8 SURGICAL APPLIED ANATOMY. [Chap. i. 



and was removed. After its removal the finger could 

 be passed through an opening with an unyielding 

 border, and came in contact with some soft substance 

 beyond. The case was considered to be one of com- 

 pound fracture of the squamous bone, with separation 

 of a fragment and exposure of the brain. A by- 

 stander, however, noticed that the bone removed was 

 dry and white, and a more complete examination of 

 the wound revealed the fact that the skull was un- 

 injured, that the supposed hole in the skull was 

 merely a laceration of the temporal fascia, that the 

 soft matter beyond was muscle and not brain, and that 

 the fragment removed was simply a piece of bone 

 which, lying on the ground, had been driven into the 

 soft parts when the woman fell. 



Abscesses in the temporal fossa are prevented 

 by the fascia from opening anywhere above the 

 zygoma, and are encouraged rather to spread into 

 the pterygoid and maxillary regions, and into the 

 neck. 



The pericranium in the temporal region is much 

 more adherent to the bone than it is over the rest of 

 the vault, and subpericranial extravasations of blood 

 are therefore practically unknown- in this part of the 

 cranial wall. 



Trephining 1 . This operation is frequently per- 

 formed in the temporal region, its object being to 

 reach extravasations of blood from the middle menin- 

 geal artery. This artery crosses the anterior inferior 

 angle of the parietal bone at a point 1| inches behind 

 the external angular process of the frontal bone, and 

 1| inches above the zygoma. 



In cutting down to the bone in the temporal 

 region the following structures are met with in order : 

 (1) The skin ; (2) branches of the superficial temporal 

 vessels and nerves; (3) the fascia continued down 

 from the epicranial aponeurosis ; (4) the temporal 



