Normal human anatomy. Cheat sheet: briefly, the most important

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Normal human anatomy. Cheat sheet: briefly, the most important

Lecture notes, cheat sheets

Directory / Lecture notes, cheat sheets

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Table of contents

General information about osteology
The structure of the spine
The structure of the belt of the upper limbs
The structure of the lower limb belt
The structure of the bones of the brain
The structure of the bones of the facial part of the skull
General information about arthrology
Classification of the joints of the belt of the upper limbs and their characteristics
The structure of the joints of the belt of the lower extremities
Joints of the bones of the skull
The connection of the vertebrae, ribs with the spine and chest
The structure and classification of muscles and their auxiliary apparatus
Muscles of the shoulder girdle and shoulder
Muscles of the hand and auxiliary apparatus of the upper limb
Pelvic and thigh muscles
Muscles of the leg and foot
Mimic and chewing muscles of the head
Deep back muscles
Muscles of the chest and abdomen
Neck muscles
The structure of the nose
The structure of the larynx
The structure of the trachea, bronchi and lungs
The structure of the kidneys
The structure of the ureters of the bladder
The structure of the vagina and uterus
The structure, innervation and blood supply of the fallopian tubes and ovaries
The structure of the external female genital organs
The structure of the prostate gland, testicles and their appendages
The structure of the penis and urethra
The structure of the mouth and cheeks
The structure of the language
The structure of the hard and soft palate and glands of the mouth
The structure of the pharynx and esophagus
The structure of the stomach
The structure of the small intestine
Structure and physiology of the jejunum and ileum
The structure of the colon and caecum
The structure of the colon
The structure of the rectum
Liver structure
The structure of the pancreas. Peritoneum
The structure of the heart
The structure of the wall of the heart
The structure of the pulmonary trunk
Branches of the external carotid artery
Branches of the subclavian artery
Brachial and ulnar arteries. Branches of the thoracic aorta
Branches of the abdominal aorta
The structure of the branches of the common iliac artery
Branches of the femoral, popliteal, anterior and posterior tibial arteries
Superior vena cava system
Veins of the head and neck
Veins of the upper limb
Veins of the pelvis and lower limb
Branches of the internal carotid artery

1. General information about osteology

Skeleton (skeleton) - the totality of all the bones of the human body. There are over 200 bones in the human body.

Human skeleton:

1) performs a supporting function, supporting a variety of soft tissues;

2) protects the internal organs, creating receptacles for them;

3) is a depot organ for many important trace elements (calcium, phosphorus, magnesium).

The bone (os) is covered on the outside by the periosteum (periosteum), inside the bone there is a medullary cavity (cavitas medullares), in which red and yellow bone marrow (medulla ossium rubra et flava) is located.

Bone is 29% organic, 21% inorganic, and 50% water.

Bone classification:

1) tubular bones (os longum). Most often they have a trihedral or cylindrical shape. The length of the bone can be roughly divided into three parts. The central part, which makes up most of the length of the bone, is the diaphysis (diaphysis), or the body of the bone, and the epiphyses (epiphysis) - the marginal parts that have a thickened shape. The epiphyses have an articular surface [facies articularis), which is covered with articular cartilage. The place where the diaphysis passes into the epiphysis is called the metaphysis. There are long tubular bones (for example, shoulders, thighs, forearms, lower legs) and short ones (for example, phalanges of fingers, metacarpals and metatarsals);

2) flat bones (ossa plana). These include the bones of the pelvis, ribs, sternum, bones of the roof of the skull;

3) mixed bones (ossa irregularia). They have a complex structure and a variety of shapes;

4) spongy bones (os breve). Often have the shape of an irregular cube (tarsal and carpal bones);

5) air bones (ossa pneumatica). They have in their thickness a cavity lined with epithelium and filled with air (for example, the upper jaw, wedge-shaped, ethmoid, frontal).

Elevations on the surface of the bone, to which ligaments and muscles are attached, are called apophyses. The apophyses include the crest (crista), tubercle (tuber), tubercle (tuberculum) and process (processus). In addition to elevations, there are depressions - a pit (fossula) and a pit (fovea).

Edges (margo) delimit the surface of the bone.

If a nerve or vessel is adjacent to the bone, then a groove (sulcus) is formed as a result of pressure.

When a nerve or vessel passes through a bone, a notch (incisura), a canal (canalis), a tubule (canaliculus) and a fissure (fissure) are formed.

2. The structure of the spine

The vertebra (vertebra) has a body (corpus vertebrae) and arches (arcus vertebrae).

The arc connects to the body through the legs (pedun-kuli arcus vertebrae), due to which the vertebral foramen (foramen vertebrae) is formed. The vertebral foramina of all vertebrae form the spinal canal (canalis vertebrale).

The cervical vertebrae (vertebrae cervicales) have a feature - the opening of the transverse process (foramen processus transverses). On the upper surface of the transverse process there is a groove for the spinal nerve (sulcus nervi spinalis).

I cervical vertebra (atlas) has no body, but has an anterior and posterior arches (arcus anterior et posterior) and a lateral mass (massa lateralis).

II cervical vertebra (axis) has a distinctive feature - a tooth (dens), located on the upper surface of the body.

At the VI cervical vertebra, the posterior tubercle is better developed than on other vertebrae, and is called sleepy (tuber-culum caroticum).

VII cervical vertebra is called protruding (vertebra prominens) due to the long spinous process.

The thoracic vertebrae (vertebrae thoracicae) have smaller vertebral foramens compared to the cervical ones. The thoracic vertebrae from II to IX have upper and lower costal fossae (fovea costales superior et inferior) on the posterolateral surfaces on the right and left.

On the anterior surface of the transverse processes of the IX vertebrae there is a costal fossa of the transverse process (fovea costalis processus transverse).

Lumbar vertebrae (vertebrae lumbales) have a massive body and additional processes (processus accessories).

The sacrum (os sacrum) consists of five lumbar vertebrae fused into a single bone. It has a base (basis ossis sacri), an apex (apex ossis sacri), a concave pelvic surface (facies pelvia) and a convex posterior surface (facies dorsalis). On the pelvic surface there are four transverse lines, at the ends of which the anterior sacral openings (foramina sacralia anteriora) open.

On the back surface there are five longitudinal ridges: median (crista sacralis mediana), paired intermediate (crista sacralis intermedia) and paired lateral ridges (crista sacralis lateralis).

The coccyx (os coccyges) consists of 4-5 coccygeal vertebrae. The coccyx is connected to the sacrum through the body and coccygeal horns.

Ribs (costae) consist of bone (os costale) and cartilaginous parts (cartilago costales). Seven pairs of upper ribs are called true and are connected by a cartilaginous part to the sternum. The remaining ribs are called false or oscillating (costae fluctuantes).

I rib differs in structure from other ribs. It has medial and lateral borders that define the upper and lower surfaces.

The sternum (sternum) consists of three parts: the handle (manubrium sterni), the body (corpus sterni) and the xiphoid process (processus xiphoideus).

The handle has jugular and clavicular notches. The handle and body form the angle of the sternum (angulus sterni).

3. The structure of the belt of the upper limbs

The shoulder blade (scapula) refers to flat bones. The shoulder blade has three corners (upper (angulus superior), lower (angulus inferior) and lateral (angulus latera-lis)) and three edges (upper (margo superior), having a notch (incisura scapulae), lateral (margo late-ralis) and medial (margo medialis)).

There are concave (anterior costal (facies costalis)) and posterior (convex) surfaces (facies posterior). The costal surface forms the subscapular fossa. The back surface has the spine of the scapula (spina scapulae).

The clavicle (clavicula) has an s-shape. The clavicle has a body (corpus claviculae), thoracic (extremitas sternalis) and acromial (extremitas acromialis) ends. The upper surface of the clavicle is smooth, and on the lower there is a cone-shaped tubercle (tuberculum conoi-deum) and a trapezoid line (linea trapezoidea).

The humerus (humerus) has a body (central part) and two ends. The upper end passes into the head (capet humeri), along the edge of which the anatomical neck (collum anatomykum) passes. Behind the anatomical neck are large (tuberculum majus) and small tubercles (tuberculum minus), from which the crests of the same name (cristae tuberculi majoris et minoris) extend.

Between the head and the body of the humerus is the thinnest place of the bone - the surgical neck (collum chirurgicum).

On the lateral surface there is a deltoid tuberosity (tuberositas deltoidea), below which the groove of the radial nerve (sulkus nervi radialis) passes. The distal end of the humerus ends with a slit (condilus humeri), the medial part of which is represented by the block of the humerus (trochlea humeri), and the lateral part is the head of the condyle of the humerus (capitulum humeri).

The bones of the forearm include the ulna and radius.

The radius (radius) has a body and two ends. The proximal end passes into the head of the radius (caput radii), on which there is an articular fossa (fovea artikularis).

Ulna (ulna). At its proximal end there is a block-shaped notch (incisura trochlea-ris), ending with two processes: the ulnar (olecranon) and the coronal (processus coronoideus).

The hand (manus) consists of the bones of the wrist (ossa carpi), metacarpus (ossa metacarpi) and phalanges (phalanges) of the fingers. The wrist (carpus) consists of eight bones arranged in two rows.

The first row is formed by the pisiform (os pisiforme), trihedral (os triquetrum), lunate (os lunatum) and scaphoid (os scaphoideum) bones. The second row of bones are hook-shaped (os hamatum), capitate (os capitatum), trapezoid bones (os trapez-oideum) and bone-trapezium (os trapezium).

There are five metacarpal bones. They distinguish the body (corpus metacarpale), the base (basis metacarpale) and the head (caput metacarpale). Phalanges of fingers. All fingers, with the exception of the thumb, have three phalanges: proximal, middle and distal. In the phalanx, the body, base and head are distinguished.

4. The structure of the belt of the lower extremities

The pelvic bone (os coxae) consists of three bones fused together: the ilium, pubic and ischium, the bodies of which form the acetabulum (acetabulum). In the center of the depression there is a hole of the same name.

The ischium (ischium) has the body and branches of the ischium. An angle is formed between the body and the branch, in the region of which the ischial tubercle (tuber ischiadicum) is located.

The ilium (os ilium) has a body (corpus os-sis illi) and a wing (ala ossis illi). The wing ends with a convex edge - the iliac crest (crista iliaca), on which three lines are distinguished: the outer lip (labium externum), the intermediate line (linea intermedia) and the inner lip (labium internum).

On the crest in front and behind there are symmetrically located protrusions: the upper anterior (spina ilia-ca anterior superior), the lower anterior (spina iliaca anterior inferior), the upper posterior (spina iliaca posterior superior) and the lower posterior iliac spine (spina iliaca posterior inferior).

The pubic bone (os pubis) has a body from which the upper branches (ramus superior ossis pubis) extend, having an iliac-pubic eminence (eminencia iliopubica).

The femur (os femoris) has a body and two ends. The proximal end passes into the head (caput ossis femoris), in the middle of which is the fossa of the same name. The transition of the head into the body is called the neck (collum femoris). On the border of the neck and body are large (trochanter major) and small (trochanter minor) skewers, connected in front by an intertrochanteric line (linea intertrochanterica), and behind - by a crest of the same name.

In the patella (patella), the base, apex, anterior and articular surfaces are distinguished.

The lower leg consists of the tibia and fibula, between which is located the interosseous space (spatium interossium cruris). The fibula (fibula) has a body and two ends.

At the proximal end is the head (ca-put fibulae), on which there is an apex and articular surface of the head (facies articularis capitis fibulae).

The distal end of the fibula forms the lateral malleolus (malleolus lateralis).

The tibia (tibia) has a body and two ends. The proximal end has a medial and lateral condyles (condylus medialis et lateralis) and an upper articular surface.

The bones of the foot (ossa pedis) consist of the bones of the tarsus (ossa tarsi), metatarsal bones (ossa metatarsi) and phalanges (phalanges). The bones of the tarsus consist of seven bones arranged in two rows.

The second row consists of five bones: the cuboid bone (os cuboideum), the sphenoid bones (medial, lateral and intermediate ossa cuneiformia) and the navicular bone (os naviculare).

Metatarsal bones are short tubular bones. They have a body, base and head.

Phalanxes. All fingers, with the exception of the thumb, have three phalanges: proximal, middle and distal. In the phalanx, the body, base and head are distinguished.

5. The structure of the bones of the cerebral part of the brain

The skull (cranium) is a collection of tightly connected bones and forms a cavity in which the vital organs are located.

The brain part of the skull is formed by the occipital, sphenoid, parietal, ethmoid, frontal and temporal bones.

The sphenoid bone (os sphenoidale) is located in the center of the base of the skull and has a body from which processes extend: large and small wings, pterygoid processes.

The body of the sphenoid bone has six surfaces: anterior, inferior, superior, posterior, and two lateral.

The large wing of the sphenoid bone (ala major) has three holes at the base: round (foramen rotundum), oval (foramen ovale) and spinous (foramen spinosum).

The small wing (ala minor) has an anterior inclined process (processus cli-noideus anterior) on the medial side.

The pterygoid process (processus pterigoideus) of the sphenoid bone has lateral and medial plates fused in front.

The occipital bone (os occipitale) has a basilar part, lateral parts and scales. Connecting, these departments form a large occipital foramen (foramen magnum).

The lateral part (pars lateralis) of the occipital bone has an occipital condyle (condylusoccipitalis) on the lower surface. Above the condyles passes the hypoglossal canal (canalis hypoglossalis), behind the condyle is the fossa of the same name, at the bottom of which is the condylar canal (canalis condylaris).

The occipital scales (squama occipitalis) of the occipital bone has an external occipital protrusion (protuberantia occipitalis externa) in the center of the outer surface, from which the crest of the same name descends.

Frontal bone. Parietal bone

The frontal bone (os frontale) consists of the nasal and orbital parts and the frontal scales, which occupy most of the cranial vault. The nasal part (pars nasalis) of the frontal bone on the sides and in front limits the ethmoid notch. The median line of the anterior part of this part ends with the nasal spine (spina nasalis), to the right and left of which is the aperture of the frontal sinus (apertura sinus frontalis), which leads to the right and left frontal sinuses. The right part of the orbital part (pars orbitalis) of the frontal bone is separated from the left ethmoid notch (incisura ethmoidalis).

The parietal bone (os parietale) has four edges: occipital, frontal, sagittal and scaly. Four corners correspond to these edges: frontal (angulus frontalis), occipital (angulus occipitalis), wedge-shaped (angulus sphenoidalis) and mastoid (angulus mastoi-deus). The parietal bone forms the upper lateral vaults of the skull.

The temporal bone (os temporale) is a receptacle for the organs of balance and hearing. The temporal bone, connecting with the zygomatic bone, forms the zygomatic arch (ar-cus zygomaticus). The temporal bone consists of three parts: squamous, tympanic and petrosal.

The ethmoid bone (os ethmoidale) consists of the ethmoid labyrinth, the ethmoid and perpendicular plates.

The ethmoid labyrinth (labyrinthus ethmoidalis) of the ethmoid bone consists of communicating ethmoid cells (cellulae ethmoidales).

6. The structure of the bones of the facial part of the skull

The body of the lower jaw (corpus mandibulae) has a lower (base (basis mandibulae)) and upper (alveolar (pars alveolaris)) parts, in the latter there are dental alveoli separated by interalveolar septa (septa interalveolaria).

On the inner surface of the body there is a chin spine (spina mentalis), to the right and left of which there are digastric fossae (fossa digastrica).

On the inner surface of the branch of the lower jaw (ramus mandibulae) there is an opening of the lower jaw (foramen mandibulae), limited on the medial side by the tongue of the same name.

The upper jaw (maxilla) has a body and four processes: zygomatic, alveolar, palatine and frontal.

The zygomatic process (processus zygomaticus) of the upper jaw is connected to the zygomatic bone.

The frontal process (processus frontalis) of the upper jaw on its medial surface has a crib crest (crista ethmoidalis), on the lateral surface - the anterior lacrimal crest (crista lacrimalis anterior).

The palatine process (processus palatinus) departs from the upper jaw, on the medial edge it has a nasal crest (crista nasalis).

The lower edge of the alveolar process (processus al-veolaris) on the upper jaw has dental alveoli (alveoli dentales), separated by interalveolar septa (septa interalveolaria).

The body of the upper jaw (corpus maxillae) has a maxillary sinus (sinus maxillaries), which communicates with the nasal cavity through the maxillary cleft.

The orbital surface forms the inferior wall of the orbit.

The inferior nasal concha (concha nasalis inferior) has three processes: ethmoid (processus ethmoida-lis), lacrimal (processus lacrimalis) and maxillary (processus maxillaris).

