Human anatomy; Medicine -- Study and teaching; Palpation
All these relative positions would be altered in a dislocation of the
ulna, but not (necessarily) in a fracture of the lower end of the
humerus.
Sometimes, though rarely, we meet with a hook-like projection of bone
above the internal condyle. It is called a ‘supra-condyloid’ process;
it can be felt through the skin, with its concavity downwards, and is
a rudiment of the bony canal which, in many mammalia, transmits the
median nerve and ulnar artery. A third origin of the pronator teres is
always attached to it; this origin covers the brachial artery.[10]
=Bursæ.=--The subcutaneous bursa over the olecranon, if distended,
would be as large as a walnut. A second bursa sometimes exists a little
lower down upon the ulna. There is also a small subcutaneous bursa
over each of the condyles.
The vertical extent of the elbow joint is limited, above by 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 amputating 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
olecranon to the styloid process (in supination). Any irregularity
could be easily detected. The styloid process of the ulna 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-carpal 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.
140. =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 extensors 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.
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