Sobotta Atlas vol-1

M uscles -» T o p o g ra p h y -► S ections N. fibularis communis

N. ischiadicus M. biceps fem oris, C aput breve

N . fibularis co m m u n is

N. c u ta n eu s surae lateralis M. tibialis anterior
R. c o m m u n ican s fibularis N . fibularis superficialis

N. cutaneus surae m edialis (N. tibialis)
M. fibularis longus

M . fibularis brevis

N. suralis fibularis profundus
M. extensor digitorum longus
N. c u ta n eu s d orsalis interm edius
M. extensor digitorum N. c u ta n eu s d orsalis m edialis
N. cutaneus dorsalis lateralis M. e xtensor hallucis brevis
N . fibularis profundus

Fig. 4.166 N . fib u la ris c o m m u n is : s e n s o ry in n e rv a tio n b y The N . fib u la r is s u p e rfic ia lis continues in the fibularis com partm ent
cu ta n e o u s nerves (p urp le ), and m o to r in n e rv a tio n b y m u scula r and provides m otor fibres to the fibularis muscles. Subsequently, it
b ra n c h e s , r ig h t s id e ; lateral view. pierces the fascia of the distal leg and splits into the tw o term inal sen­
A fte r th e division of the N . is c h ia d ic u s at the transition to the distal sory branches (N n. c u ta n e i d o rs a le s m e d ia lis and in te rm e d iu s ) for
third of the thigh, the N . fib u la ris c o m m u n is courses through the pop­ the dorsum of the foot.
liteal fossa and around the head of the fibula to the fibularis com part­ The N . fib u la ris p ro fu n d u s enters the extensor com partm ent and de­
m ent. Here the nerve divides into its tw o term inal branches (Nn. fibula- scends together w ith the A. tibialis anterior to the dorsum of the foot.
res superficialis and profundus). A t th e thigh, th e N. fibularis com m unis On its way, it provides m otor innervation to the extensor m uscles of
provides m otor innervation to the Caput breve of the M. biceps fem oris the leg and the dorsum o f the foot. Its term inal branch and provides
only. Prior to its division into th e term inal branches, th e N. fibularis com ­ sensory innervation to the skin of the first interphalangeal space.
m u nis provides th e N . c u ta n e u s s u ra e la t e r a lis fo r th e skin o f th e la­
teral calf and another branch fo r the com m unication w ith the N. cuta­
neus surae medialis.

i- Clinical R e m a r k s -------------------------------------- ly requires splitting o f the fascia o f th e leg (fasciotom y). Paralysis of
the N. fibularis profundus also show s w ith footdrop and steppage
L e sio n s o f th e N . fib u la r is c o m m u n is are the m ost com m on gait, but the sensory innervation is only com prom ised in the firs t
nerve lesions of the low er extrem ity. Potential causes are frac­ interphalangeal area. In th e a n t e r io r ta r s a l t u n n e l s y n d r o m e , the
tures o f the proxim al fibula, tig h t skiing boots or casts, or cross- cutaneous branches underneath the Retinaculum m usculorum ex-
legged position. Loss o f function of the extensor m uscles results tensorum are com pressed w ith resulting numbness at the firs t inter­
in a drop o f the fo o t ( fo o td r o p ) . As a result, patients increase the phalangeal space. Isolated injuries o f the N . fib u la r is s u p e rfic ia lis
com pensatory knee flexion (s te p p a g e g a it). Palsy o f the fibularis (as in traum a o f th e fibularis m uscles) are less com m on and cause a
m u scles re sult in s u p in a tio n p o s it io n o f th e fo o t. Sensory innerva­ supination position of the fo o t due to the m alfunction of the fibula­
tion is com prom ised fo r the lateral calf and the dorsum o f the foot. ris m uscles. Here, sensory innervation at th e dorsum o f th e fo o t is
The N . f ib u la r is p r o f u n d u s m ay be a ffe c te d in c o m p a rtm e n t syn­ com prom ised w ith intact skin sensation at the firs t interphalangeal
drom e as a result o f a traum a if the nerve and concom itant blood space.
vessels are com pressed by bleeding or sw elling o f the extensor
m uscles (a n te rio r [t ib ia l] c o m p a r tm e n t s y n d ro m e ). This frequent-

337

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Arteries of the pelvis and thigh

F ig. 4.1 6 7 A rte rie s o f th e p e lv is a n d th e th ig h , r ig h t s id e ; ventral ad ducto r m uscles and th e ham string m uscles. The R. acetabularis ana­
vie w . stom oses w ith the identically named branch of the A. obturatoria. The
The A . p ro fu n d a fe m o r is is the main artery o f the hip jo in t and the A. circum flexa fem oris lateralis courses anterior to the fem oral neck. It
thigh. The other branches of the A. fem oralis do not contribute to the supplies th e fem oral neck and w ith several branches also the lateral hip
arterial supply of the thigh. The A. profunda fem oris branches o ff the m uscles and the ventral m uscles o f the thigh. The Aa. perforantes are
A. fem oralis 3 -6 cm inferior to the inguinal ligam ent and divides into the term inal branches w hich supply the adductor and ham string muscles.
A a . c ir c u m f le x a e f e m o r is m e d ia lis and la te r a lis . In th e adult, th e f e ­ All branches anastom ose w ith each other as w ell as w ith the A. obtura­
m o ra l h e a d is alm o st exclusively supplied by the A . c irc u m fle x a fe ­ toria and th e Aa. gluteae fro m th e A. iliaca interna w h ich is th e basis fo r
m o r is m e d ia lis (R. profundus) w h ic h loops around th e Collum fem oris potential collateral circulations.
fro m behind (-► Figs. 4.57 and 4.58). The R. profundus also supplies the

338

M uscles -» T o p o g ra p h y -► S ections

Arteries of the pelvis and thigh

A rte rie s o f th e L o w e r E x tre m ity B ranches o f th e A . tib ia lis a n te rio r:
• A. recurrens tibialis posterior
Branches o f th e A. iliaca externa • A. recurrens tibialis anterior
• A. epigastrica inferior • A. malleolaris anterior medialis
• A. malleolaris anterior lateralis
- A. cremasterica/A. ligam enti teretis uteri • A. dorsalis pedis
- R. pubicus (anastom oses w ith A. obturatoria)
• A. circum flexa ilium profunda - A. tarsalis lateralis
- Aa. tarsales mediales
Branches o f th e A. fem oralis: - A. arcuata (Aa. m etatarsales dorsales Aa. digitales dorsales;
• A. epigastrica superficialis
• A. circum flexa ilium superficialis A. plantaris profunda -> Arcus plantaris profundus)
• Aa. pudendae externae
• A. profunda fem oris B ranches o f th e A . tib ia lis p o s te rio r:
• A. fibularis
- A. circum flexa fem oris medialis
- A. circum flexa fem oris lateralis - R. perforans
- Aa. perforantes (m ostly three) - R. com m unicans
• A. descendens genus - Rr. m alleolares laterales
- Rr. calcanei
Branches o f th e A. poplitea: - A. nutricia fibulae and A. nutricia tibiae
• A. superior medialis genus • Rr. m alleolares m ediales
• A. superior lateralis genus • Rr. calcanei
• A. media genus • A. plantaris medialis
• Aa. surales - R. superficialis
• A. inferior medialis genus - R. profundus (-> A rcus plantaris profundus)
• A. inferior lateralis genus • A. plantaris lateralis (-> A rcus plantaris profundus w ith
Aa. metatarsales plantares -> Aa. digitales plantares)

i- Clinical R e m a r k s -------------------------------------- an em ergency they allow fo r th e ligation of the A. fem oris proximal
to th e A. profunda fe m o ris. In contrast, th e collaterals o f th e Rete ar-
A com plete physical exam ination includes palpation o f the a r te r i­ ticulare genus around the knee are not sufficient to com pensate for
a l p u ls e s o f th e A. fem ora lis (in th e groin), th e A. poplitea (in the th e ligation o f th e A. poplitea. The Rete articulare genus is fo rm e d
popliteal fossa), the A. dorsalis pedis (at the level of th e talocalca­ by the recurrent arteries of the leg and the third perforating artery
neonavicular joint lateral o f the M . extensor hallucis longus tendon), o f the A. profunda fem oris. The arterial netw ork around the malleoli
and the A. tibialis posterior (behind th e medial malleolus) to rule out is w e ll developed and usually w arrants sufficie nt arterial supply to
occlusion of the respective blood vessels due to a rte rio s c le ro s is or the fo o t if one o f the Aa. tibiales is occluded. (The part o f the A.
e m b o li. O w ing to th e excellent blood supply o f th e Tibia (through fem oralis betw een the branching o ff of the A. profunda fem oris and
Vasa nutricia) large fluid volum es may be infused via an in tr a - th e en try into th e Canalis adductorius is clinically often referred to as
o s s e o u s a c c e s s in em erge ncy situations. Several arterial anastom o­ A. fem oralis superficialis.)
ses contribute to c o lla te ra l c irc u la tio n s at different levels o f the low ­
er extrem ity. Although the anastomoses betw een branches of the A.
profunda fe m o ris and branches o f th e A. iliaca interna are variable, in

339

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Arteries of the lower extremity

Fig. 4.168 a nd Fig. 4.169 A rte rie s o f th e lo w e r e x tre m ity , rig h t divides into the A . tib ia lis p o s te rio r w hich continues its course, and
s id e ; ventral (-► Fig. 4.168) and dorsal (-► Fig. 4.169) view s. the A . tib ia lis a n te rio r w hich pierces the M embrana interossea cruris
The A. ilia c a e x te rn a branches o ff th e A. iliaca com m unis anterior to to reach the anterior extensor com partm ent. The latter continues as A .
th e sacro-iliac jo in t and continues beneath th e inguinal ligam ent in the d o rs a lis p e d is on the dorsum o f the foot. The A. tibialis posterior pro­
Lacuna vasorum as A . fe m o ra lis . Following the passage through the vides the strong A . fib u la ris to the lateral malleolus and then continues
adductor canal it is the n referred to as A . p o p lite a (arterial supply o f the through the malleolar canal around the medial malleolus to reach the
knee joint). The A. poplitea descends underneath the tendinous arch of sole o f the foot, w here it provides tw o term inal branches (Aa. p la n ta ­
the M . soleus betw een the superficial and deep flexors of the leg and re s m e d ia lis and la te ra lis ).

340

M uscles -» T o p o g ra p h y -► S ections Veins of the lower extrem ity

V. c irc u m fle x a iliu m s u p e rficia lis V. iliaca e xte rn a
E pifascial trib u taries V. e p ig a s tric a su p e rficia lis
o f th e fe m o ral vein Vv. pudendae externae

V. c irc u m fle x a fe m o ris lateralis V. c irc u m fle x a fe m o ris m e d ialis
V. p ro fu n d a fe m o ris V. s a p h e n a a c ce sso ria
V. fe m o ralis
V. s a p h e n a m a g n a

V. p o p lite a V. s a p h e n a m a g n a
Vv. tibiales anteriores
V. s a p h e n a p a rv a V. s a p h e n a m a g n a
Vv. tibiales posteriores

Vv. fibulares

V. s a p h e n a p a rv a

Rete venosum dorsale pedis

Fig. 4.170 Veins of th e lo w er ex tre m ity, righ t side; ventral view . fem oralis at the fem oral triangle.
The deep veins (dark blue) accom pany th e respective arteries. In the On the posterior side, the V. saphena parva originates fro m the lateral
leg, usually tw o veins course together w ith th e respective artery, margin of the fo o t posterior to the lateral malleolus and ascends on the
w hereas at the thigh and the popliteal fossa only one concom itant vein m iddle o f th e calf to th e popliteal fossa to en ter th e V. poplitea. The V.
is found. The superficial venous system (light blue) consists o f tw o saphena magna and parva com m unicate through variable branches.
m ain veins w hich collect the blood fro m the dorsum and the sole of
the foot. Tributaries of th e V. saphena m agna at th e fem oral triangle:
The V. saphena m agna originates anterior to the medial malleolus • V. epigastrica superficialis
and ascends on the medial side of th e leg and thigh to the Hiatus sa- • V. circum flexa ilium superficialis
phenus (-» Fig. 4.178). Here, th e V. saphena magna receives tributaries • V. saphena accessoria
fro m several veins o f th e inguinal region (see below ) and enters th e V. • Vv. pudendae externae

341

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Veins of the lower extrem ity

S uperficial vein C om m unicating vein
Venous valve Venous valve

Perforating vein
Deep vein

Fig. 4.171 Superficial and deep veins of th e lo w er extrem ity drained via th e deep veins o f the low er e xtrem ity to the heart. Am ong
w ith venous valves: organisation principle. the many perforating veins, three groups are o f clinical relevance:
The extrem ities have a superficial epifascial venous system and a • DODD's perforating veins: interm ediate third of the medial thigh
deep subfascial venous system coursing together w ith the respec­ • BOYD's perforating veins: medial aspect of th e proximal leg
tive arteries. Both system s are connected by perforating veins (Vv.
perforantes). Venous valves direct the blood flo w from the superficial (below the knee)
tow ards th e deep veins causing the m ajor part of the blood (85%) to be • COCKETT's perforating veins: m edial aspect o f th e distal leg

Fig. 4.172 Acute crural throm bosis w ith large throm bus
(arrows) in th e V. fem oralis. [6]

i- Clinical Remarks------------------------------------

Since th e venous blood o f th e lo w e r e x tre m ity is predom inantly connective tissue w eakness w ith insufficiency of th e venous valves.
drained via the deep veins tow ards the heart, deep venous th ro m ­ But they may also result from an occlusion of the deep veins due
bosis bears the risk fo r potentially lethal pulm onary em boli caused to throm bosis. This needs to be investigated carefully, since surgi­
by floating parts of the throm bus. Dilation of the superficial veins cal removal of the superficial varicose veins can only be perform ed
(varicosis) w ith form ation o f prom inent and dilated superficial veins w hen the deep veins are not obstructed.
(varices) is a com m on condition. These are usually th e result o f a

342

M uscles -» T o p o g ra p h y -► S ections

Lymph vessels of the lower extrem ity

N odi lym phoidei
inguinales superficiales

V. s a p h e n a m a g na

V en tro m e dia l
collecting system

Fig. 4.173 and Fig. 4.174 Superficial lym ph vessels of th e lo w er drains into th e lymph nodes of the popliteal fossa (Nodi lym phoidei
ex tre m ity, righ t side; ventral (-» Fig. 4.173) and dorsal (-» Fig. 4.174) poplitei superficiales and profundi) and continues into the deep ingu­
vie w s . inal lym ph nodes (N odi lym phoidei inguinales profundi). The deep
Alongside the veins there are a superficial and a deep system of collecting system s directly drain into the deep popliteal and inguinal
collecting lym ph vessels w ith incorporated lymph nodes. The superfi­ lymph nodes.
cial ve n tro m ed ial system alongside th e V. saphena magna is th e main W h ile m o s t o f th e venous drainage fro m th e lo w e r e x tre m ity occurs via
lym phatic drainage of th e low er extrem ity and drains into the superficial the deep veins, the major part o f the lym ph is drained by th e superficial
inguinal nodes (N odi lym ph oid ei inguinales superficiales) (-» p. 344). lymph vessels.
The sm aller dorsolateral system parallels th e V. saphena parva and

343

Lower Extremity Surface a n a to m y -► Skeleton -► Im aging

Lymph nodes and lymph vessels of the inguinal region

V. circu m fle xa V. e p ig a s tric a s u p e rficia lis
s u p e rfic ia lis
N odi lym p h o id e i inguinales
V. sa ph en a s u p e rfic ia le s

Funiculus sperm aticus
Vv. pudendae externae

V. s a p h e n a a cce sso ria
(m ed ia lis)

4.175

N odi lym pho idei iliaci e xtern i N odi lym phoidei iliaci interni
A .; V. ilia c a in te rn a
A .; V. iliaca e x te rn a R e ctum
O v a riu m
N odi lym pho idei inguinales Tuba uterina
s u p e rfic ia le s , N odi superolaterales U te ru s

Lig. inguinale Vesica urinaria
N odi lym pho idei inguinales
s u p e rfic ia le s , N odi superom ediales N odi lym pho idei inguinales
p ro fu n d i
Hiatus saphenus
Nodi lym pho idei inguinales
4.176 s u p e rfic ia le s , N odi inferiores

