Anatomy, descriptive and surgical / by Henry Gray ; with an introduction on general anatomy and development by T. Holmes ; the drawings by H.V. Carter ; with additional drawings in later editions ; ed. by T. Pickering Pick.

Henry Gray

Date:: 1883

Credit: Anatomy, descriptive and surgical / by Henry Gray ; with an introduction on general anatomy and development by T. Holmes ; the drawings by H.V. Carter ; with additional drawings in later editions ; ed. by T. Pickering Pick. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

989/1036 (page 985)

$A third origin of the pronator teres is always attached to it; this origin covers the brachial arter3^^ Bursae.—The subcutaneous bursa over the olecranon, if distended, would be as large as a walnut. A second bursa sometimes exists a little lower down npon the ulna. There is also a small subcutaneous bursa over each of the con- d^des. The vertical extent of the elbow-joint is limited, above bj a line drawn from one condyle to the other; below, by a line corresponding to the lowest part of the head of the radius. 138. Interosseous Arteries.—About one inch below the head of the radius, the ulnar artery gives off the common interosseous; and this divides, about half an inch lower, into the anterior and posterior interosseous. Thus, in am- putating the forearm, say two inches below the head of the radius, four arteries at least would require ligature. By flexion of the elbow to the utmost, the circulation through the brachial artery can be arrested ; but the position is painful, and can be tolerated only for a short time. Lymphatic Gland.—There is a small lymphatic gland just above the inner condyle, in front of the intermuscular septum. It is the first to take alarm in poisoned wounds of the hand. THE FOREARM AND WRIST. 139. Ulna.—The edge of the ulna can be felt subcutaneous from the olecra- non to the styloid process (in supination). Any irregularity could be easily detected. The styloid process of the nlna does not descend so low as the styloid process of the radius, or it would impede the free abduction of the hand. Its apex is on a level with the radio-carj^al joint. The head of the ulna is plainly felt and seen projecting at the back of the wrist, especially in pronation of the forearm. It then lies between the tendons of the extensor carpi ulnaris and extensor minimi digiti. There is often a subcutaneous bursa over it. [In supi- nation, it is the styloid process, and not the head of the ulna, which is felt posteriorly.] 1-10. Radius.—The upper half of the shaft of the radius is so covered by muscles that we cannot feel it; the lower half is more accessible to the touch, especially just above and just below the part where it is crossed by the exten- sors of the thumb. Its styloid process is readily felt, and made all the more manifest by being covered by the first two extensor tendons of the thumb. It descends lower, and lies more to the front than the corresponding process of the ulna. The relative positions of these styloid processes can be best examined by placing the thumb on one and the forefinger on the other. Feel for the little bony pulley on the back of the radius near the wrist, which keeps in place the third extensor tendon of the thumb. This and the bone just above it is the place which we examine for a suspected fracture (termed Oolles's) near the lower end of the radius. 141. Carpus.—Below the styloid process of the radius, just on the inner side of the extensors of the thumb, we feel the tubercle of the scaphoid bone. Be- tween the styloid process and the tubercle is the level of the radio-carpal joint. A little lower we feel the trapezium. Just below the ulna on the palm of the hand we feel the pisiform bone; and on the inner side of this, the cuneiform. There are several transverse furrows on the palmar aspect of the wrist. The lowest of these, which is slightly convex downwards, corresponds with the upper * See on this subject a monograpli, Canalis Supra-Oondyloideus Humeri. By W. Grliber. Petersburg, 185G.$