. A treatise on the nervous diseases of children, for physicians and students. ctors;so also incomplete extension ofknee may be due to contracture offlexors of knee. Contractured mus-cles must be considered with par-ticular care. In very young chil-dren, if it is desirable to determinewhether there is any actual paraly-sis, pinch the toe steadily until thechild draws the leg away, or maybe expected to do so. With older children special testscan be made. Ask child to keepthigh flexed while you oppose; totest flexors of thigh, rest your handson its knee and ask it to push it away by lifting up t
. A treatise on the nervous diseases of children, for physicians and students. ctors;so also incomplete extension ofknee may be due to contracture offlexors of knee. Contractured mus-cles must be considered with par-ticular care. In very young chil-dren, if it is desirable to determinewhether there is any actual paraly-sis, pinch the toe steadily until thechild draws the leg away, or maybe expected to do so. With older children special testscan be made. Ask child to keepthigh flexed while you oppose; totest flexors of thigh, rest your handson its knee and ask it to push it away by lifting up thigh ; to test extension ofthigh ask it to climb on a chair or observe whether it raises hip in the child on a table and ask it to swing leg forward and backward;to keep leg straight while the physician endeavors to flex it (for extensors ofleg), or to keep leg flexed while physician attempts to straighten leg (forflexors of leg). To test flexors or extensors of foot and toes, it should beasked to perform dorsal and plantar flexion with and without Fig. 30.—Patient showing Lordosis of Verte-bral Column, due to Weakness of the Ex-tensors (Erector) of the Spine. INTRODUCTION—METHODS OF EXAMINATION. 35 To raise on tiptoes, or to raise toes while keeping heel on ground are goodtests for the posterior and anterior tibial groups. Paralysis of certain groupsis attended by contractures of others. Deformities of the feet (pes equinus,equino-varus, and valgus) result from paralysis and contractures of the flex-ors, extensors, and of the intrinsic muscles of the feet. Examination of the gait is of the utmost importance;an attempt should be made to have the child walk ; andeven if it cannot walk, the position of the legs in stand-ing, or in attempting to walk, is often quite position and cross-legged progression occurin children (spastic paraplegia or diplegia); the gait may beparetic, spastic, ataxic, or a combined form of all thr
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