Chapter 4 CLINICAL ANATOMY WITH EMPHASIS ON THE AMAZON PARROT Although the anatomy of the chicken and budgerigar has been extensively investigated, fewer anatomic studies have been conducted in Jal psittacines, and many of those haye little clinical significance. In approaching literature and in recording personal observations, the authors have endeavored to include anatomic data that have direct application in clinical situations. Further in-depth descriptions of avian structure may be found in references cited at the end of the chapter. THE INTEGUMENT Skin A complete treatise on avian integument has been published by Lucas and Stettenheim.”* ‘The skin of birds lies upon the subcutis, which is often thick and contains an abundance of fat in older psittacines. Fat may also be dermal, which may predispose certain birds to xantho- matosis, Except for the meibomian glands of the eye- lid, the uropygial gland, and holocrine glands of the external ear canal, the skin of birds is deficient in glands, However, lipoid spheres are elaborated by the epidermis in various parts of the skin.* Infections of the meibomian glands and occasional neoplasms of the uropygial gland have been noted. The uropygial (oil or preen) gland of many birds is bilobed and lies dorsal to the levator muscles of the tail and the pygostyle. Its excre~ tory ducts empty at the oil gland circlet on the oil gland papilla. Uropygial glands ave absent in Amazon Parrots, Well-developed vropygial glands have been observed in budgerigars and Green-winged Macaws, whereas they appeared JOHN S. McKIBBEN GREG J. HARRISON less developed in cockatiels, finches, canaries, cockatoos, lovebirds, African Grey Parrots, Eclectus Parrots, and Blue and Gold Macaws, Uropygial glands have not been observed in the Hyacinth Macaw. ‘Modifications of the skin of birds may take various forms.® In psittacines these include scales on the legs and feet, claws, beak, cere, crest, cheek patches, and incubation patch. Crests, dorsal on the head of birds, can be: bony, fleshy, or plumed as in cockatoos and cockatiels. Genus variations exist with these modifications. For example, the cere of the Amazon Parrot has tiny bristle (setae) feathers on it, whereas the cockatoo’s cere is completely covered with contour feathers.* Many of these modified structures are often colorfiul and may vary between males and fe- males (see Chapter 51, Sex Determination Techniques). Cheek patches of some psittacines are able to “blush” or redden when the bird is alarmed. This should not be interpreted as a pathologic condition. This area may also show evidence of bruising, which is initially pink and later changes to a darker color. Smooth muscles deep to the skin are attached to the walls of feather follicles and are respon- sible for the feather fluffing often observed in cold or sick birds trying to conserve heat. Plumed crests are raised by dermocutaneous muscles. The wing skin fold, or propatagium (wing web), is located in the angle between the arm and forearm. This membrane has been used to. tattoo psittacines but does not retain the detail achieved by tattoos on the skin over the breast muscle. ‘The ventral skin of the bird modifies during nesting to form an incubation area (brood patch).?! This area has fewer feathers and in- 3132 1 Section Two—THB NORMAL BIRD creased vascularity and serves to increase warmth for incubation of eggs. Through a feed- back mechanism, the area may help regulate the number of eggs laid within a standardized clutch size for the species. Feathers Feathers are epidermal structures analogous to hairs of mammals which comprise about 10 per cent of the body weight. Feathers serve as eater sheath evel of supestor umbiicus Remnant of anal asters Pulp exp Epidermis of shins Coracous Layer Geeminaive layer ‘Wall of flicte Cotas Asia acery Deemis Pulp Dermal pails Epidermal colle ‘ Ielerioe eabiloas insulators for maintaining body temperatures (usually between 102° F and 109° F), as displays during courtship and fighting, as nest material, and as necessities for flight. Feathers avise from tubular invaginations of the skin known as feather follicles. These follicles (Fig, 4-1) are arranged in patterns or rows (feather tracts or pyterylae) that are separated by relatively un- feathered areas (apteria). Vessels, bones, liga- ments, and muscles, which may be’ seen through the frequently transparent skin of the . have occasionally been misidentified as ais gy EB tporssis - p “am, Gis “BA — ath of atierane Gy Bae of vane —_— D Hypersshis NG Pap op - Resmane of axa artery c - Proxnal ea of acs ° yporscis B ayes of fester epitelions sheath Intervene tne ea eens Figure 4-1. Layers of the epklermis and the dermis in a growing contour feather. Insets A through D are exose-seetions ‘hrough the feather at the levels shown by the heavy arrows (From Lucas and Steltenheim, 1972),A Pannaeeos poréon oF eater Seapur Plamaceous pet of feather cola Dist unites Peoxinalumbious Chapter A—CLANICAL ANATOMY / 33 102s hook) i {ren Bit il fl sare Rachie Figure 4-2. Contour feather of the Amazon Parrot. 4, General morphology. B, 100 x magnification. lacerations or “raw” spots when the feathers have been damp, oily, or removed. Nomina Anatomica Avium classifies feathers into contour, plume, and semiplume types.” Contour Feathers Contour feathers (Fig. 4-24) have flat, closely knit vanes, although the basal part of the vane may be variably plumulaceous, Remiges (wing flight feathers or quills), rectrices (tail flight feathers), coverts, and general feathers of the body, head, neck, and limbs comprise this group. ‘The axis of remiges and rectrices is the scapus (shaft or quill). Its hollow bare portion closest to the body is the calamus, whose proximal portion is implanted in the feather follicle. The portion of the scapus where the vexilla or vane expands is the rachis, The vexilla is formed by barbs extending at 45-dogrce angles from each side of the rachis; barbules arise from each side of the barbs. On contour feathers, barbules interlock with adjacent barbules from other barbs by a system of hooks or processes arising from distal barbules (Fig. 4-28). Preening re- stores interlocking of the barbules when they become dislodged. Waterproofing is a result of this physical barrier created by interlocking feathers rather than application of an oily sub- stance from the uropygial gland to the feathers. ‘The uropygial gland fs not present in all “water- proofed” birds, and surgical removal of the gland apparently does not impair a bird. Immature or pin feathers have a vascular calamus and rachis, which can be exposed to increased incidence of trauma in pet psittacines as replacement feathers grow subsequent to wing trims. Such damage results in hemor- rhage, and treatment requires extraction of the calamus. Modified feathers resembling hairs that occur on the head of birds are called setae or bristles. Examples are the eyelashes of the Amazon and budgerigar. These eyelashes may not regrow following infection with pox or other viral dis- eases (see Chapter 19, Ophthalmology). The feather coat of the Amazon Parrot is illustrated in Figure 4-3A, The wing flight feathers (remiges) of the Amazon Parrot may be divided into three groups: (1) Primary remiges are numbered from the carpal region outward and are attached proximally to the carpometa- carpal and digital aveas (Fig. 4-3B), The pri- mary feathers are strongly connected to muscle,34 1 Section ‘Two—THE NORMAL BIRD Occiput Crown Periophthalmic region Ear coverts {auricular tract) Nape 4%, Dorsal cervical tract Mantic Interscapular tract Foreneck SP (ventral cervical tract) Scapulars | Minor wing coverts Median wing coverts Breast Back (pectoral tract) Dorsal major secondary coverts Dorsal major primary coverts Rump Secondary remiges Primary remiges Dorsal major caudal coverts Rectricos Figure 4-3. Plumage of the Amazon Parrot. A, Body areas and tractsChapter 4—CLINICAL ANATOMY J 35 Alutar remiges Carpal joint Dorsal major primary coverts ah a i meth AY 1 a AAA Dorsal major caudal coverts:-L Major ventral wing coverts c Minor ventral wing coverts Ventrat antebrachial Figure 4-3 Continued. B, Dorsal wing feathers. C, Yentral wing feathers.36 J Section Two—THE NORMAL BIRD fascia, and bone of the manus by fibrous tissue and possess much less mobility than the seeon- daries. This immobility of the primaries makes surgical approach to feather disorders of this area difficult, (2) Secondary remiges are num- bered from distal to proximal in the antebrach- ium. (3) Alular remiges vary in number from two to seven in birds” and attach to the alular digit, Tertiary remiges, extending from the hu- meral area, are also described.” Although individual variations occur, the number of primary remiges is reported to be species-specific, whereas the number of secon- dary remiges is more variable within species.” Amazon Parrots were found generally to have 