A treatise on orthopedic surgery . the test one must grasp the neck firmly in order torestrain movement except in the joint under examination. Be-cause of free motion in the cervical region fixation of the upperarticulations is often overlooked when the disease is of the sub-acute variety. The Lower Cervical Region.—The symptoms of disease of thelower cervical section, although similar in character, are oftenless marked than those of the upper region. The cervical spinebecomes straighter, and often a slight backward projection orthickening indicates the position of the disease. The head isusua
A treatise on orthopedic surgery . the test one must grasp the neck firmly in order torestrain movement except in the joint under examination. Be-cause of free motion in the cervical region fixation of the upperarticulations is often overlooked when the disease is of the sub-acute variety. The Lower Cervical Region.—The symptoms of disease of thelower cervical section, although similar in character, are oftenless marked than those of the upper region. The cervical spinebecomes straighter, and often a slight backward projection orthickening indicates the position of the disease. The head isusually turned to one side by contraction of the lateral musclesin an attitude of wryneck (Fig. 26). The pain is referred tothe neck, to the sternal region, or down the arms, following thedistribution of the brachial plexus. In the more advanced cases ones attention may be attractedto the cervical region, because the neck seems short and becausethe head is tilted backward. The entire back shows a com- 60 OETHOPEDIC SUEGEEY. Fig. Disease of the middle cervical regionat an early stage. pensatory flattening, yet no deformity is apparent until theocciput is raised and drawn forward, when a shelf-like projec-tion may be felt at what appears to be the extremity of the spine, but which is really anangular deformity at the thirdor fourth vertebra. This emphasizes the impor-tance of careful observation ofthe contour of the spine, andthe necessity of explaining toones self every change from thenormal that may be noticed. Disease at ilie cervicodnrsaljunction resembles in its symp-toms that of the upper dorsalregion. The head is usuallytilted backward (Fig. 21) or itmay be turned to one side. Dis-ease at this point is often sub-acute in character, and paral-ysis from implication of thespinal cord sometimes appearsbefore deformity is apparent. Occasionally irregularity of thepupils is present because of sympathetic involvement. The spinous process of the seventh cervical or first dorsal
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
