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Таджикский государственный медицинский университет им. Абуали ибни Сино (Авицены)

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Нормальная анатомия

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HUMAN ANATOMY – VOLUME 1

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ment of the Jacobson’s organ of vertebrates. Behind and somewhat lower than the Jacobson organ there is occasionally a blind incisive (Stensen’s) duct. It is a rudimentary structure, situated inside the incisive canal. In 70 percent of cases the nasal septum is slightly deviated to the right or left. Occasionally there is a significant deviation. The development of the nasal conchae and depth of the nasal meatuses may vary. Often there is an additional foramen behind the semilunar fissure, which communicates the middle nasal meatus with the maxillary sinus.

Larynx. The extent of calcification of laryngeal cartilages varies between individuals. Their size and shape may also have significant differences. Often the superior horns of the thyroid cartilage are absent. There is occasionally a small foramen 1–6 mm wide in one or both of its plates. The cricoid cartilage may have an additional tubercle (marginal denticle), situated on the inferior margin of its arch. The triticea cartilages may be absent, doubled or increased in size. Sometimes the cricothyroid articulations are absent. Mobility in joints of the larynx may vary. Its ligaments may be developed to various extents. Most inconstancy is noted for the muscles of the larynx. In 10 percent of cases there is a thyrotracheal or a cricotracheal muscle. In 3 percent of cases there is an unpaired transverse thyroid muscle. Very rarely there is a lateral epiglotticothyroid muscle, which raises the thyroid gland. In 20 percent of cases there is a cricoepiglottic muscle; in 9 percent — a depressor muscle of the arytenoid cartilages, in 16 percent — additional fascicles of the thyroarytenoid muscle. In 22 percent the lateral thyroarytenoid muscle is absent. In the anterior half of the ventricle of the larynx, on one or both sides, there is sometimes a small excavation called the laryngeal appendix. Its shape and size are variable.

Trachea. The length and width of the trachea are variable. The number of its cartilages ranges from 12 to 22. The shape of cartilages often has individual peculiarities. Sometime in the place of bifurcation the trachea divides into three main bronchi (trifurcation). Occasionally there are congenital fistulae between the trachea and esophagus. There is sometimes a thyrotracheal bursa between the thyroid gland and the trachea. In rare cases there is an arototracheal bursa between the trachea and aorta.

Lungs. The lungs may vary in shape and size. Often there are additional lobes in one or both lungs (up to 6 lobes in a lung). Sometimes separate bronchi extend from the main bronchi to the apexes of the lungs. Very rarely, when there are defects of the diaphragm, the lung may have an accessory lobe protruding into the abdominal cavity. The amount of connective tissue in the lungs, and the number of acini and their components may vary.

Pleura. The depth and size of pleural recesses are variable. Often there are adhesions between the parietal and visceral pleurae. In 7 percent of cases the right and left sheets of the mediastinal pleura are linked in the front behind the sternum, forming a mesocardium.

Mediastinum. The mediastinum may be narrow, or, on the contrary, unusually wide, which depends on the configuration of the thorax. The topography of the thoracic and abdominal organs may be partially or totally inverted.

Questions for revision and examination

1.Describe the structure of the pleura and its locations inside the thoracic cavity.

2.What part of the pleura is called the pulmonary ligament?

3.Name the pleural recesses. Where is each of them located?

4.Compare the projections of the lungs and the pleural cavity onto the surface of the body. How are their borders different?

5.What anatomical structures of the thoracic cavity form the mediastinum?

6.What sections is the mediastinum divided into? What organs are situated inside each of these sections?

7.What variants and anomalies of respiratory organs do you know?

CONTENTS
Preface ..................................................................................................................	3
Introduction ........................................................................................................	4
Planes and axes. General anatomical terms ......................................................	6
THE STRUCTURE OF THE HUMAN BODY ..................................................	9
Cells and tissues ...........................................................................................	9
Cells .....................................................................................................................	9
Transport of substances and membranes in the cell ...............................	15
The nucleus ..................................................................................................	16
Cell division. The cell cycle ........................................................................	19
Tissues ...............................................................................................................	21
Epithelial tissue ............................................................................................	22
Connective tissue ........................................................................................	30
The Blood ...............................................................................................	36
Skeletal tissues ......................................................................................	39
Cartilage ..................................................................................................	39
Bone tissue .............................................................................................	41
Muscle tissue ...............................................................................................	43
Nervous tissue .............................................................................................	47
MAIN STAGES OF DEVELOPMENT IN ONTOGENESIS ........................	57
LOCOMOTION APPARATUS ..........................................................................	67
Structure of bones .......................................................................................	67
Classification of bones ...............................................................................	69
Structure and chemical composition of bones .........................................	70
Development and growth of bones ...........................................................	74
Skeleton of the trunk .......................................................................................	75
Vertebrae .......................................................................................................	75
Cervical vertebrae ..................................................................................	76
Thoracic vertebrae .................................................................................	78
Lumbar vertebrae ...................................................................................	79
Sacrum .....................................................................................................	79
Coccyx .....................................................................................................	81
Ribs and sternum .........................................................................................	81
Sternum ...................................................................................................	82
Main variants and anomalies of bones of the trunk ................................	83
The skull ............................................................................................................	83
Bones of the cranial skull ............................................................................	84
Canals of the temporal bone .................................................................	93
Bones of the facial skull ..............................................................................	94
Skull as a whole ............................................................................................	99
Paranasal sinuses ................................................................................	106
Skull of a newborn .....................................................................................	110
Modifications of the skull after birth. ......................................................	112
Sexual characteristics of the skull ............................................................	113
Development of the human skull .............................................................	113
Variants and anomalies in development of the bones
of the skull ............................................................................................	115
The appendicular skeleton ............................................................................	116
Bones of the upper extremities .................................................................	118
The pectoral girdle ...............................................................................	118

