar e to o long .

 C HA PTE R IX .

TH E G LU TE A L R E G I O N .

Ba r on spassing to the consideration o f th e lower lim b

it may be well to ref er to s ome o f the pointsa lre ady
dis cus sed in one o f the earlier chapters The es sential .

d iff erence between the f ore an d hind limbso f m an w as

FI G 1 1 5 Dia gramm ati c repre en s FI G 1 16 A d i agrammatic r epre

s s
. . . .

tatio n o f th e h o uld er -gi rd le . cu tatio n o f th e pe lvi c gi rd le .

a. s s
Fir t d o r al v erte b r a S ac r um
s
a

s
. . .

Fir t r i b b H a n n c h -b o n e ( o i n n o mi n a tum )
s s
.

ss s
. .

c B r e a t -b o n e ( te r n u m )
S y m ph y i p u b i
s
. .
c . .

d S h o ul d e r -b lad e ( ca pul a)
. . ( 1 U ppe r e n d o f thi gh -
. b o n e ( f em ur ) .

c Co lla r -b o n e ( cla v i cle )

s
. .

f H um er u (b o n e o f uppe r am )
. .

th ere des c ribed an d it w as shown th at the hind limb

w as
,

des i gned to combine the f unction so f s uppo r t an d

progres sion Th e atte ntion o f the s

. tudent mus t be par
ti cular ly directed to the arrange m ent o f the bone s which
f or m th e p elvi c gi r d le by mean s
,o f w hi c h the lower limb

P 2
 Skeleto n of L o wer L imb .

s
FI G 1 17 Th e keleto n o f th e lo wer s
FI G 1 18 The ke leto n o f th e lo wer
ss
s ss s
. . . .

limb a ee n f ro m th e f ro n t . limb a e e n f r o m th e o ute r id e .

a. s
Th e ac r um d K n ee -
pan (pa te lla )
s
. . .

b Th e h a un ch -
. b o n e (o i nno mi n a tum ) . 41 . O u te r
b o n e o f le g ( b ula ) .

c Th igh -b o n e ( f em ur ) f I n n er b o n e o f leg ( ti b i a )
sf f
. . . .

g Bo n e
. o oot
 2 14 I n n o min a te Bo n e .

rticular cavity i s
a the p ub is ; p a ssing upw a rd s o utw a rd s , ,

an d backw ard s we note the expanded cur v ed pl ate o f bon e

called the i li um ; below an d s l ightly beh i nd i s the is ch ium .

The pubis an d the i s chi um ar e f u rther uni t ed by proces ses

ca lled their r a mi an d th us enclos e between them a wide hole
ca lled the thyr o id or o b tur a to r f o r a me n whi ch lies
, ,

in f ront o f ,

FI G 1 19 Haun ch -b o n e
( o ia s Fro 1z o Haun ch -b o n e ( o in n o s
s
. . . .

n o mina tum ) o f ma le e e n f ro m th e m in atum ) o f female N o te that

s s s s s
.

o ute r id e ; it i rep re en te d a th e f e male b o n e i m o re ti lte d f o r

arti cula ted wi th th e ac r um s wa rd th a n th e male , a h o wn b y ss
s
.

th e r e la ti o n o f th e po in t a an d e
to th e d o tte d ve rtical lin e .

(1. Disp ti
c or on of th e in n o m ina te b o n e .
1 An te r io r in f e r i or ili ac p in e
. s .

b P b i p ti
u c or on of th e in n o m i n a te b o n e 9 A ceta b ul um ( h o llo w f o r h ead o f thigh
Is
. . .

c h i l p ti
c a or on of th e i n n o mi na te b o n e)
s sp i il i s
.
.

bo n e i Po te r io r pi
u er o r ac n e.

shi m
. .

j S p in e o f i
s
c u
sp s
ity f is
. .

c. A n te ri o r u e r io r ili ac pin e L Tub e ro h i um

sS pi
o c

s
.
.

. ne of p ub i .

an d below th e ac etabul ar articul ar cavity above mentioned

With partsonly o f thi s
.

irregularly-s haped haunch -bone are

we immed i ate ly conce rned an d with s ome o f the se details
the reader isalre ady familiar asref erenc e h asbeen pre
,

v i o us
ly m ad e to them in the de s
,

c ription o f the abdominal

 21
5
wall san d an ks(ante p Thusthe upper border or
cr es
.
,

t o f the expanded ili ac bone h as been alread y s tudied

in i tsrelationsto the s ur f ac e Thi sdes cri be s
. a s inuous
cu rve being convex in f ront to w ard s
, the outer s ide an d
con ca ve behind . Between itstwo extremitiesthe cre s t
is als o arched in a vertica l dirco
tion the convex ity o f the cu rve
,

being directe d upwards The ex .

tr e m i ti eso f thi scre s t ca lled

res
,

pectively the a n ter io r an d p o s

to r to r s up er i o r i lia c s p i n es h a ve ,

been noted asimpo rtant deter

minantso f s u rf ace f orm the ,

a nterior corre s ponding to the de

pres s ion at the o uter s ide o f the
f old o f the groin (a nte p ,
.

the pos terior underlying the

depres sion or dimple which is
s o ch a rac te ri s tic a f eatur e o f th e
lower part o f the bac k in the
male an d f em ale ( ante p , .

The anterior two thirdsor s - o

o f the in n er s u rf ac e o f thi s plate

like bone ishollo wed o ut to f orm
the ilia c f o s s
. a Thisaff ordsan
expanded s u rf ac e f o r the s upport

o f the abdomin al contents Th e .

po s terior third o f the inner as pect

o f the ili u m i s rough an d irre F G 21 ( Aft Ri h ) I 1 er c er
S h ws
. . .

gul ar an d isad apted fo r ar ticu ili f w t the i li

,
th l ti f th
o

s
e re a on o e

lation with the s ide o f the s

ac t urr o o ac cre .

ac rum

urf ac e corre s pond s

,

to which it isrm ly united Thiss . to

the po s terior part o f the cre s t w hich curvess lightly
,

outwards The outer s

. u rf ac e o f the ili u m f u rni s hesan
extens ive attachment fo r the mus cleso f the buttock ,
 The Sa cr um . 21 7

glute sm im sb t when the leg or more properly the

u ax u u

thigh isbent forw rd t the hip joint the m sle s

, ,

lips
a a - u c

d s n overs
,

ov r thi sbony prominen e

e it Th sin c an o u c . u

the s ity f the i s

, ,

itting pos
t re the t beros u hi m nderlies u o c u u

the s
,

kin an d it is on thes e prominences that the body weight

tsin thispos
,

res ition s o th at the m us cle s ar e in no w ay

crus hed or compres ion isals

,

sed Further provi s . o made

to relieve asm uch aspos
.

s ible the partsf rom pre s su re

ities is
, , ,

fo r the f at overlying the i s c hi a l t ubero s ab und antly

mix ed with broustis sue w hi ch imp a r t s to it a highly

elas tic qual ity res embling in thisres
,
pect th at which we , ,

nd underlying the heel .

It isby the fus ion o f thes e three bonesthe ili um the

is
, ,

chi um an d the pubi s

, that th e innominate or haunch
bone isf ormed an d it isas been s
,

has a id at the point o f

f us e three bone sthat the a ceta b ulum isf ound

, , ,

ion o f thes .

We need f o r the pre s ent only compare it with the glenoid

f osson the s
a houlder bl ade Th e l atter w as
- seen to be rel a.

tiv ely s ma ll an d s hallow th usallowing great f reedom o f

uppo rt ,wherea s
,

movement an d limited s the acetabul um

is large an d deep an d better ad apted to furni s h s upport ,

s
,

th ough les well arranged to p ermit f ree movement The .

further d eta il s in connexion with thisar e res erved until

the hip joint i s- des cribed .

It i sby the union o f the two h aunch boneswith each -

other in f ront an d the s ac rum behind th at the pelv i s is

f ormed The s
. a c r um as h as been alre dy expl ain e d ( ante
,
a ,

p. is a s pecially modied part o f the vertebral col umn

or back -bone which is f ormed by the f us ion o f ve ve rte
bral s egments It iss
,

o to s peak wedged in betw een an d ,

behind the iliac portionso f the two innominate bones

.
,

with whic h it isrmly united by immovable joints .

In thisw ay provi s ion ismade f o r the trans mi ssion o f

the body w eight f rom the vertebral column downw ard s
through the two haunch bonesan d s - o on to the thigh s ,
.
218

The s urf ac e rel ations o f the s ac rum h ave been already

s tudied ( ante p , . an d the s tudent m ay be ref erred to that

des c ription f o r f urther detail s M ea n while i t m ay be
'

s
.
,

uf c ient to note th at it i s only the po s terior as pect o f

the bone w hich isa dete rminant o f the s u rf ac e c onto u rs .

The o s s eo usgirdle s o f ormed enclo s es th e pelvi c ca vity i n

whi ch ce rtain vi s c era ar e lodged Thi s cavity i s des c ribed

as
.

c ons isting o f two par tsthe true an d the fals e Th e f al s. e

pelviscorres po ndsto the hollow formed by the expanded
,

iliac bones The true pelvi s

. isth at p a rt o f the ca vity whi ch
is bo unded in f ront by the pubeson either s ,
ide by the
is c hi a an d beh i nd by the s ac rum .

The pelvi sis

,

a mo s t i m portant determinant o f f orm not

only directly ash asbeen already s
.

ufciently expl ained

ince by vari ationsin itss

, ,

b ut al s o indirectly s iz e an d
h ape it in uences
,

s the entire modelli n g o f the lo wer part

o f the tru nk an d upper pa rt o f th e thigh s It i s . on the
width o f the pelvi sthat the narrownes sor breadth o f
the lower part o f the gure depend s Thes . e diff erences give
ri s e to the cha racte ri s ti c gureso f the two s exes The .

cavity o f th e true pelvi s in the f emale isf o r s exual reas ons

la rger than that o f the male an d th usnece s
,
,

s
a rily reac ts
,

on th e f orm o f the bone swhich s u rro und it lead i n g to

ion It followsthere f ore that the

,

their grea ter expan s .

f em ale pelvi s is wider th a n the m ale On the other hand

.

the male pelvi s

,

though narrow er than the f emale is

, deeper .

e two factsaccount fo r the diff erenc esin the width

,

Thes
o f the gure ac ros sthe hip sin the two s exesan d als o
ta nce that the ank sin the f ema le are
,

f o r the circu ms
rel atively longer than thos e o f th e m ale fo r the iliac
c re s tsin the f emale do not ris e to s
,

o high a level The .

pelveso f the m ale an d f emale pres ent m any other diff er

e n c es
,
b ut the s e need not here be di s cus s ed .

A n o ther m atter o f grea t importa n ce in regard to the

i n uence o f the pe lvi s on the s urf ac e f orm i s i ts pos ition
 2 19

o f the s
in re lation to other p arts kel eton . The s
tudent will

FI G . 122. Th e ma le pe lvi s.

Fl o . 1 23. The f e male pe lvi s .

a. s
I l iac po r ti o n o f o i n n o m i n a tum .
g A ce ta b u l um
. .

b Pu b i c po r tio n o f 08 i n n o m i n a tu m h Pu b i c a r c h
sh i si s ss
. . . .

c I c al po rtio n of o n n o m i n a tu m . k Pub i c ym ph y i
s s s
. . .

d Iliac c re t S p i n e o f pub i
sp s s m is
s w
. . . .

c A n te r io r u e r io r iliac pine Th e ac r u ee n e d ge d i n b e tw ee n

s s
.

1 A n te r io r i n f e r io r iliac
.
pi n e. th e tw o i n n o m in a te b o n e b e hi n d .

experience cons
ide rable difculty in ac u q iring a c orrect
 The Femur .

upper sf the thigh bonesswell sthe tr ns

extremiti e O - a a a

ve s
e di meter f the pelvi sit will be ne es
r a O sry to sy , c a a

mo e bo t it f ter we h ve des
.

r a u ribed the n tomy f th

a a c a a o e

t igh bone
h - .

Th e thigh bone or f emur ( Figs

-
sremarkable
124 1 26) i

in ma n fo r itsgrea t length Like o ther long bonesit is

.

des cribed aso s

.

s ss s s
,

p e ing a h a f t an d tw o extremitie In .

co nnexion with the upper end o f the bone the head m us t

be s tudied Thi scons. is tso f a ro unded knob Of bone
f or ming about two third s of a s
- phere which i n the living
is
,

covered with a l ayer o f a rti c ul a r ca rtil age an d ts into

the deep s ocket o f the acetabulum on the outer s ide o f th e
h aunch bone Thisro und e d a rticul ar head i ss
- . upported

by meanso f a proc es so f bone ca lled the n eck by w hich ,

it isunite d to the upper extremity o f the s haf t forming

a ngle v ar ie s
,

with it an angle o f about Thi s according

to ci rcum s tances ; it i smore O pen in c hildren more acu te

as ually le s
,

age ad va nc es an d i s ,
us sobtus e in the f emale
than in the male
a m atter o f great importa nc e as
.

The length o f the neck is ,

it permitso f a f reer range o f movement at the hip th an

wo uld otherwis e be the ca s e cons ideri ng the depth o f the
,

arti cul ar cup an d th e prominenc e o f i ts borders ; f u rther it ,

a ct s as a lever f o r the m us cl e swhich control th e mov e m ents

of the hip -joint an d w hich ar e ins er ted around th e neck
where that part o f the bone becomesfus
,

ed w ith the s h aft .

A t thi s point there ar e tw o well m ark ed proce s s es o f bone

-

developed thes : e ar e call e d th e tr o cha n te rs They ar e .

dis tinguis h ed by the nam e sgr ea t an d s ma ll ; th e s ma ll

or les se r tr o cha n ter i s plac ed on the low er s id e o f th e n eck
as it joinsthe s haf t an d i so f little i m portance f r om o ur
,

s ta ndpoint The gr ea t tr o cha n ter iss

. ituated at the upper
an d o uter s ide o f the angle f ormed by the f us ion o f th e neck
an d s h af t an d overtopsas it were the root o f th e n eck , .

t importance asa
,

Thi sproces so f bone iso f the greates

,
 Femur The .

determin nt f srf e f orm s

a o in e its
u o ter s pe t is
ac merely c u a c

overed by s ert in thin tho gh s

,

c kin f t d , a tro g
, an c a u n ,

tendino sl yers It
,

u a be re dily f elt
. d its promi ca n a an

s
,

n e n ce a s istsin imp rting to the hip sth t width to whi ha a c

attention h slre dy been dir ted A s rule it orre

a a a ec . a c

sp ond s in p s
ition to the
o gre te s
t width f the m le g ure a o a

in thi s region ; mos t f req ently in the f em le the gr tes t u a ea

bre dth is t
a s omewh t lower level owing to the
a a a

en e f the s t neous
,

pres c ub
o f t wh i h tend s to umul te
cu a a c acc a

along the o ter d upper p rt f the thigh It isinto

u an a o .

the tro h nter m jor th t m ny f the m s

c a a leson erned a a o u c c c

in the m inten n e f th er t pos

a a ition
c in serted
o e ec ar e .

The s h f t f the thigh bone iss

a o een to be rved wh - cu en

vi e w ed f rom the s
,

ide ( Fig the onvexity f the u e . c o c rv

being dire ted f o w rd s Though vered with m s

c r a l sthe . co u c e

es ons
,

bone yet exer i s ider ble in en e on the f orm f

c a c a u c o

the limb d it isto thi sf o w rd r e f th s

, an h f t th t r a cu v o e a a

the ro nded f orm f the f ont f the thigh is

u in p rt d
o r o a ue .

On the holl w s ide f the o e i e on the b k f the o cur v . . ac o

bone the s h f t iss

,

, trengthened by the ddition f ro gh

a a o a u

ridge lled the li

ca sp Be s
ide simp rting
n ea ain re se d er a . a c a

rigidity t the b ne thi s

o ridge ds o extens ive tt hment
, a
'

or a ac

to m slesu c .

I f eriorly the lower end f the bone is

n exp nded form i ng o a ,

tw pro s
o ses lled th
ce ,d yl s Thes
ca e o ted with e co n e . ar e c a

a rticular cartilage an d enter into the f orm ation o f the knee

joint They will be more fully des
. cribed when the an a tomy

o f th at joint is con sidere d .

The pos ition o f th e thigh bone in th e limb isOblique

- .

Thi sm ay be ea s ily demons trated When we s tand in the .

military pos ition o f attention the kn ee s ar e clo se together ,

whil s t the upper extremities o f the thigh -bo nes ar e s

eparat e d
by the pelvic wi d th between the two acetab ul ar hollows .

A cc ording as the interval between th e headso f the thigh

b one s is increas ed or dimini s hed s o the obliq uity o f the ,
 The Femur .

Righ t thigh -b o n e ( fe mur ) .

Fi o . 124 . Fro n t view . FI G . 125

. Outer id e s . FI G . 126. Back vi ew .

a. H ea d .
f . A r t ic q sf
ur a ce o f co n d yl e s .

b Tro ch an te r ma o r j g I n te rc o n d ylo id n o tc h .

s
. . .

c . Tro c h an te r m i n o r . 11 . S u r f ac e fo r a ttac h m en t of gl u te u
d . N ec k.

e. E x ter n al co n dy le . i . I n te rn a l co n dy le .
 7718 H 225

of th e g reater obliquity o f the thigh bone in women it

-

f ollows tha t the angle f or med by the neck o f the f em ur

with th e s ha ft is lessobtus e than in the male .

Th e hip j o in t lies
- so deeply embedded on all s ides in es hy
mus cle s that it has b ut s li ght in u ence on the s urf ac e f orm .

It is only when the limb i s thrown as f ar bac k as po s s ible

that the head o f the f emur pus hes f orward the s of t p arts
which overlie it an d thus leads to th e obliteration o f th at
s
,

depres ion on the upper an d anterior

as pect o f the limb called the hollow
o f the thigh .

The s u rfac eso f the joint t s o

ad mirably th at atmo s pheric pres sure

alone i s su ci e n t to keep the s mooth

ro u nded articul a r hea d o f the f em ur

in contact with the hollow o f the

ac etabulu m . Thi sh asbeen demon
s tra e d experi menta lly af ter death by
t ,
3 3 2 33 6
1)
n
cutt i ng away all the m us
,
cle s
111 8 11
an d h ga th hi p j i t
e - o n

ments ; under thes e circum s tances

.

the Th th i k b l k li n
a. e c ac e.

art i cul ar surf ac e s o f the bone s sti ll pm

l gs -
t th
d ti
m
l
" 9

r e m a m e d i n con tact i ns
a c o ve r e ar cu ar

tead o f falli ng
b Th j i t
away as
e i o n ca v ty
one m i ght expect
. .

. Th l ig m t m
c, e a d en , u

ps
,

The s
,

f m i g th l
ocket o f the acetabulum f urther ,
th in
or

i f mid ;
n

te r
e ca u e

deepened by a l i gament wh i ch s
e or o

ur i s li d b m i
ne ! y ov e

st
ro und s i ts edge aff ord s a mple s
m mb e r an e r e pr e e n

, upport d by d
e d li s o tte ne .

to the head o f the f em ur through ,

which the weight o f the trunk i strans mitte d The jo int .

is a very s trong one This . is partly d ue asabove s tated

b ut i s
, ,

to the f orm o f i ts arti cu l ar su rf ac es al s o dependent

on the s
,

trength o f the ligamentsw hi ch bind the bones

together One f req uently h earso f di s
. locationso f the
s houl der joint b ut di s
-
, pl acementso f th e hip-joint ar e o f
much rarer occurrence an d ar e generally the res ult o f m uch

g re ater violen ce .
 I lz o y emo ra l n men t
'

a .

The caps ule o f the hip joint i s f ormed o f dens e brous

-

ti ssue In certain s ituation sit ismuch thicken ed an d

cribed as
.

f orms w e ll marked brous

- bandswhich are des ,

the ligamentso f the joint an d have received s p ecial

names The mos t impor tant o f thes e is one which pas ses
down in front o f the joint ; it i scalled the th o f emo r al
.

liga me n t or f rom its res emblance to an inverted Y ( A)

Thi si sattac hed to a part o f
,

the Y s
, ,

hap ed liga memt

- .

the ili um i mmediately above th e

ac eta b ul um ca lled the a n ter io r ,

i nf er io r i lia c s p i n e a n d s pre a d i ng ,

o u t i n f eri orly in a fan -s ha ped

m anner it is unit ed to the thigh ,

bone below along a rough line

called the s r a l line whi ch m arks
,

p i ,

the point o f fus ion anteriorly o f

th e n ec k o f the bone with th e
shaft ; s uperiorly thi s line is car

F or Di g m s h w
ried a ra
up along
o
the inner an d

nter or border th e grea t

.

f
.

i g th
n tt h m
e at f th ac a ien o O e
ili f m
o-e l lig m t
o ra troch anter
a en .
.

m m u
G rea t i mpo rtanc e attac he sto
b A nt i pin
a.

sp i ili s
.

thi s ligament becaus e it prevents

er o r u er o r ac e.

s
.

c. A i i f i
n te r o r ili pi n er o r ac n e.
,

exces s i ve extens ion backwar dso f

d Bi - of m e l lig m t
o ra a en

p b is
. .

th e thigh on the trun k ; it has

,

bi
5 fix ?

1 S
1 m
ac r u been already pointed o ut that
s is
. .

one o f the charac teri s ti cs

i T b hi m

u i
e ro t5 o t c n
o f man
. .

is th e f ac t th a t he alone o f al l f o ur-f ooted anim al s can

plac e th e thigh bone in s uch a po s - ition that the ax i so f

the limb fallsin line wi th the axi so f the trunk A n y .

f urther range o f movement i n thi s direction ischecked ,

howeve r by the tightening o f thi s

,
ligament .

It i s mainly owi n g to the pres enc e o f thi s ligamen t that

m a n ca n s tand erect f o r prolonged peri od swithout ex
p e n e n cm
g m uc h m us c ul ar f a ti g ue \ V hen we s ta n d u p .
 Mecha n is m of Er ect Po s tur e .

r ight th e line o f gravity p as s es

behi nd the axi s o f the hip -joint an d
the pointso f attachment o f thi s
ligament an d s , o in thi spos ition
that f orce i scons ta ntly acting in
s uch a m a nner as to keep the liga
ment tens e an d s tretched thus ,

mechani ca lly locking the j oint ; no

s pecial mus cu lar e o rt i s
'

required
to eff ect thi s pu rpos e hence we do
,

not s uff er f rom th e f atigu e w hi ch a

con s tant prolonged m us cul ar e ff ort

w ould naturally produc e .

Th e s tudent m ay s a ti sf y him s el f
as to the correctnes so f thes e obs or

v atio n s by m aking a little ex p er i

ment H e will nd th at he ca n
s
.

tand in the military pos ition o f

attention f o r a long time with
little dis com f ort an d f ati gue I f in
. .

thi s po sition the handsbe placed

on the buttock san d back o f the
,

thighsthe mus, c les o f thes e regions

will be f oun d accid or b ut s ,
lightly
contrac ted b ut i f the body be now m
'

Fi g 3 1 D 1 t ra o

bent f orward at the hipss as

s s
, . .

h w h w th o g o i e ur e
o,
h ld e t erec .

to throw the line o f gravity in Th hi k b l k li s t i

l s
ne n
ip l m s
e c ac

f ront o f thes e jointshe will nd th i di th p i

ca te
d Th
e r nc a u c e

s
, er e n co n ce rn e e ve r

it impos s
.

ible to m aintain f o r long d i ti ti l d t d l i

ca i di
is
ot e
d b
th
th
ne n ca te e

thispos ition without a s ens

r ec on ex e rc e y e

e o f th isf ll sb hi d th isf
f f g
o r ce i ty oN h t
rav . o te t a

On pas s
a e n e ax o

f atigue ing the hand along f i f th

r o ta t o n h i d i n
h s
p o e an
.

the b ack o f the thighs

f th t f th k
ro n t o t u
s
a o e n ee ,

a d over the d i s th l i mg te n t
f th sj i ts
n ren er n g e e a en

buttock s
o e ewh i h o n c ar e r e

he will now recogniz e th at pd ts g b y ,

d th te ur e
sp s s
re en on e

the mus c l e sar e

t d li o e i g i f ne t a n n ro n

po werf ully co n f th h ip (m - f m l) d
k (p s
o e o e o ra an
b h i d th e n t i e n ee o er o r
tracted par ticul arly in the former lig m t)
, a en .

Q 2
 Obliga ity f o the Pelms

vari ationsin thi sobliqu ity will obvious ly be as sociated

with alterations in the relative pos ition o f the pelvic girdle
to other p arts o f the s keleton .

A little cons ideration will enable the read er to realiz e the

impor tanc e o f the changesin f orm which ar e s econdarily
d u e to thi s The bac k o f the pelvi c girdle i s
. mad e up f o

the s ac rum an d the po s ition o f thisbone altersaccording

as
,

the entire pelvis is tilted f orward s or backwards ; th us

if tilted bac kwardsthe pos terior s urfac e o f the s

,

, ac ru m

( th a t p a rt o f it with wh ic h we a r e mo st c on c erned as a

determinant o f s urf ac e f orm ) will appro ach near er to the

vertica l whereasa f orward tilt o f the pelvi swill caus

, e
thi s su rf ac e to lie more obliqu ely the axis o f the bone
,

being directed more backward s .

But th e s ac rum f ormed as the reader i saware by the

fus ion o f s
, ,

everal s egmentso f the back bone is

,

- co n nected ,

above with th e movable pa rt o f the vertem col um n .

I f now the s ac rum an d with it th e pelvi sbe tilted ,

f or wardss o that the upper extre mi ty o f the s ac rum i s

,

thrown f urther forward sit f ollowsthat the boneso f the

,

vertebral column with which it isconnected m us

,

t be
s
, ,

bent forward too A sit ishowever nec es

. a ry f o r the ,

maintenance o f the erect pos ition without m us cu l ar f atigue ,

that the line o f gravity s hould p as sthrough the column

at c erta in points an d f all in denite rel ation to c ertai n
,

jointsit als
,
o follows that this f orward th rus t o f the entire
column mu s t be compens a ted f o r by the development o f

more s tron gly m arked curves Thi s iswhat takes place f o r

in pers
.
,

o ns where the pelvi c obl i quity i s great i e where the . .

pelvi si smuch tilted f orwardsa condition which as

,

h as
lar gely dependent on th e exis
, ,

been s a id i s , tenc e o f a s hort

ilio f emoral ligament th e curveso f the back par ti cularly
-
, ,

the lumbar curve ar e more s trongly m arked an d the

is more pronounced whereas
, ,

proj ection o f the buttocks in

individ ualsin whom th e pelvic obliquity is slight i e in , . .
230 Pelvic Ob liqmty .

pers ons who po s

ss
e sa long ilio -f emoral li gament the curve s
back ar e b ut s lightly emphas iz ed ashere th e
,

o f th e ,

Fro . 132 . FI G . 1 33.

Fig s 132, 133 s h o w th e i n ue n ce o f th e pelvic o b liq uity o n th e

ss
.
,

g u r e o f th e m ale an d f e m al e : I n Fi g 3 1 2 th e f e n 1a le p e lvi i ti lte d

s s
.

f urth e r f o rward th an in th e m ale Fig 133, a wi ll b e ee n b y n o tin g th e

s s s
, .

p o i ti o n o f th e a n te ri o r e x tre m ity o f th e il iac c re t ( an te ri o r upe ri o r iliac

s p i n e ) A s s a re u lt o f t hi s s
th e l um b a r curve i m o r e pro n o un ced i n
s s
.

Fig 132 th an i n Fig 1 33 Th i r eact o n th e o utlin e o f th e gure , th e

s
. . .

curve b e i ng m o r e pro n o un ced in th e fe male th an i n th e male .

neces sity fo r strongly marked compens d oes

atory curve s not
e Th es
ar i s . e factsm ay perhapsbe bette r understo o d by
 I nuen ce f
o Pelv ic Obli ui
q yt on Th igh . 231

re f erence to the accom panying diagram sFig 132 r epr e :

s e n ts
.

a f emale gure with well marked pelvic obliqui ty

-

an d prono unc ed cu rves in the back Fi g 133 isthat o f ,

.

a m ale in whom th e obliq ui ty o f the pelvi s is les san d

as a co n s equence the back app earsmuch atter than in
,

Fig 132 ( s
. ee al s o Figs1 19 120 p
.
, .

Thi s diff erence in th e pelvic obli qu ity reacts

,

on the f orm
o f th e thigh as well as on the trunk f o r i f the obliquity o f ,

the pelvi sbe increas ed the anterior s uperior iliac s pines

the te r ior end s f the ili ac cre st s will be thr st orw rd
( an o ) u f a

s o as
,

to lie on a plan e anterior to the plane occupied by the

s ymphys ispubi s Under thes
. e ci rcum s tanc esthe mos t ,

prominent border o f the thigh above wi ll corres pond to the

anteri or s uperior ili ac s pine an d th e anterior s ,
u rf ac e o f

th e limb wi ll s lo pe s lightly inwards an d bac kward s to the

s ymphys is pubi s ; where as when the se s ever a l bony points
lie in the s
,

ame v e r ti ca l pl ane or when th e anterior s uperior

ili ac s pineslie in a pl ane behind th at o f the pubic s

,

y m
phys isth e s u rf ac e o f the thigh between the s e two points
will be directed f orward sin s tead o f f orwar d s
,

an d inward s

as in the f ormer cas e Th e s

,

. a me thing m a
y be expre ssed
d iff erently by s aying th at in the f ormer condition the
pubic s
,

ymphys i si swithdrawn between the thighsan d

,

overh un g by a more prominent abdominal curve whereas

,

the s is lieson the s

,

u nder the l atter co ndition s ymphys am e

pl ane with the f ronts an d i s les soverhun g

,

o f the thigh s ,

by the abdominal curve

t will o f cours
.

The artis e be guided in h iss election o f

models by a ref erenc e to thes e pointsavoiding asf ar as ,

pos ible extreme conditionsan d recogniz ing th at the mos

,

s ,
t
ar e obt ained when the average is
,

pleas ing res u lts re re

p
s ented though he will not f ail to obs
, erve that in th e f emale
one meets with degrees o f ob liq uity which i f repres ented ,

in the m ale woul d be altogether o ut o f ch aracter with the

type H e may note as
,

.
, a more or le s sdenite rul e that ,
 Mo vementsat the Hzpj o znt . 233

i. e ondition o f f ull extens

in th e c ion Under thes e co n
d itio n s
. .

no change in the relative pos ition o f th es

e two parts
o f the bo dy h as taken pl ac e ; b ut i f now he exami ne s th e
condition o f the lef t hip he will ob s erve that the joint is
in a s tate o f ex io n an d it isthe combination o f e x i o n
o f th e le f t hip -joint with extens
,

ion o f the right thigh tha t

e nables hi m to pas sthe right leg behind the point through
whi ch the line o f gravity o f the body falls .

Fig 134 will at once m ake thi s

. c le ar .

Th e other movements which ta ke plac e a the hip joint

t -

ar e movements o f add uctio n

or cros ing the legsan d

,

s
or s
,

a bd uctio n epar ating the

legsR o ta tio n o f the entire
,

limb als o ta kes plac e at thi s

joint ; it i sthe movement
whereby we turn the point
o f th e f oot in or o u t Ci r cum .

d uctio n i sthe combination

in s equence o f the foregoing
m o v em e n ts e i th e r f rom with
,

in outwards o r f ro m without

inwards The s . everal move

mentsar e checked in mos t F
ins tan ce sby the ac tion o f
134 ro . .

ligamentsor els ,
e by the contact o f the neck o f the thigh
bo ne with the m argin o f the acetab ul um .

In cons idering th e m us cle swhich eff ect thes e movements

the read er mus t bear in mind one important diff erenc e
between the girdleso f the upper an d lower limbs In .

connexion with the f orm er we s tudied a number o f m us cle s

which p as sed f rom the trunk an d were ins erted into the
boneso f the s houlder-girdle ; by the ac tion o f thes e
m us c s
le the sho u lder -girdle wasmoved upon the trunk .

In con s idering the mus cul atu re o f the pelv i c gird le we

234 Gln ten sm
ax i mu s .

h ave no s uch group to examine as fo r reas on swhich

ewhere ( ante p 2 12) been f ully s
, ,

have els tated the pelvic ,

girdle i simmovably united with th e axial s

.
,

keleton o f
the trunk ; hence the ex amina tion o f the mus c les which
control the movements o f the hip m ay be at onc e pro

ce ed ed with

The glute us mawimus c le o f the b uttock h as

.

or great mus ,

ive origin from the pos

,

an exten s terior fourth o f the iliac

cre s t o f the ha n h bone f rom the apone uros
u c - iscovering
c le f rom the s
,

th e erec to r s pinae m us ide o f the lower part

o f the s ac rum f rom the s
,

ide o f the coccyx an d f rom th e

tretc h esf rom th e s
, ,

su rf ac e o f a liga ment which s ac r um

to the is chi um ca lled

, the gr eat s ac r o s
- cia tic liga men t .

A cons ideration o f thes e at tachments will enable the reader

to realiz e that the origin o f the mus c le co r res pond s pretty
accurately to the s ide o f the V s h aped interval at th e
-

roo t o f the bac k which s eparatesthe prominences

,

, o f th e

b uttocksbehind the upper an d outer limitso f which ar e

marked by the pres
,

ence o f little hollows or dimplesover

lying the pos ition o f the po s terior s uperior iliac s pines ( the
pos te rior extremitieso f the ili ac cres t) whils t the lower
ponds
,

an gle c orre s to the clef t between the buttocks .

From this a ttachment the bre s p as soutwardsfor wards

an d downward s f orming a thi ck es
,

hy s
,

, heet o f mus cle

ins
,

whi ch is erted in front into a broad tendinous aponeuro s is .

All the bres o f the u pper h alf o f the mu s cle together with

uperc i al bre s erted by mean s

,

the s o f the lower ha l f ar e ins

s is
,

o f thi s trong aponeuros into the dens e fas c ia whi ch run s

down along the outer s ide o f the thigh The bulk o f the .

bres o f the lower hal f o f the m us c le exc ept the s ,

uperc i al

ones a bove mentioned ar e attac hed by mea ns

, o f a a tten e d

tendon to a rough ridge ca lled the glutea l ri dge on the

, ,

back o f the upper third or fourth o f the s haf t o f the thigh

bone The l atter in s ertion isentirely concealed by the
mus
.

f ormer an d it is
, th e attachmen t o f th i s cle to th e fas ci a
 Gluten sm ax i mus . 2
35
of th igh wh ich givesris
th e e to the mos
t marked changes
in the su rf ac e f orm ( Pl ate s
V VI VII IX X IV pp 36 42
, , , , ,
.
, ,

44 7 ,
2 86,
hy bres
,

In the erect pos ition the es become tendinous

behind the line o f the great trochanter an d s haft o f the
thi gh bone s
~
o that the o u ter s
,
u rf ac e o f the great tro

chan ter i s merely covered by the aponeurotic ins er tion o f

the m us c le an d not by i ts eshy bres Thi s fact i s ea sily
demon s
.
,

trated by placing the hand over the trochanter when

in the upright po s ition ; under thes e co nditions the outline
an d f orm o f the troch anter can be re adily recogniz ed i r th er
if the m us cle be th rown into a powerf u l s
,

tate o f contraction ,

th e prominenc e o f the tr och anter will be s till more em

p h asiz e d by the ten s ion o f the apone u roti c l ayer s over it
an d th e con s equ ent hollowing o u t o f th e s urf ac e f orm behind

it caus ed by the retraction o f the es hy bres o f the m u s c le .

The upper border o f the mus cle de s c ribe s a cu rved o utline

upward sI ts
,

the convexity o f which is genera l direction is

.

i ndicated by a line drawn f rom a point a little in advance o f

the po s terior s uperior il i ac s pine downward soutward san d , ,

f or war ds to the tip o f the great trochanter The ou tline

c le i s
.

o f the lower border o f th e mus al so curved with

th e bend directed dow nwar d s ac ro ssthe back o f the thigh
,

pond sto the cleft

.

The h ighes t point o f thi sborder corres

between the buttockswhils , t itslowes t extremity reaches
a level corres ponding pretty clos ely to the middle o f the
outer s ide o f th e thigh ( i e the di s
. . tance from the iliac cres t
to the knee) ( Plates V VI VII IX XIV pp 32
, , , , 7,
2 .
, ,

The obliqu e direction o f the lower border o f the mus cle

is a m atter o f s ome immrtan ce as there h as been a tend ency

c ribe the dire ction o f the tr a n s ve r s
,

to as e f ur r o w of the b utto ck

or the glutea l f o ld as it is sometimes

,

ca lled to the in u enc e

o f thi s It will be evident th at thi s

,

border o f the m us cle

ca nnot be s
.

o as the direction o f the f ormer is tran s vers e

wh ils t the latter isoblique A sa matter o f fac t the
, ,

.
,
 Glutea l Fo ld. 2 37

th eth igh is abruptly s

eparated from the buttock by a well
dened furr ow caus ed by the overh an g o f th e gluteal
whils
,

region ( Fi g t in the l atter pos

ition the ow o f
the line o f the back o f the thigh iscontinu ed into the
.

Fro . 136 . Fro . 137.

o tour o f the buttock by a very open angle which mean s

c n , .

e that the f urro w which s

o f co urs eparated the two region s
now all b ut dis
,

h as appe ared ( Fig .