10 primary remiges (9 to 11 range), 10 to 13 secondary remiges, and 4 alular remiges. A gap, known as a diastema, is present in the wing in many species of birds just proximal to the fourth secondary remex.” This increased space be- tween the fourth and next proximal remex is barely noticeable in Amazon Parrots. Secondary remiges are generally numbered consecutively. ‘The remainder of the feathers that cover the wing and tail are called coverts® or tectrices. ‘The most proximal group of wing feathers (Fig, 4-3) is referred to as shoulder feathers by poultrymen, scapulars in ornithologie terminol- ogy, or humeral tract coverts, Generally 12 large tail quills (rectrices) arise from the uropygium of the Amazon Parrot. Plume and Semiplume Feathers Plume and semiplume feathers are distrib- uted over the body of adult psittacines. Plumes or down feathers have a rachis that is shorter than their longest barb. The flofly appearance results from slender barbs and filamentous, noninterlocking barbules. These feathers usu: ally underlie contour feathers and are associated with their follicles. Some birds have modified plumes called pow- der down feathers (Fig. 4-4). Powder from these feathers is reported to be keratin material that originates from surface cells of barb-form- ing Ussue within the feather germ. As the powder down feathers lose their powder and break open, they look like ordinary feathers. ‘The function of powder is unknown*; however, it is speculated to serve as an adhesive agent within the feather, to serve as a water repellant, or to produce bloom, In a clinical case observed by Harrison, a cockatoo that was apparently congenitally deficient in powder down had a dirty, unkempt appearance to the feathers, Figure 4—4. A powder down feather from a Sulphur-crested Cockatoo (Cacatua sulphurea) The amount of powder down produced is species-specific and may vary with the stage of molt.*" Powder down “patches” occur dorsal to the femoral pterylae and ventral to the pelvic pterylae areas in several cockatoo species (Um- brella, Moluccan, Red-vented, Bare-eyed, Sul- fur-crested, Rose-breasted), as well as in cock- aticls, African Grey Parrots, and sume macaws. White and Moluccan Cockatoos appear to pro- duce the most powder down. The powder may be visible on dark-colored clothing of a handler after direct contact with one of these birds, Powder down patches are apparently absent in Amazon Parrots, budgorigars, lovebirds, Eclec- tus Parrots, Palm Cockatoos, some conures, and some macaws (Blue and Gold, Green-winged, Scarlet), ‘A semiplume feather has flufly (plumula- ceous) vanes, but its rachis exceeds the length of its longest barb. Filoplume feathers are the hairlike feathers remaining on the body after plucking. ‘The color of feathers is influenced by pig- ments and diffracted light on cells or oil layers. Colors can be altered by hormones, diet, bleaching agents, dirt, surface oils, age, physical damage, disease, and temporarily by water. Molting, the process of replacing old feathers with new ones, is influenced by season, tem- perature, nutrition, egg laying, species, and sex. It has been reported! that all birds molt at least once a year, many species twice, and a fow, three times. Molting eycles generally begin after completion of the breeding season. Ama- zon Parrots appear to molt continually during the year. Postnuptial molt of wing feathers mayextend over several months in psittacines, and. new molt cycles may commenee before previous cycles are completed. According to limited personal observations (Harrison) in young Green-winged Macaws and Bare-eyed Cockatoos, the breast and head feathers are the first to be replaced, starting at three to four months of age. ‘The first molt may extend over one and one half to two years, with the wing and tail feathers molted last. Several generations of feathers can be present at one time owing to different molting rates." Some passerines such as canaries generally start molt- ing in the spring and continue throughout the summer. Figure 4-8, Articulated Amazon Parrot skeleton. Chapter 3—CLINICAL ANATOMY | 37 During the development of feathers and their accompanying vascular supply, the body's met- abolie rate increases 30 per cent.? This results in increased nutritional demand on the bird and may produce significant stress, increasing the bird’s vulnerability to disease-producing organ- isms. SKELETAL SYSTEM Birds possess both spongy and compact bones, which have both endosteum and perios- teum. Avian bones generally have thin cortices, predisposing them to fracture. Because air sacs Pygostyle chia Poti Digits and38 1 Section Two—THE NORMAL BIRD communicate with some bones such as the humerus, osteomyelitis associated with frac- tures can also result in infection of the divertie- ula of the air sacs. Air sac infections such as aspergillosis may also extend into hone through these communications” (see Chapter 14, Ra- diology). Nasal Operculum bone Prefrontal Patat 4 a Maxilla Jugal Quadratojuaat a Zygomatic arch Figure 4-6. Cranial osteology of the Am- zon Parrot. A, Lateral view. B, Ventral view. Palatine Vomer Suborbital arch Parasphenoid Laming besiparasphanoi Pneumatized bones in the Blue-fronted Am- azon include the ribs, vertebrae, humerus, cor- acoid, clavicle, sternum, lium, ischium, pubis, and cranial bones. Bone marrow, where present in bones, is rich in fat. The tibiotarsal bone may be the easiest and most useful site from which to obtain bone marrow specimens for Lateral orbitonasal foramen Medial orbitonasal foramen Mosethmoid Optic foramen ‘Temporal fossa Temporal bone Process suprameaticus Supraceeipital Exoccipital Paracecipital process Quadrato ‘Suborbital arch Jugal ‘Occipital condyie Foramen magnum,clinical cytologic evaluation, Evaluation may be more difficult in aged birds because the marrow content decreases as birds mature. Axial Skeleton ‘The axial skeleton is composed of bones of the skull, vertebral column, ribs, and sternum ‘Supreoccipital Figure 4-6 Continued. C, Dorsal view. D, Hyobranchial apparatus. Chapter 4—CLINICAL ANATOMY / 39 (fig. 45). Developmentally, cranial bones are more numerous in birds than in mammals, but in mature birds, suture lines are not usually observed owing to fusion. Figure 4-6 illustrates cranial osteology of the Amazon Parrot as iden- tified by the senior author. Unusual bones in the heads of birds are Opsreulum bone Entoglossum ‘Cornus Rostral basibranchial Parahyat process ‘Caudal basibranchiat Coratobranchial cornu ‘Trachea Epibranchial cornu Crigoid cartilage (larynx)40 1 Section Two—THE NORMAL BIRD scleral ossicles, which form a ring in each eye. ‘There are 12 such ossicles within each eye of the Amazon Parrot, These can be observed by transillumination, particularly in albino cocka- iels and by radiography. A small C-shaped opercular bone lies within the Amazon’s oper- culum, which inhibits direct observation of the nasal cavity. The hyobrancheal apparatus of the Amazon Parrot extends nearly to the tip of the tongue and should not be confused radiograph- ically with lingual foreign bodies, ‘The skull articulates with the atlas by a single occipital condyle. Practitioners who are familiar with paired occipital condyles in mammals should not diagnose the normal single occipital condyle of birds as pathologic. ‘The premaxilla forms the upper jaw and is covered by the upper beak. The mandible forms the lower jaw and is partially covered by the Intormetscarpal space ‘Corpomotacarpi: Utnar carpal: Una Rodial carpal Radius Pectoral crest Dorsal tubercle Heed Cervical sb Ventral process Clavicte Coracotd Rosteum, lower beak. The functional anatomy of the avian jaw is described by Bihler.? ‘The vertebral formula of the Amazon Parrot appears to be like that of the budgerigar: C—12, T—8, LS—8, and C—8. Fusion of components makes it difficult to ascertain the number of lumbar, sacral, and caudal components. How- ever, this area should be palpated during a physical examination to determine abnormali- ties such as curvature or periosteal thickening that may have resulted from trauma, malnour- ishment, or incubation deformities. These find- ings may be associated with clinical signs of clumsiness or inability to preen feathers, partic- ularly those of the tail. An odontoid process is present on the axis (second cervical vertebra) as in mammals. The Iumbar, sacral, last two thoracic, and first one or two caudal (coceygeal) vertebrae fuse to form Phalanges of major digit: Broximel distal Olecranon, ‘Media opleondyle Humerus ‘Acotabulum and foramen Uneinate Figure 4—7. Osteology of the axial skeleton and wing of the Amazon Parrot (skull and first seven cervical vertebrae are illustrated in Figures 4-5 and 4-6). A, Crantolateralthe synsacrum. The terminal caudal vertebrae fuse to form the pygostyle. Unlike many birds, Amazon Parrots have vertebrae with concave catidal surfaces in the thoracic