412

Skeleton of the free upper extremities ...............................................	118
Bones of the forearm .....................................................................	119
Bones of the hand .........................................................................	120
Variants and anomalies of the skeleton of the upper
extremities .......................................................................................	121
Bones of the lower extremities ..................................................................	122
Bones of the pelvic girdle ...................................................................	123
Skeleton of the free lower extremity ...................................................	125
Bones of the leg .............................................................................	126
Bones of the foot ...........................................................................	127
Variants and anomalies of the skeleton of lower
extremities .......................................................................................	128
JOINTS .................................................................................................................	129
Classification of joints ..............................................................................	129
Classification of joints (continuation) .....................................................	133
Age characteristics of joints .....................................................................	135
Articulations of the bones of the trunk ........................................................	136
Joints of the vertebral column ..................................................................	136
Articulations between the vertebral column and skull ..........................	139
The vertebral column (as a whole) ...........................................................	141
Articulation of ribs with the vertebral column .......................................	142
Articulation of the ribs with the sternum ................................................	143
The thorax (as a whole) .............................................................................	144
Articulations of the bones of the skull .........................................................	146
Articulations of the upper extremities .........................................................	148
Articulations of the pectoral girdle ..........................................................	148
Articulations of the free upper extremity ................................................	149
Articulations of the forearm and hand ....................................................	152
Movement in joints of the hand ...............................................................	156
Articulations of the lower extremities .........................................................	159
Articulations of the pelvic girdle .............................................................	159
The pelvis (as a whole) .............................................................................	161
Articulations of the free lower extremity .................................................	163
Articulations of the bones of the leg ......................................................	167
Articulations of the bones of the foot .....................................................	168
The foot as a whole ...................................................................................	174
THE MUSCULAR SYSTEM .............................................................................	175
Structure of the skeletal muscles .............................................................	176
Classification of muscles ..........................................................................	177
The auxiliary apparatus of muscles .........................................................	178
Work of muscles ........................................................................................	180
Development of muscles ...........................................................................	184
Muscles and fasciae of the back ....................................................................	185
Superficial muscles of the back ................................................................	185
Deep muscles of the back .........................................................................	188
Fasciae of the back ....................................................................................	195
Topographic anatomy and fatty tissue spaces of the back ..................	195
Muscles and fasciae of the thorax .................................................................	199
Proper muscles of the thorax ....................................................................	203
Fasciae of the thorax .................................................................................	207
Topographic anatomy and fatty tissue spaces of the torax ..................	207
Muscles and fasciae of the abdomen .............................................................	209
Muscles of the posterior abdominal wall ................................................	211