Fig. 4.175 and Fig. 4.176 Superficial lym ph nodes of th e inguinal The inguinal lymph nodes not only serve as regional lymph nodes fo r
region, Regio inguinalis (-» Fig. 4.175), and th e ir tribu taries the major part of the low er extrem ity but also collect lymph from the
(-» Fig. 4.176), righ t side; ventral view . low er quadrants of the abdom inal w all and the back, the perineal
The inguinal region harbours four to 25 epifascial superficial inguinal region and the external genitalia (-* Figs. 2.111 to 2.114). In addition,
lymph nodes (Nodi lym phoidei inguinales superficiales) which lymph from the low er parts of the Rectum and the Vagina and occa­
fu rth e r drain into one to three inguinal lym ph nodes m edial o f th e V. sionally fro m th e U terus and adjacent uterine tu b e s (along th e Lig. teres
fem oralis (Nodi lym phoidei inguinales profundi), and further into the uteri) drains into the inguinal lymph nodes.
Nodi lym phoidei iliaci externi in th e pelvis. The superficial inguinal
lym ph nodes fo rm a vertical strand along th e V. saphena magna and a
horizontal strand beneath the inguinal ligament.

i- Clinical Remarks------------------------------------

Palpation o f the lym ph nodes is part o f a com plete physical exami­ including the Rectum and fem ale reproductive organs, may thus
nation. The inguinal lymph nodes are regional stations fo r the major fo rm m etastases in th e inguinal region. In m en, ho w e ver, only the
part of the lym ph from the low er extrem ity. O nly the drainage of lym ph fro m the external genitalia (penis, scrotum ) drains into the
the lateral margin of the fo o t and the calf occurs into th e poplite­ inguinal nodes, but lym ph fro m the testes travels via the sperm atic
al nodes as th e ir regional stations w h ic h m o s tly cannot be palpa­ cord into the lumbar lymph nodes.
ted. M alignant cells fro m all regions and organs m e ntione d above,

344

M uscles -» T o p o g ra p h y -► S ections

Vessels and nerves of the inguinal region

N . c u ta n eu s fe m o ris lateralis N. genitofem oralis,
Spina iliaca anterior superior R. fem oralis
Lig. inguinale
M . iliopsoas A .; V. fe m o r a lis
N . fem oralis S eptum fem orale
A rcus iliop ectineus
Lig. pectineum N o d u s lym pho ideus inguinalis profundus
Lig. lacunare
M. pectineus Funiculus sperm aticus

A .; V. o b tu ra to ria Tuberculum pubicum
S ym physis pubica
M em brana obturatoria

o b tu ra to riu s

N. obturatorius

Fig. 4.177 Lacunae m usculorum and vasorum , righ t side; m oris lateralis is located lateral to th e M . iliopsoas near th e Spina iliaca
oblique section at the level of the inguinal ligam ent; ventral view. anterior, th e N. fem ora lis is positioned m edial to th e M . iliopsoas.
The space b e tw een Os coxae and th e Lig. in guin ale (Fossa iliopecti- Passing through th e Lacuna vasorum fro m lateral to m edial are th e R.
nea) is divided by the Arcus iliopectineus, w hich spans betw een the fem oralis of the N. genitofem oralis, the A. fem oralis, and the V. fe ­
inguinal ligam ent and the pelvic bone, into the lateral Lacuna m usculo­ moralis. Located m ost m edially are the deep inguinal lym ph nodes
rum and th e m edial Lacuna vasorum . The Lacuna m u sculorum is al­ (Nodi lym phoidei inguinales profundi).
m ost com pletely occupied by th e M . iliopsoas. The N. cutaneous fe-

M. iliacus M. psoas major
N. fem oralis (M. psoas minor, Tendo)
Lig. inguinale Arcus iliopectineus

Fascia lata A.; V. fe m o ralis
H iatus saphenus N o dus lym p h o id eu s inguinalis p rofun dus

V. c irc u m fle x a ilium s u p e rficia lis
V. e p ig a s tric a su p e rficia lis

V. s a p h e n a m a g n a Vv. pudendae externae

Fig. 4.178 Hiatus saphenus and Lacuna vasorum , right side; The Hiatus saphenus is an opening o f th e Fascia lata through w h ich the
ventral view ; after removal of the anterior abdominal wall, of the V. saphena magna passes prior to entering th e V. fem oralis. Located
Fascia iliaca and th e abdom inal viscera. m ost m edially are the deep inguinal lym ph nodes (Nodi lymphoidei
inguinales profundi) th e bigg est o f w h ich is referred to as
ROSENMUELLER's node.

i- Clinical Remarks------------------------------------ gained by piercing the skin about 1 cm medial o f the artery to insert a
righ t ventricular cardiac cath eter through th e V. fem oralis. The artery
The topography of th e Fossa iliopectinea is o f relevance fo r is accessed fo r left ventricular catheterisation or fo r arterial blood
diagnostic and therapeutic interventions. From medial ("in n e r") to gas analysis. The N. fem ora lis lies lateral to th e artery and may be
lateral, th e large vessels are oriented in the follow ing sequence: V. damaged during these interventions.
fem oralis, A. fem oralis and N. fem oralis (iVAN). Since the pulse
o f th e A. fem ora lis is easily palpated, access to th e V. fem ora lis is

dissection link 345

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Superficial vessels and nerves of inguinal region and thigh

A. fem oralis R. c u ta n eu s a n te rio r (N. iliohypogastricus)

A .; V. e p ig a s tric a su p e rficia lis N. ilioinguinalis
V. fem o ra lis
N. cu tan eu s fe m o ris lateralis
R. fe m o ralis (N. genitofem oralis) Aa.; Vv. pudendae externae

A .; V. circu m fle xa iliu m s u p e rficia lis V. sa ph en a a c c e s s o ria (lateralis)

V. s a p h e n a m a g n a
Rr. cutanei ante rio re s (N. fem oralis)

Rr. c u ta n e i (N . o b tu ra to riu s )

A. descendens genus
R. infrap atellaris (N. saphenus)

Rete patellare

Fig. 4.179 Epifascial vessels and nerves of th e inguinal region, th e A. fem oralis. The R. fem o ralis o f th e N. g enitofem o ralis passes
Regio inguinalis, th e thigh, Regio fem oris anterior, and th e knee, through the Lacuna vasorum ju s t lateral to th e A. fem oralis. The N.
Regio genus anterior, right side; ventral view. cutaneus fem oris lateralis traverses the Lacuna m usculorum medially
During the dissection of this region particularly the course of the cuta­ to the Spina iliaca anterior superior and innervates the lateral aspect of
neous nerves and the epifascial veins need to be considered. The N. th e thigh. The Rr. cutanei anteriores o f th e N. fe m o ralis pierce the
ilioinguinalis pierces the fascia above the inguinal ligam ent. Just cra­ fascia at several locations to innervate th e ventral aspect of the thigh.
nial to it, th e R. cutaneus an terio r of th e N. iliohypogastricus is M edial to th e V. saphena magna, several sm all cutaneous branches of
found. The V. saphena m agna ascends at th e medial aspect o f the th e N. obturatorius supply a variable area on the medial aspect o f the
thigh and en ters into th e V. fem ora lis through th e Hiatus saphenus. thigh. M edial and infe rior to the knee, th e R. infrapatellaris o f th e N.
Here the vein collects several tributaries fro m the inguinal region saphenus passes through the fascia. Just above the patella the thin A.
(-* p. 341). M o st o f these veins are accompanied by small branches of descendens genus courses to the Rete patellare of the knee.

346—► dissection link

M uscles -» T o p o g ra p h y -► S ections

Superficial vessels and nerves of the gluteal region and thigh

N n . clun ium s u p erio res (L1-L3)
R. cu ta n e u s la teralis (N. ilio h yp o g a stricu s)

N n . clun ium m ed ii (S1-S3)

S ulcus glutealis N. cutaneus fem oris lateralis
N n. clun ium inferio res Fascia lata
(N. cutaneus fem oris posterior) N . cu tan eu s fe m o ris p o sterio r

R. cutaneus (N. obturatorius) V. s a p h e n a p a rv a

V. s a p h e n a m a g na

Fig. 4.180 Epifascial vessels and nerves of th e gluteal region, o f the back above th e iliac crest. The N n. clunium m edii (Rr. posterio­
Regio glutealis, th e thigh, Regio fem oris posterior, and the res fro m S1-S3) traverse the M . gluteus m axim us at its origin fro m the
popliteal fossa. Fossa poplitea, right side; dorsal view. posterior side of the sacrum. The Nn. clunium inferiores are branches
There are no im portant epifascial veins on the posterior side of the o f th e N. cutaneus fe m o ris posterior and w in d around th e infe rior mar­
thigh. The V. saphena parva o f th e leg en ters th e subfascial V. poplitea gin of the M. gluteus m axim us. The N. cutaneus fem oris posterior
in th e popliteal fossa. The skin o f th e gluteal region is innervated by descends in the m iddle o f the thigh and pierces the fascia at m idlength
th re e groups o f cutaneous nerves. The N n. clunium superiores (Rr. of the thigh to provide sensory innervation to the posterior aspect of
posteriores from L1-L3) appear laterally to the autochthonous muscles the thigh.

dissection link 347

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Superficial vessels and nerves of the leg

V. sap h e n a m agna

P a te lla R. infrapatellaris N. saphenus
(N. saphenus)
V. p e rfo ra n s
Rr. c u ta n ei cruris m e d ia les N .sap h en u s

(N. saphenus) V. s a p h e n a m a g n a N. cutaneus surae
lateralis (N. fibularis
Fascia cruris V. s a p h e n a com m unis)
parva
V. p erfo ra ns

N . cutaneus surae
m e d ia lis (N . tibialis)
R. com m unicans
fib u la ris

N. suralis

Fascia cruris

N. fibularis s u p e r f ic ia l V. m arg in alis lateralis
Arcus venosus
N. c u ta n eu s dorsalis m edialis dorsalis pedis

N. c utaneus dorsalis Rete venosum
interm edius dorsale pedis
N. c utaneus dorsalis
V. m a rg in alis m e d ia lis lateralis (N. suralis)

4.181

Fig. 4.181 and Fig. 4.182 Epifascial veins and nerves o f th e leg, fibularis superficialis perforates the fascia to split into the tw o term i­
Regio cruris, and th e fo ot, Regio pedis, right side; medial nal cutaneous branches (Nn. cutanei dorsalis m edialis and in te rm e ­
(-» Fig. 4.181) and dorsolateral (-» Fig. 4.182) view s. dius) w hich continue on the dorsum of the foot. On the posterior side
The V. saphena m agna originates at the medial margin o f the fo o t an­ o f the leg, the V. saphena parva em erges fro m the epifascial veins of
terior to the medial malleolus and ascends on the medial side of the leg the lateral margin of th e fo o t and ascends posteriorly to the lateral mal­
and thigh. A t the medial aspect of the knee, the N. saphenus pierces leolus on the dorsal side of the calf, pierces the popliteal fascia, and
th e fascia. Its m ajor branch descends adjacent to th e V. saphena magna enters th e V. poplitea. A djacent th e re o f courses th e N. cutaneus surae
and splits into th e sensory term inal branches, Rr. cutanei cruris m edi- m edialis, a branch of the N. tibialis, w hich continues distally at the
ales, fo r the innervation of the ventral and medial leg and the medial distal third o f the leg as N. suralis. It frequently com m unicates w ith the
margin o f th e fo o t. The R. infrapatellaris o f th e N. saphenus pierces N. fibularis dire ctly o r via a com m unica ting N. cutaneus surae latera­
th e fascia ventral to th e V. saphena magna and supplies th e skin be­ lis. The term inal branch o f th e N. suralis supplies as N. cutaneus dor­
neath th e patella. In th e distal third o f th e lateral side o f th e leg, th e N. salis lateralis the lateral margin o f the foot.

348— ► dissection link

M uscles -» T o p o g ra p h y -► S ections

Superficial vessels and nerves of the dorsum of the foot

N .s a p h e n u s
N. cutaneus cru ris m edialis (N. saphenus)

N. fib u la ris superficialis

Retinaculum m usculorum M alleolus m edialis
extensorum inferius V. s a p h e n a m a g n a
M alleolus lateralis N .s a p h e n u s

N. cu tan eu s dorsalis m edialis V. m a rg in alis m e d ialis
N. cu tan eu s d orsalis interm edius V. p erfo ra ns

V. s a p h e n a p a rv a N. fib u la ris p ro fu n d u s, Nn. digitales
dorsales pedis
N. c utaneus dorsalis
la te ra lis

V. m a rg in alis lateralis

A rcus venosus dorsalis pedis

Vv. digitales dorsales pedis
Nn. digitales dorsales pedis

Fig. 4.183 Epifascial veins and nerves of th e dorsum o f th e fo o t. distal leg the N. fibularis superficialis perforates the fascia and splits
Dorsum pedis, right side; dorsal view onto the dorsum of the foot. into the Nn. cutanei dorsales m edialis and interm edius for the sen­
The V. saphena m agna originates at the medial margin of th e foo t sory innervation o f the dorsum o f the fo o t and the toes. The lateral
fro m the epifascial veins o f th e dorsum o f the fo o t and, thus, is a con­ margin o f th e fo o t is innervated by the N. cutaneus dorsalis lateralis
tinuation o f the Arcus venosus dorsalis. The sm aller V. saphena parva o f th e N. suralis. O nly th e firs t interphalangeal space receives sensory
originates from the lateral margin of the foot. A t the lateral aspect of the innervation from the term inal branches of the N. fibularis profundus.

dissection link 349

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Vessels and nerves of the thigh A. iliaca externa
V. iliaca e xte rn a
N. c u ta n eu s fe m o ris lateralis A. iliaca interna
A. circum flexa ilium profunda M . pectineus
M. iliacus V. sap h e n a m a g n a
N . fem oralis R. m uscularis (N. fem oralis)
A . profunda fem oris V. fe m o r a lis
A. fem oralis
M. ten so r fasciae latae M. a d d u cto r longus
M. gracilis
M. rectus fem oris
M . sartorius
M . vastus lateralis
M. vastus m edialis
R. articularis (A. descendens genus)

Fig. 4.184 Vessels and nerves of th e thigh, Regio fem oris leases sm aller branches to the inguinal region 3 -6 cm below the ingui­
anterior, right side; ventral view. nal ligam ent and as a larger branch th e A. profunda fem oris. In the
A fter removal of the fascia, the individual m uscles and the subfascial Fossa iliopectinea, the N. fem oralis creates a fan-shaped branching
vessels and nerves are displayed in th e fem oral triangle (Trigonum and divides into th e N. saphenus, several Rr. m usculares fo r m o to r in­
fem orale). The boundaries of the traingle are form ed by th e inguinal nervation o f the ventral m uscles of the thigh and the M . pectineus as
ligam ent (Lig. inguinale; proximal), th e M . gracilis (medial), and th e M. w e ll as th e Rr. cutanei anteriores providing sensory innervation to the
sartorius (lateral). skin of the ventral thigh. The large cutaneous N. saphenus continues
Beneath the inguinal ligam ent, the follow ing structures enter the trian­ the course of the N. fem oralis beneath the M . sartorius. Medial to the
gle fro m m edial to lateral: V. fem oralis, A. fem oralis, and N. fem oralis. Spina iliaca anterior superior, th e N. cutaneus fem o ris lateralis enters
The V. saphena m agna enters th e V. fem oralis. The A. fe m o ralis re­ the Lacuna m usculorum beneath the inguinal ligament.

