Brandies of BracJiial Artery 263 



in the lower part ; also to the inner side, but separated by the deep 

 fascia and the bicipital fascia, are the basilic and the median-basilic 

 veins. The artery has on either side a vena comes. 



Brandies. The superior profunda springs from the very begin- 

 ning of the brachial, and descends into the interval between the inner 

 and outer heads of the triceps, under cover of the long head, and thus 

 winds with the musculo-spiral nerve (p. 25]) to the outer condylar 

 ridge. It there passes through the external intermuscular septum and 

 lies between the supinator longus and the brachialis anticus, where it 

 anastosmoses with the radial recurrent. It Sends a branch to the 

 back of the external condyle, which anastomoses with the interosseous 

 recurrent, and another to the back of the internal condyle, which 

 anastomoses with the posterior ulnar recurrent, and the posterior 

 branches of the inferior profunda and anastomotica magna. 



The nutrient artery to the medulla enters the bone near the 

 insertion of the coraco-brachialis, and courses towards the elbow. In 

 amputation just below the middle of the arm this vessel in the 

 medullary canal may require a touch with the thermo-cauteiy. 



The inferior profunda comes off below the middle of the arm, 

 and runs with the ulnar nerve to the inner intermuscular septum, in 

 front of which a branch may descend from it to communicate with the 

 anastomotica magna and the anterior ulnar recurrent. The rest of the 

 profunda passes through the septum, lying on the inner head of triceps, 

 and anastomoses behind the condyle with the anastomotica magna, 

 superior profunda, and posterior ulnar recurrent. 



Muscular branches are given off to the coraco-brachialis, biceps, 

 and brachialis anticus. 



The anastomotica magna runs inwards on the brachialis anticus, 

 about an inch above the condyle, anastomosing with the inferior 

 profunda and the anterior ulnar recurrent ; some of it passes through 

 the septum and anastomoses with the inferior and superior profunda 

 and the posterior ulnar recurrent. Thus it anastomoses with every 

 neighbouring branch except the radial recurrent, which it is obviously 

 unable to reach without trespassing through the external intermuscular 

 septum. 



Irregularities. The division into radial and ulnar may take place 

 anywhere between the arm-pit and elbow, the two trunks descending 

 side by side. If after ligature of an unusually small brachial artery 

 pulsation continue in the radial or ulnar artery, search must be made 

 a little to the inner or outer side for a ' second bradiial? 



At the bend of elbow there is a triangular fossa which is bounded 

 on the outer side by the supinator longus, and on the inner by the 

 pronator radii teres. The latter muscle slopes outwards, and the apex 

 of the space is at the approximation of these muscles, and to the outer 

 side of the fore-arm. The base is an imaginary transverse line drawn 

 through the condyles of the humerus. Covering the fossa are skin and 



