The Vertebral Artery.
—The vertebral artery is tied through an incision commencing at the clavicle, extending along the outer border of the sternomastoid, some of whose clavicular fibers must be divided. This muscle and the anterior jugular veins being drawn to the inner side, the transverse processes of the sixth and seventh vertebræ should be found in the space between the scalenus anticus and the longus colli. The artery should be found below the seventh cervical vertebra as it enters the foramen intended for it. The vein lies in front of it, the pleura close to it, and on the left side the thoracic duct is not far away.
The Inferior Thyroid Artery.
—The inferior thyroid artery may be tied through an incision along the inner border of the sternomastoid, which is retracted outward, the carotid being found and also retracted outward. The artery lies a little below the level of the sixth vertebra, whose transverse process may be easily found. It passes inward and to the rear of the carotid, close to whose main trunk the ligature should be applied, in order to avoid the recurrent laryngeal.
Fig. 165
Fig. 166
Surgical anatomy and ligation of the axillary and subclavian arteries. (Bernard and Huette.)