region. Synovial joints lie between unfused cervical, thoracic, and caudal vertebrae, In the Amazon Parrot, synovial joints generally occur between the last seven caudal vertebrae. Ribs are classified as cervical, thoracic, and lumbar, Cervical ribs appear as fused, caudally directed lateral spines on all cervical vertebrae other than C-12, An articulating short cervical rib approximately 5 mm long is embedded in the ventrolateral neck muscles associated with the twelfth cervical vertebra in the Amazon Parrot. The first two thoracic ribs of Amazon Parrots Pectoral crest with attachment, ‘of supracoracoideal m. tendon Rt. triosseus (supracoracoid) eayal Acrocoracoideal articulating surfss, of clavicle Lat Medial angle of corzcold Coracoideal articulsting. suleus of sternum A Apex. Figure 4-7 Continued. B, Disarticulated pee- toral girdle illustrating the tendon of the supra coracoideus muscle passing through the supra~ ccaracoid foramen to elevate the wing. C, Fourth thoracic vertebra, erantolateral view. Chapter 4—CLINICAL ANATOMY / 41 consist of only vertebral components. Liga- ments join these vertebral segments to the third sternal rib. The next five thoracic ribs have ‘osseous vertebral and sternal components with joints between them. The sternal portion of the Jast thoracic rib may not reach the sternum. A caudally directed uncinate process arises from each of the second through sixth vertebral ribs. The absence of this process may be used to locate the seventh rib as a landmark for endoscopy, sexing birds, diagnostic procedures such as radiology, and. surgical intervention, particularly of the proventriculus (see Chapter 15, Endoscopy; Chapter 51, Sex Determination ‘Techniques; and Chapter 48, Selected Surgical Procedures). A long, slender sternal rib may extend from a long muscular attachment on the Pneumotricipltal fossa with pneumatic foramon I process of ooracold Cranioleteral process -Costal articulating surfaces -Costal processes Sternal fenestra Caudal sptouto of (dal articular process SS» "bore procets \ Caudal spicule of transverse process Vertebral rib42! Section Two—THE NORMAL BIRD pubis to parallel the eighth thoracic sternal rib ventrally. No lumbar ribs were observed in the Amazon Parrot, Air passages in the Amazon Parrot extend between the lungs and the vertebral portion of thoracic ribs. ‘The interclavicular air sac com- municates with the sternum and.sternal ribs, The sternum is long, with a large midventral carina (keel) serving as the attachment of the origin of the major flight muscles, The cranio- dorsal projection of the carina is the rostrum. Palpation of the carina is a valuable aspect of the physical examination to determine the rel- ative amount of muscle, degree of straighiness, and mineralization. The carina also serves as an anatomic guide for positioning patients for ra- diography, Sternal ribs articulate with the costal proo- esses of the sternum via synovial joints, The sternum articulates with the coracoid bone be- Interteansvorse foramen Articlotng coccypeal vertebrae Trochanter Portes foxse Pate sutews Lateral epicondyle Figure 4-8. Osteoloxy of the avial skeleton and leg of the Amazon Parrot (skull and frst seven cervical vertebrae are ilustrated in Figures 4-5 and 4-0). A, Caudokatenl view. 2, Proximal and distal fermur. G, Digits. D, Plantar view of the ankle area.tween the rostrum and the craniolateral process (ig. 40. Appendicular Skeleton ‘The appendicular skeleton is composed of the bones of the limbs, thoracic girdle, and pelvic girdle (Figs. 4-7 and 4-8). ‘The thoracie girdle consists of the scapula, coracoid, and clavicles, which come together to form the triosseal (su- pra-coracoid) foramen through which the ten- don of the supracoracoidens muscle passes to abduct the wing. In Amazon Parrots the clavi- cles are thin, complete bones that fuse midven- irally to form the furcula. Distal to the scapula the wing is composed of the humerus, ulna, radius, radial and ulnar caxpals, carpometacar- pus, alular digit, major digit, and minor digit. ‘The ulna is larger in diameter than the radius in the Amazon Parrot. The carpus consists of ‘two components, the radial carpal and ulnar carpal bones. The carpometacarpal bone rep- resents the distal row af carpal bones fused with the three metacarpals. One phalanx is present in the alular and minor digit and two in the major digit. The pelvic girdle is equivalent to the hip bone (Fig. 4-8), consisting of the fused ilium, ischium, and pubis. The pubis lies ventral to the ischium, from which it is separated by the ischiopubic fenestra. The pubis is a thin bone and does not form a pelvic symphysis as it does in mammals. Aviculturists sometimes attempt to determine the gender of some birds by: evaluating the amount of space between the paired pubic bones. This is not a consistently accurate method of sex determination. How- ever, from a clinical viewpoint, the relationship of the pubis to the caudal aspect of the sternum, is significant. This distance increases in cases of abdominal disease, such as ascites, organ en- largement, and tumors. The ilium is the largest bone of the pelvic irdle. The ilia are located dorsal to the three ivisions of the kidneys, similar to their location in mammals. In the Amazon Parrot, the ilia fuse with the synsacrum. Distal to the pelvic girdle the bones of the leg are the femur; patella; tibiotarsus; fibula; fused tarsometatar- sals 2, 8, 4; metatarsal 1; and in Amazon Parrots, digits 1, 2, 8, and 4. The tibiotarsus in most birds is the largest bone of the limb. The proximal fibula articulates laterally with the femur; its thin prolongation extends distally about one-third the length of the tibiotarsal bone, to which the distal end is attached. Chapter 4—CLINICAL ANATOMY | 43 Some species of birds have two digits and some three, but none has over four digits. In Amazon Parrots, digit 1 has 2 phalanges, digit 2 has 3, digit 3 has 4, and digit 4 has 5. In parrots digits 2 and 3 extend cranially and 1 and 4 caudally. Woodpeckers, toucans, and cockatoos resemble parrots in having two digits extending eranially and two caudally.” THE MUSCULAR SYSTEM ‘The muscular system of birds is composed of striated and smooth muscles. Striated skeletal muscles are of both light and dark fibers, as in domestic animals. Unusual occurrences of skel- etal muscle in the bird include the ciliary and sphincter pupillae muscles of the eye (see Chap- ter 19, Ophthalmology). Cardiac striated muscle resembles that of mammals. Figures 4-9 and 4-10 illustrate muscles associated primarily with the appendicular skeleton, which may be important surgically and when approaching frac- tures for repair. Skeletal muscles of the bird may be classified as axial or appendicular. Vanden Berge’s writ- ings serve as a guide for nomenelature and descriptions in avian myology. ‘Axial muscles of birds may be grouped to include cutaneous muscles, muscles of the head and hyobranchial apparatus, muscles of the neck and back, tail and cloacal muscles, and trunk muscles. Cutaneous Muscles Cutaneous muscles lie superficially on the head, neck, thorax, and abdomen and do not appear clinically unique in Amazon Parrots. Muscles of the Head and Hyobranchial Apparatus Although intzinsic tongue and hyobranchial muscles are poorly developed in most birds, they are well-developed in Amazon Parrots, and the paraglossus is uniquely large in the tongue.”® Muscles of the hyobranchial apparatus have been described and are related to tongue movement and swallowing. Muscles of the Neck and Back Back muscles in the bird are poorly devel- oped owing to the immobility of the synsacrum.44 1 Section Two—THE NORMAL BIRD Extensor motaearpi radials Tensor propatagialis Utnometacarpus ventralis ‘Triceps brachii Deep digital flexor f A\ exo carl una NN Pronator profundus Pronator supertciais ‘Sereatus superfcials External intercostal Femorotibialis modialis Fomorotibialis internus Gastroenomius medialis -Gastrocnemnius lateralis Flexor digitorum longus Flexor hallueis longus ‘Tibtais eranialls Figure 4-9. Appendicular musculature of the Amazon Parrot (ventrolateral view).Chapter 4—CLINICAL ANATOMY / 45. en Extensor longus digiti majoris Extensor longus alulse Extensor motaearpl vlnaris Extensor digitorum ‘communis Extensor metacarpi raialis “Tensor propatasialis Radial a. iti Femorotibielis externus: ‘Tiblalis crantals Flexor perforans iofibutaris ot pertoratus dieiti3 Floxor erueis medialis loxor crus lateralit a / Fibutaris tangas. Fibularis brevis. Flexor perforans ot perforatus digit 2 Figure 4~10. Appendicular musculature of the Amazon Parrot (dorsolateral view).46 1 Section Two—THR NORMAL BIRD The complexus (a dorsolateral cervical muscle) is sometimes referred to as the hatching muscle, It is enlarged in newly hatched psittacines and is especially large in neonatal macaws. It should not be diagnosed as an abnormal structure, as its size diminishes during the first week after hatching, Tail and Cloacal Muscles Since the tail of birds is important in flight as well as in functional and behavioral activities related to mating, egg laying, and defecation, its muscles are generally welledeveloped. Trunk Muscles Because the oblique and horizontal septa (so- called diaphragm) of the psittacine are not highly muscular, respiration is controlled mainly by the muscles of the thorax and abdo- men. The horizontal septum is closely applied to the ventral surface of the lings. The delicate vertical or oblique septum extends from the midline between the lungs, at the base of the heart, to the sternum and body wall. ‘The heart lies on the abdominal side of the septum in birds, in contrast to the heart-diaphragm rela- tionship in mammals. ‘Appendicular muscles in birds extend to the wing or leg or within these appendages. Figures 4-9 and 4-10 illustrate these muscles in the Amazon Parrot as dissected by the primary author, Wing Muscles Muscles of the thoracic girdle, brachium, and manus are named and described in the fowl by Vanden Berge.