350— ► dissection link

M uscles -» T o p o g ra p h y -► S ections Vessels and nerves of the thigh

N. cutaneus fem oris lateralis N . obturatorius
N. fem oralis A. fem oralis
M. iliacus M. pectineus
R. a c e ta b u la ris (A. o b tu ra to ria )
A. circum flexa fem oris lateralis
A. profunda fem oris A. obturatoria
M. sartorius — N. obturatorius
R. descendens A. circum flexa fem oris m edialis

(A. circum flexa fe m oris lateralis) R. su p e rficia lis
(A. circum flexa fem oris medialis)
M. rectus fem oris
R. m u scu laris (N. fem oralis) M . a dd ucto r longus

M . vastus medialis V. fe m o ralis
R. articularis (A. descendens genus) A. fem oralis
R. c u tan eu s (N. obtu ratorius)
N .sap h en u s
M. adductor magnus
S eptum interm usculare vastoadductorium
M. gracilis

N .s a p h e n u s
M. sartorius

Fig. 4.185 Vessels and nerves o f th e th ig h , Regio fem oris tor longus and the Septum intermusculare vastoadductorium which
anterior, right side; ventral view ; after partial removal o f the M. spans betw een these m uscles and the M. adductor magnus. O w ing to
sartorius and splitting of the M. pectineus. the splitting o f the M . pectineus, the ou tlet of the Canalis obturatori­
The A. and V. fem oralis and the N. saphenus are exposed up to their us is visible. Here, th e N . obtu ratorius and th e A. and V. ob tu ratoria
entrance into the adductor canal (Canalis adductorius). The entrance exit the pelvis.
o f the adductor canal is form ed by the M m . vastus m edialis and adduc­

r- Clinical Remarks------------------------------------ transduction at th e m o to r end plates, although, in som e cases it is
much m ore effective to irreversibly paralyse the N. obturatorius
In so m e cases of spasticity, th e m uscle tonus o f th o se m uscles by phenol injections. This is perform ed by introducing the needle
innervated by th e N. ob tura torius is so high th a t abduction o f the a fe w c e n tim e te rs lateral to th e pubic sym physis to reach th e N.
legs and, thus, walking and standing are not possible. Injections obturatorius exiting fro m the Canalis obturatorius.
of botulinum toxin into the adductor m uscles reduce the spasticity
and may relieve the sym ptom s. Botulinum toxin blocks th e signal

dissecti on l ink 351

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Vessels and nerves of the thigh N. obturatorius
V. s a p h e n a m a g na
V. ilia c a e x te rn a A. c irc u m fle xa fe m o ris m edialis
A. iliaca externa N. obturatorius
N . fem oralis A. obturatoria
M . iliacus
V. fe m o r a lis
A. profunda fem oris V. pro fu n d a fe m o ris

A. circum flexa R. a scen de n s M. a d d u cto r brevis
fe m o ris lateralis R. d e sce n d e n s M . a d d u cto r long us
A. perforans
Rr. m u scu lares (N. fem oralis)
M. rectus fem oris R. cu tan eu s (N. obtu ratorius)
A. perforans M. a d d u cto r longus
M. va stu s lateralis V. fe m o r a lis
M . gracilis
M. rectus fem oris M. adductor magnus
M. vastus medialis A. fem oralis
Hiatus adductorius
N .sap h en u s
A. descendens genus, R. saphenus

M . sartorius

A. descendens

A. superior m edialis genus
A. poplitea

A. inferior m edialis genus

Fig. 4.186 Vessels and nerves of th e thigh, Regio fem oris ply the fem oral neck and head as w ell as the adductor m uscles and the
anterior, right side; ventral view ; after partial removal of the M. proximal parts of the ham string muscles. There are anastom oses w ith
sartorius and M . rectus fem oris, and splitting of the M . pectineus and the A. obturatoria w hich contribute to th e supply of th e acetabular
M. adductor longus.The adductor canal is opened. fossa and th e adductors. The ascending branch (R. ascendens) o f the
The A. profunda fem oris w ith its branches is displayed. This artery A. circum flexa fem oris lateralis supplies the lateral m uscles o f th e hip,
branches o ff th e A. fem oralis 3 -6 cm below the inguinal ligam ent and th e descending branch (R. descendens). descendens supplies th e ante­
serves as main artery fo r th e thigh and th e fem oral head (-♦ pp. 271 and rior ventral m uscles o f th e thigh. The main trunk of the A. profunda fe­
338). The Aa. circumflexae fem oris m edialis and lateralis branch o ff m oris descends further and provides three Aa. perforantes to supply
the A. profunda fem oris or occasionally derive directly from the A. fe­ the deep adductor m uscles and the ham string m uscles at the dorsal
moralis. The A. circum flexa fem oris medialis has a deep branch to sup­ aspect of the thigh.

352—► dissection link

M uscles -» T o p o g ra p h y -► S ections

Vessels and nerves of the gluteal region and thigh

M. gluteus m edius, Fascia

Nn. clunium m edii (S1-S3)

M . gluteus m axim us

Nn. clunium inferiores
(N. cutaneus fem oris posterior)

Tractus iliotibialis

M. gracilis N. c u ta n eu s fe m o ris p o sterio r

M. sem itendinosus M. va stu s lateralis
M. sem im em branosus
M. biceps fem oris
V. p o p lite a N. tibialis
M. sem im em branosus N. fibularis co m m u n is

A. poplitea N. cutaneus surae lateralis
(N. fibularis com m unis)
M. gastrocnem ius
N. cutaneus surae medialis V. sap h e n a parva
M. biceps fem oris, Tendo

Fig. 4.187 Vessels and nerves of th e gluteal region, Regio th e popliteal fossa (Fossa poplitea). A s a continuation o f th e A. and V.
glutealis, the thigh, Regio fem oris posterior, and the popliteal fem oralis, th e A. and V. poplitea e n te r th e popliteal fossa a fte r exiting
fossa. Fossa poplitea, right side; dorsal view ; after removal o f the the adductor canal. Here, they are joined by the term inal branches of
Fascia lata. th e N. ischiadicus (N. tibialis and N. fibularis com m unis). In th e popliteal
The N. cutaneus fem oris posterior provides sensory innervation to fossa, the N. fibularis com m unis courses m o st laterally and superfi­
the posterior aspect of the thigh. It enters the groove between the M. cially. Located m edially and deep w ithin the popliteal fossa are the N.
biceps fem oris and the M. sem itendinosus at the inferior margin o f the tibialis, V. poplitea, and A. poplitea (NVA; fro m superficial to deep).
M . gluteus m axim us and penetrates the fascia at the m idlength o f the The V. saphena parva ascends in th e m iddle o f th e calf and drains into
thigh. This needs to be considered fo r the dissection. A t th e distal th e V. poplitea in th e popliteal fossa.
thigh, both m uscles deviate from each other and define the borders of

dissection link 353

Lower Extremity Surface a n a to m y -► Skeleton -► Im aging ->

Vessels and nerves of the gluteal region and thigh

Nn. clunium superiores (L1-L3)

Nn. clunium m edii (S1-S3)

Fascia glutea M. gluteus m axim us

Nn. clunium inferiores N. ischiad icus
(N. cutaneus fem oris posterior) A. perforans
M . b icep s fem oris, C aput longum
N. cutaneus fem oris posterior
Aa. perforantes
N. tibialis N. fibularis com m unis
M . sem itendinosus
Hiatus adductorius N . cu tan eu s s u rae lateralis
N. c u ta n eu s s u rae m edialis
M. gracilis
M. sem im em branosus N . suralis
— M. gastrocnem ius, C a pu t laterale
A . poplitea
M . sartorius
V. p o p lite a
A. superior m edialis genus
Rr. m u scu la re s (N. tib ialis)
M. gastrocnem ius, C aput m ediale

Fig. 4.188 Vessels and nerves of th e gluteal region, Regio w ind around th e fibular head and enter th e fibularis com partm ent of the
glutealis, th e thigh, Regio fem oris posterior, and th e popliteal leg be lo w the popliteal fossa. In th e region o f th e popliteal fossa, th e N.
fossa. Fossa poplitea, right side; dorsal view ; after removal of the cutaneus surae m edialis branches o ff th e N. tibialis, and the N. cu­
Fascia lata and lateral de flection o f the Caput longum o f th e M . biceps taneus surae lateralis branches o ff the N. fibularis com m unis fo r the
fem oris. sensory innervation o f th e calf. The N. cutaneus surae m edialis com ­
The N. ischiadicus descends under the guidance of th e M. biceps fe­ bines w ith a branch o f th e N. cutaneus surae lateralis to fo rm th e N.
m oris. A t th e level o f th e distal third o r higher (as s ho w n here), th e N. suralis. A t the thigh, the Aa. perforantes of the A. profunda fem oris
ischiadicus divides into its term inal branches. The N. tibialis continues pe netrate th e M . adductor m agnus lateral to th e N. ischiadicus to sup­
its original course and the N. fibularis com m unis turns laterally to ply the ham string muscles.

354—► dissection link

M uscles -» T o p o g ra p h y -► S ections Vessels and nerves of the gluteal region and thigh

A. glutea superior, R. s u p e r fic ia l Foram en suprapiriform e
M . gluteus m axim us M . gluteus m edius
M. piriform is
Foram en infrapiriform e M . gem ellus superior
N. gluteus inferio r M. obtu ra to riu s internus
M . gem ellus inferior
A. g lu te a inferio r
A .; V. p u d e n d a in te r n a R .ascen d en s
N. c u ta n eu s fe m o ris p o sterio r (A. c irc u m fle x a fe m o ris m ed ialis)
R. superficialis
N. ischiadicus (A. c irc u m fle x a fe m o ris m ed ialis)
Rr. m u scu lares (N. tib ialis) M. quadratus fem oris
M. b icep s fem oris, C a pu t longum R. profundus
(A. c irc u m fle x a fe m o ris m ed ialis)
M . sem itendinosus
M. sem im em branosus A. perforans

V. p o p lite a • M. adductor magnus
A. poplitea
Aa. perforantes
N. tibialis
M. b icep s fem oris, C aput longum

M . biceps fem oris, C aput breve

N. fibularis com m unis

N. cutaneus surae medialis N. cutaneus surae lateralis
V. s a p h e n a parva

Fig. 4.189 Vessels and nerves o f th e gluteal region, Regio pudenda interna also e xit here, but im m e diate ly w in d round th e Lig.
glutealis, th e thigh, Regio fem oris posterior, and th e popliteal sacrospinale to enter the Fossa ischioanalis beneath the Lig. sacrotube-
fossa, Fossa poplitea, right side; dorsal view ; after dissection of the rale through th e Foram en ischiadicum m inus. The N. gluteus inferior
M. gluteus m axim us and Caput longum o f the M. biceps fem oris. supplies m otor fibres to the M. gluteus maxim us. The N. gluteus
The N. ischiadicus exits the Foramen infrapiriform e together w ith the superior together w ith the A. and V. glutea superior exits the pelvis
N. cutaneus fem oris posterior and the N. gluteus inferior as w ell as through the Foramen suprapiriform e but remains at the deep level be­
w ith the A. and V. glutea inferior. The N. pudendus and the A. and V. neath the M. gluteus m edius w hich it innervates.

Clinical Remarks------------------------------------

The topography of the gluteal region explains w h y intram uscular bleedings and injuries to the nerves w hich innervate the muscles
injections m ust be applied into the M . gluteus m edius, not into facilitatin g m o ve m e n ts in th e hip (Nn. glutei superior and inferior)
the M . gluteus maxim us. W rongly placed injections may cause and th e leg (N. ischiadicus).

dissection link 355

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Vessels and nerves of the gluteal region

Rr. p ro fu n d i (A.; V. g lu te a s u p erio r) R. cutaneus lateralis (N. iliohypogastricus)
M. obliquus externus abdom inis
N. gluteus superior • C rista iliaca
- M. gluteus m edius
N. gluteus inferio r
A .; V. g lu te a in fe r io r M. gluteus m inim us
M. gluteus m edius
M. gluteus m axim us
N. c u ta n eu s fe m o ris p o sterio r M. gluteus m axim us
M . piriform is
N. ischiad icus M . gem ellus superior
A .; V. p u d e n d a in te r n a M. obtu ra to riu s internus
M. gem ellus inferior
Lig. sacrotuberale M . obturatorius externus
M . quadratus fem oris
Rr. p ro fu n d i (A. c irc u m fle x a fe m o ris m ed ialis) Trochanter m inor
M. adductor magnus

Fig. 4.190 Vessels and nerves of th e gluteal region, Regio superior through the Foramen suprapiriform e and then courses late­
glutealis, and th e thigh, Regio fem oris posterior, right side; dorsal rally betw een the M. gluteus m edius and the deeper M . gluteus m ini­
view ; the M m . glutei maxim us and medius w ere cut and partially m us to th e M . te n so r fasciae latae. It supplies m o to r fib re s to all these
reflected, th e N. ischiadicus w a s rem oved a fte r its e xit fro m the m uscles. Several branches of the A. circumflexa fem oris medialis
Foramen infrapiriforme. appear betw een the pelvitrochanteric hip m uscles and anastom ose
A fte r cutting and reflecting the M . gluteus medius, the N. gluteus w ith the gluteal arteries.
superior is exposed w h ic h exits to g e th e r w ith th e A. and V. glutea

Clinical Remarks m oral head, dissection o f th e pelvitrochanteric m uscles (in particular
of the M. quadratus fem oris and M . obturatorius externus) should
The topography o f the gluteal region has particular relevance fo r hip be avoided.
joint surgery w ith dorsal access. To prevent injury to the A. circum ­
flexa fem oris m edialis as the major blood vessel supplying the fe­

356— ► dissection link

M uscles -» T o p o g ra p h y -► S ections

Vessels and nerves of the popliteal fossa

V. s a p h e n a m a g n a N odus lym pho ideus popliteus
V. sa ph en a parva s u p e rfic ia lis
A. poplitea
N. tibialis
Nodi lym pho idei p oplitei profundi - V. p o p lite a
V entrom edial co llectin g system
M. gastrocnem ius Fascia cruris

4.191 V. s a p h e n a p a rv a
D o rso lateral co llectin g system

M. gracilis M . biceps fem oris
M. sem itendinosus
M. sem im em branosus N. tibialis
N. fibularis co m m u n is
V. p o p lite a A. superior lateralis genus
A. poplitea
A. superior m edialis genus N. cutaneus surae lateralis
V. sap h e n a parva Aa. su rales
N. cutaneus surae medialis
Rr. m u scu la re s (N. tib ialis)
M . gastrocnem ius, C a pu t laterale
J

M. gastrocnem ius, C aput m ediale

4.192

Fig. 4.191 and Fig. 4.192 Vessels and nerves of th e popliteal th e m idline o f th e leg and drains into th e V. poplitea in th e popliteal
fossa. Fossa poplitea, right side; dorsal view ; after partial fossa. The do rsolateral lym ph vessel system courses along th e V.
(-* Fig. 4.191) and c o m p le te (-► Fig. 4.192) rem oval o f th e fascia. saphena parva, w hereas the ventrom edial lym ph vessel system ac­
In th e popliteal fossa th e N. fibularis co m m un is is located m o st late­ com panies the V. saphena m agna. The firs t regional lymph nodes for
rally and superficially, fo llo w e d m edially and deeply by th e N. tibialis, the dorsolateral collecting system are the Nodi lym phoidei poplitei
V. p o plitea, and A. po plitea (N V A ). The V. saphena parva ascends in superficiales and profundi (-» p. 343).

dissection link 357

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Arteries of the popliteal fossa

M. sem itendinosus A. perforans
M. gracilis
M . b icep s fem oris
A. descendens genus
A . su p erio r m ed ialis genus Femur, Facies poplitea

M . sem im em branosus A. su p erio r lateralis genus
A. m edia genus M . biceps fem oris
A. poplitea
gastrocnem ius, C aput m ediale M . plantaris
A a. surales M. gastrocnem ius, C aput laterale
A. inferio r lateralis genus
A . inferio r m ed ialis genus
M. popliteus
M . soleus M . soleus
A . tibialis a n te rio r A. recurrens
(Truncus tibialis posterior
M em brana interossea cruris
A. tibialis p o sterio r M. soleus
A. fibularis

Fig. 4.193 Arteries of th e popliteal fossa, Fossa poplitea, right branches o ff to supply the knee joint. The Aa. surales supply the m us­
side; dorsal view ; after partial resection of the covering muscles. cles of the calf. B elow the popliteal fossa, the A. poplitea descends
The A. poplitea supplies the knee jo in t and form s arterial netw orks betw een the tw o heads of the M . gastrocnem ius and divides into the
w ith its branches above (Aa. superiores m edialis and lateralis genus) tw o term inal branches ju st beneath the tendinous arch of its M . soleus.
and be lo w (Aa. inferiores m edialis and lateralis genus) th e articular cav­ The A. tibialis posterior continues its course, and the A. tibialis an te­
ity. These arterial ne tw o rks c o n tribute to th e Rete articulare genus on rior traverses the Membrana interossea cruris to enter the ventral ex­
the ventral side of the knee. A t the level of the joint, the A. media genus tensor compartment.

i- Clinical Remarks-----------------------------------------------------------------------------------------------------

The portion of the A. poplitea betw een the branching o ff o f the A. tibialis posterior is clinically referred to as Truncus tibiofibularis.
A. tibialis anterior and the origin of the A. fibularis derived from the

358— ► dissection link

M uscles -» T o p o g ra p h y -► S ections

Vessels and nerves of the leg

M. fibularis [peroneus] longus M. tibialis anterior
N odus lym phoideus tib ialis anterior Tibia, Facies m edialis
D o rs o latera l co llectin g system
M. tibialis anterior, Tendo
Vv. tib ia le s ante rio re s V entrom edial co llectin g system

A. tibialis a n te rio r Retinaculum m usculorum extensorum
M. extensor hallucis longus
M. e xtensor d igitorum longus

Fig. 4.194 Vessels and nerves of th e leg, Regio cruris anterior, m agna and as dorsolateral collecting system alongside the V. sa­
right side; ventral view ; after spreading apart the extensor muscles. phena parva. The deep lym ph vessels accom pany th e arteries in the
The superficial lymph vessels course as ventrom edial collecting sys­ three muscular com partm ents as shown here fo r the extensor com ­
te m fro m the medial margin o f the fo o t alongside the V. saphena pa rtm e nt.