The zygomatic bone (os zygomaticum) has three surfaces (temporal, orbital and lateral) and two processes (temporal and frontal).

The lacrimal bone (os lacrimale) has a posterior lacrimal crest (crista lacrimalis posterior) on the lateral surface, which ends with a lacrimal hook (hamulus lacrimalis). The vomer (vomer) is involved in the formation of the bony septum of the nose and has two wings (alae vomeris) on the upper posterior margin.

The nasal bone (os nasale) forms the bony back of the nose; has three edges: upper, lower and lateral.

The hyoid bone (os hyoideum) has a body (corpus ossis hyoidei), large (cornu majora) and small horns (cornu minora).

The palatine bone (os palatum) consists of perpendicular and horizontal plates connected at right angles; has three processes: wedge-shaped (processus sphenoidalis), orbital (processus orbi-talis) and pyramidal (processus pyramidalis).

On the medial surface of the perpendicular plate are shell (crista conchalis) and ethmoid crests (crista ethmoidalis).

7. General information about arthrology

For the normal functioning of the skeletal system, a functionally beneficial connection of all bones is necessary.

Classification of bone joints:

1) continuous connections of bone tissue. There are three types of continuous, or fibrous, joints {articulationes fibrosae), which include injections, syndesmoses and sutures:

a) stabbing (gomphosis) is a special compound; so the teeth are connected to the bone tissue of the alveoli, while between the connecting surfaces there is a periodontium (periodontum), which is a connective tissue;

b) syndesmosis (syndesmosis) is represented by bone tissue, the fibers of which are fused with the periosteum of the connecting bones. Syndesmoses include interosseous membranes (membranae interosseae) and ligaments (ligamenta) .;

c) seams {sutura) have a small layer of connective tissue between the edges of the connecting bones. There are the following types of seams: flat {sutura plana), jagged {sutura serrata) and scaly {sutura squamosa);

2) discontinuous connections (articulationes synoviales), or joints. The joint has a complex structure, in its formation the articular surfaces of the connecting bones, covered with cartilage, the articular cavity with synovial fluid, the articular capsule and auxiliary formations (articular discs, menisci, articular lips) take part.

Articular surfaces (fades articulares) most often correspond to each other in shape.

Articular cartilage (cartilago articularis) consists of three zones: deep (zona profunda), intermediate (zona intermedia) and superficial (zona super-facialis).

The articular cavity (cavum articulare) has a small amount of synovial fluid (synovia) and is limited by the synovial membrane of the joint capsule.

The articular capsule (capsula articularis) has two layers: inner (synovial membrane (membrana synovialis)) and outer (fibrous membrane (membrana fibrosa)).

Ligaments located outside the capsule are called extracapsular (ligamentas extracapsularia), inside the capsule - intracapsular (ligamentas intracapsularia).

The articular lip (labrum articulare) complements and deepens the articular surface, located along the edge of its concave surface. Articular discs and menisci (disci et menisci articu-lares). Menisci are represented by discontinuous cartilaginous (connective tissue) crescent-shaped plates.

Synovial bags (bursae synoviales) are protrusions of the synovial membrane in thinned areas of the outer membrane of the joint capsule;

3) symphyses (symphisis), or semi-joints. In them, slight displacements of the connected bones are possible.

8. Classification of the joints of the belt of the upper limbs and their characteristics

Classification:

1) simple joints (articulatio simplex), formed by two articular surfaces;

2) complex joints (articulatio composita), formed by three or more articular surfaces;

3) complex joints that have discs or meniscus between the articular surfaces, dividing the joint cavity into two floors, and combined - anatomically isolated joints that act together.

The joints of the girdle of the upper limb (articulationes cinguli membri superioris) connect the clavicle to the sternum and scapula.

The sternoclavicular joint (articulatio sternoclavicu-laris) is formed by the clavicular notch of the sternum and the sternal articular surface of the sternal end of the clavicle.

Acromioclavicular joint (articulatio acro-mioclavicularis). The articular capsule of the joint is reinforced from above by the acromioclavicular ligament (lig. ac-romioclaviculare).

The structure of the shoulder joint (articulatio humeri). The shoulder joint is the most mobile in the human body. The shoulder joint belongs to the spherical joints. The upper part of the articular capsule is thickened and forms the coraco-brachial ligament (lig. coracohumerale).

The elbow joint (articulatio cubiti) refers to complex joints, formed by the articular surfaces of three bones - the humerus, radius and ulna.

The shoulder joint (articulatio humeroulna-ris) refers to the block joints. The proximal radioulnar joint (articulatio radioulnaris proximalis) refers to cylindrical joints.

The wrist joint (articulatio radiocarpalis) is formed by the articular disc on the medial side, the proximal surfaces of the lunate, trihedral and navicular bones and the carpal articular surface of the radius.

Intercarpal joints (articulationes intercarpales) are located between the individual bones of the wrist.

The intercarpal joint includes the pisiform joint (articulatio ossis pisiformis), which has two ligaments.

The carpometacarpal joint of the thumb (articulatio carpometacarpalis pollicis) is a saddle joint.

Intermetacarpal joints (articulationes intermetacarpa-les) have a common joint capsule, strengthened by the back and palmar metacarpal ligaments (ligg. me-tacarpalia dorsalia et palmaria).

Metacarpophalangeal joints (articulationes metacar-pophalanges) are formed by the articular surfaces of the heads of the metacarpal bones and the bases of the proximal phalanges.

The interphalangeal joints of the hand (articulationes interphalangeales manus) are formed by the head and base of the adjacent phalanx. The joints belong to the block-shaped joints. The capsule is free, reinforced on the sides with collateral ligaments (ligg. collatera-lia), thickened from the palmar side due to palmar ligaments (ligg. palmaria).

9. The structure of the joints of the belt of the lower extremities

The sacroiliac joint (articulatio sacroiliaca) is formed by the ear-shaped articular surfaces of the sacrum and pelvic bone. The sacroiliac joint is a flat joint.

The articular capsule of the joint is very strong and strongly stretched, fused with the periosteum, reinforced in front by the anterior (ligg. sacroiliaca anteriora), and behind - by the interosseous (ligg. sacroiliaca interossea) and posterior sacroiliac ligaments (ligg. sacroiliaca posteriora).

The pubic symphysis (symphisis pubica) connects the right and left pubic bones. The symphyseal surfaces of the pubic bones are covered with cartilage and fused by the interpubic disc (discus interpubicus). The symphysis is strengthened by the superior pubic ligament (lig. pubicum superior) and (from below) the arcuate ligament of the pubis (lig. arcuatum pubis), which occupies the top of the subpubic angle (angulus). The lower branches of the pubic bones, limiting the subpubic angle, form the pubic arch (arcus pubis).

The pelvic bones are connected to the sacrum with the help of the sacrotuberous ligament (lig. sacrotuberale), the continuation of which is the pelvis. The sacrum and pelvic bones, connecting with the help of the sacroiliac joints and the pubic symphysis, form the pelvis (pelvis).

The pelvis is divided into two sections: the upper (large pelvis (pelvis major)) and the lower (small pelvis (pelvis minor)).

The hip joint (articulatio coxae) refers to a variety of spherical joints - cup-shaped type (articulatio cotylica).

The bones of the lower leg, like the bones of the forearm, are connected by discontinuous and continuous connections.

The discontinuous joints include the tibiofibular joint (articulatio tibiofibularis), formed by the peroneal articular surface of the tibia and the articular surface of the head of the fibula.

Continuous connections include the interosseous membrane of the leg (membrana interossea cruris) and the tibiofibular syndesmosis (syndesmosis tibiofibularis).

The ankle joint (articulatio talocruralis) is a block joint.

The foot consists of 12 bones with little mobility. The foot has one transverse and five longitudinal arches.

The talocalcaneal-navicular joint (articulatio ta-localcaneonavicularis) is formed by two joints: the subtalar (articulatio subtalaris) and the talon-navicular (articulatio talonavicularis).

Calcaneocuboid joint (articulatio calcaneocu-boidea) refers to the saddle joints.

The wedge-shaped joint (articulatio cuneonavicula-ris) refers to flat joints.

The Lisfranc joint, or tarsal-metatarsal joints (articulationes tarsometatarsales), refers to flat joints;

Intermetatarsal joints (articulationes intermetatar-sales) are formed by the surfaces of the bases of the metatarsal bones facing each other.

Metatarsophalangeal joints (articulationes metatar-sophalangeales) are formed by the heads of the metatarsal bones and the bases of the proximal phalanges of the fingers.

The interphalangeal joints of the foot (articulationes interphalanges pedis) belong to the block joints.

10. Connections of the bones of the skull

All bones of the skull, with the exception of the connection of the temporal bone with the lower jaw, which forms the joint, are connected using continuous connections, represented in adults by sutures, and in children by syndesmoses.

Continuous connections are formed by the edges of the frontal and parietal bones, forming a jagged coronal suture (sutura coronalis); the edges of the belt bones form a serrated sagittal suture; the edges of the parietal and occipital bones are a serrated lambdoid suture (sutura lambdoidea).

The bones that form the facial skull are connected with flat sutures. Some sutures are named after the bones that form the sutures, such as the temporo-zygomatic suture (sutura temporozigomatica). The scales of the temporal bone are connected to the greater wing of the sphenoid bone and the parietal bone with the help of a scaly suture (sutura squamosa). In addition to sutures, some bones are connected using synchondrosis: the body of the sphenoid bone and the basilar part of the occipital bone - sphenoid-occipital synchondrosis (synchondrosis sphenooccipitalis), the pyramid of the temporal bone with the basilar part of the occipital bone - petrooccipital synchondrosis (synchondrosis petrooccipitalis). By the age of 20, synchondrosis is replaced by bone tissue.

Skull joints

The temporomandibular joint (articulatio tempo-romandibularis) is a complex paired elliptical joint. This joint is formed by the mandibular fossa of the temporal bone (fossa mandibularis) and the head of the lower jaw (caput mandibulae). Between these articular surfaces is the articular disc, dividing the articular cavity into two floors.

The movement in the right and left joints is symmetrical, the following movements are possible: lateral movements, lowering and raising the lower jaw and shifting the lower jaw forward and backward (to its original position).

The upper synovial membrane (membrana synovialis superior) covers the entire joint capsule, attaching along the edge of the articular cartilage, and the lower membrane (membrane synovialis inferior), in addition to the capsule, also covers the posterior surface of the articular disc. In the upper floor, the articular surface of the temporal bone is articulated with the upper surface of the articular disk, and in the lower floor, the head of the lower jaw is articulated with the lower surface of the articular disk.

The joint capsule is strengthened on the lateral side by the lateral ligament (lig. laterale), on the medial side there are auxiliary ligaments: stylomandibular (lig. stylomandibulare) and sphenomandibular ligaments (lig. sphenomandibulare).

11. Connection of the vertebrae, ribs with the spine and chest

The connection of the vertebrae (articulationes vertebrales) is carried out when the bodies, arches and processes of the vertebrae are connected.

The vertebral bodies are connected by intervertebral discs (discus intervertebrals) and symphyses (symphysis intervertebrales). The intervertebral discs are located: the first - between the bodies of the II and III cervical vertebrae, and the last - between the bodies of the V lumbar and I sacral vertebrae.

The vertebral arches are connected by yellow ligaments (lig. flava).

Articular processes form intervertebral joints (articulationes intervertebrales), related to flat joints. The most protruding articular processes are the lumbosacral joints (articulationes lumbosacrales).

The atlantooccipital joint (articulatio atlantooccipita-lis) consists of two symmetrically located condylar joints, being a combined joint.

The median atlantoaxial joint (articulatio atlanto-axialis mediana) is a cylindrical joint.

The lateral atlantoaxial joint (articulatio atlantoaxialis lateralis) refers to the combined joints, as it is formed by the articular fossa (fovea arti-cularis inferior) on the right and left lateral masses of the atlas and the upper articular surface of the body of the axial vertebra.

The sacrococcygeal joint (articulatio sacrococcigea) is formed by the top of the sacrum and the XNUMXst coccygeal vertebra.

The spinal column (columna vertebralis) is represented by the totality of all vertebrae connected to each other. The spinal column is the seat of the spinal cord, which is located in the spinal canal (canalis vertebralis).

There are five sections in the spine: cervical, thoracic, lumbar, sacral and coccygeal.

The spine has an s-shape due to the presence of physiological curves in the frontal and sagittal planes: thoracic and sacral kyphosis, cervical and lumbar lordosis, as well as pathological (thoracic scoliosis).

The ribs are connected to the vertebrae through the costovertebral joints (articulationes costover-tebrales), which are combined joints.

The joint of the head of the rib (articulatio capitis costae) is formed by the articular surface of the head of the rib and the articular surfaces of the semi-pits of adjacent thoracic vertebrae.

The costotransverse joint (articulatio costotran-sversalia) is formed by the articular surfaces of the costal fossa on the transverse process of the vertebra and tubercle of the rib.

The ribs are connected to the sternum: the XNUMXst rib fuses directly with the sternum, from the XNUMXnd to the XNUMXth ribs are connected through the sternocostal joints (articulationes sternocostales).

Intercartilaginous joints (articulationes interchondrales) can form between the cartilages of the ribs.

The chest (compages thoracicus) consists of 12 pairs of ribs, 12 thoracic vertebrae and the sternum, interconnected by various types of joints.

12. Structure and classification of muscles and their auxiliary apparatus

The muscle (musculus) consists of bundles of striated muscle fibers covered with endomysium (endomysium), represented by a connective tissue sheath. The bundles, in turn, are demarcated by perimysium (perimysium).

Epimysium (epimysium) covers the entire muscle from the outside and continues to the tendons, covers the latter, forming peritendinium (peritendinium). The set of muscle bundles forms the abdomen (venter) of the muscle, which continues into the tendon of the muscle (tendo). Muscles are attached to bones by tendons.

During muscle contraction, one of its ends shifts, while the other remains motionless, therefore, a fixed point (punctum fixum), usually coinciding with the beginning of the muscle, and a mobile point (punctum mobile), located at the opposite end of the muscle, are distinguished.

Muscle classification

The shape distinguishes between the broad muscles that form the walls of the body, and the fusiform muscles located on the limbs.

The muscle may have several heads, starting from different points and then forming a common abdomen and tendon. Biceps muscle - m. biceps, triceps - m. triceps, four-headed - m. quadriceps.

If the muscle is located on one side of the tendon, then it is called single-pinnate (m. unipena-tus), on both sides - two-pinned (m. bipenatus), on several sides - multi-pinned (m. multipenatus).

In relation to the joints, single-articular, bi-articular and multi-articular muscles are distinguished. The name of the muscles depends on:

1) functions (there are flexors (m. flexor), extensors (m. extensor), abductors (m. abductor), adductors (m. adductor), lifters (m. leva-tor), external rotators (m. supinator) , internal rotators (m. pronator));

2) the direction of the muscle or its muscle bundles (there is a straight line (m. rectus), oblique (m. obliqus), transverse (m. transversus) muscles);

3) shapes (there are trapezoid, rhomboid, round, square muscles) and size (there are long, short, large, small muscles).

Fascia (fasciae) forms a case for the muscles, separating them from each other, eliminating friction when the muscles contract relative to each other.

Each anatomical region has its own fascia. There are superficial (fasciae superficiales) and own fascia (fasciae propriae).

The superficial fascia is located under the skin, delimiting the muscles from the subcutaneous tissue.

The channels formed by the muscle tendon retainers form the tendon sheath (vagina tendinis), in which the tendon moves with the participation of the synovial sheath of the tendon (vagina synovialis tendinis).

13. Muscles of the shoulder girdle and shoulder

The deltoid muscle (m. deltoideus) starts from the outer edge of the acromion, the anterior edge of the lateral third of the clavicle, the spine of the scapula, attaching to the deltoid tuberosity.

Function: scapular part extends the shoulder; the clavicle flexes the shoulder.

Small round muscle (m. teres minor).

Function: supination of the shoulder.

The large round muscle (m. teres major) originates from the lower angle of the scapula, infraspinatus fascia, the lower part of the lateral edge of the scapula, attaching to the crest of the small tubercle of the humerus.

Function: with a fixed shoulder blade, brings the raised arm to the body.

The supraspinatus muscle (m. supraspinatus) originates from the posterior surface of the scapula above the scapular bone-fascia, attaching to the upper area of the large tubercle of the humerus.

Function: abducts the shoulder.

Infraspinatus muscle (m. infraspinatus)

Function: supination of the shoulder when the joint capsule is retracted.

The subscapularis muscle (m. subscapularis) originates from the lateral edge of the scapula, attaches to the lesser tubercle and the crest of the lesser tubercle of the humerus.

