1450 SURFACE AND SUEGICAL ANATOMY. 



To evacuate pus from the elbow-joint a vertical incision should be made over 

 the dorsal aspect of the joint, immediately lateral to the olecranon. 



The median vein is seen to bifurcate into the median basilic and median cephalic 

 veins i in distal to the middle of the bend of the elbow; opposite the same point, 

 but beneath the deep fascia, is the bifurcation of the brachial artery The median 

 basilic and median cephalic veins diverge as they ascend one on each side of the 

 biceps tendon; the larger of the two veins, viz., the median basilic is usually 

 selected for the operations of venesection and transfusion. When the elbow i 

 flexed the biceps tendon can be traced vertically through the centre of the bend of 

 the elbow almost to its insertion. Passing distally and medially from the medial 



Vena comes of brachial artery 



Lateral cutaneous nerve of forearm 



Tendon of biceps 

 Median cephalic vein 



Braehio-radialis 



Radial nerve 



Radial extensors 



Articular surface of hurnerus 



Lateral epicondyle 



Brachial artery 



Median basilic vein 



Vena comes of brachial artery 

 Tronator teres 



Ulnar vein 



Median nerve 



Brachialis muscle 



Common origin of 

 flexor muscles 



Medial epicondyle 



Uluar nerve 



uperior ulnar 

 collateral artery 



Olecranon 



Anconseus Olecranon fossa of humerus 



FIG. 1114. TRANSVERSE SECTION THROUGH THE BEND OF THE ELBOW. 



edge of the tendon is the lacertus fibrosus, which separates the median basilic vein 

 from the brachial artery. If the finger nail is insinuated beneath the medial edge 

 of the lacertus fibrosus the point of the finger will rest upon, and feel the pulsations 

 of, the brachial artery. The median nerve descends through the space a little medial 

 to' the brachial artery. The bifurcation of the radial nerve takes place in front of 

 the lateral epicondyle under cover of the brachio-radialis. The ulnar nerve can 

 be rolled beneath the finger upon the back of the medial epicondyle ; its position 

 renders it liable to injury in severe fractures about the elbow ; and in excising 

 the joint care must be taken not to injure the nerve. 



THE FOREARM AND HAND. 



The proximal half of the radius is deeply placed ; the distal half, however, is 

 easily palpated. The anterior border of its distal extremity is felt as a prominent 

 transverse ridge, situated 1 in. proximal to the thenar eminence ; immediately distal 

 to the ridge is the radio-carpal articulation. The tip of the styloid process, situated 

 nearly J in. more distal than that of the ulna, is deeply placed at the lateral 

 side of the wrist, in the hollow between the extensor tendons of the first and- 

 second phalanges of the thumb. Upon the middle of the posterior surface of 

 the distal end of the radius is the dorsal radial tubercle, which intervenes 

 between the extensor pollicis longus and the short radial extensor of the wrist; 

 the tubercle can be distinctly felt, and may be taken as a guide to the proximal end 