dissection link 359

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Vessels and nerves of the leg A. superior medialis Fig. 4.195 Vessels and nerves of th e leg,
genus Regio cruris anterior, righ t side; ventral
A. superior lateralis genus view ; after removal o f th e Fascia cruris and
Rete articulare dissecting the M m . extensor digitorum
A. inferior lateralis genus genus longus and fibularis longus.
N. fibularis com m unis Lig. patellae The A. tib ialis an terior descends in th e ex­
M. fibularis [peroneus] longus tensor com partm ent between the M. exten­
M . extensor digitorum longus A. tib ialis anterior sor digitorum longus and M . tibialis anterior
A . recu rren s tibialis a n te rio r and continues as A. dorsalis pedis on the
M. tib ialis anterior dorsum of the foot. A fter the A. recurrens ti­
N. fibularis profundus bialis posterior branches o ff at the posterior
N. fib u la ris superficialis fibularis profundus side o f the leg, the A. recurrens tibialis a n te­
M . fibularis [peroneus] longus rior appears as the next branch after trav­
M. extensor d igitorum longus ersing the Membrana interossea cruris. A t the
malleoli the Aa. m alleolares anteriores m e­
N. fibularis superficialis dialis and lateralis contribute to th e arterial
M . fibularis [peroneus] brevis ne tw ork around the ankle th a t may provide a
M . extensor digitorum longus su fficie n t collateral circulation in case o f an
occlusion of one of the arteries of the leg.
A. fib u la ris, R. p e rfo ra n s The N. fibularis com m unis w inds laterally
Rete malleolare around the head of the fibula, enters the fibu­
A. m alleo laris a n te rio r lateralis laris com partm ent, and then divides into its
M. extensor digitorum brevis tw o term inal branches. The N. fibularis su-
M. fibularis [peroneus] tertius, Tendo perficialis descends in th e fibularis com part­
m ent, provides m otor fibres to both fibularis
m uscles and pierces the fascia at the distal
third o f the leg. The N. fibularis profundus
passes over to the extensor com partm ent and
descends adjacent to the A. tibialis anterior. It
conveys m o tor innervation to all extensors of
the leg and the dorsum o f th e foot. Its term i­
nal branches convey sensory fib re s to th e firs t
interdigital space.

extensor hallucis longus

Retinaculum m usculorum
extensorum inferius
N. fibularis profundus

A. dorsalis pedis

N n. dig itales d orsales pedis

Aa. m etatarsales dorsales

i- Clinical Remarks-----------------------------------------------------------------------------------------------------

The N. fibularis com m unis may be injured near the fibular head -* p. 337). This is th e m o st com m on nerve lesion o f th e low er
(proximal fibular fractures, casts, crossed legs). The resulting para- extrem ity!
lysis of the extensor m uscles causes the toes to drop (footdrop.

360—► dissection link

M uscles -» T o p o g ra p h y -► S ections

Vessels and nerves of the popliteal fossa and leg

M. sem itendinosus M. biceps fem oris
A. N. tibialis
V. p o p lite a
M . sem im em branosus V. s a p h e n a parva
M. gastrocnem ius, C aput laterale
A .; V. su ra lis A .; V. su ra lis
M . gastrocnem ius, C aput m ediale Rr. m u scu la re s (N. tib ialis)
N . fibularis com m unis
A. inferior m edialis genus
Vv. tib ia le s p osteriores M. soleus
A rcus te n d in e u s m usculi solei
M. gastrocnem ius
M. plantaris, Tendo

N. tibialis M. fibularis [peroneus] longus
A .; V. tib ia lis p o s te r io r M a lle o la r canal
M . tibialis posterior, Tendo
R etinaculum m usculorum flexorum M . fibularis [peroneus] brevis

Tendo calcaneus M alleolus lateralis

Retinaculum m usculorum fibularium
[pe ro n eo ru m ]

Fig. 4.196 Vessels and nerves o f th e popliteal fossa. Fossa tendineus m usculi solei) and descends betw een the superficial and
poplitea, and th e leg, Regio cruris posterior, right side; dorsal deep flexor m uscles of the leg to the medial malleolus. There, it traver­
view ; a fte r removal o f the Fascia cruris and dissecting the M. ses the m alleolar canal beneath the Retinaculum m usculorum flexo­
g a s tro c n e m iu s . rum to reach the sole o f the foot.
Joined by tw o concom itant veins and the N. tibialis, the A. tibialis
posterior courses beneath the tendinous arch of the M. soleus (Arcus

i- Clinical Rem arks-----------------------------------------------------------------------------------------------------

The N. tib ialis m ay be com pressed in th e m alleolar canal (m edial m uscles o f th e fo o t. Flexion, adduction, or spreading to e s is not pos-
tarsal tu nn el syndrom e, -* p. 336). This causes burning pain sen- sible any more,
sations at the sole o f the fo o t and a loss of function of the plantar

dissecti on l ink 361

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Vessels and nerves of the popliteal fossa and leg

V. p oplitea N. fibularis com m unis

A. inferior m edialis genus A. poplitea
M . soleus M. plantaris

A. tibialis p o s te rio r M. soleus
N. tibialis A . fibularis

M. tibialis M. fle xor hallucis longus
M . flexor digitorum longus M alleolus lateralis
Retinaculum m usculorum fibularium
M alleolar canal [pe ro n eo ru m ]
M. tib ialis posterior, Tendo Tendo calcaneus

M alleolus medialis
Retinaculum m usculorum flexorum

Fig. 4.197 Vessels and nerves of th e popliteal fossa. Fossa Shortly after passing through the tendinous arch o f the M . soleus,
poplitea, and th e leg, Regio cruris posterior, right side; dorsal the A. tibialis posterior gives rise to its m ost im portant branch, the A.
view ; after dissecting the M m . gastrocnem ius and soleus. fibularis, w hich descends to the lateral malleolus.

362— ► dissection link

M uscles -♦ T o p o g ra p h y -► S ections Vessels and nerves of the leg

A . poplitea M. plantaris
A. inferior m edialis genus
M. soleus
M. popliteus A. fibularis
A. tib ialis anterior N . tibialis
(Truncus tibiofibularis)
M. fibularis [peroneus] longus
M. soleus M. fle xor hallucis longus
M. tibialis posterior M. fibularis [peroneus] brevis
A. tibialis p o s te rio r Rr. m alleo lares laterales
Tendo calcaneus
M. fle xor d igitorum longus
Rete calcaneum
M. tibialis posterior, Tendo
Rr. m a lle o la re s m e d ia le s
M. fle x o r hallucis longus, Tendo

Rr. ca lcan e i

Fig. 4.198 Vessels and nerves of th e leg, Regio cruris posterior, The A. fibularis pierces th e M . fle xo r hallucis longus and descends in
rig h t side; dorsal v ie w ; a fte r rem oval o f th e Fascia cruris and th e de epest layer dire ctly on th e M em brana interossea cruris to th e la­
dissecting th e M m . gastrocnem ius, soleus, and flexor hallucis longus. teral malleolus. Together w ith the branches of the Aa. tibiales anterior
The A. tib ialis posterior descends to g e th e r w ith th e l\l. tibialis and posterior, its Rr. m alleolares laterales com plete th e arterial net­
betw een the superficial and deep flexor m uscles o f the leg to the m e­ w o rk around the ankle w hich provides su fficie n t collaterals to com pen­
dial malleolus and continues through the m alleolar canal beneath the sate fo r an occluded vessel.
R etinaculum m u sculorum fle x o ru m to th e plantar side o f th e foo t. Rr.
m alleolares m ediales to the medial malleolus derive fro m this vessel.

dissection link 363

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Vessels and nerves of the dorsum of the foot

M. e xtensor d igitorum longus M. tib ialis anterior, Tendo
M. e xtensor hallucis longus T ib ia
R. p e rfo ra n s (A. fib ula ris) A. m alleolaris a n te rio r m edialis
A. tibialis anterior R e te m a lle o lare m ed iale

A. m alleo laris a n te rio r lateralis N. fibularis profundus
R ete m alleolare laterale Rr. m u scu lares (N. fib u la ris p ro fu n du s)

Mm. extensores digitorum et hallucis brevis A a. ta rs a le s m ediales
A . ta rsa lis lateralis
A. dorsalis pedis
A. arcuata
A. plan taris profunda

Aa. m e tatarsales dorsales M. extensor hallucis brevis, Tendo
A a. d igitales dorsales M . extensor hallucis longus, Tendo
Nn. digitales dorsales pedis

Fig. 4.199 Vessels and nerves of th e dorsum of th e fo ot, Dorsum leolares anteriores m edialis and lateralis fo r the arterial netw orks
pedis, right side; dorsal v ie w onto the dorsum o f the fo o t after around the malleoli (Rete malleolare mediale and Rete malleolare late­
removal of the tendons o f the M. extensor digitorum longus and the rale). The A. dorsalis pedis provides several sm aller Aa. tarsales m edia­
short extensors of the toes. les and one A. tarsalis lateralis to the Tarsus and then continues as A.
The A. tibialis anterior continues on the dorsum o f the foo t as A. dor­ arcuata. The latter arches to the lateral margin o f th e fo o t and gives rise
salis pedis. A fte r the innervation of the extensors of the leg and the to the Aa. metatarsales dorsales w hich continue as Aa. digitales dorsa­
dorsum of the foot, the concom itant N. fibularis profundus divides les to supply the toes. The A. plantaris profunda participates in th e per­
into term inal sensory branches w hich supply the first interdigital space. fusion of the sole of the fo o t by supplying the Arcus plantaris profun­
A t the level of the malleoli, the A. tibialis anterior provides the Aa. mal- dus.

364—► dissection link

M uscles -♦ T o p o g ra p h y -► S ections Arteries of the sole of the foot

Aa. digitales plantares propriae Aa. m etatarsales plantares
Aa. digitales plantares com m unes A. plantaris pro fu n da (A. dorsalis pedis)
R. superficialis
A rcus plan taris profundus R. profundus
A. plan taris lateralis A. plan taris m edialis

A. tibialis posterior

Fig. 4.200 A rteries of th e sole of th e fo o t, Planta pedis, right lis to th e m edial margin o f th e fo o t and a R. profundus w h ich connects
side; plantar view. to the Arcus plantaris profundus. This arterial arch is a d ire ct continu­
The plantar aspect o f th e fo o t is perfused by term inal branches o f th e ation of the A. plantaris lateralis.
A. tibialis posterior. The A. plantaris m edialis provides a R. superficia-

Figs. 4.201a to d Variations of th e arterial supply of th e toes, posterior (b). A lternatively, both arteries m ay con tribute to th e arterial
right side; plantar view. supply o f th e to e s (c and d).
The Arcus plantaris profundus may receive its main input fro m the
A. dorsalis pedis via th e A. plantaris profunda (a) or fro m th e A. tibialis

365

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Vessels and nerves of the sole of the foot

Aa. digitales plantares propriae

Nn. digitales plantares proprii

N n. d igitales N. digitalis p lan taris proprius
plan tares com m unes
Aa. m etatarsales plantares

N. plan taris lateralis,
R. superficialis

A poneurosis plan taris R etinaculum m usculorum flexorum
Rr. ca lca n e i m e d ia le s (N. tib ialis) M a lle o la r canal

N. plan taris m edialis
A. tibialis p o sterio r
N. plan taris lateralis

Fig. 4.202 Superficial layer of th e arteries and nerves of th e sole Sim ilar to th e N. ulnaris at th e hand, th e N. plantaris lateralis divides into
of th e fo ot, right side; plantar view. a R. superficialis and a R. profundus. The N. plantaris m edialis supplies
The N. tibialis already divides into its tw o term inal branches (Nn. plan­ an additional N. digitalis plantaris proprius at the medial margin of
tares m edialis and lateralis) at the medial malleolus w ithin the m al­ the foot. The sensory branches surface betw een the longitudinal fibres
leolar canal beneath the Retinaculum m usculorum flexorum . The ter­ of the plantar aponeurosis (Aponeurosis plantaris). The A. tibialis poste­
minal branches then divide further into several Nn. digitales plantares. rior divides only at the plantar aspect of the foot.

366— ► dissection link

M uscles -» T o p o g ra p h y -► S ections Vessels and nerves of the sole of the foot

M . fle x o r d igito ru m brevis, Tendines Aa. digitales plantares propriae
Aa. digitales plantares com m unes
Nn. digitales M. fle xor hallucis longus, Tendo
plantares com m unes
M. fle xor hallucis brevis
N. p lan taris lateralis
R. profundus Mm . lum bricales

A. p lan taris lateralis M. a bd ucto r hallucis
M. a b d u cto r digiti minim i M. quadratus plantae

A poneurosis plantaris N . plan taris m edialis
M. fle xor d igitorum brevis R etinaculum
m usculorum flexorum
Rete calcaneum A. tibialis p o sterio r
M a lle o la r canal
plan taris lateralis
a b d u cto r hallucis

Fig. 4.203 In te rm e d ia te layer of th e arteries and nerves of th e ing vessels from the A. tibialis posterior. The blood vessels continue
sole of th e fo ot, right side; plantar view. beneath the M. flexor digitorum brevis to reach the interm ediate layer
The M . flexor digitorum brevis and the M . abductor hallucis w e re cut to o f the neurovascular structures to the toes. On their way, the nerves
expose the neurovascular passageway of the malleolar canal. The Nn. provide m otor fibres to the short m uscles of the sole of the foot.
plantares m edialis and lateralis are accompanied by the correspond­

dissection link 367

Lower Extremity Surface a n a to m y -► Skeleton -♦ Im aging

Vessels and nerves of the sole of the foot

Nn. digitales plantares proprii M. fle xor hallucis longus, Tendo

Nn. digitales plantares Caput transversum
communes M. a d d u cto r hallucis

Aa. m etatarsales plantares Caput obliquum J

A rcus plan taris profundus M. fle xor hallucis brevis

N . plan taris lateralis R. superficialis A. p lan taris m edialis, R. superficialis
R. profundus M . fle x o r hallucis longus, Tendo
M. fle xor digitorum longus, Tendo
M. a d d u cto r hallucis, C aput obliquum
M . quadratus plantae
A. p lan taris lateralis
M. a bd ucto r d igiti m inim i M . a bd ucto r hallucis
N. p lan taris m edialis
M . fle xor digitorum brevis R etinaculum m usculorum
A poneurosis plantaris fle x o ru m

A . tibialis p o sterio r
M a lle o la r canal
N. p lan taris lateralis
M . a bd ucto r hallucis

Rete calcaneum

Fig. 4.204 Deep layer of th e arteries and nerves of th e sole of plantaris profundus continues the A. plantaris lateralis und receives
th e fo ot, right side; plantar view. blood fro m th e R. profundus o f th e A. plantaris m edialis and fro m th e A.
The M . flexo r digitorum brevis and the M. abductor hallucis w e re split plantaris profunda w hich derives from the A. dorsalis pedis. Together
to expose th e neurovascular passagew ay o f th e m alleo lar canal. In w ith th e R. profundus fro m th e N. plantaris lateralis it arches over the
addition, the Caput obliquum o f the M. adductor hallucis w as cut to M m . interossei o f the sole o f the fo o t in the deep layer o f the
dem onstrate the deep plantar arch (Arcus plantaris profundus) and neurovascular structures.
th e course o f th e R. profundus of th e N. plantaris lateralis. The Arcus

368—► dissection link

M uscles -► T o p o g ra p h y -► S ections

Foot, sagittal sections

T ib ia Tendo calcaneus
A rtic u latio subtalaris
A rticu latio talocruralis Lig. ta lo c a lc a n e u m
in te ro s s e u m
Caput tali C a lc a n e u s
Os naviculare
Os cuneiform e interm edium M. q uadratus plantae
Os cuboideum
M. fibularis [peroneus] longus, Tendo A poneurosis plantaris
O s m e ta ta rsi II
M. interosseus dorsalis pedis I
M . e xtensor d igito ru m longus, Tendo
Phalanx proxim alis
Phalanx m edia
Phalanx distalis

M. fle x o r d igito ru m longus, hallucis, digitorum brevis N. plantaris lateralis
Tendo Caput obliquum

4.205

M. tib ialis anterior, Tendo M. fle xor hallucis longus
T ib ia Linea epiphysialis
M. triceps surae, Tendo calcaneus
A rticu latio ta lo cru ra lis A rticu latio subtalaris
Talus Lig. ta lo c a lc a n e u m interosseum

(Articulatio talonavicularis) C a lc a n e u s
O s naviculare

Lig. p lan tare longum

4.206

Fig. 4.205 and Fig. 4.206 Foot, Pes, righ t side; sagittal section The section visualises the articular cavity o f the ankle jo in t (Articulatio
th ro u g h th e second phalanx (-* Fig. 4.205) and corresponding talocruralis) and the posterior cham ber of the talocalcaneonavicular
m agnetic resonance im aging (MRI) sagittal section (-» Fig. 4.206); jo in t (Articulatio subtalaris). The longitudinal arch is stabilised by three
medial view. overlying ligam entous system s (Aponeurosis plantaris, Lig. plantare
longum , Lig. calcaneonaviculare plantare) (-* Fig. 4.95).

