Medical and surgical therapy . Case IV.âRifle bullet wound : point of entry, below tlie leftclavicle in the anterior wall of the axilla; i)oint of exit, four fingersbreadths from the dorsal border of the scapula, about 5 cm. from itsinferior angle. Penetrating wound of chest. Immediate and total paralysis of arm ; copious hemorrhage fromwound with secondary haemorrhage. On examination a year after injury: there is paralysis of thesupinator longus, radial extensors, extensors of fingers and thumb,and abductor longus pollicis. Paralysis of the hypothenar musclesand interossei. Partial ])aralvsis
Medical and surgical therapy . Case IV.âRifle bullet wound : point of entry, below tlie leftclavicle in the anterior wall of the axilla; i)oint of exit, four fingersbreadths from the dorsal border of the scapula, about 5 cm. from itsinferior angle. Penetrating wound of chest. Immediate and total paralysis of arm ; copious hemorrhage fromwound with secondary haemorrhage. On examination a year after injury: there is paralysis of thesupinator longus, radial extensors, extensors of fingers and thumb,and abductor longus pollicis. Paralysis of the hypothenar musclesand interossei. Partial ])aralvsis of the biceps, flexor carpi ulnaris,and thenar muscles. Still slighter ])aralysis of deltoid, triceps,palmars, flexor carpi ulnaris, and of tlio su]ierficial and deep hypoesthesia to all kinds of sensation in the musculo-cutaneousregion of the forearm and of ulnar in the hand. Slight disturbanceof sensation of touch, heat and cold in the median, internal CERVICAL AND BRACHIAL PLEXUSES 139 Upper plexus SEAT OF LESION inBRACHIAL PLEXUS. âPhrenic. Serratus mag. â¢Latissimus subscapular Fig. 58.âHenry Meiges diagram. The black line shows probable seatof lesion. Muscles totally paralysed are marked 0, those partiallyparalysed â. NERVES. MUSCLES. Nerve to Trapezius o trapezius. Levator angull scapute. o Nerves to llhoniboideus o scapular Supra- and infraspinatusSubclavius. o muscles. i^SubscapuIaris sup. Clavicle. Ext. ant. thor. Pectoralis major Int. ant. thor. Icctoralis minor. Circumflex. Deltoid o , - Biceps Coraco-brachialis Brachialis anticus Pronator radii teres. Flexor carpi radialis. Palmaris longus. Flexor sublimis di(?. Median. Flexor profundus (2). Pronator quadratus. Abductor pollicis. Flexor brevis ])ollicis. Opponens pollicis. I. and II. Lumbricales. V Triceps. Anconeus. , Supinator lonKUS. Extensor carpi rad. long, et brev. prop, indicis. Extensor minimi dig. Extensor
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
