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By Karuna K. Chatterji

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The ulnar nerve does not come into view. Pass the needle from the inner (medial) side avoiding the median nerve [Fig. 16). F I G . 16. LIGATION OF T H E BRACHIAL A R T E R Y AT T H E ELBOW. LIGATION OF T H E RADIAL ARTERY POSITION Arm abducted at right angles and forearm supinated. stands on the outer (lateral) side of the arm. Operator 22 SURFACE MARKING Draw a line from the middle of the anticubital fossa at a level of the head of the radius to its styloid process outside the scaphoid (navicular) tuberosity (see Fig.

The external iliac vein at first lies at its inner and posterior aspect but lower down on its inner side. LIGATURE OF T H E ABDOMINAL AORTA S U R F A C E MARKING Take a point about four inches vertically above the umbilicus and a point a little below and to its left. A line joining these two points indicate the line of the artery. OPERATION (INTRAPERITONEAL) The aorta can be reached intraperitoneally or extraperitoneally. Position dorsal with the shoulders slightly raised. Make a melian vertical laparotomy incision about four inches long with the umbilicus as its centre and slightly to its left {see Fig.

And cirsoid aneurysm of the scalp. SURGICAL ANATOMY I t comes off as a posterior branch of the external carotid from a point corresponding to the branching of the facial. I t makes an upwards course under cover of the digastric and stylo-hyoid muscles to the interval between the transverse process of t h e atlas and the mastoid process. I t then turns backwards, lying a t first in a groove of the temporal bone and then on the complexus (semispinalis capitis) being covered by the posterior cervical muscles.

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