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lower fibres alone of the orbicularis contract, and the lower |
lid is elevated. The elevation of the upper lid, as in
opening the eye, is due to the levator palpebræ superioris,
which, arising within the orbit, is inserted into the upper
eyelid. Muscles are inserted into the framework of the
nostrils so as to increase or diminish the size of their
orifices, and thus to promote or impede the passage of air
into the nose. The size of the orifice is increased by
two elevator muscles inserted into the ala, or side of the
nostril; and when violent exercise is being performed, or
respiration is from any cause impeded, the nostrils are
always widely dilated. One of these elevator muscles,
which also sends a slip down to the upper lip, and is con-
sequently called the common elevator, is the muscle by
the contraction of which a sneer is expressed. A partial
closure of the nostril can be effected by small muscles
which depress and compress the alæ of the nose in man
these muscles are rudimentary as compared with the seal
and other aquatic mammals, in which a powerful sphincter
muscle closes the nostrils in the act of diving. The lips
can be elevated or depressed so as to close or open the
mouth; they can be protruded or retracted, or the corners
of the mouth can be drawn to one side or the other, by
the action of various muscles which are inserted into
these movable folds of the integument. The orbicularis
oris is a sphincter muscle, the fibres of which lie both
in the upper and lower lips; by its contraction the
mouth is closed and the lips pressed against the teeth,
as when a firm resolution is intended to be expressed.
The mouth is opened by the elevator muscles of the upper
and the depressors of the lower lip; it is transversely elon-
gated by the zygomatic and risorius muscles, which pass to
its corners, and which are brought into action in the acts
of smiling and laughing. But the muscles of the lips also
play an important
part in connection
with the reception
of food into the
mouth, and with
the act of articula-
tion.

The cavity of the mouth forms the commenceIment of the alimentary canal, and is lined by a

soft mucous mem

brane. In it the

FIG. 20.-Profile of cheek and pharynx. a, buccinator;

teeth and tongue
are situated, and
into it the secre-
tion called saliva
is poured. It
opens behind into
the pharynx. The
side walls of the
mouth are called
the cheeks, and
into the formation
of each cheek a
flattened quadrila-
teral muscle, the b, tensor; c, levator palati; d, e, f, superior, middle,
buccinator, enters. and inferior constrictors; 9, thyro-hyoid; h, hyo-
glossus; 1, mylo-hyoid; m, crico-thyroid; n, stylo-
This muscle is at- pharyngeus; o, stylo-glossus; q, fibrous band which
tached above and gives origin to buccinator and superior constrictor;
1, glosso-pharyngeal nerve; 2, superior laryngeal
below to the upper artery; 3, superior laryngeal nerve; 4, its branch to
crico-thyroid; 5, inferior laryngeal nerve and artery.
and lower jaw-
bones, behind to a fibrous band, to which the upper
constrictor muscle is also connected, so that the walls of

the mouth and pharynx are continuous with each other,
whilst in front the buccinator blends with the structures in
the lips. It compresses the cheeks, and drives the air out
of the cavity of the mouth as in playing a wind instru-
ment; hence the name, "trumpeter's muscle."

The aperture of communication between the mouth and
pharynx is named the isthmus of the fauces. It is bounded
below by the root of the tongue, on each side by the tonsils,
and above by the soft palate. The soft palate is a structure
which hangs pendulous from the posterior edge of the hard
bony palate. From its centre depends an elongated body,
the uvula, and from each of its sides two folds extend, one
downwards and forwards to the tongue, the other down-
wards and backwards to the pharynx. These folds are
called the anterior and posterior pillars of the fauces or
palate. Between the anterior and posterior pillar, on each
side, the tonsil is seated. The soft palate and its pillars are
invested by the mucous lining of the mouth and pharynx,
and contain small but important muscles. The muscles of
the soft palate and uvula, termed the elevators and tensors,
raise and make them tense during the process of deglutition.
The muscles of the posterior pillars, or palato-pharyngei, by
their contraction, approximate the walls of the pharynx to
the soft palate and uvula, whilst the muscles of the anterior
pillars, or palato-glossi, diminish the size of the fauces.
The pharynx is a tube with muscular walls, lined by a Muscles of
mucous membrane, which communicates above and in front pharynx.
with the cavities of the nose, mouth, and larynx, whilst
below it is continuous with the oesophagus or gullet. It
serves as the chamber or passage down which the food
goes from the mouth to the oesophagus in the act of
swallowing, and through which the air is transmitted from
the nose or mouth to the larynx in the act of breathing.
It lies immediately behind the nose, mouth, and larynx,
and in front of

