The Paranasal Sinuses

Connected directly or indirectly with the nasal cavity, of which they are diverticula, are four pairs of air-sinuses (Sinus paranasales), viz., maxillary, frontal, sphenopalatine, and ethmoidal.

The maxillary sinus (Sinus maxillaris) is the largest. Its external wall is formed by the maxilla, the lacrimal, and the malar. It is bounded internally by the maxilla, the inferior turbinal, and the lateral mass of the ethmoid bone. It extends backward to a transverse plane in front of the root of the supraorbital process, and its anterior limit is indicated approximately by a line drawn from the anterior end of the facial crest to the infraorbital foramen. Its upper boundary corresponds to a line drawn backward from the supraorbital foramen parallel to the facial crest. The floor is formed by the alveolar part of the maxilla; it is very irregular and is crossed by bony plates running in various directions. The last three cheek teeth project up into the cavity to an extent which varies with age; they are covered by a thin plate of bone. The cavity is divided into anterior and posterior parts by an oblique septum. The outer margin of the septum is commonly about one and a half to two inches (ca. 3.5 to 5 cm.) from the anterior end of the facial crest; from here it is directed inward, backward, and upward. The upper part of the septum (formed by the posterior end of the inferior turbinal bone) is very delicate and usually cribriform.

The position of the septum is quite variable. It is not rare to find it further forward, and in some cases it is further back than is stated above. In the recent state, i. e., when covered by the mucous membrane on both surfaces, it is nearly always complete, but in very exceptional cases there is an opening of variable size in the upper part.

The anterior compartment, often called the inferior maxillary sinus, is partially divided by the infraorbital canal into an external maxillary part and an internal smaller turbinal part. The latter communicates with the middle meatus by a very narrow slit situated at its highest part. The posterior compartment, often called the superior maxillary sinus, is also crossed by the infraorbital canal, internal to which it opens freely into the sphenopalatine sinus. It communicates dorsally with the frontal sinus through the large oval fronto-maxillary opening, situated at the level of the osseous lacrimal canal and the corresponding part of the inner wall of the orbit; the orifice is commonly about one and a half to two inches (ca. 4 to 5 cm.) long and an inch or more (2 to 3 cm.) wide. Just in front of this, and covered by a thin plate, is the narrow naso-maxillary fissure (Aditus naso-maxillaris), by which the sinus opens into the posterior part of the middle meatus.

The foregoing statements refer to the arrangement in the average adult animal. In the foal the cavity (with the exception of its turbinal part) is largely occupied by the developing teeth. In horses five to six years of age the maxillary part of the sinus is still filled up to a large degree by the embedded parts of the teeth. As the teeth are extruded to compensate the wear, more and more of the cavity becomes free, until in old age only the short roots project up in the floor, covered by a layer of bone. Other facts in this connection will be given in the description of the teeth. In exceptional cases the posterior part of the inferior turbinal is smaller than usual and leaves a considerable interval, through which the maxillary sinus communicates with the nasal cavity.

The frontal sinus (Sinus concho-frontalis) consists of frontal and turbinal parts. The frontal part is bounded chiefly by the two plates of the frontal bone, but its floor is formed in part by the lateral mass of the ethmoid. It extends forward to a plane through the anterior margins of the orbits, backward to one through the temporal condyles, and outward into the root of the supraorbital process. It is separated from the sinus of the opposite side by a complete septum. It is partially subdivided by a number of bony plates. The turbinal part is situated in the posterior part of the superior turbinal bone, roofed in by the nasal and lacrimal bones. It extends forward to a transverse plane about half-way between the anterior margin of the orbit and the end of the facial crest. Behind it is in free communication with the frontal part over the lateral mass of the ethmoid. It is separated from the nasal cavity by the thin turbinal plate. The frontal and maxillary sinuses communicate through the large opening described above.

The sphenopalatine sinus (Sinus sphenopalatinus) consists of two parts which communicate under the lateral mass of the ethmoid. The sphenoidal (posterior) part is excavated in the body of the presphenoid. The palatine (anterior) part is between the two plates of the perpendicular part of the palate bone, under the lateral mass of the ethmoid; it communicates freely with the maxillary sinus. The septum between the right and left sinuses is not usually median in the sphenoidal part.

In about one-third of the cases (according to Paulli) the sphenoidal and palatine parts are separated by a transverse septum, and the sphenoidal part then communicates only with the lower ethmoidal meatuses.

