. The practice of medicine; a text-book for practitioners and students, with special reference to diagnosis and treatment . THE BRACHIAL PLEXUS 1019 Paralysis of the deltoid is to be distinguished from ankylosis, in whichthe scapula moves with the arm, which it does not do in palsy. 2. Suprascapular Nerve.—This nerve rises from the trunk formed bythe union of the sixth, fifth, and a branch of the fourth cervical, but itsown fibers are derived from the fifth and partly from the fourth is occasionally injured alone or with the circumflex in dislocation of thehumerus, and by falls on
. The practice of medicine; a text-book for practitioners and students, with special reference to diagnosis and treatment . THE BRACHIAL PLEXUS 1019 Paralysis of the deltoid is to be distinguished from ankylosis, in whichthe scapula moves with the arm, which it does not do in palsy. 2. Suprascapular Nerve.—This nerve rises from the trunk formed bythe union of the sixth, fifth, and a branch of the fourth cervical, but itsown fibers are derived from the fifth and partly from the fourth is occasionally injured alone or with the circumflex in dislocation of thehumerus, and by falls on the shoulder, or by carrying heavy weights. Theresult is palsy of the supraspinatus and infraspinatus muscles. The firstis of little significance, but the latter causes a defect of rotation outwardof the humerus, interfering with many movements, of which one is carryingthe hand along in writing. The scapula is rotated so that the lower angleis rotated upward and inward. 3. Musculospiral Paralysis.—The musculospiral nerve arises from theposterior cord of the brachial plexus, and apparently derives its motor fibers. Fig. 177.—Wrist-drop in Musculospiral Paralysis—(Leube). from the nerve-roots forming* the plexus except the first thoracic. Withits branches the muscular, cutaneous, the radial and posterior interosseous,it supplies the triceps, all the muscles of the back of the forearm, the exten-sors of the wrist and fingers, both the supinators, as well as the skin on theradial side of the back of the hand, back of the thumb, index-finger, andhalf of the middle finger. As the musculospiral nerve is called the radialby the Germans, its paralysis is described in German literature as radialpalsy. It is more frequently paralyzed than any single nerve, because of itsposition—winding around the humerus after it leaves the plexus. It isoften bruised by crutches, producing the so-called crutch palsy, byblows and fractures, and especially by pressure when sleeping with the armov
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