1288 SURFACE ANATOMY AND SURFACE MARKINGS 





with the lobule of the auricula. About 1 cm. below and in front of the apex of 

 the mastoid process, the transverse process of the atlas can be distinguished. In 

 front of the ear the zygomatic arch can be felt throughout its entire length; its 

 posterior end is narrow and is situated a little above the level of the tragus; its 

 anterior end is broad and is continued into the zygomatic bone. The lower border 

 of the arch is more distinct than the upper, which is obscured by the attachment 

 of the temporal fascia. In front, and behind, the upper border of the arch can be 

 followed into the superior temporal line. In front, this line begins at the zygomatic 

 process of the frontal bone as a curved ridge which runs at first forward arid 

 upward, on the frontal bone, and then curving backward separates the forehead 

 from the temporal fossa. It can then be traced across the parietal bone, where, 

 though less marked, it can generally be recognized. Finally, it curves downward, 

 and forward, and passing above the external acoustic meatus, ends in the posterior 

 root of the zygomatic arch. Near the line of the greatest transverse diameter of 

 the head are the parietal eminences, one on either side of the middle line; further 

 forward, on the forehead, are the frontal eminences, which vary in prominence in 

 different individuals and are frequently unsymmetrical. Below the frontal emi- 

 nences the superciliary arches, which indicate the position of the frontal sinuses, 

 can be recognized; as a rule they are small in the female and absent in children. 

 In some cases the prominence of the superciliary arches is related to the size of 

 the frontal sinuses, but frequently there is no such relationship. Situated between, 

 and connecting the superciliary ridges, is a smooth, somewhat triangular area, the 

 glabella, below which the nasion (frontonasal suture} can be felt as a slight depres- 

 sion at the root of the nose. 



Below the nasion the nasal bones, scantily covered by soft tissues, can be traced 

 to their junction with the nasal cartilages, and on either side of the nasal bone 

 the complete outline of the orbital margin can be made out. At the junction of 

 the medial and intermediate thirds of the supraorbital margin the supraorbital 

 notch, when present, can be felt; close to the medial end of the infraorbital margin 

 is a little tubercle which serves as a guide to the position of the lacrimal sac. Below 

 and lateral to the orbit, on either side, is the zygomatic bone forming the prominence 

 of the cheek; its posterior margin is easily palpable, and on it just above the level 

 of the lateral palpebral commissure is the zygomatic tubercle. A slight depression, 

 about 1 c"m. above this tubercle, indicates the position of the zygomaticofrontal 

 suture. Directly below the orbit a considerable part of the anterior surface of the 

 maxilla and the whole of its alveolar process can be palpated. The outline of the 

 mandible can be recognized throughout practically its entire extent; in front of 

 the tragus and below the zygomatic arch is the condyle, and from this the posterior 

 border of the ramus can be followed to the angle; from the angle to the symphysis 

 the lower rounded border of the mandible can be easily traced; the lower part of 

 the anterior border of the ramus and the alveolar process can be made out without 

 difficulty. In the receding angle below the chin is the hyoid bone, and the finger 

 can be carried along the bone to the tip of the greater cornu, which is on a level 

 with the angle of the mandible: the greater cornu is most readily appreciated 

 by making pressure on one side, when the cornu of the opposite side will be rendered 

 prominent and can be felt distinctly beneath the skin. 



Joints and Muscles. The temporomandibular articulation is quite superficial, and 

 is situated below the posterior end of the zygomatic arch, in front of the external 

 acoustic meatus. Its position can be ascertained by defining the condyle of the 

 mandible; when the mouth opens, the condyle advances out of the mandibular 

 fossa on to the articular tubercle, and a depression is felt in the situation of the 

 joint. 



The outlines of the muscles of the head and face cannot be traced on the surface 

 except in the case of the Masseter and Temporalis. The muscles of the scalp 