Function: pronation and bringing the shoulder to the body. Shoulder muscles

Anterior shoulder muscle group

The biceps muscle of the shoulder (m. biceps brachii) consists of two heads. The short head (caput breve) starts from the top of the coracoid process of the scapula, and the long head (caput longum) starts from the supraspinous tubercle of the scapula.

Function: flexes the shoulder at the shoulder joint.

The coracobrachialis muscle (m. coracobrachialis) originates from the top of the coracoid process, attaching below the crest of the small tubercle to the humerus.

Function: flexes the shoulder at the shoulder joint.

Innervation: n. musculocutaneus.

The shoulder muscle (m. brachialis) originates from the lower two-thirds of the body of the humerus, attaching to the tuberosity of the ulna.

Function: flexes the forearm at the elbow joint.

Posterior shoulder muscle group

The ulnar muscle (m. anconeus) originates from the posterior surface of the lateral epicondyle of the shoulder, attaching to the lateral surface of the olecranon, the fascia of the forearm and the posterior surface of the proximal part of the ulna.

Function: extends the forearm.

The triceps muscle of the shoulder (m. tricepsbrachii) has three heads. The heads unite and form the belly of the muscle, the tendon of which is attached to the olecranon of the ulna.

Function: unbends the forearm at the elbow joint.

14. Muscles of the hand and auxiliary apparatus of the upper limb

Middle group of muscles of the hand

Palmar interosseous muscles (mm. interossei pa-lmares).

Function: lead II, IV and V fingers to III.

Dorsal interosseous muscles (mm. interossei dorsales).

Function: abduct II, IV and V fingers from III.

Worm-like muscles (mm. lumbricales).

Function: unbend the middle and distal phalanges of the II-V fingers, bend their proximal phalanges.

Muscles of the thumb

A short muscle that removes the thumb of the hand (m. Abductor pollicis brevis).

Function: abducts the thumb of the hand.

Muscle adductor thumb (m. adductor pollicis).

Function: brings the thumb of the hand.

The muscle that opposes the thumb of the hand (m. opponens pollicis).

Function: contrasts the thumb with the hand.

Short flexor thumb brush (m. flexor pollicis brevis).

Function: participates in bringing the thumb of the hand.

Muscles of the little finger elevation

The muscle that removes the little finger (m. Abductor digiti minimi). Function: removes the little finger.

Short little finger flexor (m. flexor digiti minimi brevis). Function: bends the little finger.

Short palmar muscle (m. palmaris brevis).

Function: forms mild folds on the skin of the little finger elevation.

The muscle that opposes the little finger (m. opponens digiti minimi).

Function: opposes the little finger to the thumb of the hand.

Functions and aponeuroses of the muscles of the upper limb and hand:

1) fascia of the shoulder (fascia brachii), which forms the lateral intermuscular septum (septum intermusculare brachii laterale) and the medial intermuscular septum (septum intermusculare brachii mediale);

2) fascia of the forearm (fascia antebrachii);

3) deltoid fascia (fascia deltoidei);

4) axillary fascia (fascia axillaries);

5) flexor retinaculum (retinaculum flexorum); spreading over the groove of the wrist, it turns it into a canal (canalis carpi), in which the tendon sheath of the long flexor of the thumb (vagina tendinis musculi flexoris pollicis longi) and the common flexor sheath (vagina com-munis musculorum flexorum) are located;

6) extensor retinaculum (retinaculum extenso-rium);

7) dorsal fascia of the hand (fascia dorsalis manus), consisting of deep and superficial plates;

8) palmar aponeurosis (aponeurosis palmaris).

15. Pelvic and thigh muscles

Inner pelvic muscle group

Internal obturator muscle (m. obturator in-ternus).

Upper twin muscle (m. gemellus superior).

Lower twin muscle (m. gemellus inferior).

Function: These muscles rotate the thigh outward.

Iliopsoas muscle (m. iliopsoas).

Function: flexes the hip at the hip joint.

The piriformis muscle (m. pisiformis) originates from the pelvic surface of the sacrum, attaching to the top of the greater trochanter.

Function: rotates the thigh outward.

External group of pelvic muscles

Tensor wide fascia (m. tensor fascia latae).

Function: flexes the hip, strains the iliac-tibial tract.

Gluteus maximus (m. Gluteus maximus).

Function: unbends the thigh; the posterior inferior bundles lead and turn the thigh outward, the anterior superior bundles abduct the thigh, keep the knee joint in an extended position.

Gluteus medius (m. gluteus medius)

Function: abducts the thigh, the posterior bundles turn the thigh outward, the anterior bundles inward.

Square muscle of the thigh (m. quadratus femoris).

Function: rotates the thigh outward.

Small gluteal muscle (m. Gluteus minimus).

Function: abducts the thigh, the posterior bundles turn the thigh outward, the anterior bundles inward.

External obturator muscle (m. obturator externus).

Function: rotates the thigh outward.

Thigh muscles

Anterior thigh muscle group

Quadriceps femoris (m. quadriceps femoris) Function: unbends the lower leg at the knee joint (the rectus flexes the thigh).

Tailor muscle (m. sartorius).

Function: flexes and rotates the thigh outward, flexes the lower leg.

Posterior thigh muscle group

Semitendinosus muscle (m. semitendinosus).

Function: flexes the lower leg and extends the thigh.

Semimembranous muscle (m. semimembranosus).

Function: flexes the lower leg and extends the thigh.

Biceps femoris (m. biceps femoris).

Function: flexes the lower leg at the knee joint and extends the thigh.

16. Muscles of the lower leg and foot

Short peroneal muscle (m. peroneus brevis).

Function: raises the lateral edge of the foot.

Long peroneal muscle (m. peroneus longus).

Function: raises the lateral edge of the foot

Long extensor hallucis longus (m. extensor hallucis longus).

Function: unbends the big toe.

Tibialis anterior muscle (m. tibialis anterior).

Function: strengthens the longitudinal arch of the foot. Long extensor of fingers (m. extensor digitorum longus).

The third peroneal muscle (m. peroneus tertius) departs from the lower part of this muscle.

Function: unbends the II-V fingers in the metatarsophalangeal joints and the foot in the ankle joint.

Long finger flexor (m. flexor digitorum lon-

gus).

Function: flexes and rotates the foot outward and flexes the distal phalanges of the II-V fingers.

Long flexor of the thumb (m. flexor hallu-cis longus).

Function: flexes the big toe.

Popliteal muscle (m. popliteus).

Function: flexes the leg.

Tibialis posterior (m. tibialis posterior) Function: flexes, supinates and leads the foot. Plantar muscle (m. plantaris). Function: participates in the flexion of the foot and lower leg, stretches the capsule of the knee joint. The triceps muscle of the lower leg (m. triceps surae). Soleus muscle (m. soleus).

Calf muscle (m. gastrocnemius).

Function: flexion of the lower leg and foot; with a fixed foot, it holds the lower leg on the talus.

The muscles of the dorsum of the foot include:

Short extensor of the big toe (m. extensor hallucis brevis).

Short extensor of the fingers (m. extensor digito-rum brevis).

Short little finger flexor (m. flexor digiti minimi brevis).

The muscle that removes the little toe of the foot (m. abductor di-giti minimi).

The muscle that opposes the little finger (m. op-ponens digiti minimi).

Worm-like muscles (m. lumbricales).

Square muscle of the foot (m. quadratus plantae).

Short finger flexor (m. flexor digitorum brevis).

Function: bends II-V fingers, strengthens the longitudinal arch of the foot.

Interosseous muscles (mm. interossei).

Plantar interosseous muscles (m. interossei plantares).

Dorsal interosseous muscles (m. interossei dorsales).

The muscle that leads the big toe (m. adductor hallucis).

The muscle that removes the big toe (m. Abductor hallucis).

Short flexor of the big toe (m. flexor hallucis brevis).

17. Mimic and chewing muscles of the head

Muscle of the proud (m. procerus).

Function: straightens transverse folds on the forehead.

Muscles surrounding the nasal passages

The muscle that lowers the nasal septum (m. depressor septi). Function: lowers the nasal septum. The nasal muscle (m. nasalis) consists of two parts:

1) wing part (pars alaris). Function: expands the openings of the nose, pulls the wing of the nose laterally and downwards;

2) the transverse part (pars transversa). Function: narrows the openings of the nose.

Muscles surrounding the mouth

The circular muscle of the mouth (m. Orbicularis oris) consists of the labial (pars labialis) and marginal parts (pars marginalis).

Function: participates in the act of chewing and sucking, closes the mouth gap.

The muscle that lowers the lower lip (m. depressor la-bii inferioris).

Function: lowers the lower lip down.

The muscle that raises the upper lip (m. Levator labii superior).

Function: lifts the upper lip.

Muscle that lowers the corner of the mouth (m. depressor anguli oris).

Function: lowers the corner of the mouth down and laterally. The muscle that lifts the corner of the mouth (m. Levator anguli oris).

Function: Raises the corner of the mouth.

Large zygomatic muscle (m. zygomaticus major).

Function: pulls the corner of the mouth up and out.

Small zygomatic muscle (m. zygomaticus minor). Function: Raises the corner of the mouth.

Chin muscle (m. mentalis).

Function: pulls upward and laterally the skin of the chin.

Buccal muscle (m. buccinator).

Function: presses the cheek to the lips, pulls the corner of the mouth back.

Laughter muscle (m. risorius).

Function: pulls the corner of the mouth laterally.

Muscles surrounding the eye

The muscle wrinkling the eyebrow (m. corrigator supercilli).

Function: pulls the skin of the forehead down and medially.

Circular muscle of the eye (m. orbicularis oculi).

Function: is the sphincter of the palpebral fissure.

Chewing muscles

Chewing muscle (m. masseter).

Function: raises the lower jaw, pushes the lower jaw forward.

Medial pterygoid muscle (m. rterygoideus medialis).

Function: raises the lower jaw. Lateral pterygoid muscle (m. rterygoideus lateralis).

Function: pushes the lower jaw forward. Temporal muscle (m. temporalis). Function: raises the lower jaw.

18. Deep back muscles

The deep back muscles lie in three layers: superficial, medium and deep.

Muscles of the superficial layer

Belt muscle of the neck (m. splenius cervicis).

The function extends the cervical part of the spine.

Belt muscle of the head (m. splenius capitis).

Function: unbends the cervical spine and head.

The muscle that straightens the spine (m. erector spinae).

The spinous muscle (m. spinalis) is medial, three muscles are distinguished in it.

The spinous muscle of the chest (m. spinalis thoracis.

The spinous muscle of the neck (m. spinalis cervicis).

The spinous muscle of the head (m. spinalis capitis).

Function: extends the spine.

The iliocostalis muscle (m. iliocostalis) is divided into three muscles.

Iliocostal muscle of the lower back (m. ilioco-stalis lumborum).

Iliocostal muscle of the chest (m. iliocostalis thoracis).

Iliocostal muscle of the neck (m. iliocostalis cervicis).

Function: extends the spine. The longest muscle (m. longissimus) is divided into three muscles.

The longest muscle of the head (m. longissimus capitis). The longest muscle of the neck (m. longissimus cervicis). The longest muscle of the chest (m. longissimus thoracis). Function: unbend the spine, tilt it to the side.

Muscles of the middle layer

Multifid muscles (mm. multifidi). Function: turn the spinal column around. Rotator muscles of the neck, chest and lower back (mm. ro-tatores cervicis, thoracis etlumborum). Function: turn.

Intertransverse muscles of the lower back, chest and neck (mm. intertransversarii lumborum, thoracis et cervicis).

Function: tilt the eponymous sections of the spinal column in their direction.

Interspinous muscles of the lower back, chest and neck (mm. interspinalis lumborum, thoracis et cervicis).

Function: unbend the same-name departments of the spinal column.

Suboccipital muscles (mm. suboccipitalis).

Lower oblique muscle of the head (m. obliquus capitis inferior).

Function: tilts to the side, unbends and rotates the head around the longitudinal axis of the tooth of the axial vertebra.

Upper oblique muscle of the head (m. obliquus capitis superior).

Function: with a symmetrical contraction, it unbends its head, with a one-sided contraction, it tilts its head to its side.

The large posterior rectus muscle of the head (m. rectus capitis posterior major).

Function: throws back and tilts the head to the side.

Small posterior rectus muscle of the head (m. rectus capitis posterior minor).

Function: throws back and tilts the head to the side.

Innervation: n. suboccipitalis.

19. Muscles of the chest and abdomen

The pectoralis major muscle (m. pectoralis major).

Function: lowers and brings the raised arm to the body, turning it inward.

Small pectoral muscle (m. pectoralis minor).

Function: Tilts the shoulder blade forward.

Serratus anterior (m. serratus anterior).

Function: moves the lower angle of the scapula forward and laterally, rotates the scapula around the sagittal axis.

Subclavian muscle (m. subclavius). Function: pulls the collarbone forward and down.

The transverse muscle of the chest (m. transversus thoracis).

Function: lowers the ribs, participates in the act of inhalation.

External intercostal muscles (mm. intercostales externi).

Function: raise the ribs.

Internal intercostal muscles (mm. intercosta-les interni). Function: lower ribs.

The muscles that lift the ribs (mm. Levatores costa-rum) are divided into short and long. Function: raise the ribs. Subcostal muscles (mm. Subcostales). Function: lower ribs. The structure of the diaphragm

The diaphragm (diaphragma) is a mobile muscular-tendon septum that delimits the chest and abdominal cavities.

In the diaphragm, a tendon center (center tendineum) is isolated, in which there is an opening of the inferior vena cava.

Function: when the diaphragm contracts, the volume of the thoracic cavity increases and the abdominal cavity decreases.

Abdominal muscles

Transverse abdominal muscle (m. transversus ab-dominis).

Function: reduces the size of the abdominal cavity, pulls the ribs forward to the midline.

External oblique muscle of the abdomen (m. obliquus externus abdominis).

Function: with a symmetrical contraction, it flexes the spine and lowers the ribs.

Internal oblique muscle of the abdomen (m. obliquus inter-nus abdominis).

Function: flexes the spine during symmetrical contraction.

Pyramidal muscle (m. Pyramidalis) originates from the pubic crest, weaving into the white line of the abdomen (linea alba).

Function: tenses the white line of the abdomen.

Rectus abdominis (m. rectus abdominis).

Function: with a fixed spine and pelvic girdle, lowers the chest.

The square muscle of the lower back (m. quadratus lumbo-rum).

Function: with a symmetrical contraction, it holds the spinal column in an upright position.

20. Neck muscles

Among the muscles of the neck, superficial muscles (suprahyoid (mm. Suprahyoidei), sublingual (mm. Infrahyoidei)) and deep muscles (lateral and pre-vertebral groups) are distinguished.

Superficial muscles of the neck

Sternocleidomastoid muscle (m. sternoc-leidomastoideus).

Function: with a symmetrical contraction, throws the head back,

Subcutaneous muscle of the neck (platysma).

Function: pulls the corner of the mouth down and lifts the skin of the neck.

Stylohyoid muscle (m. stylohyoideus).

Function: pulls the hyoid bone back, up and to its side.

Digastric muscle (m. didastricus).

Function: with a fixed hyoid bone, lowers the lower jaw.

Geniohyoid muscle (m. geniohyoi-deus).

Function: with closed jaws, raises the hyoid bone with the larynx.

Maxillofacial muscle (m. mylohyoideus).

Function: raises the hyoid bone with the larynx.

Sternohyoid muscle (m. sternohyoideus).

Function: pulls the hyoid bone down.

Sternothyroid muscle (m. sternothyroideus).

Function: pulls the larynx down.

Thyrohyoid muscle (m. thyrohyoideus).

Function: with a fixed hyoid bone, pulls the larynx up, brings the hyoid bone closer to the larynx.

Scapular-hyoid muscle (m. omohyoi-deus).

Function: with a fixed hyoid bone, it stretches the pretracheal plate of the cervical fascia.

Deep neck muscles

medial group

Anterior rectus capitis (m. rectus capitis anterior).

Function: Tilts head forward. Lateral rectus muscle of the head (m. rectus capitis lateralis).

Function: acting on the atlantooccipital joint, tilts the head to the side.

Long muscle of the head (m. longus capitis).

Function: Tilts head forward.

Long muscle of the neck (m. longus colli).

Function: flexes the cervical part of the spinal column, with unilateral contraction, tilts the neck to its side.

Lateral group

Anterior scalene muscle (m. scalenus anterior). Middle scalene muscle (m. scalenus medius). Posterior scalene muscle (m. scalenus posterior). The function of the scalene muscles: with fixed ribs, they bend the cervical part of the spine forward. Innervation: cervical plexus.

