Licence: Public Domain Mark
Credit: Practical anatomy. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![The tendons of the flexor carpi radial is and flexor carpi ulnaris are usually prominent, and serve as guides to the radial and ulnar arteries, which may be felt (if injected) to the outer side of each tendon. The metacarpus and pha- langes are to be examined, and the advanced student may advantageously amputate one or two fingers (middle or ring). It is to be borne in mind that the transverse mark- ings, on either the palmar or dorsal aspect of the fingers, form no guide to the articulation, which is always nearer to the nail. When the finger is bent, the prominence at the articulation is due to the proximal phalanx, and the joint is below that point. The best rule, therefore, in amputating through the phalangeal articulations, is to bend the phalanx which is to be removed to a right angle with the one above it, and to begin the incision at a point mid- way in the thickness of the upper phalanx, cutting trans- versely to a corresponding point on the opposite side. The limb should be carefully bandaged [or wrapped in a cloth], from the fingers to the middle of the upper arm, and onl}7 uncovered as may be necessary in the progress of the dissection. The arm being drawn away from the side, an incision is to be made half an inch to one side of the median line of the sternum in its whole length, and to be joined at right angles by another running along the whole length of the clavicle on to the acromion process, and thence in a vertical direction half-way down the upper arm. Another in- cision is to be made transversely from the ensiform cartilage, and must be carried beyond the posterior fold of the armpit. The large flap of skin thus marked out is to be reflected towards the arm. the dissector on the right side beginning at the lower end of the sternum, and on the left side, at its upper extremity. Beneath the skin is the subcutaneous fascia, which is often very fatty in the female. The mamma will also be exposed (an incision being carried round the nipple so as to leave it attached to the organ) in the female, or its rudiment in the male subject. In a well-developed body the fibres of the plat}-sma myoides ma}' be seen arising from the fascia below the clavicle. The Mamma, or breast, is a gland of very variable bulk lying [between the two layers of the superficial fascia and] upon the great pectoral muscle from which it is sepa- rated by a quantity of loose cellular tissue. Its base is nearly circular, and usually extends from the side of the sternum](https://iiif.wellcomecollection.org/image/b21020735_0030.jp2/full/800%2C/0/default.jpg)
