482 Anatomy Applied to Medicine and Surgery. 



and the nerve sought for, along the upper margin of this 

 muscle, about opposite to the middle of the mastoid pro- 

 cess, and, when found, traction as high as four or five 

 pounds may be employed for the purpose of stretching 

 the nerve. The spinal accessory is stretched for the 

 relief of spasmodic torticollis through an incision starting 

 at the tip of the mastoid and extending for about three 

 inches along the anterior border of the sterno-mastoid. 

 On the exposure of this muscle it is drawn forcibly back- 

 wards, and the prominent transverse process of the atlas 

 having been identified, the nerve is sought for, as it crosses 

 this process to enter the deep surface of the muscle about 

 one and a half inches below the tip of the mastoid. This 

 nerve may be stretched, as it leaves the posterior border 

 of the sterno-mastoid to cross the posterior triangle, but 

 in this situation, the action of the trapezius alone would 

 be affected, and 'hence, the operation near the rnaistoid 

 is preferable. The brachial plexus in the neck may be ex- 

 posed through an incision, which, starting about half an 

 inch above the centre of the clavicle, extends upwards for 

 about three inches. After dividing the integument, fascia 

 and platysma and drawing the external jugular out of the 

 way, the deep fascia is incised, the omo-hyoid drawn 

 downwards, and the plexus exposed with the transversalis 

 colli artery and vein crossing it about its middle. On 

 drawing these aside any particular cord of the plexus may 

 be stretched. 



Phlebotomy. When the external jugular is select- 

 ed, the incision should be made only partly through the 

 vein, i.e., the vessel should not be completely severed, 

 since the flow of blood is freer when the partial incision is 

 employed. Another point in connection with bleeding 

 from this vessel is that the incision shouW be transverse 

 to the direction of the fibres of the platysma, so that, when 



