Organic and functional nervous diseases; a text-book of neurology . are involved. When the lower arm type ispresent the seventh and eighth cervical nerves are affected. Duchenneshowed that pressure backward upon the side of the neck is liable tocompress these two nerves against the lamina of the sixth cervicalvertebra. Erb has shown that it is possible by a careful examinationto find a spot two centimetres above the clavicle, back of the outeredge of the sternomastoid muscle, corresponding to the point ofemergence of the sixth cervical nerve between the scaleni, at whichpoint irritation by the
Organic and functional nervous diseases; a text-book of neurology . are involved. When the lower arm type ispresent the seventh and eighth cervical nerves are affected. Duchenneshowed that pressure backward upon the side of the neck is liable tocompress these two nerves against the lamina of the sixth cervicalvertebra. Erb has shown that it is possible by a careful examinationto find a spot two centimetres above the clavicle, back of the outeredge of the sternomastoid muscle, corresponding to the point ofemergence of the sixth cervical nerve between the scaleni, at whichpoint irritation by the faradic current will produce a contraction in thedeltoid, biceps, brachialis anticus, and supinator longus muscles; andif the irritation be increased the extensors of the wrist will also con-tract. Pressure upon this particular region is often made duringdelivery either by the clavicle or by forceps or by the fingers of theobstetrician. This is more common when there is a breech presenta-tion and the after-coming head is extracted in the common method. Fig. Thickened cord of brachial plexus at the junction of the 5th and 6th cervical nerves found at operationon boy shown in Fig. 89. (Natural size, from a sketch by Dowd.) The index and middle fingers of the left hand being open like a forkover the shoulders of the child, traction is commonly made upon theshoulders, and the pressure of the obstetricians finger in the neck oftenproduces injury of the plexus. In some cases injury of the plexusis produced by attempts to bring down the hand or arm in breechpresentations or to replace these when the head presents. In thesecases it is probable that the roots of the nerves are torn or a portion ofthe upper cord of the plexus is torn.^ Forceps applications in anawkward position may also produce this injury. Children do notappear to be very liable to injury of the nerves in spite of the manyaccidents which befall them. I have not seen a case of traumaticneuritis in the plexus of a c
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectnervoussystem, bookye
