Surgical and obstetrical operations . f the forearm. In fatand fleshy horses the identification of the nerve is moredifficult. It may be felt upon the standing animal. With the nerve lying between the thumb and index fingerof the left hand, at the point where it begins to disappearbehind the radius after having passed over the humero-radialarticulation, stretch the superposed skin and immediatelyupon and parallel to it make an incision 5 cm. long, finstthrough the skin, then through the sterno-aponeuroticusmuscle. Any hemorrhage from the skin, subcutis, or mus-cle, is checked. The tenacula are
Surgical and obstetrical operations . f the forearm. In fatand fleshy horses the identification of the nerve is moredifficult. It may be felt upon the standing animal. With the nerve lying between the thumb and index fingerof the left hand, at the point where it begins to disappearbehind the radius after having passed over the humero-radialarticulation, stretch the superposed skin and immediatelyupon and parallel to it make an incision 5 cm. long, finstthrough the skin, then through the sterno-aponeuroticusmuscle. Any hemorrhage from the skin, subcutis, or mus-cle, is checked. The tenacula are inserted cautiously in thelips of the wound, and these being drawn apart the whiteanti-brachial fascia is brought into view and a search ismade with the index finger to determine the exact locationII Neurectomy. Median surface of the right , a, brachial artery ; n, mediannerve ; z/, brachial vein ; /, antibrachial fascia ;p^ sterno-aponeuroticus muscle. \ % •r-s i:st^-^~i>-S&^^i^. NEUROTOMY OF THE MEDIAN NERVE. 165 of the nerve, and the fascia is divided with the scalpel andan oval piece excised with the scissors immediately over much fatty tissue is found beneath the fascia it may bedissected away carefully with the scalpel or cut away withthe scissors. There now comes into view a delicate reddishcolored fascia-like membrane, the nerve sheath, behindwhich a blue cord, the brachial vein, V, is visible, the latterbeing intimately connected with the nerve sheath. Thevein lies mostly behind and beneath the nerve and may pro-ject out from beneath the border of the same. The opera-tor needs be careful not to prick this vein with the tenacula,as the hemorrhage therefrom is exceedingly annoying dur-ing the operation. It is best to avoid the use of tenaculaafter penetrating the fascia and retract the wound lipscautiously with aneurism needles instead. Still furtherforward and deeper may be felt the pulsating brachialartery. Incis
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