21. The structure of the nose area

The respiratory system (systema resoiratorium) is represented by the respiratory tract, which, in turn, is represented by tubes with a constant lumen diameter, which is ensured by the presence of bone or cartilage tissue in their wall, and lungs.

The nasal region includes the external nose and the nasal cavity.

The external nose (nasus externus) has a back of the nose (dorsum nasi), passing into the top of the nose (apexna-si), the root of the nose (radixnasi) and the wings of the nose (alaenasi), which limit the lower edges of the nostrils (nares).

The external nose is formed by bone and cartilage tissue.

Cartilages of the nose:

1) lateral cartilage of the nose (cartilago nasi lateralis); paired, participates in the formation of the side wall of the external nose;

2) large cartilage of the wing of the nose (cartilago alaris major); paired, limits the anterolateral sections of the nostrils;

3) small cartilages of the nose wing (cartilaginesalaresminoris); located behind the large cartilage of the alar nose.

Sometimes additional nasal cartilages (cartilagines nasals accessoriae) are located between the lateral and greater cartilage of the wing of the nose.

The osseous skeleton of the external nose is formed by the frontal processes of the maxillae and the nasal bones.

The nasal cavity (cavitasnasi). The nasal cavity is divided by the nasal septum into two relatively equal parts, communicating through the choanae (choanae) with the nasal part of the pharynx and through the nostrils with the environment.

The nasal septum is formed by a movable part, consisting of cartilaginous (pars cartilaginea) and membranous (pars membranacea) tissues, and a fixed part, consisting of a bone part (pars ossea). The nasal cavity has a nasal vestibule (vestibulum nasi), limited from above by the threshold of the nasal cavity (li-men nasi).

The nasal passages occupy most of the nasal cavity and communicate with the paranasal sinuses (sinus paranasales).

In the nasal cavity, the upper, middle and lower nasal passages are distinguished, lying under the nasal conchas of the same name.

In the upper posterior part of the nose of the superior turbinate there is a sphenoid-ethmoid recess (recessus sphenoethmoidalis), which has an opening of the sphenoid sinus. The superior nasal passage communicates with the posterior ethmoid cells.

The middle nasal passage communicates with the frontal sinus through the ethmoid funnel (infundibulum ethmoi-dale), the maxillary sinus, the upper and middle cells of the ethmoid bone.

The nasal mucosa (tunica mucosa nasi) has respiratory (regio respiratoria) and olfactory regions (regio olfactoria). The mucous membrane of the respiratory region is covered with ciliated epithelium and has serous and mucous glands.

The mucosa and submucosa of the inferior turbinate are rich in venous vessels that form the cavernous venous plexuses of the turbinates. The mucous membrane is supplied with blood from the ophthalmic and maxillary arteries. Venous outflow is carried out in the pterygoid plexus.

22. The structure of the larynx

The larynx (larynx) is located in the anterior region of the neck; forms a prominence (prominentia laryngea), which is strongly pronounced in men. From above, the larynx is connected to the hyoid bone, from below - to the trachea.

The pharynx communicates with the larynx through the entrance to the larynx (aditus laryngeus), bounded laterally by aryepiglottic folds (plicae aruepigloti-cae) and the epiglottis in front.

The cavity of the larynx (cavitas laryngis) is conditionally divided into three sections: upper, middle and lower.

The upper section, or vestibule of the larynx (vestibulum laryngis), continues to the folds of the vestibule (plicae vestibulares), between which there is a vestibule gap (rima vestibuli).

The middle section, or interventricular, continues from the folds of the vestibule to the vocal folds (plicae vocales). Between these folds is the ventricle of the larynx (vestibulum laryngis). The vocal folds limit the narrowest point of the larynx - the glottis (rima glottidis).

The lower part of the larynx is located under the glottis, it is the subglottic cavity (cavitas infraglotti-ca), which continues into the trachea.

The inside of the larynx is covered with a mucous membrane.

The larynx consists of paired (sphenoid, corniculate, arytenoid) and unpaired cartilages (epiglottis, thyroid and cricoid cartilages).

The thyroid cartilage (cartilago thyroidea) consists of right and left quadrangular plates (lamina dextra et lamina sinistra).

The cricoid cartilage (cartilago cricoidea) consists of an arc (arcus cartilaginis cricoideae), and a quadrangular plate (lamina cartilaginis cricoideae) located behind.

The basis of the epiglottis (epiglottis) is the epiglottic cartilage (cartilago epiglottica).

The arytenoid cartilage (cartilago arytenoidea) has a base (basis cartilaginis arytenoideae), an apex (apex cartilaginis arytenoideae) and three surfaces: medial, posterior, and anterolateral.

The corniculate cartilage (cartilago corniculata) is located in the thickness of the posterior part of the aryepiglottic fold at the top of the arytenoid cartilage and forms a corniculate tubercle (tuberculum corniculatum).

The sphenoid cartilage (cartilago cuneiformis) is also located in the thickness of the aryepiglottic fold.

Muscles that narrow the glottis:

1) thyroid muscle (m. thyroarytenoideus);

2) lateral cricoarytenoid muscle (m. cri-coarytenoidales lateralis);

3) transverse arytenoid muscle (m. arytenoi-deus transverses);

4) oblique arytenoid muscle (m. arytenoideus obliqus).

The muscle that expands the glottis is the posterior cricoarytenoid muscle (m. cricoarytenoideus posterior).

Muscles that tense the vocal cords:

1) vocal muscle (m. vocales);

2) cricothyroid muscle (m. cricothyroideus).

23. The structure of the trachea, bronchi and lungs

The trachea (trachea) begins at the level of the lower edge of the VI cervical vertebra and ends at the level of the upper edge of the V thoracic vertebra, at the level of which it is divided into two main bronchi (bronchi princi-pales dexter et sinister): right and left.

The right bronchus is wider and shorter than the left, is located vertically and is a continuation of the trachea.

The wall of the main bronchi is represented by cartilaginous semicircles facing the membranous wall backwards. The place of transition of the trachea into the main bronchi is the bifurcation of the trachea (bifurcation tracheae). In the trachea, the cervical (pars cervicalis) and thoracic (pars thoracica) parts are isolated. The thyroid gland covers the trachea in front and from the sides in the cervical part, neurovascular bundles lie on the sides of it, and the esophagus is behind it.

The basis of the wall of the trachea is made up of cartilaginous semirings (due to which the lumen of the trachea always remains constant). From the inside, the wall of the trachea is lined with a mucous membrane covered with stratified ciliated epithelium, which is located on the submucosa.

The lungs (pulmonalis) are located in the pleural sacs in the chest cavity and are separated by the mediastinal organs.

In the lungs, the following main parts are distinguished: diaphragmatic (facies diaphragmatica), costal (facies costalis) and mediastinal surfaces (facies medi-astinalis) and apex (apex pulmonis).

On the mediastinal surface just above the middle of the lung there is an oval opening - the gate of the lung (hilum pulmonis), which includes the root of the lung (radix pulmonis), represented by the incoming main bronchus, nerves and pulmonary artery and outgoing lymphatic vessels and pulmonary veins.

At the gates, the main bronchi are divided into lobar (bronchi lobales), the latter - into segmental (bronchi segmentales).

The left upper lobar bronchus (bronchus lobaris superior sinister) is divided into upper and lower reed, anterior and apical-posterior segmental bronchi. The left lower lobar bronchus (bronchus lobaris inferior sinister) is divided into upper, anterior, posterior, medial and lateral basal segmental bronchi.

The right upper lobar bronchus (bronchus lobaris superior dexter) is divided into apical, anterior and posterior segmental bronchi. The right middle lobe bronchus (bronchus lobaris medius dexter) is divided into medial and lateral segmental bronchi. The right lower lobar bronchus (bronchus lobaris inferior dexter) is divided into upper, anterior, posterior, medial and lateral basal segmental bronchi.

The segment of the lung is a section of lung tissue, facing the apex to the root of the lung, and the base - to the surface of the organ.

The segment consists of pulmonary lobules. Segmental bronchi are divided into ten orders: the lobular bronchus (bronchus lobularis) enters the lobule, where it is divided into terminal bronchioles (bronchioli terminalis).

24. The structure of the kidneys

The kidney (ren) is a paired organ that produces and excretes urine. The kidneys are firm and bean-shaped.

The kidneys have a smooth surface of dark red color. External renal fascia (fascia renalis) consists of two leaves. Below it is a fatty capsule (capsula adiposa).

In the kidneys, two surfaces are distinguished - anterior and posterior (facies anterior et facies posterior), two edges - medial and lateral (margo medialis et margo lateralis), as well as two poles - upper and lower (extremitas superior et extremitas inferior).

In the center of the medial edge there is a recess called the gates of the kidney (hilum renalis), through which the renal artery and nerve trunks are sent to the kidney, and the ureter, vein and lymphatic vessels exit. The entire set of formations entering and exiting the gate of the kidney is called the renal pedicle. The kidneys are located on both sides of the lumbar column in the lumbar region, located in the retroperitoneal space. The right kidney is slightly lower than the left.

In the kidney, there are cortical (cortex renalis) and brain (medulla renalis) substances. The cortical substance of the kidney is located superficially. The cortical substance is represented by the proximal and distal tubules of nephrons and renal corpuscles and has a dark red color.

The medulla is located under the cortex and has a lighter color. In the medulla there are collecting ducts, descending and ascending parts of the tubules, papillary tubules.

The cortical substance has a non-homogeneous structure: it distinguishes between radiant (pars radiata) (lighter areas of the cortical layer) and folded parts (pars convoluta) (darker areas).

The medulla consists of renal pyramids (pyramides renales). In each renal pyramid, a base (basis pyramidis) and an apex (apex pyramidis), or renal papilla, are distinguished. Each papilla covers a small renal calyx (calix renalis minor), which, when connected, form a large renal calyx (calixrenalis major). Three large cups, when drained, form the renal pelvis (pelvis renalis).

Five segments are distinguished in each kidney: superior, superior anterior, inferior, inferior anterior, and posterior. Several segments form the renal lobe (lobus renalis). The renal lobe is limited by the interlobular arteries and veins. The renal lobe consists of more than 500 cortical lobules. The cortical lobule (lobu-lus corticalis) is limited by the interlobular arteries and veins and includes a radiant part, around which the folded part is located.

The nephron is the structural and functional unit of the kidney. Each kidney has about 1 million nephrons. The nephron consists of the Bowman-Shumlyansky capsule and tubules. This capsule encloses the capillary network, resulting in the formation of a malpighian body (corpusculum renale).

25. The structure of the ureters of the bladder

The ureter exits the hilum of the kidney and enters the bladder. The purpose of the ureter is to carry urine from the kidney to the bladder. The average length of the ureter is 30 cm, diameter is about 8 mm.

The ureter has three physiological constrictions: at the exit from the kidney, at the transition from the abdominal part to the pelvis, and at the point of transition to the bladder. The ureters, like the kidneys, are located in the retroperitoneal space.

The ureter is divided into three parts: abdominal (pars abdominalis), pelvic (pars pelvina) and intraparietal. The abdominal part is located on the psoas major muscle.

The left ureter is located behind the transition of the duodenum into the jejunum, and the right ureter is located behind the descending part of the duodenum.

Along with the ureter are the ovarian artery and vein in women and the testicular artery and vein in men. In this part, the right ureter lies in front of the internal, and the left - of the common iliac arteries and veins. The ureter in women in the pelvic part goes behind the ovary, bending around the cervix from the outside, then located between the bladder and the anterior wall of the vagina. In men, the ureter runs outside the vas deferens, entering the bladder just below the seminal vesicle, after crossing the vas deferens.

The ureter is covered on the outside with adventitia (tunica adventitia), under it is the muscular membrane (tunica muscularis), which has two layers in the upper part and three layers in the lower. The inner shell is mucous (tunica mucosa).

The bladder (vesica urinaria) is an unpaired organ in which urine is accumulated and then excreted.

In the bladder, the following main parts are distinguished: the body (corpus vesicae), the top (apex vesicae), the bottom (fundus vesicae) and the neck (cervix vesicae). The lower part of the bladder is connected by ligaments to neighboring organs and the walls of the small pelvis.

The bladder is located in the pelvic cavity. The filled bladder is in contact with the anterior abdominal wall, rising above the pubic symphysis.

The structure of the bladder wall is the same in men and women. The bladder consists of adventitia (tunica adventitia), muscular membrane (tunica muscularis), submucosa and mucous membrane (tunica mucosa). At the bottom of the bladder, an anatomical formation called the triangle of the bladder (trigonum vesicae) is isolated, the corners of which are formed by the openings of the ureters (osti-um ureteris) and the internal opening of the urethra (ostium urethrae internum).

26. The structure of the vagina and uterus

The vagina (vagina) is an unpaired tube-shaped organ that is located in the pelvic cavity from the genital slit to the uterus. The vagina is up to 10 cm long.

From below, the vagina passes through the urogenital diaphragm.

The opening of the vagina in girls is closed by the hymen (hymen), which is a semilunar plate, which is torn during the first sexual intercourse, forming flaps of the hymen (carunculae hymenalies).

In the collapsed state, the walls of the vagina look like a slit located in the frontal plane.

Three main parts are distinguished in the vagina: the anterior (paries anterior) and posterior walls (paries posterior) and the vaginal fornix (fornix vaginae).

The inner shell of the vagina is represented by a mucous membrane (tunica mucosa), which is tightly fused with the muscular membrane (tunica muscularis), since there is no submucosa.

In the vaginal folds, the mucous membrane is thicker. The muscular membrane of the vagina consists of muscle fibers having a circular and longitudinal direction.

In the upper part of the vagina, the muscular membrane passes into the muscles of the uterus, and in the lower part it is woven into the muscles of the perineum.

The uterus (uterus) is a hollow, pear-shaped, unpaired muscular organ in which the development and gestation of the fetus takes place.

The uterus is located in the pelvic cavity, located in front of the rectum and behind the bladder.

In the uterus, there are three main parts: the body (corpus uteri), the neck (cervix uteri) and the bottom (fundus uteri). The bottom of the uterus is represented by a convex section, located above the level of confluence of the fallopian tubes into the uterus. The body of the uterus is the middle part of this organ. The isthmus of the uterus (isthmus uteri) is the site of transition of the body of the uterus to the cervix. The part of the cervix that protrudes into the vagina is called the vaginal part of the cervix, the rest is called supravaginal. On the vaginal part of the cervix there is an opening, or uterine os.

The wall of the uterus consists of three layers.

The inner shell is the mucosa, or endometrium (endometrium).

The muscular layer, or myometrium (myometrium), has a significant thickness.

The outer shell is called perimetrium (peri-metrium), or serous membrane.

The peritoneum, covering the uterus, forms two pockets: the vesicouterine cavity (excavatio vesikouterina) and the Douglas, or recto-uterine cavity (excavatio rectouterina).

27. Structure, innervation and blood supply of the fallopian tubes and ovaries

The fallopian tube (tuba uterina) is a paired organ necessary for carrying the egg into the uterine cavity from the abdominal cavity.

The fallopian tubes are oval-shaped ducts that lie in the cavity of the small pelvis and connect the ovaries to the uterus. The fallopian tubes pass through the broad ligament of the uterus in its upper edge. The length of the fallopian tubes is up to 13 cm, and their inner diameter is about 3 mm.

The opening through which the fallopian tube communicates with the uterus is called the uterine (ostium ute-rinum tubae), and the abdominal cavity opens into the abdominal cavity (ostium abdominale tubae uterinae).

In the fallopian tubes, the following parts are distinguished: the uterine part (pars uterine), the isthmus of the fallopian tube (isthmus tubae uterinae) and the ampulla of the fallopian tube (ampulla tubae uterinae), passing into the funnel of the fallopian tube (infundibulum tubae uterinae), which ends with the fringes of the tube (fimbria ovarika ). The uterine part is located in the thickness of the uterus, the isthmus is the narrowest and thickest part of the fallopian tube. The fimbriae of the fallopian tube with their movements direct the egg towards the funnel.

The inner layer of the fallopian tube is represented by a mucous membrane that forms longitudinal tubal folds. The muscular layer continues into the muscles of the uterus. Outside, the fallopian tubes are covered with a serous membrane.

The ovary (ovarium) is a paired gonad lying in the cavity of the small pelvis, in which the maturation of eggs and the formation of female sex hormones are carried out.

In the ovary, the uterine (extermitas uterina) and upper tubal ends (extermitas tubaria) are distinguished. The uterine end is connected to its own ligament of the ovary (lig. ovarii proprium). The ovary is fixed by a short mesentery (mesovarium) and a ligament that suspends the ovary (lig. suspensorium ovarii).

