332 THE MUSCLES AND FASCIA. 



of the epiglottis over it, but, as Anderson Stuart has shown, by the drawing 

 forward of the arytenoid cartilages toward the cushion of the epiglottis a move- 

 ment produced by the contraction of the external thyro-arytenoid, the arytenoid r 

 and aryteno-epiglottidean muscles. 



The morsel of food after leaving the tongue passes on to the posterior or 

 laryngeal surface of the epiglottis, and glides along^ this for a certain distance ;' 

 then the Palato-glossi muscles, the constrictors of the fauces, contract behind the 

 food ; the soft palate is slightly raised by the Levator palati, and made tense by 

 the Tensor palati ; and the Palato-pharyngei, by their contraction, pull the pharynx 

 upward over the morsel of food, and at the same time come nearly together, the 

 uvula filling up the slight interval between them. By these means the food is 

 prevented passing into the upper part of the pharynx or the posterior nares ; at 

 the same time the latter muscles form an inclined plane, directed obliquely down- 

 ward and backward, along the under surface of which the morsel descends into 

 the lower part of the pharynx. The Salpingo-pharyngeus raises the upper and 

 lateral part of the pharynx i. e. that part which is above the point where the 

 Stylo-pharyngeus is attached to the pharynx. 



Surgical Anatomy. The muscles of the soft palate should be carefully dissected, the rela- 

 tions they bear to the surrounding parts especially examined, and their action attentively studied 

 upon the dead subject, as the surgeon is required to divide one or more of these muscles in the 

 operation of staphylorraphy. Sir W. Fergusson was the first to show that in the congenital 

 deficiency called cleft palate the edges of the fissure are forcibly separated by the action of the 

 Levatores palati and Palato-pharyngei muscles, producing very considerable impediment to the 

 healing process after the performance of the operation for uniting their margins by adhesion ; he, 

 consequently, recommended the division of these muscles as one of the most important steps in 

 the operation. This he effected by an incision made with a curved knife introduced behind the 

 soft palate. The incision is to be halfway between the hamular process and Eustachian tube, 

 and perpendicular to a line drawn between them. This incision perfectly accomplishes the 

 division of the Levator palati. The Palato-pharyngeus may be divided by cutting across the 

 posterior pillar of the soft palate, just below the tonsil, with a pair of blunt-pointed curved 

 scissors ; and the anterior pillar may be divided also. To divide the Levator palati the plan 

 recommended by Mr. Pollock is to be greatly preferred. The soft palate being put upon the 

 stretch, a double-edged knife is passed through it just on the inner side of the hamular process 

 and above the line of the Levator palati. The handle being now alternately raised and 

 depressed, a sweeping cut is made along the posterior surface of the soft palate, and the knife 

 withdrawn, leaving only a small opening in the mucous membrane on the anterior surface. If 

 this operation is performed on the dead body and the parts afterward dissected, the Levator 

 palati will be found completely divided. In the present day, however, this division of the 

 muscles, as part of the operation of staphylorraphy, is not so much insisted upon. All tension 

 is prevented by making longitudinal incisions on either side, parallel to the cleft and just 

 internal to the hamular process, in such a position as to avoid the posterior palatine artery. 



7. Anterior Vertebral Region. 



Rectus capitis anticus major. Rectus capitis lateralis. 



Rectus capitis anticus minor. Longus colli. 



The Rectus capitis anticus major (Fig. 210), broad and thick above, narrow 

 below, appears like a continuation upward of the Scalenus anticus. It arises by 

 four tendinous slips from the anterior tubercles of the transverse processes of the 

 third, fourth, fifth, and sixth cervical vertebrae, and ascends, converging toward 

 its fellow of the opposite side, to be inserted into the basilar process of the occip- 

 ital bone. 



Relations. By its anterior surface, with the pharynx, the sympathetic nerve, 

 and the sheath enclosing the internal and common carotid artery, internal jugular 

 vein, and pneumogastric nerve ; by its posterior surface, with the Longus colli, the 

 Rectus capitis anticus minor, and the upper cervical vertebrae. 



The Rectus capitis anticus minor is a short, flat muscle, situated immediately 

 behind the upper part of the preceding. It arises from the anterior surface of the 

 lateral mass of the atlas and from the root of its transverse process, and, passing 



1 Walton (quoted' by A. Stuart) maintains that the epiglottis is not essential to the deglutition even 

 of liquids. 



