130 SURGICAL APPLIED ANATOMY. [CJiap. vin. 



the palate can often be distinctly felt. In dissecting up 

 muco-periosteal flaps from the hard palate, it is most 

 important to make the incision in the mucous mem- 

 brane, close to, and parallel with, the alveolus, so that 

 this artery may be included in the flap and its vitality 

 therefore not be endangered. By such an incision, 

 also, unnecessary bleeding is avoided. In dissecting 

 up the flap it should be remembered that the artery 

 runs much nearer to the bone than to the mucous 

 surface. 



The soft palate is of uniform thickness, its 

 average measurement being estimated at about a 

 quarter of an inch. When the soft palate is cleft, the 

 edges of the fissure are approximated during swallow- 

 ing by the uppermost fibres of the superior constrictor. 

 This approximation may narrow the cleft to one-third 

 or one-half of its previous size. The muscles that 

 tend to widen the cleft are, in the main, the levator 

 palati and tensor palati. It is necessary that these 

 muscles should be divided before attempting to close 

 the cleft by operation. The levator palati crosses the 

 palate obliquely from above downwards and inwards 

 on its way to the middle line, lying nearer to the 

 posterior than the anterior surface of the velum. The 

 tensor palati turns round the hamular process, and 

 passes to the middle line in a nearly horizontal direc- 

 tion. The hamular process can be felt through the 

 soft palate just behind and to the inner side of the last 

 upper molar tooth. There are three principal methods 

 of dividing these muscles : (1) Ferguson's : A small 

 knife, with the blade at right angles to the stem, is 

 passed through the cleft, and is made to divide the 

 levator palati by an incision on the posterior aspect 

 of the palate, transverse to the direction of the muscle. 

 The tensor is not divided in this procedure. (2) 

 Pollock's : A thin narrow knife, with the cutting 

 edge upwards, is introduced into the soft palate a little 



