

The Region of the Elbow. 65 



forearm and thus permit a steady and a continuous stream 

 of blood to flow when the operation is performed on them. 

 Bursae. To permit freedom of movement of the 

 skin and superficial fascia over the prominence of the 

 olecranon, a synovial bursais interposed between the sup- 

 erficial and the deep fascia on the posterior aspect of the 

 joint, and, when this bursa is inflamed, as it sometimes is, in 

 certain occupations necessitating pressure on the olec- 

 ranon, it is termed "miner's elbow;" a second bmsa 

 is situated between the lower part of the triceps tendon 

 and the back part of the upper surface of the olecranon ; 

 a third, over the head of the radius, between the orbicular 

 ligament and the common tendon of the extensor muscles; 

 and a fourth, between the tendon of the biceps and the 

 front part of the bicipital tuberosity. When the first one 

 is inflamed, i.e., "miner's elbow," its superficial situa- 

 tion over the prominence of the olecronon will permit it to 

 be readily distinguished. In inflammation of the second 

 bursa, i.e., the one beneath the triceps, there results a swell- 

 ing which appears on either side of the tendon of this muscle 

 and when the third, i.e., the one over the radial head, is 

 affected, extension of the wrist causes pain at the site of 

 the bursa, while the fourth, when inflamed, renders pro- 

 nation painful, since this position of the forearm would 

 lessen the space between the biceps tendon and the bone 

 and would thus increase the pressure on the inflamed bursa. 

 Synovitis of the elbow joint may cause an effusion into 

 the joint sufficient to distend it and to produce a 

 swelling, which, because of the comparative laxity ot the 

 posterior ligament, would be more pronounced on the 

 posterior than on the anterior aspect of the joint, and, 

 since the triceps is inserted into the olecranon, this muscle 

 would be stretched over the swelling so as to produce 

 an appreciable ridge on either side of its tendon. We 



