FASCIA OF THE SUPERIOR EXTREMITY. 725 



The shoulder has three divisions of this general apo- 

 neurotic fascia ; one covering the supra-spinatus muscle 

 and attached to the margins of the supra-spinal fossa, called 

 the supra-spinous fascia ; a second, covering the infra-spi- 

 natus and attached to the margins of the infra spinal-fossa, 

 called the infra-spinous fascia. Both of these fasciae are 

 strong and thick, and continued into the third division the 

 deltoid fascia. This latter covers the deltoid and pectoral 

 muscles, is thin, and attached above to the spine of the 

 scapula, acromion process, and external ends of the clavicle, 

 while below it is traced into the next fascia belonging to 

 the arm, and called 



Fascia Brachialis. This fascia surrounds all the muscles 

 of the arm to the elbow, sends off processes forming sheaths 

 for the same, and above the condyles of the humerus, these 

 processes separate the muscles on the front of the arm from 

 those behind. They are attached to the ridge leading to 

 the condyles, and are called internal and external intermus- 

 cular ligaments. At the end of the elbow the fascia bra- 

 chialis is increased in strength by having a broad band, 

 the bicipital aponeurosis, running into it. This band comes 

 from the inner side of the tendon of the biceps, which with 

 the fascia brachialis, is lost in the next fascia, called 

 the cubital fascia. This is the fascia of the forearm, ex- 

 tending from the elbow to the wrists. It is thicker behind 

 than before ; surrounds and forms partitions for the several 

 muscles, constituting at its upper portion intermuscular 

 ligaments, and likewise separating the superficial from the 

 deep layer of muscles, as well as affording attachment for 

 many muscular fibres. At the wrist the cubital fascia forms 

 two strong bands, the one in front, the other behind, called 

 the anterior and posterior annular ligaments. 



The anterior is a broad ligamentous band, extending 

 across the wrist from the scaphoides and trapezium on the 

 one side, to the unciform, cuneiform and pisiform bones on 

 the other. This band confines and directs the flexor ten- 

 dons of the fingers which pass beneath it. 



The posterior annular ligament stretches from the styloid 