The ovaries have fairly good mobility.

The parenchyma of the ovary is divided into brain (medulla ovari) and cortical (cortex ovari) substances. The medulla is located in the center of this organ (near the gate), in this substance there are neurovascular formations. The cortical substance is located on the periphery of the medulla, contains mature follicles (folliculi ovarici vesiculosi) and primary ovarian follicles (folliculi ovarici primarii). A mature follicle has an inner and outer connective tissue sheath (theca).

In place of the bursting follicle, a depression is formed, filled with blood, in which the corpus luteum (corpus luteum) begins to develop.

28. The structure of the external female genital organs

The external genital organs include the labia majora and labia minora, the pubis, the vestibule of the vagina with glands, the bulb of the vestibule, the clitoris, and the urethra.

The clitoris (clitoris) consists of the right and left cavernous bodies (corpus cavernosum clitoridis). Each cavernous body of the clitoris begins with the leg of the clitoris, which, when combined, form the body of the clitoris up to 3 cm long, which is covered with a protein membrane. The body of the clitoris ends with the head of the clitoris (glans clitorit-idis). The clitoris below has a frenulum (frenulum clitoritidis), and from above it is limited by the foreskin (preputium clitorit-idis).

The pubis is an elevation due to a well-defined fatty layer, covered with hair. The hairline from the pubis passes to the labia.

The labia majora limit the genital gap (rima pudenda) and are a pair of elastic skin folds up to 9 cm wide and up to XNUMX cm long. The labia majora are connected by adhesions - anterior and posterior (comissura laborum anterior et posterior). The skin of the labia majora is pigmented and has a large number of sweat and sebaceous glands.

The labia minora are located medially from the large lips and are located in the genital gap, limiting the vestibule of the vagina. The posterior sections of the labia minora form the frenulum of the labia (frenulum labiorum pudendi), which limits the fossa of the vestibule of the vagina.

The vestibule of the vagina (vestibulum vaginae) is a depression bounded from below by the fossa of the vestibule of the vagina, from above by the clitoris, and on the sides by the labia minora. The vestibule has a vaginal opening. Between the clitoris and the entrance to the vagina, the external opening of the urethra opens.

The urethra is 3 cm long and about 1 cm in diameter. The urethra is fused with the anterior wall of the vagina, has mucous and muscular membranes. The mucous membrane forms longitudinal lacunae (lacunae uretralis), in the thickness of which the urethral glands are located. The muscular layer has two layers: inner longitudinal and outer circular. In the lower part, the urethra is surrounded by muscle fibers that form an arbitrary sphincter.

On the eve of the vagina are large and small glands that secrete a mucous secret that moisturizes the walls of the vagina.

Blood supply to the external genital organs is carried out from the external pudendal artery, perineal arteries, deep arteries of the clitoris, dorsal artery of the clitoris, internal pudendal artery.

Innervation is carried out by the anterior labial branches from the ilioinguinal nerve, the perineal nerve, the genital branches from the femoral-genital nerve, the dorsal nerves of the clitoris from the pudendal nerve, the lower hypogastric plexus.

29. The structure of the prostate gland, testicles and their appendages

The prostate gland (prostata) is an unpaired glandular-muscular organ, consisting of separate acini, which secretes substances that are a component of sperm.

The gland is located in the small pelvis under the bladder. The urethra passes through the prostate, entering the base of the gland and exiting through its apex. The prostate is perforated by the vas deferens.

In the prostate, the base (basis prostatae), anterior (facies anterior) and posterior surfaces (facies posterior), inferolateral surfaces (facies in-ferlateralis) and the apex of the prostate gland (apex prostatae) are distinguished. Ligaments come from the prostate - the median and lateral pubic-prostatic ligaments (lig. puboprosta-ticae) and the pubic-prostate muscle (m. Pubopro-staticus), fixing the gland to the pubic symphysis.

The posterior surface of the prostate is separated from the ampulla of the rectum by a rectovesical plate (septum rectovesicale).

Outside, the prostate is covered with a dense capsule, from which partitions extend into the gland.

The prostate has a lobular structure, the number of lobules reaches 50. The lobules are mainly located in the lateral and posterior sections of the prostate. The glandular ducts of the acini merge in pairs and form the prostatic ducts (duktuliprostaci), which open into the urethra.

The testicle (testis) is a paired gonad of mixed secretion; produces spermatozoa and secretes hormones into the blood.

The testicles are located in the scrotum. The testicles are separated by a septum, have an oval shape and a smooth surface.

In the testicle, the upper and lower ends (extremi-tas superior et inferior), two edges - the posterior and anterior, as well as two sides - the medial and more convex lateral (facies medialis et lateralis) are distinguished.

The testicle is covered with a dense albuginea (tunika albuginea), under which is located the parenchyma of the testis (parenchyma testis).

The inner surface of the albuginea on the back side forms a small outgrowth - the mediastinum of the testicle, from which thin connective tissue partitions (septula testis) extend, dividing the testicular parenchyma into lobules (lobuli testis), the number of which reaches about 300. Each lobule has several convoluted tubules (tubuli seminiferi contorti), which, merging, form straight tubules (tubuli seminiferi recti). Only in the convoluted tubules, spermatozoa are formed, which are part of the sperm, the rest of the tubules are vas deferens.

The epididymis (epididymis) is located along the posterior edge of the testis. In the appendage, a head (caput epididymidis), a body (corpus epididymidis) and a tail (cauda epididymidis) are distinguished. The white of the testicle passes to the epididymis. The efferent tubules form the cones of the epididymis (coli epididymidis).

Innervation is carried out from the testicular plexus.

30. The structure of the penis and urethra

The penis is intended for excretion of urine and ejection of semen.

In the penis, the following parts are distinguished: the body (corpus penis), the head (glans penis), the root (radix penis) and the back (dorsum penis). At the top of the head there is an external opening of the urethra. The penis is covered with easily movable skin, which forms the foreskin (preputum penis) in the anterior section, which has glands on the inside.

The foreskin in the lower part is connected to the head with a frenulum (frenulum penis).

In the penis there are symmetrically located cavernous bodies (corpus cavernosum penis), under which there is an unpaired spongy substance (corpus spongiosum penis). The posterior ends of the cavernous bodies are called legs (crura penis), they are attached to the pubic bone. When the cavities are filled with blood, an erection occurs. The spongy body and cavernous bodies are surrounded by superficial and deep fascia. The penis is fixed by suspensory ligaments: deep (sling-like) and superficial.

The urethra (urethra masculine) begins with an internal opening (ostium urethrae in-ternum) in the wall of the bladder and ends with an external opening (ostium urethrae externum) at the top of the glans penis.

The urethra passes through the prostate, the urogenital diaphragm and the spongy body, and therefore there are three parts of it: the prostatic (pars prostatica), membranous (pars membranacea) and spongy (pars spongiosa).

The urethra has an s-shape and three physiological constrictions: in the region of the internal and external openings and in the region of passage through the urogenital diaphragm.

The scrotum (scrotum) is a protrusion of the anterior abdominal wall and consists of two separate chambers in which the testicles are located. The scrotum is located below and behind the root of the penis.

The scrotum has seven layers:

1) skin (cutis);

2) fleshy shell (tunica dartos);

3) external seminal fascia (fascia spermatica externa);

4) fascia of the muscle that lifts the testicle (fascia cre-masterica);

5) the muscle that lifts the testicle (m. Cremaster);

6) internal seminal fascia (fascia spermatica interna);

7) the vaginal membrane of the testicle (tunica vaginalis tes-tis), in which two plates are distinguished: visceral and parietal.

31. The structure of the mouth and cheeks

The vestibule of the mouth (vestibulum oris) is a small space bounded in front by the lips and cheeks, and behind by the gums and teeth.

Lips (labiae) - muscular folds that, when closed, limit the transverse oral fissure (rima oris), the ends of which are called the corners of the mouth (angulus oris). The visible surface of the lips is covered with skin, which passes into the mucous membrane inside the oral cavity. The upper lip is delimited from the cheeks by the naso-labial groove, the lower lip is delimited from the chin by the chin-labial groove.

The inner surface of the lips is formed by a mucous membrane that passes into the mucous membrane of the gums.

As a result of this transition, two longitudinal folds are formed - the frenulum of the upper and lower lips (frenulum labii superioris et frenulum labii inferioris).

The cheeks (buccae) are covered with skin on the outside, with a mucous membrane on the inside. The basis of the cheek is the buccal muscle (m. buccinator).

In the submucosa of the cheeks there is a small amount of buccal glands. Above the upper second molar on the mucous membrane of the cheek on both sides, the excretory duct of the parotid gland opens, forming the papilla of the parotid gland (papilla pa-rotidea).

The mucous membrane of the cheeks passes into the mucous membrane of the gums (gingivae), which are the alveolar processes of the upper and lower jaws.

The oral cavity (cavitas oris) with closed jaws is filled with the tongue. Its outer walls are the lingual surface of the dental arches and gums (upper and lower), the upper wall is represented by the sky, the lower - by the muscles of the upper part of the neck, which form the diaphragm of the mouth (diaphragma oris).

Teeth (dentes) are located along the upper edge of the gums in the dental alveoli of the upper and lower jaws. Teeth are modified papillae of the oral mucosa. Teeth through a continuous connection - driving (gomphosis) - motionlessly strengthened by their roots in the alveoli. The function of the teeth is to separate and chew food, form speech, and contribute to the correct pronunciation of individual sounds.

A normal adult has 32 teeth.

Each tooth has a crown, neck and root.

The crown of the tooth (corona dentis) is the most massive part of it, which is a section that rises above the gum.

The root of the tooth (radix dentis) is located in the dental alveolus. The number of roots varies from one to three.

The neck of the tooth (cervix dentis) is a small area of the tooth located between the crown and the apex.

The main components of the tooth are enamel (enamelum), dentin (dentinum) and cementum (cementum).

A person has four forms of teeth: incisors, canines, small and large molars.

The meeting of the teeth of the upper and lower jaws is called an overbite.

32. The structure of the language

Tongue (lingua) is a muscular organ involved in mixing food, the act of swallowing and articulation. The tongue has a large number of taste buds. The front part of the tongue is called the tip of the tongue (apex linguae), the back is called the root (radix linguae). Between these formations is the body of the tongue (corpus linguae). The upper wall of the tongue is called the back (dorsum linguae) and faces the palate and pharynx. The lower surface (facies inferior linguae) of the tongue is located only at the level of the apex and the initial sections of the body of the tongue. The lateral surfaces of the tongue are called the edges of the tongue (margo linguae). On the back of the tongue there is a median sulcus (sulcus medianus linguae), ending posteriorly with a fossa - a blind opening of the tongue (foramen caecum linguae). On the sides of it passes the border groove (sulcus terminalis), which is the border between the body and the root of the tongue. The mucous membrane of the tongue (tunica mucosae linguae) is pink in color, has numerous elevations - taste buds of the tongue (papillae linguae).

There are the following types of papillae:

1) conical and filiform papillae (papillae coni-cae et papillae filiformis);

2) mushroom papillae (papillae fungiformis); located on the sides and at the top of the tongue;

3) foliate papillae (papillae foliatae); located on the edges of the tongue;

4) grooved papillae (papillae vallatae). Only the mucous membrane of the root of the tongue does not have papillae; in its thickness there is an accumulation of lymphoid tissue - the lingual tonsil (tonsilla lingualis).

The mucous membrane of the lower surface of the tongue is smooth, has two longitudinal folds, which, when moving to the bottom of the oral cavity, form the frenulum of the tongue (frenulum linguae).

Near the frenulum of the tongue there are symmetrically located sublingual papillae (caruncula sublingualis), on which the excretory ducts of the sublingual and submandibular salivary glands open.

The tongue has the following muscles:

1) skeletal muscles of the tongue:

a) hyoid-lingual muscle (m. hyoglossus); pulls tongue back and down;

b) styloglossus muscle (m. styloglossus);

c) genio-lingual muscle (m. genioglossus);

2) own muscles of the tongue:

a) transverse muscle of the tongue (m. transversus linguae);

b) vertical muscle of the tongue (m. verticalis linguae);

c) the upper longitudinal muscle of the tongue (m. longitudina-lis superior);

d) upper longitudinal muscle of the tongue (m. longitudina-lis inferior).

33. The structure of the hard and soft palate and glands of the mouth

The palate (palatum) is the upper wall of the oral cavity and is divided into two parts: the hard palate, formed by bone tissue, and the soft palate.

The hard palate (palatum durum) is formed by the palatine processes of the maxillary bones and the horizontal plates of the palatine bones.

The soft palate (palatum molle) makes up one third of the palate and is located behind the hard palate. The soft palate is formed by the palatine aponeurosis and muscles.

The soft palate consists of two sections: the anterior, located horizontally, and the posterior, which hangs freely and forms a palatine curtain (velum palatinum). The back of the soft palate has a small process in the middle - the uvula. Between the arches is a small fossa (fossa tonsilla-ris), in which the palatine tonsil (tonsilla palatina) is located.

Muscles of the soft palate:

1) palatoglossal muscle (m. palatoglossus);

2) palatopharyngeal muscle (m. palatopharyngeus);

3) the muscle that raises the palatine curtain (m. leva-tor veli palatini);

4) muscle straining the palatine curtain (m. tensor veli palatini);

5) tongue muscle (m. uvulae).

The glands of the mouth (glandulae oris) produce saliva; are divided into paired large (parotid, sublingual, submandibular) and small salivary glands.

Minor salivary glands (glandulae salivariae mino-res) are located in the mucosa and submucosa of the oral cavity.

These glands are named according to their location:

1) buccal (glandulaebuccales);

2) labial (glandulaelabiales);

3) palatine (glandulae palatinae);

4) lingual (glandulae linguales);

5) molar (glandulae molares).

Major salivary glands (glandulae salivariae majores).

Parotid gland (glandula parotidea) It is located under the skin on the outer surface of the lower jaw branch and the posterior edge of the masticatory muscle. The excretory duct of the gland opens in the vestibule of the mouth at the level of the second molar.

Sublingual gland (glandula sublingualis). It is located on the upper surface of the maxillofacial muscle. Its small excretory ducts open in the oral cavity on the surface of the mucous membrane along the sublingual fold. Sometimes there is a large sublingual duct opening on the sublingual papilla along with the excretory duct of the submandibular gland.

The submandibular gland (glandula submandibularis) is located in the submandibular triangle. From the anterior part of the gland comes its excretory duct - the submandibular duct (ductus sub-mandibularis), which opens with a small opening on the sublingual papilla (near the frenulum of the tongue).

34. The structure of the pharynx and esophagus

The pharynx (pharynx) connects the oral cavity and the esophagus.

The pharynx is part of the respiratory system, conducting air from the nasal cavity to the larynx and vice versa. The pharynx communicates with the nasal cavity through the choanae and with the oral cavity through the pharynx.

Between the back wall of the pharynx and the cervical spine there is a small space (spa-tium retropharyngeum), filled with loose connective tissue,

In accordance with the organs located in front of the pharynx, three parts are distinguished in it: the nasopharynx (pars nasalis pharyngis), the oropharynx (pars oralis pharyngis) and the laryngopharynx (pars laryngea pharyngis).

The nasopharynx refers only to the respiratory tract, the oropharynx to the respiratory and digestive tracts, and the laryngopharynx to the digestive tract only.

On the inner surface of the border of the transition of the upper pharyngeal wall to the lower one there is a slight elevation - an accumulation of lymphoid tissue, or palatine tonsil (tonsilla pharyngealis), or adenoid.

On the side walls of the pharynx there is a funnel-shaped pharyngeal opening of the auditory tube (ostium pha-ryngeum tubae auditivae)

Muscular apparatus of the pharynx:

1) constrictors of the pharynx:

a) upper pharyngeal constrictor (m. constrictor pharyn-gis superior);

b) middle constrictor of the pharynx (m. constrictor pharyn-gis medius);

c) lower constrictor of the pharynx (m. constrictor pharyn-gis inferior);

2) pharynx lifters:

a) tubal-pharyngeal muscle (m. salpingopharyn-geus);

b) stylopharyngeal muscle (m. stylopharyngeus).

The esophagus (esophagus) connects the pharynx to the stomach. The esophagus resembles a tube in structure, squeezed in the anteroposterior direction. The place of transition of the pharynx into the esophagus in an adult corresponds to the VI cervical vertebra, the place of transition of the esophagus to the stomach corresponds to the level of the XI thoracic vertebra. From the chest to the abdominal cavity, the esophagus enters through the esophageal opening of the diaphragm.