It sometimes happens that in the male the gl uteal f old

, , ,
238 The Butto ck .

in plac e o f being tin gle is double As such it i s only s

. een
when the limb is
,

f ully extended .

S uperiorly the di s pos ition o f the fatty layer over th e

gl ute usmaximus diff erent in the two s
,

is exes In women .

the fat formsa thick pad whi ch p as , s esover the ili ac

cres t in f ront o f the pos terior s uperior ili ac s pine ( i e the
terior extremity o f the iliac cres t ) an d thisbecom es
. .

po s
c ontin uou s with the fatty layer which covers
,

the back an d
s ide o f the ank In th isw ay the s
. ur fac e f orm so f

the ank an d buttock sar e ble nded in one uni form curve ;
we have no s uch denition o f the s e regions as we s ee in

the male in whom the ili ac cres t is more or les sapparent

throughout itsentire extent asa s f urrow (s
,

urf ace ee

Pl ate s V VI XVII pp 36 42
The f emale back is m uch les scut up by the indication s
.
, , , , ,

o f bony an d m us c ul ar s tructure tha n isthe mal e an d

,

plays a m uch s
,

dis
,

imp ler an d more rounded contour ow i ng

to the p eculiar dis pos
,

ition o f the s uperci al fat

A n teriorly the f at o f the bu ttoc k is dis

.

tributed in a very
charac teri s ti c way in the f emale It tends
,

to accumulate
.

in con s iderable quantity on the outer s ide o f th e thigh j us t

below the trochanter Thi scircums
,

. tance accoun tsfo r the

les smarked prominence o f the trochanter in the f emale
an d a ls o explainswhy the w idth o f the gure in the
,

f em ale is us ually greater at s ome little di s

,

ta n ce below th e
level o f the troch anters than at the trochanters thems elves
,

When pres ent here in und ue amount it impar ts a cl u m s

.

y
an d u n gainly appearance to the limb parti cul arly in certa in

itionsan d models play thi s

,

pos w hi ch di s tendency to an y
ma rked extent s hould be avoided A s
,

light i lln es show

.

ever below the trochanters is not unpleas ant as it imparts

,

a more ro unded f orm to th e limb an d gives

, ,

a better o utlin e

to the outer s ide o f the thigh

The gluteus
.

max imus mus c le is a powerf ul ex te n s or o f

the hip joint It s
- . tra ighten s the thigh o n the tr unk when
 A ctio n sf o Gluten sm a ximus . 23
9
th e hip joint i s
- be nt It acts
. i n one or other o f two w ays
or by a combin ation o f both Thu si f the thigh be exed
.

on the trunk thi smus c le extend s the thigh -bone at the

hip joint or i f the trunk be bent forward on the thighsas
-

is ts
,

in the s tooping pos i tion it as s in s

,

traightening the gure

The m us
.

c le i s thrown into a pow erf ul s

,

ta te o f contraction
in s uch ac t io n s as s p rin g ing le aping ri s ing f rom a ch a ir or
r unning up s tairs
, ,

or up an incline It als
,

.o comes i nto pl ay
in s ome o f the movements o f abd uction an d add ucti on an d

li kewi s e ass ists

,

in external rotation o f the thi gh .

The gluteusmaxim us m us c le in m an h as att ained a ve ry

r em ark able development an d is , as h as been j us t s hown

largely concerned i n s
, ,

traightening the body The gure .

,

when once erect can be held in that pos ition fo r length ened
p eriod s
,

by the mechanical locking o the hip j o m t without

f -
,

an y m arked volu ntary effort though a certai n amount

cu la r contraction is neces sary to s
,

o f mus teady th e joint

ertion o f the gluteusmaximus
.

Th e importa nc e o f the in s
m us cle into the f as c i a o f the ou ter s ide o f the thigh mus t
n o t be overlooked As will be des c ribed here a f ter this
esdown to be
.

fas s
,

c i a form s a thi ckened b a nd whi ch p as

attached to the bone s o f the leg below the knee Through

esan
.

th i sp roces so f fas ci a the gl uteus m ax imusexercis

in u ence in s u pporting an d s te adyi ng the knee when that
joint isextended ; an d its action in the m ale at leas t is
demons trated by itsin uen ce on the s u rf ac e f orm s
, ,

a long

th e o u ter as p ect o f th e thigh ( Plats VII IX pp 44 .

,

o f the pelvi s
,

The relation o f certain bony parts

,

an d thigh

bo ne to the m us c le v ar i e s according to the po s ition o f the limb .

Of thes e the mos t important f rom th e pres ent s tan dpoint ,

the relation o f the tr o cha n ter maj o r to the es

,

is hy an d
tendinous partso f the mus c le In the erect pos ition the
is
,

apone uros
.

trochanter is covered merely by the tendinou s

o f the m us c le b ut i f the thigh be exed upon th e tru nk the

backward s u nder cover o f the es hy bres

,

trochan ter glides .

 I lia-
tib ia l Ba n d . 24 1

thigh b ne an d reac h abo ut three inch es

- o below it A t thi s
c le becomes blended with the s trong f as
.

point th e mus
,

ci a

which form sa band alon g the outer s

,

ide o f the thigh

Pl ate s VI I V I II IX X IV XXII pp 6 6
( 44 2 7 2 1 0

The reader will remember that the gluteus max im us h as

.
, , , , , , , , ,

an extens ive ins ertion into thi sproces so f fas ci a The

heath o f brous
.

m us cles o f th e thigh ar e inves ted by a s

m embrane much in the s a me w ay as the limb iscovered
by a tightly tting s tocking This s heath ismuch thi cker
.

along the ou ter s ide o f the l i mb an d it is thi s thickeni ng o f

the fas c i a whi ch f orms
,

the band called the i lio ti bia l ba n d

-

m ay be regarded as
.

Thi s the conjoined attened tendon o f

the gluteus maximus an d ten s or fas ci a e f emori sThe f o r mer

is t the latter is
.

ins erted into it above an d beh ind whil s ,

atta ched to it above an d in front Inf eri orly th e ilio

tibi al ban d pas s
.

esover the outer s ide o f th e knee joi nt -

an d i s ins erted into th e external tuberos ity o f the tibia

one o f th e bo nes f h e leg ) In thi s the two m s le s
( o t w a
y u c

e an important inu enc e in s

.

above des cribed exe rc is up

porti ng the kne e joint in the extended pos

- ition ( Pl ates
VII VI II IX pp 44 62
, , .
,

From the fac t that the upper end o f thi s

, ,

band is connected

with a m us cle in f ront as well as beh ind it follo ws th at th e

traction exercis ed by the combined action o f the mus cle s is
kept in the direct line o f the thigh
S uperiorly the gluteus
.

maximusan d the ten s or fas ci a e

ar e s
,

f emori s eparated by a V-s haped interval the an gle o f

which corres ponds
,

to a point two or three inches below the

grea t trochanter The s . ideso f the V co rres pond t o the
po s terior border o f the ten s or fas cia e f emori sin f ront
an d the u pper bord er o f the glute us m axim usbehind
,

S uperiorly thi s tri angular area islimited by the curved

.

m argin o f the ili ac cres t Thiss . urf ac e i s overlain by

a fas ci a whi ch s tretches over it from the gluteus maxim us
behind to the ten s or fas Under cover o f thi s
,

, c i a e in fr ont .

11
242 Gluten sm d i s e a .

fa si
c a , an d occupying the whole o f the inter val des c ribed i s

a nother o f the glu teal gro up o f m us

,

c le s ca lled th e glute

med i us s
,

( Pl a te VII IX X I V XXII
, pp 44 7 2 1 06 , .

The gluteus I ts
, , , ,

medi usi s a fan s haped m us

,

c le s-uperi or .

at tac hment i s spread over the outer s urf ac e o f the ili ac

e xp a n sion o f the h aunch bone extending from near th e -

pos
,

terior s uperi or ili ac s pine beh ind to the anterior s uperior

iliac s pine in front Inf eriorly th e bresar e gathered

.
,

into a attened tendon which is ins erted into an obliqu e

line running down wa rd san d f orwardsacros sthe outer
s u rf ac e o f the grea t troc h anter As th isattac hment lies .

below an d between the anterior an d pos terior originso f

the mus c le it followsthat th e anterior bres pas sdown
t the pos terior p as sdow nwards
,

ward s an d b ac kw ard s whil s

to this
,

an d f or ward s in sertion .

h as a id o ccup i e s as uper c i al po s
,

The m us c le as been s ition

or fas
,

in the interval between the tens c i ae f emori s

,

an d th e

gluteusmaxim usb ut it i sp artly overla in both in f ro nt

,

an d behind by the s e mus c le s .

The gluteus medi usisa powerf ul abductor o f the thigh ,

i e it drawsthe limb away f ro m the middle li ne o f th e

eparation o f the legsasin s
. .

body caus ing the s tand i n g

s tride legs Th e action o f the mus c le is till better s
,

- . s een
if the leg be rai s ed f rom the ground ; aga in we bri ng it ,

into play i f we s ta nd on one leg an d incli ne the trunk

to th e s ide over the s upporting limb The mus cle v aries .

in itsaction according to the part us ed I f the anterior

bresco ntract they will ac t asrotatorsinwardso f the
.

teri or breswill as s is
,

thigh whil s t the pos t in turn in g

the thigh ou tw ard s It plays
,

an importa nt p art in the act

.

o f w alking a s it support s th e t r unk on th e limb whi ch is in

conta c t wi th th e grou nd d u ring th e tim e th at th e Op po s
,

ite
f o ot is up l i fted .

The s u rf ac e f orm s o f the b uttoc k v ar y m uch according

ition o f the limb Ashasbeen already s

,

to the pos . tated ,

244 Surfa ce F ar m sf
o Butto ck .

brea ksup into two lineso ne o f wh ich curves down wards

t the other i s continu ed upwards Th e ange f o r
,

whi l s .
l m ed
'

by thes e two lines overlies the pro m inenc e o f th e ante r ior

s uperior iliac s pine ( s e e Pl ate XXII Fi g 1 p

In th e
ition o f the li mbswith the mus cl es
, . .

f ully extended po s
,

in
a powerf ul s ta te o f contrac tion a well marked h ollowl i es
,

behi nd the tro cha nter major Thisisowing to the tight

,

ed by the contraction o f th e glute us

.

o n ing o f the fas c i a caus

m aximus I n front this h ollow is

,

.
,
bounded by a roun d ed
elevatio n which pas s esf rom the anterior extremity o f th e
ili ac cres t downward s an d s lightly backwardsto th e front
ed by the pres ence o f the es
, ,

o f the troch anter ; th is 18 ca us hy

bres o f th e ten s or fas c i a e f emori s ( Pl ate s V I I IX pp 44 .
,

t part o f the hollow corres

, ,

The deepes pondsto th e angl e

f ormed by the tens or fas ci ae f e m oris an d the gluteus
maximus The hollow is rounded o ff above by the s u rface

hy part o f th e glu teus medius

.

elevation produc ed by the es ,

which as , h as been s a id i s s uperc i al as

,
it li es in the interval
between th e tens or an d the gl uteus m ax im us Wh en th e .

thigh i sexed th ishollow appea rsasa well mark ed -

furrow th e lower pa rt o f which runs

, down along the oute r
s ide o f the limb behind the trochanter an d upper p art o f
the s h aft o f the thigh -bone whi ls ,
t the upper an d curve s
upwards ro und the end o f the trocha nter following th e
d irection o f a line towardsthe middle o f the i li ac cres
,

t ,

mid w ay between wh ich an d the trochanter it gradually

fa des a way The anterior border o f th is f ur row i s the more
pronounced an d depend son the contrac tion o f the ten s
.

or
o f the gl u te us
,

f as c i a e an d a nterior bres mediuswhich ,

f o rm a well -m ark ed elevation on the a nterior h alf o f th e

outer s ide o f th e limb ; in f orc ed contraction o f thes e

mus c le s the ir outlinesar e s till f urther dened by a f urrow

w hi ch li es between them ( Plate XXI I Fig 1 p . .

tuden t mus
, ,

In dealing with thes e d eta ilsth e s t not ov er

look the fact that great mus cul a r development an d a gr ea te r ,
 The Femur .

Righ t t g b o n e ( f e mur )
h i h - .

Fm . 1413 . Fr o n t vi ew . Fro . 14 1
. Outer id e s . Fro . 142 . Back vi ew .

a. H ea d .
1 A r ticula r
. sf ur ace o f co n d yl e s.

b Tro ch a n ter m a o r j g I n te r -
co n dyl o i d n o tc h

s
. . . .

c. Tr o ch a n ter m in o r 11 S ur f ace f o r a ttach m en t of l

g ute u
N
. .

d . e ck .

0. E x te rn al co n d y le. i . I n te r n a l co n dyle .
248 Bo n esof the Leg .

erect pos ition it follows that the li ne o f th e th igh bon e -

very n ear ly corres pon dsto that d is p layed i n th e abov e

exp eriment
terior as p ects
.

The anteri or inf erior an d pos ,

o f the co n

d yles
,

ar e s mooth an d in the rec ent condi tion coated with

The inner s
,

arti cul ar cartil age u r face o f the i n ner condyle

rounded an d promi nent an d p roj ectsfrom th e li n e o f

.

is
the s haft more than doesthe outer the extern al s
,

urfac e

whi ch i ss omewhat attened an d les s prom inent

,

of

Towards the h inder part o f the outer s

.

urfac e o f th e extern a l

condyle there i s a well ma rked groove i n whi ch th e ten don

-

o f a m us cle i s lodged .

The condyleso f the thi gh bone are imp or tant deter

-

min antso f s urf ac e f orm The s iz e o f the knee depends

ition is als
.

upon their developmen t an d to their d i s po s

.

,
o d ue
the rounded proj ecti ng f orm o f the joint o n th e inner
s ide ascompared with th e atter app earan ce along i ts
outer as pect .

The boneso f the leg ar e two in nu mber ; th ey ar e

plac ed s ide by s ide an d s o r mly un ited to each oth er

by li gam en tsthat an y movement between them i s

,

ren
dered impos sible They diff er very m uch in s iz e ; th e
hi n -b o n e i s
.

inner ca lled the ti b ia or s by far the s to ute r

tronger o f the two It alone enters
, ,

an d s into th e f orma
upport s
.

tion o f the knee joint an d s - th e entire weight

The bula whi ch i s
,

o f the tm n k an d thi gh above . a long

lender bone lies along th e ou ter s

,

s ide o f the tibia to whi ch

it i simmovably uni ted by jointsan d ligamen ts The
, ,

bula bearsno s
.

har e in th e articu lation o f the kne e b ut

along with the tibi a enters
,

into the formation o f the an kle

joint Th e h la is
. of s mall s ervi ce as a means of s upport

hesa b on y attachm ent fo r many o f th e mus c les

,

b ut furni s
o f th e leg As regar ds th e f orm o f thes e bon esthe ti bia
ays
.

s a s
,

( or inner bone ) d i p l h a ft with two ex p anded ex

tr emi ti e s ; the u pp er e n d w h i ch s
,
u p port s th e co ndyle s o f t he
250 The Tib ia .

Bo th tuberos itiesproj ect bac kwardsf ro m the li ne o f

the s haf t to a s light extent ; their upper s u rf ac es

f orm two s omewhat rounded or oval areass ,eparated

in the middle li ne by a well marked proc es - s ca lled the

sp i n,e w h i ch p r oj ec t s upw ar ds an d o cc u pie s the n otc h

between the condyleso f the f emur when that bone isin
os itio n ; it i s u po n the upper s u rf ac es o f the s e tuber o s i
p
tiesthat th e condyleso f the f emu r res t in the vario us
pos itions o f the limb Whils t th e trans vers e w i dth o f the
tuberos itieso f the tibi a eq ualsth at o f the condyleso f
.

the f emur it will be noted that the meas urement o f th e

tuberos itiesf rom before bac kwardsismuch les sthan

,

the corres ponding d i ameter o f the f emoral condyles A t

s
.

ome li ttle d i s tanc e below a n d in f ront o f the tuberos ities

o f the tibi a th e s tudent will notice a proj ec tion call ed
the tuber cle of the tib ia Thi s . proc es siso f importance as ,

to it i s a tt ached th e powerf u l ligament the li a men tu m , g

p a te lla,e whi c h i s co nne c ted a bove with the p a te lla or
knee p a n the latter a attened bone o f nearly ci rcul ar f orm
-

which li es
,

in f ront o f the knee joint - .

The s haft o f the tibia i s somewhat tri angular in s ect ion

three margins Of thes e the anteri or forms

,

an d thu s h as .

a prominent s harp border whi ch can be traced f ro m

,

the tubercle o f the tibia downwar dswith a gentle

c urve inw ard s
,

, towardsthe anterior s u rf ac e o f the pro

j ec ti on on the in f erior extr e mi ty o f the bone whi c h

f or m s the prominence o f th e inner ankl e Thi sridge .

wi th which eve ry one i sf am iliar under the n am e o f

,

th e s ki n i s sup erci al th ro ugho u t i ts entire length i e . .

kin an d s u perc i al f as
, ,

it ismerely covered by s cia . The

s urfac e o f the s haft o f the bone immedi ately to the inner
s i de o f the s h i n iss mooth an d rounded f rom s ide to s ide ,

a n d it m a be t rac ed f rom the inner t ub e ro s

ity a bove to
y
the inner ankle below It i s wides ts uperiorly narrow e s t
toward s
.
,

the middle o f the s h aft an d expands

, again s lightly
252 The Fibula .

of th e tibia ; in th e upp er pa rt o f th e leg it liess ome

what behi nd th e tibi a whi ls t below i ts i n f erior extr emi ty
is plac ed d irectly to th e outer s
, , ,

ide o f the expand ed en d

o f the s hi n -bone The endso f the bone ar e enl arged
th e upper i tshead the lower the ex te r n a l
.
,

a n d f orm

ma lleo lusa proc es swhi ch caus esthe prominence o f th e

, ,

outer ankle .

The upper extremity o f the bula i san irregular

rounded proc es so f bone fr om whi ch pas ses a s hort up ward
tylo id p r o ces sin front o f which
,

proj ection ca lled the s

the s trong external lateral ligament o f the knee -joint i s
,

att ached On the inner s

. urf ac e o f the exp anded h ead i s

a s mall s mooth circular s urf ac e ad apted f o r ar ti cul a tion

ponding s
, , ,

wi th th e co rres urf ac e a lre ady des c ribed on the

under s urfac e o f th e overh a nging extern al tu be ro s i ty o f

the tibi a Thi s joint permi ts o f no p erc eptible movement

urrou n d ing liga men ts

.

the bonesbeing rmly u nited by s

,

S it ua ted as
.

thi sar ticu lation isbelow the level o f th e

kn e e j oint it f ollows that the upp er end o f th e bula does
,

not s hare in the f ormation o f th at joint an d isi n no

,

wi s e co ncerned in s upporting the co n dyles o f th e f em ur .

Th e s tudent will do well to determine in hi sown p ers on

th e prec i s e pos ition o f th e hea d o f the bula If he f ollows
tring when the knee is
.

the direction o f th e outer hams ,

bent thi swill lead hi m to th e h ead o f the bula whi ch

he will recogniz e asa rounded knob o f bone lying j us
, ,

t
below the level o f an d behi nd th e joint on the outer s ide .

Thi s warni ng i sneces s a ry as mos t s tudentswh en as

, ked ,

to pl ac e the nger on th e hea d o f the bu la co mmit

ta ke o f poi n ting to a s
,

th e mi s po t in advan ce o f th at
really occupied by the bone Thi spa rt o f th e b on e
outer an d anterior as
.

is subcuta neou s on i ts p ec t where i t

uperiorly it h as
,

is unco ver ed by m us c le ; s attach ed to

i t the ex tern a l la tera l ligament o f th e knee joint w hil s

- t
tri ng viz th e tendon o f the biceps mus
,

th e outer ha ms ,
. cl e
 The Pa tella . 253

of the thi gh pas ,

s es down to be in s erted into it The .

lower p art o f the s haf t an d the inf erior extremity o f

the bone will be further ref erred to in connexi on with the
des c ription o f the leg an d ankle .

The kn ee-j o i n t i s the larges t joint in the body By i ts .

great s i z e it afford s a deq ua te s upport f o r the weight o f

the trunk wh i ch i stran s m itted thro ugh it Th ree bones

.

enter into i ts f orm ation the f emur the tibi a an d a bone

hi therto des
, , ,

not cribed ca lled th e p a te lla When we.

s tra ighten the knee an d no longer contract the mus cle s

,

thi slas
,

o f the f ront o f the thi gh , t may be f elt asa

mov able d i s k lying in the loos e ti ss u es in f ront o f th e
joint I f h owever we contract th e mus
.
, , cles o f the f ront

o f the thi gh or be nd th e knee the p atell a can n o longer

be freely moved b ut i sf elt lying in clos

,

,
e contact with
th e lower end o f the thigh bone a n d p racti ca lly xed in
-
,

p os ition.

The patella con s is tso f a dis k o f bone the anterior

s u rf ac e o f whi ch i s rounded f rom s ide to s ide an d s lightly
fr om above downwa rds ; th e deep su rf ac e o f the bone i s
a d ap ted f o r arti cu l a tion with the condyle s o f the f em ur ,

on whi ch it gli desason a pulley The margin o f the .

di s k va r i e sin thi ckn es s ; in f eriorly it i s somewh at pointed

a n d h as
,

connec ted with it a s trong li gament called th e ,

liga men t of the p a te lla by mea ns ,

o f whi ch the bone i s

connec ted inf eriorly with the tu be rcle o f the tibi a Th e .

patellar li gament cons is tso f a thi ck broad band o f non

elas ti c brous ti s
s ue s o th at wh a tever the pos
, ,
ition o f the
li mb may be i f th e ligament i s drawn tight by the co n trac
tion o f the mus
,

c le s whi ch ar e attac hed to the patella the ,

di s tance between the lowes t point o f that bone an d

the tu bercle o f the tibi a never va ries In the extended .

pos ition o f the joint when the mus cle s ar e in ac tion

the lower border o f th e patella lies

, ,

abo ut one inch above

th e arti cular s ur f ac e o f the tibi a ; when the m us cle sar e

 254 The Kn ee-jo in t .

relaxed the bone s li psto a s omewhat lower l evel an d

the s train being ta ken o ff the patellar li gament becomes
, ,

la x The reader may demon .

s trate thes e f acts f o r hi m s elf

by s tanding erect an d alter
na tely contracting an d relax
i n g th e m us cles o f the thi gh ,

wh en the kne e pan will b e

-

s een to move accordi n gly .

Th e upper border o f th e bon e

is thi ck an d here as well as
idesare attach ed
, ,

at the s

the powerful es hy mus

,

cles

whi ch form the extens or

g r o u p o f the f ront o f th e

thi gh .

The p atell a playsan i m

portant part in the mo delli ng
F o 147 Th
r b sf th e Of the f ront Of the
one o e ex knee .

A ppli ed as it i s
. .

t d d igh t k
en e r f t i w n ee , ro n v e
to the lo wer
.

end o f the f emur it mas ks ,

Fi b l
at m
u a.
t h e f orm o f the c ondyle s i n

fr on t an d lls up the s
,

E t
6 l x dy l f f m
e rn a co n e o e ur . h allow
s
,
1 I t. l
a H d f b l
n d l f f m
e rn a co n

g
y
roove
e o
t
e
h s
ur .
ep a ra te them
a nteriorly a n d in f eriorly s
. ea o u a.

p P t n k
a e - t or n ee an .
p , o

s
,
1 Lig m t f th p t ll
a en o e a e a.
th t ev n whe the joint
.

a T m f hi a e n i,

exed it givesa rounded

u , o ,

appea ra nc e to the f ront o f the knee .

The knee -joi nt i s exceedi ngly complicated in the arrange

ment o f i tsarticular s u rf ac es an d the ligamen ts whi ch
strengthen it It i snot neces s a ry f o r pres ent p urpos es

to enter in to a deta iled account o f thi s

.

a rti cul a tion except

th ey res
,

to mention th a t the condyles o f the f em ur as t

itieso f th e tibi a are
,

on the upper s u rf ac e o f the tu bero s

supported by pads o f ca rtil age o f a s

,

emilun ar form whi ch ,

 The K n ee o in t
'

256
y .

an d stt hed t the s

i a h ft f the b on j s
ac t below th t
o a o e u a

s Th extern l l te l lig ment whi h is f

pro es
c . e a a ra a c o a

ro nded ord li ke form i sonne ted bove with the o ter

,

u c - c c a u

srf e f the extern l ondyle f the femu d istt hed

,

u ac o a c o r , an a ac

below to the head o f the bula .

Th e cap sule po steriorly i sformed by a bro ad mem

bran cone band ca lled the p o s ter io r liga me n t whi ch i s
, ,

united above to the f emur a long the upper edge o f th e

notc h between the condylesan d i sattached be low to th e ,

posterior margin o f the upper extremity o f the tibi a .

Fro 1 50 Th e b o n e o f th e b en t s FI G 15 1 s
Th e b o n e o f th e b e n t
s
. . . .

righ t kn ee , o uter i d e . righ t k

n ee , f ro n t vi ew .

a. Fe mur . i . I n te r n al co n dyle o f f emur .

b . Ti b ia .
p Pa te lla
. .

lLigam en t o f th e pa tella
.

3. E x te rn al co n dy le o f f em ur . .
-
t Tub er o le o f ti b ia .

In f ront the joint i senclos ed by a thi n caps ule with

whi ch the ligament o f the p atella i sinco rporated whi ls t

expans ions
,

a d dition a l upport i s
s aff or ded by tendi nous

f rom the m us c leswhich ar e ins erted into the s

,
id es o f th e

patella
will enable the read er to unders
.

A glance at the bones ta nd

th at th ere i s
one p art o f the a rticular s u rface o f th e f emoral

condyle s which n ever comes i n to contact with th e tibi a o r

 Mo vemen ts K
'

of n ee o in t.
y 25 7

s
emil u n ar cartilagesfo r i f the bones be pl aced one on th e
top o f the other asin th e extended pos
,

ition o f th e li m b
a co n s iderable arti cular s
, ,

ur fac e i s di s
played on the front o f
the condyl e swhi ch li e s above the lev el o f th e ti b i a It i s .

ts
,

on thi s tha t th e p atella res in extens ion W hen th e joint

.

is b o u t the f e mora l condyl e s hi nge an d roll on the upper

s urf ac e o f th e tibi a an d on the s emilun ar ca rtilaginous p ad s
a f ore -des c ribed in s uch a m a nner th at in extr e me ex i o n

their hi nder s ur f a c e s res t on the upper s urf ac e o f the ti b i a ,

whi ls t th e s urf ac es o f th e condyl e s w hi ch w ere previou s ly

in contact wi th th e tibi a in th e exte nded pos
,

ition ar e ,

now t urn ed forwards ; they a r e th u s bro ug ht into c on ta c t

with the deep s ur f ac e o f the p a tella whi ch cannot s hi f t
i ts pos ition owi n g to i ts
,

connexion wi th the t ubercle o f th e

tibi a by the patellar ligament Thuswhils

,

. t in extens ion
the patella res ts on a p art o f the f emora l condyles
,

p eculi ar
to its el f it pas s esin ex io n to re s t on portionso f the
condyl ar a rti cul ar s
,

urf ac es w hi ch were prev ious

,

ly in co ntact
w ith th e tibi a an d s
,

emi lunar pad s

The chi ef movemen tso f the knee ar e thos
.

e o f ex io n
an d emten s io n Flexion is
. limite d by the back o f the calf
coming into con tac t with the b ac k o f th e thigh E x te n s ion i s
.

chec ked when th e leg i s bro ught i n line w i th th e thigh by ,

ext ended or s
,

the action o f c ertain ligamentsIn thi s . traigh t .

pos ition o f th e knee it m ay be s a id th at a ll th e li gam e n ts

o f the joint a r e in a s tate o f ten s ion except one o f th e

,

cr uci al ligamen ts a n d the p art o f th e cap s ule i n fr o n t o f

the j o i rit th e pri ncipal ligam ent o f w hi ch th e ligam e tum n

e according to the s
, ,

patella e m ay or m ay not be tens ta te o f

contraction o f the m u s c l es
,

on th e front o f th e thi gh By .

thi s mean s the joint i s m ech ani ca lly lo o k e d s o th a t little or

.

no m us c ul a r eff ort i s n eces s ary to e n able us to s tan d e rec t

wi th the kneess trai gh t Th e ex p lan ation o f th i si sth a t

.

under thes e condition s th e line o f gr avity f al ls i n fr ont o f

the axi so f rotation o f th e joint an d thi sforce kee psth e
s
,
 L o ck ing of the K n eeyo in t
'

258 .

ligaments tens e thereby m ec hani cally locking the joint an d

,

preventi n g an y further movement o f extens ion Th e reader .

m ay con vinc e hims elf o f thi s in one or other o f two waysI f .

the body backwar dss

,

when s tanding erect he s ways o th a t ,

the line o f gra vity falls

,

behind the axi s o f the joint he will

elf f rom falling by the exerci s

,

only be able to prevent hi ms e

o f very violent m us c ul a r eff ort an d he will re a li z e th at th e

m us c le s n into a s
,

o f the f ront o f the thigh a r e th r o w tate o f

powerf ul contracti on ; b ut i f the body be aga in s wayed
f o rwa rd s,
o as to bring into action the ligamentsafore
mentioned no mus c ul ar eff ort i s nec es s a ry to mai ntain the

joint in i tsexte nded pos hy mas so n

,

ition an d the es
the front o f the thigh may now be f elt s
,

oft an d relaxed .

Or again an admirable demons tration o f the mechani ca l

prin ciplesinvolved i saff orded by the s
,

choolboy tri ck o f

knoc king the knee sf rom under one The victim n u

c ious attac k upon h i s
.
,

con s a t the time o f a n

y su ch s ta bi lity

in a s
,

is s tan d i n g up r ight with hi s mus c les ta te o f relaxa tion

when the blow i ss truc k b ehi nd the knee Th e joi n t .

is then held i n the extended po s ition by the tens ion o f

the ligamentsonly ; the force o f the blow however
a n d th us esthe
,

knoc ksth e knee s

,

uddenly f o rw ard s caus

line o f gra vi ty to fa ll behind the axi s

,

o f the joint w it h ,

the us ua l r e s ult th at b e f ore th e s

, ubj ect o f the experi ment

h a st i me to recover hi m s
,

e lf by bringi ng into p lay the

powerfu l mus c le s whi ch control the joint he f a llsto ,

the grou nd .

The degree o f extens ion o f the joint depend slike tha t ,

o f the hip on th e l e n g th o f i ts
, li ga m e nt s Under ordinary
.

condi tio n s th e se ar e s ui ci e n t ly long to p e rm it o f th e leg

a n d th i gh be ing bro ught i nto th e s a me s trai ght line ; ex

c e pti o n a lly w h e n thes e ligaments ar e longer th e joint m ay

o th a t th e f ront o f th e leg f orms

, ,

be mo r e f ully extended s
wi th th f ro nt o f th e thigh a s
,

e li gh t a ngle w ith a cor re

s s s
,

p o n d i n
g c ur ve a long the b a c k o f the limb A B.r ii c ke h a
260 o r Mus
Ex ten s clesof Th igh .

of the gro ps f m s ulesj ust mention d ; th t in f ro t

o u c e a n

cont ins the t s g p th t behi nd the

a ex en o r m s
ro u l s,
a ex o r u c e ,

whi ls
t the intern l omp rtment i s o pi d by the d d
a c a ccu e a ao

t s The m s
or , lesf the t s g p or thos
u c o e whi h ex en o r ro u ,
c

li e a long the f ront o f the thigh ar e f our in number v i z ,

.

the cr u reuso n either s

,

ide o f which ar e the vaeti na med

i n te r n a l a n d ex te r n a l accord ing to th eir p o s
,

ition whi ls
,

t
s
,

s s
,

s upe rci a l to all i s the r ectus f e m o r i A l l the s.e m u c le

erte d into the p a tella a n d ar e of tentimesref er red
,

a r e in s

s
,

to as the q ua d r i cep ex te n so r on acc o u ,nt o f t h e f ou r -he a d e d

a rra ngement o f their e s hy mas s .

For pres ent p urpos esit will be mos t convenient to

des c ribe the m us c le as co n s is ting o f two p a rts a s upe rc i a l

a n d a deep ; the l a tter inc l udes the cr ur eusW i th the vas ti ,

one on either s ide o f it It is . u nnec e s sa ry to cons ider th e

details o f the a ttac hment o f th e s everal pa rtso f thi s es hy
m as s ; it i s suf cient to point o ut th at it c lothes th e
f ront a n d s ideso f the thigh bone exten d i n g ashi gh as -
,

the bas e o f the outer s ide o f the great trochanter an d

f ollowing inw ard s a n d downw a rd s
,

f rom th at poi n t th e
s p ir a l line w hi c h s weep s a c r o ss the u pper p ar t o f the thigh
bo ne from the root o f the great trochanter externally to
pera or rough ridge which pas
,

the lin e a as s esa long th e

pos terior as p ect o f the s haf t o f the bone Inf er iorly thes . e
m us c le s ar e in s erted i nto th e s id es an d upper border o f th e

pa te lla The ar rangement o f the es

. hy bres is s uch th at

the whole length o f th e outer s ide o f the s haf t o f the thigh

b o ne reachi ng asf a r back asth e lin ea as
,
pera is covere d ,

with a thi ck es hy l ayer whi ch imp art sto the outer s ide
o f th e thi gh i ts ro unded conto ur an d owing outli ne whils t
i nte r n a lly the s h a f t is
,

clothed by th e va s t us i n te m us whi ch
w eep s
,

a ls os round the inner s ide o f the b o ne to th e rough

ridge on i tspos terior as pect Thispart o f the mus . c le

as sume s i ts gre ates t p ropo rtionsin th e lowes t q ua rter o f

t h e thi gh where i ts
, ro unded s urf ac e not only im par ts
 The Va tz s
'

a sst the fr nt f the thigh in thi ss

f u llne it tio o o o ua n,

b t lso i en sthe o tline f the inner s

u a ide f
n u ce u o o

the limb where it isoverl in by st p like m s le a a ra - u c

lled the st i swhi h here p s sesdown lo g its

,

ca ar o r u , c a a n

inner side ( Fig .

There is h r teri s ti diff eren e in the w y in whi h a c a ac c c a c

the l ter l po tionsf thises

a hy a r o

m s s onne ted with the

a ar e c c

p tell The o ter p rt or s

a a t s. u a va u

wt m sp s
,

e sesdown t be t
e u , a o a

t h d to the o t r s
ac ide f the
e u e o

upp er border o f the patell a f rom ,

whi ch it s endsa general ex pan

s ion over the anterior pa rt o f the
ca p sule o f the knee Th e va s tus .

i n tem us on the other hand reaches , ,

a m uch lower level on the inner

s ide o f the thigh an d is ins erted ,

FI G . 1 52 . Fr o n t vi ew o f th e m u sl s f
c e o

th e righ t th igh .

a. Te ns f si f m is
or a c ae e or

V s t s t
.

b a u ex e r n al

R t s f m is
. .

c ec u e or

V s t s s
. .

d a i t
u n er n u

S t i s
. .

c ar o r u

d ili us
. .

f Pec an a n ac

s
. .

g P ti
ec n eu

l g s
. .

h Ad d tuc o r on u
ili s
. .

t . G rac .

i Pa t e lla
. .

k . Tu b e r c le of ti b ia wi th l igam en tu m pa te l lae
atta c h e d .

l R i o -t ib ia l b an d .

m H ea d o f b u la
s s
. .

S ub cu ta n eo uu f f ti b i a

l b li q
n . r ace o .

E t ue
l b li q
0 x ern a o

sisf
. .

p Ap o n e u ro t o ex er n a o ue
s t s
. .

q Pl d
ace h th f
o v er ea o r ec u

Gl t s m di s
. .

r u eu e a

sp i ili s
. .

a A t i
n er or pi u er o r ac ne

s
.

t Il i t
ac cre

h d f g s mi s
.

s
u I
n n er t ea o a r o cn e n

s
. .

0 . Ti an ticu .
262 The Va tz s '

into the upper h alf o f the i n n er border o f the pa tella .

The lowes t bres o f the vas tus intern us a r e very obliqu e i n

their direction an d overlie the upper par t o f the inter na l

condyle o f the thi gh bone whereas th os
,

-
, e o f the exter na l
vas tusar e m uch more verti ca l in their di rection an d
in the erect pos ition do not overlie the oute r s ide o f th e
externa l condyle at a ll b ut pas sdown to the patella ab ov e
it ; here the pos terior border o f thi spart o f the mus c l e is
,

dened by a tendinousedge whi ch isemphas iz ed during

contraction . Behind thi sa fe w es hy breso f th e
crureus become s uperci a l b ut a s they ar e overlai n b y
the lower part o f the ilio tibi al band they do not exercis
,

- e
much in uence asdeterminantso f s ur f ac e f orm ( Fi g 1 2
5 .
,

an d Pl ate s VII VIII IX XXI I pp 44 62 72 .

deeper s
, , ,

ti ng on thi s
,

R es tratum o f mus
, , ,

c le an d occupyi n g ,

a po s ition cor res pondi ng to a line leadi ng f rom th e an teri or

su p eri or ili ac s pine to the pate lla th ere i sa s up erci a l

c le ca lled the r ectus s s

,

mus f e m o r i Th i s m u c le .h a sa f us i
f orm belly with upper an d lower tendons o f a ttach m en t .

