130 SURGICAL APPLIED ANATOMY. [Chap. ix. 



In wounds of the neck the great vessels often 

 escape in a marvellous manner. They are protected 

 in part by the depth at which they are situated, and 

 in part by their great mobility, lying as they do in an 

 atmosphere of loose connective tissue. Dieffenbach 

 relates a case of cut throat in which both gullet and 

 trachea were divided without any damage to the 

 great vessels. In cut throat the vessels are greatly 

 protected by the projecting thyroid cartilage above, 

 and by the contracting of the sterno-mastoid muscles 

 below. Deep gashes made across the crico-thyroid 

 space, or through the upper part of the trachea, 

 reach the great vessels more easily than would wounds 

 made with equal force in any other part of the 

 neck. 



In some cases of gunshot wound the vessels seem 

 to have been actually pushed aside, and to have owed 

 their safety to their mobility. Thus, in a case 

 reported by Longmore, the bullet passed entirely 

 through the neck from one side to the other. It 

 passed through the gullet, damaged the posterior part 

 of the larynx, but left the great vessels intact. In 

 another recorded case a boy fell upon the point of a 

 walking-stick. The end of the stick passed entirely 

 through the neck from side to side, entering in front 

 of one sterno-mastoid muscle, and emerging through 

 the substance of the opposite one. It probably passed 

 between the pharynx and the spine. The boy, who 

 left the hospital well in eighteen days, owed his safety 

 to the laxity of the cervical connective tissue, and to 

 the mobility of the main structures in the neck. 



In connection with the subject of wounds of the 

 neck it must be remembered that the most important 

 part of the spinal cord can be reached from behind, 

 through the gap between the atlas and axis. In this 

 situation the cord has been divided by one stab of a 

 knife, the instrument entering between the two bones. 



