Nervous and mental diseases . effortsis also present. 296 DISEASES OF SPINAL MENINGES AND SPINAL NERVES The sensory disturbance is obscure and often overlooked or miscon-strued as intercostal neuralgia, muscular rheumatism, etc. The posterior thoracic in its long course from theiifth, sixth, and sev-enth cervical nerves to its distribution in the serratus magnus is often sub-jected to mechanical pressure from heavy objects carried on the shoulderand by muscular compression in severe exertion or continued labor, par-ticularly in overhead work. Mowing and tailoring also furnish
Nervous and mental diseases . effortsis also present. 296 DISEASES OF SPINAL MENINGES AND SPINAL NERVES The sensory disturbance is obscure and often overlooked or miscon-strued as intercostal neuralgia, muscular rheumatism, etc. The posterior thoracic in its long course from theiifth, sixth, and sev-enth cervical nerves to its distribution in the serratus magnus is often sub-jected to mechanical pressure from heavy objects carried on the shoulderand by muscular compression in severe exertion or continued labor, par-ticularly in overhead work. Mowing and tailoring also furnish wounds occasionally involve it, and falls or blows on theback may injure it. It also suffers in association with other nerves asa part of spinal atrophies. From the usual traumatic character of thedisease, men in active middle life are most commonly affected, and onthe right side, as a rule. It occasions loeahiess in all the movements of the upper extremitythat depend upon the fixation of the scapula and impairs thoracic in-. Fig. 102a.—Partial paralysis of the right serratus magnus. spiratory expansion on the same side, but causes no absolute motor paralysis of the serratus causes a peculiar and characteristic de-formity. Attempts to put the arm forward cause the posterior borderof the scapula to widely wing out from the chest, so that a deep recessis formed behind the shoulder-blade. The upper portion of the bonemoves outward and the lower angle toward the spine. As the nerve is almost purely motor, the only sensory disturhaTweis neuralgic pain in the neck and shoulder in neuritic cases. The prog-nosis in injury to the posterior thoracic is comparatively less favorablethan in other spinal nerves. A serratus paralysis is always of long dura-tion and often permanent, even when there is every reason to believethat the condition has arisen from a simple pressure neuritis. In cases f y^ ^.?^ TevUitjumtnl hrhjn I <
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Keywords: ., bookcentury1900, booksubjectmentalillness, booksubjectnervoussys