It aris esby two tendonsthe deta ilso f which need not

,

be d es c ribed f rom the i li ac p a rt o f the ha unch -bone j us

,

,
t ,

a bove the aceta b u l um or c up f o r the reception o f th e

hea d o f the th i gh bone A t thi spoint the mus
- . c le li es

deeply having to i ts
, outer s ide the tens or fas ci ae f emori s

ide in part i s
,

wh i ls t in front o f an d a long i tsi nner s

the above mentioned s
- a r to r i usa m us c le to be p res ently
de s hy belly o f the rectus
,

c ri bed . The es cr op s up in th e

a ngle f o r med by the s e two m us c les an d p a s s esdownwards

,

tow ard s the patella into the upper border o f which it

i sin s erted by a broa d at tendon about th ree inch es
,

in length A s the es hy b elly overlies the deeper s tratum

tha t the vas
.

it only p arti a lly coversit s

,

o , ti appear on
ei ther s ide o f i t The es . hy p art o f the mus c le imp ar ts

a f ullne s sto the front o f the thi gh which isnot only

d ue to the development o f i ts bresan d the thicknes s
264 Sa r to r ius .

f orm in the longe s

f act t in the b o dy ta kes origin ab o ve
f ro m th e anteri or s uperior ili ac s
, ,

pine (a nterior extremity

o f th e i li ac cres t ) an d f rom the bone immed i ately below it ;
i t p as s esobliquely acros sth e front o f th e upper par t
o f th e thigh s o asto reach i tsinner s ide about th e
middle an d cours ing d o wn a long thi sas
, p ect o f the limb
i t p ass esbehind the mos
, ,

t prominent part o f the intern a l

c o ndyle o f the thi gh b o ne an d along the inner s - ide o f
Below thi spoi nt it form sa thin expanded
.

th e knee .

tendon w hich tu rnsforward sbeneath th e level o f th e

inner tuberos ity o f th e tibi a an d i sins
,

erted into the

s ubcut aneo us surf ac e o f the upper par t o f the s h aft o f
th at b o ne clo s e to th e tubercle i n front Th e mus c le

s
.

tra p whi ch h asb e en twi s

,

re s e mbles a ted round the

f ront o f the limb in a s pi ral fas hi on It th ushelpsto
divide the front o f th e thi gh into two re gi ons an
.

o uter an d lower occupi e d by the exte n s or mus c le s wh ich

'

h ave j us t been des

,

c rib e d an d a n upper an d inner whi c h

,

the adductor group Th e s

,

c ontains a rto ri u s overliesthe

.

rectus f emori s at i ts origin as well asthe hinder portio n

o f the vas t usinternusalong the lower an d inner as
,

p ect
o f the thigh I t al s o liesin front o f the i ns
. ertionso f
th e add uc tors Fi
( g .

The action o f thi sm us c le i s to ex the knee an d hi p

jointswhe n the kne e i sb ent it wi ll act asan inter nal
:

rota tor o f the leg on the thi gh ; it als o as is

s ts in evert
i n g the entire limb The relation o f th e mus
. cle i s bes t
u nd e rstood by a ref erence to Pl ate s VII I XXII pp 62 246 . .

I t will b e noticed th a t i ts
,

inuence on th e s urf ac e f orms

, ,

is not gr a t It helpsto dene the upp er lim i t o f th e

e .

f ullnes so f th e vas t us inter nus a n d rect us f rom th e hollow

o f the thigh whi ch li e s a bo v e th e s arto r i us a n d b etwe e n

it an d th e f urrow o f fh e gr oin In violent acti o n wh e n .

th e thi gh i s
,

ex d up o n th e tr unk th e s
e up rior attach e

m nt o f th e m us up e rior ili ac s
,

e cle to th e a nterior s pine

 cles
A dd ucto r Mus . 26 5

m ay f orm an o ts
t nding idge on the s
u a urf e r ac of the
limb .

Owing to the obliqu e pos ition o f th e thi gh-bone th ere

i sa tri angul ar interva l between the i n ner s
,

ide o f the
s haft o f the bone the inner border o f th e limb an d the
pelvi sabove Thi sinterval i soccupied by the add ucto r
,
,

m us cle s Th ey f o r m a e s
. hy mas so f triangular s h ape
a ttac hed a bove to tha t p a rt o f the pelvi s
,

wh ich i s f ormed
by the pubi sin f ront o f the acetabulum an d th at por
tion o f the i s
,

c hi um whi ch lie s i n f ront o f the i s chi a l

tuberos ity E xtern a lly an d in f er iorly thes e m us c les

p assto be ins
.

erted into nearly the whole length o f the

back o f the s h aft o f the thigh bone reaching aslow
-

dow n asa prominent s p ur on the upper s

,

ur f ac e o f the

interna l condyle w hils t internally they as s ist i n forming

the outline o f the inner s
,

ide o f the thi gh Th i ses hy

m as s
si broken up into s evera l mus c l es
.

named the cd
s dd t b is dd t m g sp ti s
,

d ucto r lo n gu a uc o r r ev a uc o r a nu ec n eu

b t it i snne es
, , , ,

an d g ilisrac sry to enter into det iled

u u c a a a

o nt f th m ll sthey i en e the srf e form s

,

acc u o e a a n u c u ac

r ther by their b lk th n by their det ils A s h s

,

a been
u a a . a

alre dy s
a t ted they lie bove d to the ih
a side f a an n er o

le here sthey s tret h ros sfrom

,

the srt ri sm s
a o u u c : ,
a c ac

the f ront o f the pelvi sto the upper pa rt o f the thigh

bone they as
, s ist in f ormi ng the oor o f the depre s s ion
whi ch liesimmedi ately be low th e groin an d which i s
Thi sco rres pondsto a
,

ca ll e d th e ho llo w of the thigh .

tri a ngula r interva l between th e s a rto ri u son the outer

s ide an d th e inner border o f th e add uctor long uson the
i nner s ide The bas . e o f th e tr i angle w h i ch isdi rected ,

upw a rd s corre spondsto Poupa rt s ligament Th e oor o f '

deepes ponds
,

th i s space i s t in th e centre an d corres on the

o f th e p e ctineus
,

inner s ide to th e an terior s u rf ac es an d

add uctor longusw hils t externally two m us c l e sca lled

iliacuswhich p as sdown from within

,

o asan d
,

the p s ,
266 The Gw a ll s .

the pelvisunder cover o f Poup art sli gament form th e

,

oute r h a lf o f the oor o f the s pac e The inu ence o f .

thes e s tructureson the s ur f ac e f orm i svery m uch

modied by the pres enc e o f an abund ance o f f at an d
other ti s su e sa n d a l s o by the in uenc e o f pos ition It .

elsa n d nerveswhich
,

ishere th at the large blood -ves s

enter the limb a re p lac ed an d lying asthey do in
a co n s er ve to mas
, ,

iderable q ua ntity o f f at th ey s k an d
obs
,

cure th e o utlines o f the s tructuresa bove enumera ted ;

the hollow ass uch only exis ts in a we ll -nouri s h ed
model when the thigh isexed upon the trunk In
,

.
,

thi spos ition the bounda ri eso f the s pac e become more
di s tinct an d the s u rf ac e conto urs attened wherea s when
the thigh isfu lly extended the front o f the limb in th is
, ,

p os ition as sumes a f ul lnes sw hich islargely dep enden t

on the f ac t th t the head an d neck o f the thigh b on e
a -
,

which underlie s ome o f the s tr ucturesenumerated are

t f orward an d s u es
,

th rus o caus e a bulging o f the tis s

which occupy a more s uperci a l pos ition ( Plates VIII XX II , ,

pp 62
t important as
.

Of the a dd ucto r gr oup the mos

,

a dete rmin ant

of s urf ac e f orm i s th e gr ac ilis Thi s . m us c le ari sesby a

thin te ndon about 2 or 2 }inchesbroa d from the bone ,

c lo se to an d parallel with the s ymphys isp ubi s The attach

behi nd thi sjoint It differs
.

ment ex tendss o mewh a t .

f rom the other members o f the gro up in not be ing a ttached

to the thigh bone I tses

- . hy breswhich f orm a broad
trap like mus svertica lly dow nwa rdsalong the
,

s - c le p as
,

i nner s ide o f the limb th us coinc iding wi th the ou t line o f

,

the upper an d inner as pect o f the thigh when viewed fro m

the f ron t A li ttle be low the level o f the middle o f th e
.

thigh it meetsthe s a rto ri us whi ch h as

, cro ssed over
th e f ront o f the thigh to reach th e inner s
s
ide an d here th e
graci li swhich i splaced i mmedi ately behind it u ually
,

becomestendinous I tstendon isclos

, ,

. ely applied to the

268 Flex o r Mus cles of Th igh .

long s d brevi ss
u an sist i exing the thigh whi lsat th n e

gr ilishelpsto b nd the knee t the s

,

ac d me time
e an a a

s
ca uesinw rd rot tion f the b nt leg Th dd tors
a a o e . e a uc

as whole m y ls
a o s sist in t rning the limb o tw rd s
a a a u u a

on f their i s
by re s a ertion into the b k f the s
o h ft f
n ac o a o

the thigh bone - .

The ha ms tr in g m us cle s f orm the ex o r gr o up whi ch

is placed on the back o f the thigh They cons is
,

t o f th e
b icep s th e s e mi te n d i n o sus an d the s
.

of the th igh , emime m

br an os us They a ll ta ke origin f rom the t ube r o s

,

. ity o f
the is c hi um ( lower a n d hinder p a rt o f the h aunch bon e ) -

a n d p as
,

sto be ins erted into the boneso f the leg two :

into th e tibi a or inner b o ne one into the bula o r

out e r bone They th usco nnect the boneso f the le g
,

with th e pelvi san d as they cros sover the back o f the hi p

jointsthey therefore control the movements
, ,

a n d knee - of

e two joi n ts
,

th e s
Thi sex o r mas sformsa thick es
.

hy column which

occupiesthe middle o f the back o f the thigh It isnot .

s uf ciently wide to in u enc e either the inner or o uter

outline o f the limb when viewed f rom behind fo r externa l

hy breso f th e vas tusexternusoverla in
,

to i t th e es
by th e ilio tibi al ba nd i sthe determinant o f the s
,

-
,
urf ac e

outline w hi ls
, t on i tsinn e r s ide the add uctor group ,

cov e red by th e s a rtori us b e low a n d the gracilisabove ,

ponds
co r re s to the outline o f th e inner as pect o f the thigh .

I n th e erect pos ition th e origin o f thes e ex o r m us c les

f rom the tuberos ity o f the is chi u m i s conc e aled by th e

lower border o f the gluteusmaxim us When the thigh .

is ex e d on the trunk th e low er border o f the gl uteus

max im uss lip sforward ov er th e is ity s
chi a l tub e ro s o th a t

e mus c l es
,

i n thi s pos ition th e s uperior attac hment o f the s

is more f ully expos ed ( Fig

uslie s
.

The b icep san d s e mite n d i n o s ide by s ide an d

s up e rc ial to th e s e mi membrano s us ; the line o f s ep aration
 s
H a m tr z ug cles
Mus
'

. 269

betw een the bic epsan d s emitend i nos us co r respondsto

the middle li ne o f the back o f the thigh A t a point .

corres ponding pretty clos ely with the j u nction o f the

lower with th e middle thi rd o f th e thigh thes e tw o
mu s c les separate fr om one another The outer one or .

b ic ep sp as s
,

estowardsthe outer s ide o f the knee be low

whi ch it isins
, ,

erted into the head o f the bul a whils t

the s usis
em ite n d i n o s directed downwardstowardsthe
,

inner s ide o f the knee an d isin s,

ert ed into the inner
as pect o f the upp er part o f the s ha ft o f the tibia j us t .

be low th e inner tube ros ity o f tha t bone an d under co ver

o f the tendinous exp ans ion o f the s a rto ri us Th e bi c ep s .

diff ersfrom the other memberso f th isgroup in pos ses s

ing a s econd head o f origin f rom the thigh bone hence -

na me Th i s s s s
,

i ts .
f e mo r a l origin i c a lled i t h o r t he a d
i n contradi s tinction to the lo n g head which ari s esa long
,

tringsfrom th e i s
,

with the other h ams chi a l t uberos ity

hort head o f the bicepsaris
.

Th e s esfrom the rough line

on th e bac k o f the thigh bone below the bony ins
- ertion
o f the bres
,

o f the gl ute us maxim usextending nea rly ,

down to the extern al condyle .

There isa marked diff erence be tw een the form so f

the bic ep san d s emi tendinos us The latter end sin a
.

long an d s lender t e ndon to whi ch circums , ta c e it n

owesi tsname abo ut the level at w hi ch the two m us

, c les

s eparate f rom one ano th e r v iz a t th j unction o f th e

, . e

lower wi th the mi ddle third o f th e thigh w hereasth e ,

bi cepsre m ainses hy until it h asreached th e lev e l o f

th knee
e .

Th e s e mime mb r a n o s us
,
s o ca ll ed on acc o u nt o f th e pecu li a r

a rrang e ment o f i tstend inousp a rtsliesa t i tsori gin ,

u nder c over o f the prec e d ing m us c le s Th e bu lk o f th e

.

es hy p a rt o f the m us c le i s plac ed on the inner s ide o f

the middle line o f th e back o f the th igh In thi ss itua
.

tion the es hy belly o f the s emiten di nos us restsupon it

270 Ha ms
tr ing Teud o us .

a bove whils
, t below the tendon o f that mus
, c le may b e

trac ed downwardson the s

,

u rf ac e o f the es hy part o f
th e s emimembranos us whi ch reaches , as low asthe upper
border o f the inter na l co ndyle o f the thigh bone Inter - .

n ally the s emimembranos us i sin relation above to a

portion o f the add uctor magnuswhils t in the lower two ,

thirds o f the th igh i t lies clo s e to the hinder border o f th e

es hy belly an d tendon o f the gracilismus c le Curvi n g .

round the hinder end o f the inte rnal condyle o f th e

thigh bone the m us
-
,
c le p as s esto be ins erte d by a s tro n g
tendon into th e back o f the inner tuberos ity o f the
tibia ( Pla te s VI VII X XII pp 42 44
that the roundnes s
.
, , ,

to the pres ence o f thes

, ,

It i s e m us c les

o f the bac k o f the thi gh i s d ue We h ave a lr eady s een .

th a t they ex ert no i n u ence on the out lineso f the inner

an d o uter as p ec ts o f the limb b u t i f the thigh be viewed
f rom the o uter s
,

ide they determine the form o f the

outli ne aswe trac e it from the fold o f the buttock to
the bac k o f the knee the s u rf ac e outline be i n g d ue

hy bellieso f the bicepsan d s emitendi nos us

,

to the es
usnot un f requ ently h asa
,

though the s emimembra nos

direct in uence on the s u rf ac e f orm a little above an d

behind the knee The reader may however be tter s

. a ti sfy
elf asto thes
,

e deta ilsby a ref erence to Plate sVII

,

hims ,

IX X XII pp 44 72 240
, , .
, ,
.

It i spa rticu la rly in the region o f th e ha m or th e

h o llo w b eh in d the kn ee that thes e mus c le sa r e mos t
rea dily di s ti n gui shed W hen the knee i sbent their
.

ro nd d co rd like tendonsm ay be f elt with eas

u e - e on

both th e inn er a n d outer as pectso f th e hinder s u rf ace

o f the jo i nt Thes e tendonsar e henc e ca lled the h am

c les
.

s tringsa term which i sals

, o applied to the mus
wi th which they ar e con nected The o ute r ha ms tr i n g
or tendon o f th e bicepsca n b e rea dily traced to i ts
.
,

ins ertion into the head o f the bula w hils t the i n ner ,
2 72 A ctio n
f o the H a m tr ing s Mus
cles .

to such a degree th at w e can bring i ts ante rior surf ac e i n

c ontact with the f ront o f the trunk S imilarly there is no .

difculty in touching the toesif we s lightly bend th e

knee s Th e accompanyin g diagram ss
. erve to illus trate
the se facts( Figs 1 54 .
,

The fo rm o f the thigh tapersfrom the hip to the kn ee .

I tsrou n dnes sd epends largely on the quantity o f fat pre s e nt

beneath the s kin In a mus cu la r model b u t sparingly covered

with fat the grouping o f th e mus c le sinto an internal an d
upper grou p (a d d uc tors) an exte rn a l an d lower gro up ( ex ,

Fxo . 1 54 Fm . 155 .

s s
Dia gra m to i ll u tra te h o w e x i o n at th e h i p -j o i n t i co n tr o lled b y th e s
s
h a m tri n g m u cle ss I n Fig 1 54 th e ha m tri n g a r e re pr e e n te d tigh tly s s s
s s
s ss s
. .

tr e tch e d wh e n the n ee i k
tra igh t In Fig 1 55 th e m u c le are h o wn
s s
. .

r e la x e d wh e n th e k
n ee i b e n t A grea te r a m o un t o f ex io n i the re b y
j
.

p e r m i tte d a t th e h i p
- o in t .

tensors) d po
. sterior
an
g ro p(
a s
) i s t on e p p rent s u ex o r a c a a a

ever l regions
,

theses resolve thems

a elves i t sf es whi h n o u r ac c

ar emore or les sd i stin tly d d f rom one otherthe c e ne an

two former by the f rrow orr s pon d ing t the u s rtori s c e o a u ,

the two l tter by th f rrow whi h p s

a s
es dow n the o t r
e u c a u e

si d f the thigh d orres

e o
pond s to the po st
an rior border c e

of th v s t sext rn s The f llne s

e a u s the inn r s
e u ide f u on e o

the thigh p s
.

es
s i s ens ibly i to the ro d es
a n s s ed by th n un n ca u e

h msatring gro p ( Pl t s VI VII VIII IX pp 4 44 6

u a e , , , ,
. 2, . 2,
 Fo r m of Fema le Th igh 73 . 2

In the f em le the s ep r tio f the thigh into regions

a a a n o ,

c ponding to the gro ping f the mus

orres le si s
u obliter ted
o c ,
a

to very gre t ext nt by the pres

a a en e f thi k sb
e c o a c u

t neo s
cu a f tty l yer ( Pl te XXIII Figs
u a a pp
a ,
. 1 , 2, .

Owing to the greater pelvic width in wom an an d the ,

con s equent greater obliquity o f the thigh bone the limb -

,

is relatively wider above c ompa red with itslength than

in the male thi sconveysthe impres
: sion th at in the
f emale the thigh is shorter th an it really is a f ac t .

Fm . 1 56. Fm . 1 57 .

s
s
Diagra m h o wi n g th e g r e ater d egre e o f o b li q uity o f th e th i gh -b o n e s
d e p e n d e n t o n th e gr ea ter pe lvi c wid th in wo man , Fig 1 57, a co m pa r e d
. s
wi th m a n , Fig 1 56
. .

the thigh i srelatively s o mewh at shorter th an in th e male ,

b ut in well -proportioned f em a lesthe s hortnes sismore

apparent th a n rea l an d i s dependent on the caus
, es af ore

mentioned I t may be note d however asa matter o f

experien ce th at it is
.
, ,

, by no meanseas y to ob tain f ema le

models with the requi s ite li mb proportions f o r in no re s
pect
do they vary s
,

o m uc h .

Th e gre ater brea dth o f the upper pa rt o f the thigh

T
2 74 Hip wid th .

an d the greater obliquity o f the thi gh bone give ri s - e in

women to a knock -kn e ed app earance Thi sisfurther em .

h si z e d by the o utline o f the ou ter s ide o f the thigh

p a

f orming a more pronoun ce d angle with the outl ine o f

the o uter s ide o f the leg than in the male When f rom .

re a t width o f the upper s e gment o f the limb t hi s a ppear

g
an c e i s undu ly pronou n c ed it gives ris e to an unpleas ant

i m pres s ion a n d modelswhich di s play thisf eature s hou ld

though much m ay be done to remedy th es
,

be dis ca rded ,
e

un pl e a s a nt line s by plac ing the limbsin s uch a pos ition

as to mod i fy c ons iderably the appea rance o f thisdef ec t .

The condition above refe rre d to when not un d uly em ,

p h as i z ed i,s a c h a rac teri sti c f e a t u re o f the f em a le g u r e,

an d impa rtsto it a f e elin g o f renement an d mod es ty

whi ch is in ke eping w ith th e whole s entiment o f the gure .

In wome n the r isa t ndency to the m as

e e sing o f f at o n
the o uter s ide o f the thigh be low the level o f the trochante r
, .

Thisas , h as been already ex pla in ed carries the wi d th o f the

,

gure in thisregion lowe r tha n in the male in whom ,

it isgenerally s ituated on a level with the trochan te rs ,

b ut in cas es where thi s f at i s pres ent in too great quantity

it des troysthe s y m m e try o f the thigh a n d prod u c e s a n

unpl e a s ant o utline a long the upper an d o ute r as e ct o f

p
th e limb .Thisdiff erenc e in the f orm o f the li mb in the
two s exe s m ay be s t be obs erve d i f we view the gure f rom
beh ind In women th e greate s
. t width a c ros sthe thigh s
is se e n to lie asa rule on a level with the foldso f the
b utto ck swhereasin the male the greate s
, t width isco n
s iderably a bove this level Thes .e diff erence s ar e apparent

in Pl ates V XVII pp 36 12 1
, , .
, .

The o utline s o f th e thigh when viewed fr om f ront or bac k

depend on the vas tusexternuso n the outer s

, ,

ide an d on
the grac ilisabove an d the s
,

ar to ri us below on the inner ,

s ide The s
. tudent s hould remember that the ilio -tibial
band overliesthe es hy breso f the vas tusexternusan d ,
 2 76 Str a igh tn es
sof L imb .

f at an d when an inte rval ex is ts between the limbsin this

pos hould be m uch les sth an in the male In either
,

ition it s
s pac e between the thighswhen the kneesare
.

ex the s
in co ntact s hou ld never be ca rried up ashigh asthe
f ork as suc h a co ndi tion is indica tive o f meagre develop
an d prod uc e s t unpleas
,

me nt o f the lower limbs a mo s an t

impres sion .

In men o f athl etic b uild one not un f req uently meets

w ith a certa in amount o f o utw ard curve in the limbs This
bow -legged appe arance in minor degreesisquite co n
.

s istent with a normal growth an d an athleti c development

ed with thos
,

an d mus t not b e confus e cas

esin whi ch the

curve s o f the limb ar e the res ult o f di s eas Brucke has 1
e .

laid down a rul e which enable sthe s tudent to determin e

when thi s outwar d curve o f the limb has ex ce eded the limi ts

co sn i ste nt with a well -shape n leg H e takes . two s tra ight

li nes ,
the inn er f rom the middle lin e o f the tm n k at the level
o f the pubi s the outer f rom the outer s ide o f the thigh j us t
where the tro chan te r li esbeneath the s Both li nes
, ,

urface .

are ca rried down s o as to meet at a point corres ponding

to the mos t elevate d pa rt o f the ins te p o f th e fo o t A s thes e .

tw o lines c ro ssthe fr ont o f the knee the patella s hould lie

where the pate lla lies ide thes
,

b etwee n them ; in cas es outs e

limi ts the curve o f the limb is un duly great an d the f orms ,

are inelegant It f ollowsfro m this

. that in men in whom
m et with the inner s
,

thisf orm o f limb is i d eso f th e knees

tand erect with the li mbs

,

m ay not be in contac t when they s

toge ther b ut m ay be s
, eparated by an interval the wid th
o f whi ch is limite d by the rule alre ad y ref erred to S uch .

a c ondition is incons is tent with the f orm characte ri s ti c o f

the female an d modelsdis
,
playing s uch a tenden cy s houl d
be avoided
in the f orm o f the th igh d ue to alte rations
.

The variations ,

The H uma n F igure, Pro fe s

sE s
ort Buk
rn r c e. Lo n d o n : Gre val 8: Cc .
,
 Fo r m of Knee 77 . 2

in itspos ition best u ders t od by a re f eren e to Pl te

,
are n o c a

XXII p 4 I i
, f the thigh on the tr nk it i s
. 2 0. n ex on o u

a lw yswell to re ogni e the pos

a ition f the nterior c z o a

sperior s
u pine f the ili rest sthi sgivessth key o ac c a u e

to the dr wing f the t ns or f s

,

a i e f emoris m sle o e a c a a u c

whi h exer is es import nt inuen e on the srf e

,

c c an a c u ac

f ormsf the pper o d o ter p rt f the limb u In slight an u a o

degreesf i the f old f the groin is

.

o exdeepened d the
on o an

pond s
,

o ter limit f th t f u row orres

u to the bony point
o a r c

in q es tion When i
u is rried f rther th
. li e ex o n ca a e n

whi h ros sesthe front f th pper p t f

,

o f i ex on c c o e u ar o

the thigh j s t below the fu row f the groin be om s

,
u r o , c e

Fm . 158 . FI G . 159 .

emphas iz ed an d thes e two f old sasthey re ach the outer

,

s ide o f the limb f orm a V or Y s - haped f old between

the s ideso f which the anterior s uperior ili ac spine can
be dis tinctly felt Th isiswell s hown in Plate XXII
.
,

Fig 1 p 240 a n d Plate XXIII Fig 2 p 245 . .

o f the knee is
. . .

urf ac e f orm s
, , , ,

The con s ideration o f th e s

ex tremely d i c ult In the rs t ins ta n ce it is very im
.

portant that the s tudent s hould have an accurate knowledge

o f the s hape o f the bonesw hi ch ente r into the f ormation
o f this join t The mos t c ommon defect met with in the
.

knee isin relation to itss iz e ; thistend sas a rule to

be too big a circums tan ce which isprinc ipally owing

,
2 78 Fo r m of Kn ee .

-
Fm 160. r i gh t k n ee wi th th e F m 16 1 D ie m em o f th e le ft k n e e
ss s
. . .

wi th th e m u cle relax ed , h o w i n g th e
s
a r r a n ge m e n t o f th e pa rt o n w h ich t h e
sur fa ce f o r m d epen d s.

F 10 161 . Th e righ t kn ee wi th th e F m 163 Diagram o f th e left k n ee

ss ss s
. . .

m u cle co n tracted w ith th e mu cle co n trac ted , h o w ing

s
.

th e ar ran ge me n t o f part .
 280 Far m of Kn ee .

elev tion whi h isus

a u lly m rked
, cff bove by sh llow
a a o a a a

f rrow or e s
u ponding to itsline f tt hment with th
c r o a ac e

p t ll
a e O a either
. side the f
11 llne ss f the lig ment i s u o a

m int ined by th p dsf f t lre dy m enti ned whi h

a a e a o a a a o c

often itso tline S periorly tt ned tri

,

help t s o u . u a a e

ang l r depres
u a sion le di g p into f rro w orres po ds
a n u a u c n

ertion f the mus

,

t th tend ino s ins lesinto itsupper

,

o e u o c

border The f llnes. son either s id e f thisdepres

u sion o

corres pondson th inner s ide to the es

, hy bresf th
e o e

vs t s int rn swhi h rs ing obliq ely ros sthe i

,

a u e u ,
c ar e co u u ac n

t er l na c on d yle
the thigh bone to reach the uppe r h al f
of -

o f the inner border o f the knee pan whils

- t a t a higher
level the bres
,

o f the vas tusexternusasthey s weep dow n ,

to be ins erted by tendinousbresinto th e outer part o f

the s uperior border o f the p ate lla limit th e s urfa ce d epre e ,

s ion exte rna lly The arching bres . o f R i cher as they pas s
sthe lo wer part o f the vas tusinternustend to em
,

a cro s

s z e the b ulge o f the e s s

,

p h a i hy p a r t o f thi m u s
c le b e low
the level at which the bresc ros s( Plate VIII p
e detailsare ordinarily abs
.

Thes
,

ent in the knee o f th e

f em a le in whom we h ave a les ss trong mus cul ar develop

ment an d a gre ater abund anc e o f s ubc utaneous

,

fat In
the anti q ue there islittle s
.

ugges tion o f detail the f or ms ,

being kept s imple an d rounded In f emale models a gr e at .

variety o f f orm is met with depending on the d is po s

, ition
o f the f at ; b ut as a rul e the exi s tence o f the p atella is
ofte ne s t ind icated by a s light hollowing an d atteni ng o f
the s urf a c e along i ts outer s ide w hich s e r ve s to emphas iz e
,

i ts pres e nc e It isby no mean suncommon when the

.
,

j oint i sf orcibly extended to meet with a triradiate ,

f urrow in front o f the joint one limb o f the f urrow over .

lying the ligament o f the patel la whil s t the two upper ,

lim b ss er ve to dene the lower an d outer bord e rso f

th e bo n e i ts e lf th e f ul ln e s
sbetween thes
, e bein g d ue to th e
s hape o f the patella whils t th e ro unded f ormson either
,
 Fo r m of Kn ee .

s
ide of es c ending fu rrow ar e caus
th e d ed by the di s pos i
tion o f the fa t on e ach s ide o f the ligament .

As viewe d fr om the oute r s ide the outline o f the f ront

,

o f the knee i s d ue to the f orm o f the f emora l c o n d yle s

an d the patella Th e pos ition o f the latter d p nd son
. e e

whether the mus cle s o f the f ront o f the thigh ar e c o n trac te d

or not It i smore prominent when the kne e isf o rcibly

.

exte nded than when it i sbent asin the latter cond ition
lipsinto the gro ove betw een the fe moral
,

the patell a s
con d yle s But be it noted th a t the ligament o f the p atell a
.
,

having once been put on the s tretch the dis tanc e be tw een ,

the tubercle o f the tibiaan d the lower border o f the patella

ca n never va ry wh atever h e the po s, ition o f th e joint In .

this view o f the limb the relation o f the f emoral condyle s

to the upper e n d o f the tibia is well s een They s hould .

appea r a s i f well s upporte d on the h ea d o f the ti b i a an d

s
,

hould not di s play a f orward thrus t as if there wa s a ri s

, k
o f their s lipping over th front o f the tibi a Th i sappear
e .

an c e i s by no meansuncommon in mo del san d imparts

to the limb an ex tremely ugly o utline the line o f the f ront ,

o f th e leg appea ring to lie behind the line o f the f ront o f

the thigh ins tead o f being continuouswith it ove r the

s
,

ur fac e prominen c e s o f th e k n ee In ex i o n o f th e joint

.
,

as the patella s inksinto the groove betw een th e tw o '

con d yle s the roun ded f orm o f the f ro nt o f th e joint b e om e s

,
c

more an d more d ue to the c o d ylesthe inne r o f w hich n , ,

b e ing the more proje ctin g o f the two helpsto d ete r m ine ,

the outline even though vi e wed fr om the outer s

. i d e The .

round nes scaus ed by thi s c ondyle i s f u rth e r e mph a s i e d by z

the bres o f the v a s tus internuswhi h ar e cros ,

sin g o b l iq u ly
c e

over it to join the inner border o f the patell a ( Pl ate X X II ,

Figs1 2 p
.
, ,
.

The o umr s ide o f the joint isove rla in by th e ilio ti b i al

band w hi ch ishere pas
,
s
i n g down to be attach e d to the
outer tube ro s i ty o f th e tibia in front o f the h ead o f th e bula
,
.
 Far m of

Th e b o n e sf tho e e x te n d e d k n ee ( righ t id e )s .

s s
,

FI G . 164 . Oute r id e . Fl o . 165 . In n er i d e .

I : F e m ur .
. Fib ula . 11 H ead
. of b ula .
b . Ti b ia .
p Pa t e.ll a o r k n ee -
pan .

0. E x te rn al co n d yle o f fe m u r . l Ligam e n t o f th e patella

.

I n te r n al co n d y le o f fe m ur . t h i b ero le o f tib ia
. .

The b o n e sf th o e b ent k n ee ( righ t id e ) s .

Fm . 166 . Fro n t view . FI G . 167 . Outer id e s .

i . I n te rn al co n d yle o f fe m ur .

p . Pate lla .

lLigam en t o f th e patella
.

e. E x te rn al co n d yle o f fe mur . t Tub ercle o f tib ia

. .
 283

Insh tionss
uc ac p t str in ona thi sb nd it
u f oram s s a a a ur

f e relie f di s
ac tin t f rom th t s
ced by th v s t s extern s a ca u e a u u

whi h lies in front ( Pl tes

,

c VII IX XXV XXVI pp 44 7a , , , , .

, 2,

292, Behind the ilio tibial band the te ndon o f the -

bi ceps mus c le m a
y be tr a c ed to the he a d o f t h e b u l a ; in
pas sing down it caus es a s u r fac e elevation c orre s ponding
to its
,

f orm an d dire ction In ex io n the relie f formed

.

by the outer hams tring ( bi cepstendon ) i sat onc e em

p h as iz ed . The rel a tion s o f the other st ru c tu re s in di ff er nt e

pos itions o f the joint ar e be s t unders tood by a re f e rence to

Pl ate XXII Figs1 2 p 240
.

. . .
, , ,

The roundnes s o f the inner s ide o f th e knee i s d ue to the

projection o f the internal condyle an d the inte r a l tub ros ity n e

o f the tibi a . Th e lo we s t bres o f the vas t us internus partly

overlie the f ormer whils t curv ing down over the pos
,
te rior
half o f the inner s ide o f th e joint are the bre so f the
sa rtori us ( here e s hy ) behind whi c h there li e in the f o l
lowing order from bef ore b ackwardsthe tendonso f the
,

grac iliss emimembranos us an d s emitendinos u s Th e s

,

,
emi .

us tendon pas s urf ac e opp o s

,

m embranos es away fr om th e s ite

the level o f th e interna l tuberos ity o f the tibia into the ,

pos terior border o f which it i s in s erted The tendons o f all

.

th e other m us c le s here enu merate d pas sdown to be attached

to the upper part o f the inne r s u rf ac e o f the s haft o f the
tibia below the internal tuberos i ty the s a rtori us f orming
ion undern ath whi c h the other two tendons
, ,

a bro a d exp ans e

ar e atta c hed to the bon e th at o f the grac ili slying on

us The s
,

a higher level th an that o f the s e m ite n d in o s e .

detail sa re not indi cated on the s urfac e f orms by s eparate

relie fstogether they combine to form a rounded elevation
which curvesover the inner s ide o f the joint In ex io n .

th e two inner h ams tringsviz the tendonso f the s emi

usbe come very pro m inent
,

membranos us an d s emitendinos , ,

particularly the latter an d s erve to carry the line o f the

back o f th e thigh acros sthe inner an d pos terior as
,

pect o f
 C HA PTE R X I .

TH E LE G AN D FOOT .

Tm; mus cle s o f the leg applying that term to the pa rt

,

o f the limb whi c h lie s below the knee are conce rned in the
m o vements
,

o f the f oot an d toe s Be f ore de s

. c ribin g them

s omethi ng mus t theref ore be s a id abo ut the bone s

,

o f the

f oot an d the an kle joint- .

The de s cription o f the bo ne s o f the leg h as been al rea dy

g iven in the previo us ch apter b u t a more det a iled acc o unt
nece s s
,

o f their lower extremitie s is a ry be f ore the re a der

can ful ly apprec i ate the s tructure an d movements o f the

ankle joint
- . Unl ike the knee both bones, o f the leg ente r

into the f ormation o f the an kle though the tibia or inner

,

bone p lays a m uch more important pa r t in i ts s tructure

than the bula or outer bone The lower end o f the tibia
is expanded an d on its inf erior s
.

, ur f ace di splays a qua dri

lateral articular area hollow f rom bef ore b ackwardsan d

,

very s lightly convex f rom s ide to s ide On the inner

.

s ide o f thi sthe bone i sprolonged downward s to f orm

a bro a d an d more or le s s pointed proce s scalled the in ter n a l
ma lle o lus The inner as
. pect o f thi s proce s siss ubcutaneous

an d corre s po nds
,

to the s urf ac e proje ction o f the inner ankle .

The outer s urf ac e o f the intern al malleolus is provided wi th

an arti cul ar f ac et whi ch i s c ontin uous wi th that already
des
,

c ribed on the under s ur fa ce o f the exp anded lower end

o f the tibi a .
 Bo n esof Leg .

The lower end o f the f ib ula isa l o enl arged an d f orms s ,

a scalled the ex te r n a l ma lle o lus Thi sisnarrower

proces .

Right ti b ia an d b ul
a a rticul a te d

Fro . 168 . Fr o n t Fm . 169 . Back Fro . 170 . Outer Fro . 17 1 . In n e r

vi e w. vi e w. vi e w . vi e w.

t Tib ia , in n e r b o n e o f leg d H ead of b ul a

s
. . . .

a Tu b e r c le o f ti b ia , to w h ic h ligam e n t c E x te rn al ma ll eo lu ( b ula )
s
. . .

o f pa te lla i a tta ch ed I : Fib u la

s s
. .

b E x ter n a l t b
u e roi ty i I n te r n a l ma lleo lu ( tib ia )
s sC s s
. . . .

c . I n te rn a l t b
u e roi ty. ohi . re t o r n.

an d more po inted than the internal malleol us The oute r .