369

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Hip joint, oblique section

M . tensor fasciae latae

M . gluteus m edius M . gluteus m inim us
A .; V. g lu te a su p e rio r M . sartorius
N. gluteus superior M . rectus fem oris, Tendo
M . iliopsoas
N. fem oralis

Lig. iliofem orale A. fem oralis
B ursa su btendinea iliaca
M. piriform is, Tendo
V. fem o ra lis
M . gem ellus superior M . p ectin eu s
**
A . profunda fem oris
M. obturatorius internus, Tendo
M . gluteus m axim us N. obturatorius
M. gem ellus inferior M . a d d u c to r longus
A .; V. g lu te a in fe rio r
N. gluteus inferior M . a d d u c to r brevis
M. obturatorius externus
N. ischiad icus M . adductor m agnus
N. cutaneus fem oris posterior
M. quadratus *
M . s em im em b ra n o s u s, Tendo M . sem itendinosus
M . bicep s fem oris,
C aput longum , Tendo

Fig. 4.207 Thigh, Femur, oblique section through th e hip joint, (M . sartorius, M . rectus fem oris), the M . tensor fasciae latae, and the
righ t side; distal v ie w illustrating th e axes o f m o v e m e n t o f th e hip superficial adductor m uscles (M m . adductores longus and brevis, M.
joint. pectineus, main part o f the M. adductor magnus). However, the dorsal
The oblique section through the thigh at the level of the fem oral head part of th e M . adductor m agnus is positioned posterior to th e transverse
sh o w s th e position o f th e diverse groups o f m uscles relative to th e ar­ axis and functions as extensor of the hip joint together w ith the
ticular head and th e axes o f m o vem en t. The M . gluteus m axim us is ham string m uscles o f w hich it is a part o f given its function and inner­
located dorsal to th e hip joint, w hereas the sm aller gluteal muscles vation.Cross-sections through the extrem ities are w ell suited to com ­
(M m . glutei m edius and m inim us) in part course ventral to the longitu­ prehend th e course o f th e neurovascular stru cture s in th e respective
dinal and transverse axes o f the hip joint. This position explains w h y the co m partm ents at several levels. A fte r exiting th e sm all pelvis, th e N.
M . gluteus m axim us acts as external rotator and extensor o f the hip, ischiadicus initially courses beneath the M. gluteus maxim us. On the
and the small gluteal m uscles function as strongest medial rotators and ventral side, the A. profunda fem oris is covered by the M. pectineus.
also as flexors o f th e hip. The M . iliopsoas is located anterior to the
transverse axis and is th e m o s t im po rtan t fle x o r o f th e hip joint. It is * transverse axis o f m o ve m e n t in th e hip joint
supported fo r this function by the anterior group of fem oral muscles * * sagittal axis o f m ovem ent in th e hip joint

370

M uscles -► T o p o g ra p h y -» S ections

Thigh, transverse section

M. vastus interm edius M . rectus fem oris
M . vastus lateralis Fascia lata
M. vastus m edialis
Femur
V. s a p h e n a m a g n a
Tractus iliotibialis A .; V. fe m o r a lis
M . biceps fem oris, C aput breve S eptum interm usculare fem oris mediale
S eptum interm usculare fem oris laterale M. sartorius
M. b icep s fem oris, C aput longum N .saphenus
Rr. m u scu lares (N. fem oralis)
M. adductor longus
N. ischiad icus M. gracilis
M. adductor magnus
M . sem itendinosus
S eptum interm usculare fem oris posterius
M. sem im em branosus

Fig. 4.208 Thigh, Femur, right side; transverse section at the The V. saphena magna is fou nd in th e epifascial subcutaneous adipose
m id-tigh level; distal view. tissue on th e m edial asp ect o f th e thigh. The A. and V. fem ora lis join tly
This cross-section show s the three m uscle groups of the thigh. The course w ith th e N. saphenus through th e adductor canal (Canalis ad-
ventral group com prises the M . quadriceps fem oris and the M . sartori­ ductorius) o f the M . quadriceps. The adductor canal is dem arcated dor­
us. M edially located are the adductor m uscles and dorsally the sally by the M m . adductores longus and magnus, medially by the M.
ham string muscles. vastus m edialis, and ven trally by th e M . sartorius. The N. ischiadicus is
positioned dorsally beneath the M . biceps fem oris.

371

Lower Extremity S urface a n a to m y -► Skeleton Im aging

Knee, transverse section

Bursa subcutanea prepatellaris R etinaculum patellae m ediale
P a te lla
E picondylus medialis
A rticu latio genus (A rticulatio Lig. collaterale tibiale
fem o ro p atellaris)
M . sartorius, Tendo
R etinaculum patellae laterale V. s a p h e n a m a g n a
M . gracilis, Tendo
E picondylus lateralis M . sem im em branosus, Tendo
Lig. collaterale fibulare M . sem itendinosus, Tendo
M . gastrocnem ius, C aput m ediale
M . biceps fem oris

M. gastrocnem ius,
C a pu t laterale
A. poplitea

V. p o p lite a

N. ischiadicus N. fib u la ris co m m u n is
N . tibialis

V. s a p h e n a p a rv a

Fig. 4.209 Knee joint, A rticulatio genus, right side; transverse m o nly referred to as "P es anserinus sup e rficia lis". Beneath it, th e in­
section; distal view. sertion o f th e M . sem im em branosus tendon is referred to as "P es an­
The transverse section through the knee joint shows the articular sur­ serinus profundus".
faces of the Articulatio fem oropatellaris. On th e posterior side, the M. The V. saphena magna is fou nd in th e epifascial subcutaneous adipose
biceps fe m o ris is positioned laterally. Therefore th is m uscle is th e m ost tissue on the medial side o f the knee. Dorsally, the term inal branches
im portant lateral rotator. On the medial side, several m uscles contrib­ o f th e N. ischiadicus (N. tibialis and N. fibularis com m unis) are th e m o st
ute to medial rotation. The tendons of the M m . sartorius, gracilis, and superficial structures, fo llo w e d fu rth e r beneath by th e V. poplitea w ith
sem itendinosus are located superficially. They insert further distally th e con fluence o f th e V. saphena parva, and de epest w ith in th e po plite­
w ith a com m on aponeurosis at the medial aspect o f the Tibia, com ­ al fossa th e A. poplitea (NVA).

372

M uscles -♦ T o p o g ra p h y -► S ections

Leg, transverse section

Fascia cruris T ib ia
S eptum interm usculare cruris anterius M em brana interossea cruris
S eptum interm usculare cruris posterius V. sa ph en a m a g na
N. saphenus
Fibula

Fascia cruris

N. cutaneus surae m edialis
V. sa ph en a parva

1 C om partim en tum cruris anterius: 2 C om partim entum cruris laterale: 3 C om partim en tum cruris posterius, 4 C om partim en tum cruris posterius,
A .; V. tib ia lis a n te rio r N. fibularis superficialis Pars profunda: P ars superficialis:
N. fibularis profundus M . fibularis [peroneus] longus A .; V. tib ia lis p o s te rio r M. triceps surae
M. tib ialis anterior M . fib ula ris [peroneus] brevis A.; V. fib u la ris M . plantaris
M. extensor digitorum longus N. tibialis
M. extensor hallucis longus M. fle xor digitorum longus
M. fibularis [peroneus] tertius M. tibialis posterior
M. fle xor hallucis longus

Fig. 4.210 Leg, Crus, righ t side; transverse section at th e m id-leg The deep flexors are directly adjacent to the M embrana interossea cru­
level w ith illustration of th e osteofibrous com partm ents; distal ris. The an terio r (extensor) co m p a rtm e n t harbours th e N. fibularis
view. profundus, th e A. tibialis and th e Vv. tibiales anteriores. The N. fibularis
The Fascia cruris is attached to the bones o f the leg by dense connec­ superficialis is located in th e lateral (fibularis) c o m p artm e n t. In the
tive tissue septa. They separate oste ofibrous c o m p a rtm e n ts in w hich deep po sterio r (flexor) co m p artm e n t, th e N. tibialis, A. tibialis poste­
the neurovascular structures are em bedded betw een the respective rior, Vv. tibialis posteriores, and - covered by the M . flexor hallucis lon­
m uscle groups (-♦ Fig. 4.211). The S eptum interm usculare anterius par­ gus - th e A. and V. fibularis are em bedded in th e m uscles. The V. saphe­
titions the extensor com partm ent anteriorly from the lateral fibularis na magna and V. saphena parva on th e dorsal side course in the
co m partm ent w h ic h in turn is separated fro m th e superficial flexo rs by epifascial layer at the medial aspect of the leg.
the Septum interm usculare posterius. The superficial flexors are isola­
ted fro m th e deep flexors by a deep layer o f the Fascia cruris. * deep part o f the Fascia cruris

373

Lower Extremity Surface anatom y Sections

Leg, transverse section

M . tib ialis anterior Fascia cruris
M. extensor hallucis longus A. tibialis a n te rio r
T ib ia
M. extensor digitorum longus N. fibularis profundus
N. fibularis superficialis M. flexor digitorum longus

S e p tu m in t e r m u s c u l a r e --------
cruris an te riu s

M. fibularis [peroneus] brevis

M . fibularis [peroneus] longus V. s a p h e n a m a g n a

S ep tu m interm usculare M em b ran a interossea
cruris posterius
Fibula M. tibialis posterior
M. flexor hallucis longus
F a scia c ru ris (d e ep layer) A . tibialis p o sterio r
M. soleus M. gastrocnem ius,
C aput m ediale
A. fibularis N . tibialis
V. sap h e n a parva

Fig. 4.211 Leg, Crus, right side; transverse section at th e mid-leg em bedded betw een th e m uscle bellies of the individual m uscle groups.
level, distal view. O f highest clinical relevance is the anterior (extensor) com partm ent
Together w ith the connective tissue septa reaching to th e bones of the w h ich harbours th e N. fibularis profundus to g e th e r w ith th e A. tibialis
leg, th e Fascia cruris con fines th e osteofibrous co m p artm ents. anterior.
These com partm ents contain the respective neurovascular structures

i- Clinical Remarks------------------------------------

Com pression syndrom es m o st c o m m only develop in th e anteri­ com pression causes a lesion o f th e N. fibularis profundus (-» p. 337)
or c o m p a rtm e n t (c o m p artm en t syndrom e), rarely in th e posterior w ith resulting functional deficits including the inability to dorsiflex
deep com partm ent. W ith posttraum atic swelling of the extensor th e fo o t in th e ankle jo in t and loss o f sensory innervation in th e firs t
muscles or after a long march the supplying blood vessels and nerves interdigital space. This condition requires the im m ediate decom pres­
may be com pressed and dam aged, causing extensive pain. This may sion by surgical incision o f the fascia (fasciotomy). Diagnostically,
also cause th e loss o f palpable arterial pulses o f the A. dorsalis pe­ the pressure w ithin the anterior com partm ent is determ ined using
dis w hich arises fro m the A. tibialis anterior. M o st frequently, the a pressure sensor w hich requires im m obilisation of the open leg.

374

Appendix

P icture C redits ..................................... 377
A b b re v ia tio n s , Term s, e tc.................. 379
Index ...................................................... 381



Picture Credits

The editors sincerely thank all clinical colleagues that made Additional illustrations w ere obtained from the following
ultrasound, com puted tom ographic and magnetic resonance images textbooks:
as w e ll as endoscopic and intraoperative pictures available:
1 B enninghoff-D renckhahn: A natom ie, Band 1 (Drenckhahn D.,
Prof. Altaras, C enter fo r Radiology, U niversity o f Giessen (Figs. 2.18; editor), 17. A ufl., Urban & Fischer 2008
2.39; 2.40)
2 B enninghoff-D renckhahn: A natom ie, Band 2 (Drenckhahn D.,
Prof. Brückmann and Dr. Linn, Neuroradiology, Institute fo r Diagnostic editor), 16. A ufl., Urban & Fischer 2004
Radiology, U niversity o f M unich (Fig. 4.148)
3 B enninghoff-D renckhahn: Taschenbuch A natom ie (Drenckhahn D.,
Prof. Daniel, D epartm ent o f Cardiology, U niversity o f Erlangen (Fig. W aschke, J., editors). Urban & Fischer 2007
10.39)
4 Berchtold, R., Bruch, H.-P., Trentz, O. (editors): Chirurgie, 6. Aufl.,
Prof. Galanski and Dr. Schäfer, D epartm ent o f Diagnostic Radiology, Urban & Fischer 2008
Hannover M edical School (Figs. 2.97; 5.3; 5.103; 6.31; 6.129)
5 Böcker, W ., Denk, H., Heitz, P. U., M och, H. (editors): Pathologie,
Prof. Gebel, D epartm ent o f Gastroenterology and Hepatology, 4. Aufl., Urban & Fischer 2008
Hannover M edical School (Figs. 6.73; 6.75; 6.76; 6.94; 6.95; 7.25)
6 Classen, M ., Diehl, V., Kochsiek, K., Berdel, W . E., Böhm , M.,
Dr. Greeven, St. Elisabeth Hospital, N euw ied (Figs. 4.96; 8.96) Schmiegel, W . (editors): Innere Medizin, 5. Aufl., Urban & Fischer
Prof. H offm ann and Dr. Bektas, Clinic fo r A bdom inal and Tranplantati- 2003

on Surgery, H annover M edical School (Fig. 4.41) 7 Classen, M ., Diehl, V., Kochsiek, K., Hallek, M ., Böhm , M.
Prof. Hohlfeld, Clinic fo r Pneumology, Hannover M edical School (Fig. (editors): Innere Medizin, 6. Aufl., Urban & Fischer 2009

