44 APPLIED ANATOMY. 



Spitzka (New York Med. Jour., Feb. 2, 1901, p. 177) has pointed out how these ventricles 

 vary in shape, and has given the surface relations in two brains. T. T. Wilson (Jour. Anat. and 

 Phys., vol. xxviii, 1894, pp. 228-235) has described and figured them in three drawings. Spitzka 

 states that the ventricles will hold about 60 c.c. of liquid. 



Cerebral Abscess. About one-half of the abscesses of the brain occur from disease of the 

 middle ear, and they are located in the temporosphenoidal lobe, in the cerebellum, or between 

 the dura and petrous portion of the temporal bone. The remainder are caused either by blows 

 or infection carried to the part in infectious diseases. They may, therefore, occur anywhere in 

 the brain. 



When the motor areas around the fissure of Rolando are involved, the location of the 

 trouble will be shown by spasm or paralysis of the corresponding muscles. If the occipital lobe 

 is affected there may be disturbance of sight, as hemiopia. Involvement of the frontal lobes 

 produces mental dulness, and if of the third left frontal gyrus, or Broca's convolution there may 

 be impairment of speech. Disease of the middle lobe of the cerebellum may be accompanied 

 by a staggering gait. In many cases localization symptoms are rare, particularly when the 

 abscess is small and located in the temporosphenoidal, parietal, or frontal lobes (see chapter on 

 cerebral localization). 



Trephining. If the abscess arises from middle-ear disease, it is customary to first open 

 the mastoid antrum (see chapter on ear) and then by removing the bone above to explore the 

 surface of the petrous portion of the temporal bone. To explore the temporal lobe an opening 

 may be made 2.5 cm. (i in.) above the external auditory meatus and a needle passed inward, 

 forward, and a little downward. 



To reach the cerebellum, the trephine should be applied 5 to 7 cm. (2 to 2^ in.) behind 

 the external meatus and well below the superior curved line. The bone at this point is apt to 

 be thin and care is to be exercised not to wound the membranes. The place of trephining in 

 abscesses from other causes is to be decided by the localizing symptoms. 



THE FACE. 



The face may be divided into the regions of the forehead, temples, ears, eyes, 

 nose, mouth, cheek, and upper and lower jaws. The regions of the eyes, ears, nose, 

 and mouth will be considered separately. Owing to the face being that part of the 

 body most open to scrutiny and most difficult of concealment, deformities and dis- 

 figurements of it, resulting from injury or disease, to both of which it is prone, 

 assume a greater importance than the same troubles elsewhere. Therefore, the 

 anatomy of the part should be studied with regard to the treatment of its various 

 affections from a cosmetic as well as from a curative point of view. What is usually 

 regarded as constituting the face embraces the anterior half of the head as viewed 

 from the front. 



The Bones. The bones of the head have been divided into those of the 

 cranium and those of the face. The bones of the cranium are eight in number, viz. : 

 the frontal, occipital, two temporals, two parietals, the sphenoid, and ethmoid. The 

 bones of the face are fourteen in number, of which twelve are in pairs, viz: superior 

 maxillary, malar, nasal, palate, lachrymal, and inferior turbinated bones the vomer 

 and inferior maxilla or mandible are the two single bones. 



From this it will be seen that the bony framework of the face embraces some of 

 the bones of the skull, as well as those of the face proper; thus, the region of the 

 forehead is formed by the frontal bone, the temporal region is formed by the frontal, 

 parietal, sphenoid, and temporal bones, all belonging to the cranium, and so on. 

 The palate bones are called face bones, yet they are placed deep in the region of the 

 vnouth and nose. 



The Soft Parts. The soft parts are likewise of importance. The skin, thin in 

 some parts, thick in others, is in many places loosely attached and has inserted in it 

 the muscles of expression. It is frequently the seat of disease, particularly of cancer. 



On each side of the face are the parotid glands, often the site of inflammations. 



The blood-vessels, both arteries and veins, particularly the former, are very 

 numerous and give special characters to wounds and diseases of the face. 



The nerves are abundant and complex. They are, with the exception of the 

 auricularis magmis, which comes from the second and third cervical, and to a 

 slight extent the occipitalis minor from the second cervical, all derived from the 

 cranial nerves and are both motor and sensory. The paralyses and neuralgias which 



