BEND OF THE ELBOW. 109 



non, where it gives off muscular and articular branches, and 

 continues down the ulnar side of the forearm to the hand. 



BEND OF THE ELBOW. 



The veins at the front of the elbow should be studied, 

 with reference to the operation of venesection. A ligature, 

 placed high up around the arm of a living person, affords, 

 in many respects, a better opportunity for studying them 

 than is found upon the dead subject. They are generally 

 irregular, and rarely correspond with the description given 

 in books ; certain relationships between them and the ar- 

 tery and nerves, should, however, be carefully noted. 



Three superficial veins return the blood from the fore- 

 arm viz: RADIAL, ULNAR, and MEDIAN the situations of 

 which are indicated by their names. The median vein 

 divides at the elbow into two short branches, which unite 

 respectively with the ulnar and radial veins ; the internal 

 branch is called the median basilic, the external the median 

 cephalic ; the basilic vein being the continuation of the 

 median basilic and ulnar, and the cephalic of the median 

 cephalic and radial veins. The disposition of these veins 

 at the elbow may be compared to the letter M ; the middle 

 angle of that letter representing the division of the median 

 vein, the superior lateral angles corresponding to the com- 

 mencement of the cephalic and basilic veins, formed by the 

 union of the median cephalic and median basilic with the 

 radial and ulnar veins, which are represented by the limb 

 upon each side of the letter. 



The MEDIAN BASILIC VEIN crosses the brachial artery, 

 being separated from it only by the aponeurotic slip given 

 to the fascia of the forearm from the tendon of the biceps. 

 Branches of the internal cutaneous nerve pass both in front 

 and behind this vein. 



The MEDIAN CEPHALIC VEIN, smaller than the median 

 basilic, passes outward along the fold of the elbow, some- 

 what less superficially ; the branches of the external cuta- 

 neous nerve pass beneath the vein. 



Notwithstanding that, in bleeding, the operator usually 

 selects the largest vein, it will be seen that the median 

 cephalic presents the more favorable conditions than the 

 median basilic, being aw r ay from the artery and above the 

 nerve, while the latter, though ordinarily the largest, is not 

 only almost in contact with the artery, but surrounded by 

 10 