The cervical part (pars cervicalis) of the esophagus starts from the VI cervical and ends at the level of the II thoracic vertebra.

The thoracic part (pars thoracica) of the esophagus ends at the level of the X thoracic vertebra and has the greatest length.

The abdominal part (pars abdominalis) of the esophagus has a small length, the left lobe of the liver is adjacent to its posterior wall.

The esophagus has three physiological constrictions: the first is at the level of the passage of the pharynx into the esophagus, the second is at the level of the intersection of the left main bronchus, the third is at the level of the passage of the esophagus through the diaphragm.

The esophagus has four main walls: mucosa (tunica mucosa), submucosa (tunica submucosa), muscular membrane (tunica muscula-ris) and serous membrane (adventitia).

35. The structure of the stomach

The stomach (ventriculus) is a sac-shaped organ located in the upper left part of the abdominal cavity and located between the esophagus and the duodenum.

The stomach has a different shape and size, depending on the degree of its filling and the state of its muscles.

The shape of the stomach changes during the maturation of the organism. There are three forms of the stomach: the shape of a horn, the shape of a stocking and the shape of a hook. The latter is the most common. The left side of the stomach is located under the diaphragm, and the right side - under the liver; a small part of the stomach is in direct contact with the anterior abdominal wall. Most of the stomach is located in the left hypochondrium, the smaller one is in the epigastric region. The cardial opening is located to the left of the body of the X thoracic vertebra, and the outlet is to the right of the body of the XII thoracic or I lumbar vertebra.

In addition to the ligamentous apparatus with the peritoneum, the stomach has ligaments with the liver, spleen and colon. The stomach contains glands that secrete gastric juice rich in digestive enzymes, hydrochloric acid, and many other physiologically active substances. The mucous membrane of the stomach produces the Castle factor, which is necessary for the absorption of vitamin B12, which, in turn, is necessary for normal blood formation.

In the stomach, the fundus (fundus ventriculi), body (corpus ventriculi), cardiac (pars cardiaca) and pyloric parts (pars pylorica), anterior (paries anterior) and posterior (paries posterior) walls, greater curvature (curvatura ventriculimajor) and lesser curvature (curvatura ventriculi minor).

The esophagus enters the stomach through the opening of the lesser curvature - the cardiac opening.

The pylorus canal passes into the duodenum; the boundary between them is a circular furrow.

The fundus of the stomach, the cardial and pyloric parts form the body of the stomach.

The stomach has all four main walls, represented by the mucous membrane, submucosa, muscular and external serous membranes.

The mucous membrane (tunica mucosa) of the stomach is covered with a single layer of cylindrical epithelium.

Due to the presence of a submucosa (tela submucosa) and a well-developed muscular plate, the mucous membrane forms numerous folds.

On the surface of the gastric mucosa there are gastric fields (arae gastricae), on the surface of which there are ventricular dimples (foveolae gastricae) - the mouths of the gastric glands that secrete gastric juice.

The muscular membrane (tunica muscularis) of the stomach is represented by three main layers: the inner, middle circular and longitudinal outer layers of oblique fibers.

The outer serous membrane (adventitia) lies on the subserous basis and covers the stomach from almost all sides; the stomach is located intraperitoneally.

36. The structure of the small intestine

The small intestine (intestinum tenue) is the next section of the digestive system after the stomach; ends with an ileocecal opening at the site of its transition to the large intestine.

The small intestine is the longest part of the digestive system. It consists of three main sections: the duodenum, jejunum and ileum.

The jejunum and ileum form the mesenteric part of the small intestine, which occupies almost the entire lower floor of the abdominal cavity.

In the small intestine, food is exposed to intestinal juice, liver bile, pancreatic juice, and the main components of food are absorbed in it.

The duodenum (duodenum) is the initial section of the small intestine. It starts from the pylorus of the stomach and goes around the head of the pancreas. The duodenum has four parts: superior, descending, horizontal, and ascending.

The upper part (pars superior) of the duodenum starts from the pylorus, departing from it on the right at the level of the XII thoracic or first lumbar vertebra, forms the upper bend (flexura duodeni superior), then passing into the descending part.

The descending part (pars descendens) originates at level I of the lumbar spine, goes down to the right of the spinal column and at level III of the lumbar spine turns to the left, forming the lower bend of the duodenum (flexura duodeni inferior).

The horizontal part (pars horizontalis) originates from the inferior flexure of the duodenum and runs horizontally at level III of the lumbar spine, touching its posterior wall with the inferior vena cava. Then she turns up and goes into the ascending part.

The ascending part (pars ascendens) originates at level II of the lumbar spine and ends with the duodenal lean bend (flexura duodenoj-ejunalis), passing into the jejunum. The muscle that suspends the duodenum (m. suspensoris duodeni) fixes this bend to the diaphragm. Behind the ascending part is the abdominal part of the aorta, next to it are the mesenteric artery and vein, which enter the root of the mesentery of the small intestine.

The duodenum is located almost entirely in the retroperitoneal space, with the exception of the ampulla (ampulla).

The wall of the duodenum consists of three membranes: mucous, muscular and serous.

The mucous membrane (tunica mucosa) is located on the muscular plate and a layer of loose adipose tissue.

The muscular membrane (tunica muscularis) of the duodenum consists of two layers: the inner circular and the outer longitudinal.

The serous membrane (adventitia) covers only the initial part of the duodenum, represented by the ampulla.

37. Structure and physiology of the jejunum and ileum

The structure, anatomical features and physiology of the jejunum (jejunum) and ileum (ileum) intestines will be considered together, since these organs have the same structure and belong to the mesenteric part of the small intestine.

The jejunum is a continuation of the duodenum, its loops lie in the upper left part of the abdominal cavity. Anteriorly, the loops of the jejunum are covered with the greater omentum; posteriorly, they are adjacent to the parietal peritoneum.

The ileum is a continuation of the jejunum, its loops lie in the lower right part of the abdominal cavity. In the cavity of the small pelvis lie the last loops of the small intestine, they are located in two layers, adjacent to the front of the bladder, and behind - to the rectum (in men) or the uterus (in women). This entire part of the small intestine is covered on all sides by the peritoneum, located intraperitoneally (with the exception of a small area in the area of attachment of the peritoneum). In the mesenteric part of the small intestine, two edges are distinguished: free and mesenteric, by which the intestine is connected with the mesentery.

The mucous membrane (tunica mucosa) consists of the muscularis mucosa and the submucosa. The mucous membrane of the mesenteric part of the small intestine has similar formations to that in the duodenum (with the exception of the duodenal glands). The main difference lies in the different number of circular folds, the number of which is greater in the mesenteric part.

In the jejunum and ileum there are group accumulations of lymphoid tissue (noduli lymphatici aggregati), located on the opposite edge from the mesentery and having a length of up to 10 cm and a width of up to 3 cm.

The place where the small intestine flows into the blind - the ileocecal opening (ostium ileocaecale) - has the valve of the same name, facing its convex part towards the large intestine. This valve is formed by folds protruding from above and below into the cavity of the caecum. Anteriorly and posteriorly, the valve leaflets converge to form the frenulum of the ileocecal valve.

The muscular membrane (tunica muscularis) consists of two layers: the inner circular (stratum circulare) and the outer longitudinal (stratum longitudinale).

The serous membrane (adventitia) of the mesenteric part of the small intestine is represented by the peritoneum.

The blood supply comes from the small intestine arteries.

Venous outflow is carried out through the veins of the same name into the portal vein.

Lymphatic outflow is carried out in the iliac-colic and mesenteric lymph nodes.

Innervation: branches of the vagus nerve.

38. Structure of the colon and caecum

The large intestine (intestinym crassum) is a continuation of the small intestine; is the final section of the digestive tract.

It starts from the ileocecal valve and ends at the anus. It absorbs the remaining water and forms feces that are excreted through the rectum. Its length is on average 1,5 m.

The large intestine is divided into three sections: the caecum with the appendix, the colon, and the rectum. The colon is divided into four parts: ascending, transverse, descending and sigmoid.

The large intestine differs from the small intestine in a number of important ways:

1) larger diameter;

2) the presence of colonic bands (taeniae coli). Distinguish the mesenteric tape (taenia mesocolica), corresponding to the place of attachment of the mesentery to it; free tape (taenia libera) located on the anterior surface of the intestine; stuffing tape (taenia omentalis), located at the place of attachment of the stuffing box;

3) the presence between the ribbons of the haustra of the colon (haustrae coli), separated from each other by transverse furrows;

4) the presence of omental processes (appendices epi-ploicae), which contain adipose tissue, on the surface of the large intestine along the omental and free bands.

The caecum (caecum) is a saccular-dilated section of the colon, starting immediately after the ileocecal valve; located in the right iliac fossa. It has a short length. With its posterior wall, the caecum is located on the iliac and psoas muscles, with its anterior wall adjacent to the anterior abdominal wall. The large intestine is covered with peritoneum on all sides, but sometimes it can be covered with peritoneum only on three sides, do not have a serous cover on the back wall, in rare cases it can have a mesentery.

From the caecum, at the point of convergence of the muscle ribbons, the vermiform appendix (appendix ver-miformis) departs. The appendix is an outgrowth of the caecum, its size is very variable.

The appendix lies intraperitoneally and has a mesentery. Most often, the appendix is \uXNUMXb\uXNUMXblocated in the right iliac fossa, sometimes descends into the small pelvis, and can even lie retroperitoneally.

The caecum (caecum) is a continuation of the ileum. They are separated by the ileocecal valve (valva ileocaecalis). The valve flaps form a frenulum or ocecal valve (frenulum valvae ileo-caecalis). Having the form of a funnel, the narrow part of the valve faces the lumen of the caecum, freely passing food from the small intestine into the large intestine. With an increase in pressure in the colon (overeating, increased gas formation), the valve flaps close, the reverse movement of food is not observed. Below this valve is the opening of the appendix (ostium appendix vermiformis).

39. Structure of the colon

The colon is located around the loops of the small intestine, which are located in the middle of the lower floor of the abdominal cavity. The ascending colon is on the right, the descending colon on the left, the transverse colon on top, and the sigmoid colon on the left and bottom.

The ascending colon (colon ascendens) is a continuation of the caecum. Rising vertically, it is first located in front of the square muscle of the lower back, then in front of the right kidney and reaches the lower surface of the right lobe of the liver. At this level, it bends to the left, forming the right flexure of the colon (flexura coli dextra) and passing into the transverse colon. The length of this section of the colon is about 20 cm.

The transverse colon (colon transversum) originates from the right bend of the colon and continues to the left bend of the colon (flexura coli sinistra), which is located in the left hypochondrium at a higher level than the right bend of the colon. The colon is located in the form of an arc and sags down. The transverse colon is located intraperitoneally and has its own mesentery, originating from the parietal peritoneum. Attached along the entire length of the omental band is a ligament coming from the stomach, called the gastrocolic ligament.

The left flexure of the transverse colon is the transition section to the descending colon (colon descendens), which goes down to the level of the left iliac fossa and passes into the sigmoid colon. Its posterior wall is not covered by the peritoneum and lies in front of the left kidney, located on the square muscle of the lower back and the iliac muscle in the left iliac fossa. From this section of the colon, a decrease in the number of haustra and their depth begins.

The sigmoid colon (colon sigmoi-deum) lies in the left iliac fossa, its continuation is the rectum. The sigmoid colon forms two loops: the proximal loop lies on the iliac muscle, and the distal loop lies on the psoas major muscle.

The mucous membrane (tunica mucosa) of the wall of the caecum and colon consists of epithelium lying on the basement membrane. Its epithelium consists of cylindrical cells and a large number of goblet glands and intestinal glands. Between the muscle bands, the mucous membrane forms semilunar folds (plicae semilunares coli).

The muscular membrane (tunica muscularis) throughout the entire length consists of two layers: the inner circular and the outer longitudinal. The longitudinal muscles form ribbons.

The peritoneum covers the following sections from all sides: the caecum, transverse and sigmoid colon.

40. The structure of the rectum

The rectum (rectum) is the final section of the large intestine and is located at its posterior wall of the pelvic cavity, which is formed by the muscles of the pelvic floor, coccyx and sacrum.

In the rectum, feces accumulate and are excreted from the body, and water is also absorbed. In front of the rectum in men are the prostate, seminal vesicles and bladder, and in women - the uterus and vagina.

The rectum has two bends: perineal (flexura perinealis) and sacral (flexura sacralis). In the rectum, two parts are distinguished: the pelvic, located above the pelvic diaphragm, and the perineal, located in the perineum and representing the anal canal (canalis analis), ending with the anus (anus). In the pelvic region, a narrow, nadampular region and a wide part are distinguished - the ampulla of the rectum (ampulla recti).

The mucous membrane of the rectum is rich in mucous and goblet glands, forms longitudinal and transverse folds. The mucosa is devoid of villi, has single lymphatic nodules. There are usually three transverse folds, they cover half the circumference of the rectum, there are non-permanent folds. There are up to 10 longitudinal folds, they are called anal columns (colu-mnae anales) and expand from top to bottom.

Transverse folds (plicae transversae recti), closing the sinuses from below, are called anal flaps (valvulae anales), their combination forms the anal crest.

In the submucosa of the zone of the anal columns there is adipose tissue, in which lies the rectal venous plexus (plexus venosus rectalis).

The mucous membrane in the region of the pillars is represented by a flat epithelium, in the region of the sinuses - by a stratified epithelium. The anal line is the boundary between the rectal mucosa and the skin. The skin of the anus is lined with stratified keratinized epithelium.

The muscular membrane throughout the entire length consists of two layers: the inner circular and the outer longitudinal, and the inner layer is better expressed. Longitudinal muscle bundles are a continuation of the muscle bands of the colon: they expand and completely cover the rectum; better expressed on the anterior and posterior walls. Part of the longitudinal muscles is part of the muscle that lifts the anus (m. Levator ani). The anterior bundle of longitudinal muscles forms the rectourethral muscle in men.

In addition to this muscle, men have a rectovesical muscle that connects the rectum to the bladder. The circular layer of muscle tissue thickens at the anus and forms the internal sphincter of the anus (m. sphincter ani interni).

The serous outer membrane is represented by the peritoneum, which covers the upper section of the rectum from all sides, the middle section - from three sides. The lower portion of the rectum is not covered by the peritoneum.

41. The structure of the liver

The liver (hepar) is the largest gland of the digestive tract; located mainly in the right upper abdominal cavity subphrenic; is a complex branched tubular gland.

The liver is involved in the processes of metabolism and hematopoiesis.

The liver has an irregular shape: the upper - convex - and the lower - concave - parts; surrounded on all sides by the peritoneum.

The upper part of the liver is called diaphragmatic (facies diaphragmatica), and the lower part is called visceral (facies visceralis).

The diaphragmatic surface of the liver corresponds in shape to the dome of the diaphragm. To this surface from the diaphragm and the anterior abdominal wall there is a supporting (crescent) ligament of the liver (lig. falciformis). It divides the surface of the liver into two lobes: the right (lobus hepatis dexter) and the left (lobus hepatis sinister), connecting behind with the coronary ligament (lig. coronarium), which is a duplication of the peritoneum.

On the visceral surface of the liver are three furrows, dividing it into four parts. The middle section between the right and left sagittal sulci is divided into two sections by a transverse sulcus. The anterior is called the square lobe (lobus quadratus), the posterior is called the caudate lobe (lobus caudatus).

The liver has two slits along its length: in the anterior part - for the round ligament (fissura ligamenti teretis), in the back - for the venous ligament (fissura ligamenti venosi).

The portal vein, nerves, hepatic artery enter the gates of the liver, and the lymphatic vessels and the common hepatic duct exit. There are four main impressions on the visceral surface of the liver: renal (impressio renalis), adrenal (impressio suprarenalis), colonic (impressio colica) and duodenal (impressio duodenalis).

The square lobe of the liver has a small depression formed by the duodenum (im-pressio duodenalis).

The caudate lobe of the liver on its anterior surface forms the papillary process (processus papillaris), on the right - the caudate process (processus cauda-tus).

The left lobe of the liver has a slight elevation on the visceral surface - the omental tubercle facing the lesser omentum. Outside, the liver is covered with a serous membrane (tunica serosa), which lies on the subserous basis. Beneath it lies a fibrous sheath (tunica fibrosa).

Inside the liver there is a connective tissue frame, in the cells of which the structural and functional units of the liver are located - hepatic lobules (lobulus hepatis).

The liver lobules are made up of hepatocytes. In the center of the lobule passes the central vein, along the periphery of the lobule there are interlobular arteries and veins, from which interlobular capillaries begin, passing into sinusoidal vessels.

