. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. f ulnar; 16, digital branches of ulnar; 17, digital branches of median. (FromBraun.) side of the fossa, and the brachial artery located and slightly dis-placed downward and inward; a long fine needle is now passed overthe tip of the finger and directed up in the long axis of the limb until THE UPPER AND LOWER EXTREMITIES 223 well within the axilla, when th
. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. f ulnar; 16, digital branches of ulnar; 17, digital branches of median. (FromBraun.) side of the fossa, and the brachial artery located and slightly dis-placed downward and inward; a long fine needle is now passed overthe tip of the finger and directed up in the long axis of the limb until THE UPPER AND LOWER EXTREMITIES 223 well within the axilla, when the injection is made; the precautionshould be followed here, as elsewhere, when making an injection in theneighborhood of vessels to continuously inject thesolution as the needle is being advanced; in thisway the vessels may be pushed aside andtheir puncture avoided. The needle is now passed behind theartery near the insertion of thetendon of the latissimus dorsireach the posterior cordthe plexus, and anadditional injec-tion made at Fig. 33-—Cuta-neous nerve areas ofthe upper extremity (an-terior view): A, Circumflex;C, lesser internal cutaneous; Dinternal cutaneous; E, musculospiral;F, musculocutaneous; C, ulnar;median. (Campbell.). Fig. 34.—Cuta-neous nerve areas ofupper extremity (poste-rior view): A, Supraclavicu-lar; B, circumflex; C, musculo-spiral; D, lesser internal cutane-ous; E, internal cutaneous; F, ulnarG, musculospiral. (Campbell.) this point; 30 to 40 of a 2 per cent. ^^novocain adrenalin solution is recommendedas the necessary amount (containing in this con-centration a quantity of the drug clearly beyond thesafe limits). While the supraclavicular injection willfind a place in our recognized methods of procedure, this last injec-tion within the axilla is, to say the least, unsurgical and is not tobe recommended. The location and distribution of the nerve-supply from theelbow down should be carefully studied for the application of regional 224 LOCAL ANEST
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