 A n kle 87 The . 2

srf e f thi s
u ac oextern l m ll eol s issb t neous d f orm s
a a u u cu a an

the elev tion f the outer kle The inner s

a o ide f the an . o

lo w er end f the b l is o mly united to the o ter s

u a ide r u

of the in ferior extremity o f th e tibia beyond whi ch it ,

proje cts co n siderably an d iss mooth an d covered with arti

,

o n l a r ca rtil age When the two bonesar e joined together

.

the two cartila ge covered s u rf ace sbe come

- contin uo u s ,

an d an a rti cu l ar re ce s sisf ormed boun ded on either s id e

res
,

by the inner an d o ute r s u rf a c es pec tively o f the tw o

malleoli an d between by the under s u rfa c e o f the lower

tudent s
,

end o f the s haft o f the tibia The s hould n o w

.

study the relationso f the malleolar pro

ces s e s The i n ter n a l ma lle o lus
. is broad er
fr om be f ore b ac kward s l esspoin ted lies .

placed s
,

at a higher level an d i s ome

wha t in f ront o f the exte rnal whi ch is
,

m ore prominent an d point d pl aced lower e ,

an d li e s
,

on a pl ane behind that o f the

int rnal Th s
e e are all d e tailso f the
e

grea tes t impor tance in the drawing o f F 7 S k t h 10 1 2 e c

the f oot an d the s s

. .

tudent would do well f b f i g h t o on e o r

s f m
,

to i mpres sthem on 1118 memory The kl

.
ee n 0

ant e rior m argin s o f the two m al l e oli ar e

roun d e d o ff in fr ont b ut pos ter iorly their bord rsar

. e e

grooved fo r the lodgement o f certain tendonswhi ch pas s

down b ehind them an d s o help to s often the s urf ac e

c onto urs corres ponding to thes e more or les sabrupt edges .

On e o f the bones o f the f oot ts into the reces sbetween

the two malleoli The joint betw een thes . e three bones is
ca lled the a n kle j o i n t
- .

Jus t as we h ave carpa l metaca rpal an d ph alangeal bones

,

in the hand s o we h ave ta r s

.

a l me ta ta r s a l an d p ha la n gea l

in the f oo t The ta r s a l bone s

, , ,

bo ne s . co r re spo nd in the f oot

to the carpal or wris t bones
- o f the hand They ar e s even
in number in plac e o f eight as in th e h and this is
.

, d ue to
 tr aga lus
The A s a n d 05 l
ca ci s . 28
9

The as tr aga lus con s is ts o f a hinder or l arge r pa rt the

upper s ide o f whi ch i s provided with a s

,

o mewh at s addle

s haped ar ti cular s u rf ac e Th e f ore pa rt o f the bone i s

. ca lled

the hea d Th i s
. rounded s u rf ac e whi c h i s moulded on an ill
d e n e d neck arti culates
,

with the navi cular bone an d thus

s
,

upports the s keleton o f the inner border o f the foot The .

hinder pa rt o f the bone 18 o f little im po rtan ce asa d e ter

minant o f s urf ace f o r m b ut i s , note worthy becaus e it links
together the bones o f the f oo t with the bone s o f the leg .

S uperiorly it ts into the reces s between the two malleoli ,

whi ch thus prevent its late ral d i s lac e m e n t an d a ls o che ck

p
exc es s ive movement f rom s ide to s ide In feriorly it re s ts
/

on the upper s r
u f ac e of the h eel -bone whils t in front it
,

arti cu late s as h as been s aid with the navi cul ar .

The 08 ca lcis
, ,

or heel b o n e is
- n o t pl ac ed directly beneath

the as tragalusb ut liesun der the oute r half or s o o f th at

bo ne It s uppo r ts the as in part on its upper s

.

. tragalus urf a c e ,

an d in par t by mean s o f a bracket like proc es

- sca lled the
s us ten taculum ta li tal us bein g another name applied to
ca l c i sf orm s
.

th e as tragalus The inn er s ide o f the o s

.

. a w ide

h ollow whi ch i s overhung by the s us ten taculum The broad .

g roo v e whi c h li e s be h ind the inner ankle an d between

it an d the prominence o f the heel a llowso f the pas sa ge

o f the nu merous structures( te ndonsves sels whi ch

into the s
,

f rom the bac k o f the leg d own ward s

,

r un ole
o f the f oot The mos t m ark ed f e ature o f the o sca lci si s
i ts
.

l arge pos te r ior extremity whi ch f orm sthe prominence

The length o f thi sproces
,

o f th e heel s variesin diff ere nt

individ ual s : it is longer in a thin narr ow an d long foot
th an in a s
, ,

hort an d broad foot The power ful tendon o f

.

the mus cle s o f the cal f ca lled the te n d o A chi llz s is ins erted

into thisproces s The outer s

. ide o f the o s cal c i s is s ub

cu taneous except where cros se d by two tendo n swhi ch pas s

down behind the external malleolus thes e tendon shelp
:

to carry the relief o f th e external malleolus on to the

U
 The A n kleyo z n t
' '

srf e form orres

u ac p nding to the o t r s
c ide f the h el
o u e o e

bone In f ront the s l isrti l teswith the b id

. o ca c a cu a cu o

d th s sppo tsthe b neswhi h lie lo g the o t

,

an u u r o c a n u er

bord er o f the f oot .

S uch further des cription o f the rema i n ing tars a l bon es

as m ay be neces sa ry i s f o r the pre s e nt del ayed un til the fo o t

as a whole i s con s idered .

The a n kle j o in t isthe articulation between th e tibia

-

an d b ul a a bove an d the as tra galusbelow The bula

takesb ut little s mi ss
.

hare in the trans ion o f the weight o f

th e leg to the f oot b ut by i ts exte rnal ma lleolar proce s s
s
,

aff ord s upport to the outer s ide o f the joint an d thus

preventslateral dis placement o f the as tragalus It is
,

through the un der s urf ac e o f the lower extre mity o f the

tibia whi ch res ts on the s a ddle -sh aped s urf ace o f the upper

as s
,

pect o f the as tragalusthat the bulk o f the weight pas es

The projection o f the inte rn al ma lleolus

.

on the inn er s
,

ide
as sis ts in strengthening the joint inte rn ally The an kle .

is f urther s upported on either s ide by v ery s trong lateral

ligaments whi ch are attac hed above to the malleolar proces ses

an d pas sdownwards as ra diating ban ds which are conn ecte d

with the s urf a ce s o f the adj ac ent bones in front below an d ,

teriorly the caps

,

behind A nteriorly an d pos ule o f th e

joint is
.

completed by thin an d we ak ligamen ts

The movementso f the ankle -joint are ma inly thos

.

o f ex io n a d exten s
n io n Under ordin ary conditionsth e
.

a xi s o f the f oot i s placed at right anglesto the ax i so f

the leg The term ex i o n is
. applied to that mov ement in

whi h th e joint i s
c bent s o as to bring the b ack -o f the f oot
nearer the front o f the leg E x tens ion is the revers
. e action ;
in it th e axis o f the f oot i s drawn more directly into line
with the ax iso f the leg the heel isra i s ed an d the to es
a ti s
.

f y hims
.

ar e pointed The reader may e as

. ily s e l f that i n

th e extre me s o f ex i o n an d exte n s ion the degree o f lateral

play o f the joint vari es ve ry cons idera bly When the joint .
 The A n kleyo z n t
' '

. 29 1

i s
stro gly exed n ticular s
u rfac e s
ar e f orc ed together
th e ar

very rmly owi ng to the fac t that the wider part o f the
urfac e o f the as
,

upper ar ti cul ar s tragalusisdr iven home

between the two malleoli an d actsl ike a wedge thus ,

Fm . 174 . Bo n e sf
o ri gh t f o o t, o ute r vi ew.

FI G . 175. Bo n e s
of l ef t f o o t, i n n e r vi ew .

a 9 I n te r n a l cun e i f o r m
salcis( h s( b ul
. .

I O c e e l-bo n e ) h E x te r n a l m a lleo l u a )
ss
.

N
. .

c a v i c ul a r . d Cub o id if M eta ta r u
s
. . . . .

0. E x tern a l c un ei f o r m . j Ph ala n ge
s
. .

f M i d dl e c un ei fo r m . k I n te r n a l m all eo lu ( tib ia )
. .

tightening the joint In extens ion the narrower por tion .

of the articular surfac e o f the as tragalusoccupiesthe

i nter val between th e two malleoli the whole joint is much ,

loo ser an d a s
mall amount o f la teral play i snow po s
sible
o tha t the s
. .

The f oot may als o be turned s ole isdir ected

U 2
 Tzb za h sa n tz cus
' ' ' '

. 293

f rom thos e whic h lie deeply on the back The tendons .

o f thes e f our mus c les passdo wn in f ront o f the ankle-joint

under cover o f th e an terior an nu l ar ligament ; they are

there fore ex o r mus c les o f the ankle tho ugh the reader
will notice that s ome o f them are named extens
,

ors This
is ill us
.

an tration o f how the action o f a mus cle va ries

according to the join tsover whi c h it pas ses ; th u s the

exten s or mus cle s o f the toe s passalong the dors a l or ex

tens or s urf ac e o f the toes an d in ac tion will s

, traighte n
or extend them b ut as
, they pas sdown to reach the toes they
cros sover the front or e x o r as pe ct o f the ankle an d thus
become ex o rs o f that jo int .

Of the s e mus c les the innermos t is the tibia lisa n ti cus .

It liesalong the oute r s ide o f the s haf t o f the tibia f rom

the upper two thirdso f whic h it aris esas well as
,

-
, f r om the
exte rnal tu beros ity o f the s a me bone deeply it ta kes
: origin
fr om the in teros s eousmembrane The mus. cle becomes
te ndinousabout the middle o f the leg an d f ollowing the
tance pas es
s
, ,

li ne o f the s hin fo r s ome dis ,

over the middl e
o f the fr ont o f the lower end o f the tibi a acro s sthe ankle
,

joint beneath the ante rior annular ligament an d re aches ,

the mi ddle o f the in ner border o f the foot round whi ch

it turns
,

to be in s erted in to the inner an d under s urfac e

o f the interna l cunei f orm bone an d the b as e o f the meta

tars a l bone o f the grea t toe Pl ate XXV Fig I p 2 2 an d
( , 9 .
, .
,

Plate XXVI p
c le is
.

A bove where the mus thi ck an d es erves

,

hy it s
to conceal the outline o f the s
, ,

harp ante rior border o f the

tibia ; it carriesthe roundnes so f the inner s urf ac e o f

the leg on to the front impartin g a f ulln es

, sto it an d co n ,

ce ali n g the s han k -like appearan ce which i s obviouswhe n

thismus cle i s was te d
. The tibialisanticusisa e x o r
o f the ankl e an d a ls
, o as sis ts in rais ing the inner border o f
th e f oot from the ground an d turn ing the s ole inwards
ide o f the tibia lisanticusisth e
.

Lying to the outer s

294 L o ng Ex ten s
o r of the To es .

lo ng ex te n s
or f
o the to e s Thism sle ris
. esf om the
u c a r

externa l tuberos ity o f the tibi a in f ront o f the point o f

i ts a rti cul ation with the head o f the bul a fr om the head

o f the b u l a f ro m the ante rior s

,

, u rf ac e o f the s haft o f that

bone an d fro m the adj acent s
, urf ac e o f the inte ros seous mem
brane Th e es. hy bres which aris e f rom the lower quarter
o f the anter ior s ur fac e o f the bul a h ave a di ff erent ins e rtion

f rom the bre s which ari s e above Thi s s mall s

. lip is ca lled

the p er o n euste r ti usan d itste ndon pas , s esto b e ins erted

into the dors a l or u pper s urf ac e o f the bas e o f the meta
tars a l bone o f the little to e Pl ate s
( X X V XXVI pp m .

The peroneuste rti usi so f little importan ce f rom the

, ,

pres e nt point o f view an d m ay f o r all prac ti ca l purpos

, es

b e dis regarded The bulk o f the breswhi ch aris

. e from
the front o f the s haft o f the bula v iz thos e whi ch s . prin g
from t h e upper three quartersunite in fr ont to form
,

-
,

a te ndon whi c h p as ses down along the anterior e dge o f th e

mus c le in the lower h al f o f the leg Under co ver o f
the ante rior annu lar li ga ment thi s
.

tendon divides i nto fo ur

s epa rate s lipswhi ch s pr ead o ut be low the level o f the liga
sto the upper or dors
,

ment an d pas al s urfac e o f the f our

outer to e swhere they f orm expans i on s whi ch are in s erte d

ec ond an d third phalanges

,

in to the bas es o f the s o f thes e

toes The breso f the pe roneustertiuslie clos e to th e

esto the little toe b ut its
.

te ndon which pas s tendon in

ing along the dors um o f the little toe curv es
, ,

place o f pas s
h as
,

o utward s to be attached as be en s, ta ted to the upper or ,

dors al s u rf ac e o f the enlarged po s terior extremity o f th e

metata rs a l bone o f that to e ( Pl ate s XXV XXVI pp 292
hy bellieso f the tibiali santi cusan d the long
.
, , ,

The es
exte n s or o f the to eslie clos e together in the upper h alf o f

the leg A t the point where thes e mus c le s become tendin ous
they s
.

e pa ra te an d in the inte r va l between th em anothe r

,

mus c le appe a rsthi s is the s pecia l exten s o r o f the grea t toe .

The s p e c ia l ex ten so r of th e g r ea t toe a rise s f r o m th e

 cles
Per o n ea l Mus . 295

middle th r e e hs o f the ante rior s urf ace o f the s haft o f th e

bula an d als o f rom the adj acent s urf ace o f the intero s s eous
membrane A t its origin it i s
,

in part concealed by the long

or o f the to esan d the ante rior tibi al mus
.

extens cle b ut

becomess uper c i a l as it o ccupiesthe interva l between

,

the te ndonso f thes e two mus c l es The tendon o f the

.

spe ci al extens or o f the grea t toe there fore occupiesan

intermedi ate pos ition between the tendons o f the f oregoing

mus c le san d entering a di s tinct comp a rtment o f the

s
, ,

anterior ann ul ar liga ment o f the a nkl e join t p as - esalong

the inner an d upper as
,

pect o f the ins te p to re ach the

dors al s ur f ac e o f the gre a t toe into the b as e o f the te rminal
erted In f ront o f the an k le this
,

phalanx o f which it is ins .

te ndon li e simmedi ately to the oute r s ide o f tha t o f the

tibialis anti cus b ut when the l atter h as pas sed to the mi ddle
o f the in ner border o f the f oot th at to the great toe be com es
,

the mos t in ternal o f the tendonspas sing a long the upper

,

s urf ac e o f the f oot .The s pe cial extens or o f the great to e

an d the long exte ns or o f the to esas their nam es
, imply act ,

as straightenersor extens ors o f the to e s b ut they al s

, o act as
e x o rs o f the f oot on the leg ( Pl ate s XXV XXVI
Lying to the ou ter s ide o f the long exte ns or o f the toes
, ,

is the group o f mus c le s which aris e from the ex te rna l

s urface o f the s haft o f the bul a Thi scompri s es the
hed by the te rm s
.

two p e ro n ea l mus cles whi ch are dis tinguis

longusan d brevi sapplied to them ; the longer o f thes
,

e
mus c le s is the more s uper c ial an d overlies the s horter
one ( Plates XXV XXVI pp 292
The p er o n eusb r evisaris
.

esf rom the lower two thi rds

, , ,

o f the exte rn a l s ur fac e o f the s haft o f the bula an d from

the interm us cul ar se p ta on either s ide o f it It ends .

in a tendon which windsround the bac k o f the external

malleolusan d isin s e rte d a long the o uter s ide o f the f oot
into th e projection at the bas e o f the metata rs
.

a l bone

o f the little to e . The p e ro ne us lo ngus ar ises f ro m the head

 cles
Mus of the Ca lt: 97
2

su f e hollow between the exte l m lleol s d th

r ac rn a a u an e

tendo A hilli sor tendon f the

c lf m s les
; the depth o ca u c

f thi shollow v ries ording to the q ntity f f t

,

o a acc ua o a

pre snt O s
e . ion lly one f the deeper m s
cca a lesf the o u c o

bac k o f the leg called the lo n g ewo r of the gr ea t to e

becomes
,

uncovered in the inte rva l a bove d es

,

c ribed thou gh

lying at s ome cons

,

iderable dis tance from the s u rf ac e ; thi s

mus c le exerc i ses b ut a s light i n uence on the s urf a c e f orm s

o f the two peronei as

.

The tendons they pas sdown behind

the outer ankle lie obliquely acros sthe outer s ur f ac e

o f the o s ca lc is or heel -bone in thi spos ition they are :

held down by a ligament ca lled the external annular ,

ligament By thismeansthe prominence o f the outer

.

ankle i s rendered les sabr upt an d the s u r face con to urs

become more rounded The peroneus

,

longus an d brevi s ac t

as
.

extens ors o f the f oot i e they as s

.ist in po inting the toes
. .

A long with the peroneus

,

te rtiusthey als o rais e the outer

border o f the f oot an d turn the s ole outwar d sthe range :

o f thi s movement islim ited Their principa l action is .

to antagoni z e the mus c le swhich tur n the s o le o f the f oot

inwards ; acc ordingly when the f oot i s

, inverted they will
draw the f oot bac k again into its normal pos ition .

The mus cle s on the back o f the leg whi ch form the
prominence o f the ca lf are s u bdivided into a s uper c i al an d

a deep gro up Th e latte r cons ists o f the long e x o rs o f the

ticus They are pl aced s

.

toes an d the tibi a li s pos o deeply

.
,

however that they have little direc t inuence on the

,

modelli ng o f the s ur fac e tho ugh by t h eir pres ence they

sto the limb The tendonso f thes c le s
,

impart a fullnes . e mus

a ll pas s down into the s ole o f the f oot in a series o f groove s ,

whi ch lie b ehind the prominence o f the inner ankle an d

between it an d the proje ction o f the heel It is here that .

light extent their es hy bellies

,

to a s crop up between the

an d the pos terior border o f the tibia as

,

te ndo A chillis will ,

b e noticed hereafte r ( Pl ate XX VI Fi g 2 p , .

,
.
298 Mus
clesof the Ca M

sp r i l muslesf the pos

Th e u e c a t ior gro p c th o er u are e

sl s d the g s
o eu an t miusThe s a l s isthe deeper f the
r o cn e . o eu o

two It ri s
. esf rom the b k f the he d d pper third
a ac o a an u

o f the s
h f t f the bul
a d f rom the b k f the s
o h ft f a , an ac o a o

the tibi long line whi h l d s

a a af rom the s u f e on the c ea r ac

extern l t be os
a ity where the he d f the b l rti l tes
u r a o u a a cu a ,

obliq ely downw rds d in w rdst blend with the pos

,

u a an terior a o

border f the bone i e th t border whi h limits pos

,

o teriorly
. a c

The m sle
.

intern l s
,

the sb t neo s
u cu a u f e f the s
u h ft a r ac o a . u c

i stt hed to thi s

a ac bord er s low down sthe j n ti on f a a u c o

the middle with the lower third o f the length o f th e

tibi a The s
. tudent wi ll obs erve that the s oleus takes origin
f rom the po s teri or borderso f bo th boneso f the leg f rom ,

the tibia on the in n er s ide an d from the bula on the outer ,

s ide the importan ce o f th is

: will b e further re ferred to .

Be tween the two bonesthe mus c le ari ses f rom a ten '

d i n o us arc h whi ch cro s

, s es over the deeper s tructures The .

es hy breswhi ch are s hort are ins erte d into a broad

tendon which gradually narrowsasit pas s es down war d s
,

Th e late ral bres o f origin as

,

they s pring from the tibia

an d bul a pas sobliquely towardsthe middle line o f the
m us c le The tendon whi ch als o re ceives the ins e rtion o f

an d is
.

the gas c alled the te nd o A ch illis

,

tro cnemius mus c le i s ,

attac hed be low to the bac k pa rt o f the t ube ros

,

ity o f th e
heel bone ( Plates
- XXV XXVI pp 292 .

The gas tro c nem i us ts

, ,

which re s
,

upon an d lie s su per c i a l

ole ushasno attachment to the boneso f the leg

,

to the s ,
.

It ari s esby two headsfrom the back o f the lower end o f

the thigh bone immediate ly above the condyles A t its
-
,
.

or igin it i spa rtly te ndinousan d pa rtly es hy The two .

bellies lie s ide by s ide be hind the kn ee with the ham s tring
ides
,

te ndon s to their inner an d oute r s : below whe re they

have es
,

ca pe d f rom the c onning in uen ce o f thes e structures ,

the be llie s o f the gas t rocnemi us become much enlarged an d

bulge o ut laterally ( Plate XXV Fig 2 p , .
, .
 Ten do A ch ll
'

z z s
.

The in ner h ead i smore prominent than the oute r an d

somewhat longer Be th bellies ar e ins
,

. e rted into the s u per

cial as pe ct o f the ten d o A ch illisabout the level o f the

,

middle o f the leg the inner head as

, h as been s a id reac hing

a s
, ,

o mewh at lower level than the ou ter A bove where the

.

two heads o f the mus

,

c le lie be hind the kn ee an d between

the ham s tringsthey ar e s

, eparated by a V-s haped inte rval
which bounds in feriorly the hollow ca lled the h am Be low .

thisthe angle o f the V is c ontin ued downwa rd s as a li ne ar

depres sion which s ervesto indi ca te the s eparation o f th e

c le : thi s
,

two halves o f the m us may be trac ed right down

to the in s ertion where it openso ut to corres
, pond with
an interva l overlying the tendon an d p lac ed between the

rounded an d s omewhat pointed in ferior extremitieso f

the es hy belli es .

As will be s een by a re f er ence to Plate XXV I g 2

'

trocnemius
.
,

the inner b elly o f the gas

,

overlaps the upper part

o f the inner or tibi al attac hment o f the s oleusan d here
the outline o f the limb as
,

determines seen f rom either f ront

or bac k The oute r belly be in g nar rower do es
.
, not overlap
oleuss
,

the outer or b ular attac h ment o f the s o th at the

gas
,

trocnemiusplaysno pa rt in determining the s urf ace

outline o f the oute r s ide o f the leg as viewed f rom the back
or fr ont ; here the outline depends o n the s oleus above an d

the peronei below ( Plate X X V Fi gs1 2 p , .

, , .

The ten d o A chi lliswhich isthe combin ed tendon o f the

trocnemi usocc upies
,

soleus an d gas ,
the lower ha lf o f the back
o f the leg . I ts siz e an d s trength vary with the mus cu l ar

development o f the model s upe riorly it m ay atta in a width

o f three in che s A t thi s

. po int it receive s the ins ertions of

the es hy bellie s o f th e gas trocnemiusgrad ually diminis hin g

in width asit pas ses downwardsit receives on either s i de
oleusasthey r un toward sth e
,

the e s hy breso f the s

middle lin e o f the ca lf from the bula on the outer s ide
an d the tibi a on th e inner s ide .
 A ctio n o f M us cles of C a l 3 0 1

the body is trans mitted to the f oot the forc e as

, ,
before being ,

applied to the extremity o f the heel .

Bu t the reader will note that the gas trocnemi us m us cle

diff ersfrom the s ole usin not being attached to the bones
o f the leg . It ari ses from the lower end o f the thigh bone -

it theref ore pas ses behind the knee an d will accordingly

under c erta in c ondition sact as
, ,

, a e x o r o f th at join t .

The s e con ditions ar e the x atio n o f the ankle - joint by the

extens or mus c le son the front o f the leg an d the relax a
tion o f the extens or mus c le so f the knee on the fr ont o f

the thigh .

In regard to the development o f the mus cle s o f the ca lf

a point o f s ome practica l impor tan ce aris e s It h asbeen

.

s hown how the f oot is to be rega rded as a lever ; the f orce

neces sa ry to eff e ct the s a me re su lts will vary invers e ly as the

length o f the lever ; thus a s hort lever will require a greater
f orce to produce the s ame re s u lt as when a long lever i s
employed It followsfrom thi sthat the development o f
.

the mus cle s o f the ca l f whi c h s upply the power will s tand
in s ome relation to the f oot E xpe rience provesthat this
.

is the cas e We n d the mos t m arked mus cu l ar develop

s
.

ment o f the calf as ociated with a s hort f oot an d a s hort

heel while a long foot an d a long h eel ar e the us u a l co n

Y e t it by no me ans
,

co m i tan ts o f a poorly developed ca l f .

f o llows that the latter type i sles sable to perf orm featso f
endurance an d fatigue than the f ormer ; indeed an examina ,

tion o f the legso f s ome o f the be s t r unning m e n o f the

d ay goe s f ar to prove th at their s u cce ssdoesnot at all
d e pend on an exces sin the bulk o f the calf f o r many o f ,

the m di s pl ay what an uneduca ted s pectator might regard

as b ut a f eeble development o f thes e m us c le s

as
.

D uring powerfu l contraction o f the s e m us cle s in the ,

a ct o f s tanding on tiptoe the es

, hy bellieso f the gas tro
cn e m i us be come outs tanding eleva tionstheir lower end s
,

where they ar e ins erte d into the tendo A chilli sf orming

302 S mjf a ce Co n to ur sf o Leg .

a brupt mar gin so f a more or les spoin te d form A t the

same time the bres o f the s
.

o le us which lie un covere d on

either s ide o f the limb f orm elongated s ur fac e elevations ,

whi ch blend inf eriorly with the mar ginso f the tendo
A chi lli sthe bro ad expanded uppe r s ur f ace o f whi ch co r

res
,

pondsto a more or les striangular attened area which

ad ua lly narrows
,

r an d merge s in f e r iorly with the idge

g r

which lead s below to the prominence o f the heel an d which

co rr es ponds
,

to tha t part o f the te ndon whi ch i s fr ee from

mus cula r bres ( Pl a te s VI , XXV , pp 4
. 2 ,

In the prole view o f the back o f the limb the outline o f

the upper half or s o o f the leg depend s o n the f orm o f the

es hy bellies o f the gas trocnemiusan d will vary according

ta te o f contrac tion below the outline depend s
,

to th e ir s : on
the te ndo A chillis Thisoutli ne is
,

. gently curved c onvex

b ackwar d s above an d s li ghtly h o llo w below wh ere it pas , s es
to the heel the latte r curve s
: h ould not be unduly e m pha
s iz e d as
, it lead s to an unpleas ant p rojection o f the heel .

In fro nt an d on the outer s ide o f the limb the anterior

border o f the s oleusisden ed by a s trai ght li near de
pres s i on whi ch pas
, s es f rom th e bac k o f the h ead o f the
bula to the outer border o f the tendo A chi llis ; thi s line
s er ves to s eparate the calf mus c les behind fr om the peronei
long an d s hort ) in f ront ( Pl e XXVI p
( a t
ide o f the limb the mus
.

On the inner s c le s
,

o f the ca l f

ar e very clea rly m apped o ut by the pos terior border o f the

tibi a This border the re ader will remember corres ponds to
pos teriorly the s
.
,

that margin o f the bone which den es

,

ub

cutaneo us s urf ace o f the s haft the s urfac e whi ch li e s between

the ex o rso f the ankle in front an d the extens or mus c l es
,

pos teriorly Behind the uppe r f ourth or s o o f thi s margin

liesthe inner prominent head o f the gas
.

tr o cnemi us where ,

it es cape s f rom under cover o f the inner hams trings as they

pas sto the inner tubero s ity o f t h e tibia The middle th ird
.

o f thi s margin lies in f ront o f the bre s o f the s oleus wh ich

 Surfa ce Co n to ur sof Le
g .

ar ise f rom the tibi a an d whi ch ar e pas

, s ing obliquely down
w ard s an d bac kwar d s to be ins erted into the in n er bo rder
o f the tendo A chilli sBelow tha t p oin t the pos
. terior border
o f the tibia i s se para ted f rom the tendo A c hillis by an
e longa te d tri an gul a r inte r va l the apex o f whi c h i s
, dir ected
upward s It is. here that the es hy bellies of s ome o f the
dee pe r mus c le spa rti cu l arly the long e x o r o f the toe s
,

become s upe rcial an d exerc i s

,

e a dir e ct in uence on the

s urface helping to ll up the gap that would other wis

, e
e xi st between the tibia an d th e tendo A chilli s The .

hollow beh ind the inner ankle i so f cre s c enti c f orm I ts

s
.

g rea te st width i b e tween the intern a l m alleol us a n d the

pro mi nence o f the heel ; s uperiorly it f ades away on the

s urf ac e corr es pond in g to the triangular interval abov e

re ferred to ; whils t in f eriorly it curve s behind an d below
the inner ankle to pas sunder the inn er border o f the f oot
an d thus reach the hollow o f th e s ole The margins
. o f this

hollow are les sabrupt than might b e expected from an

im pacti on o f the s keleton ; thi s is d ue to the arrangement o f
th e fas c i a whi ch here f or ms
,
the in tern a l a n n ula r liga me n t
an d s e r ves to bridge over the in terva l It i s . beneath thi s
s tr ucture that the tendons o f the deep m us c les o f the b ac k o f

th e leg pas s to the s ole o f the f oot The mus

. c le s which s pring
f rom the under s u rf ac e o f the heel bone an d whi ch r un
-
,

a long the inner border o f the s ole o f the f oot have als oa
cons iderable in uence in mo d i f ying the s urf ac e f orm s ; an d
the di s tribution o f the s ubcu taneous ti s
s u e whi ch here f orm s

the pad o f the heel s hould not be overlooked ( Plate XXVI ) .

In s tudyin g the outli n e o f the leg as s een fr om the fr ont

the s tudent s att n tion mus t be directed to the fac t that the
'

outli n eso f the inner an d outer s ide o f the limb do not

d epend o n an y o f the s tructures whi ch lie on the front o f
the leg b ut ar e chiey d ue to the proje ction on either s ide
c le s A long th e outer s
,

o f the m us o f the ca l f ide the b ular

attac h ment o f the s oleus determi nes the outline o f abo ut th e
3 06 F em a le Fo r m of Leg in .

joint b ut be omest on e emph s

, i ed when the k ee i s
c a c a z n

b nt ( Pl te s
e VI XXV pp 4
a 2,

id beyond wh t h sbeen s
.
, ,

Little need be s t ted in

a a a a

reg d to the in en e f the s

ar t t reslr dy desrib d
u c o r uc u a ea c e

on the f orm o f the limb ; i n powerfu l contraction the

lineso f s eparation o f the mus c le s on the f ront o f the leg
ar e indi cate d by a s erie so f s hallow longitudinal fur rows
a ll mo r e or le s sparallel an d bes t s een in the upper o r
,

es hy pa rt o f the leg Pas si n g from withi n outwards

.
,

we can recogniz e the f urro wss eparati n g the anterior

tibia l m us c l e f rom the long exte n s or o f the toesthe long ,

exten s or o f the toesf rom the peronei (long an d s hort) an d ,

the pe ron ei ( long an d s hort) from the b ular origin o f the

s oleus The s. u rf ace m arkings on the back an d inner s ide
o f the leg have b e en s ui ci e n tly expl a i n ed ( Pl ates XXI V ,

XXV pp 281 , .

We h ave taken as
,

o ur type th e S pa re athleti c male Th e .

inuence o f the mus c le s on the s ur f ace f orms i smuc h

r ed uced whenever the s ubcuta neou s fat be comes abund ant :

thi s is exemplied in the female in whom the limb pres , ents

a uni f o r mly s mooth appea rance w ith little or no indi cation
of s ubj ac ent s tructure sexcept under the mos t excep tional
c ircu m s ta nces ; the o u tline s a r e more owing a n d th e c u r ves ,

more uni fo r m In thisconnexion it m ay be noted tha t

.

in the f emal e the f ullnes so f the ca lf des c end s to a lower

leve l th an in the male In women owing to their more .
,

d li cately m o delled bonesthe s

e u rf ace f o r m s o f the inner
,

an d o u te a n kle ar e le s
r sprominent an d more round d than e

in th e male The s .hortn e s so f th e fe male f oot isno doubt

as s oc ia te d wi th the gre ater re lative develop m e nt o f the
m us cl e s o f the ca l f ( Pl a te X X III Figs I 2 p

ta te d in the ea rlier pa rt o f this

.
, .
, .

As h asbe en alre ady s

ch ap ter the s ,
ke le ton o f the f oot cons is ts o f ta rsa l me ta ta rs al ,

a n d ph a lange a l b one s The pa r t o f the f oo t f orme d by th e

,

t a rsa l bon e s exceed s i n length th at f ormed by the me ta ta rs al ,

 Fo o t Bo n esof
3 7 the . 0

an ds a eriesf met t rsls

imil rly th t f ormed by the s a ex e ds o a a a c e

in lengt h th t formed by the ph l ngesor bonesf th

a a a o e

t es Thi s rr ngement f the bones f the f oot isin

o a a o o

triki g ontr s t to wh t one s ees

.

s n c a a

in the h and ombined length

; th e c

o f th e ph al anges or n ge bo nesi s
r -

gr ea ter tha n the length o f the palm

or metaca rpal bone san d thes e in
,

turn exceed the length o f the part

o f the h and f ormed by the wr is t or
ca rpa l bones It isobviousthat.

thes e d iff erences ar e correlated with

the m ctio n s the f oot is ca lled upon

to di s charge f o r the to es
,
whi ch co r ,

res pond to the mos t freely movable

part o f the hand the n ge rsare

much reduce d in their relative pro
portions whils t that pa rt which
pond sto th e s
,

c o r res upporting pa rt

o f the hand the wris t i sgreatly

ed Ash asbeen alread y
, ,

increas .

pointe d o ut thi sincreas e in the PH } 76 Th b sf 1 e one o

igh t f t ss
.
,

iz e o f the ta rs
.

s a l elemen ts imparts f m bth e r oo a e en

Th tib i
a ter s n gth an d s
ro a o ve . e a

g re tre olidity to the d b l h ban u a ave e en re

f oot req uirements o f whi ch it s tand s m d s st p s o ve o a o ex o e

As t g l s
,

much in need fr om the nature o f b Os l is h l a . ra a u

th e d utie s it h as
. ca c or ee

to perfor m b one

s N i l s
.

The as tr aga lu an d o s c al c i s
c a v c u ar o r ca
h ave
.

p h id o

been s uf c iently desc ribed ( a nt e

d C b id
E l , i
. u o
t er na

tragalus
cun e

Th e as
6.

supports
x

p . the f m or

f Mi d d l if m . e cun e or

inner column o f the foot whi ch 9 I t l , i . n e rn a c un e

c on s istsin order f rom behind f o r i i i M t ss

,
f m or

e a ta r u

wardso f the n a vicu la r the th ree Ph l g s

. .

j j j j j t a an e or oo
s
.

cune ifo r ms
,

an d the th r ee meta ta r s
b one .

al

upp ort the th ree inner to es

,

b o n es whi ch s .

X 2
30 8 Fo o t Bo n esof the .

Th s l isor h el bone spportsth s

e c ca c ,
keleton f th e -
,
u e o e

o t r ol mn f the f ot whi h in l desf om behind

u e c u o o c c u r

the b id d the m t t sl b sf the tw

,

f orw rd sa cu o an e a ar a o ne o o

o ter toes The o ter border f the f oot s

u . we pr eed f rom
u o ,
a oc

the heel forw rd isf ormed by the s l is

a or heel bone th
, o ca c -
, e

cu boid the met t sl bone d the ph l nge sf the littl

, a ar a an a a o e

toe The me t t rsl bone f th little toe ish

,

. a a a teri d o e c a rac z e

by enl rged b s
an e ; thisf o ms m rked p j ti
a a r a a ro ec on

which can be readily f elt at the middle o f the outer bord er

o f th e f oot Trac ing the outline o f the in ner border o f
.

the f oot the o scalc i scan be recogniz ed on the inn er s ide

us
,

o f th e heel below an d in front o f the in ner ankle the s

:

te ntacul um tali o f the o s ca lc i sa n d th e as tragaluscan b e

f elt ; i n front o f the l at ter th e projec ting inner border o f
th e n avicula r bone ca lled the tubero s ity can be eas
, ily d is
tin guis
,

h e d ; lying in fr ont o f this is th e inte r nal cunei f orm

e o f the metatars
,

arti c ul a ting a nteriorly with the bas a l bone

o f th e gre a t to e thi sjoint cor res

: ponds pretty clos ely to th e
middle o f the inner bord er o f the f oo t re ckoning th e dis ta nce ,

f rom th e heel to the tip o f the great toe In fro nt the head .

o f th e me ta ta rs
,

a l bone a rti cul a te s with the rs t phalanx o f

the gr e at to e which in turn s, upports the te r mina l phalanx
o f th a t digit the r e being only two ph ala nges in th e great
toe in pl ace o f three as
,

in the othersan arrangement which ,

is in corres p onden c e w ith wh a t we h a ve se en in the case

o f th e thu mb The joint betw een the metatars

. al bone an d

the rs t phalanx o f the great to e iss upporte d beneath

by two s mall nod uleso f bone thes e ar e ca lled s es a mo id :

bone san d th e w hole joint s o f o r med co r res pondsto what

is kn own asthe ball o f the grea t to e The boneswhich .

f orm th e o uter an d inner col u mn s o f th e f o ot above r e fe rred

an d l i ame n ts
,

to are the m s elves uni ted togeth er by joints g

o f the toe s
,

with the excep tion o f cours

,

e o f the bones
. ,
which ,

a re n o t l a terally uni te d to ea c h o ther ( Fig

t asth e boneso f th e hand were arranged s o as

.

