File:Text-book of operative surgery (1903) (14764066282).jpg

Identifier: textbookofoperat1903koch (find matches)
Title: Text-book of operative surgery
Year: 1903 (1900s)
Authors: Kocher, Theodor, 1841-1917 Stiles, Harold J
Subjects: Surgery, Operative Surgery
Publisher: London : Adam and Charles Black
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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with in this partof the body. The arteries, especially of the palm, are large enough to allow of thedirect application of a ligature. Besides the incisions necessary to evacuate deepcollections of matter, and for the ligature of the vessels, there are those required inoperating on the tendons of the hand, be it for inflammatory affections of their sheathsor for suturing wounded tendons. On the dorsum we have to deal only with tendons and nerves which for the mostpart can be felt through the skin, and hence serve as guides in making incisions.Large vessels are only met with behind and along the metacarpal bone of the thumb,and these, like the nerves, can be felt through the skin. On the back of the hand a line drawn along the middle of the third digit upto the wrist separates the areas supplied respectively by the radial and ulnar nerves.The dorsal carpal arch and the metacarpal arteries are comparatively small vessels. Styloid process of ulna.—^r-^\2) Ulnar n. (dorsal br.).—~3(Kw\
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3C-5 Ext. communis digit, m.Ext. carpi rad. longior nc Supinator brevis m.Post, interosseous d. Fig. 137.—(1) Posterior interosseous nerve, below the head of the radius.(2) Dorsal branch of ulnar nerve at the wrist. 3o6 OPERATIVE SURGERY The extensor tendons at the wrist have for the most part separate synovial sheathswhich extend downwards as far as the middle of the metacarpus. On the dorsum ofthe hand the radial nerve can be felt over the base of the second metacarpal bone, andthe dorsal branch of the ulnar nerve over the base of the fifth metacarpal. In theinterval between the first and second metacarpals, on the dorsum, the radial arterycan also be traced upwards upon the base of the first metacarpal and then upon thetrapezium. The radial vein is visible as it ascends across the hollow between the tendons ofthe extensor secundi and extensor primi internodii pollicis. (i) Palm of the Hand Examination of the Structures which can be felt beneath the Skin In the palm the vessels an

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