The term ethmoidal sinus is often applied to the cavity of the largest ethmoturbinal. It communicates with the maxillary sinus.

The Bones of the Thoracic Limb the scapula

The scapula is a flat bone, situated on the anterior part of the lateral wall of the thorax, and extending obliquely from the vertebral end of the seventh or eighth rib to the sternal end of the first rib. It is curved slightly and slopes outward in adaptation to the form of the thoracic wall. It is triangular in outline, and has two surfaces, three borders, and three angles.

The external surface or dorsum (Facies lateralis s. dorsalis) is divided into two fossæ by the spine (Spina scapulæ), which extends from the vertebral border to the neck of the bone, where it gradually subsides. The free edge of the spine is thick, rough, and in great part subcutaneous. A little above its middle is a variable prominence, the tubercle of the spine (Tuber spinæ), to which the trapezius muscle is attached. The supraspinous fossa (Fossa supraspinata) is situated in front of the spine, and the infraspinous fossa (Fossa infraspinata) behind it. The former is much the smaller of the two; it is smooth and is occupied by the supraspinatus muscle. The infraspinous fossa lodges the infraspinatus muscle; it is wide and smooth in its upper part, narrower below, where it is marked by several rough lines for the attachment of the teres minor muscle; near the neck is the nutrient foramen, and a little lower is a vascular groove.

The costal surface or venter (Facies costalis) is hollowed in its length by the subscapular fossa (Fossa subscapularis); this occupies nearly the whole of the lower part of the surface, but is pointed above and separates two rough triangular areas (Facies serrata), to which the serratus magnus is attached. In the lower third there is a vascular furrow with several branches.

The anterior or cervical border (Margo cranialis) is convex and rough above, concave and smooth below.

The posterior or dorsal border (Margo caudalis) is slightly concave. It is thick and rough in its upper third, thin in its middle, and thickens again below.

The superior or vertebral border (Margo dorsalis s. basis) carries the scapular cartilage (Cartilago scapulæ). In the young subject the edge of the bone is thick, and is pitted by impressions into which the cartilage fits. The cartilage is the unossified part of the fœtal scapula. Its lower edge fits the depressions and elevations of the bone. It thins out toward the free edge, which is convex and lies alongside of the upper parts of the vertebral spines. In front it continues the line of the scapula, but behind it forms a rounded projection. The lower part of the cartilage undergoes more or less ossification, so that the vertebral border of the bone in old subjects is thin, irregular, and porous.

The anterior or cervical angle (Angulus cranialis) is at the junction of the anterior and vertebral borders and lies opposite to the second thoracic spine. It is relatively thin and is about a right angle.

The posterior or dorsal angle (Angulus caudalis) is thick and rough; its position can be determined readily in the living animal.

The inferior or articular angle (Angulus glenoidalis) is joined to the body of the bone by the neck of the scapula (Collum scapulæ). It is enlarged, especially in the sagittal direction. It bears the glenoid cavity (Cavitas glenoidalis) for articulation with the head of the humerus. The cavity is oval in outline, and its margin is cut into in front by the glenoid notch (Incisura glenoidalis), and is rounded off externally; just above its postero-external part is a tubercle to which a tendon of the teres minor is attached. The bicipital tuberosity or tuber scapulæ is the large rough prominence in front, to which the tendon of origin of the biceps brachii is attached; projecting from its inner side is the small coracoid process (Processus coracoideus), from which the coraco-brachialis muscle arises.

Development.—The scapula has four centers of ossification, viz., one each for the body of the bone, the bicipital and coracoid processes, the anterior part of the glenoid cavity, and the tuber spinæ. The last ossifies after birth and fuses with the spine about the third year. The bicipital tuberosity and coracoid fuse with the body of the bone about the end of the first year.

In old subjects the spongy substance disappears at the middle part of the fossæ, so that the bone consists here of a thin layer of compact substance. Considerable ossification of the cartilage is usual, the borders become much rougher, the muscular lines are more pronounced, and a medullary cavity may appear in the neck. Much variation occurs in dimensions and slope. The average ratio between the length and breadth (scapular index) is about 1 ∶ 0.5, but in many cases the base is relatively wider. The inclination on a horizontal plane varies from 50 to 65 degrees. Exceptionally the coracoid process reaches a length of an inch or more (2½ to 3 cm.), and the chief nutrient foramen may be on the posterior border or in the subscapular fossa.