J us to
3 m A rc e h sf o the Fo o t .

cons iderably ; in oth er wordsth e foot s p rea d s,o ut wh en

the weight o f the bod y i s thrown upon it it lengthensth e : ,

toesbeing p us hed fu rther in to th e point o f the boot an d

it becomes wider asis p roved by the tightnes sac ro s sthe
.

ins tep ( s
e e Fig .

It isimportant that the reader s hould be famil iar with

th e mech ani s m by which thes e changes ar e e ff ec ted As h as
bee n s tated the boneso f the f oot apart fr o m thos
.

e o f the
to esare arranged in a s
,

eries
,

, o f tra nsverse an d longitud in a l

arche s ; the f ormer are appar ent as they f orm the roun ded
con tour f rom s
,

ide to s ide o f the uppe r s ur fa c e o f the f oot .

The concavity o f thes e trans vers e arches ass is ts in f ormin g

the hollow o f the s ole .

Fro . 1 78 . Fro . 179.

s
Di agram to illu trate th e s ar ch e sfo th e f o o t.

( 1. Th e lo n gitud i n al arch
ss
.

b . Th e tr an ver e arch th r o ugh th e cun eif o r m: an d cub oid .

Th eexperiment with the wetted foot h as d emon strated

the exis ten ce o f a longitud inal arch o f which the pos terior ,

pillar i sthe prominence o f the heel the anterior pillar ,

co rr e s
ponding to the ball o f the great toe an d th e pad o f
the fore pa rt o f the f oot immediately extern al to it the arch :

between thes e two po in tsc oinc ide s

with the inner bor der o f
the foot whi ch i srai s ed fr om the ground Th e exi s ten ce .

e archesimpa rtsa certain amoun t o f elas

,

o f the s ticity to
the f oot ; they ar e like cur ved s prings the extremitieso f
whi ch are in contact with the groun d if over the mos t :
 h sof the Fo o t A rc e
3 . 11

elev t d p rt f th s
a e pring pres
a se be pplied the reslt
o e ur a u

wi ll be th t the s pre d t itsextremities

,

pring wi ll s
a will a ou

d the dis
,

be more widely s ep r t d t n e between the

a a e an a c

highe s t point f the rve f the s opri g d the gro nd cu o n an u

will be redu ed The r hesf the f oot t ve y m h

c . a c o ac r uc

in the sme w y ; they s

a pre d t when the we ight f the
a a ou o

body i s thrown on the f oot b t they re over them s elvest u c a

sre isremoved The el s ti ity th s

,

on e when the pres

c u . a c u

im p rted t the f oot i sf the gre tes

a o ts e i e in en bli g o a rv c a n

it t withs
o t nd the violent s
a ho k st whi h it i ssf c o c o ro

q ently sbje ted A little experiment w ill bri g thi s

u u c n

home to the reader In j umping f rom a height one lands

.

ordinarily o n the ball o f the f oot the heel b ing the las t e

thus
,

part to to uch the ground ; the s hock is much reduce d

be fore the force i s trans mitte d up through the leg b ut i f :

in place o f landi n g on the f ore part o f the f oot the read e r

j umpsf rom an incons iderable height an d landson h is
heelswith the kneesexte nded he will reali e how n u z

ple as ant the s hock is by the j arring eff ect whi ch it produces ;
a height o f a f ew in che s isqui te s uf c ient to ca us e res ults

unple as ant enough to produce a las ting eff ect on the

memory I n thi s . c as e the ar ches o f the f oot cannot yield

to the fo ce asthe s r hock isdirectly trans

, mitt d through e

the hee l bone an d as

- tragalus to the bone s o f the le g .

A part f rom the el a s ticity which i s thusimpa rte d to the

f oot the s e arche s als os e r ve a us ef ul p urpos e in protecting
equ en ces
,

the ne rvesan d ves s elso f the s ole f rom the cons

o f pre ssur e Th e re ader will n o w re a liz e how the s
. e strue
tu resas they lie in the hollow be hind the inner ankle pas
,
s ,

down i n to the s ole under cover o f the arc h whi ch rais es th e

inner bord er o f the foot f rom the ground .

The les son to be learnt from thes e obs ervationsisthat

the f oot when it s upp orts the weight o f the body on the
ro un d is longer bro ader an d atter th an when r a i s ed in
g , ,

whi ch pos ition the s train bei ng taken o ff th e ar ches

,

,
th e ,
3 1 2 Do r sm
u f
o the Fo o t
.

f oo t be comes more curved an d the elevation o f the ins te p

mo re pronoun ced .

As man only exceptionally m akes us e o f the f oot as a pre

he n s i le orga n the re ader will note th at that part o f the f oot

,

( i
. e .the toe s) whi ch c orre s pond s to the m o st mov able s egmen t
o f the hand the n ge rsis much reduced in s iz e moreover : ,

o wing to the f act that in the f oot the f urther extr emity

o f the metatars a l bo ne o f the great toe i s uni ted to the other

metatars a l bone s we have no s uch power o f oppo s ition o f

the great toe with the other toes as we pos sessin the thumb
,

an d ngers ,
f o r in the hand the di s tal end o f the me taca rpal
bone o f the thumb is fr ee an d unconne cted with the other
m etaca rpals .

Th e dors al s ur face o f the f oot owe s its f orm in great part

to the arrangement o f the bones Overlying thes e are the
whi ch are pas
.

tendons s ing down from the anterior s u rf ace

o f the leg in f ront o f the ankle As previo us. ly des c ribed ,

the tendon o f the an terior tibial mus c le may be trac ed

down f ro m the inner s ide o f th f ront o f the ankle to th e

e

middle o f the inner border o f the f oot ; in like manner the

te ndon o f the peroneus te rtiusthe m us c le whi c h i s intimate ly
co nnec ted with the lower bres
,

of origin o f the long

ext e ns or o f the to esmay be trac ed f rom the ankle imme
,

diate ly in f ront o f the lower end o f the bula to the middle

o f the o uter border o f the f oot where it is attac hed to th e

b as al bo ne o f the little to e on i ts
,

e o f the metatars upper

s urf ac e thi s
: tendon is s mall an d thin an d only exceptio nally
s an y indi ca tion o f i ts
,

g ive pre s n ce by a co r re s e ponding

s urf ac e elevation Betwe en the foregoing m us
. cle s as they
lie on either s ide o f the front o f the ankle ar e placed the
te ndonso f the long extens or o f the to esan d the s pecial
exte ns o r o f the gre a t to e The f o rmer whi ch are f our i n
numbe r pas sto the dors al su rf ace s o f the f our o ute r toe s ,

down to the dors

,

whils t th e latte r whi ch is

,
single pas ses , um

o f the gre a t to e A bove at the f ront o f the an kle th e

.
, ,
3 4
1 Mus
clesof the Fo o t .

i ider bly intens

sonsc a ied when the toes ar e f orcibly ex
tended ( Plate XXV Fig 1 Plate XXVI Fig 1 pp 292
, .
, , .
,
.
,

The appearan ce o f the back o f the foot will vary

ac c ording to the a mount o f s ubcutaneous f at pres ent : if
that i s c ons iderable in quantity the outline s
, o f the vario us

ten donsar e mas ked an d only become apparent when

ar e s
,

the mus c le s trongly contracte d S imilarly with th e

ve i nswhich us ually f orm a f eature o f s
.

ome prominence
on the back o f the f oot ; they ar e be s t s een in a model
of s pare habit where their pres ence isindicated by their
s
,

urfac e projection ; when embedde d in a l ayer o f s ub

cu taneous fat their outline is dis played rather by colour

than by elevation A sthe arrangement o f the veinso f
.

the lower limb wi ll be des c ribed here af ter it i s not n ece s

s
,

ary at pres ent to re f er f urther to them Asin the h and .

s a l bones
,

o in the f oot the inte r val s betwe e n the metatars

ca lled i n ter o s
,

are occupied by m us cles sei thes e s erve to

maintain the uni formity o f the s urfac e c onto urs an d prevent

an und ue de n ition o f thes e bone s o f the f oot .

The under s u rface o f the bones o f the f oot i s clothed

by many mus c les ; the se a re ar ra nged f o r the p u rpo se o f

ana tomi cal de s cr iption into l ayersb ut a knowledge o f
happily unneces The mus c l es
,

their deta ilsis s

ary wh i ch
ur fac e f orm are natura lly tho s
.

have mos t inuence on the s e

whi ch ar e immedi ately covered b y the s kin an d fas c ia

o f the s ole The three mos

. t important ari s e po s teriorly
f rom the under s ur fac e o f the prominenc e o f th e hee l Of .

thes e one pas sesf orward alon g either border o f the f oot
wh il s
,
.

t the third occupies an inte rmedi ate po s ition

The a bd ucto r ha lluc isor a bd ucto r of the grea t to e aris es
.

i de o f the under s
, ,

behind from the inner s u rf ac e o f the

bony p rominence o f the heel I tsbrespas . sf orwards

along the inner border o f the f oot f ormi n g a es hy
longitudinal prominence A nteriorly the mus cle isin
,

amoid bones
.

s o rted in to th e inner o f the two s es which ,

 Mus
clesof the Fo o t .
3 5
1

are plac ed o n e on either s ide o f the under s ur fac e o f the

joint between the metaca rpal bone an d r s t pha lanx o f

the great toe ( Pl ate XX VI Fig 2 p , .
, .

The a bd ucto r min im i d igiti or a bd ucto r of the little to e

,

e sbehind from the outer s

,

ari s ide o f the under s u rf a c e o f

the bony prominence o f the he el A sits . es hy bres pas s

a long the o uter border o f the f oot they ar e attac hed to

the prominent tubercle o f the bas e o f the fth metatars al

bone A nteriorly the mus

. cle i s ins erte d into the bas e
o f the rs t ph alanx o f the little toe along with the s hort
ex o r o f that digit . The es hy part o f the mus c le f orm s

the s urfac e elevation along the under s ur fac e o f the ou ter

border o f the foot between the heel bone behind an d the-

a l bone in f ront as
,

prominent s pur o f the fth metatars

well asalong th e oute r an d under s
,

ur fac e o f th at bone .

In s tanding on the f oot thisborder isin conta ct with

the ground an d is, c ompre s s
ed an d attened by the weight
thrown on it ( Pl ate XXVI Fig 1 p . .

e two mus
, ,

The action o f thes c les is indi cated by their

name Only here it i sne ces
. s a ry to wa rn the rea der that

the termsadduction an d abduction o f the toesapply to

m ovements whereby the toesare drawn to or away from
a line pas sing along the axiso f the s eco n d toe an d h a ve ,

no relation whatever to the mid dl e line o f the body .

Occupying the interval be tween thes e tw o m us c le s ,

an d lying a long the middle o f the s ole o f the f oot isthe ,

s i r um or sh o r t eazo r of the to es This

ew o r b r ev i d ig to , .

m us c le a ri s esbehind from the under s u rf ac e o f the pro

m i n e n c e o f the heel bone between the two m us

- cles j ust
In f ront it endsin f our tendonswhi ch pas s
,

d es c ribed

to the f o ur outer toes

.
,

, there to be attached to th e bas eso f

the s econd phalanges on their under s urf ac e s The es hy
.

part o f the mus cle o ccupies the central part o f the s ole ;
in the inte rvalson either s ide o f it an d in f ront s ome
hort mus cles
, ,

o f th e s o f the great an d li ttl e toe come i n

3 16 Pla n ta r Fa s
cza

r elation to the s urface . It isnot ne es

sry
c a to d well o n
thes e d eta ils f urther th an to point o ut th at to the s es amoid

bonesat the bas e o f the great to o there are attached

the s hort e x o r an d add uctorso f that digit whils t on the
ide o f the s
,

outer s ole the s hort e x o r o f the little to e

unites with th e abducto r o f that digit to be ins e r te d into
the bas e an d outer bor der o f the rs t ph alan x o f the
little toe The action o f the s
. hort ex o r o f the toesis
s u ci e n tly indi cate d b y i ts name it as s ists the lo n g ex o r
in be nding the toes towards the s ole o f the f oot
e m us ur fac e f o r ms
.

The inuence o f thes c l es on the s

o f the s ole isles sthan what one might expect owing to
the fact that the s ki n in thi s region i s
,

very thi ck an d
tough an d a ls , o becaus e there i sa con s iderable quantity
o f f at an d a l ayer o f dens e fasci a .

The p la n ta r f as cia very muc h re s embl esthe fas c ia whi ch

h as been alread y des c ribed in the h and It cons istso f

trong an d thi ck central portion whi ch overli es
.

a very s

the s hort ex o r o f the toesan d two thin ner lateral ex pan

s
,

ionswhi ch s prea d over the abducto rso f the gre at an d

little toe s res pectively The s. tro n g c entral part whi ch is ,

connecte d with the un d er s urf a ce o f the heel b e hind ,

an d with the a nterior extremitie s o f the meta tars al bones in

f ront i s ,
a s tr ucture o f no little importance asit as . sis ts
in mai nta ining the longitud i n a l arch o f the f oot by tyin g
to gether its two extremities The s ubcutaneous fat o f the
s ole o f the f oot is peci ally mo died to ena ble it to s
.

s e r ve

th e purpos e o f an elas ti c pad The fatty lobuleswhi ch

iz e are abun d antly mixed with bro us tis
s
.
,

ar e o f s mall s ue ,

which impa rts

,

to the layer s o f orm ed a remark able to ugh

ne s san d res ilien cy Thislayer ises

. pe cially thi ck over
thos e partso f the s o le on whi ch the b ulk o f the weight

f allspa rti cul arly over the he e l an d the ball o f the gre at
kin whi ch f ormsthe s upe r c ia l coverin g is
,

to e The s
e modied In n o part o f th e bo dy isit s
.

likewis . o
31 8 The To es.

to des troy their n atural beauty we are largely depe nden t

:

there f ore fo r o ur idea l on o ur kn owledge o f the antique .

In regard to the length o f the to esthere is much divers

,
ity
o f Opinion The type mos
. t f requently repres ented in th e
an tiqu e is that in whi ch the s econd toe projectsbeyond
the great toe As .a m atte r o f f ac t this condition i s more
fr equently met with in dwellers o f th e s outh fo r obs
,

e r va ,

tions made on o ur H ighland peas a ntry s ome o f whom have ,

g one about ba re f oote d f rom c hi ldho o d appea r to in dica te that

t o f the s
,

the grea t toe i s a lmos t univers ally the longes e ries

thi s is a detail however o f little moment an d the c hoice

, ,

m ay we ll be le ft to the individual tas

,

te o f the artis t Th e .

third to e iss horter than the s econd by the length o f

the nail the f ourth hardl y reac hesthe level o f the nai l
,

o f the thi rd an d the ft h pr es e n ts many varia tionsin

length ; there isanatomica l evidence that th isto e is
,

ra d ua lly undergoing a r ed uc tion in s i ze

g .

In regard to the dire ction o f the diff erent toesa certain

mis co nception ap pea rs to exis t The A nato mica l bootmaker
. .

would have us believe that the inn er bo rders o f the f oot an d

grea t toe are in line A n exa mination o f the bes

. t mo dels
appea rs to ups e t thi sview fo r normally the grea t to e ha sa
lightly outward inclination though undoubtedly thi sis
,

s ,

oftentimesund uly exaggerated by the wear ing o f poin ted

bootsThe s
. econd an d third to es as a rul e shoul d follow this
outward inc lination whils t the fth s
. houl d be s lightly in
turned the direction o f the f ourth be ing more or les s straight ,

the cas
,

or directe d s lightly inwards or outwardsas e may be .

The cle ft between the great an d s econd to es is

,

often
time ss lightly deeper than that be tween the s e cond an d

third A s a rul e the c le fts between the four outer to es are

is
.
,

linear whi ls t that between the gr eat an d s e cond to e

een in an in fant sf oot pa r ticu

,

wi d e thi sm ay be well s
:

lar ly w hen the toe s ar e outs pread A d vantage wasta ken

econd to es
.

o f thi s greate r in te rva l be tween the great an d s

 Fema le Fo o t .
3 9
1

to pas s the thong by whi ch the s and a l was held in pos ition .

The toe sappe ar longer when viewed fr om above than

when s e en fr om be low ; thi s is d ue to the web between
the toe s 8 10pi n g downwa rd s an d f orwa rd s towards the s ole .

A sthe bone so f the leg ar e rmly xed together ,

there i sno movement in the lower limb comparable

to the movementso f pronation an d s upination which
occur in the f ore ar m Th i s- . neces s ar ily limits the range
o f the movements o f the f oot as c om pa red with the h and .

A pa rt f rom the movements which have be en de s c ribed

as ta king pl a ce a t the ankle -joint the f oot m ay be tu rned

,

inward sor outward sthe latte r only to a limited extent

, .

Thes e movementstake pl ac e at the jointsbetween the

tars al bone s The toe sm ay be exed or exte nded as
.

well as moved apa rt an d drawn together ; thislatter move

ment i s f rees t between the great an d s econd toe .

The f oot o f the female i sabs olutely s maller than that

o f the m a le . If we take into con s ide ration i ts proportion
to the height we nd that it i srelatively s
, lightly s horter
in women A f oot unduly s
. mall i f repre s, ented in the
nu d e at once imparts
, a f eeling o f in s tability to the gure
tsconcede more to fas
.

In no re s pe ct do artis hion than

in the repres entation o f the female f oot one h asonly to :

imagine what the s a me f oot wo u ld look li ke i f d ive s ted

o f i ts c overings to realiz e how abs u rd i s the ction which
makesuss lavesto fas hion An other point on whi ch the
.

lay mind i s apt to be mi s led i sthe hei ght o f the ins tep .

The f oot asit res tswithin the boot i sreally s upported

on an incline the s , lope o f whi ch dependson the height

o f the heel : thi stend so f cours e to emph as i e the arch
z

on the dors u m o f the f oot as the toe s

,
ar e ne ce ssarily s ome
what bent upwards at the metatars o p ha langeal joint The
- .

re ader need only notice the appearance o f a f oot in a high

heeled s hoe to realiz e this fact N atura lly when the s
. ame

f oot i s bared an d placed at upon the groun d the curvature

320 Super cia l Vez n
'

sf o Leg .

of the ins tep i smuch re duced ; s o m arked i s the change

that I have fr equently been s truck with the cri ticis m
as s
p ed on phot g ph o r a s o f f a irly well f ormed feet to the
-
,

effect that they were undul y at

t o f cours
.

True atnes so f the f oot mus e be avoided b ut

the s
,

tudent wi ll read ily reco gniz e thiscondition ashe

ole o f the fo ot not only touches
,

will notice that the s

the gr ound at the s u rf ac e s a lready de s c ribed b ut i s ,in
contac t wi th it at the pa rts c orre s ponding to the in n e r
border an d hollow o f the s ole Whils
. t undue atnes so f th e
f oot i s ugly ex ces
, sive arching o f the dors um s houl d b e
avoid e d as
, it impartsa cramped appearanc e to it .

G re at var i ation will b e met with in the length an d

bread th o f the f oot A sa rule the width o f the f oot is
.

abou t one third o f i ts

,

- length E xce s . sive prominence o f

the heel whic h i sas so c i ate d with mar ked curvin g o f the

s
,

tendo A chillis as it pas es down to it s hould als

, o be avoided
as
,

it givesr i s e to an exceedingly unpleas an t o utl in e The

s maller bonesthe greater abundan ce o f f at an d the les s
.

, ,

m arked mus cu la r development impa rt to the f ema le f o o t

a s ofter outline an d a plumper f orm

tated in regard to cutaneo us
.

M uc h tha t has been alread y s

veinsin ge ne ral might be repe ated here b ut the read er ,

is ref erred to p 185 where the matter h asbeen previous

.
, ly
di s cus sed The blood in the veinso f the leg owsco n
.

trary to the dire c tion o f the f orce exerc i s ed by gravi ty

in cons equence there isa muc h greater te ndency f o r the
blood to accu mu late in thes e ves s e lsthan in th e upper
limb w here the ow o f the bloo d through the vein sis
ing o f the arms W e
,
.

f requently accelera ted by the ra is .

m e t w ith the longe s

e t vein in the body in the lower
limb ; it e xte nd s f rom the inner ankle up the inner s ide o f
th e leg an d thigh an d termina tes a bo ve a little be low the

inner extremity o f the f old o f the gr oin It is s

.

. upe r c i a l

throughout i tsentire le n gth an d when dis , tended wi th

 CH A PTE R XII .

TH E NE CK .

IN onsidering the anatomy o f the neck it wi ll b e

c

ne ce ss a ry in the rs t in stance to examine the s keleton

o f th i s part o f the b o d y an d note how it is united with the

head abo ve Aswass

,

tated in a previouschapte r (s ee

there are s
.

ante p eve n , .

c e r vi ca l or nec k verte brae

in that part o f the bac k
bone which pas se sthr ough
an d s upports the soft tissues

of the neck On e o f the .

cha rac teri s ti c f eatures o f

thes e ne ck vertebrae isthe
shortnes so f their s pines : to

thisthere isone exception ,

the l as t or s e venth cervi ca l

I

vertebra The reader s atten

'

F G 8 S k ll
.

as
I 1 0 d i l u an ce rv ca ve r

t b sf m sh wi g s tion be en already d irec ted

.

h
.

m ll f o

to the importance o f the s

e ra o an , n a ace

bone sl g b i - s d s
ar h t
e ra n ca e . an or pine
i ls s
.

ce r v ca pi ne
o f this
.

verteb ra asa s urfac e

promin e n ce on the bac k o f the root o f the neck (s ee

a nte p an d the name ve r te b r a p r o mi ne ns often given ,

to it ref e rsto thispeculiarity in the length o f itss

.
, ,

,
pine .
 The A tla sand Axi s .
3 3
2

In regard to the other neck verte brae the s ,

hortnes so f
their s pinesisa dis tinct advanta ge asit enablesthe
,

vertebra l colum n to be more fully extended i e bent . .

back in thiss
,

ituation than in an y other part The two

highes
, .

t o f the neck vertebrae ar e mod ied in a peculi ar

w ay to enable the s kull to arti cu late with the top o f the
verte bra l column It isnot neces
. sary th at the s tudent
s houl d be famili ar with the detailso f s tructure o f thes e
tw o vertebrae as . they have no inuen ce whatever on the
s urfac e f o r ms, b ut s ome account o f the nature o f the move
mentspos sible at thes e jointsi so f s ervi ce in enabling
the re ader to unders tand the s u bs equent account o f the
movementso f the head an d neck .

The highes t o f the cervi cal vertebrae isca lled the a tlas ,

owing to the circum s tance th at it s upports the globe o f the

head it is
: provided with a pa ir o f pecul i ar arti cular s u rf ace s

on whi ch res t the condyleso f the occipita l bone one ,

o f the bones f orming the bas e or under s urface o f th e

s k ull Thes
. e condylesm ay be compared to the rockers
on a cradle an d asthey move in the hollows
,
on the upper
s u rfac e o f the atl as they produce a rocking or nodding
movement o f the head As . sociated with thisthere m ay
be s light degrees o f obliqu e or l a te ra l movement .

Th e atlas ts on the vertebra beneath it the a x iss

o ,

ca l led very mu ch as a ring ts over a peg f o r th e latter

scalled
,

vertebra isprovi ded with an ups tand ing proc es

the o d o o id or tooth like pro ce s
n t - swhi ch is
, enclose d above

in a ring f ormed by the bony arch o f th e atl astogether

with a ligament The joint i sa pivot joint an d here take
.
-

place the movements

,

of rotation whereby the head an d ,

with it the atlasar e turned from s i d e to s ide Th e range .

movement ischecked by ligam e ntsb ut asa rule

,

o f thi s ,

the head m ay be rotated to one or other s ide o f the middle

plane o f the body to the extent o f The reader will thus
realiz e the importance o f thes e two jointsasat the upper ,

Y 2
324 M o vemen t sf o the N eck .

th e nodding movementsal one take place whils t at th e

lower the movements
,

o f rotation only occur .

In the rema inder o f the cervi cal portion o f the verte m

col umn the prin c ipa l movements ar e

eff ecte d in a bac k ward an d f orwar d

direction ; ex ten s io n or bending bac k
ward sismore free than e wio n o r
bending for wardsfo r the reas on e x
plained at the commencement o f this
,

c h a pter an d al s o beca us e the for war d

movement ischecked wh en the chin
comes into contac t with the fron t o f
the che s t .

The other movement o f which this

part o f the column iscapable isa
combin ation of ro ta tio n an d la ter a l
w i n a movement whereby we bend
e o ,

the neck to the s ide Th e neck verte

ides
.

brae ar e s o su rro unded on a ll s

by mus c les an d other ti s s

u es that u n der
ordinary cond itions they have no direct
inuence on the s urf ac e f orm s with
the s i n gle ex ce ption o f the s pine of

s
F 81 A d i g m
IG 1 a ra

s the vert b prominen Behind

. .

to h w tho g e a r ra n e ra
e an d
m t f th m s
en o l s on either s
e u c e
ide it isprin cipally mus c le
spp t th
whi h
b k b
ac -
c

Th m s
o ne
u
whi
or
c h e
we hu a
e
ve t o de a l with w h ilst i n ,

l swh i h
.

c e pc f ront the gullet windpipe an d laryn x

ar e r e re

st d i slid b l k all conceal the form o f the bony s

, .

en e n o ac

s t b thi k
,
tr uc
tures The es hy m as smet with
a re ee n o e c

i th
n g i
e s f t
reh on o e

l i s d
a c ontinuation upwards
.

is
o n an k d
behind
nec . an
of
mp ti ly th i
s
i
s s
co ara ve n n

th m id -d s
e l g i or a th a t g re
re a t gro
on u p o f m u c le whi c h h a

been already des

.

c ribed under th e nam e

o f the ere c tore s spinae ( s e e an te p the latter was

i d e o f th e s s
.

ee n to o cc upy the f ur rows on either s

,

s p i n e

o f the vertebrae b ut be ca me m uch red uce d in bulk in

,
326 L iga men tum n uc a e h .

srf
u ac e formsbehin d es hy columnson either s id e
s
.

are e pa rate d fr om one

an o ther by a brousparti
tion called the liga men tum
n uc hae a f eeble repres
, en

tativ e in m an o f the gre atly

developed elas ti c ligamen t s o

of ten met with in many o f

the lower animals A was
s tate d in an earlier chapter
. s
( C h a pter I p th e po or, .

development o f this ligame nt

in m an is as soc iated with the
as sumption o f the erec t po s

ture a po s ition in whi ch the

head ismore or les spois
,

ed

on the s um mit o f a verti ca l

c olu mn where as in the lower

the liga ment iso f
.

anim a l s

neces sity s tron g in order to

s uppo rt the h ead at th e ex

tro mity o f a more o r les s

h ori z o nta l column .

It is needles sto enter into

an y deta iled d es cr iption o f

thes e es hy mas ses o n th e

a. Plac ed sp t f
o ve r ten d in o u ar o er ecto r
s
pi n ae .

b P s
ot i sp i ili s
e r or p i u er o r ac n e.

s
.

c. H h-
b
an n a( i mi t m) one c n no na u .

4 . S o c k e t f o r h ead of th igh -
bone (acct.
b n lum )
sT b s i ty f th is
.

u e ro hi m o e c u

s s st
. .

Pro 183
th g S ho w
t t Pl d a ce hy pu t f
o vo r c
'
o cr c o r
s
e rea erec o r
m ssf musl s Th musl s
. .

pi n ae .

i s m s
a o c e e c e are
s s
.

g S pl l
en u u c e
h w ly id ; th g h M s s sf t m p l b
. .

o n on o n one e e ro o ve
i w hi h th y
n cl d g d is
e s are o e een
. t id p
t C m pl
a

sm s
c

ds ps
ro ce o e o ra o n e.

s
o lex u i u d u c e an n r cr c r vo
gure
.

on th e right id e of th e . lin e o f o cci pital bo n e .

 D eep S tr ucture sf o N eck .
3 7
2

back o f the neck asthey are in great part overl ain by

the trapez iuswhich h asbeen already des
.

c ribed (p

an d al s o by other s
.

uper c i a l m us c le sthe de s c ription o f .

whi ch will f ollow ; b ut their indirect inuence on the s u rfac e

conto urs o f the back o f the ne ck s hould not be over

looked as it is to their
pres
,

ence th at the full

an d rou nded appe a ran ce

o f thi s region i s d ue .

The f orm o f the front

o f the ne ck i s partly d ue
to mus c le an d pa rt ly to

other s tructur eswhich

ar e as s ociated with the
a limentary tract an d the

res piratory s yste m I n .

fr ont o f the verte bra l

colu mn an d co m m e n c
,

in g above at the b ack

of the mouth isthe ,

tube ca lled the gullet

or o es
,

o p h agus by whi ch
,

f ood istrans mitted to

Di g m t s h w th p s
the s tomach W l thl n
.
F
f s
84 IG

me f th s
o
. 1

t u tu s
o
.

i tho
aiti
k
ra

e r c
o

re
o

n
e o

e n ec
on

an d b elow th e arch o f
m mb
the lower j aw there is
a. o o n e,

b T h i l f h l A d m s

y id
. t g ro t yca r ( a e o e ar nx a

pp l ) a e

a bone called the hyo i d

.

L f l bc f thy id gl
e t o d e o ro an

s
. .
,

b o n e W t ll i s
d f b t-b

d l
co n ne cted w in d p i p
cr e n o r ea o n e.

h
.

, 6. e, o r e.

with the tongue Below .

I S p i . f s t h ne o i l t b (
e ve n t b ce r v ca ve r e ra ver e ra

th e hyoid bone an d

oph agusi s
,

lying in f ront o f th e gullet or oes the tr achea

or win dp ip e The upper ex tremity o f thisres
,

. piratory tube
i speculi arly modied to f orm an organ immediate ly
c once r ned in voi ce prod u ction
- the la rynx In front o f
the windpipe below the laryn x there is
.

,
a gland o f co n
,
328 The Hyo id Bo n e .

s
id si e lled the thy id b d y d onne ting thes
e rab le z ca ro o an c c e

v rio ss
a tr t res i the hyoid bon
u uc u d l ynx wi th v z . e an ar

the inferior j w b ne the b e s

,

srro nding p rtss u h s

,

u u a t c a a - o r a

m ll mus les
,

d oll r bone s n mber f s

,

bone an there c a - are a u o a c

t they do not s ule in en e the s

, ,

whi h whils c u f e a a r u c r ac

in de t il yet in b lk s s
,

f orm s ist in imp rting to the f ront

a , u a a

o f the ne k itsh r teri s ti modelling A more det iled

c c a ac c a

de sription f s
.

c ome f thes e s tr turesisne es

o sry Th o uc c a . e

hy id b o or bone f th tongue whi h is s

o ne . m ll o e c a a

lender b ne formed like U i s

,

s o sit ted t the ngle f ormed a . ua a a

by the o tlin f th s oft p rtsbelow the hi n d the

u e o e a c an

line f the f ront f the ne k The pos

o ition f the bone o c . o

v ries ording to the pos

a acc ition f the he d Wh en th o a . e

eyes dire ted s ar e t ight f orw rdsthe hyoid bone li s

c ra a e

nearly on a level with th e angle o f the lower jaw The .

read e r may s at is
fy hims el f asto the pos ition o f the bon e
by gras pi ng the tis sues o f the ne ck in thi s region rmly
between the thumb an d ngers When the head is .

exte nded or thro wn back the angle f ormed by the line

below the chin an d the lin e o f the front o f the neck i s
,

opened o ut an d the pos ition o f the bone ismore eas ily

recogniz ed ; it alwayscorres pondsto th e line o f ex ure
,

or angle where the head bend sf orwar d on the nec k .

When the head is th rown back the rs t point o f res is tance

met with in pas s ing from the c hin downward salo ng th e
mi ddl e line isthe hyoid bone I f the nge r be placed on .

thi an d then ca ri d d ownward sa well marked elevation

s r e -
,

abo ut h a l f an i n c h be lo w the level o f the hyo id bone will

eas ily be rec ogni z ed thi sprojection isd ue to one o f the :

ca rtilage s o f the l arynx or voi ce -box It is ca lled the p o mum .

A da mi or A d a m s app le

.

Thi sprojectio n i smore characteris

.

ti c o f the male than

o f the f em a le an d di ff e rs re ma rkably in the ad ult ma le
,

as c ompar ed w ith the c hild I f the nec k o f a child be .

examined there islittle or no evidence o f this pro minence ,

 The S ter n o ma
- s
t i
o a

.

Thes e s tructuresashasbeen s tate d are many o f the m

overlain by thin mus c l es
, ,

w hils t others ar e s uppo rte d

an d xed by the s am e

means A detailed d e
e appear s
.

s c ri ption o f the s

unnec es sa ry as it is on ly ,

under ex ceptional c ir cum

s tance s that they can hav e

an y dire ct in uen ce on th e

s urf ac e f orm s thus i t is :

only in the emaciated that

their outlinescan be re
co gniz ed or in s uch ex ,

tremes o f m us cul ar eff ort

as are as s ociated with the

s truggles o f an unf o rtu nate

c reature gas pin g f o r bre ath

th at their de tails are at all
F o r 85 Di g m s 1 h wi g th a ra o n e
s
. .

arra n g m t e f m en f t h o p i i
o p l a ppe oa rent e r nc a
st u tu sf th
c le which p lays
.

r c re ok e n ec
The mus.

m t id m s
th e mos
-
0. St er n o

i s m s
l u o u c e.
t imp o rta n t par t

as
b T ra pez l u u c e
-h y id m s
. .

c S. te rn e l o u c e. a determ i n ant o f the

s u rfac e f o rm s
d L j w
o wer a
o f the n ec k
. .

e H y id b

s
o o n e.

f P si is te r no m i a s
.

. i
o te r o r gl
ssf sp l
tr a n e.
the to id I n
is
.

f e r io r ly thismus
g A mi c ro p on ro ce o ca u a
f sp l
. .

h S pi ne o ca u a. c le
w b lli s m -h y i d m s
.

i i Th t f h l t e o u c e.
.

j Th y id
e

il g
o

f l y
e

ca r t
e o

(Ad m s
a e
a t tac o
hed to
o

ar
the nx
o
a nt e rio r
a

s
. ro

p l a p e u rf ac e o f the uppe r end

b ll i sf th d ig t i m s
k k Th l
s
e t wo e e o e u r c u c e.
M s ssf t m p l b the bre t b one by a
.

in . t id p
a o ro ce o of e ao ra
- o n e.

S p i d li f i pi l b
0

p H m
u e r o r c ur ve

s thi ck ro unded te ndon ; it

ne o o cc ta o n e.

a ls s s
u e ru

Fi s ib
. .

r r t r
o derive e hy an d
sC ssf sp l
. .

s s
id p
o rac o r o ce o ca u a.
s s ss s tendino br m
.

t Pl d i f -
ac e p ion f n raf p l no u u o e f
ao r o t
cah e u a.

s
.

C ll b a r- o n e.
x .

s -
o
i nner third or o o f t h e

thes
y B. b
re a t o n e.

coll ar bone ;
- e two
origins ar e s eparated by an interval o f varia ble width The .
 The S
ter n o - s
ma to id .
33 1

es hy belly forme d by the union o f thes e two attachments

pas s es upwar d s an d bac kward s toward s the part o f the s kull
immediately behind the car I f the nger be plac ed on .

the bone in thiss ituation a thick roun ded bl un t proces

, s
can be di s tin ctly f elt thi sisca lled the ma s
: to id p r o cesso f
the temp o r a l bo n e an d it isinto thi s an d the rou gh ri d ge

pas
,

s ing back f rom it ca lled the s ,

up er i o r cur ved li n e f the o

o ccip i ta l b o ne th at the m us c le i s ins erte d The exte nt o f the .

c on s
,

a ttachment o f the mu s c le to thi s ri d ge vari es idera bly

i n diff erent indivi d ual s Fi
( g 5 1 8 an d Pl a te XXVIII p
.
,
.

The s tern o mas

- toid asit pas s
e sobliquely ac ros sthe s ide

Fro 186 S h o wi n g articulatio n o f th e ll -

co ar b o n e s
( l c avi c le s
) wi th
s
. .

th e b r ea t-b o n e ( te rn um ) s .

a Co llar - s s
b o n e ( cla v i c le ) g Plac ed o ver th e b o d y of th e s
td sl
r or a

s s s
. . .

b S te r n a l en d o f co llar -b o n e v e r te b ra ; li e i n th e in ter va l b e twe e n

s s s s s
. .

t Place d o n th e r t an d e co n d r i b th e ete r n al e n d o f th e co lla r -bo n e

s s s ds
. .
,

d Th e u pper p iece o f th e b re a t- b on e a p wh i h
ace p t th c co rre on o e

s sf d p s s
.