*:* Approximately 20 per cent of a bird’s weight is attributed to the largest muscle of the body, the pectoral muscle. The pectoral muscle adducts and depresses the wing in flight. The supracoracoideus muscle lies deep to the pectoral muscle and elevates and abducts the wing in flight (see Fig, 4-7B), ‘The humeral tendon of the triceps brachii muscle is not present in all birds.* It is present in Amazon Parrots. The triceps brachii muscle aids in extension of the wing; its tendon is sometimes unilaterally transected to deflight birds, although this technique is seldom em- ployed in pet birds. The 13 muscles of the antebrachium and 10 of the manus are de- scribed in detail by ¥anden Berge. Muscles of the Leg Muscles within the hindlimb are well-deyel- oped, and in some birds ossification of the distal tendons may occur. No tendinous ossifications have been observed in dissections by the pri- mary author in the Amazon Parrot, Muscles of the legs have been described in White-fronted Amazons! and other birds." RESPIRATORY SYSTEM The respiratory system of birds is complex. Smith® has described the microscopic and sub- microscopic structure of the respiratory system in the budgerigar. Air entering the external nares in psittacines passes into the nasal cavity and then into the oral cavity through the choana, a median slit in the roof of the mouth. The nasal (salt) gland is located dorsomedial to the eye and superficial to the frontal bone in most birds; however, its structure and function have not been studied in Amazon Parrots. An operculum, protruding into the external nasal opening of Amazon Par- rots, helps prevent inhalation of foreign objects bilaterally. Air in the nasal cavity passes around and between the caudal and middle conchae (tur- binates) located caudoventral to the operculum (Fig. 4-11). These important bony structures have an extensive vascular supply that should be avoided or manipulated carefully when irri- gating or surgically exploring the nasal cavity, ‘The relationship of these structures, and that of the infraorbital sinus, to the porous calvaria and the brain makes them clinically important in rhinitis and sinus infections (Fig. 4-11). Chronic rhinitis in Amazon and African Grey Parrots often results in a caseous necrotic ob- struction of the external nares, nasal cavity, and choana; the nasal conchae and nasal septum are often destroyed. ‘The infraorbital sinus is the only paranasal sinus in the Amazon Parrot. It lies cranial, ventral, and medial to each eyeball (Fig. 411). Periorbital swelling may be associated with in- fection of this sinus. Diverticula extend from this triangular sinus into the upper beak and mandible and communicate with extensive pneumatized sections of the skull. These exten- sive communications make sinus infections difChapter 4—CLINICAL ANATOMY / 47 Inforbitl sous + ‘Medial nasal conch Figure 4-11. Cranial respiratory passages and cav- ities, A, Midsagitial view. B, Rostrolateral view Gateral wall of nasal eavity and operculum removed). , Rostrolateral view with skull removed, Antrzorbitat sinus 2, Cervicocaphalic air 36 +) etanal portion 1) cavveal portion48 J Section Tuo—THE NORMAL BIRD ficult to treat. A regional anatomic knowledge of this area is essential for surgical drainage or ‘gation. Right and left infraorbital sinuses intercommunicate in psittacine birds but not in passerines. Therefore, aspiration of both sides is ‘indicated for cultures in passerines when isolating causative agents of sinusitis. Olfactory mucosa is similar to that of mam- mals. Inspired air traversing the nasal cavity enters the oral cavity and pharynx through the choana, a median elongated triangular opening in the roof of the mouth. Air from the pharynx enters the larynx. During nasal breathing the glottis is placed directly under and opposed to the choana. Care should be taken in tube feed- ing psittacines to avoid entering the larynx, since no epiglottis is present. The coracoid cartilages are the largest laryngeal cartilages, Dut no vocal cords are present in the larynx. Trachea and Syrinx The trachea conducts air from the larynx to the syrinx. Complete rings lend structural sup- port to the trachea. Although these rings are cartilaginous in many species and in young ds, they are calcified in the adult Amazon Parrot. The trachea of the Amazon Parrot lies primarily on the right side of the neck, ventral and to the left of the esophagus, which also lies to the right of the cervical vertebrae (see Fig. 4-6), Within the thorax, the trachea terminates caudally in the syrinx, or vocal organ, ‘The syrinx of birds may be tracheal, trache- obronchial, or bronchial. The syrinx of Amazon Parrots is tracheobronchial in type. ‘The last few tracheal rings fase into a syringeal box, upon which the first pair of bronchial semirings artic- ulate. Air passing through the syrinx of psittacnes vibrates two external and two internal tympan- iform membranes to produce sound. ‘The exter- nal tympaniform membrane extends between the first and second bronchial semirings. The inner tympaniform membrane covers the me- dial surface of the tracheobronchial bifurcation and spaces between the semirings. The bron- chial muscles extending from the syringeal box to the first bronchial semiring and the broncho- trachial muscle extending from each bronchus to the trachea stretch or relax the tympaniform membranes and alter the size of the syrinx, thereby altering sounds. The narrowness of the trachea and recessive location of the typaniform membranes inhibit surgical approach to this area (e.g., foreign body removal or devocaliza- tion procedures) with current technology. ‘The syringeal muscles and syringeal functions have been described by Gaunt” in five species of psittacines. The wall of the syrinx in healthy Amazon Parrots is transparent cnough to allow visualization of the heart through its caudal wall using endoscopy. ‘The area around the outside of the syrinx is a frequent site for respiratory infections. Lungs A main bronchus connects the syrinx to each lung. Each lung lies ventral and in intimate contact with the first through eighth thoracic vertebrae and ribs. Dorsally each lung fits lat- erally into the intercostal spaces, giving them a wavy appearance when observed at necropsy. Radiographically the lungs resemble a sponge in appearance, This sponginess and pale pink color can be readily observed by endoscopy through the caudal thoracic or abdominal air sacs, Each main bronchus divides into secon- dary bronchi, which divide into parabronchi (tertiary bronchi) in the nonlobulated lungs. Parabronchi extend between secondary bronchi and anastomose with other parabronchi. The primary, secondary, and tertiary bronchi are conducting pathways. From each parabronchus arise numerous blind air capillaries that are the respiratory exchange sites. Alr Sacs Ventral secondary bronchi anastomose with the caudal thoracic air sac. The caudal contin- uation of the main bronchus is the abdominal air sac. A catheter may be passed via the trachea into the abdominal air sac. An ostium (orifice) on the lungs may be observed fiom these air sacs during endoscopy. Birds may have cervicocephalic, pulmonary, pharyngeal, and tracheal air sacs (Figs. 4-11 to 4-13), The cervicocephalic air sac system of many psittacines connects with the infraorbital sinuses at the level of the tympanic area. This air sae system has cervical and cephalic com- ponents. In comures, budgerigars, and cocka- tiels, Walsh® describes cephalic air saes arising from the infraorbital sinus and extending dor- sally between the cere and eyes to cap the dorsal skull (Fig, 4-12). This was not noted by the primary author in the Amazon Parrot. A cephalic portion does, however, extend dorsally adjacent to the occipital bone in the Amazon Parrot (Fig. 4-13). The connecting