Surgical applied anatomy / by Frederick Treves ; with the assistance of Arthur Keith.

  • Sir Frederick Treves, 1st Baronet
Date:
[1901?]
Catalogue details

Licence: Public Domain Mark

Credit: Surgical applied anatomy / by Frederick Treves ; with the assistance of Arthur Keith. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    the internal carotid artery and oculomotor nerves. The hippocarnpal convolution containing the olfactory centres lies immediately over the ganglion. The malar bone.—Such is the firmness of this hone, and so direct is its connection with the skull, that violent blows upon it are very apt to be associated with concussion. Resting as it does upon compara- tively slender bones, it is very rare for the malar bone to be broken alone. It may, indeed, be driven into the superior maxillary bone, fracturing that structure extensively, without being itself in any way damaged. A fracture of the malar bone may lead to an orbital ecchymosis, precisely like that which often attends a fracture of the skull base. 2. The parotid region.—The main part of the parotid gland is lodged in a definite space behind the ramus of the lower jaw (Fig. 18). This space is increased in size when the head is extended, and when the inferior maxilla is moved forwards, as in protruding the chin. In the latter movement, the increase in the antero- posterior direction is equal to about f of an inch. It is diminished when the head is flexed. When the mouth is widely opened the space is diminished below, while it is increased above by the gliding forwards of the condyle. These facts should be borne in mind in operating upon and in exploring the parotid space. It will be found also that in inflammation of the parotid much pain is produced by all those movements that tend to narrow the space occupied by the gland. The obliquity of the ramus of the jaw in infancy and old age causes the lower]part of the space to be, in the former instance relatively and in the latter instance actually, larger than it is in the adult. The gland is closely invested by a fascia derived from the cervical fascia. The superficial layer of the parotid fascia is very dense, is continuous behind with the fibrous sheath of the sterno-mastoid, and in front with that of the masseter. Above it is attached to the zygoma, while below it joins the deep layer. The deep layer is slender, is attached to the styloid process,