THE BRACHIAL ARTEEY. 



ygy 



the anterior circumflex and superior profunda together, or some other rarer com- 

 'hination of those vessels. The posterior circumflex is sometimes double ; and so 

 is the anterior, but more seldom. 



SURGICAL ANATOMY OF a?HE AXILLARY ARTERY. 



This artery is usually tied in the third part of its course. The limb having been 

 carried away from the chest, an incision three inches long is made about midway 

 iDetween the folds of the axilla and in the dii-ection of the axis of the limb. On 

 cutting through the deep fascia, the vein, artery and brachial nerves are exposed. 

 The vein is internal, and the artery is partly suiTounded by the nerves. The 

 ligature is passed from within outwards. In the rest of its coui'se the artery is 

 so deeply placed and m such close relations with the vein and nerves that an 

 •operation on the third part of the subclavian is both easier and more successful. 



BRACHIAL ARTERY. 



The brachial or humeral artery, the coutinuatiou of the axillary, 



Fig. 2G1. 



Fig. 261. — Dissection of the Axilla and Inside of the Akji to show the 

 Axillary and Brachial Vessels (from R. Quain) ^ 

 The greater and lesser pectoral muscles have been divided so as to expose the axillary 

 vessels : a, the inserted portion of the pectoralis major ; h, the pectoral portion ; 1, 1, 

 axillary artery ; + , + , the median nerve formed by the two portions of the plexus which 

 surround the artery ; 1', placed on a part of the sheath of the brachial vessels, and 1", on 

 the lower part of the biceps muscle, points to the brachial artery surrounded by its vente 

 comites ; 2, 2, axillary vein ; 3, 3, the basilic vein ; the upper figure is i)laced on the 

 triceps muscle, the lower on the fascia near the junction of the idnar vein : on the basilic 

 vein are seen the ramifications of the internal cutaneous nerve ; 4, on the deltoid, and 

 4', near the clavicular part of the great pectoi-al muscle, mark the cephalic vein joining 

 the acromio-thoracic and through it the axillary vein ; 5, 5, placed on tlie divided portions 

 of the pectoralis minor, point to the origin and branches of the acromio-thoracic artery ; 



6, placed on a group of axillary glands, indicates the alar thoracic and subscapular vessels ; 



7, placed on the trunk of the axillary vein, points to one of the venas comites of the 

 brachial vein, which being joined by the other higher up passes into the axillary vein ; 

 the ulnar nerve is seen passing from below the basilic vein towards the inner condyle ; 

 near 1, placed on the coraco-brachialis muscle, is seen the musculo-cutaneous nerve before 

 it passes through that muscle ; near 2, placed on the tendon of the latissimus dorsi 

 muscle, a portion of the nerve of Wrisberg. 