Between the hepatocytes are bile canaliculi (ductulus bilifer), flowing into the bile ducts, which are connected to the interlobular bile ducts.

42. The structure of the pancreas. Peritoneum

The pancreas (pancreas) is the second largest digestive gland of a complex alveolar-tubular structure, which plays an important role not only in the process of digestion, but also in the hormonal homeostasis of the body.

The main part of the parenchyma of the gland performs an external secretory function, releasing its secret into the lumen of the duodenum.

A small part of the gland, represented by the islets of Langerhans, performs an endocrine function, producing the hormone insulin.

The pancreas has a gray-pink color and is located transversely at the level of I or II lumbar vertebrae. Its length is up to 16 cm, width - up to 8 cm, thickness - up to 3 cm. The mass of the pancreas in an adult reaches 70 g.

The pancreas has a lobed structure and is covered by the peritoneum only from the front and, partially, from the bottom.

The pancreas is divided into three main parts: the body (corpus pancreatis), the head (caput pancreatis) and the tail (cauda pancreatis).

The head of the pancreas is located at the level of I-III lumbar vertebrae and is surrounded by a loop of the duodenum.

The body of the pancreas is triangular in shape and lies at the level of the XNUMXst lumbar vertebra. There are three surfaces in the body: anterior, posterior and inferior. On the anterior surface is the omental tubercle (tuber omentale). The surfaces are separated from each other by the edges of the same name.

The tail of the pancreas is a continuation of its body and reaches the hilum of the spleen. Behind this part of the pancreas lies the left kidney.

The pancreas has an excretory duct (ductus pancreaticus), which, passing through its entire parenchyma, opens into the lumen of the duodenum on the major papilla. The excretory duct in its final section has a sphincter (m. sphincter ductus pancreatici). In the region of the head, there may be an additional pancreatic duct (ductus pancreaticus accessorius).

Peritoneum (peritoneum) - a serous membrane that lines the abdominal cavity and the organs located in it.

The peritoneum is divided into parietal (peritoneum parietale), which lines the walls of the abdominal cavity, and visceral (peritoneum viscerale), which lines the organs located in it.

The peritoneum is formed by a plate of the serous membrane and mesothelium, which is a single-layer squamous epithelium. The surface of the peritoneum has an area of 1,7 m². The abdominal cavity contains a small amount of serous fluid, which provides easy sliding of the organs located in it. The abdominal cavity is closed, but in women it communicates with the external environment through the abdominal openings of the fallopian tubes, the cavity of the vagina and uterus.

43. The structure of the heart

The heart (cor) is a hollow four-chamber muscular organ that pumps oxygenated blood into the arteries and receives venous blood.

The heart consists of two atria that receive blood from the veins and push it into the ventricles (right and left). The right ventricle supplies blood to the pulmonary arteries through the pulmonary trunk, and the left ventricle supplies blood to the aorta. The left half of the heart contains arterial blood, and the right half contains venous blood; the right and left halves of the heart do not normally communicate.

In the heart, there are: three surfaces - pulmonary (facies pulmonalis), sternocostal (facies sterno-costalis) and diaphragmatic (facies diaphragmatica); apex (apexcordis) and base (basis cordis). The boundary between the atria and ventricles is the coronary sulcus (sulcus coronarius).

The right atrium (atrium dextrum) is separated from the left by an interatrial septum (septum intera-triale) and has an additional cavity - the right ear (auricula dextra). There is a recess in the septum - an oval fossa, surrounded by the edge of the same name, formed after the fusion of the foramen ovale.

The right atrium has openings of the superior vena cava (ostium venae cavae superioris) and inferior vena cava (ostium venae cavae inferioris), delimited by the intervenous tubercle (tuberculum intervenosum), and the opening of the coronary sinus (ostium sinus coronarii). On the inner wall of the right ear there are pectinate muscles (mm pectinati), ending in a border crest that separates the venous sinus from the cavity of the right atrium.

The right atrium communicates with the ventricle through the right atrioventricular orifice (ostium atrioventriculare dextrum).

The right ventricle (ventriculus dexter) is separated from the left ventricular septum (septum inter-ventriculare), in which the muscular and membranous parts are distinguished; has an opening of the pulmonary trunk (ostium trunci pulmonalis) in front and a right atrioventricular opening (ostium atrio-ventriculare dextrum) in the back. The latter is covered by a tricuspid valve (valva tricuspidalis), which has an anterior, posterior and septal cusps.

On the inner surface of the ventricle there are fleshy trabeculae (trabeculae carneae) and papillary muscles (mm. papillares), from which tendon chords begin. The opening of the pulmonary trunk is covered by the valve of the same name.

The left atrium (atrium sinistrum) has a cone-shaped extension facing anteriorly (left ear (auricular sinistra)) and five openings: four openings of the pulmonary veins (ostia venarum pulmonalium) and the left atrioventricular opening (ostium atrio-ventriculare sinistrum).

The left ventricle (ventriculus sinister) has behind the left atrioventricular opening, covered by the mitral valve (valva mitralis), consisting of the anterior and posterior valves, and the aortic opening, covered by the valve of the same name, consisting of three semilunar valves: posterior, right and left (valvulae semilunares posterior, dextra etsinistra).

44. The structure of the wall of the heart

Pericardium

The wall of the heart consists of a thin inner layer - the endocardium (endocardium), the middle developed layer - the myocardium (myocardium) and the outer layer - the epicardium (epicardium).

The endocardium lines the entire inner surface of the heart with all its formations.

The myocardium is formed by cardiac striated muscle tissue and consists of cardiac cardiomyocytes. The muscle fibers of the atria and ventricles start from the right and left (anuli fibrosi dexter et sinister) fibrous rings, which are part of the soft skeleton of the heart. Fibrous rings surround the corresponding atrioventricular orifices, forming a support for their valves.

The myocardium consists of three layers. The outer oblique layer at the apex of the heart passes into the curl of the heart (vortex cordis) and continues into the deep layer. The middle layer is formed by circular fibers. The epicardium is built on the principle of serous membranes and is a visceral sheet of the serous pericardium. The epicardium covers the outer surface of the heart from all sides and the initial sections of the vessels extending from it, passing along them into the parietal plate of the serous pericardium.

The normal contractile function of the heart is provided by its conducting system, the centers of which are:

1) sinoatrial node (nodus sinuatrialis), or Keyes-Fleck node;

2) the atrioventricular node (nodus atrioventricularis), or the Fshoff-Tavara node, passing downwards into the atrioventricular bundle (fasciculus atrioventricularis), or the His bundle, which is divided into the right and left legs (cruris dextrum et sinistrum).

The pericardium (pericardium) is a fibrous-serous sac in which the heart is located. The pericardium is formed by two layers: the outer (fibrous pericardium) and the inner (serous pericardium). The fibrous pericardium passes into the adventitia of the large vessels of the heart, and the serous one has two plates - parietal and visceral, which pass into each other at the base of the heart. Between the plates there is a pericardial cavity (cavitas pericardialis), it contains a small amount of serous fluid.

Innervation: branches of the right and left sympathetic trunks, branches of the phrenic and vagus nerves.

45. The structure of the pulmonary trunk

The pulmonary trunk (truncus pulmonalis) is divided into the right and left pulmonary arteries. The place of division is called the bifurcation of the pulmonary trunk (bifurcatio trun-ci pulmonalis).

The right pulmonary artery (a. pulmonalis dextra) enters the gate of the lung and divides. In the upper lobe, there are descending and ascending posterior branches (rr. po-steriores descendens et ascendens), apical branch (r. apicalis), descending and ascending anterior branches (rr. anteriores descendens et ascendens).

In the middle share, medial and lateral branches are distinguished (rr. Lobi medii medialis et lateralis). In the lower lobe - the upper branch of the lower lobe (r. superior lobi in-ferioris) and the basal part (pars basalis), which is divided into four branches: anterior and posterior, lateral and medial.

The left pulmonary artery (a. pulmonalis sinistra), entering the gate of the left lung, is divided into two parts. The ascending and descending anterior (rr. anteriores ascendens et descendens), reed (r. lingularis), posterior (r. posterior) and apical branches (r. apica-lis) go to the upper lobe. The upper branch of the lower lobe goes to the lower lobe of the left lung, the basal part is divided into four branches: anterior and posterior, lateral and medial (as in the right lung).

The pulmonary veins originate from the capillaries of the lung.

The right lower pulmonary vein (v. pulmonalis dextra inferior) collects blood from five segments of the lower lobe of the right lung. This vein is formed by the confluence of the superior vein of the lower lobe and the common basal vein.

The right upper pulmonary vein (v. pulmonalis dextra superior) collects blood from the upper and middle lobes of the right lung.

The left lower pulmonary vein (v. pulmonalis sinistra inferior) collects blood from the lower lobe of the left lung.

The left upper pulmonary vein (v. pulmonalis sinistra superior) collects blood from the upper lobe of the left lung.

The right and left pulmonary veins empty into the left atrium.

The aorta (aorta) has three sections: the ascending part, the arch and the descending part.

The ascending aorta (pars ascendens aortae) has an extension in the initial section - the aortic bulb (bulbus aortae), and at the location of the valve - three sinuses.

The aortic arch (arcus aortae) originates at the level of articulation of the II right costal cartilage with the sternum; has a slight narrowing, or isthmus of the aorta (isthmus aortae).

The descending part of the aorta (pars descendens aortae) begins at the level of the IV thoracic vertebra and continues to the IV lumbar vertebra, where it divides into the right and left common iliac arteries. In the descending part, the thoracic (pars thoracica aortae) and abdominal parts (pars abdominalis aortae) are distinguished.

46. Branches of the external carotid artery

1. The superior thyroid artery (a. thyroidea superior) has lateral branches:

1) sublingual branch (r. infrahyoideus);

2) sternocleidomastoid branch (r. sternoc-leidomastoidea);

3) superior laryngeal artery (a. laryngea superior);

4) cricothyroid branch (r. cricothyroideus).

2. Lingual artery (a. lingualis).

3. Facial artery (a. facialis) gives the following branches:

1) superior labial artery (a. labialis inferior);

2) inferior labial artery (a. labialis superior);

3) angular artery (a. angularis).

4) tonsil branch (r. tonsillaris);

5) mental artery (a. submentalis);

6) ascending palatine artery (a. palatine ascen-dens).

4. The posterior ear artery (a auricularis posterior) gives the following branches:

1) occipital branch (r. occipitalis);

2) ear branch (r. auricularis);

3) stylomastoid artery (a. stylomastoidea), which gives off the posterior tympanic artery (a. tympani-ca posterior).

5. The occipital artery (a. occipitalis) gives the following branches:

1) ear branch (r. auricularis);

2) descending branch (r. descendens);

3) sternocleidomastoid branches (rr. sternoc-leidomastoidea);

4) mastoid branch (r. mastoideus).

6. The ascending pharyngeal artery (a. pharyngea as-cendens) gives the following branches:

1) pharyngeal branches (rr. pharyngealis);

2) lower tympanic artery (a. tympanica inferior);

3) posterior meningeal artery (a. meningea posterior).

7. Maxillary artery (a. maxillaries), in which there are three sections - maxillary, pterygoid, pterygo-palatine, from which their branches depart.

Branches of the jaw:

1) anterior tympanic artery (a. tympanica anterior);

2) deep ear artery (a. auricularis profunda);

3) middle meningeal artery (a. meningea media);

4) lower alveolar artery (a. alveolaris inferior). Branches of the pterygoid department:

1) pterygoid branches (rr. pterigoidei);

2) masticatory artery (a. masseterica);

3) buccal artery (a. buccalis). Branches of the pterygopalatine:

1) descending palatine artery (a. palatine descen-dens);

2) wedge-palatine artery (a. sphenopalatina);

3) infraorbital artery (a. infraorbitalis).

47. Branches of the subclavian artery

Branches of the first department:

1) vertebral artery (a. vertebralis). Neck branches:

a) radicular branches (rr. radiculares);

b) muscular branches (rr. musculares);

c) anterior spinal artery (a. spinalis anterior);

d) posterior spinal artery (a. spinalis posterior);

e) meningeal branches (rr. meningei);

e) posterior inferior cerebellar artery (a. inferior posterior cerebri).

2) Basilar artery (a. basilaris):

a) labyrinth artery (a. labyrinthi);

b) middle cerebral arteries (aa. mesencephalicae);

c) superior cerebellar artery (a. superior cerebelli);

d) anterior inferior cerebellar artery (a. inferior anterior cerebelli);

e) pontine arteries (aa. pontis);

3) Right and left posterior cerebral arteries (aa. cereb-ri posterior);

4) the internal thoracic artery (a. thoracica interna) gives:

a) bronchial and tracheal branches (rr. bronchiales et tracheales);

b) sternal branches (rr. sternales);

c) mediastinal branches (rr. mediastinales);

d) perforating branches (rr. perforantes);

e) thymic branches (rr. thymici);

e) pericardial phrenic artery (a. pericardia-cophrenica);

g) muscular-phrenic artery (a. muscu-lophrenica);

h) superior epigastric artery (a. epigastrica superior);

i) anterior intercostal branches (rr. intercostals ante-riores);

5) the thyroid trunk (truncus thyrocervicalis) is divided into three branches:

a) inferior thyroid artery (a. thyroidea inferior);

6) suprascapular artery (a. suprascapularis));

c) transverse artery of the neck (a. transversa cervicis).

The costal-cervical trunk (truncus costocervicalis) is divided into the deep cervical artery (a. cervicalis pro-funda) and the highest intercostal artery (a. inter-costalis suprema).

Axillary artery (a. axillaris).

1) superior thoracic artery (a. thoracica superior);

2) subscapular branches (rr. subscapulares);

3) thoracoacromial artery (a. thoracoacromialis). Lateral thoracic artery (a. thoracica lateralis):

1) anterior artery, circumflex humerus (a. circumflexa anterior humeri);

2) posterior artery, envelope of the humerus (a. cir-cumflexa posterior humeri);

3) subscapular artery (a. subscapularis).

48. Brachial and ulnar arteries. Branches of the thoracic aorta

Brachial artery (a. brachialis) is a continuation of the axillary artery, gives the following branches:

1) superior ulnar collateral artery (a. col-lateralis ulnaris superior);

2) lower ulnar collateral artery (a. col-lateralis ulnaris inferior);

3) deep artery of the shoulder (a. profunda brachii), giving the following branches: middle collateral artery (a. collateralis media), radial collateral artery (a. collateralis radialis), deltoid branch (r. deltoidei) and arteries feeding the humerus ( aa. nutriciae humeri).

The radial artery (a. radialis) is one of the two terminal branches of the brachial artery. The terminal section of this artery forms a deep palmar arch (arcus palmaris profundus).

Branches of the radial artery:

1) superficial palmar branch (r. palmaris superfi-cialis);

2) radial recurrent artery (a. reccurens radialis);

3) dorsal carpal branch (r. carpalis dorsalis);

4) palmar carpal branch (r. carpalis palmaris). The ulnar artery (a. ulnaris) is the second terminal branch of the brachial artery. The terminal section of this artery forms the superficial palmar arch (arcus palmaris supreficialis), anastomosing with the superficial palmar branch of the radial artery.

Branches of the ulnar artery:

1) ulnar recurrent artery (a. reccurens ulnaris), dividing into anterior and posterior branches;

2) muscular branches (rr. musculares);

3) common interosseous artery (a. interuossea communis), dividing into the anterior and posterior interosseous arteries;

4) deep palmar branch (r. palmaris profundus);

5) palmar carpal branch (r. carpalis palmaris).

In the system of the subclavian, axillary, brachial, ulnar and radial arteries, there are many anastomoses that provide blood supply to the joints and collateral blood flow.

The branches of the thoracic aorta are divided into visceral and parietal.

Visceral branches:

1) pericardial branches (rr. pericardiaci);

2) esophageal branches (rr. oesophageales);

3) mediastinal branches (rr. mediastinaes);

4) bronchial branches (rr. bronchiales).

Parietal branches:

1) superior phrenic artery (a. phrenica superior);

2) posterior intercostal arteries (aa. intercostales po-steriores), each of which gives off a medial cutaneous branch (r. cutaneus medialis), a lateral cutaneous branch (r. cutaneus lateralis) and a dorsal branch (r. dorsalis).

49. Branches of the abdominal aorta

The branches of the abdominal aorta are divided into paired and unpaired. Paired visceral branches:

1) ovarian (testicular) artery (a. ovarica a testicularis). The ovarian artery gives tubal (rr. tubarii) and ureteral branches (rr. ureterici), and the testicular artery - adnexal (rr. epididymales) and ureteral branches (rr. ureterici);

2) renal artery (a. renalis);

3) middle adrenal artery (a. suprarenalis media).

