1064 DISSECTION OF THE UPPER LIMBS. 



median nerve immediately above the annular ligament. On the fore-arm 

 will be found the radial, median and ulnar veins ; in front of the elbow 

 the median- cephalic and median-basilic veins, together with the deep 

 median branch ; and in the upper arm the cephalic and basilic veins 

 (p. 466). 



5. Brachial Region more deeply. The student will now remove the 

 aponeurosis from the front of the arm. He will first dissect out the 

 brachial artery with the venae comites clinging to it and intercommunicating 

 round it, and the median nerve crossing in front (p. 381). Arising from 

 the inner side of the artery he will find the superior profunda branch 

 turning backwards with the musculo-spiral nerve, a little further down 

 the inferior profunda branch accompanying the ulnar nerve, and a little 

 above the elbow, the anastomotic resting on the brachialis anticus muscle : 

 while from the outer side of the brachial artery a variety of muscular 

 branches are observed to spring. The inferior profunda sometimes arises 

 from the superior profunda branch. Not unfrequeutly two large arteries 

 will be found in the arm, in consequence of a high division of the main 

 trunk ; the radial or ulnar artery, most frequently the former, being given 

 off from the brachial at a higher point than usual, and sometimes even as 

 high as the axillary artery. In some of these cases the aitery which arifees 

 out of place lies superficially to the aponeurosis of the limb. The biceps 

 and coraco-brachialis muscles are next to be dissected, and the deep part 

 of the musculo-cutaneous nerve, which gives them branches (pp. 212 and 

 648). The dissector will be careful to preserve the aponeurotic slip of 

 insertion of the biceps, which lies superficially to the vessels at the bead 

 of the arm. The aponeurosis is to be removed from the back of the aria, 

 and the intermuscular septa are to be examined (p. 230) : the triceps 

 muscle is to be dissected, and the superior profunda artery and musculo- 

 spiral nerve are to be traced to its outer side (pp. 214 and 652). The 

 musculo-spiral nerve is to be followed to its division into the radial and 

 posterior iuterosseous trunks, and its branches, to the brachialis anticus, 

 supiuator longus and extensor carpi radialis lorigior displayed. The space 

 in front of the elbow should next be dissected, so as to show the relations 

 in it of the brachial, uliiar, and radial arteries, with the radial recurrent 

 and anterior ulnar recurrent branches, and the median and radial nerves 

 (pp. 389 and 397). The brachialis anticus muscle should also at this time 

 be fully exposed down to its place of insertion. 



6. Shoulder- joint, <c. The articulations at the upper part of the arm 

 ought now to be examined (p. 134). The conoid and trapezoid parts of the 

 ligaments uniting the clavicle to the coracoid process are first to be dis- 

 sected, and their uses studied ; then the acromio-clavicular articulation, and 

 the suprascapular and coraco-acroinial ligaments of the scapula ; lastly, 

 the shoulder joint is to be dissected, the capsule is to be cleaned, the 

 ooraco-humeral ligament dissected, and the tendons of muscles in close 

 relation with the joint examined. When lastly the capsule is opened, 

 the origin of the long head of the biceps in connection with the gle- 

 noid ligament will be seen, and also the prolongations of the sy no vial 

 membrane round the long head of the biceps and beneath the subscapular 

 muscle. 



7. The Fore-arm in front. Let the aponeurosis be removed from the 

 front of the fore-arm, and let the five superficial muscles arising from the 

 inner coudyle of the huinerus be dissected, beginning with the pronator radii 

 teres ; exhibiting its two heads of origin with the median nerve between 



