With the handle of the aneurism needle separate the tissues between the muscles, artery, vein and nerve, then use the hook end of the aneurism needle, pass it under the artery and raise it to the surface, passing the bone separator or the forceps with the closed end underneath. Remove the individual sheath surrounding the artery. Likewise raise the vein to the surface.
If the artery and vein lie side by side and it is desired only to raise the artery, hook down between the two, away from the vein, sliding the hook forward and backward underneath the artery, then raise to the surface.
If the artery and vein lie side by side and it is desired to raise both, pass the hook around the vein first, as by hooking around the artery toward the vein the point of the hook will often rupture the vein.
How to tell an Artery from a Vein or a Nerve.
—Raise the suspected vessels to the surface, placing a bone separator underneath to form a bridge, which will cause the blood to recede on every side. If you are in doubt which is the artery, remove the individual sheath from each one.
The nerve will appear as a glistening white cord, very solid to the touch and showing bands of nerve fibres which can be separated by the aneurism hook. It will not have any central opening.
The vein will appear as a dark blue color and collapsible because of the fact that they have thinner walls than the arteries, lacking the middle circular layer of fibres. Veins have a central opening. As a rule the vein contains blood after death, which gives it the dark blue color but should it not contain blood, it resembles the artery very closely as to color.
The vein contains valves which can be seen distinctly, if the blood be pushed the opposite way from which it runs in life.
The artery is of a creamish white color and non-collapsible because of the fact that it has heavy walls and a middle circular layer of fibres. The arteries feel firm to the touch while the veins are soft and velvety. Arteries have a central opening and as a rule do not contain blood after death. They likewise do not have valves. The artery is usually more constant than the vein.
Should all these not convince you, raise the one you think is the artery with the hook, pass the forceps underneath, spread these and pass the bone separator under for a bridge and with the scalpel incise the artery about one-fourth the way. Attach the arterial tube and if there is blood present, allow it to drain by lowering the arm. When it has ceased to flow, inject very gently and slowly. If you get a half-pint of fluid in the body, you may be assured of its being the artery.