cervical por- tion of the cervicocephalic air sac in the AmazonFigure 4-12. Relationship of the tnfraorbital sinus to the cervicocephalic air sacs in the cockatiel. Unlettered arcow indicates the diviston between the eephalte portion (@) and the cervical portion (b). The crop is ¢ and infraorbital sins is d. The caudal aspect of the infraorbital sinus connects to the cervicocephalic air sacs. (From Walsh, M.: Clinical manifestations of cervicocephalic air saes of psittaeines. The Compendium, 6:785, 1984. Used with permission of Vet- cerinary Learning Systems Go., Ine.) Parrot extends bilaterally dorsolaterally in the neck from the head to the level of approximately the seventh cervical vertebra. The cervicoce- phalic and pulmonary air saes do not commu- nicate. Most birds have four paired and one unpaired pulmonary air sacs with several diverticula, These air sacs are thin-walled, lack diffuse blood vessels, and do not communicate. In contrast to the epithelia of the trachea and bronchi, which in budgerigars have been re- ported to be pseudostratified ciliated columnar epithelia,” pulmonary air sacs are lined with a single layer of low cuboidal or simple squamous epithelial cells peripherally and simple colum- nar ciliated cells near the lungs. This is covered by a thin layer of connective tissue attaching the sacs to adjacent tissues. An outer layer of mesothelium and then a connective tissue layer make up the rest of the air sac wall. In air sacculitis the caudoventral location, avascular Chapter 4—CLINICAL ANATOMY / 49 nature, and absence of peripheral cilia to re- move purulent material within air sacs results in chronic respiratory infections. Resorption of materials is slow, and related infections are difficult to treat. Psittacines have paired cervical, cranial, cau- dal thoracic, and abdominal pulmonary air sacs connecting to the lungs. An unpaired clavicular air sac lies dorsal to the crop between the clavicles. Paired extrathoracic diverticula pneu- matize the humerus, clavicles, and coracoid bones. The intrathoracic diverticulum lies just caudal to the clavicles between the coracoid bones. It extends into the sternum and the sternal ribs. Extrathoracic diverticula may also connect to vertebral pneumatic spaces. Small cervical air sacs extend cranially, dorsal to the last two or three cervical vertebrae and medial to the extrathoracic diverticula of the clavicular air sac, They connect to preumatized cervical vertebrae, Thoracic vertebrae and vertebral ribs are pneumatized directly from the lungs. Gra- nial thoracic air sacs approximate the thoracic wall cranial and lateral to the caudal thoracic air sacs on each side of the pericardium. Ab- dominal air sacs, which are the largest air sacs, lic on either side of the viscera. During some endoscopy procedures, especially in areas near the proventricnlns, sparse blood vessels have been encountered by Harrison between air sac chambers; these must be avoided during sur- gical procedures. DIGESTIVE SYSTEM The digestive system of the Amazon Parrot consists of the beak (rostrum), oral cavity, tongue, salivary glands, taste buds, pharynx, cervical esophagus, crop, thoracic esophagus, proventriculus, ventriculus, duodenum, je. junum, ileum, rectum, cloaca, pancreas, and liver, Figures 4-14 to 4-18 illustrate the posi- n and structure of these organs. Birds lack teeth but use their horny beak for prehension and incising. The egg tooth, a dorsal process on the beak, aids hatching in chicks and disappears soon after hatching. The oral and nasal cavities communicate through the choana, a cleft in the palate. ‘The Amazon Parrot’s tongue is blunt and very muscular. Elongated papillae form a brush- like tongue in lory-type parrots. This modifica- tion aids in gathering nectar, harvesting pollen, and pressing food into forms suitable for swal- lowing. Birds’ tongues have few taste buds. Taste buds are located in the palate, floor of the50. J Section Fwo—THE NORMAL BIRD mouth, base of the tongue, and floor of the pharynx * and on the laryngeal mound in some birds. Salivary glands are distributed in the walls of the oral cavity and pharynx. They include max- illary glands, palatine glands, sphenopterygoid glands, glands of the corner of the mouth, cheek glands, mandibular glands, lingual glands, and cricoarytenoid glands.” They are mucigenic and important in lubricating food. Clinically these glands and related lymphoid tissue are frequent sites of infection. Pox or hypovitaminosis A lesions may involve these glands, resulting in oral or pharyngeal abscesses. Preanesthestic atropine to control serous oral secretions is not necessary in psittacines (see Chapter 44, Eval- uation and Support of the Surgical Patient). ‘The cervical esophagus passes distally on the right side of the neck to the right of the trachea, Near the thoracic inlet the cervical esophagus enlarges in the Amazon Parrot to form the ingluvies (crop), where food is stored. In its empty state, the crop is teardrop- or U-shaped and lies primarily to the right and ventral to the trachea and cervical vertebrae. In very young birds it appears almost bilobed. ‘The crop is reduced in size in lory-type parrots. When ingluviotomies are necessary for re- moval of foreign bodies, the left lateral cranial portion of the sac is approached surgically (see Chapter 48, Selected Surgical Procedures). This site avoids the large right jugular vein and vessels branching from the right common ca- rotid artery which supply the crop. This location also minimizes the pressure from the interior. Caudal to the crop, the thoracic esophagus enters the thoracic inlet to the right of the trachea and continues caudally coursing from right to left, dorsal to the trachea, syrinx, and heart and ventral to the hilus of the lungs. The. esophagus enters the proventriculus (glandular stomach) at the craniodorsal border of the left lobe of the liver (Figs. 4-14 and 4-16). Radio- graphically on the lateral view, the esophagus appears to enter the proventriculus at a 45- degree angle. Because of the position of the proventriculus near the liver, when it is full, it may radiographically resemble hepatomegaly, especially on the ventrodorsal view (see Chap- ter 1d, Radiology). Regurgitated food used in feeding young birds may originate from the proventriculus in psittacines. In psittacines, a strong muscular sphincter separates the pro- ventriculus from the muscular ventriculus (giz- zard or non-glandular stomach), which receives ingested food into its dorsal portion from the proventriculus (Figs. 4-14 and 4-16). ‘The ventriculus in Amazon Parrots is thick- walled and composed primarily of smooth mus- cles, Its glandular secretion forms a hard kera- tinized plate that serves as a rough grinding surface against which grit grinds food. In birds not requiring extensive grinding of food, such as lory-type, the ventriculus is soft-walled and bag-like. Extensive information on the gross, histo- logic, and scanning electron microscopic mor- phology of the digestive tract of 134 psittacine species is reported by Giintert.”” The ventral ligament of the ventriculus is continuous with the falciform ligament of the liver. Together with the medial air sac walls, they partially divide the peritoneal cavity into right and left portions. This division of the right and left halves may be further appreciated by superimposing the sternum over the vertebral column. An imaginary line between the aceta- bula of the pelvis further divides the abdomen into cranial and caudal right and left quadrants (Pig. 4-16). Use of these quadrants may be helpful in anatomic orientation, particularly in radiographically identifying structures. The cranial vight and left quadrants normally contain the heart, liver lobes, lungs, gonads, adrenal glands, caudal thoracic air sacs, and part of the abdominal air sac dorsally. The proventriculus, splcen, and part of the ventri- culus additionally lie in the cranial left quad- rant. In the female the persistent gonad usually ies in the cranial left quadrant. The duodenum and pancreas lie in the right caudal quadrant. Structures in the caudal right and left quadrants include the intestinal loops, the rectum, the caudal and a portion of the middle divisions of the kidneys, and most of the abdominal air sac. ‘The major portion of the ventriculus extends into the left caudal quadrant. ‘The valvelike fold called the pylorie valve lies between the ventriculus and the duodenal logp. ‘This valve tends to restrict solid objects from leaving the ventriculus, Ingesta leaves the ven- triculus ventrally near the junction of the left cranial and caudal quadrants of the abdomen and courses caudally in the duodenal loop in the right caudal quadrant. Much of the pancreas is enclosed in and associated with the antimes- enteric border of the ascending portion of the duodenal loop. The remaining ileal and jejunal loops are suspended by a long mesentery. The posthepatie septum resembles the ammalian omentum, but no true omentum covering the viscera is present in psittacines. ‘A hepatoduodenal ligament attaches the duo- denal loop to the liver eranially. At the apex ofChapter {CLINICAL ANATOMY / 51 ommeg voRtuy a1p Jo so0s are Arruound pur oxYEsoNLNIID “EL—b OaNBL eindeos pue ‘a[aineyo “pioseioo ‘snaausny, 418 s01n91KEID “be ‘es ae jeumopqy “L es we 219804 jePNED “9 ‘es 18 9y9es0MR YeIIELD °s ‘uuniesuds pue aesqaueA ‘Sq ‘soes ate Azeuowsjnd oqut suo|suayxe onewNaUd YL seiqauian jeoiaivo owu suorsuanxa Speunaud yaya oes 31 jeomuag, suys yeiqoesguy52 Section Two—THE NORMAL BIRD “{anota [eroye] Yay) JoLeg wozeury: ay QATAR una}! 