5.71) 8 Drake, R. L., Vogl, A. W ., M itchell, A., Paulsen, F. (editors): Gray's
Prof. Jonas, Urology, H annover M edical School (Fig. 7.33) A natom ie fü r S tudenten, 1. A ufl., Urban & Fischer 2007
Prof. Kampik and Prof. Müller, Ophthalm ology, University o f M unich
9 Drake, R. L., Vogl, A. W ., M itchell, A.: Gray's A natom y fo r
(Fig. 9.66) Students, 2nd ed., Churchill Livingstone 2010
Dr. Kirchhoff and Dr. W eidem ann, D epartm ent o f Diagnostic
10 Drake, R. L., Vogl, A. W ., M itchell, A.: G ray's A tlas der A natom ie,
Radiology, Hannover Medical School (Figs. 6.131; 6.133; 7.26) Urban & Fischer 2009
Prof. Kleinsasser, Clinic and Polyclinic o f Oto-Rhino-Laryngology,
11 Fleckenstein, P., Tranum -Jensen, J.: Röntgenanatom ie, Urban &
Plastic and A esthetic Surgery, University Hospital W uerzburg Fischer 2004
(Figs. 11.41; 11.42; 11.43)
PD Dr. Kutta, Clinic and Polyclinic fo r Oto-Rhino-Laryngology, 12 Forbes, A., M isiew icz, J., C om pton, C., Quraishy, M ., Rubesin, S.,
U niversity Hospital Ham burg-Eppendorf (Figs. 8.101; 10.16; 11.16) Thuluvath, P.: A tlas o f Clinical G astroenterology, 3rd ed., M osby
Dr. Meyer, Departm ent of Gastroenterology and Hepatology, 2004
Hannover M edical School (Figs. 6.22; 6.32; 7.104)
Prof. Pfeifer, Radiology Innenstadt, Institute fo r Diagnostic Radiology, 13 Franzen, A.: Kurzlehrbuch Hals-Nasen-Ohren-Heilkunde, 3. Aufl.,
U niversity o f M unich (Figs. 2 .6 3-2 .65; 2 .6 7-2 .70; 3.52; 3.54; 3.55; Urban & Fischer 2007
4.97; 4.99; 4.100; 4.105; 4.106)
Prof. Possinger and Prof. Bick, Medical Clinic and Polyclinic II, Division 14 Garzorz, N.: BASICS N euroanatom ie, Urban & Fischer 2008
o f H em atology and O ncology, Charité Campus M itte , Berlin (Fig. 15 Kanski, J. J.: Klinische O phthalm ologie, 5. A ufl., Urban & Fischer
2.141)
Prof. Ravelli t , form erly Institute o f Anatom y, University o f Innsbruck 2003
(Fig. 2.62) 16 Kanski, J. J.: Klinische Ophthalm ologie, 6. Aufl., Urban & Fischer
Prof. Reich, Orofacial Surgery, U niversity o f Bonn (Figs. 8.60; 8.61)
Prof. Reiser and Dr. W agner, Institute fo r Diagnostic Radiology, 2008
U niversity o f M unich (Figs. 2.71; 12.105; 12.106; 12.110; 12.111) 17 Kauffmann, G. W ., M oser, E., Sauer, R. (editors): Radiologie, 3.
Dr. Scheibe, D epartm ent o f Surgery, Rosman Hospital, Breisach (Fig.
4.79) Aufl., Urban & Fischer 2006
Prof. Scheumann, Clinic fo r Abdominal and Tranplantation Surgery, 18 Lippert, H.: Lehrbuch A natom ie, 7. A ufl., Urban & Fischer 2006
Hannover M edical School (Fig. 11.58) 19 M e ttle r, F. A. (editor): Klinische Radiologie, Urban & Fischer 2005
Prof. Schillinger, D epartm ent of Gynaecology, University of Freiburg 20 M oore, K., Persaud, T. V. N., Viebahn, C. (editors): Embryologie, 5.
(Fig. 1.49)
Prof. Schliephake, Orofacial Surgery, U niversity o f G oettingen (Figs. Aufl., Urban & Fischer 2007
8.156; 8.157) 21 Schulze, S.: Kurzlehrbuch Em bryologie, Urban & Fischer 2006
Prof. Schloesser, Center fo r Gynaecology, Hannover Medical School 22 Speckm ann, E.-J., Hescheler, J., Köhling, R. (editors): Physiologie,
(Fig. 7.79)
cand. med. Carsten Schroeder, Kronshagen (Fig. 9.27) 5. Aufl., Urban & Fischer 2008
Prof. Schumacher, Neuroradiology, D epartm ent o f Radiology, 23 Trepel, M.: Neuroanatomie, 4. A ufl., Urban & Fischer 2008
U niversity o f Freiburg (Fig. 12.5) 24 W elsch, U.: Sobotta Lehrbuch Histologie, 2. Aufl., Urban & Fischer
Dr. Sei, U niversity Hospital and Polyclinic fo r Ophthalm ology,
U niversity Hospital Halle (Saale) (Fig. 9.64) 2005
Dr. S om m er and PD Dr. Bauer, Radiologists, M unich (Figs. 4.101; 25 W elsch, U., Deller, T.: Sobotta Lehrbuch Histologie, 3. A ufl., Urban
4.102)
PD Dr. Vogl, Radiology, U niversity o f M unich (Figs. 9.69; 9.70) & Fischer 2010
Prof. W itt, D epartm ent o f N eurosurgery, U niversity o f M unich (Fig. 26 W elsch, U.: A tlas Histologie, 7. A ufl., Urban & Fischer 2005
3.116) 27 W icke, L.: A tlas der R öntgenanatom ie, 7. A ufl., Urban & Fischer
Prof. Zierz and Dr. Jordan, U niversity Hospital and Polyclinic fo r
Neurology, U niversity Hospital Halle (Saale) (Figs. 8.82, 12.151) 2005
28 Rengier, F.: BASICS Leitungsbahnen, Urban & Fischer 2009

The follow ing illustrators have developed the new illustrations:
Dr. Katja D alkow ski: Figs. 1.22, 1.25, 1.26, 1.30, 1.31, 1.35, 2.94, 2.95,
2.134, 3.10, 3.33, 3.39, 3.48, 3.51, 3.57, 3.58, 3.59, 3.100, 4.4, 4.55,
4.68, 4.70, 4.90, 4.91,4.107

Jörg Mair: Figs. 1.38, 1.39, 1.40, 1.41, 2.111, 2.112, 2.135, 2.136,
2.137, 2.151, 3.40, 3.108, 3.109, 3.110, 3.111, 3.112, 3.113, 3.132,
3.134, 4.114, 4.115, 4.116, 4.117, 4.122, 4.123, 4.124, 4.131, 4.132,
4.133, 4.158, 4.160, 4.164, 4.165, 4.166, 4.170, 4.173, 4.174

Stephan W inkler: Figs. 1.15, 1.16, 2.10, 2.11, 2.104, 2.105, 2.106,
2.107, 3.66, 3.67, 4.57, 4.58



1. List of abbreviations

Singular: Arteria Plural: A rte ria e § = fem ale Percentages:
A. = L ig a m e n tu m Aa. = L iga m en ta $ - male In th e light o f the large variation in
Lig. = M u sculus M u sculi individual body m easurem ents, the
M. = Nervus Ligg. Nervi percentages indicating size should
N. = Processus Mm. Processus only be taken as approximate
Proc. = Ramus Nn. = Rami values.
R. = Vena Procc. = Venae
V. = Variation Rr. =
Var. - Vv. =

2. General term s of direction and position

The follow ing term s indicate the position of organs and parts of the longitudinalis = parallel to the longitudinal axis (e.g. Musculus
body in relation to each other, irrespective o f th e position o f th e body longitudinalis superior of the tongue)
(e.g. supine o r upright) or direction and position o f th e lim bs. These
term s are relevant not only fo r human anatom y but also fo r clinical sagittalis = located in a sagittal plane
m edicine and comparative anatomy. transversalis = located in a transverse plane
transversus = transverse direction (e.g. Processus transversus o f a
General term s
a n terior - p o s te rio r = in fro n t - behind (e.g. A rteriae tibiales anterior et thoracic vertebra)

posterior) Terms of direction and position for the limbs
ventralis - dorsalis = tow ards the belly - tow ards the back proxim alis - distalis = located towards or away from the attached end
s u p e rio r - infe rior = above - b e lo w (e.g. Conchae nasales superior et
o f a lim b or th e origin o f a structure (e.g. A rticulationes radioulnares
inferior) proximalis e t distalis)
cranialis - caudalis = tow ards the head - tow ards the tail
d e xte r - s in is te r = righ t - left (e.g. A rteriae iliacae com m unes dextra et for the upper limb:
radialis - ulnaris = on the radial side - on the ulnar side (e.g. Arteriae
sinistra)
internus - externus = internal - external radialis e t ulnaris)
superficialis - profun dus = superficial - deep (e.g. M usculi flexores
for the hand:
digitorum superficialis et profundus) palm aris - dorsalis = tow ards the palm o f the hand - tow ards the back
medius, inte rm ed ius = located b e tw een tw o oth er structures (e.g. the
o f the hand (e.g. Aponeurosis palmaris, M usculus interosseus
Concha nasalis media is located betw een the Conchae nasales dorsalis)
superior and inferior)
m edianus = located in th e m idline (Fissura mediana anterior o f the for the low er limb:
spinal cord). The m edian plane is a sagittal plane w hich divides the tibialis - fibularis = on the tibial side - on the fibular side (e.g. Arteria
body into right and left halves.
medialis - lateralis = located near to the midline - located away from tibialis anterior)
the m idline of the body (e.g. Fossae inguinales m edialis e t lateralis)
frontalis = located in a fro ntal plane, b u t also tow ards the fro n t (e.g. for the foot:
Processus fro ntalis o f the maxilla) plantaris - dorsalis = tow ards the sole of the fo o t - tow ards the back

o f th e fo o t (e.g. A rteriae plantares lateralis e t medialis, A rteria dorsa­
lis pedis)

3. Use of brackets

[ ]: Latin te rm s in square brackets re fe r to alternative te rm s as given in (): Round brackets are used in d iffe re n t ways:
th e Term inologia A natom ica (1998), e.g. Ren [Nephros]. To keep the - fo r te rm s also listed in round brackets in th e Term inologia A natom i­
legends short, only those alternative term s have been added that
d iffe r in th e root o f th e w o rd and are necessary to understand clinical ca, e.g. (M. psoas minor)
term s, e.g. nephrology. They are prim arily used in figures in w h ich the - fo r term s not included in the official nom enclature but w hich the
particular organ or stru cture plays a central role.
editors consider im portant and clinically relevant, e.g. (Crista
zygomaticoalveolaris)
- to indicate th e origin o f a given structure, e.g. R. spinalis (A.
vertebralis).



Index

A Ankle jo in t Arcus
- conventional radiograph 294-295 - venosus
A cells, Membrana synovialis 17 - dorsal extension 288 ----- dorsalis pedis 3 4 8 -3 4 9
Abdomen 6 - dorsiflexion 288 ----- palmaris
- CT angiography 34 - ginglymus 288 ---------profundus 209
Abdominal wall - hinge joint 288 ---------superficialis 209
- dermatomes 118 - hypersupination trauma 284 - vertebrae 50 -51, 53, 66, 70, 110, 113
- hernias 44 - injuries 284 Area intercondylaris
- muscles 83, 93 - ligaments 283-284 - anterior 258, 293
- - com plete lack 44 - plantar flexion 288 - posterior 258, 293
- - CT 91 - range of movement 288 Areola mammae 114
----- deep layer 88 Ankle joint fractures Arm (Brachium)
----- middle layer 8 6 -8 7 - conventional radiograph 295 - dorsal muscles 161, 170, 173-174, 181-182
----- superficial layer 82, 86 - WEBER's fractures 295 - MRI 240
- oblique muscles, frontal section 95 Ankylosis, knee joint 19 - rotation axis 134
- posterior, muscles 94 Ansa subclavia 31 - surface relief 130
- posterior aspect of the anterior wall 92,120 Antebrachium See Forearm - transverse section 240
- rectus sheath 90 Anterior 5 - ventral muscles 160
- segmental sensory innervation 118 Anterior drawer test 277 Arm bud 132
- structure 125 A nterior (tibial) com partm ent syndrome 337, Arteria(-ae)
- surface relief 43 - arcuata 3 3 9 -3 4 0 , 364
- ventral of a newborn 120 374 - auricularis posterior 106
Abduction 4 Anteversion, shoulder joint 148 - axillaris 22, 84, 194-195, 208, 211, 21 8-
- fingers 193 Anular ligament, elbow 150
- saddle joint of the thum b 154 Anular rim 53, 63 220, 222-223
- shoulder joint 148 Anulus ----- branches 219
Abductors of the hip 306 - fibrosus 45, 63, 67, 110-111 - brachialis 22, 208, 219, 222-230, 240
Accessory bones 14 - - chondrosis/osteochondrosis 73 - - superficialis 215
Acetabular rim 269 - inguinalis - carotis
- angle of 269 - - profundus 120-121, 123 - - com m unis 22, 31, 96
Acetabulum 252 ----- superficialis 8 6 -8 8 , 121, 123-125
- retroversion 269 - umbilicalis 43, 8 2 -8 3 , 86, 90 -9 1 , 119 externa 22
Acetylcholin (Parasympathicus) 30 A orta 44, 72, 100, 338 ----- interna 22
ACHILLES tendon (Tendo calcaneus) 315-317, - abdominalis See Pars abdominalis aortae - cervicalis
- descendens See Pars descendens aortae - - profunda 107
362-363, 369 - thoracica See Pars thoracica aortae - - superficialis 119
Acquired flatfoot 289 A ortic isthmus, stenosis 41, 97 - circumflexa
Acromioclavicular joint (AC joint) - erosions (usures) of the ribs 47 - - fem oris lateralis 2 7 1 ,3 3 8 -3 4 0 ,3 5 1 -3 5 2
- classification of TOSSY 159 - horizontal bypass circuit 97 ---------medialis 2 7 1 ,3 3 8 -3 4 0 ,3 5 1 -3 5 2 ,3 5 5
Acromion 42, 74, 137, 146-147, 149, 156, - vertical bypass circuit 97 ----- humeri anterior 208, 219, 222
Ape hand 205 ---------posterior 105, 208, 214, 219, 222, 225
160-163, 168-169, 218 Apertura ----- ilium profunda 96, 123, 3 3 8 -3 3 9 , 350
Adduction 4 - pelvis ---------superficialis 1 1 9 ,3 3 8 -3 3 9 ,3 4 6
- fingers 193 ----- inferior 250 ----- scapulae 1 0 5,21 9,22 5
- knee joint 275 - - superior 250-251 - collateralis
- saddle joint of the thum b 154 - thoracis ----- media 208, 225
- shoulder joint 148 ----- inferior 46 - - radialis 208, 224-225, 227, 229-231
Adductor canal 351 ----- superior 46 - - ulnaris
Adductor hiatus 305 Apex -------- inferior 208, 223
Adolescent kyphosis [SCHEUERMANN'S - capitis fibulae 259,292 ---------superior 208, 223, 226-227, 240
- dentis 51 - comitans nervi mediani 208, 229
disease] 68 - ossis sacri 56-57 - cremasterica 339
Ala ossis - patellae 272, 292 - descendens genus 339-340, 346, 352, 358
- ilii 252-253, 290 Apical 5 - digitales
- sacri 56 Aponeurosis - dorsales
Amastia 41, 114 - musculi bicipitis brachii 131,170-172,176, - — (Manus) 239
Amnion 13 ---------(Pes) 339, 364
A m niotic cavity 12 226, 230 ----- palmares
Amphiarthroses 17, 286 - palmaris 131, 188, 234, 239 -------- com munes 208, 23 3-23 5, 239, 242
Ampulla ductus deferentis 120 - plantaris 289, 322-323, 325, 366-369 ---------propriae 208, 23 3-23 5, 239, 242
Anal region Apophysis 15 ----- plantares
- regional lymph nodes 103 Appendicitis 11 ---------com munes 339, 365, 367
- superficial lymph vessels 103 Appendix verm iform is 10-11 -------- propriae 3 6 5 -3 6 7
Anamnesis 7 Arachnoidea mater spinalis 108-109, 112-113 - dorsalis pedis 22, 339-340, 360, 364
Anastomoses Arcus - - pulse 22
- cavocaval 41, 99 - anterior atlantis 50, 64, 68 - ductus deferentis 121
- portocaval 25 - aortae 22, 24, 31 - epigastrica
Angulus ----- conventional radiograph 32 - - inferior 90, 96, 101, 119-121, 123-125,
- acromii (Scapula) 137 - costalis 43, 46, 83
- costae 47 - ductus thoracici 26 338-339
- inferior scapulae 42, 74-75 - iliopectineus 120, 265, 302, 345 - - superficialis 11 9,338-339,346
- infrasternalis 43 - palmaris
- lateralis scapulae 137 ----- profundus 208, 233, 236 superior 90, 96, 100-101, 119
- mandibulae 68 ----- superficialis 208, 233, 235, 239 - fem oralis 22, 34, 93, 95, 120, 123, 303,
- sterni [LUDOVICI] 43, 46, 58 - plantaris profundus 339-340, 365, 368
- - clinical examination 46 - posterior atlantis 50, 6 4 -6 5 , 68, 80, 107— 338, 340, 345-346, 350-352, 370-371
- subpubicus 264 ----- branches 339
- superior scapulae 137 108 ----- pulse 339
----- conventional radiograph 32 - pubicus 264 - - superficialis 34, 339
- venosus 26 - tendineus musculi - fibularis 22, 339-340, 358, 360, 362-363,
Ankle joint 283-284
- arthrosis 282 levatoris ani 300 374
- - solei 315, 336, 361 - glutea
- - inferior 340, 355-356, 370

superior 355, 370

Index

Arteria(-ae) Arteria(-ae) Articulatio(-nes)
- iliaca - suprascapularis 219, 225 - cartilaginea 17
- - com munis 22, 31, 34, 338 - surales 3 3 9 -3 4 0 , 35 7-35 8, 361 - conoidea 18
- - externa 22, 34, 101, 120, 123, 338, 344, - tarsalis(-es) - costochondrales 46
- - lateralis 33 9-34 0, 364 - costotransversaria 5 3 ,6 1 ,6 9
350, 352 - costovertebrales 61-62
- - - branches 339 mediales 339-340, 364 - cotylica 269-270
- - interna 22, 34, 338, 344, 350 - testicularis 22, 120, 123 - coxae 248, 264, 269-270, 291
- inferior - thoracica - - blood supply 271
- - lateralis genus 279, 339-340, 358, 360 ----- branches 96 - - range of m ovem ent 270
- - medialis genus 279, 339-340, 352, 358, - - interna (A. mammaria interna) 94, 96-97, - cubiti 128, 134, 150

