When about to raise this vessel, the embalmer should hold the arm at right angles with the body, with the palm up, and holding the hand of the body, with the hand, draw the arm tight. In most bodies this will show plainly the tendons of the muscles between which the vessel lies, thus affording an excellent guide for the incision. The arm should never be grasped and the tissues drawn out of their normal position, as that is very misleading. The vessel should be raised at a point about three inches above the wrist joint (the space where you would feel the pulse beat in life). The operator making an incision through the skin, superficial fascia, and fat, about one-half inch in length, will plainly see the artery lying in its sheath between the two tendons of the muscles. The cut should now be opened carefully, by placing the fingers on either side of it, and the fascia dissected from the artery, when it can easily be raised with the aneurism hook. There is no other vessel at this point that can be mistaken for the radial artery. Its two venae comites, or accompanying veins, are usually attached to the artery and need not be removed, as they are very small and can give the embalmer no trouble.
How to Locate, Raise and Inject the Ulnar Artery.
—The ulnar is the larger branch of the brachial artery. It crosses obliquely the inner side of the forearm, to the beginning of its lower half, it then runs along the ulnar border to the wrist, crosses the annular ligament on the radial side of the pisiform bone (wrist bone), and immediately beyond this bone into two branches, the superficial and deep palmar arch. In its upper half it is deeply seated, being covered by all the surface muscles. It is crossed by the median nerve, which lies to the inner side for about an inch. In the lower half of the forearm the artery runs more superficially, and is covered only by the skin and superficial and deep fascia, but at that, the ulnar lies a little deeper in the wrist than the radial. The ulnar nerve lies to the inner side in the lower half and the ulnar artery is accompanied by two ulnar veins, one on either side, called the venae comites.
The Linear Guide.—Is a line drawn from the center of the bend of the elbow, to the inside of the pisiform bone in the wrist.
The Anatomical Guide.—The artery lies in a groove in the wrist, made by the flexor carpi ulnaris muscle on the outside, and the flexor digitorum sublimis on the inside.
To raise the ulnar artery, locate the valley in the lower third about one to two inches above the pisiform bone. Make an incision about an inch in length, cutting first the skin, superficial fascia, layer of fat, which will vary in thickness. The deep fascia is now reached, which should be split by means of the fascia needle and bistoury. Then separate with the handle of the knife or bone separator, the artery from its connective tissue on either side. Then with the hook raise it to the surface, and place the bone separator beneath, remove the hook, and tear off the individual sheath.
The two ulnar veins will be separated from the artery by taking away the individual sheath, which should be allowed to drop back into the incision. Proceed now to open and inject the artery the same as you would the radial or the brachial. While this artery may seem just a little more difficult to raise, still at times it has its place in arterial embalming.
How to Locate, Raise and Inject the Femoral Artery.
—The femoral artery is usually objected to, because, situated as it is, it requires an undue exposure of the limb, especially in ladies. For this reason, then, the femoral artery should never be raised in the female, excepting in accidental case when it is impossible to raise any other artery. In the male, however, the femoral with many is a favorite. The artery should be raised either in the upper or the middle thirds, but preferably in the former, as by raising at this point the artery is not very deep in the tissues as it will be further down, and at the same time one is able to get collateral circulation to the lower leg and foot by means of the deep femoral and the recurrent anterior and posterior tibials.
It is believed quite commonly, that by the injection of the femoral artery, there is a great danger of flushing the face. This belief is erroneous. Flushing of the face will result from the injection of any artery if it is full of blood and if it is found that the femoral artery contains blood, and likewise any other artery, this blood should be removed before injection takes place, and what little then remains, will not discolor the face, since it will be greatly diluted.