[graphic]
[graphic]

the five upper
cervical verte-
bræ. Its length
is from 4 to 5
inches; its widest
part is opposite
the back of the
mouth. The prin-
cipal muscles in

its walls are call-
ed the constric-
tors, and are
named, from
above down-
wards, superior,

middle, and in

ferior. They are
arranged in
pairs, and arise
from the cartil-
ages of the
larynx, from the
hyoid bone,lower
jaw, and internal
pterygoid pro-
cess of the sphe-
noid; whilst the
superior also
springs from the fibrous band to which the buccinator is
attached; their fasciculi curve backwards to the middle line
of the posterior wall of the pharynx, to be inserted into a
tendinous band which extends longitudinally along this
wall of the tube.

FIG. 21.-Interior of the pharynx, seen by opening its
posterior wall, a, a, Eustachian tube; b, b, tensor; c,
levator palati; d, levator uvala; e, e, palato-pharyngeus;
f. palato-glossus; g, h, k, the three constrictors; 1, 1, ton-

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The action of the muscles of the mouth, palate, and pharynx may now be considered in connection with the

swallow

ing.

Process of process of deglutition or swallowing. When the food is received into the mouth, it is moistened by the secretion of the salivary and other buccal glands, and is broken down by the grinding action of the molar teeth. The buccinator muscles press it from between the gums and the cheek, and, along with the movements of the tongue, aid in collecting it into a bolus on the surface of that organ. During the process of mastication the palato-glossi contract so as to close the fauces. When the bolus is sufficiently triturated and moistened, the palato-glossi relax, the tip of the tongue is pressed against the roof of the mouth, and by a heave backward of that organ the bolus is pressed through the posterior orifice of the mouth into the pharynx, where it is grasped by the superior constrictor muscles, and forced downwards by them and the other constrictor muscles into the œsophagus, and thence into the stomach. As both the nose and larynx open into the pharynx, the one immediately above, the other immediately below the orifice of the mouth, it is of great importance that none of the food should enter into these chambers, and obstruct the respiratory passages. To guard against any accident of this kind, two valvular structures are provided,—viz., the soft palate and the epiglottis,—which, whilst leaving the orifices into their respective chambers open during breathing, may effectually close them when deglutition is being performed. As the bolus is being projected through the fauces into the pharynx, the soft palate and uvula are elevated and made tense, and at the same time the wall of the pharynx is brought in contact with it by the contraction of the palatopharyngei; the part of the pharynx into which the nose opens is thus temporarily shut off from that into which the mouth opens. If laughter, however, be excited at this time, the tension of the soft palate is destroyed, and part of the food may find its way upwards into the nose. The closure of the larynx by the epiglottis is due partly to the depression of that valve and partly to the elevation of the larynx. The backward heave of the tongue relaxes the ligaments which connect the front of the epiglottis to that organ, and enables the small epiglottidean muscles to depress the valve. The elevation of the hyoid and larynx is due to the action of the mylo-hyoid, digastric, and genio-hyoid muscles, which pass from the lower jaw to the hyoid, and of the thyro-hyoid, which pass from the hyoid to the thyroid cartilage of the larynx; preliminary to their action, the lower jaw must be fixed, which is done by the closure of the mouth prior to the act of swallowing. The aperture of the larynx is thus brought into contact with the depressed epiglottis, which is adapted more exactly to the opening by a change in its form due to the projection of a cushionlike pad from its posterior surface. By these ingenious arrangements the adaptation of a single chamber to the very different functions of breathing and swallowing is effectually provided for.

JOINTS AND MUSCLES OF THE UPPER LIMB. The upper limb is jointed to the trunk at the sternoclavicular articulation. This is a diarthrodial joint: the bones are retained together by investing ligaments; a meniscus is interposed between the articular surfaces, so that the joint possesses two synovial membranes. A strong ligament, which checks too great upward movement, connects the clavicle and first rib. The two bones of the shoulder girdle articulate with each other at the diarthrodial acromioclavicular joint; but, in addition, a strong ligament, which checks too great displacement of the bones, passes between the clavicle and coracoid. The movements of the upper limb on the trunk take place at the sterno-clavicular joint, and consist in the elevation, depression, and forward and backward movement of the shoulder. The movements at the acromio-clavicular joint occur when the scapula is

rotated on the clavicle in the act of elevating the arm above the head. The muscles which cause these movements are inserted into the bones of the shoulder girdle; the trapezius into the clavicle, acromion, and spine of the scapula; the rhomboid, levator anguli scapula, and serratus magnus into the vertebral border of the scapula; the pectoralis minor into the coracoid; and the subclavius into the clavicle. Elevation of the entire shoulder, as in shrugging the shoulders, is due to the contraction of the trapezius, levator scapulæ, and rhomboideus; depression partly to the weight of the limb and partly to the action of the subclavius and pectoralis minor; movement forward to the serratus and pectoralis; and backward to the trapezius and rhomboid. In rotation of the scapula on the clavicle, the inferior angle of the scapula is drawn forward by the serratus and lower fibres of trapezius, and backward by the levator scapulæ, rhomboid, and lesser pectoral.

