240 SURGICAL APPLIED ANATOMY. [Chap. xin. 



by reflex action. Hence the bent arm. In one case 

 he cured a bent arm following bleeding by resecting 

 the old scar, which on removal was found to have 

 included within its substance some nerve filaments. 



There is a lymphatic gland situated over the 

 internal intermuscular septum of the arm, and just 

 above the internal condyle. It receives some of the 

 surface lymphatics from the inner side of the fore-arm, 

 and two or three inner fingers. In position, it is the 

 lowest gland in the upper limb. 



The bracliial artery- In forcible flexion of the 

 limb the artery is compressed between the muscular 

 masses in front of the joint, and the radial pulse is 

 much diminished or even checked. Aneurisms at the 

 bend of the elbow have been treated by flexion of the 

 limb, that position bringing more or less direct pressure 

 to bear upon the sac. In full extension of the joint 

 the artery becomes flattened out, and the radial pulse 

 diminished. In the over extension possible with 

 fractured olecranon the pulse may be stopped at the 

 wrist. Forcible extension of an elbow that has be- 

 come rigid in the bent position has caused rupture of 

 the brachial artery. 



The ulnar nerve is, from its position at the 

 elbow, very liable to be injured. The nerve may pass 

 in front of the internal condyle, and an instance is 

 reported where the nerve slipped forward over that 

 eminence whenever the elbow was bent (Quain). In 

 cases where an abnormal brachial passes beneath a 

 supracondyloid process the median nerve goes with 

 the artery. In exposing the ulnar nerve (for nerve 

 stretching, etc.) behind the elbow the nerve may be 

 found quite covered by an occasional muscle, the 

 epitrochleo-anconeus. 



The elbow joint. The strength of this joint 

 depends not so much upon either ligaments or muscles 

 a.s upon the coaptution of the bony surfaces. The 