361-363 100-101, 116, 119 radiograph 157
- intercostales posteriores 84, 97, 100 - - lateralis 96, 116, 119, 211-212, 219-221 - cuneocuboidea 248
- interossea - cuneonavicularis 248
- - anterior 208, 229, 231, 237, 239 superior 96, 100, 219, 221 - cylindrica 18
- - communis 22, 208, 228-229 - thoracoacromialis 208, 218-220 - digiti (Manus) 155
- - posterior 179, 208, 229, 231-232, 239 - ellipsoidea 18
branches 218 - femoropatellaris 248, 272, 372
recurrens 208, 230, 232 - thoracodorsalis 96, 116,219-220 - femorotibialis 248, 272
- lienalis 34 - tibialis - fibrosa 17
- ligamenti teretis uteri 339 - - anterior 22, 340, 358-360, 363-364, 374 - genus 248, 272-281, 292-293, 310, 372
- malleolaris anterior - — branches 339 - humeri 128, 134, 146-149, 169
- - lateralis 33 9-34 0, 360, 364 - - posterior 22, 340, 358, 361-363, 3 6 5 -
- - medialis 339-340, 364 radiograph 156
- mammariae 368, 374 - humeroradialis 134, 150
- - laterales 116, 211 ---------branches 339 - humeroulnaris 134, 150
- transversa colli 221 - interchondrales 46
mediales 116, 211 - ulnaris 22, 205, 207-208, 22 6-23 0, 2 3 3 - - intercuneiformes 248
- media genus 279, 33 9-34 0, 358 - intermetacarpales 153
- mesenterica 236, 241 - intermetatarsales 286
- - inferior 22, 31 - - pulse 208 - interphalangea(-ae)
- umbilicalis(-es) 24, 120 ----- distales
superior 22, 31, 34 ---------(Manus) 36, 155
- metacarpales obliterated 92 ---------(Pes) 286
- - dorsales 237-239 - vertebralis 67, 81, 96, 105, 107-108 ----- (Manus) 134
- - palmares 233, 236, 239 Arterial pulses, examination 22 - - (Pes) 248
- metatarsales - A. femoralis 339 - proximales
- - dorsales 339-340, 360, 364 - A. radialis 208 ---------(Manus) 134, 155
- - plantares 339, 3 6 5 -3 6 6 , 368 - A. ulnaris 208 ---------(Pes) 286
- musculophrenica 96, 100-101 Arteries 22 - lumbosacralis 46
- nutricia - abdominal wall 97 - manus 153-154
----- fibulae 339 - axilla 223 - mediocarpalis 134, 153
- - tibiae 339 - dorsum of the hand 238 - metacarpophalangeae 134, 154-155
- obturatoria 1 2 0 ,3 3 8 -3 3 9 ,3 4 5 ,3 5 1 -3 5 2 - elbow 230 - metatarsophalangeae 248, 286-287
- occipitalis 105-107 - forearm 226-229,231-232 - ossea 17
- perforans(-tes) 338-340, 352, 354-355, - hand 2 3 3 ,2 3 7 -2 3 9 - ovoidea 18
- lower extremity 208, 339-340 - pedis 286-287
358 - palm of the hand 2 3 4-23 6 - plana 18
- pericardiacophrenica 96, 101 - pelvis 338 - radiocarpalis 134, 153,239
- phrenica inferior 94 - popliteal fossa 358 - radioulnaris 153
- plantaris - pulses 22 ----- distalis 128, 134, 152-153
- - lateralis 33 9-34 0, 365, 367-368 - Regio antebrachii 226-227 - - proximalis 134, 150, 152
- - medialis 339-340, 365, 368 - shoulder 219, 225 - sacrococcygea 46, 57
- sole of the foot 36 5-36 8 - sacroiliaca 42, 46, 71, 248, 250, 26 4-265,
profunda 339, 364-365 - systemic circulation 22
- poplitea 22, 279, 308, 315, 340, 352-355, - thigh 338 267-268, 290-291, 300
- thoracic wall 100 - sellaris 18
357-358, 361-363, 372 - upper arm 224-225 - spheroidea 18
----- branches 339 - ventral wall of the trunk 96 - sternoclavicularis 43, 59, 135, 144
- princeps pollicis 208, 233-234, 236 Arteriosclerosis 208, 339 - sternocostales 46, 59
- profunda Arthroscopies, knee joint 281, 293 - subtalaris 248, 285, 294, 369
- - brachii 22, 105, 208, 219, 222-225, 240 Arthrosis - synovialis 17
- - femoris 22, 34, 271, 338-340, 350-352, - ankle joint 282 - talocalcaneonavicularis 248, 285, 294
- finger joints 158 - - radiograph 294
370 - Genu valgum/varum 249 - talocruralis 248, 283-284, 294, 369
- pudenda - pelvic girdle 290 - - radiograph 294-295
- - externa 11 9,33 8-3 39,3 46 - pelvis 290 - talonavicularis 369
- - interna 355-356 - radiological signs 158 - tarsi transversa (CHOPART's joint) 260, 262
- radialis 22, 208, 216, 22 6-23 0, 233, 2 3 5 - - uncovertebral gap 50 - tarsometatarsales (LISFRANC's joint) 248,
- zygapophysial joint 50
238, 241 Articulatio(-nes) 260, 262, 286
----- course 238 - acromioclavicularis 134-135, 145, 147, 156, - tibiofibularis 248, 258, 282, 292-293
- - indicis 208, 233-234, 236 - - proximalis 272
168-169 - trochoidea 18, 288
pulse 208 - atlantoaxialis - uncovertebralis 52
- recurrens - zygapophysialis 54, 68, 70-72, 268
- - radialis 208, 227-230, 339 lateralis 6 4 -6 6 Assimilation of atlas 48, 50
- - mediana Athelia 41, 114
tibialis ---------anterior 64 Atlantal arches, isolated fractures 50
---------anterior 3 3 9 -3 4 0 , 360 ---------posterior 64 Atlantoaxial joint, intermediate 64
---------posterior 3 3 9 -3 4 0 , 358 - atlantooccipitalis 6 4 -6 6 Atlantoaxial subluxation 65
- - ulnaris 208, 228-231 - bicondylaris 276
- renalis 22, 31, 34 - calcaneocuboidea 248
- spinalis anterior 113 - capitis costae 53, 61, 69
- subclavia 22, 31, 96, 100, 218-219 - carpi 153
- subscapularis 96, 208, 219, 222 - carpometacarpalis(-es) 134, 153
- superior
----- lateralis genus 3 3 9 -3 4 0 , 35 7-358, 360 pollicis 153
- - medialis genus 339-34 0, 352, 354, 357-

358, 360

Index

Atlas 46, 4 9 -5 0 , 52, 6 4 -6 6 , 78, 80 -8 1 , 107— Bones Canalis
108 - flat bones 14 - carpi 191, 205, 235
- irregular bones 14
- assimilation 48, 50 - long bones 14-15 transverse section 241
Atrium - ossification (bone age) 133 - inguinalis 123
- dextrum 24 - short bones 14 - nervi hypoglossi 65
- - conventional radiograph 32 - structure 15 - obturatorius 264, 26 9-270, 305, 345, 351
- sinistrum 24 - subchondral bone 17 - sacralis 56-57, 73
Auricula sinistra, conventional radiograph 32 Bowleg (Genu varum) 24 8-249 - vertebralis 73, 110, 112-113
Auscultation 10 BOYD's perforating veins 342 Capitulum humeri 138, 150, 157
Autonom e neuropathy 31 Brachialis pulse 22 Capsula
Autonomic nervous system 28, 30-31 Brachium 6, 130, 134 - articularis
- disorders 31 - See also Arm - - (Art. atlantoaxialis lateralis) 64
- neuropathy 31 Brain, MRI 35 - - (Art. atlantooccipitalis) 64
Axillary fossa 219-221 Breast 114-115 ----- (Art. coxae) 26 9-270
- arteries 223 - amastia 114 ----- (Art. cubiti) 150
- blood vessels 222 - anomalies 41 - - (Art. genus) 273, 293, 310
- epifascial vessels 212 - contours, radiograph 32
- lymph nodes 210-211 - lymphatic drainage 116 (Art. humeri) 147-148, 163
- nerves 212, 222-223 - polymastia 114 - - (Art. radioulnaris distalis) 152
- superficial lymph vessels 210 - radiograph 117 - - (Art. sternoclavicularis) 59, 144
Axillary space - sagittal section 115 - interna 35
- quadrangular 169, 174, 225 Breast cancer 117 Caput 6-7
- frequency in relation to the location 117 - breve
blood vessels and nerves 105 - mammography 117 - - (M. biceps brachii) 21, 84, 131, 163, 1 6 8 -
- triangular 169, 174, 225 - sentinel lymph node 117
- - blood vessels and nerves 105 Brittle nails 36 172, 222
Axis 46, 49-52, 6 4 -66, 68, 80-81 Broken neck 65 ----- (M. biceps femoris) 299, 306, 30 8-310,
Azygos system 99 Bronchus principalis dexter/sinister,
337, 355, 371
B conventional radiograph 32 - costae 47, 53, 69
Buccopharyngeal membrane 13 - epididymidis 123
B cells, Membrana synovialis 17 Bullous pemphigoid 37 - femoris 34, 254-256, 269-270, 290-291
B cell zone, lymph nodes 27 Bursa(-ae) - fibulae 246-247, 258-259, 272-274, 282,
Back (Dorsum) 6 - anserina 305
- dermatomes 104 - (Art. genus) 273 292-293, 296, 299, 302, 313
- muscles 78, 80-81 - bicipitoradialis 150, 177 - humerale (M. pronator teres) 185
- nerves 105 - coccygea 105 - humeri 138-139, 146, 156
- orientation lines 42 - infrapatellaris profunda 273, 280 - humeroulnare (M. flexor digitorum superfi­
- regions 42 - ischiadica musculi obturatorii interni 309
- segmental cutaneous nerves 104 - musculi cialis) 177, 179
- surface relief 42 ----- coracobrachialis 163 - laterale
- upper region, vessels and nerves 106 - - semimembranosi 315-317 - - (M. gastrocnemius) 274, 280, 299, 3 0 8 -
- vessels 105 - subacromialis 146, 149, 163
BAKER'S cyst 280 - subcutanea 311, 314-316, 354, 35 7-358, 361, 372
Ball and socket joint 18 - - (M. triceps brachii) 21, 83, 131, 162, 1 6 9 -
- medial clavicular joint 135 calcanea 322
- shoulder joint 148 - - infrapatellaris 302 170, 173-174, 181-182, 202-203, 2 2 4 -
- sternoclavicular joint 59 - - olecrani 131 225, 240
Basal 5 ----- prepatellaris 296, 372 - longum
Basis ----- sacralis 105 ----- (M. biceps brachii) 21, 146-147, 149, 163,
- ossis ----- spinae iliacae posterioris superioris 105 168-172, 174, 222
----- metacarpi 158 - subdeltoidea 169 ----- (M. biceps femoris) 2 9 9 -3 0 0 ,3 0 6 -3 1 0 ,
- - metatarsi 260 - subfascialis prepatellaris 280 336, 354-355, 370-371
----- sacri 56 -57, 70, 290 - subpoplitea 280 - - (M. triceps brachii) 21, 83, 105, 131, 146,
- patellae 272, 292 - subtendinea 162-163, 169-174, 202-203, 222-225,
- phalangis - - iliaca 3 0 4 -3 0 5 , 370 240
----- (Manus) 142 - - musculi - mediale
- - (Pes) 260 - — gastrocnemii medialis 315-317 ----- (M. gastrocnemius) 274, 297, 308-311,
Bayonet injury 129 - — sartorii 305 314-317, 354, 357-358, 361, 372, 374
BEKHTEREV'S (BECHTEREW's) disease 63, - - prepatellaris 302 ----- (M. triceps brachii) 21, 131, 170-174, 176-
----- subscapularis 147, 163 178, 181-183, 202-203, 222-224, 240
268 - suprapatellaris 273, 280-281 - medusae 25
BENNINGHOFF's arcades 17 - synoviales (Art. genus) 280 - obliquum (M. adductor hallucis) 325, 3 6 8 -
Bicondylar joint 272, 276 - trochanterica musculi glutei 369
Bifid ribs 47 - - maximi 307-309 - ossis metatarsi 260
Bifurcatio - - medii 309 - phalangis
- aortae 22, 34, 338 Bursitis 280 - - (Manus) 142
- tracheae, conventional radiograph 32 - - (Pes) 260
Blastocyst 12 c - profundum (M. flexor pollicis brevis) 189,
Blastocyst cavity 12 191, 242
Blisters (Bullae) 37 Calcaneal tendon (Achilles) 315-317, 36 2-363, - radiale (M . flexor digitorum superficia­
- epidermal 37 369 lis) 177, 179, 228
Block vertebra 45, 55, 68 - radii 141, 157
BOCHDALEK's triangle (Trigonum lumbocosta- Calcaneus 260-263, 283, 285, 289, 369 - rectum (M. rectus femoris) 269,304
- ossification centres 16 - reflexum (M. rectus femoris) 269, 304
le) 94 Callus 15 - superficiale (M. flexor pollicis brevis) 189,
Body regions 8 -9 Calx 9, 247 191, 236, 242
Bone marrow biopsies 58 Canalis - tali 260-263, 294, 369
Bones 14 - adductorius 303, 340, 351 - transversum
- air-filled bones 14 - arteriae vertebralis 50 ----- (M. adductor hallucis) 32 3-32 5, 368
- cartilaginous skeleton 133 ----- (M. adductor pollicis) 189-190
- ulnae 131, 140, 152, 184, 186
- ulnare (M. pronator teres) 1 7 9,18 5,22 8
Caput-collum-diaphyseal angle
(CCD angle) 256

Cardiac pacemaker, implantation access via the Clivus 64 Corpus
V. cephalica 213 C lu b fo o t 13, 132, 289 - ossis
- congenital 289 - - ilii 252-253, 291
Carotid pulse 22 Coccyx 57 - - ischii 252-253
Carpal joints 153 COCKETT's communicating perforating ve­ - - metatarsi 260, 318
Carpal tunnel 20 4-20 5, 235, 241 - - pubis 252-253
Carpal tunnel syndrome 205 ins 342 - phalangis
Carpus 133-134 Collateral arteries, Rete articulare cubiti 208 ----- (Manus) 142
- fractures 158 Collateral circulations 339 - - (Pes) 260
- joints 153 Collateral ligaments, elbow joint 150 - radii 141, 184
- ligaments 154 Collodiaphyseal angle - sterni 46, 58-59, 85
- transverse section 241 - fem ur 256 - tali 262-263
Cartilaginous joint 17 - humerus 138 - tibiae 258, 282, 292
Cartilago(-ines) Collum 6-7 - ulnae 140, 184
- articularis (Femur) 15 - anatomicum 138-139 - unguis 36
- costalis 46, 59, 88 - chirurgicum 138-139 - vertebrae 5 0 -5 3 , 55, 62, 68 -73, 113
- cricoidea 68 - costae 47, 53 Cortex, hair 38
- thyroidea 72 - femoris 254-256, 269, 290-291 Cortical sinus, lymph nodes 27
Cauda equina 73, 109, 112 - fibulae 259, 272 Cortical sinus cells 27
Caudal/caudalis (= inferior) 5 - radii 141, 150, 152, 157 Costa(-ae) 14, 47, 53, 6 9 -7 0
Cavea thoracis - scapulae 137, 156 - conventional radiograph 32
- anterior wall 85 - tali 262-263, 294 - fluctuantes 4 5 -4 6
- posterior wall 85 Colon 10-11 - spuriae 4 5 -4 6
Cavitas - conventional radiograph, barium swallow - verae 45 -4 6
- articularis 17 Costovertebral joints 61-62
- glenoidalis 137, 146, 156, 163 test 32 Coxa
- medullaris 15, 255 Columna vertebralis 46, 4 8 -4 9 , 111 - valga 256
- serosa scroti 124-125 Compartimentum cruris - vara 256
- symphysialis 268 - anterius 373 Coxarthrosis 256, 269
Cavocaval anastomoses 41, 99 - laterale 373 Cranial/cranialis (= superior) 5
Cavum serosum scroti 123 - posterius 373 Cremasteric reflex 121
Central 5 Compression syndrome Crista
Central nervous system (CNS) 28 - forearm 185 - capitis costae 47
Centrum tendineum diaphragmatis 85, 93-95 - leg 374 - colli costae 47
Cervical lordosis 49 Computed tom ography (CT) - iliaca 42, 70, 74-75, 93, 95, 105, 252, 290,
Cervical vertebral colum n 45, 47, 50 -5 2 , 66 - coronal CT of the sinuses 34
- com puted tom ography 72 - lumbar column 72 296, 299-300, 307-308, 334, 356
- lateral radiograph 68 - muscles of the abdominal wall 91 - intertrochanterica 254, 256, 290
Cervico-occipital joints 66 - vertebral colum n 72 - medialis fibulae 259
- cervico-occipital transitional region 64 Concha nasalis 34 - musculi supinatoris 140
- deep ligaments 6 4 -6 5 - media 34 - obturatoria 252-253
- ligaments 6 4 -6 5 Condylar joint 18 - occipitalis externa 50
- ventral ligaments 66 Condyloid joint, w ris t joint 154 - pubica 252
Chiasma Condylus - sacralis
- cruris 311, 316 - humeri 138 - - lateralis 56
- plantare 311, 325 - lateralis - - medialis 56
Chondrosis, Anulus fibrosus 73 ----- fem oris 25 4-25 5, 257, 272-274, 277, - - mediana 56-57, 70
CHOPART's joint (Art. tarsi transversal 260, - supraepicondylaris
281, 292-293 - - lateralis 138, 157
262, 286 - - tibiae 258, 272, 281, 292-293
- luxations 260 - medialis medialis 138, 157
Chorda - - fem oris 25 4-25 5, 272-273, 277, 281, - tuberculi
- arteriae umbilicalis 90, 119-120, 124-125 - - majoris 138
- dorsalis 13, 4 4 -4 5 292-293 - - minoris 138
- obliqua 150, 152 - - tibiae 257-258, 272, 274, 292-293, 315, Cruciate ligaments 274, 277
- urachi (Lig. umbilicale medianum) 90, 124— - injury 277
317 - reconstruction 281
125 - occipitalis 50 Crum bly nails 36
Cingulum Congenital club foot 13, 132, 289 Crural thrombosis
- pectorale 128, 134-135 Connexus intertendinei 186 - acute 342
- pelvicum 46, 248, 264 Conoid joint 18 - deep, pulmonary emboli 342
Circumduction 4 COOPER's ligaments (Ligg. suspensoria mam- Crus
Circumferentia articularis - anterius (Capsula interna) 35
- (Radius) 141, 150, 152 maria) 115 - dextrum (Pars lumbalis diaphragmatis) 9 3 -
- (Ulna) 140 Cor 10-11, 22-23, 30
Cisterna Cornu 94, 126
- cerebellomedullaris 108 - anterius (Meniscus lateralis) 293 - laterale (Anulus inguinalis superficialis) 86,
- chyli 26 - coccygeum 57
Clavicula 14, 43, 59, 83, 131, 134-136, 144, - posterius (M eniscus lateralis) 293 8 8 , 121
- sacrale 5 6 -57 - mediale (Anulus inguinalis superficialis) 82,
146, 156, 160, 162, 168-169, 171-173, 218 Coronary artery stenosis 101
- conventional radiograph 32 - bypass 101 8 6 , 8 8 , 121
Clavicular joint Coronary bypass, coronary artery stenosis - sinistrum (Pars lumbalis diaphragmatis) 94
- lateral joint 145 - transverse section 373-374
- medial joint 144 101 CT angiography
- - range of m ovem ent 135 Corpus - abdomen 34
- spheroidal joint or ball and socket joint 135 - adiposum infrapatellare (HOFFA's fat - pelvis 34
Claw foot 336 Cubita 134
Claw hand, lesions N. ulnaris 129, 207 pad) 35, 273, 293, 310 Cubital fossa
Claw toe 287 - axis 65 - arteries and nerves 230
Cleavage of the lateral vertebral arch 54 - callosum 35 - epifascial nerves 213-214, 216
Clitoris, insufficient filling of the cavernous - claviculae 43, 136 - epifascial veins 213,215-216
- costae 47 - epifascial vessels and nerves 214
body 333 - femoris 254-255, 292 Cubital pulse 22
- fibulae 259, 282, 292
- humeri 138, 172
- mammae 83

