4i8 A MANUAL OF ANATOMY 



cipital groove, this being for the passage of the long tendon of the biceps. 

 The transverse humeral ligament will be found bridging over this part of the 

 bicipital groove. The joint should now be opened by removing the posterior 

 part of the capsule, and the three gleno-humeral ligaments are to be looked for. 

 They are situated on the inner and anterior aspect of the capsule. The front 

 part of the capsule should now be removed and the glenoid ligament examined. 

 The tendon of the long head of the biceps, as it arches over the head of the 

 humerus, is to be noted, and its relation to the glenoid ligament at the apex 

 of the glenoid cavity is to be shown. The synovial membrane and movements 

 are then to be studied. 



Front ol the Forearm. — The deep fascia is to be examined and removed, 

 except the part covering the muscles arising from the internal epicondyle. 

 These muscles are to be dissected, from without inwards, in the following order : 

 pronator radii teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, 

 and flexor subUmis digitorum. Having noted the common tendon of origin 

 of these muscles, what is left of the deep fascia is to be removed, and the muscles 

 carefully separated from each other up to their origins. In doing so, the 

 strong intermuscular septa are to be noted. The small, deep head of the 

 pronator radii teres is to be displayed, with the median nerve passing between 

 the two heads of the muscle, and the ulnar artery beneath its deep head, and 

 it should be noted that the median nerve, which is at first internal to the ulnar 

 artery, crosses it to get to its outer side. 



The muscular branches of the median nerve are to be caught high up, 

 as well as its anterior interosseous branch, in connection with which latter 

 care is to be taken to preserve the median branch of the anterior inter- 

 osseous artery, which is usually of small size. The ulnar nerve is to be 

 shown entering the forearm between the two heads of the flexor carpi ulnaris, 

 where it lies between the internal epicondyle and olecranon, and gives off 

 articular twigs to the elbow- joint. Thereafter its branches to the flexor 

 carpi ulnaris and inner portion of the flexor profundus digitorum should 

 be displayed high up. 



The radial artery is next to be dissected as low as the wrist, its venae 

 comites being noted. The branches to be shown are the radial recurrent, 

 close to the origin, muscular down the forearm, and anterior radial carpal 

 and superficial volar near the wrist. The radial nerve is also to be dissected 

 until it turns to the back of the forearm beneath the tendon of the brachio- 

 radialis. The ulnar artery is then to be dissected as low as the wrist, and, 

 descending over its lower half, the palmar cutaneous branch of the ulnar 

 nerve is to be preserved. The branches of the vessel to be shown are the 

 anterior and posterior ulnar recurrents, the interosseous trunk, soon divid- 

 ing into anterior and posterior interosseous, the former of which gives off 

 the median artery (all of these branches arising high up), muscular down the 

 forearm, and posterior and anterior ulnar carpals near the wrist. The pos- 

 terior interosseous artery is to be shown passing backwards between the radius 

 and ulna, and the median branch of the anterior interosseous artery is to be 

 carefully studied, as it is sometimes of large size and may be continued into 

 the palm to join the superficial palmar arch. The ulnar nerve is to be dis- 

 sected as low as the wrist. Its occasional branch to the front of the forearm 

 below the centre is to be looked for, and the palmar cutaneous and dorsal 

 branches are to be shown, the former arising a little below the centre of the 

 forearm and the latter about 2 inches above the wrist, after which it turns 

 backwards beneath ±he tendon of the flexor carpi ulnaris. 



The flexor sublimis digitorum is then to be raised and held aside, to show j 

 the median nerve, with the median artery, descending in close contact with | 

 its deep surface as far as a little above the wrist, where the nerve comes to 

 lie on the outer side of the muscle, and gives off its palmar cutaneous branch. I 

 At this stage the dissector should carefully note that the great palmar bursa j 

 is prolonged upwards round tho flexor tendons for fully an inch above the | 

 anterior annular ligament, and the arrangement of the superficial flexor j 

 tendons in pairs before they pass beneath that ligament is to be shown. By I 

 pulling upon the individual tendons, those of the anterior pair will be seen 