30 doo} jeusponperdng opeway amyeUnay oR Jo SOAMIOTRS [FWIBIU] “p1—p aunBL4 oe eee ‘an aeynauyuanosd ye1Ue9 snyouorg Lewd {peaow: Bun] Yel) STVINAS SAIS 1437Chapter 4—CLINICAL ANATOMY / 53 “(wots [eiore] ayBu) soureg voeury spew oxp Jo somIONAS TeLIARUT “E|—p aaNBig PUES ploszuneied pue ploskyy “a sonny Ln eno hows jour ay FTW 3a1s LHOTY54 / Section Two—THE NORMAL BIRD AL. thyroid and parathyroid glands fA FA. pnctorat rant CAUDAL RIGHT QUADRANT Figure 4-16, Internal structures and quadrants of the Amazon Parrot (superficial ventrolateral view).Chapter 4—CLINICAL ANATOMY | 55 thyroid and parathyroid glands 4 4 ‘ S = Peet este Hoart i : fi CAUDAL LEFT QUADRANT CAUDAL RIGHT QUADRANT ry fenteiculus. H Kidney.emide dion {Supraduodanaltoop of teum Kidney caudal division Rectum owduet Ureter Figure 417. Internal structures and quadrants of the Amazon Parrot (deep ventrodorsal view with reflection of viscera)56 1 Section Two—THE NORMAL BIRD Coseal bursa (wostigial in adult) Openings of: uretor he ‘ois Figure 4-18, Cloaca of the female Amazon Parrot (left internal structures) the axial loop the remnant of the yolk sac (diverticulum vitellinum or Meckel’s diverticu- lum) sometimes persists as a small projection from the antimesenterie surface, especially in the budgerigar. This serves as the arbitrary junction of the jejumum and ileum. The long supraduodenal loop in the Amazon Parrot is the most distal loop of the ileum. ‘The usual gross or histologic distinctions in mammals between the portions of the small intestine (duodenum, jejunum, and ileum) are not as clear in birds, it is justifiable, however, for descriptive purposes and from the stand- point of naming regional blood vessels (Fig. 4— 19) to use the names of the small intestine as duodenum, jejunum, and ileum, Ceca are ab- sent in the Amazon Parrot and all other psitta- ines,” In macaws, Amazons, and cockatoos, the rec- tum is much shorter and generally narrower than the intestinal loops of the small intestine. The rectum is the straight portion of the intes- tinal tract extending between the ileum and the cloaca. One must be cautious in making mid- yentral surgical abdominal incisions to avoid transeeting the supraduodenal loop of the ileum, which traverses the caudal quadrants in direct apposition to the ventral abdominal mus- culature in this area. The rectum, descending caudally in the left caudal quadrant, is short in the parrot and serves little function other than water absorp- tion. Being of small diameter, it should not be confused surgically with the uterus in juvenile birds. ‘Terminally the rectum opens with the uro- genital system into the cloaca (Fig. 4-18). The midventral portion of the cloaca into which the rectum terminates is the coprodeum. A. fold separates this area from the dorsal area, called the urodeum, into which the ureters and ovi- duct or ductus deferens empty. The coprodeum and urodeum continue over a shallow septum as the proctodeum, which opens externally by way of the vent. Hysterectomy, replacement or amputation of vaginal or rectal prolapses, re- moval of cloacal papillomas, manipulation or surgical removal of retained eggs, and other cloacal surgery require knowledge of the ana- tomic location of all cloacal orifices to avoid occlusion of any of these vital openings. The pouchlike diverticulum on the mid-dor- sal wall of the proctodcum is called the cloacal bursa (of Fabricius). It is strrounded by tissue resembling that of the thymus. The cloacal bursa is largest in young birds but atrophies after the bird reaches maturity. The liver and pancreas, very important in digestion, will be discussed below under the Endocrine System. UROGENITAL SYSTEM ‘The kidneys of birds are metanephric in type and are partially divided into three sections, which are accurately termed divisions rather than lobes" (Figs. 4-19 and 4-20). The eranial renal division extends between the eighth tho- racic rib and cranial synsacrum ventyal to theChapter 4}—CLINICAL ANATOMY [57 Esophages! branches ch ome ——— Thovace val ranches x = . bu 8. | Figure 4-19, Visceral arterial supply in the Amazon Parrot,58 | Section ‘Two—THE NORMAL BIRD A ‘caudal vona eat Testes 2. ‘eran renal. 1 rants anal portal External Nae Fomotalv ani 1 porta 1 Ccoudal mesenteriow- 1 uchisdlow. Intartegmentl we. Intra oy Rectum ‘cual ach of he essen Madan canal w or ES capeiom : oe 4 {trea rime Proctodeum h Vent i KIDNEY: Cranlalaivsion Iida ietson External ines, Miata rena ‘Coudat renal Iwchisies Figure 4-20. Urogenital system of the Amozon Parrot, A, Mate with veins. B, Female with arteries. ilium. The middle renal di is recessed between the lumbar transverse processes ven- tral to the synsacrum, and the caudal renal division lies in apposition to the sacrum, The glomeruli of birds are smaller and proximal tubules larger than in mammals. A renal pelvis is absent in birds, As in other organs of birds, aggrcgates of lymphocytes are observed micro- seopically in the kidney. A slumy uric acid excretion, rather than the liquid allontom of mammals, accounts for more than 60 per cent of the urinary nitrogen excreted in birds. As pointed out by Johnson," the avian kidney is deeply recessed into bony depressions or fossae. Large nerve trunks and blood vessels traverse the kidney substance as they pass the synsacral region. ‘The combined effect of fossae, vessels, amd nerves secures the kidneys in place yather intricately. Thus it is generally difficult to excise thom, ‘The additional blood supply and fibrous adhesions accompanying renal neo- plasms generally prevent surgical removal. The ureters receive urinary ducts from cach division, are ventral to each division, and ex- tend caudally to the cloaca, The ureters open dorsal to the opening of the oviduct in the female and medial to the ductus deferens in the male. During endoscopic visualization, semi- solid urates can be observed moving in the ureters like cars of a monorail train. The Ama- zon Parrot, like other psittacines, lacks a urinary bladder and urethra.Female Reproductive System As in mammals, the female genital tract is composed of the ovary, oviduct, uterus, and vagina. In the Amazon Parrot, as in most birds, the right ovary is vestigial while the left one is functional. The unpaired oviduct, uterus, and vagina vary considerably in size and relationship to the ureters during different periods of the breeding cycle. The isthmus becomes very large and tortuous in the reproductively active fe- male, displacing the rest of the abdominal vis- cera to the right, with the exception of the traversing ileum, which is forced even more tightly against the midventral abdominal wall. These anatomic differences are important in endoscopy for sex determination and evaluation of the reproductive tract in birds. The ovary is suspended by mesovarium, the oviduets by mesosalpinx, and the uterus by mesometrium. The vagina of birds opens into the urodeum of the cloaca rather than directly to the outside. The vaginal cloacal prominence protrudes into the left dorsolateral urodeum, resembling a voleano in mature hens (Fig. 4 18). The vagina is easily entered for endoscopic viewing or diagnostic culturing in egg-laying birds. If renal biopsy is to be performed in a potential breeding female, the right kidney divisions should be chosen, since the infundi- bulum of the oviduct fans out over the kidney and must be penetrated in order to biopsy the left renal divisions, ‘The glandular region of the oviduct (magnum) first receives ova from the ovary through its ostium or infimdibulum cranially. The oviduct continues as the isthmus, which terminates in the uterus. Here more fluid albumin and the caleereous shell are added. The short vagina connects the uterus to the left side of the cloaca (Fig. 4-18). Egg formation is described in Chap- ter 5, Selected Physiology for the Ayian Prac- titioner. The vagina of the cockatiel is quite bulbous. It is the caudal site of ligation for hysterectomies in chronic egg-laying birds or birds with egg peritonitis. In hysterectomies the thin semitransparent oviduct is transected cranially following proper ligation of uterine vessels (see Chapter 48, Selected Surgical Pro- cedures). Male Reproductive System ‘The