File:Medical and surgical therapy (1918) (14782056095).jpg

Identifier: medicalsurgicalt02good (find matches)
Title: Medical and surgical therapy
Year: 1918 (1910s)
Authors: Goodwin, T. H. (Thomas Herbert), b. 1871, ed Keogh, Alfred, Sir, 1857-1936, ed
Subjects: Medicine, Military Military Medicine Surgery
Publisher: New York : D. Appleton
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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postures of the hand in a case of painful lesion ofthe median nerve. The fingers being extended and placed close together give the handthe appearance of the so-called accoucheurs hand. In this casethe fiexors of the fingers are most paralysed. D. Associated lesion of median and ulnar nerves. Clawing ofall the fingers, but most marked in the little, ring, and middle fingers. Considerable atrophy and fiattening of the thenar and hypothenareminences. The thumb is on a level with the other fingers, the palm of the handis widened and resembles the ape-hand. Atrophy of the adductor pollicis is seen; the fiabby skin makes alarge, soft fold in the space between the thumb and index finger. E. Eczematiform eruption, with large crusts covering the hand andfingers (both palmar and dorsal aspects) in a case of painful lesionof the median nerve. The patient for several months continuously made use of wet dressingsand arm baths to relieve his pain. Clinical Forms of Nerve Lesions.) (To face page 40.
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THE MUSCULO-SPIRAL NERVE 41 Idiomuscular Contraction is so liable to variationsthat we do not think useful information on the natureof the lesion can be deduced from it. In the early stages of injury idiomuscular con-traction is stronger ; especially if there has beenfracture of the bone. Later on, it diminishes inintensity, the contraction is slower, and the diminu-tion is in relation to the atrophy of the muscle. Ingrave lesions, idiomuscular contraction entirely dis-appears when there is considerable atrophy. Idiomuscular contraction of the triceps which israrely paralysed is nearly always strong ; but it mayalso be normal or even diminished. Vasomotor and Secretory Phenomena.—Disturb-ances of this kind are absent or very slight, and onlybecome important when there is affection of someother nerve or considerable vascular, osseous, arti-cular, or muscular mischief. When the hand is swollen, purple, and succulentin appearance, inquiry should be made whether thepatient does not alwa

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