Surgical anatomy of the arteries : with plates and illustrations / by Nathan R. Smith.

  • Smith, N. R. (Nathan Ryno), 1797-1877.
Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: Surgical anatomy of the arteries : with plates and illustrations / by Nathan R. Smith. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    dense tissue of the scalp and the occipito-frontal-muscle, inosculating with the opposite occipital, with the auricular, and with the temporal. Sometimes it sends a ramuluS through the parietal hole to the dura mater. The Posterior Auricular (Arteria Posterior Auris)—one of the smallest 5. ^mimmmmmmmmmmmmmmm ' and most irregular branches, sometimes comes from the occipital. Generally it springs from the external carotid above the digastric and stylo-hyoid muscles, within the parotid gland, opposite the point of the styloid process. It runs upward and backward, between the ear and the mastoid process, and ascending on the temporal bone, divides into two branches.(crf) The anterior ramifies on the rartilage of the ear—the posterior ascends on the side of the cranium, supplying the integuments and part of the tempo- ral muscle. In its ascent the trunk of the auricular gives branches to the neighboring muscles(art)- As il approaches the mastoid process, it lies behind the portio dura and separates it from the spinal accessory. Here the artery sends off* a minute twig(ft), which enters the stylo-mastoid foramen, supplying the tympanum, mastoid cells, and semi-circular canals, and anastomosing with other arteries of this region. The Pharyngeal (Arteria Pharyngea Ascendens)—arises from the posterior part of ^ ^^^^mmLmmmhhV tne external carotid, opposite the facial. It ascends along the lateral and back part of aa the pharynx, between the external and internal carotids, covered by the stylo-pharyn- geus muscle, and the constrictor superior. After a short course, in which it gives twigs(oa) to adjacent muscles, it is re- solved into two branches of equal size. The first of them, the proper Pharyngeal branch(6), lying transversely on the superior constrictor, divides into two or three ramuscles, one of which is appropriated to the last named muscle, and the others pass downward to the inferior constrictors. The second, or Meningeal branch(c), passes up between the internal carotid, the pneumo-gestric nerve, and the internal jugular vein, giving twigs to the superior cervical ganglion, the Eus- tachian tube, the recti, and the longus colli muscles, and finally penetrates the skull by the posterior foramen lacerum, to ramify on the dura mater. Another twig enters by the anterior foramen lacerum, and a third, by the anterior condyloid. axi ^^^ The Temporal (Arteria Temporalis)—is one of the ■ e two branches into which the external carotid is resolved, midway between the angle and condyle of the lower jaw. It is smaller than the internal maxillary, but is more directly continuous with the parent trunk. Its origin is involved in the parotid gland, from beneath which it emerges as it ascends between the meatus of the ear and the articulation of the jaw. It then crosses the root of the zygoma beneath the anterior muscle of the ear, and, an inch and a half above it, divides into anterior and posterior branches. Just above the zygoma, the artery is often covered by two or three veins and is accompanied by branches of the portio dura nerve. Above, the artery is covered merely by common integu- ments. • SURGICAL OBSERVATIONS. it near its origin, it might be exposed by making an incision into the angle between the digastric and the mastoid muscles, where it will be found running along the border of the former, in company with the hypoglossal nerve. Where it emerges from beneath the xplenius muscle, on the back of the head, it can be distinctly felt, as it divides into its numerous branches. Here it is often wounded by blows or falls that lacerate the scalp. It is then apt to bleed seriously, as it cannot retract far, because of the firmness of the scalp. Often compression upon the bone will command it; but the ligature is more safe. The Posterior Auris. It is never necessary to secure this artery, unless it be wounded, which, however, very rarely occurs. The Ascending Pharyngeal. This is an artery of inconsiderable magnitude. It lies so deeply buried among other important organs, that a wound which might reach it, would inflict far more important—probably fatal injury upon them. Nor if the artery were alone injured, could it be reached with the knife without causing still more serious mischief. The Temporal. In its surgical relations this is one of the most important arteries about the head. In the first part of its course it lies deeply buried in the substance of the parotid gland. There it is never approached with the surgeon's knife, unless for the purpose of extirpating the gland. It must then necessarily be sacrificed, together with the other branches which sprint from the external carotid within the gland. It is certainly matter of surprise, that an organ involving so many important arteries, should have been so often extirpated, as undoubtedly it has been by Mr. Goodlad, Mr. Carmichael and many others, and in several in- stances with but little bleeding. Many scientific anatomists still deny the possibility of this operation, it being easier for them to believe that surgeons have been deceived, or have reported incorrectly, than that an achievement, apparently so impossible, has been Mccomplished. I entertained this opinion myself, till at length I saw the gland completely extirpated, and that with but little hemorrhage. I account for this opposition of opinion and fact, on the presumption that, as the diseased parotid becomes indurated and enlarged, it recedes from its deep situation, dragging with it these arteries, pressing upon them and effecting their obliteration. In the instance to which I allude, there was bleeding but from one branch—the temporal, and that in the retrograde direction.