146 SURGICAL ANATOMY OF 



SUKGICAL ANATOMY OF THE KEGION OF THE 

 ELBOW. 



Surface Markings. This region includes the articu- 

 lation of the elbow-joint, and its immediate relations 

 present for superficial examination four surfaces. Sup- 

 posing the forearm fixed at a right angle with the hume- 

 rus, a hollow is formed in front by the muscles attached 

 to the condyles, within which lies the tendon of the 

 biceps, its margin sharp externally, and flattened in- 

 ternally where its fascia is felt passing to the muscular 

 mass attached to the inner condyle, and below which 

 can be seen or felt the pulsation of the brachial artery ; 

 beneath the skin are visible, particularly in thin per- 

 sons, the superficial veins of the bend of the elbow. On 

 the outer side can be felt the external condyle, and the 

 head of the radius; internally, the inner condyle; whilst 

 posteriorly r , nearer the inner than the outer condyle, is 

 the olecranon, with the insertion of the triceps tendon. 



The mutual relations of these structures to each other 

 should be carefully examined in every position of the 

 normal arm, in extreme and intermediate flexion and 

 extension, and in pronation and supi nation of the fore- 

 arm, and in cases of injury compared with the opposite 

 side. In complete extension, the olecranon is above the 

 level of the condyles; in semiflexion, on the same level ; 

 and in flexion, at a right angle below the level of the 

 condyles. 



Superficial Dissection of Bend of Elbow: Anterior As- 

 p ec t On reflecting the skin, which is thin, lax, and 

 thrown into folds, beneath the subcutaneous cellular 

 tissue lie the cutaneous nerves, and an important plexus 

 of veins and lymphatics. The nerves are derived from 



