342 CLINICAL APPLIED ANATOMY. 



and particularly those near the bifurcation of the common 

 carotid. 



Wounds of the Up may bleed profusely from the coronary 

 branches of the facial artery, but the haemorrhage can be readily 

 controlled temporarily by compressing these vessels between the 

 finger and thumb. The arteries lie closer to the mucous mem- 

 brane than the skin surface. In suturing it is important to 

 remember that care must be taken to approximate the edges of 

 the wound accurately, so as to bring the red margin of the lip 

 exactly into line. 



Hare-lip. A common congenital deformity is that known as 

 hare lip. In the development of the face the median fronto-nasal 

 process as a whole should become joined with the bilateral maxil- 

 lary processes, the deeper bony parts articulating with one another 

 and the superficial cutaneous portions fusing. Failure of the 

 junction of the skin edges of the lower part of the cleft between 

 the above-mentioned processes constitutes hare-lip. This may 

 vary in degree from a slight notch in the red margin of the upper 

 lip, to a cleft extending right up into the anterior naris. As a 

 rule, in a hare-lip the red margin is continued up on the sides of 

 the gap. Moreover, the cleft may be unilateral or bilateral ; if 

 bilateral, the median portion, consisting of the skin covering the 

 premaxillary bones, may be carried forwards on the end of the 

 vomer. The premaxillary bones contain the incisor teeth, and 

 in dealing with this part during the closure of the hare-lip, 

 it has to be remembered that if the bone is forced back, there is 

 a tendency for these teeth, when they appear, to be rotated back- 

 wards in such a manner that they will not close properly upon the 

 lower incisors. Hare-lip may be associated with a cleft palate. 



Median hare-lip is extremely rare. In this variety the notch 

 between the internal nasal prominences of the fronto-nasal 

 process remains unobliterated, and the cleft may be prolonged 

 by a furrow which runs on to the tip of the nose. 



After closure of a hare-lip there is a possibility that asphyxia 

 may arise, for the dressing still further diminishes the opening of 

 the anterior nares. 