male psittacine’s reproductive tract con- sists bilaterally of a testis, epididymis, and ductus deferens. The testes are intra-abdomi- Chapter 4—CLINICAL ANATOMY / 59 nal, lying just cranial to the kidney in immature or non-nuptial males. In some males and most females in breeding condition, the gonads may cover the cranial divisions of the kidneys and in some cases the adrenal glands as well. The testes are intimately associated with the abdom- inal air sacs, whose function in regulating tes- ticular temperature and spermatogenesis is con- troversial."” The left testis generally is slightly larger than the right, particularly in younger birds. ‘The testes increase in size greatly during sexually active periods, During this period they should not be confused radiographically with neoplasms. They are generally whiter when active and become darker in the inactive state." Sperm in the testicles pass from the seminifer- ous tubules of the testicles to the rete testis, efferent ductules, connecting ductules, epidi- dymal duct, and ductus deferens. The epidi- dymis is not grossly visible. The tortuous ductus deferens arises from the medial side of the testis and parallels the ureter caudally to empty into the cloacal promontory as ejaculatory ducts. The prominence of the ductus deferens in mature males is obvious during endoscopic procedures, which is a further aid in identification of the ureters. Macroscopic organized accessory sex glands are absent in the Amazon Parrot, Seminal fluid is formed by the seminiferous tubules and ef ferent ducts; a phallus is absent in the Amazon Parrot. CARDIOVASCULAR AND HEMOPOIETIC SYSTEMS ‘The heart of psittacines, although proportion- ately larger than that of mammals, has four similar chambers: the right atrium, right ven- tricle, left atrium, and left ventricle. The ventral portion of the heart is cradled by the sternum. In the Amazon Parrot, the right atrium re- ceives blood fiom the periphery via divided right and left cranial venae cayae, single caudal vena cava, and vessels directly from the pro- ventriculus (Fig. 4-21). Atrioventricular valves are thin and exhibit poorly defined cusps. The right atrioventricular valve is muscular. Super- ficial and deep branches arise from both the right and left coronary arteries and supply the myocardium; unlike mammals, deep branches are dominant.™ From the right atrium blood enters the right ventricle and then the pulmo- nary artery, passing to the lmgs. Pulmonary veins return blood from the lungs to the left60 1 Section Two—THE NORMAL BIRD. gular, [tana L. internat eat a, 1 buachlooephat unt common carotid (Caudal vens eave Hopattews Figure 4-21, Heart and related major vessels in the Amazon Parrot. A, Ventrodorsal view. B, Right caudolateral view.Figute 4-21 Continued. C, Left lateral atrium. Tt then enters the left ventricle, where it is pumped into the aorta for distribution throughout the body. Arterial supply to the appendages and viscera of the-Amazon Parrot as dissected by McKibben is illustrated in Fig- ures 4-19, 4-22, and 4-23, In Amazon Parrots the left internal carotid artery accompanies the left jugular vein in the neck, The right internal carotid artery in the proximal neck lies deep to the longus colli muscle. It emerges near the head to accompany, the. right jugular vein to the head. In birds the internal vertebral venous sinus, vertebral veins, and jugular veins retum blood from the head and neck to the cranial venae cavae. The right jugular vein, which can be used for venipuncture, is much larger in caliber than the left in the Amazon Parrot. Caudal to the cranial mesenteric artery, be- tween the kidneys, the cranial renal arteries arise from the aorta and supply each cranial division of the kidneys. ‘The middle and caudal divisions of the kidney are supplied by middle and caudal renal arteries originating from the ischiadie artery (Fig. 4-19). The cranial division of the kidney is smallest. In cockatiels, the cranial artery is easily lacerated if this division is biopsied. The middle and caudal divisions are recommended for biopsy, as the renal ar- teries in these areas are better protected by a more bulky parenchyma. On the left side, branches of the aorta or cranial renal artery supply the ovary, oviduct, and left adrenal gland: Because the ovarian Chapter 4—CLINICAL ANATOMY / 61 Cauda vena cava arteries of a cockatiel are difficult to ligate owing, to the short length and large diameter of the vessels, the ovary is not removed in a hyster- ectomy of this species. However, the infundi- bulum is sparsely vascularized and can be bluntly dissected from its attachments with little hemorrhage. The right adrenal gland receives arterial branches directly from the aorta or right eranial renal artery. ‘Testicular arteries originate from the cranial renal artery or directly from the aorta, There is no pampiniform plexus in birds, Testicular veins ompty into the caudal vena cava. Paired lumbar arteries originate from the aorta between the kidneys and supply the lim- bar area, Near the middle division of each kidney, each external iliac artery originates from the aorta, passes dorsal to the kidneys, and divides into a cranial and a caudal branch (Fig. 4-23). Renal neoplasms impinging on the external iliac arter- ies may cause ischemia, paralysis, and necrosis of the legs. The cranial branch of the external iliac artory supplies the medial cranial thigh muscles, The caudal bianch supplies the ab- dominal wall and pelvic area and enters the limb as the femoral artery. It anastomoses with the ischiadic artery near the knee, ‘The ischiadic artery arises from the aorta between the middle and caudal divisions of the kidney and supplies most of the hindlimbs (Figs. 4-19 and 4-23). ‘The caudal mesenteric artery originates from the aorta caudal to the origin of the paired ischiadic arteries. It divides into one branch62. | Section Two—THE NORMAL BIRD “Trechaa snd seophogus (eaftacted) Rt Joga. Una oop rie. Superticial radial a and propatagalis asia. it, internal carotid {commen oaot 3. jugular. © ‘Sobseapular and v. reel. Biciptala, vst mteearpal emus Intarotteous metacarpal Ulnar Recurrent unt 9. ar 8 ‘Gutanpous ulnais Aalry 8 and. 4. brachiocephalic unk 2.1 eammmon erat & 2. Ltubelavlan a. Pectoral a, Anteralthoracle A abdominal arta Figure 4-22. Artorial supply to the wing of the Amazon Parrot, accompanying the caudal mesenteric vein to the jleum (intestines) and the other supplying the rectum. The aorta terminates into the right and left internal iliac arteries, which supply the dorsolateral wall of the cloaca and pelvic mus- culature lateral to the pubis. Mesenteric and iliac veins drain the abdom- inal and pelvic regions, The caudal mesenteric (coccygeamesenteric) vein receives blood from the caudal small intestines, rectum, and cloaca. Tt terminates in both the hepatic and renal portal systems. Usually blood in the caudal mesenteric vein flows toward the kidney, but it may reverse its flow toward the liver. % The renal portal shunt is discussed in Chapter 5. Lymphatic vessels are less numerous in birds than in mammals. Inside the trunk they usually accompany arteries and outside the trunk follow veins.” Their names are generally similar to those of the vessel they accompany, Muscular dilatations of lymphatic vessels called lymphatic hearts occur in some birds. Valves are present in lymphatic vessels of birds. Primary lymphoid tissue includes the thymus and cloacal bursa. These organs are involved in the immune response. The thymus gland is a multilobed paired structure extending along the jugular vein and vagus nerve in the neck. Grossly it appears to regress in the adult Ama- zon Parrot (see Chapter 24, Relationship of the ‘Avian Immune System to Infectious Diseases). “The secondary or peripheral lymphoid tissues of birds include the spleen, bone marrow, and mural lymphoid nodes (small collections of lymphoid tissue within or close to lymphatic vessels which are not generally grossly visible in psittacines), In addition, considerable lymph- oid tissue is present in difluse or aggregated areas in the wall of the digestive tract from the oral cavity to the end of the intestines. Both solitary and aggregated lymphoid nodules have also been demonstrated in the oculonasal re-Caudal vane cava Hopatio w. At, hepatie portal Chapter 4—CLINICAL ANATOMY 1 63 Heart Abdominal aorta External Femoral 8. (— Medial femora Cranial femoral a. L.ganleulate a. External ae ¥. Isobiadie a. Iechtadle v. Cauda mosentetev Publ = esi uncle. Popa Medi las, sehindic roche Fst Caudal cna ea sete WE iy conde a hi rai iit 4 Dorsal metatarsal #3, Plo tr. Plantar matatersa a. Figure 4-23. Arterial supply to the leg of the Amazon Parrot gion, liver, pancreas, kidney, lung, endocrine organs, gonads, peripheral nerves, and skin.” The spleen lies cranial to the ventriculus on, the right of the ventral border of the proventri- culus (see