384

Index

Cupula Discus Elevation 4
- dextra, conventional radiograph 32 - intervertebralis 49, 62-64, 66 -68, 72-73, - shoulder joint 148
- sinistra, conventional radiograph 32 Ellipsoid joint, w ris t joints 154
Cutaneous innervation (segmental) 110-111 Emboli 208, 339
- back 104 Distal/distalis 5 Embryoblast 12
- lower extremity 329 Dithalamic joint 59 Embryogenesis 12
- upper extremity 196-197,329 Divisiones Embryonic disc 12
Cuticle 38 - anteriores (Plexus brachialis) 194 Eminentia
CNC (central nervous system) 28 - posteriores (Plexus brachialis) 194 - iliopubica 252
CVC (central venous catheter), V. cephalica 213 DODD's perforating veins 342 - intercondylaris 258, 272, 292
Cytotrophoblast 12 Dorsal 5 Enarthrosis (Art. cotylica) 26 9-270
Dorsal aponeuroses Encephalon 28
D - lateral tracts 192 Enteric nervous system 30
- medial tracts 186, 192 Entoderm 13
Deep (autochthonous) muscles of the back 77 - Dorsal extension Epiblast 12
79 - ankle joint 288 Epicondylus
- carpal joints 154 - lateralis
- deep layer 75, 79 - interphalangeal joints ----- (Femur) 254, 257, 272, 292, 372
- intertransversal system 77 - - (Humerus) 138, 150-151, 157, 162, 173,
- lateral tract 77 distal 155
- medial tract 77 ----- proximal 155 181-184, 214, 224, 231
- sacrospinal system 77 - metacarpophalangeal joints 155 - medialis
- spinal system 77 Dorsalaponeuroses, lateral tracts 186 - - (Femur) 25 4-25 5, 257, 272, 275, 292,
- spinotransversal system 77 Dorsalis 5
- superficial layer 74-76 Dorsiflexion, ankle joint 288 372
- transversospinal system 77 Dorsum of the fo o t (Dorsum pedis) 8 -9 , 2 4 6 - ----- (Humerus) 130, 138, 150-151, 157, 171-
Dendritic cells
- follicular 27 247, 349, 364 172, 176-179, 223, 226, 2 2 9-23 0
- interdigitating 27 - arteries 364 Epidermis 37-38
Dens axis 50 -52, 6 4 -6 5 , 68 - epifascial veins 349 Epididymis 124-125
Dermatomes 44 - fascia 296 Epidural anaesthesia 46
- abdominal wall 118 - muscles 320-321 Epiglottis 68
- back 104 - nerves 349, 364 Epimer, differentiation from myotomes 44
- disc prolapse 197 - skeleton 260-262 Epineurium 112
- lower extremity 329 Dorsum of the hand (Dorsum manus) 8, 130, Epiorchium 123-125
- stenosis of the vertebral canal 197 Epiphysis
- thoracic wall 118 186 - anularis 51, 53, 55, 63, 67
- upper extrem ity 133, 197 - arteries 238 - distalis 15
Dermis 37-38 - arteries and nerves 237-238 - proximalis 15
Descensus testis 124 - epifascial vessels 217 Epithelial root sheath 38
Dexter (= right) 5 - epifascial vessels and nerves 217 Eponychium 36
Diabetes mellitus, polyneuropathy 29 - nerves 217, 238 ERB's palsy (upper brachial plexus paraly­
Diameter - osseofibrous tunnels 183
- obliqua I/ll 250 - tendons 186 sis) 194
- transversa 250-251 - Vaginae tendinum 187 Erectile dysfunction 333
- vera 250-251 DUCHENNE's gait, loss of function of the small Eversion, talocalcaneonavicular joint 288
Diaphragm (Diaphragma) 10-11, 85, 92 -95, Extension 4
gluteal muscles 335 - elbow joint 151
101 Ductus(-us) - knee joint 272, 276
- apertures 94 - arteriosus (BOTALLO's duct) 24 - saddle joint of the thum b 154
- axial and para-oesophageal hiatal hernias 95 - deferens 120-121, 123-125 - vertebral column 60
- conventional radiograph 32 - lactiferi 115 Extensors, leg 311
- frontal section 95 - lymphaticus dexter 26, 116 External female genitalia
Diaphragmatic hernias 95 - thoracicus 26, 94, 116 - lymph nodes 103
Diaphysis 15 ----- confluence 221 - superficial lymph vessels 103
Diarthrosis 17 ----- metastases 221 External ligaments, knee joint 273, 275
Digitus(-i) 246 - venosus (ARANTIUS's duct) 24 External/externus 5
- anularis 130 Duodenum 10 Extremitas
- manus 134 Dura mater - acromialis (Clavicula) 136
- medius 130, 242 - cranialis 64 - sternalis (Clavicula) 136
- minimus [quintus] - spinalis 64, 108-109, 112-113
----- (Manus) 130 Dystonia 178 F
- - (Pes) 260-261 - M. iliopsoas 303
- pedis 248 F cells, Membrana synovialis 17
- primus (Pes) 260-261 E Facial defects, grafts of the M. pectoralis ma­
- quartus (Pes) 260-261
- secundus (Pes) 260-261 Ectoderm 13 jor 74
- tertius (Pes) 260-261 Ectopia of testis 124 Facialis pulse 22
DIP joint (distal interphalangeal joint) 155 Elbow Facies
Direction and positioning of body parts 5 - anular ligament 150 - anterior
Disc prolapse/disc herniations 73 - arteries 230 - - (Patella) 272-273
- dermatomes 197,329 - epifascial nerves 214 - - (Radius) 141, 179
- lumbar 67 - nerves 230 - - (Ulna) 140
- medial, MRI 73 Elbow joint 128, 150 - anterolateralis (Humerus) 138, 140
- posterolateral 54 - collateral ligaments 150 - anteromedialis (Humerus) 138
Discus - extensors 170 - articularis
- articularis - flexion 151 ----- acromialis 263
----- (Art. radioulnaris distalis) 152-153 - flexors 170 ----- anterior
----- (Art. sternoclavicularis) 59, 144 - hinge joint (trochoginglymus) 151 ---------(Atlas) 50
- interpubicus 264, 267-268 - pronation 151 ---------(Axis) 51
- radiograph 157 ----- calcanea
- range of m ovem ent 151 ---------anterior 263
- supination 151 ---------media 263

Index

Facies articularis calcanea Fascia Foramen (-ina)
---------posterior 263 - transversalis 78, 88, 90, 92 -9 3 , 95, 101, - ischiadicum
- - carpalis 141, 152 - - majus 265-267, 307, 334
- - claviculae 136 121, 123-125 - - minus 265-267, 300, 307, 309, 332
Fasciculus(-i) - magnum 50, 108
clavicularis 146 - lateralis (Plexus brachialis) 194-195,199, - nutricium
- - cuboidea 263 - - (Clavicula) 136
- - fibularis 258-259 218, 222 - - (Radius) 141
- - inferior - longitudinales - - (Tibia) 2 5 8-25 9
- — (Atlas) 50 - - (Aponeurosis plantaris) 322 - - (Ulna) 140
---------(Tibia) 25 8-259, 28 2-283, 293 - obturatum 34, 252, 265, 267, 290-291
- malleoli (Lig. cruciform e atlantis) 6 4 -6 5 - ovale 24
---------lateralis 259, 28 2-283 - medialis (Plexus brachialis) 194-195,199, - sacralia
---------medialis 25 8-259, 282-283 ----- anteriora 56, 71
----- navicularis (Talus) 263 218, 222 - - posteriora 56-57
----- (Patella) 2 7 2 -2 7 3 ,2 8 1 ,2 9 2 - posterior (Plexus brachialis) 194-195,199, - suprapiriforme 300, 307-308, 332, 334, 355
- - posterior (Axis) 51 - transversarium 50-52, 72
----- sternalis 136 218, 222 - venae cavae 85, 9 3 -9 4
----- superior - transversi (Aponeurosis plantaris) 322 - vertebrale 50-51, 53, 55, 72
---------(Atlas) 50 Fecal incontinence 333, 335 Forearm (Antebrachium) 6, 130, 134
---------(Axis) 50 Females, surface anatomy 6 -7 - arteries and nerves
---------(Tibia) 258 Femoral head - - deep layer 228-229, 231-232
- talaris (Calcaneus) - fractures 271 - - superficial layer 226-227
---------anterior 263, 285 - - Coxa vara 256 - compression syndrome 185
- - - media 263, 285 - necrosis 271 - conjunctions of the bones in pronation and
- - - posterior 263, 285 Femoral pulse 22
Femoral (thigh) hernias 121 supination positions 152
tuberculi costae 47 Femur 6-7, 14, 35, 248, 254-257, 272-275, - diagonal axis 134, 185
- auricularis (Os sacrum) 56-57, 252 - dorsal muscles 180-184
- costalis (Scapula) 137 281, 290-293, 305, 310, 316, 358, 371-372 - epifascial veins and nerves 216
- intervertebralis 51, 53, 55, 68-71 - adductor group 301-302 - fascia 131
- lateralis - distal end 257 - pronation 185
- - (Fibula) 259 - proximal end 256 - radial muscles 180
- spongiosa structure 256 - supination 185
(Radius) 141 - transverse section 371 - supinator muscles 170
- - (Tibia) 258 ----- through the middle of the thigh 370 - transverse section 241
- lunata 252-253, 270 Fertilisation 12 - ventral muscles 175, 177-179
- malleolaris Fetus, ultrasound image 33 Fossa
- - lateralis 262-263 Fibrae intercrurales 82, 86, 121 - acetabuli 252-253, 270, 290-291
- - medialis 262-263 Fibrous joint 17 - axillaris 13 0 ,2 1 0 -2 1 2 ,2 1 9 -2 2 3
- medialis Fibrous root sheath 38 - coronoidea 138, 157
- - (Tibia) 25 8-259, 312, 359 Fibula 14, 248, 25 8-259, 272-275, 282-284, - cubitalis 8
- - (Ulna) 140 - iliaca 252
- patellaris (Femur) 254, 257, 273, 281 294-295, 316-317, 319, 373-374 - iliopectinea 345
- pelvica 57 - ligaments 282 - infraclavicularis 131
- poplitea (Femur) 2 5 4 -2 5 5 ,2 7 2 ,2 9 2 ,3 1 0 , Fibular/fibularis 5 - infraspinata 137
Filum(-a) - inguinalis
316, 358 - radicularia 113 - - lateralis 92, 120, 124-125
- posterior - - medialis 92, 120, 124-125
----- (Humerus) 139 posteriora 108 - intercondylaris 254-255, 257, 272, 292-293
- - (Radius) 141 - terminale 112 - malleoli 259
- - (Scapula) 137 Finger joints 155 - olecrani 139, 157
- - (Tibia) 2 5 8-25 9 - arthrosis 158 - ovalis 24
- - (Ulna) 140 - extensor muscles 187 - paravesicalis 92
- sacropelvica 252 - flexor muscles 192 - poplitea 9, 247, 296, 309, 347, 35 3-35 5,
- superior (Talus) 263 - ligaments 155
- symphysialis 252, 267 - range of m ovem ent 155 357-358, 361-362
Fascia Fingers 132 - radialis 138
- antebrachii 131, 171-172,234 - examination of cuts 191 - subscapularis 137
- axillaris 82, 210 Fissura sterni congenita 58 - supraspinata 137
- brachii 82, 131, 212, 240 Flatfoot, acquired 289 - supravesicalis 120, 124-125
- clavipectoralis 82, 218 Flexion 4 - trochanterica 254-256
- cremasterica 124-125 - elbow joint 151 Fovea
- cribrosa 296 - knee joint 272,276 - articularis 141
- cruris 296, 314, 348, 357, 373-374 - saddle joint of the thum b 154 - capitis femoris 254-256, 290-291
- deltoidea 74-75 - vertebral column 60 - costalis
- dorsalis pedis 296 Flexion contracture, limited m obility 19 - - inferior (Vertebra) 53
- endothoracica 84 Follicular dendritic cells 27 ----- processus transversi 5 3 -5 4 , 6 0 -6 2 , 113
- extraperitonealis 123 Foot drop 337, 360 ----- superior 5 3 -5 4 , 60, 62
- glutea 83, 296, 307, 354 Foot (Pes) 6-7, 248, 260 - dentis 50
- infraspinata 74-76, 162, 173 - dorsiflexion position 336 - radialis (Tabatière) 186,238
- lata 296, 30 2-30 4, 307, 345, 347, 371 - epifascial veins 348 Fractures 15
- musculi serrati 84 - joints 286-287 - conventional radiographs 156
- nuchae 107 - muscles 313, 325 - healing of 15
- pectoralis 115, 163 - nerves 348 FROHSE's arcade 202-203, 227
- spermatica - pronation position, lesion of the N. tibia­ FROMENT's sign, lesion of the N. ulnaris 207
- - externa 121, 123-125 Frontal plane 4, 135
- - interna 124-125 lis 336 Frontal/frontalis 5
- thoracica - sagittal section 369 Fundus ventriculi 32
----- externa 84 - - MRI 369
----- interna 84 - synovial sheath (Vaginae tendinum) 318-319
- thoracolumbalis 62 -63, 72-79, 83, 90, 307 - tensioning of the longitudinal plantar

arch 289
Foramen(-ina) 15
- costotransversarium 53, 62
- infrapiriforme 300, 307-309, 332, 334, 355
- intervertebrale 49, 54, 63, 68, 70, 72, 110

narrowing 54, 110