444 MYOLOGY 



lateral and is applied to the tuberosity of the radius at its insertion. Opposite 

 the bend of the elbow the tendon gives off, from its medial side, a broad aponeu- 

 rosis, the lacertus fibrosus (bicipital fascia) which passes obliquely downward and 

 medialward across the brachial artery, and is continuous with the deep fascia 

 covering the origins of the Flexor muscles of the forearm (Fig. 410). 



Variations. A third head (10 per cent.) to the Biceps brachii is occasionally found, arising at 

 the upper and medial part of the Brachialis, with the fibers of which it is continuous, and inserted 

 into the lacertus fibrosus and medial side of the tendon of the muscle. In most cases this additional 

 slip lies behind the brachial artery in its coarse down the arm. In some instances the third head 

 consists of two slips, which pass down, one in front of and the other behind the artery, concealing 

 the vessel in the lower half of the arm. More rarely a fourth head occurs arising from the outer 

 side of the humerus, from the intertubercular groove, or from the greater tubercle. Other heads 

 are occasionally found. Slips sometimes pass from the inner border of the muscle over the brachial 

 artery to the medial intermuscular septum, or the medial epicondyle; more rarely to the Pronator 

 teres or Brachialis. The long head may be absent or arise from the intertubercular groove. 



The Brachialis (Brachialis anticus) (Fig. 411) covers the front- of the elbow-joint 

 and the lower half of the humerus. It arises from the lower half of the front 

 of the humerus, commencing above at the insertion of the Deltoideus, which it 

 embraces by two angular processes. Its origin extends below to within 2.5 cm. 

 of the margin of the articular surface. It also arises from the intermuscular septa, 

 but more extensively from the medial. than the lateral; it is separated from the 

 lateral below by the Brachioradialis and Extensor carpi radialis -longus. Its fibers 

 converge to a thick tendon, which is inserted into the tuberosity of the ulna and 

 the rough depression on the anterior surface of the coronoid process. 



Variations. Occasionally doubled; additional slips to the Supinator, Pronator teres, Biceps, 

 lacertus fibrosus, or radius are more rarely found. 



Nerves. The Coracobrachialis, Biceps brachii and Brachialis are supplied by the musculo- 

 cutaneous nerve; the Brachialis usually receives an additional filament from the radial. The 

 Coracobrachialis receives its supply primarily from the seventh cervical, the Biceps brachii and 

 Brachialis from the fifth and sixth cervical nerves. 



Actions. The Coracobrachialis draws the humerus forward and medialward, and at the 

 same time assists in retaining the head of the bone in contact with the glenoid cavity. The 

 Biceps brachii is a flexor of the elbow and, to a less extent, of the shoulder; it is also a powerful 

 supinator, and serves to render tense the deep fascia of the forearm by means of the lacertus 

 fibrosus given off from its tendon. The Brachialis is a flexor of the forearm, and forms an impor- 

 tant defence to the elbow-joint. When the forearm is fixed, the Biceps brachii and Brachialis 

 flex the arm upon the forearm, as in efforts of climbing. 



The Triceps brachii (Triceps; Triceps extensor cubiti) (Fig. 412) is situated on 

 the back of the arm, extending the entire length of the dorsal surface of the humerus. 

 It is of large size, and arises by three heads (long, lateral, and medial), hence its 

 name. 



The long head arises by a flattened tendon from the infraglenoid tuberosity 

 of the scapula, being blended at its upper part with the capsule of the shoulder- 

 joint; the muscular fibers pass downward between the two other heads of the 

 muscle, and join with them in the tendon of insertion. 



The lateral head arises from the posterior surface of the body of the humerus, 

 between the insertion of the Teres minor and the upper part of the groove for the 

 radial nerve, and from the lateral border of the humerus and the lateral intermus- 

 cular septum; the fibers from this origin converge toward the tendon of insertion. 



The medial head arises from the posterior surface of the body of the humerus, 

 below the groove for the radial nerve; it is narrow and pointed above, and extends 

 from the insertion of the Teres major to within 2.5 cm. of the trochlea: it also 

 arises from the medial border of the humerus and from the back of the whole 

 length of the medial intermuscular septum. Some of the fibers are directed 

 downward to the olecranon, w r hile others converge to the tendon of insertion. 



The tendon of the Triceps brachii begins about the middle of the muscle: it con- 



