THE FORE-ARM AND HAND. 1065 



them, and proceeding successively to the flexor carpi radialis, palmaris 

 lougus (which, however, is often absent), flexor sublimis digitorum, and flexor 

 carpi uluaris (p. 215) ; displaying the branches of the median nerve to the 

 first four muscles, and that of the ulnar nerve to the last-mentioned muscle 

 and to the flexor profundus digitorum (pp. 651 and 659). The course of the 

 radial and uluar arteries and nerves in the fore-arm is also to be studied. From 

 the radial artery (p. 394) will be seen given off the radial recurrent, the 

 muscular branches, the anterior carpal branch and the superficial volar ; 

 while arising from the uluar artery (p. 388) will be seen the anterior and 

 posterior uluar recurrent, and the iuterosseous, dividing into anterior and 

 posterior interosseous, and giving off the branch to accompany the median 

 nerve. This last branch, the comes nervi mediani, derives importance from 

 being not unfrequently developed as a third principal trunk of the fore-arm, 

 which passes down into the superficial palmar arch. The muscular branches 

 of the uluar artery, and its anterior and posterior carpal branches, are also 

 to be exposed. The deep layer of muscles, consisting of the flexor longus 

 pollicis, flexor profundus digitorum and pronator quadratus, are next to be 

 dissected (p. 219) ; and along with them, lying on the interosseous mem- 

 brane, and giving twi^s to the muscles, the iuterosseous branch of the 

 median nerve, and accompanying it, the anterior interosseous artery (p. 390). 

 8. The Hand in front For the dissection of the front of the hand, let 

 an incision be made down the middle of the palm, a second transversely 

 through the skin above the division of the fingers, and others down the 

 middle of each finger. Let the palmar apoueurosis be exposed (p. 231), 

 preserving the palmaris brevis muscle which is attached to its inner margin 

 (p. 225) ; and let the skin be reflected from the front of the fingers and 

 thumb, so as to exhibit the sheaths for the tendons, and the two digital 

 branches of the artery and nerve on each (p. 218). The palmar apoueu- 

 rosis is then to be removed, and the trunks of the uluar and median 

 nerves will be brought into view (pp. 649 and 651), as also the ulnar artery, 

 the superficial volar branch of the radial artery, and the superficial palmar 

 arch (p. 393). The short muscles of the thumb, viz., the abductor, opponens, 

 flexor brevis, and adductor pollicis, are to be dissected, with the twigs of the 

 median nerve supplying the three first, and the insertion of the flexor longus 

 pollicis ; then the abductor, opponens, and flexor minimi digiti, with the twigs 

 of the ulnar nerve supplying them, and its deep branch piercing them (p. 225). 

 The annular ligament is to be cleaned and the synovial sheath behind it 

 examined ; the tendons of the superficial and deep flexors are to be followed 

 to their insertions, and the lumbricales muscles dissected. The deep branch 

 of the ulnar artery may now be tiaced to the deep palmar arch, and that 

 of the ulnar nerve to its distribution iu all the interossei, two of the 

 lumbricales, the adductor pollicis and the inner part of the flexor brevis 

 pollicis muscle. The deep palmar arch and its branches are also to be fully 

 examined (p. 400). 



9. The Fore-arm and Hand Posteriorly. For the dissection of the back 

 of the fore-arm and hand let the remainder of the integument and apo- 

 neurosis be carefully reflected, and let the distribution of the ulnar and 

 radial neives to the dorsal aspects of the fingers be traced (p. 653). The 

 muscles are then to be dissected in the following order, viz., the supinator 

 longus, extensores carpi radiales longior and brevior, extensor carpi ulnaris, 

 extensor commuuis digitorum and extensor minimi digiti, the extensor 

 indicis, the three extensores pollicis, and, lastly, the anconeus and supinator 

 brevis muscles (p. 220). There will be found passing through the fibres 