The Shoulder Joint is a ball-and-socket joint, the ball Shoulder being the head of the humerus, the socket the glenoid fossa joint. of the scapula. A large capsular ligament, which is pierced by the long tendon of the biceps muscle, and lined by a synovial membrane, encloses the articular ends of the two bones, and is so loose as to permit a range of movement greater than takes place in any other joint in the body. The muscles which cause these movements are inserted into the humerus; the supra-spinatus, infraspinatus, and teres minor into the great tuberosity; the sub-scapularis into the small tuberosity; the latissimus dorsi and teres major into the bottom of the bicipital groove; the pectoralis major into its anterior border; the coraco-brachialis into the inner aspect, and the deltoid, which forms the fleshy prominence of the shoulder, into the outer aspect of the shaft. Abduction and elevation or extension of the arm outwards at the shoulder joint are due to the supra-spinatus and deltoid; adduction or depression, to the coraco-brachialis, latissimus, and teres major, assisted by the weight of the limb; movement forwards and elevation, to the anterior fibres of the deltoid, pectoralis, and subscapularis; backward movement to the latissimus and teres; rotation outwards to the infra-spinatus and teres minor; rotation inwards to the subscapularis, pectoralis, latissimus, and teres. A combination of abduction, movement forwards, adduction, and movement backwards, produces the movement of circumduction. movements of the upper limb, however, take place not only at the shoulder joint, but between the two bones of the shoulder girdle; for in elevating the arm, whilst the supraspinatus and deltoid initiate the movement at the shoulder joint, the farther elevation, as in raising the arm above the head, takes place by the trapezius and serratus, which rotate the scapula and draw its inferior angle forward. The free range of movement of the human shoulder is one of its most striking characters,

so that the arm can be moved in every direction through space, and its efficiency as an instrument of prehension is thus greatly increased. The movement of abduction, or extension, which elevates the arm in line with the axis of the scapula, is characteristically human, and a distinct Fra. 22.-Outline sketch of human huarticular area is provided on the head of the humerus for this movement. The Elbow Joint is the articulation between the humerus, Elbow. radius, and ulna: the great sigmoid cavity of the ulna is adapted to the trochlea of the humerus, and the cup of the radius to the capitellum. The joint is enclosed by a

merus. The articular area for complete extension lies to the right of the dotted line. (After Goodsir.)

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PLATE XVI

[graphic]

Joints of fore-arm.

Wrist.

Joints of

hand.

capsular ligament lined by a synovial membrane, which is subdivided into anterior, posterior, internal, and external bands of fibres. Flexion and extension are the two movements of the joint, and the range of movement is limited by the locking at the end of flexion of the coronoid process into the coronoid fossa of the humerus, and at the end of extension of the olecranon process into the olecranoid fossa. The elbow joint is a hinge with screwed surfaces; the path described by the hand and fore-arm is a spiral, so that during flexion they are thrown forwards and inwards. The muscles which cause the movements are inserted into the bones of the fore-arm. The flexors are the brachialis anticus, inserted into the coronoid of the ulna; the biceps, which forms the fleshy mass on the front of the upper arm, into the tuberosity of the radius; the supinator longus into the styloid process of the radius. The only extensor is the triceps-anconeus, which forms the fleshy mass on the back of the upper arm, and is inserted into the olecranon.

The Radio-ulnar Joints are found between the two bones of the fore-arm. The head of the radius rolls in the lesser sigmoid cavity of the ulna, and is retained in position by a ring-like ligament which surrounds it; the shafts of the two bones are connected together by the interosseous membrane, their lower ends by a capsular ligament and a triangular fibro-cartilage or meniscus. The radius rotates round an axis drawn through the centre of its head and the styloid process of the ulna; rotation of the fore-arm and hand forward is called pronation,-rotation backwards, supination. The supinator and pronator muscles are all inserted into the radius: the supinators are the longus and brevis and the biceps; the pronators are the teres and quadratus. Where delicate manipulation is required the fore-arm is semi-flexed on the upper arm, for the cupshaped head of the radius is then brought into contact with the capitellum of the humerus, and the rotatory movements of the bone can be performed with greater precision.

