4i6 A MANUAL OF ANATOMY 



a cutaneous branch of the ulnar nerve may be met with, and towards the wrist 

 the palmar cutaneous branches of the median and ulnar are to be shown. In 

 the lower third of the forearm, posteriorly and on its outer aspect, the radial 

 nerve is to be shown, as well as the dorsal branch of the ulnar nerve on its 

 inner aspect. The cutaneous veins to be dissected are the radial, median, and 

 anterior and posterior ulnar veins in the forearm ; the median basilic and median 

 cephalic at the bend of the elbow, with the deep median joining the superficial 

 median close to its termination ; and the basilic and cephalic in the arm, the 

 basilic being superficial to the deep fascia in the lower half, but subsequently 

 piercing it, and the cephalic being superficial throughout. In connection with 

 the median basiUc vein the semilunar fascia of the biceps is to be shown, and 

 one or two supracondylar glands are to be carefully looked for a little above 

 the internal epicondyle, close to the basilic vein. 



Front and Inner Side of the Brachial Region. — The deep fascia of the arm is to 

 be studied, and, as the dissection proceeds, the external and internal inter- 

 muscular septa, with the structures related to them, are to be noted. The 

 biceps and coraco-brachialis are to be dissected, and, in connection with the 

 tendon of insertion of the latter muscle, a fibrous band should be looked for 

 passing upwards to the humerus below the small tuberosity, and forming an 

 arch over the latissimus dorsi and teres major. The internal brachial ligament 

 of Struthers is to be looked for, extending from the humerus near the insertion 

 of the teres major to the internal epicondyle. The musculo-cutaneous nerve 

 is to be shown piercing the coraco-brachialis, and, by raising the biceps, the 

 nerve is to be followed between that muscle and the brachialis anticus to the 

 outer border of the biceps, where it becomes cutaneous, and its muscular 

 branches are to be shown. It may be found to give a communicating branch 

 to the median. The semilunar fascia of the biceps is to be carefully dissected, 

 and its relation to the brachial artery and median basilic vein is to be observed. 



The brachial artery is next to be dissected, and the vense comites on either 

 side of it shown. These will be found to join above, and terminate in the lower 

 part of the axillary vein. The median nerve is to be shown lying at first on 

 the outer side of the artery, then crossing it just below the centre of the arm, 

 and thereafter lying on its inner side. It gives off no branches in the arm, 

 but it may receive one from the musculo-cutaneous. The branches of the 

 brachial artery are to be shown as follows : (i) the superior profunda arises 

 high up from the inner and back part of the vessel, and accompanies the mus- 

 culo-spiral nerve to the back of the arm ; (2) the inferior profunda arises from 

 the inner side a Uttle lower down than the preceding, and accompanies the 

 ulnar nerve through the internal intermuscular septum to the interval between 

 the internal epicondyle and the olecranon ; (3) the nutrient or medullary artery 

 arises from the inner side about the lower border of the tendon of insertion 

 of the coraco-brachialis, and passes downwards to enter the medullary foramen 

 of the humerus ; (4) the anastomotica magna arises from the inner side about 

 2 inches above the elbow, and divides into two branches — anterior, passing j 

 downwards in front of the internal epicondyle beneath the pronator radii 1 

 teres, and posterior, piercing the internal intermuscular septum to reach the 

 interval between the internal epicondyle and the olecranon ; and (5) several 

 muscular branches arising from the outer side of the vessel. 



The musculo-spiral nerve is to be shown lying, for a little, behind the upper 

 part of the brachial artery, and the branches which it here gives off, namely, 

 internal cutaneous to the back of the arm, and muscular to the long and 

 internal heads of the triceps, are to be noted. One of the latter descends with 

 the ulnar nerve, as the ulnar collateral nerve of Krause, to enter the internal 

 head of the muscle low down. The ulnar nerve is to be dissected as low as the 

 internal epicondyle and the olecranon, and it is to be shown piercing thf 

 internal intermuscular septum. It gives off no branches in the arm. Th« 

 internal cutaneous nerve and the nerve of Wrisbcrg are also to be noted. Th< 

 brachialis anticus is to be dissected by displacing the biceps outwards, and it h 

 to be separated from the brachio-radialis. In this way a part of the musculo 

 spiral nerve will be exposed, and it is to be followed carefully downwards ti 

 near the external epicondyle, where its two terminal branches, radial ant 