( m an u b r i um t e r n i ) ur a c e i t the t f thre on a e ro o o e

s
.

f R ib ca r tila ge
. . n e c k , ca ll ed th e p it of th e n eck .

of the neck d ivi desthi s region into two trianglesthe one :

in front an d above it iscalled the an te rior tri angle that ,

behind an d below it the po s ter ior triangle The co n .

v ergen c e o f th e m us c les o f either s i d e be low where they

ar e attac hed to the upper en d o f the breas t bone h as
- a mo s
t
impo r tant eff ect on the mou ld ing o the s
f ur ac e f orm shere
f - :

the ir tendons o f origin f rom the breas t bone li e j us t within -

the expand e d inn er extremities o f the co ll a r bones

- as they res
t
upo n the upper border o f the s te rnum on eith e r s ide Thus .

a V s haped reces
- sis prod uced the s ides o f w hi c h ar e f ormed

by the te ndon so f the two s terno mas

- toid mus c l es whils
t ,
332 Pit
f o the N eck .

the angle o f th e V corres ponds to the uppe r border o f th e

breas t bone The depth o f the reces
- . s is f urther e mphas iz ed b y
the projection caus ed by the inn er end o f the collar bon e -

on either s ide This .depres si o n corres pon d s to th e s ur face

hollo w familiar to the read er under the name p it of the n eck .

In the m ale itsb ordersare s harply dened es pecially ,

d uring violent mus cu lar eff ort in the female owing to the
ence o f an abundant layer o f fat benea th the s
,

pres k in ,

the outlines ar e s moother an d more rounded an d the s .ur fac e

depres s ion isaltogether s o fter an d f orms a f eature o f gr ea t

beauty in the modelling o f the thr o at asit ris es from the

general f ul lnes so f the breas t ( Plates XV XVI pp 108 I I I ) . .

te rno mas
, ,

to ids
,

It is in the inte r va l betwee n the tw o s - that

th e s tructuresalrea dy en umerated li e viz th e windpipe .
,

larynx an d hyoid bone Thes

, . e aswe have s, een are ,

c overe d by a l ayer o f s m all mus c le s on either s ide Th e .

interval between th e s te rno mas toid sabove

- whi ch is
bo unded s
,

upe riorly by th e b order o f th e lower

j aw an d
in feriorly by the hyoid bone isl led up in par t by th e
mus c les
,

o f the tongue an d oor o f the mouth in par t by

elsan d in part by the s

,

blood ves - s , a liva ry gl and s ; o n e o f the

latter occupies the interval between the ear an d the an gl e

o f the j aw . Under cover o f the angle o f the jaw there is
another o f the s e glandswhi ch imparts a i lln es sto the
s u rf ac e as inward san d downward stowards
,

it s w eeps th e
hyo id bone ( Plate XXVI II p
In rega rd to the region behind an d below the s
.
,

terno
mas toid the s tudent s hould bear in mind that the
c l es sup on either s
,

trape z i usmus pas ide to reac h the bac k

o f the s kull clos e to the middle line The s am e mus c l es

o f the upper bord e rs

.

ar e ins e rted into the o u te r thi r d s

of the collar bonesthuslea ving an inte r val in fe ri orly

-

be tween the attachmentso f the s te m o mas

,

- toid an d
trapez iusc orres pondi n g to the middle third o f that
b one . A bo ve th e attachmen t o f thes
, e two mus cl es to th e
 The Pla tys
ma .

ment o f th es e various structure s A de ta il ed acco un t o f

sb ut the s
.

thisfas c i a is need les tud e nt wo ul d d o w e ll

tra ining in ue nce whi c h it exerc i s es
.

to re mem b e r the re s
on the s tr ucture s whi ch lie b enea th it It isbe tw ee n thi s
.

brousinves tment an d the s kin o f th e neck that th e s upe r

cial fat whi ch co n s ti tute s what isca lled th e s up e rc ia l

ce r vic a l f as cia lies H e re we ha ve to s

. tudy a mus c le

ca lled the p la tys ma myo id eswhi c h is a s urv i val i n man

in many an i mals
.

of a m us c le whi c h c ommonl y o cc ur s .

A n y one who h as watche d a y s e ttle on a hors e s bac k

knowsthat the latte r h asth e power o f rippli n g or wrin k

lin g itss kin in a re markable manner The mus c le w hi ch

s I ts
.

we are now des c ribing be lon gs to the s a me c la s

development variesve ry much in diff ere nt individuals

.

S ome pe ople to o ap pe ar to h a ve m uch mor e contr ol o ve r

, ,

it in ca us ing it to cont rac t tha n other s

es
.

The p la tys ma whi ch f orms

, a thin m us c u l ar s hee t ar is
below fr om the fas
.

cia c overing the gr ea t pe cto ra l th e ,

deltoid an d the trapez iusitsbres

,
: are direc te d obli quely

upwa rd s an d f orward s to pas sover the lower jaw bo n e -

fr om the chin as f ar back as the angle s ome o f itsbre s

:

are attac hed to thi s bone b ut otherspas

,
sup to blend
with th e m us c le swhich ar e connected with the lower lip
a n d angle o f the mouth ( s e e Pl ate XXVIII b p Under
o f the pres
.

ord ina ry conditions there ar e no indications e nce

o f thi s mus c le though in old people in whom the f at

as it f orms
,

hasdis appe ared it m ay b e o ften rec o gniz ed ,

the dewlap like f old swhich han g benea th the chi n The
- .

ac tion o f the mus c le is b est di s

p l aye d in the exp re s s ion s
o f f r ight an d te r ror wherein it dra w s d own the an gle o f
vers
.

the mouth an d w rinkle s the s kin o f the neck tran s e ly ;

at th e s a me time it a p pea rs to increas e the tran s vers e

dia me te r o f the root o f the neck in f ront by attening th e

sur f ac e f orm s ov r an d abo ve the c ollar bone
e - .

Of other s tructure s w hic h lie in the s upe r c ial f as c i a th e

 Co n to ursof th e N ec k .
337

only oneswhich concern us ar e the veins H ere aga in .

the remarkswhich have been m ade at the end o f the

l ast chapter ( p 320 ) might be repeated b ut thisappears
.

unne ce s s
,

a ry .

The vein which i smos t read ily s een isthe ex ter n a l

j g
u u la.r Thi s r un sdown the s ide o f the ne c k f r om the ,

region behind the angle o f the jaw to a point above the

coll a r bone an d j us
- t external to the ori gin o f the s terno
m as toid Us. u a lly the vein o f o n e s ide o f the neck is m uc h
larger than that o f the oppos ite The s u per c i al vei n s
.

be c ome dis tended with blood when the contrac tion o f the
m us c les o f the he a d an d ne c k i s prolonge d an d violent .

They al s o become prominent under the inuence o f the

emotion s I n the expres
. sion o f rage an d pas sion they
ar e more or le s sengorged Und e r all circums
. tancesd ue
care an d res traint mus t be exerc i sed in their repres entatio n .

As i n dica ted by colour they ar e o f s , ervi ce in imparting

a f eeling o f deli cacy to the s kin .

H a ving des c ribed in s ome detail the s tructureswhi ch

determine the contour so f the neck we m ay pas , son to
c on s ider the f orm o f the neck as a whole .

The neck is rounder in f ront than behind The attened .

s ur fac e o f the bac k o f the trunk i s ca rried u

p on to the b a c k
o f the ne c k without an y interruption in the s urf ac e cont o urs .

In front the rounded form o f the root o f the neck appears

implanted on the breas t between the s
,
hou lders the modelling ,

o f whi c h is dis tinct an d s eparate f rom that o f the ne ck .

The s pring o f the neck f rom the s houlders on either s ide i s

very much higher than i ts root in the middle line in front ,

where the pit o f the neck corre s pondsto the upper e d ge o f

the breas t -bone I f the gure be viewed in prole the pi t
.
,

o f the nec k is seen to lie on a very much lower level than

the s urface proje ction f ormed by the s pine o f the s eventh
cer vi ca l vertebra which mark sthe infe rior limit o f the
teriorly Thi si sd ue to the oblique pos
,

ne ck pos . itio n o f
z
 338 L ength qf N eck .

the rs t pair o f ribswhi ch with the bre as

, t bon e f orm th e
-

boundaries o f the inlet or s uperior apertu re o f the tho r ax .

The eff ect o f thi sobliquity i sth at the uppe r end o f th e

ea s
br t bone lie s
- on a level with the s econd or third dors al

vertebra an d hence it f ollows th at the root o f the ne ck

appe ars
,

to s pri n g obliquely from the uppe r end o f th e

thorax Thi s . c ircum s tan c e explain s why in pr ole the fro nt
o f the ne c k appea rs longer than the back .

M uch d i ff erenc e occurs in th e neck o f d ieren t in d i '

v i d ua ls as regard s length: Thi s is n o t-d ue to an y mar ked

di ff erence in the length o f th e c er vi ca l por tion o f th e

back bo ne f o r obs
-
, ervation spr ove that th e back -bone is
other pa rtso f th e s ke leton the leas t li able to
~

of a ll

vari ationsin i tslength Th e len gt h o f the neck depe nd s

.

largely on the elevation o f the s houlders A long neck is .

as s o c i a te d with s loping s houlderswhile broad an d s ,

quare
s houldersare the c onco m i ta ntso f a s hort neck Th e .

po ition o the s
s f houlder girdle depend s ash asbeen
-

on the for m o f the thorax aswell ason

,

n o ti ce d (p .
,
.

the development o f the mus c les whi ch ar e connected with

it . The s loping s houlder coincideswi th a collar bo ne -

w h i ch s lants outward s an d d ownward s whils t in the s q u

, a re

s hou ld e red the o uter end o f th c lav i c le lies on a higher

l v el than the s te r na l e n d Th e m us cu lar development o f
'

e .

a pe rs on with s loping s houlde rs is usua lly poor ; h e nce the

m us c le s o f th e n e ck ar e not s o b ulky this red uce sthe width

:

o f th e n e k an d te n d s
c to intens i fy the appe aran ce o f length .

Th e b ad an d s
ro qua re s- ho uldere d are us ually pers onso f
po w f ul phys
er iqu ; their muse c l e sa re usua lly s trongly
d v l o pe d n d increas
e e a e th reby the w id th o f the neck
e

f rom i ts
.

e in the wid th o f the ne ck de tr ac ts

,

Thi sincreas
a p pe a ran c e o f len gth .

M uch d e pen d sas h as

,
be e n s a id upon th e qua ntity o f
,

s ubc uta n e o us f a t which i sh re d i s trib ute d

e In women .

o f a robus t an d healthy type the mode lling o f the neck i s

 Mo vemen tsof N eck .
339

f ull an d roun d an d only in exceptional pos

, ition s a r e there

indica tion s o f the s uper ci al mus c le s The f at whi ch i s

.
,

o ften pre s e nt in con s iderable quantitiesimpartsa width

to the neck wh i ch doe s
,

away with an ppe r e f und u e

y a a an c o

len gth I n s
. u ch the ne ck i s o fte n cros sed in front by one
or two d e li cate cutaneousf olds Thi stype isas . s ociated
with a full an d well develop e d bus
- t and s houlders .

A nother type i s that in whi ch we meet with the long an d

s like neck This
w a n - . f orm occurs in women o f a s parer habit
with narrower che s ts an d more s loping s h o ulders The .

f orm s them s elves m ay be very be auti fu l b ut h ard ly convey

,

that f eeling o f rude h ealth whi ch i ss o ch aracteri s tic o f

the f ormer type H ere the s . lightnes s o f the f orm s c onvey s

a f eelin g o f deli c acy as soci ate d rather with a highly s ens itive
an d nervous c onstitution Owing to the le s
. sabun dant
layer o f s uper c i al f at we ar e in them more li able to ha ve

s ur f ace indi ca tion s o f the s uper c i a l s tructur es .

The neck un dergoesvery cons iderable modicationsin

i ts f orm ac cord ing to its pos ition The movementso f the
head on the neck h ave been a lre ady re f erred to at the
be ginning o f thi s c ha pte r As
. a m atte r o f fact the s e move
ments ar e u su a lly as sociated with c orres ponding movements
o f the ne ck . Thus wh en the head i s bent f orward the nec k
move sf orward with it A backward movement o f the
.

h ead i s us ua lly acc ompanied by e x te n s ion o f th e neck In .

like m anner the m ovementso f late ral inclination an d

,

rota tion o f the h ead an d n e ck are u s ua lly a ss ociated Th e .

reade r mus t not s uppo s e that the s e movementsm ay not be

dis as sociate d We can extend the he ad when the neck is
.

bent an d we can e x the he ad on the extende d neck b ut

, ,

the s e a ction s ar e unus ua l an d c on s trained .

In ex io n o f the h ead an d neck the hollow curve o f the

back o f the neck di s appe ars an d i s replaced by a c onvex
outline w hich i san upward an d f orwa rd continuation o f
The s
,

the cur ve o f the dors a l region o f the bac k pine o f the

.

z 2
3 40 Mo vemen tsof N eck .

sventh ervi l vert br be omesmore prominent d the

e c ca e a c an

spinesf the pper two or three dorsl ve t br

o u su lly a r e a e ca n u a

be re ogni ed The o tline f the f ront f the n k is

c z . u o o ec

con e l d by the f t th t the hin om s

c a e acinto on t t with
a c c e c ac

FI G 189. s
S ho w th e ho llo w ab o ve th e co lla r-b o n e s
wh en th e h o uld e r s
s
.

are ra i ed an d th e h ead b e n t f o r ward .

FI G 190 s
S ho w th e f o r m o f th e FI G 19 1 s
S h o w th e f o rm of th e
s
. . . .

n eck i n e x io n. n ec ki n e x te n i o n .

th e u ppe r en d o f the breas t -bo ne A s e ri e so f transverse .

f old s cro ssthe neck in front the mos t pronounce d co rre

,

s po n d in
g to the su r f a ce o f the s
kin immedi ate ly beneath

the border o f the lower jaw The inn er e n d o f the collar .

bone i s emphas iz ed an d the s light hollow which li es

, betwee n
 Mo vemen tsof N eck .

tra pez iusbec omesoblite ra te d A fullnes . s appears over the

back an d upper part o f the s houlder o win g to the relaxed
o f the anterior part o f the tra pez i us
,

bres .

When the head isturned towards the shoulder the s kin

o f th e s ide o f the ne ck f rom whic h the he ad isturned is
te nse an d s tretc h ed wh i ls
t tha t on the side to wa rdswhi c h
th e he ad is direc te d isobli quely wrin kled The s
,

ur fac e .

f orm o f the s ide o f the neck fr om whi ch the head is

turn ed is f ul l an d roun d the anterior border o f the s te m o

FI G 192 s
S ho w th e r elati o n o f FI G 193 s
S h o w the re latio n o f
s s s s s s
. . . .

th e tern o m a to id to th e urf ace

-
h
t e te rn o -ma t o id mu cle to th e
s
wh en th e h ead i turn ed to ward ss s
ur f ac e when th e h ead i b e n t to
s
th e h o uld er . s th e i d e .

m as toid mus c le is
outs ta nding though its , cl avi cul ar at tac h

ment isles smarked The s . kin as it iss

tretc hed over the
c oll a r bone emph as
- iz es th at s tructure an d th e hollow above
it iseff aced to a great exte nt though the border o f the
,

t rape z i us
,

m ay be f requently recogniz ed The pos terior .

b elly o f th e omo hyo id as

- it cros sesthe lower pa rt o f the
interval betweenthetrapez i us an d s
te rno-mas toid is s tretched ,

a n d o f te n f orm s a s ur fac e eleva tion wh e n there i s little

su b c u ta n e o us fat On th e s
. ide towards w hi c h th e he ad i s
t urn e d the hol low above the c oll ar -bone is d e ep e ned b ut ,
 Mo vemen tsof N eck .
34 3

the outline o f the s c les

upe rci a l m us iscon c ealed by the

wrinkled s kin A deep cutaneous f old denes the angle o f

the jaw an d runs
.

up behind the ea r ma rking th e interval

,

between the jaw bone an d the ante rior border o f th e upper

-

part o f the s
te m o m as
toid ( Plate s
- VIII XV XVI pp 62, , , .
,

By the rotation o f the head an d neck the s tructures which

lie in the middle line o f the neck ar e dr agged obliquely
toward sthe s ide to which th e head isturned an d in the
male as
,

, a ls
o to a s light extent in the f emale the f or m o f the
,

laryngeal cartilages is app aren t Pl a te s

( IX XVI, pp 7 2 .

In the latera l movements in whi ch the head is

, ,

inclined
towardsthe s ho ulder the s kin over the neck on the s ide
toward s whi ch i t is bent is wrinkled : the bes t m arked o f
thes e f olds c orres ponds to th e s pring o f the neck an d curves ,

round the root o f the neck f rom the i n ner end o f the collar
bone upwards an d backwar d s ac rossthe middle o f the anterior
border o f the trapez iuswhils t another f ollows more or les s
accur ately the an terior border o f the s toid pas s
,

terno mas
- ing ,

up between it an d the an gle o f the lower j aw to reac h the

bac k o f the e ar On the s

. ide f rom whi ch the head is
in clined the s terno mas toid isdis tinctly s i ts
,

- e en origin
f rom the collar bone being es
,

- pecia lly evident H ere too the .

coll ar bone i s
- brought more or les sinto prominence by
the s tretching o f the s kin over it an d the attachment o f th e
t rapez iusto it isus ua lly e as
,

ily recogniz ed A s urf ac e .

elevation depe ndent on the pos terior belly o f the omo hyoid -

m ay a l s o be noti ced Thes . e f ormswill o f cours e be very

much modied if the s hou lder from whi ch the he ad is
inclined iselevated at the s a me time ( Fig 193 an d Plate
.
,

VIII p
a id in thi s
.

to be s
,

I t only rem a in s connexion th a t the

s w eep o f the bres o f the t rape z i usas

, they pas sf rom
the occipu t an d the middle line o f the bac k o f the ne ck
downward san d outward stowardsthe oute r end o f the
 34 6 The Sk ull .

a orresponding red uction in the s

c iz e o f the nos
e in
m an In animalsthe nos
. e an d j awsf orm a muz z le or
snout whi ch projectsin front o f th at part o f th e s kull
which conta in sthe brain whils t in man the large crania l ,

box overtopsthe grea tly red uced f aci al bonesin place o f

lying on ly behind them asin the lower an imals , .

FI G . 194
. Male s
k ll
u . S id e vi ew .

a. Fr o n ta l bo n e b Par i eta l b o n e t A n gle o f lo wer j a w

s
. . . . .

c . Oc c i p ita l b o n e .
j R am u o f lo w er jaw
. .

d Te m po ra l b o n e k Co n d yle o f j aw
N sl b
. . . .

e. a a one 1 Z ygo m atic arc h .

s s s
s
. .

f . U pp er j a w -b o n e ( u pe r i o r ma x i lla ) . M a to id p ro ce o f te m po ra l b o n e .

9 C h ee k o r m a la r b o n e 3 E x t e r n al o cc ip ital p ro tub er an ce
ss
. .
. .

It . M a n d ib le o r lo we r j aw ( in f er io r o . Co ro n o id p ro c e o f lo we r j a w .

m ax i lla ) .

Th es
e two p a rts o f the s
k ull ca n be conveniently dened
in the living by d rawing a line f rom the root o f the nos e
to the o r i ce o f the ear an d thenc e bac kward s to the point ,

wh e th e neck uniteswith the pos

,

re terior part o f the

348 Bo n esof the Sk ull .

We are in no wi s e conce rned with thes e detailsnor is ,

it neces sa ry th a t we s hould f urther dis cus sthe manner in

whi ch the head arti culate swith the top o f the verte bral
col umn .This was des c ribed in the l as t chapte r ( p .

The boneso f the cranial vault as we pas sfrom before

,

backward sare named the f r o n ta l which formsthe f ore

head ; the two p a r ie ta lsone on either s
,

,
ide whi ch co n
ideso f the head ; an d
,

s titute the top an d pa rt o f the s

the o ccip ital bone whi ch f orms ,
the back o f the head Th e .

bony wa ll o f the cranium in front above an d behind ,

th e e ar i s made up o f the temp o r al bone on eac h s

,

id e .

This bone nearly completely occupies the in ter val between

the bones above mentioned ex cept in fr ont where a portion

o f one ca lled the s s

.
,

, p hen o id f o r m the w a l l
, o f the c r ani um .

It i sunnece s sa ry to des c ribe thes e in detail f o r it ,

i sby their union with each other th at they mou ld

the f orm o f the head There ar e b ut s . light ind i cations
o f the i r line s
,

o f union in the living an d the hairy ,

s c alp f urther conc ea ls an y evidenc e o f their outline s .

They ar e unite d by a s erieso f interlocking teeth -like

projec tionsan d the jointss o f ormed are ca lled s utur es .

In Chapte r II the advantage o f thisarrangement w as

,

pointe d o ut Th e bones . a r e by thi s mean s immovably uni ted

a t the s a me time th at expans ion by growth ispermitte d .

I n the aged af ter a ll growth h asc ea s

, ed thes e s'
utures ,

fr q u ently dis
e appe ar an d it i s then no longer pos sible to
eparate the bo nesasthey have become fus
,

s , ed together by
os s e o us union .

The s tructure o f thes e bon e s requi re ss ome explana tion .

Th y are compos
e ed o f a dens e inner an d ou ter layer ,

the inte r val be tween whi ch isf o rmed o f s o fte r an d more

s on
p g y o s
s eo us ti ssu e c a lled the d i
,p lo e In some sit ua tion'

. s
thisdiplo e isliable to di s appea r a t ce rta in period s o f li f e .

S p a ce sa r e thusf ormed betw e e n the i n ner an d o ute r

ha rd l aye r s Thro ugh th e ir conn e xion with the res
. pi ra to ry
 Fr o n ta l Sin us 349 .

p s
a sgesthes
a e s p s ont in i d hen e lled
ace c a a r, an ar e c ca

a ri s i s s The growth f thes

nu e . e i s in sest kespl e o a r u a ac

in the e rlier period s f li f e b t s

a ome f them o u o ar e

s
,

trikingly developed t th t g when yo th merges a a a e u

into m nh ood One f thes

a e s in s esh s s
.
pe i l intere s
t
o u a a c a

for s sit le dsto very ons

u , a ider ble modi tionsin
a c a ca

the sf e f o m f the bone The front l bone sit

ur a c r o . a a

mo ldsthe f orehe d
,

u be felt b ne th the eyebrows a ,

ca n e a ,

f orming the r he sover the h ollowsin whi h the eyes

a c c

ar e lod ged In thiss it tion it i shollow

.
d ont in s ua an c a

in s lled the f t l s
,

an i s
a r u i s Thi ss
ca p e i snot ron a nu . ac

developed in the hi ld d only to s

light extent in
c an a

the yo th In m it tt insi tsm xim m development

u . an a a a u

an d imp rt sto the bone f llnes

a s d prominen e nd er a u an c u

lyi g th eyebrows In thi sres

n e pe t m d iff ersf r m
. c an o

wom n f in th l tter the s

a , or i s is m h s m ller res
e a em nu uc a ,

bling r ther the ondition met with in hildhood Thi s

a c c .

expl inswhy wom n sf orehe d i s tter d s

a a mooth er
a

a a an

th n a m ns d
a o tsf the pers
a

, isten e in her
an acc un or c

of the j uven i le type .

The bones o f the vau lt o f the c ra ni um os si fy in a pecu li ar

w ay they ar e wh at ar e termed membrane bones In the
: - .

early s tageso f growth the bone appearslike a depos it in

the membrane which iss ub sequ ently to b e come o s s i e d
f rom thi scentre it s pread suntil the membrane h as
become a plate o f bone Thes e cen treso f os sication .

ar e readily re c o gni z ed in a yo ung child ; they con s titute

the bumpswhi ch are s

o eas

ily s een in ce rtain s itua
tions The mos
. t noti ceable o f th e s e ar e the f r o n ta l an d
the p ar ieta l e min e n cesthe former caus e the projec tion o f
the upp e r part o f the f orehead on either s ide whils t the ,

l atter can be readily f elt at s ome little dis tance above

the e ars The fu llnes . simparte d to the child sforehead

by thos e f ronta l entre so f os sica tion ism aintained

c

throughout li f e though n o t in s uc h a pro n o un ced f orm

,
.
35 0 Cr a n ium .

h orn the fact that in man the brows be come more pro
j e ct i n g owing
, to the develo p ment o f the f ron tal s
in use s ,

the f orehead S lopes more an d the frontal eminences appear

les sprominent In women the forehead ismore verti ca l

,

as
,

in them the browsdo not proj ect an d the fronta l bos ses

s eem more pronoun ced I n thi sre s pe ct again the f emale

embles
.

res the child .

The relative proportion o f the brain cas - e to the fac e

varies much at diff erent period s o f growth A part altogether .

f rom the proportions o f the head in rel ation to the res t of

the body the mos t cas
. ua l observer mus t have noticed that

FI G 196 S k ull of ad ult sh wi g

o n FI G 197 s
S ku ll o f ch ild h o wi n g
s s
. .
. .

n o f f ace to b ra
- -
p p
r o o r ti o n of face to b ra i
n ca e . p p
ro o rt i o i n ca e
.

in the child the part o f the s kull whi ch conta ins the brain
is arel tively m u ch l a rger as com p a red with the f ac e th an
wh at we s e e in the a d ult G rowth ta ke s place in both
.

thes e partsconcurrently though to a greater extent in

s
,

the s tructures o f the f a c e th an in the c ra ni a l box e l e the ,

relative proportion smet with in the ad ult cou ld not be

atta ined

iz e o f the cranial box iss

.

The s ome index to the

development o f the brain s in ce a large brain neces sarily

requ ire sa large covering The s

,

iz e o f the bra in may ,

s
.

with ce rta in re s ervation sb e reg rded a a an

,
indi tio
ca n
 352 Bo n esof Fa ce .

The mos t important o f e s

th e su in sesin onnexion with
c

the face sth t found within the upper j bone whi ch

i a a w -

though apparently s olid dis playson s e ction a l arge ca v ity

in itsinterior Bes . idesthe function above as c ribed to

thes es inus esit will b e evide n t th at by s ubs tituting hollow

bones
,

fo r solid ones the weight o f this part o f the s kull is

e ry m uch dimi n i s hed .

A mong the mo s t important o f the boneso f the face as

determinants o f f orm are the cheek or ma la r bonesThes . e

impart the width to the upper part o f the fac e If the .

n ger be pl aced upon the bro ws an d the outline o f the orbits

,

b e traced b e ne ath the s kin thes e bo n es m ay be f elt as they

f orm the margin o f thes
,

e hollows to the oute r an d lower s ide

ition betw een the oute r pa rts
,

lyi n g in this pos o f the f ronta l

bone above an d the upper jaw bone below Wide o f the

- .

orbit thos e bones f orm the promine n c e o f the cheeks Po s .

te r io r ly they can be f elt to b e s upported by an arc h o f bone

whi ch can be re ad ily trace d bac k to the regio n in f ront o f

the ear Thisiscalle d the z ygo ma tic a rch an d isin part
.
,

made up o f a backward proce s so f the cheek bone an d

-

a f o r ward proj ec tion o f the tem pora l bone Be nea th this

.

a rch , when the s ku ll iss tripped o f itses hy partsthere

is a hollow exte nding up o n ei ther s ide o f the head This .

is c a lled the te mp o r a l f o s sa an d it lodges a large mus c le

ca lle d the te mp o r a l mus cle The read er may s

. ati sfy hims e lf

as to the pres e n ce o f thismus cle by pl ac ing hi s ngers

a bove the z ygom ati c arc h an d then opening an d clos ing
the mouth alte rnate ly The bres . o f the m us c le will then

be f elt contracting f o r they are in s

, erted into the lower jaw
an d help to move th a t bone ( Figs 194 195

ses
. .

The z ygomati c arche stheref ore act asbuttres

,

to t he
cheek -bones at the s a me time tha t they all ow the bres

o f the tempo ra l m us c le to pas sbeneath them to b e ins erted

into the lower jaw .

Th e cha ra te r o f the fac e l a rge ly d epen d s

c o n the ch ee k
 The Fa cia l A ngle .
353

bones It is
. to thes e th at the M ongolian an d Tartar rac es owe
their charac teris ti c atnes s o f f ace whi lst they impart to th e
A us trali an aborigines their remarkable breadth o f features .

The prominence o f the chee k -bonesapart from thes e racial

ch a rac teri s
,

ticsdepend slargely upon th e f ulln es

, so f the
ti s sues o f the cheek . When fr om abs en ce o f f at or was ting
o f the ti s su es the cheek los es i ts roundnes sthe form o f the
malar bonesbec omes
.

more eas ily recogniz ed Under thes . e

c irc um s ta nc es we s pe ak o f a pers on w ith high ch eek bones - .

Thi spromi en c e is
n more apparent than rea l an d d epend s
u es
,

as h as been s a id on the w as ting o f the s u rro unding ti s s

rather than on an y undue projection o f the bone its el f In .

old age they become prominen t by the s inking o f the cheek s

beneath th em .

As h as been s a id one o f the chara ter is tic f e tureso f m an s

c a

s the abs the cas

.

kull is en ce o f a muz z le thou gh this

: is e it
is true th at minor degreeso f projection o f the upper jaw .

an d with it th e lower j aw ar e met with

, Th es.e variation s
i n the pos ition o f the boneslead to very characteri s ti c d i f
f e r e n c es in th e appearan ce o f the f ea tures The s tud ent
t realiz e thisby c ontras
.

m ay bes ting the tw o extremes

v iz. the idea l type repres ented in the antique an d that ,

c h arac teri s tic o f the negro races In the one the outline
.

o f the f ac e i s more or les sverti cal : in the other it s lopes

f orward .

A D utch anatomi s t named Camper w asthe rs t to d raw

atten tion to thi s d ier e n ce an d re cord it by a s c ienti c
'

method The projection o f the face can be expres sed by

termed the f acia l a n gle A bas e l ine is
.

what is . taken which

pas s es ac ro s s th e face cutting th e ori ce o f the ear pos ter iorly
an d lying on a level with the border o f the s
,

eptum o f the nos

,

in fr ont on thi s another s traight line is drawn which touches

the mos t prominent part o f the f orehead above an d the ,

anterior s u rfac e o f the upper inc is or te eth or the f ront o f

the upper lip below ; th e angle f ormed by the inters ection
A a
354 The Fa cia l A ngle .

of th e two l inesm ark ed in the accompanying dia gramsis

.
,

the f ac i al angle ( Figs198 199 c e b ) .

, ,
.

In order to meas ure thi s angle on the livin

g a v ar iety

o f di ff erent f orm s o f a pp a ra tu sisus ed b ut the method .

des c ri b ed above i f applied to a prole ou tline o f the head

, ,

wi ll ena ble the s tud nt to recogniz e the variation that may

e

take place
The angle ranges
.

f rom 62 to Thes e are the extremes .

The former gure indica tesa very marked pro jec tion th e .

la tter a more vertica l outlin e Commonly the angle .

meas ures f rom 70 to 80 th e white rac esbeing characte riz e d

Fm . 198. Head of a E ur o pe a n . Fm . 199 . He ad of a N egro .

Th e fac ia l an gle sb isf

c o r m ed b y th e two li n e s a b an d e d In th e
sb iss
.

n egro th e a n gle c m ll a er th a n in th e E um p m o win g to th e greater

p ro j
e ct i on o f th e ja ws .

by a f ac i a l
ngle o f from 75 to
a the yellow by

an ang le w hi ch va ries f ro m 70 to whils t th e negroid

racesdis pl ay a projection o f the lower part o f the fac e

whi h o ften caus
c esth e facial angle to fall below
I n other word sthe E uropean rac esh ave more or le s
,
s
straight fac e sthe yellow s , lightly s
loping fa esan d the c

b l ac k ma rked ly proje cting fac e s In the lat ter thi s

,

ap pe a r .

an c e i sfur ther emphas iz ed by the pres ence o f a broad an d

atte n e d nos e an d th i ck an d everted li ps
, .

In th e more highly c i vili ed rac es as we have s een th e z , ,

356 The Ma s
seter .

Co nne cting the lower border o f the z ygomatic arch

with the outer s u r f ac e o f the j bone corres
a w - ponding
c le ca lled the ma s s
,

to the angle isa pow erf ul mus e te r .

th e ram us
,

Of quadrila tera l f orm it overlies o f the j aw ,

conc ea l si ts
,

an d so o utline exc ept behind where th e , ,

p os terior border o f the ramuscan readily be f elt asit

p as ses up in f ront o f the e ar The m asseter th us c or r e .

s ponde to the hin d er an d lower part o f th e chee k th e ,

f ullnes so f w hich in thiss ituation i sd ue to the pres en ce

S id e of th e s uh wi g th p s
k ll s itio n e o on of th e te mpo ral an d
st m sl s
m s
.

a e er u c e .

0. Co n d yle o f lo w e r j a w 0 E x te rn a l o cci pital pro t ub eran ce

s
. . .

b Bo d y o f lo w e r j a w t Te m p ora l m u c le
s s
. . . .

c l l a la r o r c h ee k b o n e a H a to id p ro c e o f tempo ral b o n e

s
st sl
. . . .

m Ma. e er mu c e. 2. Z ygo ma tic arch .

of t hi smus cl Th e reader m ay s
e. ati s
f y him s elf asto
the co rre ctn es so f thiss t at e ment by plac ing h i s ngers
o n his cheek s a little in f ront o f an d above the an gle o f

th e j aw then on rm ly clos
: ing the j aws he will f ee l th e

ha rd n i n g ca us
e ed by the c ontrac tion o f the mus c les Thes e .

two mus c le sthe tempo ra l an d the mas

, sete r asthey aris e ,

fr om xed attach m e ntson the s ide o f th e s kull elevate

the in f erior m axil la an d s o c los e the j aws They ar e much .
 Fo r m of L o wer j aw .
357

c oncerned in ethe mov men ts

o f chewing an d are henc e

cl as s
.

ed among the mus c l es

o f mas ti cation .

The s iz e o f the low er j a w

vari es m uch being s . m a ll in
in fancy large in adult li fe
, ,

an d aga in reduced in old

age . But coinc ident with
thes e chan gesin s iz e there
ar e a l so alteration s in s
F G I f t I 20 1. n an
hape
. .

I f the j a w o f a child be
examined the angle f ormed
,

b y the ra m us with the bod y

iss een to be m uch more
o pen than that dis played
b y the ad u lt in whom it ,

m o re nearly approachesa
right angle With a d van c
.

i n g years the angle again

a l ters an d
, becomesmore
l ike that s e en in i n f a n cy .
Fr o 2 Ad lt . 20 . u .

The growth an d eruption o f

the tee th have much to do
with the f orm o f the jaw .

Whi ls t the child derives

i tsno uris hment fr om the
mother the body o f the jaw
remain ss mall ; b ut when
nature provides it with teeth
to chew i ts o wn f ood the j aw

a lters i ts shape It isonly .

Fr Old Ag o 20
3 . . e .

a f te r the p erm anent teeth

S h w th s h p f h l w j w a d t

have s
o e e o e o er a an

ucc ee de d the milk i f i ts i h

n s f
ue n c e f m i
on t e u r ace or n

y ( Fig
n an c i h d lt ( F ig n t e a u
te eth that the lower ja w
. .

w ) i l d e ( Fie w et
e . n o l e
358 The Ch in .

atta ins i ts f ull development In late r lif e when the natural

.

proc es so f decay or it may be dis

, eas e lead s to the lo s so f
the teeth a s,
hrinkage an d atrophy o f the bone take p lac e
whi ch bring about the a lterationsin f orm characteris
,

tic
o f old age .

Thes e a lterationsin the s hape an d s iz e o f the jaw are

as sociated with alterations in the s ur face f orm s an d accoun t ,

f o r the n ut crac ker appe a ranc e imparte d to the fac e s

- o f old

people in whom the j aws ar e toothl es sThe li ps an d chee ks

.

no longer s
,

upported by the te e th are thi n an d was , ted an d

f or m loos e an d wrin kled hollows .

The s iz e o f the teeth varie s in diff erent in dividuals Th e .

lower raceso f m an asa rule have l arger teeth than th e

more civili z ed This is
. no doubt accounted fo r by the fac t
that the higher racespay more atte ntion to the prepara
tion o f the ir f ood by cooking 810 Large teeth n eces , .

s a rily req u ire l arge j aws an d we can th us

, acc ount fo r the

mas sive lower j awsmet with in many s a vages Too big .

a j a w im parts a bruta l appe a ra n c e to the f ac e a f ea ture

iz ed in repres
,

whi ch draughts men have emphas enting the

c rimin a l type .

The chin isa very charac te ris ti c f e ature o f man sface ; '

it dependson the forward projection o f the central point

o f the lower j aw It presen ts
. a va riety o f f orm s ; it should
be f ull prominent an d s ome w hat s quare in the male in
t with the more pointed f orm w hich is s
, , ,

c ontras o pleas an t

a f ea tu re in women N o t un fr equently a depre s

. sion or
dimple overliesitscentre d ue to a m us cle whi c h is here
e the tis
,

atta ched to the s kin an d whi c h helpsto rais s u es

o f the c hin in c er ta in expres sions Thismus c le is .ca lled

the le va to r m en ti ; it ta kesitsorigin from th e fron t o f

the lower jaw beneath the lower lip ( Plate XX VIII Fig 2 c
, .

so f the chin isin reas

, , ,

p. The f ullnes ed by the c

quantity o f f at w hi ch un d e rliesthe s kin In cas es where .

th isisb undant the chin i scirc ums

a cribe d by a f old below
360 No s
e and Ear .

ca r tilagesplaysan important pa rt in thi sthe mos t pro

minent f eature o f the face The di s pos ition o f the n o s
. tri ls
an d the f orm o f the e n d o f the no s e depend on thess tr ue e

tures The pers is te n ce o f type i n the a rra n gem e nt o f thes e

o fte n re ma rkable as
.

pa rts is exemplied in the cha acte r is ti c r

nos e o f the J e w i s h race

e is
.

