62 LANDMARKS MEDICAL AND SURGICAL. 



effectually is outwards and a little backwards, else the artery 

 will slip off the bone. 



The musculo-spiral nerve and superior profunda artery 

 wind round the back of the humerus about its middle, and 

 come to the front of the external condyloid ridge. Thus, for 

 full three inches above the condyles, there is nothing to inter- 

 fere with operations on the back of the bone, which is here 

 broad and flat. 



136. Bend of elbow. At the bend of the elbow, the tendon 

 of the biceps can be plainly felt, as well as the pulsation of 

 the brachial artery close to its inner side, before dividing into 

 the radial and ulnar. 



Cutaneous veins. The bend of the elbow in young 

 children and in persons with fat and round arms, presents a 

 semicircular fold of which the curve embraces the lower part 

 of the biceps ; but in muscular persons we see the distinct 

 boundaries of the triangular space, formed by the pronator 

 teres on the inner side, and the supinator longus on the 

 outer. Here can be traced, standing out in strong relief 

 under the thin white skin, the superficial veins, which, in days 

 gone by, when bloodletting was the fashion, were of such 

 great importance. Their arrangement, although subject to 

 variety, is very much like the branches of the letter M, the 

 middle of the M being at the middle of the elbow. Of these 

 branches the median basilic, which runs over the tendon of 

 the biceps, is the largest and most conspicuous, and is 

 generally selected for venesection ; it crosses the course of 

 the brachial artery, nothing intervening but the semilunar 

 aponeurosis from the tendon of the biceps. 



137. Landmarks of elbow. It is of great importance to 

 be familiar with the relative positions of the various bony 

 prominences about the elbow. We can always feel the 

 internal and external condyles. The internal is the more 

 prominent of the two, and a trifle higher. 



Olecranon. We can always feel the olecranon. This is 

 somewhat nearer to the inner than to the outer condyle. 

 Between the olecranon and the internal condyle is a deep 

 depression in which lies the ulnar nerve (vulgarly called the 

 ' funny bone '). 



