Radial artery

“ When the radial artery is wounded in the hand, in which situation it is deep seated, the case requires greater consideration. When there is a large open wound, and the bleeding end or ends of the artery can be seen, a ligature should be placed on each ”

“ After considerable deposits have been formed the arteries lose their elasticity. They become hard and unyielding. A normal radial artery can easily be compressed with one finger. Sometimes the radial artery becomes so hard that it is difficult to compress it with three fingers. As the arteries grow harder they become more brittle and sometimes they break, often a fatal accident.
This hardness of the arteries impedes the circulation, for the tone and natural elasticity of the vessel walls is one of the aids to a normal circulation. ”

“ When the peripheral arteries are palpable they are not always sclerosed. The radial artery, the one usually palpated, may lie very close to the bone in a thin person. Under these conditions the artery can be easily felt. It is better then to palpate for the brachial as it lies beneath the inner edge of the biceps muscle. ”

“ The radial artery (Fig. 67, No. 4) passes downward on the outer rim of the forearm. It continues down to the carpal region, where it supplies the muscles and the skin of the carpal region it gives off the recurrent radial, which passes on the middle finger and finally anastomoses with the collateral radialis artery.
The ulnar artery (Fig. 68, No. 6 and 9) passes downward on the inner surface of the ulna to the carpal region where it gives off a branch to the wing plexus and divides into two branches, the smaller branch supplying the thumb (Fig. 68, No. 7) . ”

“ The artery might appear to be a solid mass when the dissecting knife is passed through. We have seen the anterior and posterior tibial, the popliteal, radial, ulnar, the aorta arteries, and especially the arch of the aorta thus affected. Calcification may be present at many places. These cases are frequently met with in old age.
A body of this kind, where there is fatty degeneration of the arteries, is sometimes hard to embalm. The walls of the artery will be very much weakened, and too much pressure must not be made on them while injecting fluid. ”

“ By collateral circulation is meant the anastomoses of arteries, or veins through a side branch. There are three great arterial collateral circulations in the body. One is in the arm, the deep brachial artery, and the anastomotica magna, coming off of the brachial artery and anastomosing with the recurrent radial and ulnar artery. One is in the leg, the deep femoral artery, and the anastomotica magna coming off of the femoral artery and anastomosing with the recurrent anterior and posterior tibial arteries. ”

“ Observation should be made also of the site of the carotid artery on each side, and of the jugular veins, since aortic regurgitation may be indicated by violent action of those arteries or tricuspid regurgitation by pulsation of the veins in the neck.
Long before vaso-motor physiology had any place in science the pulse was known to afford valuable indications in disease. Either of the accessible arteries will answer instead of the radial; its convenience merely makes the wrist the common place of comparison. ”

“ Fig. 364. Diagram of the arrangement of the arterial arches in an embryo of one of the Amniota. (From Gegenbaur; after Rathke.)
a. ventral aorta; a ́ ́. dorsal aorta; 1, 2, 3, 4, 5. arterial arches; c. carotid artery.
In the Amniota the metamorphosis of the arteries is in all cases very similar. Five arches, viz. the mandibular, hyoid, and three branchial arches are always developed (fig. 364) , but, owing to the absence of branchiæ, never function as branchial arteries. ”

“ It not quite as large as the common carotid, but as a rule large enough to admit the large size arterial tube. It has become a favorite with many because it is quite easy to locate and to raise, and because of its proximity to the axillary vein, a vein which is large enough to admit a drainage tube for the withdrawal of blood. Again the axillary artery is in a secluded place, being as it is in the axillary space (arm pit) . The artery [232] does not lie very deep, and is not covered by any muscles as you operate, there being practically nothing to hinder the progress of the operation. ”

“ When an arterio-venous sac has once formed, clinical observation shows that the general tendency is towards extension in the direction of least resistance. This direction of course varies with the situation of the aneurism, and also with the nature of the wound track.
Speaking generally the direction of least resistance in a typically pure perforation is towards the vein. Initial flow of blood from the wounded artery is naturally favoured towards the potential space afforded by a canal occupied by blood flowing at a lower degree of pressure. ”

“ When selecting the brachial and femoral arteries always raise them at a place below the point where collateral circulation is given off or in other words raise them in the middle third. By so doing the fluid will reach, by means of collateral circulation, the tissues of the arm and leg below the point of injection.
As far as the injection of fluid is concerned, one artery is just as good as another. All arteries are parts of the [214] same channel branches of the aorta. No valves exist in any part of their course. ”

“ It occurs with greater frequency and with greater severity in men than in women.
Atheromatous degeneration is most common in the large arterial trunks, and the changes are most marked at the arch of the aorta, opposite the flexures of joints, at the mouths of large branches, and at parts where the vessel lies in contact with bone. The presence of diseased patches in the wall of an artery diminishes its elasticity and favours aneurysmal dilatation. Such a vessel also is liable to be ruptured by external violence and so give rise to traumatic aneurysm. ”

“ For in several animals the arteries do not apparently differ from the veins; and in extreme parts of the body, where the arteries are minutely subdivided,15 as in the brain, the hand, &c., no one could distinguish the arteries from the veins by the dissimilar characters of their coats; the tunics of both are identical. And then, in an aneurism proceeding from a wounded or eroded artery, the pulsation is precisely the same as in the other arteries, and yet it has no proper arterial tunic. This the learned Riolanus testifies to, along with me, in his Seventh Book. ”

“ From the gills the afferent branchials carry the blood to the median dorsal aorta. As pectoral and pelvic fins are now developed, subclavian and iliac arteries are found rising from the dorsal aorta, though the aorta itself is continued directly backward as the caudal artery into the tail. In the Dipnoi or mud fish, in which the swim bladder is converted into a functional lung, the hindmost afferent branchial artery, corresponding to the fifth (strictly speaking the sixth) aortic arch of the human embryo, gives off on each side a pulmonary artery to that structure. ”