Unpaired visceral branches: 1) celiac trunk (truncus coeliacus). Divides into three arteries:

a) splenic artery (a. lienalis), gives branches to the pancreas (rr. pancreatici), short gastric arteries (aa. gastricae breves) and left gastroepiploic artery (a. gastroepiploica sinistra), giving omental and gastric branches;

b) common hepatic artery (a. hepatica communis); is divided into its own hepatic artery (a. hepatica propria) and gastroduodenal artery (a. gastroduodenalis). Own hepatic artery gives off the right gastric artery (a. ga-strica dextra), the right and left branches, the gallbladder artery (a. cystica) departs from the right branch. The gastroduodenal artery is divided into the superior pancreatoduodenal arteries (aa. pancreatico-duodenales superiores) and the right gastroepiploic artery (a. gastroepiploica).

c) the left gastric artery (a. gastrica sinistra), gives off esophageal branches (rr. oesophagealis);

2) superior mesenteric artery (a. mesenterica superior). Gives the following branches:

a) right colic artery (a. colica dextra); anastomoses with branches of the middle colic artery, a branch of the iliac colic artery;

b) middle colic artery (a. colica media); anastomoses with the right and left colonic arteries;

c) iliocolic artery (a. ileocolica); gives the artery of the appendix (a. appendi-cularis), colonic branch (r. colicus),

d) lower pancreatoduodenal arteries (aa. panc-reaticoduodenalies inferiors);

e) ileo-intestinal (aa. ileales) and jejunal arteries (aa. jejunales);

3) inferior mesenteric artery (a. mesenterica inferior). Gives the following branches:

a) sigmoid arteries (aa. sigmoidei);

b) left colic artery (a. colica sinistra);

c) superior rectal artery (a. rectalis superior).

Parietal branches:

1) four pairs of lumbar arteries (aa. lumbales);

2) the lower phrenic artery (a. phrenica inferior), giving the upper adrenal arteries (aa. suprarenales superiores).

50. The structure of the branches of the common iliac artery

The common iliac artery (a. iliaca communis) is divided into internal and external iliac arteries at the level of the iliac sacral joint.

The external iliac artery (a. iliaca externa) gives the following branches:

1) deep artery, circumflex ilium (a. circumflexa iliaca profunda);

2) the lower epigastric artery (a. epigastrica inferior), giving the pubic branch (r. pubicus), the crema-sternal artery (a. cremasterica) in men and the artery of the round ligament of the uterus (a. lig teretis uteri) in women.

The internal iliac artery (a. iliaca inter-na) gives the following branches:

1) umbilical artery (a. umbilicalis), presented in an adult by the medial umbilical ligament;

2) superior gluteal artery (a. glutealis superior), which is divided into deep and superficial branches;

3) lower gluteal artery (a. glutealis inferior); gives the artery that accompanies the sciatic nerve (a. comitans nervi ischiadici);

4) iliac-lumbar artery (a. iliolumbalis), giving iliac (r. iliacus) and lumbar branches (r. lumbalis);

5) uterine artery (a. uterine), giving tubal (r. tu-barius), ovarian (r. ovaricus) and vaginal branches (rr. vaginales);

6) lower vesical artery (a. vesicalis inferior);

7) lateral sacral arteries (aa. sacraleslate-rales), which give off spinal branches (rr. spinales);

8) internal genital artery (a. pudenda in-terna); gives the lower rectal artery (a. rectalis inferior) and in women: the urethral artery (a. urethralis), the dorsal and deep arteries of the clitoris (aa. dorsalis et profunda clitoritidis) and the artery of the vestibule bulb (a. bulbi vestibule); in men: urethral artery (a. urethralis), dorsal and deep arteries of the penis (aa. dorsalis et profunda penis), artery of the bulb of the penis (a. bulbi penis);

9) middle rectal artery (a. rectalis media);

10) obturator artery (a. obturatoria); divides into anterior and posterior branches. The latter gives off the acetabular branch (r. acetabularis). The obturator artery in the pelvic cavity gives off the pubic branch (r. pubicus).

51. Branches of the femoral, popliteal, anterior and posterior tibial arteries

The femoral artery (a. femoralis) gives off branches:

1) deep artery of the thigh (a. profunda femoris); lateral artery, envelope of the femur (a. circumflexa femoris lateralis), giving ascending, transverse and descending branches (rr. ascen-dens, transversus et descendens); medial artery, circumflex femur (a. circumflexa femoris medialis);

2) superficial artery, circumflex ilium (a. circumflexa iliaca superficialis);

3) superficial epigastric artery (a. epigastrica superficialis);

4) descending knee artery (a. genus descen-dens); participates in the formation of the knee articular network (rete articulare genus);

5) external genital arteries (aa. pudendae exter-nae).

The popliteal artery (a. poplitea) gives branches:

1) medial lower knee artery (a. genus inferior medialis);

2) lateral lower knee artery (a. genus inferior lateralis);

3) medial superior knee artery (a. genus superior medialis);

4) lateral superior knee artery (a. genus superior lateralis);

5) middle knee artery (a. genus media). Anterior tibial artery (a. tibialis anterior) and gives branches:

1) anterior tibial recurrent artery (a. reccurens tibialis anterior);

2) posterior tibial recurrent artery (a. reccurens tibialis posterior);

3) medial anterior ankle artery (a. mal-leolaris anterior medialis);

4) lateral anterior ankle artery (a mal-leolaris anterior lateralis);

5) muscular branches (rr. musculares);

6) dorsal artery of the foot (a. dorsalis pedis); gives off the lateral and medial tarsal arteries (aa. tarsales lateralis et medialis), the arcuate artery (a. arcuata).

Posterior tibial artery (a. tibialis posterior) gives branches:

1) medial plantar artery (a. plantaris medialis), dividing into deep and superficial branches;

2) lateral plantar artery (a. plantaris la-teralis); forms a deep plantar arch (ar-cus plantaris profundus), from which four plantar metatarsal arteries depart (aa. metatarsales plantares I-IV);

3) a branch that wraps around the fibula (r. circum-flexus fibularis);

4) peroneal artery (a. peronea);

5) muscular branches (rr. musculares).

52. System of superior vena cava

The superior vena cava (v. cava superior) collects blood from the veins of the head, neck, both upper limbs, veins of the thoracic and partially abdominal cavities and flows into the right atrium. The azygous vein flows into the superior vena cava on the right, and the mediastinal and pericardial veins on the left. Has no valves.

The unpaired vein (v. azygos) is a continuation of the right ascending lumbar vein (v. lumbalis ascendens dextra) into the chest cavity, has two valves at the mouth. The semi-azygous vein, esophageal veins, mediastinal and pericardial veins, posterior intercostal veins IV-XI and the right superior intercostal vein flow into the unpaired vein.

The semi-unpaired vein (v. hemiazygos) is a continuation of the left ascending lumbar vein (v. lumba-lis ascendens sinistra). The mediastinal and esophageal veins flow into the semi-unpaired vein, the additional semi-unpaired vein (v. hemiazygos accessoria), which receives I-VII superior intercostal veins, posterior intercostal veins.

Posterior intercostal veins (vv. intercostales posterio-res) collect blood from the tissues of the walls of the chest cavity and part of the abdominal wall. The intervertebral vein (v. interverteb-ralis) flows into each posterior intercostal vein, into which, in turn, the spinal branches (rr. spinales) and the vein of the back (v. dorsalis) flow.

The veins of the spongy substance of the vertebrae and spinal veins flow into the internal anterior and posterior vertebral venous plexuses (plexus venosi vertebrales interni). Blood from these plexuses flows into the accessory semi-unpaired and unpaired veins, as well as into the external anterior and posterior vertebral venous plexuses (plexus venosi vertebrales externi), from which blood flows into the lumbar, sacral and intercostal veins and into the additional semi-unpaired and unpaired veins.

The right and left brachiocephalic veins (vv. brachio-cephalicae dextra et sinistra) are the roots of the superior vena cava. They do not have valves. Collect blood from the upper extremities, organs of the head and neck, upper intercostal spaces. The brachiocephalic veins are formed by the confluence of the internal jugular and subclavian veins.

The deep cervical vein (v. cervicalis profunda) originates from the external vertebral plexuses and collects blood from the muscles and auxiliary apparatus of the muscles of the occipital region.

The vertebral vein (v vertebralis) accompanies the artery of the same name, receiving blood from the internal vertebral plexuses.

The internal thoracic vein (v. thoracica interna) accompanies the artery of the same name on each side. The anterior intercostal veins (vv. inter-costales anteriores) flow into it, and the roots of the internal thoracic vein are the muscular-phrenic vein (v. mus-culophrenica) and the superior epigastric vein (v. epigastrica superior).

53. Veins of the head and neck

The internal jugular vein (v. jugularis interna) is a continuation of the sigmoid sinus of the dura mater, has an upper bulb (bulbus superior) in the initial section; above the confluence with the subclavian vein is the lower bulb (bulbus inferior). There is one valve each above and below the lower bulb.

The intracranial tributaries of the internal jugular vein are the ophthalmic veins (vv. ophthalmicae superior et inferior), the labyrinth veins (vv. labyrinthi) and the diploic veins.

By diploic veins (vv. diploicae) - posterior temporal diploic vein (v. diploica temporalis posterior), anterior temporal diploic vein (v. diploica temporalis anterior), frontal diploic vein (v. di-ploica) and occipital diploic vein (v. diploica occipitalis) - blood flows from the bones of the skull; do not have valves. With the help of emissary veins (vv. emissari-ae) - mastoid emissary vein (v. emissaria ma-stoidea), condylar emissary vein (v. emissaria condylaris) and parietal emissary vein (v emissaria parietalis) - diploic veins communicate with the veins of the outer integument heads.

Extracranial tributaries of the internal jugular vein:

1) lingual vein (v. lingualis), which is formed by the deep vein of the tongue, the hyoid vein, the dorsal veins of the tongue;

2) facial vein (v. facialis);

3) superior thyroid vein (v. thyroidea superior); has valves;

4) pharyngeal veins (vv. pharyngeales);

5) mandibular vein (v. retromandibular).

The external jugular vein (v. jugularis externa) has paired valves at the level of the mouth and the middle of the neck. The transverse veins of the neck (vv. transversae colli), the anterior jugular vein (v. jugularis anterior), and the suprascapular vein (v. suprascapularis) flow into this vein.

Subclavian vein (v. subclavia) unpaired, is a continuation of the axillary vein.

54. Veins of the upper limb

These veins are represented by deep and superficial veins.

The superficial palmar venous arch (arcus ve-nosus palmaris superficialis) drains the palmar digital veins.

Paired palmar metacarpal veins flow into the deep palmar venous arch (arcus venosus palmaris profundus). The superficial and deep venous arches continue into the paired radial and ulnar veins (vv. radi-ales et vv palmares), which belong to the deep veins of the forearm. Two brachial veins (vv. brachiales) are formed from these veins.

Superficial veins of the upper limb.

The dorsal metacarpal veins, together with their anastomoses, form the dorsal venous network of the hand (rete venosum dorsale manus). The superficial veins of the forearm form a plexus in which the lateral saphenous vein of the arm (v. cephalica), which is a continuation of the first dorsal metacarpal vein, and the medial saphenous vein of the arm (v. basilica), which is a continuation of the fourth dorsal metacarpal vein, are isolated.

Visceral tributaries:

1) renal vein (v. renalis);

2) adrenal vein (v. suprarenalis); does not have valves;

3) hepatic veins (vv. hepaticae);

4) ovarian (testicular) vein (v. ovarica (testicularis)). Parietal tributaries:

1) lower phrenic veins (vv. phrenicae inferiors);

2) lumbar veins (vv. lumbales).

The portal vein (v. portae) is the largest visceral vein, its main tributaries are the splenic vein, superior and inferior mesenteric veins.

The splenic vein (v. lienalis) merges with the superior mesenteric vein and has the following tributaries: the left gastroepiploic vein (v. gastroepiploica sinistra), short gastric veins (vv. gastricae breves) and pancreatic veins (vv. pancreaticae).

The superior mesenteric vein (v. mesenterica superior) has the following tributaries: the right gastroepiploic vein (v. gastroepiploica dextra), the iliac colic vein (v. ileocolica), the right and middle colic veins (vv. colicae media et dextra), pancreatic veins (vv. pancreaticae), vein of the appendix (v. appendicularis), veins of the ileum and jejunum (vv. ileales et jejunales).

The inferior mesenteric vein (v. mesenterica inferior) flows into the splenic vein, is formed by the confluence of the sigmoid veins (vv. sigmoideae), the superior rectal vein (v. rectalis superior) and the left colonic vein (v. colica sinistra).

Before entering the gates of the liver, the right and left gastric veins (vv. gastricae dextra et sinistra), the prepyloric vein (v. prepylorica) and the gallbladder vein (v. cystica) flow into the portal vein.

55. Veins of the pelvis and lower limb

The right and left common iliac veins (vv. iliacae communes) form the inferior vena cava.

The external iliac vein (v. iliaca externa) combines with the internal iliac vein at the level of the sacroiliac joint and forms the common iliac vein. The external iliac vein receives blood from all veins of the lower limb; has no valves.

The internal iliac vein has visceral and parietal tributaries.

Visceral tributaries:

1) vaginal venous plexus (plexus venosus vaginalis), passing into the uterine venous plexus (plexus venosus uterinus);

2) prostatic venous plexus (plexus venos-us prostaticus);

3) vesical venous plexus (plexus venosus vesicalis);

4) rectal venous plexus (plexus venos-us rectalis);

5) sacral venous plexus (plexus venosus sacralis).

Parietal tributaries:

1) iliac-lumbar vein (v. ilicolumbalis);

2) superior and inferior gluteal veins (vv. glutealis su-periores et inferiors);

3) lateral sacral veins (vv. sacrales laterales);

4) obturator veins (vv. obturatoriae). Deep veins of the lower limb:

1) femoral vein (v. femoralis);

2) deep vein of the thigh {v. femoris profunda);

3) popliteal vein (v. poplitea);

4) anterior and posterior tibial veins (vv. ti-biales anteriores et posteriores); 5) peroneal veins (vv. fibulares).

All deep veins (with the exception of the deep vein of the thigh) accompany the arteries of the same name; have many valves. Superficial veins of the lower limb:

1) great saphenous vein of the leg (v. saphena magna); flows into the femoral vein, has many valves. Collects blood from the soles of the feet, the anteromedial surface of the lower leg and thigh;

2) small saphenous vein of the leg (v. saphena parva); flows into the popliteal vein, has many valves. Collects blood from the lateral part of the foot, heel region, saphenous veins of the sole and dorsal venous arch;

3) plantar venous arch (arcus venosus planta-res);

4) dorsal venous arch (arcus venosus dorsalis pedis).

56. Branches of the internal carotid artery

The internal carotid artery (a. carotis interna) supplies blood to the brain and organs of vision. The following parts are distinguished in it: cervical (pars cervi-calis), stony (pars petrosa), cavernous (pars cavernosa) and brain (pars cerebralis). The cerebral part of the artery gives off the ophthalmic artery and divides into its terminal branches (anterior and middle cerebral arteries) at the inner edge of the anterior clinoid process.

Branches of the ophthalmic artery (a. ophthalmica):

1) central retinal artery (a. centralis retinae);

2) lacrimal artery (a. lacrimalis);

3) posterior ethmoid artery (a. ethmoidalis posterior);

4) anterior ethmoid artery (a. ethmoidalis anterior);

5) long and short posterior ciliary arteries (aa. ciliares posteriores longae et breves);

6) anterior ciliary arteries (aa. ciliares anterio-res);

7) muscular arteries (aa. musculares);

8) medial arteries of the eyelids (aa. palpebrales mediales); anastomose with the lateral arteries of the eyelids, form the arch of the upper eyelid and the arch of the lower eyelid;

9) supratrochlear artery (a. supratrochlearis);

10) dorsal artery of the nose (a. dorsalis nasi).

In the middle cerebral artery (a. cerebri media) there are wedge-shaped (pars sphenoidalis) and insular parts (pars insularis), the latter continues into the cortical part (pars corticalis).

The anterior cerebral artery (a cerebri anterior) is connected to the artery of the same name on the opposite side through the anterior communicating artery (a. communicans anterior).

The posterior communicating artery (a. communicans posterior) is one of the anastomoses between the branches of the internal and external carotid arteries.

Anterior villous artery (a choroidea anterior).

Author: Kabkov M.V.

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