56 Anatomy Applied to Medicine and Surge? y. 



the brachial artery. To stretch the musculo-spiral nerve, 

 make an incision two inches in length, with its centre 

 situated at a point, about one inch above, and one-half 

 inch internal, to the apex of the external condyle. If the 

 incision be a vertical one, it will cross the obliquely directed 

 interval between the supinator longus and the brachialis 

 anticus, and, if these muscles be separated, the musculo- 

 spiral nerve, accompanied by the superior profunda 

 artery, will be exposed lying between them. 



Bloodvessels. To compress the brachial artery in the 

 upper part of its course, the pressure should be made 

 from within outwards, since, in this situation, the artery 

 lies to the inner side of the bone, but, as the vessel 

 descends, it gets in front of the bone, so that, in the lower 

 part of the arm the pressure should be directly backwards. 

 It is customary, however, to compress the brachial in 

 the neighborhood of the insertion of the coraco-brachi- 

 alis the pressure being directed outwards and slightly 

 backwards. 



Ligation of the Brachial. The brachial may be lig- 

 ated in any part of its course, the point of election, 

 however, being about the insertion of the coraco-brachi- 

 alis muscle. After the skin and the superficial and deep 

 fasciae have been divided, and care has been taken to 

 avoid the basilic vein and the internal cutaneous nerve, 

 which here lie in the superficial fascia, the inner edge of 

 the biceps is next sought for, and drawn outwards, as it 

 slightly overlaps the vessel. The pulsations of the artery 

 and the relations of the median nerve to the vessel, assist 

 in identifying it. The nerve is drawn aside, since in this 

 situation, it lies, generally, in front of the artery. The 

 sheath is opened, the venae comites separated from the 

 vessel and the ligature introduced from within outwards, 

 so as to avoid injury to the ulnar nerve, which lies to its 