The Wrist or Radio-carpal Joint is formed above by the lower end of the radius and the triangular meniscus, below by the upper articular surfaces of the scaphoid, semi-lunar, and cuneiform bones. An investing ligament, lined by a synovial membrane, and subdivided into anterior, posterior, internal, and external bands of fibres, encloses the joint. It is the oblong form of hinge-joint, and possesses two axes, a long and a short; around the long axis movements occur which bend the hand forwards, or bring it in line with the fore-arm, or bend it backwards; around the short axis the hand may be moved towards the radial or ulnar margins of the fore-arm. The flexors forward are the palmaris longus, inserted into the palmar fascia; the flexor carpi radialis into the metacarpal bone of the index; the flexor carpi ulnaris into the pisiform bone; the extensors and flexors backwards are the longer and shorter radial extensors inserted into the metacarpal bones of the index and middle fingers, and the ulnar extensor into the metacarpal bone of the little finger; the flexors and extensors of the fingers have also a secondary action on the wrist joint. The ulnar flexor and ulnar extensor of the wrist draw the hand to the ulnar side, and the radial flexor and extensor, together with the extensors of the thumb, draw the hand towards the radial border of the fore-arm.

unciform are connected to the metacarpal bones of the fingers by dorsal, palmar, and interosseous ligaments, and the metacarpal bones of the fingers have a like mode of union at their carpal ends; further, a transverse ligament extends between the distal ends of the metacarpal bones of the fingers, and checks too great lateral displacement. The range of movement at any one of these carpal joints is very slight, but the multiplicity of joints in this locality contributes to the mobility of the wrist, and makes the junction between the hand and fore-arm less rigid in its nature. The metacarpal bone of the thumb is not jointed to the index, and has a distinct saddle-shaped articulation with the trapezium, invested by a capsular ligament, so that its range of movement is extensive.

The Metacarpophalangeal and Inter-phalangeal Joints Joints of are connected by lateral ligaments passing between the fingers. bones, and by an arrangement of fibres on their dorsal and palmar surfaces.

In studying the muscles which move the digits, it will be advisable, on account of the freedom and importance of the movements of the thumb, to examine its muscles independently. These muscles either pass from the fore-arm to the thumb, or are grouped together at the outer part of the palm, and form the elevation known as the ball of the thumb; they are inserted either into the metacarpal bone or the phalanges. The thumb is extended and abducted, i.e., drawn away from the index, by three extensor muscles descending from the fore-arm, and inserted one into each of its three bones, and a small muscle, specially named abductor pollicis, inserted into the outer side of the first phalanx: its bones are bent on each other by a long and short flexor muscle; it is drawn back to the index by an adductor muscle; and the entire thumb is thrown FIG. 23.-Deep muscles of the palm of across the surface of the palm by the opponens pollicis, which is inserted into the shaft of the metacarpal bone.

The four fingers can be either bent, or extended, or drawn asunder, i.e., abducted; adducted.

[graphic]

d

the hand. 1, abductor pollicis cut short; 2, opponens; 3 and 4, subdivisions of flexor brevis; 5, adductor; 6, 6', tendon of long flexor pollicis; 7, abductor of the little finger; 8, short flexor; 9, opponens; 10, tendon of flexor carpi ulnaris; 11, tendon of long supinator; tt transverse metacarpal ligament

or drawn together, i.e., The ungual phalanges can be bent by the

c, superficial flexor; d, a lumbrical muscle; e, an interosseous muscle; f, tendinous expansion from the lumbrical and interosseous muscles joining the extensor tendon.

The Carpal and Carpo-metacarpal Joints are constructed thus:-The articular surfaces are retained in contact by FIG. 24.-Tendons attached to a finger. a, the extensor tendon; b, deep flexor, certain ligaments passing between the dorsal surfaces of adjacent bones, by others between their palmar surfaces, and by interosseous ligaments between the semi-lunar and cuneiform, semi-lunar and scaphoid, os magnum and unciform, os magnum and trapezoid; lateral ligaments also attach the scaphoid to the trapezium, and the cuneiform to the unciform. Similarly, the trapezoid, os magnum, and

action of the deep flexor muscle, the four tendons of which are inserted into them; the second phalanges by the superficial flexor, also inserted by four tendons, one into each phalanx; these muscles descend from the front of the forearm into the palm in front of the wrist, where they are

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