150 SURGICAL ANATOMY OF 



must be used cautiously. The great vascularity of the 

 region of the elbow-joint is, no doubt, one cause of the 

 success attending its excision, the inosculating branches 

 being the superior and inferior profundae, anastomotica 

 magna, anterior and posterior ulnar recurrent, interos- 

 seous recurrent, and radial recurrent. It is worthy of 

 notice that the nutrient vessels of the humerus, radius, 

 and ulna run towards the elbow-joint. 



On making a vertical section through the elbow-joint, 

 the following structures would be divided from above 

 downwards : Skin and integument, containing the su- 

 perficial veins and nerves already described, aponeurosis 

 of arm, supinator longus, pronator teres, brachial artery 

 and veins, and median nerve and musculo-spiral nerve, 

 extensor carpi radialis longior, tendon of biceps, brachi- 

 alis anticus, supinator brevis, flexor carpi radialis, exten- 

 sor carpi radialis brevior, external and internal lateral 

 ligaments, flexor sublimis, ulnar nerve, extensor carpi 

 ulnaris, flexor carpi ulnaris, anconeus, olecranon, and 

 olecranon bursa, and then the integument. The opera- 

 tion of amputation through the articulation is not one 

 frequently performed, but the flaps would contain these 

 structures. 



The articulation of the elbow-joint admits of flexion 

 and extension, and the direction of the articular surfaces 

 not being parallel to a line drawn through the condyle, 

 it follows that the axis of the forearm is not continuous 

 with that of the arm, the trochlear surface being much 

 lower down than the capitellum. The ligaments con- 

 necting the bones of the joint are very strong namely, 

 an anterior, a posterior, and two lateral, whilst there is 

 a very large synovial membrane, the arrangement of 

 which, in diseases of the articulation, causes the swell- 