413

Fasciae of the abdominal region ..............................................................	213
Topographic anatomy and fatty tissue spaces of the abdominal
walls ......................................................................................................	213
Linea alba of the abdomen ..................................................................	214
The rectus sheath ................................................................................	215
The inguinal canal ...............................................................................	217
Muscles and fasciae of the head ....................................................................	217
Muscles of fasial expression ....................................................................	217
Muscles of the roof of the skull .........................................................	218
Muscles of the eyelid and the orbit ...................................................	219
Muscles of the nose ............................................................................	220
Muscles of the mouth .........................................................................	221
Muscles of the auricular concha ........................................................	222
Masticatory muscles .................................................................................	224
Fasciae of the head ....................................................................................	226
Topographic anatomy and fatty tissue spaces of the head ..................	227
Muscles and fasciae of the neck ....................................................................	229
Superficial muscles of the neck ................................................................	229
Muscles situated above the hyoid bone ..........................................	230
Muscles situated below the hyoid bone ...........................................	232
Deep muscles of the neck .........................................................................	233
Topographic anatomy and fatty tissue spaces of the neck ..................	236
Triangles of the neck .................................................................................	238
Muscles and fasciae of the upper extremity ................................................	241
Muscles of the shoulder girdle ................................................................	241
Muscles of the free upper extremity ........................................................	244
Anterior muscles of the arm ...............................................................	244
Posterior muscles of the arm ..............................................................	245
Anterior muscles of the forearm .........................................................	246
First (superficial) layer of the anterior muscles
of the forearm ...........................................................................	246
Second layer of the anterior muscles of the forearm ..................	248
Third layer of anterior muscles of the forearm ...........................	248
Fourth (deep) layer of the anterior muscles of the forearm .......	249
Posterior muscles of the forearm ........................................................	249
Superficial layer of the posterior muscles of the forearm ..........	249
Deep layer of the posterior muscles of the forearm ...................	251
Muscles of the hand ............................................................................	252
Muscles of the thenar eminence ..................................................	254
Muscles of the hypothenar ..........................................................	255
Middle group of the muscles of the hand ...................................	256
Fasciae and synovial bursae of the upper extremity ..............................	261
Topographic anatomy and fatty tissue spaces of the upper
extremity ...............................................................................................	264
Muscles and fasciae of the lower extremity .................................................	268
Muscles of the pelvic girdle (muscles of the pelvis) .............................	268
Internal muscles of the pelvic girdle ..................................................	269
External muscles of the pelvic girdle .................................................	271
Muscles of the free lower extremity .........................................................	274
Anterior muscles of the thigh .............................................................	274
Posterior muscles of the thigh ............................................................	275
Medial muscles of the thigh ...............................................................	276
Muscles of the leg .....................................................................................	277
Anterior muscles of the leg ................................................................	278

414

Lateral muscles of the leg ...................................................................	279
Posterior muscles of the leg. ..............................................................	279
Superficial layer ..............................................................................	279
Deep layer of the posterior group of the leg muscles ................	280
Muscles of the foot .............................................................................	281
Dorsal muscles of the foot ............................................................	281
Medial group of the muscles of the sole. ....................................	283
Lateral group of muscles of the sole ...........................................	283
Middle group of the muscles of the sole ....................................	285
Fasciae, synovial bursae and sheaths of the lower extremity ...............	291
Topographic anatomy and fatty tissue spaces of the lower
extremity ...............................................................................................	294
Variants and anomalies of the skeletal muscles ......................................	298
Muscles of the trunk ...........................................................................	298
Muscles of the chest ...........................................................................	299
Muscles of abdomen ...........................................................................	299
Muscles of facial expression ..............................................................	300
Muscles of mastication .......................................................................	300
Muscles of the neck ............................................................................	301
Muscles of the upper extremity ..........................................................	302
Muscles of the lower extremities ........................................................	304
SPLANCHNOLOGY (THE STUDY OF INTERNAL ORGANS) ............	306
Topographic orientation points of internal organs ................................	310
The digestive system .......................................................................................	311
The oral cavity ...........................................................................................	313
Palate .....................................................................................................	313
Teeth .....................................................................................................	315
Tongue ..................................................................................................	317
Salivary glands ....................................................................................	321
Pharynx .......................................................................................................	325
Oesophagus ...............................................................................................	330
Stomach ......................................................................................................	332
Small intestine ............................................................................................	339
Duodenum ............................................................................................	339
Jejunum and Ileum ...............................................................................	340
Large intestine ...........................................................................................	344
Liver ............................................................................................................	351
Biliary system .......................................................................................	356
Gallbladder ............................................................................................	357
Pancreas .....................................................................................................	358
Peritoneum ..................................................................................................	362
Development of the digestive system .....................................................	371
Age characteristics of the digestive system organs ..............................	374
Variants and anomalies of the digestive organs .....................................	377
The respiratory system ..................................................................................	381
Nose ............................................................................................................	382
Nasal cavity ..........................................................................................	383
Larynx ..........................................................................................................	384
Trachea .......................................................................................................	393
Main bronchi ..............................................................................................	395
Lungs ..........................................................................................................	396
Pleura ..........................................................................................................	403
Mediastinum ..............................................................................................	405
Development of the respiratory system ..................................................	407

415

Age characteristics of the respiratory system ........................................	408
Variants and anomalies of the respiratory system .................................	409

M.R. Sapin, L.L. Kolesnikov, D.B. Nikitjuk

TEXTBOOK OF HUMANANATOMY

For medical students

Volume 1

М.Р. Сапин, Л.Л. Колесников, Д.Б. Никитюк

АНАТОМИЯ ЧЕЛОВЕКА

Учебное пособие для студентов медицинских вузов (на англ. языке)

Книга 1

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