HEAD AND NECK 



CHAPTER I 

 SUPERFICIAL EXAMINATION 



On making such an examination the eye should carefully survey the 

 different areas, noting the most salient features, after which the parts 

 should be manipulated and palpated with the hand. It is impossible 

 to too thoroughly impress the reader with the great importance of 

 such an examination, for it is only by constant practice of this nature 

 that the ability to thoroughly and completely take in a mental picture 

 of an operative area is acquired. Such ability is one of the essentials 

 to the practice of successful surgery, for it enables the operator to 

 anticipate difficulties, to avoid errors, and to perform his operation in 

 a manner which is based upon a rational knowledge of the geography 

 of his surroundings. 



At the summit of the head will be seen a transversely elongated 

 elevation, and upon palpation this will be found to be due to a 

 subjacent osseous ridge. This ridge is the occipital or lambdoid crest. 

 Running down from this crest is another crest, which is placed in 

 the middle line, and which is not easily seen on account of the bulging 

 mass of muscle on either side. This latter is the sagittal crest, and 

 the muscle on either side is the temporal. From the inferior extremity 

 of the sagittal crest a divergent ridge will be tound on either side to 

 extend obliquely downwards and outwards to the supra-orbital process 

 of the frontal bone. The latter extends across the superior aspect of 