The root o f the nos very va ria b le Formed asi t is .

b y the na s a l bone s i ts outli n e depe ndson the s

, hape a n d
dis o s ition o f t he s e bon e s In s ome the root o f the no s
p . e

i sdepre s sed an d clearly marked b y a hollow f rom the

ridge o f the b rows ; i n oth e rs it i smore projecti n g an d
'

ca rri es dow n the o utline o f the forehead .

Further des c ri tion o f this f ea t u e is u nne e s

s ry A re t
p c a r
g a .

va riety o f s hape sar e m e t with b ut the s tudent can n o w

,

r e ali z e on wha t s tr ucture s thes e m od ications in for m d e pen d .

The ex te r n a l a ud ito ry mea tusmarksthe pos ition o f th e

c ar on the s k ull It is
. a ca na l lead ing into t h e inte rior f o

the tempo ral bone placed be tw een the arti cula r hollo w f r o

th e lower ja w bone in f ront an d the projecting pro c s

- . s e

b ehind called th e ma s
,
to id p r o ces sto which the an te rior ,

b res o f the s te rno mas -toi d ar e attached .

In f ront o f this aperture the tempora l portion o f the z y o

g
mati c arch s prings .

Implante d i n an d s urro unding thi s orice is a convol ute d

leaf o f cartilage w hich w he n cove re d by s

, kin formsthe
s hell like e ar C on n ected w ith the ca rtilage below is
- .

a q uan tity o f f at ty ti s su e w hi c h f or m s the lobe o f the e ar .

G reat di ff e ren c es are s een in the s hape an d s iz e o f the ear .

I n w o m e n it s h uld b e s
o mall an d not proj e ct i n g its delicacy ,

bei n g e nhance d b y itscolour an d the light an d s hade which

i ts conto urs i m pa r t In men it s
. ho uld not b e und uly large ,

an d s hould lie los c e to the s ide o f the head

Unpleas a t f orms
n ar e d u e to irr gul ar i ties in the fold i n g
e

o f the c ar til age an d a s pre ad ing o ut o f its ed ge The lob e .

too varie sin m any being abs

,
e nt w hi ls t i n others , it is not
 Th e Mo ath .
36 1

f ree in f ront b ut istied down to the tis

, s ues o f the c heek .

A ttempts have been mad e to id entify thes e conditions wit h

rac ial characteris ticsb ut s um c i e n t h as
,
been s a id to ena ble

th e s tudent to j ud ge fo r hims el f as to the f orms mos ts u i ta ble

f o r repres entation Below an d behind the ear the hollo w

.

whi ch lies betw een the jaw in f ront an d the anterior bo rd e r

o f the s te rno mas -
toid b ehind ends a b r uptly .

We have hitherto conned o u r des c rip t ion to the bone s ,

ca rtil age s an d s
, ome o f the mus c les whi ch inuen e the c

s urf a ce f orm o f the f a c e ; b ut c overing the f ront o f the s e,

an d s e rving as a ma s k is an inves tm ent o f s

, ki n alo n g w ith
fa t an d mus c le s It i s to thi sthat o ur attention mus t

next be d ire cted It will be well in the rs

. t ins
, tance to ,

stu dy the variousopenin gson the face Of thes e there .

a e
r ve th e m outh the no s trilsan d the openings
.
,
between
the eyelids The orice o f the e ar i snot included asit
.
,

li es on the s ide o f the head an d h as alre a dy be en s uf c i ently

d es c ribed .

A ll th e s e Openingsar e li able to modication in their

f orm by the action o f the mus c le s which s urroun d them It .

is largely to thes e alterations in s hape that the e x pres s

io n
o f the emotion s is d ue .

Th e mouth the l arge s ,

t an d mos t impor tant o f thes e
aperture s f rom the point o f view o f expre s sion is the c le i t
; it va rie s much in s
,

be twee n the lips iz e an d in the f orm

o f i ts boundari es Th e lips s hould b e full an d rounded the
'

.
,

r e d pa rts being clearly dened f rom the res t by a more or

les spromine n t margi n Th upper lip s . eho uld project s ome
wh at s , o as to throw part o f th e under li p in s hado w The .

f orm o f the upper lip is of ten a f eature o f great beauty .

From th e angles o f the mo uth the re d part o f the upp e r lip

s ho uld curve over s o as to f orm an a rch the c entre o f w hi c h , .

however isinterrupted by a gentle groove w h i h pas ses c

ac ro s
,

sitsm i d d le f rom the s eptum o f the nos e A sthis .

groove joins the re d e dge o f th e lip it breaks the contin uity

362 The Mo uth .

of the curve an d imparts to it that ch aracte ri s ti c appeara nce

whi ch h asbeen n amed C upid s
bow It is '

j us t where th is
.

roove br eaks the o utline th at the li p i s mo s t prominent

g .

The upper lip vari escons iderably in length in diff erent

individ ualsa s hort lip being rega rded asone o f the
attributes
,

o f ide al be auty The lower li p though f ull

.
,

hould not project asfar forward sasthe upper Beneath

,

s .

its red pa rt it s hould be re curved an d s eparated by a broad

depre s s
ion from the prominen ce o f th e chin th us te nding to
cas tas hadow beneath which helps to ac ce ntuate its
.

, cur ved

outline A t the angleso f the mouth the red parts

. o f the

lipsare nar rowed down to a line an d tend to be i n tum e d .

The f ullnes s o f the ti ssu es o f the cheek here f orm s an angula r

depres sion which thrown in s

, had ow brea ksthe otherwi s,
e
ab r up t u nion o f the upper an d lower edges The modelling .

o f thes e pa rtsdis plays great s ubtilty o f f orm an d imparts

a deli cac y an d ni s h to the curves o f the lips It i s h ardly .

neces sary here to re min d th e re ader o f the m any de f ec ts

dis pl ayed in this f e ature .

A n und ue length o f the upper lip as well as thinnes sor

exce s s ive f ullnes so f the red partso f th e lip are characte rs
,

whi ch s hould be avoided in id eal conceptionsthough doubt .

les sthey have their value in th e repres entation o f more

realis tic types The mos. t remark able f ea tur e abo ut th e
mouth is i ts extreme mobi lity a property w hich we s
,
hall s ee

hereafter iso f the greates t val u e as a mod i f ying in uen c e

in expres s i on
tr uctur eswhi ch dete rmine the f orm o f the nos
.

The s e

h ave been alrea dy des c r ibed The f orm o f the nos

. trils d is
playsmany varietiesacco rding to the s hape o f the nos e .

Th es e openingsar e s epa rated by the s eptum whi ch joins ,

the upper lip at a point corres pond ing to its medi an f urrow
on eith r s e ide the ca rtilagesw hi ch form the a la e o f th e
e overhang the nos
,

nos trils Thes . e ca rtilages ar e s eparated

p os te riorly from th e f ullnes so f the cheek b y a curvilin ear
 6
3 4 Eyes The .

The setting f the eyesisf rther ff e ted by the pro

o u a c

mi f the brows When the s

n e n ce o e overh ng the ey s . a e

pp r deep st The orbi t l m rgin isonly re ogni ed

,

a ea - e . a a c z

as srf e form long the brows d t w rdsthe o ter

a u ac a an o a u

s
ide Belo w the s
. s
kin p sesfrom the lower lid to the
, a

cheek witho t y m d i ti being given on the srf

u an ca on u ac e

of the lower margin o f the orbit .

Of the two eyelid sthe upper is the longer an d the more

ing o f the eye ise e cte d by the
,

movable The c los

.
'

des c ent o f the upper eyelid an d not by the rais,ing o f

the lower lid The margin o f the upper lid i s
. more curved
than that o f the lower Both margi n s are furnis
. hed with
eyelas heso f whi ch the upper are the longer The margin
, .

o f the upper lid i s s u c i en tly thi ck to throw a s had ow on

the eyeball beneath it Viewed f rom the f ront or s . ide th e ,

su r fac e o f thi s m argin i s not vis ible The m argin o f the .

lower lid thinner than that o f th e upper isupturned

itions is
, , ,

an d , viewed f rom the f ront in ordi nary pos ,

c lea rly vi s ible From itscolour an d from the fact that

.

t s
, ,

being a moi s ur face it more readily catches , the light ,

it f ormsan element o f much importanc e in the drawing

o f the eye .

The inner an d outer anglesbetween th e eyelid sdiff er .

The oute r angle or ex ter n a l ca n thus , as it isca lled is f ormed ,

by the upward curve o f the lo w er eyeli d b eneath a f old

which i s c ontin uous with th e margin o f the uppe r lid In .

te rn ally the two eyelid sdo n o t directly unite with one

another b ut are s e pa rated by a s mall D s haped reces s H er e - .

which carry away the tearsan d here

,

ar e f o und the d ucts

haped vas cul a r f old w hi c h s tretches

,

a sa
l o sm a l l tri a n g ul a r -s
sthe angle bet ween the lidss upplie s
,

ac ro s the painter with

The re d tint o f this
,

Opportu nities o f a pplying loca l c olour .

f old isca rr ied in w ard sinto the rece s saforementioned .

Pas s i n g inwards toward s the ro ot o f th e no se f rom the i n n e r

ca thus
n f o r about one eighth o f an inc h a prominent s
,
- urface ,
 Eyes The . 6
3 5

rid ge ca n often be s
ee whi h isd
n c u e to the pre s ence o f a
little ligament called the te n d o o culi which un ites the eye
lids
,

w ith the inner wa ll o f the orbit .

When the eyesare c los ed asin s leep the f orm o f the

ha pe o f the eyeball This is
,

upper lid depend s

,

on the s not .

a s imple s phe re b ut cons

, ists o f pa rt o f a s phere o f s maller
diamete r place d on the f ront o f a l arger one It might be
s
.

comp a red to a w e ll -cu rved watc h -gl as pl aced on the s u r fac e

o f a c ri k t ball Thi s
c e - more pro m i n ent part o f the eyeba ll
is
.

ca lled the co r n ea ; it corr e s pond s to the colo ured pa rt o f

the eye as di stin ct from the white o f the eye The white
o f the eye i s
.

d u e to the white gli s te n ing brous coa t o f the

eyeba ll ca lled the s

, c le r o tic Thi s
. s erves as a prote c tion f o r

the delica te conte ntswi thin th e globe The corn ea l part

mis s
.

o f the eyebal l i s trans pare nt an d al low s

. o f the tran s ion
o f the c olour o f the pa rts wh i ch lie w ithin The colour o f .

the eye i sd u e to the pigment in the ir isa curtain whi h c

s ervesto control the amount o f li ght which ente rsthe

,

i n terior o f th e eye It corre s pond sto the di aphra gm

varying the s
.

o f a photo graphi c lens iz e o f the aperture or

ss s
,

u
p p i l thro u gh whi c h the lig h t p a e
o f ar as they are expos
.

Both the co m e san d s cleroti c s ,

ed
betw een th e eyelid sare covered by a deli ca te membrane
ays
,

ca lled the co n un cti va w hi c h i s s

,

j a l w kept moi t by the

s ecretion o f the tears reec ts the light which falls
,

an d th u s

upon it . In thi s w ay the high light whi ch i s ,

so importa nt

a deta il in the dra wing o f the eye i s accounte d f o r The .

pres hi gh light an d its pos

,

en ce or abs ence o f this ition will

vary with the direction o f the light falling on the eye o f the
model A mi s
. us e o f thishi gh light i s fr eq u ently s een in
produ ctions of arti st photographers
When the eye i sop e n the upper eyelid iswi thdrawn
.

within a deep f old whi ch repeats more or les saccurate ly

c ribed by i ts A bove thi s
,

the cu rve de s free margin f old the

swhich iscontinuousabove with
.

tis s ues f orm a fu llne s

366 Ex p ressio n .

the proje ting b ws V ri tionsin the o tline f thes

c ro a a u o e

det i ls
.

a f o rs e n mero s d lter with th e ex

are o c u u u an a

ion d the modelling f the p rts

,

pres s an o a .

E xpres sion is in gre t p rt d to the modi tions whi h a a ue ca c

t ke pl e in the f orm d outline f the f e t reswhi h

a ac an o a u c

h ve j us
a t been d sribed b t the s tudy f the sbj t is
e c u o u ec

et with m ny dif ulties d isby no me sse s

,

be s a yc an an o a

st rs t pp s To t ke e in point the diff eren es

s
,

a a a ea r . a a ca , c

between the expres s

ion f terror d horr r b ts light o an o ar e u

yet sm rke d th t there is H or or is

,

o a no mi s t king them a a . r

not ne s srily s s
ceo i ted with f e r nor terror with dis
a a c a g s t a u

re m rk ble f th gener l s
, ,

yet bo th are i m il rity in th

a a or e a a e

mode f their repres o ent ti on The n lys i sf thes e di ff er a a a o

sisby no me nse s d m ny s ubtiltie s

.

e n ce y a p t a an a ar e a

to espe the s
,

ca u l obs erver The tis ca t m y rely on h is

a . ar a

modelsf their o tw rd s or h pe b t it isonly ex eption u a a u c

t to thos e me nsf the ins

,

ally th t he t us
a ca n rpir tion a or a

whi h q i kens
c h isf orm s d give s
u c lif e d dire tnes sto an an c

their tions H e ein liesthe d i

ac between the
r
'

e re n ce

l tor f wh t he s
.

m h ni l t ns
ec a ca ra ees d the tis a t who o a an ar

endowswith h isw s enti m ents the s enesh repres

o nents c e .

Fort n tely ll h ve not the sme w y f l oking t

u a a a a a o o a

things ; the sme obje t pp lst p ople in diff erent

a c a ea o e

w ysone relyi g on bre dth f tre tm ent f eff e t whi ls

a n t a o a or c

whi h m y h ve esped gener l

, ,

another depend s on det ils a c a a ca a

re cogn ition
ion the broader e ects
.

S o it i s w ith the s tud y o f expres s '

:

are eas ily atta ined by what one may almos t te rm co n ven
ti o n a l method s It i s only when the more delicate s
. hades
o f di ff erenc e a re trea ted th a t we re c ogni z e the m as ter h and .

Thiscomes home to us in o ur experience o f the s tage We .

ac kno wledge s ucc es

san d condemn failure almos t intuitively .

When the mim i cry o f the ac tor fallss hort o f o ur s tandard

o f experien c e we do not he s itate to criticiz e his performance
a dvers ely yet ho w o tte n ar e we unable to explain the reas o ns
l

,
368 Ex pres sio n .

more brilli nt in ert in f ormsf ex itement d t

a c a o c ue o an

ion f itsont ntswhe e sin other

,

in re s
c e in the t ns
a e o c e . r a

conditions sin extreme pros tr tion thro gh f e r &

a a u a c .
,

tre A g in pers
,

it l ksm h f itsn t l l s
ac uc pir tion is
o a ur a u . a a

a reslt f s i m il r i en es d urious
u o ly eno gh thi s
a n u c an c u

tr nsd tion thro gh the poresf the s s

,

iss
.
,

a u a ki o i ted
u o n a c a

either with in re s or d e r s e in the mo t f blood

c a e c ea a un o

in the t neous pill ries R ef ere

cu a need only be m d e
ca a . n ce a

to the o ren e f old d l mmy s

ccur we t in s
c t tesf o a c an c a a a o

t rror to veri fy thisf t Bl s

e hing is ls o d to s ac . u a ue va

l r h ngesdependent on nervo si uen b ut sth

on a c a u n ce , a e

q lity f
ua blus h sontr s
o ted with gene l h eight
a a c a a ra

i g f the
en n olour depend s pon itstr ns
o ient
c t re u a na u

it iso ts ide the sope f pi t ri l repres

u ent tion A c o c o a a

mome t so s
.

ider tion will en ble the re der to re li

n
'

c n a a a a ze

th t whils
a t the ontr tion f the f i l m s lesi snder
c ac o ac a u c u

will the v sl r d nervo s

,

the in en e f u c o pheno
o ur , a cu a an u

me n a above ref erre d to ar e beyond o ur con tro l an d hence

beyond o ur powers o f mimi c ry s
.

o that in repre s enting th e .

various emotions the arti s t mus t rely on h is own experience

an d obs e rvation s rather than on the conventiona l eff orts of

h is mod el .

It isw ith the rs t group o f phenomena v iz thos e . .

d ue to the contraction o f the f aci al mus c le sthat we ,

ar e m a inly c o n c rned In d iscus s ing thes e we mus

e t bear
.

in mind that the openingson the face a re eac h as sociate d

w ith a par ticu l ar s ens e : the eye with s ight the nos e wi th
s
,

mell a n d the mouth w ith tas

,
te : moreover the nos e an d th e .

mouth ar e als o co ncern ed with the ad mis sion o f ai r t o

the lungs The bea rin g o f thes .

e factswill be s een here
after w hen we come to r e a li z e tha t ce rtain emotion s
, are

as soci ate d more or les sd istin tly with certa in o f thes e c

sens e s Th us the turning aw ay o f the eye sin s

. hame the
sni f g as nso c iated wi th a di s d ain f ul look an d the move
ments o f th e lips frequent ly obs erved in the expres s ion o f
 Ex p r es s
io n 6
3 9 .

dis g ust proof f the

ar e s so i tion f the
o s emotion s
with a c a o e

on s
,

p rti l r s
a ens
cu a e org ns A pers h med d e snot look
a . a a o

one in the f e ; the si g in dis ac d in impliesth t n n a a a

pers on h s m de hims aelf off ens

a ive by hi sdo r ; d in d is o u an

gus t the sme me ni g isonveyed sif by the movement

a a n c a

o f the lips on svoury mors el

an un a .

The mus les f expres csio m y be gro ped in the

o n a u

f ollowing w y i tho s e whi h in en e the movement

a v z c u c

d p rti l rly th t p rt f it whi h f orms

.
,

o f the slp ca , an a cu a a a o c

the overing f the f orehe d d thos

c o e whi h ontrol the a an c c

f the v rio usperture s f the f e i e th eyes

,

f orm o a a o ac e

s
, . .
,

no e mouth
an d .

The s ca lp co n s tso f the ti s s

,

is u es overlying the bra in

cas e fr om the browsin fr ont to th e external occ ipita l
,

protuberance behind The part o f thi swhich coversthe .

f orehead is f ree from hai r th at behind f orm s the hairy

It isloos ely co n nec ted with the un derlying bones
,

s calp .

s that it can be moved backwar dsan d f orwardson

,

the m The fr e edom o f thismovement varie s very co n s i

d e rab ly in di ff erent individ ua ls M any pos
.

sessthi s power
to a remarkable degree wh ils t in othersit isalmos
.

t
abs
,

ent
e movementsare e ecte d by the action o f certain
.

The s
'

mus c l e smo s
t important o f which is the occip ito f r o n ta lis .

cle c ons istso f two thin es

,

Thismus hy portionswith an
intermediate brous s
heet ca lled the ep icr an ia l ap o n eur o s is
Th e occ ipi ta l pa rt o f the mus
.
,

cle co vers th e bac k o f the

he ad an d is attached to the ridge on th e occ ipital bone

ca ll ed the s up er io r c u r ved li n e Thi s corre spondsto the .

j un ction o f th e ti s s
u e so f th e neck wi th the back o f

the head S upe riorly the es. hy bresar e connected

wi th the bi n d e r part o f the epi cranial aponeuros is The
the f orehead it has
.

f ron ta l pa rt o f the mus c le overlie s :

no bony attachm ent S uperiorly it ari s esfr om the f ore

i san d i nf eriorly is in s
.

part o f the epicranial apo neuros erte d ,

a b
370 Mus
clesof Ex p res
sio n .

into the s k in o f the brows an d th e root o f the n o s e ( Plate

XXVIII Fi gs1 2 n q I} p . .

it r a is es
, ,

When thismus cle contracts

, , , ,

the s ki n o f the
f oreh ead asin the expre s
, s ion o f s urpri s e an d throws ,

it into a s erieso f f oldswhi ch repeat fa irly ac curately

the curve s o f the eyebrows D es
,

cend ing f rom th e f ronta li s

.

on either s
,

ide o f the middle line an d over the root

o f the nos e are two little mus cul a r s lipscalled the p yr a
m ida les n as e have their xed poin tsbelow an d
,

i. Thes ,

ar e attach e d in p a rt to the outer s urfac e o f th e na s a l bone s

an d in pa rt to the aponeur o s
,

iswhi c h overlie s the car

ti lage s o f the no s e When thes . e mus c les ac t they theref ore

d r a w d o wn th e s kin o f the f orehea d to wardsthe centre ;

thi sisac companied by a depres sion o f the inner ends
o f the eyebrows an d a wri n kling o f the s kin over th e
root o f the nos e S uch movements
. ar e as soci ated with ex
pres sions o f di sp le asu re a s in fr owni n g ( Pl ate XXVIII m
) .

The co r r uga to r ess up er ci lii mus

,

cles
,

occupy an ob lique
pos ition above the inner ha lf o f the browsone on either
sid e They lie un der cover o f th e f rontalisan d ari s
,

. e from ,

th e bony arch o f the orbit on either s ide o f an d s lightly

a bove the root o f the no s e; s preading outward s an d u
p
wardsthey become attached to the s ki n over the middle
o f the eyebro ws When thes . e mus cle s co ntract the s kin ,

over the oute r part o f th e f oreh ead isdrawn inwardsan d ,

a s erieso f centra l longitudinal f old sisprod uced The .

m us c le is us ually co mbined in i ts action with the f oregoing ,

t h at i s to s ay either with eleva tion or depres s ion o f the s ki n

o f th e f oreh ead In thi s
. w ay the trans v erse f old s produced
by the f ronta li san d pyramidali sare modied in th e
m iddle line In co mb ination with th e c entral p art o f
s
.

the fr onta li s the co rr ugato res upe rc ilii caus e the eyebro ws
to be come oblique an d pucker th e s kin in the centre o f
th e f orehead as in the expres sion o f grief In as s
,

ociated
c les they help to emphas
,

action with the pyrami d ales mus iz e

372 The E ye in Ex p res
sio n .

strongly ompres sd c e in s t the front o f the globe which

aga

is slightly p s a ck war d at the s

,

hed b u a me time tha t the lids

are ca rried a little inw a rd s towardsthe bony attachment

o f the m us c le Pl ate XXVI I I Figs p
( 1 2 l, .
, ,
.

The eye is opened by the action o f a m us

,

c le ca lled the

le va to r p a lp eb r ae s up e r io r is ( the elev a tor o f th e upper lid

) .

This mus c le lies within the orbit an d isattached to the

I ts action is s
,

deep s
.

u rfac e o f the uppe r eyelid . uf ciently

expre s s ed by i ts name
s
.

The eye plays a mos t important part in the expre s ion o f

the emotions The change s met with in it are d ue to s everal
caus brilli ancy m ay be in creas
.

esFi rs
. t i ts ed or dimi ni s hed
e or decreas
,

acc ording to the in creas e in the tens ion o f the

c ontents o f the eyeb a ll Thes e changesar e beyond o ur
.

contro l an d ar e as
, sociated with ex al ted f eeli ngson the
one hand an d a s ens e o f depres sion on the other In th e
t in the la tter it appear s
.

f o r mer s tate the eye is bright whils

dull A n in creas whi ch bathe the s
,

. e in the tears u rface o f

the eyeba ll leadsto the more ready ree ction o f the light
fr om the moi s t expos ed s u rfac es A n exces s ive increas
. e

leadsto the s heddin g o f the tea rswhi ch takesplace in

,

certa in violent an d un c ontrollable emotion s .

The movementso f the eyeba ll which are d is tin ct f rom

'

e o f the eyelidshave a den ite inuence on expres s

,

thos , ion .

Th e do wn cas t eye indica tive o f s h ame the upturned eye

s
,

ugge s tive o f devotion the averted eye as ,

sociate d with
the expres s ion s o f di s gus t an d avers ion the down ward an d
s idelong look in co nte mp t are all well -m arked exam ples
,

Las tly we have the relation o f the ope ni ng o f the eyelids

,

as
,

to cons ider In s . uc h e motion s su rpri s e terr or an d horror , ,

the eyes a r e widely opened

m ay be as
.

The pa rtial clos ure o f the lid s socia ted with

a c o ntemptu ous look in whi ch the s ugges tion isthat the
pe rs on is not w orth looking at an d that we would experience
hut hi m o ut from o ur s
,

little los sif w e s i ght N ar rowing .

 Mus
clesof the Mauth .
375

bone immedi ately above the front teeth I tsbrespas . s

erted in part into the s
,

upward s to be ins eptum o f the nos e ,

in part into the pos teri or aspect o f the wings o f the nos tril
c le draws down the s eptum an d as iststhe co m
.

The mus s
pres s or in depres sing the als o o f the nos e an d na rro wi ng
the nos tril Under ordi nary circums
. tan ces the movemen ts
o f the al a e ar e imperc eptible in re s piration I n violent
piratory eff orts
.

ins after prolonged mus cul a r exerci s e or in

o f intens
,

condition s e exc itement accompanied by deep in

spirationsthe dila tation o f the nos trils beco mes a ch aracter

is When we wi s
,

tic f eature . h to analyz e more caref ully the

nature o f a parti cular odour we d raw the a ir up f orcibly into
the nos e an d then contract the orice s o as to prevent i ts
es cape Th es e are the s nifng movementsmovements whi ch
uch expre s
.
,

ar e o ften the invol untar y accomp animent o f s

sions as contempt an d di s dain ( Plate XXVII I Figs1 2 i ) .

, .

the mouth is
, ,

Of all the f eature s the mos t mobile an d the

mos t under o ur control Though many o f i tsmovements
ar e in a s ens e involuntarily as socia ted with certain moods
yet they may be checked by the exercis
,

e o f the will
ucc e s
.

In like manner we can with a certain degree o f s s

imul ate by the voluntary contraction o f s
,

s cles
,

ome o f its m us
the expres sions whi ch ar e habitually dependent on the more
or les s c c ordin ated a ction o f thes
- e mus c le s .

The mouth rank s rs t therefore as a modi f ying agent in

the appearan ce o f the f eature s The s . light upturn ing o f

the angle s o f the mouth impa rts to the f ace an altogether
diff e rent appearan ce from that di s played when the angles
a re down drawn
- . In s upport o f the view th at the mouth i s

su ch a n impo r tant f actor in the determination o f expre s s ion

we have only to take into cons ideration the numb er o f
mu s cle s which s u rround it .

G enera lly s peaking the mus cle s o f the mouth m a

y be
divided into groupsaccording to their action There i s
,

cle called the o r b icula r is

.

a clos in g mus o r is There ar e

.
376 Mus
clesof the Mo uth .

mus cle s which rais e the upper lip others whi ch elevate the
angle ; s
,

ome whi ch re tract the angl e san d s ome which draw

them down ; an d n ally there are thos s
,

, ,
e which depres
the lower lip
The o r b icula r iso r iscons ts
.

is o f an oval s heet o f mus c le

o f co n siderable thi cknes swhich s urround s the orice o f the

mouth I ts . inner edge corres pond sto the red marginso f
the lips I ts oute r bo rder s preads upward s to wards th e bas e
e outwards
.

o f the no s to ward s the cheek an d downward s as

low as
,

the furrow whi ch s e pa rate s

,

the lower lip from the

c hin .Th e m us c le i s con n ec ted by s lender s lipswith both
upper an d lower j aws above an d beneath the f ront te eth
, .

Th e bulk o f the m us c le however i s made up o f bres which

pas sac ros sfrom s ide to s ide an d turn upwards
, ,

an d down

ward s at the angles o f th e mouth The oute r border o f th e

elevato rs
.

mus cle is blended with the various an d depres s ors

o f the lips an d angl es an d i s al so intimately con ne cte d with
the mus o f the cheeks The mus c le clos esthe mouth
,

cle s .

an d brings the lips together it als o narrows th e mouth an d

caus es th e lip s to protrude ( Pl ate XXVIII Figs 1 2 g p ,
.
, . .

The elevators
,

o f the upper lip are two in n umbe r One

been already in part des
.

has cribed vi z the le va to r la bii .

up er io r is The bres o f thi s mus c le whi ch pas

,

s et a lo e ua s i s
to the lip are blended with the orbicu larison either s
.

ide
o f the wings o f the no s trils ( P late XXVIII F i g s I 2 k) .

s s
,

up e r i o r is
.

The le va to r la b ii s
, ,

p p
r o r i u or pe c ial elev a to r
o f the upper lip ari s es
,

f rom the f ront o the upper jaw bo ne

f -

e to the lower m argin o f the orbit ; it ismore or les s

, ,

c los

uni te d with th e prec eding m us c le an d is ins e rte d in to the

,

tis sues o f the upper lip ( Plate XXVI II Figs I 2 s ) ,

.
, , .

The elevators o f the angles o f the mo uth ar e the le va to r

a n guli o r i sm j
s d th
an d mi e z ygo ma ticu a o r an no r

s
.

The l t g l i s i e
e va o r sf rom the f
an ront futhe pper
ar t
'

ar o u

j wbone nder over f the le t r l bii speriori spro

a u c o va o a u

pri s d p s
u ,
sesdownw rd s d s
an a lightly o tw rdst be a an u a o
 The M o uth Ex pr es
s
'

378 tu io n .

sometimes lled the q d t

ca ua ra u s
m ti it p s
en s es
up w rds d
a a an

is ert d in t the ti s
sesf
,

i sn e o the lower lip blending w ith

u o

orisThe action o f thi s mus cle i s as s

,

the orbi cularis . is te d by

the bres o f the pl atys ma ( Plate XXVIII Figs I 2 d p

The le va to r meuti is mall m us

.

a s
.
, , , ,

cle whi ch ari s es fr om the

fr ont o f the lowe r j aw below the front teeth R un ning do w n
an d f orward s it s
.

wards preadso ut an d is ins

,

erte d into the

ing the chin as i ts
,

s kin o f the chin By rais name impli es

the lower li p an d protrudes
.

it a ls o elevates
, ,

it ( Plate XXVIII ,

Fig 2 c p
.
,
.

The action o f the variousmus c le s

,

on the form o f the

mouth hasbeen referred to aseac h h as been des c ribed b ut

a moment s
,

.

reection will ena ble the reader to unders tand
the complex ity o f form whi ch is the res ult o f their combined

action . N o t only i s this the cas e when the lips ar e c los ed b ut ,

an a lto gether diff erent s hape may be given to the open

mouth by the s quar ing o f the anglesor the inturni ng an d
protrus ion o f the li ps .

N ote a ls o how the mouth islike the nos e as socia ted with
te an d als
,

e viz that o f tas

,

a s pe cial s ens . o with the res pirato ry

In as
,

oc iation with tas

,

f tm cti o n s te we frequently have

movementsexpres s ure or di s
.

ive o f pleas gus t movements

would be perf ormed by the lipson the reception
,

s uch as

o f a tas ty bit or the rejection o f an uns avo ury mors el .

Th e mouth i s not on ly a c hannel through whi ch air m ay

enter an d pas sfr om the l ungs b ut a ls o exercis ,es an important

i n uenc e in s peech an d voice production In making - .

a violent m us cular eff ort af ter the ches t h as been lled with
a i r the mouth i s rmly clos ed to prevent i ts es ca pe On the .

c ompletion o f the action the mouth i s again opened an d th e

ai r expelled f rom the lungs Under ordin ary an d hea lthy

.

c ondition s the nos e alone s uf c e sf o r the purpos eso f

res piration b ut un der exceptiona l circums

, tanceswhen the
pirato ry eff ortsar e muc h increas
,

res ed the mouth isofte n ,

m ade us e o f to en able us to ge t more breath S o delicate .

380 Ex pres
sio n .

m ay be replaced by another which continuesth e curve

o f the upper lip downward s an d outward s

been already made to the as s

.

R ef erenc e h as oci ation o f

f aci al expres sion with ges ture an d pos e o f the body A s .

Prof es sor Cle lan d h as l

poin ted o ut ges ture largely depe nds
oc iation o f mental with phys ica l conditions
,

on the as s .

M ora l rectitude as expres s ed in ind ignation isas so ci ate d ,

traighte ning o f the gure ; mental depres sion is

,

with a s in
d icate d by a l ac k o f energy in the movemen ts o f the bo dy .

In like manner certa in emotions ar e expres sed by ges tures

which h ave a purely phys i cal bas isWe ofte n convey the
h to avoid or s
.

meaning that we wis hun a thing by puttin g

up the h ands as i f to pus h it as ide We bend the body .

f orwar d an d appro ach wh at ple as es us or indi cate by the

direction o f a wave o f the hand whether we des ire a pers
,

on
to a pproach or leave us Thes e examples
. ar e s uf c ient to

enable the reader to apprec iate the phys i cal reas on sfo r
the ges tures so f requently employed .

In providing a s hort s umm ary o f the mo re s trikin g

ch arac teris ti cs of some o f the expres sed emotions the details
m us t neces s a rily be brief an d the s election far from complete .

S i r Ch arle s Bell laid it d own asa general rule that

in all the exhil arating emotionsthe eyebrowseyelids ,

the nos
,

trilsan d angleso f the mouth ar e rais

, ed ; in the
depre s sing pas sion sit isthe revers e .

To thi s m ay b e added the s ugges tive rem arks o f Prof es sor

Cleland th at expres
,

s ion f o r the in fo rmation o f others
is mos t li able to be mad e with the mouth the organ o f
world ; while expres ionsthat
,

c om m un i ca tion with the s

betray thoughtsunintentionally to the outer world are
mos t liable to begin in th e eye an d forehead .

In the expres ion o f s

s uff ering as shown in a c rying
s
s
E m lutio n , E x p r e io n , a nd sti
S en a on, b y Jo h n Cle lan d , MD FRS
s s s
. . .
,

G la go w : Jam e M ac lch o e

s
s
.

3
The A n ato my of E x p r e i on . Thi rd ed i ti o n , 1844 .
382 L a ughter s
R ef lectio n Shyn es .

Laughter i sexpres
sed by the peni g mouth the
O n of th e ,

angles o f whi c h ar e either d rawn b ac k as in the bro ad

grin or drawn back an d uptur ned The upper li p is
,

, .

slightly rai s ed the nas o labi a l furrow i sdeepened an d

-

The s
,

cu r ved round the angle s o f the mo uth kin over .

the nos e isnely wrinkled an d the eyebrowsare s lightly

lowered The eyesar e pa rti ally clos
,

. ed by the contrac tion

o f the orbicul a ri s pa lpebrarum whi ch als o wrinklesthe
s
,

kin around the lid s The eyes thems

. elvesare bright an d
sparkling d ue to the acceleration o f the cir culation within
,

them .

D evotion i s as sociated w ith an upturned fac e an d eyes

an d h a nd s either clas ped or cros
,

sed on the breas t .

R eection ab s traction an d meditation are characteriz ed

,

by s light frowning movements an d a vacant look in the eyes

,

d ue to the fact th at we ar e s taring at nothi ng in parti cular

.

The eyes are not concentra te d on an

y obj ect a nd s ometime s
ar e s ugges
,

lightly d i vergent conveying j us , t the s tion o f

a s qu int .

Ill temper is
- s ugge s ted by a f ro wn an d the depres s ion o f
the angles o f the mouth sulkines sby a pouting o f the lips ,

ac compan ied with a down ward turn o f the an gle s

,

D etermination i s indicated by a rm clos ure o f th e

mouth accompanied by a deep ins pirato ry eff ort at the

s ame time tha t the whole m us cul a r s tem isread y f o r
, ,

ys
a ction A nod as when a pers on s ays I ll do it frequently
.

acc entuate s the expres

, ,

s i on .

S hynes son the other h and isoften as s ociated with

,

hing an d a des
,

blus ire to avoid look ing one in the face .

As ted by the aver ted or down turned head s hynes s

,

su gges ,

an d s hame are very much alike though th e f ormer is ,

o ft en dis tinguis h ed from the l atte r by a pouting o f the lip s

much aff ected th e fac e reddens
.

In rage th e c irculation is
an d th e vein s o f the nec k an d f orehead become di s tended
espallor isa m arked f eature ; the pers
.

In other cas on s o
 R ge S n eer ing D is
a d a in . 8
3 3

e ted becomeswhite with rage The ches

aff c . t heaves

w ith the more v iolent res piratory eff ortsan d the nos trils
quiver the mo uth isclos
,

, ed an d the te eth ar e rm ly
,

c len c hed . A t times the lips ar e protruded or it m a

y be
retracted s o as how the teeth The brows
, ,

to s
,

. ar e f rown i ng

bright an d as
,

hing ; the hair may bris

,

an d the eye is tle

s ect d i t s
,

an d the voi c e i a ff e ti c ksin th e th roat an d is

often trembling an d di s cord ant The s tsar e f requently

.

clo s e d as i f to s trike b ut in extremeso f pas s ion the mov e

eles s
,

men ts o f the ha nd s an d arm s m ay be p urpos .

In dign ation di ffersonly in degree from rage The p uls e .

is slightly qui ckened an d the colour heightened the eye is

bright an d the wings
, o f the no s tri ls ar e ra i sed the mouth
is c ommonly c ompre s sed R es pi ration ishurried an d the
.
,

gure is drawn up an d the head thrown s omewh at b ack .

