. Modern surgery, general and operative. palmar arch. Two venae comitesattend the vessel. In the upper third the ulnar nerve is well internal, but in thelower two-thirds the nerve lies near the artery and to its ulnar side. The guideis the outer edge of the flexor carpi ulnaris. Operations (PI. 4, Fig. 6, and Fig. 279).—Ligation of the Lower Third.—The position in this operation is the same as for ligation of the radial a 2-inch incision to the radial side of the tendon of the flexor carpi incision should not be taken lower than a point i inch above the pisiformbone.
. Modern surgery, general and operative. palmar arch. Two venae comitesattend the vessel. In the upper third the ulnar nerve is well internal, but in thelower two-thirds the nerve lies near the artery and to its ulnar side. The guideis the outer edge of the flexor carpi ulnaris. Operations (PI. 4, Fig. 6, and Fig. 279).—Ligation of the Lower Third.—The position in this operation is the same as for ligation of the radial a 2-inch incision to the radial side of the tendon of the flexor carpi incision should not be taken lower than a point i inch above the pisiformbone. Avoid the superficial ulnar vein in the subcutaneous tissue. Open thedeep fascia, find the tendon of the flexor carpi ulnaris, flex the wrist and drawthe tendon inward, open a second layer of fascia, clear the vessel, separate theveins, and pass the ligature from within outward to avoid the nerve. On theartery is the palmar cutaneous branch of the ulnar nerve, and this branch mustnot be included in the ligature. LIGATIONS. Plate Brachial Artery 545 Ligation of ihe Middle Third (PI. 4, Fig. 6).—In this operation the positionis the same as in the preceding one, the incision being 3 inches long. Avoidthe anterior ulnar vein and the branches of the internal cutaneous nerve inthe superficial fascia. Open the deep fascia a little external to the superficialcut (Treves). Find the space between the flexor carpi ulnaris and the super-ficial flexor, feeling with the index-finger, and when the space is discoveredflex the wrist, retract the flexor carpi ulnaris inward and the flexor sublimisdigitorum outward, open the fascia, find the ulnar nerve, look external to it forthe artery, clear the vessel, separate the venas comites, and pass the needle fromwithin outward. The ulnar artery should not be ligated in continuity in theupper third of its course. Brachial Artery.^The line of the brachial artery is from the junctionof the anterior and middle thirds of the outlet of the axilla,
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