Figs. 4-16 and 4-17), The left lateral approach is used for biopsy; the surgeon pro- ceeds dorsally over the proventriculus and moves the coiled small intestines caudally to expose the spleen. Although rounded in the Amazon Parrot, the appearance of the spleen varies according to the species (see Chapter 23, Necropsy Procedures). Enlargement in disease is a common postmortem and radiographic find- ing, SENSORY ORGANS Vision is the dominant special sense in birds. ‘The eyes are relatively large, and the muscles controlling the movement of the globe and lids are well-developed. Enucleation and surgical removal of cataracts have been described in recent veterinary literature, emphasizing the necessity for a knowledge of the anatomy of the avian eye and related structures (see Chapter 19, Ophthalmology). In addition to dorsal and ventral eyelids, the nictitating membrane, or third eyelid, is well- developed in the Arnazon Parrot. ‘The gland ofGA! Section Two—THE NORMAL BIRD. the nictitating membrane (harderian) and lacri- mal glands are present. The sclerotic ring of 12 bones previously described lends stability to the iris in the Amazon Parrot, Although the musculature of the iris is commonly considered striated, Oliphant et al. describe myoepithe- lial, smooth muscle, and striated muscle com- ponents in the Great Horned Owl. The striated component is the primary pupillary constrictor, and the myoepithelium is the primary pupillary dilator, ‘The annular band of smooth muscle is important in maintaining pupillary size. The yellow color of the iris in some birds is due to fat enclosed in crypts. Age and sex also influ- ence the color of the iris (see Chapter 51, Sex Determination Techniques, and Chapter 7, Preliminary Evaluation of a Case). ‘A densely pigmented vascular projection called the pecten extends from the retina near the optic dise into the vitreous humor of the eyes (see Chapter 19, Ophthalmology). It may assist in nourishing the retina, serve asa heating element for the eye, a means of detecting small shadows, a regulator of intraocular pressure, or sensor of magnetic fields. A fovea, or depres- sion, in the central area of acute vision of the retina may be absent in some birds, but frontal and central foveae are present in others. These ual foveae permit binocular stereoscopic vi- sion. Cones outnumber reds in birds that are active during the day and rods outnumber cones in nocturnal birds, Diurnal birds probably also have color vision, According to Evans,” birds are capable of discriminating color. This was later confirmed by Pepperberg* in African Grey Parrots, Birds have no retinal vessels comparable to those in mammals, but the retina receives its blood supply from the choriocapillaris. Tears dram into the nasal cavity via nasolacrimal ducts, which are formed by dorsal and ventral lacrimal canals in Amazon Parrots. ‘The psittacine’s middle ear has only one bony ossicle, the columella, Sounds pass from the tympanic membrane through the columella to the vestibular window, where they become pressure waves entering the perilymph system of the inner ear. The inner ear has been de- scribed by Evans.’ Pharyngotympanic tubes extend between the middle ears and pharynx, opening by a common slitlike opening into the pharynx. ENDOCRINE SYSTEM Hormones are secreted into the circulatory system. Glands with endocrine functions in- dlude the thyroid, parathyroid, ultimobranchial gland, thymus, adrenal, pituitary, and pineal body. The pancreas, testes, ovaries, liver, small intestine, kidneys, uterus, and other organs secrcte hormones as well as performing their other fimetions (see Figs. 4-14 to 4-20). Bilaterally the reddish-brown thyroid gland of psittacines is located within the thorax. It lies near the syrinx and closely related to the jugular vein and common carotid artery. En- jarged thyroid glands are reported in psitta- cines. The parathyroid glands lie on the caudal surface of the thyroid gland or in close proximity to it. The ultimobranchial gland lies caudal to the parathyroid gland associated with the com- mon carotid artery and jugular vein, Adrenal glands bilaterally lie ventral to the synsacrum just ora to the kidneys and go- nads, immediately cranial to the bifurcation of the caudal vena cava (see Figs, 4-19 and 4-20), Endoscopically, they usually appear oblong, and orange, yellow, or cream-colored. Micro- scopically, they are not clearly divided into a cortex and medulla.” The pineal gland is a mid-dorsal outgrowth from the roof of the diencephalon, lying be- tween the cerebral hemispheres and the cere- bellum. The hypophysis lies within the hypo- physeal fossa of the sella tureica portion of the basisphenoid bone ventral to the diencephalon and just caudal to the optic chiasma. The ade- nohypophysis is divided into a pars distalis and pars tuberalis. The pars intermedia is absent.'* ‘The neurohypophysis is composed of the infun- dibulum, median eminence, and neural lobe. ‘These areas are extensively supplied with nerve tracts from the hypothalamus.” The gland se- cretes nine hormones. The liver is divided into right and left lobes, with the left lobe often smaller than the right (sce Figs, 4-14 to 4-16). The liver has little connective tissue. The liver may be approached for organ biopsy procedures by a transabdom- inal percutaneous needle biopsy technique’ or in conjunction with laparoscopy with the bird in right lateral recumbency (see Chapter 15, Endoscopy, and Chapter 16, Biopsy ‘Tech- niques). A knowledge of the anatomic relation- ships is essential to avoid penetrating other organs, particularly the heart, lungs, and pro- ventriculus. A gallbladder is absent in Amazon Parrots and Indian Ring-necked Parakeets (Psittacula kramer!), although it is present in some psitta- cine species. The presence of a gallbladder appears to be variable even in individuals within a species, as observed by Gadow? in cockatiels and other birds.VENTROLATERAL VIEW Dieneephaton Pineal gland ‘Mesoncephaton ‘Corebettum -Medllaspinalis DORSAL ‘Tectam and collealus of mesencephalon? orebstaraurite -Metoncephalon (pons) Chapter 4—CLINICAL ANATOMY / 65 Corebottum iyetoncephalon ‘Motoncephaton Hypophyss (pituitary gland) LATERAL, Myelencephaton (medulla oblongata) + Previously impropei ea opti obo Figure 4-24, The brain of the Amazon Parrot. A, Left ventrolateral view. B, Dorsal view. C, Lateral view. ‘The pancreas in the Amazon Parrot lies en- closed in and adjacent to the duodenal loop. Evans’ reports a three-lobed pancreas in the budgerigar, as does Jain"? in the Indian Ring- necked Parakeet, with two ducts entering the proximal medial ascending duodenal loop and one duct on the opposite side. The bile ducts also enter in the area of the first two pancreatic ducts, NERVOUS SYSTEM ‘The clinical significance of the avian central and peripheral nervous systems is discussed in Chapter 20, Neurologic Examination, and Chapter 38, Neurologic Disorders. Figure 4~ 24 illustrates the brain of the Amazon Parrot, REFERENCES 1, Berman, $. Le:‘The hindtimb musculature of the White- fronted amazon (Amazona albifrons). ‘The Auk, 101:74-92, 1984. 2, Blackmore, F. HL: the effect of temperature, photope- riod and molt on the energy requirements of the house sparrow (Passer domesticus). Comp. Biochem. Physiol, 30:433, 1909. 8 Biibler, P./ Functional anatomy of the avian jaw appa- rats. In King, A. S., and MeLelland, J. 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Philadelphia, Med), 14():287-298, 1984, W. B. Saunders Co., 1975, 17. Lake, P. E.: The male in reproduetion, fn Belt, D. SL. Vanden Berge, J. C.: Myologica, In Baumel, J. J., et ‘and Freeman, B. ME. (eds.): Physiology and Biochem- al. (eds.): Nomina Anatomica Avium, New York, istry of the Domestic Fowl. Vol. 3. New York, Academie Press, 1979. Academie Press, 1971. 82, Walsh, M. T.: Clinical manifestations of cervieocephelic 18, Lake, P. E.: Male genital organs. In King, A. S., and air sacs of psittacines. Comp. Cont. Ed., 9:783-789, MeLelland, J. (eds.): Form and Bunetion jn Birds, 1084, Vol. Il, Now York, Acidemic Press, 1981 ACKNOWLEDGMENTS I wish to thank Drs, Susan Clubb and Berne Levine for provi ng specimens for anatomic dissection, injection, and maceration. ‘The sacrifices ad support of my wife Marge made completion of this work possible. To her I am particularly grateful. ‘The artistry and dissection assistance contributed by my son, James McKibben, and by Professor Algeron Allen of Purdue University help visualize descriptions much more clearly. The reviews by Dr. Howard E. Evans are greatly appreciated. ‘The revi JOUN S, McKIBBEN ws and editing by Dr. Julian J. Baumel are greatly appre- ciated, ‘The anatomy drawings were funded in part by a grant from the Research Institute for Avian Medicine, Nutrition and Reproduc- tion, Ine., and completed by the donation of extensive amounts of time by Professor Allen and Dr. McKibben. GREG J. HARISON