Landmarks, medical and surgical / by Luther Holden.

  • Luther Holden
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Landmarks, medical and surgical / by Luther Holden. Source: Wellcome Collection.

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    40. Sterno-mastoid muscle.—The sterno-mastoid muscle is the great surgical landmark of the neck. It stands out in bold relief when the head turns towards the opposite shoulder. Its inner border overlaps the common carotid, which can be easily compressed for a short time against the spine about the level of the cricoid cartilage. Between the sternal origins of the sterno-mastoid is the fossa above the sternum, more or less perceptible in different necks. As it heaves and sinks alternately, especially in dis- tressed breathing, it was called by the old anatomists ' fonti- culus gutturis.' In beautiful necks, as seen in the ' Venus,' it is filled up by fat. Notice the interval between the sternal and clavicular origins of the sterno-mastoid. A knife introduced a very little way into this interval would wound, slanting inwards, the common carotid ; slanting outwards, the internal jugular vein. These facts are of importance in performing the sub- cutaneous section of the tendon of this muscle. 41. Spinal accessory nerve.—The point where this nerve emerges from the posterior border of the sterno- mastoid, and becomes most superficial, is a little above the middle of a line drawn from the clavicle to the mastoid process. At this point it can be readily galvanised. 42. Carotid artery.—The course of the common carotid and the external carotid arteries is in a line drawn from the sterno-clavicular joint to a point (as a rule) midway between the angle of the jaw and the mastoid process. That part of the line below the level of the upper border of the thyroid cartilage represents the course of the common carotid ; the part above the level corresponds with the external carotid which divides a little below the neck of the jaw into its terminal branches. 43. Sterno-clavicular joint.—Many important parts lie behind the sterno-clavicular joint. There is the commence- ment of the vena innominata; behind this comes the common carotid on the left side, and the division of the arteria in- nominata on the right. Deeper still, the apex of the lung rises into the neck. c 2