“ The branches for the head, neck and upper limbs arise as three large arteries from the transverse part of the aorta; they are named innominate, left common carotid and left subclavian. The innominate artery is the largest and passes upward and to the right, to the root of the neck, where it divides into the right common carotid and the right subclavian. The carotid arteries supply the two sides of the head and neck; the subclavian arteries the two upper extremities. ”

“ Then there is given off the anterior and the posterior thoracic arteries; and finally, the pectoral, which supply the pectoralis muscles and later terminate in the carotid, the vertebral, and the cervical arteries. The carotid artery gives off an esophageal artery. The other arterial trunk given off from the common aorta is the right brachio-cephalic or brachio-cephalic dexter (Fig. 61B, No. K, 18) . The right brachio-cephalic artery gives off the subclavian, which continues as the axillary, and continues as the brachial artery. ”

“ The carotid and right subclavian arteries will then be felt lying close together crossed by the pneumogastric and recurrent nerves, the latter turning behind the subclavian. The nerves must be drawn inwards; the cardiac filaments of the sympathetic will then be observed, and drawn outwards. The subclavian vein lies below, concealed by the clavicle, and will probably not be seen during the operation. The needle should be passed round the artery from below upwards, care being taken not to injure the pleura, which lies beneath and behind the artery. ”

“ The arteries dilate, because they are filled like bladders or leathern bottles; they are not filled because they expand like bellows. This I think easy of demonstration, and indeed conceive that I have already proved it. Nevertheless, in that book of Galen headed "Quod Sanguis continetur in Arterus," he quotes an experiment to prove the contrary. An artery having been exposed, is opened longitudinally, and a reed or other pervious tube is inserted into the vessel through the opening, by which the blood is prevented from being lost, and the wound is closed. ”

“ We have met with a chronic form of arterial degeneration in elderly women, affecting especially the great vessels at the root of the neck, in which the artery is remarkably attenuated and dilated, and so friable that the wall readily tears when seized with an artery-forceps, rendering ligation of the vessel in the ordinary way well-nigh impossible. ”

“ In arterial hæmorrhage the blood is bright red in colour, and escapes from the cardiac end of the divided vessel in pulsating jets synchronously with the systole of the heart. In vascular parts—for example the face—both ends of a divided artery bleed freely. The blood flowing from an artery may be dark in colour if the respiration is impeded. When the heart's action is weak and the blood tension low the flow may appear to be continuous and not in jets. The blood from a divided artery at the bottom of a deep wound, escapes on the surface in a steady flow. ”

“ When arteries are unhealthy, the selection and proper application of a ligature are points of great importance. A larger although yet a small, round ligature should be fairly, evenly, and firmly, although not so forcibly applied as on a sound artery ”

“ When, as in Plate 9, A, the innominate artery rises to a level with C, the right sterno-clavicular junction, and when at this place it bifurcates, having on its left side, D, the trachea, and on its right side, B, the root of the internal jugular vein, together with a, the vagus nerve, the arterial vessel is said to be of normal character, and holding a normal position relative to adjacent organs. ”

“ The predominance of elastic tissue permits of great distention by the blood forced into the artery at every heartbeat, the caliber of the tube being less markedly under the control of the vasomotor nerves than is the case in the small arteries, where the muscle tissue is relatively more developed. The adventitia of the large arteries is strong and firm, and is made up of interlacing fibroelastic tissue, of which some of the bundles are arranged longitudinally. ”

“ This method of seeing the arteries is easy, whether they are filled by injection, or left empty. In the living animal, these vessels are also infinitely less susceptible of putrefaction than the skin, the cellular texture, &c. An artery often passes through a mortified part without undergoing any alteration from it; this is frequently seen in gun-shot wounds.
At the end of a period, very different according to the degree of temperature, the arterial texture yields finally to maceration and putrefaction. ”

“ The arterial circulation does not exhibit this phenomenon. I have observed that if we open the artery of the foot of an animal, and by the irritation of the nerves, make the muscles of the leg and thigh, through which this artery passes before reaching the foot, contract powerfully, the throw of blood is not stronger than during the relaxation. ”

“ In the smaller muscular arteries is seen the intimal proliferation, the stretching of the Moenckeberg type, and the calcification of the media rather than the intima. The media is thinned beneath the marked intimal proliferation so that the artery exhibits translucent areas when held to the light. Again, there is seen degeneration of the muscle and replacement by connective tissue with or without hypertrophy of the intima. In the arterioles three kinds of changes occur: a muscular hypertrophy; a fibrosis of all the coats; or a marked proliferation of the intimal endothelium. ”

“ Multiplying the number of drachms propelled by the number of pulses, we shall have one thousand half-ounces sent from this organ into the artery; a larger quantity than is contained in the whole body. This truth, indeed, presents itself obviously before us when we consider what happens in the dissection of living animals. The great artery need not be divided, but a very small branch only (as Galen even proves in regard to man) , to have the whole of the blood in the body, as well that of the veins as of the arteries, drained away in the course of no long time—some half hour or less. ”

“ When an artery has been tied, it is necessary that its parietes, inflamed by the action of the thread, most often cut by it, and brought into contact, should form adhesions, that the cure may be complete, and the ligature come off without danger. Now, nothing is more difficult and slower than their adhesion, from the difficulty with which the arterial texture inflames. Hence the frequency of hemorrhage after the operation for aneurism and other great operations. The blood often bursts out at the end of twenty, thirty, or forty days ”