By Karuna K. Chatterji
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P u t the trephine pin on the point, drive it through the scalp on to the skull, making a superficial impression on the bone. A semi-circular scalp-deep incision is made with the convexity upwards. The scalp is reflected. Now t h e choice lies between a muscle-flap operation or a split-muscle operation. The latter has distinct advantages. The temporal muscle is split down to the pericranium on a line with the puncture made by the trephine pin. Along the edges of the split the muscle is reflected from the skull and retracted outwards and inwards ; with t h e impression on the bone as a guide, a trephine, an inch or three-quarters of an inch in diameter is applied.
Fi«. 17. INCISIONS F O R LIGATINO R I G H T RADIAL AND ULNAR A R T E R I E S , AND S U P E R F I C I A L AND D E E P PALMAR ARCHES :—A. Ligation of radial in upper third of forearm ; B, of radial in middle third ; C, of radial in lower thiril ; D, of deep palmar arch ; E, Ligation of ulnar in middle third of forearm ; F, of ulnar in lower third ; G, of superficial palmar a r c h : H, Center of bend of elbow; I, Antoro-internal aspect of styloid process of radius ; J, Radial side of pisiform bone ; K, Anterior aspect of inner condyle of humérus ; L, Point on inner aspect of forearm a t junction of upper and middle thirds.
Flexor Carpi Had. AI. Sup. Long. JSrachio. radialis. Kadi al N. LIGATION OF T H E RADIAL ARTERY. Ulnar Art. M, Flex. carp. uln. Flex. Subi. Dig. Ulnar N. F I G . 19. LIGATION To face page 24. OF T H E ULNAR ARTERY. F I G . 20. POINTS OF T R E P H I N I N G MIDDLE MENINGE AL A R T E R Y . on the outer surface of the skull. F O R HAEMORRHAGE FROM T H E The course of the artery has been marked REPRODUCED FROM DAVIS' APPLIED ANATOMY By the Courtesy of THE J. B. LIPPINCOTT CO. To face page 25. 25 Divide the deep fascia.