S neering i s ch aracte r iz ed by an upturned an d averted

f ac e an d a retrac tion o f the upper lip s o as to expos e the

eye or canine tooth A s

D arwin h as pointed o ut thi s
try fo r the action isthe s a me as
.

revealsman s
,

an c es that

,

of a s narling dog when s howing h is ghting teeth or canines ,

preparatory to a tus s le with hi s antagoni s t .

In di s d ain the expres sion is a cc ompanied with a pa rti a l

c lo su re o f the eyelid s as i f the pers on lo oked at were

agr eeable to the s
,

d is ight or unworthy o f a glance In .

c on tempt the uptu rned an d wrinkl e d no s es u gg e s tsan off en

s ive odour whils ,

t in dis gus t the movements o f the lips or
the cleari n g o f the throat convey the impres s ion that the
pers on s o moved i s endeavouring to rid hi ms elf o f an ill
tas te or s ome uns avoury mouth f ul .

H elpl e s s n essisus ua lly s ugges te d by elevated eyebrows

an d wrinkled f orehea d Th e mou th 18 us
. ua lly open an d the

he ad bent to the s ide Th e elbowsare placed by the s

. ide
an d the p a lms
,

ar e upturned an d open A s hrug o f the .

s houlders helps to emphas iz e the expres sion

The expres s
.

ionso f atte ntion s urpris e as

, ton is hment an d
, ,
 Ha b itua l Ex p res
sio n . 8
3 5

a.moros e
an d ll t empered m an
i - by h islook f o r in hi m
the h abitua l mood h asbecome more o r les sperm anently
,

expres sed by every f eature in h i s

f ac e
.

One example i ss uf cient to en able the reader to re call

many others in whi ch the general temp erament is asch arac

ti cally di s
ter i s played
.
 C HA PTE R X I V

PR OPOR TI O N .

ss
Di ss from the es
cu theti s
n t ndpoint pm p ti a c a , or on re

solves itself int q es tion f t ste d d tion Beyo d

o a u o a an e uca . n

the f t th t the ide l m s

ac t lw ys
a depend on kno wledge a u a a a

of the re l the rtist isnot bo nd down by y h rd

a a u an a

pl s
,

an d f st r les H isim is
- a t repres
u ent wh t sms
. ing a o a ee ea

t him ; he m y f
o p rpos esf h isw emph s
a , i e ert in
or u o o n a z c a

pointst the expens f th s This d not ne es sri ly

,

a e o o er n ee c a

we ken h isdes
a ign on the ontr ry it often giv sp int ; c a e o

s
,

an d power t it Es p i lly isthisth

o e in reg rd
. ec a e ca a

to th e propo rtionso f the human gur e A canon o f pro .

portion i n s trict accord ance with s c ientic meas urements

would res ult in mere commonplace S c ience s eeksto .

attain an average art an ideal The artis ts earches f o r h is .

modelsamongs
,

t thos e who dis play the mos t grac eful an d

rened types trength an d f eminine beauty whils

o f m an l y s t ,

the anthropologis t an d anatomis t are conte nt to meas u re

all good b ad an d ind i ff erent in their endea vour s

, , , to s trik e ,

a me an
.

every arti s t knowsit is

.

As impos s ible to nd a mode l , .

without blemis h The ide al conception dependson th e

.

selection f rom diff erent models o f thos e feature s whi ch are

mos t ple asin g the combination forming a mas
, terpiece ver y
d i e re n t f rom the vulgar average put f orward by th e
'
388 Pr opo r tio n .

Thi sc orre s pon ds to th e proportion o f the head to height

in the A ntinous Th e G ladi ator an d the Fam e s
. e H ercules

meas u re 8 head s as al s
o the Venuso f M ilo The tendency .

in the antique isto keep the head s

,

mall in propo r tion

to the gure In thi s . w ay a s ens e o f height an d di gnity
is attained

u res
.

Fr om the chin to the f ork meas 3 he ad s d is trib ut ed

f ollows From th e chin to abo ut the level o f the n ipples

,

as

f rom this
.
,

I head ; level to a point a little above the .

navel 1 head fro m thi sto the f ork which co rre s

: ,po nds
te riorly to the f old o f the buttocksI head A rough
,

pos , .

an d -re ady method f o r s ketchi ng in the propo rtion so f the

trun k isto divide it into thirdso f whi ch the lowes t
includ es eat to the wa is
,

th e di s tance f rom the s t the middle

houlderswhils
.

that f rom the wais t to the s t the hi ghes

, t
is apportioned to the head an d n ec k .

The limbsbear the f ollowing proportion to the hea d .

The lower extre mity when s , traight me as ure s 4 he ,

ad s

f rom th e h e el to the trocha nter major an d thusequals ,

in length the head an d trunk together From the un der

s
.

urfac e o f the heel to the ar ti cul a r s urfac e o f the kn ee

meas ure s 2 head s From the a rti cul ar plane o f

. the kn ee
to the middle o f the f ur row o f the groin the di s tance
is 2 h e ad s .

A s4 he ad sh ave be en me as u red f rom the top o f

the gure to the f ork an d 4 he adsup from the he els
.

the height o f the gure equals7}headsit f ollows

,

an d as .

that the d is tan ce between the levels o f the f ork an d th e

trochanters m e as ure s h al f a head The half o f thi s

. distance ,

which overlies a point on a level wi th th e s ummit o f th e

a rch o f th e pubis corre s pondsto the centre o f the gure ,

tant f rom the top o f the head an d s

,

b e i n g di s ole o f th e
f oo t 3 } he ad s re spectively .

From the heel to the fork the limb meas ur e s ; he ads

3 ,

an d t h e ce ntre o f the pa te ll a c orre s pondsto the mid d le

390 Pr opo rtio n .

head below the level o f the s pine o f the s eventh ce r vi ca l

vertebra .

The he ad isdi vided in to two equal parts by a horiz ontal

li ne pas sing through the angles o f the eyelid s ; the s e hal ve s
are aga in divided into eq ua l p a rts s o that the head i s ,

apportion e d into f o ur par ts o f whi ch the highe s

, t incl ud e s
the h airy s calp the s econd the f orehe ad an d eyebrowsth e
e an d the fourth the mouth an d chi n Thi s
, ,

third the nos .

been pointe d o ut leavesb ut a s

,

a rrangement as has hor t ,

s pace fo r the mouth an d chin an d the s ugge s

, t ion o f Da
Vinc i that the dis
, tance between the chin an d the eyebrow
be halved an d made to corres pond with the bas e o f th e
nos e appearsto meet with general acceptation It need
,
.

hardly be pointed o ut that great individua l variations m ay

occur in the relative proportion s o f the f e atur es .

Th e bre adth o f the hea d on a level with the eyes varies

much in diff erent indiv id uals an d ra c es ; a go od proportion
appea rs to be that th iswidth s hould equa l three quar te rs
-

the head length in other wordsthe face an d f orehead

, .

A cco rding to Cous in thiswidth m ay be divided into v e

,

equal partso f which the central divis ion corres pondsto

the interva l between the eye sOn either s
,

.ide o f thisth e
eyeseach occupy a divi s ion whils t external to thes
, e

the outer orb ita l marginsan d the templess een in per

s p e c ti v e go to make u
p the o u ter f th s The b ase o f t h e .

nos e is s a id to eq ua l an e e in wid th an d the mouth

y
whic h variesgre atly m ay be s
,

tated asequa l in wi dth to

,

1 }eye s The w idth o f the nec k i s

. us ua lly abou t ha l f

a he da ,an d the length from the c hin to the pit o f th e

neck variesfrom a q uarter to one third o f a head This -

di s tance isincreas
.

ed or dimi n is hed according asthe head

is r a is ed or depre s s ed .

The table s ubjoined wh i ch is taken from Dr R icher s

, .
'

excellent treat is e will appea l to the s

, tudent asemi nently
practi ca l an d n o t und uly deta iled .
 Pr opo rtio n .

Th e h e igh o f th e t to rs
o f m ro th e chi n to th e
l
f o d o f the b u o ck tt s .

Fro m th e to p o f th e h ead to th e n av el, or to th e

l uppe r li m it o f the b u o ck b e h in d tt s .

Th e le n g h t of the uppe r e x tr e mi ty f ro m th e b o tto m

of th e h o llo w of th e arm pi t to th e tip of th e
m idd le n ger .

Fro m th e to p o f th e h ead to th e fo rk , or th e fo ld
i o f th e b u o ck b e h i n d tt s
sl
.

Th e le n g h t of th e lo w e r lim b fro m th e o e of th e
fo o tt o th e to p of th e grea t tro ch n te a r.

Th e ce n re s
t sf j o s li th e
i h d s
f m h o uld e r o in t
th t p f - e I ea ro e o o

th h d
e Th
ea . t sf th h ip j i ts
e cen li 3 h d s
re f m th t p
o e -o n e ea ro e o

of th h d e h ds
ea f m th g
,
or 4 d ea ro e ro un .

A dded to the f oregoing the f ollowing det ilswhi h ar e a , c

h ve been olle ted f om v rious

a c scour e s They do notr a c .

prof es
sto be bs ol tely ur te a b t m y ff ord th
u acc a , u a a e

student re dy me ns f tes
a ating pproxim tely the pro
a o a a

portionsf h isdr wing o a .

7} t 8 h d l gth s o ea en

6 t 7 f t l gth s
.

o oo en

s
.

9 t h d l gt h o 10 an en .

4 b itsi th d ist cu f m ti p f m iddl g

. e. e an ce ro o e n er

to tip o f e lb o w ) .

S h o uld er
2 h ead s ,
or m o re than one q uarte r o f
Em m a he igh t
W ais
.

FI G U R E t f o o t, little m o r e than h ead

!
or 1 or 1

s s
.

H ip i t h ea d ,
o r o n e-
f th o f h eigh t
.

On e s
-ixth t s
o o n e-e v e n th o f h eigh t.

Le n gth o f u ln a.

W id th of w ai s
t
ls
.

Dep h t of t u nk i
r n pro le o n a l
lev e w i h th e t n i pp e

st
.

N ice th e le n gth of face fro m eye b ro w o chi n .

Cir cum f e re n ce of t s.

Th ree f eet equa l the di s

tan ce from the s
ole o f the f oo t to
the f ork .
 Pr opo r tio n sof Fema le .

surf eswhi h in the m le

ac c a ar e s
as
o i ted wi th
c a a more
ys
powerf ul m sl r stem u cu a .

Th e ma le pe lvi s.

Fm . 20 5 . Th e f emale pe lvi s .

a. I l iac po r t io n o f o n i n n o m in atum .
g A c eta b ul um
. .

b Pub ic po rt io n o f o n in n o m in a tum b Pub i c arc h

s ss
.

sh i l p t i
. . .

c. l c a or o n o f o. in n o mi n a t um k Pub ic ym ph y i
D is s f p b is
. . .

4 t
c c re a. S pi ne o u
s s Th s m is s w dg d i
. . .

e. A t i up
n er o r e rio r ilia c pin e e a cr u een e b et w ee n
e n

s
.

I . A n te r i o r in f e r io r iliac p in e . th e tw o in n o min ate h on b ehi n d .

 Fema le Figur e .
397

Ash sbeen lre dy p inted t the obliq ity f

a a a o ou

u

o

the pelvi s
,

8) ismore m rked in the f em le th n in

22 a a a

FI G . 210 . PH} 2 1 1
. .

Fig s 2 10 , 2 1 1, s
h w o th e in ue n c e of th e pe lvic o b liq uity o n th e
ss
.

gu re f th e m ale a n d f e m ale
o In Fig 2 10 th e pelvi i ti lte d furth er
s s s
. .

f o rw ard th an i n th e m a le Fig 2 1 1 a wi ll b e e e n b y n o tin g the po iti o n

s s s
.
,

o f th e a n te ri o r e x tr e m i ty o f th e ili ac cr e t ( a n te ri o r upe ri o r ilia c pi n e

s s s s
A a re u lt o f th i the lum b a r cur ve i m o r e pr o n o un c e d i n Fig 2 10
s s s
.

th an i n g 2 1 1 . Thi re a ct o n th e o utli n e o f th e gur e , th e c urve

.
b e i n g mo re pro n o un ce d in the f e m ale th a n i n th e male .

the male ( Figs2 10 . Thisleadsto characteri s

ti c
the thighsback an d buttocks
,

appea ra n c e sin the form of , ; ,

398 Fema le Figur e .

of the s e it isonly ne e s
sry here to mention th more p
c a e ro

n o un ced f o w rd rve son the l mb r p rt f the verte m

a cur u a a o

col mn ( Figs
u . 2 10 ,

The n rrower a d more oni l thoan spports c ca rax u a

sho lder girdle f whi h the oll r bon s proportion

u - o c c a - e ar e

t ly s
a e hort r d lese s rved th n in the m le S p
an cu a a u

by n rrower hes
.

ported s thes
a e ar e t w ll d lessapower a c - a an

ful ly developed m s lesthey tend to o py hori ont l

u c ccu a z a

pos ition or m y s omewh t downw rds Thisim p rts

,

lope s a a a . a

to the fem ale neck an appearan ce o f grea te r length ( p .

an d detracts f ro m th e s u rene ss f the sho u lder whi h

q a o c ,

iss o ch a racte ristic a f eature o f the ma le The upper

limb isto the trun k proportionate ly s
.

horter than in the

male Thi siss
. olely d ue asM ars h all haspointe d o ut to
a d iff eren c e in the len th o f th e humerusth at o f the
, ,

g ,

f emale being proporti onate ly s horter than that o f the male .

Th e bone s o f the leg an d thigh are als o proportionately

s horte r than thos e o f the m ale In women the length o f .

the leg tend sto vary much more than the length o f the
thigh The length o f the lower limbstends
. to vary more
than the length o f the trunk Thuswhen s e ate d at table
.

timate o f the heightso f

,

it isvery d i cult to f orm an e s

diff erent individualsasthe len gthso f the trun ks
, are not

li able to s uch gre a t vari ations as the len gthso f the legs .

It isonly when th e s ittersris e f ro m their chairsthat

we can form an accurate co mpari s on the di ff erence i n ,

height being mainly d ue to di ff erence sin limb length .

The patella isn arrower in the f emale an d the f oot is

hor te r ; it isals
,

proportio n ate ly s o narrower relatively to

its length
The head in the female iss maller abs
.

olute ly an d pro
portionate ly than in the male though it iss ta ted to be
exua l di ff erence so f the s
,

rel atively higher The s k ull

have been already des
.

cri b ed ( p 349) an d need not here b e .

re peate d .
 Fema le Pr opo r tio n sof .

For ll pr ti l p rpos
a e sthe rulesl e dy l id down
ac ca u a r a a

f
or a pportioning the s ever l p rtsf the m le g re m y a a o a u a

be employed in dr wing the fem le sf sthey pply a a o ar a a

t
o height be ring in mind lw ysth t the trunk in
a a a a

wom n iss
,

aomewh t longer proportion tely th n in the a a a

m le Thi s s
a . esthe entre f the g re to f ll little
c au c o u a a

a bove the s ym phys isp bisi s te d f immedi t ly below u n a o a e

it sin the m le A g in the m in wom n ispropor

, a a . a ar a

The tip sf the gers

,

ti t ly s
ona e horter th n in m a an . o n

s hould b rely re h the middle f the thighs d owing

a ac o ,
an ,

to the f t th t the d iff eren e in length f the limbs

ac a isd c o ue

to d i a in the proportion f the h m e sthe pper

'

er en ce o u ru , u

ar m s ho ld be s lightly s hort r
u d the elbow pl ed e , an ac

a f raction hi gher than in the m ale In regard to the lower

limbsthough proportionately s
.

, h orter th an in the male ,

th e d i e r e n ce i s not gre at an d length o f limb tend sto

'

enhance the elegance o f the gure In thi s res pe ct s culptors .

ar e apt to un d u ly emph as iz e the len gth o f th e legsb ut

as
,

the res u ltsa r e m uch more pleas ing f rom an ae s theti c

standpoint than the oppos ite def ect the ques tion may well
be left to the individual fan cy o f the artis t As the f oot
is
.

relatively s horter in the f emale than in the male we ,

nd that a woman sheight meas u re s about f oot length s

7
whi ls t that o f a man isabout
,

It i swhen the width o f the gure i scons idered th at

the dis tinction s between the s exes ar e mos t m arked ; thes e
ar e as so c i ated with diff eren ce s in the f orm o f the os seous
fra mework p a rti cu l arly the che s , t wall an d pelvis
- .

Taking into cons ideration the height o f the female

whi ch isle s
,

sthan that o f m an by about 1 , o f h is 1

height we nd th at the s h oulders ar e not only abs olute ly

b ut a ls
,

o proportionately to the height narrower than in

the male
houldersisabout 2 h ead s
.

In m an the width o f the s

or over that is to s
,
a
y it i ssomewh a t more th an o n e -qu a rter
 Fema le Pr opo r tio n sof .

t ken on level with the pointst whi h the ili

a a rsts a c ac c e

re h the s
ac idesi s lso gre t r This ontr s tswith th a a e . c a e

condition in the m le in whom thi s di meter whi h i sf a a c o

o rs
,

e ls
,

c u sth n the m xim m hi p width m s

e a t ls o be a u - u a

onside bly les sth n the hes

,

c ra t width t ken in the m n er a c -

a a n

des rib d bove

c e a .

The h ip wid th in women is -not only gre t r in proportion a e

t the height th n in men b t isbs

o ol tely gr ter th n
a , u a u ea a

in membersf the oppos ite s f th sme height Th

o ex o e a . e

depth f the f em le g re isles

o sin ll itsdi metersi f
a u a a ,

we ex ept th r gion f the b tt ks Th ere owing to h

c e e o u oc .
,
t e

g e ter obliq ity f the pelvisthe more prono n ed b k

r a

u

o ,
u c ac

w rd thr s
a t f the sr m u d the in re s
o ed mo nt f ac u an c a a u o

i sb s
,

f t the w i dth from bef ore b kw rd s

a ,
l tely gr t r ac a a o u ea e

th n in the m l Th bd omin l w ll belo w the v l i s

a a e . e a a a na e

more ro nded d the thi gh s

u proportion t ly thi k r
,
an ar e a e c e

from back to fro n t I

Th e s u rfa c e f orm so f the fe m ale h ave been a lread y

s ui ci e n tly de s crib e d an d the po ints in which they di ff e r

by co ns
,

fr om the m ale m a y be as c e r ta ined ulting th e

c hapte rs un der whi ch the va rio us portionso f th e bod y

have be en dis c us s
ed .

It only remainsto s ay a f e w word sconcerning th e

remarkable chan ges whi ch take plac e in the proportion o f

the h uman gure from birth to ad ult li fe .

The mos t s triki n g f e atur e about a child at b i rth is th e

l arge s iz e o f i tshead Th e entire length o f the chil d . .

incl uding itstrunk an d legsi sa little ove r 4 he ad sas

ted with 7 in the ad ult The l e gs
,

contras thems elvesonly .

meas ur e a little more th an a hea d in length whil s t th e

ures as
,

trunk includin g the head m eas

, 3 he ad s compare d ,

with 4 in the a dul t .

F f th
or d t i ls
ur i g erd t t h
e a p p ti s f nth d
re lt t
arh o e ro or on o e a u e

stud t is f
en d t w k
r e erre titl d A R l f P p ti
o a f
or th H
en m e u e o ro or on or e u an

F igur e, b y th e la te Pro fe sJ h
s or o n s
Mar h a ll . S m ith , E ld er an d Co
Lo n d o n , 1879 .
 Pr opo rtio n sof Ch ild .

At birth the head is j ust about h alf the height o f the

ad ult he ad s o th at the rem a inder o f the child s length

which equals3 i n fantshead sor 1 }adult he adsmus

,

t ,

grow about four timesasrapidly to make up the ad ul t

proportion o f 6 }heads which it ultimately atta ins
A t tention has
.

a lready been ca lled to the f ac t ( p 0 th at

35 ) .

in the child the f ace is s ma ll proportionate ly to the brain

cas . e During growth coin cident with the changes a lre ady

re ferr e d to the f ace gra d ually enlarge still it attain sthe

,

ad u lt proportion s .

The rel ation o f the s iz e o f the head to the trunk a t

d i ff e rent periods o f li f e m ay be s t be expres sed in tabul ar
A t b ir th , tr u nk in clud in g head 3 h esad
s h ds
.

A t 9 year , tr un k 3} ea

s
.

s
A t 1 5 year , trun k 3% h d ea .

At 25
yea r st , run k 4 h ds ea .

With re ference to the proportion o f height at di ff erent

period s
to that o f the adult it is
f o und th at ,

H e igh t at b ir th t two -sev

ab o u th sf ad ult en o .

H e ight at 3 yea r s n e-half f d ult

o o a .

H e ight at 10 yea r s th re -q u rt so f d ult

e a er a .

The pos ition o f the cen tral point o f the gure gradually
fall slowe r as li fe advance s ; th i sdepend so f c ou rs
e on th e .

e in the len t h o f th e legs

,

in cre as g .

t
A t b ir h th e cen t re is littl b th
a le a o ve e n ave .

At 2
year sth e ce n re t ist th a l e n av e

t is l l with th ili b s
.

A t 3 year sth e ce n re ev e e ac o ne

t is
.

A t 1 0 year sth e cen re l l with th t h t s

e ve e ro c an e r .

At 13
yea r sth e ce n treist p b is a u .

I n th e ad ul t th e ce n re t ist th h f p b is
a ( m l )
e arc o u a e .

Th e growth , however isnot uni form throughout A s .

above an d between the nip p l e s

,

s
re gard the tor o th e parts
s ,
 4 3
0

grow more rapidly than thos e whi ch lie between the

nipplesan d navel In regard to th e li m bsa t birth the
upper a rms
.

legs
,

be tween knee an d ankle an d f eet are all o f

,

abo ut equa l lengths

,

In the upper extremity the length o f the hand i s a little

more than the length o f the f ore arm The hand doubles
- .

i ts length about the age o f s ix an d treble s it between th at ,

an d the ad ul t li f e .

The upper limb in the adult is 3 l time sthe length o f the

i ant sat birth a d o itsd iff erent s

n f

n f , s
egment the ore arm
f -

growsmos t rapidly In the cas e o f the lower extremity

.

the in creas e in length isvery remark able In the adult

original meas
.

it attains a length equa l to v e time s i ts ure

ment I tsrate o f growth m ay be indicate d asf ollows

.
,

m eas u red fr om the f ork to the sol e o f the foot

s lw
A t 3 year th e o e r e x tre mi ty tw i its igi l l gth ce or na en

tim s i ts igi l l gth

.

s
A t 1 2 year th e lo w er ex trem i ty f o ur e or na en

s
.

At 20 y th
ear l w e t m
o i ty ti m s
e r ex r eit s ig i l l n gth ve e or na e .

Th e thigh grows proportion t ly long r d qui ker th n a e e an c a

the other s egments o f the lim b

The above deta ilsare s tres son the

.

ufc ient to lay s

neces s ity o f s tri ct atte ntion to the detail so f the model

when repres e nting youth an d childhood We have ad .

m irable exam ple s o f thi sin the antique where in the earlier
examples
,

o f G reek art we n d an utter lack o f appre ci a tion

o f yo uth f ul f orm s Whether th is . w as d ue to a want o f

knowledge i s d if cult to s a
y ; yet the f ac t rem a in sth at the

gures o f the yo u th s in the Lao coon ar e not thos e o f boys

b ut ar e like s mall men S o als
,

o the gure o f a youth

.

prayin g the author o f whic h i sunkn own h asnone o f

the attribute so f youth b ut dis
, ,

pl aysall the bodily pro

,

portionso f an adult The gure in the arm so f Z e us

o f a c hild b u t re s
.

h as none o f the appearances em bles more ,

a m annikin .

n d 2
 Old A ge a nd D ecay .
40
5

changes in them are s een in the face where the s h edding o f

the teeth h asled to a change in f orm o f bo th upper an d
.

lower j aws The eyesals

. o have s unk more deeply in

their s ocketsan d t hough at tim es under t he in uen ce o f

excitement th ey ar e bright an d clear they lack asa r ule

, ,

e changes
,

the brillian ce o f youth Thes

. ar e b ut the outwa rd

indi cation o f proce sses whi ch mus t slowly b ut s u rely end

in death .
 IN DE X

k
A n le , i n te r n al an n ular l iga me n t o f,

A b d o m i n al m u sl s
c e , a cti o n o f, 69 A n le - k
3 m, 28 7,
0 1 290 .

ss
.

A b d o m i n al w all, an te r i o r , 55 A po n e uro c , 5 7
ssf ispi
.

s
.

a po n e u ro e o , 57 A po n e uro e c ra n i a l , 369
sf 6 sf th
.
, .

co n to ur o , 2. A rch e o e f o o t, 30 9 .

f o rm o f, i n f e m ale , 66. A r m , fe m ale, f o rm o f , 20 9

in ue n ce o f m o ve me n t s o n co n to u r s pro po r ti o n o f, 2 10.

o f, 69. s
u pe r c ve i n sf o 1 84 .

sf 55
,

li m i t o , A r mp i t, 1 22 .

sl sf 5 7
.

mu c e o , s s
A to n i h me n t
p s
si ex re o n o f, 8
3 4
sm sl
.

As t g lus88
, .

A b d ucto r h alluci u c e ( ab d ucto r ra a 2

A tl s t b
, .

th e grea t to e ) , 3 14
of a 3 3 ve r e ra , 2

s s A d it y m s
tus t
.
.

A b d ucto r i n d i c i mu cle , 198. u or l e e x e rn a 360

s
, ,
.

A b d ucto r m i n i m i d i giti m u cle, 20 0 . A x i lla, 1 0 7. S ee A rm p i t

s s
.

A b d u c to r m i n im i d i giti m u cle f ab Ax i v er te b ra, 2

3 3.
d uc to r ofth e l i ttle too ) , 3 1 5
s s
.

A b d ucto r p o ll i c i m u cle ,
1 7
9 .

A ce ta b ul um , 2 1 2, 2 1 7.

A cro mi o n pr o ce of s
s sp ca ula, 81 Bac k s
u f r ace fo rm sf o d i ffe ren ce
s
.
, ,

A d am apple, 328 b e tw ee n m ale f e m ale ,

an d 1 2 1.

s sl 65
.

A d d ucto r b re v i m u c e, 2 f o rm o f , an d b utto c ki n th e fe m a le ,
l g s m s
.

A d d ucto r on l u 65 u c e, 2 238 .

m g s m us B sf
.

A d d ucto r a nu l 65 c e, 2 ac k -b o n e cur ve o , 3 2 ; in a d ul t . 3
m usl sf th i gh
.
,

A d d ucto r c e 59 o 2 26 5 i n i n fa n t, 3
s
,

s5
, .
.

ac ti o n o f , 26 7. po i tio n o f i n m an ,4 ; i n a n i ma l
sb liq s
m s B
, , .

A d d ucto r po lli ci o l 97 uu u c e, 1 al l o f l ittle

n ge r 16 1, 200

is ssus
m s
. . .

A d d ucto r po lli c t ra nl ve r u c e, of th u m b 16 1 , 1 95

B
, .

1 98 an d o f Rich e r 2 75 .

s ss349 B s u b i ti st sf
. ,

A ir i n u e ice p c re la tio n o u r a ce

usm us
, . ,

A n co n e l c e , 1 4 7. f o rm , 144 ; actio n o f, 1 4 5.

re al ti t su f
on o r ace fo rm s4 8 1 B ice p s e x o r cru r i sm sl u c e , 268

B s ub i ti m us
, . .

An k l th 87
e, e, 2 i ce p ex o r c l c e , 1 4 2.

sf B smus
.

a n n u lar li ga m en t o , 292. i ce p cle of th e ar m , 2 1 4 .

 sth
I ri e, 365 Levato r sm sl 376
an gu li o r i
Is
, .
u c e,

g li spu l m s
.

hi m
c u 55, 2 14 2 16 . Le v ato r l
an u 89 u c e,
s
,
ca ae
.

tub e r o i ty o f, 2 16 ; in ue n ce on act i o n o f 9
sf
1.

l b ii s p i ist l
,
u r ace f o r m, 240 . Lev ato r a s
i u er o r e a ae na
mu sl 376
c e,

l b ii s p i i sp p i s
.

J I n vato r a u er o r ro r u

sl 376
.

mu c e,

m ti m s
.

Ja w, l o w e r , 34 5, 355
Le vato r
s l 358 3 78
.
en u c e,

sp i i sm sl
, .

c h an ge d ue to age , 35 7 .
Le vato r p p l b
a e rae u er o r u c e,
co n d yle o f , 355 .

3 7
co ro n o i d n o tch o f 35

co ro n o i d
, 5
o f , 355 s
s
.
Ligam e n t, great ac r o -cia tic, s s 234 .
p ro ce i li o -f e m o ra l, 226
sl s
s
.

J o in t , c a i ca ti o n o f , 24 .
i n te rc lavi cula r, 77
.

i m m o v a b le, 25 .
o r b i cul a r, 1 53

s
.

m o v ab le , 24 .

s Po upar t
'

, 2
1 6
s
.

t r uctur e o f , 23.
Y - h ape d , 226 .
Jugula r ve i n , e x te rn al, 33 7 .

Ligam e n t s4 2

s3 6
.
,

Li game n tum n uch e, 2 .

K Ligam e n tum pa te llae , 250

s
. .

K n ee , h o llo w b e h in d th e , 30 4 Lim b gi r dl e , 7 .

s s
.

u rf a ce f o r m o f , 2 77
Limb , lo w e r , i n f e ma le , 39 8
ss
.
.

K j
n ee - o i n t
Li n e p a f f m e ra o e u r , 22 2.

sm i lu s6
253.

sf
,

cru c ial li gam e n t Li n ea e e n a re , 2.

55.
ss 6
o 2

s
,

h ype r -
e x te n i o n o f , 25 8.
Li t
n eae r an v er ae , 1.

la te ral l igam e n t sf o 255.

Li ps th , 36 e, 2.

Li ttl g
,

k
lo c i n g o f, 258
e b ll f
n 6 e r, a o 1 1 , 200 .

l im b s
,

s klt f
.

L w
o er e e on o 1 1 , 2 1 3.
m ech an i m o f, in re la ti o n to
is
er ect
s
, ,

po tu r e,s 25 8.
Lum b par au 58 o ne ro , ,
1 03 .

m o ve m e n t sf o 25 7.

s
,

po te r i o r l igam e n t o f, 256 .

K n e e -pa n , 250 S ee Pa te lla

K n uck le s9
. .

M 3 1" b o n e , 352 s
s
1
'

,
1 1 9 3 20 5.
, ,
M al leo lu , ex te r n a l , 25 2, 2 86 .

i n te r n al , 25 1 , 285.

M amm ary glan d , 1 09 .

Laryn x , 32 7 M an di b le , 3 45
s
s s s sl s
s s
. .

La ti im u d o r i m u c e, 94 , 103 , 1 1 8. M a e te r m u c le , 35 7
s ss
.

acti o n o f , 1 06 M a to i d pr o ce o f te m po ral b o n e , 33 1 ,
s
.

re lati o n to u f r ace f o rm , 10 5. 360

s57
.

Laugh te r , 382 M e taca rpal b o n e 1 1 89 .

s s88
.
, ,

Leg, th e , 1 2, 285 M e ta ta r a l b o n e 2

sf th
. .
,

b o ne o e , 2 48, 285. M o u th , th e , 36 1
s
s
.

i n fe m a le , 398 th e , i n e x p re i378, 379 on,

s
s
. .

f o r m o f , i n f e m al e , 306
i n ue n ce o f f o r m o f , o n ex pr e i on

s s
.
,

i n te r m u cular epta o f , 29 2 . 3 75
sl sf 9 s sf th
.

mu c e o 2 2. m u c le o e,3 75
s s
sf 76 M usl s
,
.

t i gh t
ra ne o 2 di t
c e , re c acti o n o f, 85
sp i l i sf 3
. .
,

u er c a ve n o 20 . i n d irect acti o n o f, 86
sf sf 3 k sm m s
, .

t
ur ac e co n o ur o , 0 2. of b ac u ary o f , 1 1 7 r e la ti o n

s
i m us sf s
,

L t l l
e va o r a ae n a c e, 374 . to ur ace f o rm ,
1 19 .
4 1 2

ss
M u c le
o f th e ca lf 29 7 actio n o f, 300 . s
Orb i culari palpe b raru m mu sl c e, 3 7 1

s
.

s
s
,

o f ex p re i on, 6
3 9 Orb i t , th e , 359
Os l is3
. .

of th e f o o t, 3 14 ca c 1 288.

s
. , ,

O i n n o m in a tum , 8 H h -
b o n e.
o f th e f o re- arm, 1 6 4. . S e
e a u n c

of t h e leg 29 2 , .

o f th e m o n th , 375 .

o f th e n ec k 35 2

s374
.
,

of th e n o e, Palm , th e, 20 1 .

sf
.

of th e th igh , 259 l in e o 202

si
.
, .

Pal m a r fa c a, 20 1 .

P lm is
a arb m s
is l re v u c e , 20 3

P lm i s m s
.

a arl g s l on u u c e , 16 7

N s b s35 s 34 8
.

a al o ne , 9 P i t l b
ar e a o ne 2 2

N sl i l g s s349
. .
, ,

a a car t a e 359 P i t l mi
ar e a e n e n ce

N s-l f
. .
, ,

a o a b ial urro w , 3 79 Pate lla, 250 , 25 3.

N l
.

ave , 61 l igam e n t o f , 250 , 253.

s sl
.

N l
avi cu ar 8 b o n e, 2 8 Pectin e u m u c e , 265 .

N k h sl
.

ec t e, 3 2.
2 Pe cto ral i m a s j or mu c e , 10 6

sf 3 7
,

co n to u r o actio n o f , 1 09 .

s sf
.

s
,

d ee p t t f
r uc u re o 32 7 re la tio n to ur ace f o rm, 10 7.

s sl
.
,

f emale , 398 . Pecto ral i m i n o r m u c e, 95 .

le n gth o f 338 actio n o f , 95

sf
. .
,

mo ve me n t o th e, 324 ; in ue n ce Pe lv ic cavi ty, 2 1 2.

on sf f
ur ace or m , 339 Pe lvi c gi rd le. 7, 2 1 1
sl sf th s
. .

mu c e o e, 325 Pe lvi , 9 2 12, 2 1 8

sb
. . .

p i t O f : 771 33
3 d i ffe re n ce e tw ee n male an d

an d h o uld e r , 344 f e male , 2 1 8

N s
. .

i pple , po i ti o n o f , 10 9 f emale , 395

Ns s
. .

e ec t o n
'
o e, 359 . ob liq ui ty o f , 2 28 cu rve

alae o f , 36 2 of b ac k 2 29 e ff e c t o n th igh , 23 1

ss
.
,

m u cle o f th e , 374 i n fe m a le , 39 7
s
. .

po i ti o n o f 2 20

s s s
, .

Pe ro n e u b re vi m u cle , 29 5
s s s
.

Pe r o n e u lo n gu m u cle , 29 5
s st ti sm sl
.

Ob l iq ui ty of pe lv i 2 28 . Pe ro n e u er u u c e , 294

g s5 7
, .

Ob tura to r f o r ame n , 2 15 . Ph alan e , 9 88 1 1 2, 2

s
, .

Occ ipi tal b o n e , 34 8 . Pi i f o rm b o n e 162 . .

e x te r n al p r o tub e ran ce o f , 34 7 Pit o f n eck 77 33 2

sp s
.
. , .

u e ri o r curved l in e o f, 3 2 1 o f to m ach , 5 2

sm usl 369
.

si
.

Occ i p ito -
f ro n ta li c e. Plan tar fa 3 16
c a,

s
sf is3 3 sm usl
.

s
.

Od o n to id pro ce o ax 2 Pla ty m a myo id e c e, 336

s s
, . .

Oe o ph a gu , 327 Po m um A d a m i, 328
sd u
.

s
.

Old age , ch a n ge e to , 4 0 4 Po i ti o n of c o l lar b o n e in man

-
an d
f s
sfh s 34
.

Ole c r a n o n o a o ume r u 1 w o ma n . 84
s
s
,

slig m
. .

Olec ra n o n p f
ro ce o u ln a, 1 28 Po upa rt

a e n t, 6
5 , 2 16

sl
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S yn o v ia l m e m b ran e , 24 . Ti b ia , 1 2, 24 8, 285 . S ec S hi n -
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tub e rcle o f, 250 .

s sf 48
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m a to id pro ce o f , 33 1 , 360 Trac h ea, 32 7

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Te m po ral m u c le , 35 2 Tra pe z i um , 16 1 .

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Te n d o A ch i ll i s 89
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act i o n o f , 1 1 7. sm
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i n ue n ce on s
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a ct io n o f , 1 1 5 . re la ti o n tosu f f r a ce or m s 46
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acti o n o f ex te n or u c e o th e , Tro ch an te r o e r , 22 1 .

263 Tr o ch lea , 1 2 7.

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b ac k o f, sf u r ace f o rm sf o 2 70 .

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e x o r m u c le o f , 268 . f o rm , 1 59 .

fo ld of th e , 2 4 3. l o w er e n d o f , 1 58.

fo rm of th e , 2 72 i n e x i o n , 2 77. o lec ra n o n ssf r

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s m usl
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22 4 . U ln a r f ur ro w , 1 29, 1 72.

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Th o rax , 4 8 U p pe r a rm , 1 2 2 .

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